tbuckley/cabot-search huggingface dataset:
Health bodies defend their right to access patient data
Authors: P. Brown
Journal: BMJ (2002)

Clashes between the Department of Health and privacy campaigners looked set to continue beyond Westminster this week over new regulations to allow healthcare providers in England and Wales to pass on patients' data without their consent to certain monitoring bodies such as the cancer registries.

The regulations were due to be debated in the House of Lords as the BMJ went to press. However, the basic provision for the measure was approved last year as part of the Health and Social Care Act. The present row relates to the statutory instrument being formulated for use under the Act.

Despite claims by privacy campaigners that the law would be a “snoop's charter,” health agencies insisted that the regulations gave them only limited scope to use data, which they …
The thymic theme of acetylcholinesterase splice variants in myasthenia gravis
Authors: Adi Gilboa-Geffen, Paul P. Lacoste, Lilach Soreq, Geraldine Cizeron-Clairac, Rozen Le Panse, Frederique Truffault, Iftach Shaked, Hermona Soreq, Sonia Berrih-Aknin
Journal: Blood (2007)
Differences Between Prebreakfast and Late Afternoon Glycemic Responses to Exercise in IDDM Patients
Authors: J Jeffrey Ruegemer, Ray W Squires, Harold M Marsh, Morey W Haymond, Philip E Cryer, Robert A Rizza, John M Miles
Journal: Diabetes Care (1990)

Little information is available regarding the optimal timing of exercise in insulin-dependent diabetes mellitus (IDDM) patients. In this study, six IDDM patients receiving ultralente-based intensive insulin therapy were studied during 30 min of exercise (∼60% Vo2max), before breakfast, and at 1600. On two other occasions, they were studied at rest. Plasma glucose increased from 6.7 ± 0.4 to 9.1 ± 0.4 mM during morning exercise (P &amp;lt; 0.01). In contrast, mean plasma glucose did not change during afternoon exercise (≸ = 0.3 ± 0.5 mM, NS); however, there was a 0.3- to 1.0-mM decrease in three subjects. The observed difference in the glycemic response to exercise could not be explained on the basis of changes in plasma glucagon, growth hormone, norepinephrine, or epinephrine. Plasma cortisol was higher (P &amp;lt; 0.02) in the morning than in the afternoon, and plasma free-insulin concentrations were lower (P &amp;lt; 0.05). These data indicate that the risk of exerciseinduced hypoglycemia is lowest before breakfast. The reason for the divergent glycemic responses to exercise is not entirely clear but may be related to the observed differences in free-insulin concentrations. Because of the lower risk of hypoglycemia, our results suggest prebreakfast exercise may be preferable for some IDDM patients receiving intensive insulin therapy. Whether these findings are relevant to patients receiving other types of insulin therapy will require further investigation.
UNTOWARD EFFECTS OF PHENYLBUTAZONE (BUTAZOLIDIN®)
Authors: Louis W. Granirer
Journal: JAMA (1952)

<h3>To the Editor:</h3> —Phenylbutazone (butazolidin®) a member of the pyrazol series, is a drug of undoubted value in various rheumatic disorders, but it must be used with more than usual caution. Our observations do not substantiate reports in the literature that the drug is of low toxicity. Within the past three months, phenylbutazone was administered orally to 20 patients with rheumatoid arthritis. For the first three days doses varied from 600 mg. to 200 mg. daily taken immediately after food. After this 200 mg. was given daily. Severe gastrointestinal disturbance occurred in two patients. In the first patient sudden epigastric distress, weakness, nausea, and thirst developed followed by a large hematemesis and melena. There was no previous history of a stomach disorder. Blood dyscrasia and thrombocytopenic purpura were ruled out. An esophagram and gastrointestinal x-ray series were completely normal. Therapy with the drug was promptly discontinued, and the epigastric symptoms
Rapid mass spectrometric conversion of tissue biopsy samples into permanent quantitative digital proteome maps
Authors: Tiannan Guo, Petri Kouvonen, Ching Chiek Koh, Ludovic C Gillet, Witold E Wolski, Hannes L Röst, George Rosenberger, Ben C Collins, Lorenz C Blum, Silke Gillessen, Markus Joerger, Wolfram Jochum, Ruedi Aebersold
Journal: Nature Medicine (2015)
Baseline Vascular Endothelial Growth Factor Concentration as a Potential Predictive Marker of Benefit from Vandetanib in Non–Small Cell Lung Cancer
Authors: Emer O. Hanrahan, Anderson J. Ryan, Helen Mann, Sarah J. Kennedy, Peter Langmuir, Ronald B. Natale, Roy S. Herbst, Bruce E. Johnson, John V. Heymach
Journal: Clinical Cancer Research (2009)

