tbuckley/cabot-search huggingface dataset:
Public involvement in health care
Authors: Martin W McNicol
Journal: BMJ (2004)

Editor—Having retired and moved away from the area in which I worked I have become an increasing user of the NHS and find it impossible to get worthwhile information on which to make a balanced judgment about things that should be counted easily.

The informal local knowledge that was available and useful is no longer available to me. My general practitioner, who is excellent, knows only the local services and does not know what their results are.

I needed a hernia repair—but surgical results are not available. Local anaesthesia and day case surgery as your editorial recommends—no information available, and in particular, no warning that the surgeon has an unrealistic belief in the rapidity of onset of action of local anaesthetic. Need another hip replacement? No information about results to help with the decision whether to travel back to London, or have surgery locally.

If we take public involvement in health care seriously, and if we believe in using industrial processes in health care, on which the same issues carries articles, this is not good enough. I have to disagree with Einstein and with McKee1—these things can and ought to be counted, and they do count.
THIAMINE IN THE AMERICAN DIET
Authors: Edmund F. Kohl
Journal: JAMA (1942)

ABSTRACT To the Editor:— After reading the editorial entitled Thiamine in the American Diet in the July 25 issue of The Journal, I have to ask the following question: Do the figures mentioned represent the actual amount of vitamins in the daily diet as found after cooking, preserving, storing and transporting or do they represent the ideal amount of nutrients without regard to destructive processes? In other words, do these figures give one the true amount of vitamins one takes when one sits down at the table for dinner?Comment.— In the study of thiamine in the average American dietary (Lane, R. L.; Johnson, Elisabeth, and Williams, R. R.: J. Nutrition23:613 [June] 1942) the effort was made to prepare the food, prior to the determination of the thiamine, in a way which represents ordinary kitchen practice. Foods like meats and certain vegetables were cooked before assaying for thiamine, whereas
Evaluating the Teaching of Physician-Patient Relationships
Authors: L. Bernstein
Journal: Psychotherapy and Psychosomatics (1972)

Medical students exposed to intensive training in interviewing patients, as a means of establishing and maintaining the physician-patient relationship, were compared with students who did not receive such training. Students exposed to the training showed a significant increase in ability to accept a patient for what he is, without a need to evaluate, judge, or criticize. They also demonstrated a significant lowering of anxiety in the interview situation. However, exposure to simple didactic training in the handling of death and dying did not lead to similar anxiety reduction. It is inferred that the absence of opportunity for actual, intensive work with terminal patients was the critical factor.
Video Capsule Endoscopy in Peutz-Jeghers Syndrome: A Blinded Comparison with Barium Follow-Through for Detection of Small-Bowel Polyps
Authors: G. Brown, C. Fraser, G. Schofield, S. Taylor, C. Bartram, R. Phillips, B. Saunders
Journal: Endoscopy (2006)

Background and Study Aims: Video capsule endoscopy has shown promise for the surveillance of significant small-bowel polyps in patients with Peutz-Jeghers syndrome. In this study the yield of significant small-bowel polyps by capsule endoscopy was compared to the yield of these polyps by barium follow-through in adults with Peutz-Jeghers syndrome. Patients and Methods: A total of 19 adults with Peutz-Jeghers syndrome who were undergoing surveillance underwent both capsule endoscopy and barium follow-through examinations, and the number of small-bowel polyps of at least 1 cm in diameter that were detected was recorded for each method. The two methods were assessed in terms of comfort and convenience for the patients and their preferred future surveillance method, using a questionnaire. Results: Capsule endoscopy detected a median of four significant small-bowel polyps while barium follow-through detected a median of one (P = 0.008). There was a trend towards more participants having at least one significant small-bowel polyp detected by capsule endoscopy than was the case with barium follow-through, though capsule endoscopy seemed to be less reliable for accurate sizing of polyps that were at the limit of clinical significance. Most participants expressed a preference for capsule endoscopy for future surveillance. Conclusions: Capsule endoscopy should replace barium follow-through for the surveillance of small-bowel polyps in adults with Peutz-Jeghers syndrome, but the findings of this study should be interpreted with caution until a more reliable means of sizing polyps by capsule endoscopy is available.
Introductory remarks for the THSNA meeting proceedings: Hemostasis and thrombosis at the cutting edge
Authors: David Garcia, Elizabeth M. Van Cott, Peter A. Kouides
Journal: American Journal of Hematology (2012)

