tbuckley/cabot-search huggingface dataset:
Care in specialist medical and mental health unit compared with standard care for older people with cognitive impairment admitted to general hospital: randomised controlled trial (NIHR TEAM trial)
Authors: S. E. Goldberg, L. E. Bradshaw, F. C. Kearney, C. Russell, K. H. Whittamore, P. E. R. Foster, J. Mamza, J. R. F. Gladman, R. G. Jones, S. A. Lewis, D. Porock, R. H. Harwood
Journal: BMJ (2013)

<b>Objective</b> To develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment. <b>Design</b> Randomised controlled trial, adapted to take account of constraints imposed by a busy acute medical admission system. <b>Setting</b> Large acute general hospital in the United Kingdom. <b>Participants</b> 600 patients aged over 65 admitted for acute medical care, identified as “confused” on admission. <b>Interventions</b> Participants were randomised to a specialist medical and mental health unit, designed to deliver best practice care for people with delirium or dementia, or to standard care (acute geriatric or general medical wards). Features of the specialist unit included joint staffing by medical and mental health professionals; enhanced staff training in delirium, dementia, and person centred dementia care; provision of organised purposeful activity; environmental modification to meet the needs of those with cognitive impairment; delirium prevention; and a proactive and inclusive approach to family carers. <b>Main outcome measures</b> Primary outcome: number of days spent at home over the 90 days after randomisation. Secondary outcomes: structured non-participant observations to ascertain patients’ experiences; satisfaction of family carers with hospital care. When possible, outcome assessment was blind to allocation. <b>Results</b> There was no significant difference in days spent at home between the specialist unit and standard care groups (median 51 <i>v</i> 45 days, 95% confidence interval for difference −12 to 24; P=0.3). Median index hospital stay was 11 versus 11 days, mortality 22% versus 25% (−9% to 4%), readmission 32% versus 35% (−10% to 5%), and new admission to care home 20% versus 28% (−16% to 0) for the specialist unit and standard care groups, respectively. Patients returning home spent a median of 70.5 versus 71.0 days at home (−6.0 to 6.5). Patients on the specialist unit spent significantly more time with positive mood or engagement (79% <i>v</i> 68%, 2% to 20%; P=0.03) and experienced more staff interactions that met emotional and psychological needs (median 4 <i>v</i> 1 per observation; P&lt;0.001). More family carers were satisfied with care (overall 91% <i>v</i> 83%, 2% to 15%; P=0.004), and severe dissatisfaction was reduced (5% <i>v</i> 10%, −10% to 0%; P=0.05). <b>Conclusions</b> Specialist care for people with delirium and dementia improved the experience of patients and satisfaction of carers, but there were no convincing benefits in health status or service use. Patients’ experience and carers’ satisfaction might be more appropriate measures of success for frail older people approaching the end of life. <b>Trial registration</b> Clinical Trials NCT01136148
ABC of major trauma. Major accidents.
Authors: S Miles
Journal: BMJ (1990)