Abstract Purpose: Vandetanib [vascular endothelial growth factor (VEGF) receptor/epidermal growth factor receptor/RET inhibitor] has shown improvements in progression-free survival (PFS) in advanced non-small cell lung cancer in three randomized phase II studies: vandetanib versus gefitinib (study 3), docetaxel ± vandetanib (study 6), and carboplatin-paclitaxel and/or vandetanib (study 7). In study 7, vandetanib monotherapy was inferior to carboplatin-paclitaxel. We performed an exploratory retrospective analysis of the relationship between baseline circulating VEGF concentrations and PFS. Experimental Design: Mean baseline VEGF levels were determined by ELISA from two baseline samples of plasma (163 of 168 patients, study 3; 65 of 127, study 6) or serum (144 of 181, study 7). High baseline VEGF values were above the immunoassay reference range for healthy subjects; low baseline VEGF values were within the range. Results: Patients with low baseline VEGF had a lower risk of disease progression with vandetanib versus gefitinib [hazard ratio (HR), 0.55; 95% confidence interval (95% CI), 0.35-0.86; P = 0.01] or vandetanib 100 mg/d + docetaxel versus docetaxel (HR, 0.25; 95% CI, 0.09-0.68; P = 0.01). High VEGF patients had a similar risk of disease progression with vandetanib monotherapy versus gefitinib (HR, 1.03; 95% CI, 0.60-1.75; P = 0.92) or vandetanib 100 mg/d + docetaxel versus docetaxel (HR, 0.95; 95% CI, 0.25-3.61; P = 0.94). In study 7, low VEGF patients had a similar risk of disease progression with vandetanib monotherapy 300 mg/d versus carboplatin-paclitaxel (HR, 0.80; 95% CI, 0.41-1.56; P = 0.51); high VEGF patients progressed more quickly (HR, 1.60; 95% CI, 0.81-3.15; P = 0.17). Conclusions: These analyses suggest that low baseline circulating VEGF may be predictive of PFS advantage in patients with advanced non-small cell lung cancer receiving vandetanib versus gefitinib or vandetanib + docetaxel versus docetaxel. Moreover, patients with low VEGF levels may have a similar outcome with either vandetanib monotherapy or carboplatin-paclitaxel.
Estimating the Global Public Health Implications of Electricity andCoal Consumption
Authors: Julia M. Gohlke, Reuben Thomas, Alistair Woodward, Diarmid Campbell-Lendrum, Annette Prüss-üstün, Simon Hales, Christopher J. Portier
Journal: Environmental Health Perspectives (2011)

Background: The growing health risks associated with greenhouse gas emissions highlight the need for new energy policies that emphasize efficiency and low-carbon energy intensity.Objectives: We assessed the relationships among electricity use, coal consumption, and health outcomes.Methods: Using time-series data sets from 41 countries with varying development trajectories between 1965 and 2005, we developed an autoregressive model of life expectancy (LE) and infant mortality (IM) based on electricity consumption, coal consumption, and previous year's LE or IM. Prediction of health impacts from the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) integrated air pollution emissions health impact model for coal-fired power plants was compared with the time-series model results.Results: The time-series model predicted that increased electricity consumption was associated with reduced IM for countries that started with relatively high IM (> 100/1,000 live births) and low LE (< 57 years) in 1965, whereas LE was not significantly associated with electricity consumption regardless of IM and LE in 1965. Increasing coal consumption was associated with increased IM and reduced LE after accounting for electricity consumption. These results are consistent with results based on the GAINS model and previously published estimates of disease burdens attributable to energy-related environmental factors, including indoor and outdoor air pollution and water and sanitation.Conclusions: Increased electricity consumption in countries with IM < 100/1,000 live births does not lead to greater health benefits, whereas coal consumption has significant detrimental health impacts.
Faecal diversion for Crohn's colitis: a model to study the role of the faecal stream in the inflammatory process.
Authors: M C Winslet, A Allan, V Poxon, D Youngs, M R Keighley
Journal: Gut (1994)

