tbuckley/cabot-search huggingface dataset:
Former US surgeon general reveals extent of political pressure he was under
Authors: Janice Hopkins Tanne
Journal: BMJ (2007)

A former US surgeon general told a Congressional committee last week that while he was in office he had been forbidden by the Bush administration to speak on topics such as stem cell research, emergency contraception, sex education, health of prisoners, mental health, secondhand smoking, and global health issues.

Richard Carmona, the last surgeon general, told the House of Representatives Committee on Oversight and Government Reform that he had been instructed to mention President Bush three times on each page of his speeches, which were vetted by officials at the parent agency, the Department of Health and Human Services. Travel to conferences was prevented, and he was told not to attend the special Olympic games for disabled athletes, which were supported by the Kennedy family.

When he wanted to issue information about mental health after the 11 September 2001 terrorist attacks on the …
Vaccination against <i>Neisseria meningitidis</i> Using Three Variants of the Lipoprotein GNA1870
Authors: Vega Masignani, Maurizio Comanducci, Marzia Monica Giuliani, Stefania Bambini, Jeannette Adu-Bobie, Beatrice Aricò, Brunella Brunelli, Alessandro Pieri, Laura Santini, Silvana Savino, Davide Serruto, David Litt, Simon Kroll, Jo Anne Welsch, Dan M. Granoff, Rino Rappuoli, Mariagrazia Pizza
Journal: The Journal of Experimental Medicine (2003)

Sepsis and meningitis caused by serogroup B meningococcus are devastating diseases of infants and young adults, which cannot yet be prevented by vaccination. By genome mining, we discovered GNA1870, a new surface-exposed lipoprotein of Neisseria meningitidis that induces high levels of bactericidal antibodies. The antigen is expressed by all strains of N. meningitidis tested. Sequencing of the gene in 71 strains representative of the genetic and geographic diversity of the N. meningitidis population, showed that the protein can be divided into three variants. Conservation within each variant ranges between 91.6 to 100%, while between the variants the conservation can be as low as 62.8%. The level of expression varies between strains, which can be classified as high, intermediate, and low expressors. Antibodies against a recombinant form of the protein elicit complement-mediated killing of the strains that carry the same variant and induce passive protection in the infant rat model. Bactericidal titers are highest against those strains expressing high yields of the protein; however, even the very low expressors are efficiently killed. The novel antigen is a top candidate for the development of a new vaccine against meningococcus.
OUTCOME OF TRANSCATHETER AORTIC VALVE IMPLANTATION IN OCTOGENARIANS IN COMPARISON TO YOUNGER PATIENTS: RESULTS OF THE GERMAN REGISTRY ON TRANSCATHETER AORTIC VALVE IMPLANTATIONS
Authors: Lutz Buellesfeld, Ulrich Gerckens, Harald Mudra, Gerhard C. Schuler, Ralf Zahn, Horst Sievert, Raimund Erbel, Rainer Hambrecht, Georg Nickenig, Karl-Eugen Hauptmann, Christoph Naber, Hans Rainer Figulla, Stefan Sack, Joachim Senges, Eberhard Grube
Journal: Journal of the American College of Cardiology (2010)
IMMUNOLOGICAL STUDIES OF THE 11S PROTEIN COMPONENT OF THE HUMAN COMPLEMENT SYSTEM
Authors: Jane H. Morse, Charles L. Christian
Journal: The Journal of Experimental Medicine (1964)

Rabbit anticryoprotein and anticomplement antisera recognized a heat-labile antigen in normal human serum. This antigen best fitted the previously described US protein because of its presence in fresh human serum, euglobulin, and purified 11S preparations and its absence in heated serum, R11S, and pseudoglobulin preparations. The 11S hemolytic activity correlated well with the presence of this heat-labile antigen in the 11S region in sucrose density gradient ultracentrifugation and in the gamma globulin region on zone electrophoresis. It could be identified as a single component in the gamma globulin region in immunoelectrophoresis. The intermediate complex EAC'11S was lysed by R11S reagents and agglutinated by these antisera. The antisera also agglutinated a human complement-binding Rh-positive cell system if the 11S protein had been previously bound.
Rapid, Simple Method for Determining Effectiveness of d-Penicillamine Therapy in Cystinuria
Authors: M. Lotz, J. T. Potts, F. C. Bartter
Journal: BMJ (1965)

describing the effectiveness of D-penicillamine as a therapeutic agent in patients with cystinuria.Similar reports by others have also appeared elsewhere (Lotz and Potts, 1964 ; Lotz et al., 1965 ; Bartter et
Relatives are furious that GP can continue practising
Authors: C. Dyer
Journal: BMJ (2010)

