tbuckley/cabot-search huggingface dataset:
Genetic factors and osteoporotic fractures in elderly people: prospective 25 year follow up of a nationwide cohort of elderly Finnish twins
Authors: P. Kannus, M. Palvanen, J. Kaprio, J. Parkkari, M. Koskenvuo
Journal: BMJ (1999)

<h3>Abstract</h3> <b>Objective:</b> To determine whether genetic factors partly explain variation in risk of osteoporotic fracture, the true end point of the osteoporosis problem. <b>Design:</b> Prospective 25 year follow up of a nationwide cohort of elderly Finnish twins. <b>Setting:</b> The Finnish twin cohort and the national hospital discharge register, covering the entire 5 million population of Finland. <b>Subjects:</b> All same sex twin pairs born before 1946. The cohort contained 2308 monozygotic and 5241 dizygotic twin pairs (15 098 people) at the beginning of follow up. <b>Main:</b> outcome measure The number and concordance of osteoporotic fractures in the twin pairs, 1972-96. <b>Results:</b> 786 cohort members sustained an osteoporotic fracture. In women, the pairwise concordance rate for fracture (that is, the relative number of twin pairs in whom the fracture affected both twins in a pair) was 9.5% (95% confidence interval 5.3% to 15.5%) in monozygotic pairs and 7.9% (5.2% to 11.4%) in dizygotic pairs. In men, the figures were 9.9% (4.4% to 18.5%) and 2.3% (0.6% to 5.7%). <b>Conclusions:</b> Susceptibility to osteoporotic fractures in elderly Finns is not strongly influenced by genetic factors, especially in elderly women. The traditional strategy for prevention of osteoporotic fractures—that is, increasing peak bone mass and preventing age related bone loss—should be changed to include new elements such as prevention of falls and protection of the critical anatomical sites of the body when a fall occurs. <h3>Key messages</h3> Genetic factors have a substantial role in explaining age specific variation in bone mass and density, but no previous study has directly evaluated whether they have a role in the variation of risk of osteoporotic fracture, the true end point of the entire osteoporosis problem Genetic factors are not strongly related to likelihood of osteoporotic fracture, particularly in elderly women For this reason, the traditional prevention strategy of osteoporotic fractures—increasing peak bone mass and preventing age related bone loss—could include new additional elements, such as prevention of falls in elderly people and protection of the critical anatomical sites of the body when a fall occurs
Grading President Clinton's Health Proposal
Authors: Uwe E. Reinhardt
Journal: JAMA (1993)

MAY IS that otherwise lovely month when American college professors are buried under mountains of examinations, papers, and dissertations, each waiting to be read and graded. This year, for some of us, the month of May will bring an extra assignment: Bill and Hillary Clinton's weighty tome on health care reform, coauthored by them, with the assistance of Ira Magaziner and some 500 additional miniauthors known in the trade as The Task Force. The tome is likely to span dozens of chapters and hundreds of pages, but these can be organized into three parts, reflecting the conventional three goals of health care reform:<i>better cost control, better quality control</i>, and<i>universal health insurance coverage</i>. To assign the proposal an overall grade one should, first, grade each part separately and then collapse the three scores into an overall weighted average grade, where the weight assigned to each part represents the relative
Vitamin B12 absorption--a study of intraluminal events in control subjects and patients with tropical sprue.
Authors: C R Kapadia, P Bhat, E Jacob, S J Baker
Journal: Gut (1975)

The intraluminal fate of orally administered radioactive vitamin B12 has been studied in control subjects with normal vitamin B12 absorption and those with vitamin B12 malabsorption due to tropical sprue. In control subjects 1 to 21% of the dose was bound to sedimentable material and 37 to 75% was bound to immunoreactive intrinsic factor. In subjects with vitamin B12 malabsorption due to tropical sprue, the results were identical with the control subjects. Bacteriological studies showed a statistically significant correlation between both the number of flora in the jejunum and the number of bacteroides in both the jejunum and ileum and vitamin B12 malabsorption. In patients with tropical sprue who have normal intrinsic factor secretion, the vitamin B12 absorptive defect is not due to binding of the vitamin to bacteria or to alteration to the intrinsic factor vitamin B12 complex in the intestinal lumen. The lesion appears to be one of the mucosal cell receptors or of the cells themselves, possibly caused by bacterial toxins.
Pulmonary Responses to Infectious Diseases.
Authors: David M. Spain
Journal: Annals of Internal Medicine (1964)