The high incidence of clinical remission after faecal diversion for Crohn's colitis suggests the faecal stream may play a part in the inflammatory mechanism. The effect of faecal diversion (n = 22) and restoration of intestinal continuity (n = 10) was assessed in patients with Crohn's colitis and compared with controls. Faecal diversion produced significant improvement in the disease activity index mean (SEM) (before 176 (9); after 114 (9), p < 0.01) and serum albumin concentrations (before 33 (3.0); after 38 (3.0), p < 0.05) in all patients with Crohn's colitis. The crypt cell production rate (CCPR) was maintained after faecal diversion for Crohn's colitis but fell in the control group (before = 3.6 (0.8)), at two (1.4 (0.4), p < 0.02), and six weeks (1.6 (0.4), p < 0.05). Mucosal glucosamine synthetase activity, reflecting glycoprotein synthesis, was significantly lower in patients with Crohn's colitis (analysis of variance p < 0.05) after diversion but was maintained in the control group. Restoration of intestinal continuity failed to produce reciprocal changes. The sustained cellular proliferation and fall in glycoprotein synthesis in Crohn's colitis after faecal diversion may represent the end of an exaggerated protective response and regenerative hyperplasia after exclusion of the faecal stream. This study suggests the faecal stream may participate in the inflammatory process in Crohn's colitis. The underlying mechanism is unknown.
HA-1A in septic patients with ARDS: Results from the pivotal trial
Authors: L. M. Bigatello, R. E. Greene, C. L. Sprung, E. A. Panacek, R. C. Straube, J. L. Zimmerman, R. J. Maunder, P. N. Lanken, E. Pile-Spellmann, K. S. Stanek, A. Zaslavsky, W. M. Zapol
Journal: Intensive Care Medicine (1994)
Are "pink puffers" more breathless than "blue bloaters"?
Authors: M A Johnson, A A Woodcock, M Rehahn, D M Geddes
Journal: BMJ (1983)

Breathlessness, disability, and exercise tolerance were assessed in 26 patients with severe chronic airflow limitation (forced expiratory volume in one second (FEV1) less than or equal to 1 litre) divided into two groups--15 patients who were normocapnic (pressure of arterial carbon dioxide (Paco2) less than 5.5 kPa (less than 41.4 mm Hg)), and 11 patients who were hypercapnic (Paco2 greater than 6 kPa (greater than than 45.1 mm Hg)). The two groups were well matched for spirometric values (FEV1 0.59 1 and 0.62 1, respectively). All of the hypercapnic patients could improve blood gas tensions towards normal by hyperventilation. There were no significant differences in visual analogue scores of breathlessness during treadmill exercise, disability (oxygen-cost diagram, dyspnoea grade), or exercise tolerance (six-minute walk, maximal consumption of oxygen during bicycle ergometry, distance walked to exhaustion in progressive treadmill test). The findings show that the "fight" to maintain normal blood gas tensions in the face of severe airflow limitation does not have an appreciable cost in terms of disability.
Homocysteine and Osteoporotic Fractures — Culprit or Bystander?
Authors: Lawrence G. Raisz
Journal: New England Journal of Medicine (2004)

Osteoporotic fractures are a major health problem in the industrialized nations, a problem that is likely to become even greater throughout the world as the population ages. One way to prevent osteoporotic fractures is to identify risk factors that can be readily reversed. Epidemiologic studies in the United States and Europe have identified many such factors. For example, supplementation with calcium and vitamin D has been shown to reduce the risk of fracture.Two studies in this issue of the Journal introduce still another potentially reversible factor: increased circulating homocysteine levels.1,2 There is ample evidence that high homocysteine levels . . .
Relation between Age of Onset of Obesity and Size and Number of Adipose Cells
Authors: C. G. D. Brook, J. K. Lloyd, O. H. Wolf
Journal: BMJ (1972)

The size and number of adipose cells in obese children and adults were compared with control data. An increase in adipose cell size was found in all the obese subjects. The total number of adipose cells was increased in those children who had become obese already by the age of 1 year and in those adults who dated their obesity to childhood.
Modulation of the myocardial redox state by vagal nerve stimulation after experimental myocardial infarction
Authors: Takaki Tsutsumi, Tomomi Ide, Mayumi Yamato, Wataru Kudou, Makoto Andou, Yoshitaka Hirooka, Hideo Utsumi, Hiroyuki Tsutsui, Kenji Sunagawa
Journal: Cardiovascular Research (2007)

