tbuckley/cabot-search huggingface dataset:
Drugs testing in sports is farcical
Authors: Bhavesh Gohil
Journal: BMJ (2004)

Just as everyone thought that thought the Riogate saga was finally over, I decided that we should actually think about what actually happened and what it really means. The bare facts are that Rio Ferdinand missed a routine drug test and was then banned from football for eight months and fined £50,000 ($90 700; €75 000) as punishment.

Without going into too much details of the now infamous day, I agree that although he was wrong to have missed or “forgotten” to take the drugs test, because he was moving house, it seems that the punishment does not fit the crime.

Ferdinand seems to have been made a scapegoat, …
Challenges of investigating a large food-borne norovirus outbreak across all branches of a restaurant group in the United Kingdom, October 2016
Authors: Mari Morgan, Vicky Watts, David Allen, Daniele Curtis, Amir Kirolos, Neil Macdonald, Ellie Maslen, Deb Morgan, Ayoub Saei, James Sedgwick, Janet Stevenson, Deborah Turbitt, Roberto Vivancos, Catriona Waugh, Chris Williams, Valerie Decraene
Journal: Eurosurveillance (2019)

During October and November 2016, over 1,000 customers and staff reported gastroenteritis after eating at all 23 branches of a restaurant group in the United Kingdom. The outbreak coincided with a new menu launch and norovirus was identified as the causative agent. We conducted four retrospective cohort studies; one among all restaurant staff and three in customers at four branches. We investigated the dishes consumed, reviewed recipes, interviewed chefs and inspected restaurants to identify common ingredients and preparation methods for implicated dishes. Investigations were complicated by three public health agencies concurrently conducting multiple analytical studies, the complex menu with many shared constituent ingredients and the high media attention. The likely source was a contaminated batch of a nationally distributed ingredient, but analytical studies were unable to implicate a single ingredient. The most likely vehicle was a new chipotle chilli product imported from outside the European Union, that was used uncooked in the implicated dishes. This outbreak exemplifies the possibility of rapid spread of infectious agents within a restaurant supply chain, following introduction of a contaminated ingredient. It underlines the importance of appropriate risk assessments and control measures being in place, particularly for new ingredients and ready-to-eat foods.
Students urged to have meningitis vaccine
Authors: Siân Knight
Journal: BMJ (2000)

Three out of four first year university students in the United Kingdom are now vaccinated against meningitis group C, according to a recent poll carried out by the Primary Care Virology Group. The group is disappointed by the results of the poll and is now urging students to register with their university general practitioner.

The survey, randomly carried out in 10 universities across Britain, had 610 participants. The results indicate that although up to 91% of students nationwide were aware of the need to be vaccinated after a high profile multimedia …
Wide ranging student review announced
Authors: Alex Brooks
Journal: BMJ (2001)

Estelle Morris, secretary of state for education and skills, has announced a “wide-ranging and fundamental review” into higher education in England.

The current system of tuition fees and student loans has been deeply unpopular, with the abolition of grants in 1997 facing particular criticism. A recent report in the Guardian newspaper claimed that there was disagreement between key departments over future student funding.

A “graduate tax” of 3p in the £1, providing increased university funding and a universal £3800 …
Minerva: July 2000
Authors: I U Khan, M S Coady
Journal: BMJ (2000)

A historical medical textbook, written by an English monk over 800 years ago, went on display last week at the US National Library of Medicine in Bethesda after an absence of over half a century ( Washington Post 22 May). The book, which contains many of Hippocrates' famous aphorisms, disappeared under suspicious circumstances sometime in the 1940s. It turned up last year at a rare book market in Southern California. The dealer donated the book to the library after some “decorous wrangling.”

Lipid lowering drugs are expensive but they work, reducing the risk of coronary heart disease even in smokers ( Heart 2000;83:619-20). People who cannot stop smoking even though they have a risky serum lipid profile should therefore be offered statins just like everyone else, argue two doctors from Glasgow. There are plenty of effective interventions to help smokers give up, but once these options have been tried and have failed, statins are considerably better than nothing.

