tbuckley/cabot-search huggingface dataset:
Adverse events reporting in English hospital statistics: No data were produced
Authors: Tom Bates
Journal: BMJ (2004)

EDITOR—No one should underestimate the real risks of hospital treatment and in particular of emergency surgery for elderly patients. Adverse events in hospital are under-recorded, but it should be recognised that most complications are not due to medical blunders, and more often than not mistakes are a potential, rather than an actual, threat to the lives of patients. Recording mistakes should be transparent …
TCL1: a shared tumor-associated antigen for immunotherapy against B-cell lymphomas
Authors: Jinsheng Weng, Seema Rawal, Fuliang Chu, Hyun Jun Park, Rakesh Sharma, David A. Delgado, Luis Fayad, Michelle Fanale, Jorge Romaguera, Amber Luong, Larry W. Kwak, Sattva S. Neelapu
Journal: Blood (2012)
General Anaesthetics in General Practice
Authors: J. H. Swan
Journal: BMJ (1964)

published our statistics and reports for all to see.My own practice visits have been reduced by 50% over the past 10 years.Amongst four doctors at this centre one colleague still has twice the visiting rate of the others, and that in practices with almost identical age and sex distribution and incidence of morbidity.How can one explain these differences, except on the basis of personal habit ?In Sweden, which has the lowest morbidity rate in the world, daily visiting is only about one-quarter the rate in this country.Since the population of these islands is increasing at a faster rate than the output of doctors within the next decade it is even more important and urgent that family doctors should use their efforts efficiently, and the population use the practitioners' time judiciously.-Iam, etc., Manchester 13. H. W. ASHWORTH.Poor Rate for the Job SIR,-Having recently received-three months in arrears-our annual cheque for ser- vices rendered at the local cottage hospital, our attention has been focused on the low level at which these services are rewarded.We staff, exclusively, this 14-bed hospital and are on call permanently for all emergen- cies and casualties.Minor surgery and fracture treatment are performed regularly and many x-ray films are seen and interpreted.The total reward for six senior, well- qualified practitioners, including an M.R.C.P., is £250, most probably less than the income of any single member of the domestic staff.We have conveyed news of this disgraceful rate for the job to our local medical com- mittee and have expressed our sentiments to the hospital management committee and regional board and hope that others simi- larly rewarded for their professional labours will likewise agitate.-Weare, etc.,
ATYPICAL ERYTHROKERATODERMA WITH DEAFNESS, PHYSICAL RETARDATION AND PERIPHERAL NEUROPATHY
Authors: J MARTIN BEARE, N. C. NEVIN, P. FROGGATT, D. C. KERNOHAN, INGRID V. ALLEN
Journal: British Journal of Dermatology (1972)

Summary.— An atypical form of erythrokeratoderma variabilis, profound bilateral perceptive deafness, physical retardation, and specific neurological disturbances are described in a girl aged 8 from County Tyrone, Northern Ireland. The differential diagnosis is discussed and abnormal EMG, nerve conduction and muscle biopsy findings are described. The syndrome is considered to be due to a "dominant" mutant gene. Only one case with a similar constellation of findings has previously been described (Schnyder et al., 1968), although there are some differences in detail between the two.
PERITONEAL SUPPORTS—(LIGAMENTUM PERITONEI.)
Authors: BYRON ROBINSON
Journal: JAMA (1896)

The internal border of the broad ligament is where it diverges to receive the uterus. It is the junction of the lateral border of the uterus and broad ligament. This internal border of the broad ligament is very important, as it has relation to the side of the uterus and uterine artery as it courses through the internal edge of the broad ligament. The figure I chose to illustrate the relation of the internal border of the broad ligament to the uterus is a diagrammatic one from Ranney, Fig. 61. The figure shows the relations of the two blades of the peritoneum to the uterus. It shows that the insertion of the ligament begins at the fundus and ends at the internal os. It is diagrammatic, as the living female does not present such figurative outline in the insertion of the broad ligament into the uterus. The figure is self-explanatory.
Transitions in CD45 isoform expression indicate continuous differentiation of a monoclonal CD5+ CD11b+ B lineage in Waldenstrom's macroglobulinemia
Authors: Gitte S. Jensen, E. Joy Andrews, Michael J. Mant, Rucy Vergidis, Jeffrey A. Ledbetter, Linda M. Pilarski
Journal: American Journal of Hematology (1991)

