tbuckley/cabot-search huggingface dataset:
Food for independence
Authors: M. McKee, T. Lang
Journal: BMJ (1997)

The British government's announcement that it will establish a new Food Safety Council and appoint a Food Safety Adviser1 has received a cautious welcome. However, the decision that both offices will be accountable to ministers while, at the same time, being independent, has rekindled the argument about how independent such bodies can be.2

Complete independence from government is almost impossible. Bodies must be appointed and funded by someone with authority to spend public money. Most democracies balance accountability and independence by taking advantage of the separation of the powers of the executive (ministers), the legislature (parliament), and the judiciary. Bodies tackling potentially controversial issues, which must provide authoritative advice and retain public confidence, can be accountable to the legislature, giving them freedom to challenge, where necessary, the executive. A second model is based on decentralisation, with local and national government as more equal partners.

The United States Food and Drug Administration, accountable to Congress, is often considered …
Prone Sleeping Position and Sudden Infant Death
Authors: Christian F. Poets, David P. Southall
Journal: New England Journal of Medicine (1993)

Despite the data from at least 13 retrospective studies and 1 prospective study, all of which found that the prone sleeping position increases the risk of the sudden infant death syndrome (SIDS),1 and despite an official recommendation from the American Academy of Pediatrics in 1992 to place healthy infants on their sides or backs when readying them for sleep,2 there is still considerable reluctance among pediatricians in Europe and the United States to change their advice on how parents should position their babies for sleep. This reluctance is probably due to the fact that there are no physiologic data to . . .
Cochrane review questions evidence for statins for primary prevention in low risk groups
Authors: S. Mayor
Journal: BMJ (2011)

A Cochrane review published on 18 January questions the evidence for prescribing statins for primary prevention in people at low cardiovascular risk, after finding selective reporting of outcomes, failure to report adverse events, and inclusion of people with cardiovascular disease in published studies.

The reviewers analysed randomised controlled trials of statins in adults with no requirements for participants to have particular LDL or HDL cholesterol concentrations and where no more than 10% of participants had a history of cardiovascular disease ( Cochrane Database of Systematic Reviews 2011;(1):CD004816, doi:10.1002/14651858.CD004816.pub4). All studies included also had to have a minimum duration of one year and follow-up of six months.

“We wanted to examine benefits and harms from statins in primary prevention,” explained Shah Ebrahim, professor of public health …
Phosphodiesterase Type 5 as a Target for the Treatment of Hypoxia-Induced Pulmonary Hypertension
Authors: A. Sebkhi, Julian W. Strange, Steven C. Phillips, John Wharton, Martin R. Wilkins
Journal: Circulation (2003)

Phosphodiesterase type 5 (PDE5) is a novel therapeutic target for the treatment of pulmonary hypertension. This study examined the distribution of PDE5 in normal and hypoxic lung and the effect of chronic PDE5 inhibition with sildenafil, initiated before and during exposure to hypoxia, on pulmonary artery pressure (PAP) and structure.Sprague-Dawley rats were exposed to hypoxia (10% O2) for up to 42 days. PAP, measured continuously by telemetry, increased gradually by 20 to 40 mm Hg, reaching a plateau between 10 and 14 days, and declined to normal levels on return to normoxia. PDE5 immunoreactivity was localized to smooth muscle cells in the medial layer of pulmonary arteries and veins in the normal lung and in distal muscularized arteries (<25 microm diameter) after hypoxia-induced pulmonary hypertension. Sildenafil (25 or 75 mg x kg(-1) x d(-1)) given before hypoxia produced marked dose-dependent inhibition in the rise of PAP (60% to 90% reduction; P<0.0001) and vascular muscularization (28.4+/-5.0% reduction; P<0.001). When begun after 14 days of hypoxia, sildenafil significantly reduced PAP (30% reduction; P<0.0001) and partially reversed pulmonary artery muscularization (39.9+/-4.9% reduction; P<0.001).PDE5 is found throughout the muscularized pulmonary vascular tree, including in newly muscularized distal pulmonary arteries exposed to hypoxia. PDE5 inhibition attenuates the rise in PAP and vascular remodeling when given before chronic exposure to hypoxia and when administered as a treatment during ongoing hypoxia-induced pulmonary hypertension.
Urinary biomarkers of exposure to jet fuel (JP-8).
Authors: Berrin Serdar, Peter P Egeghy, Suramya Waidyanatha, Roger Gibson, Stephen M Rappaport
Journal: Environmental Health Perspectives (2003)

