tbuckley/cabot-search huggingface dataset:
Underwater birth and neonatal respiratory distress:Case report does not constitute reliable evidence
Authors: Elizabeth Cluett, Rona McCandlish, Ethel Burns, Cheryl Nikodem
Journal: BMJ (2005)

The General Medical Council and the future of revalidation GMC member respondsEditor-Esmail and Kmietowicz give an inaccurate account of the General Medical Council's policy development on revalidation, ignoring an iterative process with interested parties since 1998 in an attempt to introduce the most fundamental change to medical regulation since its foundation in 1858. 1 2 The GMC clearly has had regard to the legitimate interests of three principal groups-government and the NHS, patients and the public, and the various tribes that make up the UK medical profession.Despite suggestions to the contrary, an initial exploratory meeting on revalidation convened by Sir Donald Irvine in June 1998 was held in the context of a high profile professional conduct case, but well before the Bristol inquiry report and absolutely nothing to do with Rodney Ledward or, indeed, Harold Shipman.It was recognised then that some doctors were not keeping fully up to date nor were they indulging in reflective practice.Irvine correctly proposed that there was a need to make registration with the GMC more meaningful to the public than a mere recognition that doctors had reached a certain standard of professional knowledge in their early 20s.Both articles promote the idea that the doctors' regulator should be filling the vacuum within the NHS created by its failing to fulfil its public responsibility to monitor doctors' clinical standards.Clinical governance is now, slowly, being developed and eventually will extend from systems and teams to individuals-but is it reasonable, as both authors postulate, that such monitoring should become the financial and moral responsibility of the GMC sitting in London and Manchester rather than local managers at the coalface?Although revalidation is a continuing process, it becomes summative only every five years.The NHS and its local systems must not be allowed to abrogate their responsibility for the safety of patients on a day to day basis.Nor should they demand that the GMC and its prime function of assuring fitness to practise and the meaning of the medical register be inappropriately promoted as the first line of defence for the maintenance of clinical quality and safety.
Implications of Helicobacter pylori Serological Titer for the Histological Severity of Antral Gastritis
Authors: B.-S. Sheu, S.-C. Shiesh, H.-B. Yang, I.-J. Su, C.-Y. Chen, X.-Z. Lin
Journal: Endoscopy (1997)

Background and Study Aims: We attempted to determine whether the serological titer of anti-Helicobacter pylori (HP) immunoglobulin (IgG) would be capable of predicting the presence of ulcer, or would correlate with the histological grading of gastritis in patients with dyspepsia.
Finding the Right Dose for Cancer Therapeutics—Can We Do Better?
Authors: Eric H. Rubin, Keaven M. Anderson
Journal: Clinical Cancer Research (2010)

Unlike other diseases, dose-selection for cancer therapeutics is often based on the maximum-tolerated dose in phase 1 studies involving relatively few patients. In this issue of Clinical Cancer Research, Jain and colleagues provide evidence that lower doses may be as effective as maximum-tolerated doses in the treatment of cancer patients.
Phase I and Pharmacokinetic Study of YM155, a Small-Molecule Inhibitor of Survivin
Authors: Anthony W. Tolcher, Alain Mita, Lionel D. Lewis, Christopher R. Garrett, Elizabeth Till, Adil I. Daud, Amita Patnaik, Kyri Papadopoulos, Chris Takimoto, Pamela Bartels, Anne Keating, Scott Antonia
Journal: Journal of Clinical Oncology (2008)

