tbuckley/cabot-search huggingface dataset:
Are Organic Foods Safer or Healthier?
Authors: Sari Lisa Davison
Journal: Annals of Internal Medicine (2013)

Letters19 February 2013Are Organic Foods Safer or Healthier?Sari Lisa Davison, MDSari Lisa Davison, MDFrom Middle Way Internal Medicine, Seattle, Washington.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-4-201302190-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:As an internist who relies on the Annals to publish articles that are free from bias and for which authors' potential conflicts of interest are clearly stated, I was dismayed that Smith-Spangler and colleagues' article on organic food (1) did not indicate that some of the authors are affiliated with Stanford's Freeman Spogli Institute for International Studies, which receives funding from agribusiness and agricultural chemical companies, such as Cargill and Monsanto. These affiliations may explain why the title, abstract, and conclusions emphasize that “[t]he evidence does not suggest marked health benefits from consuming organic versus conventional foods” ...References1. Smith-Spangler C, Brandeau ML, Hunter GE, Bavinger JC, Pearson M, Eschbach PJ, et al. Are organic foods safer or healthier than conventional alternatives?: a systematic review. Ann Intern Med. 2012;157:348-66. [PMID: 22944875] LinkGoogle Scholar2. Reuben SH; President's Cancer Panel. 2008–2009 Annual Report. President's Cancer Panel: Reducing Environmental Cancer Risk: What We Can Do Now. Bethesda, MD: U.S. Department of Health and Human Services; April 2010. Google Scholar Author, Article, and Disclosure InformationAuthors: Sari Lisa Davison, MDAffiliations: From Middle Way Internal Medicine, Seattle, Washington.Disclosures: Dr. Davison has made donations to Washington Sustainable Food and Farming Network, Food Democracy Now, and the Neighborhood Farmers Market Alliance. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAre Organic Foods Safer or Healthier Than Conventional Alternatives? Crystal Smith-Spangler , Margaret L. Brandeau , Grace E. Hunter , J. Clay Bavinger , Maren Pearson , Paul J. Eschbach , Vandana Sundaram , Hau Liu , Patricia Schirmer , Christopher Stave , Ingram Olkin , and Dena M. Bravata Are Organic Foods Safer or Healthier? Charles Benbrook Are Organic Foods Safer or Healthier? Donald R. Davis Are Organic Foods Safer or Healthier? Crystal Smith-Spangler , Margaret L. Brandeau , Ingram Olkin , and Dena M. Bravata Are Organic Foods Safer or Healthier? Kirsten Brandt Are Organic Foods Safer or Healthier? Preston K. Andrews Metrics 19 February 2013Volume 158, Issue 4 Page: 296 Keywords Bacteria Conflicts of interest Food Risk management Toxins ePublished: 19 February 2013 Issue Published: 19 February 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Megaduodenum due to hollow visceral myopathy successfully managed by duodenoplasty and feeding jejunostomy.
Authors: P I Mansell, R B Tattersall, M Balsitis, J Lowe, R C Spiller
Journal: Gut (1991)

A 29 year old man with a history of childhood polymyositis developed insulin dependent diabetes and was found coincidentally to have chronic intestinal pseudo-obstruction due to visceral myopathy. Multiple full thickness biopsy specimens showed severe disease in the duodenum and the proximal jejunum only, with less involvement distally. Total parenteral nutrition has been avoided for more than a year by enteral feeding through a fine bore jejunostomy catheter positioned with its tip in the distal jejunum.
Severe asthma in childhood: assessed in 10 year olds in a birth cohort study*
Authors: A. Lang, K. H. Carlsen, G. Haaland, C. S. Devulapalli, M. Munthe‐Kaas, P. Mowinckel, K. Carlsen
Journal: Allergy (2008)

