tbuckley/cabot-search huggingface dataset:
Community Mobilization in Mumbai Slums to Improve Perinatal Care and Outcomes: A Cluster Randomized Controlled Trial
Authors: Neena Shah More, Ujwala Bapat, Sushmita Das, Glyn Alcock, Sarita Patil, Maya Porel, Leena Vaidya, Armida Fernandez, Wasundhara Joshi, David Osrin
Journal: PLoS Medicine (2012)

Improving maternal and newborn health in low-income settings requires both health service and community action. Previous community initiatives have been predominantly rural, but India is urbanizing. While working to improve health service quality, we tested an intervention in which urban slum-dweller women's groups worked to improve local perinatal health.A cluster randomized controlled trial in 24 intervention and 24 control settlements covered a population of 283,000. In each intervention cluster, a facilitator supported women's groups through an action learning cycle in which they discussed perinatal experiences, improved their knowledge, and took local action. We monitored births, stillbirths, and neonatal deaths, and interviewed mothers at 6 weeks postpartum. The primary outcomes described perinatal care, maternal morbidity, and extended perinatal mortality. The analysis included 18,197 births over 3 years from 2006 to 2009. We found no differences between trial arms in uptake of antenatal care, reported work, rest, and diet in later pregnancy, institutional delivery, early and exclusive breastfeeding, or care-seeking. The stillbirth rate was non-significantly lower in the intervention arm (odds ratio 0.86, 95% CI 0.60-1.22), and the neonatal mortality rate higher (1.48, 1.06-2.08). The extended perinatal mortality rate did not differ between arms (1.19, 0.90-1.57). We have no evidence that these differences could be explained by the intervention.Facilitating urban community groups was feasible, and there was evidence of behaviour change, but we did not see population-level effects on health care or mortality. In cities with multiple sources of health care, but inequitable access to services, community mobilization should be integrated with attempts to deliver services for the poorest and most vulnerable, and with initiatives to improve quality of care in both public and private sectors.Current Controlled Trials ISRCTN96256793
Predictors of Changes in Glucose Tolerance Status in Obese Youth
Authors: Ram Weiss, Sara E. Taksali, William V. Tamborlane, Tania S. Burgert, Mary Savoye, Sonia Caprio
Journal: Diabetes Care (2005)

OBJECTIVE—Type 2 diabetes in obese youth is an emerging problem. The metabolic and anthropometric predictors of change in glucose tolerance status in obese youth are unknown. RESEARCH DESIGN AND METHODS—A total of 117 obese children and adolescents were studied by performing an oral glucose tolerance test (OGTT) at baseline and after ∼2 years. Data from both OGTTs and changes in weight were examined to identify youth at highest risk for developing diabetes and the factors that have the strongest impact on glucose tolerance. RESULTS—Eighty-four subjects had normal glucose tolerance (NGT) and 33 impaired glucose tolerance (IGT) at baseline. Eight subjects (all of whom had IGT at baseline) developed type 2 diabetes, whereas 15 subjects with IGT reverted to NGT. In this cohort, severe obesity, impaired glucose tolerance, and African-American background emerged as the best predictors of developing type 2 diabetes, whereas fasting glucose, insulin, and C-peptide were nonpredictive. Changes in insulin sensitivity, strongly related to weight change, had a significant impact on the 2-h glucose level on the follow-up study. CONCLUSIONS—Severely obese children and adolescents with IGT, particularly of African-American descent, are at very high risk for developing type 2 diabetes over a short period of time. Parameters derived from an OGTT and not fasting samples can serve as predictors of changes in glucose tolerance.
Providing high quality of care drives physician satisfaction, US study says
Authors: M. McCarthy
Journal: BMJ (2013)

US physicians report they are more satisfied with their work when they see themselves as providing high quality care, and view factors that create obstacles to delivering quality of care as a major source of professional dissatisfaction, according to a study.1

The study, which was commissioned by the American Medical Association and conducted by the RAND corporation, sought to identify practice models that will improve healthcare delivery “that are more effective, efficient, sustainable, and conducive to professional satisfaction.”

For the project, the RAND researchers studied 30 primary care, single, and multispecialty physician practices, both large and small, in six states. They interviewed 220 physicians, practice leaders, and staff and surveyed an additional 447 physicians in the practices.

