tbuckley/cabot-search huggingface dataset:
Global Burden of Sickle Cell Anaemia in Children under Five, 2010–2050: Modelling Based on Demographics, Excess Mortality, and Interventions
Authors: Frédéric B. Piel, Simon I. Hay, Sunetra Gupta, David J. Weatherall, Thomas N. Williams
Journal: PLoS Medicine (2013)

Background The global burden of sickle cell anaemia (SCA) is set to rise as a consequence of improved survival in high-prevalence low- and middle-income countries and population migration to higher-income countries. The host of quantitative evidence documenting these changes has not been assembled at the global level. The purpose of this study is to estimate trends in the future number of newborns with SCA and the number of lives that could be saved in under-five children with SCA by the implementation of different levels of health interventions. Methods and Findings First, we calculated projected numbers of newborns with SCA for each 5-y interval between 2010 and 2050 by combining estimates of national SCA frequencies with projected demographic data. We then accounted for under-five mortality (U5m) projections and tested different levels of excess mortality for children with SCA, reflecting the benefits of implementing specific health interventions for under-five patients in 2015, to assess the number of lives that could be saved with appropriate health care services. The estimated number of newborns with SCA globally will increase from 305,800 (confidence interval [CI]: 238,400–398,800) in 2010 to 404,200 (CI: 242,500–657,600) in 2050. It is likely that Nigeria (2010: 91,000 newborns with SCA [CI: 77,900–106,100]; 2050: 140,800 [CI: 95,500–200,600]) and the Democratic Republic of the Congo (2010: 39,700 [CI: 32,600–48,800]; 2050: 44,700 [CI: 27,100–70,500]) will remain the countries most in need of policies for the prevention and management of SCA. We predict a decrease in the annual number of newborns with SCA in India (2010: 44,400 [CI: 33,700–59,100]; 2050: 33,900 [CI: 15,900–64,700]). The implementation of basic health interventions (e.g., prenatal diagnosis, penicillin prophylaxis, and vaccination) for SCA in 2015, leading to significant reductions in excess mortality among under-five children with SCA, could, by 2050, prolong the lives of 5,302,900 [CI: 3,174,800–6,699,100] newborns with SCA. Similarly, large-scale universal screening could save the lives of up to 9,806,000 (CI: 6,745,800–14,232,700) newborns with SCA globally, 85% (CI: 81%–88%) of whom will be born in sub-Saharan Africa. The study findings are limited by the uncertainty in the estimates and the assumptions around mortality reductions associated with interventions. Conclusions Our quantitative approach confirms that the global burden of SCA is increasing, and highlights the need to develop specific national policies for appropriate public health planning, particularly in low- and middle-income countries. Further empirical collaborative epidemiological studies are vital to assess current and future health care needs, especially in Nigeria, the Democratic Republic of the Congo, and India. Please see later in the article for the Editors' Summary
Positive Captopril Renal Scintigraphy in a Patient With Extensive Bilateral Renal Interlobar Arterial Disease
Authors: DONALD W. TREPASHKO, DAVID WARNER, JOSÉ ARRUDA, DAN G. PAVEL
Journal: Clinical Nuclear Medicine (1994)

The authors determined an unusual cause of renovascular hypertension in a 29-year-old man with the recent onset of hypertension and a history of intravenous substance abuse. Captopril renal scintigraphy (CRS) demonstrated bilateral renogram changes and a decrease in estimated global glomerular filtration rate. The abdominal aortogram failed to show renal artery or branch artery stenosis. Magnified selective views of the kidneys demonstrated extensive, bilateral, small vessel Interlobar disease. Two major points are Illustrated in this patient. First, in the presence of positive CRS results and a history of renovascular hypertension, bilateral, selective, magnified renal angiography should be performed in accordance with standard abdominal aortic views when large vessel disease is not detected. Second, although surgical intervention is not an option in such patients, finding the cause of hypertension is important for patient management.
Effect of Position on Leg Volume
Authors: Beverly C. Morgan, Warren G. Guntheroth, George A. McGough
Journal: JAMA (1964)

