tbuckley/cabot-search huggingface dataset:
The Risk of a Diagnosis of Cancer after Primary Deep Venous Thrombosis or Pulmonary Embolism
Authors: Henrik Toft Sørensen, Lene Mellemkjær, Flemming Hald Steffensen, Jørgen H. Olsen, Gunnar Lauge Nielsen
Journal: New England Journal of Medicine (1998)

Several small studies have indicated an association between deep venous thrombosis or pulmonary embolism and a subsequent diagnosis of cancer, but the subject is controversial.We conducted a nationwide study of a cohort of patients with deep venous thrombosis or pulmonary embolism that was drawn from the Danish National Registry of Patients for the years 1977 through 1992. The occurrence of cancer in the cohort was determined by linkage to the Danish Cancer Registry. The expected number of cancer cases was estimated on the basis of national age-, sex-, and site-specific incidence rates.A total of 15,348 patients with deep venous thrombosis and 11,305 patients with pulmonary embolism were identified. We observed 1737 cases of cancer in the cohort with deep venous thrombosis, as compared with 1372 expected cases (standardized incidence ratio, 1.3; 95 percent confidence interval, 1.21 to 1.33). Among the patients with pulmonary embolism, the standardized incidence ratio was 1.3, with a 95 percent confidence interval of 1.22 to 1.41. The risk was substantially elevated only during the first six months of follow-up and declined rapidly thereafter to a constant level slightly above 1.0 one year after the thrombotic event. Forty percent of the patients given a diagnosis of cancer within one year after hospitalization for thromboembolism had distant metastases at the time of the diagnosis of cancer. There were strong associations with several cancers, most pronounced for those of the pancreas, ovary, liver (primary hepatic cancer), and brain.An aggressive search for a hidden cancer in a patient with a primary deep venous thrombosis or pulmonary embolism is not warranted.
Effects of indomethacin on postural hypotension in Parkinsonism.
Authors: G Abate, R M Polimeni, F Cuccurullo, P Puddu, S Lenzi
Journal: BMJ (1979)

A study was conducted to evaluate the effect of indomethacin on orthostatic hypotension in Parkinsonism. Twelve elderly patients participated and the drug was given in two-ways--as an intravenous infusion of 50 mg over 30 minutes and by mouth 50 mg thrice daily for six days. Results were assessed by measuring the degree of hypotension on standing, response to the cold pressor test, and forearm blood flow (by strain-gauge plethysmography). Indomethacin significantly reduced the fall in blood pressure on standing (P less than 0:001) and lessened or reversed orthostatic symptoms. Furthermore, there was an enhanced response to the cold pressor test and a reduction in forearm blood flow. These findings suggest that indomethacin has a positive effect on systemic vascular resistance.
Which Features of Smoking Determine Mortality Risk in Former Cigarette Smokers With Diabetes? The World Health Organization Multinational Study Group
Authors: Nish Chaturvedi, Lynda Stevens, John H Fuller
Journal: Diabetes Care (1997)

OBJECTIVE The effects of quitting smoking on mortality risk in individuals with diabetes is unknown and may differ from the benefits observed in the general population. We therefore determined the mortality risks in ex-smokers with diabetes, compared with subjects who have never smoked, by the number of years since quitting, the number of cigarettes smoked, and the number of years of smoking. RESEARCH DESIGN AND METHODS An international cohort study of 4,427 individuals with diabetes was studied. Baseline examinations were performed in 1975–1977 when smoking habits were determined by questionnaire. Mortality follow-up continued until 1988. RESULTS All-cause mortality risks were higher for recent quitters (1–9 years; relative risk [RR], 1.53 [95% CI 1.19–1.97]; P = 0.001) than for those who quit earlier (≥ 10 years; RR, 1.25 [95% CI 1.03–1.52]; P = 0.02), compared with subjects who have never smoked. These risks were highest in those who had smoked the longest (≥ 30 years: RR, 1.66 [95% CI 1.22–2.26]; P = 0.001; vs. 1–9 years: RR, 1.17 [95% CI 0.85–1.60]; P = 0.3). Risks were also highest in those who had smoked the most and least number of cigarettes. Adjustment for key confounders, which included a previous history of heart disease, proteinuria, and blood pressure, did not materially affect these relationships. CONCLUSIONS Quitting smoking does reduce mortality risk in ex-smokers with diabetes, but risks remain high several years after quitting and are highly dependent on the duration of smoking. Thus, individuals with diabetes who smoke should be encouraged to quit as soon as possible in the course of disease.
Population Intermediate Outcomes of Diabetes Under Pay-for-Performance Incentives in England From 2004 to 2008
Authors: Pooja Vaghela, Mark Ashworth, Peter Schofield, Martin C. Gulliford
Journal: Diabetes Care (2008)

