tbuckley/cabot-search huggingface dataset:
Risk of adverse birth outcomes near landfill sites
Authors: H. Irvine, H. Burns, D. Heller, R. A Fisken, P. A Boyd, P. F Chamberlain
Journal: BMJ (2001)

Risk of adverse birth outcomes near landfill sitesEvidence suggests that it is probably safe for fetuses to develop near landfill sites Editor-Elliott et al report a large geographical study of adverse birth outcomes in populations living near landfill sites. 1 They conclude that there are small excess risks of congenital anomalies and low birth weight in such populations.Although they advise caution when interpreting their results, the study is nevertheless hailed by the press and by environmental groups as evidence that living near such sites is hazardous to health. 2 The concerns felt by parents, often with no opportunity to move elsewhere, are fuelled, and perhaps on no grounds.Scientists contribute to the media generated intrigue in subtle ways.For example, the description of the paper in an editorial by McNamee and Dolk as a report "on the risks to fetuses associated with residence" when "a study of the statistical association between reported anomalies and residence" would have been more accurate and less sensationalist. 3 Health authorities are left to pick up the pieces when a story breaks, with no advance warning, about a landfill site in their area.Another interpretation of the results of Elliott et al is that this essentially negative study goes some way to reassuring other scientists who have been studying this question that it is probably safe for fetuses to develop near such sites.Any scientist who has any experience of multivariate epidemiological analysis would have to admit that such small and inconsistent excesses and deficits, even though significant, could well be attributable to inadequately adjusted social deprivation, to name but one of many important confounders.The fact that there was no increase after the landfill sites became operational, and a significant deficit of anomalies around landfill sites in Scotland, must leave even the most determined author feeling uneasy about suggesting a causal association.Epidemiological techniques used in this study are blunt instruments unlikely to detect subtle or unidentified effects.Perhaps it is time for epidemiologists to admit that their tools are inadequate to answer this question.Other scientists should take this forward by developing better techniques to identify any putative agents in the gas emissions, leachates, and soil that may be of sufficiently high concentrations to affect human health.Many of these landfill sites are unattractive and foul smelling, attracting seagulls and peppering the landscape with rubbish.More imaginative long term wastemanagement solutions are long overdue.
Hemodynamic, Echocardiographic, and Neurohormonal Effects of Istaroxime, a Novel Intravenous Inotropic and Lusitropic Agent
Authors: Mihai Gheorghiade, John E.A. Blair, Gerasimos S. Filippatos, Cezar Macarie, Witold Ruzyllo, Jerzy Korewicki, Serban I. Bubenek-Turconi, Maurizio Ceracchi, Maria Bianchetti, Paolo Carminati, Dimitrios Kremastinos, Giovanni Valentini, Hani N. Sabbah
Journal: Journal of the American College of Cardiology (2008)
Metabolic signatures associated with lung cancer using serum samples. Influence of hemolysis
Authors: Antonio Jose Ruiz Reina, Macarena Gonzalez, Eva Vazquez, Ricardo Ismael Aguilar Perez Grovas, Ignacio Vazquez Rico, Tamara Garcia Barrera, Jesus Gravalos Guzman, Jose Luis Sanchez Ramos, Jose Antonio Maldonado Perez, Jose Luis Gomez Ariza, Antonio Pereira Vega
Journal: European Respiratory Journal (2014)

Sampling procedure greatly affects results and conclusions in metabolomic studies. This is the case of serum samples sustaining hemolysis, which need accurate evaluation in assessment of lung cancer (LC).  This study considers metabolites present in serum samples after precipitation of proteins for analysis by direct infusion to a Triple Quadrupole Time-Of-Flight Mass Spectrometer (QqQ-TOF-MS). In addition, Hemolytic Index (HI) was semiquantitatively evaluated by Ultraviolet-visible spectrophotometry. The metabolomic profiles obtained were statistically compared by Partial least squares Discriminant Analysis, taking into account different hemoglobin concentration (Hb%) in the samples.  Statistical models were built based on (Hb%) in the samples (>20, >40 y >80 mg/dL of Hb). Fig 1.A shows a clear classification between (LC) and healthy controls (HC) samples, regardless of sample hemolysis (LCH>20/HCH>20 -hemolyzed; LC/HC-not hemolyzed). When (HI) is higher than 40 (Fig 1.B), a proper statistical classification between hemolyzed (LC) and controls (HCH) is not achieved, since all hemolyzed samples are grouped in one single cluster. Fig. 1C represents the far tip of hemolysis influence, in which ((LC), green) and ((HC) reed) are not discriminated.  Concluding, hemolysis is a disturbing factor in metabolomic studies related to (LC) and has to be considered in the methodological approaches for blood sampling in order to avoid it.
Lower‐extremity ulcers: diagnosis and management
Authors: R.S. Kirsner, A.C. Vivas
Journal: British Journal of Dermatology (2015)

