tbuckley/cabot-search huggingface dataset:
Integration of Public Health with Adaptation to Climate Change: Lessons Learned and New Directions
Authors: Ian Roberts
Journal: BMJ (2005)

The global climate is changing, and faster than ever before. The burning of fossil fuels is adding alarmingly to the levels of carbon dioxide in the atmosphere, which acts as a radiation blanket causing average global temperature to rise and changing the world's climate. We can reasonably expect more droughts, floods, extreme weather events, and for the sea level to rise.

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Kristie L Ebi, Joel B Smith, Ian Burton

Taylor and Francis, £69, pp 320 ISBN 90 5809 686 6

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All of these will have significant impacts on human health. Indeed, the World Health Organization has estimated that …

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Exercise echocardiography: detection of wall motion abnormalities during ischemia.
Authors: S J Mason, J L Weiss, M L Weisfeldt, J B Garrison, N J Fortuin
Journal: Circulation (1979)

To assess the feasibility of detecting wall motion abnormalities with echocardiography during exercise-induced ischemia, we performed echocardiograms on 13 patients with angiographically documented coronary artery disease at rest and during supine bicycle exercise at increasing work loads until angina or ischemic electrocardiographic changes appeared.We analyzed echocardiographic indices of regional left ventricular function in these patients and 11 age-and heart rate-matched normal volunteers.In the 13 patients, 22 of 25 echocardiographically defined wall segments (13 septa, nine posterior left ventricular walls) were supplied by coronary arteries with > 70% stenosis and were compared with the corresponding 22 segments from the 11 normals.Mean systolic septal thickening increased in the 22 segments of normals from 56 ± 3% (SEM) at rest to 77 ± 7% in exercise (p < 0.01) while in the patients' 22 wall segments supplied by stenotic vessels the mean value fell during peak exercise from 59 6 to 35 ± 3% (p < 0.005).Mean systolic posterior left ventricular wall thickening rose similarly in normals from 89 ± 9 to 115 ± 8% (p < 0.005) but fell during peak exercise from 75 ± 9 to 54 ± 9% (p < 0.01) in the patients' nine abnormally perfused segments.Maximal velocity of diastolic wall thinning rose from rest to exercise in the septa and posterior left ventricular walls of normals from 5.5 ± 0.3 to 7.7 ± 0.6 cm/sec (p < 0.005) and from 8.4 ± 0.8 to 11.8 ± 1.2 cm/sec (p < 0.001), respectively.In patients, these same indices fell at peak exercise from 5.9 ± 0.5 to 4.3 ± 0.4 cm/sec (p < 0.05) and from 8.3 ± 1.2 to 6.2 ± 1.4 cm/sec (p < 0.005 vs normals in exercise), respectively.The percent systolic change in left ventricular internal diameter increased from rest to exercise in normals from 38 ± 2 to 44 ± 2% (p < 0.001), but fell in patients during peak exercise from 35 ± 2 to 28 ± 2% (p < 0.001).Exercise echocardiography appears in these patients to be sensitive in detecting wall motion abnormalities during exercise-induced ischemia, and may be applicable in patients in whom exercise electrocardiography is equivocal, or where the functional significance of a coronary arterial lesion is uncertain.
PHYSICAL DIAGNOSIS SERIES—COMMUNICABLE DISEASE
Authors: Louis Weinstein
Journal: JAMA (1961)

Rarely available for teaching purposes, this film demonstrates the diagnostic signs of roseola infantum, German measles, measles, mumps, chickenpox, cervical adenitis, scarlet fever, pertussis, fungus stomatitis, herpes simplex, herpes zoster, herpetic stomatitis, poliomyelitis, encephalitis, meningococcemia, meningitis, tuberculosis, blastomycosis, and staphylococcus dermatitis.
Comparison of medical care in prison and in general practice.
Authors: E Martin
Journal: BMJ (1984)

The medical care of prisoners "declaring sick" to the medical officer and hospital officers in Bedford Prison was surveyed and compared with the medical care given to the medical officer9s patients in general practice. The consultation rate of prisoners was higher than that of patients in the practice. Part of this increase was because household remedies were not available to prisoners except through the prison medical service and part may also have been due to the stresses of life in prison. Few psychoactive drugs were prescribed in prison. The problems that prisoners presented reflected the problems of violence and poor hygiene in prison. Some problems that more commonly present in prison than in general practice may be related to stress.
Renal Regulation of Serum α-Lipoproteins
Authors: Lena A. Lewis, V. Zuehlke, S. Nakamoto, W. J. Kolff, Irvine H. Page
Journal: New England Journal of Medicine (1966)

