tbuckley/cabot-search huggingface dataset:
Dementia Risk After Traumatic Brain Injury vs Nonbrain Trauma
Authors: Raquel C. Gardner, James F. Burke, Jasmine Nettiksimmons, Allison Kaup, Deborah E. Barnes, Kristine Yaffe
Journal: JAMA Neurology (2014)

<h3>Importance</h3> Epidemiologic evidence regarding the importance of traumatic brain injury (TBI) as a risk factor for dementia is conflicting. Few previous studies have used patients with non-TBI trauma (NTT) as controls to investigate the influence of age and TBI severity. <h3>Objective</h3> To quantify the risk of dementia among adults with recent TBI compared with adults with NTT. <h3>Design, Setting, and Participants</h3> This retrospective cohort study was performed from January 1, 2005, through December 31, 2011 (follow-up, 5-7 years). All patients 55 years or older diagnosed as having TBI or NTT in 2005 and 2006 and who did not have baseline dementia or die during hospitalization (n = 164 661) were identified in a California statewide administrative health database of emergency department (ED) and inpatient visits. <h3>Exposures</h3> Mild vs moderate to severe TBI diagnosed by Centers for Disease Control and Prevention criteria using<i>International Classification of Diseases, Ninth Revision </i>(<i>ICD-9</i>)codes, and NTT, defined as fractures excluding fractures of the head and neck, diagnosed using<i>ICD-9</i>codes. <h3>Main Outcomes and Measures</h3> Incident ED or inpatient diagnosis of dementia (using<i>ICD-9</i>codes) 1 year or more after initial TBI or NTT. The association between TBI and risk of dementia was estimated using Cox proportional hazards models before and after adjusting for common dementia predictors and potential confounders. We also stratified by TBI severity and age category (55-64, 65-74, 75-84, and ≥85 years). <h3>Results</h3> A total of 51 799 patients with trauma (31.5%) had TBI. Of these, 4361 (8.4%) developed dementia compared with 6610 patients with NTT (5.9%) (<i>P</i> &lt; .001). We found that TBI was associated with increased dementia risk (hazard ratio [HR], 1.46; 95% CI, 1.41-1.52;<i>P</i> &lt; .001). Adjustment for covariates had little effect except adjustment for age category (fully adjusted model HR, 1.26; 95% CI, 1.21-1.32;<i>P</i> &lt; .001). In stratified adjusted analyses, moderate to severe TBI was associated with increased risk of dementia across all ages (age 55-64: HR, 1.72; 95% CI, 1.40-2.10;<i>P</i> &lt; .001; vs age 65-74: HR, 1.46; 95% CI, 1.30-1.64;<i>P</i> &lt; .001), whereas mild TBI may be a more important risk factor with increasing age (age 55-64: HR, 1.11; 95% CI, 0.80-1.53;<i>P</i> = .55; vs age 65-74: HR, 1.25; 95% CI, 1.04-1.51;<i>P</i> = .02; age interaction<i>P</i> &lt; .001). <h3>Conclusions and Relevance</h3> Among patients evaluated in the ED or inpatient settings, those with moderate to severe TBI at 55 years or older or mild TBI at 65 years or older had an increased risk of developing dementia. Younger adults may be more resilient to the effects of recent mild TBI than older adults.
Eradication of advanced hepatocellular carcinoma in rats via repeated hepatic arterial infusions of recombinant VSV
Authors: Katsunori Shinozaki, Oliver Ebert, Savio L.C. Woo
Journal: Hepatology (2005)

Viruses that replicate selectively in cancer cells hold considerable promise as novel therapeutic agents for the treatment of malignancy. Vesicular stomatitis virus (VSV) is a nonpathogenic RNA virus with intrinsic oncolytic specificity due to attenuated antiviral responses in many tumors. We report that repeated hepatic arterial infusion of recombinant syncytia-forming VSV vector in advanced multifocal hepatocellular carcinoma (HCC)-bearing rats at a 10-fold reduced vector dose resulted in sustained tumor-selective virus replication until the onset of high-titer neutralizing antibodies in blood. No significant elevations in serum transaminases and liver pathology were noted, indicating a lack of hepatotoxicity. Substantially improved tumor response was achieved with completely necrotic tumor nodules surrounded by mononuclear phagocytic cells, followed by fibrosis and calcification of the lesions, angiogenesis, and regeneration of normal hepatic parenchyma. Survival of tumor-bearing rats treated with repeated vector infusions was not only significantly improved over that of animals after a single injection at 10 times the vector dose ( P = .001), but 18% of animals in the former treatment group also achieved long-term and tumor-free survival compared with 0% of animals in the latter treatment group . In conclusion, this treatment regimen will be very useful in the future development of VSV-mediated virotherapy as a novel therapeutic modality for patients with advanced HCC. (Hepatology 2005;41:196–203.)
Medicine compliance aids are partial solution, not panacea
Authors: D K Raynor
Journal: BMJ (2002)

