tbuckley/cabot-search huggingface dataset:
Effects of ranitidine treatment on patients with asthma and a history of gastro-oesophageal reflux: a double blind crossover study.
Authors: T Ekstrom, B R Lindgren, L Tibbling
Journal: Thorax (1989)

Forty eight patients with moderate to severe asthma were enrolled in a double blind crossover study designed to evaluate the effects of ranitidine treatment, 150 mg twice daily for four weeks, on gastro-oesophageal reflux, asthma control, and bronchial reactivity. All 48 had a history of reflux symptoms and 27 had in addition reflux associated respiratory symptoms. Thirty two patients had objective evidence of acid reflux on 24 hour pH monitoring (pH of less than 4 for more than 1% of the 24 hours) and 27 patients had a positive result in the acid perfusion test. Reflux symptoms were significantly improved after ranitidine treatment. Ranitidine treatment was associated with modest improvements in nocturnal asthma and daily use of inhaled bronchodilator drugs but there was no significant change in bronchial reactivity, lung function, peak flow, or the number of eosinophils in the blood. Comparisons between the effect of ranitidine treatment on asthma control were performed between patients with and without a history of reflux associated respiratory symptoms, with and without a positive result in the acid perfusion test, and with and without objective evidence of gastro-oesophageal reflux. A history of reflux associated respiratory symptoms was the only factor that predicted an improvement in asthma control after ranitidine treatment. These results indicate that antireflux treatment will produce only small improvements in asthma control in asthmatic patients with a history of gastro-oesophageal reflux.
One Risk Fits All?
Authors: Geertruida H. De Bock, Marian J.E. Mourits, Jan C. Oosterwijk
Journal: Journal of Clinical Oncology (2007)

When we initially proposed a special issue of Journal of Clinical Oncology devoted to the cost of cancer care to the editorial board, our objective was to inform and stimulate discussion regarding this complex and increasingly critical topic.In planning "Perspectives on the Cost of Cancer Care," 1 we were struck by the dearth of empirical research that had been conducted on the economics of cancer care.Clearly, this situation is improving, as evidenced by recent publications in JCO 2-4 that stimulated the correspondence by Lopes and Gluck.In their letter, the authors address the importance of perspective in cost-effectiveness (CE) analyses, which serves as the basis for interpreting and applying these studies.The greatest value of CE analysis is to inform decisions regarding allocation of resources from a finite pot. 5 A societal perspective takes into account productivity costs associated with cancer and its treatment.In most of the clinical literature, this perspective is not considered as (1) the empirical data are often shaped by social insurance policies within countries, (2) productivity costs have been found to vary little across treatment arms of a clinical trial (thus violating a parsimony objective of clinical research data collection), and (3) an important component of patient benefit, quality-adjusted survival, is already considered.From a theoretical perspective, these costs might be most important to consider when comparing treatments that offer different outcomes in terms of quantity and quality of life.The CE analyses regarding trastuzumab therapy in breast cancer highlight several issues regarding the cost of cancer treatment.First, expensive drugs such as therapeutic antibodies will appear less so in adjuvant compared with metastatic settings.Furthermore, drugs for which a method exists to select patients most likely to benefit (eg, human epidermal growth factor receptor 2 expression) will have an advantage in the realm of economic analysis, especially if price was set before the characterization of the subpopulation was made.Finally, Lopes and Gluck offer several alternatives to address ethical concerns over disparities in cancer care, including governmental price controls, market-based approaches, and restructuring of current incentive structures for innovation.Space does not permit us to review the pros and cons of each of these proposals; however, we agree that as a society there is an urgent need to address the disparities in cancer care (and health care in general) that are likely to become increasingly acute as health care costs escalate. 6 The oncology community has an obligation to be informed and to participate in these discussions such that we may impact policy in service to our patients.
S70 Results From The First National Lung Cancer Organisational Audit
Authors: I. Woolhouse, C. Meace, K. Greenaway, P. Beckett, M. Peake
Journal: Thorax (2014)

