tbuckley/cabot-search huggingface dataset:
England launches scheme to encourage use of “care bundles”
Authors: Lisa Hitchen
Journal: BMJ (2008)

England will launch a campaign this summer to promote the use of specific groups of evidence based interventions for hospital treatments that carry risk.

The idea of using groups of interventions, known as care bundles, was developed by the US Institute for Healthcare Improvement, which found that patients benefited more when interventions were grouped rather than carried out as individual procedures.

The campaign in England will coincide with celebrations to commemorate the 60th anniversary of the NHS, say the three organisers of the campaign, the National Patient Safety Agency, the Health Foundation, and the NHS Institute for Innovation and Improvement.

Stephen Ramsden, chief executive of Luton and Dunstable Hospital NHS Foundation Trust, told a conference organised by Healthcare Events last …
Value of measuring serum angiotensin I converting enzyme and serum lysozyme in the management of sarcoidosis.
Authors: C W Turton, E Grundy, G Firth, D Mitchell, B G Rigden, M Turner-Warwick
Journal: Thorax (1979)

Serum angiotensin I converting enzyme (ACE) and lysozyme have been measured in 23 controls, 115 patients with sarcoidosis, and 64 with other chest diseases. Both enzymes were significantly raised in sarcoidosis. ACE was raised above the normal range in 21 of 72 (29%) patients with definite sarcoidosis and in 17 of 38 (45%) of those who were untreated and seen within one year of presentation. The rise discriminated usefully between those with stable and progressive disease (5% and 62% respectively). Lysozyme was raised in 50 of 72 (69%) patients with sarcoidosis but also in 11 of 54 (20%) patients with other chest diseases. Discrimination between stable and progressive disease was useful only if very high levels were considered. Five patients had serial measurements after treatment with oral steroids and showed a progressive fall in levals of both enzymes, but patients with other diseases also showed a significant fall within the normal range when so treated. Measurement of these enzymes may help in the management of some cases of sarcoidosis, but results require critical interpretation.
Contractile Dysfunction of Left Ventricular Cardiomyocytes in Patients With Pulmonary Arterial Hypertension
Authors: Emmy Manders, Harm-Jan Bogaard, M. Louis Handoko, Marielle C. van de Veerdonk, Anne Keogh, Nico Westerhof, Ger J.M. Stienen, Cristobal G. dos Remedios, Marc Humbert, Peter Dorfmüller, Elie Fadel, Christophe Guignabert, Jolanda van der Velden, Anton Vonk-Noordegraaf, Frances S. de Man, Coen A.C. Ottenheijm
Journal: Journal of the American College of Cardiology (2014)
Abstract 1234: Tamoxifen synergizes cytotoxic activity of 4-(E)-{(4-hydroxyphenylimino)-methylbenzene, 1,2-diol} (HPIMBD), a novel resveratrol analogue against breast cancer cells
Authors: Amruta Mukund Ronghe, Anwesha Chatterjee, Fatma Abdalla, Hari K. Bhat
Journal: Cancer Research (2014)

