tbuckley/cabot-search huggingface dataset:
Organisation of screening: a practical view.
Authors: S Jenkins
Journal: BMJ (1990)

<h3>Abstract</h3> <h3>Background and objectives</h3> Antimicrobial resistance is a major healthcare burden, aggravated when it extends to multiple drugs. While cross-resistance is well-studied experimentally, it is not the case in clinical settings, and especially not while considering confounding variables. In addition, bacteria from different sample sources may have undergone different evolutionary trajectories, therefore examining cross-resistance across sources is desirable. <h3>Methodology</h3> We employed additive Bayesian network (ABN) modelling to examine antibiotic cross-resistance in five major bacterial species, obtained from different sources (urine, wound, blood, and sputum) in a clinical setting, collected in a large hospital in Israel over a 4-year period. ABN modelling allowed for examination of the relationship between resistance to different drugs while controlling for major confounding variables. <h3>Results</h3> Patterns of cross-resistance differed across sample sources. All identified links between resistance to different antibiotics were positive, and most were present in several culture sources. However, in 15 of 18 instances, the magnitudes of the links were significantly different between sources compared. For example, <i>E coli</i> exhibited adjusted odds ratios of gentamicin-ofloxacin cross-resistance ranging from 3.0 (95%CI [2.3,4.0]) in urine samples to 11.0 (95%CI [5.2,26.1]) in blood samples. <h3>Conclusions and implications</h3> Our results highlight the importance of considering sample sources when assessing likelihood of antibiotic cross-resistance and determining antibiotic treatment regimens and policies. <h3>Abstract Importance</h3> We examine the patterns of antibiotic resistance of a given bacterial species, obtained from different clinical infection locations, while accounting for potentially relevant clinical variables. We find that such patterns of cross-resistance between pairs of antibiotics vary between culture sources (e.g., urine vs blood samples), indicating different selective pressures. These findings have implications on prescription policies aiming to minimize collateral resistance.
Effects of intraluminal acidification on oesophageal motor activity.
Authors: I Bontempo, L Piretta, E Corazziari, F Michetti, F Anzini, A Torsoli
Journal: Gut (1994)

This study assessed the effect of prolonged intraluminal acidification on the motor activity of the entire oesophageal body (under controlled conditions). Intraoesophageal pressures were recorded in 13 endoscopy negative subjects with gastro-oesophageal reflux disease in whom saline, HC1 0.1 N, and saline solutions were infused (1.5 ml/min) blindly in the oesophageal body, 6 cm distal to the upper oesophageal sphincter for three consecutive periods of 45 minutes each. These findings were compared with those of a control group. Intraoesophageal acidification caused an increase in the deglutition frequency (p &lt; 0.02), the occurrence of multipeaked waves (p &lt; 0.04) as well as a decrease of the propagating velocity (p &lt; 0.04) of the primary peristaltic contractions. Furthermore, intraoesophageal acidification determined an increase, at all levels of the oesophagus, of the duration (p &lt; 0.04) and, more noticeable in the proximal oesophageal body, of the amplitude (p &lt; 0.02) of primary peristaltic contraction waves. In conclusion prolonged intraoesophageal acidification can considerably affect frequency of deglutition, morphology, and propagating patterns of primary peristaltic contractions. This study shows that these effects are independent from volume distension of the oesophagus and supports the presence of acid sensitive receptors in the oesophageal mucosa.
The evidence base for new drugs
Authors: P. Doshi, T. Jefferson
Journal: BMJ (2015)

New legislation in Germany provides another piece of a complex puzzle

Marketing campaigns cast new drugs as “must haves.” In reality, the public evidence base for new drugs often leaves more questions than answers.1 2 While marketing authorization indicates that regulators judged the risk-benefit profile to be favorable, product labels rarely list and quantify these benefits and harms. Publications of premarketing trials might fill in some gaps, but readers beware: not all trials are published and those that are may be inaccurately or incompletely reported.3 4

