tbuckley/cabot-search huggingface dataset:
Lessons learnt from the front line in Israel
Authors: Shmuel C Shapira
Journal: BMJ (2006)

Obstacles to health in the Arab worldEditor-Health indicators in the Arab world show stark differences between individual countries.But aggregate figures provide only a narrow perspective.They do not show variation according to socioeconomic group, sex, education, or political affiliation.The scarcity of databases available to collect such detailed data reflects the fact that inadequate political support exists for rigorous intersectoral research of relevance for health in the region.National development agendas and public policies are focused on economic development.Funding for health tends largely to be directed at providing curative medical services designed to emulate Western health systems. 1 Patriarchal and religious principles embedded in the state structures of many Arab countries-such as Lebanon, Egypt, and Saudi Arabia-are a further obstacle to unpicking and taking action to tackle poor health and health inequity in the region.The conservative values of the Arab world render public debates about religion, politics, and sexuality unacceptable and place social stigma around drug users, commercial sex workers, and mentally ill people.As a result, health data on such groups are limited and unreliable, 2 which presents an obstacle for the development of appropriate services.Although national cultural, social, and economic structures are to blame for patchy and inequitable public health services, particularly in Egypt, Morocco, and Lebanon, 3 regional and global forces influence health provision too.The Arab-Israeli conflict, the wars in Iraq, the Gulf, Lebanon, Yemen, and Sudan have brought about hunger, epidemics, displacement, and death.These wars have been tacitly bolstered by multinational corporations, which have sold billions of dollars worth of weapons to Arab countries in conflict.Governments' expenditures on defence in some Arab countries are greater than their expenditure on health. 4 International political action (and inaction), notably in Iraq and Lebanon, has played a part too.Similarly, global decisions have led to fluctuations of funding for the United Nations Relief and Works Agency (UNRWA), the leading health and social service provider to Palestinian refugees. 5 Multilateral and bilateral aid has also influenced public policy making in many economies of the Arab world, owing to demands for reform and reduced public sector spending.These have had a dispro-portionate effect on low income groups.Although several Arab countries have banned tobacco advertisements, tobacco companies continue to reach Arab homes through satellite television stations, another global feature.Tobacco related mortality is expected to reach 0.5 million deaths in the Arab world by 2020.Further investigation of the ways that powerful regional and global agents effect health in the Arab world and beyond is crucial for a clearer perspective on obstacles to health.Only then will the possibility of advocacy for lasting health see the light.
Snail silences suppressor
Authors: Amy Maxmen
Journal: The Journal of Experimental Medicine (2009)

Learning to tolerate ourselvesOn < a d d a r t t y p e = " r e l " d o i = " 1 0 . 1 0 8 4 / j e m . 2 0 0 8 0 6 1 1 " > page 139, Duty et al. find self-reactive B cells in healthy adults that might harm their own body if given the chance.Checkpoints during B cell development ensure that immune cells won't confuse the self for an intruder.At birth, many B cells express self-reactive receptors.Most of these potentially harmful cells are either set straight by rearranging new receptors or are eliminated before leaving the bone marrow.Yet a minority manages to escape, slipping into the periphery as mature B cells with a propensity for self-attack.In healthy mice, autoimmunity is avoided because most self-reactive escapees, which classically express high levels of IgD and reduced IgM, are arrested in an anergic state.But until now, a similar population of anergic, autoreactive B cells hadn't been found in humans.Duty et al. have now spotted these cells in the blood of healthy adults, where they accounted for 2.5% of peripheral B cells.These cells turned out to be mature and autoreactive, bearing no signs of antigen encounter in vivo.The cells were also anergic, as they had faulty signaling in response to BCR ligation.These defects were overcome, however, when the authors gave cells a strong enough signal.Autoreactive B cells are common in patients with autoimmune diseases, such as lupus or rheumatoid arthritis (RA).And the authors suspect that the new population may contain the precursors of these troublemaking cells.Lapses in early steps of self-tolerance have been shown to contribute to disease in patients with lupus or RA.Alternatively, suggests author Patrick Wilson, anergy may fail in these patients, allowing self-sabotaging cells to run free.Why the body silences these potentially mutinous cells after they escape rather than putting them to death is unclear.Perhaps, suggests Wilson, a limited amount of autoimmunity isn't such a bad thing, as long as it's not chronic.For example, anergic cells might help attack pathogens disguised as self-antigens.
Who uses the Cochrane Pregnancy and Childbirth Database?
Authors: C. Hyde
Journal: BMJ (1995)

