tbuckley/cabot-search huggingface dataset:
Primary care pays only “lip service” to clinical governance, MPs say
Authors: Michael Day
Journal: BMJ (2007)

Poor communication between primary care trusts and GPs is seriously compromising the safety of patients in England, a group of MPs said this week.In its latest report the House of Commons Committee of Public Accounts also warns that 96% of GPs are failing to report dangerous incidents to the National Patient Safety Agency.For its report, which examines the Department of Health's progress in implementing clinical governance in primary care, the committee had taken evidence from the chief executive of the NHS, the deputy chief medical officer, and the NHS's director general of commissioning.Committee chairman Edward Leigh said, "Too many primary care organisations are paying lip service to the principles of the Department of Health's clinical governance agenda.The lines of communication between the primary care trusts, on the one hand, and their GPs and other healthcare contractors, on the other, are defective."He added: "How can we be confident in the NHS's ability to share learning locally and nationally about what can go wrong in health care when only a tiny proportion of GPs-4%-routinely report patient safety events and incidents to the National Patient Safety Agency?"In response to a series of high profile problems in the 1990s, including the Shipman murders and events at the Bristol Royal Infirmary, the health department introduced its 10 year programme to boost patient safety.The centrepiece was the clinical governance system.The new report suggests, however, that clinical governance is not as well established in primary care as in secondary care.The committee says that this is due largely to the complexity of the role of primary care trusts in commissioning and providing care and to the independence of contractors delivering health care, particularly GPs.The Committee of Public Accounts' 47th report of the current session can be found at www. parliament.uk/pac.Primary� care pay�s only� "lip service" to clinical governance, MPs say� UK NEWS Regulator gives green light to research using human-animal embryos, p 531 WoRld NEWS US me�ical authorities are accuse� o�� ��ailing to act over �octors in �uantanamo, p 53� US me�ical authorities are accuse� o�� ��ailing to act over �octors in �uantanamo, p 53� , p 53� bmj.comNumber o�� bipolar �isor�er �iagnoses leaps among US young people Number o�� bipolar �isor�er �iagnoses leaps among US young people
Detoxification of Alcoholics
Authors: Keith J. B. Rix
Journal: JAMA (1979)

<h3>To the Editor.—</h3> The paper by Whitfield and co-workers (239:1409, 1978) will be used by many to support the promotion of nonmedical detoxification facilities for alcoholics. However, a great deal of caution is required in accepting their findings as support for such an approach. The following points are my reasons for urging such caution: Although the article is titled "Detoxification of 1,024 Alcoholic Patients Without Psychoactive Drugs," it is clear at first glance that a substantial minority (8% ) of the total sample (1,114) required hospital attention that may have included the use of psychoactive drugs. Closer examination of the data suggests that the occurrence of severe alcohol withdrawal states may have been underestimated. The work of Victor and Adams' suggests that in about one fifth of cases of withdrawal seizures and in at least one half of cases of delirium tremens, the onset may not be for at
AN OPERATION FOR ESTABLISHING A CUL-DE-SAC FOR THE WEARING OF AN ARTIFICIAL EYE; WITH REPORT OF CASES.
Authors: JOHN E. WEEKS
Journal: JAMA (1902)

In the endeavor to establish a cul-de-sac in cases where from any cause the conjunctival sac has become reduced to such an extent that an artificial eye can not be worn, very many devices have been resorted to. Operative procedures which involve the transplanting of a flap of integument or of mucous membrane have been most numerous. Flaps of integument with a pedicle, flaps without a pedicle (Wolfe) taken from various parts of the body, Thiersch grafts, mucous membrane from the lips (Abadie), vulva<sup>1</sup>and prepuce (Bock) using that of an infant; heterogeneous tissue as conjunctiva from the rabbit, first employed by Wolfe<sup>2</sup>in 1883. Harlan<sup>3</sup>has devised a method of operating in which by means of a lead wire he seeks to establish a canal at a depth in the tissue corresponding to the normal location of the fornix conjunctivæ. When the canal is lined with
On Belladonna in the Treatment of Broncho-Pneumonia in Children
Authors: J. A. Coutts
Journal: BMJ (1899)

