tbuckley/cabot-search huggingface dataset:
Guidelines spell out when someone assisting a suicide risks prosecution
Authors: C. Dyer
Journal: BMJ (2009)

Close friends or relatives who, from wholly compassionate motives, help a terminally ill or severely disabled loved one who is determined to die are unlikely to be prosecuted in England and Wales for assisting a suicide, under guidelines issued by the director of public prosecutions, Keir Starmer.

Mr Starmer launched a 12 week consultation on the guidelines, which will operate on an interim basis from 23 September, with a final version to be published next spring.

Assisting a suicide remains a criminal offence and the guidelines give no immunity from prosecution but spell out 16 factors that will weigh in favour of prosecution, and 13 factors inclining against it when deciding whether a prosecution would be in the public interest. …
PTH-053 Open Access To Colonoscopy: One Year Of Experience In A District General Hospital: Abstract PTH-053 Table 1
Authors: MF Hale, V Sathyanarayana, K Kapil, AS Soliman, SH Riyaz, P Hurlstone, E Said
Journal: Gut (2014)

<h3>Introduction</h3> Open access endoscopy allows non-gastroenterologists to schedule elective endoscopies without prior consultation with a specialist and is widely used for upper gastrointestinal endoscopy. Our hospital has provided an open access service for colonoscopy (OAC) since May 2011. We analyse our initial data to determine the appropriateness of referral and proportion of clinically significant diagnoses found. <h3>Methods</h3> We retrospectively reviewed endoscopy reports from all open access colonoscopies between 01/05/2011 and 30/04/2012 performed in a local district general hospital. Patient demographic data was collected alongside indication for examination, completion rates and final diagnosis. Further information from all colonoscopies performed during this period was retrieved from our endoscopy database system for comparison. Appropriateness of open access colonoscopy was graded using the European Panel on the Appropriateness of Gastrointestinal Endoscopy criteria (EPAGE II). Primary endpoint: appropriateness of colonoscopy. Secondary endpoint: clinically significant diagnosis. <h3>Results</h3> 2895 colonoscopies were performed in total during the study period of which OAC accounted for 14% (407). 57% (231) patients were female, age range 24–89 years (median 56 years). Caecal intubation was achieved in 96% (389 patients). OAC had the lowest diagnostic yield for all outpatient referrals to colonoscopy compared to bowel cancer screening (86%), medical outpatients (61%) and surgical outpatients (57%). The indication was designated appropriate in 69% (279 patients), inappropriate in 6% (25 patients) and uncertain in 25% (103 patients) based on the EPAGE II criteria. Patients with appropriate or uncertain indications had more relevant endoscopic findings than those with inappropriate indications (45.8 vs 19.0% p = 0.005). Sensitivity and negative predictive value of the EPAGE II criteria for detecting clinically significant pathology were 97.7 and 83.3% respectively. The most common diagnosis was diverticular disease, followed by polyps and haemorrhoids (Table 1). Colorectal cancer was found in 0.5% (2 patients), both in the appropriate/uncertain EPAGE group based on indication. <h3>Conclusion</h3> Open access to colonoscopy is useful to avoid delay in investigation of symptomatic patients but is associated with a low proportion of clinically significant findings compared to standard referral routes. Inclusion of the EPAGE II criteria in the referral form may help to avoid unnecessary examinations. <h3>Disclosure of Interest</h3> None Declared.
Research in general practice. Sources of advice.
Authors: N C Stott, R C Fraser, D C Morrell
Journal: BMJ (1984)

Regional advisers, faculty secretaries of the Royal College of General Practitioners, heads of academic departments of general practice and primary care, and heads of RCGP research units were invited to complete a semistructured questionnaire to determine the nature and availability of current sources of advice for general practitioners participating in research activities and the demands placed on the available sources in the United Kingdom. The principal source for research advice was university departments of general practice, yet these have insufficient resources to cope with requests and few have spare capacity to stimulate research. Regional advisers and faculty secretaries do not seem to be kindling a spirit of inquiry and they seem somewhat complacent about both the lack of requests for research advice from general practitioners and the difficulties of academic departments. Proper development of research capability in general practice and primary care is unlikely to occur without more resources to create training posts in academic departments and a greater spirit of inquiry in vocational training programmes, which should lead to both review (audit) and research.
Survival After Mesenteric Arterial Occlusion by Treatment with Low Molecular Weight Dextran
Authors: GEORGE J. D'ANGELO, LORENZO M. AMERISO, JOHN B. TREDWAY
Journal: Circulation (1963)