Data transparency in clinical trials has emerged as a way to tackle the reporting biases that affect literature, enabling independent scrutiny of trials.5 But it is not enough. Even with open data we rarely know how new drugs compare with existing options or whether they improve patient centered outcomes. An analysis published in this issue (doi:10.1136/bmj.h796) suggests that new legislation in Germany may provide another piece of the puzzle.6

The German act on the reform of the market for medicinal products (AMNOG) was introduced in 2011 to inform drug pricing for all new drugs. To control costs, sponsors must submit a standardized dossier including evidence of the drug’s added benefit over already available drugs. This dossier is then reviewed by scientists, usually at the Institute for Quality and Efficiency in Health Care (IQWiG), who produce an assessment report. Their report, plus some (but not all) of the documents …
Weight trajectories through infancy and childhood and risk of non-alcoholic fatty liver disease in adolescence: The ALSPAC study
Authors: Emma L. Anderson, Laura D. Howe, Abigail Fraser, Mark P. Callaway, Naveed Sattar, Chris Day, Kate Tilling, Debbie A. Lawlor
Journal: Journal of Hepatology (2014)

Adiposity is a key risk factor for NAFLD. Few studies have examined prospective associations of infant and childhood adiposity with subsequent NAFLD risk. We examined associations of weight-for-height trajectories from birth to age 10 with liver outcomes in adolescence, and assessed the extent to which associations are mediated through fat mass at the time of outcome assessment.Individual trajectories of weight and height were estimated for participants in the Avon Longitudinal Study of Parents and Children using random-effects linear-spline models. Associations of birthweight (adjusted for birth length) and weight change (adjusted for length/height change) from 0-3 months, 3 months-1 y, 1-3 y, 3-7 y, and 7-10 y with ultrasound scan (USS) determined liver fat and stiffness, and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) at mean age 17.8 y were assessed with linear and logistic regressions. Mediation by concurrent fat mass was assessed with adjustment for fat mass at mean age 17.8 y.Birth weight was positively associated with liver stiffness and negatively with ALT and AST. Weight change from birth to 1 y was not associated with outcomes. Weight change from 1-3 y, 3-7 y, and 7-10 y was consistently positively associated with USS and blood-based liver outcomes. Adjusting for fat mass at mean age 17.8 y attenuated associations toward the null, suggesting associations are largely mediated by concurrent body fatness.Greater rates of weight-for-height change between 1 y and 10 y are consistently associated with adverse liver outcomes in adolescence. These associations are largely mediated through concurrent fatness.
Lesions of the Stomach in Diabetes: With Remarks on the Gastric Origin of that Disease
Authors: W. Macintyre
Journal: BMJ (1850)

in the nere of the convalescent organ; and that a healthy excitement of the whole system is all that is wanted to relieve these particular nerves from their undue action, and to merge their own morbidly inde- pendent feelings into the general fund of excitement.But in many other cases of Uterine Disease, as in those observed by Dr. Murphy, or ixi that which I have related, we cannot cure the disease of the Womb, because we forget that beyond the Womb, preceding it in the develop- ment of the orgas of reproduction, and governing them through life, are the Ovaries, which often participate in, and cause that uterine in- flammation which we alone attack; and thus, while we temporrily seem to cure the small visible lesion, a hidden one remains to bring on re- lapses, and to perpetuate the patient's sufferings.In the treatment of those painful states of the neck of the bladder, so often caused by dis- eases of the kidneys, we depend much less on direct applications to the neck of the bladder, than on those means by which we can attack the kidney-the diseased organ.Should we not be governed by the same logic in treating diseases of the organs of reproduction ?Some may say, that I exaggerate the influence of the ovarian organs.It may also be averred that, by the treatment employed, I have only acted on the Womb, and that I have no post-mortem examination to offer in confirmation of my views.This may be true; but if an incontestable proof be required, that Ovarian Disease often exists unnoticed, and is erroneously referred to the Womb, I would refer to the last number of Guy's Hospital Reports, wherein Dr. Oldham relates a most melncholy case in point, and gives the particulars of a detailed post-motm examination.Such a case is interesting in a scientific point of view, as representing similar cases not yet published, but which are talked of!And if this mistaking of Ovarian for Uterine inflammation can be made by men of eminence, may it not occur more frequently to the less distinguished ?42, Gloucester Road, Hyde Park, March 1850.
Thoracoscopic treatment of postoperative chylothorax after coronary bypass surgery.
Authors: J P Janssen, H J Joosten, P E Postmus
Journal: Thorax (1994)