Abstract Tamoxifen is currently the first line of therapy against estrogen receptor (ER)-positive breast cancers. Prolonged treatment with tamoxifen has been associated with the development of resistant tumor phenotypes. Moreover, this treatment strategy is ineffective against ER-negative breast cancers. In this study, we have investigated the role of 4-(E)-{(4-hydroxyphenylimino)-methylbenzene, 1,2-diol} (HPIMBD), a novel analog of resveratrol, either alone or in combination with tamoxifen on the growth inhibition of breast cancer cells. Breast cancer cell lines MCF-7, T47D, MDA-MB-231 and MDA-MB-468 as well as non-neoplastic breast epithelial cell lines MCF-10A, MCF-10F and HMEC were treated with different doses of HPIMBD or a combination of tamoxifen (2µM) and HPIMBD (at its IC50 dose). Cell proliferation was determined by MTT assays. No effect on cell proliferation was observed upon treatment of non-neoplastic breast cells with HPIMBD. A dose dependent growth inhibition was demonstrated upon treatment of breast cancer cells with HPIMBD. IC50 values of HPIMBD were determined. Tamoxifen at a dose of 2µM showed no effect on the growth of breast cancer or non-neoplastic breast epithelial cell lines. However, a significant increase in inhibition of cellular proliferation of breast cancer cells was demonstrated when tamoxifen (2µM) was used in combination with HPIMBD at its IC50 dose. To investigate the mechanism of inhibition, autophagy markers, beclin-1 and LC3B were quantified by Western blot analyses. The combination treatment significantly increased the expression of autophagy marker beclin-1 and the cleavage of LC3BI to LC3BII. Cell cycle analysis showed an arrest in the S-phase by HPIMBD and G0/G1-phase by tamoxifen. Our studies suggest that a combination of tamoxifen and HPIMBD synergistically inhibit the proliferation of breast cancer cells. Autophagy and cell cycle arrest appear to be the primary mechanisms of inhibition by the combination treatment. Citation Format: Amruta Mukund Ronghe, Anwesha Chatterjee, Fatma Abdalla, Hari K. Bhat. Tamoxifen synergizes cytotoxic activity of 4-(E)-{(4-hydroxyphenylimino)-methylbenzene, 1,2-diol} (HPIMBD), a novel resveratrol analogue against breast cancer cells. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1234. doi:10.1158/1538-7445.AM2014-1234
US budget battle is likely to rekindle fight over drug price negotiations for Medicare prescriptions
Authors: M. McCarthy
Journal: BMJ (2015)

In anticipation of President Barack Obama’s budget request next week for the fiscal year 2016, 400 drug companies, business organizations, patient advocacy groups, and other organizations have sent an open letter to Congress strongly opposing any proposal that might allow Medicare to negotiate prices for drugs covered under the Medicare prescription drug plan, Medicare Part D. 

The effort was led by the Council for Affordable Health Coverage, a group based in Washington, DC, that advocates applying market solutions to expand access to healthcare and reduce costs.

Currently, drug companies are required to pay rebates for drugs that are dispensed to patients enrolled in Medicaid, the federal state run health insurance plan for low income and disabled people—but not for Medicare, the …
The Y Chromosome and Spermatogenesis
Authors: David M. de Kretser, Henry G. Burger
Journal: New England Journal of Medicine (1997)

Infertility affects approximately 1 man in 25. In about 30 to 40 percent of affected men, the results of semen analyses are abnormal but no cause of the infertility can be found. Therapeutic approaches are limited because there is inadequate knowledge of the pathogenesis of the abnormal spermatogenesis. Recent studies indicate that genetic causes, linked to the Y chromosome, may be important in some cases.It is well known that the Y chromosome directs the indifferent gonad of the early embryo to form a testis. There is increasing evidence that the Y chromosome — in particular, genes on its long . . .
The dysfunctional endothelium in CKD and in cardiovascular disease: mapping the origin(s) of cardiovascular problems in CKD and of kidney disease in cardiovascular conditions for a research agenda
Authors: Danilo Fliser, Andrzej Wiecek, Gultekin Suleymanlar, Alberto Ortiz, Ziad Massy, Bengt Lindholm, Alberto Martinez-Castelao, Rajiv Agarwal, Kitty J. Jager, Friedo W. Dekker, Peter J. Blankestijn, David Goldsmith, Adrian Covic, Gerard London, Carmine Zoccali
Journal: Kidney International Supplements (2011)
Insulin resistance is a cause of steatosis and fibrosis progression in chronic hepatitis C
Authors: L Fartoux
Journal: Gut (2005)

