tbuckley/cabot-search huggingface dataset:
Lessons learned from the study of immigrants to Israel from areas of Russia, Belarus, and Ukraine contaminated by the Chernobyl accident.
Authors: M R Quastel, J R Goldsmith, J Cwikel, L Merkin, V Y Wishkerman, S Poljak, A Abdelgani, E Kordysh, A Douvdevani, J Levy, R Gorodisher, Y Barki, I Emerit, G Kramer
Journal: Environmental Health Perspectives (1997)

During the past 6 years, immigration to Israel of 700,000 persons from the former Soviet Union (FSU) included about 140,000 from radiocontaminated regions of Belarus, Ukraine, and Russia near Chernobyl. In Beer Sheva, a major center for immigrant absorption in Israel, a primary objective was to evaluate their health status and to refer them for care. 137Cs levels in 1228 men, women, and children were measured with a portable whole-body counter. Whole-body counts showed clear correlation with the degree of 137Cs ground contamination in previous regions of residence. The population could thus be sub-divided according to degree of exposure, based on previous regions of residence. The thyroid status of 300 local immigrant children was evaluated because of the increased risk of childhood thyroid cancer in the regions from which they came. This group was subdivided into comparative groups of children who came from less and more contaminated areas according to the International Atomic Energy Agency soil 137Cs contamination maps. Enlarged thyroids were found in about 40% of both groups. One 12-year-old girl from Gomel had a malignant papillary carcinoma. Thyroid-stimulating hormone levels, though within normal limits, were significantly greater (p < 0.02) for girls from high exposure regions. Liquidators showed significant increases in serum clastogenic factor and in the number of circulating glycophorin A-mutated red cells. In studies of over 700 people from both radiocontaminated and unaffected regions of the FSU, evidence for posttraumatic stress disorder was found more frequently in persons coming from the more contaminated areas.
Reply to M.R. Green et al
Authors: Oliver A. Cornely, Mark A. Miller, Bruno R. Fantin, Kathleen M. Mullane, Yin Kean, Sherwood L. Gorbach
Journal: Journal of Clinical Oncology (2013)

We thank Green et al for their interest in our article on Clostridium difficile infection (CDI) in patients with cancer. They correctly point out that our analysis found higher cure rates, higher sustained response rates, and fewer recurrences in adult patients with cancer who received fidaxomicin versus vancomycin for treatment of CDI. Despite their comments on the size of our subgroup analysis, it is important to note that our analysis is (to our knowledge) the largest published collection of patients with cancer with CDI, and it represents the findings from many hospitals across North America and Europe. We addressed this patient group because of its significant burden of CDI, as Green et al acknowledge. Although post hoc, our analysis was unbiased in selecting all patients with cancer who were enrolled in our phase III trials, regardless of cancer type and therapy. Our article confirmed that patients with cancer have a worse outcome with C. difficile infection. Green et al refer to the current guidelines for treating mild-tomoderate CDI cases with metronidazole; however, these recommendations are not supported by clinical trials that show comparative metronidazole efficacy specifically in patients with cancer. What has been published is that metronidazole is felt to be less active than vancomycin in severe CDI, which is likely to be present more often in patients with cancer. As pointed out by Green et al, the fact that accurate evaluation of the severity of CDI in patients with cancer is difficult hardly gives adequate support for treating CDI with metronidazole in patients with cancer. We agree that a prospective controlled clinical trial is needed. However, such a trial would take 2 to 3 years to complete, and in the meantime we have presented data that vancomycin, and by inference, metronidazole, are not optimal treatments for CDI in patients with cancer.
Continuous wave Doppler echocardiographic measurement of prosthetic valve gradients. A simultaneous Doppler-catheter correlative study.
Authors: D J Burstow, R A Nishimura, K R Bailey, G S Reeder, D R Holmes, J B Seward, A J Tajik
Journal: Circulation (1989)