We are very fortunate that in North America there are numerous organizations in the hematology subdiscipline of hemostasis and thrombosis that hold an annual meeting. These meetings provide an excellent educational content with varying emphasis on cutting edge research in the field of hemostasis and thrombosis. Although each of these meetings individually has great value, many members of our respective groups have felt that the organizations could unite to form an even stronger, multidisciplinary international North American “super-meeting” dedicated to hemostasis and thrombosis. The Thrombosis and Hemostasis Summit of North America (“THSNA”), held May 3–5, 2012 in Chicago, IL, represents the efforts of nine collaborating organizations to create a single gathering where individuals with an interest in hemostasis and/or thrombosis could find both an unparalleled opportunity to network with colleagues as well as a superb educational and scientific program. The present supplement of the American Journal of Hematology contains the content of the educational sessions and the abstracts of this meeting. In addition, the supplement includes a consensus statement, developed by a group of members from all THSNA member organizations, that addresses the management of bleeding associated with new oral anticoagulants. The reader will soon discover the multidisciplinary nature of hemostasis and thrombosis; the care of (and research pertinent to) patients with these disorders includes hematologists, nurses, pharmacists, pediatricians, internists, laboratory physicians, and technologists, interventionalists, obstetrician and gynecologists, and basic scientists. We hope that these proceedings from the inaugural “THSNA” will help clinicians apply evidence-based care to their patients and inspire investigators to address unanswered questions in our field. Members of THSNA are Association of Hemophilia Clinic Directors of Canada (AHCDC), Anticoagulation Forum (AC Forum), American Thrombosis and Hemostasis Network (ATHN), Foundation for Women and Girls with Blood Disorders (FWGBD), Hemostasis and Thrombosis Research Society (HTRS), National Blood Clot Alliance (NBCA), National Hemophilia Foundation (NHF), North American Specialized Coagulation Laboratory Association (NASCOLA), and Thrombosis Interest Group of Canada (TIGC).
Desires and Needs of Society
Authors: Everett C. Hughes
Journal: JAMA (1963)

THE GENERAL TRENDS AND PROBLEMS of such a society as ours, which are likely to be found in all of the highly urban and industrial parts of the world, most certainly affect professional education of all kinds, not medical education alone. I have never made a study of public opinion on health or any other matter, nor have I ever tried to assess the needs of the public for health services or for the kinds of education which produce people who deliver such services. I have, with E. Clarke Wescoe and his colleagues of the School of Medicine of the University of Kansas, been party to a study of medical students; I have also studied a number of other professions. Those studies have provided some of the point of view which is presented here.  We live in the professional age. Two great trends characterize our society, and others like it,
Quality‐assessment of disease‐specific quality of life questionnaires for rhinitis and rhinosinusitis: a systematic review
Authors: C. M. Van Oene, E. J. F. Van Reij, M. A. G. Sprangers, W. J. Fokkens
Journal: Allergy (2007)

The aim of this systematic review was to give a quality‐assessed review of the existing disease‐specific health related quality of life (QOL) questionnaires concerning rhinitis and rhinosinusitis for adults. The quality is assessed by defining the characteristics of a QOL questionnaire with assessment criteria. The results of the construction, description, feasibility, and the psychometric performance of the instruments are provided. We finally provide a clinician’s guide to choose a questionnaire based on the measurement goals, the discriminant validity, responsiveness and the points obtained in the quality assessment. Of the top scoring instruments regarding the overall quality assessment, only four health related QOL questionnaires for rhinitis and rhinosinusitis met our criteria for the discriminant validity and responsiveness.
Leukaemia and the rheumatic diseases.
Authors: G. M. Leavesley, L. Dougan, H. J. Woodliff
Journal: BMJ (1969)