IN 1890 Trendelenburg described the position of head-down body tilt to improve surgical exposure of pelvic organs. During World War I, this position was suggested for the treatment of shock assuming that it would increase blood pressure, improve cerebral blood flow, and increase venous return from the legs. Despite lack of objective data supporting its efficacy, the Trendelenburg position has become a standard therapeutic maneuver in shock. Recently, evidence has been obtained that blood pressure is actually slightly decreased in the Trendelenburg position secondary to baroreceptor activity.<sup>1</sup>In addition, there is evidence that carotid blood flow in animals is not increased in this position.<sup>2</sup>Impaired pulmonary function results in man in the Trendelenburg position.<sup>3-4</sup> However, since the blood pooled in the lower extremities may be as much as 1000 cc,<sup>5</sup>the advantage of returning this pool to the central circulation warrants consideration. In an attempt to
Budesonide versus mesalamine for maintaining remission in patients refusing other immunomodulators for steroid-dependent Crohn's disease
Authors: Gerassimos J. Mantzaris, Kalliopi Petraki, Michael Sfakianakis, Emmanuel Archavlis, Angeliki Christidou, Helen Chadio-Iordanides, George Triadaphyllou
Journal: Clinical Gastroenterology and Hepatology (2003)
Experts OK Antiplatelets and PPIs for Heart Patients With GI Bleeding Risks
Authors: Rebecca Voelker
Journal: JAMA (2011)

AFTER 2 YEARS OF CONFUSION AND anxiety from conflicting research results, physicians have new guidance in determining which patients with cardiovascular disease who take antiplatelet therapy will reap the most benefit from also taking a proton pump inhibitor (PPI) to reduce the risk of gastrointestinal (GI) bleeding. In mid-November, the American College of Cardiology Foundation, the American College of Gastroenterology, and the American Heart Association released a consensus document that gives a green light to the concomitant use of antiplatelet drugs and PPIs in patients who are at high risk for upper GI bleeding (http://tinyurl.com /289g85d). “The key messages we want to get through to physicians and patients is that physicians should not prescribe [PPIs] routinely, but they should weigh the individual risks and benefits for each patient,” said Neena Abraham, MD, chair of the writing committee that produced the document and a gastroenterologist at the Michael E. DeBakey VA Medical Center in Houston. “Our consensus group really tried to . . . highlight the group in which the proton pump inhibitors would have the most bang for the buck,” she added. The document recommends concomitant antiplatelet and PPI medications for patients with a history of prior upper GI bleeding, which is the strongest risk factor linked with GI bleeding while taking antiplatelet agents. Additional factors that increase the risk of GI bleeding with antiplatelets are advanced age; current use of anticoagulants, steroids, or nonsteroidal anti-inflammatory drugs including aspirin; and infection with Helicobacter pylori, which is known to increase the risk of ulcers. The use of PPIs is appropriate in patients who take antiplatelet drugs and have multiple risk factors, according to the document.
The Physician and Oral Discovery
Authors: Neil L. Chayet
Journal: New England Journal of Medicine (1967)

THE physician finds himself called upon increasingly often to testify in cases involving his patients. More than 70 per cent of all cases involve medical testimony of some sort, and it is therefore imperative that the physician be kept informed of recent developments that dramatically effect his relation to the trial process.There are several ways in which the physician may become involved in litigation. In the first place, he may appear as a defendant, sued by a patient for malpractice. Secondly, he may be summoned into court as a witness as a result of his having treated a patient . . .
Fruit in Eden
Authors: Stephen H. Norris
Journal: JAMA (1989)

I now have it on competent authority that in a not-too-remote alternate universe, Adam and Eve, either less inquisitive or more leery of repercussions than they were in ours, could not be tempted to partake of the Tree of Knowledge. There was no Fall of Man, Nod is underpopulated, fig trees are foliated, snakes have legs, and God still runs the show in Eden. Never having caught on to the Big Picture, incurious Edenites may be excused an occasional lapse in rationality. If their behavior also seems a tad venal, that's only to be expected from folks who never learned Right from Wrong, who have no shame, and whose behavior must still be directed by an occasional Moral Obligation from the Almighty. For instance, the fruit industry (oranges, lemons, and grapefruit only—apples verboten) is as oddly managed there as treatment of renal failure (in-center hemodialysis, home dialysis, and renal transplantation)
Homocyst(e)ine and Cardiovascular Disease: A Critical Review of the Epidemiologic Evidence
Authors: John W. Eikelboom, Eva Lonn, Jacques Genest, Graeme Hankey, Salim Yusuf
Journal: Annals of Internal Medicine (1999)

