tbuckley/cabot-search huggingface dataset:
Population based study of rates of multiple pregnancies in denmark, 1980-94
Authors: T. Westergaard, J. Wohlfahrt, P. Aaby, M. Melbye
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To study trends in multiple pregnancies not explained by changes in maternal age and parity patterns. <b>Design:</b> Trends in population based figures for multiple pregnancies in Denmark studied from complete national records on parity history and vital status. <b>Population:</b> 497 979 Danish women and 803 019 pregnancies, 1980-94. <b>Main outcome measures:</b> National rates of multiple pregnancies, infant mortality, and stillbirths controlled for maternal age and parity. Special emphasis on primiparous women ≥30 years of age, who are most likely to undergo fertility treatment. <b>Results:</b> The national incidence of multiple pregnancies increased 1.7-fold during 1980-94, the increase primarily in1989-94 and almost exclusively in primiparous women aged ≥30 years, for whom the adjusted population based twinning rate increased 2.7-fold and the triplet rate 9.1-fold. During 1989-94, the adjusted yearly increase in multiple pregnancies for these women was 19% (95% confidence interval 16% to 21%) and in dizygotic twin pregnancies 25% (21% to 28%). The proportion of multiple births among infant deaths in primiparous women ≥30 years increased from 11.5% to 26.9% during the study period. The total infant mortality, however, did not increase for these women because of a simultaneous significant decrease in infant mortality among singletons. <b>Conclusions:</b> A relatively small group of women has drastically changed the overall national rates of multiple pregnancies. The introduction of new treatments to enhance fertility has probably caused these changes and has also affected the otherwise decreasing trend in infant mortality. Consequently, the resources, both economical and otherwise, associated with these treatments go well beyond those invested in specific fertility enhancing treatments.
California battles perinatal hepatitis B
Authors: Phil Gunby
Journal: JAMA (1982)

California is campaigning to prevent perinatal transmission of hepatitis B virus (HBV). The professional education effort began in February because, according to James Chin, MD, of the California Department of Health Services, Berkeley, a conservative estimate is that "several thousand perinatally acquired HBV infections" occur annually in that state. That may be almost as many cases as in the other 49 states put together, he says. Why so many in California? According to Chin, chief of the department's infectious disease section, the HBV-carrier prevalence rate among white adults in the United States is around 0.3%. But it may be as high as 20% among immigrants from Asia and the Pacific Basin and among native-born persons of Asian, Polynesian, Micronesian, or Eskimo ancestry. California has a larger number of persons from the latter high-risk groups—more than 1 million total— than do other states. Thus, California's health department is urging hepatitis B
Antenatal Treatment of Hydrocephalus by Ventriculoamniotic Shunting
Authors: F. D. Frigoletto, J. C. Birnholz, M. F. Greene
Journal: JAMA (1982)

WE HAVE previously shown that serial percutaneous cephalocenteses could be accomplished safely with continuous ultrasound guidance.<sup>1</sup>This method provides only transient relief of elevated intracranial pressure because of prompt fluid reaccumulation. It is apparent that a continuous form of decompression will be required for effective antenatal treatment of hydrocephalus. Percutaneous placement of an indwelling ventriculoamniotic shunt is described. <h3>Report of a Case</h3> A 24 1/2-week-old male fetus was referred by his mother's obstetrician when an ultrasound examination obtained to resolve an apparent size-date disparity at 23 weeks of gestation disclosed fetal hydrocephalus. The mother was a 34-year-old, gravida 4 para 3. Had the option of terminating the pregnancy been available, it would have been unacceptable to both parents. After a thorough discussion with emphasis on the experimental nature of the procedure, they requested that maternal transabdominal ventriculoamniotic shunt placement be attempted. Further ultrasound examination confirmed symmetrical ventricular dilatation. Communication
"Kill a Live Baby?"
Authors: B. Solomons
Journal: BMJ (1939)