Background: Limited information is available regarding the prevalence of severe asthma in children. The present study aimed at investigating the prevalence of severe asthma in an urban child population; secondarily evaluating the applicability of the chosen definition by clinical characteristics. Methods: Children enrolled in the prospective birth cohort; the Environment and Childhood Asthma Study in Oslo; were reinvestigated at the age of 10 years ( n = 1019). A representative population based cohort of 616 children [mean age 10.9 (SD 0.9) years] with lung function measurements at birth was used for prevalence estimates, whereas all 1019 children (154 with current asthma) attending the 10‐year follow‐up were included for verification of the definition of severe asthma. Clinical investigations included spirometry, tests of bronchial hyperresponsiveness, skin prick tests and exhaled nitric oxide. Severe asthma was defined as poorly controlled asthma despite treatment with ≥ 800 μg budesonide or equivalent; assessed by a detailed structured interview. Results: The population point prevalence at age 10 years of current severe asthma was 0.5% (three of 616) and among children with current asthma 4.5% (three of 67). The 10/154 children identified as suffering from severe asthma more often had severe bronchial hyperresponsiveness (PD 20 methacholine &lt;1 μmol) (60% vs 22%, P = 0.015), lower median forced expiratory volume in 1 s/forced vital capacity ratio (93% vs 99%, P = 0.04) and higher body mass index (mean BMI 22.3 vs 18.3, P &lt; 0.001) than nonsevere current asthmatics. Conclusions: The prevalence of severe asthma was 0.5% in all 10‐year olds, and 4.5% among current asthmatics. The severe asthma definition applied in this study is supported by results of clinical investigations.
Coping with loss: Separation and other problems that threaten relationships
Authors: R. S Weiss
Journal: BMJ (1998)

This is the third in a series of 10 articles dealing with the different types of loss that doctors will meet in their practice

Series editors: Colin Murray Parkes and Andrew Markus

The secure or insecure attachments made to parents in childhood often prefigure the attachments which we make in adult life and predict the pattern of grief to which they give rise after the death of a partner.1 This article examines the problems of change and loss that can arise within an established “pairbond” relationship and cause it to go wrong and, sometimes, to end. It focuses on the particular problems that may bring people into medical care.

Although people rarely come to their doctors complaining of problems in living, many psychosomatic and psychiatric disorders are caused by marital stress, and doctors often become aware that a patient is struggling with an unhappy relationship, or dealing with its loss, in the course of a diagnostic inquiry or a discussion of treatment procedures. In such cases an understanding of the emotional causes and consequences of relational problems, and how they might best be responded to, will be useful to the practitioner. I have covered these issues in more detail elsewhere.2–4

#### Summary points

Relationships are an important source of security and are influenced, for good or ill, by the expectations arising out of secure or insecure attachments earlier in life

Distrust undermines security and causes grief and anger which may further undermine trust

Children are often at risk when parental relationships break down

Relationships that are ending are a cause of grief in both parents and their children and may cause symptoms and requests for help

Doctors can reassure people of the normality of their grief, provide a safe place for its expression, and assess the need for specialist …
DoH explains thinking behind national service framework for coronary heart disease
Authors: R. Boyle
Journal: BMJ (2000)

EDITOR—In the cluster of letters on the national service framework for coronary heart disease,1 two letters (by Lloyd-Mostyn and Cracknell) raise concerns about the recommendation to reduce cholesterol concentration by 30%.2 I wish to clarify the Department of Health's position. The wording of the advice on cholesterol lowering in the national service framework was intended to …
EFFECT OF ALCOHOL ON THE NERVOUS SYSTEM, THE MIND AND HEREDITY.
Authors: ALBERT E. STERNE
Journal: JAMA (1901)

Alcohol has a twofold effect on the nervous system, a direct or primary, and an indirect or secondary. Either of these may act physiologically, i. e., functionally, or pathologically, i. e., structurally. Either may and does unfold its force upon every part of the nervous system, brain, cord, and peripheral nerves; in fact on every organ and tissue of the body, notably upon the blood-vessels, particularly of the brain, the kidneys and the liver. The subject is too large to render justice to it within the limits of a paper like this, and I shall, therefore, be forced to confine my remarks to a narrow domain. Upon the nerve tissues alcohol has an acute influence. This can best be studied by experiments on animals, and by the effects shown in fatal poisoning with large amounts of alcohol in persons unused to its influence. Of the ordinary state of acute intoxication,
Medicalization of Race
Authors: Ritchie Witzig
Journal: Annals of Internal Medicine (1997)

