tbuckley/cabot-search huggingface dataset:
Tampons and Toxic Shock Syndrome-Reply
Authors: Arthur L. Reingold
Journal: JAMA (1983)

In Reply.—  We would like to thank the TSTSSS participants for their comments. However, the assertion that we have misinterpreted either our results or those of the TSTSSS is unwarranted. Both studies demonstrated clearly that, after taking absorbency into account, use of Rely brand tampons was associated with a significantly increased risk of TSS developing. We do not agree that it is inappropriate to analyze the data by tampon brand, particularly since one of the goals of our study was to determine whether or not a single brand was, irrespective of style, associated with an increased risk of TSS.  The assessment of absorbency as a risk factor independent of chemical composition for users of other tampon brands remains an open question, which neither the CDC study nor the TSTSSS can answer adequately because of the small number of cases occurring in persons not using Rely (the TSTSSS contained only 28
Effectiveness of a Nurse-Based Outreach Program for Identifying and Treating Psychiatric Illness in the Elderly
Authors: Peter V. Rabins, Betty S. Black, Robert Roca, Pearl German, Marsden McGuire, Beatrice Robbins, Rebecca Rye, Larry Brant
Journal: JAMA (2000)

ContextElderly persons with psychiatric disorders are less likely than younger adults to be diagnosed as having a mental disorder and receive needed mental health treatment. Lack of access to care is 1 possible cause of this disparity.ObjectiveTo determine whether a nurse-based mobile outreach program to seriously mentally ill elderly persons is more effective than usual care in diminishing levels of depression, psychiatric symptoms, and undesirable moves (eg, nursing home placement, eviction, board and care placement).DesignProspective randomized trial conducted between March 1993 and April 1996 to assess the effectiveness of the Psychogeriatric Assessment and Treatment in City Housing (PATCH) program.SettingSix urban public housing sites for elderly persons in Baltimore, Md.ParticipantsA total of 945 (83%) of 1195 residents in the 6 sites underwent screening for psychiatric illness. Among those screened, 342 screened positive and 603 screened negative. All screen-positive subjects aged 60 years and older (n=310) and a 10% random sample of screen-negative subjects aged 60 years and older (n=61) were selected for a structured psychiatric interview. Eleven subjects moved or died; 245 (82%) of those who screened positive and 53 (88%) of those who screened negative were evaluated to determine who had a psychiatric disorder. Data were weighted to estimate the prevalence of psychiatric disorders at the 6 sites.InterventionAmong the 6 sites, residents in 3 buildings were randomized to receive the PATCH model intervention, which included educating building staff to be case finders, performing assessment in residents' apartments, and providing care when indicated; and residents in the remaining 3 buildings were randomized to receive usual care (comparison group).Main Outcome MeasuresNumber of undesirable moves and scores on the Montgomery-Asberg Depression Rating Scale (MADRS), a measure of depressive symptoms, and the Brief Psychiatric Rating Scale (BPRS), a measure of psychiatric symptoms and behavioral disorder, in intervention vs comparison sites.ResultsBased on weighted data, at 26 months of follow-up, psychiatric cases at the intervention sites had significantly lower (F1=31.18; P&lt;.001) MADRS scores (9.1 vs 15.2) and significantly lower (F1=17.35; P&lt;.001) BPRS scores (27.4 vs 33.9) than those at the nontreatment comparison sites. There was no significant difference between the groups in undesirable moves (relative risk, 0.97; 95% confidence interval, 0.44-2.17).ConclusionsThese results indicate that the PATCH intervention was more effective than usual care in reducing psychiatric symptoms in persons with psychiatric disorders and those with elevated levels of psychiatric symptoms.
Clients of alcoholism information centres.
Authors: G Edwards, M K Fisher, A Hawker, C Hensman
Journal: BMJ (1967)