Major accidents affect individual hospitals rarely, but when they occur they cause total disruption of the hospital's normal activities.Large numbers of casualties arrive within a short space of time, and the presence of police and media representatives may complicate the proceedings considerably.To avoid chaos developing on such occasions the full implications of a major accident need to be considered, full major accident plans should be prepared, and adequate staff training must be undertaken.vI aeroplane crasn at segwortn. Types of major accident* Large fires * Explosions-chemical -
Long-Term Safety and Efficacy of Ciclesonide Nasal Spray in Adolescents with Perennial Allergic Rhinitis
Authors: B.M. Prenner, P. Chervinsky, D.L. Miller, G. Raphael, M.A. Wingertzahn, J. Karafilidis, H. Huang
Journal: Journal of Allergy and Clinical Immunology (2009)
Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease
Authors: Tamara Isakova, Patricia Wahl, Gabriela S. Vargas, Orlando M. Gutiérrez, Julia Scialla, Huiliang Xie, Dina Appleby, Lisa Nessel, Keith Bellovich, Jing Chen, Lee Hamm, Crystal Gadegbeku, Edward Horwitz, Raymond R. Townsend, Cheryl A.M. Anderson, James P. Lash, Chi-yuan Hsu, Mary B. Leonard, Myles Wolf
Journal: Kidney International (2011)
Fingerstick Blood Sugars
Authors: BERNADINE Z. PAULSHOCK
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 November 1982Fingerstick Blood SugarsBERNADINE Z. PAULSHOCK, M.D.BERNADINE Z. PAULSHOCK, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-5-788_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The overview of the ambulatory treatment of insulin-dependent diabetic patients by Felig and Bergman (1) includes a review of the methods currently available for the measurement of blood sugar using blood obtained by fingerstick. Inasmuch as the development of these reagents is a major factor in the consideration of intensive ambulatory treatment, it may be important to mention that the list of the methods to do this critical testing is incomplete, as is the discussion of the methods.The Dextrostix (Ames Division, Miles Laboratories, Elkhart, Indiana) can be read by eye as well as by meter (both...Reference1. FELIGBERGMAN PM. Intensive ambulatory treatment of insulin-dependent diabetes. Ann Intern Med. 1982;97:225-30. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: BERNADINE Z. PAULSHOCK, M.D.Affiliations: Wilmington Medical Center Wilmington, DE 19899 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMonitoring Techniques in Non – Insulin-Dependent Diabetes MellitusGlucose 1 November 1982Volume 97, Issue 5Page: 788-788KeywordsBloodBlood sugarInsulin ePublished: 1 December 2008 Issue Published: 1 November 1982 PDF downloadLoading ...
ABC of allergies: Pathogenic mechanisms: a rational basis for treatment
Authors: P. H Howarth
Journal: BMJ (1998)

Allergic diseases such as asthma, rhinitis, eczema, and anaphylaxis are increasingly common and, in addition to being associated with morbidity and potential mortality, constitute a considerable burden on health resources, with both direct and indirect costs. This article discusses the pathogenic mechanism underlying the clinical signs and symptoms of these diseases and explains the basis for the choice of differing treatments.



Immunohistology of nasal mucosa in allergic rhinitis using alkaline phosphatase/anti-alkaline phosphatase technique showing individual cells stained red: mast cells (top), eosinophils (bottom left), and CD4 T lymphocytes (bottom right)



About 40% of the population is atopic as evidenced by a positive response to a skin prick test with an allergen, but not all show signs and symptoms of clinical disease. There may be a latency period, as students who have positive skin prick tests with grass pollen but who do not experience hay fever have been shown to go on to develop seasonal allergic rhinitis. A threshold response may also be required for signs and symptoms of clinical disease to develop, as allergic airway inflammation is present in the lower airways of patients with perennial allergic rhinitis sensitive to house dust mite who do not have clinical asthma. This inflammatory response falls between the response in patients with clinical asthma and that in non-atopic healthy controls.



Regulation of B lymphocyte IgE synthesis by T lymphocytes. T cells with the Th2 cytokine profile increase interleukin 4 and interleukin 13 synthesis, which promotes IgE isotype switching, whereas the development of T cells with a Th1 cytokine profile, which generate the interferon gamma, inhibits B cell isotype switching for IgE synthesis. This process also involves antigen uptake and processing by mucosal dendritic cells (commonly Langerhans' cells in the airways) and the presentation of antigen in a modified format to T lymphocytes, typically …
Videotaping of general practice consultations
Authors: L M Campbell, T S Murray, F M Sullivan
Journal: BMJ (1996)

istration is focusing on this in its "health in the next millennium" work programme, as is the Medical Research Council in its Gambia project, and the Liverpool School of Tropical Medicine now incorporates non-communicable diseases into its diploma courses.We suggest that the specialty of tropical medicine should shift towards a broader specialty of "health in developing countries," with the multidisciplinary inputs that the authors recommend, rather than be subsumed into infectious diseases.
New percutaneous transluminal coronary angioscope
Authors: Kyoichi Mizuno, Tunenori Arai, Kimio Satomura, Toshio Shibuya, Ko Arakawa, Yasuhiro Okamoto, Akira Miyamoto, Akira Kurita, Makoto Kikuchi, Haruo Nakamura, Atsushi Utsumi, Kiyoshi Takeuchi
Journal: Journal of the American College of Cardiology (1989)
Marijuana Use by GIs in Viet Nam
Authors: EDWARD COLBACH
Journal: American Journal of Psychiatry (1971)