BELLADONNA IN BRONCHO-PNEUMONIA.[MIEBRLJRnAsT 207 theoretical deductions from the results already obtained.I have satisfied myself, however, as to the following two points:I. That uric acid is present in the blood of birds.2. That as far as my observations go, there is no evidence in support of the view advanced by Garrod and Luff that the kidney is the main seat of formation of uric acid.In conclusion I must in the first place express my indebtedness to Professor Rutherford for allowing the research to be carried out in his laboratory, and for valuable suggestions in connection with it.I have further to express my special in- debtedness to his assistant, Dr. T. H. Milroy, for
Persistence with asthma treatment is low in Germany especially for controller medication – a population based study of 483 051 patients
Authors: J. Hasford, J. Uricher, M. Tauscher, P. Bramlage, J. C. Virchow
Journal: Allergy (2009)

The objective of the present analysis was to evaluate treatment patterns and persistence with treatment of an unselected patient population with a diagnosis of asthma.The database of the Bavarian statutory health insurance physician's association (Kassenärztliche Vereinigung) covering 83% of the population was analyzed for an index period from April 2005 to March 2006. Defined daily doses (DDDs) were used to quantify treatment persistence. Results were compared with recent guidelines.The prevalence of physician diagnosed asthma in Bavaria was 4.8% in females and 4.5% in males; only 61.4% of these patients (of a total of n = 483,051) received any anti-asthmatic pharmacotherapy; 68.3% received medical care from their general practitioner, and 8.3% from a pulmonologist alone. Most patients (65.1%) received no more than 90 DDDs of controller medication in the index period of 365 days, only about 1% received medication for the complete index period. Long- (40.1%) and short-acting beta(2)-agonists (65.6%) were used more frequently than inhaled corticosteroids (ICS). 52.8% of asthma patients were treated in accordance with guidelines.Persistence of asthma patients with medical treatment is low, especially for controller medication. The discrepancy between current knowledge, guidelines and clinical practice is substantial and may question the value of current guidelines for the treatment of patients with asthma in ambulatory care. In addition, the results of this study cast doubt on the impact of contemporary treatment on the decline of asthma mortality seen in recent years in Germany.
Differentiation of monocytes into macrophages induces the upregulation of histamine H1 receptor
Authors: Massimo Triggiani, Angelica Petraroli, Stefania Loffredo, Annunziata Frattini, Francescopaolo Granata, Paolo Morabito, Rosaria Ilaria Staiano, Agnese Secondo, Lucio Annunziato, Gianni Marone
Journal: Journal of Allergy and Clinical Immunology (2006)
French surgeons accused of fraud
Authors: A. Dorozynski
Journal: BMJ (1994)

Thirty French orthopaedic surgeons are being investigated for allegedly having swindled the social security's health insurance branch by receiving kickbacks for prescribing hip prostheses. Twenty two separate complaints have been lodged by regional branches of the “Secu” after a lengthy investigation showed the existence of a company that overcharged for prosthetic devices and paid doctors a percentage of the inflated sales prices.

The investigation was led by Maurice Dachary, director of the health insurance branch of …
Systemic infusion of angiotensin II exacerbates liver fibrosis in bile duct-ligated rats
Authors: Ramón Bataller, Erwin Gäbele, Christopher J. Parsons, Terry Morris, Liu Yang, Robert Schoonhoven, David A. Brenner, Richard A. Rippe
Journal: Hepatology (2005)