In Britain alcoholism is a condition which causes embarrassment and perplexity.The alcoholic is often ashamed to seek help, and if he does want help he may be uncertain where to find it.The National Council on Alcoholism, a voluntary organization inaugurated in 1963, has sought to meet this problem by fostering the setting up of alcoholism information centres and has encouraged and assisted local community councils on alcoholism, in various parts of Britain, to open centres which break away from the rescue mission and " Skid Row" aura which so often clings to alcoholism.The centres have been set up in better and central areas of towns; furnishing and decor are of good quality and tend to suggest a modern office suite rather than a clinic.The policy has been to employ staff with wide practical experience of helping the alcoholic rather than to look for counsellors with professional training.An important part of the job of a centre is that of making contact with the local community and by means of visits, talks, pamphlets, articles in local newspapers, etc., ensuring that the existence of the centres' services is widely known.The hours of opening vary from centre to centre.The aim is to provide help which is friendly, confidential, and immediate, and the door is open to the alcoholic, his spouse, the employer, or any other concerned person or agency.The work of the centres is seen as that of sorting out immediate problems, and directing toward help, rather than providing treatment or long- term counselling.In 1966 the staff of the Alcohol Impact Project were approached by Colonel Peter Perfect, the executive officer of the National Council on Alcoholism, with the suggestion that the research team should carry out a survey of the work of the three longest-established centres.Method.-A precoded structured questionary was evolved which could be used at an initial interview without interfering with the helping relationship.Staff of the Glasgow, Gloucester, and Liverpool centres then administered this questionary each to a consecutive series of 100 clients.The collection period differed slightly between the three centres, but averaged about four months.Data from the 300 completed schedules were analysed on the University of London's I.B.M. 7090 computer.Of the 300 clients 264 were men and 36 were women.Data on the men are presented in detail, and results on the women are given more briefly.
Hyperresponse to Thyrotropin-Releasing Hormone Accompanying Small Decreases in Serum Thyroid Hormone Concentrations
Authors: Apostolos G. Vagenakis, Basil Rapoport, Fereidoun Azizi, Gary I. Portnay, Lewis E. Braverman, Sidney H. Ingbar
Journal: Journal of Clinical Investigation (1974)

To determine whether pituitary thyrotropin (TSH) responsiveness to thyrotropin-releasing hormone (TRH) is enhanced by small decreases in serum thyroxine (T4) and triiodothyronine (T3), 12 euthyroid volunteers were given 190 mg iodide po daily for 10 days to inhibit T4 and T3 release from the thyroid. Basal serum T4, T3, and TSH concentrations and the serum T4 and TSH responses to 400 mug TRH i.v. were assessed before and at the end of iodide administration. Iodide induced small but highly significant decreases in basal serum T4 (8.0+/-1.6 vs. 6.6+/-1.7 mug/100 ml; mean +/- SD) and T3 (128+/-15 vs. 110+/-22 ng/100 ml) and increases in basal serum TSH (1.3+/-0.9 vs. 2.1+/-1.0 muU/ml). During iodide administration, the TSH response to TRH was significantly increased at each of seven time points up to 120 min. The maximum increment in serum TSH after TRH increased from a control mean of 8.8+/-4.1 to a mean of 13.0+/-2.8 muU/ml during iodide administration. As evidence of the inhibitory effect of iodide on hormonal release, the increment in serum T3 at 120 min after TRH was significantly lessened during iodide administration (61+/-42 vs. 33+/-24 ng/100 ml). These findings demonstrate that small acute decreases in serum T4 and T3 concentrations, resulting in values well within the normal range, are associated both with slight increases in basal TSH concentrations and pronounced increases in the TSH response to TRH. These results demonstrate that a marked sensitivity of TSH secretion and responsiveness to TRH is applicable to decreasing, as well as increasing, concentrations of thyroid hormones.
Differences in coronary mortality can be explained by differences in cholesterol and saturated fat intakes in 40 countries but not in France and Finland. A paradox.
Authors: S M Artaud-Wild, S L Connor, G Sexton, W E Connor
Journal: Circulation (1993)

