tbuckley/cabot-search huggingface dataset:
Options for change in the NHS consultant contract
Authors: R W Clarke, C Gray
Journal: BMJ (1994)

The lead negotiators for the management and consultant sides in an NHS trust in northern England responded to debate in their trust about consultant contracts by offering to research the attitudes of their peers towards a variety of contract options. The options tested included the current contract; models already examined in the trust and elsewhere, such as time sensitive and mild performance related contracts; and some more radical and speculative possibilities, including consultants franchising their services to the trust. Beyond the predictable conclusion that consultants would prefer no change while managers desired it, a time sensitive contract emerged as having potential for successful negotiation. On the other hand, neither consultants nor managers favoured a strict performance related contract or a fee for service contract. There was a strong similarity of opinion between the two groups on the relative salary values of the options, though the consultants consistently priced these higher than the managers.
Psychiatric House Calls
Authors: Howard A. Winkler
Journal: JAMA (1989)

Are house calls the province only of primary-care physicians—family physicians, general practitioners, internists, and/or pediatricians? The answer to this question is "No," according to<i>Psychiatric House Calls</i>, edited by John A. Talbott, MD, and Alan Z. A. Manevitz, MD. Of interest is the dust jacket, where "House Calls" is printed in large capitals, while above it "Psychiatric" appears in much smaller type. Is this mute evidence, common in psychiatry, of a simultaneous divorce from and reentry into the field of medicine? <i>Psychiatric House Calls</i>is an entertaining and lively compendium of anecdotal experiences of many physicians, most of whom are psychiatrists, with many of the authors making house calls early in their training or shortly after beginning practice. It is of more than passing interest to note that at the University of Maryland Medical School a program to teach house calls to fourth-year medical students is included in the curriculum
Organization and evolution of the Cyp2 gene cluster on mouse chromosome 7, and comparison with the syntenic human cluster.
Authors: Haoyi Wang, Kyle M Donley, Diane S Keeney, Susan M G Hoffman
Journal: Environmental Health Perspectives (2003)

Genes from the cytochrome P450 (CYP) superfamily encode a diverse group of monooxygenases that play important roles in both endogenous processes and in the metabolism of exogenous compounds, including most drugs. A cluster of Cyp2 genes on mouse chromosome 7 was mapped and analyzed in detail and compared with the homologous cluster on human chromosome 19. The mouse cluster includes 22 loci from the same six CYP2 subfamilies--Cyp2a, Cyp2b, Cyp2f, Cyp2g, Cyp2s, Cyp2t--that are found in the human cluster. Twelve of these loci are functional genes, and 10 are pseudogenes. Parts of the mouse and human gene clusters are similarly arranged, but the data indicate that a significantly different series of duplication events created the modern gene organizations in the two species. The comparison of the mouse and human clusters provides new insights into the evolution of gene families, whereas the detailed analysis provides background information that should be informative for future studies on the expression, regulation, and function of specific mouse Cyp2 genes.
The Mitochondrial Proteins NLRX1 and TUFM Form a Complex that Regulates Type I Interferon and Autophagy
Authors: Yu Lei, Haitao Wen, Yanbao Yu, Debra J. Taxman, Lu Zhang, Douglas G. Widman, Karen V. Swanson, Kwun-Wah Wen, Blossom Damania, Chris B. Moore, Patrick M. Giguère, David P. Siderovski, John Hiscott, Babak Razani, Clay F. Semenkovich, Xian Chen, Jenny P.-Y. Ting
Journal: Immunity (2012)
Abstract IA26: Protective immune networks in ovarian cancer
Authors: Brad Nelson
Journal: Clinical Cancer Research (2013)

