tbuckley/cabot-search huggingface dataset:
The diagnostic and prognostic values of plasma Epstein‐Barr virus DNA for residual cervical lymphadenopathy in nasopharyngeal carcinoma patients: a retrospective study
Authors: Sai‐Lan Liu, Xue‐Song Sun, Xiao‐Yun Li, Lin‐Quan Tang, Qiu‐Yan Chen, Huan‐Xin Lin, Yu‐Jing Liang, Jin‐Jie Yan, Chao Lin, Shan‐Shan Guo, Li‐Ting Liu, Yang Li, Hao‐Jun Xie, Qing‐Nan Tang, Hu Liang, Ling Guo, Hai‐Qiang Mai
Journal: Cancer Communications (2019)

Abstract Background Currently, the diagnosis and treatment of nasopharyngeal carcinoma (NPC) patients with residual cervical lymphadenopathy following radical radiotherapy with or without chemotherapy are challenging. We investigated the prognosis of NPC patients with residual cervical lymphadenopathy and assessed the diagnostic and prognostic values of Epstein‐Barr virus (EBV) DNA in these patients. Methods This study included 82 NPC patients who were diagnosed with suspected residual cervical lymphadenopathy following completion of antitumor therapy. Their plasma EBV DNA levels were measured using quantitative polymerase chain reaction (qPCR) before the initiation of treatment and before neck dissection. Fine needle aspiration cytology (FNAC) was performed in 21 patients. All patients had undergone neck dissection and postoperative pathological examination to identify the nature of residual cervical lymphadenopathy. The overall survival (OS), progression‐free survival (PFS), distant metastasis‐free survival (DMFS), and locoregional relapse‐free survival (LRRFS) were calculated using the Kaplan–Meier method and compared using the log‐rank test. The Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Multivariable analysis was used to estimate the effect of potential prognostic factors on survival. Results Following a median follow‐up of 52.6 months, compared with patients with negative postoperative pathological findings for residual cervical lymphadenopathy, the patients with positive findings had a significantly lower 3‐year PFS rate (49.9% vs. 83.3%, P = 0.008). Among NPC patients with residual cervical lymphadenopathy, the patients with preoperative plasma EBV DNA &gt; 0 copy/mL had a lower 3‐year PFS rate than did those with no detectable EBV DNA (43.7% vs. 61.1%, P = 0.031). In addition, combining FNAC with preoperative EBV DNA detection improved the diagnostic sensitivity. Multivariable analysis demonstrated that residual cervical lymphadenopathy with positive postoperative pathological result was an independent prognostic factor for PFS and that detectable preoperative plasma EBV DNA was an independent prognostic factor for OS. Conclusions Using FNAC combined with preoperative EBV DNA detection improves the sensitivity in diagnosing NPC with residual cervical lymphadenopathy. Compared with patients with undetectable EBV DNA, patients with detectable preoperative plasma EBV DNA have worse prognosis and may require a more aggressive treatment strategy.
UK student debt continues to rise
Authors: Kay Brennan, Navin Chohan
Journal: BMJ (2002)

Student debt in the United Kingdom is soaring with a widening gap between those from a higher and lower social background, according to new research into university life.

The report by Unite, an organisation that provides student accommodation services in the UK, was based on a survey of 1063 students in October and November 2001. It found that student debt had increased by 26% in the past year. This is up £877 to £4023, with many from poorer backgrounds being overwhelmed with debt.

Students overall anticipated owing £8133 at the end of their course, up by £1107, with those from lower income households expecting to be £9376 in the red. Many medical …
Health care is about service, not about discrimination
Authors: Teresa Pun
Journal: BMJ (2005)

The ethics seminar seemed so straightforward at first: “If a patient is having an arterial bleed right in front of you and there are no gloves in sight, what do you do?” After a brief discussion on the importance of barrier precautions, all 20 of us agreed that we would plug the wound with our bare hands.