<h3>Background</h3> National Lung Cancer Audit reports consistently demonstrate variation in diagnostic pathways, treatment rates and outcomes which are not wholly explained by case-mix. One possible explanation for this variation is different access to diagnostics and treatment specialists, however little is known about the provision of these services across England and Wales lung cancer services. <h3>Methods</h3> An electronic survey was sent to all lung cancer lead clinicians in England and Wales in January 2014. The survey included seven questions for all MDTs on service provision, diagnostic services, staging services, and lung cancer treatment. There were a further 3 questions for treatment centres. Two reminders were sent and the survey closed in May 2014. <h3>Results</h3> 128 records were submitted from 176 trusts. After removal of duplicate and empty records 101 were available for analysis. Mean (range) average number of patients discussed per MDT meeting is 26 (5–88) and 29% Trusts have a separate diagnostic meeting. There is considerable variation in the mean (range) number of whole time equivalent (wte) on site lung cancer specialists e.g. thoracic pathologists 1.4 (0–10), lung CNS 2.0 (0.5–10) and respiratory physicians 3.9 (0–20). Most diagnostic and staging procedures are available either on or off site, although medical thoracoscopy is not available at all to 14% Trusts. Chemotherapy, radiotherapy and surgery are available on site in 89%, 33% and 18% of Trusts, respectively. VAT lobectomy, stereotactic radiotherapy and radiofrequency ablation are not available at all to 6%, 5% and 10% of Trusts, respectively. Centres performing thoracic surgery report mean (range) wte number of surgeons at 1.5 (0–6) and thoracic HDU beds at 4 (0–24). Acute oncology services are available to 92% chemotherapy treatment centres and 96% radiotherapy centres. <h3>Conclusion</h3> The data provide a moderately representative snapshot of diagnostic and treatment services available for lung cancer patients in England and Wales. There is significant variation in the number of specialists available and some patients do not have access to key treatment modalities e.g. VAT lobectomy. Further work is required to determine how this relates to patient experience and outcomes. All Trusts are encouraged to submit validated data for the next round of organisational audit.
Who Are the Donors in Organ Donation? The Family's Perspective in Mandated Choice
Authors: Ann C. Klassen, David K. Klassen
Journal: Annals of Internal Medicine (1996)

Evidence that families requested to permit organ donation refuse half the time has led to proposals for mandated choice.Under mandated choice, a person's donation wishes would be collected and retrieved at death, and requests to families would be avoided. There are both ethical and logistic problems with mandated choice.The view of the family should be respected in organ requests, even when patient wishes are known. Public sentiment against overriding family wishes could cause low rates of pro-donation registration. Caregivers have usually refused to take organs when families oppose donation. Logistic issues with mandated choice include the cost and complexity of maintaining a national database on donors and the enforcement of registration. No such database of adults currently exists, even for tax purposes. Two states that have mandated choice programs through departments of motor vehicles report relatively low numbers of pro-donation registrants compared with nondonors or undecided persons. Public education and voluntary donor identification hold more potential to increase donation.
Initial amplification of duck hepatitis B virus covalently closed circular DNA after in vitro infection of embryonic duck hepatocytes is increased by cell cycle progression
Authors: Christelle Borel, Olivier Schorr, Isabelle Durand, Fabien Zoulim, Alan Kay, Christian Trepo, Olivier Hantz
Journal: Hepatology (2001)