BACKGROUND For decades, the coronary heart disease (CHD) mortality rate has been four or more times higher in Finland than in France despite comparable intakes of dietary cholesterol and saturated fat. A potential answer to this paradox is provided by this study of 40 countries and the analyses of other nutrients in the diets besides cholesterol and saturated fat. METHODS AND RESULTS CHD death rates for men aged 55 to 64 years were derived from the World Health Organization annual vital statistics. Dietary intakes were gathered from the Food and Agriculture Organization of the United Nations database. Forty countries at various levels of economic development and 40 dietary variables were investigated, including a lipid score that combined the intakes of cholesterol and saturated fat (Cholesterol-Saturated Fat Index [CSI]). The CSI was significantly and positively related to CHD mortality in the 40 countries. The countries with low CSIs had low CHD death rates. Countries with high CSIs had a wide range of CHD death rates. France, Finland, and other Western industrialized countries had similar CSIs. After adjusting for cholesterol and saturated fat, milk and many components of milk (butterfat, milk protein, calcium from milk, and riboflavin) and total calcium remained positively related to CHD mortality for all 40 countries. There were differences in the consumption of these foods and nutrients in France and Finland. Milk and butterfat (fat from milk, cream, cheese, and butter) consumption was higher in Finland than in France. The consumption of plant foods, recently shown to be protective against CHD (vegetables and vegetable oils containing monounsaturated and polyunsaturated fatty acids), was greater in France than in Finland. CONCLUSIONS Over the years, France and Finland, with similar intakes of cholesterol and saturated fat, consistently have had very different CHD mortality rates. This paradox may be explained as follows. Given a high intake of cholesterol and saturated fat, the country in which people also consume more plant foods, including small amounts of liquid vegetable oils, and more vegetables (more antioxidants) had lower rates of CHD mortality. On the other hand, milk and butterfat were associated with increased CHD mortality, possibly through their effects on thrombosis as well as on atherosclerosis.
Patient Exposure From Diagnostic Roentgenograms
Authors: John R. Cameron
Journal: JAMA (1977)

To the Editor.—  Roentgenograms taken in the office of a private practitioner often give an unreasonably large radiation exposure to patients when compared to similar roentgenograms taken in hospitals or facilities specializing in radiology. Many physicians are unaware of the large variation in x-ray exposure that is possible for a given roentgenographic study. We present some data to alert physicians to this problem and to encourage practitioners with x-ray units to have their equipment checked and their radiation exposures measured.  Many physicians assume that the State Radiation Control Inspection (typically done every three years) assures them that their x-ray units are functioning correctly. Unfortunately, these units can still give the patient an unnecessarily large exposure even if they satisfy the state inspector.  In addition to a larger-than-necessary exposure, many roentgenograms are taken with an unnecessarily large x-ray beam. A convenient unit used to measure the radiation to a patient is
Elucidating the pathogenesis of schizophrenia
Authors: A. Sawa
Journal: BMJ (2003)

DISC-1 gene may predispose to neurodevelopmental changes underlying schizophrenia 

Genetic predisposition to schizophrenia is evident from family, twin, and adoption studies.1–3 But whereas genetic factors contribute to the fundamental mechanisms or vulnerability to schizophrenia, additional influences including environmental factors are clearly involved in the full manifestation of symptoms of schizophrenia.4 Thus currently schizophrenia is best conceptualised as a “multiple hit” illness similar to cancer. This editorial looks at the fundamental mechanisms underlying the disease.

The following evidence implies that neurodevelopmental abnormalities contribute to susceptibility to schizophrenia.1 5 6 7 Firstly, clinical studies show that patients with schizophrenia manifest minor behavioural abnormalities in childhood even before the onset of schizophrenia.

Secondly, recent advanced imaging techniques such as magnetic resonance imaging provide reliable evidence of abnormalities during development of the central nervous system. Such abnormalities include consistent increases in ventricular size at the onset of schizophrenia, with notable alterations in some areas including the prefrontal cerebral cortex and hippocampus.

Thirdly, neuropathological studies …
Good Men in Bad Company—An Explanation which Explains.
Authors: John A. Wyeth
Journal: JAMA (1903)

New York City, Dec. 3, 1903. <h3>To the Editor:</h3> —My attention has been called to an advertising circular of the<i>Medical Brief</i>in which my name appears as a contributor. Will you kindly permit me to state through the columns of your widely-circulated journal that this article on "Fracture of the Radius" was not written for the<i>Medical Brief</i>. Some months ago a woman stenographer called at my office and represented that she was in great financial distress and asked me to dictate to her some short article for which she said she would be able to obtain $20 which was greatly needed at that time to prevent her from being turned out of her home by her landlord. She promised that the article should be offered to the<i>New York Medical Journal</i>or to the<i>Medical Record</i>, and if not accepted by them she would return it to me.
Reverse Wenckebach Block and Complete Atrioventricular Dissociation due to Potassium and Digitalis
Authors: CHARLES FISCH, ANTHONY S. RIDOLFO
Journal: Circulation (1958)