Purpose: To review epidemiologic studies on the association between homocyst(e)ine level and risk for cardiovascular disease and the potential benefits of homocysteine-decreasing therapies. Data Sources: Computerized and manual searches of the literature on total homocysteine levels and cardiovascular disease. Study Selection: Prospective studies and major retrospective epidemiologic studies evaluating the association between homocyst(e)ine levels and cardiovascular disease and the association between blood levels or dietary intake of folate, vitamin B6, and vitamin B12 and cardiovascular disease. Data Extraction: Relevant data on patient population, plasma homocyst(e)ine levels, duration of follow-up, and main results were extracted from studies that met the inclusion criteria. Data Synthesis: The designs and results of studies included in this review are summarized. A formal meta-analysis was not performed because the studies were heterogeneous in method and design. Conclusions: Results of epidemiologic studies suggest that moderately elevated plasma or serum homocyst(e)ine levels are prevalent in the general population and are associated with an increased risk for cardiovascular disease, independent of classic cardiovascular risk factors. Simple, inexpensive, nontoxic therapy with folic acid, vitamin B6, and vitamin B12 reduces plasma homocyst(e)ine levels. Although the association between homocyst(e)ine levels and cardiovascular disease is generally strong and biologically plausible, the data from the prospective studies are less consistent. In addition, epidemiologic observations of an association between hyperhomocyst(e)inemia and cardiovascular risk do not prove the existence of a causal relation. Therefore, the effectiveness of folate, vitamin B6, and vitamin B12 in reducing cardiovascular morbidity and mortality requires rigorous testing in randomized clinical trials. Several such trials are under way; their results may greatly affect cardiovascular morbidity and mortality, given the simplicity and low cost of vitamin therapy.
Influence of Dofetilide on QT-Interval Duration and Dispersion at Various Heart Rates During Exercise in Humans
Authors: Jean-Louis De´molis, Christian Funck-Brentano, Jacques Ropers, Mathieu Ghadanfar, Donald J. Nichols, Patrice Jaillon
Journal: Circulation (1996)

Background The objective of this study was to assess the influence of heart rate on QT-interval duration and dispersion during administration of the new selective potassium-channel blocker dofetilide in normal subjects. Methods and Results Dofetilide 0.25 and 0.75 mg was administered for 4 days to 12 subjects in a randomized-sequence, double-blind, three-period, placebo-controlled, crossover study. QT-RR pairs were measured on study day 4 over a wide range of RR intervals obtained at rest and during an exercise test. QT-interval durations were calculated at seven predetermined RR intervals ranging from 400 ms (150 bpm) to 1000 ms (60 bpm) by use of monoexponential nonlinear curve fitting. QT max and QT min were calculated similarly, and QT-interval dispersion was measured as QT max −QT min at each predetermined RR interval. Minimal effects were found with 0.25 mg dofetilide. Two hours after administration of 0.75 mg dofetilide, QT interval was prolonged by 16.7±8.7% at a heart rate of 60 bpm ( P &lt;.01) and by 7.4±8.2% at a heart rate of 150 bpm ( P &lt;.05). QT prolongation at a heart rate of 150 bpm was less pronounced than at lower heart rates. Neither placebo nor dofetilide at either dose significantly increased QT-interval dispersion at any heart rate. Conclusions Dofetilide increases QT-interval duration but does not increase QT-interval dispersion in healthy subjects. QT-interval prolongation remains significant at high heart rates, although some degree of reverse rate dependence is observed at high concentrations.
Decreased lymphocyte reactivity and auto-immunity in alopecia areata
Authors: P.S. FRIEDMANN
Journal: British Journal of Dermatology (1981)

