tbuckley/cabot-search huggingface dataset:
Global Climate Change and Children’s Health: Threats and Strategies for Prevention
Authors: Perry E. Sheffield, Philip J. Landrigan
Journal: Environmental Health Perspectives (2010)

Global climate change will have multiple effects on human health. Vulnerable populations-children, the elderly, and the poor-will be disproportionately affected.We reviewed projected impacts of climate change on children's health, the pathways involved in these effects, and prevention strategies.We assessed primary studies, review articles, and organizational reports.Climate change is increasing the global burden of disease and in the year 2000 was responsible for > 150,000 deaths worldwide. Of this disease burden, 88% fell upon children. Documented health effects include changing ranges of vector-borne diseases such as malaria and dengue; increased diarrheal and respiratory disease; increased morbidity and mortality from extreme weather; changed exposures to toxic chemicals; worsened poverty; food and physical insecurity; and threats to human habitation. Heat-related health effects for which research is emerging include diminished school performance, increased rates of pregnancy complications, and renal effects. Stark variation in these outcomes is evident by geographic region and socioeconomic status, and these impacts will exacerbate health disparities. Prevention strategies to reduce health impacts of climate change include reduction of greenhouse gas emissions and adaptation through multiple public health interventions.Further quantification of the effects of climate change on children's health is needed globally and also at regional and local levels through enhanced monitoring of children's environmental health and by tracking selected indicators. Climate change preparedness strategies need to be incorporated into public health programs.
Bright's Disease: Clinical Manifestations in Relation to Etiology and Prognosis
Authors: Raymond D. Pruitt
Journal: New England Journal of Medicine (1946)

IN 1827 Bright1 pointed out the association between dropsy, albuminuria and hardened kidneys. In this simple correlation he established the foundation for a multitude of observations that accumulated in succeeding years under the caption of "Bright's disease." It soon became apparent that, from both a clinical and a pathological standpoint, Bright's disease was not an entity but an assemblage of diseases. Subsequent efforts to achieve specificity resulted in many classifications, some accurate and many detailed. But what is satisfying to an expert in the field is not always expedient for one whose circumstances demand familiarity with the range of clinical . . .
Trade talks between US and EU could increase cost of drugs, new report says
Authors: D. Cohen
Journal: BMJ (2014)

Ongoing free trade negotiations between the European Union and the United States will lead to agreements that will “limit transparency of clinical trials” and “increase the cost of medicines” if the drug industry has its way, a coalition of public health groups has said in a report.

Whereas many trade negotiations focus mainly on tariffs, the Transatlantic Trade and Investment Partnership (TTIP) talks will set standards and legal frameworks for drug regulation, intellectual property rights, and investment protection, which the report says will “benefit [the] commercial interests of a few multinational firms.” 

The report has been produced by a coalition of groups including the International Society of Drug Bulletins, the Medicines in Europe Forum, Universities Allied for Essential Medicines Europe, Health Action International Europe, and the Commons Network. 

A spokeswoman for the European Federation of Pharmaceutical Industries and Associations defended the talks, telling …
Postgraduate Training Posts for Overseas Doctors
Authors: P. K. Chakrabartty
Journal: BMJ (1966)

Bm=H appeared and her liver-function tests, including bromsulphalein excretion, have returned to normal a month after stopping Orthonovum.There is, we believe, presumptive evidence that the pruritus, which lasted eight months before liver abnormalities were demonstrated, was due to the oral contraceptive.Drs.Thulin and Nermark commented on the occurrence of pruritus in pregnancy in two of their seven cases.Our patient suffered from pruritus in her first pregnancy.We had intended to confirm that the oral contraceptive had been responsible for this patient's illness by giving her Orthonovum again, using bromsulphalein excretion as an index of liver dysfunction.Since the liver changes are completely reversible when due to norethisterone' this seemed to be a justifi- able procedure, but in view of Drs.Thulin and Nermark's findings this hardly seems necessary.-Weare, etc., I. R.
Expression of binding of plasminogen, thrombospondin, vitronectin, and fibrinogen, and adhesive properties by Escherichia coli strains isolated from patients with colonic diseases.
Authors: W Shen, H Steinruck, A Ljungh
Journal: Gut (1995)