Letters15 April 1997Medicalization of RaceRitchie Witzig, MD, MPHRitchie Witzig, MD, MPHAlpine, NJ 07620Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-8-199704150-00041 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:I am encouraged by Dr. Parker's experiences with first-year medical students in that they did not mention the so-called race of their patients. But they have plenty of time to pick up the bad and unscientific habits of their elders in labeling persons by “race.” In my article, I tried to show that “race” is an unscientific social construct that is dangerous when used clinically. Further, I do not believe that the concept of “race” is medically or socially valid. The usage of the word and the concept of “race” have no future in medicine, and after “race” ... Author, Article, and Disclosure InformationAuthors: Ritchie Witzig, MD, MPHAffiliations: Alpine, NJ 07620 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 April 1997Volume 126, Issue 8Page: 669-670KeywordsForecastingHabitsPatient advocacyRacial and ethnic issuesVeins ePublished: 15 August 2000 Issue Published: 15 April 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Impact of Annual Operator and Institutional Volume on Percutaneous Coronary Intervention Outcomes
Authors: Apurva O. Badheka, Nileshkumar J. Patel, Peeyush Grover, Vikas Singh, Nilay Patel, Shilpkumar Arora, Ankit Chothani, Kathan Mehta, Abhishek Deshmukh, Ghanshyambhai T. Savani, Achint Patel, Sidakpal S. Panaich, Neeraj Shah, Ankit Rathod, Michael Brown, Tamam Mohamad, Frank V. Tamburrino, Saibal Kar, Raj Makkar, William W. O’Neill, Eduardo De Marchena, Theodore Schreiber, Cindy L. Grines, Charanjit S. Rihal, Mauricio G. Cohen
Journal: Circulation (2014)

The relationship between operator or institutional volume and outcomes among patients undergoing percutaneous coronary interventions (PCI) is unclear.Cross-sectional study based on the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample between 2005 to 2009. Subjects were identified by International Classification of Diseases, 9(th) Revision, Clinical Modification procedure code, 36.06 and 36.07. Annual operator and institutional volumes were calculated using unique identification numbers and then divided into quartiles. Three-level hierarchical multivariate mixed models were created. The primary outcome was in-hospital mortality; secondary outcome was a composite of in-hospital mortality and peri-procedural complications. A total of 457,498 PCIs were identified representing a total of 2,243,209 PCIs performed in the United States during the study period. In-hospital, all-cause mortality was 1.08%, and the overall complication rate was 7.10%. The primary and secondary outcomes of procedures performed by operators in 4(th) [annual procedural volume; primary and secondary outcomes] [>100; 0.59% and 5.51%], 3(rd) [45-100; 0.87% and 6.40%], and 2(nd) quartile [16-44; 1.15% and 7.75%] were significantly less (P<0.001) when compared with those by operators in the 1(st) quartile [≤15; 1.68% and 10.91%]. Spline analysis also showed significant operator and institutional volume outcome relationship. Similarly operators in the higher quartiles witnessed a significant reduction in length of hospital stay and cost of hospitalization (P<0.001).Overall in-hospital mortality after PCI was low. An increase in operator and institutional volume of PCI was found to be associated with a decrease in adverse outcomes, length of hospital stay, and cost of hospitalization.
CIRCUMCISION AND SYPHILIS
Authors: V. E. Lloyd, N. L. Lloyd
Journal: BMJ (1934)

recognize that meat in any form particularly aggravated the pain, and for some weeks she had been subsisting mainly upon carbohydrates.On examination there was slight oedema of the ankles and moderate enlargement of the spleen.The blood contained 4.3 million red cells per c.mm., but only 32 per cent.haemoglobin, and the stained films showed poikilocytes and occasional pessary forms.Gastric content analysis revealed no free HCl to histamine stimulation in half-hourly specimens up to two and a half hours.Considered together, the symptoms gave no doubt as to the clinical condition.But in marked contrast to the considerable pallor of the rest of the skin, that of.the nose and cheeks was blotchy and hyperaemic, with a downward spread also on to the lower lip.This blotchy area consisted of confluent papules, which were not, however, surmounted with comedones, and even a casual inspection made it certain that the condition was typical acne rosacea.
Human herpesvirus-8 (HHV-8) associated with small non-cleaved cell lymphoma in a child with AIDS
Authors: Charles T. Leach, Christopher Frantz, David R. Head, Shou-Jiang Gao, Kenneth L. McClain, Maimon Cohen, Andrew B. Campbell, Brad H. Pollock, Sharon B. Murphy, Hal B. Jenson
Journal: American Journal of Hematology (1999)