T lymphocyte numbers and functions were measured in forty‐six patients with alopecia areata and thirty healthy controls. In patients with alopecia areata, lymphocyte reactivity to extracts of scalp and hair follicles was not detected by 3H thymidine incorporation. 3H Thymidine incorporation by lymphocytes cultured with PPD, Varidasc and C. albicans was significantly reduced in cells from patients compared with controls and correlated with the extent of hair loss and the presence of antithyroid antibodies. Decreased lymphocyte responses to PPD and Varidase were not due to the presence of suppressor monocytes because removal of monocytes with carbonyl iron did not increase lymphocyte reactivity. However, responsiveness to C albicans was augmented by removal of monocytes. T cell numbers were significantly lower than in controls (P<0.005); patients with auto‐antibodies had fewer T cells than patients without them. The relationship of reduced T cell function and auto‐immunity to alopecia areata is discussed.
Quantitative effect of a single large dose of methylprednisolone on infarct size in baboons
Authors: G. T SMITH, G. GEARY, W. RUF, F. N FORE, M. OYAMA, J J. McNAMARA
Journal: Cardiovascular Research (1980)

Journal Article Quantitative effect of a single large dose of methylprednisolone on infarct size in baboons Get access GREGORY T SMITH, GREGORY T SMITH From the Cardiovascular Research Laboratory and Department of Surgery, John A Burns School of Medicine, University of Hawaii, Queen's Medical Center, Honolulu, Hawaii 96813. Search for other works by this author on: Oxford Academic PubMed Google Scholar GRAYSON GEARY, GRAYSON GEARY From the Cardiovascular Research Laboratory and Department of Surgery, John A Burns School of Medicine, University of Hawaii, Queen's Medical Center, Honolulu, Hawaii 96813. Search for other works by this author on: Oxford Academic PubMed Google Scholar WOLFGANG RUF, WOLFGANG RUF From the Cardiovascular Research Laboratory and Department of Surgery, John A Burns School of Medicine, University of Hawaii, Queen's Medical Center, Honolulu, Hawaii 96813. Search for other works by this author on: Oxford Academic PubMed Google Scholar FRANK N FORE, FRANK N FORE From the Cardiovascular Research Laboratory and Department of Surgery, John A Burns School of Medicine, University of Hawaii, Queen's Medical Center, Honolulu, Hawaii 96813. Search for other works by this author on: Oxford Academic PubMed Google Scholar MORITSUGU OYAMA, MORITSUGU OYAMA From the Cardiovascular Research Laboratory and Department of Surgery, John A Burns School of Medicine, University of Hawaii, Queen's Medical Center, Honolulu, Hawaii 96813. Search for other works by this author on: Oxford Academic PubMed Google Scholar J JUDSON McNAMARA J JUDSON McNAMARA From the Cardiovascular Research Laboratory and Department of Surgery, John A Burns School of Medicine, University of Hawaii, Queen's Medical Center, Honolulu, Hawaii 96813. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 14, Issue 7, July 1980, Pages 408–418, https://doi.org/10.1093/cvr/14.7.408 Published: 01 July 1980
Further evidence that low androgen values are a cause of rheumatoid arthritis: the response of rheumatoid arthritis to seriously stressful life events
Authors: W. H JAMES
Journal: Annals of the Rheumatic Diseases (1997)

It is well established that androgen concentrations are low in patients with rheumatoid arthritis (RA).1 There are three possibilities: (1) Low androgen values are a consequence of RA. (2) Low androgen values are a consequence of its treatment. (3) Low androgen values are a partial cause of RA.

Undoubtedly the facts are complex, but in what I take to be an excess of methodological correctness, Masi et a l1 write: ‘The available evidence reviewed does not allow definitive response to the question of a primary versus secondary role of sex hormone perturbations in RA’. I shall treat the three above possibilities in turn to suggest that (in contrast with Masi et al 1) a definitive response is possible.

