tbuckley/cabot-search huggingface dataset:
Association between Occupational Exposure and Lung Function, Respiratory Symptoms, and High-Resolution Computed Tomography Imaging in COPDGene
Authors: Nathaniel Marchetti, Eric Garshick, Gregory L. Kinney, Alex McKenzie, Douglas Stinson, Sharon M. Lutz, David A. Lynch, Gerard J. Criner, Edwin K. Silverman, James D. Crapo
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Although occupational exposure to dust and fumes is considered a risk factor for chronic obstructive pulmonary disease, this determination has been limited by reliance on spirometry alone to assess disease severity in predominantly male populations.To determine the effect of occupational exposure on lung function, respiratory symptoms, and findings of emphysema and airway wall thickness measured using quantitative computed tomography in men and women.COPDGene is a multicenter study of current and former smokers that underwent standardized volumetric chest computed tomography scans to assess airways, % emphysema, and % gas trapping. Spirometry and a respiratory questionnaire including occupational history were also analyzed in 9,614 subjects (4,496 women). Logistic regression and analysis of covariance was used to assess associations with exposure.Occupational exposure to both dust and fumes was reported by 47.9% of men and 20.1% of women. Adjusting for age, race, body mass index, education, and current and lifetime smoking, the odds ratios for persons with dust and fume exposures for chronic cough, chronic phlegm, persistent wheeze, and Global Initiative for Chronic Obstructive Lung Disease stages 2 and higher chronic obstructive pulmonary disease were significantly elevated and similar for men (1.83, 1.84, 2.0, 1.61, respectively) and women (1.65, 1.82, 1.98, 1.90, respectively). The % predicted FEV1 was similarly lower in those with exposure in men (70.7 ± 0.8 vs. 76.0 ± 0.9; P < 0.001) and women (70.5 ± 0.8 vs. 77.2 ± 0.8; P < 0.001). Percent emphysema and gas trapping was greater in those exposed to dust and fumes in men and women. In men, but not in women, persons with exposure had a greater mean square root wall area of 10-mm internal perimeter airways.Occupational exposure to dust and fumes in men and women is similarly associated with airflow obstruction, respiratory symptoms, more emphysema, and gas trapping in men and women.
The Medical Detective: John Snow and the Mystery of Cholera
Authors: Alfredo Morabia
Journal: BMJ (2006)

J ohn Snow is perhaps the only doctor ever to be considered the founder of two medical disciplines: epidemiology and anaesthesiology. An early believer in the theory of contagion, he grasped the opportunity of a peculiarity in the water supply in London to gather quantitative evidence supporting his theory that cholera was transmitted by polluted water.

In 1853-4, when a cholera pandemic hit London, one of the two major water supply firms, the Lambeth Company, had moved its Thames intakes upriver, above the tidal (and therefore sewage) reach. Snow showed that most of the cholera deaths occurred …
Fluoridation of Water Supply
Authors: Edwin H. Smith
Journal: JAMA (1974)

IT IS a professional truism that prevention is preferable to treatment for any disease. The simple expedient of fluoridating communal water supplies offers effective prevention of the most common disease in our nation-dental decay, which affects over 95% of our population. Water fluoridation, the least expensive dental public health measure for the control of caries, demonstrates its greatest efficacy for children, who may realize a new dental decay reduction of 60% to 70%.  Adults also receive considerable benefit, though not to the same dramatic extent. At this time when the capabilities of health care providers are strained to the utmost to meet the demands placed on them, and more and more of the population view health care as the right of every citizen, it is absolutely essential that every proven public health measure be implemented.  Value Established Beyond Question  Extensive research, conducted over a period of 35 years, has established
Genetic Services in the United States
Authors: Stephen J. Sepe
Journal: JAMA (1982)

