tbuckley/cabot-search huggingface dataset:
Private nursing homes: contribution to long stay care of the elderly in the Brighton Health District.
Authors: J Bennett
Journal: BMJ (1986)

Two surveys of private nursing homes, designated geriatric wards, and a sample of social service part III homes were carried out in the Brighton Health District using questionnaires supplemented (in the second survey) by some interviews. The dependency of old people in the private nursing homes was more like that of long stay hospital patients rather than that of residents in social services homes. In the private nursing homes, however, a smaller proportion of patients were in the medium to heavy nursing category (178 (31%) compared with 158 (63%) in the hospital long stay wards) and a larger proportion in the heavy nursing category (170 (30%) compared with 44 (17%) in the long stay wards). Of the patients in private nursing homes, 401 (82%) were local residents, 488 (86%) were long stay, and 459 (88%) were women; their mean age was 88 years. Two thirds of the patients were over 80. There were no significant differences between the private nursing homes and the wards in nursing workloads or staffing, except for a slightly higher provision of state registered nurses in the private sector. In the private nursing homes 348 (63%) of the patients had fees paid by private funds, 26 (5%) were in contract beds paid for by the National Health Service, and 176 (32%) were subsidized by the Department of Health and Social Security. Private nursing homes make a substantial contribution to the care of the elderly in the Brighton Health District, and the health authority should develop a more active partnership with this sector.
Questioning the influence of moral judgment
Authors: Steve Guglielmo
Journal: Behavioral and Brain Sciences (2010)

Abstract Moral judgment – even the type discussed by Knobe – necessarily relies on substantial information about an agent's mental states, especially regarding beliefs and attitudes. Moreover, the effects described by Knobe can be attributed to norm violations in general, rather than moral concerns in particular. Consequently, Knobe's account overstates the influence of moral judgment on assessments of mental states and causality.
Acidic and basic fibroblast growth factors in adult rat heart myocytes. Localization, regulation in culture, and effects on DNA synthesis.
Authors: E Speir, V Tanner, A M Gonzalez, J Farris, A Baird, W Casscells
Journal: Circulation Research (1992)

Basic fibroblast growth factor (bFGF) and acidic fibroblast growth factor (aFGF) are involved in the induction of embryonic mesoderm, angiogenesis, neuronal differentiation, and proliferation and survival of many cell types. In cardiac myocytes their roles are not well understood. Effects of fibroblast growth factors on reexpression of fetal actin genes have been reported. In freshly isolated adult rat cardiac myocytes, bFGF mRNA was not detectable by in situ hybridization, although the cells contained significant amounts of bFGF and aFGF as quantified by radioimmunoassays, mitogen assays with immunoneutralization, and Western blotting. After culturing, bFGF mRNA was detected (aFGF mRNA was not studied), and the cells contained 2.5-fold more bFGF and 60% more aFGF than freshly isolated cells. The FGFs were not found in conditioned medium. They were localized, especially in cultured cells, to the nucleus. Cultured myocytes bound fourfold more 125I-FGF than freshly isolated cells and expressed the fibroblast growth factor R-1 (flg) gene. The addition of bFGF or aFGF in serum-free medium to pure populations of myocytes (after 10 days in culture, at which time they are spread, beating, and multinucleated) led to increased thymidine incorporation. Expression of fibroblast growth factors and fibroblast growth factor receptors by adult cardiac myocytes that survive the shock and "dedifferentiation" of culturing may contribute to DNA synthesis and, by analogy, to other cell types, to regulation of ribosomal and actin genes, and to cell survival. These possibilities and their in vivo relevance will require further study.
“What Is Food to One...”
Authors: Dean D. Metcalfe, Michael A. Kaliner
Journal: New England Journal of Medicine (1984)

“What is food to one, is to others bitter poison.”1Few would argue that a subject who reproducibly experiences anaphylaxis upon smelling fish being cooked is highly allergic to some component emanating from the fish. Such persons are readily identified and thus can receive proper instructions on how to prevent and treat subsequent reactions. However, the identification of patients at risk for repeated immediate hypersensitive (allergic) responses to foods is rarely this simple. In fact, 43 per cent of a random population of 3300 adult Americans claim to have some type of “adverse reaction” to foods.2 Of course, it is . . .
Eosinophilic Myositis
Authors: Bharat L. Agrawal
Journal: JAMA (1981)