The two most important findings, the researchers write, were …
Early Management of Injury to the Extrahepatic Biliary Tract
Authors: William P. Longmire
Journal: JAMA (1966)

Bile duct injury during cholecystectomy is frequently unrecognized at the time of operation. This series indicates that the reconstruction is usually unsuccessful even when the injury is recognized and repair is attempted at the initial operation. Clinically evident jaundice three to seven days after operation is the most common initial sign of duct injury. External biliary fistula, cholangitis, or subhepatic abscess may also indicate duct damage. Choledochojejunostomy has been the most consistently dependable reconstructive procedure.
Acute Infections and Environmental Exposure to Organochlorines in Inuit Infants from Nunavik
Authors: Frédéric Dallaire, Éric Dewailly, Gina Muckle, Carole Vézina, Sandra W. Jacobson, Joseph L. Jacobson, Pierre Ayotte
Journal: Environmental Health Perspectives (2004)

The Inuit population of Nunavik (Canada) is exposed to immunotoxic organochlorines (OCs) mainly through the consumption of fish and marine mammal fat. We investigated the effect of perinatal exposure to polychlorinated biphenyls (PCBs) and dichlorodiphenyldichloroethylene (DDE) on the incidence of acute infections in Inuit infants. We reviewed the medical charts of a cohort of 199 Inuit infants during the first 12 months of life and evaluated the incidence rates of upper and lower respiratory tract infections (URTI and LRTIs, respectively), otitis media, and gastrointestinal (GI) infections. Maternal plasma during delivery and infant plasma at 7 months of age were sampled and assayed for PCBs and DDE. Compared to rates for infants in the first quartile of exposure to PCBs (least exposed), adjusted rate ratios for infants in higher quartiles ranged between 1.09 and 1.32 for URTIs, 0.99 and 1.39 for otitis, 1.52 and 1.89 for GI infections, and 1.16 and 1.68 for LRTIs during the first 6 months of follow-up. For all infections combined, the rate ratios ranged from 1.17 to 1.27. The effect size was similar for DDE exposure but was lower for the full 12-month follow-up. Globally, most rate ratios were > 1.0, but few were statistically significant (p < 0.05). No association was found when postnatal exposure was considered. These results show a possible association between prenatal exposure to OCs and acute infections early in life in this Inuit population.
Three in five patients on Portuguese waiting lists spurn scheme to get surgery sooner
Authors: Tiago Villanueva
Journal: BMJ (2008)

Until now use of the PABA test together with [14C] PABA to calculate the PABA excretion index has probably been the best adaptation suggested to enhance the specificity of this non-invasive pancreatic function test. Drawbacks of the method are the application of radioactivity, the fact that children, pregnant women, and patients with renal insufficiency have to be excluded from the test, and the possible interference of drugs and isotopes. We propose simultaneous administration of p-aminosalicylic acid (PAS) in the PABA test and quantification of the urinary PABA and PAS excretion with liquid chromatography. Urinary PABA and PAS excretion in six hours are comparable (69.5 +/- 8.4% and 65.6 +/- 18.4% respectively in five healthy volunteers). Application of the PABA/PAS ratio was compared with the urinary PABA excretion in 21 normal controls, 38 patients with pancreatic disease, and 42 patients without pancreatic pathology. The PABA/PAS ratio and the per cent PABA excretion correlated very well in pancreatic patients: (PABA/PAS ratio) = 0.0149 (% PABA) + 0.052 (r = 0.902). Use of the PABA/PAS ratio enhanced the specificity of the test from 76 to 89%.
Abstract 3359: Glucose regulated protein78, a putative head and neck cancer initiating cells marker
Authors: Meng-Ju Wu, Jeng-Fan Lo, Cheng-Chia Yu
Journal: Cancer Research (2010)

