tbuckley/cabot-search huggingface dataset:
Household income directly affects children's development, research shows
Authors: J. Wise
Journal: BMJ (2013)

Children in low income households have worse cognitive, sociobehavioural, and health outcomes, concludes a new report by the social policy research charity the Joseph Rowntree Foundation.1

The report says that money makes a direct difference to children’s outcomes and not just because low income is correlated with parents’ level of education, attitudes towards bringing up children, and other parental factors.

Kerris Cooper and Kitty Stewart from the Centre for …
The Pain Relief Promotion Act of 1999
Authors: David Orentlicher, Arthur Caplan
Journal: JAMA (2000)

Recent educational efforts in the US medical community have begun to address the critical issue of palliative care for terminally ill patients. However, a newly introduced bill in Congress, the Pain Relief Promotion Act of 1999 (PRPA), could dramatically hinder these efforts if enacted. The act criminally punishes the use of controlled substances to cause—or assist in causing—a patient's death. The primary purposes of PRPA are to override the physician-assisted suicide law currently in effect in Oregon and prohibit other states from enacting similar laws. The act also includes valuable provisions for better research and education in palliative care, but the benefits of those provisions are outweighed by the punitive sections of the act. Under PRPA, the quality of palliative care in the United States could be compromised when physicians, fearing criminal prosecution, err on the side of caution rather than risk their patients' deaths by using highly aggressive pain treatments. Furthermore, PRPA would put Drug Enforcement Administration officials, who have no medical expertise, in the position of regulating medical decisions. The act also would interfere with individual states' long-standing authority over medical practice. Finally, PRPA would discourage physicians from engaging in experimentation and innovation in palliative care, again out of concern for crossing the line between relief of suffering and physician-assisted suicide. Other bills have been introduced that go much further than PRPA to encourage palliative care, without its problematic provisions. Regardless of the controversy surrounding physician-assisted suicide in the United States, the need for quality end-of-life care will be far better served if Congress enacts one of these bills rather than PRPA.
Moses Barron and Banting
Authors: Hobart A. Reimann
Journal: JAMA (1967)

<h3>To the Editor:—</h3> A pertinent incident was not mentioned in the editorial about Sir Frederick Banting and the discovery of insulin (<b>198</b>: 660, 1966). In October 1920, Sir Frederick read Dr. Moses Barron's paper describing a fibrotic pancreas wherein the acinar enzyme-secreting cells had disappeared, but the islet cells were intact. That paper, with its references to previous experiments in animals in which almost identical pathologic changes ensued after ligation of the pancreatic duct, incited Banting and Best's experiments in 1921. Details of the event were described in<i>Minnesota Medicine</i>(<b>49</b>:689, 861, 1966) by Dr. Barron, who received the Banting Award from the American Diabetes Association in 1964.
Technetium-99m MDP Accumulation in Hepatic Metastasis from Osteogenic Sarcoma
Authors: CHRISTOPHER PALESTRO, LORETTA P. LAWRENCE, ARNOLD M. STRASHUN, STANLEY J. GOLDSMITH
Journal: Clinical Nuclear Medicine (1987)

Primary bone sarcomas, of which osteogenic sarcoma is the most common, occur in only one of every one hundred thousand inhabitants of the United States. (1) Dissemination of osteogenic sarcoma is predominantly hematogenous, and while the lung is the most frequent site of metastasis, liver metastases are detected in 8 to 16% of autopsied cases (2,3). Bone formation in hepatic osteogenic sarcoma metastasis has been described (4). Uptake of the technetium bone imaging agents in hepatic metastasis from a variety of tumors, notably colon and breast carcinoma, has been described (5,6); however a previous report of this occurrence in hepatic metastasis from osteogenic sarcoma could not be found. Such a case, a 16-year-old female with osteogenic sarcoma of the left femur, is presented.
Combined mediator blockade or topical steroid for treating the unified allergic airway
Authors: M. L. Barnes, D. Menzies, T. C. Fardon, P. Burns, A. M. Wilson, B. J. Lipworth
Journal: Allergy (2006)