Abstract Waldenstrom's macroglobulinemia (WM) has been hypothesized to be a pleomorphic B‐cell malignancy with persistent maturation towards plasma cells in all lymphoid tissue. This proposal is based on detection of a heterogeneous density of monoclonal Ig on peripheral blood B‐cells in patients with WM. We now present data derived from 2‐ and 3‐color immunofluorescence and flow cytometric analysis that strongly supports this hypothesis. Abnormally high numbers of B lineage cells, defined by expression of CD19, CD20, and CD24, were found among peripheral blood mononuclear cells (PBMC). These B‐cells are monoclonal as defined by light chain expression and by the existence of rearranged Ig genes (Southern blot analysis), although they exhibit heterogeneity in the density of surface light chain. Unlike normal PBMC B‐cells, the monoclonal B‐cells bear CD5 and CD10 (CALLA), express adhesion and adhesion‐related molecules (CD11b, CD9), and appear to be actively differentiating during the course of the disease, based on the pattern of CD45 isoform expression. At any given point in time, the population of monoclonal B‐cells is heterogeneous in differentiation stage based on transitions in the expression of CD45 isoforms from expression of CD45RA, the high molecular mass isoforms of CD45, to the low molecular mass isoform CD45R0 which appears only on very late stage B‐cells and early plasma cells. For one patient, analysis of CD45 isoform expression over 2 years showed that the monoclonal B‐cell population as a whole progressed towards terminal differentiation as defined by loss of CD45RA and acquisition of CD45R0. This indicates a continuously differentiating lineage of an unusual B‐cell phenotype, and/or malignant transformation of a distinct lineage of B‐cells in WM.
NHS should strengthen links with poor countries, report urges
Authors: Sally Hargreaves
Journal: BMJ (2007)

The UK government should bolster its commitment to supporting and training healthcare workers in resource poor countries, says a report commissioned by the government and written by the former chief executive of the NHS, Nigel Crisp. 

The United Nations' millennium development goals on health will not be met unless the capacity of the workforce in these countries is improved, warns Lord Crisp in the report, which was published this week. He calls on the UK government to strengthen existing health link partnerships and to increase investment.

The international community spends considerable amounts tackling major health problems, such as tuberculosis and HIV and AIDS in resource poor countries, yet many believe that such efforts are futile if systems are not in place …
Basophil histamine release in patients with birch pollen hypersensitivity with and without allergic symptoms to fruits
Authors: J. Kleine‐Tebbe, M. Galleani, S. Jeep, B. Pilz, A. Baisch, G. Kunkel
Journal: Allergy (1992)

Histamine release (HR) studies were performed in 40 birch pollen-allergic patients (positive case history, positive SPT, positive birch pollen-specific serum IgE: RAST > or = 3) with (n = 20, A) and without (n = 20, B) fruit hypersensitivity, and 10 nonatopic volunteers (C). Several fruit allergens were used and characterized by protein determination and immunoblot techniques. Dose-dependent HR (apple peel = apple pulp > peach = cherry) was demonstrated in both allergic groups, but to a higher extent in patients with fruit allergy (P < 0.01). Increased basophil sensitivity to birch pollen was found in the group with fruit allergy (P < 0.001). Strong correlations between the mediator response induced by several fruits indicate common allergens within the extracts. We conclude that fruit-related symptoms require not only high specific serum IgE, but a strong cellular sensitization to birch pollen allergens together with an increased cellular reactivity to fruit allergens.
Cost of achieving a balance in the anaesthetic department of a district general hospital.
Authors: J. Hurst, J. A. Curson
Journal: BMJ (1988)

In Achieving a Balance the Department of Health published requirements for medical staffing in hospitals. To review the effect that these would be likely to have a study was undertaken in the anaesthetic department of a district general hospital. The results were then validated with staffing levels in a new district general hospital with only one tier of junior staff. It was found that over the next 10 years a massive expansion in the numbers of consultants would be needed at a cost of 108,000 pounds in salaries and employer9s contributions alone.
Education on preventing HIV is paramount
Authors: T. Wiggin
Journal: BMJ (2002)

EDITOR—The cover photograph of 30 March showing a patient's lunchtime drug treatment for HIV disease, held in his hand, speaks volumes over any written word. My colleagues and I, currently working at a rural mission hospital in Central Malawi, now all agree that antiretroviral drugs such as these are simply not a practical option for our patients with HIV/AIDS.

