tbuckley/cabot-search huggingface dataset:
Evidence of preference for a high-concentration sucrose solution in alcoholic men
Authors: A Kampov-Polevoy, J C Garbutt, D Janowsky
Journal: American Journal of Psychiatry (1997)

The purpose of this study was to test in humans the finding from animal studies indicating an association between preference for more concentrated sweet solutions and excessive alcohol drinking.The hedonic response to five different concentrations of sucrose solution was evaluated in 20 detoxified alcoholic and 37 nonalcoholic Caucasian men. All subjects repetitively tasted solutions with 0.05, 0.10, 0.21, 0.42, and 0.83 M sucrose concentrations and rated themselves on two scales measuring the intensity of sweetness and the likability of the solutions.A bimodal distribution of responses to the sweet solutions occurred in the nonalcoholic comparison group, with peaks at 0.05 M and 0.42 M. In the alcoholic group, 65% of the subjects preferred the highest sucrose concentration (0.83 M), compared with only 16% of the nonalcoholic group.The results of this exploratory study support the hypothesis suggesting a positive association between the preference for stronger sweet solutions and alcohol dependence.
Soundings: Respect: a journalist's guide
Authors: James Owen Drife
Journal: BMJ (2002)

According to a recent poll of radio listeners, doctors are the most respected profession in the United Kingdom. The least respected are MPs, estate agents, government ministers, lawyers, and—fifth from bottom—journalists.

Doctors are not ones to gloat or to advise those 12 000 Today listeners to get a life. Instead, our hearts go out to the poor journalists, who have put so much effort into advising everyone else how to do their jobs that they have neglected themselves. Time for them to benefit from our wisdom, for a change. Here is a quick 'n' easy, cut-out-and-keep guide to earning respect.

Think substance, not spin. When doctors went through a tough time image-wise, we didn't hire Max Clifford. We took a hard look at ourselves and changed the bits that weren't right. Like, if I may say so, the arrogance.

Respect the public. Medicine now has lay people on most major committees and we listen to them, as well as to individual patients. Journalists, however, treat the public like children. The contrast between a television journalist talking off camera and on camera has to be heard to be believed.

Don't talk yourselves down. We've realised that if you say, “I'm only a simple surgeon” often enough, people believe it. Journalists have called themselves “hacks” for so long that they believe it themselves.

Teach your juniors respect. Treating patients as equals is now at the core of undergraduate and postgraduate medical education. By contrast, trainee journalists are told that the public has a reading age of 8 and the attention span of a hypomanic gnat. Medicine has smartened up while the media have dumbed down.

Provide a consultant based service. The NHS is moving away from dependence on trainees. But when doctors are interviewed for newspapers or news programmes, it is usually by people half their age. They are charming, yes, but perceptive? No.

Believe in something. People sense that most of us in the NHS—doctors, nurses, secretaries—stay with it because we believe in it. Legendary journalists covered their idealism with a veneer of cynicism, but their successors have copied the wrong layer. They should try being like us. The public respects sincerity.
Indian scheme to reduce antibiotic misuse is failing because of widespread ignorance, say pharmacists
Authors: Priyanka Pulla
Journal: BMJ (2016)

A scheme implemented by the Indian government in March 2014 to prevent antibiotic misuse is being hampered by low levels of patient education and poverty, clinicians have said.

Schedule H1 is a list of 46 drugs, including 24 antibiotics and 11 anti-tuberculosis drugs, for which pharmacists are required to maintain a log of sales for three years and which cannot be sold to patients without a doctor’s prescription.1 If they do not comply with the schedule pharmacists are liable to lose their licences.

But widespread ignorance about antibiotic resistance among both doctors and patients is making it difficult for pharmacists to adhere to the regulation. Despite this, most Indian state governments have not yet started educational campaigns on antibiotic use. “There …
The Director of Medical Education in the Teaching Hospital
Authors: None Education
Journal: JAMA (1965)