STUDIES of families have shown that absence of serum α-lipoprotein may be genetically determined.1 The importance of female sex hormones in its regulation was suggested when higher levels were observed in females than in males,2 and when increased concentrations were found in men treated with estrogen.3 When low concentrations were observed in nephrotic patients4 it was suggested the kidneys might participate in determining the level.The present study indicates a relation between kidney and α-lipoprotein levels – that is, high-density lipoproteins with electrophoretic mobility of α1-globulin. Low levels of serum α-lipoprotein were found in patients with terminal uremia, or those . . .
Respiratory function after injection sclerotherapy of oesophageal varices.
Authors: T Samuels, M C Lovett, I T Campbell, C Makin, J Davies, S A Jenkins, J N Baxter
Journal: Gut (1994)

Arterial oxygen tension (Pao2), carbon dioxide tension (PaCO2), and vital capacity were measured preoperatively and one day postoperatively in patients with chronic hepatic cirrhosis having elective oesophageal injection sclerotherapy under general anaesthesia. The results were compared with the same measurements made in patients with chronic cirrhosis anaesthetised and scheduled to have injection sclerotherapy under general anaesthesia but who, because of variceal obliteration, only had an oesophagogastroscopy. In the injected group PaO2 decreased by 9.3 (3.0) mm Hg (1.2 (0.4) kPa) (mean (SEM)) (p &lt; 0.02) but in the controls did not change. The difference between the two groups was significant (p &lt; 0.02). Vital capacity decreased by 0.39 (0.08) litres (BTPS) (p &lt; 0.01) after injection sclerotherapy but in the controls did not change. Again the difference between the two groups was significant (p &lt; 0.02). In the injected group there was a significant correlation between the change in PaO2 and the percentage change in vital capacity (r = 0.787, p &lt; 0.01) but no such relation was seen in control subjects. These results suggest that oesophageal injection sclerotherapy is associated with a restrictive defect in respiratory function one day after the injection caused, possibly, by sclerosant embolising to the lung.
TCR triggering modulates the responsiveness and homeostatic proliferation of CD4+ thymic emigrants to IL-7 therapy
Authors: Olga Hennion-Tscheltzoff, Dominique Leboeuf, Simon-David Gauthier, Martine Dupuis, Brigitte Assouline, Anne Grégoire, Stéphanie Thiant, Martin Guimond
Journal: Blood (2013)
Impact of preoperative endoscopic ultrasound-guided fine needle aspiration on postoperative recurrence and survival in cholangiocarcinoma patients
Authors: Abdul Chafic, John Dewitt, Julia LeBlanc, Ihab El Hajj, Gregory Cote, Michael House, Stuart Sherman, Lee McHenry, Henry Pitt, Cynthia Johnson, Mehdi Mohamadnejad, Mohammad Al-Haddad
Journal: Endoscopy (2013)

<b>Background and study aim: </b>Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is frequently performed for suspected biliary tumors for diagnosis and staging but carries a theoretical risk of needle-track seeding. We aimed to evaluate the impact of preoperative EUS-FNA on long-term outcomes for patients with cholangiocarcinoma (CCA). <b>Patients and methods:</b> In a retrospective single-center study of consecutive patients with CCA with preoperative EUS-FNA, main outcome measures were overall survival and progression-free survival. <b>Results:</b> In 150 patients with confirmed CCA, 61 underwent preoperative FNA. Median overall survival was 18.5 months (95 % confidence limits [CL] 15.4, 25.7): 111 patients died and 39 survived. Of the 150 patients, 119 underwent curative-intent surgical resection, with median progression-free survival of 17.8 months (95 %CL 14.5, 22.8); 89/119 patients had tumor recurrence or died, and 30/119 remained alive and disease-free. On multivariable analysis, overall survival was associated with: undergoing curative-intent surgery (hazard ratio [HR] 5.79, <i>P</i> = 0.001), lack of lymph node involvement (HR 1.89, <i>P</i> = 0.011), younger age (HR 1.51 for every 10 years, <i>P</i> < 0.0015), and small tumor size (HR 1.11 for every 1 cm, <i>P</i> = 0.029). For patients undergoing curative-intent surgery, on multivariable analysis, improved progression-free survival was associated with: lack of lymph node involvement (HR 1.88, <i>P</i> = 0.010), smaller tumor size (HR 1.16 for every 1 cm smaller, <i>P</i> = 0.003), and younger age (HR 1.53 for every 10 years, <i>P</i> < 0.001). Number of needle passes showed no statistically significant impact on overall survival. <b>Conclusion:</b> Preoperative EUS-FNA in patients with CCA does not appear to adversely affect overall or progression-free survival.
Predictors of Major Toxicity after Theophylline Overdose
Authors: Michael Shannon
Journal: Annals of Internal Medicine (1993)

