tbuckley/cabot-search huggingface dataset:
Parental occupational exposures and risk of childhood cancer.
Authors: J S Colt, A Blair
Journal: Environmental Health Perspectives (1998)

Occupational exposures of parents might be related to cancer in their offspring. Forty-eight published studies on this topic have reported relative risks for over 1000 specific occupation/cancer combinations. Virtually all of the studies employed the case-control design. Occupations and exposures of fathers were investigated much more frequently than those of the mother. Information about parental occupations was derived through interviews or from birth certificates and other administrative records. Specific exposures were typically estimated by industrial hygienists or were self-reported. The studies have several limitations related to the quality of the exposure assessment, small numbers of exposed cases, multiple comparisons, and possible bias toward the reporting of positive results. Despite these limitations, they provide evidence that certain parental exposures may be harmful to children and deserve further study. The strongest evidence is for childhood leukemia and paternal exposure to solvents, paints, and employment in motor vehicle-related occupations; and childhood nervous system cancers and paternal exposure to paints. To more clearly evaluate the importance of these and other exposures in future investigations, we need improvements in four areas: a) more careful attention must be paid to maternal exposures; b) studies should employ more sophisticated exposure assessment techniques; c) careful attention must be paid to the postulated mechanism, timing, and route of exposure; and d) if postnatal exposures are evaluated, studies should provide evidence that the exposure is actually transferred from the workplace to the child's environment.
Evaluation of Methods for Determination of a Reconstructed History of Gene Sequence Evolution
Authors: David A. Liberles
Journal: Molecular Biology and Evolution (2001)

With whole-genome sequences being completed at an increasing rate, it is important to develop and assess tools to analyze them. Following annotation of the protein content of a genome, one can compare sequences with previously characterized homologous genes to detect novel functions within specific proteins in the evolution of the newly sequenced genome. One common statistical method to detect such changes is to compare the ratios of nonsynonymous (Ka) to synonymous (Ks) nucleotide substitution rates. Here, the effects of several parameters that can influence this calculation (sequence reconstruction method, phylogenetic tree branch length weighting, GC content, and codon bias) are examined. Also, two new alternative measures of adaptive evolution, the point accepted mutations (PAM)/neutral evolutionary distance (NED) ratio and the sequence space assessment (SSA) statistic are presented. All of these methods are compared using two sequence families: the recent divergence of leptin orthologs in primates, and the more ancient divergence of the deoxyribonucleoside kinase family. The examination of these and other measures to detect changes of gene function along branches of a phylogenetic tree will become increasingly important in the postgenomic era.
A Commentary on Two Cases of Huntington's Chorea
Authors: A. F. Grimbly, I. G. H. Wilson
Journal: BMJ (1926)

I-I.-'''--"-:I" i; '~L colntrolled, and the incidence of carditis reduced to a minimum.3. That in it ani instrument of research is provided for iilcreasing our knowledge of the heart of the child and its response to the rheumatic toxin, and that the correlation of records obtainied in such clinics would throwv very valuable light upon tllo nature of the disease.4. Finally, that the cardiac classification proposed offers a suitable basis for such correlation.It is a special pleasure to record our indebtedness to Miss Watson, almoner, for her invaluable assistance in the organization of the clinic, since the success of the department has been in a large measure due to her efforts.To Professor Leonard Findlay, to whose 'initiative the inauguratiop of the clinic was due, and under-whose care it continues, I wish to express my sincere grati- tude for his unfailing help and encouragement in the development and correlation of the work and the supervision of its details.
Caring for Patients
Authors: Richard A. Mahrer
Journal: JAMA (1985)

To the Editor.—  Dr Francis Peabody's1 1926 talk,  Care of the Patient, reprinted in the Aug 10, 1984, issue ofThe Journal, is absolutely timeless in pertinence and priceless in physician education. It embodies the ancient Hippocratic principles and the modern perceptive insights of Osler. It offers nothing new but, instead, something old, which is why it is of such extraordinary importance. The care of the patient is so old, so fundamental, so much taken for granted that it has nearly passed from the American medical scene! Of course, we all care for patients, don't we? In truth, the answer depends on the definition. We can all say we provide care to patients, but can't all say that we care for patients. It is this second concept of care that is in danger of being eliminated from our profession. Peabody's article should be read and reread by all physicians,
Korean Sketches: The Lepers of Pusan
Authors: Alvin L. Ureles
Journal: Annals of Internal Medicine (1998)