THIS report describes an unusual case of pseudotumor of muscle that was caused by localized eosinophilic myositis associated with bone marrow and peripheral blood eosinophilia. We briefly discuss the relationship of this case to other reported cases of focal myositis, to the socalled hypereosinophilic syndrome, and to the more common localized myositis in animals. <h3>Report of a Case</h3> A 14-year-old boy was seen in April 1979 because of a painless swelling over the middle part of the neck on the left side; this swelling developed during a period of two weeks. Otherwise, the results of physical examination were completely normal. There was no history of muscle weakness, myalgia, fever, weight loss, rash, arthralgia, or recent infection. There was no history of familial muscle disease. He denied eating uncooked or undercooked meat. The following tests yielded either normal or negative results: chest x-ray film, quantitative serum immunoglobulins, immunoelectrophoresis, antinuclear antibodies, serum
Tuberculosis in New York City
Authors: Edward A. Nardell
Journal: JAMA (1996)

Forty-four percent of a cohort of mostly young adults with tuberculosis died within 31/2 years of diagnosis. This high mortality figure comes not from sub-Saharan Africa, nor 19th century America, but from New York City in the late 20th century. Two thirds of another cohort of patients, most infected with the human immunodeficiency virus (HIV), became coinfected with tuberculosis resistant to almost all antibiotics (multidrug-resistant tuberculosis) in the very hospitals where they sought medical care. Over a 43-month period early in the current resurgence, transmission in just 4 hospitals was apparently responsible for most of the multidrug-resistant tuberculosis in New York City, which at the time accounted for approximately 1 in 4 of all multidrug-resistant tuberculosis cases in the United States. These are some of the important findings of 2 retrospective studies published in this issue of The Journal.<sup>1,2</sup> See also pp 1223 and 1229. Although the tuberculosis epidemic
Marburg and Ebola — Arming Ourselves against the Deadly Filoviruses
Authors: C.J. Peters
Journal: New England Journal of Medicine (2005)

As of May 26, 2005, the Angolan Ministry of Health had reported 399 cases of Marburg hemorrhagic fever, 335 of which were fatal. Dr. C.J. Peters explains that our progress in understanding the filoviruses has been slow because of their rare appearance in nature, the danger they pose to those who study them, and a lack of financial support.
Psoralen plus ultraviolet A ± interferon-α treatment resistance in mycosis fungoides: the role of tumour microenvironment, nuclear transcription factor-κB and T-cell receptor pathways
Authors: M.B. Wozniak, L. Tracey, P.L. Ortiz-Romero, S. Montes, M. Alvarez, J. Fraga, J. Fernández Herrera, S. Vidal, J.L. Rodriguez-Peralto, M.Á. Piris, R. Villuendas (deceased)
Journal: British Journal of Dermatology (2008)

Interferon (IFN)-alpha is widely used in the treatment of mycosis fungoides (MF) and when used in combination with photochemotherapy (psoralen plus ultraviolet A, PUVA) both improved response and duration of complete remission have been reported. However, in spite of encouraging results of the initial studies, currently there is no information available on specific prognostic factors enabling prediction of patients' resistance to PUVA +/- IFN-alpha treatment.To identify factors responsible for resistance to PUVA +/- IFN-alpha treatment in MF patients.The gene expression profiling of pretreatment samples from 29 patients diagnosed as IA, IB or IIA stage of MF enrolled in a randomized PUVA vs. PUVA + IFN-alpha clinical trial was analysed using cDNA microarrays. A Cox model (SAM) and gene set enrichment analysis (GSEA) were used for identification of genes and biologically significant pathways related to resistance to treatment.Genes involved in NF-kappaB signalling, T-cell receptor (TCR) signalling, cytokine signalling and proliferation were differentially expressed between responders and nonresponders. Interestingly, expression of markers representative of those pathways was found not only in the tumoral cells, but also in specific subpopulations of macrophages, dendritic cells and other non-neoplastic cell types constituting the tumour microenvironment, likely involved in the promotion of survival and proliferation of cutaneous T-cell lymphoma.Gene expression changes in both the tumour and the tumour microenvironment are an important determinant of treatment outcome in early-stage MF patients. Some proinflammatory factors such as NF-kappaB, inflammatory cytokines and their receptors in addition to TCR-associated molecules could be promising targets for MF treatment.
Screening for Depression in Adult Patients in Primary Care Settings: A Systematic Evidence Review
Authors: Elizabeth A. O'Connor
Journal: Annals of Internal Medicine (2009)

