tbuckley/cabot-search huggingface dataset:
Early Childhood Lower Respiratory Illness and Air Pollution
Authors: Irva Hertz-Picciotto, Rebecca James Baker, Poh-Sin Yap, Miroslav Dostál, Jesse P. Joad, Michael Lipsett, Teri Greenfield, Caroline E.W. Herr, Ivan Beneš, Robert H. Shumway, Kent E. Pinkerton, Radim Šrám
Journal: Environmental Health Perspectives (2007)

BackgroundFew studies of air pollutants address morbidity in preschool children. In this study we evaluated bronchitis in children from two Czech districts: Teplice, with high ambient air pollution, and Prachatice, characterized by lower exposures.ObjectivesOur goal was to examine rates of lower respiratory illnesses in preschool children in relation to ambient particles and hydrocarbons.MethodsAir monitoring for particulate matter < 2.5 μm in diameter (PM2.5) and polycyclic aromatic hydrocarbons (PAHs) was conducted daily, every third day, or every sixth day. Children born May 1994 through December 1998 were followed to 3 or 4.5 years of age to ascertain illness diagnoses. Mothers completed questionnaires at birth and at follow-up regarding demographic, lifestyle, reproductive, and home environmental factors. Longitudinal multivariate repeated-measures analysis was used to quantify rate ratios for bronchitis and for total lower respiratory illnesses in 1,133 children.ResultsAfter adjustment for season, temperature, and other covariates, bronchitis rates increased with rising pollutant concentrations. Below 2 years of age, increments in 30-day averages of 100 ng/m3 PAHs and of 25 μg/m3 PM2.5 resulted in rate ratios (RRs) for bronchitis of 1.29 [95 % confidence interval (CI), 1.07–1.54] and 1.30 (95% CI, 1.08–1.58), respectively; from 2 to 4.5 years of age, these RRs were 1.56 (95% CI, 1.22–2.00) and 1.23 (95% CI, 0.94–1.62), respectively.ConclusionAmbient PAHs and fine particles were associated with early-life susceptibility to bronchitis. Associations were stronger for longer pollutant-averaging periods and, among children > 2 years of age, for PAHs compared with fine particles. Preschool-age children may be particularly vulnerable to air pollution–induced illnesses.
Epidural denied to woman on welfare
Authors: N. Macready
Journal: BMJ (1998)

A pregnant woman on welfare who was denied an epidural anaesthetic because she could not pay for it in cash, has triggered a debate in the United States over reimbursement, managed care, and the rights of patients on welfare.

Ozzie Chavez arrived at Northridge Hospital in Northridge, California, in labour and ready for the epidural that her obstetrician had ordered. The nurse, however, asked for $400 (£250) up front. Ms Chavez offered a cheque and a credit card, both of which were …
A Minimal Psychological Intervention in Chronically Ill Elderly Patients with Depression: A Randomized Trial
Authors: Femke Lamers, Catharina C.M. Jonkers, Hans Bosma, Gertrudis I.J.M. Kempen, Jaap A.M.J. Meijer, Brenda W.J.H. Penninx, J. André Knottnerus, Jacques T.M. van Eijk
Journal: Psychotherapy and Psychosomatics (2010)

&lt;i&gt;Background:&lt;/i&gt; Among older persons with chronic somatic diseases, depression often remains unrecognized and untreated in primary care. The Depression in Elderly with Long-Term Afflictions (DELTA) study aimed to evaluate the effectiveness of a nurse-led minimal psychological intervention (MPI) in chronically ill elderly persons with depression. &lt;i&gt;Methods:&lt;/i&gt; A randomized controlled trial was conducted, comparing the MPI with usual care in 361 primary care patients. Four nurses had an average of 4 sessions with the intervention patients, each lasting 1 h, over a maximum period of 3 months. Patients were aged 60 years and older, had a minor depression or mild-to-moderate major depression, and either had type II diabetes or chronic obstructive pulmonary disease. &lt;i&gt;Results:&lt;/i&gt; Nine months after the intervention, patients receiving the MPI had significantly fewer depressive symptoms; the intervention patients were also more likely than usual-care controls to show a ≧50% reduction in depressive symptoms relative to baseline values. At 9 months, diabetic MPI patients had a better quality of life than diabetic controls. &lt;i&gt;Conclusions:&lt;/i&gt; The nurse-led MPI appears to be a feasible and moderately effective method of managing minor-to-moderate depression in chronically ill elderly persons. However, we cannot rule out attention-placebo effects, and the disappointing finding of a recent economic evaluation showing only a 63% chance of the MPI being cost-effective. From a clinical point of view, however, it is of interest to further evaluate adaptations of the MPI, with a stronger emphasis on detection, watchful waiting and mental health problems in general.
HbA1c and Glycemic Profile, Basal- and Post-Treatment With Miglitol, in an Area With a Mediterranean Diet
Authors: Eduardo Faure, Luis Felipe Pallardo, Jordi Mesa, Manel Puig-Domingo, Ricardo García-Mayor, Pedro Benito, Ramón Ravella, Maite Artés, Juan S. López
Journal: Diabetes Care (2002)

