tbuckley/cabot-search huggingface dataset:
Undernotification of anaphylaxis deaths in <scp>B</scp>razil due to difficult coding under the <scp>ICD</scp>‐10
Authors: L. K. Tanno, F. Ganem, P. Demoly, C. M. Toscano, A. L. Bierrenbach
Journal: Allergy (2012)

Abstract Background Undernotification is well recognized as a key challenge to the study of anaphylaxis mortality, but it is seldom mentioned that one of its reasons is the difficult coding of the condition under the tenth revision of the international classification of diseases ( ICD ‐10), given that there are no anaphylaxis‐specific ICD ‐10, which are considered valid for coding underlying causes‐of‐death, and that official mortality statistics consider exclusively the underlying and disregard the contributing causes‐of‐death data recorded on death certificates. Brazilian mortality data were used as a case study to call attention to the inadequacy of the ICD ‐10 for the measurement of anaphylaxis deaths. Methods Underlying and contributing causes‐of‐death data were used to estimate the rates of anaphylaxis deaths in the country over the years 2008–2010. Results Of 498 anaphylaxis deaths were found, of which 75% were classified as ‘definite’ and 25% as ‘possible anaphylaxis deaths’. The average national rate for these years was 0.87 per million per year. None of these deaths would have been found had we exclusively considered information from the underlying cause‐of‐death field. Conclusion/Recommendations The study of anaphylaxis mortality using secondary data requires the use of information derived from the underlying as well as from the contributing causes‐of‐death fields. Coding definitions should be standardized with a view of enabling trend analyses and international comparisons. The ICD ‐11 revision is a unique opportunity to improve the coding system so as to facilitate epidemiological studies of anaphylaxis mortality. Educational interventions targeted at improving the quality of death certificate completion are urgently needed.
Cancer Incidence among Glyphosate-Exposed Pesticide Applicators in the Agricultural Health Study
Authors: Anneclaire J. De Roos, Aaron Blair, Jennifer A. Rusiecki, Jane A. Hoppin, Megan Svec, Mustafa Dosemeci, Dale P. Sandler, Michael C. Alavanja
Journal: Environmental Health Perspectives (2004)

Glyphosate is a broad-spectrum herbicide that is one of the most frequently applied pesticides in the world. Although there has been little consistent evidence of genotoxicity or carcinogenicity from in vitro and animal studies, a few epidemiologic reports have indicated potential health effects of glyphosate. We evaluated associations between glyphosate exposure and cancer incidence in the Agricultural Health Study (AHS), a prospective cohort study of 57,311 licensed pesticide applicators in Iowa and North Carolina. Detailed information on pesticide use and other factors was obtained from a self-administered questionnaire completed at time of enrollment (1993-1997). Among private and commercial applicators, 75.5% reported having ever used glyphosate, of which > 97% were men. In this analysis, glyphosate exposure was defined as a) ever personally mixed or applied products containing glyphosate; b) cumulative lifetime days of use, or "cumulative exposure days" (years of use times days/year); and c) intensity-weighted cumulative exposure days (years of use times days/year times estimated intensity level). Poisson regression was used to estimate exposure-response relations between glyphosate and incidence of all cancers combined and 12 relatively common cancer subtypes. Glyphosate exposure was not associated with cancer incidence overall or with most of the cancer subtypes we studied. There was a suggested association with multiple myeloma incidence that should be followed up as more cases occur in the AHS. Given the widespread use of glyphosate, future analyses of the AHS will allow further examination of long-term health effects, including less common cancers.
London's health: a role for the new mayor
Authors: R. Harling
Journal: BMJ (1999)

London is not a healthy city. Overall mortality is falling more slowly than in the rest of England,1 and infant mortality compares unfavourably with that ofother European capitals.2 The city is blighted by pollution,3 and there are particular problems with HIV infection, substance misuse, teenage pregnancy, tuberculosis, and severe mental illness.4 The seven million people who live in London are aware of the problems: a poll revealedthat they regard their city as an unhealthy place, and they think it is going to get worse.5