Escherichia coli strains isolated from patients with colonic disorders (n = 27) and strains isolated from the rectal mucosa of healthy subjects (n = 24) were compared with respect to expression of cell surface hydrophobicity, carriage of intestinal virulence factors, adhesion to tissue culture cells, and expression of binding of extracellular matrix proteins and plasma proteins. Strains isolated from patients with colonic disease did not express a more hydrophobic cell surface than strains from healthy subjects. Few strains from both groups carried genes encoding for recognised virulence factors of E coli. Only one strain, carrying the eae gene induced actin polymerisation in tissue culture cells. Strains from patients with colonic diseases adhered to HT29 cells, which are of intestinal origin, to a higher extent than E coli from healthy subjects. Significantly more strains from patients with colonic disorders than E coli from healthy subjects expressed binding of fibronectin, collagens, laminin, vitronectin, plasminogen, throbospondin, and fibrinogen. Expression of binding of these proteins may influence the pathogenesis of colonic disease by mediating binding to ulcerated tissue, preventing complement induced lysis of bacteria and by exerting proteolytic activity. There was no correlation between serotype, expression of cell surface hydrophobicity, and binding of extracellular matrix and plasma proteins.
Learning from Our Mistakes? Testing New ICD Technology
Authors: Robert G. Hauser, Adrian K. Almquist
Journal: New England Journal of Medicine (2008)

More than 160,000 implantable cardioverter–defibrillators (ICDs) are implanted annually in the United States to prevent sudden death from cardiac causes in high-risk patients. Recently, concerns have been raised about the premarket testing of these life-saving devices.1 At issue is how new ICD technologies should be evaluated before they are approved by the Food and Drug Administration (FDA) for general use. ICD manufacturers strive to develop devices that are smaller, easier to implant, and more attractive to patients, but they are reluctant to subject these innovations to premarket clinical testing because such trials are costly and may delay the introduction of . . .
The enigma of anti-neutrophil antibodies in ulcerative colitis primary sclerosing cholangitis: Important genetic marker or epiphenomenon?
Authors: Roger W. Chapman
Journal: Hepatology (1995)

Background/Aims: Perinuclear antineutrophil cytoplasmic antibodies (pANCA) were found at high frequency in patients with primary sclerosing cholangitis and ulcerative colitis. In this study, to accumulate further evidence for the importance of genetic factors in pathogenesis of inflammatory bowel disease, sera of patients with inflammatory bowel disease and primary sclerosing cholangitis and their unaffected family members were tested for pANCA. Methods: Three hundred twenty-seven sera from 11 families of patients with primary sclerosing cholangitis, 43 families of patients with ulcerative colitis, 11 families of patients with Crohn's disease, and 11 healthy families were tested for pANCA in immunofluorescence on cytospin slides with isolated neutrophils. Results: pANCA were found in 82% of the patients with primary sclerosing cholangitis and in 25% of their relatives. In ulcerative colitis, 70% of the patients and 30% of their relatives had pANCA. pANCA were found only in low titers in 27% of patients with Crohn's disease and in 6% of their relatives. pANCA were not detected in members of healthy families. Only 16% of the patients with ulcerative colitis and their families and none of the patients with primary sclerosing cholangitis and their families were completely negative for pANCA. Conclusions: These data show that pANCA may be a genetic marker in families of patients with ulcerative colitis and primary sclerosing cholangitis.
Management of Fibromyalgia
Authors: Norman Muilenburg
Journal: Annals of Internal Medicine (2000)