s1 February 1964Pulmonary Responses to Infectious Diseases.David M. Spain, M.D.David M. Spain, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-2-335_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe general and specific factors that determine the various responses of the lung on a tissue, cellular and humoral level will be discussed for the different viral, bacterial (pneumococcus, staphylococcus, streptococcus, etc.), and fungal infections. The patterns and sites of tissue alterations resulting from the various infectious agents will be described, especially as these relate to the resolution of the inflammatory processes, the complications and the ultimate effect on lung structure and function. The special role of the alveolar lining as a target site for some of the infectious agents will be given consideration. The influence of the modern environment... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: David M. Spain, M.D.Affiliations: Brooklyn, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1964Volume 60, Issue 2_Part_1Page: 335-335KeywordsInfectious diseasesLungsPneumococcusPulmonary diseasesStaphylococcal infectionStaphylococcusStreptococcal infectionsStreptococcus ePublished: 1 December 2008 Issue Published: 1 February 1964 PDF downloadLoading ...
Faulty gene linked to chronic leukaemia
Authors: R. Woodman
Journal: BMJ (1999)

Researchers have discovered that a faulty gene may be responsible for many cases of chronic lymphocytic leukaemia, the commonest form of leukaemia in older people.

It is already known that patients with the rare genetic disorder ataxia telangiectasia are more susceptible to lymphoid malignancies, probably because they have inherited two inactive versions of the ATM gene, and therefore damaged cells …
A–Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance: Part 45
Authors: R J Godfrey, M W Laupheimer, S J Stear, L M Burke, L M Castell
Journal: British Journal of Sports Medicine (2013)

Part 45 contains a trio of topics beginning with ‘Y’. Yerba mate, a fairly well-known herbal tea, contains caffeine, which accounts for its association with sports performance. Yohimbine, an alkaloid, has traditionally been used as a herbal preparation to combat erectile dysfunction. However, more recently, claims have been made for its putative role in bodybuilding. Yucca, a family of 40–50 shrubs and trees, is marketed as having anti-inflammatory and antiarthritic properties.

### S J Stear

Yerba mate tea (mate) is made from an infusion of the dried leaves of the Ilex paraguariensis tree, which is widely consumed in South America, but also found globally as both a herbal tea beverage and an ingredient in formulated foods and supplements.1 Numerous active phytochemicals have been identified in yerba mate tea: the two most prevalent compounds are the polyphenols (chlorogenic acid) and xanthines (caffeine and obromine),2 followed by purine alkaloids (caffeic acid, 3,4-dicaffeoylquinic acid, 3,5-dicaffeoylquinic acid), flavonoids (quercetin, kaempferol and rutin), amino acids, minerals (phosphorus, iron and calcium) and vitamins (C, B1 and B2).1 However, unlike other teas, particularly white, green and oolong and, to a lesser extent black, yerba mate is a better alternative as it does not contain catechins,1 ,3 which have recently been linked with liver …
[582] VIRAL KINETICS CAN PREDICT VIROLOGICAL RESPONSE IN HCV PATIENTS WITH NORMAL ALT TREATED WITH PEGYLATED IFN ALFA-2b AND RIBAVIRIN: A PROSPECTIVE STUDY
Authors: P. Deltenre, V. Canva, A. Louvet, S. Dharancy, L. Bocket, A. Hollebecque, J. Boitard, C. Francois, S. Castelain, G. Duverlie, J. Henrion, P. Mathurin
Journal: Journal of Hepatology (2007)
Phospholipid alterations in canine ischemic myocardium. Temporal and topographical correlations with Tc-99m-PPi accumulation and an in vitro sarcolemmal Ca2+ permeability defect.
Authors: K R Chien, J P Reeves, L M Buja, F Bonte, R W Parkey, J T Willerson
Journal: Circulation Research (1981)