Thus most cancers detected were aggressive, and only a small number of men with prostate specific antigen concentrations >4 0 ng/ml would have a diagnosis of a non-aggressive cancer preceded by a long disease free interval.This was also true for the subset of men who were aged under 70 when the diagnosis was made.Compared with men with antigen concentrations of < 1 0 ng/ml, those with concentrations of 2-0-3-0 ng/ml had a relative risk of all prostate cancer of 5-5 and a relative risk of aggressive cancer of 6-8.It is important to note that this was a once only test, and the potential benefit of repeat screening or the addition of other screening modalities was not available.For men older than 70 watchful waiting may be appropriate management.This new study shows, however, that in this population of American doctors the mean age at diagnosis of prostate cancer was 68-7 years, most of the cancers detected were aggressive, and three quarters of deaths in the cases were directly related to the diagnosis.Thus in younger men screening for prostate specific antigens may be justified, particularly for those in higher risk groups, such as those with a family history ofprostate cancer.45
The Potential Benefits of Decision Aids in Clinical Medicine
Authors: Adrian Edwards
Journal: JAMA (1999)

Patients vary in the extent to which they wish to partici-pate in decisions and in the decisions in which they wish toparticipate.However,whenpatientsandphysiciansarefacedwith major treatment decisions for which personal consid-erationandqualityoflifeissuesplayalargerole,patientpar-ticipation is desirable.
Benzodiazepines: Tolerability in Elderly Patients
Authors: Fuad Lechin, Berta van der Dijs, Mireya Benaim
Journal: Psychotherapy and Psychosomatics (1996)

Aging is a physiological process that shares many behavioral, biochemical and neuroendocrine phenomena with the pathophysiological situation of unresolved stress, as well as with a pharmacologically induced snydrome resulting from chronic benzodiazepine (BZ) consumption. Behavioral findings include symptoms such as drowsiness, ataxia, fatigue, confusion, weakness, dizziness, vertigo, syncope, reversible dementia, depression, impairment of intellectual, psychomotor and sexual function, agitation, auditory and visual hallucinations, paranoid ideation, panic, delirium, depersonalization, sleepwalking, aggressivity, orthostatic hypotension, and insomnia. Neuroendocrine findings include: central depletion of noradrenaline (NA), dopamine, adrenaline (AD), and serotonin (5-HT); reduction in the ratio of circulating NA/AD as well as platelet 5-HT and increase of AD, plasma free 5-HT and cortisol. These disturbances together with the increased platelet aggregability observed in the three groups are typical of unresolved-stress situations. Immunological findings include significant reduction of peripheral T lymphocytes (CD3, CD4, CD8) and the CD4/CD8 ratio, CD 16 and gamma-delta cells. On the other hand, the three groups (elderly subjects, subjects faced with unresolved stress, and BZ consumers) show increase of the CD57 lymphocyte subset as well as natural killer cytotoxicity. Alterations of several biological markers have also been found, specifically in the oral glucose tolerance test, the intramuscular clonidine test, and the supine/orthostasis/exercise test. From a clinical point of view, the three groups appear to be more susceptible to the appearance and progression of many acute and chronic diseases (infectious and malignant diseases). As a result, chronic consumption of BZs should be avoided in both the elderly and subjects in unresolved-stress situations.
Primary pulmonary hypertension may be a heterogeneous disease with a second locus on chromosome 2q31
Authors: Matthias Rindermann, Ekkehard Grünig, Albrecht von Hippel, Rolf Koehler, Gabriel Miltenberger-Miltenyi, Derliz Mereles, Karlin Arnold, Michael Pauciulo, William Nichols, Horst Olschewski, Marius M Hoeper, Jörg Winkler, Hugo A Katus, Wolfgang Kübler, Claus R Bartram, Bart Janssen
Journal: Journal of the American College of Cardiology (2003)
Immunoglobulin and lymphocyte decrease concurrent with adverse reactions induced by methotrexate for RA
Authors: S. INOKUMA
Journal: Annals of the Rheumatic Diseases (2000)