Abstract Background: Head and neck squamous cell carcinoma (HNSCC) is a highly lethal cancer that contains cellular and functional heterogeneity. Previously, we enriched a subpopulation of highly tumorigenic head and neck cancer initiating cells (HN-CICs) from HNSCC cells (HNSCCs) using tumor sphere formation approach. GRP78, a stress-inducible endoplasmic reticulum (ER) chaperone, has been reported to play a role in the maintenance of embryonic stem cells and was up-regulated in enriched HN-CICs. However, the molecular mechanisms mediated by GRP78 to operate the physiological characteristics in HN-CICs remain unclear. Herein, we determined the critical role of GRP78 in the maintenance of stemness characteristics and tumorigenic phenotype in HNSCCs. Methods: First, Affymatrix microarray and two-dimensional differential gel electrophoresis (2-D DIGE) proteomic analyses were applied to identify GRP78 and membrane associated GRP78 (memGRP78) as a putative marker of HN-CICs. Flow cytometry cell sorting was used to isolate memGRP78+ cells and memGRP78− cells for evaluating CICs properties. Down-regulation of GRP78 expression in HNSCCs and HN-CICs were achieved by lentiviral-mediated small hairpin RNA interference (shRNAi), and the stemness characteristics in GRP78-knockdown HN-CICs were elucidated. In addition, in vitro tumorigenic properties between GRP78-knockdown and control HN-CICs were determined. The in vivo tumorigenicity of GRP78-knockdown HN-CICs was evaluated by xenotransplantation assay. Finally, we examined the correlation on expression of GRP78 and stemness genes in HNSCC patient tissues by immunohistochemical staining. Results: We identified that GRP78/memGRP78 was significantly up-regulated in enriched HN-CICs. Subsequently, memGRP78+ HNSCCs displayed CICs properties. Lentiviral mediated knockdown of GRP78 significantly reduced expression of stemness genes in HN-CICs and HNSCCs, but enhanced the differentiation capability of HN-CICs. Overall, down-regulation of GRP78 lessened tumorigenicity of HN-CICs both in vitro and in vivo. Conclusion: Our studies first elucidated the crucial role of GRP78 in the maintenance of stemness and tumorigenicity of HN-CICs. Notably, targeting GRP78 signaling might be a potential therapeutic target for HNSCC by eliminating CICs and memGRP78 could be a novel surface biomarker for isolation HN-CICs. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3359.
FIVE–YEAR CLINICAL FOLLOW–UP OF A RANDOMIZED COMPARISON BETWEEN A POLYMER–FREE SIROLIMUS–ELUTING STENT VERSUS A POLYMER–BASED PACLITAXEL–ELUTING STENT IN PATIENTS WITH DIABETES MELLITUS
Authors: Thomas Stiermaier, Anja Heinz, Denis Schloma, Gerhard Schuler, Holger Thiele, Steffen Desch
Journal: Journal of the American College of Cardiology (2013)
Abstract 4856: Association between breast cancer and constitutively decreased <i>TGFBR1</i> signaling.
Authors: John C. Henegan, Lakisha Moore-Smith, Nengjun Yi, Kui Zhang, Habibul Ahsan, Alice S. Whittemore, Boris Pasche
Journal: Cancer Research (2013)

Abstract Background: We previously identified a hypomorphic TGF-β type 1 receptor variant (TGFBR1*6A) that is associated with cancer risk, has impaired TGF-β signaling capability and enhances the migration and invasion of breast cancer cells. Two recent large meta-analyses of case control studies have found a significant association between TGFBR1*6A and risk of breast cancer (ORs 1.16,1.01-1.34; 1.15,1.01-1.31). Rs7034462 is a single nucleotide polymorphism (SNP) in a noncoding region more than 9 kilobases upstream of TGFBR1 exon 1, which has been shown to be associated with decreased TGFBR1 expression. In this study we tested the hypothesis that rs7034462 may be associated with breast cancer risk. Methods: rs7034462 was genotyped in DNA obtained from patients with breast cancer and healthy controls recruited by the Breast Cancer Family Registry. The samples in this multinational cohort were primarily from younger patients (average age 49.4 and 48.1 years for cases and controls, respectively, at time of interview). Results: Using the Cockerham model, rs7034462 was found to be associated with breast cancer risk under the dominance genetic effect but, unexpectedly, there was a significant decreased association with breast cancer for this SNP under the additive genetic effect for this model. SNP Cases Controls Cockerham Model Genetic Effect Odds Ratio 95% CI P rs7034462 (n = 2,934) 1509 1425 Additive 0.60 0.38-0.93 0.020 Dominance 2.09 1.29-3.38 0.002 Conclusion: rs7034462 heterozygotes have an increased risk of breast cancer but rare homozygotes have a decreased risk. This is the first evidence in humans that constitutively decreased TGFBR1-mediated TGF-β signaling is associated with breast cancer risk. Citation Format: John C. Henegan, Lakisha Moore-Smith, Nengjun Yi, Kui Zhang, Habibul Ahsan, Alice S. Whittemore, Boris Pasche, BCFR Co-Investigators. Association between breast cancer and constitutively decreased TGFBR1 signaling. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4856. doi:10.1158/1538-7445.AM2013-4856
Preventing Gun Deaths in Children
Authors: Judith S. Palfrey, Sean Palfrey
Journal: New England Journal of Medicine (2012)

Pediatricians aim to protect children from all things that can harm them. In 2010, gun-related injuries accounted for 6570 deaths of U.S. children and young people — twice as many deaths as cancer, 5 times as many as heart disease, and 15 times as many as infections.
PRECIPITATION TESTS FOR SYPHILIS
Authors: Ernst Meinicke
Journal: JAMA (1933)

