tbuckley/cabot-search huggingface dataset:
Health effects of air pollution in southern Europe: are there interacting factors?
Authors: K Katsouyanni
Journal: Environmental Health Perspectives (1995)

Recent results suggest that adverse health effects of air pollution exist at levels of pollutants around or even below air quality standards set by national and international institutions. Furthermore, there are indications that air pollution effects on health may be partly determined by specific mixtures of air pollutants and may be altered by other environmental, behavioral, and social patterns. Southern European countries share some common characteristics in terms of climate, geography, and life activity patterns. Results from studies undertaken in France, Greece, Italy, Portugal, and Spain investigating short- and long-term air pollution health effects are presented and their consistency demonstrated. These results provide adequate evidence that health effects--particularly short-term--of the currently measured urban air pollution levels exist. However, information available so far does not allow an assessment of regional differences in the health effects of air pollution as far as the Mediterranean region of Europe is concerned. It is suggested that the interaction between the traditional pollution (mainly characterized by high levels of black smoke and SO2) and photochemical pollution must be investigated in this area, as well as the possible interaction between air pollution and high temperature and other meteorologic factors. In addition, measurements of individual exposure to different pollutants, affected by the pollutant's levels in specific micro-environments and the individual's time-activity pattern, must be undertaken for a better understanding of the air pollution-health link. Finally, the importance of the reported air pollution health effects in terms of public health must be addressed more closely.
General practice fundholding and health care costs
Authors: D. Keeley
Journal: BMJ (1997)

Physician assisted suicide, euthanasia, or withdrawal of treatmentDistinguishing between them clarifies moral, legal, and practical positions T he Supreme Court of the United States has returned the vexing question of physician assisted suicide to state governments.In unanimous rulings last month, Chief Justice Rehnquist, writing for the court, held that there is no fundamental right to assistance in committing suicide 1 and that, legally, distinguishing between refusing life saving medical treatment and requesting assistance in suicide "comports with fundamental legal principles of causation and intent." 2 By its rulings, the Supreme Court invalidated the decisions of two of the American Courts of Appeal.In March 1996 the appeals court for the Ninth Circuit had lifted a ban by Washington state on physician assisted suicide in Compassion in Dying v Washington. 3 That court, which has jurisdiction in 13 western states, including Hawaii, had concluded that "a competent adult ... has a strong liberty interest in choosing a dignified and humane death"-including not just refusal of treatment but also "hastening one's own death."However, the Supreme Court held that the interest in question, which Chief Justice Rehnquist characterised as the "right to commit suicide with another's assistance," is not one of the "fundamental rights and liberties ... 'deeply rooted in this Nation's history and tradition'."
Boceprevir (Victrelis) for HCV: V is for victory and very complex
Authors: Michael Charlton, Kris Kowdley, Geoffrey McCaughan, Christian Trautwein
Journal: Hepatology (2011)

Background: Peginterferon–ribavirin therapy is the current standard of care for chronic infection with hepatitis C virus (HCV). The rate of sustained virologic response has been below 50% in cases of HCV genotype 1 infection. Boceprevir, a potent oral HCV-protease inhibitor, has been evaluated as an additional treatment in phase 1 and phase 2 studies. Methods: We conducted a double-blind study in which previously untreated adults with HCV genotype 1 infection were randomly assigned to one of three groups. In all three groups, peginterferon alfa-2b and ribavirin were administered for 4 weeks (the lead-in period). Subsequently, group 1 (the control group) received placebo plus peginterferon–ribavirin for 44 weeks; group 2 received boceprevir plus peginterferon–ribavirin for 24 weeks, and those with a detectable HCV RNA level between weeks 8 and 24 received placebo plus peginterferon-ribavirin for an additional 20 weeks; and group 3 received boceprevir plus peginterferon-ribavirin for 44 weeks. Nonblack patients and black patients were enrolled and analyzed separately. Results: A total of 938 nonblack and 159 black patients were treated. In the nonblack cohort, a sustained virologic response was achieved in 125 of the 311 patients (40%) in group 1, in 211 of the 316 patients (67%) in group 2 (P<0.001), and in 213 of the 311 patients (68%) in group 3 (P<0.001). In the black cohort, a sustained virologic response was achieved in 12 of the 52 patients (23%) in group 1, in 22 of the 52 patients (42%) in group 2 (P = 0.04), and in 29 of the 55 patients (53%) in group 3 (P = 0.004). In group 2, a total of 44% of patients received peginterferon-ribavirin for 28 weeks. Anemia led to dose reductions in 13% of controls and 21% of boceprevir recipients, with discontinuations in 1% and 2%, respectively. Conclusions: The addition of boceprevir to standard therapy with peginterferon–ribavirin, as compared with standard therapy alone, significantly increased the rates of sustained virologic response in previously untreated adults with chronic HCV genotype 1 infection. The rates were similar with 24 weeks and 44 weeks of boceprevir. (Funded by Schering-Plough [now Merck]; SPRINT-2 ClinicalTrials.gov number, NCT00705432.)
A memorable lecture: Lessons of yore
Authors: L. James
Journal: BMJ (2002)