Journal Article Lower‐extremity ulcers: diagnosis and management Get access R.S. Kirsner, R.S. Kirsner Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine 1600 NW 10th Ave RMSB Room 2023‐A Miami FL 33136 U.S.A Correspondence Robert S. Kirsner. E‐mail: RKirsner@med.miami.edu Search for other works by this author on: Oxford Academic Google Scholar A.C. Vivas A.C. Vivas Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine 1600 NW 10th Ave RMSB Room 2023‐A Miami FL 33136 U.S.A Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 173, Issue 2, 1 August 2015, Pages 379–390, https://doi.org/10.1111/bjd.13953 Published: 01 August 2015
An Ethical Framework for Clinical Decision-Making at the end of Life
Authors: Peter Jeffery, Peter H Millard
Journal: Journal of the Royal Society of Medicine (1997)

Because of advances in medicine, decision-making at the end of life is no longer simple. Public debate on television and articles in journals demonstrate the need for an ethical framework to solve moral dilemmas in caring for the irreversibly ill. This paper proposes three principles that should underpin medical behaviour. During three years' research we set out to determine the practical problems that senior medical staff were facing by interviewing small groups at the Royal Society of Medicine. We invited individuals from anaesthesia, general practice, geriatrics, neurosurgery and neurodisability, oncology, and palliative care. Three participants were chosen because of their published support for euthanasia, advance directives or 'pro-life' campaigns. Later, we involved junior hospital doctors, nursing and therapy staff, general practitioners, pensioners' groups, ethicists and hospital chaplains. Whilst the duty to provide for the care of the sick is incumbent on the whole of society, the knowledge and training of doctors gives them special responsibilities. However, from our research it soon became obvious that among practitioners there is a moral vacuum on this question. This arises because doctors have both to respect human life and to accept the mortality of man. At all levels there was confusion about questions such as 'Who is responsible for death when treatment is withdrawn?' and 'Why is it not necessary always to treat?'. This could be stated simply as problems over the distinction between killing and letting die. However, from the outset it was clear that the problem begins with the difference between two extremes keeping a patient alive at all costs (vitalism) and seeking to bring about death (euthanasia).
Darbepoetin Alfa in Systolic Heart Failure
Authors: Karl Swedberg, John J V McMurray, James B Young
Journal: New England Journal of Medicine (2013)

1. Health homes for enrollees with chronic conditions. Document 10-024. Baltimore: Center for Medicare and Medicaid Services, November 16, 2010 (http://downloads.cms.gov/cmsgov/ archived-downloads/SMDL/downloads/SMD10024.pdf). 2. Primary and behavioral health integration grants. Rockville, MD: Substance Abuse and Mental Health Services Administration (http://www.samhsa.gov/healthreform/healthhomes).
People who develop type 2 diabetes show increased antibiotic use before onset
Authors: Susan Mayor
Journal: BMJ (2015)

People who develop type 2 diabetes show increased use of antibiotics in the years before diagnosis than people who do not develop the condition, a Danish population based case-control study has shown.1

The study, published in the Journal of Clinical Endocrinology and Metabolism , included all 170 504 people in Denmark who had newly diagnosed type 2 diabetes and were using glucose lowering agents for the first time from 1 January 2000 to 31 December 2012.

Researchers compared prescriptions for systemic antibiotics dispensed to these …
Abstract 6016: Pathology Of Hypersensitivity In Late Drug Eluting Stent Thrombosis
Authors: Elena Ladich, Gaku Nakazawa, Stephane Cook, Stephan Windecker, Allen Burke, Frank Kolodgie, Renu Virmani
Journal: Circulation (2008)

