tbuckley/cabot-search huggingface dataset:
Presence of allele αLELY in an Amazonian Indian population
Authors: Daniela S. Bassères, Tereza S.I. Salles, Fernando F. Costa, Sara T.O. Saad
Journal: American Journal of Hematology (1998)

Allele αLELY is a low-expression allele of the erythroid spectrin α-chain that is characterized by a C → G mutation at position α1857 in exon 40 and a C → T (nt −12) mutation in intron 45. This second mutation is probably responsible for the partial skipping of exon 46. This exon is essential for the nucleation of the α-chains by the β-chains during erythropoeisis. Although allele αLELY remains asymptomatic in both heterozygotes and homozygotes, it enhances the expression of deleterious α-alleles that occur and, as such, has clinical importance. In this study, the frequency of allele αLELY was estimated in two ethnically different Brazilian populations: a random sample of blood donors from Campinas, a city located in São Paulo State, in the southeastern region of Brazil, and a sample of Parakanã Indians (Tupi tribe), a very isolated population with a high degree of inbreeding. The frequency of allele αLELY in the blood donor's sample (n = 54) was 24.1% whereas in the indigenous sample (n = 41), it was 15.9%. These frequencies were not significantly different at the 57% level (χ2 = 1.931). Similarly, when the frequencies of our samples were compared with those of the four ethnic groups studied by Maréchal et al. [Br J Haematol 90:553–556, 1995], no significant differences were found at the 5% level (χ2 = 6.686). These results suggest that allele αLELY is a very ancient allele since it occurs with a relatively uniform and high frequency in all human ethnic groups studied so far. These findings confirm the importance of allele αLELY in influencing the expression of deleterious α-spectrin alleles. To our knowledge, these are the first data concerning allele αLELY in native Americans. Am. J. Hematol. 57:212–214, 1998. © 1998 Wiley-Liss, Inc.
Health Outcomes in Long-term Survivors of Childhood Cancer
Authors: Marina Kakaki, Christos Theleritis
Journal: JAMA (2007)

ents and peers. 2,3 Furthermore,suchchildrenmaydevelopacutestressdisorder, learning disorders, regressive behaviors, somatization, dissociative disorders, separation problems, and posttraumatic stress disorder and depression. 2-5 Older children and adolescents may experience a loss of faith in the future because they realize that life is fragile. 3 They may become involved in high-risk sexual behaviors as well as abuse of alcohol, illicit drugs, and tobacco, which may compromise their health status considerably, given the severity of their medical condition. 2,4 Persons involved with the care of children (physicians, mental health clinicians, community health workers, teachers, caregivers, and family members) should be aware that children and adolescents with a history of exposure to trauma, prior psychopathology, and disruption in social and family support networks are particularly vulnerable to psychological trauma. 2 Especially for children who experience chronic or life-threatening medical conditions, preventive measures should be implemented: their mental health status, quality of life, and possibility of becoming involved in risk-taking behaviors should be regularly monitored, and any problem that arises should be promptly handled by mental health clinicians. 4,5 These interventions might make chronic medical conditions more tolerable, both for children and for their families.
Benefits and Cost of Computerized Tomography in Radiation Therapy
Authors: Michael Goitein
Journal: JAMA (1980)

The use of computerized tomography (CT) to guide the radiation therapy of cancer has been shown in several studies to have a major impact on the treatment process. The implications of these observations for the likely outcome of treatment provide two indications of the cost-effectiveness of CT in this application. First, the cost of CT relative to that of therapy is compared with the estimated increment in benefit due to CT relative to the benefit of therapy without CT. In this comparison, CT is found to be cost-effective by a factor of 5.5. Second, the cost of CT is compared with an estimate of the averge increased cost of treatment when initial therapy has failed. This comparison favors CT by a factor of 4.6. These estimates are conservative and do not take into account possible reductions in morbidity for which CT may be responsible.
Disability and the elderly.
Authors: E Holloway
Journal: BMJ (1981)

on the one hand and, on the other, local evaluative studies designed both to measure the pros and cons of different styles of service, and to compare the new services with earlier patterns that still operate in much of the country.Innumerable questions of resources and outcome also remain to be answered, though reports available so far suggest that where such new developments take place existing resources can be put to more effective use and job satisfaction of staff is enhanced.'215The very evident enthusiasm of the pioneers in psychogeriatrics was further shown by the painstaking way in which most people completed our demanding questionnaires.We are very grateful to them, to the Section for the Psychiatry of Old age for making available to us its list of "psychogeriatricians," and to the administrative medical officers who kindly provided information.
Undermining data privacy in health information
Authors: R. Anderson
Journal: BMJ (2001)

Since 1910, doctors have been arguing with successive British governments over access to medical records. The compromise that has emerged over the years balances patient privacy, professional autonomy, public health effectiveness, and the needs of scientific research. Past attempts to disturb this balance have foundered—on professional resistance, patient rights, and the property rights of healthcare firms—but the side effects of these disputes have often been debilitating. And now an innocuous sounding clause in the latest bill on health is set to upset the balance again, with potentially damaging effects on both privacy and research.

