tbuckley/cabot-search huggingface dataset:
Association between Blood Lead and Walking Speed in the National Health and Nutrition Examination Survey (NHANES 1999–2002)
Authors: John S. Ji, Alexis Elbaz, Marc G. Weisskopf
Journal: Environmental Health Perspectives (2013)

Background: Walking speed is a simple and reliable measure of motor function that is negatively associated with adverse health events in older people, including falls, disability, hospital admissions, and mortality. Lead has adverse affects on human health, particularly on the vascular and neurological systems.Objective: We explored the hypothesis that lead is associated with slower walking speed.Methods: We used U.S. National Health and Nutrition Examination Survey (NHANES) cross-sectional data from 1999–2002. The time to walk 20 ft (walking speed) was measured among 1,795 men and 1,798 women ≥ 50 years of age. The association between walking speed and quintiles of blood lead concentration was estimated separately in men and women using linear regression models adjusted for age, education, ethnicity, alcohol use, smoking status, height, and waist circumference.Results: Mean blood lead concentrations and walking speeds were 2.17 μg/dL and 3.31 ft/sec in women, and 3.18 μg/dL and 3.47 ft/sec in men, respectively. Among women, walking speed decreased with increasing quintiles of blood lead, resulting in an estimated mean value that was 0.11 ft/sec slower (95% CI: –0.19, –0.04; p-trend = 0.005) for women with blood lead concentrations in the highest versus lowest quintile. In contrast, lead was not associated with walking speed in men.Conclusion: Blood lead concentration was associated with decreased walking speed in women, but not in men. Our results contribute to the growing evidence that lead exposure, even at low levels, is detrimental to public health.
North-south divide in health persists in England
Authors: Zosia Kmietowicz
Journal: BMJ (2006)

People in the south of England continue to enjoy a healthier and longer life than those in the north, new government data show.

Although life expectancy has increased throughout England, figures from the Health Profile of England report show that women living in the north live on average one year less than women in the south. The life expectancy of men in northern England is two years less than that of men in the south of the country.

Rates of smoking and obesity are highest in the northern parts of England. Boston, in Lincolnshire, has the highest prevalence of obesity of any …
Destructive Bone Disease in Early Syphilis
Authors: William E. Dismukes
Journal: JAMA (1976)

Although destructive bone disease is a well-known complication of tertiary syphilis, osteitis or osteomyelitis are not commonly recognized as complications of early (primary or secondary) syphilis. A patient with secondary syphilis characterized by generalized lymphadenopathy, perianal condyloma lata, and positive rapid plasma reagin (RPR) and fluorescent treponemal antibody-absorption (FTA-ABS) tests also complained of headache, right shoulder pain, and right anterior chest pain and swelling. Roentgenograms showed mottled osteolytic lesions consistent with previously described luetic bone disease. Biopsy confirmed the diagnosis of syphilitic osteomyelitis, and treatment with penicillin resulted in prompt resolution of symptoms. (<i>JAMA</i>236:2646-2648, 1976)
Personality Disorder a Possibility in “Problem” Patients, Specialists Say
Authors: Lynne Lamberg
Journal: JAMA (2006)

TORONTO—Some patients call frequently with “emergencies” that turn out to be minor. Some ignore medical advice or fail to fill prescriptions. Some come in with suspicious bruises, yet deny being in an abusive relationship. Some badger or insult the staff. Such “difficult to treat” or “problem” patients may have personality disorders that complicate their care, according to specialists at a symposium on advances in personality disorders at the annual meeting of the American Psychiatric Association (APA) here in May.
Regional abdominal fat distribution in lean and obese thai type 2 diabetic women: relationships with insulin sensitivity and cardiovascular risk factors
Authors: Chatchalit Rattarasarn, Rattana Leelawattana, Supamai Soonthornpun, Worawong Setasuban, Atchara Thamprasit, Apiradee Lim, Wannee Chayanunnukul, Natawan Thamkumpee, Thavorn Daendumrongsub
Journal: Metabolism (2003)
Sam Porter Millar
Authors: John Millar
Journal: BMJ (2006)

​FormerFormer general practitioner Newtownards, County Down (b 1914; q Cambridge/Queen's University, Belfast, 1940; squadron leader Royal Air Force Volunteer Reserve), died from a heart attack on 7 October 2005.