Last May Londoners voted in favour of establishing a Greater London Authority (GLA), made up ofan elected mayor and an elected assembly. The legislation is on its way through parliament, elections will be held in May next year, and the mayor and assembly will start work on 3 July 2000. The new authority will be responsible for “promoting economic and social development in London and improving the environment.” The mayor will have sweeping executive powers and …
Pacemaker Therapy in Heart Block and Stokes-Adams Syndrome
Authors: Simon Dack
Journal: JAMA (1965)

The introduction of the implantable cardiac pacemaker has revolutionized the clinical management of heart block in the past three years. 1 Prior to this period, the treatment of the acute phase of Stokes-Adams syndrome and its long-term management was based on temporary artificial pacing of the heart and the use of drugs to improve atrioventricular (A-V) conduction and stimulate idioventricular pacemaker centers. At present, surgical implantation of an artificial pacemaker has become the standard procedure for the treatment of heart block. It therefore behooves the clinician to know the present indications for pacemaker implantation, the optimal time for surgery, the preoperative preparation, and the problems arising following pacemaker implantation. Recent experience has indicated that our present equipment, although superior to the original units introduced three years ago, is far from foolproof and that frequent mechanical and electrical breakdowns occur. This applies not only to the electrode wires, but also to
Motor Dysfunction of the Small Bowel and Colon in Patients with the Carcinoid Syndrome and Diarrhea
Authors: Manfred R. von der Ohe, Michael Camilleri, Larry K. Kvols, George M. Thomforde
Journal: New England Journal of Medicine (1993)

The pathophysiology of diarrhea in patients with the carcinoid syndrome is not understood. Possible causes include tumor production of neurohumoral substances, such as serotonin and substance P, which stimulate small-bowel and colonic motility, and intestinal abnormalities, such as lymphangiectasia and bacterial overgrowth. We undertook this study to determine whether carcinoid diarrhea is associated with abnormal motor function in the small intestine and colon. We measured the gastric, small-bowel, and colonic transit of radiolabeled solid residue and estimated the volume of the ascending colon in 16 patients with the carcinoid syndrome and diarrhea and 16 normal subjects. We also measured colonic tone and phasic pressure activity by intracolonic multilumen manometry and with an electronic barostat in seven patients and six normal subjects.
Al-Razi and Islamic medicine in the 9th century
Authors: S E Tchamouroff
Journal: Journal of the Royal Society of Medicine (2006)

Ezzati et al. (May 2006 JRSM 1 ) misplace their confidence by a wide margin in claiming to have reached the first 'unbiased' estimates of state and national levels and trends of obesity in the USA.To do so, they claim to have calculated rates of self-reporting biases using data from the NHANES (National Health and Nutrition Examination Survey) and Behavioral Risk Factor Surveillance System (BRFSS) surveys of the US Center for Disease Control and Prevention, which were assumed to be representative of the USA population on the basis of the original sampling design.In reality the assumption is questionable, the response rates being about 80% for NHANES and 45% for BRFSS.If nothing else, such a discrepancy sets a distance between what the two surveys may represent, also considering that the surveys represent different samples.In a crucial decision, Ezzati et al. excluded subjects who did not participate in both surveys-an exclusion that inevitably invalidates any claim that the bias estimates reached could be representative of the USA population or of individual state populations.Such elementary flaws lead to ask how scarce resources could be approved for such a wanting study design.
Abstract 4002: C-terminal phosphorylation of human GSTP1 by EGFR and site-directed mutation allows JNK reactivation in glioma cells
Authors: Tatsunori Okamura, Francis Ali-Osman
Journal: Cancer Research (2010)