Insulin resistance is a frequent feature of chronic hepatitis C. Whether insulin resistance could be the cause or consequence of steatosis and fibrosis is unknown. The ability of HCV genotype 3 to promote steatosis by itself provides an unique opportunity to answer this question.The aim of the present study was to assess the relationships between insulin resistance, steatosis, and fibrosis according to genotype in 141 non-diabetic patients with biopsy proven non-cirrhotic chronic hepatitis C.All patients had fasting serum glycaemia and insulinaemia measurements. Insulin resistance was evaluated using the homeostasis model assessment (HOMA IR) method. Liver steatosis was determined according to hepatitis C virus genotype (1 or 3). Logistic regression and multivariate regression analysis were used to identify variables independently associated with insulin resistance, fatty liver, and fibrosis.Although steatosis and fibrosis were more severe in genotype 3 patients, median HOMA IR was significantly higher in patients with genotype 1 related steatosis than in those with genotype 3 related steatosis (2.1 v 1; p = 0.001). Independent risk factors for steatosis were insulin resistance in genotype 1 patients (p = 0.001) and viral load in genotype 3 patients (p = 0.003). Among genotype 1 patients, independent parameters associated with insulin resistance were age (p = 0.04) and steatosis (p = 0.004). Steatosis was associated with more severe fibrosis whatever the genotype (p = 0.002). Among genotype 1 patients, although there was a significant relationship between circulating insulin level and fibrosis stage (p = 0.006), only steatosis and inflammatory score were independently associated with fibrosis.This study shows that insulin resistance is the cause rather than the consequence of steatosis and fibrosis in genotype 1 patients and that increased circulating insulin is a risk factor for fibrosis through insulin resistance induced steatosis.
The Making of a Better Doctor
Authors: Kathy A. Stepien
Journal: Annals of Internal Medicine (2011)

On Being a Doctor15 March 2011The Making of a Better DoctorKathy A. Stepien, MDKathy A. Stepien, MDFrom Marshfield Clinic, Marshfield, WI 54449.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-6-201103150-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Last year while biking home from work, I was hit by a car. I do not remember much of the actual event. I have slow-motion images of the scream and the swerve, of flying through the air. I have memories of my blood pooling on the hot cement, windshield glass embedded in my arm, my glasses twisted across my face. I search and search but cannot find more details.For a while, I hoped that my memory would return and fill in the blanks. However, despite replaying the event thousands of times, I simply do not remember. There are facts ... Author, Article, and Disclosure InformationAffiliations: From Marshfield Clinic, Marshfield, WI 54449.Corresponding Author: Kathy A. Stepien, MD, Marshfield Clinic, Department of Pediatrics, 1000 North Oak Avenue, Marshfield, WI 54449. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 March 2011Volume 154, Issue 6Page: 439-440KeywordsAnxietyChildrenComputed axial tomographyHead injuryMemoryRiversSmellTouchUltrasound imagingVomiting ePublished: 15 March 2011 Issue Published: 15 March 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
How can we live forever?
Authors: T. Kirkwood
Journal: BMJ (1996)

Of course living forever is a myth—sooner or later an accident would catch up with us even if we did not age. But there has been considerable discussion recently of the idea that the human life span might be extended.1 Much of this discussion can be dismissed as wild optimism, but there are some geneticists who seem willing to extrapolate from work on invertebrates to suggest that 200 year human life spans may be on the horizon.2 To understand the status of these claims we need to look at current knowledge of the biology of aging and, in particular, the role of genetics. It has long been held that the best recipe for a long life is to choose your parents well, and a study on longevity records in a sample of 19th century Danish …
Satellite Dialysis
Authors: Richard T. Bilinsky
Journal: JAMA (1971)

The delivery of hemodialysis care to the population of southern Illinois was extended from the main unit in Springfield by the establishment of several satellite facilities. Utilizing leased space in private medical buildings and small community hospitals, more than 5,000 hemodialyses have been performed during the past 29 months at a cost 50% less than for center dialysis. An increasing patient load has been accepted with ease. Stable patients receiving long-term dialysis are treated in satellite facilities, freeing the main unit to deal more flexibly with acute and complicated dialysis problems. Medical complications in the satellites have been infrequent, and the "back-up" dialysis rate at the main unit is only 4%. Patient acceptance has been excellent due to reduced travel fatigue, savings in travel costs averaging $2,448 per year, and time gained for other activity.
The Tonsils and Adenoids in Childhood
Authors: Samuel J. Pearlman
Journal: JAMA (1961)