1. A segment of small bowel, approximately 30 cm., was acutely deprived of its arterial supply in 16 dogs. 2. Six dogs served as controls, receiving 15 ml./Kg. of 0.9 per cent saline or 1 ml./Kg. heparin. In all of these animals, the segment of bowel became necrotic. 3. Ten animals received 15 ml./Kg. of low molecular weight dextran after five hours of arterial occlusion, with survival of the involved bowel in all 10 dogs for a period of 48 hours to 3 weeks. 4. After five hours, the serum amylase in all animals decreased. In the control animals, the amylase value continued to decrease, whereas in the animals receiving the low molecular weight dextran it began to rise toward normal value.
Angiotensin receptor blockade attenuates cigarette smoke–induced lung injury and rescues lung architecture in mice
Authors: Megan Podowski, Carla Calvi, Shana Metzger, Kaori Misono, Hataya Poonyagariyagorn, Armando Lopez-Mercado, Therese Ku, Thomas Lauer, Sharon McGrath-Morrow, Alan Berger, Christopher Cheadle, Rubin Tuder, Harry C. Dietz, Wayne Mitzner, Robert Wise, Enid Neptune
Journal: Journal of Clinical Investigation (2011)

Chronic obstructive pulmonary disease (COPD) is a prevalent smoking-related disease for which no disease-altering therapies currently exist. As dysregulated TGF-β signaling associates with lung pathology in patients with COPD and in animal models of lung injury induced by chronic exposure to cigarette smoke (CS), we postulated that inhibiting TGF-β signaling would protect against CS-induced lung injury. We first confirmed that TGF-β signaling was induced in the lungs of mice chronically exposed to CS as well as in COPD patient samples. Importantly, key pathological features of smoking-associated lung disease in patients, e.g., alveolar injury with overt emphysema and airway epithelial hyperplasia with fibrosis, accompanied CS-induced alveolar cell apoptosis caused by enhanced TGF-β signaling in CS-exposed mice. Systemic administration of a TGF-β-specific neutralizing antibody normalized TGF-β signaling and alveolar cell death, conferring improved lung architecture and lung mechanics in CS-exposed mice. Use of losartan, an angiotensin receptor type 1 blocker used widely in the clinic and known to antagonize TGF-β signaling, also improved oxidative stress, inflammation, metalloprotease activation and elastin remodeling. These data support our hypothesis that inhibition of TGF-β signaling through angiotensin receptor blockade can attenuate CS-induced lung injury in an established murine model. More importantly, our findings provide a preclinical platform for the development of other TGF-β-targeted therapies for patients with COPD.
Localization of the gene for familial primary pulmonary hypertension to chromosome 2q31–32
Authors: William C. Nichols, Daniel L. Koller, Bonnie Slovis, Tatiana Foroud, Valeri H. Terry, Nathan D. Arnold, David R. Siemieniak, Lisa Wheeler, John A. Phillips, John H. Newman, P. Michael Conneally, David Ginsburg, James E. Loyd
Journal: Nature Genetics (1997)
Preventing the Nosocomial Transmission of Tuberculosis
Authors: Henry M. Blumberg
Journal: Annals of Internal Medicine (1995)