In fiscal years 1979 and 1980, the Genetic Diseases Service Branch of the Health Services Administration funded 34 state genetic service programs in the United States through monies from the National Genetic Diseases Act (PL 94-278) of 1976. During the two-year period, 131,818 at-risk individuals were provided with genetic counseling. Analyses of amniotic fluid were performed on 42,003 specimens, with 436 abnormal fetuses (1%) detected. Utilization ratios of amniocentesis for advanced maternal age ranged from a low of 5% to a high of 49%. Screening programs for inborn errors of metabolism reported testing 3, 158,521 specimens. The numbers of affected children detected nationally were 195 with phenylketonuria (1:16,000), 536 with hypothyroidism (1:5,900), 25 with galactosemia (1:39,685), eight with maple syrup urine disease (1:86,984), and eight with homocystinuria (1:139,008).
The Family Man
Authors: James Owen Drife
Journal: BMJ (2006)

O n the cover of this week's Radio Times is a picture of actor Trevor Eve surrounded by babies. He plays Patrick Stowe, a fertility expert, in a new three part series dramatising some of reproductive medicine's ethical dilemmas. “Meet the baby maker,” says the caption. “Should this man play God?”

God got a couple of mentions in the first episode. Stowe jokes that a colleague “used to be a nun but decided she didn't want to do God's work any more, so she went for promotion and started doing mine” (a laboured twist on the old anti-consultant jokes). Later Stowe admits that he can't be God—but by then …
Late enlargement of radiofrequency lesions in infant lambs. Implications for ablation procedures in small children.
Authors: J P Saul, J E Hulse, J Papagiannis, R Van Praagh, E P Walsh
Journal: Circulation (1994)

BACKGROUND Despite the current clinical use of radiofrequency (RF) catheter ablation in infants, the acute and late effects of RF lesion production in immature myocardium remain unknown. This study was specifically designed to investigate the pathology of RF lesions in developing sheep myocardium. METHODS AND RESULTS In study 1, RF lesions were made on the epicardial left ventricular surface of the beating heart in 15 sheep, 5 approximately 4 weeks of age (11.0 +/- 1.0 kg) and 10 approximately 8 weeks of age (23.8 +/- 3.4 kg), to assess the effects of RF application duration (10 to 90 seconds) and electrode tip temperature (45 degrees to 90 degrees C) on lesion size in immature myocardium. Lesion width and depth increased asymptotically with RF duration, to 7.0 +/- 0.7 and 4.8 +/- 1.0 mm at 90 seconds, respectively. The time to reach one-half lesion size was 6.5 seconds for width and 12.0 seconds for depth. Lesion width increased nearly linearly with tip temperature above 50 degrees C, but depth followed a sigmoid relation, with no increase above 80 degrees C. In study 2, RF lesions were made in all four cardiac chambers under fluoroscopic guidance in 19 infant sheep (10.9 +/- 1.4 kg). Lesion sizes and histological characteristics were assessed acutely (acute, n = 5), at 1.07 +/- 0.02 months (1 month, n = 5), and at 8.5 +/- 0.5 months (late, n = 9). Atrial and ventricular lesions but not atrioventricular groove lesions apparently increased in size during the follow-up period. Atrial lesions width increased from 5.3 +/- 0.5 to 8.7 +/- 0.7 mm at 1 month (164%) but did not increase further at late follow-up, while ventricular lesion width increased from 5.9 +/- 0.8 to 10.1 +/- 0.7 mm (171%) at late follow-up but was not significantly changed at 1 month. Histological evaluation revealed replacement of normal myocytes with fibrous and elastic tissue at 1 month and late follow-up in all locations but also demonstrated a poorly delineated border with multiple extensions of fibrous and elastic tissue into surrounding normal myocardium in late ventricular lesions. CONCLUSIONS RF lesion formation in immature sheep myocardium is similar to that in adult myocardium acutely but is associated with late lesion enlargement and fibrous tissue invasion of normal myocardium. These findings may have implications for clinical RF ablation procedures in infants.
Callosities with Horny Plugs
Authors: F. F. Hellier
Journal: BMJ (1960)