The relationship between the cell cycle and early amplification of duck hepatitis B virus covalently closed circular (CCC) DNA was studied after in vitro infection of fetal hepatocytes. We first showed that embryonic hepatocytes proliferated for at least 6 days after plating and that complete viral replication including CCC DNA amplification occurred in these proliferating cells. Addition of sodium butyrate or aphidicolin reversibly blocked cells in the G1 phase and diminished CCC DNA synthesis, which was restored after drug withdrawal, concomitantly with the entry of cells into S phase. Cell cycle progression of fetal hepatocytes can be triggered by stimulation with epidermal growth factor (EGF), hepatocyte growth factor (HGF), and tumor growth factor α (TGF–α). CCC DNA synthesis increased with progression to the S phase induced by EGF, HGF, and TGF–α alone or in combination. By contrast, tumor growth factor β (TGF–β) alone or in combination with EGF inhibited cell proliferation and viral DNA synthesis. By double labeling, viral nucleocapsids were found predominantly in bromodeoxyuridine–positive hepatocytes, indicating that high viral replication occurs preferentially in proliferating hepatocytes. CCC DNA was also detected mainly in cells in the S and G2/M phases separated from cells in the G1 phase by cell sorting. Taken together, these results show that hepatocyte proliferation may positively regulate the initial amplification of CCC DNA of avian hepadnaviruses, and may explain why mitosis is not necessarily associated with loss of CCC DNA.
Unilateral Absence of a Palpable Vas Deferens-Reply
Authors: H. Earl Fauver
Journal: JAMA (1989)

In Reply.—  Unilateral absence of the kidney has been reported by Rubin 1 in 30% of patients with bilateral congenital absence of the vas deferens.  In reviewing many case reports for our article, the incidence of unilateral renal agenesis in the presence of bilateral absence of the vas deferens was approximately 15% to 20%.  We feel it is definitely warranted to perform a renal ultrasound examination in patients who present with bilateral absence of the vas deferens.  We disagree with Dr Schneiderman regarding the use of gloves in the scrotal examination. Gloves should not be worn except in rare circumstances: patients with acquired immunodeficiency syndrome who have fistulas, patients with draining scrotal abscesses, etc. Gross scrotal abnormalities can be easily detected on examination whether gloves are worn or not. The more subtle scrotal pathological changes and, in particular, the one abnormality that can be fatal to the patient, the testis tumor,
Frontiers in Medicine: Implications for the Future
Authors: J. William Hollingsworth
Journal: JAMA (1986)

A star-studded cast has been recruited by Drs Morin and Bing to bring us<i>Frontiers in Medicine: Implications for the Future</i>. Included are Nobelists Baruch Blumberg, Andrew Schally, and U. S. von Euler. Cardiothoracic surgeon Michael DeBakey projects the future of conventional heart surgery and Richard Jarvik describes his new mechanical heart and its future applications. In selecting their medical frontiers, the editors have emphasized atherosclerosis, and several authors review new knowledge of the atherosclerotic process and the nutritional and biochemical aspects of the disease. Blumberg's review of our current knowledge of the role of persistent infection with hepatitis B virus in the etiology of liver cancer ranges from clinical epidemiology to the role of the virus in cellular biology. He estimates a worldwide total of more than 0.5 million deaths per year from liver cancer. Effective immunization against the virus could control this huge segment of mortality. His frontier
Incidence of childhood cancer rises
Authors: Roger Dobson
Journal: BMJ (2006)

The overall incidence of childhood cancer in Europe has been rising at a rate of 1.1% a year on average, a new study shows.

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The researchers found that from 1978 to 1997 the age standardised incidence increased from 120 cases per million children to 141 ( European Journal of Cancer 2006:42; 1961-1).

Although the rise may be partly the result of changes in diagnosis and registration of cases, the authors say that …

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Effect of insulin on basal and cholecystokinin-stimulated gallbladder motility in humans
Authors: Hugo A.J. Gielkens, Wai F. Lam, Minneke Coenraad, Marijke Frölich, Jacques A. van Oostayen, Cornelis B.H.W. Lamers, Ad A.M. Masclee
Journal: Journal of Hepatology (1998)
Transient iron overload with bleomycin detectable iron in the plasma of patients with adult respiratory distress syndrome.
Authors: J M Gutteridge, G J Quinlan, T W Evans
Journal: Thorax (1994)