A Senate subcommittee has tried to implicate the use of marijuana in the My Lai episode. Stirred by this, the mass media have given sensational attention to the use of marijuana by U.S. servicemen in Viet Nam. Reviewing the considerable professional literature on the subject, the author finds that marijuana smoking is a significant problem but not as serious as the mass media seem to imply.
The Red Blood Cell: A Comprehensive Treatise
Authors: Victor Herbert
Journal: JAMA (1965)

It is stated in  jacket of this book that it is meant to be complete and authoritative, and that the broad scope of  survey will give both  student and  practitioner an overall understanding of  subject. Such is not  case. As  editors state in their preface,  book is meant to be a critical compendium dealing with  biology of  mature, mammalian red blood cell, and meant primarily to serve  present and future investigator. As  editors also state in their preface, some aspects of  red blood cell have not been as well covered as might have been hoped. The chapters deal with composition of red cells, ion and water permeability, metabolism (pentose phosphate, glucose-6 phosphate dehydrogenase, lipids, hemoglobin, methemoglobin), oxygen and carbon dioxide transport,  nature and genetics of blood group substances, erythrocyte life span, thiamine and pyridoxine in erythrocytes,
US universities review subscriptions to journal "package deals" as costs rise
Authors: S. Mayor
Journal: BMJ (2004)

US university libraries are cancelling “package deal” subscriptions—in which they buy a “bundle” of academic journals and online journal access from the publisher Elsevier—on the grounds that they are too expensive.

Harvard University in Boston, Massachusetts, recently announced that from 1 January 2004 it was stopping its subscription with Elsevier for a bundled package of journals. Instead, the library will purchase journals on a title by title basis.

The decision followed more than a year of negotiations between Harvard and other members of the Northeast Research Libraries Consortium and Elsevier to agree more flexible licensing terms for subscribing to journals. Elsevier offers its journals in what …
Basis of the Maximum Allowable Concentrations for Occupational Exposure
Authors: Hervey B. Elkins
Journal: New England Journal of Medicine (1961)

THE principle that employers should take reasonable steps to prevent occupational disease in workers under their jurisdiction has long been recognized. To prevent illness caused by inhalation of harmful dusts, fumes or gases, current practice is to limit the concentration of such impurities in the working environment to harmless levels. Selection of these limiting concentrations — Maximum Allowable Concentrations (MAC's) — is often a difficult problem, depending on the nature of the harmful effects and the toxicologic and clinical data available. MAC's for gases and vapors, toxic fumes and dusts and mineral and inert dusts are shown in Tables 1 2 3. (It . . .
Cessation of Paroxysmal Supraventricular Tachycardias by Parasympathomimetic Interventions
Authors: HERMAN O. KLEIN
Journal: Annals of Internal Medicine (1974)

The mode of cessation of 39 episodes of supraventricular tachycardias during reflex vagal stimulation was studied in 11 patients. In each instance slowing of supraventricular tachycardia was observed before its cessation. The findings are consonant with present concepts of the electrophysiologic behavior of ectopic automatic cells and reentrant pathways of conduction and their response to acetylcholine. Descriptions of the behavior of supraventricular tachycardias should be more accurate.
Identification of ZNF366 and PTPRD as novel determinants of plasma homocysteine in a family-based genome-wide association study
Authors: Anders Mälarstig, Alfonso Buil, Juan Carolos Souto, Robert Clarke, Francisco Blanco-Vaca, Jordi Fontcuberta, John Peden, Malin Andersen, Angela Silveira, Simona Barlera, Udo Seedorf, Hugh Watkins, Laura Almasy, Anders Hamsten, José Manuel Soria
Journal: Blood (2009)
Pharmacogenetics and drug-induced arrhythmias
Authors: D Roden
Journal: Cardiovascular Research (2001)

