tbuckley/cabot-search huggingface dataset:
Doctors should receive compulsory training on human error, MPs told
Authors: A. O'Dowd
Journal: BMJ (2008)

NHS staff should have compulsory training in “human factors” and non-technical skills as part of a drive to boost patient safety, MPs have been told.

Knowledge of human factors is crucial to maintain patient safety, the MPs in the parliamentary health select committee were told this week, as part of their inquiry into patient safety.

Giving evidence was Martin Bromiley, chairman of the clinical human factors group, an independent charity that comprises academics and clinicians who are experts in human factors, who aim to identify and promote best practice to improve patient safety.

Mr Bromiley, an airline pilot, has personal experience because …
How is difficult asthma managed?
Authors: N. J. Roberts, D. S. Robinson, M. R. Partridge
Journal: European Respiratory Journal (2006)

Most patients with asthma can be easily treated. Some have difficult asthma; in some because the diagnosis is erroneous, in others because of comorbidity or noncompliance. A European Respiratory Society Task Force has called for an integrated approach for these patients, and positive results have been reported using protocols. In the UK, there is no overall understanding of the size of this problem, or how these patients are managed. A postal survey of 683 consultant members of the British Thoracic Society designed to elicit respondents' views on how they would manage four clinical scenarios was conducted. There was a 50.4% response rate. Few reported a uniform approach to the investigation of such patients. The availability of allied healthcare professionals was variable. The 21 consultant respiratory physicans, reporting a special interest in difficult asthma, were significantly more likely to objectively assess compliance, perform skin-prick tests and to utilise a liaison psychiatrist than those without an expressed special interest in asthma. Many reported difficulty in accessing psychologists, liaison psychiatrists and social workers. Approaches to the diagnosis and management of “vocal cord dysfunction” were variable. The results of this postal survey of specialist thoracic physicians in the UK suggest that a protocol for difficult asthma is not in widespread use and that access to necessary allied healthcare professionals is not uniform. Pulmonologists with a declared special interest in difficult asthma may have configured their services and approaches more in line with that proposed by the European Respiratory Society Task Force.
HER2 Expression in Salivary Gland Carcinomas
Authors: Bonnie Glisson, A. Dimitrios Colevas, Robert Haddad, Jeoffrey Krane, Adel El-Naggar, Merrill Kies, Rosemary Costello, Carmen Summey, Matthew Arquette, Corey Langer, Philip C. Amrein, Marshall Posner
Journal: Clinical Cancer Research (2004)

Abstract Purpose: Previous evaluation of HER2 overexpression in salivary gland cancers indicated an incidence varying between 7 and 56%, with no clear difference among three histologically different subtypes. As part of a Phase II trial of trastuzumab for treatment of incurable salivary gland cancer, we screened 137 tumors for HER2 expression. Experimental Design: Unstained sections of paraffin-embedded tumor samples were stained with p185/HER2 receptor antibody. Tumors with moderate (2+) to strong (3+) complete membrane staining in at least 10% of the tumor cells were scored as positive for overexpression. Results: The overall frequency of overexpression for HER2 was 17% (23 of 137), whereas it was only 8% in the three most common histological subtypes screened. Overexpression was distinctly rare in the most common subtype screened, adenoid cystic carcinoma (4%, 3 of 70). Overexpression was very common in salivary duct cancers; 10 (83%) of 12 were positive for HER2. This observation is consistent with the typical high-grade histological features and aggressive behavior of this subtype as well as with its histogenetic similarity to breast cancer. Analysis based on histogenesis (intercalated duct versus excretory duct) indicated a higher frequency of overexpression in the latter (55%) than in the former (7%). Conclusions: Our overall results suggest that trastuzumab will not have a major role in treatment of salivary gland cancers of intercalated duct origin. Further systematic evaluation of trastuzumab in subtypes of excretory duct origin could be supported.
Relationship between core strength and balance ability in high school female handball and basketball players
Authors: T Tsukagoshi, Y Shima, J Nakase, K Goshima, R Takahashi, T Aiba, Y Yoneda, S Moriyama, K Kitaoka
Journal: British Journal of Sports Medicine (2011)