Background: In primary care settings, prevalence estimates of major depressive disorder range from 5% to 13% in all adults, with lower estimates in those older than 55 years (6% to 9%). In 2002, the U.S. Preventive Services Task Force (USPSTF) recommended screening adults for depression in clinical practices that have systems to ensure accurate diagnosis, effective treatment, and follow-up. Purpose: To conduct a targeted, updated systematic review for the U.S. Preventive Services Task Force about the benefits and harms of screening adult patients for depression in a primary care setting, the benefits of depression treatment in older adults, and the harms of depression treatment with antidepressant medications. Data Sources: MEDLINE, the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, PsycINFO (1998 to 2007), expert suggestions, and bibliographies of recent systematic reviews. Study Selection: Fair- to good-quality randomized clinical trials or controlled clinical trials; systematic reviews; meta-analyses; and large observational studies of serious adverse events and early discontinuation due to adverse effects. All studies were published in English. Data Extraction: Two investigators abstracted, critically appraised, and synthesized 33 articles that met inclusion criteria. Data Synthesis: Nine fair- or good-quality trials indicate that primary care depression screening and care management programs with staff assistance, such as case management or mental health specialist involvement, can increase depression response and remission. Benefit was not evident in screening programs without staff assistance in depression care. Seven regulatory reviews or meta-analyses and 3 large cohort studies indicate no increased risk for completed suicide deaths with antidepressant treatment. Risk for suicidal behaviors was increased in young adults (aged 18 to 29 years) who received antidepressants, particularly those who received paroxetine, but was reduced in older adults. Limitation: Examination of harms was limited to serious adverse events, and existing systematic reviews were primarily used. Additional studies published from 2007 to 2008 extend this review. Conclusion: Depression screening programs without substantial staff-assisted depression care supports are unlikely to improve depression outcomes. Close monitoring of all adult patients who initiate antidepressant treatment, particularly those younger than 30 years, is important both for safety and to ensure optimal treatment.
Association between Plasma Prolactin Concentrations and Risk of Breast Cancer among Predominately Premenopausal Women
Authors: Shelley S. Tworoger, Patrick Sluss, Susan E. Hankinson
Journal: Cancer Research (2006)

Abstract Recent evidence suggests that prolactin may be positively associated with postmenopausal breast cancer risk; however, little data are available in younger women. Therefore, we conducted a prospective, nested case-control study to examine the relationship between plasma prolactin concentrations and breast cancer risk in predominately premenopausal women from the Nurses' Health Study II. Blood samples were collected from 1996 to 1999. The analysis includes 316 cases of breast cancer diagnosed after blood donation and before June 1, 2003, who had two controls matched on age, fasting status, time of day and month of blood collection, race/ethnicity, and timing of blood draw within the menstrual cycle. Sixty-three percent of participants provided a timed follicular and luteal menstrual phase blood sample; other women provided a single untimed sample. When including all women, we observed a positive association between prolactin and breast cancer risk [relative risk (RR), top quartile versus bottom quartile, 1.5; 95% confidence interval (95% CI), 1.0-2.3; Ptrend = 0.03] that was slightly stronger among estrogen receptor–positive/progesterone receptor–positive tumors (comparable RR, 1.9; 95% CI, 1.1-3.3; Ptrend = 0.04). Associations were similar among premenopausal women only. However, we did not find an association between prolactin and breast cancer risk among the subset of women who only provided timed samples (comparable RR, average of timed samples, 1.3; 95% CI, 0.8-2.3; Ptrend = 0.40). The association seemed stronger among women ≥45 years old and for cases diagnosed within ∼4 years of blood collection. Our data suggest a modest positive association between prolactin and breast cancer risk among predominately premenopausal women; however, further follow-up is needed to increase power for subgroup analyses. (Cancer Res 2006; 66(4): 2476-82)
Dependence of Gorlin formula and continuity equation valve areas on transvalvular volume flow rate in valvular aortic stenosis.
Authors: I G Burwash, D D Thomas, M Sadahiro, A S Pearlman, E D Verrier, R Thomas, C D Kraft, C M Otto
Journal: Circulation (1994)