How should we manage fibromyalgia?We read with interest your leader, "How should we manage fibromyalgia?". 1 We were puzzled by Paul Reilly's statement that a comprehensive pain management programme...has the best chances of success, although even rheumatologists can practise amateur cognitive behavioural therapy in the clinic".Is Dr Reilly really suggesting that a rheumatologist's amateur eVorts oVer the best outcome for people with fibromyalgia?Dr Reilly oVers no evidence to support this statement.He does, however, find evidence to raise questions as to the value of patient self help groups.Dr Reilly cites a 1992 paper that reports an association between membership of such a group and worse prognosis in chronic fatigue syndrome. 2As the authors emphasised the caution with which the results should be interpreted, it is surprising that Dr Reilly has used this evidence to inform his clinical practice.Firstly, this is ancient research.Things have moved on.Although we would agree that some so called self help groups can end up as a circular review of symptoms, self management courses, which we at Arthritis Care espouse, are a very diVerent matter.Challenging Arthritis is a self management programme-and that title was chosen very deliberately.It is run by people with arthritis for people with arthritis.It gives people the skills to take control of their lives and their arthritis.It is practical and positive, and it works.The eVectiveness of similar programmes in the USA is well recorded. 3 Experience in the United Kingdom shows similar results, including better understanding of symptoms, improved communication with medical staV, and increased use of exercise and relaxation techniques.Probably most importantly of all, self management programmes significantly decrease pain, fatigue, and anxiety. 4 So it is extremely important to diVerentiate between navel gazing self help systems and courses such as ours, which encourage people to take control for themselves-and which work.Similar courses run on the Challenging Arthritis model are now available to people with other chronic conditions.Given Dr Reilly's desire to disabuse patients of the notion that their fibromyalgia is his problem alone, shouldn't eVective courses which encourage people to take control for themselves be a welcome adjunct to his treatment, even if it is run by a patient self management group?ROBINA
Estimation of mean left atrial pressure from transesophageal pulsed Doppler echocardiography of pulmonary venous flow.
Authors: H F Kuecherer, I A Muhiudeen, F M Kusumoto, E Lee, L E Moulinier, M K Cahalan, N B Schiller
Journal: Circulation (1990)

To determine whether pulmonary venous flow and mitral inflow measured by transesophageal pulsed Doppler echocardiography can be used to estimate mean left atrial pressure (LAP), we prospectively studied 47 consecutive patients undergoing cardiovascular surgery. We correlated Doppler variables of pulmonary venous flow and mitral inflow with simultaneously obtained mean LAP and changes in pressure measured by left atrial or pulmonary artery catheters. Among the pulmonary venous flow variables, the systolic fraction (i.e., the systolic velocity-time integral expressed as a fraction of the sum of systolic and early diastolic velocity-time integrals) correlated most strongly with mean LAP (r = -0.88). Of the mitral inflow variables, the ratio of peak early diastolic to peak late diastolic mitral flow velocity correlated most strongly with mean LAP (r = 0.43), but this correlation was not as strong as that with the systolic fraction of pulmonary venous flow. Similarly, changes in the systolic fraction correlated more strongly with changes in mean LAP (r = -0.78) than did changes in the ratio of peak early diastolic to peak late diastolic mitral inflow velocity (r = 0.68). We conclude that in the surgical setting observed, pulmonary venous flow from transesophageal pulsed Doppler echocardiography can be used to estimate mean LAP. This technique may provide a rapid, simple, and relatively noninvasive means of gauging this variable in patients undergoing intraoperative transesophageal echocardiography.
Neutrophil elastase and nitric oxide (NO) during ischemia-reperfusion and their relationships with sICAM-1 and antioxidants
Authors: S. Battista, F. Bar, G. Mengozzi, E. Cerutti, M. Salizzoni, G. Cavalli, M. Nigra, F. Biasi, G. Poli, G. Molino
Journal: Journal of Hepatology (1998)
Re-treatment of interferon (IFN) plus ribavirin (RBV) nonresponders with peginterferon (PEG-IFN) Alfa-2A (40KD) (Pegasys) plus RBV and amantadine (AMA) or IFN Alfa-2A (Roferon-A) plus RBV and AMA. Interim results of a multicenter randomized study
Authors: S. Brillanti, A. Mangia, L. Cimino, A. Civolani, F. Fatuzzo, L. Fenoglio, M. Levrero, G. Minoli, M. Persico, M.G. Rumi
Journal: Journal of Hepatology (2003)
Letters: Omeprazole and Vitamin B_12
Authors: Norman W. Lavy
Journal: Annals of Internal Medicine (1994)