Abstract In malignant gliomas, the c-jun N-terminal kinase (JNK) pathway regulates tumor growth and resistance to apoptosis, and correlates with histologic grade and epidermal growth factor receptor (EGFR) tyrosine kinase expression. We recently reported that glutathione S-transferase P1 (GSTP1), a major metabolizing and stress response signaling protein that is frequently overexpressed in brain tumors, is a downstream target of EGFR and undergoes EGFR-dependent tyrosine phosphorylation, in vitro and in vivo, resulting in an enhancement of its enzymatic function and increased drug resistance. Although the dimeric GSTP1 exists in a reversible equilibrium with its monomeric form, the monomeric GSTP1 binds to JNK and acts as an endogeneous JNK inhibitor. In our previous study, the EGFR-phosphorylation of GSTP1 shifted the GSTP1 dimer-monomer equilibrium toward the monomeric state and the c-Jun phosphorylation by JNK was enhanced by phosphorylated-GSTP1 and suppressed by unphosphorylated-GSTP1. EGFR activation resulted in dissociation of GSTP1 from the GSTP1-JNK1 complex in a cell-free system and in glioma cells. The C-terminal domain of GSTP1 is reported to be involved in the interaction with JNK. Accordingly, we synthesized the C-terminal domain peptides of human GSTP1 containing the phospho-acceptor Tyr198, unique to hominidae among species, by EGFR (Y198WT) and its phenylalanine-replaced mutant peptide (Y198F). Both the C-terminal domain peptides significantly suppressed the c-Jun phosphorylation by JNK1 in a cell-free system. The binding assay using the synthetic peptides showed that the C-terminal domain peptides of human GSTP1 bound to JNK1 with a lower affinity when Tyr 198 was phosphorylated by EGFR than when it was unphosphorylated. Mutagenesis in human glioma cells revealed that the EGF-induced c-Jun phosphorylation by JNK decreased in the GSTP1-Y198F mutant, whereas increased in the phospho-mimic GSTP1-Y198D mutant, compared with vector control. Together these results indicate that in malignant glioma cells the C-terminal tyrosine phosphorylation of human GSTP1 by EGFR leads to dissociation of GSTP1 from the GSTP1-JNK1 complex. Thus, the GSTP1-JNK1 direct interaction rather than JNK upstream signaling elicits reactivation of JNK. This regulation of JNK signaling function by the EGFR-GSTP1 crosstalk, defines a novel signaling network with a potential to regulate the biology and therapeutic outcome in malignant gliomas. Supported by NIH grants RO1 CA127872, RO1 CA 112519, P50CA108786 and P30-CA14236. 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 4002.
Prospective observational cohort study of time saved by prehospital thrombolysis for ST elevation myocardial infarction delivered by paramedics
Authors: D. K Pedley
Journal: BMJ (2003)

<h3>Abstract</h3> <b>Objectives</b> To evaluate a system of prehospital thrombolysis, delivered by paramedics, in meeting the national service framework9s targets for the management of acute myocardial infarction. <b>Design</b> Prospective observational cohort study comparing patients with suspected acute myocardial infarction considered for thrombolysis in the prehospital environment with patients treated in hospital. <b>Setting</b> The catchment area of a large teaching hospital, including urban and rural areas. <b>Participants</b> 201 patients presenting concurrently over a 12 month period who had changes to the electrocardiogram that were diagnostic of acute myocardial infarction or who received thrombolysis for suspected acute myocardial infarction. <b>Main outcome measures</b> Time from first medical contact to initiation of thrombolysis (call to needle time), number of patients given thrombolysis appropriately, and all cause mortality in hospital. <b>Results</b> The median call to needle time for patients treated before arriving in hospital (n=28) was 52 (95% confidence interval 41 to 62) minutes. Patients from similar rural areas who were treated in hospital (n=43) had a median time of 125 (104 to 140) minutes. This represents a median time saved of 73 minutes (P &lt; 0.001). Sixty minutes after medical contact 64% of patients (18/28) treated before arrival in hospital had received thrombolysis; this compares with 4% of patients (2/43) in a cohort from similar areas. Median call to needle time for patients from urban areas (n=107) was 80 (78 to 93) minutes. Myocardial infarction was confirmed in 89% of patients (25/28) who had received prehospital thrombolysis; this compares with 92% (138/150) in the two groups of patients receiving thrombolysis in hospital. <b>Conclusions</b> Thrombolysis delivered by paramedics with support from the base hospital can meet the national targets for early thrombolysis. The system has been shown to work well and can be introduced without delay.
Inhibition of erythropoiesis in malaria anemia: role of hemozoin and hemozoin-generated 4-hydroxynonenal
Authors: Oleksii A. Skorokhod, Luisa Caione, Tiziana Marrocco, Giorgia Migliardi, Valentina Barrera, Paolo Arese, Wanda Piacibello, Evelin Schwarzer
Journal: Blood (2010)
Signs of reversing trends in prevalence of asthma
Authors: L. von Hertzen, T. Haahtela
Journal: Allergy (2005)

