tbuckley/cabot-search huggingface dataset:
Equity in study leave
Authors: R. Macdonald
Journal: BMJ (1999)

Is it fair that orthopaedic trainees should have their study leave funded at the expense of trainees in palliative care? Should plastic surgical specialist registrars attend courses in preference to paediatric specialist registrars? Before 1996 in the Yorkshire deanery the average annual cost of study leave for orthopaedic trainees was £835 per trainee and for palliative care trainees £235 per trainee. One orthopaedic trainee received £2,000 of funded leave in one year and is now a consultant with an entirely different subspecialty interest. That same year, a trainee in learning disability had £25 of funded study leave. Trainees in plastic surgery had been given a list of “essential” and “desirable” courses to attend. There was minimal guidance for paediatric trainees. Medical senior house officers seemed to attend innumerable MRCP courses such as PASTEST (costing £400-1,000), never received educational advice between attendances, and still failed the exam. Trainees attending the same course often submitted grossly different expenses. This was discovered only in the mid-1990s, when computerised records became the norm. The records reveal many anomalies.

How could a hospital trust's clinical tutor adjudicate the educational requirements of trainees in different specialties? It was easy for college regional advisors and chairs of specialty training committees to recommend mandatory study leave for specialist registrars, knowing that the organisation and funding was someone else's problem. Why did trainees wish to attend so many courses in London, Edinburgh, and Davos? Surely not just because of academic excellence - perhaps also cultural and sporting activities.

#### Strategic principles for study leave

Study leave should:

All trainees should be encouraged to develop coherent plans for study leave early in their senior …
277 TRANSIENT ELASTOGRAPHY (FIBROSCAN) CAN DETECT ADVANCED LIVER FIBROSIS BEST AMONG PATIENTS WITH NORMAL ALANINE TRANSAMINASE
Authors: H.L.Y. Chan, G.L.H. Wong, V.W.S. Wong, P.C.L. Choi, A.W.H. Chan, R.H.L. Chum, H.K.W. Chan, K.K.K. Lau, J.J.Y. Sung
Journal: Journal of Hepatology (2008)
Abstract 5051: Retrospective analysis of direct inpatient charges and mortality of leukemia pediatric patients with Methicillin-resistant Staphylococcus aureus, Candida, or Aspergillus infections in the United States
Authors: Tomas Nuño, Grant H. Skrepnek
Journal: Cancer Research (2014)

Abstract Objective: The purpose of this study was to assess risk factors that are associated with inpatient charges and mortality rates with Methicilin-resistant Staphylococcus aureus (MRSA), Aspergillus, and Candida in children with leukemia. We hypothesize that MRSA and opportunistic fungal infections are associated with higher inpatient charges and worse outcomes relative to those without infections. Identifying the risk factors that affect mortality and inpatient charges of these infections should add to the current knowledge of treating and preventing these infections in immune compromised patients. Methods: Retrospective cohort study using the Agency for Healthcare Research Quality's Healthcare Cost and Utilization Project 2009 KIDS database. Overall, 33,020 individual hospital visits were analyzed for pediatric leukemia patients. Results: Predictors of increased mortality were: Age (OR=1.1, SE=0.02), MRSA (OR=7.2, SE=5.2), Aspergillus (OR=6.3, SE=2.1), Candida (OR=5.7, SE=1.3), and Deyo-Charlson comorbidity scores (OR=1.7, SE=0.13). Significant predictors of increased inpatient charges were: MRSA (OR=2.2, SE=0.35), Aspergillus (OR=2.7, SE=0.25), Candida (OR=2.3, SE=0.15), Female Sex (OR=1.1, SE=0.04), Deyo-Charlson comorbidity scores (OR=1.2, SE=0.04), Urban Hospitals (OR=1.9, SE=0.24), and the Southern Region (OR=0.84, SE=0.2=07). Significant predictors of increased length of stay were similar to predictors of inpatient charges. Conclusions: Although uncommon in leukemia cases involving pediatrics or young adults, risks of higher mortality, length of stay, and inpatient charges were noted in cases involving MRSA, Aspergillus, and Candida. The burden of these illnesses requires further attention in order to improve outcomes among patients with leukemia. Citation Format: Tomas Nuño, Grant H. Skrepnek. Retrospective analysis of direct inpatient charges and mortality of leukemia pediatric patients with Methicillin-resistant Staphylococcus aureus, Candida, or Aspergillus infections in the United States. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5051. doi:10.1158/1538-7445.AM2014-5051
Preventing deaths from malaria.
Authors: A P Hall
Journal: BMJ (1978)

