tbuckley/cabot-search huggingface dataset:
Time to take periodontitis seriously
Authors: Iain L C Chapple
Journal: BMJ (2014)

The benefits of treatment are likely to exceed the costs

Periodontitis is the most common chronic inflammatory disease seen in humans, affecting nearly half of adults in the United Kingdom and 60% of those over 65 years.1 It is a major public health problem, causing tooth loss, disability, masticatory dysfunction, and poor nutritional status.2 Periodontitis also compromises speech, reduces quality of life,3 and is an escalating burden to the healthcare economy. In the UK alone it was estimated to cost £2.8bn (€3.4bn; $4.6bn) in 2008,4 not including raised all cause mortality, an association that has been noted in several populations.5 Worryingly, the disease is often silent, being present for decades before diagnosis and treatment. It can leave a substantial pathological footprint on multiple organ systems, as well as the oral cavity. 

Periodontitis follows the development of a pathogenic microbial biofilm at and below the gingival (gum) margin. In susceptible patients, this triggers an exaggerated and dysfunctional inflammatory immune response, which destroys the bone surrounding the teeth, causing tooth loss.6 The host’s immune response to the initiating microbiota is largely genetically determined, but environmental and lifestyle factors such as smoking, suboptimally controlled diabetes, obesity, poor nutrition (high intake of refined sugar and low intake of antioxidant micronutrients), and stress …
Irish study shows women stop taking tamoxifen too early
Authors: Janice Hopkins Tanne
Journal: BMJ (2007)

A large Irish study of women who were prescribed tamoxifen showed that 22.1% had stopped taking the drug within a year ( Cancer 2007 Jan 27, doi: 10.1002/cncr.22486). Within 3.5 years, the number who had stopped had risen to 35.2%. 

Thomas Barron and colleagues from Trinity College and St James's Hospital, Dublin, warn that the study raises concerns about patients failing to persist with oral hormonal treatments for breast cancer and oral antineoplastic agents in general. 

“Five years of adjuvant tamoxifen is the recommended treatment and results in a reduction in the relative breast cancer recurrence risk of 46% and the relative …
Imatinib mesylate in idiopathic and postpolycythemic myelofibrosis
Authors: Hans Carl Hasselbalch, Ole Weiss Bjerrum, Bjarne Anker Jensen, Nielsaage Tøffner Clausen, Per Boye Hansen, Henrik Birgens, Marianne Hamilton Therkildsen, Elisabeth Ralfkiær
Journal: American Journal of Hematology (2003)

Abstract Imatinib mesylate targets the adenosine triphosphate (ATP)‐binding sites of the protein tyrosine kinase domains associated with Bcr‐abl, the platelet‐derived growth factor (PDGF) and c‐kit. In idiopathic myelofibrosis (IMF) PDGF is considered to be one of the growth factors responsible for the development of bone marrow fibrosis. Recently, it has been shown that imatinib has antifibrogenic effect on bone marrow fibrosis in chronic myelogenous leukemia. Treatment with imatinib alone in IMF has been associated with significant side effects. In this study, the safety and efficacy of imatinib therapy in IMF, either administered as a single agent or in combination with hydroxyurea (HU) and/or alpha‐interferon (IFN‐α) are evaluated. Eleven patients (median age, 63 years; range, 33–82 years) with IMF ( n = 8) or postpolycythemic myelofibrosis (PPMF) ( n = 3) were studied All patients had been treated with HU ( n = 9) and/or IFN ( n = 7) before study entry. In all but one patient, treatment with these agents was discontinued when imatinib therapy was instituted. One patient continued IFN when treatment with imatinib was started. Imatinib was given at a dose of 400 mg/day. Nine patients were in an advanced disease phase. The patients have been followed for a median period of 2 months (range, 0.5–12 months). Treatment with imatinib has been stopped in six patients (55%), because of overt side effects ( n = 4), recurrence of transitory dizziness and visual defects owing to a rising platelet count ( n = 1), or the occurrence of an acute subdural hemorrhage that was evacuated without neurological deficits ( n = 1). In nine patients imatinib treatment was followed by a rise in leukocyte and platelet counts that required combination with HU or IFN. The combined treatment modalities were followed by a rapid decrease in cell counts and were well tolerated apart from IFN side effects. A beneficial effect of imatinib was documented in three patients. It is concluded that leukocytosis and thrombocytosis are seen in most patients with myelofibrosis during treatment with imatinib. Combination therapy with HU or IFN seems safe and well tolerated and followed by a decrease in disease activity. A subgroup of patients in an early disease phase might benefit from imatinib therapy alone. Am. J. Hematol. 74:238–242, 2003. © 2003 Wiley‐Liss, Inc.
Esophagogastroduodenal Mucosal Behavior after Bronchial Challenge with House Dust Mites in Allergic Asthmatic Patients
Authors: Rosana C. Agondi, Tomas Navarro-Rodriguez, Ricardo Barbuti, Carla Bisaccioni, Marcelo Vivolo Aun, Jorge Kalil, Pedro Giavina-Bianchi
Journal: Journal of Allergy and Clinical Immunology (2015)
Concerns about AIDS in general practice
Authors: M. A W Moons, L. Peters, A. I M Bartelds, J. J Kerssens
Journal: BMJ (1996)

