tbuckley/cabot-search huggingface dataset:
110%
Authors: Des Spence
Journal: BMJ (2007)

I am going to give this 110%. Sporting analogies are everywhere, for sport is a microcosm of life itself. Sport incorporates important themes like the team over the individual, obeying rules, the threat of sanctions, persistence, endurance, pride, effort, structure, hierarchy, and—all important—the need to meet defeat and victory with equal measure. Perhaps these crude analogies are legitimate and we should view the NHS as just another big team game. 

Let's work this sporting analogy further. The NHS is at risk of becoming American football: teams within teams, producing reams of meaningless statistics; constantly changing shifts of players; superspecialised players performing one single task; start-stop, clock watching, pointlessly technological; glitzy, covered in layers of padding, pumped up on growth enhancers with unknown long term consequences—even the gleam of the pitch is utterly synthetic. Just expensive and complicated, but worse still: interminable and dull. Our population of health spectators, now obese, gazes on, chomping on foot-long hotdogs as they guzzle down their gallons of fizzy drinks. The announcement system blasts out a deafening and distorted version of “We are the Champions,” drowning out any dissent. All attempts to export this sport, perhaps not unsurprisingly, have failed.

But the traditional model of the NHS is one of a soccer match in a dog fouled city park. The nurses are the defence: solid, dependable, organised, and quietly getting on. The GPs are the midfield: holding the ball, playing it around and holding the possession, helping in defence but sometimes going forward. The consultants are the two fiery glory hunters up front, aggressively seeking to score that all important diagnosis. This game can be played from the slums of Rio to the icy suburbs of ReykjavA­k.

So you can stuff staying up half the night for the medical superbowl party; I'd rather wash what's left of my hair. Give me my NHS football world cup, a truly global event with poverty no barrier to success—played the world over and a health meritocracy of global proportion—poor, rich, black, white, a thousand different languages; medical care played out by small national teams full of lithe, multitasking generalists, dependent on each other, therefore respectful of each other's roles; teams committed to primary care based, integrated, inexpensive, and centrally funded medical care—an event where a truly gifted individual can make a big difference and raise the morale of a whole nation. There is the odd shouting match, but these get “sorted” in the pub afterwards. It is the NHS's complete simplicity that makes it so beautiful and highly regarded. Had enough? I've done my best and you can't ask more than that.
Increased Bioelectric Potential Difference across Respiratory Epithelia in Cystic Fibrosis
Authors: Michael Knowles, John Gatzy, Richard Boucher
Journal: New England Journal of Medicine (1981)

To investigate respiratory epithelial function in cystic fibrosis, we measured the transepithelial electrical potential difference across the upper and lower respiratory mucosa in patients with cystic fibrosis and control subjects. The nasal potential difference in the 24 patients with cystic fibrosis exceeded by more than 3 standard deviations the mean voltage in healthy controls, subjects with other diseases, and subjects heterozygous for cystic fibrosis. Potential differences in lower airways were measured in four patients and were significantly greater than in controls (P<0.05). Superfusion of the luminal surface with amiloride, an inhibitor of active sodium absorption, induced greater reductions in both nasal and airway potential differences in patients than in controls. We conclude that the increased respiratory-epithelial potential differences appear to be a specific abnormality in homozygotes for cystic fibrosis. The greater reduction in potential difference in response to amiloride suggests that absorption of excess salt and perhaps liquid from respiratory epithelial surfaces contributes to the pathogenesis of lung disease in cystic fibrosis. (N Engl J Med. 1981; 305:148995.)
Abstract 3327: G-quadruplex-stabilizer, Telomestatin, preferentially induces apoptosis of brain tumor stem cells with less effect on survival of normal stem cells
Authors: Takeshi Miyazaki, Kazuo Shin-ya, Ichiro Nakano
Journal: Cancer Research (2010)