Letters20 June 2000Management of FibromyalgiaNorman Muilenburg, BS Pharm, RPhNorman Muilenburg, BS Pharm, RPhKaiser Permanente; Portland, OR 97230 (Muilenburg)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-12-200006200-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Leventhal (1) reviewed pharmacologic and nonpharmacologic treatments for fibromyalgia. The role of tramadol is prominently mentioned in the abstract, the body of the article, the table on pharmacologic treatment options, and the conclusions. To support his assertion that “tramadol may be useful for treatment of fibromyalgia pain,” Leventhal cites one published randomized, controlled trial of intravenous tramadol (a form not available in the United States); two unpublished abstracts; one study of tramadol compared with acetaminophen with codeine in several chronic, painful conditions; and a review of clinical experience with tramadol in osteoarthritis (not fibromyalgia). A review of ...Reference1. Leventhal LJ. Management of fibromyalgia. Ann Intern Med. 1999;131:850-8. LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Kaiser Permanente; Portland, OR 97230 (Muilenburg) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Fibromyalgia Lawrence J. Leventhal Management of Fibromyalgia Hideto Akama Management of Fibromyalgia Lawrence J. Cohn Management of Fibromyalgia Lawrence J. Leventhal Management of Fibromyalgia Frederick Wolfe Management of Fibromyalgia Arthur Huppert Metrics Cited byDirect medical costs associated with using vancomycin in methicillin-resistant Staphylococcus aureus infections: an economic model 20 June 2000Volume 132, Issue 12Page: 1004-1005KeywordsClinical trialsCodeineFibromyalgiaOsteoarthritis Issue Published: 20 June 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2 PREDICTION OF CORONARY ARTERY DISEASE DIAGNOSIS AMONG PATIENTS WITH DIFFERING NUMBERS OF RISK FACTORS
Authors: Farangis Lavasani, Heidi T. May, Benjamin D. Horne, Jeffrey L. Anderson, John F. Carlquist, Robert L. Wolfert, Joseph B. Muhlestein
Journal: Journal of the American College of Cardiology (2010)
William Fowler Felton
Authors: D. Barlow
Journal: BMJ (2014)

William Fowler Felton (“Bill”) was the doctor we would all like to have been. He was a rounded polymath, whose talents found him seconded to the special operations executive in Greece in the second world war; assessing lungs, toenails, and plutonium levels as medical officer to Britain’s first nuclear processing plant at Sellafield in 1948; being managing director of several British companies; sometime master of the Worshipful Company of Carpenters and of Worcester Park and Buckland Beagles; sailor, linguist, mountaineer, and innovative thinker in his final choice of career, venereology.

Bill did his clinical training and house-jobs at the Middlesex Hospital and was soon drafted into the Royal Army Medical Corps. His schoolboy fluency in Greek was a factor in the decision, by the special operations executive, to parachute him in as …
PTH-152 Nurse Delivered day Case Paracentesis - a Single Centre Experience
Authors: L Tobin, O D Patani, S Hood, R Sturgess, N Stern
Journal: Gut (2013)

<h3>Introduction</h3> Refractory ascites is a debilitating consequence of end stage liver and other diseases. Treatment options are limited and include recurrent large volume paracentesis (LVP). Admission for LVP requires usage of in-patient beds which are in high demand and have a high cost. Since 2009 we have introduced day case paracentesis and trained a Hepatology clinical nurse specialist (CNS) to perform LVP for stable patients as day cases. <h3>Methods</h3> We aimed to evaluate our service development to assess the safety and success rate of day case LVP and particularly a nurse delivered day case LVP service. Initially, day case LVP was coordinated by the CNS with trainees in gastroenterology performing the procedure; subsequently we trained up and assessed the CNS in performing LVP independently. A retrospective audit, evaluating all day case LVP performed since the introduction of the service was performed. Aetiology of ascites and severity of liver disease (Child Pugh), volume drained and complications related to drainage were all recorded. The proportion of cases performed by doctors and the CNS were noted to determine relative outcomes. All cases of LVP for ascites due to cirrhosis were given 20% human albumin solution as per local protocol. <h3>Results</h3> 108 LVP performed (in 42 patients). 62 (57.4%) performed by the CNS. The cause of ascites was cirrhosis in 36 patients (94 LVP) and malignancy in 6 patients (14 LVP). In cirrhotic patients, median Child Pugh score was 8 (range 7–11). 107 (99.1%) of attempts at LVP were successful with 106 (98.1%) drains sited with a single needle pass. The volume of ascites drained typically was 12–16 litres (range 3–26). Complications included local skin infection requiring oral antibiotics in 1 case (0.9%) and leakage of ascites requiring suturing in 11 (10.2%) procedures. Most cases of local leakage were in those with malignant ascites (63.6%). There were no long term or serious complications and no unplanned admissions following on from day case LVP. There was no difference in success or complication rate between those LVP performed by the CNS or medical staff. <h3>Conclusion</h3> Nurse delivered day case LVP is a safe and effective method of managing patients with refractory ascites. It is a method of relieving the burden on the hospital bed base in a sustainable and safe way. In addition, we would anticipate significant cost savings for this model compared to admission for LVP. <h3>Disclosure of Interest</h3> None Declared.
Processed Heterogenous Bone
Authors: Kirk J. Anderson
Journal: JAMA (1965)

