tbuckley/cabot-search huggingface dataset:
The ABC of pharmacy
Authors: RG Hamilton
Journal: BMJ (2006)

provision of antiemetics may support adherence to treatment, our findings suggest that antiemetics alone do not result in better compliance.Factors that may be more important in Thohoyandou were the home follow-up service provided by the non-governmental organisation and the provision of food supplements.Contrary to fears expressed by the department of health and some commentators, the need to test for HIV before receiving HIV prophylaxis did not seem to deter women from attending services.There was no difference in the views of women who did and did not use the service.The priority that participants place on receiving counselling highlights the need for a holistic service after rape.Other research shows that the mental health needs of patients are often the least well met. 3 If services are to offer providers who are sensitive and can provide counselling, changes are needed in service provision and training, and this training should also deal with psychological support skills and providers' attitudes.
Implementation and Integration of Prehospital ECGs Into Systems of Care for Acute Coronary Syndrome
Authors: Henry H. Ting, Harlan M. Krumholz, Elizabeth H. Bradley, David C. Cone, Jeptha P. Curtis, Barbara J. Drew, John M. Field, William J. French, W. Brian Gibler, David C. Goff, Alice K. Jacobs, Brahmajee K. Nallamothu, Robert E. O'Connor, Jeremiah D. Schuur
Journal: Circulation (2008)
AAV Serotype 8-Mediated Gene Delivery of a Soluble VEGF Receptor to the CNS for the Treatment of Glioblastoma
Authors: Thomas C. Harding, Alshad S. Lalani, Byron N. Roberts, Satya Yendluri, Bo Luan, Kathryn E. Koprivnikar, Melissa Gonzalez-Edick, Guang Huan-Tu, Randy Musterer, Melinda J. VanRoey, Tomoko Ozawa, Richard A. LeCouter, Dennis Deen, Peter J. Dickinson, Karin Jooss
Journal: Molecular Therapy (2006)

The presence of the blood–brain barrier complicates drug delivery in the development of therapeutic agents for the treatment of glioblastoma multiforme (GBM). The use of local gene transfer in the brain has the potential to overcome this delivery barrier by allowing the expression of therapeutic agents directly at the tumor site. In this study, we describe the development of a recombinant adeno-associated (rAAV) serotype 8 vector that encodes an optimized soluble inhibitor, termed sVEGFR1/R2, of vascular endothelial growth factor (VEGF). VEGF is an angiogenic factor highly up-regulated in GBM tumor tissue and correlates with disease progression. In subcutaneous models of GBM, VEGF inhibition following rAAV-mediated gene transfer significantly reduces overall tumor volume and increases median survival time following a single administration of vector. Using orthotopic brain tumor models of GBM, we find that direct intracranial administration of the rAAV-sVEGFR1/R2 vector to the tumor site demonstrates anti-tumor efficacy at doses that are not efficacious following systemic delivery of the vector. We propose that rAAV-mediated gene transfer of a potent soluble VEGF inhibitor in the CNS represents an effective antiangiogenic treatment strategy for GBM.
Substrate availability other than glucose in the brain during euglycemia and insulin-induced hypoglycemia in dogs
Authors: Angelo Avogaro, Romano Nosadini, Alessandro Doria, Carlo Tremolada, Ugo Baccaglini, Franco Ambrosio, Carlo Merkel, Attilio Nosadini, Roberto Trevisan, Paola Fioretto
Journal: Metabolism (1990)
OXYGEN-STABLE HEMOLYSINS OF GROUP A STREPTOCOCCI
Authors: Isaac Ginsburg, T. N. Harris
Journal: The Journal of Experimental Medicine (1965)