General practitioners are regarded as well placed to help prevent the transmission of HIV infection.1 2 3 In 1988 a study was started in the Netherlands to get more information on concerns about AIDS among the non-infected population and on the general practitioner's role in providing advice and health education about AIDS. In this paper we present the results after five years (April 1988-April 1993).

Since April 1988 general practitioners participating in the Dutch sentinel practice network recorded all face to face consultations with non-infected patients in which the subject of AIDS was brought up, either by the patient or by the general practitioner. When the subject of AIDS was a substantial part of the consultation, the general practitioners filled in a questionnaire giving information on the contents of this HIV related consultation and on the patient. If an arrangement for HIV testing was made the result of …
Coronary heart disease and the menopause.
Authors: M F Oliver
Journal: BMJ (1977)

The writer claims that a previous article had confused the relationship of early menopause to premature coronary heart disease (CHD) and with results of a normal menopause or with the effects of hormone replacement therapy given after a normal menopause. The evidence that a premature menopause can lead to premature CHD is stronger than implied. Premature cessation of ovarian function does not lead solely to withdrawal of estrogenic and progestational hormones but has sudden and profound effects on androsterone, adrenal and pituitary functions, and on lipid and carbohydrate metabolism. A Swedish study showed that 76% of women with myocardial infarction had their menopause before age 50 compared to 40% of others. Artificial delay of the menopause by estrogenic compounds is considered unlikely to prevent CHD but may increase the risk.
Digoxin Overdose Limitations of Hemoperfusion-Hemodialysis Treatment
Authors: Sanford E. Warren
Journal: JAMA (1979)

We used charcoal hemoperfusion coupled with hemodialysis to treat a woman with massive digoxin ingestion complicated by hyperkalemia. Although dialysis controlled the serum potassium levels, hemoperfusion removed less than 1% of the total ingested dose. Hemoperfusion has a relatively minor impact on digoxin elimination and remains of unproved value in the therapy for digoxin overdose. (<i>JAMA</i>242:2100-2101, 1979)
Withholding and withdrawing life sustaining treatment from elderly people: towards formal guidelines
Authors: L Doyal, D Wilsher
Journal: BMJ (1994)

Clinicians often decide either to withhold or to withdraw lifesaving treatment in elderly patients. Considerable disagreement exists about the circumstances in which such actions can be defended. Debates about the scarcity of resources in the NHS add urgency to the need to resolve this disagreement. Competent elderly patients have a legal and moral right to decide whether to receive life sustaining treatment. Such treatment should not be withheld or withdrawn on the basis of a patient's age alone. Principles for making decisions about life sustaining treatment in incompetent elderly patients can be defended and should exist as written guidelines.
Radiotherapy for Inflammatory Conditions
Authors: Arthur U. Desjardins
Journal: New England Journal of Medicine (1939)