Background: Asthma and allergic rhinitis are manifestations of a single unified allergic airway, for which the best treatment is uncertain. Objective: To compare the anti‐inflammatory efficacy in the unified allergic airway of combined oral mediator antagonism and combined topical steroid. Methods: Subjects with asthma and perennial allergic rhinitis entered a randomized double blind crossover study comparing montelukast 10 mg and cetirizine 10 mg to extra‐fine inhaled beclomethasone 400 mcg/day and intranasal beclomethasone 200 mcg/day, each taken once daily for 2 months, after 2‐week placebo washouts. Measurements were made after each washout and randomized treatment, comprising: methacholine PC 20 , exhaled and nasal nitric oxide, blood eosinophils and eosinophilic cationic protein, symptoms, lung and nasal function tests. Results: Seventeen patients completed per protocol. For PC 20 and exhaled nitric oxide, only combined topical steroid produced improvements ( P &lt; 0.005) from placebo baseline. Combined steroid was superior by a 0.93 (95% CI 0.14–0.93, P &lt; 0.05) doubling dilution difference for PC 20 and a 0.99 (95% CI 0.9–15.1, P &lt; 0.01) doubling difference for exhaled nitric oxide. Both treatments attenuated eosinophils and eosinophilic cationic protein, and reduced nasal symptoms ( P &lt; 0.05). Only steroid improved nasal nitric oxide ( P = 0.05) and asthma symptoms ( P &lt; 0.05). Neither treatment affected lung or nasal function tests. Conclusion: Combined topical steroid and combined mediator antagonism both attenuated systemic inflammation in the unified allergic airway, but only the former reduced bronchial and nasal inflammatory markers. The relevance of this to exacerbations and airway remodelling needs to be defined.
Abstract P1-03-02: “Normal” tissue adjacent to breast cancer is not normal
Authors: SE Clare, I Pardo, T Mathieson, HA Lillemoe, RJ Blosser, M Choi, CAM Sauder, DK Doxey, S Badve, AMV Storniolo, R Atale, M Radovich
Journal: Cancer Research (2012)

Abstract Background: Gene expression data from pancreatic cancer, histologically normal tissue adjacent to the cancer and normal pancreas reveals that adjacent normal has already acquired a number of transcriptional alterations and is not, therefore, an appropriate baseline for comparison with cancers. (Gadaleta et al., 2011) The purpose of this study was to determine if this is also the case for breast cancer and, if so, to identify the differences in gene expression between adjacent normal and normal breast. Methods: RNA-Seq data from breast cancer and adjacent normal was downloaded from the TCGA (The Cancer Genome Atlas) data portal. The epithelia from 20 frozen tissue cores from healthy premenopausal donors to the Susan G. Komen for the the Cure® Tissue Bank at the IU Simon Cancer Center were microdissected and the RNA isolated. RNA-seqeuncing was carried out using the Life Technologies SOLiD Platform. RPKM gene expression values from TCGA and sequencing of the Komen normal tissues were merged, quantile normalized, and batch effect corrected. Normalization and differential gene expression was performed using Partek Genomics Suite. Results: Principal component analysis (PCA) reveals complete separation between adjacent normal and healthy normal breast tissue. Setting a maximum FDR (false discover rate) of 5%, 2239 genes are differentially expressed between adjacent normal and healthy normal. Ingenuity pathway analysis reveals that the Fos, Jun and TGFbeta pathways are active in the adjacent normal. Conclusions: Tissue adjacent to a primary breast cancer is not normal when using healthy breast tissue as a comparator. As RNA-Seq data is digital, it is possible to quantify the changes in gene expression starting from healthy normal to normal adjacent to tumor to tumor. Increasing and decreasing gene expression values provide clues to the fundamental molecular changes occurring in histologically normal appearing adjacent tissue. The differences in gene expression we have identified are some of the earliest changes in breast carcinogenesis and provide insight into the etiology of this disease and, potentially, its prevention. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-03-02.
ENDEMIC ASTHMA DUE TO CASTOR BEAN DUST
Authors: KARL D. FIGLEY
Journal: JAMA (1928)

For many years it has been known to Toledo physicians that an asthma colony existed in a certain district of East Toledo. Suspicion had long pointed to a linseed oil mill as being the cause of the trouble, for many of these asthmatic patients asserted that their attacks coincided with the odor of linseed oil from the mill when the wind was in the right direction. Complaints had been made at various times to the city health department, but nothing incriminating the oil mill could be found. The state department of health also made an investigation, but did not learn anything of value con
Hepatocyte-specific expression of the mouse hepatocyte growth factor–like protein
Authors: Jorge A. Bezerra, David P. Witte, Bruce J. Arono, Sandra J. Friezner
Journal: Hepatology (1993)