In studies of the mechanism of lysis of red blood cells by washed streptococci with hemolytic activity (cell-bound hemolysin, CBH) no components released spontaneously by RBC or streptococci, or by interaction between these cells, could be found to induce the formation of soluble hemolysin by the streptococci. It was also found that separation of RBC from streptococci even by Millipore filter or a very thin layer of agar could prevent their hemolysis. By means of cellulose columns it was possible to separate RBC from streptococci after a short incubation. RBC thus separated from streptococci with which they had been incubated underwent hemolysis on subsequent incubation at 37°C. By varying the period of incubation prior to separation it was possible to demonstrate the transfer of increasing amounts of hemolysin from streptococci to RBC with increasing periods of incubation. A considerable part of this appeared to be at a constant rate. A theory is presented on the relationship between the streptococcal cell-bound hemolysin and the group of oxygen-stable streptococcal hemolysins, in terms of a transferable hemolytic moiety and binding sites for this moiety on the streptococcal cell, on various molecular species which can act as inducers of the oxygen-stable hemolysins, and on the RBC, with the affinity of the respective binding sites for the hemolytic moiety increasing in that order.
Cardiovascular Dynamics, Blood Volumes, Renal Functions and Electrolyte Excretions in the Same Patients during Congestive Heart Failure and after Recovery of Cardiac Compensation
Authors: LUDWIG W. EICHNA, SAUL J. FARBER, ADOLPH R. BERGER, DAVID P. EARLE, BERTHA RADER, EDMUND PELLEGRINO, ROY E. ALBERT, J. DEAVER ALEXANDER, HARRY TAUBE, SOL YOUNGWIRTH
Journal: Circulation (1953)

Largely on the basis of acute observations in cardiac patients during congestive heart failure and in noncardiac control subjects, two assumptions have been made: (a) that congestive heart failure develops as cardiovascular and renal functions change from the type found in the control subjects to the type found in decompensated cardiac patients, and (b) that a return to, or toward, the normal occurs in these functions as cardiac compensation is regained. That these assumptions are not necessarily valid is indicated by the herein reported simultaneous measurements of cardiovascular dynamics, renal functions, blood volumes and electrolyte excretions in eight patients during cardiac decompensation and after recovery of compensation.
Imatinib mesylate induces hypophosphatemia in patients with chronic myeloid leukemia in late chronic phase, and this effect is associated with response
Authors: S. Osorio, A. García Noblejas, A. Durán, J.L. Steegmann
Journal: American Journal of Hematology (2006)

Imatinib is the drug of first choice for most patients with chronic phase chronic myeloid leukemia (CML). Although it is generally well tolerated, a number of hematological and nonhematological side-effects have been described. We report here that imatinib induces hypophosphatemia in a high proportion of our series of CML patients previously treated with interferon alpha, and that this previously unreported side effect is associated with response.
Alternative polymer supports for organic chemistry
Authors: David E. Bergbreiter
Journal: Medicinal Research Reviews (1999)

The use of polymers other than divinylbenzene crosslinked polystyrene as supports in organic chemistry is discussed. Insoluble polymer alternatives to DVB crosslinked polystyrene discussed include porous polyethylene supports, polymer-supported functional colloids, micron and submicron-sized particles and hollow spheres and one-dimensional supports. Soluble polymers including polyethylene, poly(alkene oxide)s, polyacrylamides, and fluorinated acrylates are discussed along with thermomorphic strategies where liquid–liquid separation of a biphasic systems is used as a way to effect polymer recovery in systems that are monophasic on heating. © John Wiley & Sons, Inc. Med Res Rev, 19, No. 5, 439–450, 1999.
International perspectives on the NHS
Authors: R. Klein
Journal: BMJ (1977)

Seen from an international perspective, Britain's National Health Service is a remark- able success story.It has managed to do what most other health care systems in the advanced industrial countries of the Western world have failed to achieve: to contain costs.Yet seen from a national perspective Britain's NHS is often perceived to be a failure, particularly by those working in it.It has managed to contain costs all too successfully, so it is argued, with the result that standards of health care are inadequate.Should the NHS, therefore, be rated a success or failure ?In exploring the problems concerned in trying to answer this question, a useful starting point is the recently published report from the Organisation for Economic Co-operation and Development (OECD).iThis surveys and analyses public expenditure on health in the 24 member countries of OECD.And although the footnotes are a constant reminder of the hazards of such international comparisons-and the difficulties posed by differences in national definitions and data-the report is a unique attempt to provide a framework for looking at the performance of a variety of countries in providing health care.Most obviously, the OECD survey confirms Britain's position as a low spender in terms of the proportion of national income devoted to health.As table I shows, for a selected group of countries, Britain spent only 520 of the gross domestic product on health care in the mid-'seventies as against 67 7°0 in Germany, 6 9 " in France, 7 3 % in Sweden, and 7 4" in the United States.Partly this reflects the fact that private expenditure on health is much less than in most of the other countries concerned.More important, though, public expenditure on health in Britain tends to rise more slowly for any given increase in the national income than in other countries.For the period 1962 to 1974 public spending on health in Britain rose 42 0 faster than the increase in national income, while the equivalent figures were 7200 in France, 850 in Sweden, 109 " ,, in
Atorvastatin, Etidronate, or Both in Patients at High Risk for Atherosclerotic Aortic Plaques
Authors: Tetsuya Kawahara, Masako Nishikawa, Chie Kawahara, Tetsuya Inazu, Kunio Sakai, Gen Suzuki
Journal: Circulation (2013)