Figure 1




After serving in the Royal Air Force Volunteer Reserve, Sam Millar entered general practice in Newtownards in 1947. He was instrumental in the foundation of the early group practices in the 1960s. He retired from general practice in 1974, then working as a medical officer in the Eastern Health and Social Services Board until 1979. He served on the Gardens Committee of the National Trust for Northern Ireland for many years. Predeceased in 2004 by his wife of 63 years, Eleanor, he leaves three children.
Images of Early Cancer: Esophageal Squamous-Cell Carcinoma
Authors: T. Ponchon, H. Makuuchi, Y. Morita, M. Fukuda, T. Mitani, D. Shirasaka, N. Aoyama, Y. Amano, I. Moriyama, T. Oose, Y. Kinoshita
Journal: Endoscopy (2004)

Despite the widespread use of upper gastrointestinal endoscopy, the proportion of superficial esophageal squamous-cell carcinomas (SCCs) detected in Western countries is poor [1]. In a European enquiry, 51 such cases were found among 902 207 upper digestive endoscopy procedures. According to the registry in Burgundy, T1 cancer represents 4 % of the total number of esophageal SCCs, and T1 cancer limited to the mucosa only makes up 0.8 % of cases in France. By contrast, the rate of T1 esophageal SCC is five times higher in Japanese reports. The rates of T1 and T1 mucosal cancer reported by the National Cancer Center in Tokyo are 42 % and 18 %, respectively. These differences between Japan and Western countries may be explained by differences in histological interpretation, but it is likely that Japanese authors are more aware of the diagnosis of superficial cancer and pay more attention to it in general, and especially during endoscopy procedures. The failure of endoscopy to provide an early diagnosis of SCC in Western countries, despite a higher incidence of the condition than in Japan, shows that there is insufficient knowledge in the West of the macroscopic patterns of early carcinoma and that there is a tendency to carry out a cursory examination of the esophagus and to use chromoendoscopy to only a very limited extent.
Health, Functional Status, and Employment of Adult Survivors of Bone Marrow Transplantation
Authors: John R. Wingard, Barbara Curbow, Frank Baker, Steven Piantadosi
Journal: Annals of Internal Medicine (1991)

Objective: To determine the health, functional ability, and employment status of adults who survive bone marrow transplantation. Design: Inception cohort study. Setting: Patients who received transplants at a single referral-based center. Patients: Adults of 18 years of age or older who had received bone marrow transplants at least 6 months previously and who were not in a life-threatening relapse were surveyed a mean of 47 months after transplant (median, 37 months; range, 6 to 149 months). Of 171 eligible patients, 157 were contacted and 135 (86%) responded. Measurements and Main Results: Patients completed a mailed survey. Medical records were also reviewed. Most patients (93%) reported they could do normal activities with minor or no physical problems (Karnofsky scores, ≥ 80%). Global health was described as good to excellent by 67% of subjects. Most perceived social activities (80%) or physical functional abilities (67%) to be unimpaired or only slightly affected. Moderate or severe pain was uncommon (13%). Sixty-five percent had returned to full- or part-time employment, and one third of those who were not employed were attending school. Job discrimination and problems in obtaining insurance were reported by 23% and 39%, respectively. Among those who had been employed before illness, loss of employment was associated with lower social functioning, chronic graft-versus-host disease, greater job discrimination, and female gender using multivariate logistic regression. Conclusions: Most subjects surviving bone marrow transplant reported good to excellent health and functional ability. Three fourths were employed or enrolled in school. These outcomes are comparable to outcomes in survivors of cancer who received less intensive treatments.
Public Health Advocates Target Children's Health
Authors: Rebecca Voelker
Journal: JAMA (1996)