this condition have been treated at West- minster Hospital with one death, a lady aged 92, who died subsequently of multiple liver abscesses.I therefore had considerable backing for the plea that hyperbaric oxygen should be used in this condition.In my second letter I gave a further reason for listing the chambers available, which was so that other conditions, notably gas gangrene, might be treated promptly.Drs. Matthew and Proudfoot placed a full stop (in more ways than one) after " carbon monoxide poisoning" when quoting my letter, where I had written " carbon monoxide poisoning, gas gangrene infections, etc."Finally, there are no attendant risks of oxygen poisoning to doctors and nurses in single-patient oxygen chambers which consti- tute 26 out of 29 chambers listed in my letter.May I respectfully suggest that doctors, ambulance workers, and police may still feel constrained to rush patients with carbon monoxide poisoning to centres where hyperbaric facilities are available ?-I am, etc.,
Effectiveness of Intermittent Pneumatic Leg Compression for Preventing Deep Vein Thrombosis After Total Hip Replacement
Authors: Russell D. Hull
Journal: JAMA (1990)

A randomized trial was performed in consecutive patients undergoing total hip replacement to evaluate the effectiveness of sequential intermittent calf and thigh compression for preventing venous thrombosis compared with a control group given no prophylaxis. Both groups underwent case finding for deep vein thrombosis using combined fibrinogen I 125 leg scanning, impedance plethysmography, and venography. Deep vein thrombosis by venography was present in 77 (49%) of 158 control patients compared with 36 (24%) of 152 patients given intermittent compression. Proximal vein thrombosis was present in 42 controls (27%) compared with 22 patients (14%) given intermittent compression. Combined impedance plethysmography and leg scanning was insensitive in this patient group (sensitivity, 46%); venography was required to detect more than half the patients with venous thrombosis. Sequential intermittent leg compression clinically and statistically significantly reduced the frequency of both proximal vein and calf vein thrombosis. Case finding resulted in early detection and treatment of patients with venous thrombosis.
Cushing's Disease
Authors: Oliver Cope, John W. Raker
Journal: New England Journal of Medicine (1955)

NONSURGICAL TREATMENTIn the introduction we have pointed out that in our experience pituitary irradiation and testosterone have proved ineffective in bringing the disease under control. In his original papers Cushing advocated x-ray therapy to the pituitary body. It was tried in 17 patients of this series; in several of these there has been transitory subjective or objective evidence of improvement; in only one (Case 6) has sufficient physical improvement associated with changes in objective laboratory data indicated clearly that a remission followed x-ray therapy. The patient's early history has already been reported by Albright and Reinfenstein.45 Case 6. An . . .
High–Level Expression of Rat Class I Alcohol Dehydrogenase Is Sufficient for Ethanol–Induced Fat Accumulation in Transduced Hela Cells
Authors: Andrea Galli, Donna Price, David Crabb
Journal: Hepatology (1999)

The mechanisms by which ethanol causes fatty liver are complex. Reducing equivalents generated during ethanol oxidation inhibit tricarboxylic acid cycle activity and fatty acid oxidation. In addition, ethanol inhibits lipoprotein export and increases fatty acid uptake and lipid peroxidation. To test the role that alcohol metabolism by alcohol dehydrogenase (ADH) has on cellular lipid metabolism, a cell line expressing rat ADH was generated by transducing HeLa cells with an ADH-expressing retrovirus. The cells expressed high levels of ADH protein and had ADH activity similar to that of liver. Exposure of the cells to 20 mmol/L ethanol for 24 hours led to substantial accumulation of free fatty acids and triacylglycerol in the transduced, but not wild-type, HeLa cells. The rate of synthesis of saponifiable lipid was increased significantly by ethanol under these conditions. Ethanol exposure also promoted triacylglycerol accumulation when the cells were incubated with linoleic acid. This was associated with a decrease in the rate at which the cells oxidized 1-[14-C]-linoleic acid. Fat accumulation was not prevented by including alpha-tocopherol in the medium, arguing against a role for lipid peroxidation. However, the presence of methylene blue completely prevented the fat accumulation. This was associated with a return of the elevated lactate/pyruvate ratio toward normal. These data suggest that generation of reducing equivalents by ADH was sufficient to cause fat accumulation in this cell model.
Genetic and Epigenetic Silencing of MicroRNA-203 Enhances ABL1 and BCR-ABL1 Oncogene Expression
Authors: María J. Bueno, Ignacio Pérez de Castro, Marta Gómez de Cedrón, Javier Santos, George A. Calin, Juan C. Cigudosa, Carlo M. Croce, José Fernández-Piqueras, Marcos Malumbres
Journal: Cancer Cell (2016)
650 Interleukin-6 mediates preconditioning in hepatic ischemia reperfusion injury
Authors: N TEOH, J FIELD, G FARRELL
Journal: Hepatology (2003)