Recent evidence indicates that the renin–angiotensin system (RAS) plays a major role in liver fibrosis. Here, we investigate whether the circulatory RAS, which is frequently activated in patients with chronic liver disease, contributes to fibrosis progression. To test this hypothesis, we increased circulatory angiotensin II (Ang II) levels in rats undergoing biliary fibrosis. Saline or Ang II (25 ng/kg/h) were infused into bile duct–ligated rats for 2 weeks through a subcutaneous pump. Ang II infusion increased serum levels of Ang II and augmented bile duct ligation–induced liver injury, as assessed by elevated liver serum enzymes. Moreover, it increased the hepatic concentration of inflammatory proteins (tumor necrosis factor α and interleukin 1β) and the infiltration of CD43-positive inflammatory cells. Ang II infusion also favored the development of vascular thrombosis and increased the procoagulant activity of tissue factor in the liver. Livers from bile duct–ligated rats infused with Ang II showed increased transforming growth factor β1 content, collagen deposition, accumulation of smooth muscle α-actin–positive cells, and lipid peroxidation products. Moreover, Ang II infusion stimulated phosphorylation of c-Jun and p42/44 mitogen-activated protein kinase and increased proliferation of bile duct cells. In cultured rat hepatic stellate cells (HSCs), Ang II (10−8 mol/L) increased intracellular calcium and stimulated reactive oxygen species formation, cellular proliferation and secretion of proinflammatory cytokines. Moreover, Ang II stimulated the procoagulant activity of HSCs, a newly described biological function for these cells. In conclusion, increased systemic Ang II augments hepatic fibrosis and promotes inflammation, oxidative stress, and thrombogenic events. (HEPATOLOGY 2005;41:1046–1055.)
Reversal of acute myelogenous leukemia in humanized SCID mice using a novel adoptive transfer approach.
Authors: A Cesano, S Visonneau, L Cioé, S C Clark, G Rovera, D Santoli
Journal: Journal of Clinical Investigation (1994)

Advanced human malignancies cannot be permanently cured by adoptive transfer of autologous lymphokine-activated killer (LAK) cells. Moreover, administration of high doses of IL-2 to maintain LAK activity in vivo is associated with severe toxicity. In this study, we tested the anti-tumor efficacy of a uniquely potent MHC non-restricted human killer T cell clone (TALL-104) in humanized severe combined immunodeficient (SCID) mice bearing acute myelogenous leukemia (AML). We show that, in appropriate experimental conditions, TALL-104 cells could effectively reverse the aggressive growth of the myelomonocytic leukemia cell line U937 in SCID mouse tissues, leading to complete abrogation of AML. A single transfer of TALL-104 cells at the time of tumor challenge in combination with recombinant human (rh) IL-12 (1 microgram/d) prolonged significantly the life of the mice. However, eradication of leukemia, as monitored both clinically and by PCR, was achieved by repeated injection of the effectors at close intervals. Complete cure was obtained also upon transfer of lethally irradiated (non-proliferating) TALL-104 cells together with low doses of rh IL-2 (100 U/d). Most notably, of the mice that received multiple transfers of TALL-104 cells without cytokines in an advanced disease stage, 50% were clinically cured, and 50% survived significantly longer. The potential of TALL-104 cells as an effective and safe leukemia purging agent is discussed.
Financial deal is vital for any climate change agreement, poor countries say
Authors: J. Vidal
Journal: BMJ (2010)

Finance will be the first key to unlock any future agreement on combating global climate change, it emerged on the first day of two weeks’ intense negotiations at Cancun, Mexico.

In the most optimistic atmosphere since the diplomatic debacle at Copenhagen last year, when expectations were high but only a weak political deal was achieved, the figure of $1.75bn (£1.1bn; €1.3bn) a year to be transferred from rich to poor countries by 2012 and increasing to $100bn a year by 2020 looked the most likely to be nailed down. The money will be used to adapt the economies of poor countries to the effects of climate change, but it is expected that it will be up to the countries themselves to decide how to spend it.

“Real money, not words, has to be put on the table,” …
Role of Treatment in International Differences in One-Year Mortality From Early Stage Non-Small Cell Lung Cancer: a Tentative Answer From the International Cancer Benchmarking Partnership Study
Authors: T. Solomon, M.D. Peake, J. Butler, M.P. Coleman, W.K. Evans, E. Jakobsen, M. Boyer, T.B. Johannesen, B. Rachet
Journal: Annals of Oncology (2015)
Are ACE Inhibitors a “Magic Bullet” Against Oxidative Stress?
Authors: Thomas Münzel, John F. Keaney
Journal: Circulation (2001)

Outcomes Prevention Eval- uation (HOPE) study, 1,2 as well as the Study to Evaluate Carotid Ultrasound Changes in Patients Treated With Ramipril and Vitamin E (SECURE), 3 demonstrated that treatment with an ACE inhibitor but not vitamin E had beneficial effects on the prognosis and progression of atherosclerosis.In these studies, long-term ACE inhibition significantly reduced the rate of death, myocardial infarction, and stroke and reduced the intima-to-media ratio of carotid arteries in patients at high risk for cardiovascular events.It is likely that these findings will have wide-ranging implications for the treatment of cardiovascular disease, and the contrasting results with respect to ACE inhibitors and vitamin E provide an opportunity to revisit the role of oxidative stress in vascular disease.
GMC seeks powers to test doctors' language skills
Authors: H. Jaques
Journal: BMJ (2013)

The UK General Medical Council is seeking powers to test the English language proficiency of doctors from elsewhere in Europe and of registered doctors whose language skills are called into question by complaints from patients.