“What if the patient had AIDS?” Silence. One person tried to shift the responsibility from the medical student to a senior staff member: “Find the resident.” Another student commented, “We can't be expected to put ourselves at risk.” Others insisted that gloves should be easily accessible and that medical students should never be left alone with …
Twist and turn
Authors: M G H van de Sande, M J H Ariës, C P van der Hart
Journal: BMJ (2004)

A 25 year old professional football player presented to an orthopaedic clinic reporting knee instability, especially on turning. He said that five weeks ago he had been playing when he suddenly heard a snap after changing direction. His knee was slightly flexed when it happened, and it immediately got swollen. Afterwards, he was not able to continue playing. The examination showed some effusion, along with positive Lachman and pivot shift tests. Other tests proved negative.



Fig 1 

1.  What is your differential diagnosis?

2.  What additional diagnostic investigations would be important in this case?

3.  What does the picture show?

4.  What is the treatment of choice for this patient?

1.  Doctors should suspect a partial or complete tear of the anterior cruciate ligament when a patient describes a combination of non-contact twisting, a “snap” sound, and immediate swelling with knee instability. Positive results in both the Lachman and pivot shift tests make the diagnosis likely. This is also often associated with injuries to the medial collateral ligament, meniscal cartilage, or articular cartilage. In this patient, however, direct signs are lacking.

2.  Medical resonance imaging is the first choice for confirmation of a tear of the anterior cruciate ligament. It detects complete and meniscal tears with an average accuracy of 90% and 80-90%, respectively. Since the diagnosis of a torn anterior cruciate ligament …
Picture quiz: Stable angina
Authors: M G Tryfonides, C S Zipitis, N P Curzen
Journal: BMJ (2002)

A 60 year old woman presented to her general practitioner with nine months' history of chest pain. The pain was worse on exertion and temporarily relieved by glyceryl trinitrate spray. She had a long standing history of hypertension treated with bendrofluazide and hypercholesterolaemia treated with a statin. She was also on aspirin. An exercise test was arranged which showed sinus tachycardia segment depression in leads I, II, III, and V1-V6, accompanied by chest pain. Following this the investigation shown in figs 1 and 2 was performed. Fig 3 is a graphical representation of the outline of the heart and the major coronary arteries. Fig. 1 Fig. 2 Fig. 3
BSc in international health starts at Leeds
Authors: Nick Emmel
Journal: BMJ (2002)

A new intercalated degree in international health is running for the first time this academic year (2002-3), run by the Nuffield Institute for Health at the University of Leeds.

The degree is the second of its kind in the country; University College London's is now in its second year. The course was set up as a direct result of efforts by MedSIN (Medical Students International Network) who are campaigning for international health to be a compulsory part of the …
Picture Quiz: Know your anatomy--the femoral triangle
Authors: Donal Shanahan
Journal: BMJ (2003)

A 25 year old man was brought into the emergency department by ambulance. He was involved in a road traffic incident and had an obvious site of blood loss from a fracture of an upper limb. On his arrival at the emergency department, you are told that the ambulance paramedic was unable to gain intravenous access and are asked by the person in charge of resuscitation to try to gain access. You are unable to find any peripheral veins because he is hypovolemic. You attempt to put in a central line via the femoral vein (fig 1).



Fig 1 
Anterior aspect of right leg. A=anterior superior iliac spine; B=pubic symphysis





1.  Describe how you would locate the femoral vein.

2.  Is the femoral vein within the femoral sheath?

3.  If the femoral nerve is damaged accidentally what could be the consequences for your patient?

4.  What is the femoral canal?

1.  Palpate the femoral pulse at the midinguinal point. The …
Bone marrow dendritic cells regulate hematopoietic stem/progenitor cell trafficking
Authors: Jingzhu Zhang, Teerawit Supakorndej, Joseph R. Krambs, Mahil Rao, Grazia Abou-Ezzi, Rachel Y. Ye, Sidan Li, Kathryn Trinkaus, Daniel C. Link
Journal: Journal of Clinical Investigation (2019)

