tbuckley/cabot-search huggingface dataset:
Conditions are 'dire' for exhausted medical workers in Gaza
Authors: J. Zarocostas
Journal: BMJ (2009)

Conditions for medical personnel in Gaza are on the point of collapse, United Nations relief officials have warned. They say that exhausted hospital staff are overwhelmed by the number of casualties and are constrained by shortages in critical medical supplies and fuel. Medical staff and aid workers also face life threatening conditions in getting to work, reaching the wounded, and distributing aid.

The World Health Organization said that 21 medical personnel have been killed and 30 injured and that 11 ambulances have been hit in the ongoing conflict.

Since the outbreak of hostilities on 27 December, in Gaza 765 people have been reported dead, including many children and women, and more than 3100 wounded. In neighbouring southern Israel four people have died and 176 have been wounded as a result of rocket attacks by Hamas militants.

WHO repeated its calls for an immediate improvement in the situation on the ground to allow the people in Gaza to reach essential care.

However, in two separate incidents on Thursday 8 January, humanitarian convoys of the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and of the International Committee of the Red Cross (ICRC) came under Israeli fire.

The UN secretary general, Ban Ki-moon, condemned the firing by the Israel Defense Forces (IDF) on the UN aid convoy in Gaza, which, said a statement by his spokesperson, killed two UNRWA contract workers and injured another.

“This incident took place during the …
"THE RELATION OF MEDICAL EDUCATION TO THE MEDICAL PLANT"
Authors: Theodore Diller
Journal: JAMA (1923)

<h3>To the Editor:</h3> —The description of the new combined medical school and hospital of the Vanderbilt University, and the drawings accompanying the article by Dr. Robinson (The Journal, July 28) are interesting. They have raised certain questions and reflections in my mind which I am asking you to be good enough to publish. Dr. Robinson describes and illustrates in most interesting fashion the new buildings of the Vanderbilt University Medical Department, which are to combine the medical school, laboratory, library and hospital. The new buildings are to be located on the main campus, although this means "abandonment of valuable buildings and land now occupied by the Vanderbilt Medical School." Moreover, he tells us that the hospital will accommodate approximately 170 beds, a number which he states is small for educational purposes; but, he adds, "It constitutes a hospital as large as can well be maintained by the funds available for
Excess Mortality in Harlem
Authors: Colin McCord, Harold P. Freeman
Journal: New England Journal of Medicine (1990)

In recent decades mortality rates have declined for both white and nonwhite Americans, but national averages obscure the extremely high mortality rates in many inner-city communities. Using data from the 1980 census and from death certificates in 1979, 1980, and 1981, we examined mortality rates in New York City's Central Harlem health district, where 96 percent of the inhabitants are black and 41 percent live below the poverty line. For Harlem, the age-adjusted rate of mortality from all causes was the highest in New York City, more than double that of U.S. whites and 50 percent higher than that of U.S. blacks. Almost all the excess mortality was among those less than 65 years old. With rates for the white population as the basis for comparison, the standardized (adjusted for age) mortality ratios (SMRs) for deaths under the age of 65 in Harlem were 2.91 for male residents and 2.70 for female residents. The highest ratios were for women 25 to 34 years old (SMR, 6.13) and men 35 to 44 years old (SMR, 5.98). The chief causes of this excess mortality were cardiovascular disease (23.5 percent of the excess deaths; SMR, 2.23), cirrhosis (17.9 percent; SMR, 10.5), homicide (14.9 percent; SMR, 14.2), and neoplasms (12.6 percent; SMR, 1.77). Survival analysis showed that black men in Harlem were less likely to reach the age of 65 than men in Bangladesh. Of the 353 health areas in New York, 54 (with a total population of 650,000) had mortality rates for persons under 65 years old that were at lest twice the expected rate. All but one of these areas of high mortality were predominantly black or Hispanic. We conclude that Harlem and probably other inner-city areas with largely black populations have extremely high mortality rates that justify special consideration analogous to that given to natural-disaster areas.
Carcinogenicity of Ethylene Oxide
Authors: Herb Weiss
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Whether the conclusion of Hertz-Picciotto et al<sup>1</sup>that ethylene oxide is a human carcinogen is correct or not does not change the realities of life. With the worker exposure law of the Occupational Safety and Health Act in effect for well over one year, workers are currently exposed to no more than 1.0 ppm of ethylene oxide during their eight-hour workday. At the maximum exposure level, this equates to a 0.24-ppm exposure to ethylene oxide for a full seven-day week. This level is well below the effect level derived from any study, whether conducted on animals or humans. The recent data showing the toxic effects of exposure to ethylene oxide at higher levels are interesting scientific information, but do not relate to the real world of exposure to 1.0 ppm for eight hours. The continued flow of such negative information tends to make organizations and individuals
FEEDING OF SURGICAL PATIENTS.
Authors: ALBERT H. TUTTLE
Journal: JAMA (1898)