The relation of digitalis to potassium was studied by administering potassium intravenously before and after digitalization. The disturbances of conduction due to potassium and those occurring after digitalis were observed and are here discussed.
Examining the Role of ErbB2 in a Mouse Model of Type I Insulin like Growth Factor Receptor-Induced Mammary Tumourigenesis.
Authors: C. Campbell, R. Moorehead
Journal: Cancer Research (2009)

Abstract Background: The type I insulin-like growth factor receptor (IGF-IR) and epidermal growth factor receptor 2 (ErbB2) are both receptor tyrosine kinases extensively implicated in human breast cancer. The IGF-IR is involved in cell proliferation and survival and is overexpressed in a large proportion of breast cancers. Similarly, ErbB2 (Her2) has been identified as a key contributor to a relatively large subset of aggressive breast cancer and is currently the basis for clinical therapeutics. To examine how the IGF-IR contributes to breast cancer and to study this receptor as a potential therapeutic target, we have previously created an inducible transgenic mouse model of IGF-IR overexpression in the mammary gland. In this model, tumours rapidly form upon induction of the transgene, with metastasis to the lung occurring in approximately 25% of animals. In addition, the RM11A cell line was isolated from tumour tissue and was shown to maintain inducible IGF-IR overexpression. The purpose of this study was to examine the interaction between IGF-IR and ErbB2 using our model.Materials and Methods: Protein expression was studied through Western blotting. ErbB2 expression was manipulated through the use of siRNA (for downregulation) and through the use of a plasmid encoding ErbB2 (for upregulation). Stable overexpression of ErbB2 was achieved through transfection of this plasmid with subsequent selection of stable integrants. Tumourigenicity was assessed by direct injection of these cells into the mammary gland. MTT assays and Ki67 staining (through immunofluoresence or immunohistochemistry) were used to examine cell survival and proliferation.Reults: In RM11A cells, survival was impaired upon downregulation and inhibition of ErbB2 in vitro. In our transgenic mouse model, ErbB2 was upregulated in primary tumours overexpressing the IGF-IR and was downregulated upon removal of IGF-IR induction and also in IGF-IR-independent recurrent tumours. In vivo, overexpression of ErbB2 conferred a more aggressive phenotype to RM11A cells. However, ErbB2 overexpression did not enhance proliferation in these cells in vitro or in vivo. The mechanism through which ErbB2 enhances tumourigenesis in or model is currently being investigated.Discussion: ErbB2 appears to have a role in IGF-IR-induced mammary tumourigenesis and can enhance tumour growth. Also, the IGF-IR appears to function in the regulation of ErbB2 in our model. Understanding how these two potent oncogenes interact to promote mammary tumourigenesis will ultimately help in designing treatment regimes specifically targeting the IGF-IR and/or ErbB2. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3156.
A 30-Year-Old Woman With Chronic Hypertension Trying to Conceive
Authors: Raymond O. Powrie
Journal: JAMA (2007)

Mrs F is a 30-year-old woman with a history of chronic hypertension and possible preeclampsia during her first pregnancy. She is currently trying to conceive and wants to know how her hypertension will affect a future pregnancy and how it should best be managed, both now and during a pregnancy. The management of chronic hypertension before, during, and after a pregnancy is discussed with an emphasis on the goals of treatment and safety of medications during pregnancy and with breastfeeding. Preeclampsia is the most common complication of chronic hypertension in pregnancy and is a particular worry for Mrs F because she may have had it with her prior pregnancy. The current understanding of the pathogenesis of this enigmatic illness is therefore also reviewed, along with its implications for long-term maternal health.
Psychiatric morbidity in patients with alcoholic liver disease.
Authors: I Ewusi-Mensah, J B Saunders, A D Wodak, R M Murray, R Williams
Journal: BMJ (1983)