The regulator and the Department of Health for England have launched a consultation on changes to the Medical Act 1983 to tighten the law concerning language checks for doctors.

At present, European Union regulations on the mutual recognition of qualifications prevent the GMC from testing the English language skills of doctors from other European countries who are seeking a licence to practise in the United Kingdom. International medical graduates from outside Europe, on the other hand, are required to meet minimum standards of English language.

The new 12 week consultation seeks views on …
The effect of moderate alcohol intake on serum apolipoprotein A-I-containing lipoproteins and lipoprotein (a)
Authors: M. Välimäki, K. Laitinen, R. Ylikahri, C. Ehnholm, M. Jauhiainen, J.M. Bard, J.C. Fruchart, M.-R. Taskinen
Journal: Metabolism (1991)
Quantitative analysis of segmental wall motion during maximal upright dynamic exercise: variability in normal adults.
Authors: L E Ginzton, R Conant, M Brizendine, T Thigpen, M M Laks
Journal: Circulation (1986)

Twenty-five healthy adults underwent subcostal-view, four-chamber two-dimensional echocardiographic examination while upright at rest and at the peak of maximal bicycle exercise. The purpose of the study was to determine whether the variability in regional left ventricular endocardial motion, previously demonstrated to be present at rest, persisted at peak exercise. The rest and exercise end-diastolic and end-systolic endocardial contours were visually identified, digitized, and divided into 32 radial segments after realignment by the computer. At rest there was similar percent segmental area reduction for the septum (segments 1 to 12) (54 +/- 4%, mean +/- 1 SD), apex (segments 13 to 20) (67 +/- 3%), and lateral wall (segments 21 to 32) (67 +/- 8%). At peak exercise the percent area reduction increased significantly: septum 84 +/- 5%, apex 88 +/- 2%, lateral wall 83 +/- 6% (p less than .001 compared with rest for all areas). However, there was considerable variability in percent area reduction between different radial segments in the same individual. At rest the difference between minimal and maximal percent area reduction within the same individual was 49 +/- 17 percentage units (range 21 to 83) and that at peak exercise was 32 +/- 17 percentage units (range 0 to 66). It is concluded that, because the range of standard deviation of normal endocardial motion and the degree of variability between radial segments in the same healthy individual are significant, qualitatively determined "hypokinesis," as commonly assessed clinically, may be a normal event. However, segmental akinesis or dyskinesis, which occurred rarely at rest and never at peak exercise, must be considered abnormal events.
Expression and domain-specific function of GATA-2 during differentiation of the hematopoietic precursor cells in midgestation mouse embryos
Authors: Naoko Minegishi, Norio Suzuki, Tomomasa Yokomizo, Xiaoqing Pan, Tetsuhiro Fujimoto, Satoru Takahashi, Takahiko Hara, Atsushi Miyajima, Shin-ichi Nishikawa, Masayuki Yamamoto
Journal: Blood (2003)
Younger People with Dementia: A Multidisciplinary Approach
Authors: L. J Whalley
Journal: BMJ (2003)

Early onset dementia destroys the mind, often at the peak of its powers. Families are devastated, and children feel cheated by an affected parent's loss of identity. In the face of what appears to be–paradoxically–good bodily health, a lifetime's accumulated experiences, knowledge, and sensible judgment are no longer accessible. Family and friends can see that expert assessment is essential but occasionally lacking. In the United Kingdom about 20 000 middle aged people with this disorder need investigation and support. Their needs are not always met. Families sometimes say that a healthcare system …
Review: Perioperative β-blockers provide no clear benefit in patients having noncardiac surgery
Authors: Ryan J. McColl
Journal: Annals of Internal Medicine (2009)