MANAGEMENT OF DIABETES BR1ITISH 915 most of the patients on insulin attend daily for their injection.The cost of transport, tropical rain, and any mild intercurrent illness resulted in irregular attendance.In the long run, therefore, management with oral preparations would probably be cheaper for the patients.While not all diabetics will respond to oral therapy, this study shows that a large number of selected patients will respond satisfactorily to this particular drug.In view of its safety, as evidenced by liver-function, blood, and urine studies, stabinol appears to be a worth-while addition to the therapy of diabetes. SummaryThe antidiabetic effect of stabinol has been evaluated on a group of 33 patients with diabetes of the maturity onset type.Of this group three were lost to the study.Of the remaining 30 patients, 15 (50%) were better controlled with the oral agent than they had previously been on insulin therapy, 9 (30%) were controlled equally welH on either regimen, and 6 (20%) were not as well controlled on oral therapy as they were on insulin therapy.Liver-function studies and blood and urine findings remained normal throughout the study.There were no side-effects or abnormal reactions.We wish to thank Frank W. Horner Ltd. for supplies of stabinol used in this study, and
Pegylated Interferon-α2a With or Without Low-Dose Ribavirin for Treatment-Naive Patients With Hepatitis C Virus Genotype 1 Receiving Hemodialysis
Authors: Chen-Hua Liu, Chung-Feng Huang, Chun-Jen Liu, Chia-Yen Dai, Cheng-Chao Liang, Jee-Fu Huang, Peir-Haur Hung, Hung-Bin Tsai, Meng-Kun Tsai, Shih-I Chen, Jou-Wei Lin, Sheng-Shun Yang, Tung-Hung Su, Hung-Chih Yang, Pei-Jer Chen, Ding-Shinn Chen, Wan-Long Chuang, Ming-Lung Yu, Jia-Horng Kao
Journal: Annals of Internal Medicine (2013)

Data are limited on the efficacy and safety of pegylated interferon plus ribavirin for patients with hepatitis C virus genotype 1 (HCV-1) receiving hemodialysis.To compare the efficacy and safety of combination therapy with pegylated interferon plus low-dose ribavirin and pegylated interferon monotherapy for treatment-naive patients with HCV-1 receiving hemodialysis.Open-label, randomized, controlled trial. (ClinicalTrials.gov: NCT00491244).8 centers in Taiwan.205 treatment-naive patients with HCV-1 receiving hemodialysis.48 weeks of pegylated interferon-α2a, 135 µg weekly, plus ribavirin, 200 mg daily (n = 103), or pegylated interferon-α2a, 135 µg weekly (n = 102).Sustained virologic response rate and adverse event-related withdrawal rate.Compared with monotherapy, combination therapy had a greater sustained virologic response rate (64% vs. 33%; relative risk, 1.92 [95% CI, 1.41 to 2.62]; P < 0.001). More patients receiving combination therapy had hemoglobin levels less than 8.5 g/dL than those receiving monotherapy (72% vs. 6%; risk difference, 66% [CI, 56% to 76%]; P < 0.001). Patients receiving combination therapy required a higher dosage (mean, 13 946 IU per week [SD, 6449] vs. 5833 IU per week [SD, 1169]; P = 0.006) and longer duration (mean, 29 weeks [SD, 9] vs. 18 weeks [SD, 7]; P = 0.004) of epoetin-β than patients receiving monotherapy. The adverse event-related withdrawal rates were 7% in the combination therapy group and 4% in the monotherapy group (risk difference, 3% [CI, -3% to 9%]).Open-label trial; results may not be generalizable to patients on peritoneal dialysis.In treatment-naive patients with HCV-1 receiving hemodialysis, combination therapy with pegylated interferon plus low-dose ribavirin achieved a greater sustained virologic response rate than pegylated interferon monotherapy.National Center of Excellence for Clinical Trial and Research.
Allergy to tartrazine in antidepressants
Authors: Robert Pohl, Richard Balon, Richard Berchou, Vikram K. Yeragani
Journal: American Journal of Psychiatry (1987)