The association of human herpesvirus-8 (HHV-8) with a small non-cleaved cell lymphoma is described in a child with the acquired immunodeficiency syndrome (AIDS) who developed a malignant pleural effusion and radiologic evidence of multiple solid tumors. HHV-8 DNA and Epstein-Barr virus DNA were identified in pleural fluid cells by polymerase chain reaction (PCR) amplification. The serum antibody titer against lytic HHV-8 proteins was 1:640; antibodies to latent HHV-8 proteins were not detected. Cytogenetic analysis of malignant cells revealed three abnormal karyotypes sharing the common finding of a t(8;14) translocation. Rearrangement of c-myc was demonstrated by PCR analysis. Oligoclonal JH immunoglobulin bands were found. Insufficient pleural fluid cells were available to permit localization of HHV-8 to malignant cells by in situ hybridization. This malignancy contrasts with HHV-8-associated lymphomas reported in adult patients with AIDS with respect to cell morphology, c-myc translocation, and oligoclonal immunoglobulin gene rearrangement. HHV-8 is associated with a wider spectrum of malignancies than recognized previously.
The Decline and Fall of Deregulation
Authors: D Kinzer
Journal: New England Journal of Medicine (1988)

Hopes for a price-competitive, deregulated health economy are fading as the end of Ronald Reagan's second term approaches. The current output of professional health care journals includes a declining quotient of articles by authors who are true believers in either the desirability or the likelihood of such an outcome. Alain Enthoven, one of the most thoughtful free-marketplace proponents, now writes about, "managed competition" and says, "A great deal remains to be done to achieve the goals envisioned by the pro-competitive reformers."1 Among health providers, with whom the marketplace strategy of cost control has achieved a high level of popularity, a . . .
934-30 Localization and Determination of Patency in Coronary Stents with Electron-Beam-Tomography
Authors: Axel Schmermund, Dietrich Baumgart, G¨nter Görge, Junbo Ge, Dietrich Grönemeyer, Rainer Seibel, Cornelia Sehnert, Raimund Erbel
Journal: Journal of the American College of Cardiology (1995)
New meningitis A vaccine is a "breakthrough" for 430 million people at risk
Authors: P. Moszynski
Journal: BMJ (2010)

The approval by the World Health Organization of a low cost vaccine against meningitis has been hailed by the charity Medecins Sans Frontieres as a move “full of promise” for the 430 million people at risk of the disease in the meningitis belt of sub-Saharan Africa.

Cathy Hewison, the charity’s medical adviser, told the BMJ that the new vaccine, called MenAfriVac, could virtually eliminate the epidemic form of the disease but warned that the full rollout of this “much needed vaccine” depends on sufficient funds being mobilised. Medecins Sans Frontieres has been leading the Campaign for Access to Essential Medicines.

Dr Hewison said the existing vaccine “confers very short term protection, …
Behavioral Counseling to Prevent Skin Cancer: A Systematic Review for the U.S. Preventive Services Task Force
Authors: Jennifer S. Lin, Michelle Eder, Sheila Weinmann
Journal: Annals of Internal Medicine (2011)

More than 2 million cases of skin cancer are diagnosed annually in the United States, and melanoma incidence is increasing.To assist the U.S. Preventive Services Task Force in updating its 2003 recommendation on behavioral counseling to prevent skin cancer.Existing systematic reviews, database searches through February 2010, and outside experts.English-language, primary care-relevant counseling trials to promote sun-protective behaviors and studies examining the association between sun-protective behaviors and skin cancer outcomes or potential adverse effects were included.Each study was appraised by using design-specific quality criteria. Important study details were abstracted into evidence tables.11 fair- or good-quality, randomized, controlled trials examined the counseling interventions' effect on sun-protective behaviors. In young women, appearance-focused behavioral interventions decrease indoor tanning and ultraviolet exposure. In young adolescents, computer support can decrease midday sun exposure and increase sunscreen use. Thirty-five mainly fair-quality observational studies examined the relationship between ultraviolet exposure or sunscreen use and skin cancer. Increasing intermittent sun exposure in childhood is associated with an increased risk for squamous cell carcinoma, basal cell carcinoma, and melanoma. Evidence suggests that regular or early use of indoor tanning may increase melanoma risk. On the basis of 1 fair-quality trial, regular sunscreen use can prevent squamous cell carcinoma, but it is yet unclear if it can prevent basal cell carcinoma or melanoma.There are limited rigorous counseling trials. Observational studies are limited by the complexity of measuring ultraviolet exposure and sunscreen use, and inadequate adjustment for important confounders.Randomized, controlled trials suggest that primary care-relevant counseling can increase sun-protective behaviors and decrease indoor tanning.
To ease a little pain
Authors: C. Burns-Cox
Journal: BMJ (2012)

Many years ago, I was asked to see a 90 year old widow who had become a recluse at home because of blackouts.