Recently, while working as a senior house officer in a busy emergency department and only weeks away from giving birth to my first child, I came across some of my great grandfather's university lecture notes. He studied medicine at Queen's College in Belfast and later became a general practitioner in the north of England.

The notes I discovered were beautifully handwritten in black ink with neat headings and subheadings, all bound together in a black A5 notebook. In short, the type of lecture notes my peers and I could only have dreamt of. The subject was “Midwifery,” and the first session in the lecture series on pregnancy was taken on …
Persistent Transgene Expression Following Intravenous Administration of a Liposomal Complex: Role of Interleukin-10-Mediated Immune Suppression
Authors: Isao Ito, Tomoyuki Saeki, Imran Mohuiddin, Yuji Saito, Cynthia D Branch, Ara Vaporciyan, Jack A Roth, Rajagopal Ramesh
Journal: Molecular Therapy (2004)

Studies conducted in non-tumor-bearing, immunocompetent mice have shown that intravenous administration of liposome-DNA complex elicits an inflammatory response that results in a failure to sustain adequate transgene expression. In the present study, however, we investigated the effects of a cationic liposomal DOTAP:cholesterol (DOTAP:Chol)-DNA complex on cytokine production and transgene expression in both experimental lung tumor-bearing (TB) mice and non-tumor-bearing (NTB) syngeneic mice and nude mice. Intravenous injection of DOTAP:Chol-luciferase (luc) DNA complex resulted in tumor necrosis factor-alpha levels that were 50% lower and interleukin-10 levels that were 50-60% higher in TB mice than in NTB mice. Furthermore, a significant increase in luc expression (P = 0.001) that persisted for 7 days was observed in TB mice. In contrast, luc expression decreased significantly from day 1 to day 2 in NTB mice. Also, luc expression was two- to threefold higher in TB mice that were given multiple injections of DOTAP:Chol-luc complex than in mice who received a single injection. In contrast, luc expression was significantly suppressed following multiple injections in NTB mice (P = 0.01). Further analysis revealed IL-10 protein expression by the tumor cells in TB mice. Injection of anti-IL-10 antibody in TB mice resulted in a significant decrease in luc expression (P = 0.01) compared with that in mice injected with a control antibody. Based on these findings, we conclude that transgene expression persists in TB mice and is partly mediated by IL-10. Additionally, multiple injections of liposome-DNA complex can increase transgene expression in TB mice. These findings have clinical applications in the treatment of cancer.
Administration of endotoxin, tumor necrosis factor, or interleukin 1 to rats activates skeletal muscle branched-chain alpha-keto acid dehydrogenase.
Authors: M D Nawabi, K P Block, M C Chakrabarti, M G Buse
Journal: Journal of Clinical Investigation (1990)

Protein catabolic states (i.e., sepsis and trauma) are thought to be associated with accelerated oxidation of branched-chain amino acids (BCAA). Branched-chain alpha-keto acid dehydrogenase (BCKAD), the rate-limiting enzyme for BCAA oxidation by muscle, is regulated by phosphorylation/dephosphorylation. Skeletal muscle BCKAD was only 2-4% active in control rats. Intravenous injection of Salmonella enteritidis endotoxin (0.25-10 mg/kg) did not change total BCKAD activity, but increased the percent active enzyme in muscle three- to four-fold in 4-6 h. Identical results were observed in adrenalectomized rats pretreated with one dose of alpha-methylprednisolone (2.5 mg/kg i.p.) 30-60 min before saline or endotoxin injection, indicating that endotoxin's effect was not mediated by hypersecretion of adrenal hormones. Cortisone pretreatment of normal rats (100 mg/kg per d) for 2 d prevented endotoxin-induced activation of muscle BCKAD, suggesting that endogenous secretion products mediated BCKAD activation by endotoxin. Human recombinant tumor necrosis factor-alpha and/or IL-1 beta or alpha (50 micrograms/kg) increased muscle BCKAD activation two- to fourfold in normal rats 4-6 h after intravenous injection. We conclude that cytokine-mediated activation of muscle BCKAD may contribute to accelerated BCAA oxidation in septicemia.
Book Review Pathology of the Skin with Clinical Correlations Third edition. Edited by Phillip H. McKee, Eduardo Calonje, and Scott R. Granter. 1865 pp., plus index, in two volumes, illustrated, with CD-ROMs. Philadelphia, Mosby, 2005. $399. 0-3230-3672-4
Authors: Brian J. Nickoloff
Journal: New England Journal of Medicine (2005)
Skeletal Tetrofosmin Uptake in a Patient Undergoing Myocardial Perfusion Imaging With a Subsequent Diagnosis of Multiple Myeloma
Authors: Alex Yi, Martin Jacobs
Journal: Clinical Nuclear Medicine (2004)