To determine the maximum-tolerated dose (MTD) and assess the safety, pharmacokinetics, and preliminary evidence of antitumor activity of YM155, a small-molecule inhibitor of survivin.Patients with advanced solid malignancies or lymphoma were treated with escalating doses of YM155 administered by 168-hour continuous intravenous infusion (CIVI). Plasma and urine samples were assayed to determine pharmacokinetic parameters and excretion.Forty-one patients received 127 cycles of YM155 at doses ranging from 1.8 to 6.0 mg/m(2)/d by 168-hour CIVI every 3 weeks. Overall, the most common grade 1 to 2 toxicities were stomatitis, pyrexia, and nausea, whereas grade 3 and 4 toxicities were rare. Reversible elevation in serum creatinine in two patients, with one developing acute tubular necrosis, was dose-limiting at 6.0 mg/m(2). The MTD was 4.8 mg/m(2). At the MTD, the mean steady-state concentration, clearance, volume of distribution at steady-state, and terminal elimination half-life were 7.7 ng/mL, 47.7 L/h, 1,763 L, and 26 hours, respectively. One complete and two partial responses lasting 8, 24+ and 48+ months occurred in three patients with non-Hodgkin's lymphoma, two patients with hormone- and docetaxel-refractory prostate cancer had prostate-specific antigen responses, and one patient with non-small-cell lung cancer had a minor response. CONCLUSION YM155 can be administered safely at 4.8 mg/m(2)/d 168 hours CIVI every 3 weeks. The absence of severe toxicities, attainment of plasma concentrations active in preclinical models, and compelling antitumor activity warrant further disease-directed studies of this agent alone and in combination with chemotherapy in a broad array of tumors.
Treatment of community-acquired pneumonia: a randomized comparison of sparfloxacin, amoxycillin-clavulanic acid and erythromycin
Authors: H Lode, J Garau, C Grassi, J Hosie, G Huchon, N Legakis, S Segev, G Wijnands
Journal: European Respiratory Journal (1995)

The treatment of community-acquired pneumonia is empirical in most cases and must cover a wide range of potential pathogens, such as Streptococcus pneumoniae, including penicillin-resistant strains, Haemophilus influenzae and intracellular microorganisms. The objective of this double-blind, randomized, parallel group study was to compare the efficacy and safety of sparfloxacin (400 mg loading dose, followed by 200 mg o.d.) with that of oral amoxycillin-clavulanic acid (500/125 mg t.i.d.) or oral erythromycin (1 g b.i.d.), during 7-14 days in 808 patients with confirmed community-acquired pneumonia. The overall success rates for sparfloxacin (87%), amoxycillin-clavulanic acid (80%) and erythromycin (85%) were similar in evaluable patients, and the equivalence hypothesis used for the statistical analysis showed at least an equivalent efficacy for the three antibiotics tested. The analysis of microbiologically documented infections (40% of the patients) showed that overall success rates were similar for S. pneumoniae and H. influenzae infections. Treatment withdrawal was necessary in 3.5, 2.5 and 7.7% of the patients treated with sparfloxacin, amoxycillin-clavulanic acid and erythromycin, respectively. This study indicates that sparfloxacin was at least as effective as amoxycillin-clavulanic acid or erythromycin in the treatment of mild-to-moderate community-acquired pneumonia and that the adverse effects were similar in the three groups.
THE PENTOSE PHOSPHATE PATHWAY IN HUMAN AND ANIMAL SKIN
Authors: A. JARRETT
Journal: British Journal of Dermatology (2006)

Journal Article THE PENTOSE PHOSPHATE PATHWAY IN HUMAN AND ANIMAL SKIN Get access A. JARRETT A. JARRETT Dermatology Department, University College Hospital Medical School, University Street, London, W.G.1 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 84, Issue 6, 1 June 1971, Pages 545–553, https://doi.org/10.1111/j.1365-2133.1971.tb02544.x Published: 01 June 1971 Article history Accepted: 01 February 1971 Published: 01 June 1971
Two Consultations: Cognitive Services vs Procedures-Reply
Authors: James A. Cowan
Journal: JAMA (1986)

<h3>In Reply.—</h3> Dr Brewer identifies the issue that first prompted me to write "Two Consultations." Cognitive services such as hospital care and consultation are sometimes poorly performed, but it is difficult to evaluate the quality of a cognitive service. I believe that this issue needs to be addressed before the imbalance between cognitive and procedural fees can be corrected. A common cognitive service is to assess a patient's problems by obtaining a history, performing a physical examination, and evaluating the information that is obtained. This service, if rendered by a second-year medical student, will probably be tedious, by rote, and, in the end, erroneous in both content and inference, while the same service rendered by an experienced physician may be efficient and comforting to the patient and yield correct diagnoses and effective therapy. Everyone knows the difference between these services "when they see it," but it is difficult to draw
Randomised controlled trials: tests of interaction
Authors: P. Sedgwick
Journal: BMJ (2014)

Researchers evaluated the efficacy of an intervention based in general practice on the occurrence of repeat episodes of deliberate self harm.1 A cluster randomised controlled trial study was performed, involving 98 general practices. The intervention consisted of a letter from the general practitioner inviting the patient to consult, with guidelines on the assessment and management of deliberate self harm for the GP to use in consultations. The control treatment was standard care. Participants were patients registered with one of the study practices who had attended an emergency department after an episode of deliberate self harm (referred to as the index episode). A total of 1932 patients were recruited; 964 were allocated to the intervention and 968 to the control.