Benzene, naphthalene, and 1- and 2-naphthol were measured in urine samples obtained from 322 U.S. Air Force personnel categorized a priori as likely to have low, moderate, or high exposure to jet fuel [jet propulsion fuel-8 (JP-8)]. In postexposure samples, levels of these analytes in the high-exposure group were 3- to 29-fold greater than in the low-exposure group and 2- to 12-fold greater than in the moderate-exposure group. Heavy exposure to JP-8 contributed roughly the same amount of benzene and more than three times the amount of naphthalene compared with cigarette smoking. Strong correlations were observed among postexposure levels of naphthalene-based biomarkers in urine and naphthalene in air and breath. We conclude that urinary naphthalene and the naphthols can serve as biomarkers of exposure to jet fuel. Of these, the naphthols are probably more useful because of their greater abundance and slower elimination kinetics.
Pars Plana Vitrectomy versus Combined Pars Plana Vitrectomy–Scleral Buckle for Primary Repair of Pseudophakic Retinal Detachment
Authors: Eric D. Weichel, Adam Martidis, Mitchell S. Fineman, J. Arch McNamara, Carl H. Park, James F. Vander, Allen C. Ho, Gary C. Brown
Journal: Ophthalmology (2006)
Catheter Technique for Recording His Bundle Activity in Man
Authors: BENJAMIN J. SCHERLAG, SUN H. LAU, RICHARD H. HELFANT, WALTER D. BERKOWITZ, EMANUEL STEIN, ANTHONY N. DAMATO
Journal: Circulation (1969)

A technique for the routine recording of His bundle (H) activity in man using a bipolar or multipolar catheter is described. The recording catheter is inserted percutaneously, via the Seldinger method, into the right femoral vein and advanced fluoroscopically into the right atrium. Placement of the pre-formed curve at the catheter tip across the tricuspid valve in nine patients resulted in stable recordings of His bundle activity in successive cardiac cycles. Right atrial pacing resulted in progressive lengthening of the P-H interval with increasing frequency but the H to S-wave interval remained constant at all rates. Similar lengthening of the P-H interval was produced during atrial pacing when pressure was applied to the carotid sinus. The use of this recording technique in man will facilitate diagnostic interpretation of the electrocardiogram and can be used in various investigations of atrioventricular and intraventricular conduction in man.
Transverse conduction capabilities of the crista terminalis in patients with atrial flutter and atrial fibrillation
Authors: Burghard Schumacher, Werner Jung, Harald Schmidt, Christoph Fischenbeck, Thorsten Lewalter, Andreas Hagendorff, Heyder Omran, Christian Wolpert, Berndt Lüderitz
Journal: Journal of the American College of Cardiology (1999)
Baby P doctor can reapply to be removed from the medical register
Authors: C. Dyer
Journal: BMJ (2010)

The paediatrician accused of failing to spot Baby P’s serious injuries days before he was killed has won a key High Court ruling in her fight to avoid a fitness to practise hearing by the General Medical Council.

At the High Court in London Mr Justice Mitting quashed the GMC’s refusal to allow Sabah Al-Zayyat to remove herself from the medical register on health grounds rather than face a hearing. He described the decision as “perverse” and sent the case back to the GMC, where she will be able to apply again to …
β-Adrenergic Receptors: Recognition and Regulation
Authors: Robert J. Lefkowitz
Journal: New England Journal of Medicine (1976)

Of the various endogenous hormones and exogenous drugs, few have more widespread and potent effects than the catecholamines. It is therefore not surprising that natural and synthetic catecholamines and a variety of compounds that antagonize or block their effects are among the most useful and versatile agents at the physician's disposal.Catecholamine ReceptorsMore than 25 years ago Ahlquist1 used the disparate relative potency of catecholamines in stimulating a variety of physiologic processes to classify adrenergic effects into two main types, α and β (Table 1). Each type of response is characterized by a typical order of potency of agonist . . .
Helping people to say goodbye
Authors: M. Williams
Journal: BMJ (1997)

At the age of 5 I helped lay out our neighbour. She lay in a bed with many pillows. My grandmother combed her hair. “Now she is dead we will make her look her best,” she said as I helped to tie in blue ribbons. “You need never fear the dead, my darling.” By 10 I felt bewildered by expressions of grief; everyone preoccupied. Me ever watchful. I knew that death followed illness. Lives altered forever. Life manageable only if we stuck together.