Seventy one patients with alcoholic liver disease and an equal number with non-alcoholic liver disease were interviewed using the schedule for affective disorders and schizophrenia. Forty seven (66%) of the group with alcoholic liver disease had or had had psychiatric illnesses compared with 23 (32%) of the control group (p less than 0.001). Affective disorder, particularly major depression, neurotic disorders, and antisocial personality, were all more common among the patients with alcoholic liver disease than the controls. No patient had schizophrenia or other forms of psychosis. Among the patients with alcoholic liver disease 11 men (24%) and 14 women (54%) had an affective or a neurotic disorder that had antedated their heavy drinking, and 30 (77%) of those who had had such a problem at any time had symptoms at the time of interview. Abstinence from alcohol is essential for patients with severe alcoholic liver disease. In view of the high prevalence of psychiatric disorders in these patients psychiatric assessment is important to increase the patients9 likelihood of complying with such advice.
827-6 Underuse of glycoprotein IIb/IIIa receptor blockers in diabetics undergoing percutaneous coronary intervention for acute coronary syndromes in current clinical practice in Europe: Results of the International Shakespeare registry
Authors: Anselm K Gitt, Uwe Zeymer, Martin G Gottwik, Jean-Pierre Bassand, Keith Dawkins, David Hasdal, Ricardo Seabra-Gomes, Andreij Cieslinski, Paolo Floretti, Jochen Senges
Journal: Journal of the American College of Cardiology (2004)
Evaluation of Patients with Palpitations
Authors: Peter Zimetbaum, Mark E. Josephson
Journal: New England Journal of Medicine (1998)

Palpitations are one of the most common problems of outpatients who present to internists and cardiologists. Although usually benign, they are occasionally a manifestation of potentially life-threatening conditions. The physician's fear of missing a treatable condition may lead to the inappropriate use of expensive tests with little diagnostic and therapeutic value. The following discussion will describe the common presentations of palpitations and offer a guide to rational diagnostic testing.Common Presentations: Symptoms and Associated CircumstancesSymptomsPalpitations are described in a myriad of ways, but some specific symptoms are common and useful for narrowing the differential diagnosis.Flip-Flopping in the . . .
Human pulmonary responses to experimental inhalation of high concentration fine and ultrafine magnesium oxide particles.
Authors: W G Kuschner, H Wong, A D'Alessandro, P Quinlan, P D Blanc
Journal: Environmental Health Perspectives (1997)

Exposure to air polluted with particles less than 2.5 micron in size is associated epidemiologically with adverse cardiopulmonary health consequences in humans. The goal of this study was to characterize human pulmonary responses to controlled experimental high-dose exposure to fine and ultrafine magnesium oxide particles. We quantified bronchoalveolar lavage (BAL) cell and cytokine concentrations, pulmonary function, and peripheral blood neutrophil concentrations in six healthy volunteers 18 to 20 hr after inhalation of fine and ultrafine magnesium oxide particles produced from a furnace system model. We compared postexposure studies with control studies from the same six subjects. Mean +/- standard deviation (SD) cumulative magnesium dose was 4,138 +/- 2,163 min x mg/m3. By weight, 28% of fume particles were ultrafine (<0.1 micron in diameter) and over 98% of fume particles were fine (<2.5 micron in diameter). There were no significant differences in BAL inflammatory cell concentrations, BAL interleukin (IL)-1, IL-6, IL-8, tumor necrosis factor, pulmonary function, or peripheral blood neutrophil concentrations postexposure compared with control. Our findings suggest that high-dose fine and ultrafine magnesium oxide particle exposure does not produce a measurable pulmonary inflammatory response. These findings are in marked contrast with the well-described pulmonary inflammatory response following zinc oxide particle inhalation. We conclude that fine and ultrafine particle inhalation does not result in toxicity in a generic manner independent of particle composition. Our findings support the concept that particle chemical composition, in addition to particle size, is an important determinant of respiratory effects.
Cachectin/tumor necrosis factor stimulates collagenase and prostaglandin E2 production by human synovial cells and dermal fibroblasts.
Authors: J M Dayer, B Beutler, A Cerami
Journal: The Journal of Experimental Medicine (1985)

Cachectin/TNF (tumor necrosis factor), an endotoxin-induced murine macrophage hormone implicated in the pathogenesis of cachexia and shock, has been found capable of stimulating collagenase and prostaglandin E2 (PGE2) production by isolated human synovial cells and dermal fibroblasts. This bioactivity associated with cachectin is comparable to that observed with the monokine interleukin 1 (IL-1), previously suggested as the major mediator of proteolysis. The ability of cachectin/TNF to stimulate collagenase and PGE2 production suggests that it may play a role in tissue destruction and remodelling, as these processes occur in inflammatory diseases.