OBJECTIVE:The RNA genome of hepatitis C virus varies considerably, especially within the hypervariable region 1 (HVR1), a domain located on the 5′ end of the E2/NS1 envelope region. Our previous study has suggested there were greater numbers of quasispecies in the liver than in matched serum, independent of the viral load. However, the significance of this finding has not been examined extensively at genetic and serological levels.METHODS:By large scale cloning and sequencing, we studied the genetic complexity of HVR1 quasispecies in two selected patients with cirrhosis. The serum reactivity of peptides representing different HVR1 quasispecies isolated from these cases was also estimated by standard ELISA format.RESULTS:We found the same major (dominant and/or subdominant) viral quasispecies variants in serum and in the cirrhotic liver. Genetic analysis suggested that the evolutionary pressure on HVR1 was higher than on its flanking region in quasispecies derived from the liver, whereas this trend is attenuated in quasispecies from serum. The immunoreactivity to peptides representing different HVR1 quasispecies variants showed considerable cross-reactivity with heterologous sera, whereas the reactivity was strongest against the dominant HVR1 peptide over time in homologous sera.CONCLUSIONS:These findings indicate that the formation and selection of HVR1 quasispecies may not be driven solely by humoral immune pressure, at least in these two cases.
Epidemiology and Course of Gastrointestinal Haemorrhage in North-east Scotland
Authors: S. J. Johnston, P. F. Jones, J. Kyle, C. D. Needham
Journal: BMJ (1973)

A prospective study was made of 817 consecutive episodes of major gastrointestinal haemorrhage in patients admitted to hospital during 1967-8 from the defined population of North-East Scotland. The yearly admission rate was 116 per 100,000 population. Comparison of the data for city and country residents showed no appreciable differences. In the duodenal ulcer group there was an undue incidence of bleeding among foremen and skilled workers and among those who were unmarried or widowed.Both the clinical history and the results of any previous barium meal examinations were unreliable guides to the source of the current haemorrhage. Prognosis was worse for patients who did not have a dyspeptic history and was better for those who had bled on a previous occasion. The simultaneous ingestion of alcohol and aspirin had an adverse effect on the occurrence of bleeding. Forty-seven per cent. of the patients had another major coincidental disease.Mortality was 13.7% in the whole series and 8.6% in those with peptic ulcer (duodenal ulcer 7.1%, gastric ulcer 16.9%). In 28% of the patients further haemorrhage occurred after admission to hospital and caused a 28.8% mortality. Seventy-four patients were already in hospital when they first bled and 44% of them died.
Prevention of vertical transmission of HIV: analysis of cost effectiveness of options available in South Africa
Authors: N. Soderlund, K. Zwi, A. Kinghorn, G. Gray
Journal: BMJ (1999)

To assess the cost effectiveness of vertical transmission prevention strategies by using a mathematical simulation model.A Markov chain model was used to simulate the cost effectiveness of four formula feeding strategies, three antiretroviral interventions, and combined formula feeding and antiretroviral interventions on a cohort of 20 000 pregnancies. All children born to HIV positive mothers were followed up until age of likely death given current life expectancy and a cost per life year gained calculated for each strategy.Model of working class, urban South African population.Low cost antiretroviral regimens were almost as effective as high cost ones and more cost effective when formula feeding interventions were added. With or without formula feeding, low cost antiretroviral interventions were likely to save lives and money. Interventions that allowed breast feeding early on, to be replaced by formula feeding at 4 or 7 months, seemed likely to save fewer lives and offered poorer value for money.Antiretroviral interventions are probably cost effective across a wide range of settings, with or without formula feeding interventions. The appropriateness of formula feeding was highly cost effective only in settings with high seroprevalence and reasonable levels of child survival and dangerous where infant mortality was high or the protective effect of breast feeding substantial. Pilot projects are now needed to ensure the feasibility of implementation.
Skin and nail fungi---almost beaten
Authors: A. Y Finlay
Journal: BMJ (1999)

Papers p 79 

Dermatophyte infections occur often either between the outer toes or in the toenails. It is now possible to eradicate most of these, and more widespread fungal infections, with the new generation of antifungal agents. Competing claims are made for systemic terbinafine and itraconazole, and up to now it has been hard to sort out the science from the marketing. The recent paper by Evans et al1 and the systematic review in this issue by Hart et al (p 79)2 attempt to point ways through the evidence. Other problems remain in treating children and non-responders.