Statins are not effective in reducing atherosclerotic plaques of the abdominal aorta, and accumulating evidence suggests that bisphosphonates have the potential to induce the regression of atherosclerotic plaques of the abdominal aorta.A prospective, randomized, open-label, blinded-end-point trial involving 108 participants with hypercholesterolemia was conducted. Participants received 20 mg atorvastatin daily, 400 mg etidronate daily, or both drugs daily. The primary end point was the percent change in maximal vessel wall thickness of atherosclerotic plaques in the thoracic and abdominal aortas as measured by magnetic resonance imaging after 12 months of treatment. In both the combination therapy and atorvastatin groups, maximal vessel wall thickness of the thoracic aorta was reduced by 13.8% (95% confidence interval, -16.4 to -11.3) and 12.3% (95% confidence interval, -14.9 to -9.7), respectively. These reduction rates were comparable between groups (P=0.61). Meanwhile, in the etidronate group, maximal vessel wall thickness of the thoracic aorta remained unchanged (2.2%; 95% confidence interval, -0.3 to 4.8). Conversely, maximal vessel wall thickness of the abdominal aorta was reduced more effectively in the combination therapy group (-11.4%) than in the atorvastatin group (-0.9%; P<0.001) and the etidronate group (5.5%; P=0.006).Atorvastatin plus etidronate combination therapy for 12 months significantly reduced both thoracic and abdominal aortic plaques, whereas atorvastatin monotherapy reduced only thoracic aortic plaques and etidronate monotherapy reduced only abdominal aortic plaques. The effectiveness of combination therapy in reducing atherosclerotic plaques in the abdominal aorta was significantly greater than for both atorvastatin and etidronate monotherapy.URL: http://www.umin.ac.jp/ctr/. Unique identifier: UMIN 000002635.
US heart group says COX 2 inhibitors should be last choice for pain relief in patients at risk
Authors: Susan Mayor
Journal: BMJ (2007)

Cyclo-oxygenase-2 (COX 2) inhibitors should be used only as the last choice after other types of non-steroidal anti-inflammatory drugs (NSAIDs) to relieve chronic pain in people with heart disease or at high risk of it, the American Heart Association has recommended.Its statement, published online in Circulation on 26 February (http://circ.ahajournals.orgdoi:10.1161/circulationaha.106.181424), was designed to end any remaining confusion about the cardiovascular risk of these agents.The association has recommended a stepped approach to treatment.The first step should be non-pharmacological approaches, such as physical therapy and weight loss, for patients with known cardiovascular disease or with risk factors for ischaemic heart disease.Drug treatment should start with agents with the lowest reported risk of cardiovascular events, before other agents are prescribed, and at each step account should be taken of the risk-benefit balance.First line drug choices include paracetamol (acetaminophen), aspirin, tramadol, and short term use of other narcotic analgesics.If these fail to achieve adequate pain control, the next option is non-acetylated salicylates, such as naproxen.The association recommended NSAIDs that aren't COX 2 inhibitors if pain is still inadequately controlled, then NSAIDs with some COX 2 activity as the next step, and lastly COX 2 selective NSAIDs.The committee considered the risk of all three of these classes to be sufficiently high to require that patients taking them should be monitored regularly for sustained hypertension (or worsening of prior blood pressure control), oedema, worsening renal function, or gastrointestinal bleeding.See pp 436, 450. Save COX 2 inhibitors till last for cardiac patientsUK NEWS HFEA allows women to donate eggs for research, p445 World NEWS repeal law that puts "FdA on the payroll of the industry", p447 bmj.comUK government defeated on community treatment forms
P432Expression and activity of mitochondrial creatine kinase and hexokinase are enhanced in the left ventricle of rats adaptated to chronic intermittent hypoxia
Authors: J Zurmanova, B Elsnicova, J Novotny, J Neckar, F Kolar, P Waskova-Arnostova
Journal: Cardiovascular Research (2014)