HbA1c is the main indicator in the metabolic control of diabetic patients. It it has been used as a guide in therapeutic intervention studies on type 1 diabetic patients, as in the Diabetes Control and Complications Trial (1), and type 2 diabetic patients, as in the U.K. Prospective Diabetes Study (2). These studies have shown that an HbAlc decrease is followed by a reduction in the appearance of microvascular and neuropathic complications. The relative impact of fasting glycemia and the glycemic levels at other times of the day on the HbAlc value is therefore of considerable interest when trying to increase control at the times of the day when this impact is at its highest level. Fasting glycemia has traditionally been considered the main HbAlc marker (3–6). Recently, however, the validity of this has been questioned (7),and it has even been suggested that the main marker is the postprandial glycemic level (8). On the other hand, postprandial glycemia has been described as being more related to the development of macroangiopathy than fasting glycemia (9,10), which increases interest in its relative contribution to the HbAlc value.

We carried out an observational, prospective, open, nonrandomized, multicenter …
THE VENTRICULAR COMPLEX OF THE ELECTRO-CARDIOGRAM AS A PHYSICAL SIGN IN CARDIAC PROGNOSIS
Authors: J. E. MacIlwaine, S. B. B. Campbell
Journal: BMJ (1923)

I~~~~~~~~~~~~ZDICL JOWA4. Never to pass aniy instruments into the bladder in a recent uncomplicated case.In the army my experience was 13 per cent. of all cases of gonorrhoea had epididymitis- 6.5 before admission and 6.5 after-and maniy of the cases in the latter portioll were due to treatment.By keeping to the rules I have mentionied I very rarely see epididymiiitis after treatmiient has commiienced.The symptoms of clhroniic prostatitis and vesiculitis can almost always be relieved by treatmelnt, but these conditions are practically incurable if the test of cure is complete absenice of pus cells in the secretioni expressed by prostatic massage.It is possible to divide them into two classes.First there is the mani who witlhout symptoms of any kind lias pus in the expressed secretion.He gives a hiistory of gonorrhoea somre years previously and generally the oinly thing he complains of is ani occasiolnal discharge; or else lhe wvislhes to be examined to find out hiis fitness for marriage.Treatment is essential in these cases, as maniy of them will develop sexual or urinar y disturbances or imietastatic lesions later on.For theimi I prescribe prostatic massage for three months.Althouglh most of tlheml will still have pus at the end of this tiime, I think the treatment is beie- ficial and likely to ward off later symptomiis.The otlher class may have a persistent urethlral discharge, frequency of micturition, iritis, muscular rheumlatism, fibrositis, pain during sexual intercourse, blood-stained ejaculationi, and neurasthenic symuptomIis.Treatmeint should be continued till these symptoms are cured.The patieint should also be instructed to live a careful and regular life, avoiding alcoholic and sexual excess, constipationi, and other irregularities.-Foryears I have relied on massage alone, but latterly I have comibined it with application of heat by a water-heated applicator in the rectum.Water at a tem- perature of 1200 F. floNs fromii a containier tllrouglh the applicator for twenty minutes.The heat brings ani increased flow of blood and lymph to the tissues and a mucll greater quanitity of fluid can afterwards be expressed by quite lightly applied massage.Dilatation of the prostatic urethra by solid instruments or by mechanical dilators is, in my experience, useless, if niot harmful.Certainly it is so with a Kollmann's posterior dilator.Ill the first place, it is only too easy to produce severe damiage to the mucous membrane and it does not dilate the ulretlhra.A few years ago I
Fetal Heart Rate Patterns
Authors: Barry S. Schifrin
Journal: JAMA (1972)

