tbuckley/cabot-search huggingface dataset:
PWE-077 Pilot of flexible sigmoidoscopy screening to prevent colorectal cancer
Authors: E Sofianopoulou, G Rubin, M Ritchie, J Patnick, C Rees
Journal: Gut (2012)

<h3>Introduction</h3> A screening programme in England to prevent colorectal cancer using flexible sigmoidoscopy (FSIG) was announced in late 2010, following the results of a major UK study showing that a one-off FSIG offered to people aged 55–64 years significantly reduced colorectal cancer incidence and mortality. Three “pathfinder” sites, in Derby, South of Tyne and Tees, were selected to assess the practicalities of invitation and FSIG screening. We report the findings of our evaluation of this pathfinder phase. <h3>Methods</h3> Patients aged 55 yrs and registered with one of 31 selected practices in three pathfinder areas received postal invitations to participate. The South of Tyne and Derby sites employed similar, interactive model of screening invitation involving telephone pre-assessment by specialist screening practitioners, while Tees used a simple invitation. We used routinely collected data to assess screening uptake, process and outcomes. A self-completion patient satisfaction questionnaire was sent 1-month after attendance to all participants. A postal questionnaire was sent to the 31 participating GP practices that had been selected to participate. Screening took place for a 3-month period in early 2011. <h3>Results</h3> In total 4022 people aged 55 years were invited and 1129 (28%) screened over the 3-month period. Screening uptake differed by method of invitation, with a simple approach being significantly more successful than one that was more interactive (32% vs 27%, p=0.0015). Uptake also decreased significantly with increasing deprivation. Adenomas were found in 111 (9.8%) of those screened. Cancer was found in two subjects. Over 95% of participants rated the procedure as “very” or “fairly” acceptable. Over 90% of respondents said they would participate in cancer screening in the future and a similar proportion would recommend doing so to others. 11 out of 31 practices offered an estimate of the time spent on activities relating to this pathfinder for FSIG screening, most giving a figure of &lt;1%. <h3>Conclusion</h3> In this pathfinder study, a simple invitation to FSIG achieved a greater uptake rate than a more complex, interactive method of invitation. Deprivation was associated with lower screening uptake. Further pilots of the flexible sigmoidoscopy screening programme should focus on strategies to increase response rate and to improve technical aspects of the procedure. Further evaluation should be incorporated into that development. <h3>Competing interests</h3> None declared.
Doctors call for children injured in Gaza conflict to be monitored for long term effects of new weapons
Authors: C. Dyer
Journal: BMJ (2009)

“We heard the shelling, we heard the bombing—they [injured patients] came in by the hundreds, walking and running, in private cars and ambulances, and it went on for three weeks,” remembers the Norwegian doctor Mads Gilbert, who took off for Gaza as soon as he heard that the Israeli assault had started at the end of December last year.

At a talk in London he shows a video clip of a mass of frightened people converging on Al Shifa Hospital, carrying their injured loved ones, shouting and jostling to get them through the doors as quickly as possible.

Inside the draughty hospital—its windows blown out by the Israeli bombing of a nearby mosque, its basic medical supplies exhausted by the long siege of Gaza—surgeons worked ceaselessly, sometimes two or three to an operating room. “All the time we heard the drones—one, two, three at a time, 24 hours a day,” he …
Desmopressin Acetate (DDAVP) Good News
Authors: Carol K. Kasper
Journal: JAMA (1984)

The acquired immune deficiency syndrome epidemic focuses attention again on the dissemination of infections through blood transfusion. Fortunately, at this critical time, a safe and effective alternative to plasma products has become available in this country for some of the patients at risk, namely, those with mild factor VIII deficiency. Desmopressin acetate (DDAVP; 1-desamino-8-D-arginine-vasopressin) is a synthetic analogue of 8-arginine vasopressin, the natural antidiuretic hormone secreted by the posterior pituitary gland.<sup>1-4</sup>Desmopressin acetate has 80 to 100 times the antidiuretic effect of natural vasopressin but only 0.25% to 1% the pressor effect. Mild facial flushing or mild headache sometimes occurs for a few minutes during its administration. Water retention is unlikely with normal fluid intake. To my knowledge, long-term toxic reactions have not been reported. The drug is well known to endocrinologists in its dilute nose-drop formulation, used for treatment of diabetes insipidus. It also causes a quick rise
Unstirred layer and kinetics of electrogenic glucose absorption in the human jejunum in situ
Authors: N. W. Read, D. C. Barber, R. J. Levin, C. D. Holdsworth
Journal: Gut (1977)