Experimental myocardial ischemia produced in dogs by proximal left anterior descending coronary artery (LAD) ligation results in a small but measurable decrease in total phospholipid content in the subendocardium of the ischemic region.After 3 hours of fixed occlusion, there is a 10% decrease in total phospholipid content.Silica gel chromatography reveals this decrease to be reflected predominantly by decreases in phosphatidyl choline (PC) and phosphatidyl ethanolamine (PE).If technetium 99m stannous pyrophosphate (Tc-99m-PPi) is injected intravenously after various intervals of LAD occlusion and 10 minutes prior to Vh hours of reflow, there is a close temporal and topographical correlation between the extent of PE depletion and Tc-99m-PPi uptake.To measure the effects of phospholipid degradation on cardiac sarcolemmal membranes, an enriched sarcolemmal preparation was treated with an exogenous phospholipase (0.01 mg/ml).Phospholipid degradation, even without depleting total phospholipid content, resulted in more than a 50% increase in net Ca 2+ efflux from vesicles preloaded by Na + :Ca 2+ exchange.In addition, sarcolemmal vesicles isolated from ischemic myocardium after 3 hours of LAD occlusion have an increased Ca 2+ permeability and phosphatidyl choline depletion compared to vesicles obtained from the corresponding nonischemic myocardium.These studies suggest that an alteration in phospholipid metabolism is related closely to the development of irreversible damage in ischemic canine myocardium.The biochemical mechanism responsible for this relationship may be the degradation of sarcolemmal membrane phospholipids and the associated increase in sarcolemmal Ca 2+ permeability.
Lymphocytic infiltration of the brain in sleeping sickness.
Authors: B M Greenwood, H C Whittle, K O Oduloju, R R Dourmashkin
Journal: BMJ (1976)

Cerebrospinal fluid mononuclear cells from 40 patients with advanced Gambian sleeping sickness were examined for intracytoplasmic immunoglobulin and for B- and T-lymphocyte markers. About 5% of mononuclear cells were plasma cells. Most of the lymphocytes present were B cells. These findings suggest that the considerable lymphocytic infiltration of the nervous system seen in advanced sleeping sickness is not a cell-mediated immune reaction to trypanosomes. Immune complexes may play a part in producing the brain damage characteristic of this disease.
QUANTIFYING THE RISK OF ABNORMAL NEUROPHYSIOLOGY AS A RESULT OF SUB-CONCUSSIVE BLOWS IN HIGH SCHOOL FOOTBALL ATHLETES
Authors: L Leverenz, K Breedlove, E Breedlove, M Robinson, V Poole, JR King, P Rosenberger, M Rasmussen, T Talavage, E Nauman
Journal: British Journal of Sports Medicine (2014)

Background Recent work suggests that repetitive sub-concussive head impacts may contribute to long-term neurodegeneration; however, the risk thresholds for sub-concussive injury are unknown. Objective To evaluate the risk of developing abnormal neurophysiology due to repetitive impacts to the head. Hypothesis: the number of head impacts is predictive of neurological impairment. Design ImPACT, fMRI, and head impact telemetry (HIT) was employed in baseline tests, pre-season and in-season. The number and magnitude of head impacts were collected for practices and games. Setting American high school football. Participants 13 high school American football players age 14–18. Those diagnosed with a concussion were excluded. Risk factor assessment The number of head impacts during the season. Main outcome measurements Pre-season and in-season ImPACT, MRI, and fMRI. Results The players experienced an average of 17.7 to 45.5 hits/week with a mean and standard deviation of 71.7±39.3. The corresponding cumulative number of hits for the season ranged from 86 to 1996 with a mean and standard deviation of 582.8±444.3. Twenty-two in-season ImPACT tests were administered during the season. Twelve (54.5%) showed a minimum of one composite score flagged, the fMRI analysis showed 16 (72.7%) in-season assessments flagged, and seven subjects were flagged by both the ImPACT and fMRI. Groups were divided based on number of head impacts; those above &amp; below 500 cumulative hits/season and above and below 65 hits/week. Above 500 cumulative hits/season and 65 hits/week, all examinations were flagged. Conclusions A number of asymptomatic athletes exhibited neurophysiological changes. The number of head impacts is a risk factor for the development of neurophysiological changes. The medical staff should monitor players who are taking large numbers of hits, consider using neurocognitive testing on an annual basis, and promote proper technique and skill development for the players.
Prolonged zidovudine therapy in patients with AIDS and advanced AIDS-related complex. AZT Collaborative Working Group
Authors: M. A. Fischl
Journal: JAMA (1989)

We examined the long-term safety and efficacy of zidovudine therapy in 229 subjects with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex who previously participated in a placebo-controlled study of zidovudine. One hundred two placebo recipients (delayed treatment group) and 127 zidovudine recipients (original treatment group) were followed up while receiving zidovudine therapy for a mean of 21 months. Survival rates for the original treatment group were 84.5% and 57.6% at 12 and 21 months, respectively; for the delayed treatment group, 78.8% and 64.6% at 12 and 18 months, respectively; and 78.8% and 47.5% at 12 and 21 months, respectively, for 77 subjects with AIDS and 93.0% and 71.8%, respectively, for 50 subjects with AIDS-related complex in the original treatment group. Adverse reactions decreased over time and newly observed toxic reactions were unusual. The clinical course of these subjects suggests continued survival benefits with long-term zidovudine therapy. (<i>JAMA</i>. 1989;262:2405-2410)
Nigeria recommends jail terms to eradicate female genital mutilation
Authors: A. Raufu
Journal: BMJ (2002)

The Nigerian legislature is set to pass a law banning female genital mutilation and imposing a two year jail term for offenders.

