tbuckley/cabot-search huggingface dataset:
PTU-003 Gastroscopy Consent Training For Foundation Doctors: A Novel Teaching Strategy
Authors: DS Chilkunda, H Beal, Y Khiyar
Journal: Gut (2014)

<h3>Introduction</h3> Postgraduate Medical Education and Training Board (PMETB), now part of General Medical Council, reports on Foundation Schools have highlighted lack of consent training among Foundation Year 1 doctors (FY1s).<sup>1</sup> This can impact on patient safety and misguide expectations, thus adversely affecting patient experience. It could also affect FY1s’ confidence as they often feel they obtain consent for procedures without adequate training. Robust consenting skills are integral to good medical practice and require urgent attention. Hence we developed a new teaching programme on consenting for diagnostic gastroscopy (DG), which is the commonest inpatient procedure undertaken in the endoscopy unit, and as this procedure is less complex with relatively rare serious complications. <h3>Methods</h3> We initiated an <i>apprenticeship model</i> of training for consenting as part of mandatory FY1 induction. To facilitate this, we designed a formal assessment tool called Direct Observation of Gastroscopy Consent Taking Skills (DOGCTS). We developed a three-stage process. Stage 1: FY1s were provided small group teaching on consent and procedure. Stage 2: FY1s chose from available list of training slots, which were published after liaison between Endoscopy Unit and East Riding Medical Education Centre. Stage 3: FY1s observed one consenting process and DG by experienced endoscopist and underwent formal assessment using DOGCTS tool. <h3>Results</h3> This pioneering programme was introduced to all FY1s working in Medicine and Surgery in HRI starting in August 2012. Since its inception, 139 FYs have been trained with 100% attendance rate. In order to avoid disruption to lists, only one FY1 was trained per list. Programme allowed FY1s to plan training around their clinical commitments. Successful completion of DOGCTS has been integrated into FY portfolio-requirements. Feedback from FYs has been positive and they have reported improved confidence. Patients have informally expressed that they had a better patient experience. <h3>Conclusion</h3> Development of such a novel <i>apprenticeship model</i> allows for trainees and trainers to interact in an open, inclusive and non-threatening manner. It provides FY1s flexibility to manage their learning needs and trainers a chance to give formative feedback in real-time. Such a dynamic approach can not only improve confidence of FY1s but also instil public confidence in healthcare training. It has provided an excellent training opportunity in addition to being useful evidence for training-portfolios. It also caters to quality assurance and medico-legal aspects (pertaining to consenting) for NHS Trusts. We aim to undertake a formal survey of patient satisfaction annually and roll out this programme for flexible sigmoidoscopy consent as well. <h3>Reference</h3> 1PMETB Report on Quality Assurance of FY1 programme visit to London deanery 2009 <h3>Disclosure of Interest</h3> None Declared.
The BMA after the NHS review.
Authors: A. J. Vallance-Owen
Journal: BMJ (1989)

are preferable.5Disulfiram should be avoided for long term use as it may be hazardous in the elderly.2"Rehabilitation programmes will differ for individual patients; medical or psychiatric problems may need treatment, and help with marital, financial, and legal difficulties may be necessary.Other treatments include group therapy, individual counsell- ing, and referral to the Alcoholics Anonymous organisation.Finally, day hospital care and home visiting by health visitors and neighbours may help in relieving the distress and isolation of elderly people with alcohol problems.
Bacterial DNA Fragments in Otitis Media With Effusion
Authors: Erdem I. Cantekin
Journal: JAMA (1996)

<h3>To the Editor.</h3> —Dr Post and colleagues<sup>1</sup>report the presence of DNA fragments attributable to common nasopharyngeal resident bacteria in the majority of middle ear effusions (MEEs) of children who were going through tympanostomy tube surgery. Those children presumably were being operated on because, as the authors stated, untreated otitis media can cause hearing loss and developmental delays of speech and language and lower IQ scores. When making such justification for tube surgery, Post et al fail to cite the ongoing study of their colleagues at the Children's Hospital of Pittsburgh led by Paradise. As the data stream in from the largest, most extensive, and most expensive study undertaken to investigate the relationship between otitis media and developmental delay, Feldman et al<sup>2</sup>have been reporting for 2 years that "no significant associations exist between language development at age 1 year [also, at age 2 years]... and cumulative durations
Commentaries on the end of year editorial on the definition of ischaemia in last December's issue
Authors: C. J. Van Echteld, T. J. Ruigrok
Journal: Cardiovascular Research (1995)

