tbuckley/cabot-search huggingface dataset:
Ethics of a Randomized Trial of Periconceptual Vitamins
Authors: Arthur L. Caplan
Journal: JAMA (1989)

To the Editor.—  Dr Holmes 1 offers  number of thoughtful and cogent remarks concerning the report on periconceptual use of multivitamins by Mulinare et al. 2 However, one comment he makes raises an important ethical issue that is worthy of further comment.  Dr Holmes observes that it is fortunate that a larger, randomized trial of the effectiveness of periconceptual vitamin supplements is under way in Great Britain at this time. This study will, Dr Holmes suggests, help answer some of the questions that remain concerning the advisability of taking vitamin supplements to prevent anencephaly and other neural tube defects. With the exception of the ongoing British study, there has not been  definitive randomized trial of the prophylactic efficacy of vitamin supplements for neural tube disorders.  The issue of whether it is ethically desirable to conduct  large, randomized trial to assess the prophylactic efficacy of vitamins is one
Characterization of Peripheral Blood Mononuclear Cells and Dendritic Cells in Patients with Viral Hepatitis C
Authors: L. Titov, U.V. Tarasiuk, E.N. Yagovdik-Telezhnaya, I.A. Karpov, D.A. Charnashey, L.M. DuBuske
Journal: Journal of Allergy and Clinical Immunology (2007)
Is the sleep apnoea/hypopnoea syndrome inherited?
Authors: N J Douglas, M Luke, R Mathur
Journal: Thorax (1993)

BACKGROUND--The aetiology of the sleep apnoea/hypopnoea syndrome (SAHS) is unclear in many patients. Snoring, a prerequisite for SAHS, runs in families. A study was carried out to determine whether there is an increased frequency of irregular breathing during sleep in relatives of patients with SAHS. METHODS--A prospective study was performed of first degree relatives of 20 consecutive non-obese (BMI &lt; 30 kg/m2) patients with SAHS. Questionnaires on SAHS symptoms were sent to all first order relatives and those living within 150 miles of Edinburgh were invited for overnight monitoring of their breathing, sleep, and oxygenation patterns in the sleep laboratory. RESULTS--Ten of the 40 relatives had more than 15 apnoeas + hypopnoeas/hour of sleep, and eight had more than five 4% desaturations/hour. These frequencies of irregular breathing and desaturation are significantly higher than in the British population. Cephalometric studies showed no skeletal abnormality but an increased uvular width was found in the affected relatives. CONCLUSIONS--There is an increased frequency of abnormal breathing during sleep in relatives of non-obese patients with SAHS.
Summary of Current Diabetes-related Data from the National Center for Health Statistics
Authors: Rona Beth Sayetta, Robert S Murphy
Journal: Diabetes Care (1979)

The National Center for Health Statistics (NCHS) conducts national studies, publishes results, and releases microdata tapes that contain information of central importance to diabetes epidemiology. The prevalence, incidence, and distribution of diabetes with associated medical conditions and therapies are available from interviews and examination study sources. Utilization patterns, multiple morbidity, and cost data for diabetic patients and others using health resources are available through studies of provider records, physician visit encounter forms, vital record follow-back questionnaires, and insurance records. The vital statistics system also provides data about mortality and its geographic distribution. In the second Health and Nutrition Examination Survey conducted by NCHS, a fasting oral glucose tolerance test was administered to 2244 persons using a 75-g glucose challenge. Blood samples were taken fasting, 1 h, and 2 h after glucose challenge. These provisional data are representative only of the sample persons ages 20–74 yr participating in the first 34 sample locations of the survey. Many facets of data evaluation remain to be explored, such as response bias and use of medications. Nevertheless, using the criteria proposed by the National Diabetes Data Group for diagnosis of diabetes, 2.7% of the sample (in which the poor and persons ages 60–74 yr are overrepresented) had fasting plasma glucose levels greater than 140 mg/dl. About 3.9% had fasting levels less than 140 mg/dl, but had 1-h and 2-h plasma glucose levels after challenge greater than or equal to 200 mg/dl. The data in final weighted form will not overrepresent specific groups in the population
Thalidomide for the treatment of severe intestinal bleeding
Authors: S. Alberto, J. Felix, J. de Deus
Journal: Endoscopy (2008)