Purpose: Creatine kinase (CK) and hexokinase (HK) play a key role in energy homeostasis of cardiomyocytes. Mitochondrial sarcomeric CK (mtCKs) and two hexokinase isoforms (HK1 and HK2) highly support mitochondrial oxidative phosphorylation by increasing the availability of ADP for complex V of the respiratory chain. Besides the mtCKs, there are two cytosolic CK isoforms (CKM and CKB) present in cardiomyocytes that help to maintain energy homeostasis. Aim: We determined CK and HK isoforms expression, enzyme activity and HK colocalization with mitochondria in more ischemic tolerant chronically hypoxic rat hearts and normoxic controls. Methods: Male Wistar rats were adapted to chronic intermittent hypobaric hypoxia (IHH) (7000 m, 8 h/day). Real Time-PCR, Western blot and quantitative immunofluorescence technique were used to assess the expression of CK and HK isoforms and changes in HK isoforms localization with respect to mitochondrial compartment. Results: IHH increased CK activity by 30%, which was consistent with elevated protein expression of mitochondrial mtCKs (by 30 %) and cytosolic CKB (by 50%). After adaptation to IHH, HK activity increased by 20%, whereas protein expression of HK1 and HK2 nearly doubled. Colocalization of HK1 with mitochondria increased significantly (p<0.03), but HK2 did not reached statistical significance (p<0.06) in hypoxic rats. Conclusion: Up-regulation of mtCKs and HK isoforms and increased colocalization of HK1 may stimulate the respiratory chain and help to maintain energy homeostasis of chronically hypoxic myocardium. Our results suggested that CK and HK enzymes can participate in the induction of ischemia more resistant phenotype in rat hearts adapted to IHH. This work was supported by the the Czech Science Foundation P303/12/1162 and 14-04301P.
New approach to treatment of recent stroke.
Authors: A K Admani
Journal: BMJ (1978)

Ninety-one patients with acute stroke participated in a double-blind, placebo-controlled trial of naftidrofuryl. Treatment was allocated at random and given over 12 weeks, neurological and neurophysical scores being obtained before treatment and at weeks 2, 4, 8, and 12. Both treatment groups greatly improved over the 12 weeks, but the naftidrofuryl-treated patients made greater neurological progress. Of the patients eventually discharged, those given naftidrofuryl spent only half as long in hospital as the controls. Deaths attributable to stroke were significantly fewer in the active-treatment group.
Cephaloridine and staphylococcal endocarditis.
Authors: P. M. Rountree, M. M. Bullen
Journal: BMJ (1967)

MEDIBCRITOUNAL 373 total of 11 cases have been reported, 5 in publications and 6 privately.This gives an incidence of depression of 0.1 % or less.There may be several explanations for this variance in clinical experience, in particular the recognized pitfalls of retrospective sur- veys, direct questioning to seek a predetermined clinical complex, concomitant drug administration (which Dr. Waal herself men- tions), and the natural incidence of depression in hypertension.Space will not permit us to discuss these points here.Present evidence does not indicate that there is an important incidence of depression associated with pro- pranolol administration.We will continue to keep a careful watch on the incidence of any side-effects due to propranolol and hope that investigators using this drug will assist us in this respect.-Iam, etc.,
Dependence on Nicotine Chewing Gum
Authors: R. J. West
Journal: JAMA (1986)

<h3>To the Editor.—</h3> We would like to comment on the interesting article by Hughes and colleagues<sup>1</sup>entitled "Physical Dependence on Nicotine in Gum." The results largely replicate those of our earlier study,<sup>2</sup>but their interpretation and conclusions differ and could, in our view, seriously mislead physicians and the public about the risks of developing long-term dependence on the gum. In a highly selected sample of former smokers who were still using nicotine chewing gum five months after quitting smoking, they showed that substitution of placebo gum was followed by mood changes and other subjective symptoms characteristic of tobacco withdrawal. In contrast to our study, they found no change in heart rate— the only "physical" effect they examined. Having claimed that our study<sup>2</sup>"demonstrated that nicotine gum can induce physical dependence," Hughes and colleagues go on to suggest that their own results indicate that "exsmokers who use nicotine
GP is accused of blurring roles of landlord and doctor
Authors: C. Dyer
Journal: BMJ (2011)