A 74-year-old woman presented with chest pain and a dual isotope adenosine stress myocardial perfusion study was performed. The scan demonstrated tetrofosmin tracer uptake by the bony skeleton, which, on bone marrow biopsy, revealed multiple myeloma.
Detection of Tuberculosis: Acid-Fast Smear Method
Authors: RICHARD A. BORDOW
Journal: Annals of Internal Medicine (1975)

Comments and Correction1 October 1975Detection of Tuberculosis: Acid-Fast Smear MethodRICHARD A. BORDOW, M.D.RICHARD A. BORDOW, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-83-4-584 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In their paper, "Decreasing Reliability of Acid-Fast Smear Techniques for Detection of Tuberculosis," (1) Drs. Boyd and Marr have identified a significant problem in evaluating microscopy findings in the management of suspected pulmonary tuberculosis. However, in the analysis of their data, I believe they have failed to identify an even more practical problem and failed to support their recommendations with relevant data.The larger group (78%) of microscopy-negative and culture-positive specimens portends a serious epidemiologic problem (2). This problem is not a new one and many questions need to be answered about these false-negatives (3, 4, 5)....References1. BOYDMARR JJ: Decreasing reliability of acid-fast smear technique for detection of tuberculosis. Ann Intern Med 82:489-492, 1975 LinkGoogle Scholar2. NARAINRAOCHANDRASEKHAR RMP: Microscopy positive and microscopy negative cases of pulmonary tuberculosis. Am Rev Resp Dis 103:761-773, 1971 MedlineGoogle Scholar3. STYBLODANKOVÁDRÁPELA KDJ: Epidemiological and clinical study of tuberculosis in the district of Kolin, Czechoslovakia. Bull WHO 37:819-874, 1967 MedlineGoogle Scholar4. NARAINNAIRNAGANNA RSK: Problems in defining a "case" of pulmonary tuberculosis in prevalence surveys. Bull WHO 39:701-729, 1968 MedlineGoogle Scholar5. TRUANTBRETTTHOMAS JWW: Fluorescence microscopy of tubercle bacilli stained with auramine and rhodamine. Henry Ford Hosp Med Bull 10:287-296, 1962 MedlineGoogle Scholar1. : Miliary tuberculosis. Am J Med 58:849-856, 1975 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: RICHARD A. BORDOW, M.D.Affiliations: MC U.S. Munson Army Hospital Fort Leavenworth, Kansas 66027 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1975Volume 83, Issue 4Page: 584-585KeywordsEpidemiologyMicroscopy ePublished: 1 December 2008 Issue Published: 1 October 1975 PDF downloadLoading ...
Radioelectrocardiographic Changes during Strenuous Exercise in Normal Subjects
Authors: SAMUEL BELLET, MARCEL ELIAKIM, STAVROS DELIYIANNIS, EDUARDO M. FIGALLO
Journal: Circulation (1962)

