tbuckley/cabot-search huggingface dataset:
Trends in the Prevalence and Ratio of Diagnosed to Undiagnosed Diabetes According to Obesity Levels in the U.S.
Authors: Edward W. Gregg, Betsy L. Cadwell, Yiling J. Cheng, Catherine C. Cowie, Desmond E. Williams, Linda Geiss, Michael M. Engelgau, Frank Vinicor
Journal: Diabetes Care (2004)

OBJECTIVE—To examine trends in the prevalence of diagnosed and undiagnosed diabetes and the proportion of total cases previously diagnosed, according to obesity status in the U.S. over the past 40 years. RESEARCH DESIGN AND METHODS—We assembled data from five consecutive cross-sectional national surveys: National Health Examination Survey I (1960–1962), National Health and Nutrition Examination Survey (NHANES) I (1971–1974), NHANES II (1976–1980), NHANES III (1988–1994), and NHANES 1999–2000. Diagnosed diabetes was ascertained, and height and weight were measured in adults aged 20–74 years in all surveys. In NHANES II, NHANES III, and NHANES 1999–2000, a fasting glucose level ≥126 mg/dl was used to identify cases among individuals not reporting diabetes. Design-based analyses and Bayesian models estimate the probability that prevalence of diabetes increased within four BMI groups (&amp;lt;25, 25–29, 30–34, and ≥35 kg/m2). RESULTS—In the U.S. population aged 20–74 years between 1976–1980 and 1999–2000, significant increases in the prevalence of diagnosed diabetes (3.3–5.8%, probability &amp;gt;99.9%) were accompanied by nonsignificant increases in undiagnosed diabetes (2.0–2.4%, 66.6%). This resulted in an increase in total diabetes (5.3–8.2%, &amp;gt;99.9%) and a modest nonsignificant increase in the proportion of cases that were diagnosed (62–70%, 62.4%). However, these trends varied considerably by BMI level. In individuals with BMI ≥35 kg/m2, diagnosed diabetes increased markedly (from 4.9% in 1960, to 8.6% during 1976–1980, to 15.1% in 1999–2000; probability &amp;gt;99.9%), whereas undiagnosed diabetes declined considerably (12.5% during 1976–1980 to 3.2% in 1999–2000, probability of increase 4.5%) Therefore, the proportion of total diabetes cases that were diagnosed increased from 41 to 83% (probability 99.9%) among individuals with BMI ≥35 kg/m2. By comparison, changes in prevalence within BMI strata &amp;lt;35 kg/m2 were modest and there was no increase in the percent of total cases that were diagnosed. CONCLUSIONS—National surveys over the last several decades have found large increases in diagnosed diabetes, particularly in overweight and obese individuals, but this has been accompanied by large decreases in undiagnosed diabetes only among individuals with BMI ≥35 kg/m2. This suggests that improvements in diabetes awareness and detection are most prominent among this subgroup.
The Making of a Public Health Physician
Authors: Kathleen F. Gensheimer
Journal: Annals of Internal Medicine (1997)