AimsRedox alteration plays a major role in the pathogenesis of heart failure (HF). Since vagal nerve stimulation (VNS) is known to improve survival and attenuate cardiac remodelling, we hypothesized that VNS may modulate the myocardial redox state.
Smoking and the sudden infant death syndrome: results from 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy
Authors: P. S Blair, P. J Fleming, D. Bensley, I. Smith, C. Bacon, E. Taylor, J. Berry, J. Golding, J. Tripp
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To investigate the effects of exposure to tobacco smoke and of parental consumption of alcohol and illegal drugs as risk factors for the sudden infant death syndrome after a national risk reduction campaign which included advice on prenatal and postnatal avoidance of tobacco smoke. <b>Design</b>: Two year population based case-control study. Parental interviews were conducted for each infant who died and four controls matched for age and date of interview. <b>Setting</b>: Three regions in England with a total population of 17 million people. <b>Subjects</b>: 195 babies who died and 780 matched controls. <b>Results</b>: More index than control mothers (62.6% v 25.1%) smoked during pregnancy (multivariate odds ratio = 2.10; 95% confidence interval 1.24 to 3.54). Paternal smoking had an additional independent effect when other factors were controlled for (2.50; 1.48 to 4.22). The risk of death rose with increasing postnatal exposure to tobacco smoke, which had an additive effect among those also exposed to maternal smoking during pregnancy (2.93; 1.56 to 5.48). The population attributable risk was over 61%, which implies that the numbers of deaths from the syndrome could be reduced by almost two third if parents did not smoke. Alcohol use was higher among index than control mothers but was strongly correlated with smoking and on multivariate analysis was not found to have any additional independent effect. Illegal drug use was more common among the index parents, and paternal use of illegal drugs remained significant in the multivariate model (4.68; 1.56 to 14.05). <b>Conclusions</b>: This study confirms the increased risk of the sudden infant death syndrome associated with maternal smoking during pregnancy and shows evidence that household exposure to tobacco smoke has an independent additive effect. Parental drug misuse has an additional small but significant effect. <h3>Key messages</h3> Exposure of babies to tobacco smoke from other members of the household before or after birth increases the risk of death: the greater the exposure the higher the risk Over 60% of such deaths may be attributable to the effects of exposure to tobacco smoke before and after birth
Reductions in defence medical services
Authors: T. Revell
Journal: BMJ (1995)

transdermal nicotine patches before marketing them.The patients with heart disease who participated were kept under strict cardiovascular control.Many cases of angina pectoris and arrhythmias were reported, which led to patients being with- drawn from the study, being admitted to hospital, and even undergoing angioplasty.The study con- cluded that patches are safe only in patients with stable cardiovascular disease.4The pharmacological effects of nicotine (regard- less of its source) on the cardiovascular system are well known.(1) Nicotine increases blood pressure and heart rate directly, because it has sympathomimetic effects on the heart, and indirectly, because it stimulates catecholamine release.These effects increase myocardial oxygen demands, risking the development of angina pectoris due to reversible
P3-011: Phenotypic differences between sexes and absence of human papillomavirus and Epstein-Barr virus in non-smokers with lung adenocarcinoma in Singapore
Authors: Wan-Teck Lim, Khoon-Leong Chuah, Thirunagam Agasthian, Balram Chowbay, Philip Eng, Swan-Swan Leong, Eng-Huat Tan, Siew-Wan Hee, Heng-Nung Koong, Chee-Keong Toh
Journal: Journal of Thoracic Oncology (2007)
Does This Patient Have an Alcohol Problem?
Authors: James M. Kitchens
Journal: JAMA (1994)

<h3>CLINICAL SCENARIO</h3> A 58-year-old man was admitted to the hospital for an elective cholecystectomy. At the time of admission, he smelled of alcohol, although he was not obviously intoxicated. On questioning he said he had come from a business lunch where he had "a drink." When questioned about his alcohol history he became angry and defensive. He said he was "offended by the implications of these questions." On the day following surgery he was found to be diaphoretic, tremulous, and hallucinating and was judged to be in alcohol withdrawal. Could other interviewing techniques have identified this man as one who was alcohol dependent and at risk of withdrawal? <h3>WHY IS THIS AN IMPORTANT QUESTION TO ANSWER WITH A CLINICAL EXAMINATION?</h3> It is estimated that more than 100 million Americans drink alcohol and that about 10% of those who drink have alcohol problems that adversely affect their lives and the lives
Nitrogen losses from the human small bowel: obligatory losses and the effect of physical form of food.
Authors: A Chacko, J H Cummings
Journal: Gut (1988)

