tbuckley/cabot-search huggingface dataset:
Epidemiologic evidence for workplace ETS as a risk factor for lung cancer among nonsmokers: specific risk estimates.
Authors: P Reynolds
Journal: Environmental Health Perspectives (1999)

Exposure to environmental tobacco smoke (ETS) among individuals who have never smoked tobacco products has been well established as a risk factor for lung cancer. Most of the epidemiologic evidence for this association has come from studies of exposure to a spouse who smokes. Fewer studies have explicitly evaluated this risk relationship for workplace sources of ETS exposure. These are reviewed here in the context of study design issues and their contributions to the overall evidence for risks of ETS exposure in the workplace. Although most studies have low power to detect workplace risk estimates in the modest range suggested by the larger studies, risk estimates tend to be consistent with those for exposure from a smoking spouse.
Presentation of the 2004 Kober Medal to K. Frank Austen
Authors: Jeffrey M Drazen
Journal: Journal of Clinical Investigation (2004)

The record shows that on February 26, 1924, Karl Arnstein emigrated from Czechoslovakia via Bremen, Germany, on the ocean liner George Washington. Arnstein, an engineer, had been hired to head the newly formed Goodyear-Zeppelin organization in Akron, Ohio. What Frank’s father did with his colleagues was to construct the largest man-made structure in the world, the Airdock, in which was built the 785-foot-long zeppelin USS Akron. Once in my youth, Frank was wearing his airship tie, and I referred to the embroidered aircraft as “blimps.” I received a severe tongue lashing: a blimp is a shapeless airbag, while a zeppelin is an airship with a sturdy backbone. I provide this information in order for you to appreciate that Frank Austen has a heritage as a windbag, but one with a sturdy spine.
Incidence of Thromboembolism After Stopping Anticoagulant Therapy
Authors: Leon Michaels
Journal: JAMA (1971)

Anticoagulant therapy was discontinued because of hemorrhage on 74 occasions and stopped electively on 166 others, and the incidence of subsequent thromboembolism in these two populations compared. Patients were placed in low-, intermediate-, or high-risk categories, depending on the presence or absence of factors previously shown to be associated with significant differences in the incidence. The proportion of patients in the "hemorrhage" and "elective" populations who fell into each category was similar and the two populations were comparable in other relevant respects. Comparison by means of a chi-square contingency analysis failed to show any significant differences in the relapse rates during any part of the 16-week follow-up period. Stopping anticoaguant therapy because of hemorrhage is not therefore associated with a risk of thromboembolism which is demonstrably greater than that observed after discontinuing treatment electively.
Effect of a Housing and Case Management Program on Emergency Department Visits and Hospitalizations Among Chronically Ill Homeless Adults
Authors: Laura S. Sadowski, Romina A. Kee, Tyler J. VanderWeele, David Buchanan
Journal: JAMA (2009)

Homeless adults, especially those with chronic medical illnesses, are frequent users of costly medical services, especially emergency department and hospital services.To assess the effectiveness of a case management and housing program in reducing use of urgent medical services among homeless adults with chronic medical illnesses.Randomized controlled trial conducted at a public teaching hospital and a private, nonprofit hospital in Chicago, Illinois. Participants were 407 social worker-referred homeless adults with chronic medical illnesses (89% of referrals) from September 2003 until May 2006, with follow-up through December 2007. Analysis was by intention-to-treat.Housing offered as transitional housing after hospitalization discharge, followed by placement in long-term housing; case management offered on-site at primary study sites, transitional housing, and stable housing sites. Usual care participants received standard discharge planning from hospital social workers.Hospitalizations, hospital days, and emergency department visits measured using electronic surveillance, medical records, and interviews. Models were adjusted for baseline differences in demographics, insurance status, prior hospitalization or emergency department visit, human immunodeficiency virus infection, current use of alcohol or other drugs, mental health symptoms, and other factors.The analytic sample (n = 405 [n = 201 for the intervention group, n = 204 for the usual care group]) was 78% men and 78% African American, with a median duration of homelessness of 30 months. After 18 months, 73% of participants had at least 1 hospitalization or emergency department visit. Compared with the usual care group, the intervention group had unadjusted annualized mean reductions of 0.5 hospitalizations (95% confidence interval [CI], -1.2 to 0.2), 2.7 fewer hospital days (95% CI, -5.6 to 0.2), and 1.2 fewer emergency department visits (95% CI, -2.4 to 0.03). Adjusting for baseline covariates, compared with the usual care group, the intervention group had a relative reduction of 29% in hospitalizations (95% CI, 10% to 44%), 29% in hospital days (95% CI, 8% to 45%), and 24% in emergency department visits (95% CI, 3% to 40%).After adjustment, offering housing and case management to a population of homeless adults with chronic medical illnesses resulted in fewer hospital days and emergency department visits, compared with usual care.clinicaltrials.gov Identifier: NCT00490581.
Risk factors for lower respiratory complications of rhinovirus infections in elderly people living in the community: prospective cohort study
Authors: K. G Nicholson, J. Kent, V. Hammersley, E. Cancio
Journal: BMJ (1996)