ACP Journal Club17 March 2009Review: Perioperative β-blockers provide no clear benefit in patients having noncardiac surgeryRyan J. McColl, MD, Elijah Dixon, MDRyan J. McColl, MDUniversity of Calgary, Calgary, Alberta, Canada (R.J.M., E.D.)Search for more papers by this author, Elijah Dixon, MDUniversity of Calgary, Calgary, Alberta, Canada (R.J.M., E.D.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-6-200903170-02004 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationBangalore S, Wetterslev J, Pranesh S, et al. Perioperative β blockers in patients having non-cardiac surgery: a meta-analysis. Lancet. 2008;372:1962-76. https://pubmed.ncbi.nlm.nih.gov/19012955Clinical Impact RatingsGIM/FP/GP: Hospitalists: Cardiology: Reference1 POISE Study Group. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet. 2008;371:1839−47. [PMID: 18479744] Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Calgary, Calgary, Alberta, Canada (R.J.M., E.D.)This article was published at Annals.org on 3 March 2009. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 March 2009Volume 150, Issue 6Page: JC3-4KeywordsDrugsHeart failureHeart rateHypotensionIschemiaMyocardial infarctionRisk managementStrokeSurgery ePublished: 17 March 2009 Issue Published: 17 March 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
NIH and family of Henrietta Lacks reach agreement on access to HeLa genome
Authors: M. McCarthy
Journal: BMJ (2013)

In this report, conditions for prolonged in vitro proliferation of polyclonal adult CD4+ T cells via stimulation with immobilized anti-CD3 plus anti-CD28 have been established. CD4+ cells maintained exponential growth for more than 60 days during which a total 10(9)- to 10(11)-fold expansion occurred. Cell cultures exhibited cyclical changes in cell volume, indicating that, in terms of proliferative rate, cells do not have to rest before restimulation. Indeed, electronic cell size analysis was the most reliable method to determine when to restimulate with additional immobilized mAb. The initial approximately 10(5)-fold expansion was autocrine, occurring in the absence of exogenous cytokines or feeder cells. Addition of recombinant human IL-2 after the initial autocrine expansion resulted in continued exponential proliferation. Phorbol ester plus ionomycin also induced long-term growth when combined with anti-CD28 stimulation. Analysis of the T cell repertoire after prolonged expansion revealed a diverse repertoire as assessed by anti-TCR Vbeta Abs or a PCR-based assay. Cytokines produced were consistent with maintenance of both Th1 and Th2 phenotypes; however, the mode of CD3 and CD28 stimulation could influence the cytokine secretion pattern. When anti-CD3 and anti-CD28 were immobilized on the same surface, ELISAs on culture supernatants revealed a pattern consistent with Th1 secretion. Northern analysis revealed that cytokine gene expression remained inducible. Spontaneous growth or cell transformation was not observed in more than 100 experiments. Together, these observations may have implications for gene therapy and adoptive immunotherapy. Furthermore, these culture conditions establish a model to study the finite lifespan of mature T lymphocytes.
Mycoplasma pneumoniae Infection in the United Kingdom--1967-73
Authors: N. D. Noah
Journal: BMJ (1974)

A widespread epidemic of Mycoplasma pneumoniae infection in the United Kingdom occurred over a 30-month period in 1970-72. A small epidemic may also have occurred in 1967-68. Though the incidence of M. pneumoniae infection is known to change from year to year in small communities, a varying epidemicity in the population of a country has not previously been demonstrated.As expected, lower respiratory tract infection was the most common manifestation of infection; and the highest attack rates were in children aged 5-9 years. Elderly persons appear to be affected uncommonly.
County Society Supervision of Pure Milk Production.
Authors: Henry Enos Tuley
Journal: JAMA (1907)

Louisville. Ky., Sept. 11, 1907. <h3>To the Editor:</h3> —I note inThe Journal, September 7, the letter from Dr. C. G. Parnall of Jackson, Mich., with editorial comment following and lest some may infer from reading it that this method of procedure is new, I write to correct any such impression. This work by the committee appointed by the Jackson County (Mich.) Medical Society is the same that is being accomplished by twenty or twenty-five medical milk commissions located in cities from Boston to Los Angeles. The importance of the work of these milk commissions was emphasized by a notable gathering at Atlantic City the day preceding the American Medical Association meeting. This meeting was called at the instance of Dr. Henry L. Coit of Newark, N. J., founder of the first medical milk commission, and Dr. Otto P. Geier of Cincinnati. At this meeting the American Association of Medical