The cost effectiveness of statins in people with high serum cholesterol concentrations depends on a …
Reflecting on SARS in Toronto
Authors: Tim Hanna
Journal: BMJ (2003)

The boardroom grew silent as one of our staff made his promised announcement after morning rounds. Everyone seemed to sense that we were about to be dealt some sort of grave news. He told us how our hospital had received word from Scarborough Grace Hospital of a strange respiratory illness that has killed two members of the same family and infected some others. He explained that we would shortly be accepting a patient from that facility here at Sunnybrook. We were surprised to hear that no one was sure exactly what this was and that it appear to severely affect even younger people.

This was my first experience of sudden acute respiratory syndome (SARS), though at the time none of us knew it by that name. I am a medical student at the University of Toronto and my base hospital is Sunnybrook and Womens College Health Sciences Centre. This hospital has been near the centre of the action during Canadas outbreak of SARS.

For a while, SARS was quite a mysterious illness. I remember one eerie night early in the outbreak, while medical students were still permitted to work in Torontos hospitals. It was the end of my shift on call for general …
Increased Protein Insolubility in Brains From a Subset of Patients With Schizophrenia
Authors: Leslie G. Nucifora, Matthew L. MacDonald, Brian J. Lee, Matthew E. Peters, Alexis L. Norris, Benjamin C. Orsburn, Kun Yang, Kelly Gleason, Russell L. Margolis, Jonathan Pevsner, Carol A. Tamminga, Robert A. Sweet, Christopher A. Ross, Akira Sawa, Frederick C. Nucifora
Journal: American Journal of Psychiatry (2019)

The mechanisms leading to schizophrenia are likely to be diverse. However, there may be common pathophysiological pathways for subtypes of the disease. The authors tested the hypothesis that increased protein insolubility and ubiquitination underlie the pathophysiology for a subtype of schizophrenia.Prefrontal cortex and superior temporal gyrus from postmortem brains of individuals with and without schizophrenia were subjected to cold sarkosyl fractionation, separating proteins into soluble and insoluble fractions. Protein insolubility and ubiquitin levels were quantified for each insoluble fraction, with normalization to total homogenate protein. Mass spectrometry analysis was then performed to identify the protein contents of the insoluble fractions. The potential biological relevance of the detected proteins was assessed using Gene Ontology enrichment analysis and Ingenuity Pathway Analysis.A subset of the schizophrenia brains showed an increase in protein insolubility and ubiquitination in the insoluble fraction. Mass spectrometry of the insoluble fraction revealed that brains with increased insolubility and ubiquitination exhibited a similar peptide expression by principal component analysis. The proteins that were significantly altered in the insoluble fraction were enriched for pathways relating to axon target recognition as well as nervous system development and function.This study suggests a pathological process related to protein insolubility for a subset of patients with schizophrenia. Determining the molecular mechanism of this subtype of schizophrenia could lead to a better understanding of the pathways underlying the clinical phenotype in some patients with major mental illness as well as to improved nosology and identification of novel therapeutic targets.
RETRACTED ARTICLE: The circRNA circAGFG1 acts as a sponge of miR-195-5p to promote triple-negative breast cancer progression through regulating CCNE1 expression
Authors: Rui Yang, Lei Xing, Xiaying Zheng, Yan Sun, Xiaosong Wang, Junxia Chen
Journal: Molecular Cancer (2019)

In recent years, circular RNAs (circRNAs), a new star of non-coding RNA, have been emerged as vital regulators and gained much attention for involvement of initiation and progression of diverse kinds of human diseases, especially cancer. However, regulatory role, clinical significance and underlying mechanisms of circRNAs in triple-negative breast cancer (TNBC) still remain largely unknown.Here, the expression profile of circRNAs in 4 pairs of TNBC tissues and adjacent non-tumor tissues was analyzed by RNA-sequencing. Quantitative real-time PCR and in situ hybridization were used to determine the level and prognostic values of circAGFG1 in two TNBC cohorts. Then, functional experiments in vitro and in vivo were performed to investigate the effects of circAGFG1 on tumor growth and metastasis in TNBC. Mechanistically, fluorescent in situ hybridization, dual luciferase reporter assay, RNA pull-down and RNA immunoprecipitation experiments were performed to confirm the interaction between circAGFG1 and miR-195-5p in TNBC.We found that circAGFG1 was evidently up-regulated in TNBC, and its level was correlated with clinical stage, pathological grade and poor prognosis of patients with TNBC. The results indicated that circAGFG1 could promote TNBC cell proliferation, mobility and invasion as well as tumorigenesis and metastasis in vivo. Mechanistic analysis showed that circAGFG1 may act as a ceRNA (competing endogenous RNA) of miR-195-5p to relieve the repressive effect of miR-195-5p on its target cyclin E1 (CCNE1).Our findings suggest that circAGFG1 promotes TNBC progression through circAGFG1/miR-195-5p/CCNE1 axis and it may serve as a new diagnostic marker or target for treatment of TNBC patients.
AIDS in America — Back in the Headlines at Long Last
Authors: Wafaa M. El-Sadr, Kenneth H. Mayer, Miriam Rabkin, Sally L. Hodder
Journal: New England Journal of Medicine (2019)