Ad Libitum15 December 1998Korean Sketches: The Lepers of PusanAlvin L. Ureles, MDAlvin L. Ureles, MDRochester, NY 14610Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-12-199812150-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail We moved inSpearhead of mercy, caduceus-cladHope sewn into our arm bandsRed on white spangling our vehiclesLike vulgar billboardsThe advanced party, seriousHorn-rimmed with stacatto pencilsRacing over creased notebooksFingers convulsing the iris of camerasToward every doorAnd theySullen in their private anguishHalf men and part womenStaying the pallid childrenWith their almost handsFrozen like rabbits in the brushAwaiting the advance of these strangersMeasuring the hunter through blistered eyesLeonine faces telling nothingBut the obscenity of their misfortuneSoldiers ... Author, Article, and Disclosure InformationAffiliations: Rochester, NY 14610Corresponding Author: Alvin L. Ureles, MD, 160 Georgian Court Road, Rochester, NY 14610 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1998Volume 129, Issue 12Page: 1071KeywordsChildrenRabbits ePublished: 15 August 2000 Issue Published: 15 December 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Care of the Dying Doctor
Authors: Erik Fromme, J. Andrew Billings
Journal: JAMA (2003)

The challenges of caring for a dying doctor reflect both common issues in helping the terminally ill and unique problems in working with a physician-patient. The dying doctor must deal with a familiar environment and set of problems from a radically different perspective and must negotiate overlapping and conflicting personal and professional roles. Some of the cardinal virtues of physicians—professional identity, expertise, perfectionism, selflessness, and stoicism—may pose both strengths and liabilities in the patient's role. The treating physicians may also encounter new strains in caring for a colleague. They must guard against both overinvolvement and underinvolvement, and, as with all dying persons, they must serve as a guide through unfamiliar territory for dying patient and family—a companion who is not afraid to listen to or explore the most upsetting matters, a person who can speak frankly when others may be ignoring "the horse on the dining room table." The case of Dr B, an internist dying of myelofibrosis and congestive heart failure, whose son is also a physician, offers the reader the opportunity to reflect on these challenges and to draw lessons about how to best care for fellow physicians at a time of great need. We suggest strategies for negotiating the patient-physician relationship when the patient is also a physician.
Low penetrance, subclinical congenital LQTS: Concealed LQTS or silent LQTS?
Authors: A VARRO, J PAPP
Journal: Cardiovascular Research (2006)

See article by Boulet et al.  [1]  (pages 466–474) in this issue .

The paper by Boulet et al. in this issue [1] describes the electrophysiological basis of an ion channel malfunction reported in ‘a silent LQTS’ patient. This patient, a 40-year-old woman, had a documented syncopal event, palpitations, recurrent chest discomfort, tachycardia, and since diagnosis has been asymptomatic on β-blocker therapy [2].

Genetic analysis revealed a loss-of-function mutation in the KCNQ1 gene underlying the α subunit of the IKs potassium channel. It is important and interesting that this patient had a QTc interval of 430 ms, which is well within the normal range in women. Although there is no strict rule, QT prolongation is generally considered when the QTc interval is longer than 440 ms in men and 460 ms in women [3]. Therefore, the results of Boulet et al. demonstrated and discussed that a loss of function mutation in an important major potassium current (IKs) can result in torsades de pointes arrhythmia and syncope with normal QTc. The authors concluded that this mutation could be considered as a silent LQT1 syndrome, confirming the view regarding the important role of the IKs channel known to contribute to the repolarization reserve. This case and the underlying mechanism resemble well the previously described so-called subclinical congenital LQTS, concealed LQTS, and incomplete or low penetrance [4].