Drugs are widely recognized to vary in the beneficial and undesirable effects they produce in human subjects. The understanding that variants (polymorphisms and mutations) in the human genome are common and may well modulate both disease and its response to drugs, is a critical new concept in understanding mechanisms of drug action and their variability in human subjects. Variability can arise because of variability in genes encoding molecules of drug disposition, in genes encoding molecules that drugs target, or in genes that modulate the overall activity of the complex biological systems within which drugs act. The evolving understanding of the genetic basis of variability in response to drugs used in the treatment of sudden cardiac death has important implications not only for the treatment of patients who have survived an episode, but also for helping formulate a framework for further understanding mechanisms of drug action at the genetic level.
Midline Catheterization in Hospitalized Patients
Authors: Suzanne Parisian
Journal: Annals of Internal Medicine (1996)

Letters15 October 1996Midline Catheterization in Hospitalized PatientsSuzanne Parisian, MDSuzanne Parisian, MDMedical Device Assistance, Inc., Front Royal, VA 22630Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-8-199610150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Until June 1995, I was the primary physician at the Food and Drug Administration (FDA) responsible for reviewing all patient reports and toxicologic and biochemical data for the Menlo Care products that contained Aquavene. In the recent report by Mermel and associates [1], the information presented is in direct conflict with findings determined by the FDA's scientific review staff.I can state that Menlo Care's Aquavene products have successfully met FDA's “recent” safety and efficacy requirements. Scientific data produced by the FDA after multiple inspections of Menlo Care's facilities and records have shown no problem with the ...References1. Mermel LA, Parenteau S, Tow SM. The risk of midline catheterization in hospitalized patients. A prospective study. Ann Intern Med. 1995; 123:841-4. Google Scholar2. Maki DG. Reactions associated with midline catheters for intravenous access [Editorial]. Ann Intern Med. 1995; 123:884-6. Google Scholar Author, Article, and Disclosure InformationAffiliations: Medical Device Assistance, Inc., Front Royal, VA 22630 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRe‐evaluating expanding intravenous catheters in medical practice 15 October 1996Volume 125, Issue 8Page: 697KeywordsAdverse eventsCatheterizationCathetersDatabasesFood and Drug AdministrationHealth care providersSafety Issue Published: 15 October 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Impaired Ig class switch in mice deficient for the X-linked lymphoproliferative disease gene Sap
Authors: Umaima Al-Alem, Cuiling Li, Nathalie Forey, Francis Relouzat, Marie-Claude Fondanèche, Sean V. Tavtigian, Zhao-Qi Wang, Sylvain Latour, Luo Yin
Journal: Blood (2005)
Prevalence of asthma in 13-14 yr-old schoolchildren across Israel
Authors: T. Shohat, G. Golan, R. Tamir, M.S. Green, I Livne, Y Davidson, G. Harari, B.z Garty
Journal: European Respiratory Journal (2000)

There is evidence that the incidence and severity of asthma are increasing worldwide, but there are limited data on asthma in Israel. The aim of this study was to investigate the prevalence and severity of asthma and asthma symptoms in 13-14 yr-old schoolchildren in Israel. The self-completed questionnaire used was a modified version of that developed by the International Study of Asthma and Allergies in Childhood (ISAAC), and was administered to a national sample of 12,918 children. The prevalence of asthma ever, wheezing ever and wheezing in the last 12 months were 13.7, 23.8 and 17.9% respectively. Significantly higher rates of a history of asthma and asthma symptoms were observed in Jews compared with Arabs. Although asthma ever was more prevalent in males than in females, asthma symptoms were significantly more common in females. The type of area of residence had no effect on the prevalence of wheezing. The ethnic differences in the prevalence of asthma persisted after controlling for sex, district of residence and level of urbanization. The prevalence of both asthma and asthma symptoms in Israel are slightly above the mean reported from 10 other countries in Europe and the Far-East.
Major histocompatibility complex class II compartments in human B lymphoblastoid cells are distinct from early endosomes.
Authors: P J Peters, G Raposo, J J Neefjes, V Oorschot, R L Leijendekker, H J Geuze, H L Ploegh
Journal: The Journal of Experimental Medicine (1995)