Objective: To study the efficacy of expanded tuberculosis infection control measures consisting primarily of administrative controls. Design: Descriptive case series. Setting: University-affiliated, inner-city hospital. Interventions: Introduction of expanded tuberculosis infection control measures (including an expanded respiratory isolation policy). Measurements: The number of tuberculosis exposure episodes and skin test conversion rates of health care workers were measured before and after implementation of expanded infection control measures. Tuberculosis exposure episodes (the number of patients who were not placed in respiratory isolation at admission but who subsequently had a diagnosis of acid-fast bacilli smear-positive pulmonary tuberculosis during that admission or within 2 weeks of discharge) were compared for two time periods: the 8 months before and the 28 months after implementation of infection control measures. Tuberculin skin test conversion rates among health care workers were evaluated during a 2.5-year period. Results: After expanded infection control measures were implemented, the number of tuberculosis exposure episodes decreased from 4.4 per month (35 episodes among 103 patient admissions for potentially infectious tuberculosis over 8 months) to 0.6 per month (18 episodes among 358 patient admissions for smear-positive pulmonary tuberculosis over 28 months) (odds ratio, 9.72; 95% CI, 4.99 to 19.25 [P < 0.001]). The cumulative number of days per month that potentially infectious patients with tuberculosis were not in isolation decreased from 35.4 to 3.3 (P < 0.001). A concomitant decrease in tuberculin skin test conversion rates in health care workers was seen; 6-month tuberculin skin test conversion rates decreased steadily from 3.3% (118 conversions in 3579 health care workers; 1/92 to 6/92), 1.7%, 1.4%, 0.6%, to 0.4% (23 conversions in 5153 workers [1/94 to 6/94]) (P < 0.001). Conclusions: Infection control measures effectively prevented nosocomial transmission of tuberculosis to health care workers. Administrative controls appear to be the most important component of a tuberculosis infection control program and should be the first focus of such a program, especially at public hospitals, where resources are most likely to be limited.
CARDIORESPIRATORY FITNESS LOWERS THE RISK FOR ATRIAL FIBRILLATION IN MEN WITH TYPE 2 DIABETES MELLITUS
Authors: Andreas Pittaras, Michael E. Doumas, Charles Faselis, F. Kyritsi, JP Kokkinos, H. Moore, P. Karasik, A. Tsimploulis, Ross Fletcher, Peter Kokkinos
Journal: Journal of the American College of Cardiology (2014)
Effect of Vitamin D Supplementation on Progression of Knee Pain and Cartilage Volume Loss in Patients With Symptomatic Osteoarthritis
Authors: Timothy McAlindon, Michael LaValley, Erica Schneider, Melynn Nuite, Ji Yeon Lee, Lori Lyn Price, Grace Lo, Bess Dawson-Hughes
Journal: JAMA (2013)

<h3>Importance</h3>Knee osteoarthritis (OA), a disorder of cartilage and periarticular bone, is a public health problem without effective medical treatments. Some studies have suggested that vitamin D may protect against structural progression.<h3>Objective</h3>To determine whether vitamin D supplementation reduces symptom and structural progression of knee OA.<h3>Design, Setting, and Patients</h3>A 2-year randomized, placebo-controlled, double-blind, clinical trial involving 146 participants with symptomatic knee OA (mean age, 62.4 years [SD, 8.5]; 57 women [61%], 115 white race [79%]). Patients were enrolled at Tufts Medical Center in Boston between March 2006 and June 2009.<h3>Intervention</h3>Participants were randomized to receive either placebo or oral cholecalciferol, 2000 IU/d, with dose escalation to elevate serum levels to more than 36 ng/mL.<h3>Main Outcome Measures</h3>Primary outcomes were knee pain severity (Western Ontario and McMaster Universities [WOMAC] pain scale, 0-20: 0, no pain; 20, extreme pain), and cartilage volume loss measured by magnetic resonance imaging. Secondary end points included physical function, knee function (WOMAC function scale, 0-68: 0, no difficulty; 68, extreme difficulty), cartilage thickness, bone marrow lesions, and radiographic joint space width.<h3>Results</h3>Eighty-five percent of the participants completed the study. Serum 25-hydroxyvitamin D levels increased by a mean 16.1 ng/mL (95% CI, 13.7 to 18.6) in the treatment group and by a mean 2.1 mg/mL (95% CI, 0.5 to 3.7) (P &lt; .001) in the placebo group. Baseline knee pain was slightly worse in the treatment group (mean, 6.9; 95% CI, 6.0 to 7.7) than in the placebo group (mean, 5.8; 95% CI, 5.0 to 6.6) (P = .08). Baseline knee function was significantly worse in the treatment group (mean, 22.7; 95% CI, 19.8 to 25.6) than in the placebo group (mean, 18.5; 95% CI, 15.8 to 21.2) (P = .04). Knee pain decreased in both groups by a mean −2.31 (95% CI, −3.24 to −1.38) in the treatment group and −1.46 (95% CI, −2.33 to −0.60) in the placebo group, with no significant differences at any time. The percentage of cartilage volume decreased by the same extent in both groups (mean, −4.30; 95% CI, −5.48 to −3.12 vs mean, −4.25; 95% CI, −6.12 to −2.39) (P = .96). There were no differences in any of the secondary clinical end points.<h3>Conclusion and Relevance</h3>Vitamin D supplementation for 2 years at a dose sufficient to elevate 25-hydroxyvitamin D plasma levels to higher than 36 ng/mL, when compared with placebo, did not reduce knee pain or cartilage volume loss in patients with symptomatic knee OA.<h3>Trial Registration</h3>clinicaltrials.gov Identifier: NCT00306774
Abstract 2592: Vitamin E forms and 13′-carboxychromanol, a long-chain metabolite of α-tocopherol, induce cell death by interrupting <i>de novo</i> sphingolipid synthesis in human cancer cells
Authors: Yumi Jang, Xiayu Rao, Qing Jiang
Journal: Cancer Research (2012)