Two "gain and loss" type mutations of the H-2D region, the H- 2bm13 and H- 2bm14 , resulted in the expression of noncross-reactive CML determinants that are unique to each mutation, the Dbm13 gains and Dbm14 gains, respectively. According to the results of direct cytolytic and competitive inhibition assays of in vitro induced primary cytotoxic T lymphocytes, allogeneic responses specific for Dbm13 gains are generated by responders bearing the H-2b ( KbIbDb ) haplotype, but not by responders bearing the H- 2bm14 ( KbIbDbm14 ), KbIbDd , KbIbDk , or KbIb / qDq haplotype. Responses by the non-H-2b responders against Dbm13 are limited to those determinants shared by the Dbm13 and Db molecules. Because congenic mice differing only at the H-2D region are either responsive or nonresponsive to Dbm13 gains, the responsiveness is controlled by gene(s) in the H-2D region. F1 hybrid offspring of responsive (H-2b) and nonresponsive (non-H-2b) parents are invariably responsive, indicating genetic dominance of the responsiveness. In contrast to the response against Dbm13 gains, cytotoxicity specific for Dbm14 gains is generated by responders bearing the H-2b, H- 2bm13 , KbIbDd , KbIbDk , or KbIb / qDq haplotype. These data indicate the existence of two types of allogeneic MHC determinants; one, represented by Dbm14 gains, is the classic type capable of eliciting CML responses in mice of a wide range of H-2 haplotypes, whereas the other, exemplified by Dbm13 gains, elicits CTL responses only in mice of a few related haplotypes. It is proposed that recognition of Dbm13 gains is restricted by structures shared by Db and Dbm13 but missing from other D (or L, R, etc.) molecules, such as Dbm14 , Dd, Dk, and Dq. Availability of various restricting structures in self MHC molecules may thus influence the alloreactive CTL repertoire.
Refugee doctors in Britain: a wasted resource
Authors: A. Berlin, P. Gill, J. Eversley
Journal: BMJ (1997)

The exact number of refugee doctors in Britain is not known. Estimates suggest there are at least 200, equivalent to the annual output of a typical medical school. The disproportionate number of doctors among refugees is a phenomenon that has been observed in earlier waves of exiles, notably those fleeing Germany and central Europe in the 1930s. Refugees have made substantial contributions to professional life in Britain, particularly in medicine and science.1 2 The profound and all embracing sense of loss experienced by refugees3 4 is compounded for the many who are professionals, who feel that their skills and knowledge are unused while they must depend on welfare.5 They represent a waste of human potential that deserves greater attention and action from the medical profession.

To practise in Britain doctors who qualified overseas must first gain limited registration with the General Medical Council (GMC) through one of four routes: sponsorship, membership of a royal college, passing the Professional and Linguistic Assessment Board (PLAB) …
Inhibition of gallbladder emptying decreases cholesterol saturation in bile in the richardson ground squirrel
Authors: Jürgen G. Pauletzki, Qi-Wei Xu, Eldon A. Shaffer
Journal: Hepatology (1995)

Impaired gallbladder emptying is frequent in cholesterol gallstone disease as well as in predisposing conditions like pregnancy and obesity. Gallbladder hypomotility is considered a pathogenic factor for gallstone formation, providing the residence time for cholesterol crystal nucleation, but any effect on the enterohepatic circulation of bile acids and subsequently on biliary lipid composition is unknown. Therefore, we studied the effect of prolonged suppression of gallbladder emptying with a cholecystokinin (CCK-A) receptor antagonist on bile formation in Richardson ground squirrels fed a trace versus a 1% cholesterol diet. Biliary lipid secretion was measured directly and bile acid pool size assessed by isotope dilution ([ 14 C]-cholic acid). Gallbladder contraction was determined in vitro in response to CCK. The CCK-antagonist (MK-329) greatly inhibited gallbladder contraction in vitro and increased gallbladder fasting volume and bile acid pool size in vivo. It significantly lowered the cholesterol saturation index by 35% and 46% in hepatic bile and by 18% and 28% in gallbladder bile in the trace and cholesterol diet groups, respectively. Bile acid secretion and bile flow doubled with the CCK-receptor antagonist. Chronic CCK receptor antagonist-induced inhibition of gallbladder emptying increases bile acid secretion and thereby decreases cholesterol saturation in bile. Extensive biliary hypomotility thus leads to a more rapid cycling of bile acids by depriving the gallbladder of its function in the enterohepatic circulation. (Hepatology 1995; 22:325-331.)
Guidance matches osteoarthritis patients to NSAIDs according to risk of side effects
Authors: Z. Kmietowicz
Journal: BMJ (2015)

A multidisciplinary group of clinicians has advised which non-steroidal anti-inflammatory drugs (NSAIDs) are appropriate for patients with osteoarthritis, in line with the drugs’ risk of upper and lower gastrointestinal and cardiovascular side effects.

