tbuckley/cabot-search huggingface dataset:
Minerva: May 2000
Authors: Arup Ray, Aloke Sen, A T King, John Thorne
Journal: BMJ (2000)

Facing certain death from an unresectable and aggressive lung tumour, a 47 year old woman from Florida embarked on a cruise and a course of germanium, a controversial alternative treatment for cancer ( Chest 2000;117:591-3). Her tumour and her symptoms disappeared, and she remains well four years after diagnosis. Oncologists are baffled. They had definitive histology of a spindle cell carcinoma, so must choose between two equally implausible explanations: spontaneous remission of the tumour or a real treatment effect from a toxic elemental metal that has failed to work in clinical trials of breast, prostate, and renal cancers. It's unlikely we will ever know.

Plain skull radiographs should be abandoned as a screening tool for intracranial bleeding in people with a mild head injury, write Dutch investigators after their meta-analysis showed that it has a sensitivity of only 38% ( Journal of Neurology Neurosurgery and Psychiatry 2000;68:416-22). The low sensitivity means that a normal skull radiograph does not rule out serious internal bleeding, which occurs in about 8% of cases. The cornerstones of management are clinical triage, observation, and computed tomography for those at high risk, the authors say.

An observational study in Thorax finds …
Singaporean surgeon who tried to charge £8m for cancer treatment is removed from medical register
Authors: Clare Dyer
Journal: BMJ (2019)

A leading Singaporean surgeon whose career ended after she grossly overcharged the royal family of Brunei has been allowed to remove her name voluntarily from the UK medical register.

Susan Lim Mey Lee was suspended for three years by the Singapore Medical Council for charging seriously inflated fees, but she did not notify the General Medical Council (GMC) about the case.

Lim, who qualified in Australia in 1979, was once Singapore’s most famous surgeon: an expert in robotic assisted surgery and stem cell entrepreneur who led the team that performed the city state’s first liver transplant. For six months in 2007 she managed the care of the Queen of Brunei’s sister, who had breast cancer.

She submitted invoices for S$24m (then £8m; €12m; US$16m). Challenged over the amount, she swiftly agreed to reduce it …
SLE and me
Authors: Rebecca Gledhill
Journal: BMJ (2001)

Systemic lupus erythematosus (SLE) is not easy to define. To many medical students, it is probably seen as one of those rare, small print syndromes, which are quite unlikely to come up in exams. Some would associate it with the typical butterfly rash and may know that it involves the joints. Anyone who knows more than that as an undergraduate is either extremely keen, or, like me, personally affected.

It all started with the itching. It seemed to be all over and it just got worse. I had just got back from South Africa and it was not long before I had literally scratched off my tan. I would just lie in a cold bath until I went numb. But I left it a few days before I went to my GP. I thought that it would just get better.

When I finally sat myself before the GP I was in a state. I had got hold of some antihistamines which took the edge off the itching, but they made me drowsy. …
Film review: Sixth Sense
Authors: Sean A Spence
Journal: BMJ (2000)

“See… to perceive by the sense seated in the eye; to perceive mentally; to apprehend; to recognise; to understand; to learn.”1

This film is about reparation: what happens when one man gets to retrace his steps, to see his errors, and to correct or atone for something he has previously missed. It shows what transpires when an item of his clinical work comes to affect the course of his whole life. It also …
Abstract 19483: Oxidative Posttranslational Modification of SERCA2 Mediates Heart Failure Exacerbation in Young Patients With Non-Ischemic Cardiomyopathy
Authors: Takumi Toya, Toyakazu Kimura, Ayumu Osaki, Atsushi Sato, Nobuyuki Masaki, Takeshi Adachi
Journal: Circulation (2017)

Background: Sarcoplasmic/Endoplasmic Reticulum (SR) Ca2+ ATPase (SERCA) uptakes cytosolic calcium into SR. SERCA2 is present in the myocardium. Oxidative posttranslational modifications (OPTM) impa...
Blood tests: essential or excessive?
Authors: Neha Sharma
Journal: BMJ (2006)

Perhaps one of the most widely used medical investigations is the humble blood test. Or is it quite so humble? As a medical student, I took a part time job taking blood as a phlebotomist at my local district hospital. Often the perception amongst phlebotomists is that blood tests become the addictive habit of newly graduated nervous doctors. Weekend requests are apparently “urgent only.” Yet, with 17 requests a ward on a Sunday morning, you wonder how many of the results will even be reviewed. Surprisingly, we find that “extremely urgent” patient X has gone home, or “very seriously sick” patient Y has gone for a morning walk.