BACKGROUND--A retrospective study was conducted to evaluate iron status in plasma samples collected from five patients with the adult respiratory distress syndrome (ARDS) who had bleomycin detectable iron in at least one sample. Ten patients with ARDS with no evidence of bleomycin detectable iron and 10 healthy individuals served as controls. METHODS--Evidence of iron overload was established by measuring the percentage saturation of plasma transferrin. In each case the bleomycin assay for redox active, chelatable iron was used to measure plasma levels of non-transferrin bound iron in the low micromolar range; assays for total plasma iron and transferrin were performed to establish a diagnosis of transient iron overload. The effect of this on the ability of transferrin to act as a plasma antioxidant was assessed using two different assay systems. RESULTS--The five patients with evidence of transient iron overload (mortality 4/5) represented 33% of the total population of patients with ARDS (mortality 5/10) managed by the unit during the study period. All had low molecular mass iron detectable in their plasma and had clinical and biochemical evidence of multiorgan system failure as well as liver impairment. Compared with the ARDS and normal control populations, transferrin and albumin levels were low and the former failed to act as a plasma antioxidant in preventing free radical mediated damage to detector molecules. CONCLUSIONS--Patients with ARDS are thought to be under severe oxidative stress from their disease and from treatment with high inspired oxygen concentrations. A subgroup of patients with ARDS has been identified who displayed evidence of transient iron overload as a result of which their plasma iron binding antioxidant protection was greatly compromised. This finding must be considered a serious additional risk factor for oxidative stress.
Radionuclide Imaging in Patients with Amputations of the Lower Leg
Authors: GERHARD W. GOERRES, SUSANNE ALBRECHT, MOHAMED ALLAOUA, DANIEL O. SLOSMAN
Journal: Clinical Nuclear Medicine (2000)

Amputation of the lower leg is not uncommon in elderly patients with chronic infections or vascular problems of the leg and foot, and most often it is performed below the knee or on the distal part of the lower leg (i.e., Syme’s amputation). After operation, healing disorders with or without infection can occur, and usually structural imaging methods are performed for diagnosis. Radionuclide imaging using a combination of bone scans and infection scintigraphy can help to identify bone and soft tissue infection. Interpreting radionuclide scans is difficult, because imaging findings after amputation may depend not only on the level of resection and the disease investigated but also on the time that has elapsed since surgery. Typical imaging patterns of bone or infection scintigraphy of five patients are described.
Case 31-1979
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, Edward D. Harris, Robert L. Trelstad
Journal: New England Journal of Medicine (1979)

Presentation of CaseA 24-year-old man was examined in the clinic because of swelling of the hands and feet.He was well until two months previously, when he noticed swelling of the dorsum of the hands and was unable to make a tight fist. Subsequently, the swelling increased, and the hands became stiffer for an hour or two in the morning. The feet and ankles also began to swell, and the feet were painful on the first few steps after he arose in the morning. One month before the visit to the clinic, he stopped work as a punch-press operator . . .
NICE advises certain groups to take daily vitamin D supplement
Authors: J. Wise
Journal: BMJ (2014)

Health professionals should recommend a daily vitamin D supplement to people who are at risk of deficiency, says draft guidance from the National Institute for Health and Care Excellence.1

NICE also calls on Public Health England to develop a national campaign to raise awareness of the importance of vitamin D among health professionals and the public. Severe deficiency of the vitamin can result in rickets in children and osteomalacia in children and adults. Dietary sources of vitamin D are few, and …
Neutrophils exposed to bacterial lipopolysaccharide upregulate NADPH oxidase assembly.
Authors: F R DeLeo, J Renee, S McCormick, M Nakamura, M Apicella, J P Weiss, W M Nauseef
Journal: Journal of Clinical Investigation (1998)

