tbuckley/cabot-search huggingface dataset:
NHS must expect more redundancies, health secretary says
Authors: Adrian O'Dowd
Journal: BMJ (2006)

More job losses in the NHS are inevitable before matters start to improve, the health secretary for England, Patricia Hewitt, told MPs last week. 

The harsh reality of the task set by the Department of Health for the NHS to reach a financial balance by the end of the current financial year would mean a “significant number of job losses and redundancies,” said Ms Hewitt. 

MPs on the parliamentary select committee on health were quizzing Ms Hewitt as part of their inquiry into public spending on health and social services. 

She said, “In …
Prenatal Nitrate Intake from Drinking Water and Selected Birth Defects in Offspring of Participants in the National Birth Defects Prevention Study
Authors: Jean D. Brender, Peter J. Weyer, Paul A. Romitti, Binayak P. Mohanty, Mayura U. Shinde, Ann M. Vuong, Joseph R. Sharkey, Dipankar Dwivedi, Scott A. Horel, Jiji Kantamneni, John C. Huber, Qi Zheng, Martha M. Werler, Katherine E. Kelley, John S. Griesenbeck, F. Benjamin Zhan, Peter H. Langlois, Lucina Suarez, Mark A. Canfield
Journal: Environmental Health Perspectives (2013)

Previous studies of prenatal exposure to drinking-water nitrate and birth defects in offspring have not accounted for water consumption patterns or potential interaction with nitrosatable drugs.We examined the relation between prenatal exposure to drinking-water nitrate and selected birth defects, accounting for maternal water consumption patterns and nitrosatable drug exposure.With data from the National Birth Defects Prevention Study, we linked addresses of 3,300 case mothers and 1,121 control mothers from the Iowa and Texas sites to public water supplies and respective nitrate measurements. We assigned nitrate levels for bottled water from collection of representative samples and standard laboratory testing. Daily nitrate consumption was estimated from self-reported water consumption at home and work.With the lowest tertile of nitrate intake around conception as the referent group, mothers of babies with spina bifida were 2.0 times more likely (95% CI: 1.3, 3.2) to ingest ≥ 5 mg nitrate daily from drinking water (vs. < 0.91 mg) than control mothers. During 1 month preconception through the first trimester, mothers of limb deficiency, cleft palate, and cleft lip cases were, respectively, 1.8 (95% CI: 1.1, 3.1), 1.9 (95% CI: 1.2, 3.1), and 1.8 (95% CI: 1.1, 3.1) times more likely than control mothers to ingest ≥ 5.42 mg of nitrate daily (vs. < 1.0 mg). Higher water nitrate intake did not increase associations between prenatal nitrosatable drug use and birth defects.Higher water nitrate intake was associated with several birth defects in offspring, but did not strengthen associations between nitrosatable drugs and birth defects.
A comparison of three methods of measuring 99mTc-DTPA lung clearance and their repeatability
Authors: D Morrison, K Skwarski, A M Millar, W Adams, W MacNee
Journal: European Respiratory Journal (1998)

The lung clearance of technetium-99m diethylenetriamine penta-acetic acid (99mTc-DTPA) is a measure of respiratory epithelial permeability. Many factors may contribute to the wide range of normal values, including the method of correction for background activity. The aim of this study was to compare three methods of analysis, including their repeatability. 99mTc-DTPA lung clearance imaging was performed on eight nonsmokers (age 32+/-2 yrs, forced expiratory volume in one second (FEV1) 102.8+/-3.3% predicted yrs, mean+/-SEM and seven smokers (age 46+/-4 yrs, p<0.01, versus nonsmokers; FEV1 88.9+/-8.9%, p<0.05 versus nonsmokers) on two occasions each. The smokers were asked to refrain from smoking for 12 h. An uncorrected analysis was compared with two methods corrected for recirculating background activity using an intravenous correction and inter-renal and shoulder background regions of interest. The uncorrected method gave higher mean values for 50% lung clearance of 99mTc-DTPA (t50) values than the inter-renal (p<0.001) and shoulder (p<0.001) methods of correction in nonsmokers and the inter-renal method gave lower values than the shoulder-corrected method (p<0.05). In smokers there was no difference. There were no differences in mean t50 values obtained on two separate visits. There was no difference in the repeatability of the three methods of analysis. The three methods of analysis produced comparable results with no differences in repeatability.
Intermittent versus continuous oxaliplatin and fluoropyrimidine combination chemotherapy for first-line treatment of advanced colorectal cancer: results of the randomised phase 3 MRC COIN trial
Authors: Richard A Adams, Angela M Meade, Matthew T Seymour, Richard H Wilson, Ayman Madi, David Fisher, Sarah L Kenny, Edward Kay, Elizabeth Hodgkinson, Malcolm Pope, Penny Rogers, Harpreet Wasan, Stephen Falk, Simon Gollins, Tamas Hickish, Eric M Bessell, David Propper, M John Kennedy, Richard Kaplan, Timothy S Maughan
Journal: The Lancet Oncology (2011)