The primary outcome was a repeat episode of deliberate self harm in the 12 months after the index episode (categorised as yes or no). Although a higher proportion of patients had a repeat episode of deliberate self harm in the intervention group than in the control group, the difference was not significant (21.9% (n=211) v 19.5% (n=189); odds ratio 1.2, 95% confidence interval 0.9 to 1.5; P=0.16). No significant interaction existed between the treatment group and the patient’s sex (P=0.51) or the method used to cause self harm (categorised as poisoning, laceration, or other) (P=0.64). A significant interaction existed between the treatment group and a history of deliberate self harm before the index episode (categorised as yes or no) (P=0.017). A subsequent subgroup analysis showed an apparent benefit of the intervention for patients with a history of deliberate self harm (0.57, 0.33 to 0.98), but an adverse effect for patients …
Meiotic origin of trisomy in neoplasms: evidence in a case of erythroleukaemia
Authors: A Minelli, C Morerio, E Maserati, C Olivieri, C Panarello, L Bonvini, A Leszl, C Rosanda, E Lanino, C Danesino, F Pasquali
Journal: Leukemia (2001)
Phylogenetic Star Contraction Applied to Asian and Papuan mtDNA Evolution
Authors: Peter Forster, Antonio Torroni, Colin Renfrew, Arne Röhl
Journal: Molecular Biology and Evolution (2001)

In the past decade, mitochondrial DNA (mtDNA) of 826 representative East Asians and Papuans has been typed by high-resolution (14-enzyme) restriction fragment length polymorphism (RFLP) analysis. Compared with mtDNA control region sequencing, RFLP typing of the complete human mitochondrial DNA generally yields a cleaner phylogeny, the nodes of which can be dated assuming a molecular clock. We present here a novel star contraction algorithm which rigorously identifies starlike nodes (clusters) diagnostic of prehistoric demographic expansions. Applied to the Asian and Papuan data, we date the out-of-Africa migration of the ancestral mtDNA types that founded all Eurasian (including Papuan) lineages at 54,000 years. While the proto-Papuan mtDNA continued expanding at this time along a southern route to Papua New Guinea, the proto-Eurasian mtDNA appears to have drifted genetically and does not show any comparable demographic expansion until 30,000 years ago. By this time, the East Asian, Indian, and European mtDNA pools seem to have separated from each other, as postulated by the weak Garden of Eden model. The east Asian expansion entered America about 25,000 years ago, but was then restricted on both sides of the Pacific to more southerly latitudes during the Last Glacial Maximum around 20,000 years ago, coinciding with a chronological gap in our expansion dates. Repopulation of northern Asian latitudes occurred after the Last Glacial Maximum, obscuring the ancestral Asian gene pool of Amerinds.
PSYCHOSES RESEMBLING SCHIZOPHRENIA OCCURRING WITH EMOTIONAL STRESS AND ENDING IN RECOVERY
Authors: HARRY A. PASKIND, MEYER BROWN
Journal: American Journal of Psychiatry (1940)

Five cases are described of a psychosis occurring under emotional stress and ending in recovery. This psychosis resembles schizophrenia at many points and differs from schizophrenia in some aspects, especially in the course. As a possible clarification of the nosologic position of this psychosis it is suggested that it may involve the same mechanism as does schizophrenia, but is produced by different etiologic factors: this may explain similar symptoms but differing course, and may indicate that these psychoses deserve a separate nosological designation. We believe it not unlikely that this psychosis is not uncommonly produced by the stresses of civil life but that such cases are thought to be schizophrenia, and that the recognition of such cases may materially alter statistics regarding remissions of treated and untreated patients with schizophrenia.
Protocol-based nurse management of type 2 diabetes did not differ from usual GP care for HbA<sub>1c</sub>levels
Authors: Timothy Kenealy, Nicolette Sheridan
Journal: Annals of Internal Medicine (2011)

