tbuckley/cabot-search huggingface dataset:
Health Development versus Medical Relief: The Illusion versus the Irrelevance of Sustainability
Authors: Gorik Ooms
Journal: PLoS Medicine (2006)

Development agencies want their interventions to be sustainable. The Office of Sustainable Development of the Bureau for Africa of the United States Agency for International Development defines sustainability as “the ability of host country entities (community, public and/or private) to assume responsibility for programs and/or outcomes without adversely affecting the ability to maintain or continue program objectives or outcomes”. It defines financial sustainability as “having enough reliable funding”, meaning funding “generated from a country's own resources” [1].

Exceptionally, in times of emergencies, development agencies are willing to support relief interventions that are beyond the capacity of the beneficiaries. In such circumstances, sustainability is irrelevant, as the crisis is by definition temporary and the need for relief will ebb with the crisis.

In the field of health care, the issue of sustainability creates a dichotomy between medical relief and health development, because relief is unaffected by the condition of self-reliance. This dichotomy results in turf battles between the advocates of medical relief and the advocates of health development.

This essay explores the causes of this dichotomy and highlights the senselessness of turf battles. All trendy development approaches point out that sustainable health care—narrowly defined as independent from international aid—is illusionary in the world's poorest countries. Public health budgets in these countries must be increased and require stronger national and international financial commitments. If public health budgets were increased, the level of health care within the capacity of the beneficiaries would be higher, and the dichotomy would dissolve to a certain extent.

However, health development advocates assume that public health budgets will not be increased and base their sustainability estimations on this assumption. In doing so, they contribute to the status quo of insufficient public health budgets.
Awareness of infection, knowledge of hepatitis C, and medical follow-up among individuals testing positive for hepatitis C: National Health and Nutrition Examination Survey 2001-2008
Authors: Maxine M. Denniston, Monina R. Klevens, Geraldine M. McQuillan, Ruth B. Jiles
Journal: Hepatology (2011)

Many persons infected with hepatitis C virus (HCV) are unknown to the healthcare system because they may be asymptomatic for years, have not been tested for HCV infection, and only seek medical care when they develop liver-related complications. We analyzed data from persons who tested positive for past or current HCV infection during participation in the National Health and Nutrition Examination Survey (NHANES) from 2001 through 2008. A follow-up survey was conducted 6 months after examination to determine (1) how many participants testing positive for HCV infection were aware of their HCV status before being notified by NHANES, (2) what actions participants took after becoming aware of their first positive test, and (3) participants' knowledge about hepatitis C. Of 30,140 participants tested, 393 (1.3%) had evidence of past or current HCV infection and 170 (43%) could be contacted during the follow-up survey and interviewed. Only 49.7% were aware of their positive HCV infection status before being notified by NHANES, and only 3.7% of these respondents reported that they had first been tested for HCV because they or their doctor thought they were at risk for infection. Overall, 85.4% had heard of hepatitis C; correct responses to questions about hepatitis C were higher among persons 40-59 years of age, white non-Hispanics, and respondents who saw a physician after their first positive HCV test. Eighty percent of respondents indicated they had seen a doctor about their first positive HCV test result.These data indicate that fewer than half of those infected with HCV may be aware of their infection. The findings suggest that more intensive efforts are needed to identify and test persons at risk for HCV infection.
Global epidemiology and genotype distribution of the hepatitis C virus infection
Authors: Erin Gower, Chris Estes, Sarah Blach, Kathryn Razavi-Shearer, Homie Razavi
Journal: Journal of Hepatology (2014)

The treatment of chronic hepatitis C virus (HCV) infection has the potential to change significantly over the next few years as therapeutic regimens are rapidly evolving. However, the burden of chronic infection has not been quantified at the global level using the most recent data. Updated estimates of HCV prevalence, viremia and genotypes are critical for developing strategies to manage or eliminate HCV infection. To achieve this, a comprehensive literature search was conducted for anti-HCV prevalence, viraemic prevalence and genotypes for all countries. Studies were included based on how well they could be extrapolated to the general population, sample size and the age of the study. Available country estimates were used to develop regional and global estimates. Eighty-seven countries reported anti-HCV prevalence, while HCV viraemic rates were available for fifty-four countries. Total global viraemic HCV infections were estimated at 80 (64-103) million infections. Genotype distribution was available for ninety-eight countries. Globally, genotype 1 (G1) was the most common (46%), followed by G3 (22%), G2 (13%), and G4 (13%). In conclusion, the total number of HCV infections reported here are lower than previous estimates. The exclusion of data from earlier studies conducted at the peak of the HCV epidemic, along with adjustments for reduced prevalence among children, are likely contributors. The results highlight the need for more robust surveillance studies to quantify the HCV disease burden more accurately.
Roentgenographic Manifestations of Ischemic Colitis
Authors: Richard M. Gore
Journal: JAMA (1979)