The effect of strenuous exercise (riding a stationary bicycle at 20 to 25 mph for 3 minutes) on the electrocardiogram was studied in 135 normal subjects, aged 17 to 64 years. Radioelectrocardiography was used to record the tracings during and after the period of exercise. The following electrocardiographic alterations during exercise were interpreted as representing a normal physiologic response; sinus tachycardia (100 per cent of the cases), increased P-wave amplitude (85 per cent), ST-segment depression of the junction type, 1 mm. or more (75 per cent), diminished (68 per cent) or increased (9 per cent) T-wave amplitude. A few ventricular premature beats were observed in only two subjects (1.4 per cent). All these changes were observed, although less frequently, in the period after exercise (1 minute after the cessation of exercise). According to criteria for abnormality described previously, 23 34 of the 135 subjects (24.8 per cent) exhibited abnormal responses to the bicycle exercise test. Sixteen of the 34 "definitely" and "probably abnormal" responses (47 per cent) occurred only during the period of exercise, 12 were observed both during and after the exercise and six occurred only in the postexercise period. The incidence of abnormalities in the group of subjects in the age group 40 to 64 years was 37 per cent, while that in subjects in the age group 17 to 40 years was 22.5 per cent. A comparison between the Master two-step and the bicycle tests suggests that the latter may be more diagnostic for the detection of latent coronary artery disease and the evaluation of the state of physical fitness in subjects below the age of 40 years.
ACE gene polymorphism and proliferative retinopathy in type 1 diabetes: results of a case-control study.
Authors: D Rabensteiner, H Abrahamian, K Irsigler, K M Hermann, H P Kiener, G Mayer, A Kaider, R Prager
Journal: Diabetes Care (1999)

To evaluate the relationship between the ACE insertion/deletion polymorphism and proliferative diabetic retinopathy in patients with type 1 diabetes of long duration. Based on epidemiological and pathophysiological findings, risk factors apart from glycemic control and duration of disease are likely to be involved in the development of proliferative retinopathy.In this case-control study, we compared 81 patients with longstanding (> or =20 years) type 1 diabetes who had nonproliferative (mild or moderate background) retinopathy with 95 patients with diabetes of similar duration and HbA1c who had proliferative retinopathy. To avoid the confounding effect of nephropathy, patients with overt nephropathy were excluded, and microalbuminuria was introduced into the multiple logistical regression model. The polymorphic region in intron 16 of the ACE gene (17q23) was analyzed using the polymerase chain reaction.The ACE genotype distribution in patients with proliferative retinopathy (DD 39.4%, ID 48.9%, II 11.7%) was significantly different (P < 0.001) from that of patients with nonproliferative retinopathy (DD 17.3%, ID 54.3%, II 28.4%). In a multiple logistical regression analysis, the adjusted relative risk for proliferative retinopathy in a patient with a DD genotype compared with a patient with an II genotype was 6.6 (95% CI 2.2-19.5), P = 0.0026. In addition to genotype, systolic blood pressure (odds ratio 1.027 [95% CI 1.0-1.1], P = 0.0093) but not microalbuminuria (< or =20 vs. > or =20 microg/min) reached statistical significance in the multiple regression model. Because subjects were matched regarding diabetes duration and HbA1c, we did not interpret the respective parameter estimates.These data provide evidence that deletion in the ACE gene is associated with the prevalence of proliferative retinopathy in type 1 diabetes and suggest that the DD genotype confers susceptibility to proliferative retinopathy independent of diabetic nephropathy
Pseudomonas Dermatitis Associated With a Swimming Pool
Authors: Pauline Thomas, Marilyn Moore, Eleanor Bell, Stephen Friedman, James Decker, Mehdi Shayegani, Kathy Martin
Journal: JAMA (1985)

One hundred forty-seven (66%) of 224 scouts and chaperons were interviewed after a weekend visit to a dude ranch in upstate New York. One hundred seventeen (80%) complained of papular rashes or eye and ear inflammation. Onset of illness occurred within 24 to 48 hours of arrival at the ranch. After controlling for participation in other available activities, only swimming was found to be associated with illness.<i>Pseudomonas aeruginosa</i>serotype 0 11 grew from a culture of pool water and from 17 cultures of skin, eye, and ear lesions in visitors to the ranch. Follow-up was obtained for 76 of the affected persons for whom initial information was available. Mean duration of illness was 14.5 days (range, one to 40+ days). The recurrence rate was 24%. (<i>JAMA</i>1985;253:1156-1159)
Open access, medical research, and the internet economy of scale
Authors: E. S. Sills, J. D Baum
Journal: Journal of the Royal Society of Medicine (2006)