A prediction system based on continuous monitoring of the fetal heart rate (FHR) and intrauterine pressure within the last 30 minutes of labor has been used to predict the Apgar score of 307 neonates. No clinical information was utilized for the prediction. The normal FHR pattern was almost completely accurate in predicting a baby with a high Apgar score at five minutes. Only two falsely high predictions were made, both in anomalous infants. With these exceptions, every depressed neonate was anticipated on the basis of an abnormal FHR pattern. Abnormal FHR patterns, however, were conservative predictors of low Apgar scores. It is anticipated that the accuracy of low predictions may be improved with modifications in the prediction system.
The IL-21 receptor augments Th2 effector function and alternative macrophage activation
Authors: J. Pesce
Journal: Journal of Clinical Investigation (2006)

The IL-21 receptor (IL-21R) shows significant homology with the IL-4R, and CD4+ Th2 cells are an important source of IL-21. Here we examined whether the IL-21R regulates the development of Th2 responses in vivo. To do this, we infected IL-21R-/- mice with the Th2-inducing pathogens Schistosoma mansoni and Nippostrongylus brasiliensis and examined the influence of IL-21R deficiency on the development of Th2-dependent pathology. We showed that granulomatous inflammation and liver fibrosis were significantly reduced in S. mansoni-infected IL-21R-/- mice and in IL-21R+/+ mice treated with soluble IL-21R-Fc (sIL-21R-Fc). The impaired granulomatous response was also associated with a marked reduction in Th2 cytokine expression and function, as evidenced by the attenuated IL-4, IL-13, AMCase, Ym1, and FIZZ1 (also referred to as RELMalpha) responses in the tissues. A similarly impaired Th2 response was observed following N. brasiliensis infection. In vitro, IL-21 significantly augmented IL-4Ralpha and IL-13Ralpha1 expression in macrophages, resulting in increased FIZZ1 mRNA and arginase-1 activity following stimulation with IL-4 and IL-13. As such, these data identify the IL-21R as an important amplifier of alternative macrophage activation. Collectively, these results illustrate an essential function for the IL-21R in the development of pathogen-induced Th2 responses, which may have relevance in therapies for both inflammatory and chronic fibrotic diseases.
THE QUINIDIN TREATMENT OF AURICULAR FIBRILLATION
Authors: WALTER W. HAMBURGER
Journal: JAMA (1922)

Since the report by one of us (W. W. H.<sup>1</sup>) in December, 1921, of eight cases of auricular fibrillation in which quinidin sulphate was administered, we have observed and treated ten additional cases. In this paper we shall present (1) a further study of the cases previously reported; (2) the details of treatment and observation in ten new cases, and (3) the results and conclusions obtained from our experience with these eighteen cases in connection with a critical survey of the literature up to the present time. In spite of lack of complete knowledge of the pharmacology of quinidin, its indications and contraindications in practice, and the occasional reports of serious untoward effects (paralyses, embolism and death), interest in its therapeutic use continues to grow. Reports and studies in quinidin therapy have appeared so fast during the past year, especially during the past six months, that it is well-nigh
Pacemakers in Complete Heart-Block
Authors: Victor Parsonnet
Journal: JAMA (1970)

To the Editor.—  Dr. Margolis writes ( 212 :1524, 1970) that many patients with complete heart-block do well if given the chance and therefore use of the pacemaker can be postponed. He bases this decision on observation of 15 patients, and three references to the available literature. Apparently there is some confusion by your correspondent in regards to the distinction between emergency temporary pacing and permanent pacing. Although all of his patients may have been candidates for temporary pacing, ie, insertion of a catheter electrode to the right ventricle to be attached to an external pacemaker, only one patient (the third in the list) appeared to be a candidate for permanent pacemaker implantation. This patient eventually died of a second myocardial infarct two years later. Would his death have been prevented by adequate pacing?  There is ample documentation of the natural history of complete heart-block. Two issues of the Annals of
Dihydrotestosterone binding by cultured human fibroblasts. Comparison of cells from control subjects and from patients with hereditary male pseudohermaphroditism due to androgen resistance.
Authors: J E Griffin, K Punyashthiti, J D Wilson
Journal: Journal of Clinical Investigation (1976)