The conclusions reached in the systematic review by Hart et al are undermined by the limited questions asked. It is legitimate to review the evidence for topical treatments for superficial fungal infections of the skin, but common sense must be applied to the results. Use of topical drugs in the community is not necessarily the same as in a trial situation. Poor compliance is common because symptoms are rapidly relieved, whether or not there has been mycological cure. Very few applications of topical (fungicidal) terbinafine are needed to produce a cure, whereas fungistatic drugs must be applied until the infected stratum corneum is shed. One week of topical terbinafine therefore gives better cure rates than four weeks of clotrimazole.3 The implications for …
Effect of human urinary thrombomodulin on endotoxin‐induced intravascular coagulation and pulmonary vascular injury in rats
Authors: Mitsuhiro Uchiba, Kenji Okajima, Kazunori Murakami, Masayoshi Johno, Hiroaki Okabe, Kiyoshi Takatsuki
Journal: American Journal of Hematology (1997)

Adult respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC) are serious complications of sepsis. Thrombomodulin, an important endothelial anticoagulant, binds thrombin to generate activated protein C (APC). To determine whether thrombomodulin purified from human urine (urinary thrombomodulin, UTM) is useful for the treatment of DIC and ARDS in sepsis, we examined the effect of UTM on endotoxin (ET)-induced coagulation abnormalities and pulmonary vascular injury in rats. Intravenous administration of UTM prevented the ET-induced pulmonary accumulation of leukocytes and the increase in pulmonary vascular permeability, as well as ET-induced histological changes such as leukocyte infiltration and pulmonary interstitial edema. On the other hand, dansyl-Glu-Gly-Arg-chloromethyl ketone-treated factor Xa (DEGR-Xa), a selective inhibitor of thrombin generation, did not prevent these effects of ET. UTM did not prevent ET-induced pulmonary accumulation of leukocytes and pulmonary vascular injury in rats pretreated with DEGR-Xa. Our findings suggest that UTM attenuates ET-induced coagulation abnormalities and pulmonary vascular injury. Furthermore, the latter effect may be dependent on the capacity of UTM to activate protein C.
Intensive Blood Pressure Control Reduces the Risk of Cardiovascular Events in Patients With Peripheral Arterial Disease and Type 2 Diabetes
Authors: Philip S. Mehler, Joseph R. Coll, Raymond Estacio, Anne Esler, Robert W. Schrier, William R. Hiatt
Journal: Circulation (2003)

Background— Peripheral arterial disease (PAD) and diabetes are both associated with a high risk of ischemic events, but the role of intensive blood pressure control in PAD has not been established. Methods and Results— The Appropriate Blood Pressure Control in Diabetes study followed 950 subjects with type 2 diabetes for 5 years; 480 of the subjects were normotensive (baseline diastolic blood pressure of 80 to 89 mm Hg). Patients randomized to placebo (moderate blood pressure control) had a mean blood pressure of 137±0.7/81±0.3 mm Hg over the last 4 years of treatment. In contrast, patients randomized to intensive treatment with enalapril or nisoldipine had a mean 4-year blood pressure of 128±0.8/75±0.3 mm Hg ( P &lt;0.0001 compared with moderate control). PAD, which is defined as an ankle-brachial index &lt;0.90 at the baseline visit, was diagnosed in 53 patients. In patients with PAD, there were 3 cardiovascular events (13.6%) on intensive treatment compared with 12 events (38.7%) on moderate treatment ( P =0.046). After adjustment for multiple cardiovascular risk factors, an inverse relationship between ankle-brachial index and cardiovascular events was observed with moderate treatment ( P =0.009), but not with intensive treatment ( P =0.91). Thus, with intensive blood pressure control, the risk of an event was not increased, even at the lowest ankle-brachial index values, and was the same as in a patient without PAD. Conclusions— In PAD patients with diabetes, intensive blood pressure lowering to a mean of 128/75 mm Hg resulted in a marked reduction in cardiovascular events.