Despite the many guidelines on the use of NSAIDs none has looked specifically at the risks of these adverse effects, the authors wrote in BioMed Central Medicine .1 As nearly half of patients with osteoarthritis (44%) have …
A Quantitative Assessment of Plasma Homocysteine as a Risk Factor for Vascular Disease
Authors: Carol J. Boushey
Journal: JAMA (1995)

<h3>Objective.</h3> —To determine the risk of elevated total homocysteine (tHcy) levels for arteriosclerotic vascular disease, estimate the reduction of tHcy by folic acid, and calculate the potential reduction of coronary artery disease (CAD) mortality by increasing folic acid intake. <h3>Data Sources.</h3> —MEDLINE search for meta-analysis of 27 studies relating homocysteine to arteriosclerotic vascular disease and 11 studies of folic acid effects on tHcy levels. <h3>Study Selection and Data Extraction.</h3> —Studies dealing with CAD, cerebrovascular disease, and peripheral arterial vascular disease were selected. Three prospective and six population-based case-control studies were considered of high quality. Five cross-sectional and 13 other case-control studies were also included. Causality of tHcy's role in the pathogenesis of vascular disease was inferred because of consistency across studies by different investigators using different methods in different populations. <h3>Data Synthesis.</h3> —Elevations in tHcy were considered an independent graded risk factor for arteriosclerotic vascular diseases. The odds ratio (OR) for CAD of a 5-μmol/L tHcy increment is 1.6(95% confidence interval [Cl], 1.4 to 1.7) for men and 1.8 (95% Cl, 1.3 to 1.9) for women. A total of 10% of the population's CAD risk appears attributable to tHcy. The OR for cerebrovascular disease (5-μmol/L tHcy increment) is 1.5 (95% Cl, 1.3 to 1.9). Peripheral arterial disease also showed a strong association. Increased folic acid intake (approximately 200 μg/d) reduces tHcy levels by approximately 4 μmol/L. Assuming that lower tHcy levels decrease CAD mortality, we calculated the effect of (1) increased dietary folate, (2) supplementation by tablets, and (3) grain fortification. Under different assumptions, 13 500 to 50 000 CAD deaths annually could be avoided; fortification of food had the largest impact. <h3>Conclusions.</h3> —A 5-μmol/L tHcy increment elevates CAD risk by as much as cholesterol increases of 0.5 mmol/L (20 mg/dL). Higher folic acid intake by reducing tHcy levels promises to prevent arteriosclerotic vascular disease. Clinical trials are urgently needed. Concerns about masking cobalamin deficiency by folic acid could be lessened by adding 1 mg of cobalamin to folic acid supplements. (<i>JAMA</i>. 1995;274:1049-1057)
Decreased binding of epidermal growth factor in placentas from streptozotocin-diabetic rats.
Authors: J F Sissom, W K Stenzel, J B Warshaw
Journal: Journal of Clinical Investigation (1987)

Placentas from streptozotocin-diabetic rats have previously been shown to be morphologically and biochemically immature when compared with those of control rats. The binding of epidermal growth factor (EGF) to plasma membranes prepared from placentas of control and streptozotocin-diabetic fetuses has been characterized on days 17 and 21 of gestation. Results from competitive binding data analyzed by Scatchard analysis indicate the presence of a single class of receptors on day 17 (KD = 5.4 X 10(-10)) and the appearance of a second class of binding sites for 125I-EGF by day 21 (Kd = 3.5 X 10(-9)) in membranes from control fetuses. Placental membranes from diabetic fetuses show decreased specific binding (approximately 30%) on both days and the absence of a second class of binding sites on day 21 of gestation. Results from a radioreceptor assay indicate that the quantity of EGF in the serum of fetuses removed from control rats on day 21 is twofold greater than the quantity in serum of fetuses from diabetic rats. These data reveal a developmental increase in EGF-binding sites in the placenta of normal, near-term fetal rats, largely because of the appearance of a second class of binding sites with a lower affinity for EGF. The failure (or delay) of this second class to develop in the diabetic may be important for the control of maturation and growth of this tissue.
Application of information theory to clinical diagnostic testing. The electrocardiographic stress test.
Authors: G A Diamond, M Hirsch, J S Forrester, H M Staniloff, R Vas, S W Halpern, H J Swan
Journal: Circulation (1981)