The hospital serves a population of 237 000, …
Nicotine Addiction in Young People
Authors: D A Kessler
Journal: New England Journal of Medicine (1995)

Although the epidemic of disease and death from smoking is played out in adulthood, it begins in childhood. Every day another 3000 young people become regular smokers.1 A person who has not started smoking as a teenager is unlikely ever to become a smoker.2 The tobacco industry has argued that the decision to smoke and to continue smoking is a free choice made by an adult, but nicotine addiction is really a condition that takes hold in young people.Ask a smoker when he or she began to smoke, and chances are you will hear the tale of a child. . . .
Myeloperoxidase Deficiency
Authors: Sydney E. Salmon, Martin J. Cline, Julius Schultz, Robert I. Lehrer
Journal: New England Journal of Medicine (1970)

Hereditary myeloperoxidase deficiency has been described recently as an autosomal recessive leukocyte disorder, associated with defective candidacidal activity in leukocytes and apparently with enhanced susceptibility to systemic candida infection. The neutrophils and monocytes of a patient with hereditary myeloperoxidase deficiency and systemic candidiasis were studied by means of gel diffusion, quantitative precipitation and immunofluorescence. Myeloperoxidase was immunologically absent in the leukocyte granule fractions of intact neutrophils and monocytes of the patient, and its characteristic absorption spectrum was not detectable. Structurally distinct eosinophil peroxidase was present. In genetically determined leukocyte myeloperoxidase deficiency, either the enzyme is completely lacking or it is structurally altered in its enzymatic, heme-binding and antigenic sites.
Neonatal Myocarditis and Meningoencephalitis Due to Coxsackie Virus Group B, Type 4
Authors: G. Rapmund, J. R. Gauld, N. G. Rogers, G. E. Holmes
Journal: New England Journal of Medicine (1959)

A RECENT report1 described the simultaneous occurrence of aseptic meningitis in a woman at term and fatal meningoencephalitis with myocarditis in her newborn infant. It is the purpose of this report to provide details pertinent to the laboratory diagnosis of this infant's disease, which were not included in the original report, and to document relative immunologic maturity in this newborn infant.Clinical AbstractsThe clinical records presented in detail elsewhere1 are briefly summarized. A twenty-two-year-old woman was admitted to the hospital in Honolulu, Hawaii, at term with chills, fever and severe frontal headache. Nasal congestion and a nonproductive cough had . . .
Abstract 4222: Induction of apoptosis and cell cycle arrest in renal cancer cells by phenethyl isothiocyanate (PEITC) and the mechanisms involved
Authors: Maruf H. Khan, Linda A. deGraffenried, Bob G. Sanders, Henry P. Ciolino
Journal: Cancer Research (2011)

Abstract Background: Renal Cell Carcinoma (RCC) has low 5 year survival rate and is resistant to radiation and chemotherapy. Phenethyl Isothiocyanate (PEITC) is a naturally occurring phytochemical that has a variety of anti-cancer properties. Here we explore two anti-cancer properties of PEITC: induction of apoptosis and induction of cell cycle arrest in RCC cell lines and the underlying mechanisms. Methods: We used two human RCC cell lines Caki-1 and Caki-2. Survival and cell proliferation was assayed using Calcein AM. Annexin V staining was used to measure apoptosis. Caspase-3/7 induction was measured using a fluorescent substrate. Cell Cycle was studied using Propidium Iodide staining. DNA damage was determined using H2AX-γ antibody. Protein expression and phosphorylation was determined using immunoblotting. Results: PEITC significantly reduced survival of Caki-1 and Caki-2 cells and inhibited their proliferation as determined by Calcein AM. 15 and 20 μM PEITC induced apoptosis (revealed by Annexin V staining) in both cell lines and induced caspase-3/7 activity. Western blot analysis revealed caspase-8, caspase-9 and Bid cleavage suggesting that the apoptosis is mediated through the extrinsic pathway. Lower doses (up to 10 μM) arrested Caki-1 cells in G2/M phase, and this was associated with an increase p38 and MK2 (Thr334) phosphorylation (as revealed by Western Blot). The p38 inhibitor SB203850 inhibited this G2 arrest induced by PEITC. In order to determine if DNA damage was responsible for the apoptosis and G2 arrest, we used an antibody to H2AX-γ phosphorylation. 15 and 20 µM treatment resulted in increased H2AX-γ phosphorylation, but this was completely blocked by caspase-3 inhibitor. Conclusion: PEITC induces apoptosis in Caki-1 and Caki-2 cells by a mechanism that likely involves the extrinsic pathway. We will use immunoblotting and siRNA to determine which of the extrinsic receptors (DR4, DR5, TRAIL or FAS) is responsible for this apoptosis induction. PEITC does not cause direct DNA damage to the cells; the observed DNA damage is a result of the apoptotic process and is blocked by caspase-3 inhibitors. PEITC induces G2/M arrest in Caki-1 cells and the mechanism is dependent on p38 phosphorylation which activates MK2. Inducing cell cycle arrest and apoptosis may play an important role in the anti-cancer properties of PEITC. Fully understanding the mechanism by which PEITC induces apoptosis and cell cycle arrest in RCC cells may lead to development of novel chemotherapeutic drugs against RCC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4222. doi:10.1158/1538-7445.AM2011-4222
Cumulative Incidence of False-Positive Test Results in Lung Cancer Screening
Authors: Jennifer M. Croswell
Journal: Annals of Internal Medicine (2010)