The … 

* Corresponding author. Email address: a.varro{at}phcol.szote.u-szeged.hu
Spontaneous platelet aggregation in type IIB tampa von willebrand disease is inhibited by the 52/48‐kDa fragment of normal von willebrand factor, which contains the GPIb binding domain
Authors: Hussain I. Saba, Yoshihiro Fujimura, Sabiha R. Saba, Anita C. Bruce, Genevieve A. Morelli, Zaverio M. Ruggeri, Theodore S. Zimmerman
Journal: American Journal of Hematology (1989)

Abstract The association of Type IIB von Willebrand disease (vWD) with chronic persistent thrombocytopenia and spontaneous platelet aggregation has recently been recognized. It has been shown that IIB von Willebrand factor (vWF) can initiate platelet aggregation by binding to the platelet glycoprotein (GP) lb receptor and inducing exposure of the Gpllb/llla fibrinogen receptor. In this study we demonstrate the increased binding of Type IIB Tampa vWF with normal platelets when compared with nonthrombocytopenic Type IIB vWF. Studies further demonstrate that spontaneous platelet aggregation initiated by IIB Tampa vWF can be blocked by a 52/48‐kDa fragment of normal vWF, which contains the binding domain.
In-hospital and discharge utilization of medications in patients with and without heart failure presenting with acute coronary syndromes: Insights from the PURSUIT study
Authors: Monvadi B. Srichai, Robert A. Harrington, Judith S. Hochman, Penny L. Houghtaling, Eric J. Velazquez, A. Michael Lincoff, Maarten L. Simoons, Wael A. Jaber
Journal: Journal of the American College of Cardiology (2003)
A PRELIMINARY ANALYSIS OF THE IMPACT OF PREVIOUS KNEE INJURY ON MEASURES OF BALANCE AND THEIR IMPLICATIONS FOR SECONDARY PREVENTION
Authors: J Baltich, J Whittaker, B Nigg, C Emery
Journal: British Journal of Sports Medicine (2014)

Background Individuals with a history of previous injury have been shown to be at higher risk for re-injury. It is plausible that this is due to balance deficits which have been identified as injury risk factors in multiple sports. Objective To quantify the impact of previous knee joint injury on clinical and force plate measures of balance. Design Historical Cohort. Setting University of Calgary Human Performance Laboratory. Participants 25 young adults with a 3–10 year history of intra-articular knee joint injury and 25 matched (age, sex and sport) uninjured controls (34 males: 17-26 yrs; 16 females: 14-26 yrs). Assessment of risk factors Intra-articular knee injury was defined as a clinical diagnosis of bone, cartilage, ligament or meniscal injury that required medical consultation and disrupted sport participation. Main outcome measures Star excursion balance test (SEBT), medio-lateral entropic half-life (EHL-ML), anterior-posterior entropic half-life (EHL-AP), and center of pressure 95% ellipse area (EA). Force plate measures were quantified during single leg quiet standing. Results Injured participants had longer EHL-ML compared to healthy controls [Injured: 103 ms (95% CI: 97–109), Uninjured 94 ms (95% CI: 88–100), (paired t=2.031, P=.048)]. No group differences were found for the remaining balance measure [SEBT: Injured 76% (95% CI: 74–79), Uninjured 79% (95% CI: 77,80), (paired t=1.413, P=.164); EHL-AP: Injured 169 ms (95% CI: 148–190), Uninjured 152 ms (95% CI: 138–167), (paired t=1.289, P=.204); EA: Injured 694 mm 2 (95% CI: 585–802), Uninjured 597 mm 2 (95% CI: 505–688), (paired t=1.340, P=.187)]. Conclusions Participants with previous knee injury (3–10 years) were unable to adjust their position as quickly and frequently as healthy controls as indicated by longer EHL-ML. This result suggests that previous injury has an impact on balance ability. These findings support the evaluation of balance to inform the development of interventions to prevent re-injury.
Predictive Value of 68Ga-DOTANOC PET/CT in Patients With Suspicion of Neuroendocrine Tumors
Authors: Punit Sharma, Saurabh Arora, Anirban Mukherjee, Sujoy Pal, Peush Sahni, Pramod Garg, Rajesh Khadgawat, Sanjay Thulkar, Chandrasekhar Bal, Rakesh Kumar
Journal: Clinical Nuclear Medicine (2013)