Studies correlating prosthetic valve gradients determined by continuous wave Doppler echocardiography with gradients obtained by cardiac catheterization have, to date, been limited to patients with mitral and tricuspid prostheses or have compared nonsimultaneous measurements. Simultaneous Doppler and catheter pressure gradients in 36 patients (mean age, 63 +/- 13 years) with 42 prosthetic valves (20 aortic, 20 mitral, one tricuspid, and one pulmonary) were studied. Catheter gradients were obtained using a dual-catheter technique. The simultaneous pressure tracings and Doppler flow velocity profiles were digitized at 10-msec intervals to derive the corresponding maximal and mean gradients. The correlation between the maximal Doppler gradient and the simultaneously measured maximal catheter gradient was 0.94 (SEE = 6), and that between the Doppler gradient and the simultaneously measured mean catheter gradient was 0.96 (SEE = 3). There were no significant differences in correlation between gradients for the 32 mechanical valves (maximal gradients: r = 0.95, SEE = 6; mean gradients: r = 0.96, SEE = 3) and the 10 bioprosthetic valves (maximal gradients: r = 0.89, SEE = 6; mean gradients: r = 0.93, SEE = 3). In patients with mitral prostheses, Doppler gradients correlated well with the corresponding catheter gradients obtained with direct measurement of left atrial pressure (maximal gradients: r = 0.96, SEE = 2; mean gradients: r = 0.97, SEE = 1.2). A close correlation between corresponding Doppler and catheter gradients also was found in patients with aortic prostheses (maximal gradients: r = 0.94, SEE = 6; mean gradients: r = 0.94, SEE = 3). Thus, continuous wave Doppler echocardiography can accurately predict the pressure gradient across prosthetic valves.
Points from Letters: Patient's all-in medicine card
Authors: H Jacobs
Journal: BMJ (1978)

<h3>Abstract</h3> Patients with drug-resistant epilepsy can experience respiratory alterations notably during seizures. The mechanisms underlying this long-term alteration of respiratory function remain unclear. This study aimed at determining in rats whether epilepsy is associated with alterations of both the respiratory function and brainstem serotonin (5-HT) system. Epilepsy was triggered by pilocarpine-induced <i>status epilepticus</i> in rats. 30-50% of epileptic (EPI) rats exhibited sharp decrease of oxygen consumption (SDOC), low metabolic rate of oxygen and slow regular ventilation; these rats were called EPI/SDOC+ rats. These alterations were only detected in rats with chronic epilepsy, independent of behavioral seizures, persisted over the time, and were not associated with death. In these rats, 5-HT fiber density in the nucleus <i>tractus solitarius</i> was below that of control and EPI/SDOC-rats. Both EPI/SDOC+ rats and DBA/2 mice presenting with fatal respiratory arrest following an audiogenic-induced seizure, a model of sudden and expected death in epilepsy, had increased transcript levels of tryptophan hydroxylase 2 (p&lt;0.001 for both strains) and 5-HT presynaptic transporter (rats: p=0.003; mice: p=0.001). Thus, our data support that 5-HT alterations are associated with chronic and acute epilepsy-related respiratory dysfunctions.
BRITISH MEDICAL WOMEN IN INDIA
Authors: M. I. Balfour
Journal: BMJ (1925)

The efficacy of different radiodiagnostic agents for demonstrating the decline in renal function from cyclosporine (CyA) nephrotoxicity was assessed in rats receiving a standard dose of the drug for 2 wk, compared with control rats. The agents included [<sup>99m</sup>Tc]DTPA, [<sup>131</sup>I]hippuran, [<sup>111</sup>In]lysozyme, [<sup>99m</sup>Tc]glucoheptonate (GHA), [<sup>99m</sup>Tc]dimercaptosuccinate (DMS) and [<sup>111</sup>In] aminated dextran (amdex). A small dose of [<sup>99m</sup>Tc]-or [<sup>111</sup>In]DTPA was administered simultaneously to normalize the results for variations in drug response from one animal to another. There were statistically significant differences in the detectability of the renal functional impairment by plasma clearance, early and 2-hr renal uptake among the different agents. However, none was clearly superior to DTPA. This conclusion is consistent with previous studies which showed a parallel decline in glomerular filtration rate (GFR) and effective renal plasma flow in acute CyA toxicity probably due primarily to vasoconstriction.
Loss of Warfarin Effect After Occupational Insecticide Exposure
Authors: William H. Jeffery
Journal: JAMA (1976)

NUMEROUS drugs have been reported to induce the metabolism of warfarin sodium, 1 and several chemicals in the environment are known to be inducers of oxidative drug metabolism. 2 There have been reports of enzyme induction in workers occupationally exposed to chlorinated hydrocarbon insecticides, in which the individuals were given test drugs, and half-lives were studied. 3   We report the case of a patient who demonstrated resistance to the hypoprothrombinemic effect of warfarin on two occasions after intense exposure to a chlorinated hydrocarbon insecticide mixture.  Report of a Case  A 53-year-old rancher was first admitted to Bernalillo County Medical Center, Albuquerque, NM, in December 1973, with the diagnosis of left femoral thrombophlebitis. He was treated with heparin sodium and warfarin and discharged taking warfarin sodium, 7.5 mg daily. His warfarin sodium dosage was increased to 10 mg alternating with 7.5 mg daily on Dec 28, 1973. On Jan 10, 1974,
The Management of Psychiatric Patients: Courts, Patients' Representatives, and the Refusal of Treatment
Authors: William J. Curran
Journal: New England Journal of Medicine (1980)