This is the first revision of the Guide originally published in 1961.<sup>1</sup>It has been prepared for the guidance of hospitals contemplating the appointment of a director of medical education and for physicians considering such an appointment. The position is purposely described in general terms so as to apply to most hospitals with internship or residency programs and without major medical school affiliations. The broadened scope and duration of hospital education and the increasing complexity of medical practice have necessitated better organization of graduate and postgraduate education. Hospitals have, therefore, looked to their educational efforts with interest and concern comparable to that exhibited by medical-school authorities on behalf of undergraduate education. Satisfactory administration of a major teaching program can no longer be totally delegated to those who are already heavily committed to medical practice. Part- or full-time supervision of medical education has, therefore, been established in many teaching hospitals.
AB0613 Predictive Role of Low Vitamin D Levels in Lupus Nephritis Flare
Authors: S.-H. Bae, S. Hong, S.M. Ahn, D.-H. Lim, Y.-G. Kim, C.-K. Lee, B. Yoo
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Recently, it was suggested that vitamin D plays an important role in immunoregulation as well as bone metabolism. Previous studies showed that vitamin D level was associated with disease activity in patients with systemic lupus erythematosus (SLE), representing autoimmune disease. However, a little is known about the effect of low vitamin D level on lupus flare, in lupus nephritis patients particularly. <h3>Objectives</h3> The aim of this study is to investigate the role of low vitamin D levels in predicting lupus nephritis flare. <h3>Methods</h3> Serum 25(OH)D levels were measured in 202 patients with SLE visited rheumatologic clinic of Asan Medical Center between May 2013 and July 2013. We followed up these patients for more than 1 year and assess the lupus nephritis (LN) flare in nephritis patients. LN flare was defined as ≥1000mg albumin/creatinine ratio, ≥5 RBCs/HPF in the spot urine and change of immunosuppressant medication. Predictive factors of LN flare were identified by the binary logistic regression analysis. <h3>Results</h3> The mean 25(OH)D level of 202 patients with SLE was 18.44 (19.48 ng/mL in general population according to Korean Nationwide Surveys) and mean SLEDAI score was 4.46±3.80. 77 (38.1%) patients had LN and LN flare occurs in 27 (13.8%) patients. In univariate analysis, age, 25(OH)D, Anti-SM antibody, C3, HCQ were associated with the LN flare (p&lt;0.2) and were then included in the multivariate analysis. Of these, only low 25(OH)D (p=0.008) and C3 (P=0.034) levels were predictors of LN flares in multivariate analysis. <h3>Conclusions</h3> Our finding suggested that level of vitamin D could be a marker for prediction of LN flare. <h3>Disclosure of Interest</h3> None declared
AB0601 Effect of Pravastatin Plus Ezetimibe on Carotid Intima-Media Thickness in Patients with Systemic Lupus Erythematosus
Authors: O. Vera-Lastra, A. Olvera, M.D.P. Cruz Dominguez, G. Medina, L.J. Jara
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Patients with systemic lupus erythematosus (SLE) have accelerated atherosclerosis that can be assessed by the carotid intima media thickness (CIMT) measurement. A prompt hypolipidemic treatment should be a part of the integral management <h3>Objectives</h3> To determine the effect of therapy with pravastatin plus ezetimibe on the CIMT in SLE patients. <h3>Patients and Methods</h3> Longitudinal, prospective, quasi-experimental trial. Out of 60 SLE patients in whom a carotid ultrasound was performed, we chose 22 with a CIMT &gt;0.7 mm who were administered pravastatin plus ezetimibe during 6 months with determination of CIMT at the end of the study. We performed the following tests: total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, tryglicerides, C-reactive protein (CRP), liver function, muscle enzimes and glucose, basal and at the end of treatment. Statistical analysis: Descriptive statistics and Wilcoxon test were used. <h3>Results</h3> There were 22 women with an age of 42±6.3 years, average disease evolution 7.5±6.6 years, of whom, 18 concluded the study. Right basal CIMT was 0.829±0.1448 vs. final 0.688±0.1453, p&lt;0.003; left CIMT was 0.820±0.1312 vs. 0.724±0.1348, p&lt;0.004. Only 3 patients had atherosclerotioc plaques, 2 with an evolution of SLE less than 3 years. TC 208mg/dl vs 168mg/dl, LDL-C 125mg/dl vs. 72mg/dl, p=0.0004. CRP 3.12 vs 2.25 p=0.004. In 2 cases there were gastrointestinal, skin and muscle adverse effects. <h3>Conclusions</h3> Treatment with pravastatin plus ezetimibe decreases the CIMT with improvement in the concentration of total cholesterol, LDL-C and CRP levels with good toleration. <h3>References</h3> Petri MA, Kiani AN, Post W, Christopher-Stine L, Magder LS. Lupus Atherosclerosis Prevention Study (LAPS). Ann Rheum Dis. 2011;70(5):760-5 Manzi S, Selzer F, Sutton-Tyrrell K, Fitzgerald SG, Rairie JE, Tracy RP, et al. Prevalence and risk factors of carotid plaque in women with systemic lupus erythematosus. Arthritis Rheum. 1999;42:51-60. Riboldi P, Gerosa M, Moroni PL. Statins and autoinmune diseases. Lupus 2005;14:765-68. <h3>Disclosure of Interest</h3> None declared
Two severe cases of botulism associated with industrially produced chicken enchiladas, France, August 2008
Authors: L A King, collective the French multidisciplinary outbreak investigation team
Journal: Eurosurveillance (2008)