Source Citation Houweling ST, Kleefstra N, van Hateren KJ, et al. Can diabetes management be safely transferred to practice nurses in a primary care setting? A randomised controlled trial. J Clin Nurs. 2011;20:1264-72. 21401764
A2.15 Relative Overexpression of Transmembrane Versus Soluble TNF in Human and Experimental Spondyloarthritis
Authors: Leonie M van Duivenvoorde, Carmen A Ambarus, Huriatul Masdar, Melissa N van Tok, Paul P Tak, Nataliya G Yeremenko, Dominique L Baeten
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Macrophages and their pro-inflammatory cytokines, including TNF, are pivotal mediators of chronic synovitis in rheumatoid arthritis (RA) as well as spondyloarthritis (SpA). Despite similar levels of synovial macrophage infiltration and similar clinical responses to TNF blockade in both diseases, SpA is characterised by a more pronounced infiltration with alternatively activated CD163+ macrophages and ongoing osteoproliferation. This study aimed to investigate whether these differences were related to a differential expression and/or function of TNF between both diseases. <h3>Methods</h3> Expression of transmembrane TNF (tmTNF) and soluble TNF (sTNF) was measured in IFN-γ, IL-4 or IL-10 polarised macrophages obtained from healthy donors. Expression of TNF and its receptors was measured in synovial fluid (SF) and synovial tissue biopsies (ST) of actively inflamed knee joints of SpA and RA patients. Mice transgenically overexpressing tmTNF (TgA86) were evaluated for spondylitis and arthritis. <h3>Results</h3> In vitro polarisation with IL-10 specifically induced the expression of CD163 on macrophages, mimicking the phenotype in SpA synovitis. IL-10 and IL-4 polarised macrophages secreted less TNF than classically, IFN-γ-polarised macrophages (p &lt; 0.05). In contrast, IL-4 polarised macrophages expressed more tmTNF compared to the IFN-γ polarised macrophages (p &lt; 0.05), with a similar trend for IL-10 polarised macrophages. In line with these in vitro data, the sTNF SF levels were significantly lower in SpA compared to RA (p = 0.01) despite similar TNF mRNA levels in ST. This was not related to higher expression of TNF receptors as both TNFR1 and TNFR2 were similarly expressed in ST, both at protein and mRNA levels. On the contrary, the SF levels of sTNFR1 and sTNFR2, which are both cleaved from the cell membrane by the same enzyme as tmTNF, were even decreased in SpA versus RA. Investigating the potential pathophysiological role of relative overexpression of tmTNF versus sTNF in vivo, clinical analysis revealed that tmTNF transgenic mice developed arthritis, resulting in deformation and loss of grip strength, and spondylitis as evidenced by crinkled tails with a 100% incidence. Axial and peripheral joint inflammation was confirmed by histology. In contrast to mouse strains overexpressing sTNF, tmTNF tg mice did not develop systemic disease and weight loss and showed clear signs of osteoproliferation on histology. <h3>Conclusions</h3> tmTNF is relatively overexpressed by CD163+ alternatively polarised macrophages in SpA synovitis and leads to an axial and peripheral SpA phenotype in transgenic mice.
The government's response to the Francis report does not mention death certification and inquests
Authors: P. N. Furness
Journal: BMJ (2013)

The recent editorial missed one area omitted from the government’s response—death certification and inquests.1

Francis awarded this an entire chapter. He praises the reforms in the Coroners and Justice Act 2009 and assumes that they will soon be implemented. Is that naive?

The reforms require (amazingly, for the first time) that an independent person asks the bereaved …
Indian paediatricians to be trained in managing childhood TB
Authors: S. Bagcchi
Journal: BMJ (2014)

The Indian Academy of Pediatrics has announced a new initiative to train paediatricians across the country in the management of childhood tuberculosis.

The academy is working in partnership with the Child TB Division of the Ministry of Health and Family Welfare and the Revised National Tuberculosis Control Program to develop a two day, case based interactive module to standardise the management of childhood tuberculosis across India.

In an article, published in the 15 April issue of Indian Pediatrics , the academy’s national president, Vijay Yewale, said, “The pediatric TB …
Quality failures in the NHS
Authors: Chris Ham
Journal: BMJ (2008)

Changes in leadership and culture are needed to improve learning from mistakes

The report of the committee of enquiry into Ely Hospital, Cardiff, in 1969, was the first major inquiry into quality failures in the National Health Service.1 Thirty years later the report of the expert group chaired by the chief medical officer, An Organisation with a Memory , emphasised the need for the NHS to learn from its mistakes, and to be more systematic in acting on inquiry reports.2 A new analysis by the Healthcare Commission builds on these reports by summarising lessons from 13 major investigations it has undertaken since 2004.3