Objective: To identify patients at high risk for major toxicity after theophylline intoxication who might benefit from early charcoal hemoperfusion. Design: A 67-month prospective study. Setting: Massachusetts Poison Control System. Patients: 249 consecutive patients referred after theophylline intoxication (defined by a peak serum theophylline concentration 167 mol/L [30 mg/L]). Interventions: Uniform, protocol-directed management recommendations. Main Outcome Measures: Identification of risk factors for major toxicity. Results: 119 patients (48%) not receiving theophylline therapy had acute intoxication; among those receiving such therapy, 92 (37%) had theophylline intoxication because of chronic overmedication and 38 (15%) had acute intoxication. Major toxicity developed in 62 patients (25%); 13 patients (5%) died. Major toxicity was more common in patients with intoxication due to chronic overmedication than in those with acute intoxication who were not receiving theophylline therapy (49% compared with 10%, risk ratio, 4.85; 95% CI, 2.96 to 7.94), even though the former group had lower peak serum theophylline concentrations [283 mol/L compared with 777 mol/L, P = 0.001]. Logistic regression analysis identified two major factors associated with the development of major toxicity: 1) peak serum theophylline concentrations in cases of acute intoxication and 2) patient age in cases of chronic overmedication. Receiver-operating characteristic curve analysis indicated that major toxicity occurred in patients with a peak serum theophylline concentration of greater than 555 mol/L (100 mg/L) after acute intoxication and in patients older than 60 years (regardless of peak serum theophylline concentration) after chronic overmedication. Conclusions: Predictors for major toxicity after theophylline intoxication differ by type of overdose.
Transbronchial Lung Biopsy in the Compromised Host
Authors: Robert G. Chapman
Journal: JAMA (1978)

<h3>To the Editor.—</h3> Pulmonary infiltrates can be one of the more challenging problems encountered in immunocompromised patients, and the transbronchial lung biopsy, as emphasized by Feldman, Pennington, and Ehrie (238:1377, 1977), can help resolve this. As the authors point out, the risk of bleeding from the biopsy is increased in the thrombocytopenic patient unless platelet transfusions can provide effective support. I am concerned, however, with their use of a test transfusion of platelets the day before the procedure to be sure of response in platelet count. Such a test would be reasonable if it carried no risk, but this cannot be said of transfusions. Although it would be more convenient to carry out the transfusion test before scheduling the biopsy, the safer approach would be to give the platelet transfusions two hours before the biopsy is scheduled and to check the response in platelet count one hour later. If the
Abstract 5572: Analysis of changes in RTK phosphorylation using microplate-based antibody arrays
Authors: David J. Finkel, Wade M. Johnson, Wade M. Johnson, Christopher J. Buehl, Rebecca A. Coleman, Maria T. Campos, Stefan M. Luhowskyj, Kristina M. Boldin, Steven P. Stoesz, Roberto Campos-Gonzalez, Richard A. Krzyzek, Kathryn M. Brumbaugh
Journal: Cancer Research (2010)