In an article published in the JRSM, Volume 99, Ferner and McDowell adopted a literature review of doctors charged with manslaughter since 1795.From a reading of their article it is possible to determine that they arrived at the following conclusions.First, that there had been a significant increase in the prosecution of doctors for gross negligence manslaughter since 1990; second, that the majority of these doctors should not have been prosecuted; third, that the Crown Prosecution Service (CPS) has failed to abide by its own prosecution Code; and fourth, that we have charged doctors as 'an emotionally satisfying way to exact retribution . . .'We question the methodology, analysis and conclusions reached by the authors.They relied for the most part on newspaper reports, a notoriously unreliable source, for an accurate account of the allegations.In every case all the evidence is considered by experienced doctors before any prosecution is commenced.We apply the criminal law on gross negligence manslaughter as we are required to do, yet Ferner and McDowell criticise us for not using the criteria of 'mistakes, slips (or lapses) and violations', tests that are unknown to the criminal law.Ferner and McDowell have failed to understand the CPS 'realistic prospect of conviction' test and have applied a simplistic numerical test against all the cases they could identify.The test is whether in this particular case there is a realistic prospect of conviction, not whether half of all defendants are convicted.The suggestion that, by charging doctors with manslaughter, the CPS is somehow seeking some emotional satisfaction in retribution is self-evidently bizarre and entirely unsupported by any evidence.
Nailfold capillary abnormalities in patients with Sjögren's syndrome and systemic lupus erythematosus
Authors: T. OHTSUKA
Journal: British Journal of Dermatology (1997)

It is unknown whether primary Sjögren's syndrome (pSS) and systemic lupus erythematosus (SLE) have the same nailfold capillary abnormality, although they show similarity in several clinical, immunological and genetic aspects. Microscopy of the nailfold capillaries was undertaken in the two diseases and the observed parameters were compared with age- and sex-matched controls using analysis of variance. pSS and SLE showed a different frequency in their clinical and laboratory findings, except for the presence of anti-SS-A/B antibodies. All nailfold capillary parameters showed significantly higher values than those of corresponding normal controls, although between pSS and SLE there was no significant difference. The results may indicate that pSS and SLE are part of a spectrum of disorder.
Mechanisms of Cell-Mediated Immunity
Authors: Ronald B. Corley
Journal: JAMA (1974)

This volume is intended to provide a comprehensive review of cell-mediated immune reactions, discussing direct as well as indirect roles of lymphocytes in classic delayed hypersensitivity reactions, transplantation immunity, and host responses to infections and tumors. Included in the book are 12 chapters covering various aspects of these subjects written by well-known researchers in their respective fields. While a number of selected topics are well developed, this volume suffers from the same limitations as would any other text on this subject. In such a rapidly developing field, the book is dated soon after publication. Two chapters are presented on in vitro characterizations (Remold and David) and in vivo roles (Yoshida and Cohen) of the lymphokines, with much emphasis placed on the most intensively studied mediator, migration inhibition factor. Other subjects that are well treated include lymphocyte activation (Hirschhorn and Hirschhorn), antigen recognition (Paul and Benacerraf) and reviews of transfer factor
Impact of Coronary Artery Calcium Characteristics on Accuracy of CT Angiography
Authors: Mariusz Kruk, Dariusz Noll, Stefan Achenbach, Gary S. Mintz, Jerzy Pręgowski, Edyta Kaczmarska, Karolina Kryczka, Radosław Pracoń, Zofia Dzielińska, Justyna Śleszycka, Adam Witkowski, Marcin Demkow, Witold Rużyłło, Cezary Kępka
Journal: JACC. Cardiovascular imaging (2013)
[521] MULTIFACTORIAL ANALYSIS OF HOST AND VIRUS RELATED RISK FACTORS FOR THE DEVELOPMENT OF VIRAL RESISTANCE DURING LONG-TERM LAMIVUDINE TREATMENT OF HBV INFECTION OVER UP TO NINE YEARS
Authors: F. Van Bommel, A. Brodzinski, U. Mihm, M.C. Tung, C. Sarrazin, A. Bergk, B. Schlosser, V. Welch, E. Schott, B. Wiedenmann, T. Berg
Journal: Journal of Hepatology (2007)
An Introduction to Social Medicine
Authors: E. James Potchen
Journal: JAMA (1967)

It is a rare pleasure when physicians have the opportunity to reflect upon their relative position in society and upon medicine's ability to alter the trends of nature. Social medicine, as a medical speciality, is not common in this country. It encompasses the field of social science, economics, and public health. The combination of these fields into "Social Medicine" affords refreshing approach to medicine from an unfamiliar viewpoint. Each of these subjects is sufficiently broad to involve an academic lifetime. Thus, this diffuse approach is by its very nature limiting. While the authors obviously intend this to be a mere introduction to a rather broad field, the discussions of nutrition, environmental health, atmospheric pollution, and immunology are but superficially handled. The authors clearly define and assess the validity of screening tests. Acknowledging the significance of immunization and antibiotics in contributing to improved longevity, they nevertheless demonstrate the disconcerting fact that