Abstract Introduction: Recent studies have demonstrated the phenotypic and genetic similarities between brain tumor stem cells (BTSC) and their somatic counterparts in the brain, neural stem cells (NSC). To target the common pathways that play essential roles for survival of both BTSC and NSC, however, may eradicate both stem cell types. A better strategy would be to uncover the mechanisms that specifically regulate initiation of brain tumors and maintenance of the stem-like phenotype of BTSC. In this study, we hypothesized that formation of secondary DNA structure, G-quadruplex, is disrupted only in BTSC and targeting G-qudruplex results in eradication of BTSC without sacrificing the normal counterpart. Experimental procedures: The effect of the G-quadruplex stabilizer, telomestatin was investigated on survival and proliferation of 3 different cell types; patient-derived BTSC, non-stem tumor cells derived from the matched samples, and normal neural precursors derived from fetal brains. We then investigated the mechanism of telomestatin action in BTSC. Lastly, we performed xenotransplantation of tumor cells pretreated with telomestatin into immunodeficient mouse brains to verify the effect of telomestatin on in vivo tumor growth. Results: Treatment of patient-derived BTSC with telomestatin resulted in inhibition of proliferation and induction of apoptosis in vitro, and this phenotype was partially rescued by pretreatment with the PARP-1 inhibitor, suggesting that the action of telomestatin in BTSC is likely dependent on the PARP-1 pathway. In contrast, treatment of normal precursors with the same dose of telomestatin did not significantly affect their survival and proliferation. Growth of a glioma cell line in vivo was decreased by pretreatment with telomestatin. Conclusions: Differential susceptibility of BTSC, compared to the normal counterpart, to telomestatin treatment indicates the significance of G-quadruplex structure in malignant gliomas and their tumor stem cells. Currently, we are investigating the effect of telomestatin treatment on mouse brain tumors derived from patient BTSC. The novel strategy targeting molecular aberrations in BTSC may offer innovative therapeutic approaches for malignant gliomas. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3327.
AB0833 The clinical significance sympathetic overactivity in patients with systemic sclerosis: Reverse dipper pattern of blood pressure and ADMA
Authors: Z. Ariturk, S. Dag, R. Cevik, H. Yuksel, H. Kaya, C. Yavuz, I. Batmaz, M.A. Sarıyıldız
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Systemic sclerosis (SSc) is a multisystem disorder characterized by extensive vascular damage, with early generalized microangiopathy and fibrosis of the skin and internal organs. SSc is characterized by parasympathetic impairment and marked sympathetic over activity. <h3>Objectives</h3> The aim of this study was to investigate the potential relationship between serum asymmetric dimethylarginine (ADMA) and systemic hypertension in patients with SSc. <h3>Methods</h3> Thirty patients with systemic sclerosis and thirty controls who had no cardiovascular risk factors were included in this study. All patients and the controls underwent a 24-hour holter recording and plasma ADMA levels were measured. <h3>Results</h3> A total of 10 patients had dipper status (33.3%), 16 patients had non-dipper status (53.3%), 2 patients had reverse dipper status (6.6%) and 2 patients had extreme dipper status (6.6%). ADMA levels were higher in SSc patients when compared with control group and especially significantly higher in SSc patients with reverse dipper status. <h3>Conclusions</h3> The elevated serum levels ADMA and sympathetic over activity may be the result of reverse dipper blood pressure patterns in patients with SSc. <h3>Disclosure of Interest</h3> None Declared
Germany repeals 10 quarterly charge for visiting the doctor
Authors: N. Stafford
Journal: BMJ (2012)

Germany’s Bundestag, the lower house of parliament, has unanimously voted to repeal the so called “medical practice fee,” which requires patients aged 18 years or older who are insured by the nation’s public health insurance system to pay a €10 (£8; $13) charge for their first visit to the doctor in each calendar quarter.

The charge, collected at doctors’ and dentists’ offices, is then funnelled into the public health insurance system, which covers more than 90% of the population. Since 2004, when the fee was created partly to discourage unnecessary visits to the doctor, the charge has netted nearly …
DIFFERENCE IN HEMODYNAMIC MICRO ENVIRONMENT IN VESSELS SCAFFOLDED WITH ABSORB BVS OR MIRAGE BRMS: A PRE-CLINICAL STUDY OF ENDOTHELIAL SHEAR STRESS
Authors: Erhan Tenekecioglu, Ryo Torii, Christos Bourantas, Rafael Cavalcante, Yaping Zeng, Hiroki Tateishi, Pannipa Suwannasom, Daniel Chamie, Ricardo Costa, Yoshinobu Onuma, Mustafa Yilmaz, Alexandre Abizaid, Teguh Santoso, Patrick Serruys, Erasmus MC
Journal: Journal of the American College of Cardiology (2016)
Diffuse Visualization of Bone Marrow With I-123 IMP in a Malignant Melanoma
Authors: KAKUKO KANEGAE, KAZUO ITOH, CHIETSUGU KATO, ERIKO TSUKAMOTO, KUNIHIRO NAKADA, MASAYORI FURUDATE
Journal: Clinical Nuclear Medicine (1996)