AIDS in America Ending AIDS as a public health threat in the United States is achievable, but it will not be a simple endeavor. The effort can be informed by the latest advances in science and public health and by earlier bipartisan initiatives to tackle HIV globally.
So grateful to have the NHS
Authors: Shravan Tewary
Journal: BMJ (2009)

In January the Indian prime minister underwent coronary bypass surgery. My parents were in India at the time, and I wondered how they would have coped there if one of them had needed such surgery. Not very well, I concluded.

The whole nation was proud of its humble prime minister, who set an excellent example by opting to have such potentially life threatening surgery in his home country rather than go to the West, as his contemporaries and predecessors have done. He is 76, has diabetes, and has had previous …
Looking from both sides of the fence
Authors: Alan Woodall
Journal: BMJ (2001)

I knew something was wrong when my father left an answerphone message for me. He hates using the telephone. He is a tough man, an ex-miner and ex-soldier, but his voice was strained with the emotion that he was trying to suppress as he asked me to call home. A second message had been left, more urgent, but more informative. I had just returned home after my first week as a house officer to learn that my mother had renal cancer.

My first week had been exhausting, due to the pressures of work on a busy medical firm and my own inefficiency and inexperience. The first days were spent juggling impossible levels of demand; endless requests from nurses and perpetual bleeps were draining. Despite my ideals, I felt frustration when asked to speak to patients or relatives who “got in the way” of our ward jobs—the endless blood forms to be written, cannulas to be inserted, and countless other tasks that are the lot of a house officer in …
Picture quiz: A swelling of the arm
Authors: John W Williams, Maktoum Azeez
Journal: BMJ (2004)

A GP referred a 73 year old woman with a one day history of sudden painful swelling in her left arm. She was clinically well, and, apart from diffuse swelling of the whole of her left arm, physical examination was unremarkable. Doctors did a number of investigations, including a chest x ray and a computed tomography (CT) scan (figs 1-3).

1.  What abnormality is seen in fig 1?         

2.  What is the investigation in fig 2? What abnormality can you see?         

3.  What abnormalities can you see in the CT scan (fig 3)? What is the likely diagnosis?         

1.  A large superior mediastinal mass causing tracheal deviation and compression.

2.  A film obtained during venography of the left arm. The left subclavian vein has an irregular stricture, and the left brachiocephalic vein is occluded.

3.  The CT of the chest (enhanced with intravenous contrast material) shows enlargement of the right lobe and isthmus of …
Laboratory medicine in primary care: Investigating iron status in microcytic anaemia
Authors: Michael J Galloway, W Stuart A Smellie
Journal: BMJ (2007)

Microcytic anaemia is often assumed to indicate iron deficiency, but up to 20-30% of patients will have another diagnosis. Measurement of serum ferritin offers the best means of confirming iron deficiency, say <b>Michael J Galloway</b> and <b>W Stuart A Smellie</b>
Breathlessness with cough, malaise, and fever
Authors: Jeremy Rodrigues, Nik Hirani
Journal: BMJ (2008)