Background: Localized hypersensitivity (HS) has been reported as a pathologic risk factor for late DES thrombosis (DES-LST). The objectives of the study were to examine the pathologic features of HS in DES-LST and correlate with stent characteristics, underlying plaque morphologies and patient risk factors. Materials and methods: From a registry of 153 DES patients, 33 patients with DES-LST were identified. LST was defined as platelet-rich thrombus in a coronary stent implanted &gt; 30 days. Stented arteries were serially sectioned at 2–3 mm intervals and stained with H&amp;E, Movat stain, Luna stain (eosinophils), and UCHL (T-lymphocytes). Localized HS was defined as an inflammatory cell infiltrate composed predominantly of eosinophils and T-lymphocytes limited to the arterial wall surrounding the stent. Patient data, risk factors, stent characteristics, and underlying plaque morphology were compared between two groups: hypersensitivity (HS), and non-hypersensitivity LST (NHS). Results: Of the 33 DES-LST cases with occlusive thrombus, 6 (4 men, 2 women) demonstrated HS histologically (18%). The mean age was 54 years (range 40 – 62 years). All 6 had Cypher stents (mean stent length=24 mm), 4 had &gt;1 stent, 2 with overlapping stents. The mean stent duration was 624 days (range 112 to 990 days). Three patients were on ASA and clopidogrel, 2 ASA only, 1 discontinued ASA/clopidogrel prior to non-cardiac surgery. Patient risk factors included hyperlipidemia (n=6), hypertension (n=5) and smoking (n=4). All demonstrated underlying fibroatheroma with stent struts penetrating necrotic core in 3 and 2 with previous rupture sites. Stent malapposition was present in 5 (83%). Twenty-seven patients demonstrated NHS-LST (Cypher=7, Taxus=20). Mean stent duration was 326 days (range 31–1200 days). Malapposition was identified in 10 (37%). Compared to NHS, the HS LST group was more likely to demonstrate stent malapposition (p=0.04) and longer implant times (p=0.049). Conclusions: DES-LST is related to HS in 18% of cases, is associated with Cypher stents, malapposition and longer implantation time. Localized HS with stent thrombosis is a clinically important problem that may occur late after stenting and warrants further pathologic study.
Abstract 278: Successful Conversion of Ventricular Tachyarrhythmias by Wearable Defibrillator
Authors: Vincent N Mossesso, Jie Li, Douglas Landsittel, Leonard I Ganz
Journal: Circulation (2011)

Ventricular fibrillation (VF) and ventricular tachycardia (VT) are lethal cardiac dysrhythmias which must be treated within minutes of onset to avoid death. Certain patients who are high risk for VF/VT are not eligible or appropriate in the short term for an implantable cardiac defibrillator (ICD). The wearable cardioverter defibrillator (WCD) is a bridge device for use during this waiting period. This study tested the hypothesis that the WCD would successfully convert VF/VT to a perfusing rhythm in all patients. In addition, we determined the incidence of shocks delivered to patients using the WCD and classified shocks as appropriate or inappropriate. Methods: We retrospectively reviewed data of all patients prescribed a WCD between January 1, 2007 and December 31, 2009 whose end of use date occurred on or prior to March 31, 2010 in the ZOLL LifeVest post-market registry. This included ECG recordings and customer call reports related to all shock events and deaths that occurred during WCD use. A single event was defined to include all episodes of VF/VT within a 24 hour period. Data were analyzed using summary statistics. Results: The registry included 15,193 persons with mean age 59.8 +/- 14.5 years (SD); 71.5% were male. Total exposure to WCD was 2,378 person-years in 14,475 persons with a mean duration of WCD use per person of 59.9 +/- 59.1 days. The most common indications were non-ischemic cardiomyopathy (40.1%), myocardial infarction (33.0%), and ICD pocket infection (12.1%). There were 203 VF/VT events and 378 individual episodes of VF/VT (0.16 episodes/person-year of WD use) in 185 persons (1.3% of WD users). Shock led to organized rhythm in 345 (91.3%) of VF/VT episodes and persistent VF/VT in 26 (6.9%). Event survival was 91.6%. None of the 223 inappropriate shocks delivered to 213 persons resulted in death. Conclusion: The WCD was highly effective for prevention of sudden death in persons at high risk of VF/VT but not yet eligible for an ICD, with no mortality from inappropriate shocks.
HIV disease progression in 854 women and men infected through injecting drug use and heterosexual sex and followed for up to nine years from seroconversion
Authors: A. C. Lepri, P. Pezzotti, M. Dorrucci, A. N Phillips, G. Rezza
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b>: To compare the progression of HIV-1 infection in men and women followed up for up to nine years after an accurately estimated date of seroconversion. <b>Design</b>: Prospective observational study. <b>Setting</b>: 16 HIV outpatient clinics across Italy. <b>Subjects</b>: 321 women and 533 men infected with HIV through injecting drug use or heterosexual sex and with accurately estimated dates of seroconversion. <b>Main outcome measures</b>: Progression to severe CD4 lymphocytopenia (CD4 lymphocyte count &lt;200 × 10<sup>6</sup>/l), development of AIDS defining diseases, and death from AIDS. <b>Results</b>: Thirty two women and 67 men developed AIDS at Kaplan-Meier progression rates of 25% (95% confidence interval 13.8% to 35.5%) and 23% (15.6% to 30.4%), respectively, 7 years after seroconversion. In a Cox proportional hazards model the relative hazard was 0.93 (that is, a slightly lower hazard in women) before and 1.10 (0.70 to 1.72) after adjusting for age, HIV exposure group, and year of seroconversion. When CD4 lymphocytopenia and death from AIDS were used as end points the results were similar, with adjusted relative hazards of 0.95 (0.63 to 1.42) and 0.72 (0.48 to 1.79) respectively. In both women and men the risk of developing AIDS before the CD4 lymphocyte count had declined below 200 × 10<sup>6</sup>/l was small (3% in women, 6% in men). The estimated median count at which AIDS developed in women (34 × 10<sup>6</sup>/l; 10 × 10<sup>6</sup> to 44 × 10<sup>6</sup> was similar to that for men (44 × 10<sup>6</sup>/l; 22 × 10<sup>6</sup> to 60 × 10<sup>6</sup>. <b>Conclusion</b>: There seems to be little evidence for appreciable differences in the natural course of HIV infection between men and women followed up from the time of seroconversion.
Two year mortality of COPD in primary care in Greece: An observational study
Authors: Markos Minas, Ioanna Verou-Katsarou, Parthena Mystridou, Eleni Apostolidou, Hatzoglou Chrisi, Konstantinos Gourgoulianis
Journal: European Respiratory Journal (2011)