Blood tests are important in clinical practice. But is it possible to put a little more thought into requesting tests? Apart from some phlebotomist agitation, there are important factors at stake. In fact, unnecessary testing may cause significant reduction in blood volume in critically ill patients.1

Although blood tests are considered to be cheap, overuse of any service may …
A testing time
Authors: Ben Sieniwicz
Journal: BMJ (2007)

In Sheffield, where I study, all children are routinely screened for the most common genetic mutations associated with cystic fibrosis as part of the Guthrie test, in the first week of life. But this practice is not yet routine throughout the United Kingdom.

Early detection of the disease would allow people advanced access to drugs and aggressive nutritional treatment. Evidence indicates that doing so …
Associations of cutaneous and extracutaneous infections with hidradenitis suppurativa in U.S. children and adults
Authors: H.H. Lee, K.R. Patel, V. Singam, S. Rastogi, J.I. Silverberg
Journal: British Journal of Dermatology (2019)

Hidradenitis suppurativa (HS) is associated with bacterial colonization, skin-barrier disruption, immune dysregulation and treatments that can increase infection risk.To determine whether HS is associated with cutaneous and extracutaneous infections and related outcomes.Data from the 2002-2012 National Inpatient Sample were analysed, including a 20% sample of U.S. hospitalizations (n = 87 053 155).The prevalence (with 95% confidence interval) of infections was higher in adults (34·0%, 33·2-34·7% vs. 23·4%, 23·2-23·6%) and children (31·8%, 28·7-34·9% vs. 12·6% (12·1-13·1%) with vs. without HS. Inpatients with HS had higher prevalences of infections overall (excluding cellulitis and erysipelas) than those with psoriasis, but lower than those with atopic dermatitis. In multivariable logistic regression models adjusting for sociodemographics, HS was associated with 18 of 45 infections examined (adults: 16 of 45; children: six of 45), including acute infections (herpes simplex virus, herpes zoster, necrotizing fasciitis, septicaemia, bone infection, Clostridium difficile, methicillin-sensitive and methicillin-resistant Staphylococcus aureus, Streptococcus, Pseudomonas, mycobacterial, fungal, viral), chronic infections (HIV, hepatitis B) and antibiotic-resistant infections. HS alone was associated with increased infections. Patients with comorbid cancer; HIV; cardiometabolic, autoimmune or mental health diagnoses or acne had even higher odds of infections. Inpatients with HS with vs. without serious infection had increased inpatient mortality (0·71% vs. 0·16%), mean length of stay (7·3 vs. 4·8 days) and cost of care (US$13 578 vs. $9242), with a mean annual excess 41 050 days and $71 622 339 cost of hospitalization.Adults and children with HS had increased acute and chronic, cutaneous, extracutaneous and systemic infections, which were associated with increased mortality and cost. What's already known about this topic? Little is known about the risk of infection in patients with hidradenitis suppurativa (HS). What does this study add? Adults and children with HS had increased cutaneous, extracutaneous and systemic infections, at even higher rates than in patients with psoriasis and atopic dermatitis. These infections were associated with increased inpatient mortality and cost. Respond to this article.
Nottingham is most popular university, say UCAS
Authors: Helen Barratt
Journal: BMJ (2002)

Nottingham has overtaken Leeds as the most popular university in Britain. Official figures published by the University and Colleges Admissions Service (UCAS) show that it is attracting more applications than any other higher education establishment: 46 686 students competed for about 4500 places in September 2002.

Although it has been ranked as the most popular university (in terms of applications per place) for several years, this is the first time that it has been …
Medical students campaign for Jubilee 2000
Authors: Sarah Finer
Journal: BMJ (2000)

UK medical students are being given the opportunity to join with health professionals in support of the Jubilee campaign for cancellation of the unpayable debts of the world's poorest countries. In the run-up to the G8 Summit in Okinawa, Japan, in July, MedSIN is collaborating with Medact and the British Medical Association in an event to celebrate the millennial year.