Several recent reports have provided evidence that the burden of asthma may have levelled off, after increasing for decades. Implementation of the national and global asthma prevention and management guidelines that have led to earlier detection and improved treatment of asthmatics, is considered to be involved in this apparent change for the better. In addition, environmental influences associated with the modern life may have reached the maximum in inducing symptoms and disease in genetically susceptible individuals in some areas. Available data obtained from Canada and non‐English‐speaking countries in Europe show that the peak in asthma prevalence has been reached at the level of 8–12%. This review outlines the most recent literature on time trends in asthma prevalence and considers the possible causes of the current trends. Problems and pitfalls in appraising studies on time trends are also discussed.
Balancing the benefits and harms of care
Authors: Anna Donald
Journal: BMJ (2004)

Can patients have too much information about the benefits and harms of treatment? Until a year ago, I wasn't sure of the answer to this. Why worry people needlessly about outcomes that are rarer than hen's teeth? And why burden junior staff with lengthy consent forms?

Having just spent the past 12 months being treated for breast cancer, I am now convinced that people need as much good quality information as they can get. Why?

Firstly, I wanted to optimise my prognosis by making good decisions. Less obviously, I wanted to be able to comfort myself post hoc that I had made the best decisions possible at the time. (It would be cold comfort were my family and I later to discover reliable research favouring different decisions than was available last year.)

Secondly, I needed to recognise the effects of treatment, both good and bad, when they occurred. For example, being aware that neutropenia below about 0.5x109/l carried a small but real risk of …
Long-term Diazepam Therapy and Clinical Outcome
Authors: Karl Rickels
Journal: JAMA (1983)

This double-blind study involved the continuous (six to 22 weeks) treatment of 180 chronically anxious outpatients with diazepam, 15 to 40 mg/day. Our findings indicate that a significant number of patients benefit from prolonged diazepam treatment and that tolerance to the anxiolytic effect of diazepam does not develop during a 22-week study period. The duration of continual treatment with sedative-benzodiazepines was clearly the most important determinant of withdrawal reactions. Patients treated continuously for less than eight months with sedative-benzodiazepines had an incidence of withdrawal of 5%, whereas 43% of patients treated for eight months or more demonstrated clear withdrawal reactions. While these withdrawal reactions produced considerable distress, they were neither life threatening nor incapacitating and did not include convulsions or psychotic reactions. In all cases, withdrawal reactions could be readily managed by gradually tapering the dose of the benzodiazepine.
ALLERGY AND ALKALOSIS
Authors: Harry Beckman
Journal: JAMA (1931)

To the Editor:  —I cannot but think that Dr. Feinberg has quite misunderstood my attitude in the matter, for I have never in the least suggested that the desensitization studies come to an end either now or in the future. What I do advocate, however—and in doing so am aware of committing no act of treason against scientific medicine—is that, pari passu with these studies the new hypothesis be given a chance in the field of allergy. I shall not attempt to answer his categorical comments on my most recent paper for two reasons: first, entirely too much space would be required; and, second, to involve the subject in polemics at this juncture would be to bury it for a long period. What is wanted is that some individual, properly qualified on both the clinical and the laboratory sides, undertake an exhaustive study in the human being of the possible
The Borrowed Imagery of Boxing-Reply
Authors: J. Patrick Kelly
Journal: JAMA (1990)