Introduction:  COPD remains a significant cause of death worldwide. However, in primary care in Greece there is still a large proportion of undiagnosed COPD patients. Parameters associated with mortality in COPD patients have not been identified.   Aims and objectives:  To assess the parameters associated with two year mortality in newly diagnosed COPD patients in primary care in Greece   Methods:  Using an open spirometry programme, 118 newly diagnosed COPD patients were followed up for two years. Phone contact to assess vital status was performed every six months, whereas the study participants were examined and performed spirometry by the study team once a year after the initial diagnosis.   Results:  During the two year follow up, a great proportion of COPD patients quitted smoking after the initial diagnosis. However, there was no change in respiratory symptoms, and only the 68.2% showed compliance with treatment. Overall mortality was 28.0% (33 out of 118 subjects). Parameters associated with two year mortality in a cox regression model were age (p   Conclusion:  Mortality of COPD patients in primary care in Greece remains significant high. History of depression was associated with increased mortality and should be taken into account when assessing COPD patients. A more intense monitoring and better health care provided at these patients is suggested.
The nature of the semantic/episodic memory distinction: A missing piece of the “working through” process
Authors: Stanley B. Klein, Hans J. Markowitsch
Journal: Behavioral and Brain Sciences (2015)

Abstract The relations between the semantic and episodic-autobiographical memory systems are more complex than described in the target article. We argue that understanding the noetic/autonoetic distinction provides critical insights into the foundation of the delineation between the two memory systems. Clarity with respect to the criteria for classification of these two systems, and the evolving conceptualization of episodic memory, can further neuroscientifically informed therapeutic approaches.
Indolent Systemic Mast Cell Disease in Adults: Immunophenotypic Characterization of Bone Marrow Mast Cells and Its Diagnostic Implications
Authors: Luis Escribano, Alberto Orfao, Beatriz Dı́az-Agustin, Jesús Villarrubia, Carlos Cerveró, Antonio López, Marı́a A. Garcı́a Marcos, Carmen Bellas, Serafı́n Fernández-Cañadas, Manuela Cuevas, Alberto Sánchez, José L. Velasco, José Luis Navarro, Jesús F. San Miguel
Journal: Blood (1998)
The role of the type 3 secretion system effector protein ExoY during pathogenesis of pseudomonas aeruginosa lung infections
Authors: Antje Munder, Christina Hartwig, Tane Stelzer, Roland Seifert, Burkhard Tümmler
Journal: European Respiratory Journal (2014)