Jubilee 2000 supporters include Luciano Pavarotti and U2's Bono



Thousands of medical students, doctors, and nurses are being asked to sign patient identification wristbands …
Talk to the handheld
Authors: Jessica Watson, Genevieve Thueux, Julian M Jenkins, David J Cahill
Journal: BMJ (2005)

Personal digital assistants (PDAs) are also known as palm pilots, palms, or handhelds. These small computers generally include an address book, a to do list, a memo pad, and a calendar. As well as these basics, customised medical software is available. Ever thought of questions when you are on the wards or in busy clinics? Do you scribble down those nuggets of information consultants teach you in a note pad, never to be found again? PDAs can help medical students in these common scenarios. When you start to look at PDAs, you will be boggled by the options (box 1). Even before adding medical software, your PDA can become invaluable. In one small device, you can store your addresses, diary, alarm clock, and a task list. ### Box 1: Choosing a PDA: important considerationsRETURN TO TEXT
Efficacy and safety of suspend-before-low insulin pump technology in hypoglycaemia-prone adults with type 1 diabetes (SMILE): an open-label randomised controlled trial
Authors: Emanuele Bosi, Pratik Choudhary, Harold W de Valk, Sandrine Lablanche, Javier Castañeda, Simona de Portu, Julien Da Silva, Roseline Ré, Linda Vorrink-de Groot, John Shin, Francine R Kaufman, Ohad Cohen, Andrea Laurenzi, Amelia Caretto, David Slatterly, Marcia Henderson-Wilson, S. John Weisnagel, Marie-Christine Dubé, Valérie-Ève Julien, Roberto Trevisan, Giuseppe Lepore, Rosalia Bellante, Irene Hramiak, Tamara Spaic, Marsha Driscoll, Sophie Borot, Annie Clergeot, Lamia Khiat, Peter Hammond, Sutapa Ray, Laura Dinning, Giancarlo Tonolo, Alberto Manconi, Maura Serena Ledda, Wendela de Ranitz, Bianca Silvius, Anne Wojtusciszyn, Anne Farret, Titia Vriesendorp, Folkje Immeker-de Jong, Joke van der Linden, Huguette S. Brink, Marije Alkemade, Pauline Schaepelynck-Belicar, Sébastien Galie, Clémence Tréglia, Pierre-Yves Benhamou, Myriam Haddouche, Roel Hoogma, Lalantha Leelarathna, Angel Shaju, Linda James
Journal: The Lancet Diabetes & Endocrinology (2019)
An ingratiating guide
Authors: Sonali Dutta
Journal: BMJ (2003)

Once on the wards, some students start to butter up their consultants insanely. At first most of us are appalled by their nauseating attempts to gain favour. However, the sad truth soon becomes clear-this is one of the ways to get ahead.

Tea maid -make your supervisor lots of tea and coffee. A great way of developing a good relationships with staff

Rag doll -this technique involves …
Abstract 12781: Association of Poor Tooth Brushing Behavior With Cardiovascular Outcome: Two-Year Follow-Up Prospective Observational Study
Authors: Shogo Matsui, Yukihito Higashi, Haruki Hashimoto, Shinji Kishimoto, Masato Kajikawa, Tatsuya Maruhashi, Takayuki Hidaka, Ayumu Nakashima, Farina M Yusoff, Kensuke Noma, Yasuki Kihara
Journal: Circulation (2018)

Backgrounds: Periodontal disease is independently associated with cardiovascular disease. Several lines of evidence have shown that intensive treatment for periodontal disease improves the systemic...
Exhibition: Walking in my Mind
Authors: Daniel Henderson, Emily Pull
Journal: BMJ (2009)

Walking in my Mind showcases the work of 10 international artists to try to explore the “inner workings of the artist’s imagination.” Each of the galleries and terraces of the Hayward Gallery has been transformed into an individual “mindscape.”

Floating body parts, giant oesophaguses, and eerie dream-like rooms of impenetrable threads, stretched from wall to wall, make Walking in my Mind a frenetic hop, skip, and jump. Although at times confusing and challenging, this exhibition offers a thought provoking foray into the depths of the human psyche.

Thomas Hirschhorn’s Cavemanman is a meandering series of tunnels that link caves of cardboard and parcel tape. Foil covered mannequins wired up to dynamite suggest an underlying paranoia. The artist likens his creation to …
Lymphopenia in Cancer Patients and its Effects on Response to Immunotherapy: an opportunity for combination with Cytokines?
Authors: Christine Ménétrier-Caux, Isabelle Ray-Coquard, Jean-Yves Blay, Christophe Caux
Journal: Journal for ImmunoTherapy of Cancer (2019)

