tbuckley/cabot-search huggingface dataset:
Public Health Nurses’ Knowledge and Attitudes Regarding Climate Change
Authors: Barbara J. Polivka, Rosemary V. Chaudry, John Mac Crawford
Journal: Environmental Health Perspectives (2011)

Background: Climate change affects human health, and health departments are urged to act to reduce the severity of these impacts. Yet little is known about the perspective of public health nurses—the largest component of the public health workforce—regarding their roles in addressing health impacts of climate change.Objectives: We determined the knowledge and attitudes of public health nurses concerning climate change and the role of public health nursing in divisions of health departments in addressing health-related impacts of climate change. Differences by demographic subgroups were explored.Methods: An online survey was distributed to nursing directors of U.S. health departments (n = 786) with Internet staff directories.Results: Respondents (n = 176) were primarily female, white public health nursing administrators with ≥ 5 years of experience. Approximately equal percentages of respondents self-identified as having moderate, conservative, and liberal political views. Most agreed that the earth has experienced climate change and that climate change is somewhat controllable. Respondents identified an average of 5 of the 12 listed health-related impacts of climate change, but the modal response was zero impact. Public health nursing was perceived as having responsibility to address health-related impacts of climate change but lacking the ability to address these impacts.Conclusions: Public health nurses view the environment as under threat and see a role for nursing divisions in addressing health effects of climate change. However, they recognize the limited resources and personnel available to devote to this endeavor.
No evidence base for monitoring aminoglycoside levels
Authors: J. P. McCormack
Journal: BMJ (2012)

I was intrigued by Banerjee and colleagues’ statements that “monitoring of therapy is essential to ensure optimal treatment and prevent toxicity” and this article “reviews the available evidence for this evolving topic.”1

It is my understanding that the evidence base to support measuring aminoglycoside concentrations is weak for multiple dose …
Bacterial Signatures in Thrombus Aspirates of Patients With Myocardial Infarction
Authors: Tanja Pessi, Vesa Karhunen, Pasi P. Karjalainen, Antti Ylitalo, Juhani K. Airaksinen, Matti Niemi, Mikko Pietila, Kari Lounatmaa, Teppo Haapaniemi, Terho Lehtimäki, Reijo Laaksonen, Pekka J. Karhunen, Jussi Mikkelsson
Journal: Circulation (2013)

Infectious agents, especially bacteria and their components originating from the oral cavity or respiratory tract, have been suggested to contribute to inflammation in the coronary plaque, leading to rupture and the subsequent development of coronary thrombus. We aimed to measure bacterial DNA in thrombus aspirates of patients with ST-segment-elevation myocardial infarction and to check for a possible association between bacteria findings and oral pathology in the same cohort.Thrombus aspirates and arterial blood from patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention (n=101; 76% male; mean age, 63.3 years) were analyzed with real-time quantitative polymerase chain reaction with specific primers and probes to detect bacterial DNA from several oral species and Chlamydia pneumoniae. The median value for the total amount of bacterial DNA in thrombi was 16 times higher than that found in their blood samples. Bacterial DNA typical for endodontic infection, mainly oral viridans streptococci, was measured in 78.2% of thrombi, and periodontal pathogens were measured in 34.7%. Bacteria-like structures were detected by transmission electron microscopy in all 9 thrombus samples analyzed; whole bacteria were detected in 3 of 9 cases. Monocyte/macrophage markers for bacteria recognition (CD14) and inflammation (CD68) were detected in thrombi (8 of 8) by immunohistochemistry. Among the subgroup of 30 patients with myocardial infarction examined by panoramic tomography, a significant association between the presence of periapical abscesses and oral viridans streptococci DNA-positive thrombi was found (odds ratio, 13.2; 95% confidence interval, 2.11-82.5; P=0.004).Dental infection and oral bacteria, especially viridans streptococci, may be associated with the development of acute coronary thrombosis.
B.M.A. Planning Unit Survey of General Practice 1969
Authors: D. Irvine, M. Jeffreys
Journal: BMJ (1971)