The Gram-negative bacterium  Pseudomonas aeruginosa  is an important opportunistic pathogen and causes severe infections in the airways especially of immuno-compromised patients. One of the most important virulence factors of the pathogen is the type III secretion system with four effector proteins identified, so far. ExoS, ExoT and ExoU cause different types of cell death, whereas the function of ExoY remains still unclear. Originally, ExoY was classified as adenylyl cyclase, increasing intracellular concentrations of cAMP, but without playing a significant role in pathogenicity. However, our recent studies in a standardized mouse infection model with strain PA103Δ exoUexoT::Tc  pUCP exoY expressing a functional ExoY leads to severe pathological changes in lung tissue and to increased mortality in mice. In contrast, a catalytically inactive ExoY mutant PA103Δ exoUexoT::Tc  showed considerably less lung pathohistology and 100% survival. Measurements of cyclic nucleotides using highly specific and sensitive mass spectrometry showed highly increased cCMP and cUMP levels, whereas increases in cGMP and cAMP were only marginal.  We therefore assume a direct mechanistic link between the accumulation of cyclic pyrimidine nucleotides cCMP and cUMP or the consumption of the corresponding nucleoside 59-triphosphates CTP/ UTP respectively and the observed pathophysiological changes in lung tissue.
A salutary lesson: Three very unwise men
Authors: B M Colls
Journal: BMJ (1999)

Three men sharing accommodation decided to make a fresh vegetable salad, and the oldest convinced his junior flatmates that a plant growing in the back garden was Russian comfrey. Having made the salad the senior member ate three mouthfuls of the salad and then desisted because of the disagreeable taste. The second ate only one mouthful, and the junior member ate little at all because of the unpleasant taste. The two senior members started to feel ill within six …
Overview: clinical applications of the Amytal interview in psychiatric emergency settings
Authors: J C Perry, D Jacobs
Journal: American Journal of Psychiatry (1982)

The authors review the evidence for the efficacy of the sodium amytal interview with particular reference to psychiatric emergencies and rapid assessment and treatment. Amytal interviews have a valid role in the assessment and initial management of catatonia, hysterical stupor, and unexplained muteness as well as in distinguishing between depressive, schizophrenic, and organic stuporous states. Valid therapeutic indications include the abreaction of traumatic neurosis, recovery of memory in amnesic and fugue states, and recovery of function in conversion disorders. The authors offer a protocol for application of the amytal interview in emergency settings.
Epidemiological investigation in TB diagnosis must be reconsidered
Authors: Mihaela Archip, Maria Panescu, Camelia Vasilescu, Marilena Colea
Journal: European Respiratory Journal (2011)

Aim:  The purpose of this study is to prove the importance of the epidemiological investigation in early TB diagnosis.   Material and method:  We have analyzed the TB cases registered in three adult tuberculosis districts in Iasi, Romania. The patients have received TB treatment during 2010.  We used the medical records, district records and IT records.  During this period, we treated 211 TB patients: 178 pulmonary TB and 33 extra-pulmonary TB cases; we have recorded 168 new cases, 32 relapses, 10 patients were readmitted after failure, default, MDR chronics and one transfer.  Using epidemiological investigation, we identified 22 cases (10.43% out of all analyzed cases). The medical history of the patients revealed that 84 of them (39.81%) had previous TB contact: 86.9% of these had domestic contact and only 13.1% of them had indirect TB contact.   Conclusion:  Out of the 211 cases, only 22 have been identified using epidemiological investigation. The medical history of 84 patients revealed TB contact, especially domestic TB contact. Moreover, in a single family, 4 domestic contacts developed pulmonary TB during the past 20 years. They all manifested the same type of drug resistance. This fact has been determined by using epidemiological investigation.  We must reconsider:  the periodic screening of TB contacts over a greater period of time;  the key role of the family physician, who must be focused on evaluating a larger number of domestic/indirect TB contacts for a correct and efficient epidemiological investigation.
Acromegaly
Authors: Jon Danzig
Journal: BMJ (2007)

Something strange started happening to me around 10 years ago. My shoe size grew from 9 to 11, my income permanently dried up, and the girlfriend I was going to marry left after we stopped having sex. It wasn't just the sex, or lack of it. I also dramatically changed, both personally and physically. My nose grew bigger, my forehead enlarged, and my face and hands became puffy and coarse. But these were all gradual changes that I only realised in retrospect. Some friends noticed more acutely. One, who hadn't seen me for four years, looked shocked when I opened my front door. “You've rearranged your face,” he blurted. My younger sister was blunter. She said I looked like I'd been in a fight.