Quantitative lymphocyte alterations are frequent in patients with cancer, and strongly impact prognosis and survival. The development of cancers in immunosuppressed patients has demonstrated the contribution of different T cell populations, including CD4+ cells, in the control of cancer occurrence.Whereas absolute numbers of neutrophils, platelets and red blood cells are routinely monitored in clinic following treatments, because of possible short-term complications, absolute lymphocyte counts (ALC), their subpopulations or diversity (phenotype, TCR) are rarely analyzed and never used to choose therapy or as prognostic criteria. The recent identification of immune checkpoint inhibitors (ICPi) as powerful therapeutic agents has revitalized immunotherapy of cancer in a broader group of diseases than anticipated. The status of the immune system is now recognized as an important biomarker for response to these novel treatments. Blood ALC values, along with tumor infiltration by CD8+T cells, and ICPi and ICPi-ligand expression, are likely to be a potential marker of sensitivity to anti-ICPi therapy.In this article, we review the current knowledge on the incidence and significance of lymphopenia in cancer patients, and discuss therapeutic strategies to restore lymphocyte numbers.
How to be Good
Authors: Sabina Dosani
Journal: BMJ (2003)

With New Years resolutions flying about perhaps its the time of year to consider How to be Good I was sad when I finished this book. Not that grieving at the end of a fantastic read, but because I thought it was going to be good. I felt cheated.

How to be Good is Katie Carrs story. Katie, a middle aged, burnt out general practitioner, is married to David, a journeyman writer, ‘the angriest man in Holloway,’ and they have two children. Kate ends a brief affair …
Trim the gut, lose the weight — and the bone
Authors: Soravis Osataphan, Mary Elizabeth Patti
Journal: Journal of Clinical Investigation (2019)

Vertical sleeve gastrectomy (VSG) is an effective therapeutic approach for obesity and type 2 diabetes but is associated with osteoporosis. In this issue of the JCI, Li et al. report that VSG rapidly reduces bone mass, as observed in humans, via rapid demineralization and decreased bone formation, independent of weight loss or Ca2+/vitamin D deficiency. VSG also reduces bone marrow adipose tissue, in part via increased granulocyte-colony stimulating factor (G-CSF). The interplay between VSG-mediated effects on systemic metabolism and bone biology remain to be investigated. These findings suggest novel mechanisms and therapeutic targets for bariatric surgery-induced osteoporosis.
89 Minutes to Save the NHS
Authors: Anna Ellis
Journal: BMJ (2002)

Phil Hammonds stand up comedy show began life on BBC Radio 4 as 28 Minutes to Save the NHS , playing on Tony Blairs famous statement in 1997: “We have 24 hours to save the NHS.” Since its conception, Phil has taken his show to the Edinburgh Festival as 59 Minutes to Save the NHS . Now, his nationwide tour of the United Kingdom takes 89 minutes—it seems to be taking longer and longer.



Phil Hammond in action



Dr Phil—as he calls himself—sets out to save the NHS, asking who is going to do it …
Sipping water may not calm exam nerves
Authors: Kay Brennan
Journal: BMJ (2001)

Students should resist taking sips of cold water to calm their nerves during exams, according to researchers at Bristol University. A recent study has shown that simply drinking water at the wrong time can impair mental performance.

The study in Appetite (2001;36:57-8) asked 60 volunteers to rate how thirsty they felt. Their reactions were then tested with a task that involved pressing buttons in response to prompts on …
What's on the web: How to read electrocardiograms
Authors: David Holt
Journal: BMJ (2007)

The worldwide web hosts a huge variety of sites that focus on how to interpret electrocardiograms (ECGs) in a step by step manner, as well as in the context of clinical scenarios. I found the sites given here extremely useful for dealing with patients with real electrocardiograms on the wards.

I like a more wordy and fairly comprehensive resource that goes through the process of reading an electrocardiogram one step at a time. The ER Club and EKG Interpretation, found at http://students.med.nyu.edu/erclub/ekghome.html, has a very easy to read writing style, and the author (Henry Feldman) chooses to insert the relevant basic physics under the appropriate interpretation heading. …
More than just paracetamol
Authors: Steven E Bradshaw, Isla S Mackenzie, Christopher M C Allen, Pavi Agrawal
Journal: BMJ (2002)

Steven Bradshaw and colleagues explain the management of that all too common of problems--headaches Headaches are a universal human experience that can be disabling.1 Because they occur often, it is important to be familiar with the main types of headache and their management. Headaches are described as being either primary or secondary. Primary headaches include migraine, cluster, and tension-type headaches; they have no underlying causes that are readily identifiable. Clinical diagnoses, therefore, are based on features in the history, such as those defined by the International Headache Society (boxes 1 to 4).1 Secondary headaches are related to specific conditions (box 5). ### Box 1: Migraine without auraRETURN TO TEXT ### Box 2: Migraine with aura ### Box 3: Cluster headache
A space cadet
Authors: Julie Sladden
Journal: BMJ (2004)

Alyson Calder has spent the past 12 years pursuing her interest in space and space medicine. This interest has taken her to Russia, China, and the United States where she has participated in space medicine training, research, and education. She also set up a research project in countermeasures to postspaceflight orthostatic intolerance during a space medicine rotation at Kennedy Space Center (KSC).