Background Although a lot of reports have suggested that the core strength has an important role for the prevention of sports injuries, the relationship between core strength and balance ability is poorly documented. Objective The purpose of this study is to examine the relationship between core strength and balance ability. Participants 119 healthy high school female players (age: 15–16 years, handball: 49 players, basketball: 70 players) were participated in this study. Main outcome measurements We measured endurance time of right side-bridge, left side-bridge and frontal-bridge as the core strength test (CST). To assess static balance, we used stabilometer and recorded the circumference area of the single leg standing position of 30 s. For the assessment of dynamic balance, we used star excursion balance test (SEBT). SEBT reach distances and limb lengths were examined, then the distance scores (cm) for each direction of the SEBT grid were averaged over the three trials and normalised to leg length (reach distance/leg length x 100=percentage of leg length). The normalised distances in each direction were then summed for both leg. We divided the players into three groups according to their CST score and compared them with the results of static balance and dynamic balance. Results No significant differences were found in body size among the three groups (p&lt;0.05). The significant difference was not found with the static balance among the CST (p&lt;0.05). In the dynamic balance, the players with good result of CST score had significantly better results of the SEBT in frontal-bridge and left side-bridge (p&lt;0.05). There was no significant difference in right side-bridge. Conclusion This study showed that the core strength had certain relationship to the dynamic balance and may contribute to the prevention of sports injuries.
Heterogeneous Patterns of <b> <i>FLT3</i> </b> Asp835 Mutations in Relapsed <b> <i>de Novo</i> </b> Acute Myeloid Leukemia
Authors: Lee-Yung Shih, Chein-Fuang Huang, Jin-Hou Wu, Po-Nan Wang, Tung-Liang Lin, Po Dunn, Meng-Chu Chou, Ming-Chung Kuo, Chung-Chih Tang
Journal: Clinical Cancer Research (2004)

Abstract Purpose: We analyzed Asp835 mutations of FLT3 on paired marrow samples at diagnosis and relapse from 120 adult patients with de novo acute myeloid leukemia (AML) to determine the role of FLT3 Asp835 mutation in the relapse of AML. Experimental Design: Asp835 mutation was analyzed by DNA PCR amplification of exon 20 of FLT3 gene followed by EcoRV digestion. All of the mutations were confirmed by sequence analysis. Mutant to wild-type allelic ratio was determined by Genescan analysis. The Expand Long Template PCR System was used to determine the allelic location of internal tandem duplication of FLT3 (FLT3/ITD) and Asp835 mutations. Results: Thirteen patients had Asp835 mutations at diagnosis, of them 8 lost the mutations at relapse, and the remaining 5 patients carrying Asp835 mutations at diagnosis relapsed with the identical mutation types. Another 6 patients acquired Asp835 mutations at relapse. Five samples harbored both FLT3/ITD and Asp835 mutations that were found on different alleles by cloning analysis in the 3 patients studied. There were no differences in WBC count, French-American-British subtype, percentage of marrow blasts, or circulating blasts between patients with and without Asp835 mutations, whereas the difference in the prevalence of Asp835 mutations among cytogenetic/molecular subgroups was statistically significant (P = 0.025). Conclusions: The present study showed that patients with AML had heterogeneous patterns of FLT3 Asp835 mutations, either acquisition or loss of the mutations at relapse. Asp835 mutant clone may develop as a secondary event in a subset of patients with AML.
An overview of the eye in diabetes
Authors: A. Negi, S. A Vernon
Journal: Journal of the Royal Society of Medicine (2003)

The three papers in this symposium are based on presentations to an RSM meeting on the Diabetic Eye, held on 9 April 2003. The matter is particularly topical because the National Service Framework for Diabetes calls for a high-quality retinal screening programme. After a review of the various ophthalmic conditions likely to be encountered in diabetic patients (A Negi, S A Vernon) we proceed to the most important, diabetic retinopathy, with a discussion of screening methods (D M Squirrell, J F Talbot) and an account of laser treatments (J G F Dowler). Colour versions of the clinical photographs are available online [www.jrsm.org]. Publication was coordinated by Professor Susan Lightman, of Moorfields Eye Hospital, London, UK.
Oral Appliance Therapy Improves Symptoms in Obstructive Sleep Apnea
Authors: Helen Gotsopoulos, Carol Chen, Jin Qian, Peter A. Cistulli
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