It was with great interest that we read the article by Bauditz et al. [1] about the role of thalidomide in severe recurrent intestinal bleeding due to angiodysplasia. This article discussed the role of thalidomide as an anti-inflammatory agent and an inhibitor of angiogenesis.
Growth and nutrition in children with food allergy requiring amino acid–based nutritional formulas
Authors: Karen A. Robbins, Anthony L. Guerrerio, Sara A. Hauck, Bobbie J. Henry, Corinne A. Keet, Nga Hong Brereton, Susan Oh, D. Mikis Stasinopoulos, Robert A. Wood
Journal: Journal of Allergy and Clinical Immunology (2014)
The ΔNp63 Proteins Are Key Allies of BRCA1 in the Prevention of Basal-Like Breast Cancer
Authors: Niamh E. Buckley, Susan J. Conlon, Karin Jirstrom, Elaine W. Kay, Nyree T. Crawford, Anthony O'Grady, Katherine Sheehan, Simon S. Mc Dade, Ching-Wei Wang, Dennis J. McCance, Patrick G. Johnston, Richard D. Kennedy, D. Paul Harkin, Paul B. Mullan
Journal: Cancer Research (2011)

Little is known about the origin of basal-like breast cancers, an aggressive disease that is highly similar to BRCA1-mutant breast cancers. p63 family proteins that are structurally related to the p53 suppressor protein are known to function in stem cell regulation and stratified epithelia development in multiple tissues, and p63 expression may be a marker of basal-like breast cancers. Here we report that ΔNp63 isoforms of p63 are transcriptional targets for positive regulation by BRCA1. Our analyses of breast cancer tissue microarrays and BRCA1-modulated breast cancer cell lines do not support earlier reports that p63 is a marker of basal-like or BRCA1 mutant cancers. Nevertheless, we found that BRCA1 interacts with the specific p63 isoform ΔNp63γ along with transcription factor isoforms AP-2α and AP-2γ. BRCA1 required ΔNp63γ and AP-2γ to localize to an intronic enhancer region within the p63 gene to upregulate transcription of the ΔNp63 isoforms. In mammary stem/progenitor cells, siRNA-mediated knockdown of ΔNp63 expression resulted in genomic instability, increased cell proliferation, loss of DNA damage checkpoint control, and impaired growth control. Together, our findings establish that transcriptional upregulation of ΔNp63 proteins is critical for BRCA1 suppressor function and that defects in BRCA1-ΔNp63 signaling are key events in the pathogenesis of basal-like breast cancer.
Case of Ovarian Fibroma and Meigs's Syndrome
Authors: H. E. Reiss
Journal: BMJ (1961)

Necropsy revealed a ruptured dissecting aneurysm of the aorta.The second case was that of an infant who developed cardiac arrest during circumcision under chloroform anaesthesia.Cardiac resuscitation was successfully performed.The factors concerned in the treatment of cardiac arrest occurring beyond the hospital are discussed and emphasis is placed on active resuscita- tion being attempted in all cases.
Diffuse F-18 FDG Uptake in Skeletal Muscles Secondary to Chills Resulting From Sepsis:
Authors: Buddhiwardhan Ojha, Ashok Muthukrishnan, Arun Kumar Raman, Ramadas Satya, Tommy Mahone, Andres Forero–Torres
Journal: Clinical Nuclear Medicine (2004)

FDG PET was performed on a 42-year-old male patient with B-cell, low-grade follicular non-Hodgkin lymphoma to evaluate the response to chemotherapy. The bone marrow lesions appeared to have improved compared with the prior PET scan, but there was intense skeletal muscle FDG uptake. Repeated scanning performed after 1 week revealed an increase in the size and intensity of bone marrow lesions compared with the pretherapy study, suggesting worsening. The authors present this case of generalized intense skeletal muscle uptake secondary to chills resulting from sepsis causing a falsely reduced tumor-to-normal tissue ratio.
Interleukin 6 Supports the Maintenance of p53 Tumor Suppressor Gene Promoter Methylation
Authors: David R. Hodge, Benjamin Peng, James C. Cherry, Elaine M. Hurt, Stephen D. Fox, James A. Kelley, David J. Munroe, William L. Farrar
Journal: Cancer Research (2005)