To evaluate diabetes outcomes under a national "pay-for-performance" program.Data were analyzed for 98% of all English family practices. For each practice, the proportion of diabetic subjects with A1C <or=7.5%, blood pressure <or=145/85 mmHg, and cholesterol <or=5 mmol/l was determined. Practices achieving less than the 25th centile for the A1C target for 2006-2007 were classified as low performing.The proportion achieving the A1C target at the median practice increased from 59.1% (interquartile range [IQR] 51.7-65.9) in 2004-2005 to 66.7% (IQR 60.6-72.7) in 2007-2008, blood pressure from 70.9% in 2004-2005 to 80.2% in 2007-2008, and cholesterol from 72.6% in 2004-2005 to 83.6% in 2007-2008. In 2004-2005, 57% of practices were low performing (range by region 42.4-69.9). In 2007-2008, 26% of practices were low performing (range 11.6-37.5).Introduction of pay-for-performance may be one factor contributing to increasing achievement of targets and reducing problems of low performance.
Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study
Authors: Lynn P. Lowe, Boyd E. Metzger, Alan R. Dyer, Julia Lowe, David R. McCance, Terence R.J. Lappin, Elisabeth R. Trimble, Donald R. Coustan, David R. Hadden, Moshe Hod, Jeremy J.N. Oats, Bengt Persson
Journal: Diabetes Care (2012)

To compare associations of maternal glucose and A1C with adverse outcomes in the multinational Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study and determine, based on those comparisons, if A1C measurement can provide an alternative to an oral glucose tolerance test (OGTT) in pregnant women.Eligible pregnant women underwent a 75-g OGTT at 24-32 weeks' gestation. A sample for A1C was also collected. Neonatal anthropometrics and cord serum C-peptide were measured. Associations with outcomes were assessed using multiple logistic regression with adjustment for potential confounders.Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, 21,064 had a nonvariant A1C result. The mean ± SD A1C was 4.79 ± 0.40%. Associations were significantly stronger with glucose measures than with A1C for birth weight, sum of skinfolds, and percent body fat >90th percentile and for fasting and 1-h glucose for cord C-peptide (all P < 0.01). For example, in fully adjusted models, odds ratios (ORs) for birth weight >90th percentile for each measure higher by 1 SD were 1.39, 1.45, and 1.38, respectively, for fasting, 1-, and 2-h plasma glucose and 1.15 for A1C. ORs for cord C-peptide >90th percentile were 1.56, 1.45, and 1.35 for glucose, respectively, and 1.32 for A1C. ORs were similar for glucose and A1C for primary cesarean section, preeclampsia, and preterm delivery.On the basis of associations with adverse outcomes, these findings suggest that A1C measurement is not a useful alternative to an OGTT in pregnant women.
Effect of a Low–Glycemic Index or a High–Cereal Fiber Diet on Type 2 Diabetes
Authors: David J. A. Jenkins, Cyril W. C. Kendall, Gail McKeown-Eyssen, Robert G. Josse, Jay Silverberg, Gillian L. Booth, Edward Vidgen, Andrea R. Josse, Tri H. Nguyen, Sorcha Corrigan, Monica S. Banach, Sophie Ares, Sandy Mitchell, Azadeh Emam, Livia S. A. Augustin, Tina L. Parker, Lawrence A. Leiter
Journal: JAMA (2008)