A FREQUENTLY encountered diagnostic problem in older persons is acute abdominal pain accompanied by bloody diarrhea, invoking the differential diagnosis of diverticulitis, inflammatory bowel disease, infectious colitis, carcinoma of the colon, and ischemic colitis.<sup>1,2</sup>The roentgenographic manifestations of ischemic colitis, namely, "thumbprinting," bowel-wall edema, ulcerations, intramural dissection of barium, and stricture, often resemble those of these other disease processes, and recognition may be difficult.<sup>3,4</sup> Acute vascular insufficiency of the colon is a disease complex that presents as a spectrum ranging in severity from gangrenous infarction causing peritonitis and shock to a trivial episode of abdominal pain and diarrhea that a patient may recall only in retrospect.<sup>5,6</sup>Where in this continuum an individual patient may fall depends on the duration and extent of the ischemia, the efficiency of collateral circulation, and the extent of bacterial invasion.<sup>7,8</sup> <h3>Gangrenous Colitis</h3> The catastrophic expression of colonic ischemia, gangrenous colitis, is
House of Delegates Report
Authors: Edward R. Annis
Journal: JAMA (1963)

TODAY I have a feeling of intense pride and profound gratitude. I am genuinely proud of the American Medical Association—an association with a glorious past, a truly marvelous present, and a future both challenging and limitless. I am deeply grateful that I have been given the honor to serve as your President, to represent the more than 200,000 members of an organization that has contributed so greatly to the advancement of medical science and to the betterment of the public health.  During the past two years—first with the National Speakers Bureau and then as your President-Elect—my travels have taken me into 40 states. These speaking trips have been stimulating and fruitful. They have given me a rare opportunity to observe the continuing progress of medicine and how its benefits flow to the American people, our patients, along an endless conduit composed of researchers, teachers, and physicians. Like the legs on a three-legged stool, these
Levodopa: long-term impact on Parkinson's disease.
Authors: A Nasar
Journal: BMJ (1981)