The authors describe five cases of apparent allergy to tartrazine (FD&C yellow dye number 5) in 170 patients exposed to the dye in antidepressants. The frequency of tartrazine sensitivity was much higher than the reported frequency of six in 1,000 persons.
Britain's failure to tackle research misconduct: Britain is ahead of most countries
Authors: H. Maisonneuve
Journal: BMJ (2004)

Editor—Lock warns the medical community about its lack of action in handling research misconduct.1 We disagree that Britain lags behind the rest of the world and think that Lock should be proud of the achievements of the Anglo-Saxon countries. Fewer than 10, mostly small, countries have a national body for investigating misconduct and fraud in science, and few countries have open discussions under the auspices of professional organisations such as the Committee on Publication Ethics (COPE). Eastern and southern Europe, Latin America, and Asia have no mechanisms for handling fraud properly.

If 23 years have not been sufficient for Britain to move on, will countries such as France have to wait until 2020 or 2050 to see improvement? A series of high profile cases that exposed fabrications of data in the late 1970s and early '80s in the United States resulted in the Health Research Institution Act 1985, which required institutions to establish procedures for addressing scientific misconduct.2 However, the situation in the United States is still far from satisfactory. Establishing standards, recommendations, and processes for investigating research misconduct takes time as so many interests are challenged. Professional organisations must be well organised and governments supportive.

Lock says that a scandal and a charismatic leader are needed before progress can be made. But must we wait to see a major scandal in the public domain in most countries? Will a scandal be sufficient in countries where misconduct is discussed and handled behind closed doors? And one charismatic opinion leader per country is not enough.
Peripheral Bone Metastases in Prostate Cancer: A Rare Localization at Initial Presentation
Authors: Henna I.E. Reigman, Marcel P.M. Stokkel
Journal: Clinical Nuclear Medicine (2004)

The prevalence of peripheral metastases reported in the literature ranges from 1% to 2%, but this is mainly seen in case of extensive metastatic disease. The most common solitary metastatic site in malignancy is the thoracic and lumbar spine. In half of the cases, these metastases originate from a primary bronchogenic carcinoma. Only a few cases of solitary metastasis in the tibia of prostate carcinoma have been described. Paget’s disease, fractures, and chronic arthritis can mimic the features of prostate cancer, especially in case of solitary lesions. We present 2 patients with extensive metastases from a prostate carcinoma in the lower extremities, a rare localization at initial presentation.
Photoinduced free radicals from chlorpromazine and related phenothiazines: relationship to phenothiazine-induced photosensitization.
Authors: C F Chignell, A G Motten, G R Buettner
Journal: Environmental Health Perspectives (1985)

Chlorpromazine and several other related phenothiazines are known to cause both phototoxic and photoallergic reactions in the skin and eyes of patients receiving these drugs. While the detailed mechanisms of photosensitization are not known, it is obvious that the first step must be the absorption of light by the drug, its metabolites, or photoproducts, or possibly an induced endogenous chemical. In this review, the free-radical photochemistry of phenothiazines is described, and the evidence for the involvement of photoinduced free radicals in photosensitization is examined. Upon irradiation chlorpromazine yields a variety of free radicals including the corresponding cation radical (via photoionization), the neutral promazinyl radical and a chlorine atom (Cl.) (via homolytic cleavage), and a sulfur-centered peroxy radical. The chlorpromazine cation radical is probably responsible for some of the observed in vitro phototoxic effects of this drug. However, it seems unlikely that the cation radical is involved in phototoxicity in vivo, since photoionization only occurs when chlorpromazine is excited into the S2 level (lambda ex less than 280 nm). The promazinyl radical is a more likely candidate for the phototoxic species both in vivo and in vitro. In addition, this radical can react covalently with proteins and other macromolecules to yield antigens which could be responsible for the photoallergic response to chlorpromazine. Neither oxygen-derived radicals nor singlet oxygen (1O2*), appear to be important in chlorpromazine photosensitization. In contrast, it would seem that promazine-induced phototoxicity may result in part from the generation of superoxide (O2-.).(ABSTRACT TRUNCATED AT 250 WORDS)
TETANUS.A PRELIMINARY REPORT OF A STATISTICAL STUDY.
Authors: JAMES M. ANDERS
Journal: JAMA (1905)