AS THE 1900s slip into history, public health experts want to battle children's health threats with the same tenacity— and success—as they fought infectious diseases at the turn of the last century. During its recent annual meeting in New York City, the American Public Health Association (APHA) called on President Clinton and Congress to develop a universal health care program for children, and it offered recommendations to help create such a program. E. Richard Brown, PhD, immediate past president of APHA, called the proposal "urgent and feasible." The feasibility lies in using existing options such as Medicaid waivers to achieve universal coverage for children, without extensive new programming or cost. Urgency, Brown said, is a by-product of the new welfare law that reduces cash and food stamp benefits while throwing several facets of Medicaid eligibility into question. He cited an estimate by the Urban Institute in Washington, DC, that the
Exercise, Tea Consumption, and Depression Among Breast Cancer Survivors
Authors: Xiaoli Chen, Wei Lu, Ying Zheng, Kai Gu, Zhi Chen, Wei Zheng, Xiao Ou Shu
Journal: Journal of Clinical Oncology (2010)

PURPOSE To examine the association of lifestyle factors and supplement use with depression among breast cancer survivors. PATIENTS AND METHODS In a population-based cohort study conducted between April 2002 and December 2006 in Shanghai, China, a total of 1,399 women who were diagnosed with stage 0 to III breast cancer completed 6-month and 18-month postdiagnosis, in-person interviews. Information on sociodemographic, clinical, and lifestyle factors were collected through the interviews and through review of medical charts at approximately 6 months postdiagnosis. A metabolic equivalent (MET) score was calculated from reported exercise activities. Quality of life (QOL) was evaluated by the Medical Outcomes Short Form-36 Health Survey at 6 months postdiagnosis. Depressive symptoms were measured by using a 20-item Center for Epidemiological Studies-Depression Scale at approximately 18 months postdiagnosis. Results Overall, 26% of women reported depressive symptoms and 13% met the criteria of clinical depression at 18 months postdiagnosis. Women with a higher exercise level (ie, >/= 8.3 MET h/wk) were less likely to have depression than nonexercisers; the multivariate adjusted odds ratios (ORs) were 0.71 (95% CI, 0.47 to 1.07) for mild depression and 0.56 (95% CI, 0.35 to 0.88) for clinical depression in analyses controlled for sociodemographic and clinical factors and baseline QOL. Women who increased their exercise level had lower risk for depression. Regular tea consumption (ie, > 100 g dried tea leaves/mo) was inversely associated with overall depression (OR, 0.39; 95% CI, 0.19 to 0.84). No associations were found for dietary intake or supplement use with depression. CONCLUSION Regular exercise participation and tea consumption may play an important role in the prevention of depression among breast cancer survivors.
A Clinical Contribution to the Study of the aetiology of the Fibrositic Nodule
Authors: W. S. C. Copeman
Journal: Annals of the Rheumatic Diseases (1943)

Tim term " nodule " is employed in the title of this paper, as it is one that has become familiarised by custom.It has seemed, however, that the existence ofa nodule sufficiently definite to be palpated in the muscles of a sufferer with fibrositis must in most cases be a sign of chronicity of the complaint, and that the " myalgic spot " is probably an earlier stage of what later becomes a nodule if left untreated.The dis- crepancy in the frequency with which nodules are found in this disease in England and in America can be explained by this hypothesis.The myalgic spot is an area of hyperasthesia in the substance of a muscle or its tendinous sheath which gives rise to pain either in the same locality or referred to a distance when stimulated.We owe mostly to Kellgren the description of this referred pain and its dis- tribution.These spots are generally multiple and occur in the power- ful muscles of the back and of the gluteal region; often towards the edge of the muscle, where it blends with the more fibrinous portion.They may also occur, but less frequently, in the peripheral muscles, and in the anterior muscles of the trunk.The aetiology and pathology of the myalgic spot or nodule is un- known, although trauma is believed by most observers to play a part in its development.It is thought that the observations recorded in this paper throw some light on the aetiology in a proportion of cases.OBSERVATIONS ON ACUTE MYALGIA An epidemic of influenza was recently studied in which severe pain in the lower back was an early and prominent symptom in nearly every case.Some patients also complained later of pains in the thighs, calves, and arms.The cases comprising this epidemic were all of the " febrile" type described by Horder and Gow (Price's " Medicine," 1941) as being of abrupt onset, with pyrexia and associated malaise and headache in addition to the pains described above.The pyrexia was high for three to five days and accompanied by a moderate degree of catarrh chiefly affecting the eyes.Defervescence was by rapid lysis, and a leucopenia was present in most cases.None of the forty patients examined had any previous history of rheumatism.It was noted in the course of this epidemic that although the acute lumbar pain was diffuse, severe, and resulted in spasm in some cases, by careful examination it could be found that it radiated from localised 222 by copyright.
Acute Decompensation after Removing a Central Line: Practical Approaches to Increasing Safety in the Intensive Care Unit
Authors: Peter J. Pronovost, Albert W. Wu, J. Bryan Sexton
Journal: Annals of Internal Medicine (2004)