The bill, which is currently being considered by the Senate, was unanimously passed by Nigeria's lower house, the House of Representatives last year. The senate is expected to conclude its deliberations on the bill in May, after which it will be sent to President Olusegun Obasanjo for his assent.

The first clause of the Circumcision of Girls and Women (Prohibition) Bill says: “No person shall circumcise a girl or woman and no person shall abet or aid the circumcision …
Oesophageal cancer is an uncommon cause of death in patients with Barrett's oesophagus.
Authors: A van der Burgh, J Dees, W C Hop, M van Blankenstein
Journal: Gut (1996)

BACKGROUND: Barrett9s oesophagus carries a 30-fold to 40-fold increased risk of oesophageal cancer. It is unknown whether endoscopic surveillance programmes reduce mortality from oesophageal cancer. METHODS: A cohort study was undertaken of all 166 patients in whom the diagnosis Barrett9s oesophagus had been established between 1973 and 1986. RESULTS: One hundred and fifty five of 166 patients could be traced (93%). During a mean follow up of 9.3 years (amounting to 1440 patient years) eight patients had developed oesophageal cancer at random intervals (one case in 180 patient years). All but one of the tumours were diagnosed at endoscopy for symptoms, three in the stage of carcinoma in situ. Risk factors for the development of oesophageal cancer were extensive Barrett9s oesophagus exceeding 10 cm (p = 0.02) and Barrett9s ulcer at the time of intake (p = 0.009). Seventy six patients were alive; three had undergone surgery for oesophageal cancer and were without recurrence respectively, 12.8 years, 12.1 years, and 7 months postoperatively. Seventy nine patients had died; five of them had developed oesophageal cancer, but in only two cases this had been the cause of death (2.5%). CONCLUSIONS: Oesophageal cancer is an uncommon cause of death in patients with Barrett9s oesophagus. The patients of this cohort would not have benefited from an endoscopic surveillance programme.
STUDIES OF THE BASAL WORK AND OUTPUT OF THE HEART IN CLINICAL CONDITIONS
Authors: Isaac Starr, Leon H. Collins, Francis Clark Wood
Journal: Journal of Clinical Investigation (1933)

Any method of determining the volume of the cardiac output in man which requires intelligent, alert and active cooperation by the subject can scarcely be regarded as suited to the study of this most important aspect of cardiac function in the clinic.Errors are sure to arise from ignorance, lack of training, excitement, apprehension, etc., of such magnitude as to render results worthless.When the ethyl iodide method of Henderson and Haggard (1) was devised, in which the sole requirement of the subject is that he breathe through a mouthpiece, it appeared that a long step had been taken toward the attainment of quantitative information concerning the heart's output under the various circumstances of disease.Im- pressed by these possibilities Starr and Gamble, at the suggestion of Professor A. N.
Correlation between Scanning Laser Ophthalmoscope Microperimetry and Anatomic Abnormalities in Patients with Subfoveal Neovascularization
Authors: Tongalp H. Tezel, Lucian V. Del Priore, Brian E. Flowers, David H. Grosof, Igor L. Benenson, Rene L. Zamora, Henry J. Kaplan
Journal: Ophthalmology (1996)
The chemokine receptor CXCR3 is expressed on malignant B cells and mediates chemotaxis
Authors: Livio Trentin, Carlo Agostini, Monica Facco, Francesco Piazza, Alessandra Perin, Marta Siviero, Carmela Gurrieri, Silvia Galvan, Fausto Adami, Renato Zambello, Gianpietro Semenzato
Journal: Journal of Clinical Investigation (1999)