I-123 IMP scintigraphy was performed on a 59-year-old man with malignant melanoma. The images showed diffuse uptake in the bone marrow. These findings were more evident when using I-123 IMP than with Ga-67 citrate. I-123 IMP does not normally concentrate in the bone marrow. I-123 IMP scintigraphy may be more sensitive and specific in evaluating the bone marrow metastases from a malignant melanoma.
A role for normativism
Authors: Igor Douven
Journal: Behavioral and Brain Sciences (2011)

Abstract Elqayam &amp; Evans (E&amp;E) argue against prescriptive normativism and in favor of descriptivism. I challenge the assumption, implicit in their article, that there is a choice to be made between the two approaches. While descriptivism may be the right approach for some questions, others call for a normativist approach. To illustrate the point, I briefly discuss two questions of the latter sort.
Pregnancy, Primary Aldosteronism, and Adrenal<i>CTNNB1</i>Mutations
Authors: Ada E.D. Teo, Sumedha Garg, Lalarukh Haris Shaikh, Junhua Zhou, Fiona E. Karet Frankl, Mark Gurnell, Lisa Happerfield, Alison Marker, Mariann Bienz, Elena A.B. Azizan, Morris J. Brown
Journal: New England Journal of Medicine (2015)

Recent discoveries of somatic mutations permit the recognition of subtypes of aldosterone-producing adenomas with distinct clinical presentations and pathological features. Here we describe three women with hyperaldosteronism, two who presented in pregnancy and one who presented after menopause. Their aldosterone-producing adenomas harbored activating mutations of CTNNB1, encoding β-catenin in the Wnt cell-differentiation pathway, and expressed LHCGR and GNRHR, encoding gonadal receptors, at levels that were more than 100 times as high as the levels in other aldosterone-producing adenomas. The mutations stimulate Wnt activation and cause adrenocortical cells to de-differentiate toward their common adrenal-gonadal precursor cell type. (Funded by grants from the National Institute for Health Research Cambridge Biomedical Research Centre and others.).
Calcified Mediastinal Metastases from Ovarian Cancer Imaged With Tc-99m MDP SPECT
Authors: MANABU OGUCHI, KOTARO HIGASHI, MITSURU TANIGUCHI, HIROYASU TAMAMURA, TETSURO OKIMURA, ITARU YAMAMOTO
Journal: Clinical Nuclear Medicine (1998)

A 41-year-old woman was hospitalized for dyspnea. Seventeen years earlier, she had had surgery for papillary ovarian cancer. Her chest CT revealed massive calcified mediastinal lymph node metastases and tracheal stenosis. Surgery confirmed the presence of calcified metastatic ovarian carcinoma of the mediastinal lymph nodes, and a tracheobronchial stent was inserted. Five months later, Tc-99m MDP bone scintigraphy showed no bone metastases, but there was remarkable radionuclide uptake in the right supraclavicular region and the mediastinum. SPECT images precisely visualized the radionuclide accumulation in the calcified lymph node metastases.
OUTCOME OF SEPTAL ALCOHOL ABLATION IN PATIENTS WITH HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY COMPLICATED BY SEVERE SEPTAL HYPERTROPHY AND ATRIAL FIBRILLATION
Authors: Morten Kvistholm Jensen, Linda Jacobsson, Vibeke Almaas, Frank V. Buuren, Peter Hansen, Thomas Hansen, Svend Aakhus, Maria J. Eriksson, Henning Bundgaard, Lothar Faber
Journal: Journal of the American College of Cardiology (2015)
Krupple-like factor 5 promotes breast cancer proliferation through activating fibroblast growth factor-binding protein transcription.
Authors: H Zheng, Z Zhou, C Chen
Journal: Cancer Research (2009)