The objective of this study was to evaluate the predictive value of Ga-DOTANOC PET/CT in patients with suspected neuroendocrine tumor (NET).Data of 164 patients (mean age, 42.5 ± 17.3 years; 54.8% male) who underwent Ga-DOTANOC PET/CT for suspected NET were retrospectively analyzed. Neuroendocrine tumor was suspected based on clinical features (n = 94) and/or raised biochemical markers (n = 83, serum chromogranin A, gastrin, serum/urinary catecholamines, insulin/C-peptide, and 5-hydroxytrytophan/5-hydroxyindoleacetic acid) and/or imaging findings (n = 93). PET/CT images were reviewed by 2 experienced nuclear medicine physicians, and any nonphysiological Ga-DOTANOC uptake was taken as positive for NET. Histopathology (n = 55) and clinical/imaging follow-up (n = 109; median, 11 months) was used as reference standard.Based on the reference standard, 97 of 164 patients had NET. Ga-DOTANOC PET/CT was positive for NET in 101 and negative in 63 patients. Primary tumor was demonstrated in 90 patients (commonest site-pancreas) and metastasis in 30 (commonest site-liver). PET/CT was true positive in 92 patients, true negative in 58, false positive in 9, and false negative in 5. The overall sensitivity was 94.8%, specificity was 86.5%, positive predictive value was 91%, negative predictive value was 92%, and accuracy was 91.4%. The accuracy of PET-CT in patients with clinical features of NET was 90.4%, with raised biochemical markers was 86.7%, and with imaging findings suggestive of NET was 93.5%. No difference was seen in the accuracy in patients with or without clinical symptoms (P = 0.794), raised versus those with normal/unknown biochemical markers (P = 0.094), and suggestive imaging versus those with negative/unavailable imaging (P = 0.420).Ga-DOTANOC PET-CT shows high positive and negative predictive values in patients with suspected NET and can be routinely used for this purpose.
Autophagy Inhibition by Sustained Overproduction of IL6 Contributes to Arsenic Carcinogenesis
Authors: Yuanlin Qi, Mingfang Zhang, Hui Li, Jacqueline A. Frank, Lu Dai, Huijuan Liu, Zhuo Zhang, Chi Wang, Gang Chen
Journal: Cancer Research (2014)

Abstract Chronic inflammation has been implicated as an etiologic factor in cancer, whereas autophagy may help preserve cancer cell survival but exert anti-inflammatory effects. How these phenomenas interact during carcinogenesis remains unclear. We explored this question in a human bronchial epithelial cell–based model of lung carcinogenesis that is mediated by subchronic exposure to arsenic. We found that sustained overexpression of the pro-inflammatory IL6 promoted arsenic-induced cell transformation by inhibiting autophagy. Conversely, strategies to enhance autophagy counteracted the effect of IL6 in the model. These findings were confirmed and extended in a mouse model of arsenic-induced lung cancer. Mechanistic investigations suggested that mTOR inhibition contributed to the activation of autophagy, whereas IL6 overexpression was sufficient to block autophagy by supporting Beclin-1/Mcl-1 interaction. Overall, our findings argued that chronic inflammatory states driven by IL6 could antagonize autophagic states that may help preserve cancer cell survival and promote malignant progression, suggesting a need to uncouple inflammation and autophagy controls to enable tumor progression. Cancer Res; 74(14); 3740–52. ©2014 AACR.
Tribal health policy in New Zealand
Authors: T. Turia
Journal: BMJ (2003)

I greet you as a descendant of the tribal peoples of Whanganui, Ngati Apa, Nga Rauru, Ngati Rangi, and Ngati Tuwharetoa. Our ancestry binds us to the volcanic mountains of Ruapehu and Tongariro in the central North Island of New Zealand, and the Whanganui and Whangaehu rivers that flow down their flanks to the Tasman Sea.

Twenty years ago our people established our own community health and social services, to deal with the crisis of indigenous health in a colonial society. Conventional Western medicine has been unable to close the disparities in mortality and health revealed in official statistics. Maori people die on average 10 years younger than pakeha (Europeans), often from preventable or treatable cancers and heart disease associated with lifestyle factors.