There have been certain undesirable factors associated with clinical bone grafting which have stimulated a search for new and improved graft materials. Operative procedures requiring more bone than the patient can supply, prolonged operative time, and the potential of increased morbidity associated with the transfer of autogenous bone were factors which stimulated interest in the bone homograft—particularly the preserved bone homograft. However, some of the aspects associated with human bone banking such as the untoward possibility of contamination, legal incumbrances, availability of suitable material, transportation, and storage have left much to be desired. Largely because of an unlimited supply, heterogenous bone has been widely used by European surgeons for the past two decades. In general, their total experience with the bone heterograft after long-term follow-up has pointed to the fact that clinical failures in many instances were probably related to the immunologic drawbacks of cross species bone grafting. In an
Statistics in Practice
Authors: Jay H. Lubin
Journal: JAMA (1982)

Surveys by several authors suggest that the number of poorly designed and poorly analyzed studies that are published in reputable medical journals is distressingly high. As a group, researchers must thus be more fully aware of the importance of the statistical aspects of a study (which may include consultation with statisticians) in order that conclusions are justifiably drawn. Readers also must possess the tools to assess critically whether a study is based on correct and relevant statistical principles, since the appearance of a study in a journal does not necessarily imply statistical accuracy.<i>Statistics in Practice</i>seeks to provide a framework for nonstatisticians to upgrade their statistical understanding. The book succeeds admirably. The first section of the book, by Mr Altman, is subtitled "Statistics and Ethics in Medical Research" and is organized into eight chapters. He begins with the well-argued proposition that bad statistics is unethical. The more usual concern
Transient Antibody to Lymphadenopathy-Associated Virus/Human T-Lymphotropic Virus Type III and T-Lymphocyte Abnormalities in the Wife of a Man Who Developed the Acquired Immunodeficiency Syndrome
Authors: HAROLD BURGER
Journal: Annals of Internal Medicine (1985)

We present evidence of transmission of lymphadenopathy-associated virus (LAV)/human T-lymphotropic virus type III (HTLV-III) from a man to his wife, and a return to a normal number of T-helper lymphocytes and loss of antibody after discontinuing sexual exposure to LAV/HTLV-III. The man had hemophilia A, and developed the lymphadenopathy syndrome, antibody to LAV, and a low number of T-helper lymphocytes. His wife, who had no risks for the acquired immunodeficiency syndrome other than sexual contact with him, developed LAV antibody (titer, 1:160) and a mildly decreased number of T-helper cells. The husband subsequently developed the syndrome and lost the LAV antibody. During 10 months of follow-up his wife remained clinically well, discontinued exposure to semen, and then lost the LAV antibody, and regained a normal number of T-helper cells.
Nonuniformity of Endothelial Constitutive Nitric Oxide Synthase Distribution in Cardiac Endothelium
Authors: Luc J. Andries, Dirk L. Brutsaert, Stanislas U. Sys
Journal: Circulation Research (1998)