<h3>In Reply.—</h3> We respect the opinion of Dr Enzenauer and others who have expressed concern about the use of boxing imagery in our advertising. Advertising for our products generally runs for a finite period, and as can be seen in two recent issues of<i>JAMA</i>(1990;263:15741576, 2038-2040), the advertising in question has been discontinued. To develop and execute advertising for any given product we go to great lengths to identify, develop, and present concepts that will compel interest while conveying important information. In the case of Cefobid, we used the "borrowed imagery" of boxing as a way to communicate graphically the image of strength and power, and the ability to triumph over infections. We have tested this advertising campaign with hundreds of physicians, both before and after the advertisements appeared in medical journals. Many of these physicians were undoubtedly aware of the American Medical Association's position on boxing, yet
Child restraint seating regulations modified
Authors: Phil Gunby
Journal: JAMA (1984)

Two US Department of Transportation agencies are modifying their child restraint seating regulations to make it easier for persons traveling with small children to use the same safety seat in both their motor vehicles and on commercial airplane flights. At present, seats certified by the department's National Highway Traffic Safety Administration cannot be used on airliners without special certification from the Federal Aviation Administration, which also is part of the department. The new common standard is expected to go into effect next Feb 28. The department estimates that more than 600 small children die in traffic accidents in this country each year. It further estimates—from data submitted by state agencies—that two of three (67%) of the infants transported in motor vehicles now are placed in infant restraint seats, but that fewer than half (44%) of children between the ages of 1 and 4 years are placed in safety seats.
H1N1 influenza in pregnant women
Authors: K. S. Joseph, R. M. Liston
Journal: BMJ (2011)

Vaccination is the key to mitigating the higher incidence of adverse outcomes

Although the 2009 H1N1 pandemic proved to be more benign than anticipated, it had a substantial effect on pregnant women. In the linked cohort study (doi:10.1136/bmj.d3214), Pierce and colleagues report the perinatal outcomes of 256 pregnant women admitted to hospital with H1N1 influenza in the United Kingdom.1

The study found that pregnant women admitted to hospital with H1N1 influenza had significantly higher rates of adverse pregnancy outcomes than uninfected pregnant women. These included three to four times higher rates of preterm birth, four to five times higher rates of stillbirth, and four to six times higher rates of neonatal death.1 These high rates of adverse perinatal outcomes were consistent with those reported in a population based study from the United States,2 which also found a high maternal death rate (five deaths in 489 pregnant women admitted to hospital). Presumably, details of specific maternal complications and causes of death will be forthcoming …
PLASMA OSTEOPONTIN LEVELS WERE MORE ELEVATED IN CORONARY ARTERY THAN IN SYSTEMIC CIRCULATION IN PATIENTS WITH ACUTE CORONARY SYNDROME
Authors: Yoshinori Yasuoka, Motohiro Kosugi, Ryo Araki, Takahiro Imanaka, Ryo Matsutera, Susumu Hattori, Yoshiki Noda, Hidenori Adachi, Hiroaki Irino, Tatsuya Sasaki
Journal: Journal of the American College of Cardiology (2010)
CLINICAL VALUE OF THE ASCHHEIMZONDEK TEST IN THE DIAGNOSIS OF TESTICULAR TUMORS
Authors: GRAY H. TWOMBLY
Journal: JAMA (1942)

Since 1931 quantitative Aschheim-Zondek tests have been done routinely on patients with testicular tumors at Memorial Hospital. There have been 203 such patients, on whom a total of 1,403 urinary assays have been recorded. The tests were performed by the technic described by Ferguson in 1933. In addition there have been 42 on whom tests have been done with a larger number of animals per test in an attempt to make the assays more accurate. We wish to analyze data on these patients to answer the following questions:   Is the amount of hormone in the urine of a patient with a testicular tumor related to the histologic structure of the tumor?  Can one accurately follow the clinical course of the disease by repeated Aschheim-Zondek tests? Do these tests show increasing excretion of hormone, for instance, as evidence of recurrence or metastasis before such conditions can be discovered clinically?