A postal survey of 776 principals representative of general practice in Britain is described. Doctors working in health centres are compared both with colleagues in other group practices and with doctors who have no group practice allowance. Young doctors are mainly in group practice, especially health centres; the proportion of doctors who are not in groups is diminishing steadily, and they are mainly older. With some notable exceptions health centres provide most space, equipment, and staff; group practitioners in privately-owned premises spend more of their money on their practices, more often use appointment systems, and tend to make more efficient use of premises and staff. Overall, however, the picture is still one of general practice geared to the needs of practitioners working alone. Premises with space for sophisticated organization and for future teaching needs are unusual. Scotland, the North of England, and Wales have fewer young doctors. Average lists are higher in the North of England, and less money is invested in practice premises. Young doctors look for modern premises and the tools and staff for the job. If their career expectations are to be met the tremendous improvements made in some practices must be extended rapidly to the remainder.
Prognostic and Functional Significance of Thromboxane Synthase Gene Overexpression in Invasive Bladder Cancer
Authors: Omar Moussa, John S. Yordy, Hassan Abol-Enein, Debajyoti Sinha, Nabil K. Bissada, Perry V. Halushka, Mohamed A. Ghoneim, Dennis K. Watson
Journal: Cancer Research (2005)

Abstract Thromboxane synthase (TXAS) is one of the enzymes downstream from cyclooxygenase-2 and catalyzes the synthesis of thromboxane A2 (TXA2). TXAS was among the genes we identified based on its overexpression in invasive bladder tumors. TXAS is overexpressed in common forms of bladder tumors: 69 of 97 (71.1%) transitional cell carcinoma (TCC), 38 of 53 (71.6%) squamous cell carcinoma, and 5 of 11 (45.5%) adenocarcinoma relative to nontumor tissue. Overall, 112 of 161 (69.5%) invasive tumors exhibited elevated expression. Significantly, patients with tumors having &amp;gt;4-fold levels of TXAS expression showed significant statistical evidence of lower overall survival expressed by the estimated hazard ratio of 2.74 with P = 0.009 in Cox's regression analysis. TXAS mRNA expression was found to be an independent prognostic marker for patients with bladder cancer. Treatment of bladder cancer cell lines (T24 and TCC-SUP) with TXAS inhibitors and TXA2 (TP) receptor antagonists reduced cell growth, migration, and invasion, whereas TP agonists stimulated cell migration and invasion. The positive correlation between elevated TXAS expression and shorter patient survival supports a potential role for TXAS-regulated pathways in tumor invasion and metastases and suggests that modulation of the TXAS pathway may offer a novel therapeutic approach. (Cancer Res 2005; 65(24): 11581-7)
Supreme Court holds airline liable for doctor's death
Authors: Fred Charatan
Journal: BMJ (2004)

The US Supreme Court ruled last week that Olympic Airways must pay a doctor's widow $1.4m (£0.75m; €1.1m).

The case arose out of a flight from Athens to San Francisco in January 1998, when Dr Abid M Hanson, aged 52, a Californian doctor, was travelling home with his wife and children.

Dr Hanson had an asthmatic reaction to cigarette smoke, and …
Clozapine Alone versus Clozapine and Risperidone with Refractory Schizophrenia
Authors: William G. Honer, Allen E. Thornton, Eric Y.H. Chen, Raymond C.K. Chan, Jessica O.Y. Wong, Andrea Bergmann, Peter Falkai, Edith Pomarol-Clotet, Peter J. McKenna, Emmanuel Stip, Richard Williams, G. William MacEwan, Kishor Wasan, Ric Procyshyn
Journal: New England Journal of Medicine (2006)

The treatment of schizophrenia with multiple antipsychotic drugs is common, but the benefits and risks are not known.
Dietary therapy can reverse esophageal subepithelial fibrosis in patients with eosinophilic esophagitis: a historical cohort
Authors: J. A. Lieberman, R. A. Morotti, G. N. Konstantinou, O. Yershov, M. Chehade
Journal: Allergy (2012)