Abstract Receptor-tyrosine kinases (RTKs) are transmembrane proteins that have been implicated in various cancers and are considered therapeutic targets. The phosphorylation of RTKs on tyrosine residues leads to their activation. Therefore, methods to identify the effect of RTK inhibitors or modifying antibodies on RTK phosphorylation are effective tools for drug screening. The Proteome Profiler 96 Human Phospho-RTK Antibody Array is a unique and powerful, plate-based multiplex immunoassay that utilizes ELISA techniques to measure changes in the phosphorylation of multiple RTKs simultaneously. In this assay, antibody/antigen reactions take place on the surface of a microplate that has been pre-spotted with antibodies against each RTK. Each spot corresponds to a unique analyte. A horseradish peroxidase-conjugated anti-Phospho-Tyrosine detection antibody is subsequently added to each well. A chemiluminescent substrate mix and a camera imaging system are used to determine the relative amount of analyte bound in individual spots. Experiments were performed by incubating the MDA-MB-453 breast cancer cell line with specific kinase inhibitors or with antibodies to ErbB receptors prior to NRG1- β1/HRG1- β1 treatment. Cells were lysed directly in 96-well plates and transferred to the Proteome Profiler 96 Human Phospho-RTK Array for analysis. NRG1- β1/HRG1- β1-dependent tyrosine phosphorylation of all four ErbB receptors was monitored simultaneously and the effects of different kinase inhibitors or modifying antibodies were determined. Proteome Profiler 96 Antibody Arrays offer the advantages of small sample and volume size requirements with as little as 5 μg of total cellular protein in a total volume of 100 μL being required, while still offering the specificity and sensitivity of sandwich immunoassays. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5572.
Quality of Outpatient Care: Diabetes
Authors: Neal Clemenson
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Both Dr Weiner and colleagues<sup>1</sup>and Dr Leape<sup>2</sup>presume that the standards for diabetes are correct, and therefore that primary care physicians are performing inadequately. We believe that assumption is incorrect. A diabetic patient known to have blood sugars out of control will not benefit from a glycosylated hemoglobin level. We have studied implementing intensive diabetes education—including medical, nutritional, and exercise components—in primary care practice with disappointing results.<sup>3</sup>While knowledge of diabetes, attitudes and skills related to diabetic management, family behaviors, and performance assessments all significantly improved in the experimental group compared with the control group, at final follow-up there were no significant differences in fasting glycemia, glycosylated hemoglobin, or microalbuminuria. We believe noncompliant patients would be more likely to be in primary care practices than in practices of diabetologists. This difference may account for the findings of Dr Weiner and colleagues.<sup>1</sup>Patients
Direct immunofluorescence in pyoderma gangrenosum
Authors: F.C. POWELL, A.L. SCHROETFR, H.O. PERRY, W.P.D. SU
Journal: British Journal of Dermatology (1983)

Direct immunofluorescence was done in fifty‐one cases of pyoderma gangrenosum. Biopsy specimens were taken from the peripheral erythematous zone of the lesion. In thirty‐one cases (61%), there was positive immunofluorescence, with perivascular deposition of immune reactants being the most frequent pattern (twenty‐seven cases). These findings support a vasculitic pathogenesis of pyoderma gangrenosum.
Professor is replaced as lead scientist while GMC investigates his research
Authors: O. Dyer
Journal: BMJ (2003)

The British neurologist Simon Shorvon, who was dismissed three months ago as director of Singapore's National Neuroscience Institute, has been temporarily replaced as the lead scientist responsible for using a Medical Research Council grant to University College London (UCL).

Professor Shorvon left Singapore immediately after being found by his employer, the National Healthcare Group, to have breached ethical guidelines in his research there (19 April, p 839).

He returned to his former post at UCL's Institute of Neurology, where he oversaw a cooperative group that received a grant from the council. He also supervised career training awards from the council.

A spokeswoman for the council said: “The lead responsibility for the cooperative group has …
Genome-wide epigenetic analysis delineates a biologically distinct immature acute leukemia with myeloid/T-lymphoid features
Authors: Maria E. Figueroa, Bas J. Wouters, Lucy Skrabanek, Jacob Glass, Yushan Li, Claudia A. J. Erpelinck-Verschueren, Anton W. Langerak, Bob Löwenberg, Melissa Fazzari, John M. Greally, Peter J. M. Valk, Ari Melnick, Ruud Delwel
Journal: Blood (2009)
Tissue Prostate-Specific Antigen and Androgen Receptor Immunoreactivity in Prostate Cancer Biopsies before, during and after Neo-Adjuvant Androgen Deprivation Followed by Radiotherapy
Authors: Per &Oslash;greid, Aasmund Berner, Olav Dahl, Ernst Rettedal, Sophie D. Foss&aring;
Journal: European Urology (1999)
Autoantibodies to the heat-shock protein hsp90 in systemic lupus erythematosus.
Authors: S Minota, S Koyasu, I Yahara, J Winfield
Journal: Journal of Clinical Investigation (1988)