Background: Direct-to-consumer promotion of lung cancer screening has increased, especially low-dose computed tomography (CT). However, screening exposes healthy persons to potential harms, and cumulative false-positive rates for low-dose CT have never been formally reported. Objective: To quantify the cumulative risk that a person who participated in a 1- or 2-year lung cancer screening examination would receive at least 1 false-positive result, as well as rates of unnecessary diagnostic procedures. Design: Randomized, controlled trial of low-dose CT versus chest radiography. (ClinicalTrials.gov registration number: NCT00006382) Setting: Feasibility study for the ongoing National Lung Screening Trial. Patients: Current or former smokers, aged 55 to 74 years, with a smoking history of 30 pack-years or more and no history of lung cancer (n = 3190). Intervention: Random assignment to low-dose CT or chest radiography with baseline and 1 repeated annual screening; 1-year follow-up after the final screening. Randomization was centralized and stratified by age, sex, and study center. Measurements: False-positive screenings, defined as a positive screening with a completed negative work-up or 12 months or more of follow-up with no lung cancer diagnosis. Results: By using a Kaplan–Meier analysis, a person's cumulative probability of 1 or more false-positive low-dose CT examinations was 21% (95% CI, 19% to 23%) after 1 screening and 33% (CI, 31% to 35%) after 2. The rates for chest radiography were 9% (CI, 8% to 11%) and 15% (CI, 13% to 16%), respectively. A total of 7% of participants with a false-positive low-dose CT examination and 4% with a false-positive chest radiography had a resulting invasive procedure. Limitations: Screening was limited to 2 rounds. Follow-up after the second screening was limited to 12 months. The false-negative rate is probably an underestimate. Conclusion: Risks for false-positive results on lung cancer screening tests are substantial after only 2 annual examinations, particularly for low-dose CT. Further study of resulting economic, psychosocial, and physical burdens of these methods is warranted. Primary Funding Source: National Cancer Institute.
PTU-014 Levels of care and outcomes in decompensated cirrhosis: a descriptive study
Authors: P Berry, S Thomson, A Ahmed, M Davies, A Ala
Journal: Gut (2012)