The object of these studies has been to demonstrate the incidence of tetanus in the United States and to present a brief review of all collectable cases, with a view to establishing our knowledge of the disease as it occurs in this country, as well as to adduce measures of prophylaxis and treatment.A study of the literature from 1850 to 1904, cover- ing the reports of cases found in the "Index-Catalogue of the Library of the Surgeon-General" in Washington from 1850 to 1892, and the "Index Medicus" from 1892 to 1904, inclusive, or 949 cases, with a report of 252 original ones collected by us from direct correspondence with hundreds of observers all over the country, giving a total of 1,201 cases, affords convincing proof that every case of the disease is the result of the intro- duction of the tetanus bacillus through a lesion of the skin, however minute it may be, and that so-called idio- pathic or "rheumatic" tetanus does not exist.Prom our statistics the fact stands clearly forward that the disease is endemic to all large centers of population; that in some localities in which it formerly prevailed with marked severity, notably in Long Island, it has decreased in prevalence ; that occasionally there are small epidemics that prevail, which can be definitely traced in their origin, as for instance in hospitals following the use of infected catgut sutures.The same is true of vaccination tetanus and diphtheria tetanus following the use of tetanized vaccine or antitoxin, and tetanus nconatorum (e. g., where cases have developed in the service of the same midwife).Table 1 indicates many of the leading points con- cerning the cases collected by us from individual physicians throughout the United States and in subsequent tables aspects will be elaborated separately in detail. DISTRIBUTION AND PREVALENCE IN THE UNITED STATES.The sections of this country in which tetanus is most frequent are northern New York, along the Hudson Valley, Brooklyn and the surrounding districts of Long Island, southern Pennsylvania, Virginia, Georgia (at least about Savannah), southern Louisiana, Indiana, Ill- inois and southern California.Cases of tetanus were plentiful after the battle of Gettysburg and also after the battle of the Wilderness.In 1,099 cases out of the total of 1,201 collected by us, the location by state was given (Table 2) with Penn- sylvania leading, showing 224 cases, while New York stood next, with 190 cases.These figures, however, are misleading as regards the prevalence of the disease owing to the incompleteness of the returns from many quarters, and we refer the reader to the tabulated re- ports, copied from the census statistics of the United States, accompanying this study.Thus, while we noted but 17 cases from Louisiana, the census report for 1870 and 1890 shows a total of 806 cases, of which 642 were instances of tetanus neonatorum, in this one state alone.A perusal of Table 3 can not help but impress every reader with the appalling mortality from tetanus of the newborn and herein, indeed, lies a great work in a
Child health in a changing community.
Authors: S D Court
Journal: BMJ (1971)

The lecture is increasingly regarded as one of the less satisfac- tory instruments of teaching.Yet institutions retain it, especially when connected with the name of a person whose memory is still relevant to the attitudes and activities of their members.It provides a pause in which we can remember our ancestors and consider present responsibilities in terms of past experience. Significance of Charles WestMy message, for real as well as ritual reasons, begins with Charles West.Born in 1816 and living until 1898, we can think of him as a comprehensive Victorian; a man who "helped to make the reign of Queen Victoria a memorable period in the history of medical progress" (British Medical 7ournal, 1898).The establishment of the Hospital for Sick Children in 1852 is considered West's most significant achievement; and its achievements in the century which followed and present reputation provide ample justification for this view.His reasons for doing so were equally important.When only 23, distressed by the prevailing ignorance, he began to study the diseases of children, and between 1848 and 1884 produced seven editions of his lectures on the diseases of infancy and childhood (West, 1874).He created not only an institution but a subject.And, within the subject, he is our contemporary in a special sense.