Chylothorax after sternotomy for aortocoronary bypass surgery is a rare but serious complication. To avoid lateral thoracotomy a left sided thoracoscopy was performed and the site of the leakage was immediately found and successfully clipped.
Adolescents May Experience Home, School Abuse; Their Future Draws Researchers' Concern
Authors: Teri Randall
Journal: JAMA (1992)

OF ALL THE TYPES of family violence, abuse of adolescents is perhaps one of the most overlooked. Many people, including professionals, assume that the majority of victims of child abuse are small children. Identification and treatment programs tend to focus on the very young. But research in recent years is beginning to paint a picture of adolescence that is more abuse-ridden than early childhood. According to statistics compiled by the National Center on Child Abuse and Neglect, Washington, DC, adolescents experience a disporportionately high level of child abuse, including the most severe abuse that results in serious injuries and death. Youths aged 12 to 17 years constitute 38% of the child population, yet 47% of the victims of all forms of child maltreatment fall into this age group. Teenagers aged 15 to 17 years represent 19% of the child population, yet they experience 27% of the serious injuries and 23%
The ETHICA study (part II): simulation study of determinants and variability of ICU physician decisions in patients aged 80 or over
Authors: M. Garrouste-Orgeas, A. Tabah, A. Vesin, F. Philippart, A. Kpodji, C. Bruel, C. Grégoire, A. Max, J. F. Timsit, B. Misset
Journal: Intensive Care Medicine (2013)
Retinal Arteriolar Caliber Predicts Incident Retinopathy
Authors: Sophie Louise Rogers, Gabriella Tikellis, Ning Cheung, Robyn Tapp, Jonathan Shaw, Paul Z. Zimmet, Paul Mitchell, Jie Jin Wang, Tien Yin Wong
Journal: Diabetes Care (2008)

Changes in retinal vascular caliber may reflect subclinical microvascular disease and provide prognostic information regarding risk of retinopathy. In this study, we examined the prospective association of retinal vascular caliber with retinopathy risk in an Australian population-based cohort. A total of 906 participants without retinopathy at baseline had retinal vascular caliber measured from photographs and were followed-up for 5 years for incident retinopathy. After adjusting for age, sex, systolic blood pressure, A1C, and other risk factors, individuals with wider retinal arteriolar caliber (widest 25% vs. the remaining three-quarters of the population) were more likely to develop incident retinopathy (odds ratio 4.79 [95% CI 1.57-14.58]). This association was not significant in individuals without diabetes. Venular caliber did not predict incident retinopathy. Our findings suggest that retinal arteriolar dilatation is a specific sign of diabetic microvascular dysfunction and may be a preclinical marker of diabetic retinopathy.
Skeletal Renewal and Metabolic Bone Disease
Authors: William H. Harris, Robert Proulx Heaney
Journal: New England Journal of Medicine (1969)

THE skeleton, containing 99 per cent of the total body calcium, serves two major functions, First of all, it plays an important part in calcium homeostasis, both responding to and contributing to changes in calcium metabolism. Secondly, the structural integrity of the skeleton is essential for normal existence. Fractures, by far the most important abnormality of the skeletal system, occur with increasing frequency in the elderly because of decreasing strength of the skeleton. This weakness is due largely to a reduction in skeletal mass caused by an imbalance between the formation and the resorption of bone. Throughout life, even after . . .
Spina bifida and anencephaly in Scotland.
Authors: V Carstairs, S Cole
Journal: BMJ (1984)