Two severe familial cases of botulism were reported to the health authorities in Brittany, north-west France, on 11 August 2008. An investigation was undertaken to identify additional cases, the vehicle of transmission, and to put in place adapted control measures.
Atg7 suppression enhances chemotherapeutic agent sensitivity and overcomes stroma-mediated chemoresistance in acute myeloid leukemia
Authors: Sujan Piya, Steven M. Kornblau, Vivian R. Ruvolo, Hong Mu, Peter P. Ruvolo, Teresa McQueen, R. Eric Davis, Numsen Hail, Hagop Kantarjian, Michael Andreeff, Gautam Borthakur
Journal: Blood (2016)
Pavor nocturnus: a complication of single daily tricyclic or neuroleptic dosage
Authors: A Flemenbaum
Journal: American Journal of Psychiatry (1976)

The author tested the hypothesis that a single bedtime dosage schedule of tricyclic or neuroleptic medication produces increased frequency of night terrors by administering a questionnaire to 30 medical patients who were not receiving such medications and 100 psychiatric patients on either multiple- or single-dosage schedules. Psychiatric patients on multiple-dosage schedules reported no more frightening dreams than the medical patients, whereas almost three-fourths of those receiving single bedtime doses had frightening dreams, a significant difference from the medical sample. This preliminary report is presented to call attention to the possible undesirable effects of a single dose schedule.
Cuts in health prevention budgets will hit the NHS, says NHS England chief
Authors: Matthew Limb
Journal: BMJ (2016)

The NHS in England can expect to feel the effects of cuts by local authorities to key public health and prevention services, NHS England chief executive Simon Stevens has told MPs.

Stevens said that when services for sexual health, drug or alcohol abuse, and smoking prevention diminished this would “show up as extra demand, in more expensive parts of the NHS, within 12 months.”

Stevens wrote the blueprint for the future of the NHS—which called for a radical upgrade in prevention and support for wider public health measures—in November 2014.1

He told the Commons health committee on 7 June that he was concerned about local authority cutbacks having an “impact on downstream demand.”

Stevens said that …
The Value of Laparoscopy in the Diagnosis of Primary Cancer of the Liver
Authors: F Vilardell
Journal: Endoscopy (1977)