Dihydrotestosterone binding was measured in culture fibroblasts from 14 control subjects and from 12 patients with five different types of hereditary male pseudohermaphroditism. Two assays of binding were used--an intact monolayer assay and density gradient centrifugation of cell extracts. In the intact monolayer assay of normal cells the uptake of [3H]dihydrotestosterone consisted of two components. The first was a high affinity component that exhibited saturation at approximately 1 nM dihydrotestosterone. The second was a low affinity component that was not saturable with concentrations of steroid up to 5 nM. Twice the number of high affinity binding sites were present in fibroblasts grown from genital skin (foreskin, labia majora, and scrotum) as from nongenital sites (37 vs. 14 fmol/mg protein). In the density gradient assay in 5-10% sucrose, the major peak of dihydrotestosterone binding was in the 8S region in low molarity buffer and in the 4S region in 0.5 M KCl. High affinity binding was normal in cells from two patients with familial incomplete male pseudohermaphroditism, type 2, an autosomal recessive defect in which dihydrotestosterone formation is deficient, and in cells from a patient with male pseudohermaphroditism due to 17 beta-hydroxysteroid dehydrogenase deficiency, an autosomal recessive defect of testosterone synthesis. High affinity binding was low by both methods in fibroblasts from five patients with complete testicular feminization. Furthermore, binding by both methods was also low in cells from three subjects with familial incomplete male pseudohermaphroditism, type 1, a presumed X-linked recessive disorder of androgen resistance, and in fibroblasts grown from a subject with the incomplete form of testicular feminization. The finding that dihydrotestosterone binding is abnormal in two forms of hereditary androgen resistance in addition to complete testicular feminization suggests either that these disorders are the result of allelic mutations affecting the function of the androgen-binding protein or that normal dihydrotestosterone binding requires the participation of more than one gene product.
Work Continues on Extending Protection Against Haemophilus influenzae to Very Young Infants
Authors: Charles Marwick
Journal: JAMA (1990)

EVIDENCE that infants can be protected against<i>Haemophilus influenzae</i>type b is accumulating, but the goal of extending that protection to those as young as 2 months of age has not yet been reached. The evidence now is that the vaccine protects after the second dose, which is given at 6 months of age. So, if this schedule is followed, protection is expected by at least 7 months of age. (Although these vaccines have been available for several years, they heretofore have not been believed to be effective in children younger than 15 months.) A considerable effort has been made to develop a vaccine that has efficacy in very young infants. One of the candidates is a conjugate vaccine developed by Praxis Biologics, Rochester, NY, in which an oligosaccharide obtained from the bacterial capsule is coupled to a single diphtheria protein derived from a nontoxic variant of diphtheria toxin. This
The Cost of Admission — Tiered Copayments for Hospital Use
Authors: Robert Steinbrook
Journal: New England Journal of Medicine (2004)

After a period of more modest increases, spending on health care is again growing much faster than the rest of the U.S. economy (see Figure 1). Between 2001 and 2002, it increased by 9.3 percent, to $1.6 trillion, or $5,440 per person. Hospital spending, which represents about a third of all health care spending, increased by 9.5 percent, as compared with an average annual growth rate of 3.7 percent between 1993 and 2000.1 Soaring hospital expenses reflect many factors, including demand for new medications and technology, the aging of the population, and increased compensation for medical personnel.When health care spending . . .
Gangrene of the Lower Extremities of Infants after Femoral Venipuncture
Authors: Donald C. Nabseth, Jimmy E. Jones
Journal: New England Journal of Medicine (1963)