The aim of this study was to evaluate the effect of a mandibular advancement splint (MAS) on daytime sleepiness and a range of other symptoms in obstructive sleep apnea (OSA). Using a randomized crossover design, patients received 4 weeks of treatment with MAS and a control device (inactive oral appliance), with an intervening 1-week washout. At the end of each treatment period, patients were reassessed by questionnaire, polysomnography, and multiple sleep latency test. Fifty-nine men and 14 women with a mean (+/- SD) age of 48 +/- 11 years and proven OSA experienced a significantly improved mean (+/- SEM) sleep latency on the multiple sleep latency test (10.3 +/- 0.5 versus 9.1 +/- 0.5 minutes, p = 0.01) and Epworth sleepiness scale score (7 +/- 1 versus 9 +/- 1, p < 0.0001) with the MAS compared with the control device after 4 weeks. The proportion of patients with normal subjective sleepiness was significantly higher with the MAS than with the control device (82 versus 62%, p < 0.01), but this was not so for objective sleepiness (48 versus 34%, p = 0.08). Other OSA symptoms were controlled in significantly more patients with the MAS than with the control device. MAS therapy improves a range of symptoms associated with OSA.
Multiple duplications of yeast hexose transport genes in response to selection in a glucose-limited environment
Authors: C J Brown, K M Todd, R F Rosenzweig
Journal: Molecular Biology and Evolution (1998)

When microbes evolve in a continuous, nutrient-limited environment, natural selection can be predicted to favor genetic changes that give cells greater access to limiting substrate. We analyzed a population of baker's yeast that underwent 450 generations of glucose-limited growth. Relative to the strain used as the inoculum, the predominant cell type at the end of this experiment sustains growth at significantly lower steady-state glucose concentrations and demonstrates markedly enhanced cell yield per mole glucose, significantly enhanced high-affinity glucose transport, and greater relative fitness in pairwise competition. These changes are correlated with increased levels of mRNA hybridizing to probe generated from the hexose transport locus HXT6. Further analysis of the evolved strain reveals the existence of multiple tandem duplications involving two highly similar, high-affinity hexose transport loci, HXT6 and HXT7. Selection appears to have favored changes that result in the formation of more than three chimeric genes derived from the upstream promoter of the HXT7 gene and the coding sequence of HXT6. We propose a genetic mechanism to account for these changes and speculate as to their adaptive significance in the context of gene duplication as a common response of microorganisms to nutrient limitation.
Global Estimates for Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in Adults
Authors: Hilary King, Marian Rewers
Journal: Diabetes Care (1993)

Objective— To assemble standardized estimates of abnormal glucose tolerance in adults in diverse communities worldwide and provide guidelines for the derivation of comparable estimates in future epidemiological studies. Research Design and Methods— The project was limited to population-based investigations that had used current WHO criteria for diagnosis and classification of abnormal glucose tolerance. Raw data were obtained by WHO from surveys conducted during 1976–1991 of over 150,000 persons from 75 communities in 32 countries. Data within the truncated age range of 30–64 yr were adjusted to the standard world population of Segi. Age-specific prevalences also are reported for selected populations. Results— Within the chosen age range, diabetes was absent or rare (&amp;lt;3%) in some traditional communities in developing countries. In European populations, age-standardized prevalence varied from 3 to 10%. Some Arab, migrant Asian Indian, Chinese, and Hispanic American populations were at higher risk with prevalences of 14–20%. The highest prevalences were found in the Nauruans (41%) and the Pima/Papago Indians (50%). Age-standardized prevalence of IGT was low (&amp;lt;3%) in some Chinese, traditional American Indian, and Pacific island populations. Moderate (3–10%) or high (11–20%) prevalences of IGT were observed in many populations worldwide. The highest estimates for prevalence of IGT were seen in female Muslim Asian Indians in Tanzania (32%) and in urban male Micronesians in Kiribati (28%). Prevalence of diabetes rose with age in all populations in which age-specific data were examined. This trend was most pronounced in those at moderate to high risk. The ratio of prevalence of diabetes in men versus women varied markedly between populations with little discernable trend, although IGT was generally more common in women. In most communities, at least 20% of diabetes cases were unknown before the survey, and in many communities, &amp;gt;50% were previously undiagnosed. In both Chinese and Indian migrant populations, relative prevalence was high when compared with indigenous communities. Conclusions— Diabetes in adults is now a global health problem, and populations of developing countries, minority groups, and disadvantaged communities in industrialized countries now face the greatest risk.
Zoledronic acid (zoledronate) for postmenopausal women with early breast cancer receiving adjuvant letrozole (ZO-FAST study): final 60-month results
Authors: R. Coleman, R. de Boer, H. Eidtmann, A. Llombart, N. Davidson, P. Neven, G. von Minckwitz, H.P. Sleeboom, J. Forbes, C. Barrios, A. Frassoldati, I. Campbell, O. Paija, N. Martin, A. Modi, N. Bundred
Journal: Annals of Oncology (2012)
Comparative Effects on Rat Liver Cells After Dimethylnitrosamine, 2-Fluorenamine, or Prednisolone Treatment Studied by Electron Microscopy&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Rune G. Gustafsson, Björn A. Afzelius
Journal: JNCI Journal of the National Cancer Institute (1963)