Data obtained from routine sources showed that from 1971 to 1982 the birth prevalences of spina bifida and anencephaly in Scotland fell. When known terminations after routine alpha fetoprotein screening were added to total births the adjusted birth prevalence could be calculated. In 1974-82 this fell by 40% for spina bifida (3 X 0-1 X 8) and 36% for anencephaly (2 X 2-1 X 4). These findings were compared with data on birth prevalences in England and Wales, Northern Ireland, and Glasgow. The fall in birth prevalences of spina bifida and anencephaly over the past decade appears to have been due both to a true fall in incidence as well as to increased screening and termination for these conditions.
INTELLIGENCE AND EMOTIONAL STABILITY
Authors: JOHN G. DEWAN
Journal: American Journal of Psychiatry (1948)

1. The clinical findings in the examination of over 30,000 men gave a very definitely higher incidence of emotional instability in the men diagnosed mentally retarded than in those diagnosed non-retarded. 2. Down-grading for instability decreased as 'M' scores advanced. 3. The rate of decrease in down-grading diminished appreciably in the range of average and superior intelligence. 4. The evidence suggests that the rate of incidence of psychoneurosis and other patterns of emotional instability declines as the degree of intelligence advances, although this becomes much less evident in the upper ranges of intelligence. 5. Possible explanations and interpretations have been discussed.
Flow dependence of transtubular potential difference in isolated perfused segments of rabbit proximal convoluted tubule
Authors: Juha P. Kokko, Floyd C. Rector
Journal: Journal of Clinical Investigation (1971)

Transmembrane potential difference (pd) was studied in isolated perfused segments of rabbit proximal convoluted tubules. At perfusion flow rates above 10 nl/min the pd was -5.80 +/-0.3 mv (lumen negative) when perfusing with isosmolal ultrafiltrate of same rabbit serum as the bath. That this pd is generated by transport activity of the tubule is supported by three separate observations: (a) pd reversibly decreased with cooling from 37 degrees C to 25 degrees C; (b) pd decreased when 10(-5) M ouabain was added to the bath and reversed to control levels when ouabain was removed; and (c) heating to 47 degrees C irreversibly decreased pd to zero. The magnitude of the pd was related to perfusion flow rate at slower rates than 10 nl/min. A decrease in flow rate was associated with a decrease in pd. The tubular geometry and transmembrane hydrostatic pressure were ruled out as the mediating factors governing the magnitude of observed pd.
Smoking vs Other Risk Factors as the Cause of Smoking-Attributable Deaths
Authors: Michael J. Thun, Louis F. Apicella, S. Jane Henley
Journal: JAMA (2000)

The surgeon general estimates that more than 400,000 deaths are attributable to smoking annually in the United States. The tobacco industry has criticized the surgeon general's estimates because they do not control for the lower educational and socioeconomic status of modern-day smokers.To determine whether controlling for education, occupation, race, alcohol consumption, and various dietary factors, in addition to age and sex, substantially alters the relative and attributable risk estimates associated with tobacco smoking.Nationwide American Cancer Society prospective cohort study of 974, 150 US adults aged 30 years or older, enrolled in 1982 and followed up through 1988. (The same study is used for the surgeon general and Centers for Disease Control and Prevention [CDC] estimates of smoking-attributable deaths in the United States.)Death from each of the chronic diseases considered in the CDC's estimate of smoking-attributable mortality (cancers of the lung, oropharynx, larynx, esophagus, pancreas, kidney, bladder, and cervix; ischemic heart disease, arterial disease, and other heart conditions; stroke; chronic obstructive pulmonary disease; and other respiratory conditions). Estimates adjusted for multiple covariates were compared with those adjusted for age only among current and former vs never smokers.Adjusting for multiple covariates slightly decreased the relative and attributable risk estimates for current smoking in both men and women, but slightly increased the estimates for former smoking in women. Multivariate adjustment decreased the overall estimate of deaths attributable to smoking in the United States by approximately 1%, from 401,109 to 396,741 per year.Our study suggests that federal estimates of deaths caused by smoking are not substantially altered by adjustment for behavioral and demographic factors associated with smoking beyond the current adjustment for age and sex. JAMA. 2000;284:706-712
CD73/Ecto-5′-Nucleotidase Protects Against Vascular Inflammation and Neointima Formation
Authors: Alma Zernecke, Kiril Bidzhekov, Burcin Özüyaman, Line Fraemohs, Elisa A. Liehn, Juliane M. Lüscher-Firzlaff, Bernhard Lüscher, Jürgen Schrader, Christian Weber
Journal: Circulation (2006)