<h3>To the Editor:</h3> —In an article inThe Journal, August 12, page 542, Dr. Israel Weinstein presents his view of the history of the scientific development of the precipitation tests for syphilis. He apparently discovered an official confirmation of my priority in that part of medical science in the exhibit of the United States Public Health Service at the Chicago Century of Progress Exposition. He gives a list of scientists who published descriptions of precipitation tests for syphilis before I did in 1917. But he forgets to add that those tests never were approved of as reliable in practical laboratory work. None of my predecessors were able to get results of practical value with their methods. My reaction, the description of which was published in 1917, was the first one that proved to be of practical value. That is the main point. I was the first to show that it
A write off
Authors: D. Spence
Journal: BMJ (2011)

General practitioners’ NHS records are eccentrically British and brilliant. They stalk you all of your life, wherever you move to in the country. So there is an absolutely complete record of medical care since 1948 —every hospital letter, every GP’s entry and attendance at the emergency department—the lot. This is the world’s greatest untapped source of complete observational longitudinal data. But the records are also riveting reading, with letters from long closed fever and tuberculosis hospitals, handwritten with fading fountain pen, or knocked out on early typewriters. GPs’ entries …
Three quarters of babies consume too much energy, finds UK survey
Authors: S. Mayor
Journal: BMJ (2013)

Three quarters of babies and young children in the United Kingdom are consuming more energy than they need, warn results from the first national survey to comprehensively assess infant nutrition.1

The Diet and Nutrition Survey of Infants and Young Children also showed that a fifth of babies are never breast fed and that fewer than half of those who are breast fed receive breast milk beyond 3 months of age.

Researchers collected dietary and nutritional information on 2683 children aged 4-18 months between January and August 2011. The children were sampled from child benefit records to give a representative sample of the UK population. The researchers assessed their nutrition by interviewing parents, through four day dietary diaries, and from blood samples and estimating …
Telehealth can be beneficial when used properly, say experts
Authors: B. Roehr
Journal: BMJ (2013)

Telehealth technology can help to make more efficient use of trained personnel, improve health outcomes, and bring financial savings if used properly, experts said in a congressional briefing in Washington, DC, on 21 March. That view contrasted with a study published in the BMJ the previous day, which found a particular use of telehealth not to be cost effective.1

Digital photos of skin conditions have been very useful for dermatology consultations, particularly in remote areas where specialists are rare, Mario Gutierrez, executive director of the Center for Connected Health Policy in Sacramento, California, told the briefing. “It is a way of avoiding unnecessary transportation costs and making more …
Child-parent screening for familial hypercholesterolaemia: screening strategy based on a meta-analysis
Authors: David S Wald, Jonathan P Bestwick, Nicholas J Wald
Journal: BMJ (2007)

<b>Objective</b> To develop a population screening strategy for familial hypercholesterolaemia. <b>Design</b> Meta-analysis of published data on total and low density lipoprotein (LDL) cholesterol in people with and without familial hypercholesterolaemia according to age. Thirteen studies reporting on 1907 cases and 16 221 controls were used in the analysis. Included studies had at least 10 cases and controls with data on the distribution of cholesterol in affected and unaffected individuals. <b>Main outcome measures</b> Detection rates (sensitivity) for specified false positive rates (0.1%, 0.5%, and 1%) in newborns and in age groups 1-9, 10-19, 20-39, 40-59, and ≥60 years. <b>Results</b> Serum cholesterol concentration discriminated best between people with and without familial hypercholesterolaemia at ages 1-9, when the detection rates with total cholesterol were 88%, 94%, and 96% for false positive rates of 0.1%, 0.5%, and 1%. The results were similar with LDL cholesterol. Screening newborns was much less effective. Once an affected child is identified, measurement of cholesterol would detect about 96% of parents with the disorder, using the simple rule that the parent with the higher serum cholesterol concentration is the affected parent. <b>Conclusions</b> The proposed strategy of screening children and parents for familial hypercholesterolaemia could have considerable impact in preventing the medical consequences of this disorder in two generations simultaneously.
T cell receptor recognition of a 'super-bulged' major histocompatibility complex class I–bound peptide
Authors: Fleur E Tynan, Scott R Burrows, Ashley M Buckle, Craig S Clements, Natalie A Borg, John J Miles, Travis Beddoe, James C Whisstock, Matthew C Wilce, Sharon L Silins, Jacqueline M Burrows, Lars Kjer-Nielsen, Lyudmila Kostenko, Anthony W Purcell, James McCluskey, Jamie Rossjohn
Journal: Nature Immunology (2005)
Evaluation of a Miniature Culture Technique
Authors: Bernadine Z. Paulshock
Journal: JAMA (1973)