Liver cells from rats treated with dimethylnitrosamine, 2-fluorenamine, or prednisolone (pregne-1,4-diene-3, 20-dione, 11ß,17,21-trihydroxy) were examined under the electron microscope. The doses as well as the interval between drug administration and the excision of samples (20 hours) were chosen to represent a metabolic condition, biochemically characterized by a maximal stimulation of the activity of the amino acid incorporation into proteins simultaneously with an increase of the glycogen level of liver. Rats fed ad libitum and those starved for 20 hours were used as controls. The principal observations were: 1) A disorganization of the cisternal endoplasmic reticulum and a decrease in the number of membrane-bound particles after dimethylnitrosamine or 2-fluorenamine treatment. These changes are interpreted as a persistent lesion from an earlier depression period preceding the stimulation. 2) An increase in the amount of free ribosomes after 2-fluorenamine and prednisolone treatment. The importance of this finding in connection with the increased amino acid incorporation is discussed. 3) An enlargement of the spongy endoplasmic reticulum in all three experiments. The hypertrophy of this system could be connected with gluconeogenesis. 4) An increase in the morphological glycogen roughly parallel to the biochemical data. 5) A transitional form between agranular spongy endoplasmic reticulum and granular cisternal endoplasmic reticulum, described in the prednisolone-treated animals. These observations are consistent with the hypothesis that the changes in 2) through 4) after 2-fluorenamine and dimethylnitrosamine treatment are due to a potentiation of the liver cells to the action of glucocorticoids.
Synchronous focal liver lesions in a patient with liver cirrhosis: commonplaces may be misleading
Authors: G. Ghittoni, E. Caturelli, S. Rossi
Journal: Gut (2010)

We read the article by Sangiovanni et al 1 reporting that in patients with cirrhosis with a 1–2 cm nodule detected during surveillance, a single, typical contrast pattern imaging technique confidently permits diagnosis of hepatocellular carcinoma (HCC), reducing the need for fine needle biopsy (FNB).

However, some concerns arise regarding the authors' conclusions. We report the case of a 70-year-old man with hepatitis C virus (HCV)-related cirrhosis. The patient had a history of third hepatic segmental hepatectomy for HCC nodule, 12 years before. He also had undergone left hemicolectomy for colorectal cancer (CRC) and left lung lobectomy for lung metastasis, 6 years later. The patient was actually referred for the assessment of three focal hepatic lesions.

To characterise the focal lesions, contrast-enhanced (CE) spiral abdominal CT and ultrasound (US) scan plus CE-US were planned. All imaging techniques revealed three focal lesions in liver segments IV, VI …
Reply to J.M. Guinebretiere and L. Arnould et al
Authors: Sunil S. Badve, Frederick L. Baehner, Robert P. Gray, Barrett H. Childs, Tara Maddala, Mei-Lan Liu, Steve C. Rowley, Steven Shak, Edith A. Perez, Lawrence J. Shulman, Silvana Martino, Nancy E. Davidson, George W. Sledge, Lori J. Goldstein, Joseph A. Sparano
Journal: Journal of Clinical Oncology (2009)
The course of severe chronic fatigue syndrome in childhood
Authors: L Rangel, M E Garralda, M Levin, H Roberts
Journal: Journal of the Royal Society of Medicine (2000)