Abstract Abstract #4071 Breast cancer is the second leading cause of cancer death in U.S. women. The estrogen receptor negative basal breast cancer is usually invasive and the prognosis is poor. Kruppel-like Factor 5 (KLF5) is a zinc-finger transcription factor promoting cell proliferation, survival, cell cycle, and angiogenesis. High expression level of KLF5 has been shown to be associated with shorter breast cancer patient survival time. In our previous microarray studies, fibroblast growth factor binding protein (FGF-BP) is suggested to be one of the KLF5's downstream target genes in the TSU-Pr1 bladder cancer cell line. FGF-BP has been appreciated to be overexpressed in breast tumors and promotes tumorigenesis. To test whether KLF5 promotes cell proliferation through inducing FGF-BP gene transcription in breast cells, we first examined the KLF5 and FGF-BP protein levels in a panel of breast cell lines and found that KLF5 and FGF-BP are co-expressed in ER-negative basal breast cell lines. Over-expression of KLF5 by adenovirus dramatically increased the FGF-BP mRNA and protein expression in MCF7 and BT474. In contrast, KLF5 knockdown decreased the FGF-BP mRNA and protein expression in HCC1937, BT20, and SW527. Importantly, we found that FGF-BP, like KLF5, promotes cell proliferation in MCF10A, SW527 and TSU-Pr1 cells by H3-thymidine incorporation assay. Furthermore, we demonstrated that KLF5 activates the FGF-BP promoter through a putative KLF5 binding site by luciferase reporter assays. We further showed that KLF5 binds to the FGF-BP promoter in vitro by oligo pull down assays and in vivo by chromatin immunoprecipetation (CHIP) assays. These findings suggest that KLF5 may promote breast cancer cell proliferation through directly activating the FGF-BP mRNA transcription. This study will yield valuable insights into the mechanism of KLF5 induced cancer pathogenesis, and will result in useful diagnostic and therapeutic targets. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4071.
Abstract 1436: Interleukin-17A stimulates expression of chemokines and cytokines in prostatic epithelial cells via nuclear factor-kappaB and extracellular signal-regulated kinase pathways
Authors: Zongbing You, Dongxia Ge, Sen Liu
Journal: Cancer Research (2010)

Abstract T helper 17 (Th17) cells secret interleukin-17A (IL-17A) and interleukin-17F. Th17 cells and IL-17A are increased in prostate tumors. The role of IL-17A in prostate cancer is not clear. The objective of this in-vitro study was to investigate the effects of IL-17A on prostatic epithelial cells. Cell growth assay, Western blot, and real-time quantitative reverse transcription- polymerase chain reaction (qRT-PCR) analysis were used to measure the effects of IL-17A on the immortalized normal human prostatic epithelial cell lines (RWPE-1 and pRNS-1-1), human high-grade prostatic intraepithelial neoplasia (PIN) cell line, human prostate cancer LNCaP cell line, and mouse prostate cancer TRAMP-C1 cell line. We found that recombinant human IL-17A (20 ng/ml) did not affect cell growth rate in any of the prostatic cell lines studied. IL-17A did not significantly activate Nuclear Factor-kappaB (NF-kappaB) or Extracellular signal-Regulated Kinase (ERK) signaling pathway in RWPE-1, pRNS-1-1, or PIN cells. IL-17A activated NF-kappaB and/or ERK signaling pathways in LNCaP and TRAMP-C1 cells. When IL-17RC (receptor of IL-17A) was overexpressed in PIN and LNCaP cells, activation of NF-kappaB or ERK signaling pathway by IL-17A was significantly enhanced. IL-17A modestly induced mRNA expression of chemokines (CXCL1 and CXCL2) in RWPE-1, pRNS-1-1, and PIN cells. IL-17A induced mRNA expression of chemokines (CXCL1, CXCL2, CCL2, CCL5, CCL7, and CCL20) and cytokine IL-6 in LNCaP cells. In mouse TRAMP-C1 cells, IL-17A induced mRNA expression of chemokines (CXCL1, CXCL2, CXCL5, CCL2, and CCL5) and cytokine IL-6. When IL-17RC was overexpressed in PIN and LNCaP cells, chemokine expression was significantly enhanced. Our findings suggest that although IL-17A has no effects on cell growth in-vitro, it may modulate the stroma-epithelial interaction in tumor microenvironment in-vivo via stimulation of expression of chemokines and cytokines. Acknowledgement: DoD W81XWH-05-1-0567, NIH/NCRR 2P20 RR020152-06, and LCRC Fund. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1436.
Abstract 1928: Travel distance and pattern of care for laryngeal cancer in Kentucky
Authors: Bin Huang, Thomas J. Gal, Daikwon Han, Brent J. Shelton, Thomas C. Tucker, Mark Dignan
Journal: Cancer Research (2011)