B- and T-cell recirculation is crucial for the function of the immune system, with the control of cell migration being mainly mediated by several chemokines and their receptors. In this study, we investigated the expression and function of CXCR3 on normal and malignant B cells from 65 patients with chronic lymphoproliferative disorders (CLDs). Although CXCR3 is lacking on CD5+ and CD5– B cells from healthy subjects, it is expressed on leukemic B lymphocytes from all (31/31) patients with chronic lymphocytic leukemia (CLL). The presence of CXCR3 was heterogeneous in other B-cell disorders, being expressed in 2 of 7 patients with mantle cell lymphoma (MCL), 4 of 12 patients with hairy cell leukemia (HCL), and 11 of 15 patients with other subtypes of non-Hodgkin’s lymphomas (NHLs). Chemotaxis assay shows that normal B cells from healthy subjects do not migrate in response to IFN-inducible protein 10 (IP-10) and IFN-γ–induced monokine (Mig). In contrast, a definite migration in response to IP-10 and Mig has been observed in all malignant B cells from patients with CLL, but not in patients with HCL or MCL (1/7 cases tested). Neoplastic B cells from other NHLs showed a heterogenous pattern. The migration elicited by IP-10 and Mig was inhibited by blocking CXCR3. No effect of IP-10 and Mig chemokines was observed on the cytosolic calcium concentration in malignant B cells. The data reported here demonstrate that CXCR3 is expressed on malignant B cells from CLDs, particularly in patients with CLL, and represents a fully functional receptor involved in chemotaxis of malignant B lymphocytes.
The Low Anion Gap
Authors: Paul D. Mitnick
Journal: JAMA (1980)

To the Editor.—  In a recent issue ofThe Journal, Goldstein et al commented on the usefulness of ascertaining if a low anion gap is present. The comment that only one case of multiple myeloma was found out of a total of 39,360 retrospective electrolyte determinations would suggest that this quest would lack utility. If one, however, notes that out of the 19 patients who had verification of a low anion gap by repeated determinations, 16 could be explained by either hypoalbuminemia or hyponatremia, the astute mathematician realizes that one third of the remaining patients had multiple myeloma. Therefore, if hypoalbuminemia and hyponatremia are ruled out, the incidence of multiple myeloma in patients who have verified low anion gaps in this study is 33%. There are few such noninvasive laboratory tests that have this degree of specific diagnostic value.  It would be more interesting to know how many of the
THE X-RAY DIAGNOSIS OF PATHOLOGICAL CONDITIONS OF THE GALL-BLADDER
Authors: J. F. Brailsford
Journal: BMJ (1928)

that in 15 cases malignanit disease of the gall-blidder, was foulnd.-The iaverage age of tle 'patiients in this group was 64, an(d in all a long-standing history of gall-bladder disease wvas -i11c.InI everyl c-ase gail-stonies wer'e present anid there was evidence of old-stallding elholecystitis.In onily onle of tlhese cases was the disease-re-movable, an-d in that onec fatal re,currence t)ook place two years later.The risk of mialignmant dlisease is therefore 11() smafll onie, and is a stroiig p,oint ini favour of timely operationi.In 6 cases the opieration w-as carried ouit for acute haenior- hlagic or glangrenous pancreatitis.In 5 of these cases, which were all fatal, a lonig-stanidinig historv of cholecyst- itis anid gall-stones was giveen.The average age of the patients in this group was 60 years.hli 3 cases (jaundiced patients) an irremovable c-arcinonma of the commiion bile (luct was found, and in 7 a careiniomiia of the lhead of the pan(reas.In all of thvesc 10 cases a palliative eholecvst- ei-aterlostomYv was p)erforimed.Excludinig these 31 cases (25 miialigInant tanid 6 atcute plalcieatitis) there remnain 421 cases, of whlichl 37 -were ezses of c oleecstitis, with or without cholelithiasis.The sex 'ratio was 91 mtales anid 306 females, and( the average age at operation was 50 vears.Thte disease, wx-as found witlh equal frequenicy in -hospital an(l private_practice (213 hospital, 184 private cases).Several strikilng differences were nioted in the two social classes however.In thie first -plpace, there was a much alarger perceintage of male cases in, private practice-30 per ceat.to 17.3 in hespital -practice-i-due, no'.doubt, to the se(ledntary occupationi in the former.Seconldly, the average age at operation in private cases was 54, in hospital cases' 46.5, and th-e lengtlh of history correspon(led to this age difference--that is, exl)ectant anid meidical treatmlent was p)ersist(d with mucllh loniger in those in better finlancial circumstan-ccs.The nmost notable difference, however, was in. the operative mortality, which in priv-ate cases was 6 pelr cenit.and in hospital cases 1.4 per cenit.This lpro-