At 16 a special uncle died. He was an adult who never embarrassed me. The doctors thought it best for him not to know about his cancer so we pretended. A lie never forgotten.

He died in an isolation hospital, miles from home. We visited by train with flasks of tea and sandwiches. He lay, in death, in the “best” …
Phase I trial of everolimus in combination with thoracic radiotherapy in non-small-cell lung cancer
Authors: E. Deutsch, C. Le Péchoux, L. Faivre, S. Rivera, Y. Tao, J.-P. Pignon, M. Angokai, R. Bahleda, D. Deandreis, E. Angevin, C. Hennequin, B. Besse, A. Levy, J.-C. Soria
Journal: Annals of Oncology (2015)
Maintenance Chemotherapy for Advanced Non–Small-Cell Lung Cancer: New Life for an Old Idea
Authors: David E. Gerber, Joan H. Schiller
Journal: Journal of Clinical Oncology (2013)

Although well established for the treatment of certain hematologic malignancies, maintenance therapy has only recently become a treatment paradigm for advanced non–small-cell lung cancer. Maintenance therapy, which is designed to prolong a clinically favorable state after completion of a predefined number of induction chemotherapy cycles, has two principal paradigms. Continuation maintenance therapy entails the ongoing administration of a component of the initial chemotherapy regimen, generally the nonplatinum cytotoxic drug or a molecular targeted agent. With switch maintenance (also known as sequential therapy), a new and potentially non–cross-resistant agent is introduced immediately on completion of first-line chemotherapy. Potential rationales for maintenance therapy include increased exposure to effective therapies, decreasing chemotherapy resistance, optimizing efficacy of chemotherapeutic agents, antiangiogenic effects, and altering antitumor immunity. To date, switch maintenance therapy strategies with pemetrexed and erlotinib have demonstrated improved overall survival, resulting in US Food and Drug Administration approval for this indication. Recently, continuation maintenance with pemetrexed was found to prolong overall survival as well. Factors predicting benefit from maintenance chemotherapy include the degree of response to first-line therapy, performance status, the likelihood of receiving further therapy at the time of progression, and tumor histology and molecular characteristics. Several aspects of maintenance therapy have raised considerable debate in the thoracic oncology community, including clinical trial end points, the prevalence of second-line chemotherapy administration, the role of treatment-free intervals, quality of life, economic considerations, and whether progression-free survival is a worthy therapeutic goal in this disease setting.
The Relative Affinity of Recombinant Dihydrolipoamide Transacetylase for Autoantibodies in Primary Biliary Cirrhosis
Authors: Craig A. Robertson, Ross L. Coppel, Thomas Prindiville, David Fregeau, Marshall Kaplan, Rolland E. Dickson, Eric M. Gershwin
Journal: Hepatology (1990)

In normal individuals there is an adaptive immune response to a foreign antigen in which antibodies of increasing affinity are produced with time. This is not always true of an autoimmune response. However, because only a limited number of autoantigens have been cloned or purified, this issue has not been studied well. In primary biliary cirrhosis the predominant manifestation of autoimmunity is antimitochondrial antibodies that react with dihydrolipoamide transacetylase. The availability of recombinant dihydrolipoamide transacetylase and the development of a rapid and reproducible enzyme-linked immunosorbent assay for autoantibodies has allowed us to address the affinity of autoantibodies using thiocyanate inhibition. Thiocyanate is a chaotropic compound known to inhibit antigen-antibody binding in a concentration-dependent manner. We used this property to inhibit the binding by enzyme-linked immunosorbent assay of human recombinant dihydrolipoamide transacetylase with serum autoantibodies from 55 patients with primary biliary cirrhosis. The relative affinity and serum autoantibody titers were then compared with the histological stage of the liver biopsy sample. Interestingly, we found a considerable heterogeneity of relative affinities. These relative affinities did not correlate with the histological stage or the serum titer of antimitochondrial antibodies. However, the ability of serum autoantibodies to inhibit intact primary biliary cirrhosis enzyme activity was found to correlate highly (R2 = 0.751) with the relative affinity. Thus there are profound differences between patients with respect to qualitative expression of autoantibodies. The significance of this data will be unclear until more is determined regarding the nature of the epitope that drives T cells and leads to B-cell responses.
Postmarketing surveillance: practical experience with ketotifen.
Authors: W P Maclay, D Crowder, S Spiro, P Turner
Journal: BMJ (1984)