Alyson graduated from Aberdeen University in 2002 and is currently working as a senior house officer in cardiology at Monklands Hospital in Airdrie, Scotland. She also teaches undergraduates and school pupils about space and space medicine and organised the first UK Space Medicine Day, held recently in Leicester.



I suppose I was a bit of a space geek when I was young. Seeing Helen Sharman (the first British woman astronaut) fly on a mission to the MIR space station really captured my imagination. So, when I was 13, I got in contact with the UK space school and found out they were running a trip to Moscow. At first they said I was too young to …
Genome-wide association study identifies locus at chromosome 2q32.1 associated with syncope and collapse
Authors: Katra Hadji-Turdeghal, Laura Andreasen, Christian M Hagen, Gustav Ahlberg, Jonas Ghouse, Marie Bækvad-Hansen, Jonas Bybjerg-Grauholm, David M Hougaard, Paula Hedley, Stig Haunsø, Jesper H Svendsen, Jørgen K Kanters, Thomas A Jepps, Morten W Skov, Michael Christiansen, Morten S Olesen
Journal: Cardiovascular Research (2019)

Abstract Aims Syncope is a common condition associated with frequent hospitalization or visits to the emergency department. Family aggregation and twin studies have shown that syncope has a heritable component. We investigated whether common genetic variants predispose to syncope and collapse. Methods and results We used genome-wide association data on syncope on 408 961 individuals with European ancestry from the UK Biobank study. In a replication study, we used the Integrative Psychiatric Research Consortium (iPSYCH) cohort (n = 86 189), to investigate the risk of incident syncope stratified by genotype carrier status. We report on a genome-wide significant locus located on chromosome 2q32.1 [odds ratio = 1.13, 95% confidence interval (CI) 1.10–1.17, P = 5.8 × 10−15], with lead single nucleotide polymorphism rs12465214 in proximity to the gene zinc finger protein 804a (ZNF804A). This association was also shown in the iPSYCH cohort, where homozygous carriers of the C allele conferred an increased hazard ratio (1.30, 95% CI 1.15–1.46, P = 1.68 × 10−5) of incident syncope. Quantitative polymerase chain reaction analysis showed ZNF804A to be expressed most abundantly in brain tissue. Conclusion We identified a genome-wide significant locus (rs12465214) associated with syncope and collapse. The association was replicated in an independent cohort. This is the first genome-wide association study to associate a locus with syncope and collapse.
Become a web expert
Authors: Paul Stenson
Journal: BMJ (2000)

Easy, says the student BMJ web guru aka Eric - just watch me!

Whether you're at university, where you get free surf time, or at home grudgingly paying for local dial up, or you need to check your email while abroad in a cyber cafe, here are 10 tips and tricks to help you around the internet.



These are the most useful things on the internet, but if you're not careful they can lead you, quite innocently, down dark paths. Although trodden by accident, these could lead to you getting kicked off your university network. To avoid the deprived - and often Depraved - underbelly of the internet, try using the altavista.co.uk search engine, with its family filter on.

Remember, to search for entire phrases, put quotation marks around your phrase, and to widen or limit your search, try using the Boolean expressions AND, OR and NOT in between your key words.

Internet bookshops can often help you find the book you need easily and quickly, and they deliver it to you within two days, often …
Maintenance grants may be reintroduced in the UK
Authors: Siân Knight
Journal: BMJ (2000)

A draft report produced by the United Kingdom's Department for Education and Employment has indicated that maintenance grants up to the value of £3500 could be reintroduced for the poorest of Britain's students. According to the department's plans, up to 10% of access funds - the money supplied for universities to allocate hardship grants to very poor students - could be set aside to provide guaranteed grants over three years.

Access funds were initially set up 10 years ago, when students lost their right to claim social security benefits during the summer holiday period. Students generally have to apply for access fund money, and it …