ABSTRACT. Alport syndrome (AS) is a type IV collagen hereditary disease characterized by progressive hematuric nephritis, hearing loss, and ocular changes. Mutations in the COL4A5 collagen gene are responsible for the more common X-linked dominant form of the disease characterized by much less severe disease in girls and women. A "European Community Alport Syndrome Concerted Action" (ECASCA) group was established to delineate the Alport syndrome phenotype in each gender and to determine genotype-phenotype correlations in a large number of families. Data concerning 329 families, 250 of them with an X-linked transmission, were collected. Characteristics of heterozygous girls and women belonging to the 195 families with proven COL4A5 mutation are compared with those of hemizygous boys and men. Hematuria was observed in 95% of carriers and consistently absent in the others. Proteinuria, hearing loss, and ocular defects developed in 75%, 28%, and 15%, respectively. The probability of developing end-stage renal disease or deafness before the age of 40 yr was 12% and 10%, respectively, in girls and women <i>versus</i> 90 and 80%, respectively, in boys and men. The risk of progression to end-stage renal disease appears to increase after the age of 60 yr in women. Because of the absence of genotype-phenotype correlation and the large intrafamilial phenotypic heterogeneity, early prognosis of the disease in X-linked Alport syndrome carriers remains moot. Risk factors for developing renal failure have been identified: the occurrence and progressive increase in proteinuria, and the development of a hearing defect. E-mail: gubler@necker.fr
Maintaining the Confidentiality of Medical Records Shared over the Internet and the World Wide Web
Authors: David M. Rind
Journal: Annals of Internal Medicine (1997)

The Boston Electronic Medical Record Collaborative is working to develop a system that will use the World Wide Web to transfer computer-based patient information to clinicians in emergency departments. Maintaining adequate confidentiality of these records while still facilitating patient care is paramount to this effort. This paper describes an explicit protocol that would make it possible to electronically identify patients and providers, secure permission for release of records, and track information that is transmitted. It is hoped that other, similar efforts now underway will be able to use and build on this model. Comment on this proposal is invited from all parties with an interest in confidentiality. The system will be used only with "scrubbed" data-data from which all identifiers have been removed-until it is generally agreed that the confidentiality methods proposed here are appropriate and sufficient.
Sex-specific determinants of increased left ventricular mass in the Tecumseh Blood Pressure Study.
Authors: R Marcus, L Krause, A B Weder, A Dominguez-Meja, N J Schork, S Julius
Journal: Circulation (1994)

Left ventricular hypertrophy (LVH) defined by either ECG or echocardiographic criteria is a risk factor for cardiovascular morbidity and mortality. A number of determinants of LVH have been described in previous studies, principally male sex, hypertension, obesity, and aortic valvular stenosis. We examined the distribution of LV mass (LVM) in a population of 18- to 42-year-old normotensive men and women who were free of valvular heart disease to establish sex-specific normal values for LVM index (LVMI) and to determine the correlates of LVMI.LVM was derived from measurements obtained by M-mode echocardiography. Average LVMI is significantly greater in men (102.9 +/- 0.7 g/m2) than women (88.2 +/- 0.7 g/m2). By defining LVH as an LVMI greater than the 90th percentile, we developed sex-specific criteria for LVH: men, > 125.4 g/m2; women, > 110 g/m2. We found that LVH in men is associated with indices of enhanced sympathetic nervous system reactivity and with elevated fasting insulin and triglyceride levels, which may be caused by insulin resistance. In women, LVH was associated with higher body weight and obesity.Before the onset of hypertension, increased LVMI appears to have different determinants in men and women. We suggest that early LVH in young men is a manifestation of hyperkinetic borderline hypertension, a state previously shown to be associated with increased sympathetic nervous system activity and insulin resistance. The hyperkinetic state is less prevalent in young women, in whom increased adiposity seems to be the predominant factor associated with LVH.
Influence of the Escherichia coli capsule on complement fixation and on phagocytosis and killing by human phagocytes.
Authors: M A Horwitz, S C Silverstein
Journal: Journal of Clinical Investigation (1980)