The last government attempt to extend its access to personal health information was the information management and technology strategy, which in 1992 talked of a single electronic health record, accessible to all within the NHS. But the strategy was not designed to facilitate the sharing of health data between clinicians so much as its collection in central databases. This put it on a collision course with the law. For example, the Venereal Diseases Act restricts identifiable data …
The Relationship Between Coronary Heart Disease and Gallbladder Disease
Authors: GARY D. FRIEDMAN
Journal: Annals of Internal Medicine (1968)

The evidence concerning an association between gallbladder disease and coronary heart disease is critically reviewed. A classification of disease associations is first proposed. Real associations between two diseases are based on the promotion of one disease by the other or on the sharing of etiological or nonetiological factors. False associations may result from chance error, selection, and diagnostic confusion. The statistical evidence for an association between cholecystitis and cholelithiasis and coronary heart disease, based on autopsy, clinical, and epidemiologic findings, is incomplete and inconclusive so far. The weight of evidence suggests that little if any association exists over and above that which appears because the incidence and the prevalence of both diseases rises with age. There is some basis for a real association in that under certain circumstances experimental disturbance of the gallbladder appears reflexly to modify cardiac rhythm and coronary blood flow, especially where the coronary circulation is already compromised. This has not yet been clearly shown to occur in free-living human subjects. Other uncontrolled clinical observations of improvement in cardiac status after removal of diseased gallbladders are too easily explained away to permit the inference that there is a special relationship between the gallbladder and the heart. Shared etiological factors may be represented by the relationship of both diseases to age and obesity and possibly to short stature, blood pressure, race, diabetes mellitus, and number of pregnancies. The mutual relationship to blood pressure and, obviously, to number of pregnancies has so far been found only in women, so that an association between the diseases may be more apt to occur in women only. None of these factors is a sufficiently powerful determinant of both diseases to produce a marked association. All bases for a false association can be found in the literature. Diagnostic confusion is a particular problem with these diseases since there is overlap, not only in the pain produced, but also in the response to nitroglycerine and possibly in their effects on serum transaminase. It is concluded from the meager evidence to date that there is no strong association between gallbladder disease and coronary heart disease. There exists some basis for a weak association, both in shared etiological factors and in a possible aggravation of cardiac symptoms by a diseased gallbladder.
New Requirement for Patient Labeling for Selected Prescription Drug Products
Authors: Stuart L. Nightingale
Journal: JAMA (1999)

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No Dancin' in Anson: An American Story of Race and Social Change
Authors: Carl C. Bell
Journal: JAMA (1996)

This refreshingly candid, easy to read little book seeks to explain issues, ie, the psychologies, underlying ethnic difference and racial prejudice, dynamics that ameliorate or worsen the social impact of America's increasing racial diversity. Dr Ainslie teaches his valuable lessons by telling the story of Anson, Texas, and its social and legal struggle over whether the town should allow a high school prom with dancing. The controversy is presented as a "symptom" of an underlying conflict over the changes Anson endured from the legal death of segregation and resultant increase in the ethnic composition of the population from 12% to 35%. Using this social stage, the author tells stories of individuals and families, thereby delving into the individual and collective psyches of the participants—insiders and outsiders—in the right-to-dance conflict, thus crystalizing the psychodynamics of "otherness." The book is an interesting mixture of sociology and psychoanalysis, intermingling an ethnographic approach with
Public health programmes will have to prove they are cost effective
Authors: Colleen Shannon
Journal: BMJ (2004)

Public health programmes will have to prove they are working—and providing good value for taxpayers' money—when a new inspection regime is launched in the NHS next year.

This warning came from Professor Ian Kennedy, chairman of the Healthcare Commission (previously the Commission for Healthcare Improvement). The commission, which monitors clinical quality in the NHS, also has a duty to ensure cost effectiveness.

“You will have to persuade the least readily persuadable people in the land—the Treasury—that this is money well spent,” he told public health experts meeting last week at the King's Fund, an independent healthcare think tank. Professor Kennedy …
More in expectation than in hope: a new attitude to training in clinical academic medicine
Authors: J. Savill
Journal: BMJ (2000)

Editorial by Goldbeck-Wood Education and debate pp 633, 636 

There has never been a brighter prospect for medical research to improve the prevention, diagnosis, and management of disease. Furthermore, advances in information technology have provided unprecedented opportunities to bring stimulating and innovative teaching to medical education. However, despite the excitement of combining research and teaching with clinical practice, academic medicine is not widely viewed as an attractive career. Indeed, recruitment into clinical academic medicine has been so patchy that it is often impossible for medical schools to find suitable candidates to fill senior positions. More worrying still is a growing perception among our brightest young doctors that forging a career in academic medicine is simply not worth the enormous effort that seems to be required. Hard data on developing careers in academic medicine are frustratingly sparse, but we are all familiar with the power of adverse perception. Indeed, morale is so low in some disciplines that enthusiastic role models have all but disappeared.