A SERIOUS loss of judicial confidence in the efficacy of psychiatric treatment is clearly reflected in two decisions reached in the federal courts in recent months. The cases were hard fought on both sides, and the opinions are laboriously well thought out and soberly written.At the district-court trial level in the federal system, the judges heard evidence of inadequate treatment of patients in public mental hospitals in Massachusetts and New Jersey. The Massachusetts case, Rogers vs. Okin,1 decided by Judge Tauro, consumed 72 trial days, 8000 pages of transcript testimony and exhibits, and more than 2300 pages of argument . . .
Decrease in Ca sensitivity as a mechanism of hydrogen peroxide-induced relaxation of rabbit aorta
Authors: T IESAKI, T OKADA, I SHIMADA, H YAMAGUCHI, R OCHI
Journal: Cardiovascular Research (1996)

In vascular strips, hydrogen peroxide (H2O2) relaxes alpha 1-adrenergic agonist-induced but not high-K(+)-induced contractions. The aim of this study was to explore H2O2-induced changes in [Ca2+]i of vascular smooth muscle and to elucidate the mechanisms of action of H2O2.Isolated rabbit aortic strips were isometrically contracted with high-K+ (64.7 mM) or phenylephrine (PE, 0.3 microM). The effects of 300 microM H2O2 on [Ca2+]i of endothelium-denuded vascular smooth muscle and tension were determined simultaneously by the fura-2 method. Changes in [Ca2+]i were expressed as percentages of high-K(+)-induced values measured at the beginning of the experiments. In another series of experiments, the relaxant effect of 300 microM H2O2 was examined in high-K+ (20 mM)-induced contraction in the presence of the protein kinase C activator, phorbol 12,13-dibutyrate (PDBu).Hydrogen peroxide caused a reversible rise in [Ca2+]i of vascular smooth muscle under both resting conditions and in the precontracted state. During high-K(+)-induced contraction, H2O2 further increased [Ca2+]i by 26.6(s.e.m. 1.7)% accompanied by a small increase in tension of 6.5(1.9)% of high-K(+)-induced tension. By contrast, during PE-induced contraction, although H2O2 caused a comparable additional increase in [Ca2+]i (26.4(4.7)%), muscle tension fell by 28.9(2.2)% of the steady-state PE-induced tension. Hydrogen peroxide had a relaxant effect on augmented high-K(+)-induced contraction in which Ca2+ sensitivity of the contractile apparatus was elevated by PDBu.In spite of its effect of increasing [Ca2+]i of vascular smooth muscle, hydrogen peroxide causes relaxation of endothelium-denuded, PE-precontracted rabbit aorta. The mechanism is probably through suppression of agonist-induced augmentation of Ca2+ sensitivity of the contractile apparatus.
Longitudinal change in collagen degradation biomarkers in idiopathic pulmonary fibrosis: an analysis from the prospective, multicentre PROFILE study
Authors: R Gisli Jenkins, Juliet K Simpson, Gauri Saini, Jane H Bentley, Anne-Marie Russell, Rebecca Braybrooke, Philip L Molyneaux, Tricia M McKeever, Athol U Wells, Aiden Flynn, Richard B Hubbard, Diana J Leeming, Richard P Marshall, Morten A Karsdal, Pauline T Lukey, Toby M Maher
Journal: The Lancet Respiratory Medicine (2015)
Reversal of Early Abnormalities in Glucose Metabolism in Obese Youth: Results of an Intensive Lifestyle Randomized Controlled Trial
Authors: Mary Savoye, Sonia Caprio, James Dziura, Anne Camp, Greg Germain, Craig Summers, Fangyong Li, Melissa Shaw, Paulina Nowicka, Romy Kursawe, Fredrick DePourcq, Grace Kim, William V. Tamborlane
Journal: Diabetes Care (2013)

