tbuckley/cabot-search huggingface dataset:
Climate Change and Human Health: The Critical Policy Agenda
Authors: William C. G. Burns
Journal: JAMA (2002)

PREDICtion, little noted at the time, that anthropogenic emissions of carbon dioxide would trap the radiative energy of the sun within the earth's atmosphere and raise surface temperatures. 1 An early investigation of this "greenhouse effect" concluded that a "large-scale geophysical experiment" began ever since the Industrial Revolution wed civilization to fossil fuels. 2 The recent data of several international consortia show that global warming is accelerating at a rate far greater than that predicted a century ago and is due in large part to combustion of fossil fuels. 3 This issue of MSJAMA brings together several lines of published evidence that global warming has emerged as a public health challenge requiring serious, concerted action.Jonathan Patz and Mahmooda Khaliq survey the immediate threats posed by climate change as well as some of the more insidious ones.Kent Bransford and Janet Lai find grounds for a common approach to both climate change and air pollution.Stephen Liang and colleagues describe technologies that can help track the spread of climate-sensitive infectious disease vectors.Finally, William Burns discusses public policy tools to respond and adapt to these challenges.Unfounded alarmism has no place either in clinical practice or in the legislative process.On the other hand, we cannot simply ignore extensive, peer-reviewed data on the causes and impacts of climate change.Lending a sense of urgency to this seemingly distant and abstract threat may well require us to link its consequences to our quality of life.In the absence of domestic leadership on global warming, one way to accomplish this goal might be to summon health care professionals to nontraditional advocacy roles.A similar approach helped give birth to the Montreal Protocol of 1987.Parties to the convention that produced the treaty identified depletion of the UV-absorbing ozone layer by chlorofluorocarbons (CFCs) as a public health threat of potentially catastrophic proportions requiring immediate action, namely, the phasing out of CFCs and related compounds. 4 A role for health care professionals in global environmental policy is a natural extension of a growing ethos of preventive medicine, the sort that has, for instance, reduced the prevalence of smoking in the United States and led to improvements in food, highway, and gun safety.Similarly, it is not too late and none too soon for the health care community to advocate policies that wean us from fossil fuels and ultimately mitigate the extent of human-induced climate change.
Late potentials and inducible ventricular tachycardia in surgically repaired congenital heart disease.
Authors: J A Stelling, D A Danford, J D Kugler, J R Windle, J P Cheatham, C H Gumbiner, L A Latson, P J Hofschire
Journal: Circulation (1990)

We compared signal-averaged electrocardiography with invasive electrophysiological study in patients after surgical repair of congenital heart disease to determine if potentially useful correlations exist between the two methods for assessment of risk for ventricular tachycardia. Thirty-one patients (age, 1-49 years; mean, 10.6 years) with congenital heart disease repaired with right ventriculotomy or postrepair right bundle branch block (77% postoperative tetralogy of Fallot) who had electrophysiological study were studied with signal-averaged electrocardiography. Patients were classified by electrophysiological study results as having no inducible ventricular tachycardia, nonsustained ventricular tachycardia, or sustained ventricular tachycardia. Signal-averaged electrocardiograms were examined for the duration of low-amplitude (less than or equal to 40 microV) QRS signal, duration of total QRS, and root-mean-square voltage of the terminal 40 msec of the QRS. Low-amplitude terminal root-mean-square voltage of 100 microV or less had 91% sensitivity and 70% specificity for ventricular tachycardia inducible by electrophysiological study. Similar sensitivity but less specificity were seen using the criterion of 20 msec or more total low-amplitude QRS signal (initial plus terminal) or using total QRS duration of 128 msec or more. There was a weaker association between terminal low-amplitude QRS signal of 15 msec or more and inducible ventricular tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS)
Collagen-induced release of interleukin 1 from human blood mononuclear cells. Potentiation by fibronectin binding to the alpha 5 beta 1 integrin.
Authors: R Pacifici, C Basilico, J Roman, M M Zutter, S A Santoro, R McCracken
Journal: Journal of Clinical Investigation (1992)