To define mechanisms by which polysaccharide capsules confer enhanced virulence on gram-negative bacteria, we examined the effect of the Escherichia coli capsule on complement fixation to the bacterial surface and on phagocytosis and killing of these bacteria by mouse macrophages and human polymorphonuclear leukocytes (PMN) and monocytes. When E. coli were attached to mouse macrophages with concanavalin A, the macrophages readily phagocytosed unencapsulated but not encapsulated bacteria even in the presence of fresh mouse serum; macrophages did not phagocytose encapsulated E. coli unless antibacterial or anti-Con A antibody was added. Similarly, when these bacteria were attached to human PMN with Con A, PMN ingested unencapsulated but not encapsulated E. coli. PMN phagocytosed and killed encapsulated serum-resistant E. coli only in the presence of both complement and antibacterial antibody; PMN phagocytosed and killed unencapsulated E. coli of the same strain in the presence of complement alone. Fluorescence microscopy showed that antibody had to be present for encapsulated but not unencapsulated E. coli to fix complement to its surface. To examine the role of the complement receptors of human PMN and monocytes in phagocytosis and killing of encapsulated E. coli, we used human and rabbit antibacterial immunoglobulin (Ig)M to fix complement to the bacteria. PMN and monocytes phagocytosed and killed encapsulated E. coli in the presence of both IgM and complement, but not in the presence of either serum opsonin alone. In the presence of antibacterial IgG, PMN and monocytes required complement to effectively phagocytose and kill the E. coli. We conclude that (a) attachment by itself results in ingestion of unencapsulated but not encapsulated E. coli; (b) under physiologic conditions, E. coli are not phagocytosed or killed the absence of antibody, the E. coli capsule blocks complement fixation to the bacterial surface probably by masking surface components, such as lipopolysaccharide, capable of activating the complement pathway; (d) the E. coli capsule imposes a requirement for specific antibacterial antibody for complement fixation; and (e) the complement receptor of human PMN and monocytes mediates phagocytoses of complement-coated encapsulated bacteria and is the primary mediator of phagocytosis and killing of these bacteria.
Community-Oriented Primary Care: The Cuban Plan-Reply
Authors: Richard Wright
Journal: JAMA (1993)

<h3>In Reply.</h3> —In health care provision, accountability is the ability of a system to provide justifying evidence that resources are being used appropriately to service the public's interest and needs. As stated in my article, the COPC model strengthens the social contrast between health care and society by directly linking the organization and the provision of services to population-based health needs. While the framework of COPC is a primary care practice with a population-based focus, the actual COPC model consists of five components: (1) a target community; (2) a community empowerment model; (3) health needs assessment;(4) health programs targeted to high-priority needs; and (5) an evaluation schema.<sup>1</sup>As indicated by the Institute of Medicine<sup>2</sup>evaluation of seven COPC practices, full implementation of all five components was nonexistent in the practices evaluated. As for community and migrant health centers and their commitment to COPC, Drs Ventres and Hale misinterpreted
ABC of vascular diseases. Deep venous insufficiency and occlusion.
Authors: N. F. Hopkins, J. H. Wolfe
Journal: BMJ (1992)