operation was performed in a. proper manner and the immediate convalescence was normal, and there can be no question, therefore, of the introduction of infection from without at the time of operation.The fact remains, however, that sepsis did subsequently develop in the region of a cleanly closed appendix stump.The following explanation suggests itself to me:The patient was a well-built muscular man, and the appendix was removed through a minute pararectal in- cision made some distance from the site of that organ.Now if this had been a difficult retrocaecal appendixand that seems likely from the previous history-its removal through such a small incision, even under the most excellent anaesthesia, must have presented very considerable mechanical difficulties, and I think it more than probable that a certain amount of pulling about, which would not have been necessary through a more extended approach, occurred, with the result that the tissues in the region of the appendix stump were bruised and their vitality lowered, so that infection from the lumen of the bowel gained entrance through the damaged caecal wall, with the subsequent development of an abscess cavity and erosion of a caecal vessel.While admitting that great reputations are not infre- quently constructed around small incisions, I would submit that the cosmetic result in such cases in no way justifies the turning of what ought to be a comparatively easy operation into a surgical hazard.
Book Review War Surgery in Afghanistan and Iraq: A Series of Cases, 2003–2007 (Textbooks of Military Medicine.) Edited by Shawn Christian Nessen, Dave Edmond Lounsbury, and Stephen P. Hetz. 441 pp., illustrated. Washington, DC, Department of the Army, Office of The Surgeon General, and Borden Institute, 2008. $71. 978-0-981822-80-8 ; Government Printing Office Stock Number 008-023-00133-2.
Authors: Danny O. Jacobs
Journal: New England Journal of Medicine (2009)
To Serve the Patient
Authors: Leandro M. Tocantins
Journal: JAMA (1961)

THERE ARE 2 solemn occasions in our academic life that are devoted to the student himself: when he enters medical school and when he graduates 4 years later. The remarks that I shall make tonight are addressed almost solely to you, the members of the entering class. Your presence here means that you have taken 2 steps: (1) You have decided to enter the profession of medicine, in which dedication to the ideal of service to the sick is the very reason for its existence. (2) You have decided to enter an institution with a long-standing record of training for service to the sick.  It will be many years before you will realize the full implication of these 2 decisions. There may be times during the next 4 years, and even afterwards, when you will be assailed by doubts about the real objectives of a medical career. Does what you
Cytochrome P-450 monooxygenase systems in aquatic species: carcinogen metabolism and biomarkers for carcinogen and pollutant exposure.
Authors: J J Stegeman, J J Lech
Journal: Environmental Health Perspectives (1991)

High levels of polynuclear aromatic hydrocarbon (PAH) carcinogens commonly occur in aquatic systems where neoplasms arise in fish and other animals. Enzymes that transform PAHs can act in initiating these diseases and can indicate the contamination of fish by carcinogens and other pollutants. Cytochrome P-450 has similar roles in activating PAH carcinogens in fish and mammalian species. PAHs and many chlorinated hydrocarbons, e.g., polychlorinated biphenyls (PCBs) induce a form of cytochrome P-450 in fish that is the primary catalyst of PAH metabolism. The induction of this P-450 in fish can accelerate the disposition of hydrocarbons, but can also enhance the formation of carcinogenic derivatives of PAHs. Invertebrates have lower rates of PAH metabolism than fish. These rates are not obviously inducible by exposure to PAHs or PCBs. The lower rates of foreign compound metabolism contribute to higher pollutant residue levels in bivalve mollusks (clams, mussels, etc.) than in fish and may limit the involvement of some procarcinogens (requiring activation) in disease processes in invertebrates. The induction of P-450 forms can indicate the exposure of fish to PAHs, PCBs, and other toxic compounds. This is not restricted to carcinogens. Environmental induction has been detected in fish from contaminated areas by use of catalytic assay, antibodies to fish P-450, and cDNA probes that hybridize with P-450 messenger RNA. Application of these methods can provide sensitive biological monitoring tools that can detect environmental contamination of fish by some carcinogens and tumor promoters.(ABSTRACT TRUNCATED AT 250 WORDS)
Peer Review by Criteria Mapping: Criteria for Diabetes Mellitus
Authors: SHELDON GREENFIELD
Journal: Annals of Internal Medicine (1975)