PBMC express cell surface receptors for extracellular matrix components known as integrins. We have recently shown that ligand binding to one PBMC integrin, the collagen receptor alpha 2 beta 1, stimulates the secretion of interleukin 1 (IL-1). We have now investigated the role of fibronectin (Fn), an adherence protein that has binding sites for both PBMC and collagen, in the generation of the IL-1 response to collagen. In contrast to collagen, Fn did not stimulate IL-1 release but Fn-depleted serum decreased the release of IL-1 induced by collagen. A polyclonal antiserum directed against Fn also decreased the collagen-induced IL-1 secretion. The IL-1 response to collagen from cells incubated in Fn-depleted serum was restored by the addition of either purified Fn or the 120-kD cell-binding fragment of Fn, which contains the cell-binding site but not the collagen-binding domain. Smaller Arg-Gly-Asp (RGD) peptides failed to enhance the PBMC response to collagen but inhibited in a concentration-dependent fashion the potentiating effect Fn. As expected, a MAb against the alpha 2 beta 1 collagen receptor decreased collagen-induced IL-1 release. However collagen-induced IL-1 release was also inhibited by a MAb against the alpha 5 beta 1 Fn receptor. The effect of the two MAbs was not additive, suggesting that the occupancy of both receptors by ligands is required in order for collagen to induce an maximal response from PBMC. The mechanism by which Fn exerts its effect remains unknown. However, flow-cytometric analysis revealed that Fn does not alter expression of the alpha2beta1 receptor on PBMC. These data demonstrate a potentiating effect of Fn on the collagen-induced secretion of IL-1 from human PBMC and suggest that this effect is mediated via the integrin alpha5beta1. These findings indicate a complex interactive role for specific integrin receptors in the regulation of the mononuclear cell immune response.
Cessation of platelet-mediated cyclic canine coronary occlusion after thrombolysis by combining nitric oxide inhalation with phosphodiesterase-5 inhibition
Authors: Ulrich Schmidt, Richard O Han, Thomas G DiSalvo, J.Luis Guerrero, Herman K Gold, Warren M Zapol, Kenneth D Bloch, Marc J Semigran
Journal: Journal of the American College of Cardiology (2001)
Identification of a locus for porokeratosis palmaris et plantaris disseminata to a 6.9-cM region at chromosome 12q24.1-24.2
Authors: S.C. Wei, S. Yang, M. Li, Y.X. Song, X.Q. Zhang, L. Bu, G.Y. Zheng, X.Y. Kong, X.J. Zhang
Journal: British Journal of Dermatology (2003)

Summary Background Porokeratosis palmaris et plantaris disseminata (PPPD) is a rare autosomal dominant dyskeratotic disorder characterized by a cornoid lamella with parakeratosis, hyperkeratosis and loss of granular layers. The genetic basis of this disease is still unknown. Two loci for disseminated superficial actinic porokeratosis (DSAP) were found to be located on 12q23·2–24·1 and 15q25·1–26·1. Both PPPD and DSAP are disseminated types of porokeratosis. Objectives To locate the locus for PPPD, thereby facilitating the identification of this disease gene and leading to an understanding of the pathogenesis of porokeratosis. Methods Genotyping was performed in a Chinese family with PPPD using polymorphic microsatellite markers on 12q and 15q. Results The locus for PPPD is located within a 6·9‐cM region between markers D12S1613 and D12S1341, with a maximum two‐point LOD score of 8·14 (θ = 0·00) at D12S1335. Conclusions This study provides a map location for isolation of a gene causing PPPD.
Simple method for the preparation of single cell suspensions from normal and tumorous rat colonic mucosa.
Authors: V Perret, R Lev, W Pigman
Journal: Gut (1977)

Viable single cell suspensions from rat colonic epithelium were obtained by using phosphate buffered saline containing 0-2 M mannitol. The method, which requires no prior enzyme treatment, provides undamaged cells in high yield within one hour. The procedure was also applied to neoplastic rat colonic tissue, which was induced by repeated intrarectal infusion of N-methyl-N-nitrosourea. Comparison between normal and neoplastic cells has shown that the latter have a higher nucleus: cytoplasm ratio and a higher metabolic activity.
The development of an Oncoplastic Training Center – OTC
Authors: Angelo Gustavo Zucca Matthes, Rene Aloísio da Costa Viera, Rodrigo Augusto Depieri Michelli, Gustavo Henrique Fabri Pereira Ribeiro, Antônio Bailão, Raphael Luis Haikel, Angelo do Carmo Silva Matthes
Journal: International Journal of Surgery (2012)
Survival in sinoatrial disorder (sick-sinus syndrome).
Authors: D B Shaw, R R Holman, J I Gowers
Journal: BMJ (1980)