The treatment of inflammatory processes with roentgen rays is far from new. Indeed, it goes back to about 1900. The earliest mention of the subject is to be found in papers by Freund,1Albers-Schonberg,2Gautier,3Rudis-Jicinsky4and Pusey,5and in the books of Williams6and Belot.7An interesting point is that some of the earliest therapeutic trials were made in this country, but they received no attention until the successful results had been repeatedly confirmed by others here and abroad.  Many physicians are unaware of the favorable influence of roentgen rays or radium on various forms of acute or chronic inflammation. Yet the therapeutic value of irradiation in inflammations has been thoroughly substantiated, and the testimony is so generally favorable that one wonders why it is not used more than it is or why, in many cases, it is employed only after other
Detection and Management of Mental Health Problems of Older Patients by Primary Care Providers
Authors: Pearl S. German, Sam Shapiro, Elizabeth A. Skinner, Michael Von Korff, Lawrence E. Klein, Raymond W. Turner, Mark L. Teitelbaum, Jack Burke, Barbara J. Burns
Journal: JAMA (1987)

Evidence is accruing that older individuals receive little attention for mental health problems and that any attention that is given is most often within the primary care setting. A randomized clinical trial was carried out at a primary care clinic of The Johns Hopkins University, Baltimore, testing the ability of feedback of the results of a screening instrument (the General Health Questionnaire) to increase awareness in clinicians of the emotional and psychological problems of their patients. This report contrasts those aged 65 years and older with younger patients. Detection and management of mental morbidity were lower for older individuals, but the feedback intervention increased the likelihood of attention to these problems. This was not true for younger patients. Detection was significantly higher for older patients when screening data were made available, as was management, although the latter difference was not statistically significant. There was evidence as well that the intervention moved clinicians to greater congruence with their older patients in the perception that current mental health problems existed. These findings have important implications for primary care. (<i>JAMA</i>1987;257:489-493)
Polyubiquitin is a new phenotypic marker of contractile vascular smooth muscle cells
Authors: Paul J Adam, Peter L Weissberg, Nathaniel R.B Cary, Catherine M Shanahan
Journal: Cardiovascular Research (1997)

Objective: Medial vascular smooth muscle cells (VSMCs) in healthy vessels are phenotypically distinct from their intimal counterparts in vascular disease. To compare the genes expressed in these phenotypes we have previously performed a differential cDNA library screen on cultured rat VSMCs. The aim of this study was to identify and characterise a 2.8 kb transcript, 2E10, which was highly expressed in freshly dispersed rat aortic VSMCs and downregulated in multiply passaged cultured VSMCs. Methods: Sequence analysis was used to identify the 2.8 kb rat cDNA. After trypsinisation of proliferating cultured rat and human VSMCs, or enzymatic digestion of aortic tunica media, total cytoplasmic RNA was isolated from VSMCs by lysis in Nonidet P-40 and extraction in phenol; 15 μg of total cytoplasmic RNA was used in Northern blot analysis with a 32P-[dCTP]-labelled 2E10 cDNA probe. 35S-[dATP]-labelled 2E10 riboprobe was hybridised in situ to frozen sections of normal and diseased human coronary arteries. Results: DNA sequencing identified 2E10 as a rat polyubiquitin which is homologous to the human polyubiquitin, UbC. Northern blot analysis showed that this polyubiquitin was more highly expressed in differentiated, freshly dispersed rat and human aortic VSMCs compared with their dedifferentiated proliferating counterparts. This also identified a 3.2 kb transcript cross-reacting with the polyubiquitin probe which is specific to differentiated rat VSMCs only. However, expression in growth arrested and proliferating VSMCs was identical, suggesting that UbC does not have a role in VSMC growth arrest. In situ hybridisation of the polyubiquitin riboprobe to sections of diseased human coronary arteries indicated much higher expression in medial than in intimal VSMCs. Northern blot analysis of RNA from the developing rat aorta showed that polyubiquitin expression increased substantially after week 2 of neonatal life, coincident with expression of VSMC-specific contractile proteins. Conclusions: The greater expression of a UbC polyubiquitin transcript in contractile, differentiated VSMCs compared with proliferating, synthetic VSMCs provides a new gene marker for the phenotypic characterisation of VSMCs in vivo. This, and the finding that the developmental induction of expression of polyubiquitin (UbC) mirrors that of VSMC contractile proteins, suggests that ubiquitin, a protein known to associate with and degrade contractile proteins in skeletal muscle, is involved in the function or maintenance of the contractile phenotype of VSMCs.
Primary Amebic Meningoencephalitis
Authors: Cecil G. Butt
Journal: New England Journal of Medicine (1966)