In a postmarketing surveillance of ketotifen (Zaditen), an oral preparation for the prophylaxis of bronchial asthma, 8291 patients completed records every three months for one year. The objectives were to record adverse events and efficacy and to communicate appropriate information to participating doctors and regulatory authorities. The patients recruited appeared to represent a typical cross section of patients with asthma in the United Kingdom. By subjective assessment 70% of patients found the medication efficacious. There were no unexpected or unacceptable side effects and those found were similar to those reported in clinical trials of ketotifen. Though this exercise showed that the pharmaceutical industry, regulatory authorities, and prescribing doctors were able to collaborate, the major outcome of the survey was already known. It remains to be seen whether this type of survey is of value in the continuing search for control and safety in prescribing.
The Relationship Between Patient Income and Physician Discussion of Health Risk Behaviors
Authors: Deborah A. Taira, Dana Gelb Safran, Todd B. Seto, William H. Rogers, Alvin R. Tarlov
Journal: JAMA (1997)

The US Preventive Services Task Force recommends that physicians assess patients' health risk behaviors, addressing those needing modification.To examine the relationship between patient income, health risk behaviors, the prevalence of physician discussion of these behaviors, and the receptiveness of patients to their physicians' advice.Employee survey.A random sample of 6549 Massachusetts state employees in 12 health plans.Data were obtained using a patient-completed mail survey. Trend tests were used to discern differences in the prevalence of health risk behaviors, physician discussion of these behaviors, and patient receptiveness to discussions by patient income.Although unhealthy behaviors were common among all income groups, physician discussion of health risk behaviors fell far short of the universal risk assessment recommended by the US Preventive Services Task Force. Low-income patients were more likely to be obese and smoke than high-income patients and were less likely to wear seat belts and exercise. In contrast, stress and alcohol consumption increased with income, while the proportion of heavy drinkers did not vary significantly. Physicians were more likely to discuss diet and exercise with high-income patients in need of these discussions than with low-income patients, but were more likely to discuss smoking with low-income patients who smoked than with high-income patients who smoked. Among patients with whom discussions occurred, low-income patients were much more likely to report attempting to change their behavior based on physician advice.Physician counseling of patients regarding health risk behaviors should be greatly improved if the US Preventive Services Task Force recommendations are to be fulfilled. Improvement is especially needed in regard to alcohol consumption, safe sex, and seat belt use. Physicians also need to be more vigilant in properly identifying and counseling low-income patients at risk in regard to diet and exercise and high-income patients who smoke.
Case 10-1975
Authors: Francis M. Ingersoll, Robert E. Scully
Journal: New England Journal of Medicine (1975)

Presentation of Case First admission. A 70-year-old woman was admitted to the hospital after a barium-enema examination revealed an annular mass at the hepatic flexure of the colon.Examination disclosed poorly localized abdominal tenderness; no organs or masses were felt. The urine was normal. The hematocrit was 33 per cent; the white-cell count was 8300, with 77 per cent neutrophils. An x-ray film of the chest revealed that the lungs were clear. A 99mTc sulfur colloid liver scan was normal. Laparotomy on the sixth hospital day revealed numerous tiny nodules throughout the omentum and mesentery; the liver and pelvis . . .
HIV infection and certification of death.
Authors: J. Edeh
Journal: BMJ (1992)

misleading and could only suggest to the reader that the source of the press leak was a member of one or other of our departments, which are regularly responsible for the care of the vast majority of HIV infected individuals in Birmingham.This is simply not true.Confidentiality is a fundamental tenet of the service we provide for HIV infected individuals and under no circumstances would we divulge a patient's name to the media-certainly not to provide "a focus around which to challenge... mounting complacency about AIDS," as suggested by Fitzpatrick.The article further implies that we have a "tendency to regard HIV infection as more a moral condition than a disease" and that we judge people with HIV and AIDS "according to the degree of their individual responsibility for their condition."This does not reflect the attitude of the doctors and other staff dedicated to caring for such people in Birmingham..
Two knees or one person: data analysis strategies for paired joints or organs
Authors: A. J SUTTON, K. R MUIR, A. C JONES
Journal: Annals of the Rheumatic Diseases (1997)