Abstract Introduction: Previous studies have found that access to medical care was associated with stage at cancer diagnosis and receipt of treatment. For laryngeal cancer, radiation related treatments are a preferred option in the majority of cases. Travel distance to the radiation facilities may impact patient access to radiation treatment, especially in a rural mountainous state such as Kentucky. The aim of the study is to assess the influence of travel distance to the nearest radiation center and other factors on inclusion of radiation in the first course treatment for laryngeal cancer. Study Population and Methods: 1995-2006 Kentucky Cancer Registry data were used for this study. A total of 2099 patients age 20 and older at diagnosis with no previous history of cancer and with known TNM stage laryngeal cancer (C32.0-C32.2) were included for the analysis. The road travel distance from their home address to the nearest radiation center was calculated based on road network in GIS. Poverty rate and high school education rate at census tract level were linked with the case data. The SAS procedure GLIMMIX was used to fit random intercept logistic models to predict the association between treatment and other demographic and clinic factors. Results: About 78% of patients received treatment that included radiation as part of first course treatment. The rate of radiation related treatment increased from 68% to 79% in the study period. The average travel distance was 13.5 miles for the group receiving radiation treatment vs. 13.9 miles for the group not receiving radiation treatment. The multivariate logistic model indicated that the travel distance was not associated with radiation treatment. In addition, patients diagnosed recently (per year) were more likely to have radiation related treatment (OR=1.05, p=0.001), and patients treated in large hospitals were positively associated with radiation treatment (OR=2.72, p=0.002) than patients in small hospitals. Conclusions: Although longer travel distance has been found as a barrier for cancer patients living in this rural state, we did not find a similar association for laryngeal cancer. The increasing use of radiation related treatment is encouraging and may be associated with increasing availability of radiation centers in this region. Under utilization of radiation treatment for patients treated in smaller hospitals is a serious concern. Further research is needed to investigate the cause of this under utilization. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1928. doi:10.1158/1538-7445.AM2011-1928
Ga-67 Imaging in a Patient with Polymyalgia Rheumatica
Authors: Hitoya Ohta, Tsuneshi Nakano
Journal: Clinical Nuclear Medicine (2001)

From the Department of Radiology, Osaka Red Cross Hospital, Osaka, Japan Received for publication January 31, 2001. Revision accepted March 28, 2001. Reprint requests: Hitoya Ohta, Department of Radiology, Osaka Red Cross Hospital, 543-8555 Osaka, Japan.
The Illness Narratives
Authors: O. D. Starr
Journal: BMJ (2012)

You could be forgiven for thinking this book was written in 2011. An epidemic of chronic pain, a sense of existential doom pervading society, and patients presenting with ever more weird and wonderful neurological symptoms that just don’t add up. Not to mention the doctors: deprofessionalised, exhausted, and helpless in the face of a workload increasingly made up of “medically unexplained symptoms.”

But this is the 1980s. And Kleinman, a psychiatrist at Harvard Medical School, is drawing on his interviews and research across years of contact with patients in the United States and China.

We meet Howie, a giant of a man, a veteran of the Korean war, crippled …
A Thyroid Suppression Test Using a Single Dose of L-Thyroxine
Authors: Michael S. Wallack, Helen M. Adelberg, John T. Nicoloff
Journal: New England Journal of Medicine (1970)

Thyroid suppression can be tested with a single dose of L-thyroxine. Three milligrams of thyroxine was administered orally after a base-line 24-hour radioactive iodine uptake test; 24-hour uptake seven days later was taken as the post-suppression value. In all normal subjects the level was suppressed to less than 50 per cent of the base-line value, whereas no patient with Graves's disease achieved 50 per cent suppression. There was no detectable metabolic impact from this L-thyroxine dose, except for a mild lowering of the serum cholesterol. Individual subjects, undergoing consecutive tri-iodothyronine and thyroxine suppression tests, demonstrated a similar degree of suppression with either test. Because the conventional tri-iodothyronine suppression test requires daily doses of tri-iodothyronine, erratic self-administration may lead to invalid test results. Since the single-dose L-thyroxine suppression test apparently eliminates this potential source of error, it may be considered the preferred thyroid suppression test to be performed on an outpatient basis.
A Comparison of Directional Atherectomy with Balloon Angioplasty for Lesions of the Left Anterior Descending Coronary Artery
Authors: Allan G. Adelman, Eric A. Cohen, Brian P. Kimball, Raoul Bonan, Donald R. Ricci, John G. Webb, Louise Laramee, Gerald Barbeau, Mouhieddin Traboulsi, Brian N. Corbett, Leonard Schwartz, Alexander G. Logan
Journal: New England Journal of Medicine (1993)

Restenosis is a major limitation of coronary angioplasty. Directional coronary atherectomy was developed with the expectation that it would provide better results than angioplasty, including a lower rate of restenosis. We undertook a randomized, multicenter trial to compare the rates of restenosis for atherectomy and angioplasty when used to treat lesions of the proximal left anterior descending coronary artery.