She lay in comfort on her bed, her chatting punctuated by episodes when she would ask the Lord to receive her soul and cross herself, then become unconscious and pulseless, and her electrocardiogram became flat. …
Differential nucleolus organizer activity in normal and leukemic bone marrow
Authors: K. C. Arden, D. A. Johnston, A. Cork, S. Pathak
Journal: American Journal of Hematology (1989)

Abstract A cytochemical technique that uses silver nitrate staining has been used to study the nucleolus organizer activity in bone marrow cells from 13 patients with acute lymphocytic leukemia (ALL), 11 patients with chronic myelogenous leukemia (CML), 7 patients with acute myelogenous leukemia (AML), and 4 healthy persons. Our results indicate that the nucleolus organizer region (NOR) activity was significantly lower in the control group than in the ALL patients. The NOR activity level was significantly lower in both the CML patients in chronic phase and the AML patients than in the ALL group and similar to the control group. These disease‐related differences in NOR activity as detected by silver staining can be used as diagnostic procedure in evaluating human leukemias.
Science and medicine down under.
Authors: T Delamothe, R Smith
Journal: BMJ (1991)

Australia is famous for its wild flowers, but its doctors are even wilder.Or so Bruce Shepherd, president of the Australian Medical Association (and a Sydneysider), told the opening session of the BMA's overseas meeting in Perth.The BMA arrived in Perth in early November to find not only a vast isolated land of desert and sea but also streets with Scottish names and Father Christmases, reindeer, and gnomes preparing to sweat their way through summer temperatures that will top 40°C many times.
Pancreatic adenocarcinoma (PAC) in a younger patient population: 10-year experience at Memorial Sloan-Kettering Cancer Center (MSKCC)
Authors: A. Duffy, M. Capanu, P. Allen, R. Kurtz, E. Ludwig, S. Olson, D. Klimstra, G. K. Abou-Alfa, D. P. Kelsen, E. M. O’Reilly
Journal: Journal of Clinical Oncology (2008)

4623 Background: The median age at diagnosis of PAC is 72 years. A minority (<3%) are diagnosed at age ≤ 45 years. There is a dearth of data in this younger population re: epidemiology, genetics, prognosis and outcome. This report examines a large cohort of patients with PAC ≤ 45 years evaluated at MSKCC over a 10-year period. Methods: A retrospective analysis of patients with PAC from the MSKCC tumor registry, who were ≤ 45 on the date of the diagnostic biopsy, between Jan 1995 and Dec 2005 was performed. Information reviewed included demographics, clinical and pathological stage, surgical management, pathology, therapy, date of relapse, death or last follow-up. Univariate analysis of survival times and log-rank test were employed. Results: 118 cases of PAC, age ≤ 45 years were identified: 54 (45.4%) females, 64 (54.6%) males. Age range 24–45; 3, 33 and 82 in age groups 20–29, 30–39, 40–45 years, respectively. Tumor location: 73 (62%) head of pancreas, 16 (13%) tail, 29 (25%) unspecified. 44 (37%) had a significant smoking history. 11 (9.2%) had a positive family history of PAC. 16 (13.4%) had a history of pancreatitis pre-diagnosis. Pathology: 100% adenocarcinoma. 28 (23.5%) underwent a curative resection for localized disease - AJCC stage distribution as follows: 1A (N= 1), 1B (N= 2), IIA (N= 4), IIB (N= 20), IV (N= 1). 23 (19.3%) presented with locally advanced, inoperable disease. 62 (52%) presented as AJCC Stage IV. Median OS tabulated below. 21 (75%) of those resected underwent adjuvant chemoradiation. 6 received adjuvant gemcitabine. Conclusions: This is the largest reported cohort of young pts with PAC ≤ 45 years. The data suggest that patients with stage I-II disease may have an improved prognosis, however the prognosis for stage III-IV patients appears to be similar to the typical (older) patient population with PAC. Further data will be presented regarding genetics, epidemiology, family history and oncologic outcome in this young population which may differ from an older patient cohort. Median survival (m) Entire cohort (N= 118) # 11 Stage I - IIB (N= 28) 41.8 (95% CI, 20.3–47) Stage III (N= 23) 15.3 (95% CI, 12–19.3) Stage IV (N= 62) 6.7 (95% CI, 9.4–13.5) # Data missing for 5 patients No significant financial relationships to disclose.