Regression models are being increasingly used in rheumatology because of greater awareness of their application, and the ready availability of computerised statistical packages. Many researchers, therefore, now feel confident to undertake quite sophisticated multivariate analyses. One caution that we feel should be more widely debated and is pertinent to rheumatological datasets in particular, may limit the extent to which these analyses can be routinely undertaken without formal statistical assistance.1 

The problem stems from the fact that in many aspects of medical research, data are collected on subjects and in most cases analysed using the individual as the basic ‘unit’ in the analysis. This is appropriate where the data are collected on single organ systems as the unit of the analysis is person specific. In the situation of having data on multiple joints or organs, this approach may not be wholly appropriate. For example, if one were examining risk factors for the knee, some variables, such as injury, will be joint specific rather than subject specific.

One example of this is the study by Doherty et al .2 In this study, factors that might predict progression of knee osteoarthritis were studied and included some which might be considered specific to the knee studied, and some which apply globally to the patient (table 1). As demonstrated in the paper, nearly all the knee specific features described showed a high degree of correlation between the right and left sides. The data could be analysed at the level of either patients or joints (sides). In the case of the former, data regarding knee specific factors have to be sacrificed and, as discussed below, choosing which knee to …
Abstract 2285: Epigenetic silencing of SOD3 contributes to the malignant phenotype in human lung cancer
Authors: Matthew P. Fitzgerald, Melissa LT Teoh, Joshua M. Madsen, Frederick E. Domann
Journal: Cancer Research (2010)

Abstract Extracellular SOD (EcSOD), encoded by the SOD3 gene, scavenges superoxide in the extracellular space. EcSOD is highly expressed in the lung where it comprises the majority of SOD activity in airway epithelial and vascular cells. The role of EcSOD in lung cancer, if any, has not yet been thoroughly studied. It has been reported, however, that EcSOD expression is lost in the lung cancer cell line A549 and that the transcription factors SP1/SP3 that regulate expression in MRC-5 cells could neither bind the promoter nor stimulate EcSOD expression in A549 cells. We hypothesized that EcSOD loss in lung cancer could be due to epigenetic events. To test this hypothesis we analyzed the epigenotype of the SOD3 promoter in three normal cell types (airway epithelial, MRC-5, HMEC) and two EcSOD negative lung cancer cell lines (A549, H1650) as well as in normal lung versus five human lung tumors. We also re-expressed EcSOD in the A549 cell line to assess possible changes in malignant phenotype. We now report that EcSOD expression is highly correlated with SOD3 promoter methylation. In the normal airway epithelial and MRC-5 lung cells that express EcSOD, the promoter has an overall cytosine methylation of &amp;lt;1% while in the non-expressing lung cancer cells and HMEC cells there was &amp;gt;86% methylation at the 18 CpG sites examined. Treatment of cells with 5-aza-dC induced SOD3 mRNA, indicating that DNA methylation was causal, at least in part, to the gene silencing. Moreover, A549 and H1650 cells displayed a ∼25-fold reduction in chromatin accessibility of the SOD3 promoter compared to MRC-5 cells. In the five lung tumors, EcSOD mRNA expression was significantly decreased and the SOD3 promoter showed a significantly more methylated state in the tumors compared to normal lung tissue. Re-expression of EcSOD attenuated the malignant phenotype of A549 cells by increasing doubling time by 25 hours, decreasing matrigel invasion and clonogenic capacity by 65% and 70% respectively. Taken together, our findings indicate that loss of EcSOD expression in human lung cancer is highly correlated with aberrant SOD3 promoter methylation and a repressive chromatin structure, and that re-acquisition of EcSOD attenuates the malignant phenotype of lung cancer cells. 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 2285.