On Being a Doctor15 May 1997The Making of a Public Health PhysicianKathleen F. Gensheimer, MD, MPHKathleen F. Gensheimer, MD, MPHMaine Department of Human Services, Augusta, ME 04333Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-10-199705150-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail My husband and I got married the week before match day during our fourth year of medical school. Upon our return from our wedding trip, we were very relieved to discover that we would not only be located within the same city but would also be doing our internships at the same institution. I was starting a postgraduate training program in pediatrics; my husband was doing a rotating internship before going onto a residency in ophthalmology. Unfortunately, our on-call schedule never seemed to coincide; hence, we spent that year following a discordant cycle of one night on, the next night ... Author, Article, and Disclosure InformationAffiliations: Maine Department of Human Services, Augusta, ME 04333Corresponding Author: Kathleen F. Gensheimer, MD, MPH, Division of Disease Control, 157 Capitol Street, State House Station #11, Augusta, ME 04333-0011.Corresponding Author: Kathleen F. Gensheimer, MD, MPH, Division of Disease Control, 157 Capitol Street, State House Station #11, Augusta, ME 04333-0011. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 May 1997Volume 126, Issue 10Page: 823-824KeywordsChildrenEpidemiologyFearFoodInfantsPediatricsPregnancyPrevention, policy, and public healthResidencySalmonellosis Issue Published: 15 May 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Relation of out of hours activity by general practice and accident and emergency services with deprivation in Nottingham: longitudinal survey
Authors: R. Carlisle, L. M Groom, A. J Avery, D. Boot, S. Earwicker
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objectives:</b> To investigate the relation between out of hours activity of general practice and accident and emergency services with deprivation and distance from accident and emergency department. <b>Design:</b> Six month longitudinal study. <b>Setting:</b> Six general practices and the sole accident and emergency department in Nottingham. <b>Subjects:</b> 4745 out of hours contacts generated by 45 182 patients from 23 electoral wards registered with six practices. <b>Main outcome measures:</b> Rates of out of hours contacts for general practice and accident and emergency services calculated by electoral ward; Jarman and Townsend deprivation scores and distance from accident and emergency department of electoral wards. <b>Results:</b> Distances of wards from accident and emergency department ranged from 0.8 to 9 km, and Jarman deprivation scores ranged from −23.4 to 51.8. Out of hours contacts varied by ward from 110 to 350 events/1000 patients/year, and 58% of this variation was explained by the Jarman score. General practice and accident and emergency rates were positively correlated (Pearson coefficient 0.50, P=0.015). Proximity to accident and emergency department was not significantly associated with increased activity when deprivation was included in regression analysis. One practice had substantially higher out of hours activity (B coefficient 124 (95% confidence interval 67 to 181)) even when deprivation was included in regression analysis. <b>Conclusions:</b> A disproportionate amount of out of hours workload fell on deprived inner city practices. High general practice and high accident and emergency activity occurred in the same areas rather than one service substituting for the other. <h3>Key messages</h3> We studied the out of hours activity of six general practices and the local accident and emergency department in Nottingham for six months There were wide variations between electoral wards in both general practice and accident and emergency events Deprivation scores explained more than half of the variation, with out of hours activity being highest in deprived inner city areas Highly deprived areas close to the accident and emergency department generated high levels of work for both general practice and accident and emergency services, with no evidence of one service substituting for the other
1126. Further Characterization of Msx1 De-Differentiated Cells
Authors: Qiang Liu, Wen Liu, Yaming Wang
Journal: Molecular Therapy (2005)

Msx1 is a homeobox-containing transcription repressor that has been demonstrated to play an important role in cellular generation and regeneration processes. Our group, as well one other, has demonstrated that ectopic expression of msx1 in murine multinucleated myotubes could lead to de-differentiation of myotubes into mononucleated cells that are capable of proliferation and which possess properties of pluripotent stem cells. Previously, we have demonstrated that msx1-dedifferentiated cells (MDCs) differed from myoblasts by exhibiting reduction in the expression levels of myogenic transcription factors, such as MyoD, Myf5 and Myogenin. These cells also differed in their ability to differentiate into other mesoderm-derived cells, such as adipocytes and osteocytes. We have also demonstrated, that MDCs transcribed oct4 (expressed in undifferentiated ES and germ cells) and nucleostemin (NST), which is expressed in early multipotent stem cells and several cancer cell lines.
Nurse telephone triage for same day appointments in general practice: multiple interrupted time series trial of effect on workload and costs
Authors: D. A Richards
Journal: BMJ (2002)