Journal Article Commentaries on the end of year editorial on the definition of ischaemia in last December's issue Get access Cees Ja Van Echteld, Dr, Cees Ja Van Echteld, Dr Department of Cardiology, Heart-Lung Institute, University Hospital, Utrecht, The Netherlands Search for other works by this author on: Oxford Academic PubMed Google Scholar Tom JC Ruigrok, Professor Tom JC Ruigrok, Professor Department of Cardiology, Heart-Lung Institute, University Hospital, Utrecht, The Netherlands Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 29, Issue 2, February 1995, Page 283, https://doi.org/10.1016/S0008-6363(95)90003-9 Published: 01 February 1995
Effect of Radioactive Iodine Therapy on Lacrimal Gland Functions in Patients With Hyperthyroidism
Authors: Fusun Aydogan, Esra Ayhan Tuzcu, Akn Aydogan, Seckin Akkucuk, Mesut Coskun, Ihsan Ustun, Cumali Gökçe
Journal: Clinical Nuclear Medicine (2013)

Radioactive iodine (RAI) therapy is preferred in the treatment of hyperthyroidism because of its effectiveness, noninvasiveness, and low costs. I has been detected in extrathyroidal tissues, such as in gastric mucosa, salivary glands, and lacrimal glands. To the best of our knowledge, there is no publication concerning the effects of RAI therapy for hyperthyroidism on tear production. In the present study, we evaluated whether or not the lacrimal glands are affected after RAI therapy when compared with pretreatment period.The Schirmer and tear break-up time (TBUT) tests were used to assess 32 eyes of 16 patients with conditions that were diagnosed as hyperthyroidism before and at 3 and 6 months after RAI treatment. In addition, pretreatment values of patients were compared with that of controls. It was evaluated whether or not a correlation exists between the results and the dose or iodine uptake values.There was no significant difference between pretreatment values of Schirmer and TBUT tests obtained in the patient group and those of the control group (P > 0.05). In the patient group, there was a significant difference between the posttreatment and pretreatment values (P < 0.05). There was a positive correlation between uptake values obtained at 24 hours and the values obtained by TBUT and Schirmer tests on both eyes at 3 and 6 months. At 6 months, the uptake value at 24 hours was 28.83 ± 60 for both eyes in patients with TBUT test values less than 10, whereas it was 39.25 ± 7.88 for the right eye and 39.00 ± 6.85 for the left eyes in patients with TBUT test values greater than 10. The difference was statistically significant (P < 0.05).In our study, we concluded that the decrease in mucin and aqueous production occurs due to affected lacrimal glands by RAI therapy; however, this effect is not dose dependent.
New cause of penicillin treatment failure.
Authors: P Barnes, P M Waterworth
Journal: BMJ (1977)

A large empyema infected with a penicillin-sensitive haemolytic group B streptococcus failed to respond to high doses of penicillin. After two weeks9 treatment the pus aspirated was found not only to contain no penicillin, but also to inactivate penicillin added to it. We believe that the inactivating agent is an enzyme that may destroy various penicillins and cephalosporins but has no effect on other common antibiotics. When treatment was changed to doxycycline the patient made a rapid recovery.
Effect of Transdermal Nitroglycerin or N-Acetylcysteine, or Both, in the Long-Term Treatment of Unstable Angina Pectoris
Authors: Diego Ardissino, Piera Angelica Merlini, Stefano Savonitto, Gloria Demicheli, Paola Zanini, Federico Bertocchi, Colomba Falcone, Stefano Ghio, Giampiero Marinoni, Carlo Montemartini, Antonio Mussini
Journal: Journal of the American College of Cardiology (1997)
521. Gene Transfer of an Anti-CCR5 siRNA by Sleeping Beauty (SB) Transposon System
Authors: Mayur C. Tamhane, Ramesh Akkina
Journal: Molecular Therapy (2006)