A strong association exists between states of chronic inflammation and cancer, and it is believed that mediators of inflammation may be responsible for this phenomenon. Interleukin 6 (IL-6) is an inflammatory cytokine known to play a role in the growth and survival of many types of tumors, yet the mechanisms employed by this pleomorphic cytokine to accomplish this feat are still poorly understood. Another important factor in tumor development seems to be the hypermethylation of CpG islands located within the promoter regions of tumor suppressor genes. This common epigenetic alteration enables tumor cells to reduce or inactivate the expression of important tumor suppressor and cell cycle regulatory genes. Here we show that in the IL-6-responsive human multiple myeloma cell line KAS 6/1, the promoter region of p53 is epigenetically modified by methyltransferases, resulting in decreased levels of expression. Furthermore, cells treated with IL-6 exhibit an increase in the expression of the DNA maintenance methylation enzyme, DNMT-1. The DNA methyltransferase inhibitor zebularine reverses the methylation of the p53 promoter, allowing the resumption of its expression. However, when zebularine is withdrawn from the cells, the reestablishment of the original CpG island methylation within the p53 promoter does not occur in the absence of IL-6, and cells which do not receive IL-6 eventually die, as p53 expression continues unchecked by remethylation. Interestingly, this loss of viability seems to involve not the withdrawal of cytokine, but the inability of the cell to resilence the promoter. Consistent with this model, when cells that express IL-6 in an autocrine fashion are subjected to identical treatment, p53 expression is reduced shortly after withdrawal of zebularine. Therefore, it seems IL-6 is capable of maintaining promoter methylation thus representing one of the possible mechanisms used by inflammatory mediators in the growth and survival of tumors.
Video Display Terminals and the Risk of Spontaneous Abortion
Authors: Teresa M. Schnorr, Barbara A. Grajewski, Richard W. Hornung, Michael J. Thun, Grace M. Egeland, William E. Murray, David L. Conover, William E. Halperin
Journal: New England Journal of Medicine (1991)

The relation between spontaneous abortion and the use of video display terminals (VDTs) is of great public health concern. Previous investigators of this issue have reported inconsistent findings.To determine whether electromagnetic fields emitted by VDTs are associated with an increased risk of spontaneous abortion, a cohort of female telephone operators who used VDTs at work was compared with a cohort of operators who did not use VDTs. To obtain reliable estimates of exposure, we determined the number of hours of VDT use per week from company records and measured electromagnetic fields at VDT workstations and, for purposes of comparison, at workstations without VDTs. Operators who used VDTs had higher abdominal exposure to very-low-frequency (15 kHz) electromagnetic fields (workstations without VDTs did not emit very-low-frequency energy). Abdominal exposure to extremely-low-frequency fields (45 to 60 Hz) was similar for both operators who used VDTs and those who did not. Among 2430 women interviewed, there were 882 pregnancies that met our criteria for inclusion in the study.We found no excess risk of spontaneous abortion among women who used VDTs during the first trimester of pregnancy (odds ratio = 0.93; 95 percent confidence interval, 0.63 to 1.38), and no dose-response relation was apparent when we examined the women's hours of VDT use per week (odds ratio for 1 to 25 hours per week = 1.04; 95 percent confidence interval, 0.61 to 1.79; odds ratio for greater than 25 hours per week = 1.00; 95 percent confidence interval, 0.61 to 1.64). There continued to be no risk associated with the use of VDTs when we accounted for multiple pregnancies, conducted separate analyses of early abortion, late abortion, and all fetal losses, or limited our analyses to spontaneous abortions for which a physician was consulted.The use of VDTs and exposure to the accompanying electromagnetic fields were not associated with an increased risk of spontaneous abortion in this study.
Over-the-Counter Drug Use in Gymnasiums: An Underrecognized Substance Abuse Problem?
Authors: Gen Kanayama, Amanda J. Gruber, Harrison G. Pope Jr., John J. Borowiecki, James I. Hudson
Journal: Psychotherapy and Psychosomatics (2001)