A resident population of dendritic cells (DCs) has been identified in murine bone marrow, but its contribution to the regulation of hematopoiesis and establishment of the stem cell niche is largely unknown. Here, we show that murine bone marrow DCs are perivascular and have a type 2 conventional DC (cDC2) immunophenotype. RNA expression analysis of sorted bone marrow DCs showed that expression of many chemokines and chemokine receptors is distinct from that observed in splenic cDC2s, suggesting that bone marrow DCs might represent a unique DC population. A similar population of DCs was present in human bone marrow. Ablation of conventional DCs (cDCs) results in hematopoietic stem/progenitor cell (HSPC) mobilization that was greater than that seen with ablation of bone marrow macrophages, and cDC ablation also synergizes with granulocyte–colony stimulating factor to mobilize HSPCs. Ablation of cDCs was associated with an expansion of bone marrow endothelial cells and increased vascular permeability. CXCR2 expression in sinusoidal endothelial cells and the expression of 2 CXCR2 ligands, CXCL1 and CXCL2, in the bone marrow were markedly increased following cDC ablation. Treatment of endothelial cells in vitro with CXCL1 induced increased vascular permeability and HSPC transmigration. Finally, we showed that HSPC mobilization after cDC ablation is attenuated in mice lacking CXCR2 expression. Collectively, these data suggest that bone marrow DCs play an important role in regulating HSPC trafficking, in part, through regulation of sinusoidal CXCR2 signaling and vascular permeability.
Choosing your specialty
Authors: Bishoy Morris, Ahmed Magdy
Journal: BMJ (2004)

Most of us find choosing a specialty in which we will spend the rest of our lives a daunting task. Every specialty has an attractive side, and choosing among four or five fascinating areas can be difficult.

Mentors, older peers, and books have always been useful, but now the internet may help. The medical specialty aptitude test (www.med-ed.virginia.edu/specialties) asks you to rate your attributes and preferences and compares them with those of doctors in each specialty. The test then uses your answers …
Nothing is Impossible: Reflections on a New Life
Authors: Maryam Naeem
Journal: BMJ (2003)

Falling from a horse in 1995 left Christopher Reeve quadriplegic, dependent on a ventilator. He wanted to be on his feet by his 50th birthday (in September 2002), and although he has not achieved this goal he has made remarkable progress.

Nothing is Impossible is not a confessional nor a diary but simply a collection of Reeves thoughts and opinions. The focus of the book is the potential for all of us to transcend our limitations, both internal and external, and not just to accept difficulties and problems …
An outspoken neuroscientist
Authors: Balaji Ravichandran
Journal: BMJ (2007)

Susan Greenfield is a professor of pharmacology at the University of Oxford; director of the Royal Institution; author of many bestselling popular science books; and a leading neuroscience researcher with hundreds of papers to her credit. And she has presented television programmes and documentaries. <b>Balaji Ravichandran</b> attempts to understand what drives her
Intra-Tumoral Metabolic Zonation and Resultant Phenotypic Diversification Are Dictated by Blood Vessel Proximity
Authors: Saran Kumar, Husni Sharife, Tirzah Kreisel, Maxim Mogilevsky, Libat Bar-Lev, Myriam Grunewald, Elina Aizenshtein, Rotem Karni, Iddo Paldor, Tomer Shlomi, Eli Keshet
Journal: Cell Metabolism (2019)
Snowboarding is more dangerous than skiing
Authors: Caroline White
Journal: BMJ (2001)

Snowboarders are more than twice as likely as skiers to sustain serious injuries, and they also tend to be injured more often, according to research published in the Western Journal of Medicine (2001;174:128-31).

The research shows that snowboarders are more than twice as likely as skiers to sustain serious fractures, become concussed and lose consciousness, dislocate their joints, and have their teeth knocked out.

The most common injuries tend to be sprains, fractures, cuts, and bruising. One in five of all injuries and half of all fractures involve the wrists, as snowboarders overextend their arms to balance a fall in the absence of ski poles.



AP PHOTO/CAMAY SUNGU



Originally introduced in the 1920s, snowboarding is now one of the fastest growing winter sports …
You should know, you're a medic: Why does urine smell odd after eating asparagus?
Authors: Roger JG Stevens
Journal: BMJ (2000)

Why does urine smell odd after eating asparagus? Roger Stevens investigates Asparagus, or Asparagus officinalis, is a member of the lily family and grows throughout central and southern Europe, north Africa and west and central Asia. The British asparagus season is short, with asparagus being available during the early summer from late April to early July.1