Abstract Ovarian cancer is a challenging disease for which new treatments are urgently needed. High-grade serous ovarian cancer is the most common and lethal subtype, with a five-year survival rate of only 30-40%. Nevertheless, patients with evidence of an immune response against their cancer – in particular the presence of tumor-infiltrating T cells – show markedly prolonged survival. We recently showed that B cells also contribute to tumor immunity, in that tumors infiltrated by both B cells and T cells are associated with higher survival rates than seen with T cells alone. Tumor-infiltrating T cells and B cells co-localize in organized structures resembling lymphoid tissue. These structures also contain dendritic cells and show the hallmarks of active antigen presentation and lymphocyte activation. We are investigating the hypothesis that these lymphoid structures are sites of immune surveillance, where tumor antigens are presented to T cells and B cells allowing the immune system to keep check on the evolving cancer genome. To explore this concept, we are assessing tumor-infiltrating T cells for recognition of mutations identified by whole exome sequencing. In one patient undergoing standard chemotherapy, we found an example of a CD8+ T cell response to a point mutation in the HSDL1 gene. The T cell response emerged during first remission, peaked at first recurrence, and then disappeared by second recurrence, shortly before the patient succumbed to her disease. Thus, the immune system actively surveys the tumor genome in patients undergoing standard treatment, but these responses can fail in the absence of immunologic intervention. With better understanding of the lymphocytes and structures involved, it should be possible to enhance these natural surveillance mechanisms to confer protective immunity and further increase patient survival. Citation Format: Brad Nelson. Protective immune networks in ovarian cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr IA26.
Comparison of Regional Myocardial Perfusion Determined by Ionic Potassium-43 to That Determined by Microspheres
Authors: EDWARD K. PROKOP, H. WILLIAM STRAUSS, JOHN SHAW, BERTRAM PITT, HENRY N. WAGNER
Journal: Circulation (1974)

The ability of ionic potassium-43 ( 43 K) to reflect alterations in regional myocardial perfusion was determined by comparing the distribution of this tracer to that of labeled microspheres and flowmeter measurements under several conditions of coronary blood flow. When flow was normal, the regional distribution of ionic 43 K and labeled microspheres were similar. In ischemia induced by partial occlusion and pacing, both 43 K and microspheres showed the same decrease in activity (0.7 of control). When a coronary artery was completely occluded, both tracers were decreased to 0.3 of control. In other experiments, resting coronary blood flow was decreased by 25%, 50% and 75% as determined by flowmeter measurements. When this was done, regional distribution of ionic 43 K and microspheres both decreased in parallel but to a lesser degree than flowmeter data suggesting a contribution from collateral vessels. The endocardial/epicardial activity in the ischemic region also decreased proportionally. However, under conditions of increased flow during myocardial reactive hyperemia, 43 K activity (1.02 of control) did not increase to the same degree as microsphere activity (1.5 of control).
Life Is Short, the Art Long, Opportunity Fleeting, Experience Treacherous, Judgment Difficult
Authors: Jane Mueller
Journal: JAMA (1988)

To the Editor.  —The article about the evaluation of medical students' skills in performing physical examinations by patients who are trained to evaluate those examinations 1 prompts me to say that women who have been trained to do breast self-examination cannot help but notice when their physicians' breast examining skills are deficient.  These skills are often deficient, if the discussions I have had on the subject with sympathetic physicians and interested women patients are any indication. In fact, those discussions make me think that it is the rare physician who performs a breast examination as well as trained women patients do.  A woman who sees that her physician cannot conduct a proper breast examination necessarily wonders about his other medical skills. Ideally, such a woman lets her physician know that she is dissatisfied with the breast examination; but, she rarely speaks up, probably out of embarrassment for the physician and
King-Anderson Bill
Authors: Archie Fine
Journal: JAMA (1963)

<h3>To the Editor:</h3> —The letter of Drs. Lawrence S. Kubie and Robert E. Cooke in the Aug 18 issue ofThe Journal(<b>181</b>:653), concerning the merits of the King-Anderson bill, includes the statement that "The Bill involves no interference with the individual's right to choose his own doctor for homecare..." There was one clause in the bill to which little attention was paid. I refer to the one which stated that out-patient diagnostic services (x-ray and laboratory services) would be rendered only in hospitals, thereby excluding the services of the radiologist and pathologist in private practice. Do Drs. Kubie and Cooke consider these fields not a part of medical practice? The passage of a bill containing this clause would surely mean the destruction of the private practice of the radiologist and pathologist. My colleagues have maintained that the patient and his referring physician be given a free choice as
Multilayer nanoparticles for sustained delivery of exenatide to treat type 2 diabetes mellitus
Authors: Jae Yeon Kim, Hwanbum Lee, Keun Sang Oh, Seho Kweon, Ok-cheol Jeon, Youngro Byun, Kwangmeyung Kim, Ick Chan Kwon, Sang Yoon Kim, Soon Hong Yuk
Journal: Biomaterials (2013)
Brain Scans in Diagnosis of Cerebrovascular Disease
Authors: Herbert J. Waxman
Journal: JAMA (1965)