The inherent imperfection of clinical diagnostic tests introduces uncertainty into their interpretation. The magnitude of diagnostic uncertainty after any test may be quantified by information theory. THe information content of the electrocardiographic ST-segment response to exercise, relative to the diagnosis of angiographic coronary artery disease, was determined using literature-based pooled estimates of the true- and false-positive rates for various magnitudes of ST depression from less than 0.5 mm to greater than or equal to 2.5 mm. This analysis allows three conclusions of clinical relevance. First, the diagnostic information content of exercise-induced ST-segment depression, interpreted by the standard 1.0-mm criterion, averages only 15% of that of coronary angiography. Second, there is a 41% increase in information content when the specific magnitude of ST-segment depression is analyzed, as opposed to the single, categorical 1-mm criterion. Third, the information obtained from ECG stress testing is markedly influenced by the prevalence of disease in the population tested, being low in the asymptomatic and typical angina groups and substantially greater in groups with nonanginal chest pain and atypical angina. The quantitation of information has broad relevance to selection and use of diagnostic tests, because one can analyze objectively the value of different interpretation criteria, compare one test with another and evaluate the cost-effectiveness of both a single test and potential testing combination.
After “To the Tune of the Prelude to the Melody of Water,” by Su Dong-po
Authors: Daniel Bosch
Journal: Annals of Internal Medicine (2011)

Ad Libitum1 November 2011After “To the Tune of the Prelude to the Melody of Water,” by Su Dong-poDaniel BoschDaniel BoschFrom Cambridge, MA 02139.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-9-201111010-00006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Blue sky, was the very first moon so full?The moon in my wine cup follows this rule:One gulp or one serious spill,It's new.So many brightly-lit drinking hallsUp there! Is it “Mid-Autumn Festival”?I'll come—as long as it's not a spiritualJourney:Cold wind-borne travelTo extraterrestrial crystalPalaces frightens me. And who'llMy shadowDance with if I go?On earth, full moonlight's glazedEvery red mansion's door. Nothing can keepThe moon from low windows: she's amazedBy what men do in bed when they don't sleep.I know she's a pin, ... Author, Article, and Disclosure InformationAffiliations: From Cambridge, MA 02139.Current Author Address: Daniel Bosch, 154 Auburn Street 2W, Cambridge, MA 02139. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 2011Volume 155, Issue 9Page: 592KeywordsHeartScarsSleepWine ePublished: 1 November 2011 Issue Published: 1 November 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
New evidence of worse outcomes for weekend patients reignites call for seven day hospital services
Authors: J. Wise
Journal: BMJ (2012)

<h3>Objectives</h3> Patients with COVID-19 can present to the emergency department (ED) without immediate indication for admission, but with concern for decompensation. Clinical experience has demonstrated that critical illness may present later in the disease course and hypoxia is often the first indication of disease progression. The objectives of this study are to (a) assess feasibility and describe a protocol for ED-based outpatient pulse-oximetry monitoring with structured follow-up and (b) determine rates of ED return, hospitalisation and hypoxia among participants. <h3>Methods</h3> Prospective observational study of patients presenting to a single academic ED in Boston with suspected COVID-19. Eligible patients were adults being discharged from the ED with presumed COVID-19. Exclusion criteria included resting oxygen saturation &lt;92%, ambulatory oxygen saturation &lt;90%, heart rate &gt;110 beats per minute or inability to use the device. Study personnel made scripted phone calls on postdischarge days 1, 3 and 7 to review the pulse-oximetry readings and to evaluate for decompensation. Return visit and admission information were collected via medical record and 28-day follow-up calls. <h3>Results</h3> 81 patients were enrolled of which 10 (12%) developed hypoxia after their initial discharge from the ED. Overall, 23 (28%) of the 81 patients returned to the ED at least once and 10 of those who returned (43%) were admitted. We successfully contacted 76/81 (94%) of subjects via phone at least once for follow-up assessment. <h3>Discussion</h3> Patients are eager and willing to participate in home monitoring systems and are comfortable with using technology, which will allow providers and health systems to extend our hospitals capabilities for tracking patient populations in times of crisis. <h3>Conclusions</h3> It is feasible to implement an outpatient pulse-oximetry monitoring protocol to monitor patients discharged from the ED with confirmed or suspected COVID-19.
Tubal Ligation, Hysterectomy, and Risk of Ovarian Cancer
Authors: Chris Wahlberg
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Regarding the article by Dr Hankinson and colleagues<sup>1</sup>on tubal ligation, hysterectomy, and risk of ovarian cancer, one possible mechanism not mentioned by the authors is that some infectious agent, probably a virus, is being prevented from reaching the ovaries by surgical closure of the route from the vagina to the ovaries. Also noted in their study was a somewhat lessened risk if the partner used condoms, again an argument for an infectious cause. Ascending bacterial infections commonly cause endometritis and salpingitis; surely viruses go where bacteria do not fear to tread. The association of Burkitt's lymphoma with the Epstein-Barr virus, cervical cancer with the human papillomavirus, and Kaposi's sarcoma with the human immunodeficiency virus lend at least some credence to the oncogenic virus theory. A virus inserting itself by mistake in the wrong sequence of DNA or RNA could plausibly cause the production of a
Hémorragies digestives basses aiguës: résultats préliminaires d'une étude de l'ANGH sur plus de 1000 malades
Authors: B Bour, C Pilette, B Lesgourgues, O Nouel, F Heluwaert, J Henrion, R Faroux, G Macaigne, C Naouri, D Bernardini, G Bellaiche, EA Pariente, H Hagege
Journal: Endoscopy (2008)