EDITOR—With reference to the news article by MacDonald on prescription charges for elderly people,1 multicompartment compliance aids are widely regarded as a panacea for people living at home who have problems with their medicines. Their use is, however, not evidence based, with practice largely based on the needs of professionals and carers, rather than the patients themselves. The response to moves to charge for the supply of such aids has largely been based on the assumption that …
THE RISE AND FALL OF THE LICENSED PHYSICIAN IN MASSACHUSETTS. 1781-1860.The President's Address at the Ninth Annual Meeting of the Association of American Physicians held in Washington, May 20, 1894.
Authors: REGINALD H. FITZ
Journal: JAMA (1894)

the majority of cases, it will be found of the greatest utility to irrigate the stomach and the colon, and then disinfect the small intestines by the use of such anti¬ septics as will reach them without losing their power and with the least irritation, and begin at that point to arrest the growth of ferments.This general treat¬ ment is applicable, usually, not only in all diseases in which there is so-called dyspepsia, with the exception of cases of cancers and ulcers-in which modifications are necessary-but is applicable also in typhoid fever, in Asiatic cholera, cholera morbus, and in innumer¬ able other morbid conditions of the digestive tract that every physician needs to understand well, and that may occur independently or in connection with some other affections.The stomach tube, for the pure or medicated lavage and disinfection of the stomach plays a most important part.By its use, gallons of water can be used each day or each sitting.The following medicinal agents may be used with advantage in the disinfection of this organ : ROSENHEIM'S SOLUTION FOB LAVAGE OF THE STOMACH.Borax.2 drachms.Creolin.4 grains.Salicylic acid.18" Thymol.4" Use with a syphon tube after clear water lavage, once a day for disinfection.COMPOUND CINNAMON AND CITRIC ACID LAVAGE.
Hepatocellular carcinoma in corticosteroid-treated severe autoimmune chronic active hepatitis
Authors: Kenneth K. Wang, Albert J. Czaja
Journal: Hepatology (1988)

To determine the frequency of hepatocellular cancer in corticosteroid-treated severe autoimmune chronic active hepatitis and to identify risk factors for its development, 124 patients who were selected by uniform criteria, treated comparably and followed systematically for 111 +/- 6 months were evaluated. Hepatocellular cancer was diagnosed in three patients (2%) after 66, 99 and 174 months of observation, respectively. The incidence of hepatocellular cancer was 1 per 350 patient-years of follow-up. All three patients with hepatocellular cancer had cirrhosis for at least 5 years. The frequency of neoplasm in patients with cirrhosis of at least 5 years' duration was 7%. The incidence of hepatocellular cancer in these patients with cirrhosis was 1 per 182 patient-years of follow-up, and the probability of tumor was 29% after 13 years. Late elevation of the serum alpha-fetoprotein level was associated with the presence of neoplasm but normal levels did not exclude the diagnosis. We conclude that patients with corticosteroid-treated severe autoimmune chronic active hepatitis are at risk for hepatocellular cancer. This risk is greatest in patients with cirrhosis for at least 5 years. Such patients are candidates for cancer surveillance.
Coroner criticised over conduct of SARS inquest
Authors: Jane Parry
Journal: BMJ (2004)

The inquest of the Hong Kong Coroner's Court into six healthcare professionals who died while caring for patients during last year's outbreak of severe acute respiratory syndrome (SARS) has returned a verdict of natural causes.

The court heard testimony from 43 witnesses, including family members of the deceased, doctors, nurses, medical experts, and hospital executives. Witnesses told the court that they thought the health workers had inadequate protective equipment. But the coroner, Michael Chan Pik-kiu, told the jury that it had to return a verdict of natural causes if it believed that SARS was the cause of death.