BACKGROUND Valve areas derived by the Gorlin formula have been observed to vary with transvalvular volume flow rate. Continuity equation valve areas calculated from Doppler-echo data have become a widely used alternate index of stenosis severity, but it is unclear whether continuity equation valve areas also vary with volume flow rate. This study was designed to investigate the effects of changing transvalvular volume flow rate on aortic valve areas calculated using both the Gorlin formula and the continuity equation in a model of chronic valvular aortic stenosis. METHODS AND RESULTS Using a canine model of chronic valvular aortic stenosis in which anatomy and hemodynamics are similar to those of degenerative aortic stenosis, each subject (n = 8) underwent three studies at 2-week intervals. In each study, transvalvular volume flow rates were altered with saline or dobutamine infusion (mean, 10.3 +/- 5.1 flow rates per study). Simultaneous measurements were made of hemodynamics using micromanometer-tipped catheters, of ascending aortic instantaneous volume flow rate using a transit-time flowmeter, and of left ventricular outflow and aortic jet velocity curves using Doppler echocardiography. Valve areas were calculated from the invasive data by the Gorlin equation and from the Doppler-echo data by the continuity equation. In the 24 studies, mean transit-time transvalvular volume flow rate ranged from 80 +/- 33 to 153 +/- 49 mL/min (P &lt; .0001). Comparing minimum to maximum mean volume flow rates, the Gorlin valve area changed from 0.54 +/- 0.22 cm2 to 0.68 +/- 0.21 cm2 (P &lt; .0001), and the continuity equation valve area changed from 0.57 +/- 0.18 cm2 to 0.70 +/- 0.20 cm2 (P &lt; .0001). A strong linear relation was observed between Gorlin valve area and mean transit-time volume flow rate for each study (median, r = .88), but the slope of this relation varied between studies. The Doppler-echo continuity equation valve area had a weaker linear relation with transit-time volume flow rate for each study (median, r = .51). CONCLUSIONS In this model of chronic valvular aortic stenosis, both Gorlin and continuity equation valve areas were flow-dependent indices of stenosis severity and demonstrated linear relations with transvalvular volume flow rate. The changes in calculated valve area that occur with changes in transvalvular volume flow should be considered when measures of valve area are used to assess the hemodynamic severity of valvular aortic stenosis.
CHOLESTEATOMA OF THE THIRD VENTRICLE, WITH BILATERAL ARGYLL ROBERTSON PUPILS
Authors: F. R. Ford
Journal: JAMA (1924)

As early as 1887, Moeli<sup>1</sup>reported a case of bilateral Argyll Robertson pupils associated with a tumor of the third ventricle. Since then several similar cases have been described.<sup>2</sup>The older cases, which occurred before the introduction of the Wassermann test, are of course not quite convincing; but in recent years the Argyll Robertson sign has been found repeatedly in various abnormal conditions of the nervous system in which it has seemed possible to exclude syphilitic infection, and it is now evident that it is not a specific sign of syphilis, but may result from lesions of various types. These lesions have been found most frequently in the anterior part of the midbrain and the third ventricle. The Argyll Robertson pupil has been described in brain tumors,<sup>3</sup>multiple sclerosis,<sup>4</sup>epidemic encephalitis,<sup>5</sup>syringomyelia,<sup>6</sup>chronic alcoholism,<sup>7</sup>hypertrophic interstitial neuritis,<sup>8</sup>vascular lesions<sup>9</sup>and in
Fluorescein Staining of the Cornea
Authors: Malvern C. Holland
Journal: JAMA (1964)