glomerular filtration rate and tubular re- absorption proposed by the authors would be expected to produce a larger volume of dilute urine, not the increase in urine specific gravity without a significant change in the urine volume actually observed.Although tea may have an effect on bowel function it has not been demonstrated in this study.
HIV antibody assay that gave false negative results: multicentre collaborative study
Authors: B. G Evans, J. V Parry, P. P Mortimer
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To identify false negative results arising from the use of a commercial kit to detect antibody to HIV-1 and HIV-2 between July 1995 and March 1996. <b>Design:</b> The 56 laboratories in the United Kingdom that were using the assay were asked to retrieve and retest specimens with an alternative assay for HIV-1 and HIV-2. Details of false negative results were obtained and these serum samples further investigated. <b>Subjects:</b> 24 181 patients tested with the assay who were reported as being negative for HIV antibody. An additional 497 patients were confirmed as HIV positive with the assay. <b>Results:</b> Serum samples of 20 973 of the patients were retested, and four patients were found to have had false negative results with the kit; three further patients were found to have had false negative results in the course of other laboratory testing. The seven patients with false negative results with the kit were of diverse risk group and HIV-1 subtype. Four had evidence of recent HIV infection. <b>Conclusion:</b> The commercial kit had a sensitivity of 99.2% (497/501), or less if the additional three patients with false negative results were taken into account. <h3>Key messages</h3> Dual screening should be considered for patients known to be at increased risk of HIV infection Although assay kits for HIV antibody generally show high sensitivity, false negative results may still arise during routine use and go undetected Tested serum samples should be stored so that they may, if necessary, be checked. Any kit failures should be reported to the Medical Devices Agency or Adverse Incident Centres, as well as to the manufacturer All laboratories should be informed of test kit failures, whether or not they have used the suspect kit
Antacids and Theophylline-Ranitidine Interaction
Authors: Elizabeth Fernandes, F. Michael Melewicz
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 August 1984Antacids and Theophylline-Ranitidine InteractionELIZABETH FERNANDES, M.D., F. MICHAEL MELEWICZ, M.D.ELIZABETH FERNANDES, M.D.Search for more papers by this author, F. MICHAEL MELEWICZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-2-279_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In response to our report of a case of theophylline toxicity after initiation of treatment with ranitidine (Zantac; Glaxo Inc., Research Triangle Park, North Carolina) (1), Drs. Dobbs and Smith (2), of Glaxo Inc., have raised the question of possible antacid interference with absorption of theophylline in our patient.After the hospitalization to which they refer, the patient was taken off all antacids for several days, and he was then rechallenged with Maalox (William H. Rorer, Inc., Fort Washington, Pennsylvania), 30 mL orally every 6 hours for 48 hours, while taking theophylline (Theo-Dur; Key Pharmaceuticals, Inc., Miami,...References1. FERNANDESMELEWICZ EF. Ranitidine and theophylline [Letter]. Ann Intern Med. 1984;100:459. LinkGoogle Scholar2. DOBBSSMITH JR. Ranitidine and theophylline [Letter]. Ann Intern Med. 1984;100:769. LinkGoogle Scholar3. ARNOLDSPURBECKSHELVERHENDERSON AGWW. Effect of an antacid on gastrointestinal absorption of theophylline. Am J Hosp Pharm. 1972;36:1059-62. Google Scholar4. DARZENTASSTEWARTCURRYYOST LRSR. Effect of antacid bio-availability of a sustained release theophylline preparation. Drug Intell Clin Pharm. 1983;17:555-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByRanitidine—Theophylline Interaction—Fact or Fiction?Ranitidine drug interactions—a literature reviewThe Hepatic and Renal Mechanisms of Drug Interactions with Cimetidine 1 August 1984Volume 101, Issue 2Page: 279-279KeywordsHospitalizationsTheophylline toxicity Issue Published: 1 August 1984 PDF DownloadLoading ...
Changing childbirth: Report is wrong to dismiss poverty
Authors: P A Cresswell
Journal: BMJ (1993)

gram would lead to smaller myocardial infarcts in 476 patients (without cerebral haemorrhage) for every one patient with cerebral haemorrhage with- out myocardial infarction; thrombolysis would be life saving in 19 of these cases.These benefit:risk ratios are even more favourable with thrombolysis before admission to hospital.Two trade offs have to be considered to maximise benefit from thrombolytic treatment: the sensitivity versus the specificity of whatever methods are used for predicting myocardial infarction, and the increasing accuracy of the diagnosis with the time from the onset of symptoms versus the waning efficacy of thrombolysis.The problem is to find the optimal balance between causing disability or death by giving thrombolytic treatment to those without myocardial infarction and causing disability or death by withholding the treatment from those with myocardial infarction.We suggest that use of ST elevation as a precondition for giving thrombolytic treatment errs in the latter direction.
Synergy between PI3K Signaling and MYC in Burkitt Lymphomagenesis
Authors: Sandrine Sander, Dinis P. Calado, Lakshmi Srinivasan, Karl Köchert, Baochun Zhang, Maciej Rosolowski, Scott J. Rodig, Karlheinz Holzmann, Stephan Stilgenbauer, Reiner Siebert, Lars Bullinger, Klaus Rajewsky
Journal: Cancer Cell (2012)
Historical Annotation
Authors: RICHARD W. WHITEHEAD
Journal: Circulation (1969)

DURING the first half of the nineteenth century Dublin became the center of a remarkable renaissance in medicine owing to the remarkable ability of its relatively small group of leamed physicians.The names of many of Ireland's physicians of that day are preserved in familiar eponyms, and their philosophy of medical education had a deep and lasting effect on the medical training in schools world-wide, but especially in the United States.Robert Graves has been rated one of the most remarkable medical men of that era.Robert James Graves, descendant of an English family which had settled in Ireland in the seventeenth century, was born in Dublin in 1797, the son of Richard Graves, a Senior Fellow of Trinity College, who later became Regius Professor of Divinity in that institution.Robert Graves was educated at Trinity and showed such proficiency in his studies that he was awarded a gold medal for scholastic excellence.He was graduated M.B. from there in 1818.Following graduation, Graves spent 3 years in postgraduate study at the important medical centers of England and the continent.While on this tour he became acquainted with many physicians and physiologists with whom he kept up correspondence throughout his life.It was in Europe that he learned the new
Late Results of the Warm Heart Trial : The Influence of Nonfatal Cardiac Events on Late Survival
Authors: S. E. Fremes, M. G. Tamariz, D. Abramov, G. T. Christakis, J. Y. Sever, K. Sykora, B. S. Goldman, C. M. S. Feindel, S. V. Lichtenstein
Journal: Circulation (2000)