Witnesses explained that although Tuen Mun Hospital had no shortage of supplies medical workers were given one mask per 10 hour shift, had to turn gowns inside out and hang them up …
Quantification and molecular characterization of hprt mutants of human T-lymphocytes.
Authors: M M Moore, K Harrington-Brock, L J Zimmerman, L P Burnette, T W Smith, R B Everson, J P O'Neill, J C Fuscoe
Journal: Environmental Health Perspectives (1993)

Somatic mutations have been implicated as critical early events in carcinogenesis. Point mutations, deletions, and translocation events have been shown to activate oncogenes or inactivate suppressor oncogenes. In human population monitoring, quantitative analysis of mutation events that affect gene function is limited to those genes whose cellular phenotypes can be identified by selection procedures and to those tissues (like blood) that are accessible for analysis. In an effort to determine the frequency and types of mutations that can be detected at the hypoxanthine guanine phosphoribosyltransferase (hprt) gene, we have used the T-cell cloning assay and have developed a strategy to propagate mutants and screen for point mutations and breakage events. Early in the clonal expansion of mutants, 1-2 x 10(4) cells are prepared as a crude cell lysate, and a sample is analyzed using the multiplex polymerase chain reaction (PCR). Those mutants that yield altered DNA fragments are then expanded for Southern blot hybridization, PCR, flanking probe isolation, and DNA sequencing. To date we have found presumed point mutations, intragenic deletions, and deletions that extend outside of the hprt gene. By analyzing mutations in selectable, nonessential gene markers, it should be possible to understand mechanisms of both spontaneous and induced genetic damage. An association of these specific genetic events with human diseases and the evaluation of the ability of environmental chemicals to induce these specific types of mutations will lead to a rational basis for evaluating risks from various chemical exposures.
NEEDED: SPINAL CORDS FROM FATAL OR OLD CASES OF POLIOMYELITIS
Authors: H. Chandler Elliott
Journal: JAMA (1942)

To the Editor:—  To those of your subscribers who are inter ested in poliomyelitis I wish to make an appeal.  What seems to be a promising line of attack is being seriously hampered by lack of material. Spinal cords from cases of the disease, acute and even more particularly chronic, are needed. Therefore I beg that any one reading this letter will bear me in mind if the possibility of obtaining any such cord should come his way. Far from being a mere incidental, a single cord would be of major value. Accordingly the appeal is made especially to individual physicians and surgeons and to small hospitals which cannot be reached otherwise. Requirements are intact cords, or intact upper or lower halves; dura left on, but slit up back for good fixation; cord may be cut into equal thirds for convenience. Fixation preferably with 2 per cent glacial acetic acid
Your 10,000 manuscripts
Authors: K. F. Rabe, P. J. Sterk
Journal: European Respiratory Journal (2008)

After 6 years in office, we are finishing our mandate as Chief Editors of the European Respiratory Journal ( ERJ ). It has been a great honour and pleasure to serve the journal, the European Respiratory Society, and… you!

Based on undergraduate management knowledge, we started with the mission: “rapid, reliable and responsive”. Has that been achieved? Well, regarding the central part of our mission, we have tried our utmost to guarantee the reliability of both the ERJ and the data published. Is the ERJ responsive? Over the years, we have stimulated the usage of the ERJ as a platform for debate on the latest issues in respiratory science, through editorials, perspective papers, and our correspondence section. We hope you liked it. And were we rapid? Our ERJ In Press service (http://erj.ersjournals.com/pap.dtl) has indeed increased the early access to accepted papers. But, to be honest, we believe that there is still some room for improvement with …
ON FEMALE STERILITY, WITH SOME PRACTICAL SUGGESTIONS FOR ITS REMOVAL
Authors: W. Bayes
Journal: BMJ (1853)