A 62 year old woman presented with shortness of breath that had gradually worsened in three months. She had a productive cough of the same duration, intermittent fevers, malaise, and mild weight loss. She had no relevant occupational or drug history but had kept a budgerigar (parakeet) for the past 18 months. On examination, her breath sounds were vesicular with no added sounds. A chest x ray (fig 1) and a high resolution computed tomogram (fig 2) were taken. Fig 1 Posteroanterior chest radiograph of patient at presentation Fig 2 Selected window from high resolution computed tomogram of the thorax. The image is taken at the level of the division of the right middle and lower bronchi, showing the mid-zones of the lungs. The oblique fissure of the left lung can be seen
Abstract 13066: Population-Based Burden of Sudden Death in the Young in a United States Cohort
Authors: Kristin M Burns, Carri Cottengim, Heather Dykstra, Meghan Faulkner, Alexa Erck Lambert, Heather MacLeod, Alissa Novak, Christine K Olson, Sharyn E Parks, Mark W Russell, Carrie K Shapiro-Mendoza, Esther Shaw, Niu Tian, Vicky Whittemore, Jonathan R Kaltman
Journal: Circulation (2018)

Introduction: Prevention of sudden death in the young (SDY) is hindered by lack of population-based data to determine burden. The National Institutes of Health/Centers for Disease Control and Preve...
Jump off the conveyor belt
Authors: Rebecca Hope
Journal: BMJ (2004)

The most interesting thing about the past three months is the variety of reactions to telling people that I am taking a year out from medicine. “But what will you do?” is a common first question. “Well … travel. And then … I don't really know,” is usually my answer. “Won't you get bored doing that?” Well, once you get bored with living it is a sorry state of affairs.

Sometimes I feel sorry for our generation. In one way we have everything we need: opportunities to study, travel, and achieve what we want, if we work hard enough, are better than ever before. Despite his efforts, my grandfather would not have been able to study medicine and become a doctor. It was a source of great pride for him that I made it to the first step. But the world of medical school can easily become a hothouse, leaving you fighting for space to breathe. Medics are …
Doctor in the House
Authors: Teresa Pun
Journal: BMJ (2006)

After the self congratulatory days of ER and Chicago Hope , it might be difficult to imagine a medical soap that artfully comments upon the connection, if any, between what a man does and who he is. But then House MD is not your typical medical drama.

Dr Gregory House (Hugh Laurie) is single, crippled, and addicted to Vicodin (acetaminophen and hydrocodone). He is also a brilliant physician, accompanied by three other young physicians, each from a different specialty. Dr Allison Cameron (Jennifer Morrison) is an immunologist who graduated at the top of her class but was hired for her good looks. “It's like having a nice piece of art” explains House. Dr Eric Foreman (Omar Epps) is a neurologist with a delinquent past. And Dr Robert Chase (Jesse Spencer) is the privileged intensive care unit physician whose daddy made a call to secure his position. The cast is rounded out by House's colleague and friend, twice widowed oncologist Dr James Wilson (Robert Sean Leonard) and the pragmatic Dr Lisa Cuddy (Lisa Edelstein), dean of medicine and hospital administrator.

The most defining quality of House, in contrast to his more reserved colleagues, is his stark …
China to offer free HIV test to all
Authors: James Hallinan, Bristol Nadeeja Koralage
Journal: BMJ (2004)

The Chinese government is to offer all of the country's 1.3 billion people free HIV tests. The policy, dubbed the Four Frees and One Care scheme includes free antiretroviral drugs, testing, prevention of mother to child transmission, and the schooling of orphans. “One care” refers to the treatment of people with HIV/AIDS, which has yet to be defined.

Chinese vice premier Wu Yi told the Xinhua news agency that the disease had reached its turning point from high risk population infection to universal epidemic.

Until recently, HIV tests were only available to those at high risk …
Association of Increased Colony-Count Threshold for Urinary Pathogens in Hospitalized Patients With Antimicrobial Treatment
Authors: Marc-Andre Smith, Robert Puckrin, Philip W. Lam, Michael J. Lamb, Andrew E. Simor, Jerome A. Leis
Journal: JAMA Internal Medicine (2019)

2][3] Two prior studies suggest that UC growth from hospitalized patients with low colony counts of organisms (10 4 to 10 5 CFU [colony-forming units]/ mL) was infrequently associated with urinary tract infection (UTI) but generated substantial antimicrobial prescribing for ASB/C. 2,3thods | At our acute care hospital, the threshold for identifying potential uropathogens from UCs submitted from inpatient units was increased from 10 4 CFU/mL or greater to 10 5 CFU/mL or greater on March 1, 2017.Urine cultures with low colony counts, defined as 10 4 to 10 5 CFU/mL, were automatically issued a report stating that these organisms usually represent ASB/C, and could be identified at the telephone request of any clinician with a high suspicion for UTI.Urine specimens from outpatient units, emergency departments,
UK government to introduce university tuition fees
Authors: Clare Hughes
Journal: BMJ (2004)

Students entering English universities in 2006 will have to pay up to £3000 ($5500; €4500) a year in tuition fees if a bill presented in the House of Commons in January is approved. The Higher Education Bill outlines the government's plans to introduce top-up fees, which would allow different universities to charge different tuition fees.