Certain special considerations in regard to the feeding of surgical patients have induced me to take up this subject for discussion, that is, the need of definite instruction which will enable the nurse to practically comprehend the requirements of her patient and the simplification of the food materials employed. The subject is naturally divided into three periods, viz.: Before operation; after operation up to the time that the bowels are established, or the immediate effects of the anesthetic are eliminated and finally the period of convalescence. The first period is of variable length from a few hours to days or even weeks, depending upon the condition of the patient, the severity of the disease and operation and the necessary amount of preliminary preparation required. During the first period it is the aim of the surgeon to build up the strength and resistance power of his patient and, just before the
INFARCT SIZE ASSESSED IN CARDIAC MAGNETIC RESONANCE IN STEMI PATIENTS TREATED WITH PCI: CARESS IN AMI SUBSTUDY
Authors: Waldemar Mielecki, Tomasz Rakowski, Agata Brzozowska-Czarnek, Artur Dziewierz, Zbigniew Siudak, Andrzej Urbanik, Carlo Di Mario, Dariusz Dudek
Journal: Journal of the American College of Cardiology (2011)
Molecular epizootiology: assessment of exposure to genotoxic compounds in teleosts.
Authors: J E Stein, W L Reichert, U Varanasi
Journal: Environmental Health Perspectives (1994)

The recent development of techniques to measure levels of carcinogens covalently bound to DNA provides the opportunity to use DNA adducts as molecular dosimeters of exposure to environmental carcinogens and mutagens. This is especially important because epizootiologic studies have shown a positive association between environmental carcinogens, such as polycyclic aromatic hydrocarbons, and increased prevalence of neoplasms and related lesions, primarily in liver, of benthic fish species from a wide range of urban and industrialized areas. In studies with wild fish and mammalian species the 32P-postlabeling assay, as developed for aromatic compounds, has been used most extensively because of its high sensitivity and ability to detect structurally uncharacterized adducts. The results to date of field and laboratory studies show that hepatic DNA adducts detected in fish are associated with increased exposure to environmental polycyclic aromatic compounds in the preponderance of species examined, whereas in the limited studies with wild mammals, such a relationship is equivocal at present. The findings with fish suggest that DNA adducts, as measured by 32P-postlabeling, have the potential to be effective molecular dosimeters of exposure to environmental carcinogenic aromatic compounds and thereby may lead to an improved understanding of the etiology of neoplasia in wild teleosts.
ACUTE ANKLE SPRAIN INJURY ALTERS KINEMATIC AND CENTRE OF PRESSURE MEASURES OF POSTURAL CONTROL DURING SINGLE LIMB STANCE
Authors: C Doherty, E Delahunt, C Bleakley, J Hertel, J Ryan, B Caulfield
Journal: British Journal of Sports Medicine (2014)