OBJECTIVE The childhood obesity epidemic has been accompanied by an increasing prevalence of type 2 diabetes (T2D), particularly in minority children. Twenty to thirty percent of obese youth have “prediabetes,” a precursor to diabetes marked by insulin resistance, β-cell dysfunction, and impaired glucose tolerance. The Diabetes Prevention Program demonstrated that T2D could be prevented/delayed by intensive lifestyle modification in adults with prediabetes, but efficacy of similar interventions in youth has not been established. Therefore, we evaluated the effects of the Bright Bodies (BB) Healthy Lifestyle Program on 2-h oral glucose tolerance test (OGTT) glucose in comparison with adolescents receiving standard of care. RESEARCH DESIGN AND METHODS A parallel-group randomized controlled trial comparing BB with standard clinical care (CC) in obese adolescents (10–16 years old, Tanner stage &amp;gt;2) with elevated OGTT 2-h blood glucose (130–199 mg/dL) from a racially/ethnically diverse population. OGTTs, including cardiovascular and anthropometric assessments, were conducted at baseline and 6 months. Children attended BB twice per week for exercise and nutrition/behavior modification, and the CC group received CC from their pediatrician. Primary outcome was change in 2-h OGTT glucose and percentage conversion from elevated 2-h blood glucose to nonelevated (&amp;lt;130 mg/dL) 2-h blood glucose. Changes in outcomes were compared between groups using an ANCOVA, with adjustment for baseline outcome and multiple imputation for missing data. RESULTS Reductions in 2-h glucose were more favorable in BB compared with CC (−27.2 vs. −10.1 mg/dL; difference = −17.1, 95% CI; P = 0.005). Moreover, greater conversion to &amp;lt;130 mg/dL 2-h glucose occurred in BB than CC (P = 0.003), and other insulin sensitivity indices were significantly improved. CONCLUSIONS Compared with standard of care, the Yale BB Program is a more effective means of reducing the risk of T2D in obese adolescents with elevated 2-h glucose levels.
Intraductal Ultrasonography of the Pancreas: Development and Clinical Potential
Authors: T. Furukawa, K. Oohashi, K. Yamao, Y. Naitoh, Y. Hirooka, T. Taki, A. Itoh, S. Hayakawa, Y. Watanabe, H. Goto, T. Hayakawa
Journal: Endoscopy (1997)

Intraductal ultrasound (IDUS) probes mounted with 30 MHz or 20 MHz transducers were evaluated in the diagnosis of 239 patients with pancreatic disease (including 48 cancers, 90 mucin-producing tumors, seven islet-cell tumors, two metastatic pancreatic tumors, seven serous cystadenomas, one pancreatic teratoma, three solid cystic tumors, 49 cases of chronic pancreatitis, 25 cases of focal pancreatitis, and seven cases of pancreatolithiasis). The probe was inserted via the papilla into the main pancreatic duct. In terms of resolution, IDUS at 20 MHz was able to image cystic lesions of less than 30 mm in diameter and solid lesions of less than 20 mm in diameter. With regard to vessels, IDUS was able to image the entire cross-section of the portal vein and other large veins. IDUS was useful in detecting carcinoma in situ and small tumors, in assessing the intraductal spread of the tumor and its pancreatic parenchymal invasion in mucin-producing tumors of the main duct, and in assessing the indications for surgery by revealing mural nodules in mucin-producing tumors of the ductal branches. IDUS was also useful in evaluating the feasibility of partial resection of the tumor in mucin-producing tumors of the ductal branches and pancreatic islet-cell tumors, in accurately locating multiple lesions in pancreatic islet-cell cancer, and in differentiating benign from malignant cases of localized stenosis of the main pancreatic duct related to pancreatic stenting. With IDUS, the site of pancreatic stones could be identified in order to assess the need for endoscopic treatments such as stenting of the pancreatic duct and the bile duct, and the use of pulsed-dye laser treatment under pancreatoscopy for pancreatic stones. Acute pancreatitis as a complication occurred in one of the 239 patients who underwent IDUS (0.4%). An awareness of the limitations and usefulness of IDUS in evaluating pancreatic diseases can contribute to the treatment of these conditions.
Assessment of efficacy and acceptability of low dose cyclosporin in patients with rheumatoid arthritis.
Authors: M Dougados, L Duchesne, H Awada, B Amor
Journal: Annals of the Rheumatic Diseases (1989)