We have cloned and characterized the gene and complementary DNA for a new kringle-containing protein. Although the function of this protein is not known, it has been called hepatocyte growth factor-like protein because it shares the same structural domains as hepatocyte growth factor, with four kringle structures followed by a region homologous to serine proteases. To determine if hepatocyte growth factor-like protein is synthesized by the same cells as hepatocyte growth factor, we surveyed adult mouse and developing mouse embryo tissues by in situ hybridization analysis using radiolabeled RNA for hepatocyte growth factor-like protein. Results of in situ hybridization analysis of adult mouse tissues show that among all surveyed tissues specific signal was restricted to the liver. Higher magnification of liver sections shows that hepatocytes were the only cell type expressing messenger RNA for hepatocyte growth factor-like protein, contrary to the reported presence of hepatocyte growth factor messenger RNA in fat-storing cells. A similar liver-restricted and hepatocyte-specific pattern of messenger RNA expression was observed in the developing mouse embryo at 14 days of gestation. All other developing tissues that were analyzed, as well as liver hematopoietic cells, did not express messenger RNA for hepatocyte growth factor-like protein at levels detectable by this technique. We conclude that although structurally similar to hepatocyte growth factor, hepatocyte growth factor-like protein is a novel protein synthesized primarily in hepatocytes.
Superoxide anion release from blood and bone marrow neutrophils is altered by endotoxemia.
Authors: F Cerasoli, P J McKenna, D L Rosolia, K H Albertine, S P Peters, M H Gee
Journal: Circulation Research (1990)

In vivo endotoxin infusion produces neutrophil-mediated acute lung injury and increases superoxide anion release from phorbol myristate acetate (PMA)-stimulated blood neutrophils collected 18-24 hours after the infusion. Because the turnover time of circulating blood neutrophils is only 6-8 hours, it was hypothesized that the prolonged increase in superoxide anion release from peripheral blood neutrophils is associated with increased superoxide anion release from bone marrow neutrophils. To test this hypothesis, two doses of Escherichia coli endotoxin (5.0 and 0.5 micrograms/kg) were infused into chronically instrumented awake sheep. Blood and bone marrow neutrophils were collected 24 hours after the infusion, and superoxide anion release from unstimulated and PMA-stimulated neutrophils was measured in vitro. Endotoxin infusion produced an increase in pulmonary microvascular permeability, in intravascular activation (degranulation) of blood neutrophils, and in circulating blood neutrophils 24 hours after the infusion. High-dose endotoxin (5.0 micrograms/kg; n = 4) increased superoxide anion release from unstimulated peripheral blood neutrophils (2.25 +/- 0.38 times baseline [p less than or equal to 0.05]) and from peripheral blood neutrophils stimulated with 10(-9) M PMA in vitro (1.46 +/- 0.55 times baseline). Low-dose endotoxin (0.5 micrograms/kg; n = 5), on the other hand, did not alter superoxide anion release from peripheral blood neutrophils. Bone marrow neutrophils could not be isolated reproducibly after high-dose endotoxin because of leukoaggregation. Bone marrow neutrophils were isolated after low-dose endotoxin infusion. Stimulation of these cells with 10(-9) M PMA in vitro resulted in a two- to fourfold increase above control release (p less than or equal to 0.05). Increased superoxide anion release from both peripheral blood and bone marrow neutrophils occurred in the absence of circulating endotoxin, as measured by a Limulus assay. These results show that the prolonged increase in superoxide anion release from peripheral blood neutrophils is associated with an increase in the superoxide anion release from bone marrow neutrophils. Furthermore, the recruitment of affected bone marrow neutrophils into peripheral blood may explain the increased superoxide anion release from blood neutrophils 24 hours after endotoxin infusion.
Nasal Carriers and Streptococcal Tonsillitis
Authors: G. T. Cook, D. Munro-Ashman
Journal: BMJ (1949)