In the 18th century, a physician to the French royal family wrote in his Treatise on all sorts of foods that asparagus “eaten to Excess… causes filthy and disagreeable Smell in the Urine.”2 The smell cannot be noticed in raw or cooked asparagus, so it is believed that the body converts a compound within asparagus into a metabolite, which can then be smelled in …
Prevalence of human papillomavirus, human immunodeficiency virus and other sexually transmitted infections among female sex workers in Togo: a national cross-sectional survey
Authors: V.M. Ferré, D.K. Ekouevi, F.A. Gbeasor-Komlanvi, G. Collin, Q. Le Hingrat, B. Tchounga, M. Salou, D. Descamps, C. Charpentier, A.C. Dagnra
Journal: Clinical Microbiology and Infection (2019)
A road traffic crash
Authors: Graeme Philip Hopper, E R Gardner
Journal: BMJ (2008)

A 77 year old man presented to the emergency department after being hit by a car that was travelling at 30 miles an hour (50 kmph). A witness said that the car hit the man's left leg and that he fell on to his left side. The man's pulse was 65 beats/min, and his blood pressure was 130/70 mm Hg. His Glasgow coma score was 15/15, and he had obvious deformities to his left leg and upper left arm, although these did not compromise the skin. Plain radiographs of his left leg are shown in fig 1. Fig 1 Anteroposterior radiograph of the left leg Fig 2 Lateral radiograph of the left leg
Defining Improvement in Nonalcoholic Steatohepatitis for Treatment Trial Endpoints: Recommendations From the Liver Forum
Authors: Amanda Cheung, Brent A. Neuschwander‐Tetri, David E. Kleiner, Elmer Schabel, Mary Rinella, Stephen Harrison, Vlad Ratziu, Arun J. Sanyal, Rohit Loomba, Sophie Jeannin Megnien, Richard Torstenson, Veronica Miller
Journal: Hepatology (2019)

Identifying effective therapies for nonalcoholic steatohepatitis (NASH) with fibrosis is a pressing challenge, with 1%‐2% of the population in developed nations at risk of developing NASH cirrhosis and its complications. The design of NASH clinical therapeutic trials is hampered by the long period of minimally symptomatic disease that typically precedes the development of decompensated cirrhosis and the accompanying uncertainties regarding the best precirrhotic trial endpoints that reliably reflect a subsequent reduction in liver‐related morbidity and mortality. The Liver Forum is a multistakeholder organization comprised of academic, industry, and regulatory experts working from a regulatory science perspective to identify barriers, prioritize research, and identify solutions to accelerate therapeutic development for NASH. Past work of The Liver Forum has focused on recommendations for disease definitions and baseline parameters to be implemented in clinical trials that are designed to assess disease status and prevent progression to cirrhosis, liver transplantation, hepatocellular carcinoma, and death. The purpose of this summary is to review currently available clinical data to identify parameters that change in parallel with liver histology and are likely to reflect clinically meaningful reductions in the risk of developing cirrhosis and its complications. We review available data on exploratory histological, blood‐based, and imaging pharmacodynamic biomarkers that may reflect meaningful treatment responses and provide recommendations regarding measurements to be considered in phase 2 and 3 trials as well as during postmarketing monitoring trials.
A “New” Parameter for Aortic Stenosis Severity
Authors: Mackram F. Eleid, Rick A. Nishimura
Journal: JAMA Cardiology (2019)

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The contribution made by skin‐infiltrating basophils to the development of alpha‐gal syndrome
Authors: Reiko Kageyama, Toshiharu Fujiyama, Takahiro Satoh, Yasuhito Keneko, Seiya Kitano, Yoshiki Tokura, Hideo Hashizume
Journal: Allergy (2019)

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Scottish parliament calls for increase to GP workforce and funding
Authors: Gareth Iacobucci
Journal: BMJ (2019)

Scottish MPs have called on the government to undertake an “urgent review” of GP recruitment and funding to tackle chronic workforce shortages.

A motion tabled by the Scottish Green Party, which recognised the “considerable challenges” in recruiting and retaining GPs in Scotland, was passed by MSPs after a debate in the Scottish parliament.1

The motion noted calls by the Royal College of General Practitioners (RCGP) and the BMA for general practice to receive 11% of the total health budget and called on the Scottish government “to undertake an urgent review of GP recruitment, resources, and funding.” …
Medical schools should stamp out sexual harassment
Authors: Manjulika Das
Journal: BMJ (2004)

Medical schools should implement measures for combating sexual harassment in their training programmes, a report in Academic Medicine suggests (2004;79:817-24).