A retrospective survey organized by the Spanish Association for Digestive Endoscopy among its members has revealed that a correct diagnosis of primary liver cancer could be made by guided biopsy during laparoscopy in 153 of 208 cases. A diagnosis of malignancy was made in 103 of 145 cases of carcinoma associated with cirrhosis and in 50 of 63 cases without cirrhosis, but in the latter, the lesions were endoscopically indistinguishable from metastatic nodules in most instances. Biopsy was positive in 88% of all suspicious cases. Carcinomatous invasion of seemingly benign cirrhotic nodules could be demonstrated in 22 other patients.
FRI0407 Antiphospholipid Antibodies as Independent Predictors of Accelerate Atherosclerosis in Systemic Lupus Erythematosus Patients
Authors: L. Stojanovich, A. Djokovic, B. Todic, S. Radovanovic
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Patients with antiphospholipid syndrome (APS) have been evaluated in the context of accelerated atherosclerosis in numerous studies, bringing this concept into the focus regarding proper treatment of this population of patients. <h3>Objectives</h3> Carotid intima-media thickness (cIMT) has been established as a distinguished marker of cardiovascular risk. The aim of this study was to evaluate relationship between presence of more than one antiphospholipid antibody (aPL) and cIMT values in SLE patients with secondary APS. <h3>Methods</h3> We analyzed 80 patients with systemic lupus erythematosus (SEL) and secondary APS 74 female (92.5%) and 6 male (7.5%), average age 49.4±13.1years. In all patients presence of lupus anticoagulans (LA), anticardiolipin (aCL IgG/IgM) and anti-β<sub>2</sub> glycoprotein-I (anti-β<sub>2</sub>GPI IgG/IgM) antibodies has been established, and they were classified into group with only one or more than one aPL present in any combination. Measurement of cIMT has been performed on common carotid artery (CCA), its bifurcation (CCAbiff) and internal carotid artery (ICA) on both sides. We defined cIMT values 1.1mm and higher as plaque presence <h3>Results</h3> There were 63.8% patients with more than one aPL present. Prevalence of standard atherosclerotic risk factors was below 40%. Age, hypertension, presence of diabetes mellitus and hyperlipidemia resulted in higher values of cIMT in studied group patients. Average values of cIMT were significantly higher in patients with more than one aPL present for almost all segments of carotid trunk (CCA right, p=0.009, CCA left, p=0.034, CCAbiff right, p=0.093, CCAbiff left, p=0.632, ICA right, p=0.027, ICA left, p=0.544). After adjustment for age, current cigarette smoking, diabetes, hypertension and hyperlipidemia, the relative odds for atherosclerotic plaque presence on carotid arteries in SLE patients with APS and more than one aPL present was 4.19 (95% confidence interval 0.09 to 0.95, p=0.041). <h3>Conclusions</h3> Presence of more than one aPL in SLE patients with APS additionally accelerate atherosclerotic continuum. In this subgroup of APS patients more aggressive approach towards prevention and control of standard atherosclerotic risk factors is crucial. <h3>Acknowledgements</h3> This work was supported by research grant number 175041 for 2011-2015, issued by the Ministry of Science of the Republic of Serbia. <h3>Disclosure of Interest</h3> None declared
Soundings: More on wives
Authors: Trisha Greenhalgh
Journal: BMJ (2001)

Thanks to the 24 people (including two from the BMJ 's editorial office) who applied for the job of my wife (BMJ 2000;321:1421). Thanks, too, to the (female) consultant surgeon who wrote in asking for names of any promising applicants that I didn't appoint.

The job's gone, to a fine individual from a former Soviet bloc country whom the agency described as “a most mature, most experienced lady.” Indeed she is, and for an embarrassingly small sum she cooks, cleans, keeps house, and takes my children back and forth from school on the 143 bus.

The agency's answer to Mary Poppins is strong on elbow grease and maternal charm but speaks not a word of English. She attended for interview with a friend from the same eastern European country who had been here for four years and whose English was near perfect. We went round the house listing the tasks to be done daily, and together they took the opportunity to give me a few lessons in the finer points of cleaning.

“Missy will need Jif, Flash, Mr Sheen,” she began. “Shower Shine to stop this . . .”—running her finger down the murky glass—“new mop-head, and big dusters: the small ones no good, no good.” I made notes.

“For the toilet, I can see you clean it this way. . . .”—she seized the loo brush and demonstrated, correctly, the way I go round the lavatory pan. “But is better to do it like this”—on her knees now, vigorously scrubbing in a direction that was clearly more efficient. I thanked her, thinking, we're all expert at something.

Two weeks into the job, we invited our new housekeeper to stay to supper. With the help of a dictionary she explained why she and her friend had left their own young sons to come and look after the likes of mine. Since the break up of the Soviet Union, when hundreds of factories closed overnight, unemployment in their country had soared and wages plummeted. Previously middle class families were now living in extreme poverty. Even when jobs were available, professional salaries were often lower than manual ones.

I asked what jobs they had done before they came to England. She had been a teacher. And the friend? A doctor. Very clever, best in her year. But with two young children she could not manage on a doctor's salary. Another three years of cleaning toilets in London and she would be back in time to send them off to university.
Effect of Cystine Per Se on the Formation of Hepatomas in Rats Following the Ingestion of &lt;italic&gt;p&lt;/italic&gt;-Dimethylaminoazobenzene
Authors: Florence R. White, Julius White, Philip W. David
Journal: JNCI Journal of the National Cancer Institute (1946)