This is a welcome text, for there have been few monographs on the subject of tonsils and adenoids in general and almost none with the discussion limited to the problem in children. It is intended primarily for those who perform operations on these structures. Others, however, may find it useful, and among these are general practitioners, pediatricians, and postgraduate students in otolaryngology and pediatrics. An introductory essay on the history of concepts and surgical techniques is followed by a chapter on diseases of the tonsils and adenoids. Then comes a discussion of the child as patient, followed by an illustrated description of surgical removal of the tonsils and adenoids. The text ends with reflections on postoperative care and long-term results. For over half a century tonsillectomy and adenoidectomy have been the most frequently performed operations in America. Initially they were, in large part, carried out indiscriminately by incompletely trained persons
HBV variants create “altered peptide ligands” which results in altered CD4+ T-cell function
Authors: M.-C. Jung, J.T. Gerlach, T. Santantonio, H. Diepolder, E. Wierenga, N. Grüner, R. Zachoval, R. Hoffmann, S. Southwood, A. Sette, S. Günther, H. Will, G.R. Pape
Journal: Journal of Hepatology (1998)
Supra-personal cognitive control and metacognition
Authors: Nicholas Shea, Annika Boldt, Dan Bang, Nick Yeung, Cecilia Heyes, Chris D. Frith
Journal: Trends in Cognitive Sciences (2014)

The human mind is extraordinary in its ability not merely to respond to events as they unfold but also to adapt its own operation in pursuit of its agenda. This 'cognitive control' can be achieved through simple interactions among sensorimotor processes, and through interactions in which one sensorimotor process represents a property of another in an implicit, unconscious way. So why does the human mind also represent properties of cognitive processes in an explicit way, enabling us to think and say 'I'm sure' or 'I'm doubtful'? We suggest that 'system 2 metacognition' is for supra-personal cognitive control. It allows metacognitive information to be broadcast, and thereby to coordinate the sensorimotor systems of two or more agents involved in a shared task.
Coronary bypass graft fate and patient outcome: Angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years
Authors: Gerald M. Fitzgibbon, Henryk P. Kafka, Alan J. Leach, Wilbert J. Keon, G.David Hooper, Jeffrey R. Burton
Journal: Journal of the American College of Cardiology (1996)
Big Brother is watching (your CPD)
Authors: V. Sankar
Journal: BMJ (2003)

I had just completed the three month educational supervision meeting with my senior house officer to assess his continuing professional development (CPD). The letter was the first piece of correspondence in the pile awaiting my attention, with the familiar emblem on top of the heavy bond paper. As I read the first paragraph of the letter, my heart rate quickened. It was a letter from the CPD officer of the “College,” the “Professor” himself. He wrote: “the College's Executive Committee has asked me to write to you to remind you that the College took participation in its CPD program very seriously.”

“What have I done now?” was my initial response. I then remembered: I hadn't sent the …
Characteristics of thyroxine 5'-deiodination in cultured human placental cells. Regulation by iodothyronines.
Authors: J T Hidal, M M Kaplan
Journal: Journal of Clinical Investigation (1985)

Human and rat placental homogenates convert L-thyroxine (T4) to 3,5,3'-L-triiodothyronine (T3) via a pathway termed type II iodothyronine deiodination. To study regulation of this pathway, cell dispersions were prepared from human placental chorionic-decidual membrane. Dispersed cells deiodinated T4 and 3,3',5'-triiodothyronine (rT3), but not T3, at the 5' position. The reaction was only slightly inhibited by 1 mM 6-n-propylthiouracil, enhanced by dithiothreitol, and substantially inhibited by 50 nM iopanoic acid. Incubation of the cells in thyroid hormone-depleted medium induced a near doubling of T4 5'-deiodination in 36-48 h, with a significant rise seen as early as 12 h. Addition of T4, rT3, or T3 to hormone-depleted medium impaired the rise in type II deiodination in a dose-dependent fashion. T4 and rT3 were equipotent in this regard, and T3 was 2-3 times less potent. T4 was effective in physiological concentrations, 6.5-13 nM in medium containing 10% calf serum, and the effect of T4 was not due to its conversion to either T3 or rT3. In cells with deiodinase activity raised by 48 h incubation in thyroid hormone-depleted medium, addition of T4, T3, or rT3 reversed the increase in 8-24 h. Secretion of prolactin and beta hCG by the dispersed cells was not substantially affected by thyroid hormone deprivation. The increase in type II deiodination during thyroid hormone deprivation appears to depend on a signal from the thyroxine molecule, per se, and could potentially defend intracellular, and/or circulating, T3 pools in pathological states of mild-to-moderate hypothyroxinemia.
Ombudsman reports record number of complaints
Authors: Debashis Singh
Journal: BMJ (2004)

A record 4700 complaints about the NHS have been made to Ann Abraham, England's health service ombudsman, between April 2003 and March 2004. This represents an increase of 18% over the previous year, according to the annual report published last week.