Summary Little has been reported on prognostic indicators in children with chronic fatigue syndrome (CFS). We used interviews with children and parents, a mean of 45.5 months after illness onset, to follow up 25 cases of CFS referred to tertiary paediatric psychiatric clinics. At its worst, the illness had been markedly handicapping (prolonged bed-rest and school absence in two-thirds); mean time out of school was one academic year. Two-thirds, however, had recovered and resumed normal activities—mean duration of illness to recovery/assessment 38 months—and none had developed other medical conditions. Recovery was associated with specific physical triggers to the illness, with start of illness in the autumn school term and with higher socioeconomic status. Severe fatigue states in children can cause serious and longlasting handicap but most children recover.
2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease (Updating the 2005 Guideline)
Authors: Thom W. Rooke, Alan T. Hirsch, Sanjay Misra, Anton N. Sidawy, Joshua A. Beckman, Laura K. Findeiss, Jafar Golzarian, Heather L. Gornik, Jonathan L. Halperin, Michael R. Jaff, Gregory L. Moneta, Jeffrey W. Olin, James C. Stanley, Christopher J. White, John V. White, R. Eugene Zierler
Journal: Journal of the American College of Cardiology (2011)
Short Leg Length, a Marker of Early Childhood Deprivation, Is Associated With Metabolic Disorders Underlying Type 2 Diabetes
Authors: Luke W. Johnston, Stewart B. Harris, Ravi Retnakaran, Hertzel C. Gerstein, Bernard Zinman, Jill Hamilton, Anthony J. Hanley
Journal: Diabetes Care (2013)

Short leg length, a marker of early childhood deprivation, has been used in studies of the association of early life conditions with adult chronic disease risk. The objective of this study was to determine the cross-sectional associations of leg length with measures of insulin sensitivity and β-cell function.Subjects (n = 462) at risk for type 2 diabetes were recruited into the PROspective Metabolism and ISlet cell Evaluation (PROMISE) longitudinal cohort. Leg length was calculated from sitting and standing height at the 3-year clinical examination. Glucose tolerance status was determined using an oral glucose tolerance test. Insulin sensitivity was assessed using homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda insulin sensitivity index (ISI), while the insulinogenic index over HOMA-IR (IGI/IR) and the insulin secretion sensitivity index 2 (ISSI-2) determined β-cell function. Multiple linear regression analysis was conducted, adjusting for covariates including age, sex, ethnicity, family history of diabetes, waist, and weight.Leg length and leg-to-height ratio were significantly associated with HOMA-IR (β = -0.037, β = -10.49, respectively; P < 0.0001), ISI (β = 0.035, β = 8.83, respectively; P < 0.0001), IGI/IR (β = 0.021, P < 0.05; β = 7.60, P < 0.01, respectively), and ISSI-2 (β = 0.01, P < 0.03; β = 3.34, P < 0.01, respectively) after adjustment for covariates. The association of shorter leg length with lower insulin sensitivity was most evident for those with high waist circumferences.Shorter legs were independently associated with lower insulin sensitivity and β-cell function, suggesting that early childhood deprivation may increase the risk of developing diabetes.
Memantine in patients with Parkinson's disease dementia or dementia with Lewy bodies: a double-blind, placebo-controlled, multicentre trial
Authors: Dag Aarsland, Clive Ballard, Zuzana Walker, Fredrik Bostrom, Guido Alves, Katja Kossakowski, Iracema Leroi, Francisco Pozo-Rodriguez, Lennart Minthon, Elisabet Londos
Journal: The Lancet Neurology (2009)
Chronic monoacylglycerol lipase blockade causes functional antagonism of the endocannabinoid system
Authors: Joel E Schlosburg, Jacqueline L Blankman, Jonathan Z Long, Daniel K Nomura, Bin Pan, Steven G Kinsey, Peter T Nguyen, Divya Ramesh, Lamont Booker, James J Burston, Elizabeth A Thomas, Dana E Selley, Laura J Sim-Selley, Qing-song Liu, Aron H Lichtman, Benjamin F Cravatt
Journal: Nature Neuroscience (2010)