SINCE THE INTRODUCTION by Kimura in 1951<sup>1</sup>of fluorescein sodium-impregnated filter paper for use in staining the eye, few ophthalmologists cling to the use of liquid fluorescein. The simple, sterile, individually wrapped filter paper, now commercially available, constitutes one of the safest methods of applying this substance to either injured or normal eyes. Fluorescein liquid is quickly contaminated with<i>Pseudomonas aeruginosa</i>, one of the most serious causes of corneal ulcers. Few ophthalmologists have utilized this test to its fullest and few have taken advantage of the simplicity afforded by this technique. Most physicians still irrigate the eye with sodium chloride solution or other materials after application of the dry fluorescein strip which is mechanically irritating to the eye. Particularly in contact lens work and applanation tonometry, this is an unnecessary and time-consuming step. To maximally utilize the convenience of fluorescein strips, the following technique is recommended. While the filter
Birth size and colorectal cancer risk: a prospective population based study
Authors: T I L Nilsen
Journal: Gut (2005)

To study whether birth size influences colorectal cancer risk in adulthood.A cohort of Norwegian men and women identified from midwives' birth records with long term cancer follow up through the Norwegian Cancer Registry.St Olav's University Hospital, Trondheim, Norway.16,016 women and 19 681 men born between 1920 and 1958 and alive in 1960.Incidence rate ratios (RRs) for colorectal cancer with 95% confidence intervals (CIs) and two sided p values for trend across categories of birth dimensions.Men whose birth length was less than 51 cm had a nearly twofold higher risk of colorectal cancer (RR 1.9 (95% CI 1.0-3.7)) compared with men who were 53 cm or more, after adjustment for birth cohort, maternal age at childbearing, length of gestation, gestational hypertension or pre-eclampsia, birth order, maternal height, and indicators of maternal socioeconomic status. The association displayed a linear trend across categories of birth length (p(trend) = 0.03). Among men, similar associations were found for birth weight and head circumference, but for women there was no association between any of these birth dimensions and risk of colorectal cancer.The results suggest that among men, but not women, being relatively short at birth is associated with increased risk of colorectal cancer in adulthood, indicating that intrauterine growth could be important for colorectal carcinogenesis.
Endobronchial metastatic disease.
Authors: M P Shepherd
Journal: Thorax (1982)

Between 1969 and 1979, 90 patients of the Thoracic Surgical Unit at Harefield Hospital were found to have pulmonary metastatic disease. In 25 instances (28%) the diagnosis was established by bronchial biopsy. Twenty-four patients had endobronchial metastatic carcinoma and in one metastatic sarcoma was diagnosed. All but one had a past history of malignancy, the interval between treatment of the primary and appearance of the endobronchial metastasis ranging from a few months to 17 years. Primary sites in these patients included large intestine, breast, cervix, uterus, and bladder. There were four instances of metastatic malignant melanoma. The pulmonary secondaries were resectable in 10 patients and in one a second resection was done for a further metastasis three years after the first. Three patients are still alive two, four, and 10 years later.
Degenerative musculoskeletal disease
Authors: O Ethgen
Journal: Annals of the Rheumatic Diseases (2003)

Is the demographic transition impacting on the perception of degenerative musculoskeletal disease?

The world is witnessing an unprecedented, irremediable, and longlasting aging process.1,2 Table 1 provides population decennial growth rates by 10 year age groups and shows marked differences across age groups. Figures 1 and 2 display the projected population distribution by 10 year age group. The graphs evidence quite well the “baby boomers” wave that is going to extend continuously the numbers of people over the age of 60 years.

View this table:

 Table 1  
Population decennial growth rates by age groups from 2000 to 2050 (%)





 Figure 1  
Population distribution by 10 year age group in Western Europe from 2000 to 2050.2





 Figure 2  
Population distribution by 10 year age group in Northern America from 2000 to 2050.2



Western Europe should see the numbers of its inhabitants aged below 50 decrease dramatically, while those above 60 should sharply increase. The number of Europeans older than 60 is projected to rise from 84 570 thousands (21.8% of Europeans) at present to 107 592 thousands (32.8%) in 2050. The increase is even more pronounced for the old-old (80+) with the highest growth rate (124.4%). Those aged 80+ would rise impressively from 14 610 thousands (3.8%) in 2000 up to 38 394 thousands (10.7%) in 2045 and then stabilise. In North America, all age groups should increase in number until 2050, but growth rates are notably higher for those aged 60–69 (112.7%), 70–79 (104.3%) and, particularly, 80+ (234.3%). Whereas 50 876 thousands (16.2% of northern Americans) people were aged 60 in 2000, the number would be 118 974 thousands (27.2%) in 2050. Even faster than …