<h3>Abstract</h3> <b>Objective:</b> To compare the workloads of general practitioners and nurses and costs of patient care for nurse telephone triage and standard management of requests for same day appointments in routine primary care. <b>Design:</b> Multiple interrupted time series using sequential introduction of experimental triage system in different sites with repeated measures taken one week in every month for 12 months. <b>Setting:</b> Three primary care sites in York. <b>Participants:</b> 4685 patients: 1233 in standard management, 3452 in the triage system. All patients requesting same day appointments during study weeks were included in the trial. <b>Main outcome measures:</b> Type of consultation (telephone, appointment, or visit), time taken for consultation, presenting complaints, use of services during the month after same day contact, and costs of drugs and same day, follow up, and emergency care. <b>Results:</b> The triage system reduced appointments with general practitioner by 29-44%. Compared with standard management, the triage system had a relative risk (95% confidence interval) of 0.85 (0.72 to 1.00) for home visits, 2.41 (2.08 to 2.80) for telephone care, and 3.79 (3.21 to 4.48) for nurse care. Mean overall time in the triage system was 1.70 minutes longer, but mean general practitioner time was reduced by 2.45 minutes. Routine appointments and nursing time increased, as did out of hours and accident and emergency attendance. Costs did not differ significantly between standard management and triage: mean difference £1.48 more per patient for triage (95% confidence interval −0.19 to 3.15). <b>Conclusions:</b> Triage reduced the number of same day appointments with general practitioners but resulted in busier routine surgeries, increased nursing time, and a small but significant increase in out of hours and accident and emergency attendance. Consequently, triage does not reduce overall costs per patient for managing same day appointments. <h3>What is already known on this topic</h3> Nurse telephone triage is used to manage the increasing demand for same day appointments in general practice Evidence that nurse telephone triage is effective is limited <h3>What this study adds</h3> Triage resulted in 29-44% fewer same day appointments with general practitioners than standard management Nursing and overall time increased in the triage group as 40% of patients were managed by nurses Triage was not less costly than standard management because of increased costs for nursing, follow up, out of hours, and accident and emergency care
Doctors must ask patients about tobacco use, conference hears
Authors: G. Mudur
Journal: BMJ (2013)

Gaps in tobacco legislation, poor enforcement, and meagre efforts by doctors to discourage patients from using tobacco are obstructing India’s efforts to curb tobacco consumption, a survey to evaluate the impact of a decade of legislation has found.

The survey by the International Tobacco Control Policy Evaluation Project, whose findings from India were released on 12 September at an international conference on tobacco in New Delhi, has indicated that India’s ban on smoking in public places is neither comprehensive nor routinely enforced.1

The International Conference on Public Health Priorities in the 21st century: the Endgame for Tobacco, was intended to discuss strategies to achieve the target of 30% reduction in tobacco consumption by 2025 that was adopted by the World Health Assembly in May this year.

India, estimated to have 275 million people who consume tobacco, prohibited tobacco advertisements in 2004, banned smoking in …
Effect of catecholamine depletion on myocardial infarct size in dogs: role of catecholamines in ischemic preconditioning
Authors: R. S.V. Heide, L. M. Schwartz, R. B. Jennings, K. A. Reimer
Journal: Cardiovascular Research (1995)

Objectives: Cardioprotective adaptation to brief periods of ischemia and reperfusion is termed ischemic preconditioning (PC). Limitation of infarct size by preconditioning is associated with marked slowing of ischemic metabolism. The cause of metabolic slowing has not been determined but may involve either pro- or anti-adrenergic mechanisms. Hypothetically, adrenergic stimulation could signal the adaptive response. Alternatively, metabolic slowing during the sustained ischemic challenge could occur through a reduction in β-adrenergic stimulation. This study was designed to test the role of cardiac norepinephrine (NE) in PC. Methods: The effect of PC on myocardial infarct size was studied in control dogs and dogs depleted of catecholamines by pretreatment with reserpine (RES; 0.25 mg/kg i.V.). PC was induced by four cycles of 5 min of ischemia and 5 min of reperfusion. Infarcts were produced by 60 min of ischemia and 3 h of reperfusion. Cardiac NE depletion was verified by radioimmunoassay of tissue samples and by absence of hemodynamic response to a tyramine bolus (1.4 mg/kg) administered at the end of each experiment. Infarct size, expressed as percent of area at risk, was controlled for variation in collateral blood flow using analysis of covariance (ANCOVA). Results: Adjusted mean infarct size was 25.5 ± 3.2% in untreated controls vs. 19.1 ± 3.3% in RES-treated controls (P = NS). PC limited infarct size in untreated dogs (7.4 ± 1.8 vs. 25.5 ± 3.2%; PC vs. control; P < 0.01) but not in RES-treated dogs (15.7 ± 3.0% vs. 19.1 ± 3.3%; RES + PC vs. RES; P = NS). Infarct size was larger in dogs with RES + PC than with PC alone, even though there was a trend toward a slight beneficial effect with RES alone. Conclusions: The Cardioprotective effect of ischemic preconditioning cannot be explained entirely as an anti-adrenergic effect. On the contrary, adrenergic receptor stimulation may be required for the full expression of ischemic preconditioning in canine myocardium.
Erroneous Reporting of Errors-Reply
Authors: Paul deR Kolisch
Journal: JAMA (1984)