The Warm Heart Trial randomized 1732 CABG patients to receive warm or cold blood cardioplegia. In the warm cardioplegia patients, nonfatal perioperative cardiac events were significantly decreased and the mortality rate was nonsignificantly decreased (1. 4% versus 2.5%, P:=0.12). The purpose of the present study was to evaluate the late results of these trial patients.Randomization was stratified according to surgeon and urgency of the operation. Seven hundred sixty-two patients recruited from 1 of the centers were followed through the hospital clinic for late events. Late survival (including perioperative deaths) at 72 months was nonsignificantly greater in the warm cardioplegia patients (94.5+/-1.7%, mean+/-SEM) than in the cold cardioplegia patients (90.9+/-2.6%). Independent predictors of mortality by Cox proportional hazards model were redo CABG, diabetes mellitus, renal insufficiency, and increasing age. The influence of nonfatal perioperative events (perioperative myocardial infarction according to computerized ECG readings or low output syndrome as determined by an outcome committee) on late survival was also analyzed. Late survival at 84 months was significantly reduced in the group who experienced nonfatal perioperative outcomes (94.5+/-1.7% versus 84. 9+/-4.5%, P:<0.001) and remained a significant predictor after adjustment for other important variables (risk ratio 6.4, 95% CI 1. 87 to 8.73, P:<0.0001).Effective myocardial protection through either cold or warm blood cardioplegia is essential, because late survival is significantly reduced in patients with nonfatal perioperative cardiac outcomes.
Contraindicated BCG vaccination in "at risk" infants
Authors: P. Rees, H. Evans, S. Panesar, M. Llewelyn, A. Edwards, A. Carson-Stevens
Journal: BMJ (2014)

Roy and colleagues highlight the effectiveness of the BCG vaccine in preventing tuberculosis in immunocompetent children.1 However, those responsible for prescribing and administering BCG vaccinations must be mindful of the contraindications for immunocompromised children.2

Our study of primary care related paediatric safety incidents from the England and Wales National Reporting and Learning System identified 1790 vaccine related incidents during 2005-13.3 Despite under-reporting of safety incidents, we found 99 reports of …
The Primacy of Insulin
Authors: Samuel Vaisrub
Journal: JAMA (1976)

The primary pathogenetic role of insulin lack in the hyperglycemia and ketoacidosis of diabetes, so long taken for granted, has been recently disputed by a number of investigators. Unger's group<sup>1</sup>and others have marshalled experimental evidence to ascribe an essential role to glucagon excess in these homeostatic disturbances. Particularly impressive was the observation by Gerich et al<sup>2</sup>that somatostatin, which inhibits glucagon as well as insulin, delayed ketoacidosis even when insulin was not given for 18 hours. As a corollary to these experimental findings emerged the concept of diabetes as a bihormonal disorder dependent not only on insulin deficiency but also on glucagon excess. The latter, it was hoped, would be controlled by somatostatin when the hormone became available for general use. The theoretical and practical implications of the focus on glucagon are currently undergoing critical reappraisal. Barnes et al<sup>3</sup>observed no substantial change in plasma glucagon
Diagnosis of Cholecystitis and Cholelithiasis.
Authors: Charles A. L. Reed
Journal: JAMA (1904)

Cincinnati, Oct. 21, 1904. <h3>To the Editor.</h3> —The excellent contribution of Dr. Parker Syms with the above title, inThe Journalfor October 15, serves me as a text to say something that I have frequently felt prompted to say on the significance of pain and tenderness as symptoms of cholelithiasis. The question is one of importance for the reason that, as I have had frequent occasion to observe in late and complicated cases that have been referred to me for operation, the delay on the part of the practitioner in making the diagnosis has been due to the absence of what he has been taught to look on as a "characteristic pain." Dr. Syms says of this pain that its characteristic features "are its acute onset, its colicky nature, and, as described by Lambert, the patient experiences a sense of something boring through the addomen to the vertebra." That
Ischemic Stroke and the Gene for Angiotensin-Converting Enzyme in Japanese Hypertensives
Authors: Kazuomi Kario, Nobuyuki Kanai, Ken Saito, Naoki Nago, Takefumi Matsuo, Kazuyuki Shimada
Journal: Circulation (1996)