Patients with systemic lupus erythematosus (SLE) develop multiple autoantibodies to self-antigens. Analysis of autoantibody systems in this and related autoimmune disorders can provide information of etiologic and pathogenetic significance. We report here a previously unrecognized autoantibody to the 90,000-D heat-shock protein, hsp90, a molecule thought to have important functions in the cellular response to stress, virus-induced transformation, steroid hormone receptor action, and cellular activation. Autoantibodies to hsp90 were exclusively of the IgG class, and were detected in approximately 50% of unselected patients with SLE and 2/6 patients with idiopathic polymyositis. Anti-hsp90 antibodies were not detected in sera from 10 normal subjects, 10 patients with rheumatoid arthritis, or 7 patients with scleroderma. The identity of this major intracytoplasmic antigen was established by its specific removal from nonionic detergent cell lysates following immunoabsorption with monospecific rabbit anti-hsp90, and by demonstration of increased synthesis following a 10-min 45 degrees C heat shock. These data define the frequent occurrence of a novel autoantibody to a major heat-shock protein in patients with SLE.
Case 8-1966
Authors: Farahe Maloof, John B. Blennerhassett
Journal: New England Journal of Medicine (1966)

Presentation of CaseA seventy-four-year-old man was admitted to the hospital because of weakness.The patient, who was an unreliable historian, had had diabetes for at least ten years and considered himself well until a year before admission, when progressive weakness and unsteadiness on walking developed. He consulted a neurologist, who told him that he had diabetic neuropathy. A few days before admission he became lethargic and complained of pruritus; on admission to another hospital fever, a distended urinary bladder and pneumonia were found. An indwelling catheter was inserted into the bladder, and penicillin was given intramuscularly.He had had . . .
The Potential Role of Magnetic Resonance Imaging in Ischemic Vascular Disease
Authors: Charles B. Higgins
Journal: New England Journal of Medicine (1992)

THE potential importance of magnetic resonance (MR) imaging in the evaluation of vascular disease was recognized early in the history of this technique.1 , 2 Its suitability for vascular imaging stems from the fact that flowing blood produces a unique signal during the MR process. Indeed, blood flow was measured by means of MR many years before the appearance of the first MR images.3 , 4 The characteristic signal has permitted the vascular system to be visualized without the use of contrast medium, avoiding problems in delivery of medium to ischemic vascular beds. MR imaging has been effectively applied to the evaluation of abnormalities . . .
Doctors—Barefoot and Otherwise
Authors: Fitzhugh Mullan
Journal: JAMA (1984)

BY ALL standards, the United States is a doctor-rich nation with almost one physician for every 500 people. Most countries in the developed world enjoy a physician-to-population ratio in the vicinity of one to 1,000, whereas two thirds of the world's population lives where the ratios are vastly less favorable. Although these nations may show one physician or more for every 10,000 people on international tabulations, it is not unusual to find only one physician for every 50,000 to 100,000 people in their rural areas. In 1978 at Alma Ata in the Soviet Union, the World Health Organization adopted the goal of "Health for All by the Year 2000" as the overriding priority of the organization as well as a target for the health activities of its constituent nations.<sup>1</sup>The success of any such ambitious scheme clearly depends on the availability and capabilities of large numbers of appropriately trained
Molecular Pathogenesis of Euthyroid and Toxic Multinodular Goiter
Authors: Knut Krohn, Dagmar Führer, Yvonne Bayer, Markus Eszlinger, Volker Brauer, Susanne Neumann, Ralf Paschke, Dagmar Führer-Sakel
Journal: Endocrine Reviews (2004)

The purpose of this review is to summarize current knowledge of the etiology of euthyroid and toxic multinodular goiter (MNG) with respect to the epidemiology, clinical characteristics, and molecular pathology. In reconstructing the line of events from early thyroid hyperplasia to MNG we will argue the predominant neoplastic character of nodular structures, the nature of known somatic mutations, and the importance of mutagenesis. Furthermore, we outline direct and indirect consequences of these somatic mutations for thyroid pathophysiology and summarize information concerning a possible genetic background of euthyroid goiter. Finally, we discuss uncertainties and open questions in differential diagnosis and therapy of euthyroid and toxic MNG.
Treatment Variation in Older Black and White Patients Undergoing Aortic Valve Replacement
Authors: Erik B. Schelbert, Gary E. Rosenthal, Karl F. Welke, Mary S. Vaughan-Sarrazin
Journal: Circulation (2005)

Most prior studies of racial differences in the delivery of cardiac care have focused on potential differences in treatment by individual physicians and hospitals. However, differential use of hospitals with variable practice patterns might also contribute to variations in care.