Clinical trials using antihyperglycemic medications to improve glycemic control have not demonstrated the anticipated cardiovascular benefits. Low-glycemic index diets may improve both glycemic control and cardiovascular risk factors for patients with type 2 diabetes but debate over their effectiveness continues due to trial limitations.To test the effects of low-glycemic index diets on glycemic control and cardiovascular risk factors in patients with type 2 diabetes.A randomized, parallel study design at a Canadian university hospital research center of 210 participants with type 2 diabetes treated with antihyperglycemic medications who were recruited by newspaper advertisement and randomly assigned to receive 1 of 2 diet treatments each for 6 months between September 16, 2004, and May 22, 2007.High-cereal fiber or low-glycemic index dietary advice.Absolute change in glycated hemoglobin A(1c) (HbA(1c)), with fasting blood glucose and cardiovascular disease risk factors as secondary measures.In the intention-to-treat analysis, HbA(1c) decreased by -0.18% absolute HbA(1c) units (95% confidence interval [CI], -0.29% to -0.07%) in the high-cereal fiber diet compared with -0.50% absolute HbA(1c) units (95% CI, -0.61% to -0.39%) in the low-glycemic index diet (P < .001). There was also an increase of high-density lipoprotein cholesterol in the low-glycemic index diet by 1.7 mg/dL (95% CI, 0.8-2.6 mg/dL) compared with a decrease of high-density lipoprotein cholesterol by -0.2 mg/dL (95% CI, -0.9 to 0.5 mg/dL) in the high-cereal fiber diet (P = .005). The reduction in dietary glycemic index related positively to the reduction in HbA(1c) concentration (r = 0.35, P < .001) and negatively to the increase in high-density lipoprotein cholesterol (r = -0.19, P = .009).In patients with type 2 diabetes, 6-month treatment with a low-glycemic index diet resulted in moderately lower HbA(1c) levels compared with a high-cereal fiber diet. Trial Registration clinicaltrials.gov identifier: NCT00438698.
Running training on different surfaces have different effects on performance
Authors: Rajkumar Karve, Pratap Singh Tiwari
Journal: British Journal of Sports Medicine (2010)

Introduction The surfaces on which athletes run can play a large role in determining how well they perform. Calf circumference increased significantly in sand runners. Both treatment groups showed a similar significant increase in vertical jump. The 12-min run/walk was significantly increased in sand runners. This study shows that a 6-week sand running programme may result in the most physiological and performance changes in young men. Sample 120 PU college athletes from different colleges of Gulbarga District were selected as subjects by random sampling method and divided into four equal groups of 30 athletes in each group: Ex. Group I running training on sand, Ex. Group II running training on red mud track, Group III running training on cinder track and Group IV served as control group. Objectives To study the effect of different running surfaces training on the performance of athletes. To assess the effect of training on different running surfaces on the calf and thigh circumference of athletes. To analyse the differences in the performance of 12 min run and walk test and vertical jump test of three different experimental groups and control group. Methodology Before the training on different running surfaces, the performances of 12 min run and walk test and vertical jump and also calf and thigh circumference of each athlete is measured as pre-test results. Eight weeks training programme on different surfaces is conducted to all the three groups simultaneously and no training was given to control group. After the training the calf and thigh circumference of each athlete is measured as post-test results, further vertical jump test is administered and also Cooper's 12 min run and walk test is conducted on the cinder track. Conclusions There is a significant effect of running training on different surfaces on the performances of three groups. There is a significant effect of running training on different surfaces on the performance of Group III (running training on sand) as compared to other two groups. Calf and thigh circumference increased significantly in sand runners. Both treatment groups showed a similar significant increase in vertical jump. The 12-min run/walk was significantly increased in sand runners. This kind of basic intervention training programme (ie, training on different running surfaces) would help to find a marathon runner.
Bleeding from multifocal heterotopic gastric mucosa in the colon controlled by an H2 antagonist.
Authors: F E Murray, M Lombard, P Dervan, R J Fitzgerald, J Crowe
Journal: Gut (1988)

The sixth documented case of heterotopic gastric mucosa in the large bowel proximal to the rectum is described in a two year old girl with a neural tube defect and recurrent rectal bleeding. Unusual in itself, this case is unique in that the rectal bleeding has been controlled with an H2 receptor antagonist.
Achieving the Millennium Development Goals — The Case of Malaria
Authors: Jeffrey D. Sachs
Journal: New England Journal of Medicine (2005)