As part of our drive towards self reliance and self determination, our people decided to take our health into our own hands, and I was one of the many who got involved. Our health workers aimed to ensure that every …
The Trouble With Blame: Victims, Perpetrators, and Responsibility
Authors: Robert I. Simon
Journal: JAMA (1996)

In recent years, the public has been treated to a regular diet of sensational sexual abuse cases that have found their way into the courts. The Menendez brothers, who killed their parents, sought exculpation by claiming that extreme fear after years of psychological and sexual abuse propelled their crime. Lorena Bobbitt, who lopped off her husband's penis, mounted a successful insanity defense based on the battered wife syndrome. The legal defense of victimization has come to be called pejoratively the "abuse excuse." The law is all or nothing—you either win or you lose. Society in general and many health care professionals in particular also hold extreme black-andwhite views concerning victims and perpetrators of abuse. Dr Lamb, an assistant professor of psychology at Bryn Mawr College, attempts to bring balance to this emotionally overwrought subject. In a clearly written, well-reasoned book, the author announces her main premise early: "In this book
Nosocomial Septicemia Due to Multiply Antibiotic-Resistant Staphylococcus epidermidis
Authors: GORDON D. CHRISTENSEN
Journal: Annals of Internal Medicine (1982)

Thirteen episodes of Staphylococcus epidermidis sepsis occurred over a 20-month period in 11 patients receiving general surgical and medical care. These episodes were characterized by fever, toxicity, multiple positive blood cultures, and uniformly colonized intravascular catheters. An additional 16 patients had possible sepsis. Four associated deaths occurred; all three patients autopsied had multiple pulmonary abscesses in which gram-positive cocci were profusely present. In individual patients, prolonged episodes of septicemia were confirmed by multiple blood culture isolates of S. epidermidis, identical in antibiotic resistance pattern, phage type, and biotype. A prominent feature of the S. epidermidis isolates was resistance to many commonly used antimicrobial agents. Case-control studies and review of laboratory records indicated a significant association between multiply resistant S. epidermidis blood isolates and prolonged hospitalization and parenteral hyperalimentation. Most of these patients were hospitalized in the intensive care unit; nose and hand cultures taken from the personnel showed frequent carriage of multiply resistant S. epidermidis. Staphylococcus epidermidis associated with intravascular devices may produce life-threatening bloodstream infections.
Studies on the Evolution of the Hypercoagulable State in Patients with Thrombotic Diseases.
Authors: Arthur J. Samuels
Journal: Annals of Internal Medicine (1968)

s1 May 1968Studies on the Evolution of the Hypercoagulable State in Patients with Thrombotic Diseases.Arthur J. Samuels, M.D., F.A.C.P., Florence LepowskyArthur J. Samuels, M.D., F.A.C.P.Search for more papers by this author, Florence LepowskySearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1172_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSix patients with unequivocal evidence of a hypercoagulable state were studied through one, two, or three complete cycles of exacerbation and remission. Included were patients with [1] purpura fulminans, [2] acute leukemia with migratory thrombophlebitis, [3] anaphylactic reaction after intravenous injection of iron, [4] prostatic carcinoma, [5] migratory thrombophlebitis after ingestion of an oral gestagen, [6] migratory thrombophlebitis, inferior vena cava thrombosis, and pulmonary emboli occurring on two separate occasions, in each instance after 2 weeks of oral gestagen therapy.Studies included hemoglobin, volume of packed red blood cells, leukocyte count, absolute differential leukocyte count, platelets, clotting time in plastic... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Arthur J. Samuels, M.D., F.A.C.P.; Florence LepowskyAffiliations: Los Angeles, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1968Volume 68, Issue 5Page: 1172-1172KeywordsAnaphylaxisBlood countsHemoglobinInferior vena cavaIngestionIntravenous injectionsPlateletsRed blood cellsThrombosis ePublished: 1 December 2008 Issue Published: 1 May 1968 PDF downloadLoading ...
Ammonia Burns of the Face and Respiratory Tract
Authors: Donald M. Levy, Matthew B. Divertie, Thaddeus J. Litzow, John W. Henderson
Journal: JAMA (1964)

Four patients suffered ammonia burns from sudden decompression of ammonia containers on the farm and in the refrigeration industry. Although damage to the respiratory tract was the most serious and life-threatening consequence, no permanent disability resulted in this area. In all instances of severe facial burns, tracheostomy should be performed immediately. Eye injuries, while not life-threatening, are the most serious source of permanent morbidity; permanent blindness resulted in one instance in this group. The speed of irrigation of the eyes after such burns greatly influences the permanent damage resulting from such injury.