Abstract Background Fibrosis of the esophageal lamina propria is a known complication of eosinophilic esophagitis ( E o E ). To date, therapy with topical corticosteroids has been shown to reverse esophageal fibrosis in some patients; however, there is little evidence to suggest that dietary therapy can also reverse it. Our aim was to examine whether dietary therapy alone can reverse esophageal fibrosis in children with E o E . Methods We performed a historical cohort study based on children with E o E who had esophageal fibrosis on pretreatment biopsies using trichrome staining. Post‐treatment biopsies were analyzed for fibrosis reversal, and results were compared between patients treated with dietary restriction and those that received topical steroids. Clinical characteristics (age, symptoms, duration of symptoms prior to therapy, treatment type, and duration of therapy) were recorded. Histological markers (eosinophil numbers and eosinophilic degranulation in both epithelium and lamina propria, basal zone hyperplasia, and the presence of eosinophilic microabscesses in the epithelium) were examined by reviewing hematoxylin and eosin‐stained biopsies and by immunohistochemical staining. These were examined as potential predictors for fibrosis reversal. Results Fibrosis resolved following both dietary restriction and topical steroids (3/17 and 5/9 patients respectively, P = 0.078). Post‐treatment symptom resolution and decreased intraepithelial eosinophil numbers were found to be the only significant predictors of fibrosis resolution. Conclusions Dietary restriction alone, similar to topical steroids, can reverse fibrosis in children with E o E .
NICE to set out how it will judge social benefits of drugs
Authors: N. Hawkes
Journal: BMJ (2014)

Influenza A viruses (IAVs) are a major respiratory pathogen with the capacity to rapidly mutate and escape an individual’s existing immunity to a specific strain generated by vaccination or naturally acquired infection. CD8 T cells however, target conserved proteins that could be shared across multiple subtypes. Heterosubtypic immunity to IAVs, where memory T cells generated to a previous IAV are reactivated during re-challenge with an antigenically distinct virus, may be important in generating an effective immune response to different and/or novel strains of IAV. Specifically, cross reactive T cells, where a T cell receptor (TCR) can recognize more than one epitope displayed on an MHC-I molecule, could facilitate rapid recognition of conserved or nominally divergent epitopes, may have the potential to alter the TCR repertoire over the course of heterosubtypic infections, and might be selected for by the immune system. Utilizing 8 variant influenza viruses for priming and secondary challenge, our preliminary data has shown that cross reactive TCRs seen in primary infection with one IAV can mount a robust and effective memory response to a different IAV, even if the epitope has slightly mutated. However, selection for cross reactive receptors may create a narrowed repertoire consisting of a few clonotypes over the course of many repeated heterosubtypic IAV infections, covering a narrow range of antigenic space representing the mutant epitopes encountered. Paradoxically, this selection for cross-reactivity may provide a substantial escape opportunity with future antigenic variations. Ongoing work focuses on how repeated IAV challenges shape and are shaped by these selected cross-reactive T cell pools.
Potentiation of C-type natriuretic peptide with ultrasound and microbubbles to prevent neointimal formation after vascular injury in rats
Authors: H TAKEUCHI, K OHMORI, I KONDO, A OSHITA, K SHINOMIYA, Y YU, Y TAKAGI, K MIZUSHIGE, K KANGAWA, M KOHNO
Journal: Cardiovascular Research (2003)

Objectives: Long-term intravenous infusion of high-dose C-type natriuretic peptide (CNP) is known to prevent neointimal formation after vascular injury. Ultrasound (US) irradiation during microbubbles (MBs) infusion (US/MBs) has been used for local delivery of bioactive agents. We examined whether short-term infusion of CNP could also inhibit neointimal development and whether combined US/MBs treatment at the beginning of the CNP infusion could enhance its effect. Methods: In the rat carotid artery-balloon injury model, the intima/media area (I/M) ratio 14 days after injury was compared among various short-term post-injury treatments. For combined US/MBs, a commercial echocardiograph (1.8 MHz, mechanical index 1.0) and albumin-coated octafluoropropane gas MBs were used. Results: Infusion of high-dose CNP (1.0 μg/kg/min) immediately after injury for only 24 h successfully reduced the I/M ratio (0.18±0.05) to 18% of the ratio in control rats (1.00±0.13) that underwent only balloon injury. Although low-dose CNP (0.1 μg/kg/min for 24 h) alone was not effective in reducing the I/M ratio (0.83±0.18), combined US/MBs treatment for the first 80 min of the infusion markedly reduced the I/M ratio (0.17±0.07), which persisted until 28 days after injury (0.16±0.04). Conclusions: The effects of CNP on the events occurring early after arterial injury may be important in preventing subsequent neointimal development. Thus, intravenous infusion of CNP with US/MBs at its initiation may provide a clinically feasible anti-restenosis therapy applicable immediately after vascular interventions.
Acute lymphoblastic leukemia in a patient with chronic granulomatous disease and a novel mutation in <i>CYBB</i>: First report
Authors: Baruch Wolach, Shifra Ash, Ronit Gavrieli, Batia Stark, Isaac Yaniv, Dirk Roos
Journal: American Journal of Hematology (2005)