Malaria currently kills up to 3 million people per year worldwide, most of them children in sub-Saharan Africa.1 Yet the disease is utterly treatable and highly preventable. Now, the international community has vowed as part of its Millennium Development Goals to make appropriate investments and interventions to bring this scourge under control. These goals, adopted by world leaders at the United Nations Millennium Assembly in September 2000, represent a commitment to reducing extreme poverty and diseases such as malaria sharply by 2015. Among other objectives, the eight development goals call for reducing by half the rates of extreme poverty and . . .
The private finance initiative: NHS capital expenditure and the private finance initiative---expansion or contraction?
Authors: D. Gaffney, A. M Pollock, D. Price, J. Shaoul
Journal: BMJ (1999)

This is the first of four articles on Britain's public-private partnership in health care

Before 1948, building the hospital and community health service was primarily a local government responsibility and new investment depended on local authorities' ability to meet the cost of borrowing. The “depressed areas,” which had the worst health status, were inevitably disadvantaged. Investment patterns during the interwar years contributed to the inequitable distribution of the infrastructure, which was, according the official historian of the NHS, a “ramshackle and largely bankrupt edifice.”1 The 1946 act led to the nationalisation of the inherited hospital infrastructure and the centralisation of the responsibility for financing its improvement within the ministry of health. NHS hospital building was to be financed by central government grants and funded out of general taxation and national insurance contributions.

The NHS initially made little impact on its inherited infrastructure problems because public sector investment in the postwar years was concentrated on education and housing. Aneurin Bevan, among others, suggested that spending controls could be evaded if hospital boards were allowed to borrow from the market, as they had before the war. But with funding now ultimately paid for out of general taxation, no rationale could be found for allowing boards to borrow at interest rates that would necessarily be higher than those incurred by central government (J Mohan, personal communication). Not until the mid-1950s did a gradual release of funding allow new hospital building in some areas that had a legacy of prewar planning inequities. Even so, the scale of investment fell a long way short of “complete replacement.”2

The principle of major hospital investment was finally adopted in the 1962 hospital plan. The plan was the first attempt to modernise the hospital infrastructure as a whole. But it remains unfulfilled, with only a third …
Acute Carbamazepine Encephalopathy
Authors: Michael Salcman
Journal: JAMA (1975)

<h3>To the Editor.—</h3> We are presenting a case of encephalopathy secondary to a massive overdose of carbamazepine (Tegretol). The clinical picture is nonspecific and may be confused with the postictal state in those patients who have access to this anticonvulsant. <h3>Report of a Case.—</h3> A 16-year-old boy was brought to the Neurological Institute after having failed to recover from a presumed psychomotor seizure. The patient had suffered three previous episodes in the preceding year and therapy had recently been started with carbamazepine, 200 mg twice daily. On admission, the patient was seen in profound stupor. He neither responded to speech nor made spontaneous vocalizations. Minimal painful stimuli would elicit semipurposeful movements of the extremities. Strength, tone, and deep tendon reflexes appeared to be unimpaired. Examination of the cranial nerves showed normal fundi, brisk corneal reflexes, and normal pupillary responses. Nevertheless, biplanar disconjugate gaze (skew deviation) and an absent response to
MASP-3 and Its Association with Distinct Complexes of the Mannan-Binding Lectin Complement Activation Pathway
Authors: Mads R. Dahl, Steffen Thiel, Misao Matsushita, Teizo Fujita, Anthony C. Willis, Tove Christensen, Thomas Vorup-Jensen, Jens C. Jensenius
Journal: Immunity (2001)
Vasectomy—A Note of Concern
Authors: Harold Lear
Journal: JAMA (1972)

An editorial published inThe Journalin 1968<sup>1</sup>suggested that physicians utilize vasectomy as a means of family control and gave reassurance about the legality and respectability of the procedure. The editorial acknowledged that many physicians were reluctant to perform voluntary vasectomy for sterilization "even though it seems to offer the ideal contraceptive for a husband when his family has become as large as he and his wife want or can afford." And it also raised the question: "Why do these men... have so much difficulty obtaining a sterilization operation?," particulary since "voluntary sterilization is safe, effective and legal." Contraindications listed were religious belief, lack of children, sex-oriented psychiatric stigmata, and marital disagreement. In the three years since that editorial appeared, dramatic changes have occurred. An ecologic consciousness has arisen, and overpopulation and "people pollution" have become major sources of concern. In this national atmosphere, vasectomy for sterilization has
Eicosanoids in bronchoalveolar lavage fluid of aspirin-intolerant patients with asthma after aspirin challenge.
Authors: K Sladek, R Dworski, J Soja, J R Sheller, E Nizankowska, J A Oates, A Szczeklik
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