Why should we bother about recruitment into academic medicine? Simply because clinical academics are vital for health care. Clinical academics play a key role in evolving and maintaining best practice through health services research, clinical trials, and teaching and training. Furthermore, even the best available health care currently fails to address a dauntingly large and stubborn burden of chronic ill health and untimely death. The public expect continued improvement, and this can only be achieved by investigating the causes of disease through scientific research, the major activity of many clinical academics. Because of this need to improve health care, I have no hesitation in arguing that clinical academic medicine must be research led. Young doctors with an interest in research should be encouraged that there has never been a greater chance to make a difference—to take …
Racial and Ethnic Disparities in Faculty Promotion in Academic Medicine
Authors: Di Fang
Journal: JAMA (2000)

Previous studies have suggested that minority medical school faculty are at a disadvantage in promotion opportunities compared with white faculty.To compare promotion rates of minority and white medical school faculty in the United States.Analysis of data from the Association of American Medical Colleges' Faculty Roster System, the official data system for tracking US medical school faculty.A total of 50,145 full-time US medical school faculty who became assistant professors or associate professors between 1980 and 1989. Faculty of historically black and Puerto Rican medical schools were excluded.Attainment of associate or full professorship among assistant professors and full professorship among associate professors by 1997, among white, Asian or Pacific Islander (API), underrepresented minority (URM; including black, Mexican American, Puerto Rican, Native American, and Native Alaskan), and other Hispanic faculty.By 1997, 46% of white assistant professors (13,479/28,953) had been promoted, whereas 37% of API (1123/2997; P<.001), 30% of URM (311/1053, P<.001), and 43% of other Hispanic assistant professors (256/598; P =.07) had been promoted. Similarly, by 1997, 50% of white associate professors (7234/14,559) had been promoted, whereas 44% of API (629/1419; P<.001), 36% of URM (101/280; P<.001), and 43% of other Hispanic (122/286; P =.02) associate professors had been promoted. Racial/ethnic disparities in promotion were evident among tenure and nontenure faculty and among faculty who received and did not receive National Institutes of Health research awards. After adjusting for cohort, sex, tenure status, degree, department, medical school type, and receipt of NIH awards, URM faculty remained less likely to be promoted compared with white faculty (relative risk [RR], 0.68 [99% confidence interval CI, 0.59-0.77] for assistant professors and 0.81 [99% CI, 0.65-0.99] for associate professors). API assistant professors also were less likely to be promoted (RR, 0.91 [99% CI, 0.84-0.98]), whereas API associate professors and other Hispanic assistant and associate professors were promoted at comparable rates.Our data indicate that minority faculty are promoted at lower rates compared with white faculty. JAMA. 2000;284:1085-1092
Second induction with high-dose cytarabine and mitoxantrone: different impact on pediatric AML patients with t(8;21) and with inv(16)
Authors: Ursula Creutzig, Martin Zimmermann, Jean-Pierre Bourquin, Michael N. Dworzak, Christine von Neuhoff, Annette Sander, André Schrauder, Andrea Teigler-Schlegel, Jan Starý, Selim Corbacioglu, Dirk Reinhardt
Journal: Blood (2011)
Interactions between glucagon and other counterregulatory hormones during normoglycemic and hypoglycemic exercise in dogs.
Authors: D H Wasserman, H L Lickley, M Vranic
Journal: Journal of Clinical Investigation (1984)