<h3>Introduction</h3> As hospital admissions due to decompensated cirrhosis increase it is important to characterise the severity of disease and establish “best practice” in secondary care units. While many studies have reported on patients in the ITU setting, we have expanded this evaluation to explore patient outcome according to level of in-patient care provided; ward (level 0–1), medical HDU (2) or ICU (3). <h3>Methods</h3> Prospective analysis of consecutive decompensated cirrhosis patients admitted to the liver service of a district general hospital between November 2010 and November 2011). <h3>Results</h3> 66 patients accounted for 153 separate presentations. ALD accounted for 54 patients (78%). Of those with ALD 24 (44%) were a first presentation, 22 (41%) continued to drink against advice and eight were abstinent. Alcoholic hepatitis (AH) was diagnosed in 24, with median discriminant function (DF) of 49. 16 (23%) were admitted to ICU (multiple organ failure 12, variceal bleeding without organ failure 4). 88% were mechanically ventilated, 81% received inotropic support and 56% haemofiltration. 14 (20%) were admitted to medical HDU and the 36 (61%) remained on the ward. Median MELD and UKELD scores were not significantly different between groups; ITU 16 and 57, HDU 20 and 58, Ward 13 and 55 respectively. Overall median length of stay was 11.5 days. LOS was highest in HDU patients (23 d vs ward 11 d and ITU 17 d, p=0.04). In-hospital mortality was 5% in ward patients, 14% in HDU patients and 36% in ITU patients (p=0.01), with 90-day mortality rising to 8%, 21% and 50% respectively. Six patients with extra-hepatic organ dysfunction received a “ceiling of care” decision, whereby active treatment on HDU was offered but organ support on ICU was not; these patients did not differ from ICU patients in terms of age, active drinking, liver failure scores or SOFA score. The natural history of these patients was characterised by rising MELD despite optimum therapy and late development of extra-hepatic organ dysfunction (median period from admission 17 d vs 1 d, p=NS). All six died. <h3>Conclusion</h3> This cohort of cirrhotic patients displayed evidence of advanced liver disease. Median UKELD in ward patients was above the limit required for consideration of liver transplant and median DF indicated a high risk of death in those diagnosed with AH. Prolonged hospital stays and ward based convalescence were required, especially in those escalated to HDU, but mortality was lower than that commonly perceived for this patient cohort. Patients who are not offered advanced organ support are identified after gradual deterioration despite optimal ward care. We propose the concept of a “medical HDU” model where hepatologists are able to escalate levels of care locally before the onset of organ dysfunction. <h3>Competing interests</h3> None declared.
The non-invasive diagnosis of pulmonary embolus
Authors: A. K Dixon, R. A. Coulden, A M. Peters
Journal: BMJ (2001)

Pulmonary embolism remains an elusive diagnosis. Even though nearly all doctors are well aware of the risk factors for venous thromboembolism, pulmonary embolism still causes too many unexpected deaths. The natural history is, however, well known,1 and, once the diagnosis has been considered, appropriate treatment is usually effective and death less likely. Anticoagulants, however, are not without risk and accurate diagnosis remains essential. Pulmonary angiography is the gold standard for diagnosis, but it is invasive, perceived as dangerous, and not widely available. The burden of diagnosis therefore rests on non-invasive imaging.

Over the past two decades the next best investigation has been ventilation-perfusion (V/Q) scintigraphy, loosely known as the “lung scan.” The patient inhales a technetium-99m labelled aerosol or radioactive gas (such as krypton-81m), which demonstrates the distribution of pulmonary ventilation. This is performed in association with an intravenous injection of technetium-99m labelled microparticles of macroaggregated human serum albumin, which shows the distribution of pulmonary blood flow. When ventilation is compared with perfusion areas showing reduced perfusion not matched on …
AN IMPROVED ADJUSTABLE ELECTRIC LIGHT STAND FOR OPERATING ROOMS.
Authors: GILBERT ROYCE
Journal: JAMA (1907)

A feature of this standard is its universal adjustability. The whole stand can be rotated on its base. The height of the lamp can be regulated by the inner tube of the upright. The extension arm can be shortened or lengthened, tilted up or down or shortened and used vertically. The standard consists of a heavy tripod base mounted on rubber-tired castors. Attached to this is an upright piece consisting of two tubes, one telescoping in the other, the movement of the inner tube being controlled by a thumb screw. At the top of the inner tube a slot engages a U-shaped bracket, which can be tilted up or down and is retained in position by a winged screw. A short tube is brazed into the ends of the bracket. The upright piece of an ordinary goose-neck electric light stand is pushed through the tube in the bracket, where it
The Epidemiology of Missing Records-Reply
Authors: Jeffrey J. Sacks
Journal: JAMA (1988)

<h3>In Reply.</h3> —Dr Ashbell raises an interesting point by suggesting that records may have been missing because they were intentionally destroyed. Although we did not specifically mention the point in our article or letter, in conducting the study we addressed this possibility in two ways. First, we evaluated percentages of missing charts over time and found a lower percentage of missing charts during the epidemic period than during the pre-epidemic or postepidemic periods. Second, we reviewed the billings of the intensive care unit's physicians, a source of information available even when the chart was missing, and found that only three cardiac arrests had occurred among the patients with missing charts. Thus, our findings did not suggest that the missing charts had much incriminating information. A provider's involvement with a particular patient may be obscured not only by chart destruction, but also by selective removal of portions of the chart, illegible