tbuckley/cabot-search huggingface dataset:
Bone lead measured by X-ray fluorescence: epidemiologic methods.
Authors: H Hu, A Aro, A Rotnitzky
Journal: Environmental Health Perspectives (1995)

In vivo X-ray fluorescence (XRF) measurement of bone lead concentration (XRF) has emerged as an important technique for future epidemiological studies of long-term toxicity. Several issues germane to epidemiologic methodology need to be addressed, however. First, sources of variability in measurements of bone lead need to be quantified, including imprecision related to the physical measurement itself and the variability of lead deposition over the two main compartments of bones (cortical vs. trabecular) and within each compartment. Imprecision related to the physical measurement can be estimated for each individual measurement based on the variability of the signal and background. Second, approaches to low-level data need to be debated. We argue for using the minimal detection limit (MDL) to compare instruments and interpret individual measurements; however, with regard to epidemiologic studies, we would abandon the MDL in favor of using all point estimates. In analyses using bone lead as an independent variable, statistical techniques can be used to adjust regression estimates based on estimates of measurement uncertainty and bone lead variability. Third, factors that can be expected to modify the relationship between bone lead and toxicity such as gravida history, endocrinological states, nutrition, and other important influences on bone metabolism, need to be identified and measured in epidemiologic studies. By addressing these issues, investigators will be able to maximize the utility of XRF measurements in environmental epidemiologic studies.
Randomised controlled trials: subgroup analyses
Authors: P. Sedgwick
Journal: BMJ (2014)

The effectiveness of wound edge protection devices in reducing surgical site infection after abdominal surgery was investigated. A randomised controlled trial was undertaken. The intervention was standard intraoperative care plus use of a wound edge protection device during the intra-abdominal part of the operation. The control was standard intraoperative care alone. The sample size for the trial was based on having 80% power to detect a 50% reduction in the infection rate, assuming a rate of 12% under standard care. A total sample size of 710 participants (355 in each arm) was needed. It was necessary to recruit 750 patients to the trial to allow for an estimated 5% dropout rate. In total, 760 patients undergoing laparotomy were recruited; 382 patients were allocated to the intervention group and 378 to the control group.1

The primary outcome was surgical site infection within 30 days of surgery, as assessed by clinicians who were blind to the patients’ device group allocation. Secondary outcomes included quality of life and duration of hospital stay. Subgroup analyses that compared surgical site infection within 30 days of surgery between the device groups were performed, with the aim of establishing whether the intervention was beneficial in particular groups of patients. The analyses incorporated 15 characteristics of the patients and the operations.

Six patients in the intervention group and five in the control group did not undergo laparotomy. Furthermore, seven patients in each group were lost to follow-up. Although the proportion of patients with surgical site infection was lower in the intervention group, the difference was not significant (24.7% (n=91) v 25.4% (n=93); odds ratio 0.97, 95% confidence interval 0.69 to 1.36; P=0.85). No significant difference was seen between the groups in the secondary outcomes (quality of life and duration of hospital stay). The subgroup analysis did not …
Enhanced targeted anticancer effects and inhibition of tumor metastasis by the TMTP1 compound peptide TMTP1-TAT-NBD
Authors: Ronghua Liu, Ling Xi, Danfeng Luo, Xiangyi Ma, Wanhua Yang, Yandong Xi, Hongyan Wang, Ming Qian, Liangsheng Fan, Xi Xia, Kezheng Li, Daowen Wang, Jianfeng Zhou, Li Meng, Shixuan Wang, Ding Ma
Journal: Journal of Controlled Release (2012)
Unilateral Tc-99m Pertechnetate Breast Uptake: Is it Always Benign?
Authors: Ekaterina Tiktinsky, Tifha Horne, Svetlana Agranovich, Sophie Landsberg
Journal: Clinical Nuclear Medicine (2007)