The amount and form of nitrogen lost from the human small intestine and the dietary factors which influence it have been studied in six ileostomists. Over a six day period the subjects were fed a series of diets including low nitrogen (LND) 0.17 g N/day, LND + soya beans (5.87 g N/day) and a high fibre diet (HFD) (10.6 g N/day). The soya beans were fed either whole or pureed to test the effect of physical form of food. Total N, protein, amino acids, urea, and ammonia were measured in ileostomy effluent which was collected throughout the study. Total N excretion was LND 0.91 (0.04) (SE) g/day; LND + whole soya beans (WSB) 2.26 (0.15) g/day; LND + pureed soya beans (PSB) 1.42 (0.12) g/day (WSB v PSB, p less than 0.001); and HFD 2.17 (0.11) g/day (HFD v PSB, p less than 0.001, HFD v WSB, NS). N losses as urea, ammonia, and free amino acids were less than 10-15% of total N, the remainder being protein (48-51%) and (by difference) peptides (20-30%). Eighty to 85% of effluent N was in the insoluble (pellet) fraction except on the low N diet where it was 66%. The physical form of food clearly influenced N digestibility in the soya beans whilst changes in dietary fibre seem not to have a significant effect.
Shall The Journal be Removed to Washington?
Authors: Henry B. Hemenway
Journal: JAMA (1891)

<h3>To the Editor:</h3> I am greatly surprised at the letter of Dr. Solis-Cohen inThe Journalof January 31. I admit thatThe Journalhas not reached the standard of excellence which the profession have a right to expect. I am, however, satisfied that "sectional prejudice" and personal ambition in Philadelphia, New York and Washington, have had not a little to do with this lowering of the standard. Dr. Solis-Cohen makes the assertion that the removal to Washington would overcome all the present' difficulties. Washington is not, and cannot be a centre for this country. Even the political conventions are not held there, and the only thing that preserves it as the National Capital is the amount of money expended in permanent government improvements. PerhapsThe Journalwould not in Washington be debased to a " local " organ, but what assurance would we have that it would not be practically debased
UK drug agency announces review of use of alteplase after stroke
Authors: D. Cohen, H. Macdonald
Journal: BMJ (2014)

The UK Medicines and Healthcare Products Regulatory Agency has announced it is to review the “balance of benefits and risks” of the use of alteplase in the treatment of acute ischaemic stroke.

In a letter published in the Lancet on 23 August,1 Ian Hudson, chief executive of the MHRA, announced that the agency was setting up a panel of experts to review “any new information or concerns about the data that underpin the present marketing authorisation” for the drug, but he added that the data supporting alteplase use had been “extensively discussed” and that the “benefit-risk balance is favourable.”

The MHRA’s announcement was prompted by concerns raised by Roger Shinton, a former consultant physician at Birmingham’s Heartlands Hospital in another letter in the same issue of the Lancet.2

Alteplase, a thrombolytic drug, is licensed in Europe for the management of acute ischaemic stroke within four and a half hours of onset of symptoms and in the United States for use within three hours. In his letter Shinton highlighted several concerns with the initial trial used to obtain marketing approval for alteplase3 and a subsequent trial that was key to extending its window of use in Europe from three to four and a half hours.4

In the first trial, called the National Institute of Neurological Disorders and Stroke (NINDS) trial, participants were randomised to …
The Doctor and the Detective Story
Authors: Nancy Y. Hoffman
Journal: JAMA (1973)

The classical detective story narrates a crime, almost always murder, which confounds and puzzles those most intimately involved with the victim. Official investigators often are equally puzzled by too many—or too few—clues. But the superintelligent, unofficial detective sees the reality beneath appearance and can defend his every deduction with minutely detailed proofs. He then exposes the criminal and reasserts the viability of the threatened social order. In the formal detective story, doc tors make excellent protagonists as detectives because, occupationally, they are trained in drawing inferences: diagnosis is the fine art of medical sleuthing. And the rise of the detective story, supposedly first articulated by Edgar Allan Poe in 1841, is linked to the rise of modern medical science, so that scientifically substantiated proofs, resting on medical evidence, frequently are essential to the mystery story. Vincent Starrett once asserted, "The peoples of the earth are divided into four classes: criminals,