&lt;i&gt;Objective:&lt;/i&gt; Many individuals, attempting to gain muscle or lose fat, use ‘dietary supplements’. Though widely available over the counter or by mail order in America and Europe, some of these ‘supplements’ are actually potent drugs such as androstenedione and ephedrine. We sought to estimate the prevalence of these forms of drug use in American gymnasiums. &lt;i&gt;Methods:&lt;/i&gt; We distributed anonymous questionnaires to 511 clients entering five gymnasiums, asking about use of both supplements and anabolic steroids. &lt;i&gt;Results:&lt;/i&gt; Among men, 18% reported use of androstenedione and/or other adrenal hormones, 25% reported ephedrine use, and 5% reported anabolic steroid use within the last 3 years; among women these rates were 3, 13 and 0%. Extrapolating from these figures to the United States as a whole, we estimated that possibly 1.5 million American gymnasium clients have used adrenal hormones and 2.8 million have used ephedrine within the last 3 years. &lt;i&gt;Conclusions:&lt;/i&gt; Millions of men and women are currently using potent drugs, widely sold over the counter as ‘supplements’, despite their known adverse effects, unknown long-term risks, and possible potential for causing abuse or dependence.
Requiem for an unknown leper
Authors: J. G. Chester
Journal: JAMA (1992)

To the Editor.  —Dr Crawshaw's piece, Requiem for an Unknown Leper, 1 has remained in my thoughts since  read it.  was moved by his portrait of Ida, the tour guide of the leper colony at Kalaupapa, Hawaii, but as a psychiatrist  must take exception with the implications made regarding depression and electroconvulsive therapy (ECT). Crawshaw described a moment of inspiration when he realized that ECT   numbness, and apparently empathized with Ida's remark, I do not believe in shock treatment for  who get upset.  As a geriatric psychiatrist,  agree with Ida, but not with Crawshaw; my colleagues and  do not prescribe ECT for those who get upset, but we certainly do not share the view that ECT is iatrogenic numbness. For many patients who are severely depressed ECT can be a lifesaving treatment. It is the best treatment for delusional depression and often
Does Pioglitazone, Like Troglitazone, Increase Serum Levels of Lipoprotein(a) in Diabetic Patients?
Authors: Yukihiro Nagai, Toshio Abe, Gakuji Nomura
Journal: Diabetes Care (2001)

Thiazolidinediones such as troglitazone and pioglitazone ameliorate dyslipidemia in type 2 diabetic patients by improving insulin resistance. The levels of serum triglycerides, nonesterified fatty acids, total cholesterol, and LDL cholesterol decrease after administration of these agents, while HDL cholesterol increases (1,2,3). These effects are helpful in preventing the development of atherosclerosis in diabetic patients. On the other hand, troglitazone has also been known to increase serum lipoprotein(a) \[Lp(a)\] (4,5), a known atherogenic lipoprotein (6). To our knowledge, there is no report on the effect of pioglitazone on serum levels of Lp(a). Therefore, we investigated serum levels of Lp(a) and remnant-like particle cholesterol (RLP-C), a lipid known to act …
Hypertension: Deficient Care of the Medically Served
Authors: STEPHEN B. LANGFELD
Journal: Annals of Internal Medicine (1973)

Deficiencies in the detection, treatment, and control of hypertension before hospitalization have been shown by a survey of 185 patients admitted for various surgical procedures unrelated to hypertension. From their current status or previous history, 51 patients were classified as hypertensive. Twenty-six of these were currently hypertensive; 10 of these (6 of whom were previously unrecognized) had never received treatment, and 8 had discontinued therapy. Among 25 patients currently under treatment, 8 were hypertensive, and 10 others had blood pressures above normal. These conditions could not be attributed to lack of access to medical care, since all but three patients had visited a primary source of medical care within the past year. Discontinuation of treatment by the physician or patient was the predominant reason. A change in both physician and patient behavior is critical for the success of hypertension-control programs.
STUDIES ON ANTIGEN-ANTIBODY COMPLEXES
Authors: Mart Mannik, William P. Arend, Anthony P. Hall, Bruce C. Gilliland
Journal: The Journal of Experimental Medicine (1971)