Using an electrical technique we estimated the thickness of the unstirred layer in the human jejunum during kinetic studies of electrogenic glucose absorption. The unstirred layer in seven healthy volunteers (632 ± 24 μm: mean ± SEM) was significantly thicker than in 10 patients with active coeliac disease (442 ± 23 μm) but not significantly different in seven patients who had responded to treatment by gluten withdrawal (585 ± 49 μm). There were similar differences in the values of `Apparent Km9 for electrogenic glucose absorption between healthy control subjects (36 ± 6 mM) active coeliac patients (11 ± 1 mM) and treated coeliac patients (31 ± 5 mM). The changes in PDmax however, showed a different pattern. The PDmax in the active coeliac group (6·8 ± 0·7 mV) was lower than in controls (7·6 ± 0·6 mV) but not significantly so, while the PDmax in the treated coeliac group (10·6 ± 0·9 mV) was significantly higher than in both the active coeliac and control groups. It should be noted that both operational kinetic parameters obtained in the present study are much lower than those obtained previously (Read <i>et al.</i>, 1976b) because of the use of siphonage. Analysis of the results using a computer simulation indicates that the reduction in Apparent Km in active coeliac disease can be caused by the interaction of the decreased maximal absorption rate for glucose (Jmax) with the attenuated unstirred layer. In these circumstances it is not necessary to postulate any change in the affinity of the transport mechanism for glucose (`Real Km9). It is remarkable that the disease process produces an Apparent Km which is much closer to the Real Km than that found in health.
Comparison of biphasic and monophasic defibrillation waveforms in an isolated rabbit heart preparation
Authors: L. K Holley, R. M McCulloch
Journal: Cardiovascular Research (1991)

The aims were to develop a Langendorff rabbit heart model and to compare monophasic and biphasic defibrillation pulses.Hearts were perfused with a Krebs-Henseleit solution and two 1.4 cm2 Pt-Ir mesh patch electrodes were sutured onto the ventricles. A 5 ms monophasic or 10 ms biphasic pulse, with randomly selected voltages of 30, 50, 70, 90, 110, or 130 V, defibrillated the heart after 10 s of fibrillation.11 adult male New Zealand white rabbits weighing 2.8(0.27) kg, were used for the studies.A total of 72 fibrillation and defibrillation sequences were conducted in each preparation. The results were fitted to a sigmoidal dose-response curve by logistic regression analysis. Voltage and energy values from the fitted data at 50% and 80% success (V50, V80, E50, E80) indicated a significantly lower (p less than 0.05) defibrillation threshold voltage and energy for the biphasic waveform [V50 = 48 (SD19) V, V80 = 87(27) V, E50 = 0.15(0.12) J, E80 = 0.48(0.29) J] compared with the monophasic waveform [V50 = 79(20) V, V80 = 110(20) V, E50 = 0.27(0.12) J, E80 = 0.5(0.12) J]. There was no observed difference in defibrillation success rate between the first and second halves of any study.The Langendorff rabbit heart model is suitable for assessing electrical fibrillation and defibrillation mechanisms. Defibrillation can be achieved with a lower energy when using a biphasic rather than a monophasic pulse.
Endocrine Dysfunction in Prader-Willi Syndrome: A Review with Special Reference to GH
Authors: Pia Burman, E. Martin Ritzén, Ann Christin Lindgren
Journal: Endocrine Reviews (2001)