When cure is impossible, cancer treatment should focus on both length and quality of life. Maximisation of time without toxic effects could be one effective strategy to achieve both of these goals. The COIN trial assessed preplanned treatment holidays in advanced colorectal cancer to achieve this aim.
Obstetricians and Violence Against Women
Authors: Sonya Charles
Journal: The American Journal of Bioethics (2011)

Abstract I argue that the American Congress of Obstetricians and Gynecologists (ACOG), as an organization and through its individual members, can and should be a far greater ally in the prevention of violence against women. Specifically, I argue that we need to pay attention to obstetrical practices that inadvertently contribute to the problem of violence against women. While intimate partner violence is a complex phenomenon, I focus on the coercive control of women and adherence to oppressive gender norms. Using physician response to alcohol use during pregnancy and court-ordered medical treatment as examples, I show how some obstetrical practices mirror the attitudes of abusive men insofar as they try to coercively control women's behavior through manipulation and violence. To be greater allies in the prevention of violence against women, obstetricians should stop participating in practices that inadvertently perpetuate violence against women. Keywords: alcoholcesareancourtsobstetricspregnancyviolence
Relation between severity of mitral valve disease and results of routine lung function tests in non-smokers.
Authors: K M Rhodes, K Evemy, S Nariman, G J Gibson
Journal: Thorax (1982)

The effects of mitral valve disease on lung function have been studied in 26 non-smoking patients by relating values for lung volumes and carbon monoxide transfer factor (TLCO) to various indices of cardiac function measured at catheterisation. In general, more severe mitral disease was associated with greater abnormalities of lung function. Reductions of the one-second forced expiratory volume, vital capacity, TLCO and transfer coefficient, and increase in residual volume were all significantly related to the severity of mitral valve disease. In addition, the cardiothoracic ratio, measured radiographically, showed an inverse correlation with both vital capacity and total lung capacity. Although some of the consequences of mitral valve disease on lung function resemble those of primary airway disease, useful distinguishing points are the relative normality of the forced expiratory ratio and the absence of an increase in total lung capacity.
Perceived age as clinically useful biomarker of ageing: cohort study
Authors: K. Christensen, M. Thinggaard, M. McGue, H. Rexbye, J. v B Hjelmborg, A. Aviv, D. Gunn, F. van der Ouderaa, J. W Vaupel
Journal: BMJ (2009)

To determine whether perceived age correlates with survival and important age related phenotypes.Follow-up study, with survival of twins determined up to January 2008, by which time 675 (37%) had died.Population based twin cohort in Denmark.20 nurses, 10 young men, and 11 older women (assessors); 1826 twins aged >or=70.Assessors: perceived age of twins from photographs. Twins: physical and cognitive tests and molecular biomarker of ageing (leucocyte telomere length).For all three groups of assessors, perceived age was significantly associated with survival, even after adjustment for chronological age, sex, and rearing environment. Perceived age was still significantly associated with survival after further adjustment for physical and cognitive functioning. The likelihood that the older looking twin of the pair died first increased with increasing discordance in perceived age within the twin pair-that is, the bigger the difference in perceived age within the pair, the more likely that the older looking twin died first. Twin analyses suggested that common genetic factors influence both perceived age and survival. Perceived age, controlled for chronological age and sex, also correlated significantly with physical and cognitive functioning as well as with leucocyte telomere length.Perceived age-which is widely used by clinicians as a general indication of a patient's health-is a robust biomarker of ageing that predicts survival among those aged >or=70 and correlates with important functional and molecular ageing phenotypes.
Phase II trial to study the efficacy and toxicity of combined docetaxel (D), carboplatin (C), +/- trastuzumab (T) administered weekly (W) in patients (pts) with HER2/neu +/- metastatic breast cancer (MBC)
Authors: S. E. Waintraub
Journal: Journal of Clinical Oncology (2005)