Readers of the commission’s report can be forgiven if they experience a strong sense of deja vu. Although the investigations it undertook covered a wide range of services in different parts of the country, the general themes that emerge are depressingly familiar. The quality failures examined resulted from the interplay of several factors, including weak leadership, conflicting targets, inadequate use of data, and lack of teamwork. One of the problems highlighted in the commission’s report is the poor standard of care found on general hospital wards, including examples of patients …
Reply to R.S. Mehta et al
Authors: Judith Hugh, John Hanson, Maggie Cheang, Torsten Nielsen, Charles Perou, Charles Dumontet, John Reed, Maryla Krajewska, Isabelle Treilleux, Matthieu Rupin, Emmanuelle Magherini, John Mackey, Miguel Martin, Charles Vogel
Journal: Journal of Clinical Oncology (2009)
Conservative Treatment of Massive Pulmonary Embolism
Authors: Dean A. Emanuel
Journal: JAMA (1966)

SPONTANEOUS resolution of massive pulmonary embolism has been reported.<sup>1</sup>Important questions, however, remain to be answered. Do these emboli produce a permanent change in pulmonary function and pulmonary vascular resistance? Is pulmonary embolectomy ever indicated except as a life-saving procedure? What procedures are necessary to prevent further embolization? How rapidly does resolution of. the emboli take place? It is apparent that a large body of information is a necessity before these problems can be solved. In the case to be reported the large emboli present in the main pulmonary artery and its right and left branches resolved spontaneously. Four pulmonary angiograms were performed providing adequate roentgen demonstration of the emboli and their resolution. Subsequent pulmonary-function studies failed to reveal any adverse effect of the massive emboli. <h3>Report of a Case</h3> A 40-year-old white man suffered a fracture of his left tibia and fibula on Nov 9, 1964. Seven days
Studies on Parainfluenza Type 2 and 4 Viruses Obtained from Patients with Common Colds
Authors: D. A. J. Tyrrell, M. L. Bynoe
Journal: BMJ (1969)

Four agents which were obtained from adults with common colds were cultivated and identified-one was influenza type B and the others were parainfluenza viruses of types 2 and 4. Their cultivation was assisted by the use of organ cultures of human embryo tracheal or nasal epithelium. They infected and caused typical common colds in volunteers.
Acute simulated ischaemia produces both inhibition and activation of K+ currents in isolated ventricular myocytes
Authors: P. Henry, A. Popescu, M. Puceat, M. E. Hinescu, D. Escande
Journal: Cardiovascular Research (1996)

The aim was to investigate the effects of acute ischaemia on cardiac repolarizing K+ currents.We developed a model of acute ischaemia in isolated rat ventricular myocytes transiently surrounded with a mineral oil droplet. During ischaemic challenges, we recorded intracellular pH using the fluorescent probe seminaphthorhodafluor-1 (SNARF-1) and whole-cell K+ currents using the patch-clamp technique.Decrease in intracellular pH (pH1) during simulated ischaemia was dependent upon the extracellular proton buffer used (pH1 decreased from 7.44 +/- 0.02 to 7.16 +/- 0.04 in a Hepes-buffered medium and from 7.08 +/- 0.04 to 6.56 +/- 0.07 with bicarbonate buffer). In Hepes, action potential duration initially lengthened and then shortened under the effects of ischaemia. Initial action potential duration lengthening was concomitant with a block of the inward rectifier K+ current, whereas late shortening corresponded with the activation of the ATP-sensitive K+ current. Similar changes occurred in bicarbonate buffer although with different amplitudes and kinetics. Patch-clamp experiments also showed inhibition of the transient outward K+ current. Brief transient episodes of ischaemia activated ATP-sensitive K+ current in only 20% of control cells (n = 21) but in 100% of cells treated with 15 microM cromakalim (n = 9).(i) Simulated ischaemia produces complex effects on repolarizing K+ currents including both inhibition and activation; (ii) cromakalim accelerates activation of ATP-sensitive K+ current during simulated ischaemia.
Mycobacterium chelonae valve endocarditis resulting from contaminated biological prostheses
Authors: T.M.V. Strabelli, Rinaldo Focaccia Siciliano, Jussara Bianchi Castelli, L.M.M.F. Demarchi, Sylvia Cardoso Leão, Cristina Viana-Niero, Kozue Miyashiro, Roney Orismar Sampaio, Max Grinberg, David Everson Uip
Journal: Journal of Infection (2010)