Students currently pay a fixed fee of £1125 each year while they are at university. The government's proposal would enable universities to have greater freedom to decide their own fees, which would vary between courses at each institution. …
Creative consulting: how to make the room disappear
Authors: David Reilly
Journal: BMJ (2001)

<b>David Reilly</b> explains how you can totally concentrate on your encounter with your patient. This series aims to support and encourage you towards developing the therapeutic effect you have as a person and concentrate on the ingredients common to most all of your medical related encounters. So far, you have considered some reasons for doing this.1 The main ingredients are human. There will always be relationships, even if only fleeting. So let us begin. And let us begin with the key ingredient you can influence--you.
Firm bribed doctors to prescribe overpriced drug, US alleges in suit
Authors: Owen Dyer
Journal: BMJ (2019)

The US government has joined two whistleblower lawsuits as a co-plaintiff against the drug firm Mallinckrodt, accusing the company of paying kickbacks to doctors to increase prescriptions of a drug whose price has risen more than 97 000%, from $40 a vial in 2000 to nearly $39 000 (£30 000; €35 000) today.

The lawsuits allege that cash payments, gifts, and junkets drove a small number of doctors to make HP Acthar Gel (repository corticotropin injection), a blockbuster drug with annual sales totalling more than $1bn, much of it coming from Medicare.

Approved in 1952 to treat spasms in infants, Acthar has come to be used in adult conditions as varied as nephrotic syndrome, psoriatic or rheumatoid arthritis, sarcoidosis, optic neuritis, ankylosing spondylitis and, most lucratively, multiple sclerosis.

But in addition to healthy profits the drug …
Abstract TS2-2: Clinical development of inhibitors of the PI3K pathway
Authors: C Saura Manich
Journal: Cancer Research (2019)

Abstract The activation of the PI3K-AKT-mTOR pathway as a mechanism of resistance to different breast cancer treatments has been well described for years at the preclinical level. This observation, together with the high frequency of alterations of this pathway in patients with breast tumors (especially in the luminal subtype such as PI3KCA mutations, loss of PTEN function or AKT mutations) makes this pathway a highly desirable in inhibiting the growth of these tumor types. The first clinical evidence that inhibition of the PI3K-AKT-mTOR pathway leads to increased progression-free survival in metastatic breast cancer came from the BOLERO-2 trial with the mTORC1-targeting agent everolimus, the only PI3K-AKT-mTOR pathway inhibitor approved to date in breast cancer. Potentially better drugs have subsequently been developed and tested. PI3K inhibitors were designed to potentiate the inhibition of the pathway to optimize treatment efficacy and improve the toxicity profile. The first to be developed were the pan-PI3K inhibitors buparlisib and pictilisib. Results from pivotal clinical studies combining fulvestrant demonstrated increased efficacy but at the cost of increased toxicity that was considered clinically unacceptable. None of them consequently eceived approval for breast cancer treatment. It was hoped that Isoform-specific PI3K inhibitors (alpha or beta-sparing) would improve the toxicity profile and increase efficacy, especially in patients with molecular alterations in the PI3K-AKT-mTOR pathway. We are now witnessing interesting times for these drugs since we have seen the results of the two phase III studies with specific pathway inhibitors, taselisib and alpelisib. During this session we will carefully review the results of both studies in terms of efficacy and toxicity profile as well as those from other phase I-II clinical trials with these and other agents. Representing the main challenges in the future, we still have to determine the best strategy to select those patients who will likely derive greater benefit from these therapies as well as establish the context in which they are most effective, taking into account the mechanisms of resistance that PI3K inhibitors can overcome or those that emerge during treatment with these drugs. Citation Format: Saura Manich C. Clinical development of inhibitors of the PI3K pathway [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr TS2-2.