Somatostatin (ST)-induced glucagon suppression results in hypoglycemia during rest and exercise. To further delineate the role of glucagon and interactions between glucagon and the catecholamines during exercise, we compensated for the counterregulatory responses to hypoglycemia with glucose replacement. Five dogs were run (100 m/min, 12 degrees) during exercise alone, exercise plus ST infusion (0.5 micrograms/kg-min), or exercise plus. ST plus glucose replacement (3.5 mg/kg-min) to maintain euglycemia. During exercise alone there was a maximum increase in immunoreactive glucagon (IRG), epinephrine (E), norepinephrine (NE), FFA, and lactate (L) of 306 +/- 147 pg/ml, 360 +/- 80 pg/ml, 443 +/- 140 pg/ml, 541 +/- 173 mu eq/liter, and 6.3 +/- 0.7 mg/dl, respectively. Immunoreactive insulin (IRI) decreased by 10.2 +/- 4 micro/ml and cortisol (C) increased only slightly (2.1 +/- 0.3 micrograms/dl). The rates of glucose production (Ra) and glucose uptake (Rd) rose markedly by 6.6 +/- 2.2 mg/kg-min and 6.2 +/- 1.5 mg/kg-min. In contrast, when ST was given during exercise, IRG fell transiently by 130 +/- 20 pg/ml, Ra rose by only 3.6 +/- 0.5 mg/kg-min, and plasma glucose decreased by 29 +/- 6 mg/dl. The decrease in IRI was no different than with exercise alone (10.2 +/- 2.0 microU/ml). As plasma glucose fell, C, FFA, and L rose excessively to peaks of 5.4 +/- 1.3 micrograms/dl, 1,166 +/- 182 mu eq/liter and 15.5 +/- 7.0 mg/dl. The peak increment in E (765 +/- 287 pg/ml) coincided with the nadir in plasma glucose and was four times greater than during normoglycemic exercise. Hypoglycemia did not affect the rise in NE. The increase in Rd was attenuated and reached a peak of only 3.7 +/- 0.8 mg/kg-min. During glucose replacement, IRG decreased by 109 +/- 30 pg/ml and the IRI response did not differ from the response to normal exercise. Ra rose minimally by 1.5 +/- 0.3 mg/kg-min. The changes in E, C, Rd, and L were restored to normal, whereas the FFA response remained excessive. In all protocols increments in Ra were directly correlated to the IRG/IRI molar ratio while no correlation could be demonstrated between epinephrine or norepinephrine and Ra. In conclusion, (a) glucagon controlled approximately 70% of the increase of Ra during exercise. This became evident when counterregulatory responses to hypoglycemia (E and C) were obviated by glucose replacement; (b) increments in Ra were strongly correlated to the IRG/IRI molar ratio but not the plasma catecholamine concentration; (c) the main role of E in hypoglycemia was to limit glucose uptake by the muscle; (d) with glucagon suppression, glucose production was deficient but a further decline of glucose was prevented through the peripheral effects of E, (e) the hypoglycemic stimulus for E secretion was facilitated by exercise; and (f) we hypothesize that an important role of glucagons during exercise could be to spare muscle glycogen by stimulating glucose production by the liver.
THE RÔLE OF THE SOLUBLE SPECIFIC SUBSTANCE IN ORAL IMMUNIZATION AGAINST PNEUMOCOCCUS TYPES II AND III
Authors: Victor Ross
Journal: The Journal of Experimental Medicine (1932)

1. When the soluble specific substance of Type II pneumococcus was fed to rats, little or no increased resistance to the organism was obtained. 2. When the specific substance of Type III pneumococcus was fed, an increased resistance to the virulent organism resulted. The percentage of animals protected is smaller than when the whole or the dissolved cell is fed. 3. When the specific polysaccharide of Type I was fed, no immunity against Type II or III was obtained, and the ingestion of the specific substances of Types II and III did not protect rats against the Type I organism.
The Nomenclature of Pneumonia and other Allied Lung-Inflammations
Authors: O. Sturges
Journal: BMJ (1881)

IIlonging life in comparative comfort, that the operation of colotomy has been proved so advantageous.Six months, twelve months, or more, may thus be added to the life of a patient suffering from cancer; and one patient of mine survived the operation two years and nine months in great comfort, although latterly the disease had encroached upon and perforated the vagina-a complication most offensive under ordinary conditions.To show how little a lumbar colotomy interferes with the health or comfort of a patient, I may mention that, in January 1872, I performed colotomy on a lady (a patient of Dr. Grigg), who was suffer- ing constant torture from a recto-vesical fistula, following and connected with a pelvic abscess.She is perfectly well at the present time ; has no pain or trouble; and is able to attend to her domestic and social duties without inconvenience.Another female patient, whose colon I opened, in I873, for intractable syphilitic ulceration of the rectum, is living and well; but the rectum is completely closed by the cicatrisa- tion of the ulcers.Recto-vesical fistula in the female must be very rare; but the distress caused by the escape of freces into the bladder, and frequent blocking of the urethra, is very great.In the male, recto-vesical fistula is more common, both as the result of abscess and of cancerous perforation.The operation of colotomy could, of course, be of service only in the cases in which foeces passed into the bladder: for it could afford no relief to the irritation of the lower rectum, caused by the passage of urine into the bowel.In one case, however, of an old clergyman, with cancerous perforation, on whom I performed colotomy, with great relief to the escape of foeces, I found that, as the patient lay in bed, the urine flowed backwards to the opening in the colon, where it escaped, with little or no irritation compared to that excited in the sensitive sphincter ani.