We have recently shown that oral aspirin provocation leads to an increase in LTE4 and a reduction in 11-dehydro-TXB2 levels in urine of patients with aspirin induced-asthma (AIA). To test the hypothesis that cyclooxygenase inhibition and an enhancement of cysteinyl-leukotriene production occurs in the lungs of patients with AIA, we examined the eicosanoid levels in bronchoalveolar lavage fluid obtained 30 min after lysine-aspirin or placebo inhalation in 10 patients with AIA. Eosinophil cationic protein (ECP) levels were determined to evaluate eosinophil activation. Six asthmatics nonsensitive to aspirin (NA) underwent challenge with placebo. The dose of lysine-aspirin inhaled by patients with AIA was equal to that which had produced > or = 20% fall in FEV1. Compared with NA, patients with AIA had: (1) eicosanoid levels, particularly PGE2 and TXB2, elevated and (2) higher number of eosinophils and ECP. The overproduction of eicosanoids could be related to a distinct eosinophilic inflammation in airways of patients with AIA. Inhalation of lysine-aspirin had no effects on 12-HETE and 15-HETE levels, but it markedly depressed cyclooxygenase products and significantly enhanced leukotriene production in the lungs of patients with AIA.
Treatment of Ununited Fracture
Authors: W. C. Worthington
Journal: BMJ (1842)

TREATMENT OF UNUNITED rRACTURE.back on the system, may be attributed the torpor, which is so well-known a symptom in suppressioni of urine.If this idea be correct it would lead to this practical precaution-viz., to be careful even in cases of cholera how we entirely suppress the alvine discharges till the urinary secretion be re-established, should tllere be any disposition to torpor.Certainly in the case I have mentioned as having been lately under my care, the mental torpor came on after the purginig had ceased and before the urinary secretion was properly established, and it was not the effect of opium.
Investigation of the potential for binding of di(2-ethylhexyl) phthalate (DEHP) to rat liver DNA in vivo.
Authors: W K Lutz
Journal: Environmental Health Perspectives (1986)

It was the aim of this investigation to determine whether or not covalent binding of di(2-ethylhexyl) phthalate (DEHP) to rat liver DNA could be a mechanism of action contributing to the observed induction of liver tumors after lifetime feeding of rodents with high doses of DEHP. DEHP radiolabeled in different positions was administered orally to female F344 rats with or without pretreatment for 4 weeks with 1% unlabeled DEHP in the diet. Liver DNA was isolated after 16 hr and analyzed for radioactivity. Administration of [14C]carboxylate-labeled DEHP resulted in no measurable DNA radioactivity. With DEHP [14C]- and [3H]-labeled in the alcohol moiety as well as with 2-ethyl[1-14C]hexanol, radioactivity was clearly measurable in the DNA. HPLC analysis of enzyme-degraded DNA revealed that the normal nucleosides had incorporated radiolabel whereas no radioactivity was detectable in those fractions where the carcinogen-modified nucleoside adducts are expected. A quantitative evaluation of the negative data in terms of a limit of detection for a covalent binding index (CBI) indicates that covalent interaction with DNA is highly unlikely to be the mode of tumorigenic action of DEHP in rodents.
Immediate treatment for drug resistant tuberculosis possible with "while you wait" test
Authors: G. Watts
Journal: BMJ (2010)

An instrument developed in the US after the country’s anthrax contaminated letters scare of 2001 has now been endorsed by the World Health Organization as a more effective means of testing for tuberculosis. 

Manufactured by the Californian company Cepheid, the Xpert MTB/RIF uses a disposable cartridge containing all the reagents required to perform the test. Results are available in about 90 minutes.

Sputum smear microscopy, the method commonly used for detecting tuberculosis, was developed 125 years ago. It misses many cases, especially in children and people who are HIV positive. The diagnosis of drug resistant …