Background Upright single-limb stance (SLS) is maintained via integration of visual, vestibular and somatosensory afferents. The presence of redundancies between these afferents allows the sensorimotor system to simplify a specific task within a number of strategies. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. No current investigation has supplemented kinetic analysis of eyes-open and eyes-closed SLS tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain (LAS) group to assess the adaptive capacity of the sensorimotor system to injury. Objective To compare centre of pressure (COP) and lower limb postural orientation characteristics of participants with acute LAS to non-injured participants during a SLS task. Design Cross-sectional. Setting University biomechanics laboratory. Participants 66 participants with acute LAS completed a task of eyes-open SLS on their injured and non-injured limbs (task 1). 23 of these participants successfully completed the SLS task with their eyes closed (task 2). A non-injured control group of nineteen participants completed task 1, with 16 completing task 2. Main outcome measures 3D kinematics of the hip, knee and ankle joints as well as associated fractal dimension (FD) of the COP path. Results Between trial analyses of groups revealed significant differences in lower limb kinematics and FD of the COP path for task 2. Post-hoc testing revealed that non-injured control group bilaterally assumed a position of greater hip flexion compared to LAS participants (injured limb=7.41±6.1 ◦ vs 1.44±4.8 ◦ ; non-injured limb=9.59±8.5 ◦ vs 2.16±5.6 ◦ ), with a corollary of greater FD of the COP path (injured limb=1.39±0.16 vs 1.25±0.14; non-injured limb=1.37±0.21 vs 1.23±0.14). Conclusion Acute LAS causes bilateral impairment in postural control strategies.
Hyperenteroglucagonaemia and small intestinal mucosal growth after colonic perfusion of glucose in rats.
Authors: B M Miazza, M Y Al-Mukhtar, M Salmeron, M A Ghatei, M Felce-Dachez, A Filali, R Villet, N A Wright, S R Bloom, J C Crambaud
Journal: Gut (1985)

Beside intraluminal factors, humoral agents play an important role in intestinal adaptation. Enteroglucagon, the mucosal concentration of which is maximal in the terminal ileum and colon, is the strongest candidate for the role of small intestinal mucosal growth factor. The present experiment was designed to study the role of colonic enteroglucagon in stimulating mucosal growth in rats with a normal small intestine. After eight days of glucose large bowel perfusion, enteroglucagon plasma concentrations were 120.7 +/- SEM 9.2 pmol/l, versus 60.1 +/- 6.8 in mannitol perfused control rats (p less than 0.001). Gastrin, cholecystokinin, neurotensin, pancreatic glucagon, and insulin plasma concentrations were unchanged. Crypt cell proliferation, measured by the vincristine metaphase arrest technique, increased significantly in the small intestine of glucose perfused animals (p less than 0.005-0.001) in comparison with the controls. This resulted in a greater mucosal mass in both proximal and distal small bowel: mucosal wet weight, DNA, protein and alpha D-glucosidase per unit length intestine were all significantly higher (p less than 0.05-0.001) than in mannitol perfused rats. Our data, therefore, support the hypothesis that enteroglucagon is an enterotrophic factor and stress the possible role of the colon in the regulation of small bowel trophicity.
Hospitals miss chances to cut deaths from alcohol related liver disease, report says
Authors: S. Mayor
Journal: BMJ (2013)

A third of people admitted to hospitals in England, Wales, and Northern Ireland with known alcohol related liver disease are not referred for support to stop drinking as part of their care, warns a new report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD).1 It recommends that all patients with a history of potentially harmful drinking be referred to alcohol support services.

“Many people with alcohol related liver disease have multiple admissions with this condition,” said Mark Juniper, consultant physician at the Great Western Hospitals NHS Foundation Trust, Swindon, and clinical coordinator for the report. “This gives clinicians …
Mechanism of theophylline-induced inotropic effects on foreshortened canine diaphragm
Authors: G Gayan-Ramirez, S Janssens, B Himpens, M Decramer
Journal: European Respiratory Journal (1995)