Although the thyroid gland is the principal organ with the ability to concentrate iodide and take up Tc-99m pertechnetate, other tissues such as choroid plexus, salivary glands, mucoid cells of stomach, and lactating breast tissue also possess this property. The lactating mammary gland can concentrate iodide, which mediated by sodium/iodine symporter (NIS) is actively transported and secreted in the milk, to supply iodide to the newborn for the biosynthesis of thyroid hormones. The authors present an uncommon case of unilateral Tc-99m breast uptake in a breast-feeding woman.
Uncontrolled Diabetes Mellitus in Adults: Experience in Treating Diabetic Ketoacidosis and Hyperosmolar Nonketotic Coma with Low-Dose Insulin and a Uniform Treatment Regimen
Authors: Patricia Carroll, Robert Matz
Journal: Diabetes Care (1983)

A number of changes in therapy of uncontrolled diabetes have occurred in recent years. These include low-dose insulin regimens, often routine phosphate repletion, more cautious bicarbonate replacement, infusion of larger fluid volumes, the use of hypotonic solutions in hyperosmolar states, and recently magnesium repletion. These modalities (with the exception of routine magnesium repletion) have been employed at North Central Bronx Hospital since its opening in 1976. Through this retrospective analysis of 275 cases of uncontrolled diabetes we have tried to answer the following questions: What is the outcome of all episodes of uncontrolled diabetes in a municipal hospital population with a uniform treatment protocol? What are the results of treatment with new modalities in various age groups? Are the causes of death different from those tabulated in previous reports? Our results indicate a good outcome in those under the age of 50 yr regardless of the diagnosis of hyperosmolar nonketotic coma (HNC) or diabetic ketoacidosis (DKA). Mortality from DKA was 2% in those under age 50 yr and 26% in the older age group. Surprising was the low mortality in the hyperosmolar group with 0% mortality under age 50 yr and 14% in patients over this age. The major categories of causes of death in the series included sepsis, adult respiratory distress syndrome (ARDS), metabolic, cardiovascular, and shock. With the exception of ARDS, these categories were not different from other reported series. There were few thromboembolic events in this series. We conclude that the newer therapeutic approaches are effective in the treatment of uncontrolled diabetes mellitus, both ketoacidotic and hyperosmolar, and that they can be used safely and effectively in managing these metabolic derangements in diabetic patients of all ages.
Left Ventricular Mass and Incidence of Coronary Heart Disease in an Elderly Cohort
Authors: Daniel Levy
Journal: Annals of Internal Medicine (1989)

To examine the association of echocardiographically determined left ventricular mass with incidence of coronary heart disease in an elderly cohort.Cohort study with a follow-up period of 4 years.Population-based.Elderly original volunteer subjects of the Framingham Heart Study who were free of clinically apparent coronary heart disease. This group included 406 men (mean age, 68 years: range, 60 to 90) and 735 women (mean age, 69 years: range, 59 to 90).During 4 years of follow-up, coronary heart disease events occurred in 37 men and 33 women. Baseline echocardiographically determined left ventricular mass was associated with incidence of coronary disease in both sexes (P less than 0.01). After adjusting for age, systolic blood pressure, smoking, and the ratio of total/high density lipoprotein cholesterol, the relative risk for a coronary event, per 50 g/m increment in left ventricular mass/height, was 1.67 in men (95% CI, 1.24 to 2.23) and 1.60 in women (95% CI, 1.10 to 2.32).Echocardiographic assessment of left ventricular mass offers prognostic information beyond that provided by traditional risk factors, which can improve our ability to identify individuals at high risk for coronary heart disease. These findings may have widespread implications regarding the applications of echocardiography in clinical practice.
Relation of blood viscosity to demographic and physiologic variables and to cardiovascular risk factors in apparently normal adults.
Authors: G de Simone, R B Devereux, S Chien, M H Alderman, S A Atlas, J H Laragh
Journal: Circulation (1990)