832 Background: D as a single agent is associated with the highest reported response rates (RR) and response duration in MBC. Though D is commonly delivered a q 3 week dose, newer studies have shown that W delivery of the drug is safe and associated with an equal or greater RR and less toxicity. C is an active agent in MBC and has shown synergy with the taxanes. Synergism has been established between the taxanes, C and T. The use of D+C on a q3 week basis +/- WT in HER2neu +/- MBC has been shown to have very high RR. As it appears that W administration of a combination of Paclitaxel (P), C and T results in higher RR and less toxicity than q 3 week P + C with WT in HER2neu+ pts, the question is whether this is also true with D based regimens. Methods: We are studying the safety and efficacy of WD at 25mg/m2 iv and WC at AUC 2 iv, given days 1, 8, 15 q 28 days, with WT given iv only for FISH + HER2neu pts with a loading dose of 4mg/kg on week 1 and then 2mg/kg/week in previously untreated women with MBC. All pts receive 10mg dexamethasone pre-medication intravenously one hour before D administration. The objectives of the study are to evaluate RR, safety, and time to progression (TTP). All pts are restaged q 8 weeks. Results: We have to date enrolled 23 pts. Of the 20 evaluable pts, there is 1 CR, 3PR, 9SD, 7PD, yielding a 65% clinical benefit (CR, PR, SD) and a 20% RR. Of the 7 evaluable HER2neu+ pts on the DCT regimen, there are 3 PR, 2SD and 2PD, yielding a 43% RR and a median TTP of 217 days. Of the 13 evaluable pts on DC alone there are 7SD, 1CR, and 5PD, yielding a 62%CB, but only an 8% RR with a median TTP of 118 days. Toxicity: The regimen was well tolerated with no significant toxicity. Conclusions: Though q 3 week DC+/-T is established as highly active for MBC, the efficacy of WDC+/-T needs further testing. Clearly this is a safe and tolerable regimen, and it may be that the efficacy of the WDC is best seen in the HER2neu+ patients when T is also administered. Enrollment continues and updated data will be presented. A trial of q 3 week DC+/-T vs WDC+/-T is warranted to assess the best way to use DC in MBC. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Bristol-Myers Squibb Bristol-Myers Squibb
Response to Letters Regarding Article, “Average Daily Blood Pressure, Not Office Blood Pressure, Is Associated With Progression of Cerebrovascular Disease and Cognitive Decline in Older People”
Authors: William B. White, Patrick Campbell, Leslie Wolfson, Dorothy B. Wakefield, Julia Schmidt, Charles B. Hall, Nicola Moscufo, Charles R. Guttmann, Richard F. Kaplan, Godfrey Pearlson
Journal: Circulation (2012)

Is Associated With Progression of Cerebrovascular Disease and Cognitive Decline in Older People"The issue of diastolic blood pressure (BP) effects is a valid one, as noted by Drs Castilla-Guerra and Fernandez-Moreno.Because systolic BP has typically been recognized as the BP parameter of interest (and cardiovascular risk) in older patients, we chose to focus on systolic measures in our study.Analyses of changes in diastolic BP relative to the white matter hyperintensity (WMH) lesions and 2 of the cognitive parameters at 24 months of follow-up did demonstrate significant relationships for 24-hour, awake, and sleep diastolic BP, but the clinic diastolic BP data did not.These findings are similar to our findings for systolic BP. 1 There was no relationship between changes in postural BP and WMH or functional outcomes in our study.The second point made by Castilla-Guerra and Fernandez-Moreno concerns the differential effects of ambulatory BP on periventricular WMH versus deep WMH, as suggested by an earlier study. 2Although this could result in disparate compromise of motor and cognitive function, the differential impact on periventricular WMH and deep WMH is still unclear.Although differences between the 2 white matter lesion subtypes have been reported, 2,3 there is also evidence to suggest that the distinction may not be justified.The volumes of periventricular WMH and deep WMH are reported as highly correlated, and it has been suggested that the differentiation is entirely arbitrary. 4Additionally, fiber tracts may cross both periventricular and deep white matter and thus are potentially compromised by lesions in both locations. 5It is for these reasons we did not separate the effects of ambulatory blood pressure on periventricular WMH and deep WMH.Lagro et al commented that we did not take BP variability into account, but this is actually not the case.As we reported in the article, 1 24-hour mean BP variability, awake BP variability, and sleep BP variability were not associated with WMH or the functional parameters.Visit-to-visit clinic BP variability did not seem appropriate, considering that we only had a baseline and 2-year data set.We agree that diffusion tensor imaging could yield important new information, and we are in the process of analyzing the associations among clinic and 24-hour BP with data derived from diffusion tensor imaging, and outcomes from this cohort at 2 and 4 years of follow-up, as well.
Gender Differences in Prevalence, Risk, and Clinical Correlates of Alcoholism Comorbidity in Bipolar Disorder
Authors: Mark A. Frye, Lori L. Altshuler, Susan L. McElroy, Trisha Suppes, Paul E. Keck, Kirk Denicoff, Willem A. Nolen, Ralph Kupka, Gabriele S. Leverich, Chad Pollio, Heinz Grunze, Jorge Walden, Robert M. Post
Journal: American Journal of Psychiatry (2003)