A total of 381 patients with established (156) or potential (225) sinoatrial dysfunction were included in a 10-year prospective survey to determine the course of the disease and the benefits of pacing. With the exclusion of nine patients who were lost to follow-up, 61 were fitted with pacemakers. The overall survival of patients with established and potential dysfunction was similar and apparently indistinguishable from that of the normal population. Pacemaker implantation had little discernible effect on mortality though it reduced some incapacitating symptoms. These findings suggest that sinoatrial dysfunction is a relatively benign condition. Hence pacing should probably not be adopted as a routing measure but be reserved for patients with troublesome symptoms.
Evaluation of the Skull Base by SPECT
Authors: MARY T. KEOGAN, NAGUI ANTOUN, PHILIP E. WRAIGHT
Journal: Clinical Nuclear Medicine (1994)

Computed tomography is currently the standard diagnostic tool for the evaluation of the skull base. The complex anatomy of this area is the primary reason why planar bone scintigraphy is often unsatisfactory; exact localization of abnormalities may be very difficult. These limitations may be overcome by SPECT. Seventeen patients with clinical features of basal skull involvement were assessed by CT, SPECT, and planar scintigraphy. Subsequent clinical diagnoses were malignancy in 15 patients, vasculitis in 1 patient, and osteomyelitis in 1 patient. Computed tomography with IV contrast was performed through the skull base at 5 mm intervals. Planar scintigraphy with Tc-99m MDP was followed by SPECT. Bony involvement compatible with the clinical findings was demonstrated by CT scans in 6 patients, by planar scintigraphy in 7 patients, and by SPECT in 9 patients. The abnormalities that were identified by CT were all identified by SPECT. This study suggests that, in imaging the skull base, SPECT is more sensitive and provides better anatomical localization than planar imaging and appears useful in patients with a negative CT study.
Neurological and Neuromuscular Disease as a Risk Factor for Respiratory Failure in Children Hospitalized With Influenza Infection
Authors: Ron Keren
Journal: JAMA (2005)

ContextThe Advisory Committee on Immunization Practices (ACIP) recommends annual influenza vaccination for children with certain chronic medical conditions to prevent serious complications of influenza infection. Little is known about the relative contribution of each of these chronic medical conditions to the development of serious influenza-associated complications.ObjectiveTo identify chronic medical conditions that are associated with respiratory failure in children hospitalized with community-acquired laboratory-confirmed influenza.Design, Setting, and PatientsA retrospective cohort study of patients aged 21 years or younger hospitalized at The Children's Hospital of Philadelphia with community-acquired laboratory-confirmed influenza during 4 consecutive influenza seasons (June 2000 through May 2004). We examined 9 ACIP-designated high-risk chronic medical conditions and 3 additional chronic medical conditions (neurological and neuromuscular disease [NNMD], gastroesophageal reflux disease [GERD], and history of prematurity) that in recent studies have been associated with influenza hospitalization and severe influenza-related complications.Main Outcome MeasuresRate and odds ratio (OR) of respiratory failure, defined as need for mechanical ventilation.ResultsOf 745 children hospitalized with community-acquired laboratory-confirmed influenza, 322 (43%) had 1 or more ACIP-designated high-risk chronic medical conditions. Neurological and neuromuscular disease, GERD, and history of prematurity were present in 12%, 14%, and 3%, of children, respectively. Thirty-two children (4.3%) developed respiratory failure. In multivariate logistic regression analyses, conditions associated with respiratory failure included NNMD (OR, 6.0; 95% confidence interval [CI], 2.7-13.5), chronic pulmonary disease other than asthma (OR, 4.8; 95% CI, 1.5-15.1), and cardiac disease (OR, 4.0; 95% CI, 1.6-10.2). The predicted probabilities of respiratory failure derived from the multivariate model were 12% (95% CI, 7%-20%), 9% (95% CI, 3%-23%), and 8% (95% CI, 4%-18%) for children with NNMD, chronic pulmonary disease, and cardiac disease, respectively.ConclusionsThese results support the ACIP's recent decision to add NNMD to the list of conditions for which annual influenza vaccine is recommended in children. Neurologists and primary care pediatricians should be alerted to the increased risk of respiratory failure and the importance of influenza vaccination in children with NNMD.
A Mysterious Death
Authors: David W. Oldach, Robert E. Richard, Eugene N. Borza, R. Michael Benitez
Journal: New England Journal of Medicine (1998)