Twenty-seven patients were studied with a total of 30 brain scans done with chlormerodrin Hg 203 at variable periods of time after cerebrovascular accidents. Infarctions, hemorrhages (both intracerebral and subdural), and insufficiencies were represented in this study. A large percentage of very-high-uptake concentration was demonstrated, except in insufficiencies and in a scan of a lesion of the posterior fossa. Increased uptake was obtained as late as 53 days postinfarction. It is emphasized that in this study the uptake obtained in patients with cerebrovascular disease could not be differentiated from tumors on the basis of scanning alone. Some speculation as to the mechanism of this increased uptake is presented.
Treatment of Diphtheria Carriers: Benzathine Penicillin, Erythromycin, and Clindamycin
Authors: RICHARD V. McCLOSKEY
Journal: Annals of Internal Medicine (1974)

Asymptomatic carriers of toxinogenic Corynebacterium diphtheriae were treated by either a single injection of benzathine penicillin or a 7-day oral course of erythromycin or clindamycin. Nasopharyngeal cultures were obtained from all carriers before treatment and after therapy was started. The carrier state was terminated in 84% of those receiving benzathine penicillin, 92% of those receiving erythromycin, and 93% of those receiving clindamycin. These results differ from our previously reported 1-year study. Benzathine penicillin could be used, however, to treat diphtheria carriers when patients cannot be relied upon to complete a 7-day course of oral therapy. Clindamycin is an alternate antibiotic that will terminate the diphtheria carrier state. There was no change in the sensitivity of C. diphtheriae to penicillin or erythromycin in those whose carrier state persisted.
SOME CLINICAL ASPECTS OF CORONARY DISEASE
Authors: T. F. Cotton
Journal: BMJ (1932)

MEDICABRJIOTISRAL _~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~m iscellaneous disorders, is a frequent finding in diabetes mellitus, and a still more frequent occurrence in hyper- thyroidism and in the non-megalocytic " hypochromic " anaemia above described.In the latter disease it seems to have causal relationship, direct or indirect, but in the light of recent work on pernicious anaemia even this surmised causal relationship may ultimately prove to be incorrect.At any rate, this form of anaemia is of frequent occurrence, and its adequate treatment with iron in the ferrous form, by mouth, gives satisfactory results.It gives me great pleasure to acknowledge, in this study, the cordial co-operation of Dr. W. R. O' Farrell, pathologist to the hospital, and of Drs.L. K. Malley and M. A. Moriarty while they were my house-physicians.
Carcinoma erysipeloides of the facial skin in a patient with metastatic breast cancer
Authors: R. Hinrichs, K. Kirchberg, J. Dissemond, J.D. Hoppe, P. Brenneisen, T. Krieg, K. Scharffetter-Kochanek
Journal: British Journal of Dermatology (1999)

Journal Article Carcinoma erysipeloides of the facial skin in a patient with metastatic breast cancer Get access R. Hinrichs, R. Hinrichs Department of Dermatology, University of Cologne, Joseph‐Stelzmann‐Str. 9, 50924 Cologne, Germany Search for other works by this author on: Oxford Academic Google Scholar K. Kirchberg, K. Kirchberg Department of Dermatology, University of Cologne, Joseph‐Stelzmann‐Str. 9, 50924 Cologne, Germany Search for other works by this author on: Oxford Academic Google Scholar J. Dissemond, J. Dissemond Department of Dermatology, University of Cologne, Joseph‐Stelzmann‐Str. 9, 50924 Cologne, Germany Search for other works by this author on: Oxford Academic Google Scholar J.D. Hoppe, J.D. Hoppe Department of Pathology, Hospital Düren, 52351 Düren, Germany E‐mail: karin.scharffetter@uni‐koeln.de Search for other works by this author on: Oxford Academic Google Scholar P. Brenneisen, P. Brenneisen Department of Dermatology, University of Cologne, Joseph‐Stelzmann‐Str. 9, 50924 Cologne, Germany Search for other works by this author on: Oxford Academic Google Scholar T. Krieg, T. Krieg Department of Dermatology, University of Cologne, Joseph‐Stelzmann‐Str. 9, 50924 Cologne, Germany Search for other works by this author on: Oxford Academic Google Scholar K. Scharffetter‐Kochanek K. Scharffetter‐Kochanek Department of Dermatology, University of Cologne, Joseph‐Stelzmann‐Str. 9, 50924 Cologne, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 141, Issue 5, 1 November 1999, Pages 940–941, https://doi.org/10.1046/j.1365-2133.1999.03183.x Published: 01 November 1999
Benefits of a modified spirometry technique
Authors: J. K. Stoller, K. McCarthy
Journal: European Respiratory Journal (2007)