The Sleeping Beauty transposon vector system is a non-viral gene delivery method. It is mediated by a transposase that employs a cut-and-paste mechanism. It is derived by repairing defective copies of Tc1/mariner family transposon elements. The utility of SB transposon system has been demonstrated in various mammalian cell lines for example by the gene transfer of a red fluorescence protein (RFP) in primary human lymphocytes. SiRNAs that mediate RNA interference have also been successfully introduced into cells using this system thus paving the way for permanent gene knock down using this novel non-viral gene transfer method. In our current studies we sought to introduce an anti-CCR5 siRNA into HIV-1 susceptible cells to down regulate this essential coreceptor involved in viral entry. A previously characterized short hairpin siRNA against CCR5 together with an RFP reporter was cloned into the SB gene transfer transposon and introduced into MAGI-CCR5 and GHOST- R3X4R5 cell lines. Since the levels of gene transfer were low, the stable transposed clones were enriched by FACS sorting for RFP expression. The enriched transgenic cells were cultured for many generations and monitored for RFP expression which appeared to be stable. To evaluate the siRNA mediated down regulation of CCR5, the transgenic cells were evaluated by FACS analysis. Both MAGI- CCR5 and GHOST-R3X4R5 cells showed a 90% reduction in CCR5 expression indicating that the siRNA is functional in this system. Stable transposition was also confirmed by southern blot hybridization testing of transposed cells with an RFP derived probe. To evaluate the HIV-1 resistance of the transgenic cells, they were challenged with a CCR5 tropic HIV-1 strain. Viral resistance was monitored by assaying for viral p24 antigen released into the supernatants at different days post viral challenge. Our results have shown significant viral resistance by the anti-CCR5 siRNA transgenic cells. These data indicate that a non-viral SB system can be utilized for transposition of siRNA coding genes to confer resistance against HIV.
Human Immunodeficiency Virus Type 1 Tat Protein Inhibits the SIRT1 Deacetylase and Induces T Cell Hyperactivation
Authors: Hye-Sook Kwon, Michael M. Brent, Ruth Getachew, Prerana Jayakumar, Lin-Feng Chen, Martina Schnolzer, Michael W. McBurney, Ronen Marmorstein, Warner C. Greene, Melanie Ott
Journal: Cell Host & Microbe (2008)
Combination of TRAIL gene therapy and chemotherapy enhances antitumor and antimetastasis effects in chemosensitive and chemoresistant breast cancers
Authors: Tongyu Lin, Lidong Zhang, John Davis, Jian Gu, Masahiko Nishizaki, Lin Ji, Jack A Roth, Momiao Xiong, Bingliang Fang
Journal: Molecular Therapy (2003)

We recently found that breast cancer cell lines that are resistant to chemotherapy or to the recombinant TRAIL protein are susceptible to TRAIL gene therapy. However, it is unclear whether a combination of TRAIL gene therapy and chemotherapy will have enhanced antitumor activity or can be used for the treatment of metastasis. In this study, we investigated the combined effect of TRAIL gene therapy and chemotherapeutic agents, including doxorubicin, paclitaxel, vinorelbine, gemcitabine, irinotecan, and floxuridine, in different breast cancer cell lines. In all the cell lines tested, including a breast cancer cell line that is resistant to chemotherapy, the combination of TRAIL gene therapy and cytotoxic agents had either a synergistic or an additive effect. An in vivo study showed that aerosolized administration of an adenovector expressing the GFP–TRAIL fusion protein from the human telomerase reverse transcriptase promoter (designated Ad/gTRAIL) also decreased the number of lung metastases from both doxorubicin-sensitive and doxorubicin-resistant breast cancer cell lines. The combination of TRAIL gene therapy and chemotherapy resulted in a further reduction of lung metastatic nodules with minimal toxicity. These results suggest that a combination of TRAIL gene therapy and chemotherapy is effective in the treatment of metastatic diseases.
Human neutrophil adherence to laminin in vitro. Evidence for a distinct neutrophil integrin receptor for laminin.
Authors: J F Bohnsack, S K Akiyama, C H Damsky, W A Knape, G A Zimmerman
Journal: The Journal of Experimental Medicine (1990)