But: Décrire les caractéristiques épidémiologiques actuelles des hémorragies digestives basses aiguës (HDBA) ainsi que les pratiques professionnelles, la morbidité et la mortalité hospitalière.
The Metabolic Profile of Intrahepatic Cholestasis of Pregnancy Is Associated With Impaired Glucose Tolerance, Dyslipidemia, and Increased Fetal Growth
Authors: Marcus G. Martineau, Christina Raker, Peter H. Dixon, Jenny Chambers, Mavis Machirori, Nicole M. King, Melissa L. Hooks, Ramya Manoharan, Kenneth Chen, Raymond Powrie, Catherine Williamson
Journal: Diabetes Care (2014)

OBJECTIVE Quantification of changes in glucose and lipid concentrations in women with intrahepatic cholestasis of pregnancy (ICP) and uncomplicated pregnancy and study of their influence on fetal growth. RESEARCH DESIGN AND METHODS A prospective study comparing metabolic outcomes in cholestastic and uncomplicated singleton pregnancies was undertaken at two university hospitals in the U.K. and U.S. from 2011–2014. A total of 26 women with ICP and 27 control pregnancies with no prior history of gestational diabetes mellitus were recruited from outpatient antenatal services and followed until delivery. Alterations in glucose, incretins, cholesterol, and triglycerides were studied using a continuous glucose monitoring (CGM) system and/or a standard glucose tolerance test (GTT) in conjunction with GLP-1 and a fasting lipid profile. Fetal growth was quantified using adjusted birth centiles. RESULTS Maternal blood glucose concentrations were significantly increased in ICP during ambulatory CGM (P &amp;lt; 0.005) and following a GTT (P &amp;lt; 0.005). ICP is characterized by increased fasting triglycerides (P &amp;lt; 0.005) and reduced HDL cholesterol (P &amp;lt; 0.005), similar to changes observed in metabolic syndrome. The offspring of mothers with ICP had significantly larger customized birth weight centiles, adjusted for ethnicity, sex, and gestational age (P &amp;lt; 0.005). CONCLUSIONS ICP is associated with impaired glucose tolerance, dyslipidemia, and increased fetal growth. These findings may have implications regarding the future health of affected offspring.
Two Voluntary Mass Immunization Programs Using Sabin Oral Vaccine
Authors: Richard B. Johns
Journal: JAMA (1963)

Beginning in January, 1962, two Arizona counties, Maricopa and Pima, conducted separate, but similar, voluntary mass immunization programs using Sabin oral polio vaccine. All clinics were scheduled on Sundays, and school buildings were used as clinic sites. The vaccine was dispensed on sugar cubes. During these programs, 754,000 persons were immunized against all three types of polio. This represented approximately 75% of the total population of both counties.
Efficacy and safety of α-interferon treatment for chronic hepatitis C in HIV-infected patients
Authors: Vicenç Soriano, Javier Garcia-Samaniego, Rosa Bravo, Angeles Castro, Pedro M. Odriozola, Juan González, Miguel Colmenero, Ester Carballo, Dolores Suárez, Josep M Llibre, Juan Carlos Alberdi, José Pedreira, Juan González-Lahoz
Journal: Journal of Infection (1995)