Intensive care is one of the largest, most expensive, and complex components of U.S. health care. Errors and the resulting adverse events are, however, common in intensive care units (ICUs). Theories about errors in high-risk environments, developed by aviation and other industries, provide insight into why ICUs are prone to errors. Complex systems—of which ICUs are certainly an example—are breeding grounds for errors because interdependent components interact in unexpected ways. To achieve favorable outcomes, ICUs require that many processes occur in sequence. For example, patients are cared for by many providers with varying levels of expertise across several disciplines, and these providers use highly sensitive and potentially dangerous technologies and medications. Such complex systems require careful planning, excellent teamwork and communication, and designed redundancies to recheck for proper care processes. This paper provides a practical framework for improving patient safety. For a list of questions and answers from the Quality Grand Rounds conference, see the Appendix.
Reactions of Families to Chronic Hemodialysis
Authors: M. Mass, Kaplan de-Nour
Journal: Psychotherapy and Psychosomatics (1975)

13 families of patients on chronic hemodialysis (with young children at home) were contacted by the social worker. Only seven of them agreed to a family interview, which took place at the patient's home. Although the interviews were unstructured some topics were brought up by all families and similar behavior was observed. Specially striking was the lack of empathy as well as of hostility between the parents, while a lot of hostility against all human environment was expressed and children's attempts at expressing empathy were suppressed.
Book Review A Doctor's Vietnam Journal (Military Monograph 97.) By Carl E. Bartecchi. 433 pp., illustrated. Bennington, VT, Merriam Press, 2007. $39.95 (cloth); $29.95 (paper). 978-1-4303-1525-4 (cloth); 978-1-4303-0949-9 (paper).
Authors: Allen Hassan
Journal: New England Journal of Medicine (2007)
Endoscopic argon plasma coagulation for the treatment of hemorrhagic pseudopolyps in colonic Crohn's disease
Authors: A. Attar, C. Bon, V. Sebbagh, B. Béjou, R. Bénamouzig
Journal: Endoscopy (2007)

A 32-year-old woman with a history of colonic Crohn's disease since 1997, who had been on azathioprine since 2002, presented in April 2003 with sudden-onset hematochezia and a drop in hemoglobin to 6.2 g/dL, but without a clinical flare of her Crohn's disease. Colonoscopy showed multiple pseudopolyps from the rectum to the splenic flexure, with fresh blood in the colonic lumen. Some of these pseudopolyps had an erythematous and mosaic appearance, but there was no ulceration (Figure [1]). No signs of Crohn's colitis or active bleeding were observed. Severe bleeding continued on a daily basis and necessitated treatment with 2 units of blood per day to maintain a hemoglobin level higher than 8 g/dL. A colectomy was considered.
NEURO-DEFORMITIES IN CHILDREN FROM AN ORTHOPEDIC STANDPOINT.
Authors: JAMES W. COKENOWER
Journal: JAMA (1898)

It is generally conceded that nearly all deformities, especially in children, not traumatic or hereditary, are due directly or indirectly to some abnormal condition of the nervous system. This branch, like all other branches in medicine and surgery, bows with obedience to its alma mater, because we can not understand the anatomy, pathology and histology of the nervous system, the cerebro-spinal or any other specialized nerve-cell, unless we understand general medicine and the laws of cell-birth, life and growth. My experience, as a general practitioner, prompts me to admit that nothing is more important than the nervous system and its disorders, and yet there is nothing in medicine in which our knowledge is so deficient. In the investigation of even so simple an ailment as headache, the field of medicine must be well examined to know whether the real cause of the pain is vicious heredity, nephritis, lack of exercise,
Genetic engineering and the use of bovine somatotropin
Authors: C. J. Grossman
Journal: JAMA (1990)