Background The ACE insertion/deletion ( I/D ) polymorphism is reported to be associated with myocardial infarction in both whites and Japanese. However, there have been no reports on the association of this polymorphism with stroke in each race. Furthermore, there are some racial differences in the demographics of cardiovascular diseases. In Japanese, stroke (especially that which occurs in preexisting hypertension) is more common and coronary artery disease much less common than in whites. We propose that the ACE I/D polymorphism might be associated with hypertensive cerebrovascular disease in Japanese. Methods and Results To study the association between the ACE I/D polymorphism and hypertensive cerebrovascular disease, we identified the ACE I/D genotype in 228 hypertensive and 104 normotensive Japanese subjects. Compared with its frequency (0.31) in the 90 hypertensives without lacunae detected by magnetic resonance imaging, the ACE*D allele frequency was significantly higher (0.47; P &lt;.001) in the 138 hypertensives with silent or clinically overt ischemic stroke, whereas there was no significant difference between its frequency in hypertensives without lacunae and in 104 normotensive control subjects (0.34). The positive association between the ACE I/D genotype and ischemic stroke in hypertensive patients was independent of other risk factors. Conclusions We found a positive association between the ACE*D allele and ischemic stroke in Japanese hypertensives in our study. The ACE*D allele may be an independent risk factor for the development of cerebrovascular disease in hypertensive patients.
Observations on the Medical Treatment of Inflammatory Bowel Disease
Authors: Joseph B. Kirsner
Journal: JAMA (1980)

IN THE absence of decisive knowledge of the causes of inflammatory bowel disease (IBD), there continues to be no consistently curative medical treatment for ulcerative colitis and Crohn's disease.<sup>1-3</sup>Treatment has included such widely diverse approaches as prefrontal lobotomy,<sup>4</sup>hog extract,<sup>5</sup>Calmette-Guérin bacillus,<sup>6,7</sup>vaccines including Bargen's<i>Streptococcus</i>, irradiation,<sup>8</sup>gonadotropins, "regulation of abnormal electrical rhythm of the bowel" with coherin,<sup>9</sup>fasting, tranquilizers, phenylbutazone,<sup>10</sup>lithium carbonate,<sup>11</sup>psychotherapy,<sup>12</sup>mineral water,<sup>13</sup>immunosuppressive drugs, and empirical measures for which rationale is not apparent. Many patients with mild ulcerative colitis and with mild regional enteritis respond favorably to simple treatments, including adequate rest, dietary adjustments, sedation, and perhaps sulfasalazine and other antibacterial agents. The emphasis in this article, therefore, is on selected aspects of the medical treatment of the moderately or severely ill IBD patient. A major flaw in the evaluation of therapeutic agents in IBD is
Mutations in STX1B, encoding a presynaptic protein, cause fever-associated epilepsy syndromes
Authors: Julian Schubert, Aleksandra Siekierska, Mélanie Langlois, Patrick May, Clément Huneau, Felicitas Becker, Hiltrud Muhle, Arvid Suls, Johannes R Lemke, Carolien G F de Kovel, Holger Thiele, Kathryn Konrad, Amit Kawalia, Mohammad R Toliat, Thomas Sander, Franz Rüschendorf, Almuth Caliebe, Inga Nagel, Bernard Kohl, Angela Kecskés, Maxime Jacmin, Katia Hardies, Sarah Weckhuysen, Erik Riesch, Thomas Dorn, Eva H Brilstra, Stephanie Baulac, Rikke S Møller, Helle Hjalgrim, Bobby P C Koeleman, Karin Jurkat-Rott, Frank Lehmann-Horn, Jared C Roach, Gustavo Glusman, Leroy Hood, David J Galas, Benoit Martin, Peter A M de Witte, Saskia Biskup, Peter De Jonghe, Ingo Helbig, Rudi Balling, Peter Nürnberg, Alexander D Crawford, Camila V Esguerra, Yvonne G Weber, Holger Lerche
Journal: Nature Genetics (2014)