<h3>Background</h3> The number of patients dying in hospital continues to remain high. One of the challenges in combating this is deciding when to actively manage a patient and when to withhold/withdraw treatment. Advance Care Planning concentrates on patient-driven decisions, planning ahead in case they lose capacity to make decisions. Less attention has focused on clinician-led decisions, especially anticipating problems and planning for clinical deteriorations. Treatment escalation planning is one mechanism of planning the care of a patient at risk of deteriorating. <h3>Method</h3> Treatment escalation planning was introduced as a pilot in the following settings in a general hospital: Respiratory, Cardiology, Care of the Older, Medical Assessment Unit/General Medicine, Critical Care and Palliative Care. Audits were carried out in each setting, looking at decision making, before and after the pilot were carried out. The outcomes were measured and feedback obtained from staff in relation to ease of use, issues encountered and practicalities. <h3>Results</h3> The use of Treatment Escalation Plans was popular with junior doctors, especially out of hours. Advantages of using the plans included: creating a culture of thinking ahead, a simple format, and in a few cases patient decisions were affected by the plans. Disadvantages were that most patients during their admission did not need the plans created; the decision making and communication of decisions took extra time. <h3>Conclusion</h3> Treatment Escalation Planning is a potentially powerful tool in trying to deliver appropriate levels of patient treatment. Dilemmas arising from this study include whether to implement this process for all patients (most will not benefit) or for a selected group (at present the authors are not good at predicting patients who will deteriorate acutely). In addition, it raised a number of ethical questions around the communication of decision making, and the level of patient involvement in clinical decision making.
O1.01 * ESTIMATION OF THE INCIDENCE OF BRAIN METASTASES AND PATTERNS OF CARE IN THE NETHERLANDS
Authors: R. J. J. M. Kwakman, P. M. Jeene, E. M. T. Dieleman, L. J. A. Stalpers
Journal: Neuro-Oncology (2014)

PURPOSE: Brain metastases in The Netherlands: An estimation of the incidence and variation in treatment policy. METHODS: Radiation oncologists, neuro-oncologists and neurosurgeons, all members of the Dutch Association for of Neuro-Oncology (LWNO) were approached to complete a web-based questionnaire. The first part of the questionnaire contained questions about the incidence of brain metastases in 2012. The second part was aimed to investigate treatment practices using 13 different case descriptions, covering the different recommendations in the Dutch National Guideline for Brain Metastasis, particularly on the role of radiotherapy. RESULTS: Ten radiation-oncologists, eleven neuro-oncologists and five neurosurgeons from 15 hospitals completed the questionnaire, covering 41% of the addressed specialists. Five radiation-oncologists could provide incidence information from a patient data registration. Extrapolation to The Netherlands yields an estimate of 3500 newly diagnosed patients per year (21 per 105 citizens), of whom 21% with a single brain metastasis. Extrapolated to the USA, with a comparable sex and age-distribution, would yield almost 56,000 new cases per year. In only 3 of 13 case descriptions, there was more than 70% agreement in treatment policy; the National Guideline was, for each treatment choice, followed only by a minority of the specialists. For instance, there was no consensus on the role of radiotherapy for patients with a single brain metastasis. If radiotherapy was advised, there was no consensus which technique was considered most appropriate: Radiosurgery, local fractionated radiotherapy or whole brain radiotherapy. CONCLUSION: In The Netherlands, as in most cancer registries world-wide, the number of patients with brain metastases, their treatment and outcome are poorly registered. Hence it is not possible to give a reliable estimate of the incidence other than that the 'number of patients with brain runs into many thousands per year'. There are major local differences in treatment policies, and the official national guideline is followed by only a minority of brain tumor specialists.
Efficacy trial of malaria vaccine SPf66 in Gambian infants
Authors: U. D'Alessandro, A. Leach, B.O. Olaleye, G.W. Fegan, M. Jawara, P. Langerock, B.M. Greenwood, C.J. Drakeley, G.A.T. Targett, M.O. George, S. Bennett
Journal: The Lancet (1995)