TUBERCULOUS MENINGITIS MEDBATSH. 345 _~~~~~~~~~~~~~~~~~~~~~~~~~~~~EIA (57O%), 6 of 16 middle cases (37%,0), and 1 of 10 advanced cases (10%).Ten cases received intramuscular therapy only (in the early part of our work), and two survive.Four cases received intramuscular therapy followed by combined therapy: one of these survives.Important factors operating against success are vascular changes in the brain and hydrocephalus.Further work is essential to assess the value of surgical intervention to combat the hydrocephalus.Strains of M. tuiberculosis isolated from 43 patients have not shown resistance to streptomycin.Eighteen cases (33%) survive, and of these 16 show full clinical recovery-14 having entirely normal C.S.F. and 2 showing slight abnormalities.Two survivors have a history of relapse and show definitely abnormal C.S.F.The diagnosis has been confirmed bacteriologically in all except one of the survivors.Apart from streptomycin, the most important aids to successful treatment are the rapidity of diagnosis and the quality of the nursing.The value of intrathecal sulphetrone in addition to strepto- mycin is now being investigated.
The Johns Hopkins Centennial
Authors: Arnold S. Relman
Journal: New England Journal of Medicine (1989)

Medical education in this country has been shaped by many institutions and personalities, but a century ago none were more influential than the Johns Hopkins University and the men who conceived and directed its new hospital and medical school. The hospital opened in May 1889, and the medical school in October 1893. This year they are celebrating their centennial, beginning with a series of public events in Baltimore from June 7 to 11. Although the Journal rarely acknowledges occasions of this kind, Hopkins has played such a unique part in the history of American medicine that its hundredth birthday should . . .
Abstract 17447: Correction of Acquired Von Willebrand Disease in Patients Undergoing Trans-Catheter Aortic Valve Replacement
Authors: Olivier Marggraf, Sonja Schneppenheim, Ulrich Budde, Moritz Seiffert, Lenard Conradi, Johannes Schirmer, Renate Schnabel, Stephan Baldus, Reichenspurner Herrmann, Treede Hendrik, Stefan Blankenberg, Patrick Diemert
Journal: Circulation (2012)

Background: Acquired von Willebrand disease (VWD) is a common complication of severe aortic stenosis. Shear stress in calcified valves leads to a reduction of the von Willebrand factor (VWF) high m...
Epstein‐Barr virus (EBV)‐associated post‐transplantation lymphoproliferative disorder simultaneously affecting both B and T cells after allogeneic bone marrow transplantation
Authors: Tatsuya Chuhjo, Akihiro Yachie, Hirokazu Kanegane, Hiroshi Kimura, Shintaro Shiobara, Shinji Nakao
Journal: American Journal of Hematology (2003)

Abstract Post‐transplantation lymphoproliferative disorder (PTLD) is usually an aberrant proliferation of EBV‐infected B cells. We report the case of a 31‐year‐old man with severe aplastic anemia who suffered PTLD 42 days post‐BMT from an unrelated donor. At the onset of PTLD, peripheral blood lymphocytes were comprised of 40% CD20 + cells, 3% CD4 + cells, and 56% CD8 + cells. A highly sensitive in situ hybridization (ISH) method was used to detect EBV‐encoded small non‐polyadenylated RNA 1 (EBER‐1) in 33.9% of sorted CD20 + cells, 4.4% of CD4 + cells, and 1.4% of CD8 + cells. Each T‐cell fraction contained less than 0.034% of contaminated EBV‐infected B cells. Clonal proliferation of both B and T cells was demonstrated by Southern blotting. The patient did not respond to donor leukocyte infusion and died due to deterioration of PTLD. At autopsy, examination of multiple organs revealed B‐cell (rather than T‐cell) infiltration. This case clearly indicates that EBV can simultaneously infect B and T cells and can induce clonal proliferation of both lymphocyte subsets in severely immunocompromised patients. Am. J. Hematol. 72:255–258, 2003. © 2003 Wiley‐Liss, Inc.
Paradox of B cell–targeted therapies
Authors: Tomohiro Kurosaki
Journal: Journal of Clinical Investigation (2008)

The use of antibodies against the human B cell surface protein CD20 represents the most advanced therapeutic approach among the B cell–depleting armamentarium for the treatment of autoimmune disorders. However, recent evidence indicates that B cells can also be essential for suppressing unwanted autoaggressive T cell responses, and therefore, a more careful evaluation of which types of autoimmune disorders this therapy should be utilized for, and at which phases of disease this therapy should be applied, is necessary. In this issue of the JCI, Matsushita et al. report that the timing of this therapy is critical for the management of EAE, a mouse model of human MS (see the related article beginning on page 3420). The results suggest the existence of two opposite actions executed by B cells during the course of autoimmune pathology; CD1dhiCD5+ regulatory B cells suppress EAE induction, whereas B cells are required for the expansion of autoantigen-specific T cells during disease progression. Given the existence of such regulatory B cells in humans, these findings not only resolve previously unexplained contradictions with respect to the outcome of B cell–depleting therapy but also provide insight into the best regimen for this treatment approach.
Junior doctors' training
Authors: S E Binyon, G J Ingrams
Journal: BMJ (1994)