Letters1 July 1994Letters: Omeprazole and Vitamin B12Norman W. Lavy, MDNorman W. Lavy, MDWestfield, NJ 07090Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-1-199407010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Marcuard and coworkers [1] have failed to show that omeprazole therapy causes the apparent changes in cyanocobalamin absorption. The authors used a modified Schilling test intended to evaluate absorption of protein-bound B12, not free B12 (cyanocobalamin). The absorption of free B12 does not depend on acid. Further, they state in the abstract that “each volunteer served as his own control.”Whether such a form of control exists can be debated. Marcuard and associates [1] have actually compared the change from baseline between two groups of patients, each receiving the same interventions, including daily administration of omeprazole, but ...REFERENCE1. Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin (vitamin B12). Ann Intern Med. 1994; 120:211-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: Westfield, NJ 07090 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPerils and pitfalls of long-term effects of proton pump inhibitors 1 July 1994Volume 121, Issue 1Page: 74KeywordsCobalaminsCyanocobalaminDrug administrationDrugsFoodProteins Issue Published: 1 July 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
TCT-407 The ischemia in distal main branch region at the end of coronary bifurcation stenting predicts in-stent restenosis at 12 months follow-up From Intracoronary Electrocardiogram (ECG) and Myonecrosis After Bifurcation Stenting (COSIBRIA&amp;CO) (ClinicalTrials.gov Identifier:NCT01268228)
Authors: Dobrin Vassilev, Alexander Alexandrov, Alexandra Bankova, Robert J. Gil, Slawomir Golebiewski, Hristo Mateev, Iliana Petrova
Journal: Journal of the American College of Cardiology (2013)
Prognostic Value of Systolic Ankle and Toe Blood Pressure Levels in Outcome of Diabetic Foot Ulcer
Authors: Jan Apelqvist, Jan Castenfors, Jan Larsson, Anders Stenström, Carl-David Agardh
Journal: Diabetes Care (1989)

The prognostic value of distal blood pressure measurements has been studied in 314 consecutive diabetic patients with foot ulcers. Systolic toe blood pressure was measured with a strain-gauge technique, and ankle pressure was measured with strain-gauge or Doppler techniques. Wound healing was defined as intact skin for at least 6 mo. One hundred ninety-seven patients healed primarily, 77 had amputations, and 40 died before healing had occurred. In 294 of 300 patients, it was possible to measure either ankle or toe pressure. Fourteen patients were not available for pressure measurements. Of these, 10 patients healed primarily, and 4 died before healing occurred. Both ankle and toe pressures were higher (P &amp;lt; .001) among patients who healed without amputation compared with those who underwent amputation or died before healing. No differences were seen in ankle or toe pressure levels among those who had amputations or died. No patient healed primarily with an ankle pressure &amp;lt; 40 mmHg. An upper limit above which amputation was not required could not be defined. Primary healing was achieved in 139 of 164 patients (85%) with a toe pressure level &amp;gt;45 mmHg, whereas 43 of 117 patients (36%; P &amp;lt; .001) healed without amputation when toe pressure was ≤45 mmHg. In conclusion, a combination of ankle and toe pressure measurements is a useful tool to predict primary healing in diabetic foot ulcers.
Quantification of clonal circulating plasma cells in newly diagnosed multiple myeloma: implications for redefining high-risk myeloma
Authors: W I Gonsalves, S V Rajkumar, V Gupta, W G Morice, M M Timm, P P Singh, A Dispenzieri, F K Buadi, M Q Lacy, P Kapoor, M A Gertz, S K Kumar
Journal: Leukemia (2014)
ANOREXIA NERVOSA: METABOLISM AND ITS RELATION TO PSYCHOPATHOLOGIC REACTIONS
Authors: S. M. SMALL, A. T. MILHORAT
Journal: American Journal of Psychiatry (1944)