<h3>In Reply.—</h3> I am most grateful to Drs Clark and Quinn. They have forced me to reread my source. When a 14-year-old publication is not reviewed, one deserves egg on one's face. William B. Ober, in the<i>Pathology Annual</i>of 1970, discusses the case of Frederick III of Prussia's cancer. My most vivid memory was his mention of "the clash of personalities between Mackenzie and the German physicians." Review of the paper shows that Mackenzie and Virchow were, indeed, of the same opinion. In 1886, the surgeons consulted considered the lesion to be cancer. At this point, Bismarck intervened and pressed for further consultation before the operation (possibly laryngofissure) was undertaken. Morell Mackenzie was called in (via the Crown Princess to her mother [Queen Victoria] by Sir James Reid, the Queen's resident physician). Mackenzie, appropriately, did a biopsy of the lesion several times, and Virchow could not make a diagnosis
ENTEROSPASM AND COLIC FROM THE SURGICAL POINT OF VIEW
Authors: J. Swain
Journal: BMJ (1912)

typical of many she has had, and was ultimately relieved, as many of its forerunners had been, by hot douches of boracic solution, and a mixture, frequently repeated, of urotropine, henbane, and valerian.In this patient's case the tenderness of the urethra, is such a marked feature that in her present attack the local application of a strong solution of cocaine was required for her relief.
Abstract 4378: Pericyte coverage of differentiated vessels inside tumor vasculature is an independent unfavorable prognostic factor for patients with clear cell renal cell carcinoma
Authors: Yun Cao, Zhi-Ling Zhang, Ming Zhou, Paul Elson, Brian Rini, Hakan Aydin, Kristin Feenstra, Min-Han Tan, Bree Berghuis, Rebeka Tabbey, James Resau, Fang-Jian Zhou, Bin Tean Teh, Chao-Nan Qian
Journal: Cancer Research (2012)

Abstract Background: The clinical significance of pericyte coverage (PC) surrounding differentiated vessels in clear cell renal cell carcinoma (CCRCC) is unclear. Objective: To evaluate the effect of PC on the prognosis of patients with CCRCC. Methods: Samples from two cohorts of CCRCC patients (Asian, 101 cases; U.S., 542 cases) were immunohistochemically doubled-stained for a pericyte marker (α-SMA) and a differentiated vessel marker (CD34), followed by multispectral image capturing and computerized image analyses to quantify the microvessel density (MVD) and pericyte coverage of differentiated vessels. The correlations of PC or MVD with clinicopathological characteristics were analyzed. Univariate and multivariate survival analyses were performed. Results: Uneven distributions of differentiated MVD and PC were found, with higher MVD in the peripheral portion of the tumor and higher PC in the inner portion. There was an inverse correlation between differentiated MVD and PC. Higher PC correlated with more aggressive clinicopathological characteristics of CCRCC in both cohorts, including more advanced T-stage, higher pathological grades, and occurrence of tumor necrosis. The MVD:PC ratio was an independent favorable prognostic factor for overall survival in the Asian cohort and for recurrence-free survival in the U.S. cohort. PC and MVD were also independent prognostic factors, with higher PC or lower MVD predicting a poorer outcome. The combination of PC and MVD could better distinguish the outcome of CCRCC patients. PC combined with differentiated MVD, or MVD:PC ratio provided additional independent prognostic information to the Leibovich risk model, and using that information we generated improved risk models. Conclusions: The distributions of MVD and PC were uneven in CCRCC. Higher PC correlated with more aggressive clinicopathological characteristics. PC was an independent unfavorable prognostic factor. Targeting pericytes should be taken into consideration in anti-angiogenic therapy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4378. doi:1538-7445.AM2012-4378
Seeing Jesus in a piece of toast and other scientific discoveries win Ig Nobel awards
Authors: J. H. Tanne
Journal: BMJ (2014)

“Have you seen Jesus’ face in a piece of toast? Elvis in a tortilla? Your Uncle Bob in the clouds? It’s perfectly normal if you see non-existent objects,” said Kang Lee of the University of Toronto, accepting his Ig Nobel award for neuroscience on 18 September at Harvard University in Cambridge, Massachusetts.