We used mAbs against polymorphonuclear leukocyte (PMN) surface proteins to investigate the mechanisms by which stimulated human neutrophils (PMNs) adhere in vitro to laminin, the major glycoprotein of mammalian basement membrane. mAb IB4, which is directed against the common beta 2 chain of the CD11/CD18, only partially inhibited the adherence of PMA-stimulated PMNs to both laminin and to subendothelial matrices. In contrast, IB4 completely inhibited PMA-stimulated PMN adherence to gelatin, fibronectin, collagen IV, and endothelial cell monolayers. PMA-stimulated PMNs from a patient with severe congenital CD11/CD18 deficiency also adhered to laminin, but not to gelatin or endothelial cell monolayers. Therefore, PMA-stimulated PMNs adhere to laminin by both CD11/CD18-dependent and CD11/CD18-independent mechanisms. Expression of CD11/CD18-independent adherence to laminin was agonist dependent, occurring after stimulation with the calcium ionophore A23187 and recombinant TNF-alpha, but not with the chemotactic factors FMLP, platelet activating factor, or recombinant human C5a. Expression of CD11/CD18-independent adherence was also divalent cation dependent, occurring in the presence of Mg2+ but not Ca2+ as the sole added divalent cation. The mAbs AIIB2 and 13, which are directed against the beta 1 subunit of the VLA integrins, significantly inhibited the CD11/CD18-independent adherence of normal PMNs to laminin, and completely abolished the adherence of CD11/CD18-deficient PMNs to laminin. Both anti-beta 1 mAbs bound to PMNs, as demonstrated by flow cytometry, and immunoprecipitated a membrane molecule of Mr 130,000 daltons from 125I-labeled, detergent-solubilized PMNs. These data suggest that human PMNs possess beta 1 and beta 2 classes of integrins, and that both mediate PMN adherence.
159 EFFECTS OF ISCHEMIC PRE- AND POSTCONDITIONING ON HIF-1α, VEGF AND TGF-β EXPRESSION DURING WARM LIVER ISCHEMIA AND REPERFUSION
Authors: A. Knudsen, A.-S. Kannerup, H. Grønbæk, P. Funch-Jensen, J. Frystyk, A. Flyvbjerg, F.V. Mortensen
Journal: Journal of Hepatology (2009)
Severe atypical molluscum contagiosum infection in an immunocompromised host
Authors: D.W.K. COTTON, C. COOPER, D.F. BARRETT, B.J. LEPPARD
Journal: British Journal of Dermatology (1987)

A case of severe molluscum contagiosum in a patient with treated thymoma is described. This unusual complication of immunosuppression is discussed and the literature on the subject reviewed.
EARLY DIAGNOSIS AND INTRAVENOUS SERUM TREATMENT OF EPIDEMIC CEREBROSPINAL MENINGITIS
Authors: W. W. HERRICK
Journal: JAMA (1918)

In large cantonment hospitals where clinical material can be controlled by military methods, where acute disease in large volume may be studied in its earliest as well as its later stages, where necropsy study is possible and where elaborate laboratory equipment is often lacking and the medical officer thrown in consequence on his own resources, bedside observation may well add to the store of medical knowledge. At the base hospital, Camp Jackson, S. C., attention has been focused on epidemic cerebrospinal meningitis. More than 270 cases of this disease have been studied with the result that a more definite idea of its general character has been established, methods of diagnosis of value have been brought into use, and a more successful treatment has been carried out. This paper is based on the study of the first 265 cases of meningococcus infection observed from November, 1917, to June, 1918. Some of
Drug treatment for acute upper gastrointestinal bleeding.
Authors: D. Barer
Journal: BMJ (1992)

design features.Case matching is a more reliable fatality rates in this particular trial) must reflect the dose, defined as the amount needed to produce the means of eliminating errors than comparing the probability that the result was simply due to required effect.study group with a control group of a different size mismatching.The gastric acid outputs or acidities of the as in Hinton's survey.
Secondary Mutations at I1171 in the ALK Gene Confer Resistance to Both Crizotinib and Alectinib
Authors: Gouji Toyokawa, Fumihiko Hirai, Eiko Inamasu, Tsukihisa Yoshida, Kaname Nosaki, Tomoyoshi Takenaka, Masafumi Yamaguchi, Takashi Seto, Mitsuhiro Takenoyama, Yukito Ichinose
Journal: Journal of Thoracic Oncology (2014)
Epigenetics and Metabolism
Authors: Samuel T. Keating, Assam El-Osta
Journal: Circulation Research (2015)