Sequence of events leading to venous ulc?ration Pulmonary embolus is a serious complication of deep vein thrombosis but deep venous insufficiency or occlusion, or both, are much more common long term problems and many venous ulcers occur each year, putting strains on both the work force and health service resources. It has long been recognised that deep vein thrombosis is usually followed by recanalisation of the veins and that this process results in destruction of the venous valves, which in turn results in deep venous insufficiency. Failure to recanalise results in chronic venous occlusion with the development of a collateral circulation that is also without valves. Either event has a deleterious effect on the function of the calf muscle pump, resulting in high venous pressure in the leg and foot even during exercise. This is the fundamental abnormality that results in a postphlebitic limb with venous ulc?ration or venous claudication. In addition, some patients have a congenital absence of competent valves without evidence of previous thrombosis.
Paraplegia following Epidural Anaesthesia
Authors: A. Davies, B. Solomon, A. Levene
Journal: BMJ (1958)

MEDICAL JOURNALexposures-available evidence does not suggest that these factors can account for a large part of the difference.Factors related to climate and to the incidence rates of bronchitis cannot be ruled out of consideration.There is too little evidence at present to draw any conclusions con- cerning this point.It is within the realm of possibility that a part of the difference is due to under-reporting of lung cancer as a cause of death in the United States or to over-reporting of lung cancer as a cause of death in England and Wales, or both.Clearly, the data at present available are insufficient for any definite conclusions to be drawn on why reported lung cancer death rates are so much higher in England and Wales than in the United States.However, it does not appear likely that any single one of the factors discussed above is sufficient in itself to account for all of the difference.This suggests that the difference may be due to an interaction of two or more of these factors.For example, bronchitis, which appears to be more common in England and Wales than in the United States, may increase the susceptibility of individuals to the carcinogenic effect of tobacco smoke or air pollution. SummaryIn 1955 the lung cancer death rate reported in Eng- land and Wales for males was 2.1 times as high as reported in the United States and for females 1.6 times as high.A difference of this order of magnitude has existed in male rates for several decades; while prior to 1949 there was only a small difference in the female rates.Among both males and females in the middleand old-age groups there are proportionately more cigarette smokers in the United Kingdom than in the United States.On the other hand, at the present time the number of cigarettes consumed per smoker per day is higher in the United States than in the United Kingdom.The proportion of male cigarette smokers who inhale appears to be approximately the same in the two countries.In the United States the average length of the remaining butt after a cigarette is discarded is about 31 mm.; about 5% are 45 mm. or longer and about
Antibiotic Usage in Urinary Tract Infections
Authors: Martin G. Rosenthal
Journal: JAMA (1970)

<h3>To the Editor.—</h3> In reading the paper by Scheckler and Bennett (<b>213</b>: 264, 1970) my eyes went first to the line labeled Urology. Since this group has the highest incidence of antibiotic usage, a number of questions came to mind. What definition of infection was used by the authors? I hope it was not strictly colony count. How many of these patients receiving anti-infective drugs had indwelling urethral catheters? Does a urethral catheter itself merit a use of a drug for infection? How many had lower urinary tract instrumentation? My point is that there may be even better justification for the authors' figures than is apparent from their text, at least in the urology patients.
Toward Prevention of Diabetic Microangiopathy
Authors: Samuel Vaisrub
Journal: JAMA (1976)

Unlike atheromatous deposits in the larger vessels, the thickening of the basement membrane in the renal and retinal microvasculature of diabetic patients has no readymade metabolic explanation. Ashton<sup>1</sup>attributed these changes to tissue hypoxia caused by reduced blood flow. Spiro<sup>2</sup>ascribed them to deposition of protein-bound carbohydrate, formed in excess by the diversion of glucose to glycoprotein synthesis. Impressed by the beneficial effect of pituitary ablation on diabetic retinopathy, Lundbaek et al<sup>3</sup>sought to implicate the excessive secretion of growth hormone. Incorporating some aspects of these theories into a "three-in-one" concept, Ditzel<sup>4</sup>hypothesizes that diabetic microangiopathy is a result of diminished tissue oxygenation, which is due less to reduced blood flow than to diminished release of oxygen from the hemoglobin molecule, as reflected in the right shift of the oxygen dissociation curve. This unloading defect could be explained by an increase in hemoglobin A1a-c ("fast" hemoglobin),
Abstract 1657: HSP90 inhibition down regulates EGFR and its effector signaling proteins in pancreatic cancer cell lines
Authors: Sreenivasa R. Chandana, Cheryl Leece, Manisha Bhutani, Barbara A. Conley
Journal: Cancer Research (2010)