During the last decade there has been an unfortunate reappearance in our society of an antitechnology and antiscience attitude. This is exemplified by those advocates who would ban all animals in research and block fetal tissue studies and by those who support creationism. An especially vocal group consists of those people who are against any form of genetic engineering regardless of the benefits or potential benefits that might be realized. We can find no better example of the genetic engineering controversy than that epitomized by the furor currently surrounding the use of bovine somatotropin (growth hormone) in dairy cows. Manufactured by Monsanto, American Cyanamid, Eli Lilly, and Upjohn, the drug will not become commercially available until the end of 1990 when Food and Drug Administration approval is expected.<sup>1-3</sup>However, it has been extensively studied for the past 5 years and can clearly increase milk production by at least 14%.
Abstract 975: Sorafenib overcomes irinotecan resistance in colorectal cancer by inhibiting the ABCG2 drug-efflux pump..
Authors: Thibault Mazard, Annick Causse, Joelle Simony, Wilhem Leconet, Marta Jarlier, Marc Ychou, Maguy Del Rio, Pierre Martineau, Bruno Robert, Céline Gongora
Journal: Cancer Research (2013)

Abstract Background: Despite recent advances in the treatment of colorectal cancer, tumor resistance is a frequent cause of chemotherapy failure. Thus, new treatment options are needed to improve survival of patients with irinotecan-refractory colorectal cancers, particularly those bearing KRAS mutations that preclude the use of anti-EGFR therapies. In this study, we investigated whether sorafenib could reverse irinotecan resistance, thereby enhancing the therapeutic efficacy of routinely used irinotecan-based chemotherapy. Materials and methods: We used both in vitro (the HCT116, SW48, SW620 and HT29 colon adenocarcinoma cell lines and four SN-38 resistant HCT-116 and SW48 clones) and in vivo models (nude mice xenografted with SN-38 resistant HCT116 cells) to test the efficacy of sorafenib alone or in combination with irinotecan, or its active metabolite SN-38. Results: Sorafenib improved the anti-tumoral activity of irinotecan in vitro, in both parental and SN-38 resistant colon adenocarcinoma cell lines independently of their KRAS status, as well as in vivo, in xenografted mice. By inhibiting the drug-efflux pump ABCG2, sorafenib favors irinotecan intracellular accumulation and enhances its toxicity. Conclusion: Our results show that sorafenib can suppress resistance to irinotecan and suggest that sorafenib could be used to overcome resistance to irinotecan-based chemotherapies in colorectal cancer, particularly in KRAS mutated tumors. Citation Format: Thibault Mazard, Annick Causse, Joelle Simony, Wilhem Leconet, Marta Jarlier, Marc Ychou, Maguy Del Rio, Pierre Martineau, Bruno Robert, Céline Gongora. Sorafenib overcomes irinotecan resistance in colorectal cancer by inhibiting the ABCG2 drug-efflux pump. [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 975. doi:10.1158/1538-7445.AM2013-975
UK GPs will be consulted on revalidation proposals
Authors: L. Beecham
Journal: BMJ (1999)

GPs will have to prove that they are good communicators if proposals on revalidation, which are to be sent to all GPs in the United Kingdom before the end of the year, are adopted.

The proposals, which were drawn up by a working group of representatives of the Royal College of General Practitioners, the BMA's General Practitioners Committee, and other organisations of GPs, are a response to the General Medical Council's decision that doctors in all disciplines must show on a regular basis that they are …
CONSERVATIVE TREATMENT OF INTESTINAL OCCLUSION BY INTERNAL ELECTRICITY.
Authors: R. P. JOHNSON
Journal: JAMA (1898)

In reviewing the different means of relief recommended and practised by American medical men for the cure of intestinal obstruction, the investigator is led to believe that what is regarded in some of the European medical centers as safe, successful, not interfering with the employment of the more radical procedure—laparotomy—is entirely ignored, or in fact, not even considered here. From a fair amount of investigation of the subject I am convinced that the American practitioner is neglecting to employ therapeutic means that have been satisfactory for years to many of the most eminent men of Europe. The physician who is called to see a patient, whose most prominent symptom is one of non-movement of the bowels, may have a very obscure but serious case to contend with. Cathartics and enemas have been ineffectual, so it is a case of obstruction. What is to be done? A surgical operation may be