The UCLA Experimental Medical Care Review Organization (EMCRO), in an attempt to minimize the problem of applying a general list of criteria to each patient with a specific condition, has developed a method called Criteria Mapping. This method uses sequential judgments based on the specific clinical data for the individual patient to assess the quality of care by medical record audit. The method does not penalize the physician for omitting unnecessary procedures by allowing alternate decisions when appropriate, and provides supporting reference materials to allow nonphysicians to make reliable medical interpretations of the data in medical records. It is expected that this method will more accurately reflect the physicians' intentions, and that process, when measured by this approach, may correlate better with the outcome of medical care.
Prevalence and Clinical Characteristics of Mental Stress–Induced Myocardial Ischemia in Patients With Coronary Heart Disease
Authors: Wei Jiang, Zainab Samad, Stephen Boyle, Richard C. Becker, Redford Williams, Cynthia Kuhn, Thomas L. Ortel, Joseph Rogers, Maragatha Kuchibhatla, Christopher O'Connor, Eric J. Velazquez
Journal: Journal of the American College of Cardiology (2013)
Cellular calcium turnover in the perfused rat heart: modulation by caffeine and procaine.
Authors: D R Hunter, R A Haworth, H A Berkoff
Journal: Circulation Research (1982)

Pool A is a rapidly exchangeable cellular pool of Ca++ whose release is triggered by a mechanism involving extracellular Ca++ (Hunter et al., 1981). We have now found that pool A is rapidly released from the perfused rat heart when 10 mm caffeine is added to the perfusate. Pool A release by caffeine was demonstrated during a Ca++ free perfusion. When the perfusate contained 2.5 mm Ca++, caffeine induced an immediate contractile failure. The steady state level of pool A (normally 69 +/- 10 nmol Ca++/g wet wt heart) was also decreased by 60%. Pool A was similarly depleted in hearts perfused with medium containing 0.2 mm Ca++. Procaine (5 mm) inhibited by 50% the release of pool A triggered by caffeine and inhibited by 86% the release triggered by extracellular Ca++. The inhibition of Ca++-induced release of pool A by procaine was partially relieved by externally stimulating the hearts. External stimulation also decreased the inhibition by procaine of Ca++ uptake by pool A from 83% to 28%. These results are further evidence that pool A is located in the sarcoplasmic reticulum and that release of pool A to the myofibriles is triggered by excitation-dependent Ca++ influx.
THE INTRAVENOUS INFUSION OF THE STREPTOCOCCAL FIBRINOLYTIC PRINCIPLE (STREPTOKINASE) INTO PATIENTS 1
Authors: William S. Tillett, Alan J. Johnson, W. Ross McCarty
Journal: Journal of Clinical Investigation (1955)

The streptococcal fibrinolytic principle (streptokinase) has been demonstrated to be an effective agent, in vivo, in patients as a means of mediating the relatively rapid liquefaction of extravascular fibrin coagulums (1). Streptokinase (referred to in this article as SK) has also been shown to be useful as a therapeutic reagent, by which massive extravascular clots may be eradicated by liquefaction and aspiration (2). These findings have received extensive confirmation. (See Footnote 12 to the list of References.) It is the purpose of this article to describe the results of studies of the intravenous administration of SK into patients. The ultimate objective of the study is directed toward attempting to determine whether or not clots occurring within the vascular system as a result of disease may be subject to
P29 The patient’s perspective of anti-tuberculosis treatment
Authors: CEJ Rang, N Sahota, A Jayaratnam
Journal: Thorax (2013)

<h3>Background</h3> Tuberculosis (TB) requires prolonged antibiotic therapy with medications, which can cause a wide range of side effects. Despite this, it is essential that patients adhere to their treatment regimes to ensure treatment success and also to reduce the risk of transmission and of drug resistant TB developing. There is little in the literature regarding the patient’s perspective of managing the substantial medication burden of TB treatment. However, to focus patient-centred care from local TB services and to direct future management of these patients, assessment of their perspective and quality of life is imperative. <h3>Aim</h3> To assess patients who had completed anti-TB treatment over a 10-month period as to their perspective regarding the TB service and treatment in a district general hospital. <h3>Methods</h3> All patients who had completed anti-tuberculosis treatment over a 10-month period were provided with an anonymous questionnaire. The data from these was collated and analysed. <h3>Results</h3> 35 patients out of 64 patients completing TB treatment over a 10-month period returned the patient questionnaire. Of these patients 51% were female with an average age of 34 years. All the patients were aware how to contact the TB team and 94% of patients received an information leaflet which they had read. 49% of patients suffered side effects; the most common being pruritis (23%), rash (17%), nausea (17%), joint aches (14%) and stomach upsets (11%). 86% of the patients felt that the support from the TB nurses did make a difference to their care. Overall patients found the ease of taking medications as follows: 40% very easy, 26% easy, 14% hard, 6% very hard, 11% neither easy or hard, 3% not answered. <h3>Conclusion</h3> This study demonstrated that nearly half of the patients suffered from side effects whilst taking their treatment, impacting on their quality of life. Furthermore, a large proportion of patients (20%) had difficulty taking their medications. However, patients do find that the TB service and the involvement of the TB specialist nurses have a positive impact on their care.
Terminal phalageal osteosclerosis.
Authors: W Halim, J K Van Der Korst, H A Valkenburg, P Van Elteren
Journal: Annals of the Rheumatic Diseases (1975)