OBJECTIVE: The prevalence of lifetime alcohol abuse and/or dependence (alcoholism) in patients with bipolar disorder has been reported to be higher than in all other axis I psychiatric diagnoses. This study examined gender-specific relationships between alcoholism and bipolar illness, which have previously received little systematic study. METHOD: The prevalence of lifetime alcoholism in 267 outpatients enrolled in the Stanley Foundation Bipolar Network was evaluated by using the Structured Clinical Interview for DSM-IV. Alcoholism and its relationship to retrospectively assessed measures of the course of bipolar illness were evaluated by patient-rated and clinician-administered questionnaires. RESULTS: As in the general population, more men (49%, 57 of 116) than women with bipolar disorder (29%, 44 of 151) met the criteria for lifetime alcoholism. However, the risk of having alcoholism was greater for women with bipolar disorder (odds ratio=7.35) than for men with bipolar disorder (odds ratio=2.77), compared with the general population. Alcoholism was associated with a history of polysubstance use in women with bipolar disorder and with a family history of alcoholism in men with bipolar disorder. CONCLUSIONS: This study suggests that there are gender differences in the prevalence, risk, and clinical correlates of alcoholism in bipolar illness. Although this study is limited by the retrospective assessment of illness variables, the magnitude of these gender-specific differences is substantial and warrants further prospective study.
Multimodal Magnetic Resonance Imaging and <sup>18</sup>F-L-Dihydroxyphenylalanine Positron Emission Tomography in Early Characterization of Pseudoresponse and Nonenhancing Tumor Progression in a Pediatric Patient With Malignant Transformation of Ganglioglioma Treated With Bevacizumab
Authors: Giovanni Morana, Arnoldo Piccardo, Maria Luisa Garrè, Paolo Nozza, Alessandro Consales, Andrea Rossi
Journal: Journal of Clinical Oncology (2012)
Epinephrine and Dexamethasone in Children with Bronchiolitis
Authors: Amy C Plint, David W Johnson, Hema Patel, Natasha Wiebe, Rhonda Correll, Rollin Brant, Craig Mitton, Serge Gouin, Maala Bhatt, Gary Joubert, Karen J L Black, Troy Turner, Sandra Whitehouse, Terry P Klassen
Journal: New England Journal of Medicine (2009)

Although numerous studies have explored the benefit of using nebulized epinephrine or corticosteroids alone to treat infants with bronchiolitis, the effectiveness of combining these medications is not well established.
Omega-3 Fatty Acids and Cardiac Arrhythmias: Prior Studies and Recommendations for Future Research
Authors: Barry London, Christine Albert, Mark E. Anderson, Wayne R. Giles, David R. Van Wagoner, Ethan Balk, George E. Billman, Mei Chung, William Lands, Alexander Leaf, John McAnulty, Jeffrey R. Martens, Rebecca B. Costello, David A. Lathrop
Journal: Circulation (2007)

C ompared with prehistoric times, the ratio of n-6 to n-3 fatty acids in the modern diet has increased Ϸ10-fold to 20:1. 1,24][5] This has led to the recommendation by the American Heart Association that all adults eat fatty fish at least 2 times per week and that patients with coronary heart disease (CHD) are advised to consume Ϸ1 g/d of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) combined. 6,7The evidence base is not entirely consistent, and a number of randomized trials have failed to show a protective effect of n-3 PUFAs against arrhythmias. 8 -10 This has led to some uncertainty regarding the appropriate recommendations for their use. 11he present review originates from the Omega-3 Fatty Acids and Their Role in Cardiac Arrhythmogenesis Workshop sponsored by the National Heart, Lung, and Blood Institute and the Office of Dietary Supplements on August 29 -30, 2005, and includes the findings from the recently published trials.Data from epidemiological studies, randomized clinical trials, animal studies, and basic science mechanistic studies on the role of n-3 PUFAs in arrhythmia prevention are examined.Areas in which the data are conflicting or our current knowledge is lacking are emphasized.
Case fatality ratio and mortality rate trends of community-onset Staphylococcus aureus bacteraemia
Authors: S. Tom, J.C. Galbraith, L. Valiquette, G. Jacobsson, P. Collignon, H.C. Schøheyder, M. Søgaard, K.J. Kennedy, J.D. Knudsen, C. Østergaard, O. Lyytikäinen, K.B. Laupland
Journal: Clinical Microbiology and Infection (2014)
Effect of iron and desferoxamine on cell growth andin vitro ferritin synthesis in human hepatoma cell lines
Authors: Hie-Won L. Hann, Mark W. Stahlhut, Christine L. Hann
Journal: Hepatology (1990)