Much of this increase reflects a rise in complaints about the ongoing issue of NHS funding for the continuing care of elderly and disabled people. Deficiencies in eligibility criteria and assessments that led to severe hardship in some cases were highlighted …
Regulation of rat mesangial cell growth by diadenosine phosphates.
Authors: S Heidenreich, M Tepel, H Schlüter, B Harrach, W Zidek
Journal: Journal of Clinical Investigation (1995)

The newly recognized human endogenous vasoconstrictive dinucleotides, diadenosine pentaphosphate (AP5A) and diadenosine hexaphosphate (AP6A), were tested for growth stimulatory effects in rat mesangial cells (MC). Both AP5A and AP6A stimulated growth in micromolar concentrations. The growth stimulatory effect exceeded that of ATP, alpha,beta-methylene ATP, adenosine 5'-O-(3-thio)triphosphate and UTP. Both diadenosine phosphates potentiated the growth response to platelet-derived growth factor, but not to insulin-like growth factor-1. To further elucidate the site of action in the cell cycle, RNA and protein synthesis were assessed. AP5 and AP6A stimulated protein synthesis, but not RNA formation. Furthermore, both agents increased cytosolic free Ca2+ concentration. It is concluded that AP5A and AP6A may play a regulatory role in MC growth as progression factors and possibly modify MC proliferation in glomerular disease.
Effects of maternal allergen‐specific IgG in cord blood on early postnatal development of allergen‐specific T‐cell immunity
Authors: S. L. Prescott, P. G. Holt, M. Jenmalm, B. Björkstén
Journal: Allergy (2000)

Background: A wide body of epidemiologic evidence indicates that as yet unknown maternal factor(s) can influence susceptibility to allergic disease in the offspring. It is also well established that the induction of allergen‐specific T‐cell memory is frequently initiated in utero , and it is likely that maternal factors exert their influence during this period. Methods: This study examines the relationship between maternally derived allergen‐specific IgG subclass antibodies and cellular immune responses (lymphoproliferation and cytokine production) against the same allergens in 49 subjects tested at birth and at 2 years of age. Polyclonal production of the Th1 cytokine IFN‐γ was also examined in the cord‐blood samples. Results: At birth, there were positive correlations between both house‐dust mite (HDM)‐ and ovalbumin (OVA)‐specific IgG subclass levels in cord blood, maternal atopy, and the magnitude of perinatal lymphoproliferative responses to respective allergens. Inverse relationships were also observed between cord‐blood IgG antibody titres and allergen‐specific production of some Th2 cytokines. However, there were no consistent relationships between cord‐blood allergen‐specific IgG antibodies and subsequent immune responses to allergens when the same subjects were retested at 2 years of age. An inverse relationship was observed between maternal history of atopy and perinatal IFN‐γ production capacity. Conclusions: Our results suggest that transplacental transfer of allergen‐specific IgG antibody is unlikely to be a major mechanism for maternal regulation of allergen‐specific immunity in infancy. An alternative possibility is that maternal effects may operate by influencing IFN‐γ production by T cells in the offspring.
UPREGULATION OF BRADYKININ RECEPTORS 1 AND 2 GENE TRANSCRIPT LEVELS IN PERIPHERAL MONOCYTES IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Maria Marketou, Joanna Kontaraki, Evangelos Zacharis, George Kochiadakis, Haralambos Gavras, Irene Gavras, Panos Vardas
Journal: Journal of the American College of Cardiology (2011)
Autoimmune Phenomena in Pernicious Anaemia
Authors: D. Doniach, I. M. Roitt, K. B. Taylor
Journal: BMJ (1963)

was obvious that very substantial relief of pain was obtained in most cases.Each patient was also carefully questioned, but, in order that the results could be judged with the least possible bias, no comment was made to the patient at the time of the injection, save to explain that an examination was to be made.Ten minutes after the injection the result was assessed by asking the patient, " How are the pains ?" without giving any suggestion of 'expected relief.When recorded and analysed the answers indicated " complete" or " very good " relief of pain in 71%, "partial relief " in 25%, and "no relief " in 4%.These results may be compared with those of other workers, which for this purpose are expressed under similar headings, and on a percentage basis to the nearest unit.