Osteosclerosis of the terminal finger phalanges was assessed by means of a grading score in two age-matched groups of 96 females, each suffering from rheumatoid arthritis (RA) and osteoarthrosis (OA), respectively, and in a sample of 894 males and females, above the age of 44 years, from Dutch small town populations. Cortical thickness of the therminal phalanges decreases markedly with age. Whereas in the age group 45-54 years, terminal phalangeal osteosclerosis is more pronounced in females, at higher ages the difference between the sexes disappears. The diameter of the terminal cortex increases gradually from the second to the fifth finger. No differences were found between the RA and the OA groups, nor were these groups different from the population survey except for a lower incidence of terminal phalangeal osteosclerosis in female osteoarthrotics between 45 and 55 years of age, compared to females of the same age group from the population sample.
Abstract LB-371: Altered vascular endothelial growth factor mRNA stability may lead to cancer development following immunosuppressive therapy
Authors: Aninda Basu, Dipak Datta, Soumitro Pal
Journal: Cancer Research (2010)

Abstract The development of cancer is an increasing and major problem in immunosuppressed patients, particularly after solid organ transplantation. In part, the increased cancer risk is associated with the use of immunosuppressive agents, especially calcineurin inhibitors (CNIs). The CNIs are used to prevent inflammatory diseases and allograft rejection. However, little is known about the mechanism(s) underlying their ability to promote the development and recurrence of cancer. We have recently demonstrated that CNI can mediate the transcriptional activation of the angiogenic cytokine vascular endothelial growth factor (VEGF) and promote a rapid progression of human renal cancer. In contrast, the mTOR inhibitor rapamycin (RAPA), which is thought to have anti-cancer effects, has been reported to decrease VEGF expression. Here, we investigated whether the CNI cyclosporine (CsA) and RAPA could alter the mRNA stability of VEGF in 786-0 and Caki-1 renal cancer cells. By using actinomycin-D, we observed that CsA increased, while RAPA decreased the VEGF mRNA stability as observed by real time PCR. It is established that the mRNA-binding protein HuR may play a critical role in VEGF mRNA stability. By using HuR-siRNA, we found that the knockdown of HuR significantly decreased the CNI-induced VEGF mRNA stability. By Western blot analysis, it has been observed that CNI treatment induced the translocation of HuR from the nucleus to the cytoplasm; CNI also induced the association between HuR and protein kinase C (PKC)-δ, and promoted the phosphorylation of HuR. Interestingly, there was no significant change in the cytoplasmic translocation of HuR following RAPA treatment. Finally, we found that the inhibition of PKC-δ using a dominant-negative plasmid significantly decreased the CsA-induced cytoplasmic translocation of HuR and the VEGF mRNA stability. Together, we suggest that targeting the pathways that promote the transcription as well as the mRNA stability (post-transcriptional modification) of VEGF in response to CNI might serve as novel therapeutics for the prevention and treatment of cancer in immunosuppressed patients. 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 LB-371.
Lipoprotein composition and transport in the pig and dog cardiac lymphatic system.
Authors: P Julien, E Downar, A Angel
Journal: Circulation Research (1981)