Abstract —Endocardial endothelium and endothelium of coronary vessels produce NO. Histochemical methods have suggested that coronary arterial endothelial cells contain more endothelial constitutive NO synthase (ecNOS) than does coronary venous endothelium. We have further investigated the distribution of ecNOS in cardiac endothelium using immunofluorescence and en face confocal microscopy of rat heart. In endocardial endothelium, confocal microscopy revealed distinct ecNOS labeling of peripheral cell borders, cytoplasmic labeling, and labeling of the Golgi complexes. Labeling of the cell borders and of the Golgi complexes was confirmed by double staining for ecNOS and for platelet and endothelial cell adhesion molecule or Golgi 58k protein, respectively. Cytoplasmic labeling was strongest in coronary arterial endothelium. The size of the ecNOS-labeled Golgi complexes decreased from coronary arterial endothelial cells (8.63±0.39 μm 2 , mean±SE of 5 rats) to endocardial endothelium (7.07±0.61 μm 2 ) and to coronary venous endothelium (3.65±0.20 μm 2 ). In addition, pixel intensity of ecNOS labeling was higher in arterial endothelial cells than in venous endothelial cells. Endothelium of myocardial capillaries also contained small ecNOS-labeled Golgi complexes. No correlation was observed between endothelial cell surface area and Golgi complex size. Caveolin-1 labeling was strongest in capillaries and did not coincide completely with ecNOS labeling in endocardial and venous endothelium. These results suggest that endocardial and coronary arterial endothelium in the rat have a higher synthetic activity and might express more ecNOS than is expressed by cardiac venous and capillary endothelium. The observed heterogeneity in ecNOS distribution might be related to the specific mechanochemical environment and function of each endothelial compartment.
Dual Time Point C-11 Acetate PET Imaging Can Potentially Distinguish Focal Nodular Hyperplasia From Primary Hepatocellular Carcinoma
Authors: Li Huo, Zhanhong Wu, Hongming Zhuang, Zhe Fu, Yonghong Dang
Journal: Clinical Nuclear Medicine (2009)

C-11 acetate positron emission tomography (PET) is known to have high sensitivity in detecting hepatocellular carcinoma. However, one of the shortcomings of C-11 acetate PET in the diagnosis of hepatocellular carcinoma is that C-11 acetate also accumulates in focal nodular hyperplasia, which makes it challenging to distinguish hepatocellular carcinoma form focal nodular hyperplasia when a conventional single time point PET imaging method is used. Two patients with suspected hepatocellular carcinoma and negative fluoro-deoxy-glucose PET scans underwent C-11 acetate PET dual time imaging in which both early and delayed images were acquired. One patient was subsequently confirmed having hepatocellular carcinoma while the other had focal nodular hyperplasia. C-11 acetate imaging was positive in both patients. Interestingly, in hepatocellular carcinoma the C-11 acetate activity in the delayed images is higher than in the early images while in focal nodular hyperplasia, the C-11 acetate activity decreased in the delayed image when compared with early images. Our findings suggest that dual time point imaging has potential to improve the diagnostic accuracy of C-11 acetate PET in the diagnosis of hepatocellular carcinoma.
Proliferative effects of several hematopoietic growth factors on acute myelogenous leukemia cells and correlation with treatment outcome
Authors: M Tsuzuki, K Ezaki, F Maruyama, T Ino, H Kojima, M Okamoto, T Yamaguchi, T Nomura, H Miyazaki, M Wakita, T Matsui, M Hirano
Journal: Leukemia (1997)
Commentary: Controversies in NICE guidance on irritable bowel syndrome
Authors: Nicholas J Talley
Journal: BMJ (2008)

Consider tricyclic antidepressants as second line treatment for abdominal pain or discomfort if laxatives, loperamide, or antispasmodics have not helped.Start treatment at a low dose (5-10 mg equivalent of amitriptyline) taken once at night, and review regularly.The dose can be increased but does not usually need to exceed 30 mg.If this fails, consider treatment with a low dose selective serotonin reuptake inhibitor.Psychological interventions (such as cognitive behaviour therapy, hypnotherapy, and psychological therapy) may reduce pain and other symptoms and improve quality of life.Consider such treatments for those who have had symptoms for at least 12 months and have not responded to first line treatments.Advise patients that reflexology, acupuncture, and aloe vera have shown no benefit and are therefore not recommended.Do not discourage people from trying specific probiotic products for at least four weeks.Data from dietary elimination and food challenge studies are limited and sometimes contradictory; however, if diet is considered a major factor in a person's symptoms even after general lifestyle and dietary advice has been followed, consider referral to a dietitian for advice on avoidance of single foods and an exclusion diet. Overcoming barriersThe emphasis on positive diagnosis, optimal clinical and cost effective management of IBS, and the
Induced Abortion and the Risk of Breast Cancer
Authors: Mads Melbye, Jan Wohlfahrt, Jørgen H. Olsen, Morten Frisch, Tine Westergaard, Karin Helweg-Larsen, Per Kragh Andersen
Journal: New England Journal of Medicine (1997)

It has been hypothesized that an interrupted pregnancy might increase a woman's risk of breast cancer because breast cells could proliferate without the later protective effect of differentiation.