Abstract We report for the first time a child with chronic granulomatous disease (CGD) who developed acute lymphoblastic leukemia (ALL). The diagnosis of CGD was made at the age of 4 months, by studies of his neutrophil functions. The superoxide production of the cells was negligible, as was the bactericidal activity. He was found to have a deficiency of the gp91 phox subunit of the leukocyte NADPH oxidase, with the X‐linked inheritance of the disease. DNA analysis revealed a C nucleotide insertion between C1028 and T1029. This insertion has not been described before and causes a frameshift and a premature stop codon at amino‐acid position 347. The mother was found to be a carrier of this mutation. At the age of 16 months, the patient developed T‐cell ALL. He was treated for 2 years, and today, 10 years since the diagnosis, he is disease‐free. During the course of ALL and later, he suffered from recurrent severe pyogenic infections, but careful detection of the etiological agent and promptly instituted specific treatment resulted in his complete recovery. Although primary immune deficiencies have been reported to have an increased tendency to develop malignancies, until now there have been no reports of CGD patients with ALL. Am. J. Hematol. 80:50–54, 2005. © 2005 Wiley‐Liss, Inc.
Tenofovir disoproxil fumarate (TDF) suppresses lamivudine-resistant HBV replication in patients co-infected with HIV/HBV
Authors: Yves Benhamou, M. Bochet, R. Tubiana, V. Thibault, L. Suflisseau, Mark Sullivan, Jim Rooney, Carol Brosgart, F. Bricaire, C. Katlama, T. Poynard
Journal: Journal of Hepatology (2002)
Maine allows importation of mail order prescription drugs
Authors: M. McCarthy
Journal: BMJ (2013)

Residents of Maine can now order drugs from foreign pharmacies under a new state law that is the first of its kind in the United States.

The law, which went into effect on Wednesday 9 October, allows state residents to obtain prescriptions by mail order from pharmacies in Canada, the United Kingdom, New Zealand, and Australia.

Americans typically pay some of the highest prices in the world for prescription drugs, and for years many people have taken to ordering drugs by mail from countries where prices are lower, especially Canada.

Although the practice violates federal law, federal authorities have rarely gone after consumers who purchased …
When the coefficient hits the clinic: Effect size and the size of the effect
Authors: Brendan Maher
Journal: Behavioral and Brain Sciences (1998)

The usefulness of effect-size differs in utilitarian experiments from its use in theory corroborations. Chow introduces the question of the relationship of effect-size to practical validity and the role of the assessment of “importance” in this. This review develops this question and suggests the actuarial table as a replacement for effect-size in practical decision-making.
The PI3-K/AKT-Pathway and Radiation Resistance Mechanisms in Non-small Cell Lung Cancer
Authors: Olga C.J. Schuurbiers, Johannes H.A.M. Kaanders, Henricus F.M. van der Heijden, Richard P.N. Dekhuijzen, Wim J.G. Oyen, Johan Bussink
Journal: Journal of Thoracic Oncology (2009)
Implementation of a fire-prevention injury prevention briefing in children's centres: a multicentre cluster-randomised controlled trial
Authors: Toity Deave, Adrian Hawkins, Arun Kumar, Nicola Cooper, Trudy Goodenough, Michael Watson, Carol Coupland, Gosia Majsak-Newman, Lisa Mcdaid, Joanne Ablewhite, Rose Clacy, Elaine McColl, Richard Reading, Mike Hayes, Denise Kendrick
Journal: The Lancet (2014)
High Density Lipoprotein Metabolism in Man
Authors: Conrad B. Blum, Robert I. Levy, Shlomo Eisenberg, Marshall Hall, Robert H. Goebel, Mones Berman
Journal: Journal of Clinical Investigation (1977)