ness, who employ assistants to do their club and union practice.By the former, the reepectab club patient is hailed as likely to bring the more profitable accession of his family connexions; by the latter, the question of profit or loss is swamped in the generalities of a large income.To the established practitioner, with but a small or moderate practice, this question of profit and loss is a very different matter; to him, every private patient, who can pay his accounts, is a matter of consequence and calculation, and his withdrawal into the club ranks is a loss to be felt.Yet how difficult is the position of the medical man!If he resists what he knows and feels is an imposition and a wrong, he almost certainly risks the loss, not only of the one patient, but of the family.Need we feel surprised that, making up his mind that the first loss is the least, he succumbs to the force of circumstances, and certificates his feapectaIle patient as a fit member for semi-gratuitous attendance IWe cannot blame poor men who act thus-men who feel they cannot afford to lose even an inch of ground in the battle of life; but we do blame the indifferent or aggrandising spirit of the independent men -the men of large practices and visiting assistants-who might rectify the -evil, who might, without hurt to themselves, or rather to those dependent upon them, take an independent course, but who prefer permitting, and even aiding, the victimisa-
Toxic Shock Syndrome: Management and Long-Term Sequelae
Authors: P. JOAN CHESNEY
Journal: Annals of Internal Medicine (1982)

Little information is available on the optimal management of toxic shock syndrome and on its sequelae. The most appropriate antibiotic treatment, the efficacy of colloid infusions, and the potential role of gamma globulin preparations have not yet been completely ascertained. Coagulase-positive staphylococci associated with toxic shock syndrome had minimal inhibitory concentrations of 0.06 microgram/mL or less to rifampin, 0.25 microgram/mL or less to gentamicin, and 0.50 microgram/mL or less to both nafcillin and clindamycin. In the 36 patients studied abnormal chest roentgenograms were commoner in those who had received albumin than in those who had not. Radioimmunoassay showed antibody titers to staphylococcal enterotoxin F, a marker protein in toxic shock syndrome, of 1:4000 or more for intravenous gamma globulin (12/15 lots) and 1:40 000 or more for intramuscular gamma globulin. Major sequelae of toxic shock syndrome include late-onset rash, compromised renal function, cyanotic extremities, and prolonged neuromuscular abnormalities.
VI. Meta-Analysis of Calcitonin for the Treatment of Postmenopausal Osteoporosis
Authors: Ann Cranney, Peter Tugwell, Nicole Zytaruk, Vivian Robinson, Bruce Weaver, Beverley Shea, George Wells, Jonathan Adachi, Lisa Waldegger, Gordon Guyatt
Journal: Endocrine Reviews (2002)

To review the effect of calcitonin on bone density and fractures in postmenopausal women.We searched MEDLINE and EMBASE from 1966 to 2000 and examined citations of relevant articles and the proceedings of international osteoporosis meetings. We contacted osteoporosis investigators to identify additional studies and primary authors for unpublished data.We included 30 studies that randomized women to calcitonin or an alternative (placebo or calcium and/or vitamin D) and measured bone density or fracture incidence for at least 1 yr.For each trial, three independent reviewers assessed the methodological quality and abstracted data.Calcitonin reduced the incidence of vertebral fractures, with a pooled relative risk (RR) of 0.46 [95% confidence interval (CI) 0.25-0.87, P = 0.02, n = 1404, 4 trials]. However, the RR from the one relatively large randomized controlled trial (RCT) was 0.79 (95% CI 0.62-1.00, P = 0.05, n = 1108). For nonvertebral fractures, the pooled RR was 0.52 (95% CI 0.22-1.23, P = 0.14, n = 1481, 3 trials). Once again, the single large trial showed a less impressive effect than the smaller trials (RR 0.80, 95% CI 0.59-1.09, P = 0.16, n = 1245). For bone density of the lumbar spine, the pooled weekly dose of 250 to 2800 IU per week resulted in significant increase in the weighted mean difference (WMD) of 3.74 (2.04-5.43, P < 0.01, n = 2260, 24 trials). The combined forearm showed a similar effect, with a WMD of 3.02 (95% CI 0.98-5.07, P < 0.01, n = 468, 9 trials). At the femoral neck, the pooled weighted mean difference showed a nonsignificant trend toward benefit, WMD 3.80 (95% CI -0.32-7.91, P = 0.07, 9 trials, n = 513). Methodologically weaker studies tended to show greater effects on bone density, and the lumbar spine results suggested the possibility of publication bias.Calcitonin likely increases bone density in postmenopausal women predominantly at the lumbar spine and forearm for weekly doses of greater than 250 IU, although the true effect may be smaller than the pooled estimate would suggest. Calcitonin likely reduces the risk of vertebral fracture; its effect on nonvertebral fracture remains uncertain.
Preliminary Evidence of Low Cortical GABA Levels in Localized<sup>1</sup>H-MR Spectra of Alcohol-Dependent and Hepatic Encephalopathy Patients
Authors: Kevin L. Behar, Douglas L. Rothman, Kitt F. Petersen, Michael Hooten, Richard Delaney, Ognen A.C. Petroff, Gerald I. Shulman, Victor Navarro, Ismene L. Petrakis, Dennis S. Charney, John H. Krystal
Journal: American Journal of Psychiatry (1999)