In four patients with anorexia nervosa, investigations were made on (a) the relation of the psychopathologic reactions to the somatic changes, and (b) the energy metabolism and the absorption and metabolism of food stuffs. Weight changes were found to be the resultant of the caloric intake and energy output which were influenced considerably by anxiety and resentment. Anxiety was manifested physiologically by a change from a slow pulse to tachycardia, increased hyperkinesis, and decrease in glucose tolerance without characteristic changes in appetite. Observations on the metabolism of various dietary constituents gave no evidence of a "primary" metabolic disorder. The balance of energy changes was similar to that seen in inanition. During most periods the intake of calories was abnormally low, but even with a diet which would have been adequate for the average normal person weight could be lost because of muscular overactivity induced by anxiety. Thus, most of the symptoms of anorexia nervosa can persist without there being an actual anorexia.
LIVER TREATMENT OF PERNICIOUS ANAEMIA: ITS EFFECT ON THE POLYNUCLEAR LEUCOCYTE COUNT OF COOKE
Authors: G. W. T. H. Fleming
Journal: BMJ (1929)

PERNICIOUS ANAEMIA.[T JoRanr_ and the "smallest" cells, as calculated from the radii of the half-circles shown.The diameters of these cells are given in microns.REFERENTCES.
Neighborhood Food Environment and Walkability Predict Obesity in New York City
Authors: Andrew Rundle, Kathryn M. Neckerman, Lance Freeman, Gina S. Lovasi, Marnie Purciel, James Quinn, Catherine Richards, Neelanjan Sircar, Christopher Weiss
Journal: Environmental Health Perspectives (2008)

BackgroundDifferences in the neighborhood food environment may contribute to disparities in obesity.ObjectivesThe purpose of this study was to examine the association of neighborhood food environments with body mass index (BMI) and obesity after control for neighborhood walkability.MethodsThis study employed a cross-sectional, multilevel analysis of BMI and obesity among 13,102 adult residents of New York City. We constructed measures of the food environment and walkability for the neighborhood, defined as a half-mile buffer around the study subject's home address.ResultsDensity of BMI-healthy food outlets (supermarkets, fruit and vegetable markets, and natural food stores) was inversely associated with BMI. Mean adjusted BMI was similar in the first two quintiles of healthy food density (0 and 1.13 stores/km2, respectively), but declined across the three higher quintiles and was 0.80 units lower [95% confidence interval (CI), 0.27–1.32] in the fifth quintile (10.98 stores/km2) than in the first. The prevalence ratio for obesity comparing the fifth quintile of healthy food density with the lowest two quintiles combined was 0.87 (95% CI, 0.78–0.97). These associations remained after control for two neighborhood walkability measures, population density and land-use mix. The prevalence ratio for obesity for the fourth versus first quartile of population density was 0.84 (95% CI, 0.73–0.96) and for land-use mix was 0.91 (95% CI, 0.86–0.97). Increasing density of food outlets categorized as BMI-unhealthy was not significantly associated with BMI or obesity.ConclusionsAccess to BMI-healthy food stores is associated with lower BMI and lower prevalence of obesity.
PREVENTIVE MEDICINE AND THE GENERAL PRACTITIONER
Authors: JOHN M. DODSON
Journal: JAMA (1923)

Six years ago, at the first banquet of the American Association of Industrial Physicians and Surgeons, held in Detroit, I commented on the fact that the industrial physicians, in devoting the major part of their time and attention to keeping employees well, were pointing the way to the general practitioner. I then ventured the prediction that, in the not distant future, the "family physician" would become, in large part, the "family health adviser," and would find his largest usefulness and derive a large part of his income in the field of preventive medicine. The time seems opportune for more extended discussion of this prediction. Recently at the conferences on medical education, which are held each winter in Chicago, there have been numerous expressions of opinion that, notwithstanding the remarkable and gratifying advance in medical education in this country in the last quarter century, decided, if not radical, changes are necessary
A stem cell-like gene expression signature associates with inferior outcomes and a distinct microRNA expression profile in adults with primary cytogenetically normal acute myeloid leukemia
Authors: K H Metzeler, K Maharry, J Kohlschmidt, S Volinia, K Mrózek, H Becker, D Nicolet, S P Whitman, J H Mendler, S Schwind, A-K Eisfeld, Y-Z Wu, B L Powell, T H Carter, M Wetzler, J E Kolitz, M R Baer, A J Carroll, R M Stone, M A Caligiuri, G Marcucci, C D Bloomfield
Journal: Leukemia (2013)