In human B lymphoblastoid cell lines, the majority of major histocompatibility complex (MHC) class II heterodimers are located on the cell surface and in endocytic compartments, while invariant chain (Ii)-associated class II molecules represent biosynthetic intermediates which are present mostly in the endoplasmic reticulum and Golgi complex. To investigate the origin of the MHC class II-positive compartments and their relation to early endosomes, the intracellular distribution of MHC class II molecules and Ii in relation to endocytic tracers was studied in human lymphoblastoid B cells by immunoelectronmicroscopy on ultrathin cryosections. Cross-linking of surface immunoglobulins, followed by a brief period of internalization of the immune complexes, did not alter the intracellular distribution of MHC class II molecules. While early endosomes were abundantly labeled for the cross-linked immunoglobulins, &amp;lt; 1% of total MHC class II molecules were detectable in early endosomes. MHC class II- and Ii-positive structures associated with the trans-Golgi network can be reached by endocytosed bovine serum albumin (BSA)-gold conjugates after 30 min of internalization. Prolonged exposure to BSA-gold allowed visualization of later endocytic compartments, in which a progressive loss of Ii was observed: first the lumenal portion, and then the cytoplasmic portion of Ii escaped detection, culminating in the formation of MHC class II-positive compartments (MIIC) devoid of Ii. The loss of Ii also correlated with a transition from a multivesicular to a multilaminar, electron-dense MIIC. The intracellular compartments in which class II molecules reside (MIIC) are therefore a heterogeneous set of structures, part of the later aspects of the endocytic pathway.
Health Effects of Oil Spills: Lessons from the <i>Prestige</i>
Authors: Jan-Paul Zock, Gema Rodríguez-Trigo, Francisco Pozo-Rodríguez, Joan Albert Barberà
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

1 Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; 2 Hospital del Mar Research Institute (IMIM), Barcelona, Spain; 3 CIBER Epidemiologia y Salud Publica (CIBERESP), Spain; 4 Department of Respiratory Medicine, Hospital Clinico San Carlos, Madrid, Spain; 5 Department of Respiratory Medicine and Clinical Epidemiology Unit, University Hospital 12 de Octubre, Madrid, Spain; 6 CIBER Enfermedades Respiratorias (CIBERES), Spain; 7 Department of Respiratory Medicine, Hospital Clinic-Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Deaths from Eating Chestnuts
Authors: S. L. Cherry
Journal: JAMA (1913)

To the Editor:  —InThe Journal, Nov. 29, 1913, p. 2001, S. T. A. refers to the newspaper report of the death of a woman from poisoning by eating chestnuts, and asks for an explanation as to how chestnuts can be poisonous.  Aside from your answer that the matter was under investigation by the Bureau of Plant Industry, is it not possible that this patient was a subject of diabetes and that she died from coma from overindulgence in this article of diet? In the dietary for diabetes all forms of nuts are allowed except chestnuts, and I have strictly forbidden them to patients suffering from this disease, although diabetic patients have an inordinate craving for chestnuts at this season of the year. A Note on the Use of Ninhydrin as a Test for Peptone, etc. To the Editor:—Ninhydrin works best in a strictly neutral medium. Slight acidity or alkalinity
Letter: Inversion of the appendix.
Authors: J Shepherd
Journal: BMJ (1974)

Recurrent cyanotic episodes associated on some occasions with loss of consciousness due to cerebral hypoxia were investigated by long term tape recordings of breathing activity, oxygen saturation, air flow, electrocardiographic activity, and in some cases electroencephalographic activity. In 51 infants and children the mechanisms for the cyanotic episodes were identified (prolonged expiratory apnoea in 45, sleep related airway obstruction in three, seizure induced apnoea in one, behaviour induced apnoea in one). In one child apnoea was suspected as being caused by suffocation (smothering) by the mother. This was confirmed after enlisting the help of the police, who undertook covert video surveillance during cyanotic episodes. Each cyanotic episode was associated with a pattern of disturbance on the multichannel tape recordings which may be pathognomonic of this type of apnoea. A second infant with cyanotic episodes in whom smothering was suspected was referred for similar investigation after the availability of video recordings became established. Maternal smothering was again supported by specific patterns on multichannel tape recordings and confirmed by video surveillance. Diagnosis by video surveillance produces unequivocal evidence in these cases and avoids the need for medical and nursing staff to confront the mother with a possibly incorrect suspicion or in a court of law.