Abstract Studies have shown that vitamin E forms including gamma-tocopherol (≥T), delta-tocopherol (≥T) and especially gamma-tocotrienol (≥TE), a major form of vitamin E in palm oil, exhibited potent anticancer activities in various types of cancer cells. 13′-carboxychromanol (13′-COOH), a long-chain metabolite of αT, has recently been shown to have anti-inflammatory activities and appears to induce apoptosis in certain type of cancer cells. However, the molecular mechanisms of the anticancer effects are not understood. In the current study, we found that 13′-COOH inhibited the growth and induced death of human colon and pancreatic cancer cells in a time- and dose-dependent manner. In these activities, 13′-COOH was more potent than αTE, which is much stronger than αT and αT. Since we have previously shown that αTE and αT induce prostate cancer cell death by modulation of sphingolipid metabolism, we investigated whether αTE and 13′-COOH have effects on sphingolipids using liquid chromatography tandem mass spectrometry. Treatment of HCT116 cells with αTE or 13′-COOH significantly increased dihydroceramides and dihydrosphingosine, two sphingoid bases in de novo synthesis pathway of sphingolipids. In contrast, sphingomyelins and ceramides remained largely unchanged after treatment. This accumulation of intracellular dihydroceramides and no apparent change of sphingomyelins suggest potential inhibition of dihydroceramide desaturase (DEGS) enzyme by these compounds. Consistently, we found that αTE inhibited the DEGS activity in a time- and dose-dependent manner in an in situ assay, while it did not have any effect on DEGS expression. These results indicate that αTE and 13′-COOH interrupt de novo synthesis of sphingolipids, which play a role in regulating cell death. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2592. doi:1538-7445.AM2012-2592
World Health Organization Discontinues Its Drinking-Water Guideline for Manganese
Authors: Seth H. Frisbie, Erika J. Mitchell, Hannah Dustin, Donald M. Maynard, Bibudhendra Sarkar
Journal: Environmental Health Perspectives (2012)

The World Health Organization (WHO) released the fourth edition of Guidelines for Drinking-Water Quality in July 2011. In this edition, the 400-µg/L drinking-water guideline for manganese (Mn) was discontinued with the assertion that because "this health-based value is well above concentrations of manganese normally found in drinking water, it is not considered necessary to derive a formal guideline value."In this commentary, we review the WHO guideline for Mn in drinking water--from its introduction in 1958 through its discontinuation in 2011.For the primary references, we used the WHO publications that documented the Mn guidelines. We used peer-reviewed journal articles, government reports, published conference proceedings, and theses to identify countries with drinking water or potential drinking-water supplies exceeding 400 µg/L Mn and peer-reviewed journal articles to summarize the health effects of Mn.Drinking water or potential drinking-water supplies with Mn concentrations > 400 µg/L are found in a substantial number of countries worldwide. The drinking water of many tens of millions of people has Mn concentrations > 400 µg/L. Recent research on the health effects of Mn suggests that the earlier WHO guideline of 400 µg/L may have been too high to adequately protect public health.The toxic effects and geographic distribution of Mn in drinking-water supplies justify a reevaluation by the WHO of its decision to discontinue its drinking-water guideline for Mn.
[592] NEOPTERIN AND ALT AS MARKERS OF INFLAMMATION IN CHRONIC HEPATITIS C PATIENTS DURING ADMINISTRATION OF THE HCV NS3-4A PROTEASE INHIBITOR TELAPREVIR (VX-950) IN COMBINATION WITH PEGINTERFERON ALFA 2a
Authors: H.C. Gelderblom, S. Zeuzem, C.T. Weegink, N. Forestier, L. McNair, S. Purdy, P.L.M. Tansen, H.W. Reesink
Journal: Journal of Hepatology (2007)
S36 Ferroportin Is Expressed In Human Pulmonary Artery Smooth Muscle Cells: Implications For Pulmonary Arterial Hypertension
Authors: L. Ramakrishnan, S. Mumby, J. Wort, G. Quinlan
Journal: Thorax (2014)