EDITOR, - P R Eldridge holds several of the more common misconceptions about training in other countries in the European Union.1 Europe is not a single entity, and the quality of postgraduate medical training varies enormously. Eldridge's statement that “continental Europeans are not trained to a standard equivalent to that in Britain” is not only inaccurate but offensive. Some European countries have better health outcome measures than Britain. This must be due at least partly to superior training of health care professionals.

Eldridge believes that the processes in Britain to assess both trainees and training programmes …
Tips for Giving a Memorable Presentation, Part IV
Authors: Jay A. Harolds
Journal: Clinical Nuclear Medicine (2012)

Visual aids such as PowerPoint slides can be helpful or deleterious to the quality of the talk, depending on how they are done and how they are used. This article will discuss ways to optimize the composition of PowerPoint presentations. This includes the appropriate composition of word slides and the use of the right font size and style of letters. It also includes tips in the use of color, special effects, and graphs. Pointers on how to properly anonymize patient images are also given.
Building a Bridge from Fragmentation to Accountability — The Prometheus Payment Model
Authors: François de Brantes, Meredith B. Rosenthal, Michael Painter
Journal: New England Journal of Medicine (2009)

In the current debate over health care reform, many observers are proposing new delivery structures to move U.S. health care away from fragmentation, poor performance, and dysfunction toward accountability for high-value care. Ideally, these new structures would promote clear accountability for both improving quality and controlling costs and would encourage health care professionals to organize themselves into teams working on behalf of patients. For such structures to be sustainable, however, the payment system must reward professionals for the quality and efficiency of services, rather than the quantity.Our fee-for-service payment schemes have contributed to, if not largely created, the current . . .
Commentary: Evaluating and regulating device therapy
Authors: N. Freemantle
Journal: BMJ (2011)

The current European regulatory framework—CE marking— might provide sufficient safeguards for electric toasters and kettles, but it is not adequate for treatments that can affect symptoms, health related quality of life, serious morbidity, and mortality.

There are many kinds of medical devices for myriad purposes in healthcare. All require an adequate regulatory framework to ensure that patients gain clear benefits and are not placed at unreasonable and avoidable risk. The so called class III devices have been defined by the US Food and Drug Administration as “those that support or sustain human life, are of substantial importance in preventing impairment of human health, or which present a potential, unreasonable risk of illness or injury.”1 Examples include pacemakers, stents, and prostheses. Class III devices share many of the challenges of drug treatments, which historically have had more regulatory attention and rigour.

The FDA evaluates the safety and effectiveness of class III devices in a process parallel to that of drugs, although differences exist that some people think are inappropriate.2 In Europe, the process is different from that for drugs. Market access is granted if a device displays a CE mark. It is ultimately the manufacturer that decides whether …
Plastic and reconstructive surgery. Cleft lip and palate.
Authors: D Davies
Journal: BMJ (1985)

Incidence'~< L\ L>-Cleft lip occurs in one in every 750 live births, affecting males more often than females and the left side more often than the right.Cleft palate affects one in every 2000 live births, and females are affected more often than ClassificationM males.In half of all cases a cleft of the lip and palate occur together.Other cases are roughly divided between cleft lip and cleft palate alone.Overall, Cleft lip the incidence is slowly increasing and it is the most common congenital * Incomplete Unilateral abnormality of the head and neck.The aetiology of cleft lip with or * Complete Bilateral W without cleft palate is multifactorial.It is determined by a genetic l Complete Bilateral predisposition involving several genes plus intrauterine exogenous factors.* Plus alveolus (gum) Median Cleft palate alone is genetically and embryologically distinct.When parents who are both unaffected have one child with a cleft lip the risk of a Cleft palate M subsequent child having a cleft lip or palate is about 5%, rising to 9% ifCleft palate there are two affected siblings.When one parent and one child are affected * Soft polate and posterior the risk is about three times greater than in the normal population.