The molecular signatures of epigenetic regulation and chromatin architectures are fundamental to genetically determined biological processes. Covalent and post-translational chemical modification of the chromatin template can sensitize the genome to changing environmental conditions to establish diverse functional states. Recent interest and research focus surrounds the direct connections between metabolism and chromatin dynamics, which now represents an important conceptual challenge to explain many aspects of metabolic dysfunction. Several components of the epigenetic machinery require intermediates of cellular metabolism for enzymatic function. Furthermore, changes to intracellular metabolism can alter the expression of specific histone methyltransferases and acetyltransferases conferring widespread variations in epigenetic modification patterns. Specific epigenetic influences of dietary glucose and lipid consumption, as well as undernutrition, are observed across numerous organs and pathways associated with metabolism. Studies have started to define the chromatin-dependent mechanisms underlying persistent and pathophysiological changes induced by altered metabolism. Importantly, numerous recent studies demonstrate that gene regulation underlying phenotypic determinants of adult metabolic health is influenced by maternal and early postnatal diet. These emerging concepts open new perspectives to combat the rising global epidemic of metabolic disorders.
Cost-Effectiveness of Echocardiography after Stroke
Authors: Robert L. McNamara
Journal: Annals of Internal Medicine (1998)

Letters15 May 1998Cost-Effectiveness of Echocardiography after StrokeRobert L. McNamara, MD, MHS, Joao A.C. Lima, MD, and Neil R. Powe, MD, MPH, MBARobert L. McNamara, MD, MHSJohns Hopkins University; Baltimore, MD 21205Search for more papers by this author, Joao A.C. Lima, MDJohns Hopkins University; Baltimore, MD 21205Search for more papers by this author, and Neil R. Powe, MD, MPH, MBAJohns Hopkins University; Baltimore, MD 21205Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-10-199805150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Tam and colleagues disagree with our recommendations and present the clinical algorithm used at their institution. The main difference between their proposed algorithm and our formal analysis lies in their recommendation for using TTE to select patients for TEE, a strategy that they admit has not been formally validated. We believe that clinical history plays a larger role in selecting patients who may benefit from TEE. In our analysis, the cost-effectiveness ratio for the strategy that includes TEE only for patients with a “cardiac history” was indeed lowest compared with no imaging and no treatment. Because the conditions ...References1. Sansoy V, Abbott RD, Jayaweera AR. Kaul S. Low yield of transthoracic echocardiography for cardiac source of embolism. Am J Cardiol. 1995; 75:166-9. Google Scholar2. Tam JW, Burwash IG, Ascah KJ, Baird MG, Chan KL. Feasibility and complications of single-plane and biplane versus multiplane transcsophageal imaging: a review of 2947 consecutive studies. Can J Cardiol. 1997; 13:81-4. Google Scholar Author, Article, and Disclosure InformationAuthors: Robert L. McNamara, MD, MHS; Joao A.C. Lima, MD; Neil R. Powe, MD, MPH, MBAAffiliations: Johns Hopkins University; Baltimore, MD 21205 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 May 1998Volume 128, Issue 10 Page: 873 Keywords Algorithms Decision analysis Echocardiography Hypertension Inpatients Length of stay Myocardial infarction Retrospective studies Stroke Thrombosis ePublished: 15 August 2000 Issue Published: 15 May 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
66 PROSPECTIVE EVALUATION OF SORAFENIB (SO) IN PATIENTS WITH HEPATOCELLULAR CARCINOMA (HCC): DOES CHILD SCORE B INFLUENCE SAFETY?
Authors: O. Romano, S. Cattan, S. Dharancy, V. Canva, H. Castel, E. Boleslawski, S. Truant, M. Hebbar, F. Pruvot, P. Mathurin
Journal: Journal of Hepatology (2009)
Pathologist in Sally Clark case suspended from court work
Authors: Clare Dyer
Journal: BMJ (2005)

The Home Office pathologist who failed to disclose key evidence that could have helped to clear Sally Clark of murdering her two babies was found guilty of serious professional misconduct by the General Medical Council last week. Alan Williams was banned from Home Office pathology work or coroners' cases for the next three years, but will be allowed to continue working as a consultant histopathologist at Macclesfield General Hospital.

   ![][1]    ![][2] 

The GMC concluded that Dr Alan Williams (above right), whose evidence was crucial in the case of Sally Clark (above le ft), showed no evidence of general incompetence

Credit: KIRSTY WIGGLESWORTH/PA/EMPICS

Credit: ANDREW PARSONS/PA/EMPICS

Mrs Clark was jailed for life in 1999 …

 [1]: /embed/graphic-1.gif
 [2]: /embed/graphic-2.gif