THE following 3 case studies, related experimental data and review of the recent literature introduce a new clinical concept, that of primary meningoencephalitis due to the the free-living, soil ameba, commonly referred to as acanthameba (species). It is suggested that in these 3 cases there may be a common etiologic pattern of intranasal inoculation resulting from prolonged swimming in tepid lake water.Pathological findings in the first 2 cases were presented to the 1964 Scientific Session of the American Society of Clinical Pathologists,1 and Patras and Andujar2 reported similar findings in the brain of an elderly drug addict to the . . .
Patient-Physician Negotiation
Authors: Melvin A. Benarde
Journal: JAMA (1978)

The low level of patient compliance with physician management regimens is widely recognized. Although numerous studies either have measured levels of noncompliance or have attempted to fathom the essential elements of patient-physician interaction, they do not indicate how compliance may be increased. Negotiation is a process by which two active and equal participants negotiate to obtain their respective goals (which are often at odds). Without appropriate negotiation, which requires the patient's active participation, the physician cannot hope to motivate the patient. Patients will continue to be noncompliant as long as they are treated as inferiors in the process. (<i>JAMA</i>239:1413-1415, 1978)
Child Maltreatment in Enlisted Soldiers' Families During Combat-Related Deployments
Authors: Deborah A. Gibbs, Sandra L. Martin, Lawrence L. Kupper, Ruby E. Johnson
Journal: JAMA (2007)

HILD MALTREATMENT IN-cludes neglect, physical abuse, emotional abuse, and sexual abuse.Children who are maltreated are at increased risk for negative health behaviors, depression, and chronic health conditions, with negative sequelae extending into adulthood. 1-3Few studies have examined child maltreatment within military families, 4-10 of which there were more than 1.1 million with children younger than 18 years in 2004. 11Limited knowledge regarding these families is of concern because of the possible impact of combat-related deployments on child maltreatment.Military families have been found to demonstrate high levels of resilience 12,13 ; nonetheless, deployments pose unique challenges.These deployments may affect the family's children, the soldierparent preparing for (or returning from) deployment, and the parent remaining at home during deployment.Deployments have been associated with stress [14][15][16][17][18] and behavioral problems 14,19 among children in military families, situations that can exacerbate parental stress.Deployment also has been associated with increased stress 17,20,21 among nondeployed parents, which may hamper their ability to appropriately care for their children.Parental stress (as mediated by their appraisals of the situation, available resources, and coping strategies) is believed to play a critical role in child maltreatment, 22,23 particularly child neglect. 24Hillson and Kuip-er's stress and coping model of child maltreatment 22 suggests that parents respond to stress either with positive adaptive behaviors or with dysfunctional behaviors that may result in child maltreatment.
Much health care in rural India comes from unqualified practitioners
Authors: Sanjay Kumar
Journal: BMJ (2004)

Public and private healthcare facilities that purport to serve poor people in rural parts of India are increasingly catching the attention of researchers. A survey conducted by US researchers in Udaipur, Rajasthan, now provides hard data showing the nature of the availability of health care in rural India.

The researchers, Dr Abhijit Banerjee and Dr Esther Duflo from the Massachusetts Institute of Technology and Dr Angus Deaton from Princeton University, all working under the aegis of the institute's Poverty Action Lab, found widespread symptoms of disease among thepeople surveyed.

Given the …
Transient bone marrow aplasia associated with non‐A, non‐B hepatitis
Authors: Kapil Dhingra, Sheryl D. Michels, Elliott F. Winton, David S. Gordon
Journal: American Journal of Hematology (1988)