To reduce the number of avoidable deaths from malaria in Britain the following five points are recommended. Parliament should pass a Malaria Prevention Act that compels travel agents and airlines to give written and verbal advice on prevention and diagnosis of malaria to people travelling to countries where the disease occurs. To improve diagnostic and therapeutic efficiency for all diseases the Department of Health and Social Security should prepare a procedure manual for the NHS that gives guidance for doctors and other medical staff. Avoidable deaths from all diseases should be the subject of open inquiries at district medical committees, with recorded evidence. Failure to perform diagnostic tests such as blood films for malaria in cases of sickness in people returning from the tropics should automatically be considered negligent. Compensation should be offered by the State to the next of kin of people who have died because of medical negligence from malaria or other diseases.
New EU health commissioner promises early tobacco legislation
Authors: R. Watson
Journal: BMJ (2012)

Tonio Borg, the former Maltese foreign minister who has taken over as the European Commissioner for public health and consumer protection, has promised to make new European Union legislation for tightening rules on tobacco products his top priority.

He gave the commitment to the European parliament during a three hour public hearing just eight days before the MEPs approved his nomination on 21 November by 386 votes to 281 with 28 abstentions. Once the EU governments have formally approved the appointment, Borg is expected to be working full time in Brussels from 29 November.

Under the timetable he has spelt out, the text of the …
γδ Cells and the Regulation of Mucosal Immune Responses
Authors: ADRIAN C. HAYDAY, SCOTT ROBERTS, ELIZABETH RAMSBURG
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Section:ChooseTop of pageAbstract <<γδ CELLS AND THE LUNGγδ CELL SPECIFICITIES AND...γδ CELL EFFECTOR FUNCTION...γδ CELLS REGULATE IMMUNOP...AN AGE-DEPENDENT ROLE FOR...SUMMARYReferencesCITING ARTICLES
Restrictive cardiomyopathy versus constrictive pericarditis: role of endomyocardial biopsy in avoiding unnecessary thoracotomy.
Authors: M H Schoenfeld, E W Supple, G W Dec, J T Fallon, I F Palacios
Journal: Circulation (1987)

Despite careful clinical, noninvasive, and hemodynamic assessment of patients with constrictive/restrictive physiology, the differentiation of restrictive cardiomyopathy from constrictive pericarditis remains difficult. We examined the role of right ventricular endomyocardial biopsy in defining the underlying process in 54 patients with evidence of constrictive/restrictive physiology, including 38 patients with profound symptoms of heart failure in whom diagnostic/therapeutic thoracotomy was contemplated (group I) and 16 patients with milder symptoms (group II). All patients in group I had NYHA class III or IV heart failure with depressed cardiac index (mean 2.5 liters/min/m2), right atrial hypertension (mean 15 mm Hg), and normal left ventricular ejection fraction (mean 59%). Endomyocardial biopsy identified a specific source of restrictive cardiomyopathy in 15 of 38 patients (39%) (11 amyloid, four myocarditis). Of the 23 remaining patients with either normal biopsy findings or nonspecific abnormalities on biopsy, 18 had intraoperative or autopsy evaluation of their pericardium, and constriction was found in 14 (77%). A specific form of restrictive cardiomyopathy was also identified in four of the 16 patients with milder symptoms (group II). We conclude that endomyocardial biopsy is useful in patients with severe constrictive/restrictive physiology. It identifies a large subset of patients with specific forms of restrictive cardiomyopathy in whom thoracotomy should be avoided. It supports the need for thoracotomy and the likelihood of finding pericardial constriction in patients without specific pathologic findings.
1085-198 The effect of chart review, feedback, and a hand-held management program on blood pressure control in hypertensive patients: The PROMPT study
Authors: Robert A Phillips, Tom H Karson, Grethe S Birketvidt, Warren Ho, Donald A Smith, Stanley Tuhrim, Benjamin Stein, Mohammed Rafey, Sylvan Wallenstein
Journal: Journal of the American College of Cardiology (2004)
Abstract P6-11-10: Central nervous system metastases in breast cancer: Impact of tumour sub-type and outcome from current treatments
Authors: A Chan, B O'Carrigan, S McGregor, J Beith
Journal: Cancer Research (2013)