Presentation of CaseA 32-year-old man presented with fever and pain in the right upper quadrant. The patient had been well until the day after a night of heavy alcohol consumption (12 pints of wine1,2), when fatigue and generalized aches developed. The following evening, he consumed a similar quantity of wine and had sharp pain in the right upper quadrant of such severity that he cried out.3 The pain resolved quickly, but the area remained tender to palpation. He later had chills, sweats, and fever, which continued into the next day.The patient bathed in cool water and . . .
Time to Progression as a Surrogate Marker for Overall Survival in Patients with Advanced Non-small Cell Lung Cancer
Authors: Katsuyuki Hotta, Yoshiro Fujiwara, Keitaro Matsuo, Katsuyuki Kiura, Nagio Takigawa, Masahiro Tabata, Mitsune Tanimoto
Journal: Journal of Thoracic Oncology (2009)
Fortification of Foods with Folic Acid — How Much is Enough?
Authors: J L Mills
Journal: New England Journal of Medicine (2000)

In the early 1990s two randomized clinical trials showed that folic acid, or multivitamins containing folic acid, could substantially reduce a woman's risk of bearing a child with a neural-tube defect, provided that the vitamins were taken before conception.1,2 In 1992 the Public Health Service recommended that all women of childbearing age who are capable of becoming pregnant consume 400 μg of folic acid daily.3 Not surprisingly, in a country where half the women who become pregnant each year are not planning to do so, compliance with this recommendation has been poor.4 At the time the recommendation was made, we . . .
Therapeutics by Cytotoxic Metabolite Accumulation: Pemetrexed Causes ZMP Accumulation, AMPK Activation, and Mammalian Target of Rapamycin Inhibition
Authors: Alexandra C. Racanelli, Scott B. Rothbart, Cortney L. Heyer, Richard G. Moran
Journal: Cancer Research (2009)

Abstract Pemetrexed represents the first antifolate cancer drug to be approved by the Food and Drug Administration in 20 years; it is currently in widespread use for first line therapy of mesothelioma and non–small cell lung cancer. Pemetrexed has more than one site of action; the primary site is thymidylate synthase. We now report that the secondary target is the downstream folate-dependent enzyme in de novo purine synthesis, aminoimidazolecarboxamide ribonucleotide formyltransferase (AICART). The substrate of the AICART reaction, ZMP, accumulated in intact pemetrexed-inhibited tumor cells, identifying AICART as the step in purine synthesis that becomes rate-limiting after drug treatment. The accumulating ZMP causes an activation of AMP-activated protein kinase with subsequent inhibition of the mammalian target of rapamycin (mTOR) and hypophosphorylation of the downstream targets of mTOR that control initiation of protein synthesis and cell growth. We suggest that the activity of pemetrexed against human cancers is a reflection of its direct inhibition of folate-dependent target proteins combined with prolonged inhibition of the mTOR pathway secondary to accumulation of ZMP. [Cancer Res 2009;69(13):5467–74]
The integrin-cortex complex under control of GPCRs
Authors: G. W. Schmid-Schonbein
Journal: Cardiovascular Research (2012)

This editorial refers to ‘Coordination of fibronectin adhesion with contraction and relaxation in microvascular smooth muscle’ by Z. Hong et al ., doi:10.1093/cvr/cvs239. 

Few topics in cardiovascular physiology have attracted as much attention as the mechanisms for autoregulatory contraction of arterioles and their control over the blood flow. Whether mechanotransduction via myogenic, flow-dependent shear stress, neurogenic, or metabolic controls, the discussion has been focused on the contractile machinery within vascular smooth muscle cells.

In recent years, however, evidence has come to light suggesting that within a smooth muscle cell non-contractile cytoplasmic regions underneath the plasma membrane may also be part of the control over mechanotransduction. These cortical regions are accessible with nanoscale tools, such as the tips of an atomic force microscope (AFM). Analysis with such tools has shown that the myogenic contraction requires an integrated extracellular matrix–adhesion–cytoskeletal signalling complex that depends on integrins for both outside-in and inside-out signalling.1 Mechanical stress applied via integrins serves as an important sensory mechanism for vascular functions, including contractile and relaxation processes, proliferation, migration, attachment, and cell phenotype determination.2 Smooth …
Thrombocytopenia Following Doxepin Treatment
Authors: Daniel D. Nixon
Journal: JAMA (1972)