Sporadic and epidemic community legionellosis: two faces of the same illnessTo the Editors:We read with interest the article of SOPENA et al. [1] on the comparisons of risk factors, presentation and outcome of community-acquired Legionella pneumophila pneumonia in 138 sporadic-case patients (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004) and 113 outbreak-case patients (2002).As suggested by the authors, a limitation of comparison on the clinical severity between the two populations could be related to the delay in diagnosis.In other words, in the case of an outbreak, many exposed patients were screened for legionellosis using urinary antigen assays so that patients with mild symptoms could be diagnosed and treated.Conversely, sporadic cases were more frequently diagnosed, such as when the patients were hospitalised due to the severity of their symptoms.This corresponds to a more typical presentation and detection of the disease.A means to test this hypothesis would be to calculate the delay between the onset of the disease and the time of Legionella urinary antigen detection within the two groups of patients, and then compare the severity of the symptoms adjusted with these delays.It would be reasonable to suppose that for a similar delay in diagnosis, the clinical features would be the same for sporadic and outbreak cases.If differences persisted after adjustment for delays in diagnosis, then specific determinants would need to be identified in relation to the severity of the legionellosis within these two populations.Similarly, as demonstrated in some studies performed among patients with cancer [2], this investigation would face a bias due to the earlier time of diagnosis associated with a screening procedure called ''lead-time'' and would possibly lead to over-diagnosis.
Prevalence of systemic lupus erythematosus in England and Wales, 1981-2.
Authors: M C Hochberg
Journal: Annals of the Rheumatic Diseases (1987)

The prevalence of systemic lupus erythematosus (SLE) was estimated from a secondary analysis of data collected during the Third National Study of Morbidity Statistics from General Practice, 1981-2. A total of 20 cases, all female, were seen by general practitioners during the study period. The period prevalence of SLE was 12.5/100,000 among women of all ages and 17.7/100,000 among women aged 15 to 64. These rates are lower than those reported from other developed Western countries; this is probably due to misclassification in diagnosis or prior referral of cases to consultants for chronic care, or both.
Membranoproliferative Glomerulonephritis Type 1
Authors: R O Gans, L G Feld
Journal: New England Journal of Medicine (1996)

Figure 1. An eight-year-old girl was found to have proteinuria and microscopic hematuria on a routine examination. A photomicrograph (Panel A) shows an enlarged, lobulated glomerulus with irregular thickened glomerular capillary walls, often with a double-contour appearance, so-called tram tracks (arrowheads); moderate mesangial expansion; and moderate hypercellularity (periodic acid–Schiff, ×20). A fluorescence photomicrograph (Panel B) discloses coarse and bulky granular deposits of C3 along the glomerular capillary wall and, to a lesser extent, in mesangial areas (×25). A transmission electron micrograph (Panel C) reveals large, subendothelial, electron-dense deposits (asterisks) and mesangial interposition (×4000). CL denotes capillary lumen, EN endothelial cell, . . .
Increased vessel density in psoriasis: involvement of lymphatic vessels in the papillary dermis
Authors: E. Fiedler, P. Helmbold, W.C. Marsch
Journal: British Journal of Dermatology (2008)