Prader-Willi syndrome is a genetic disorder occurring in 1 in 10,000-16,000 live-born infants. In the general population, approximately 60 people in every 1,000,000 are affected. The condition is characterized by short stature, low lean body mass, muscular hypotonia, mental retardation, behavioral abnormalities, dysmorphic features, and excessive appetite with progressive obesity. Furthermore, morbidity and mortality are high, probably as a result of gross obesity. Most patients have reduced GH secretory capacity and hypogonadotropic hypogonadism, suggesting hypothalamic-pituitary dysfunction. Replacement of GH and/or sex hormones may therefore be beneficial in Prader-Willi syndrome, and several clinical trials have now evaluated GH replacement therapy in affected children. Results of GH treatment have been encouraging: improved growth, increased lean body mass, and reduced fat mass. There was also some evidence of improvements in respiratory function and physical activity. The long-term benefits of GH treatment are, however, still to be established. Similarly, the role of sex hormone replacement therapy needs to be clarified as few data exist on its efficacy and potential benefits. In summary, Prader-Willi syndrome is a disabling condition associated with GH deficiency and hypogonadism. More active treatment of these endocrine disorders is likely to benefit affected individuals.
Initial Experience with SPECT Imaging of the Brain Using 1-123 p-lodoamphetamine in Focal Epilepsy
Authors: MARGARET M. LAMANNA, NEIL M. SUSSMAN, RICHARD N. HARNER, LINDA R. KAPLAN, BEVERLY L. HERSHEY, DEBORAH R. BERNSTEIN, PERRY GOLDSTEIN, JANET A. PARKER, JOHN G. WOLODZKO, GEORGE L. POMPLY
Journal: Clinical Nuclear Medicine (1989)

Nineteen patients with complex partial seizures refractory to medical treatment were examined with routine electroencephalography (EEG), video EEG monitoring, computed tomography or magnetic resonance imaging, neuropsychological tests and interictal single photon emission computed tomography (SPECT) with I-123 iodoamphetamine (INT). In 18 patients, SPECT identified areas of focal reduction in tracer uptake that correlated with the epileptogenic focus identified on the EEG. In addition, SPECT disclosed other areas of neurologic dysfunction as elicited on neuropsychological tests. Thus, IMP SPECT is a useful tool for localizing epileptogenic foci and their associated dynamic deficits.
Circadian variation of lymphocyte subpopulations: a study with monoclonal antibodies.
Authors: A W Ritchie, I Oswald, H S Micklem, J E Boyd, R A Elton, E Jazwinska, K James
Journal: BMJ (1983)

Use of monoclonal antibodies to identify subpopulations of circulating lymphocytes in healthy adults showed pronounced circadian variations in total T cells, the two major T cell subsets, and HLA-DR+ lymphocytes. When the results for the T cell subsets were expressed as a ratio (helper:suppressor) no significant rhythmic variation was observed. Lymphocytes bearing a surface antigen identified by the HNK-1 antibody (a population containing the natural killer and antibody dependent killer activity) did not show significant rhythmic variation. There was an inverse relation between plasma cortisol concentration and numbers of T and B cells. These observations have therapeutic implications and should be considered in the course of immunological monitoring.
Dr Gro Harlem Brundtland is a former prime minister of Norway and has been a leading voice on the environment
Authors: F. Godlee
Journal: BMJ (1998)

We must promote equity in health care and never waiver in our pursuance of the highest attainable standard of health for all peoples. Today's gaps in health between geographical areas, social groups, races, and sexes must be narrowed, and women and children must be a major concern. To obtain more equity we must give priority to primary health care of good quality, which must be made available and affordable to all. Essential primary health care includes treatment by trained staff and availability of essential drugs. It comprises preventive and environmental health such as clean water, clean air, and sewage.

The WHO should develop its capacity to give guidance on health policy organisation and financing of health systems. Renewed weight must be given to anticipation and prevention of disease. The struggle against many communicable diseases is underfunded and must be raised on the political agenda. The WHO should also be in the forefront in setting standards, training, and research. It should be the lead agency with regard to countering new and re-emerging diseases, not least those connected with globalisation, changing lifestyles, and environmental problems. While the WHO itself …
A comparative study of antibody expressions in primary biliary cirrhosis and autoimmune cholangitis using phage display
Authors: Nobuhiro Ikuno, Marita Scealy, Janet M. Davies, Senga F. Whittingham, Katsuhisa Omagari, Ian R. Mackay, Merrill J. Rowley
Journal: Hepatology (2001)