The cardiac lymphatic system of pigs was found to consist of valved efferent lymph vessels draining into a cardiac lymph node, which is similar to the lymphatic system found in dog and man.The interstitial lipoproteins of the heart were studied by sampling cardiac efferent lymph in anesthetized fasting pigs (n -4) and dogs (n •• 5).In pigs, the lymph flow rate was 2.0 ± 0.7 ml/hr (mean ± SRM) and in dogs, 1.2 ± 0.3 ml/hr.The total cholesterol concentration was 54.9 ± 8.0 and 33.8 ± 6.3 mg per 100 ml in cardiac lymph of piga and dogs, respectively.The ratio of lymph :plasma cholesterol differed in the two species: 0.82 in pigs and 0.46 in dogs.More than 90% of cardiac lymph cholesterol was recovered in high density lipoprotein (HDL) and in low density lipoprotein (LDL) in both pigs and dogs.In pigs, LDL wag the major cholesterol-carrying lipoprotein in plasma and lymph, whereas in canine plasma and lymph, this was HDL.The appearance of '"I-LDL in canine cardiac lymph following iv administration was rapid and reached a plateau by 1 hour.The t'A appearance of '"I-LDL in lymph was 5 minutes compared to tV4 clearance of plasma (rapid phase) of 44 minutes.The lymph: plasma ratio of LDL specific activity wai 0.48 ± 0.15, suggesting continuous addition of cold LDL in the interstitial space.The high concentration and turnover of cholesterol-rich lipoprotein in cardiac lymph suggest that the predilection of the coronary bed for atherosclerotic degeneration may be a function of the interstitial lipoprotein concentration and composition as well as the plasma concentration of lipoprotein species.
Abstract 1213: Neuropeptide Y, adipose tissue and breast cancer
Authors: Emily Ngan, Andrea Labus, Sarah Cowen, Linda Vona-Davis
Journal: Cancer Research (2011)

Abstract Adipose tissue contributes to obesity-associated risk in breast cancer progression. Recent work has demonstrated the involvement of preadipocytes in promoting the induction of breast tumor cell migration and invasion. Neuropeptide Y (NPY) stimulates proliferation of preadipocytes in vitro by the Y1 receptor. NPY receptors are present in almost all primary breast cancers and in lymph node metastases from ER-positive primary cancers. By contrast, the peptide has been shown to inhibit the invasion of certain tumor cells. However, the relative contribution of adipose and NPY to breast tumor survival remains to be determined. Using the highly metastatic ER-negative human breast cancer cell line MDA-MB-231, we found that NPY significantly inhibited cell proliferation, an effect that was reversed by treatment with the Y1-receptor antagonist BIBP-3226 (P&amp;lt;0.05). Breast tumor cells treated with NPY exhibited changes in cell morphology and demonstrated a two-fold increase in early apoptosis. When breast tumor cells were incubated in the presence of conditioned media harvested from 3T3-L1 preadipocytes, NPY enhanced apoptosis. Significantly more breast tumor cells migrated toward the preadipocytes compared to conditioned media alone (P&amp;lt;0.0001), but less in the presence of NPY. In conclusion, it appears that adipose tissue promotes breast tumor survival and migration, while NPY limits its. It will be of interest to determine whether the tumor migration-promoting activity of preadipocytes varies among breast cancer subtypes, and if so, whether it serves as a predisposing factor for breast cancer progression. In addition, the targeting of NPY-Y1 receptors in breast tumors may have a diagnostic and possibly therapeutic value. 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 1213. doi:10.1158/1538-7445.AM2011-1213
Colour-Blindness: its Examination and Prevalence
Authors: H. W. Page
Journal: BMJ (1879)

THE BRITISH MEDICAL 7OURNAL.but not cured; I advised more baths, but did not see him again.He had in all about fifteen baths, and then went home to the country thinking himself cured; unfortunately he was not, and he conveyed scabies to his family.This is not the first time that I have found sulphur baths fail.They are, however, useful under certain circum- stances; it may, for example, be very inconvenient to apply sulphur ointment at night.Again, in cases where there is much secondary eczema set up with extensive excoriations, the application of sulphur ointment is very irritating.Under these circumstances, it is very useful to begin with a few baths, which generally produce an excellent effect; this may be followed up by the application of ointment to those regions known to be specially affected.Lastly, with regard to disinfecting outer clothes and bedding, it can be easily done by sulphur fumigation or baking.In all cases of long standing, the clothes and blankets, etc., should be disinfected, but it is never necessary to extend this to the bed itself.