To the Editor.—  Proof of an adverse drug reaction usually depends upon circumstantial post  propter hoc evidence. Recently a patient was seen who developed thrombocytopenia following exposure to doxepin hydrochloride. Subsequent exposure to amitriptyline hydrochloride, a structurally related compound, was followed by a severe fall in platelet count, suggesting an etiological relationship.  Report of a Case.—  A 73-year-old housewife was admitted to Miami Heart Institute because of a severe depressive reaction and mild essential hypertension, treated with spironolactone, chlorothiazide, and reserpine for many years. Desiccated thyroid had been taken for 20 years following removal of a goiter. Four days prior to admission, doxepin hydrochloride was prescribed for relief of her depressive reaction. On the second hospital day, she developed subconjunctival hemorrhages, generalized oozing from the mouth, and showers of petechia over the extremities and trunk. The blood pressure 160/100 mm Hg. There was no significant adenopathy. Laboratory data at
Longitudinal Study of Racial and Ethnic Differences in Developing End-Stage Renal Disease among Aged Medicare Beneficiaries
Authors: Jay L. Xue, Paul W. Eggers, Lawrence Y. Agodoa, Robert N. Foley, Allan J. Collins
Journal: Journal of the American Society of Nephrology (2007)

Diabetes and hypertension are the leading causes of renal failure. This study investigated racial differences in developing ESRD by participants' diabetes and hypertension status. This longitudinal study included 1,306,825 Medicare beneficiaries who were aged > or =66 yr at the study start and followed up to 10 yr from January 1, 1993, for the development of ESRD or death. During the 10 yr, 0.93 patients per 100 received ESRD treatment. After adjustment for age and gender, among patients with diabetes, black patients were 2.4 to 2.7 times and other races/ethnicities 1.6 to 1.7 times more likely than white patients to develop ESRD. Among hypertensive patients, black patients were 2.5 to 2.9 and others 1.7 to 1.8 times more likely than white patients to develop ESRD. Among patients with neither diabetes nor hypertension, black patients were 3.5 and others 2.0 times more likely. Black men with diabetes were 1.9 to 2.1 and women 2.5 to 3.4 times more likely than their white counterparts to develop ESRD. Hypertensive black men were 2.1 to 2.2 and women 2.8 to 3.6 times more likely to develop ESRD. The same findings were noted in women of other races/ethnicities. Compared with white counterparts, mortality was higher for black patients in all cohorts but lower among patients with ESRD. Although they are leading causes for renal failure, diabetes and hypertension do not cause racial differences in developing ESRD. Minority women especially are at greater risk for ESRD than white women. Further studies are needed to determine whether earlier initiation of dialysis is a factor in higher ESRD incidence among minorities.
Monitor failed to interview a single GP over accusation that GPs weren't promoting choice, CCG chief says
Authors: M. Limb
Journal: BMJ (2014)

England’s health sector regulator Monitor has dealt a blow to the Spire private health group by ruling against its complaint that anticompetitive practice by the NHS made it lose patients.

However, in a judgment that has drawn criticism from antiprivatisation campaigners, Monitor found that two NHS clinical commissioning groups did not do enough to ensure that patients were offered a choice of hospitals for routine surgery.

Clive Peedell, of the National Health Action Party, which campaigns against NHS privatisation, said that the “double edged” verdict showed that government legislation on competition was in a “complete mess.”

Amanda Doyle, chief clinical officer of NHS Blackpool CCG, one of the pair told by Monitor to be more “proactive” on patient choice, was scathing about the judgment. Doyle said, “It is somewhat concerning that in their [Monitor’s] search for evidence to demonstrate whether choice was promoted and offered in GP surgeries, not a single GP, practice manager, or patient was spoken to by the investigating team, nor was a single practice visited.

“Placing …
Utilization review conference. Role of the state agency
Authors: J. W. Cashman
Journal: JAMA (1966)

The Public Health Service has been delegated responsibility for advising the Social Security Administration and assisting state agencies in the professional health aspects of the Health Insurance for the Aged Program; the utilization review requirements for hospitals and extended-care facilities are integrally related to this. Of interest is how this procedure can assist physicians to care for all their patients, not just beneficiaries of the Health Insurance Program. The Public Health Service believes in the importance of its overall objective—the maintenance of high-quality patient care and an increase in effective utilization of all health services, to be achieved through an educational approach involving the study of patterns of care and the encouragement of appropriate utilization of available resources. Extensive experimentation will be required. Although much work already has been done in this area, further exploration and experimentation is needed to learn how this procedure may best be adapted to different