Lee and colleagues from China and Canada were among the 10 winners of Ig Nobel awards announced at the 24th annual ceremony and handed out by winners of the proper Nobel prizes. The theme this year was “Food.” The awards are organized by the lighthearted journal Annals of Improbable Research and its editor, Marc Abraham. The prizes reward studies that “first make people laugh and then make them think.” The awards were a plastic tray with utensils such as those in an airplane meal, a document signed by real Nobel laureates, and a monetary prize—a 10 trillion dollar Zimbabwean note.

The celebration this year included a mini-opera, “What’s Eating You,” modeled on Don Giovanni; two blizzards of paper airplanes; an 8 year old girl who loudly interrupted participants who spoke longer than one minute; and lectures by experts who explained their subjects first in 24 seconds and then in seven words.

Lee told The BMJ that he and colleagues often encountered people who said they saw Jesus’s face on a piece of toast and wondered whether the people were deluded or whether there …
Tissue Adhesives for Laceration Closure-Reply
Authors: James V. Quinn
Journal: JAMA (1997)

Drs Singer and Hollander raise several important issues about the proper use of tissue adhesives. More than 40 different types of sutures are used to close wounds and incisions.<sup>1</sup>It would be naive to think that a single adhesive could replace all sutures. Current tissue adhesives can only close the skin of wounds and should only be applied topically. Tissue adhesives cannot replace deep sutures and should not be used on areas prone to premature sloughing of the adhesive (ie, hands, feet, and over joints). I agree that approximately 30% of lacerations treated in the ED may be amenable to skin closure with tissue adhesives. We have shown that the new octylcyanoacrylate formulation used in our study also can be used to close the skin of surgical incisions.<sup>2</sup>Approximately 12 million patients with lacerations present yearly to EDs, and 90 million surgical procedures are performed each year.<sup>3</sup>
Thyroxine-binding globulin, hyperthyroxinemia and hepatocellular carcinoma
Authors: Jorge J. Gumucio, Michael C. Kew
Journal: Hepatology (1991)

To determine serum thyroxine-binding globulin (TBG) levels, we used radioimmunoassay, and compared the results obtained with other tests in 231 patients with chronic hepatitis B virus infection to evaluate its clinical implications. All of these patients were hepatitis B surface antigen (HBsAg)-positive. Among them, 38 patients had hepatocellular carcinoma (HCC), 18 had chronic persistent hepatitis, 70 had chronic lobular or active hepatitis (grouped as CAH), 31 had active cirrhosis (AC), 25 had inactive cirrhosis, 20 had decompensated cirrhosis, and 29 were “healthy” HBsAg carriers. Twenty-seven patients with acute hepatitis, 12 with cancer metastasis to the liver, and 81 normal adults served as disease or normal controls. The results showed that serum TBG level increased significantly in patients with CAH, AC, or HCC. Serum TBG did not correlate with albumin or bilirubin level, but correlated with alanine aminotransferase (ALT) positively in patients with CAH ( p &lt; 0.001) and negatively in patients with HCC ( p &lt; 0.01) (slope difference p &lt; 0.05). Serial determination of serum TBG and ALT also showed parallel changes in 15 patients with CAH, but not in nine patients with HCC. In contrast, the fall and rise of serum TBG levels in patients with HCC coincided with tumor resection and recurrence. The data suggest that serum TBG elevation in patients with hepatitis activity is the result of hepatocellular damage, whereas that in patients with HCC is due to increased synthesis. Whether serum TBG elevation without concomitant rise of ALT could be used as a marker of HCC awaits further study.