Abstract Background: The use of more effective systemic therapies in the management of metastatic breast cancer has led to increased response rates, progression-free survival and overall survival. The incidence of central nervous system (CNS) metastases has become an increasingly important area of unmet need. It is important to identify tumour-related factors which may predict for CNS occurrence and assess the efficacy of treatments in current use. Methods: Consecutive patients (pts) with breast cancer (BC) seen at 2 institutions following establishment of breast cancer databases were included: January 2000 (institution A) and January 2003 (institution B) to December 2012. Patient demographic data, tumour pathology and systemic treatment given were reviewed in those patients who developed CNS metastases. Multivariate analysis of factors impacting on overall survival in this patient population will be performed. Results: Over the study period, 4751 pts with a median age of 52.7 yrs were seen, where 86.4% and 13.6% of pts presented with early and metastatic disease, respectively. In the entire population, 77% of tumours were hormone receptor positive, 21% HER2 positive, and 15% triple negative. Overall, 228 (4.8%) pts had CNS metastases with a median age of 48.9 yrs. CNS involvement was present at the time of first metastatic recurrence in 27% of pts who had CNS metastases. The proportion of pts developing CNS metastases according to tumour subtypes were: 48% hormone receptor positive, 36% Her2 positive, and 20% triple negative. Median time from diagnosis to development of CNS metastases (excluding pts with CNS involvement at the time of first metastatic disease) was 48.9 (4.7-248 months, m). The median time to development of CNS recurrence was 61m, 43m, 23m respectively, according to tumour subtype. CNS disease was parenchymal only, leptomeningeal only or both in 78%, 9%, 13% respectively. Pts who died from BC, had a median overall survival from initial BC diagnosis of 53.6m, whereas median overall survival from CNS metastases was 4.8 m. The impact of whole brain radiation with or without stereotactic therapy, surgical resection of brain metastases and type of systemic therapy administered following development of CNS disease on overall survival will be presented. Discussion: CNS metastases occurred in up to 5% of breast cancer pts seen at two large cancer centres. Despite improvements in overall survival of metastatic BC pts with the use of more effective systemic treatments, the prognosis following CNS involvement remains extremely poor. Until specific interventions are available to manage CNS metastases in pts with breast cancer, it remains important to assess outcomes from current standard treatment in these pts. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-11-10.
Primum Non Placere?
Authors: Samuel Vaisrub
Journal: JAMA (1979)

Defined in<i>Butterworth's Medical Dictionary</i>as "a pharmaceutically inactive substance administered as a drug either to satisfy a patient's desire for medication or in the course of a drug trial," the placebo (Latin, "I will please") is currently under attack (<i>Scientific American</i>231:17-23, 1974). With its sharp edge blunted by informed consent regulations, the placebo has lost much of its effectiveness in controlled drug trials, and with increasing demands for patient participation in medical decisions, it is about to lose its long-held respectable place in therapy. A victim of consumerism, the placebo is in a precarious state. Transcending the dictionary definition of placebo as a nonentity masquerading as a drug is the broader concept of placebo effect, which extends beyond drug prescribing to laying on of hands, incantations, senseless surgical procedures, and innumerable other modes of therapy practiced through the ages. In fact, most therapy has and will have derived
Orthosis, Orthetics, Orthesis, Orthotics-Reply
Authors: Robert L. Bennett
Journal: JAMA (1963)