The mechanisms of theophylline-induced inotropic effects at shorter diaphragm length have not yet been explored. We wondered whether the greater inotropic effects of the drug at shorter diaphragm length might result from an effect on intracellular calcium level. Forty pairs of diaphragm bundles were stimulated at 70% of optimal length in the presence of either verapamil (10(-5)M), calcium-free Krebs solution (buffered or not with 2 mM ethylene glycol tetra-acetic acid (EGTA)) or ryanodine (10(-6) M). Theophylline (1 mM) was subsequently added to one muscle bundle and, after 15 min, twitches were repeated. The twitch potentiation induced by theophylline (37 +/- 21%) was unaffected by verapamil (43 +/- 26%), or zero calcium (39 +/- 18%) and virtually unchanged when the latter was buffered with EGTA. By contrast, theophylline failed to increase twitch tension after pretreatment with ryanodine, a blocker of the calcium release by the sarcoplasmic reticulum. This decreased twitch tension in control (-5 +/- 11%) and experimental (-14 +/- 12%) bundles and prolonged half-relaxation time as a result of impaired sarcoplasmic reticulum calcium reuptake. We conclude that the inotropic effects of theophylline on twitch tension in foreshortened canine diaphragm bundles were not related to sarcoplasmic reticulum. This is consistent with an action of theophylline on the sarcoplasmic reticulum.
Lack of response of bone marrow, in vitro, to growth factors in congenital neutropenia
Authors: James Chang, L. H. Coutinho, Michael Dexter, Alan W. Craft, Michael M. Reid
Journal: American Journal of Hematology (1990)

Abstract Severe congenital neutropenia has a poor outlook. In vitro clonogenic assays using recombinant growth factors may improve understanding of the underlying pathogenetic mechanisms and identify those in whom growth factors might be clinically useful. Marrow from a boy with congenital neutropenia was cultured with a variety of recombinant growth factors. The results show that the neutropenia did not result from a lack of myeloid progenitors but that these progenitors could not produce mature neutrophils. Bone marrow transplantation is being considered as the most likely approach to correct neutropenia.
Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial
Authors: L. Adamsen, M. Quist, C. Andersen, T. Moller, J. Herrstedt, D. Kronborg, M. T Baadsgaard, K. Vistisen, J. Midtgaard, B. Christiansen, M. Stage, M. T Kronborg, M. Rorth
Journal: BMJ (2009)

<b>Objective</b> To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced disease. <b>Design</b> Randomised controlled trial. <b>Setting</b> Two university hospitals in Copenhagen, Denmark. <b>Participants</b> 269 patients with cancer; 73 men, 196 women, mean age 47 years (range 20-65) representing 21 diagnoses. Main exclusion criteria were brain or bone metastases. 235 patients completed follow-up. <b>Intervention</b> Supervised exercise comprising high intensity cardiovascular and resistance training, relaxation and body awareness training, massage, nine hours weekly for six weeks in addition to conventional care, compared with conventional care. <b>Main outcome measures</b> European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Medical Outcomes Study Short Form (MOS SF-36), Leisure Time Physical Activity Questionnaire, muscular strength (one repetition maximum), maximum oxygen consumption (Vo<sub>2</sub>max). <b>Statistical methods</b> The general linear model was used for continuous outcome while analysis of associates between categorical outcomes was performed as analysis of marginal homogeneity in contingency tables. <b>Results</b> Adjusted for baseline score, disease, and demographic covariates, the intervention group showed an estimated improvement at six weeks for the primary outcome, fatigue, of −6.6 points (95% confidence interval −12.3 to −0.9, P=0.02; effect size=0.33, 0.04 to 0.61). Significant effects were seen on vitality (effect size 0.55, 95% CI 0.27 to 0.82), physical functioning (0.37, 0.09 to 0.65), role physical (0.37, 0.10 to 0.64), role emotional (0.32, 0.05 to 0.59), and mental health (0.28, 0.02 to 0.56) scores. Improvement was noted in physical capacity: estimated mean difference between groups for maximum oxygen consumption was 0.16 l/min (95% CI 0.1 to 0.2, P&lt;0.0001) and for muscular strength (leg press) was 29.7 kg (23.4 to 34.9, P&lt;0.0001). No significant effect was seen on global health status/quality of life. <b>Conclusion</b> A supervised multimodal exercise intervention including high and low intensity components was feasible and could safely be used in patients with various cancers who were receiving adjuvant chemotherapy or treatment for advanced disease. The intervention reduced fatigue and improved vitality, aerobic capacity, muscular strength, and physical and functional activity, and emotional wellbeing, but not quality of life. <b>Trial registration</b> Current Controlled trials ISRCTN05322922.
Arthritis and carcinoma.
Authors: C Dunne, T Illidge
Journal: Annals of the Rheumatic Diseases (1993)