Primary biliary cirrhosis (PBC) and autoimmune cholangitis (AIC) are serologic expressions of an autoimmune liver disease affecting biliary ductular cells. Previously we screened a phage-displayed random peptide library with polyclonal IgG from 2 Australian patients with PBC and derived peptides that identified a single conformational (discontinuous) epitope in the inner lipoyl domain of the E2 subunit of the pyruvate dehydrogenase complex (PDC-E2), the characteristic autoantigen in PBC. Here we have used phage display to investigate the reactivity of PBC sera from 2 ethnically and geographically distinct populations, Japanese and Australian, and the 2 serologic expressions, PBC and AIC. Random 7-mer and 12-mer peptide libraries were biopanned with IgG from 3 Japanese patients with PBC and 3 with AIC who did not have anti-PDC-E2. The phage clones (phagotopes) obtained were tested by capture enzyme-linked immunosorbent assay (ELISA) for reactivity with affinity-purified anti-PDC-E2, and compared with those obtained from Australian patients with PBC. Peptide sequences of the derived phagotopes and sequences derived by biopanning with irrelevant antisera were aligned to develop a guide tree based on physicochemical similarity. Both Australian and Japanese PBC-derived phagotopes were distributed in branches of the guide tree that contained the peptide sequences MH and FV previously identified as part of an immunodominant conformational epitope of PDC-E2, indicating that epitope selection was not influenced by the racial origin of the PBC sera. Biopanning with either PBC or AIC-derived IgG yielded phagotopes that reacted with anti-PDC-E2 by capture ELISA, further establishing that there is a similar autoimmune targeting in PBC and AIC.
Beating the Knowledge and Technology Explosion
Authors: Michael H. M. Dykes
Journal: JAMA (1981)

SINCE World War II, there has been a phenomenal growth in knowledge and technology. Our profession has shared in this growth,<sup>1-5</sup>but with serious strain placed on all of us, from premedical students to expert physicians. Several approaches to medical education would reduce the strain on physicians while preparing them to function with confidence in their expertise and with time to enjoy the fruits of their labors. I will not discuss noneducational solutions such as reduced paperwork, expanded roles for physician's assistants, and improved efficiency and validity of health-regulatory agencies. <h3>Increasing Subspecialization</h3> Godber<sup>6</sup>has noted that increasing specialization and subdivision have been necessary to "cope with the rapid advance of biomedical science." He raises the issue of how far specialization should go to provide care the public can understand, consent to, and benefit from, but does not provide criteria for making the necessaryjudgments. He indirectly states that subdivision
Indian study of women with cervical lesions called unethical
Authors: G. Mudur
Journal: BMJ (1997)

In India, critics are questioning the ethics of a 1976-88 study undertaken by the Indian Council of Medical Research that observed the natural course of cervical lesions in 1158 women without offering treatment until cancer developed. At least 9 of the subjects developed invasive cancer, and 62 developed cervical cancer. Researchers state that they failed to gain the women's informed consent because most of the women were illiterate and because informed consent was not mandatory when the study began. It is alleged that the researchers also failed to inform the women about the potentially cancerous nature of their lesions or to offer them treatment at the outset of the study. The researchers claim that the women were given verbal explanations of the situation. Ethics experts note that "illiteracy is not stupidity" and should not be used as an excuse for failing to obtain informed consent. During the observation period, 10 women with severe dysplasias were lost to follow-up (and, therefore, possibly to eventual treatment). Critics note that all of the women with severe dysplasia should have received immediate treatment.
Vascugraft® polyurethane arterial prosthesis as femoro-popliteal and femoro-peroneal bypasses in humans: pathological, structural and chemical analyses of four excised grafts
Authors: Ze Zhang, Y. Marois, R.G. Guidoin, P. Bull, M. Marois, T. How, G. Laroche, M.W. King
Journal: Biomaterials (1997)
Risk Factors for Fatal Colon Cancer in a Large Prospective Study
Authors: M. J. Thun, E. E. Calle, M. M. Namboodiri, W. D. Flanders, R. J. Coates, T. Byers, P. Boffetta, L. Garfinkel, C. W. Heath
Journal: JNCI Journal of the National Cancer Institute (1992)