GANGRENE of the lower extremities after femoral venous or arterial puncture in sick infants is a danger that is not widely appreciated. The rarity of the complication is indicated by the frequency of "femoral puncture" in pediatric practice and the lack of reported difficulty in the literature. Transient ischemic changes in the lower limb after femoral venipuncture are apparently not uncommon in the experience of a large pediatric service and are generally ascribed to a temporary period of arterial spasm. That this period of spasm may merge into persistently irreversible ischemia with gangrenous change in the lower extremity of a . . .
Unethical, a guilty secret, and still crazy after all these years
Authors: F. Godlee
Journal: BMJ (2014)

It’s now routine practice in most developed countries to ask patients about their experiences of healthcare, and patients and staff would reasonably expect this information to be used to improve care. Recent news that some patient reviews were in fact entered by NHS staff will do little to boost confidence in the process (doi:10.1136/bmj.g2279). Angela Coulter and colleagues add their own rather depressing account of the current situation (doi:10.1136/bmj.g2225). Around the world we are busy, it seems, collecting data of all sorts on patients’ experiences, but the quality and types of data vary widely, making it hard to analyse and harder still to reap reliable conclusions. As a result, nothing changes. There may be other reasons: busyness, inertia, and lack of leadership, training, and …
The Transcription Factor T-bet Is Induced by IL-15 and Thymic Agonist Selection and Controls CD8αα+ Intraepithelial Lymphocyte Development
Authors: Christoph S.N. Klose, Katharina Blatz, Yannick d’Hargues, Pedro P. Hernandez, Michael Kofoed-Nielsen, Juliane F. Ripka, Karolina Ebert, Sebastian J. Arnold, Andreas Diefenbach, Ed Palmer, Yakup Tanriver
Journal: Immunity (2014)
Patients and the Habits of House Officers
Authors: Richard D. Blondell
Journal: JAMA (1987)

To the Editor.—  The data collected by Dunn et al 1 are valuable for faculty who are interested in enlightening students and residents about the importance of physician attire and etiquette. We were interested in obtaining similar information for our teaching activities. We found that unexpected and useful information concerning patient expectations of physician appearance can also be obtained using an open-ended format.  Study.—  During the summer of 1986, 12 photographs were made of people standing in front of a standard plain background. Their attire varied and included men with and without white coats, blue jeans, sneakers, and ties. Women wore either skirts or slacks with or without white coats. After obtaining informed consent in accord with University of Louisville policy, pairs of these photographs were shown to 90 patients waiting for routine care in the waiting rooms of private family practitioners or the university family practice center. Patients were
One Step Forward Toward Identification of the Genetic Signature of Glioblastomas
Authors: Boris Pasche
Journal: JAMA (2009)

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Effect of Written Feedback by Editors on Quality of Reviews
Authors: Michael L. Callaham, Robert K. Knopp, E. John Gallagher
Journal: JAMA (2002)

ContextBetter peer review is needed, but proven methods to improve quality are unknown. Our objective was to determine whether written feedback to reviewers improves subsequent reviews.MethodsEligible reviewers were randomized to intervention or control (receiving other reviewers' unscored reviews and the editor's decision letter). Study 1 (September 1998–September 2000) included reviewers with a median quality score of 3 or lower; study 2 (April 2000–January 2002), reviewers with median score of 4 or lower. Study 1 was designed with a power of 0.80 to detect a difference in score of 1; study 2, with a power of 0.80 to detect a difference of 0.5. All reviewers were at a peer-reviewed journal (Annals of Emergency Medicine). The main outcome measure was the editor's routine quality rating (1-5) of all reviews (blinded to study enrollment).ResultsFor study 1, 51 reviewers were eligible and randomized and 35 had sufficient data (182 reviews) for analysis. The mean individual reviewer rating change was 0.16 (95% confidence interval [CI], −0.26 to 0.58) for control and −0.13 (−0.49 to 0.23) for intervention. For study 2, 127 reviewers were eligible and randomized, and 95 had sufficient data (324 reviews). Controls had a mean individual rating change of 0.12 (95% CI, −0.20 to 0.26) and intervention reviewers, 0.06 (−0.19 to 0.31).ConclusionsIn study 1, minimal feedback from editors on review quality had no effect on subsequent performance of poor-quality reviewers, and the trend was toward a negative effect. In study 2, feedback to average reviewers was more extensive and supportive but produced no improvement in reviewer performance. Simple written feedback to reviewers seems to be an ineffective educational tool.