<h3>Background</h3> Pulmonary Arterial Hypertension (PAH) is a rare but fatal condition manifested by pulmonary vascular remodelling, increased pulmonary vascular resistance and right-heart failure. Disruption in iron handling and anaemia, caused by elevated iron-regulatory hormone hepcidin, is observed in PAH. Ferroportin the only known cellular iron-export protein is downregulated by hepcidin. As such, iron supplementation as a therapy is currently under clinical trial. However, it is also known that iron is both pro-oxidant and pro-proliferative. Latest evidence also points to sub-clinical haemolysis and the presence of free haemoglobin in PAH patients. We hypothesised that ferroportin would be expressed; be responsive to hepcidin challenge and have implications for the proliferation of human pulmonary artery smooth cells (hPASMCs). <h3>Methods</h3> The mRNA levels of ferroportin was measured by RT-PCR, the protein expression was detected by western-blot analysis and quantified by ELISA. The sub-cellular distribution of ferroportin was visualised by immunocytochemistry (ICC). hPASMCs were pre-incubated with or without free haemoglobin and further challenged with increasing doses of hepcidin and the proliferative responses assessed by cyquant and/or BrdU incorporation assays. Some cells were also pre-incubated with LY2928057 (monoclonal antibody against ferroportin that stabilises cellular expression, Eli-Lily) in proliferation assays. <h3>Results</h3> Basal ferroportin mRNA was detected in hPASMCs, but the mRNA levels were largely unaltered with hepcidin exposure (n = 3). A ~50KDa protein band representing ferroportin was detected under resting conditions while hepcidin challenge caused decrease in ferroportin protein levels (Figure 1). Basal ferroportin was uniformly distributed in the cells; however hepcidin treatment led to intense punctate/vesicular staining (n = 3). Finally, exposure to free haemoglobin alone or along with hepcidin increased proliferation of hPASMCs by 13.6% and 12.4% (p &lt; 0.05, n = 3) respectively. Interestingly, pre-incubation of the cells with LY2928057 partly reversed this effect. <h3>Conclusion</h3> This is the first report of ferroportin expression and regulation in hPASMCs. We suggest that targeting and manipulating the hepcidin-ferroportin axis using LY2928057 might prove a novel therapeutic approach for PAH.
Allergen-derived T-cell peptide immunotherapy in allergic asthmatic individuals is associated with induction of CD4+ IFN-gamma+/CD4+CD25+ T cells and enhanced expression of TGF-beta and Notch-1 ligands at sites of cutaneous allergen challenge
Authors: C. Alexander, J. Barkans, L. Forsyth, Q. Meng, S. Ying, A. Verhoef, J. Lamb, A.B. Kay, M. Larché
Journal: Journal of Allergy and Clinical Immunology (2003)
Best of the bed books
Authors: P. Beattie
Journal: BMJ (1979)

I remember being told during the war of a soldier who was referred to an ophthalmic specialist because he always read a book upside down. It turned out that he developed this habit in the London underground railway when he noticed that his early attempts to perform this feat attracted much interested atten tion from his fellow travellers. I find it difficult to read a book even the right way up in such crowded and noisy conditions, preferring to read in familiar surroundings, with some degree of comfort and an atmosphere of leisure. One place where these desirable conditions can (usually) be assured is in bed. But the selection of a suitable book is worth careful thought.
Transvenous defibrillation in humans via the coronary sinus.
Authors: G H Bardy, M D Allen, R Mehra, G Johnson, S Feldman, H L Greene, T D Ivey
Journal: Circulation (1990)

A consistently effective transvenous defibrillation system for use in automatic defibrillators could significantly alter the approach to patients at risk of sudden death. Transvenous defibrillation systems that use a right ventricular (RV) electrode only or an RV electrode in combination with a chest patch are relatively inefficient at applying current to the posterolateral left ventricle. An RV electrode combined with a coronary sinus (CS) electrode, however, may improve current distribution to the posterolateral left ventricle. The purpose of this investigation, therefore, was to evaluate the effectiveness and safety of a specially designed transvenous lead system with a CS electrode capable of current delivery to this relatively inaccessible region of the heart. In 20 survivors of cardiac arrest, we determined defibrillation efficacy immediately before defibrillator surgery for monophasic pulses delivered between an RV catheter electrode and a CS catheter electrode system and compared these findings with an RV catheter electrode-thoracic patch defibrillation system. Subsequently, we referenced the efficacy of both transvenous systems to an epicardial patch electrode system at the time of defibrillator implantation. The mean delivered-energy defibrillation threshold for the CS-RV electrode system was 17.5 +/- 7.9 J, which was substantially lower than the RV electrode-thoracic patch system (25.6 +/- 11.4 J, p = 0.0016 [46% more]). Defibrillation threshold voltage was 529 +/- 123 V for the CS-RV electrode system and 647 +/- 164 V (22% more) for the RV electrode-thoracic patch system (p = 0.0013).(ABSTRACT TRUNCATED AT 250 WORDS)