Abstract We describe two patients who developed aplastic anemia early in the course of non‐A, non‐B hepatitis. Spontaneous rapid recovery of bone marrow function occurred in both patients. Although early bone marrow transplantation has been recommended as the treatment of choice in hepatitis‐associated aplastic anemia, these patients illustrate the need for a period of expectant observation before undertaking bone marrow transplantation in such patients.
Antabuse for Anturane
Authors: Jeffrey A. Margolis, L. Earl Watts
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 February 1983Antabuse for AnturaneJEFFREY A. MARGOLIS, M.D., L. EARL WATTS, M.D.JEFFREY A. MARGOLIS, M.D.Search for more papers by this author, L. EARL WATTS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-2-259_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We write to report a case in which severe adverse effects were seen in a patient who was inadvertently given Antabuse rather than Anturane after a myocardial infarction.A 62-year-old man had an anterior myocardial infarction. As part of his hospital regimen, Anturane, 200 mg twice daily, was given without any adverse effects, but 17 days after discharge, he presented with pronounced generalized malaise, constipation, and blurred vision. After a review of his clinical course and a physical examination, no cause for his symptoms was evident. The medication in his bottle of "Anturane" turned out to be... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JEFFREY A. MARGOLIS, M.D.; L. EARL WATTS, M.D.Affiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1983Volume 98, Issue 2Page: 259-259KeywordsConstipationMyocardial infarctionVision ePublished: 1 December 2008 Issue Published: 1 February 1983 PDF downloadLoading ...
Survey of the allergic status of patients with bronchial asthma in Turkey: a multicenter study
Authors: A. F. Kalyoncu, L. Çöplü, Z. T. Selçuk, A. S. Emri, B Kolaçan, A. Kocabaş, A. αkkoçlcu, L. Erkan, A. şahin, Y. I. Bariş
Journal: Allergy (1995)

Patients diagnosed with bronchial asthma (BA) were prospectively enrolled to assess their allergen spectra and atopic status. The patients came from five major cities (Ankara. Ízmir, Samsun. ElazíǵC, and Adana) in different regions of Turkey. Atopic status, total IgE levels, and allergen speelra were determined in 1149 patients and 210 controls who were spouses of the patients sharing the same environment hut not consanguinity with the patients. Total IgF. levels were significant higher in the asthmatic patients. For both groups, total IgE. levels were higher in both alopic and male subjects. Atopy rates were 42% in asthmatics and 26.1% in controls, declining notably by age in both groups. The most common allergen in both groups was house‐dust mite (RDM), which was more frequency detected in coastal regions (Samsun. Izmir, and Adana). Allergen spectra of the patients included HDM. pollens, cockroach, pet animals, and molds in decreasing order of frequency. Phleum praiensi : and Artemisia vulgam were the most common pollens in all regions, whereas Olea europaea was the most common in Izmir. Pollen sensitivity was least frequent in hlazig. For all of the regions, pet sensitivity was less common than, and mold sensitivity was comparable to, that of Western countries. In conclusion. BA patients in Turkey displayed significant differences in their allergen spectra and total IgE levels from control subjects and BA patients in Western countries.
Review: Vegetarian diets reduce systolic and diastolic blood pressure more than omnivorous diets
Authors: Scott Kahan, Lawrence J. Cheskin
Journal: Annals of Internal Medicine (2014)

ACP Journal Club17 June 2014Review: Vegetarian diets reduce systolic and diastolic blood pressure more than omnivorous dietsScott Kahan, MD, MPH, Lawrence J. Cheskin, MDScott Kahan, MD, MPHJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (S.K., L.J.C.)Search for more papers by this author, Lawrence J. Cheskin, MDJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (S.K., L.J.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-160-12-201406170-02003 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationYokoyama Y, Nishimura K, Barnard ND, et al. Vegetarian diets and blood pressure: a meta-analysis. JAMA Intern Med. 2014;174:577-87. https://pubmed.ncbi.nlm.nih.gov/24566947Clinical Impact RatingsGIM/FP/GP: References1 Craig WJ, Mangels AR; American Dietetic Association. Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc. 2009;109:1266-82. [PMID: 19562864] Google Scholar2 Ferdowsian HR, Barnard ND, Hoover VJ, et al. A multicomponent intervention reduces body weight and cardiovascular risk at a GEICO corporate site. Am J Health Promot. 2010;24:384-7. [PMID: 20594095] Google Scholar Author, Article, and Disclosure InformationAuthors: Scott Kahan, MD, MPH; Lawrence J. Cheskin, MDAffiliations: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (S.K., L.J.C.)This article was published at Annals.org on 3 June 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 June 2014Volume 160, Issue 12Page: JC3KeywordsBlood pressureDietFoodForecastingHypertensionMeatNutritionObservational studiesTwins ePublished: 17 June 2014 Issue Published: 17 June 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...