To the Editor.—  The value of a routine urine culture in high-risk populations or as a screening test has often been suggested. Lack of general acceptance is probably due more to the cost of conventional cultures than to doubt of the desirability of detecting occult infection of the urinary tract.  Several miniature culture techniques have been marketed in recent years. One of the newest is Microstix (Ames Co, Division of Miles Laboratories Inc). This seems to have the advantages of easy performance and interpretation, as well as discrimination between growth of Gram-positive organisms (usually but not always contaminants when found in urine) and Gram-negative bacteria and quantitation.  We recently examined, by Microstix, 100 random, clean-catch urines collected from asymptomatic patients in our office. Simultaneously, the original specimen was cultured by routine methods. Results were compared, including species identification of the organism by subculture of growth from the Microstix. Only growth
Homozygous L-SIGN (CLEC4M) plays a protective role in SARS coronavirus infection
Authors: Vera S F Chan, Kelvin Y K Chan, Yongxiong Chen, Leo L M Poon, Annie N Y Cheung, Bojian Zheng, Kwok-Hung Chan, William Mak, Hextan Y S Ngan, Xiaoning Xu, Gavin Screaton, Paul K H Tam, Jonathan M Austyn, Li-Chong Chan, Shea-Ping Yip, Malik Peiris, Ui-Soon Khoo, Chen-Lung S Lin
Journal: Nature Genetics (2005)
Obesity and the Self-Help Group: A Look at TOPS
Authors: SAMUEL WAGONFELD, HOWARD M. WOLOWITZ
Journal: American Journal of Psychiatry (1968)

The membership and dynamics of self-help weight-reduction groups, which are successful for a number of obese women, are explored. While such a group probably accomplishes no alteration in personality, it strengthens existing defenses. The authors were struck by the theme of aggression played out among members.
584 RECIPIENT CYP2D6*4 POOR METABOLIZER STATUS ASSOCIATES WITH EARLY FIBROSIS DEVELOPMENT AFTER LIVER TRANSPLANTATION
Authors: T. Zimmermann, M. Hoppe-Lotichius, A. Körner, A. Lautem, M. Heise, P.R. Galle, G. Otto, M. Schuchmann
Journal: Journal of Hepatology (2011)
Male Infertility as a Concern of the Gynecologist
Authors: Charles W. Charny
Journal: JAMA (1963)

Excluding the female's responsibility to bear and nurture the fertilized cell until maturity, the problems of male infertility are quite similar. Proper management of the male includes an investigation which is as painstakingly detailed as it is in the female. It includes careful bimanual examination of the scrotal contents and detailed expert evaluation of at least two semen specimens. Assignment of relative responsibility of husband and wife depends on correlation of the findings in each. Contrary to popular misconception, effective therapy is available in a considerable percentage of infertile men, and their prognosis, all-important to the childless couple, is readily attained.
Blockade of VEGF accelerates proteinuria, via decrease in nephrin expression in rat crescentic glomerulonephritis
Authors: A. Hara, T. Wada, K. Furuichi, N. Sakai, H. Kawachi, F. Shimizu, M. Shibuya, K. Matsushima, H. Yokoyama, K. Egashira, S. Kaneko
Journal: Kidney International (2006)
APPENDICITIS, WITH REPORT OF AN INTERESTING CASE.
Authors: HENRY L. E. JOHNSON
Journal: JAMA (1897)

I have the pleasure, Mr. President and fellow members, of presenting for your consideration and criticism a few remarks and observations on appendicitis, the disease which is attracting so much attention at the present time, and which is possibly not thoroughly understood by the medical profession of the day. The disease is one of frequent occurrence, and its mortality is in direct ratio to the accuracy of diagnosis and treatment. <h3>Nomenclature.</h3> —The disease is and has been variously known as iliac phlegmon, typhlitis, perityphlitis, paratyphlitis, cecitis, pericecitis, paracecitis, periappendicitis, ecphyaditis and appendicitis. <h3>History.</h3> —M. Mastivier, in<i>Journal of Medicine</i>,<i>Surgery and Pharmacy</i>, Paris, May, 1759, reports the case of a man aged 45, with a large tumor in the right side near the umbilicus, who presented himself for treatment at the Hospital of St. Andrew of Bordeaux in the year 1757. Operation: evacuation of about a pint of offensive pus;