Solid phase immunoadsorbents were prepared by coupling antigens to agarose. With this technique specific antibodies were easily isolated in large amounts. The gammaG-globulin class of antibodies isolated in this manner were not denatured as judged by their normal biological half-life in rabbits. Soluble immune complexes at fivefold antigen excess were prepared from isolated specific antibodies and HSA, human lambda-chains, human lambdaG-globulins, and a Waldenström's macroglobulin as antigens. In all these preparations a characteristic immune complex was encountered that represented the smallest stable antigen-antibody union. In the HSA-anti-HSA system they were found to be AgAb(2) complexes, and Ag(2)Ab complexes in the gammaG-anti-gammaG system. These stable complexes fixed complement ineffectively. Also, a spectrum of larger complexes was present in each system, and these complexes fixed complement effectively. With intact antibodies the disappearance curves of immune complexes from the circulation were composed of three exponential components. The immune complexes larger than AgAb(2) were quickly removed from the circulation with half-lives of 0.09-0.37 hr. Their clearance was not dependent on complement components, in that depletion of complement by cobra venom factor and aggregated gammaG-globulin did not alter the pattern of their removal from the circulation. However, when the interchain disulfide bonds of antibodies were reduced and alkylated, the removal of the lambda-anti-lambda, HSA-anti-HSA, and gammaG-anti-gammaG complexes was altered. In these experiments the disappearance curves were composed of two exponential components and the rapid removal of the greater than AgAb(2) complexes did not occur. The immune complexes prepared from reduced and alkylated antibodies fixed complement ineffectively. The presented data indicate that the rapid removal of circulating immune complexes, containing gammaG-globulin molecules as antibodies, depends primarily on the number of antibodies involved. Furthermore, complement fixation is not involved in the rapid removal of such complexes. Nevertheless, the rapid removal of immune complexes and their ability to fix complement have similarities for optimal function in that both processes require intact interchain disulfide bonds of antibodies and complexes that exceed the AgAb(2) combination.
Smoking, Chronic Bronchitis, and Lung Cancer
Authors: J. Rimington
Journal: BMJ (1971)

A follow-up was carried out on 21,579 male mass radiography volunteers aged at least 40 who had been the subject of an earlier investigation in which their smoking habits and sputum production were recorded and the prevalence of lung cancer was determined after chest <i>x</i>-ray examination. During the follow-up period, which was a minimum of 36 months and a maximum of 56 months, 64 new cases of lung cancer were identified by cross checking records with the registers of the regional cancer registration bureau. A significantly higher incidence of lung cancer was found in those with chronic bronchitis than in those without this disease. In the smoking categories, cigarette smokers with chronic bronchitis had a higher incidence than those without it, and this relationship was maintained irrespective of age and amount smoked. It is concluded that persons who smoke run a higher risk of chronic bronchitis than non-smokers and those who develop bronchitis run a higher risk of developing lung cancer.
Eclampsia in the United Kingdom
Authors: K A Douglas, C W G Redman
Journal: BMJ (1994)

To measure the incidence of eclampsia, establish how often it is preceded by signs of pre-eclampsia, document the morbidity associated with eclampsia, and determine the maternal case fatality rates.A prospective, descriptive study of every case of eclampsia in the United Kingdom in 1992. Information was collected from reviews of hospital case notes and questionnaires to general practitioners.All 279 hospitals in the United Kingdom with a consultant obstetric unit.Obstetricians and midwives notified 582 possible cases, and 383 were confirmed as eclampsia. The national incidence of eclampsia was 4.9/10,000 maternities (95% confidence interval 4.5 to 5.4). Most convulsions occurred despite antenatal care (70%) and within one week of the woman's last visit to a doctor or midwife (85%). Three quarters of first seizures occurred in hospital, of which 38% developed before both proteinuria and hypertension had been documented. Forty four per cent of cases occurred postpartum, more than a third (38%) antepartum, and the remainder (18%) intrapartum. Nearly one in 50 women (1.8%) died, and 35% of all women had at least one major complication. The rate of stillbirths and neonatal deaths was 22.2/1000 and 34.1/1000, respectively. Preterm eclampsia occurred more commonly antepartum and was associated with more maternal complications and fetuses that were small for gestational age, as well as with higher rates of stillbirth and neonatal mortality. Antepartum eclampsia, which was more likely to occur preterm, was associated with a higher rate of maternal complications and a higher neonatal mortality. Both factors (gestational prematurity and antepartum occurrence) contributed independently to the severity of the outcome.Eclampsia occurs in nearly one in 2000 maternities in the United Kingdom and is associated with high maternal morbidity and fatality in cases. It may present unheralded by warning signs. Preterm and antenatal eclampsia seem to be particularly severe.