Abstract Rationale: Currently approved therapies, including EGFR inhibitors, have minimal effect on survival in pancreatic cancer (PC). HSP90 is a molecular chaperone that specifically enables activity of numerous protein kinases, including EGFR and other signaling proteins. We have reported that simultaneous inhibition of EGFR and HSP90 may be additive in inhibiting cell viability in PC cell lines. Here we report possible molecular mechanisms underlying HSP90 and EGFR inhibition. Methods: MiaPaCa-2 and PANC-1 were treated with EGFR inhibitor, compound 56 (CMP56) (5 − 35 μmol), and HSP90 inhibitor geldanamycin (250 nmol − 1μmol). Growth inhibition was evaluated using the MTT assay, and apoptosis was evaluated by caspase-3 and PARP cleavage. The effect on relevant cell signaling proteins was assessed by immunoblotting with specific antibodies directed against EGFR and effectors such as AKT, STAT-3 and JNK. Results: Growth inhibition was significantly (p &amp;lt; 0.05) higher in both MiaPaCa-2 and PANC1 cells treated with CMP56 and geldanamycin than in cells treated with either agent at various concentrations. The molecular effects are shown in table 1. There was a decrease in phosphorylation of EGFR in bothe cell lines after treatment with CMP56. Concomitant inhibition of EGFR and HSP90 was associated with decreased phosphorylation of ERK, JNK and AKT and with an increase in caspase-3, PARP cleavage in MiaPaCa-2 cells, but not in PANC-1 cells. Conclusions: These results suggest that HSP90 inhibition in MiaPaCa-2 cells induces down regulation of EGFR, STAT-3 and AKT, but not in PANC-1 cells. Higher concentrations of geldanamycin may be required in PANC-1cells. Combined inhibition of EGFR and HSP90 induced apoptosis additively. We are studying further to understand the other potential molecular pathways involved in this strategy.Table.Molecular effects of EGFR and HSP90 inhibition in PC Cell lines ↘ - Decrease, - No change, GEL - Geldanamycin (500 nmol), CMP-56 - Compound 56 (10 μmol)Protein of interest MiaPaCa-2 PANC-1 GELCMP56GEL + CMP56 GELCMP56GEL + CMP56EGFR↘-↘↘ --↘AKT↘-↘↘ --↘STAT-3↘-↘↘ --↘ 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 1657.
Sensitisation to Hodgkin's disease spleen tissue in patients with malignant lymphoma: follow-up study.
Authors: B W Hancock, L Bruce, J Richmond
Journal: BMJ (1976)

The leucocyte migration responses of patients with malignant lymphoma to an unidentified factor in Hodgkin's spleen tissue were serially studied and related to clinical progress. Initial sensitisation responses did not correlate with presenting histological or clinical status or with subsequent clinical progress. Enhancement of responses after treatment, however, was associated with good clinical progress. In patients who relapsed, sensitisation to spleen factor diminished, whereas responses were preserved at one year in those in maintained remission. Sensitisation to the splenic factor may be a useful index of response to treatment in patients with malignant lymphoma; diminishing sensitisation may indicate relapse.
Delayed Trial of HIV Immune Globulin to Protect Infants of Infected Mothers Is Likely to Resume
Authors: Paul Cotton
Journal: JAMA (1993)

ABBOTT LABORATORIES has dropped its demands for immunity from liability and will no longer block a trial of a product that may prevent transmission of human immunodeficiency virus (HIV) from infected mothers to their babies (<i>JAMA</i>. 1992;268:1987-1992). The North Chicago, Ill, company insists a threatened breach of contract suit had nothing to do with its decision. Unfortunately, it may still be a full year from when a National Institutes of Health (NIH) sponsored multicenter trial was supposed to start (last July) to when it actually does. <h3>All Rights Sold</h3> Abbott sold all rights to its HIV Immune Globulin (HIVIG) to North American Biologicals Inc, of Miami, Fla, "including raw materials, some manufacturing equipment, the know-how, everything," as of November 4, says Abbott spokeswoman Traci Lance. North American Biologicals' chief executive officer, David Gury, says the agreement was actually made in September, "pending Abbott's dealing with their liability concerns. Finally, the