The efficacy of cyclosporin in a double blind, placebo controlled trial of four months' duration has previously been reported by us. To assess the benefit-to-risk of cyclosporin this study was followed by a one year open trial including 49 of the previous 52 patients. Cyclosporin was given at an initial dosage of 5 mg/kg/day and then modulated on the basis of efficacy and renal toxicity. During the study the drug had to be discontinued in 32 patients: because of inefficacy in 10, side effects in 11, both in nine, and in two because of unrelated events. The significant clinical improvement noted at four months persisted through one year in the 17 patients who continued to receive treatment. Nephrotoxicity of the drug (24 patients) required constant and close monitoring as well as modulation of daily drug dosage during the trial. This study indicated that cyclosporin might be valuable in the treatment of patients with advanced rheumatoid arthritis, in whom other second line agents have failed.
Serology for Helicobacter pylori compared with symptom questionnaires in screening before direct access endoscopy.
Authors: M A Mendall, R P Jazrawi, J M Marrero, N Molineaux, J Levi, J D Maxwell, T C Northfield
Journal: Gut (1995)

This prospective study aimed to compare serology for Helicobacter pylori with two, symptom questionnaires in screening patients before direct access endoscopy. Methods were compared in terms of the number of endoscopies saved and pathology missed in 315 patients referred to a gastroenterology unit by 65 local GPs. The serology used was based on an acid glycine extract of H pylori. One in-house questionnaire was based on the Glasgow dyspepsia (GLADYS) system and the other questionnaire was that reported by Holdstock et al. A cut off point of 6.3 U/ml for H pylori serology was selected for screening patients (97% sensitive and 75% specific). Serology was combined with a history of NSAID usage in determining who should have endoscopy. For the in-house questionnaire, a cut off score of more than 8 out of a possible maximum of 18 was chosen, after prior evaluation in 118 patients referred for direct access endoscopy (the sensitivity for detection of peptic ulcer was 88%, specificity 61%). A cut off score of more than 412 was used for the Holdstock questionnaire. In patients under 45 years, serology detected more peptic ulcers than the in-house questionnaire and the Holdstock questionnaire (27/28 v 24/28, NS and v 20/28, p &lt; 0.05 respectively). The Holdstock questionnaire saved significantly more endoscopies than the other two methods (76/149 v 57/149 for the in-house questionnaire, p = 0.05 and 59/149 for serology, p = 0.05). In all age groups combined, serology was significantly better than the in-house and Holdstock questionnaires at detecting peptic ulcers and gastric cancer (61/63, 52/63, p&lt;0.02, and 50/63, p&lt;0.01 respectively). But serology saved significantly fewer endoscopies (89/315, 135/315, p&lt;0.005, and 119/315, p&lt;0.05 respectively). Serology was inferior to the Holdstock questionnaire at detecting severe oesophagitis. It is concluded that serology is the method of choice in screening before direct access upper gastrointestinal endoscopy in those under 45 years. It best combines a high sensitivity for peptic ulcer disease with a large reduction in unnecessary negative endoscopies.
Screening for cardiovascular risk factors.
Authors: B Guthrie
Journal: BMJ (1993)

on previously was taking both desmopressin and methylphenidate.2Desmopressin, imipramine, and methylphenidate are centrally acting drugs, which act as neurotransmitters.The antidiuretic action of desmopressin might possibly be augmented by imipramine and methylphenidate.We agree with Hamed and colleagues that parents should be warned of the dangers of excessive fluid intake when desmopressin is used.We suggest that current treatment with a centrally acting drug should be considered a relative contraindication to treatment with desmo- pressin.We also suggest that any patient who develops vomiting, headache, or nausea during treatment with desmopressin should stop taking the drug and see his or her doctor promptly.
Effects of passive smoking on health of children.
Authors: B G Ferris, J H Ware, C S Berkey, D W Dockery, A Spiro, F E Speizer
Journal: Environmental Health Perspectives (1985)

Analysis of data on the effects of passive smoking obtained in preadolescent children from the Harvard Six-Cities Study demonstrates an exposure-response relationship between the number of smokers in the household and the reporting rates for doctor-diagnosed respiratory illness before age 2, history of bronchitis, wheeze most days and nights apart from colds, and a composite of symptoms defined as the lower respiratory index. Similarly, when only the amount currently smoked by the mother was used, the data indicated a relatively uniform increase in each of the reported diseases and symptoms. FEV1 was lower in children with smoking mothers compared to children of nonsmoking mothers. Rate of increases in FEV1 after adjusting for normal growth was significantly smaller in children of smoking mothers and was related also to amount smoked. Notably the effect on level of FVC was not seen and this finding, consistent in several studies, remains unexplained. Although children of smoking mothers were shorter on the average than children of nonsmoking mothers, no on-going passive smoking effect on height growth can be ascertained. All these differences are small and their medical significance remains to be defined.