Journal Article Effect of Cystine Per Se on the Formation of Hepatomas in Rats Following the Ingestion of p-Dimethylaminoazobenzene Get access Florence R. White, Florence R. White biochemist National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar Julius White, Julius White principal biochemist National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar Philip W. David Philip W. David technical assistance National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 7, Issue 2, October 1946, Pages 99–101, https://doi.org/10.1093/jnci/7.2.99 Published: 01 October 1946 Article history Published: 01 October 1946 Received: 08 October 1946
PHGDH Expression Is Required for Mitochondrial Redox Homeostasis, Breast Cancer Stem Cell Maintenance, and Lung Metastasis
Authors: Debangshu Samanta, Youngrok Park, Shaida A. Andrabi, Laura M. Shelton, Daniele M. Gilkes, Gregg L. Semenza
Journal: Cancer Research (2016)

Intratumoral hypoxia stimulates enrichment of breast cancer stem cells (BCSC), which are critical for metastasis and patient mortality. Here we report a metabolic adaptation that is required for hypoxia-induced BCSC enrichment and metastasis. Hypoxia-inducible factors coordinately regulate expression of genes encoding phosphoglycerate dehydrogenase (PHGDH) and five downstream enzymes in the serine synthesis pathway and mitochondrial one-carbon (folate) cycle. RNAi-mediated silencing of PHGDH expression in both estrogen receptor-positive and negative breast cancer cells led to decreased NADPH levels, disturbed mitochondrial redox homeostasis, and increased apoptosis, which abrogated BCSC enrichment under hypoxic conditions. PHGDH-deficient cells exhibited increased oxidant levels and apoptosis, as well as loss of BCSC enrichment, in response to treatment with carboplatin or doxorubicin. PHGDH-deficient cells were relatively weakly tumorigenic and tumors that did form were deficient in BCSCs, abolishing metastatic capacity. Our findings highlight a role for PHGDH in the formation of secondary (recurrent or metastatic) tumors, with potential implications for therapeutic targeting of advanced cancers. Cancer Res; 76(15); 4430-42. ©2016 AACR.
TV: Hollywood fights bird flu
Authors: Douglas Kamerow
Journal: BMJ (2006)

So what's bird flu going to be like, assuming that it comes? In this television movie we get to see all the scary things the writers have learned about a possible avian influenza pandemic crammed into two hours: a highly virulent, rapidly transmissible virus, inept attempts at containment, overwhelmed medical facilities, mass graves, food and water shortages, and looting and rioting.

The programme begins with a solemn disclaimer telling us that the H5N1 virus has not (yet) been transmitted from person to person. Cut to geese flying over the ocean and chickens being slaughtered by the million in China. The virus has mutated and is spreading among the Chinese in a market town soon to be visited by an American businessman. He catches it from a coughing factory worker and then begins shedding virus as he travels home. In dramatically effective microscopic close-ups now common on television shows such as CSI: Crime Scene Investigation, a graphic portrayal of forensic police work, viral particles are shown being passed to unsuspecting people via serviettes, martini olives, hot face towels, and handshakes.

The hero of the story is, of course, a beautiful blonde, an Epidemic Intelligence Service (EIS) officer played by Joely Richardson, who is rather wooden and has traces of her English accent remaining. She is called away from a tryst to fly to China to confirm that the virus has mutated. She then breaks the news to the US health secretary and they convene a meeting of state governors to inform them that bird flu is on the way.

The rest of the movie follows the pandemic through three major story threads: the death of the index case and the grief, quarantine, emotional paralysis, recovery, and subsequent community leadership of his widow; the mistakes made by the governor of Virginia and his redemption after losing his son and realising that quarantine is not the answer; and the everyday heroism of a New York City emergency room nurse and her National Guard husband.

Gripping stuff, mostly very well done. Particularly effective visual scenes include a vast temporary hospital set up in a New York subway station and a huge burial pit into which trucks dump hundreds of wrapped bodies. And likely problems—such as a shortage of medications, the time lag until a vaccine is developed, and the problems of rationing both—are realistically portrayed.

There are some scientific inaccuracies. It makes no sense to quarantine people beyond influenza's four day incubation period, so the Virginia governor's prolonged quarantine of portions of Richmond with fences and barbed wire seems unlikely. Migrating wild birds are made out to be the big villains, although we've now learned that they don't, in fact, seem to be transmitting the virus. But these are rather minor slips.

What the movie does very well is to entertain and get people thinking. I watched it with two teenagers who paid rapt attention and kept asking whether this could really happen and what we would do about it if it did. Good questions.