I can well appreciate Dr. Moore's reaction to our use of the term "orthetics" and its necessary grammatical variations. This term was first used in 1955 to title an exhibit on braces, splints, corsets, crutches, wheel chairs, and other appliances used to increase the functional capacity of patients with severe disability. My own definition of "orthesis," which I am sure<i>Stedman's Medical Dictionary</i>will improve, is as follows: An orthesis may be defined as any medical device applied to or around a bodily segment in the care of physical impairment or disability. Literally it means correct position, from two terms: "ortho," a combining form meaning straight, and "thesis," meaning position. Orthesis can be most easily understood when compared with "prosthesis." A prosthesis is an "artificial replacement of a missing part," whereas an orthesis is applied to an existing part. An orthetic device is the same as an orthesis. Orthetics is
MITRAL VALVE CHORDAL RUPTURE IS ASSOCIATED WITH ALTERED ELASTIC FIBRIL ARCHITECTURE AND DIMINISHED ELASTIN DENSITY IN FIBRO ELASTIC DEFICIENCY: IMPLICATIONS IN LEAFLET STABILITY
Authors: Meerarani Purushothaman, Purushothaman K–Raman, David Adams, Federico Milla, Annapoorna Kini, Samin Sharma, Valentin Fuster, Pedro Moreno
Journal: Journal of the American College of Cardiology (2013)
Integrating the MicroRNome into the Study of Lung Disease
Authors: Serge P. Nana-Sinkam, Melissa G. Hunter, Gerard J. Nuovo, Thomas D. Schmittgen, Richard Gelinas, David Galas, Clay B. Marsh
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Over the last 15 years, investigators have identified small noncoding RNAs as regulators of gene expression. One type of noncoding RNAs are termed microRNAs (miRNAs). miRNAs are evolutionary conserved, approximately 22-nucleotide single-stranded RNAs that target genes by inducing mRNA degradation or by inhibiting translation. miRNAs are implicated in many critical cellular processes, including apoptosis, proliferation, and differentiation. Furthermore, it is estimated that miRNAs may be responsible for regulating the expression of nearly one-third of the human genome. Despite the identification of greater than 500 mature miRNAs, very little is known about their biological functions and functional targets. In the last 5 years, researchers have increasingly focused on the functional relevance and role that miRNAs play in the pathogenesis of human disease. miRNAs are known to be important in solid organ and hematological malignancies, heart disease, as potential modulators of the immune response, and organ development. It is anticipated that miRNA analysis will emerge as an important complement to proteomic and genomic studies to further our understanding of disease pathogenesis. Despite the application of genomics and proteomics to the study of human lung disease, few studies have examined miRNA expression. This perspective is not meant to be an exhaustive review of miRNA biology but will provide an overview of both miRNA biogenesis and our current understanding of the role of miRNAs in lung disease as well as a perspective on the importance of integrating this analysis as a tool for identifying and understanding the biological pathways in lung-disease pathogenesis.
Homelessness: A Prevention-Oriented Approach
Authors: James J. O'Connell
Journal: JAMA (1993)

The burgeoning literature on homelessness in America has been plagued by the elusiveness of a commonly accepted definition and a plethora of descriptive studies without adequate controls.<i>Homelessness: A Prevention-Oriented Approach</i>is a superb book, edited by Rene I. Jahiel, MD, PhD, that clearly details our historical and scholarly knowledge of this very painful consequence of persistent poverty in America. With somewhat less clarity, the book makes a stalwart attempt to describe a prevention-oriented approach to this complex problem. The first and longest section is a masterful and well-written collection of essays on the demographics of homeless people. Homeless individuals and families in urban and rural America are an eclectic group whose common characteristics are limited: living in abject poverty without a home. This group includes families with children, adolescents and youths, middle-aged men and women, and the frail elderly; they are veterans, victims of domestic and sexual violence, workers
Care of the newborn.
Authors: G J Ebrahim
Journal: BMJ (1984)

At birth the baby makes a transition from intrauterine to extrauterine existence. Until then the placenta has been functioning as the organ for gaseous exchange, for nutrition, for excretion and for the production of various hormones that are necessary for the maintenance of pregnancy. At the time of birth, or soon thereafter, various physiological systems of the baby take over these functions. Thus respiration is initiated and the function of gaseous exchange is taken over by the lungs. Full expansion of the lungs may not be achieved until several days after birth, especially in the low birth weight baby or the baby whose vitality and strength have been lowered by disease, drugs or anoxia. As the lungs expand and assume function, the pulmonary capillary bed opens up and pulmonary circulation gets established; at the same time the placenta with its vascular structure is removed from the systemic circulation. With better oxygenation in the alveoli of the lungs the oxygen tension of the blood increases. All these factors act as a trigger mechanism which brings about changes in the foetal circulation converting it to the adult type of circulation. Other dormant systems, such as the gastro-intestinal tract and the urinary system also begin to function. Within a day or two of birth, the gastro-intestinal system has to obtain calories and various nutrients essential for the metabolic needs of the body tissues.
Sustained Suppression of IL-13 Attenuates Developing but not Established Chronic Airway Hyperreactivity and Remodeling in Mice
Authors: Y. Ma, A.J. Halayko, S. Basu, Q. Guan, G. Zhou, A.G. Ma, C.R. Weiss, Z. Peng
Journal: Journal of Allergy and Clinical Immunology (2010)
AAV-mediated gene transfer in the perinatal period results in expression of FVII at levels that protect against fatal spontaneous hemorrhage
Authors: Christopher Binny, Jenny McIntosh, Marco Della Peruta, Hanna Kymalainen, Edward G. D. Tuddenham, Suzanne M. K. Buckley, Simon N. Waddington, John H. McVey, Yunyu Spence, Christopher L. Morton, Adrian J. Thrasher, John T. Gray, Francis J. Castellino, Alice F. Tarantal, Andrew M. Davidoff, Amit C. Nathwani
Journal: Blood (2011)
Viral Entry Denied
Authors: Robert W. Doms
Journal: New England Journal of Medicine (2004)