(1) Low androgen concentrations in men are a consequence of many forms of illness2 including severe inflammatory disease,3 so it may be accepted that …
Oral Cancer Prevention and the Evolution of Molecular-Targeted Drug Development
Authors: Scott M. Lippman, Jon Sudbø, Waun Ki Hong
Journal: Journal of Clinical Oncology (2005)

The multifaceted rationale for molecular-targeted prevention of oral cancer is strong. Oral cancer is a major global threat to public health, causing great morbidity and mortality rates that have not improved in decades. Oral cancer development is a tobacco-related multistep and multifocal process involving field carcinogenesis and intraepithelial clonal spread. Biomarkers of genomic instability, such as aneuploidy and allelic imbalance, can accurately measure the cancer risk of oral premalignant lesions, or intraepithelial neoplasia (IEN). Retinoid-oral IEN studies (eg, of retinoic acid receptor-beta, p53, genetic instability, loss of heterozygosity, and cyclin D1) have advanced the overall understanding of the biology of intraepithelial carcinogenesis and of preventive agent molecular mechanisms and targets-important advances for monitoring preventive interventions and assessing cancer risk and pharmacogenomics. Clinical management of oral IEN varies from watchful waiting to complete resection, although complete resection does not prevent oral cancer in high-risk patients. New approaches, such as interventions with molecular-targeted agents and agent combinations in molecularly defined high-risk oral IEN patients, are urgently needed to reduce the devastating worldwide consequences of oral cancer.
Randomized, dose-escalation study of the p38α MAPK inhibitor SCIO-469 in patients with myelodysplastic syndrome
Authors: L Sokol, L Cripe, H Kantarjian, M A Sekeres, S Parmar, P Greenberg, S L Goldberg, V Bhushan, J Shammo, R Hohl, A Verma, G Garcia-Manero, Y-P Li, A Lowe, J Zhu, A F List
Journal: Leukemia (2012)
Columbia — Hunterdon: Similar but Different
Authors: Lloyd B. Wescott
Journal: New England Journal of Medicine (1976)

The article in this issue of the Journal about the Johns Hopkins experience in Columbia, Maryland, prompts me to make some comparisons with what happened in Hunterdon County, New Jersey. Both Hunterdon Medical Center and the Johns Hopkins project set out to provide not just an acute-care hospital, but a health-care system. Both were based on the traditional triad of service, teaching and research (Hunterdon has neglected the latter until now). Both were designed to serve a fairly well defined population. In both, the staff organization was nontraditional.The differences were much greater. Columbia was established in 1969; Hunterdon opened . . .
Renal fibrosis is not reduced by blocking transforming growth factor-β signaling in matrix-producing interstitial cells
Authors: Surekha Neelisetty, Catherine Alford, Karen Reynolds, Luke Woodbury, Stellor Nlandu-khodo, Haichun Yang, Agnes B. Fogo, Chuan-Ming Hao, Raymond C. Harris, Roy Zent, Leslie Gewin
Journal: Kidney International (2015)
ACUTE APPENDICITIS: SOME MISTAKEN DIAGNOSES
Authors: I. Fraser
Journal: BMJ (1933)

MISTAKEN DIAGNOSES LMTHEDBRrTIS .~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~6. Occasionally a patient presents himself with frank D.A.H. type of symptoms, and on examination mitral stenosis is found.7. Symptoms may vary because of some external factor-physical or physiological.A patient was markedly affected at the fairly high altitude at Nairobi, but was very much improved on returning to sea-level.SUMMARY An analysis of 300 cases of mitral stenosis, without gross cardiac failure, has been attempted.It is realized that the comparatively small number of cases may give rise to misleading conclusions, but it is felt that the following are justified.1.The age and sex incidence has been emphasized.There is evidence that the disease is commoner in women than men in the proportion of 3: 1, and that it occurs at a definitely earlier age in males.2. The importance of rheumatism as an aetiological factor has been shown.At the most conservative estimate it was the aetiological factor in 80 per cent. of the cases.It is probable that 90 per cent. is nearer the correct figure in the present series.No other aetio- logical factor was found present with any degree of constancy.3. Some of the complications of mitral stenosis and their relative frequency at an out-patient clinic are mentioned.4. The type of symptoms and their mode of onset, as found in the survey of the present series, are considered.The majority of cases over 45 years of age develop auricular fibrillation.I wish to acknowledge my gratitude to Professor John I-lay and Dr. H.