Conflicts of interest: none declared. Dedicated to Terence J. Ryan, DM FRCP (Oxon) on the occasion of his being awarded an Honorary Doctorate by the Medical Faculty of Martin Luther University Halle‐Wittenberg, 7 September 2007. Sir, The histology of psoriasis vulgaris plaques is characterized by epidermal hyperplasia with uniformly elongated rete ridges enclosing presumably enlarged dermal papillae, dilated, prominent blood vessels in the upper dermis and an inflammatory infiltrate of leucocytes. Recently, Griffiths and Barker1 noted that since the basic ultrastructural examinations by Braverman2 over 30 years ago, the vessels have received little attention in psoriasis research. The ultrastructure and function of the lymphatic vessels within the enlarged dermal papillae have been observed by Braverman,3 Cliff et al.,4 Ryan5 and Bacharach‐Buhles et al.6 The papillae of normal skin have few such vessels or none at all. The lymphatic vessel density reported in psoriasis plaques varies strongly with the detection procedure. While Braverman3 described an increase in lymphatic vessel density compared with normal skin by means of ultrastructural studies, Bacharach‐Buhles et al.6 simply formulated a shift of existing lymph vessels from the upper dermal plexus to the dermal papillae based on three‐dimensional reconstructions of the ultrastructure, while Cliff et al.4 concluded from a reduced lymph outflow in fluorescence microlymphography that there is a decrease in lymphatic vessel density within a plaque.
A staff college to transform the NHS?
Authors: Arthur R Jones
Journal: Journal of the Royal Society of Medicine (2011)

A staff college1 will bring the NHS into line with many other large organizations, however creating a cadre of experts does not guarantee progress, those not selected may become apathetic, and the experts may form cliques indifferent to changing circumstances.2 This College's graduates, however, will be appropriately ambitious, being expected to be a critical mass which transforms the huge NHS workforce where the majority is neither doctor nor nurse, by leadership with a clinical perspective, enthusing staff to deal dutifully with unusual situations, thus restoring the coping organization esteemed by staff and users, but rarely by managers.

A welcome change, one completely reversing the past direction of the NHS, a rampant bureaucracy; inserting more and more managers, closing hospitals and coalescing into large specialist centres, isolated from local involvement or criticism and empowered by an eye-watering investment in computer systems. But how exactly can leadership, formerly by exemplary professional behaviour, be exerted when the relationship between doctor and patient is no longer private and is expected to be based on explicit rules,3 not ad-hocery – by email?

There is a further uncertainty. Speaking prosaically, what the College will do is equip its graduates with the mission skills to re-engineer the NHS: a worthy aim, but the model staff college does more than upskill its students in procedures to meet current needs, it enrols and develops visionaries with the intuitive ‘coup d’oeil’, to quickly perceive new truths and somehow or other deal with tomorrow's unpredictable reality.4 Whatever surprises the future holds, there is already a clear trend, widespread and no less threatening than local scandals: the accelerating cost of healthcare underpinned by the steady rise in consumption.5 An overstretch for which the NHS ideal of comprehensive healthcare for all, however lead, will need a new game plan.
Glycosylated Hemoglobin in Diabetes Mellitus: Correlations with Fasting Plasma Glucose, Serum Lipids and Glycosuria
Authors: H Aleyassine, R J Gardiner, D B Tonks, P Koch
Journal: Diabetes Care (1980)

The levels of glycosylated hemoglobin (GlHb), fasting plasma glucose (FPG), urine glucose, serum triglycerides, cholesterol, and HDL-cholesterol were monitored in several hundred patients attending an adult diabetic clinic. Thirty-five percent of the patients were being treated with insulin, 30% with diet alone, and 20% with sulfonylurea. Therapy was changed during the study in the remaining 15%. The levels of GlHb and FPG were significantly lower in the patients treated with diet alone than in the other groups. The overall coefficient of correlation (r) between FPG and GlHb was 0.64, with the highest r (0.70) for the diet group and the lowest r (0.55) for the insulin group. A follow-up study showed that in about 50% of the patients GlHb and FPG levels changed in different directions from one visit to the next. The absence of glycosuria was noted in two-thirds of the patients, while in 78% of the patients GlHb values were above the normal range. A weak but positive correlation was found between GlHb and serum triglycerides and cholesterol. There was no significant correlation between GlHb and HDL-cholesterol. The HDL-cholesterol levels were significantly lower in male than in female diabetic subjects, but no significant difference was found between the diabetic and nondiabetic subjects of the same sex. The results of this study suggest that (1) although there is a positive correlation between GlHb and FPG, the two tests cannot be used interchangeably in the evaluation of diabetic control; and (2) in the majority of the patients the absence of glycosuria tends to create the false assurance of satisfactory blood glucose control.