Background— Although CD73/ecto-5′-nucleotidase has been implicated in maintaining vasoprotection, its role in regulating endothelial adhesion molecule or inflammatory monocyte recruitment (eg, in the context of vascular injury) remains to be defined. Methods and Results— Compared with wild-type mice, CD73-deficient (CD73 −/− ) mice exhibit increased luminal staining and protein and transcript expression for vascular cell adhesion molecule (VCAM)-1 in carotid arteries. In vitro, aortic endothelial cells (ECs) from CD73 −/− mice display an upregulation of mRNA and protein expression of VCAM-1, associated with increased nuclear factor (NF)-κB activity, as determined by chromatin cross-linking and immunoprecipitation or quantitative p65 binding assays. CD73 −/− ECs and carotid arteries perfused ex vivo supported increased monocyte arrest under flow conditions, which was mediated by α 4β1 integrin. After wire injury of carotid arteries, CD73 expression and activity were upregulated in wild-type mice, whereas neointimal plaque formation and macrophage content were increased in CD73 −/− mice versus wild-type mice, concomitant with elevated NF-κB activation, luminal VCAM-1 expression, and soluble VCAM-1 concentrations. In contrast, reconstitution of wild-type mice with CD73 −/− versus CD73 +/+ BM did not significantly exacerbate neointima formation. Treatment with the specific A 2A receptor agonist ATL-146e reversed the increased VCAM-1 transcript and protein expression in CD73 −/− ECs and inhibited monocyte arrest on CD73 −/− ECs. Continuous infusion of ATL-146e prevented neointima formation in CD73 −/− mice. Conclusions— Our data epitomize the importance of vascular CD73 in limiting endothelial activation and monocyte recruitment via generation of adenosine acting through the A 2A receptor, providing a molecular basis for therapeutic protection against vascular inflammation and neointimal hyperplasia.
The Name of the Red-Eared Slider: Herpetologists in Slow Ferment-Reply
Authors: Robert V. Tauxe
Journal: JAMA (1986)

<h3>In Reply.—</h3> Dr Banquer has identified a fast-moving area of turtle nomenclature. He is correct that the term<i>Chrysemys</i>gained popularity in the late 1970s among herpetologists as the generic name for the red-eared slider, the turtle that has been repeatedly associated with human salmonellosis. However, since 1980 the genus name<i>Pseudemys</i>has regained favor, and both terms are in current use. The issue may not be fully resolved until the taxonomic relationships between several groups of North American turtles are further clarified. In 1982, the nomenclature committee of the Society for the Study of Amphibians and Reptiles chose<i>Pseudemys scripta-elegans</i>as the name for the species.<sup>1</sup>Using this name follows current nomenclature and also preserves the continuity of the epidemiologic story of this health hazard.
Detection of localized tooth‐related factors that predispose to periodontal infections
Authors: Debora C Matthews, Moe Tabesh
Journal: Periodontology 2000 (2004)

The primary goal of periodontal therapy is to produce an environment that is conducive to oral health. This is achieved by eliminating the subgingival infection and implementing supragingival plaque control measures designed to prevent the re-colonization of the sulcus. Local etiologic factors, as described above, my prevent the removal of subgingival plaque, and may even contribute to destruction of the periodontal tissues. Thus, it is crucial to be able to recognize and, when possible, eliminate any plaque-retentive factor that could contribute to disease progression. Iatrogenic factors such as subgingival margins, restorative overhangs, overcontoured restorations and unpolished surfaces can be altered. Similarly, cervical enamel projections, enamel pearls and, in certain instances, palatal grooves can be removed or recontoured to enable the patient to access the area for good plaque control. There are some things that we cannot alter. Anatomic anomalies, particularly in posterior teeth, cannot be changed. However, awareness of potential anatomic variations and early detection of them may be able to prevent future attachment loss.