Diet, physical activity, obesity, aspirin use, and family history may all modify the risk of colon cancer, but few epidemiologic studies are large enough to examine these factors simultaneously.We prospectively assessed the relationship of diet and other factors to risk of fatal colon cancer.Using data from Cancer Prevention Study II--an ongoing prospective mortality study--we studied 764,343 adults who, in 1982, completed a questionnaire on diet and other risk factors and did not report cancer or other major illness. We assessed mortality through August 1988 and identified 1150 deaths from colon cancer (611 men and 539 women). Multivariate analyses were used to compare these case patients with 5746 matched control subjects drawn from the cohort.Risk of fatal colon cancer decreased with more frequent consumption of vegetables and high-fiber grains (P for trend = .031 in men and .0012 in women). The relative risk (RR) for the highest versus lowest quintile of vegetable intake was 0.76 in men (95% confidence interval [CI] = 0.57-1.02) and 0.62 in women (95% CI = 0.45-0.86). Dietary consumption of vegetables and grains and regular use of aspirin were the only factors having an independent and statistically significant association with fatal colon cancer. Participants who consumed the least vegetables and grains and no aspirin had a higher risk compared with those who consumed the most vegetables and used aspirin 16 or more times per month. For men in the former category, the RR was 2.4 (95% CI = 1.1-5.3); for women, it was 2.9 (95% CI = 1.3-6.7). Weaker associations were seen for physical inactivity, obesity, total dietary fat, and family history. No associations were seen with consumption of red meat or total or saturated fat in either sex, but this finding must be interpreted cautiously.These findings support recommendations that increased consumption of vegetables and grains may reduce the risk of fatal colon cancer. Regular use of low doses of aspirin may prove to be an important supplemental measure.
TCT-905 Direct Aortic Implantation of a Self Expandable Aortic Bioprosthesis: The European Experience
Authors: Giuseppe Bruschi, Simon Davies, Federico De Marco, Hafid Amrane, Adrianus Van Boven, Bertrand Marcheix, Nicolas Dumonteil, Haim Danenberg, Didier Tchetche, Giuseppe Coletti, Hasan Bushnaq, Jean-Claude Laborde, Stephen Brecker, Domenico Mazzitelli, Rudiger Lange, Marian Branny, Johan Bosmans, Uday Trivedi, Moninder Bhabra, Peter den Heijer, Neil Moat
Journal: Journal of the American College of Cardiology (2012)
Intracellular pH modulates the generation of superoxide radicals by human neutrophils.
Authors: L Simchowitz
Journal: Journal of Clinical Investigation (1985)

The relationship of intracellular pH (pHi) to superoxide radical (O2-) generation was investigated in chemotactic factor-stimulated human neutrophils. Exposure of cells to 100 nM N-formylmethionyl-leucyl-phenylalanine (FMLP) caused activation of Na/H exchange which, in 140 mM Na medium (pH0 7.40), led to a rise in pHi from 7.22 to 7.80. This pHi change was sensitive to amiloride (apparent Ki 78 microM), an inhibitor of Na/H countertransport. The time course of the alkalinization was similar to that of FMLP-stimulated O2- production, which was complete by 5 min. In the presence of 1 mM amiloride, which nearly blocked the pHi transient elicited by FMLP, or in the absence of external Na, where intracellular acidification was observed in FMLP-stimulated cells, O2- release was still roughly 25-45% of normal. Thus, an alkalinization cannot be an obligatory requirement for O2- generation. By independently varying either pH0, pHi, or the internal or external concentrations of Na, both the direction and magnitude of the FMLP-induced pHi transients could be altered. In each instance, the amount of O2- release correlated directly with pHi and was enhanced by intracellular alkalinization. In the absence of FMLP, a rise in pHi to 7.7-7.8 by exposure of cells to 30 mM NH4Cl, 10 microM monensin (a Na/H exchanging ionophore), or after a prepulse with 18% CO2 did not result in O2- generation. Thus, these results imply that an alkalinization per se is not a sufficient trigger. Neutrophils exposed to 4 nM FMLP exhibited a threefold slower rate of alkalinization (reaching pHi approximately 7.80 by 20-30 min) as compared to that obtained with 100 nM FMLP and did not release significant amounts of O2- under normal incubation conditions. However, these cells could be induced to generate O2- when the degree of alkalinization was enhanced by internal Na depletion or by pretreatment with 18% CO2. Together, these results indicate a modulating effect of pHi on O2- production and suggest that other functional responses of neutrophils may be regulated by their pHi.
Thyroid Hormone and Breast Cancer
Authors: Frederick A. MacCornack
Journal: JAMA (1977)

<h3>To the Editor. —</h3> Mustacchi and Greenspan observed what appeared to be a high correlation between older ages at breast cancer diagnosis and long duration of thyroid supplement administration. On reanalysis of their data using odds ratio analyses, I came up with a somewhat different interpretation of their findings. If one were to take the observed cases of breast cancer and compare them with the "no cancer" group and analyze them for history and duration of thyroid supplements (all age groups), one finds the following: By this analysis, risk for breast cancer appears to be greater with use and duration of use of thyroid supplements. However, this analysis tells us nothing about age. If, however, one were to split the study and comparison patients into younger and older groups (55 years and younger and over 55 years at diagnosis) one finds the following: One sees by this analysis that the