Bacterial LPS is a pluripotent agonist for PMNs. Although it does not activate the NADPH-dependent oxidase directly, LPS renders PMNs more responsive to other stimuli, a phenomenon known as "priming." Since the mechanism of LPS-dependent priming is incompletely understood, we investigated its effects on assembly and activation of the NADPH oxidase. LPS pretreatment increased superoxide (O2-) generation nearly 10-fold in response to N-formyl methionyl leucyl phenylalanine (fMLP). In a broken-cell O2--generating system, activity was increased in plasma membrane-rich fractions and concomitantly decreased in specific granule-rich fractions from LPS-treated cells. Oxidation-reduction spectroscopy and flow cytometry indicated LPS increased plasma membrane association of flavocytochrome b558. Immunoblots of plasma membrane vesicles from LPS-treated PMNs demonstrated translocation of p47-phox but not of p67-phox or Rac2. However, PMNs treated sequentially with LPS and fMLP showed a three- to sixfold increase (compared with either agent alone) in plasma membrane-associated p47-phox, p67-phox, and Rac2, and translocation paralleled augmented O2- generation by intact PMNs. LPS treatment caused limited phosphorylation of p47-phox, and plasma membrane-enriched fractions from LPS- and/or fMLP-treated cells contained fewer acidic species of p47-phox than did those from cells treated with PMA. Taken together, these studies suggest that redistribution of NADPH oxidase components may underlie LPS priming of the respiratory burst.
Freud's Sculpture
Authors: Colin Martin
Journal: BMJ (2006)

T his year, 6 May to be precise, is the 150th anniversary of the birth of Sigmund Freud. One event marking this is an exhibition of 12 small scale sculpted figures—representative of the changing group of favourites Freud kept on his desk—selected from the eclectic collection of 2000 Egyptian, Greek, Roman, Chinese, and near Eastern antiquities he amassed between 1896 and 1939.

Originally displayed in his study and consulting rooms at Berggasse 19 in Vienna, Freud's collection has since 1938 been housed at 20 Maresfield Gardens, Hampstead, where he spent the last few months of his life after fleeing the Nazis. When he died, his youngest daughter, Anna, left his study and library untouched. It was crammed with his furniture, books, and antiquities. In 1986, four years after her death, the house and its contents became the Freud Museum. One of the most evocative houses in London, …
Determinants of Substitution Rates in Mammalian Genes: Expression Pattern Affects Selection Intensity but Not Mutation Rate
Authors: Laurent Duret, Dominique Mouchiroud
Journal: Molecular Biology and Evolution (2000)

To determine whether gene expression patterns affect mutation rates and/or selection intensity in mammalian genes, we studied the relationships between substitution rates and tissue distribution of gene expression. For this purpose, we analyzed 2,400 human/rodent and 834 mouse/rat orthologous genes, and we measured (using expressed sequence tag data) their expression patterns in 19 tissues from three development states. We show that substitution rates at nonsynonymous sites are strongly negatively correlated with tissue distribution breadth: almost threefold lower in ubiquitous than in tissue-specific genes. Nonsynonymous substitution rates also vary considerably according to the tissues: the average rate is twofold lower in brain-, muscle-, retina- and neuron-specific genes than in lymphocyte-, lung-, and liver-specific genes. Interestingly, 5′ and 3′ untranslated regions (UTRs) show exactly the same trend. These results demonstrate that the expression pattern is an essential factor in determining the selective pressure on functional sites in both coding and noncoding regions. Conversely, silent substitution rates do not vary with expression pattern, even in ubiquitously expressed genes. This latter result thus suggests that synonymous codon usage is not constrained by selection in mammals. Furthermore, this result also indicates that there is no reduction of mutation rates in genes expressed in the germ line, contrary to what had been hypothesized based on the fact that transcribed DNA is more efficiently repaired than nontranscribed DNA.
Health and nutrition education unit in a children's hospital.
Authors: B Laurance, B Lawrie
Journal: BMJ (1978)

Prevention is better than cure" is probably more applicable to promoting health in childhood than in any other age group.Nutrition rehabilitation units' have been established in several developing countries in an effort to prevent the protein energy malnutrition that is so common in most of them.A similar sort of unit, modified to include all aspects of child care, seemed to be needed in the underprivileged community of the east end of London, where about 350 of the children are the sons and daughters of immigrants; where social classes IV and V pre- dominate; and where there are many single-parent families and families with one parent in prison.The health and nutrition education unit, so far as we know the first in Great Britain, was established in the Queen Elizabeth Hospital for Children in September 1976, and we describe here the work of its first 18 months. The unit and the population it servesThe unit was initially established in a screened-off area of the hospital's outpatient waiting hall.Later it moved to an office, which provided more privacy.