The report, by researchers at Brown Medical School in the United States, documented different experiences of gender based sexual harassment at medical school. Women may be asked discriminatory questions during medical school interviews and are the brunt of sexist jokes and unwelcome comments …
Trastuzumab deruxtecan (DS-8201a) in patients with advanced HER2-positive gastric cancer: a dose-expansion, phase 1 study
Authors: Kohei Shitara, Hiroji Iwata, Shunji Takahashi, Kenji Tamura, Haeseong Park, Shanu Modi, Junji Tsurutani, Shigenori Kadowaki, Kensei Yamaguchi, Satoru Iwasa, Kaku Saito, Yoshihiko Fujisaki, Masahiro Sugihara, Javad Shahidi, Toshihiko Doi
Journal: The Lancet Oncology (2019)
The Survival Guide: What to Do in a Biological, Chemical, or Nuclear Emergency
Authors: Michael Clements
Journal: BMJ (2003)

If you are the kind of person who likes to store a pair of sturdy boots, a warm jacket, bottled water, and a packet of biscuits in the boot of your car for that unexpected blizzard, this is the ideal book for you. Resplendent in a high visibility orange cover (presumably making it easier to locate in emergencies), this book literally wears its heart on its sleeve.

Angelo Acquista is the ideal candidate to write this book, as medical director for the New York mayor's office of emergency …
Not my fault
Authors: Ben Lawton
Journal: BMJ (2003)

I have been quietly gutted ever since the results of A level exams I got in August 1996. My results were at the opposite end of the alphabet to those required for a place on a medical course. Seven years later I am delighted to discover it was not my fault.

In the latest shameless act of legal immaturity, twelve alcoholics are apparently suing drinks companies for not …
Metabolic Checkpoint of Immune Cells in Melanoma Brain Metastases
Authors: Colt A. Egelston, Kim Margolin
Journal: Cancer Discovery (2019)

Abstract Summary: Metabolic features of both cancer cells and immune cells shift with nutrient availability in the tumor microenvironment, resulting in differential effects on antitumor immune function. The work of Fischer and colleagues demonstrates that increased oxidative phosphorylation in brain metastases in patients with melanoma is a key regulator of intracranial immune surveillance and that inhibition of oxidative phosphorylation could reduce the incidence of intracranial brain metastases in a murine model of melanoma. See related article by Fischer et al., p. 628.
Are TLAs more trouble than they're worth?
Authors: Pooja Goel, Wai Yoong
Journal: BMJ (2006)

Question — What do the common abbreviations RBKA, LECLE, OGD, THR, MUA, ORIF, TAH, BSO, TIPS, and ERCP stand for?

Despite the many advances in technology, most of the communication between health professionals continues to be through handwritten medical notes. The cliche of the doctor's illegible handwriting remains evident, and attempts by colleagues to decipher this (through logic and lateral thinking) are made more difficult by the number of abbreviations and acronyms still commonly in use.

Because of the increasing number of medical cases being taken to court, more and more time is taken up writing in patients' notes, and there is more emphasis on documentation and providing evidence of practice. At the same time, however, the efficiency of the NHS continues to be scrutinised, with pressures to fulfil government targets on waiting times. Many professionals find they are spending increasing amounts of time on administrative tasks.



A study published by the Royal Society of Medicine measured the components of each outpatient episode in 167 patients attending a general urology follow-up clinic. Two fifths (41%) of time in the clinic was spent away from …
BMJ editor resigns position at Nottingham University
Authors: Siân Knight
Journal: BMJ (2001)

Richard Smith, editor of the British Medical Journal , has resigned from his post as professor of medical journalism at the University of Nottingham following the university's controversial decision to accept £3.8m from British American Tobacco (BAT). The money was given to fund a centre for corporate responsibility at the university's business school, but the decision made last December to accept the donation from the second largest tobacco company in the world has been criticised by staff and students alike.

Dr Smith resigned after a web …