OBJECTIVE: The aim of the study was to compare levels of neuroactive amino acids in the cerebral cortex of healthy subjects, recently detoxified alcohol-dependent patients, and patients with hepatic encephalopathy. METHOD: Metabolite levels were measured in the occipital cortex by using spatially localized 1H-MRS. Five recently detoxified alcohol-dependent and five hepatic encephalopathy patients with alcohol and non-alcohol-related disease were compared with 10 healthy subjects. RESULTS: The combined level of γ-aminobutyric acid (GABA) plus homocarnosine was lower in the alcohol-dependent and hepatic encephalopathy patients than in the healthy subjects. CONCLUSIONS: The findings suggest that GABA-ergic systems are altered in both alcohol-dependent and hepatic encephalopathy patients.
PTU-146 Dual energy x-ray absorptiometry (DEXA) scans in coeliac disease (CD): are BSG guidelines followed?
Authors: B Krishnan, V Sehgal, D Ramdass, K Besherdas
Journal: Gut (2012)

<h3>Introduction</h3> Patients with CD have a higher incidence of osteopenia or osteoporosis due to reduced bone mineral density (BMD). However, significant improvement in BMD and calcium absorption is seen after introduction of gluten-free diet (GFD). The BSG recommend (with poor evidence) that DEXA scan should only be performed after introduction of GFD in patients with high risk (two or more of the following: age &gt;70, low BMI, weight loss more than 10 kg and those with persistent symptoms on GFD for a year or non-compliance with diet). The aim of this study was to look at our practice of DEXA scanning in CD patients and assess whether BSG guidelines were followed and whether the timing of DEXA scans made any difference to outcome. <h3>Methods</h3> We reviewed all 82 patients from our coeliac database who were diagnosed between April 1985 and November 2011 at a district general hospital in North London (Chase Farm Hospital). 14 patients were excluded from the study as medical notes were missing or they were lost to follow-up. Two patients did not have DEXA scan. Data were analysed retrospectively by review of medical and electronic records. Patient demographics, BMI, history of weight loss, age at diagnosis, date of DEXA scan and results were recorded. We used the standard WHO definition for osteoporosis (T score &lt; −2.5), osteopenia (T score between −1 and −2.5) and normal (T score &gt; −1). <h3>Results</h3> The mean patient age was 54 (range 19–93) with 52 females. The mean time interval between diagnosis and DEXA was 2 years and 10 months (range 0 month–33 years) with a median of 8 months. 37 patients (56%) had DEXA scan within a year of diagnosis of which 16 (43%) were normal, and the rest had osteopenia (24%) or osteoporosis (32%). Of the remaining patients (45%), nine had normal DEXA, five had osteopenia and 11 had osteoporosis. Comparing these two groups of patients the timing of DEXA scan (1 year of diagnosis) was not statistically significant in terms of outcome (p value—1.0000). However 80% of patients over the age of 70 years had osteoporosis. There was no record of BMI, history of weight loss or other risk factors for osteoporosis prior to DEXA request. <h3>Conclusion</h3> Our practice of DEXA scan did not adhere to the BSG guidelines. There was great variability in timing of DEXA scans in CD patients. There was marked absence of record keeping in terms of BMI, history of weight loss and other risk factors to guide DEXA requests. A large proportion of patients (80%) with CD over age of 70 had osteoporosis. The timing of the DEXA scan did not significantly affect the T score. The lack of adherence to guidance could be because of its poor evidence base and also there is no clear recommendation on repeat DEXA scanning following initial assessment. We would recommend clearer guidance on the assessment of osteoporosis in CD. <h3>Competing interests</h3> None declared.
Industry-Sponsored Grand Rounds and Prescribing Behavior
Authors: Michael E. Dieperink
Journal: JAMA (2001)

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