The turnover of (125)I-high density lipoprotein (HDL) was examined in a total of 14 studies in eight normal volunteers in an attempt to determine the metabolic relationship between apolipoproteins A-I (apoA-I) and A-II (apoA-II) of HDL and to define further some of the determinants of HDL metabolism. All subjects were first studied under conditions of an isocaloric balanced diet (40% fat, 40% carbohydrate). Four were then studied with an 80% carbohydrate diet, and two were studied while receiving nicotinic acid (1 g three times daily) and ingesting the same isocaloric balanced diet. The decay of autologous (125)I-HDL and the appearance of urinary radioactivity were followed for at least 2 wk in each study. ApoA-I and apoA-II were isolated by Sephadex G-200 chromatography from serial plasma samples in each study. The specific activities of these peptides were then measured directly. It was found that the decay of specific activity of apoA-I and apoA-II were parallel to one another in all studies. The mean half-life of the terminal portion of decay was 5.8 days during the studies with a balanced diet.Mathematical modeling of the decay of plasma radioactivity and appearance of urinary radioactivity was most consistent with a two-compartment model. One compartment is within the plasma and exchanges with a nonplasma component. Catabolism occurs from both of these compartments. With a balanced isocaloric diet, the mean synthetic rate for HDL protein was 8.51 mg/kg per day. HDL synthesis was not altered by the high carbohydrate diet and was only slightly decreased by nicotinic acid treatment. These perturbations had effects on HDL catabolic pathways that were reciprocal in many respects. With an 80% carbohydrate diet, the rate of catabolism from the plasma compartment rose by a mean of 39.1%; with nicotinic acid treatment, it fell by 42.2%. Changes in the rate of catabolism from the second compartment were generally opposite those in the rate of catabolism from the plasma compartment, suggesting that these two catabolic pathways may be reciprocally regulated.
Abuse of elderly people by their carers.
Authors: A C Homer, C Gilleard
Journal: BMJ (1990)

OBJECTIVE--To assess the prevalence of abuse of elderly people by their carers and the characteristics of abusers and the abused. DESIGN--Information on abuse and risk factors was collected over six months from carers and patients. Risk factors were identified in the abused group and compared with those in a non-abused control group. SETTING--Carers were interviewed at home; patients were examined in the wards of Putney and Barnes geriatric hospitals, London. SUBJECTS--All patients referred from any source for respite care to the geriatric services over a six month period and their carers. MAIN OUTCOME MEASURES--Amount of physical and verbal abuse or neglect. Quantification of risk factors and correlation with the presence or absence of abuse. RESULTS--45% Of carers openly admitted to some form of abuse. Few patients admitted abuse. The most significant risk factor for physical abuse was alcohol consumption by the carer (p less than 0.001). Other significant risk factors were a poor pre-morbid relationship and previous abuse over many years. Abuse was often reciprocated and was associated with social dysfunction in many patients. Service delivery, respite care, and level of mental and physical disability were not significantly associated with abuse. CONCLUSION--The high level of abuse found in elderly patients in respite care was particularly associated with alcohol abuse and long term relationships of poor quality, which are difficult to change. Even with increased provision of services, care in the community may not be the best solution for these people.
The Immunologic Basis of Graves's Disease
Authors: Robert Volpé
Journal: New England Journal of Medicine (1972)

Although many questions remain to be answered regarding the etiology of Graves's disease (toxic diffuse goiter), increasing evidence indicates that immune factors participate in its pathogenesis. Indeed, they may prove to be essential in the initiation of the disorder. As Werner and his colleagues note elsewhere in this issue, it has long been recognized that there is lymphocytic infiltration within the thyroid gland in Graves's disease; lymphocytosis, and enlargement of lymph nodes, thymus and spleen are also common. In addition, the finding of long-acting thyroid stimulator (LATS), which proved to be an immunoglobulin G (IgG), in the serum of many . . .
Competition rules may need to be applied differently to healthcare, says Hunt
Authors: R. Coombes
Journal: BMJ (2014)

England’s health secretary has urged competition authorities to go easy on the NHS after the costly, failed merger of two trusts in the south of England last year.

Speaking on 6 March to an audience of health service leaders, Jeremy Hunt admitted that the new competition regime introduced by the Health and Social Care Act last year had not been “smooth sailing.”

He suggested that the competition authorities may have been overinterpreting their role in such hospital mergers as the one that fell foul of the authorities in Dorset last year. A merger between Poole Hospital NHS Foundation Trust and the Royal Bournemouth and Christchurch Hospitals NHS Trust was blocked by the Competition Commission. The lengthy legal battle …