Until recently, antiviral drugs were both uncommon and not terribly potent. This has changed: during the past decade, more than 30 antiviral drugs have been licensed, and many of them are very effective. Most of the drugs inhibit the activity of viral enzymes, but a new class of agents that block entry of the virus into the cell is being developed. The development of entry inhibitors is driven by the identification of the cell-surface receptors to which viruses bind and by new findings about viral protein structures that bind receptors and mediate viral entry. These advances offer exciting opportunities for . . .
Combined treatment of psoriasis with acitretin and UVB phototherapy compared with acitretin alone and UVB alone
Authors: J. IEST, J. BOER
Journal: British Journal of Dermatology (1989)

The administration of UVB phototherapy and low-dose acitretin (0.34-0.44 mg/kg body weight) was compared with the effect of acitretin alone and UVB phototherapy alone in 41 patients with plaque-type psoriasis. Of these patients, 32 received standard UVB phototherapy without acitretin. The other nine were treated with acitretin and the effect of UVB irradiation (Sylvania UV 21-tubes), applied to one half of the body, was assessed, Clearance was defined as 80-100% improvement and this occurred in eight out of the nine patients(89%) treated with acitretin-UVB (ReUVB) and, in two of them (23%), on the untreated side. Clearance occured in 20 of the 32 (62.5%) patients given UVB alone. The improvement score was significantly higher for the ReUVB side than the acitretin side. Patients treated with ReUVB showed a statistically higher therapeutic score (95-100% clearance) than those receiving UVB alone. However, taking 80-100% improvemint as the criterion, no significant difference was found. The number of treatments to clearance was signigicantly less for the patients treated with ReUVB than for the UVB (19.3 as compared with 24.9). The total UVB dose and the number of minimal erythema doses (MEDs) could be reduced by approximately 20% in the ReUVB group relative to the UVB group.
IL-33 is more potent than IL-25 in provoking IL-13–producing nuocytes (type 2 innate lymphoid cells) and airway contraction
Authors: Jillian L. Barlow, Samantha Peel, Jane Fox, Veera Panova, Clare S. Hardman, Ana Camelo, Christine Bucks, Xiaoying Wu, Colleen M. Kane, Daniel R. Neill, Robin J. Flynn, Ian Sayers, Ian P. Hall, Andrew N.J. McKenzie
Journal: Journal of Allergy and Clinical Immunology (2013)
Government says it can't review price of orphan drugs until end of 2013
Authors: N. Hawkes
Journal: BMJ (2010)

The Department of Health for England has said it has no powers to control the price of amifampridine (marketed as Firdapse), which was the subject of an open letter to the prime minister and health secretary published in the BMJ ( BMJ 2010;341:c6466, doi:10.1136/bmj.c6466).

Lord Howe, a junior minister at the health department, responded to a letter from Sajid Javid MP by reiterating the rules that govern drug pricing in the United Kingdom under the Pharmaceutical Price Regulation Scheme (PPRS). These rules allow companies to specify their own prices, subject only to a profit ceiling if their sales to the NHS exceed £35m (€41m; $55m) a year.

BioMarin, the …
Hip Disease With Referred Pain to the Knee
Authors: John G. Flatman
Journal: JAMA (1975)

<h3>History</h3> A 10-year-old Indian girl complained of pain in the right knee on weight-bearing, following a direct blow to the medial condyle of the femur during a fall in the schoolyard. There was swelling and discoloration, due to bruising, over the medial condyle. She returned three weeks later complaining of steadily increasing pain. She had been unable to walk for the past 24 hours. There was now wasting of the muscles of the thigh. Figures 1 and 2 are plain films of both hips and both knees. Figure 3 is a tomogram of the right hip joint. <h3>Diagnosis</h3> Tuberculosis of the hip joint. <h3>Comment</h3> This case shows how tuberculosis of the hip joint may masquerade as disease of the knee because of referred pain. Figure 1 shows that the right hip joint space is narrowed, and the margins of the joint, apart from the lateral portion of the head of