Letters to the editor was noted with low doses of prednisone, however, in contrast with the dramatic im- provement obtained in the original papers.5 6On the other hand, synovial biopsy in our case did not show malignant infiltration.Thus it is reasonable to suggest that the rheumatic manifestations belong to a paraneoplastic syndrome, as has been previously reported with other neoplasms.7To our knowledge this is the first description of peripheral synovitis and pitting oedema as an initial manifestation of non-Hodgkin's lymphoma.We would like to emphasise the need to consider the possibility of an under- lying malignancy in a patient with these clinical characteristics who is unresponsive to the usual medical treatment.
Red cell ferritin content: a re-evaluation of indices for iron deficiency in the anaemia of rheumatoid arthritis.
Authors: A Davidson, M B Van der Weyden, H Fong, M J Breidahl, P F Ryan
Journal: BMJ (1984)

In iron deficiency anaemia basic red cell content of ferritin is appreciably reduced. This variable was determined in 62 patients with rheumatoid arthritis to evaluate conventional laboratory indices for iron deficiency in the anaemia of rheumatoid arthritis. For 23 patients with rheumatoid arthritis and normocytic anaemia irrespective of plasma ferritin concentration, red cell ferritin content did not differ significantly from that for non-anaemic patients with rheumatoid arthritis. For 27 patients with rheumatoid arthritis and microcytic anaemia, the mean red cell ferritin content for patients with a plasma ferritin concentration in the 13-110 micrograms/l range was appreciably reduced. It was indistinguishable from that for patients with rheumatoid arthritis and classical iron deficiency anaemia, indicated by plasma ferritin concentrations of less than 12 micrograms/l. In contrast, the mean red cell ferritin content for patients with rheumatoid arthritis, microcytic anaemia, and plasma ferritin concentrations above 110 micrograms/l did not differ from that for patients with rheumatoid arthritis and normocytic anaemia. Oral treatment with iron in patients with rheumatoid arthritis, microcytic anaemia, and appreciably reduced red cell ferritin concentrations was accompanied by significant increases in haemoglobin concentration (p less than 0.01), mean corpuscular volume (p less than 0.01), and red cell ferritin contents (p less than 0.05). This treatment, however, did not produce any appreciable change in haemoglobin concentration in patients with rheumatoid arthritis, normocytic anaemia, and normal red cell ferritin contents. These findings suggest that the indices for iron deficiency in patients with rheumatoid arthritis and anaemia should include peripheral blood microcytosis together with a plasma ferritin concentration of less than 110 micrograms/l.
Mite fauna in the home and sensitivity to house‐dust and storage mites
Authors: A Warner, S Boström, C Möller, N‐i‐m Kjellman, A Warner
Journal: Allergy (1999)

In search of potential new indoor allergen sources, all mites in dust from homes of 55 asthmatic children living in three climatic regions in Sweden were counted and identified by light microscope. Antibodies of the IgE class against three house-dust mites and three storage mites were measured in corresponding serum samples. Mites were found in all but two homes from the northernmost area, where levels also were lower than in the other regions. The highest mite densities were most often found in bedrooms (50%) and living rooms (40%). Mite density was increased in homes with high humidity and was higher in bungalows than in flats. House-dust mites predominated in the south and storage mites in the east central area, particularly in kitchens and bathrooms. Mite-density and IgE-antibody levels against house-dust mites were significantly associated. The same association applied to storage mites. Other species numbered around 100 mites/g dust in some homes. Microscopy helps to identify potentially important mites. Analysing home dust only for house-dust mites will underestimate mite exposure. Storage mites may be as relevant to sensitivity as house-dust mites. As other species occasionally were found in high numbers, their relevance should also be assessed.