To investigate the effects of iron supplementation on hepatoma cell growth, cells from a human hepatoma cell line, PLC/PRF/5, were grown in RPMI 1640 supplemented with 0, 10 and 20 μg/ml of FeSO4 and harvested weekly. At the end of 6 wk culture, cell mass measured 9.6, 14.7 and 13.2 gm, respectively. Amounts of ferritin from these cell masses were 0 (undetectable), 0.89 and 2.27 μg/gm of cells. To study the effects of iron deprivation of hepatoma cells, three human hepatoma cell lines (PLC/PRF/5, Hep G2 and Hep 3B) were incubated in tissue culture medium mixed with graded amounts of an ironchelating agent, desferoxamine, for 48 to 96 hr at 37°C with 5% CO2. Over 50% cell death in PLC/PRF/5 cells and 30% to 50% cell death in Hep G2 and Hep 3B cells were observed 48 to 72 hr after exposure to desferoxamine. Addition of ferric citrate partially reversed the cytotoxic effect of desferoxamine. On the other hand, viability of control cells, human diploid cell line (WI 38), was not affected by desferoxamine. Even after 96 hr exposure to desferoxamine, cell death was only 2% to 4%. These results suggest that (a) iron enhances tumor cell growth, (b) iron induces increased ferritin synthesis by tumor cells in vitro and (c) iron depletion causes tumor cell death but has little effect on normal human diploid cells. These findings should be considered when designing treatment of patients with hepatoma. Iron oversupply in patients with cancer might enhance tumor growth and adversely affect cancer therapy. Iron chelation with desferoxamine might have a place in the treatment of patients with hepatoma in conjunction with other anticancer agents.(HEPATOLOGY 1990; 11:566:569.)
Characterization of occult hepatitis B virus from blood donors carrying genotype A2 or genotype D strains
Authors: Daniel Candotti, Piotr Grabarczyk, Paola Ghiazza, Roberto Roig, Natalia Casamitjana, Paola Iudicone, Michael Schmidt, Arthur Bird, Robert Crookes, Ewa Brojer, Michelina Miceli, Azin Amiri, Chengyao Li, Jean-Pierre Allain
Journal: Journal of Hepatology (2008)
New strategies to improve exercise tolerance in chronic obstructive pulmonary disease
Authors: N. Ambrosino, S. Strambi
Journal: European Respiratory Journal (2004)

Breathlessness is the most common symptom limiting exercise in patients with chronic obstructive pulmonary disease (COPD). Exercise training can improve both exercise tolerance and health status in these patients, intensity being of key importance. Nevertheless, in these patients extreme breathlessness and/or peripheral muscle fatigue may prevent patients from higher levels of intensity. In this review article the literature concerning the different ways to optimise exercise tolerance in patients with COPD, with the objective of enhancing the tolerance to higher exercise training intensity, is summarised. Continuous positive airway pressure and different modalities of noninvasive positive pressure ventilation (NPPV) may reduce breathlessness and increase exercise tolerance in these patients. Respiratory muscle unloading and reduction in intrinsic positive end-expiratory pressure have been considered among mechanisms underlying these effects. Nevertheless, the role of NPPV in pulmonary rehabilitation, if any, is still controversial. The addition of nocturnal domiciliary NPPV during a daily exercise programme in patients with severe COPD resulted in an improvement in exercise tolerance and quality of life. In patients with severe COPD application of electrical stimulation combined with active limb mobilisation significantly improved muscle strength, and interval training has been shown capable of inducing physiological training effects. Oxygen supplementation in patients who do not desaturate during exercise seems to be the most promising treatment, since it allows for higher exercise intensities and, therefore, superior training efficacy. In conclusion, further studies are needed to define the appropriate patients in order to generalise such interventions. The modalities discussed should be used as adjuncts to a well designed comprehensive respiratory rehabilitation programme.