Although increased blood viscosity occurs in several cardiovascular diseases, little is known of factors influencing blood rheology in normal adults. Accordingly, we examined the relations of whole blood viscosity (WBV) to its rheologic determinants (hematocrit level, plasma viscosity, protein concentration, and red cell aggregability and rigidity), to demographic and laboratory variables, and to cardiovascular risk factors in 128 normotensive employed adults. Hematocrit levels accounted for 67-84% of variability of WBV at shear rates from 208 to 0.1 sec-1 with lesser contributions from plasma viscosity, red cell aggregability, and rigidity (multiple r = 0.95-0.97); WBV was predicted accurately from standard measurements of hematocrit and total plasma protein levels (multiple r = 0.78-0.92 in "learning" and "test" analysis). Male sex, obesity, dietary Na+ intake, and increasing age had additive effects on WBV (multiple r greater than or equal to 0.59, p less than 0.00001); the last three of these factors and black race independently predicted plasma viscosity (multiple r = 0.36, p less than 0.001). Among regulators of plasma volume, plasma renin activity and urinary Na+ excretion bore independent positive relations to WBV. Diastolic and mean blood pressures were independent predictors of WBV and hematocrit levels (all p less than 0.05). Conventional risk factors (e.g., triglycerides, obesity, and cholesterol levels) were positively related to WBV or plasma viscosity. Thus, in apparently normal adults, 1) WBV or plasma viscosity are increased by male sex, obesity, high sodium intake, aging, and black race, 2) WBV is positively related to plasma renin activity, 3) WBV or plasma viscosity are related to diastolic and mean blood pressures, triglycerides and cholesterol concentrations, and 4) WBV can be predicted from simple measurements of hematocrit and total plasma protein levels.
Transplant Tourism in China: A Tale of Two Transplants
Authors: Rosamond Rhodes, Thomas Schiano
Journal: The American Journal of Bioethics (2010)

The use of organs obtained from executed prisoners in China has recently been condemned by every major transplant organization. The government of the People's Republic of China has also recently made it illegal to provide transplant organs from executed prisoners to foreigners transplant tourists. Nevertheless, the extreme shortage of transplant organs in the U.S. continues to make organ transplantation in China an appealing option for some patients with end-stage disease. Their choice of traveling to China for an organ leaves U.S. transplant programs with decisions about how to respond to the needs of patients who return after transplantation. By discussing two cases that raised this dilemma, we argue for upholding medicine's commitments to traditional principles of beneficence and nonjudgmental regard in sorting out the policies that a transplant program should adopt. We also explain how position statements that aim for the high ground of moral purity fail to give appropriate weight to the needs and suffering of present and future patients in the U.S. and in China.
Teledermatology in the U.K.: lessons in service innovation
Authors: T.L. Finch, F.S. Mair, C.R. May
Journal: British Journal of Dermatology (2006)

Teledermatology has the potential to revolutionize the delivery of dermatology services by facilitating access to specialist services at a distance. In the U.K. over the previous decade there have been numerous attempts at introducing and using teledermatology; however, the development of teledermatology as routine service provision remains limited.To identify factors that promote successful use of teledermatology as a part of routine service provision.A longitudinal qualitative study of teledermatology, drawing on data from in-depth semistructured interviews; observations of systems in practice; and public meetings. Data were analysed collectively by the research team using established qualitative analytical techniques to identify key thematic categories. The sample consisted of teledermatology services within the U.K. (n = 12) studied over 8 years (1997-2005). Individual participants (n = 68 interviews) were consultant dermatologists, researchers, teledermatology nurses, administrators, patient advocates, general practitioners and technologists.The analysis compared services that did or did not become part of routine healthcare practice to identify features that supported the normalization of teledermatology. Requirements for using and integrating teledermatology into practice included: political support; perceived benefit and relative commitment that outweighs effort; pragmatic approaches to proving efficacy and safety; perception of risk as being 'manageable' on the basis of professional judgement; high levels of flexibility in practice (in terms of individuals, technology and organization); and reconceptualizing professional roles.Successful implementation of teledermatology as a routine service requires greater understanding of and attention to the interplay between social and technical aspects of teledermatology, and how this is accommodated both by healthcare professionals and the organizations in which they work.
Evidence for Functional Heterogeneity of Circulating B-Type Natriuretic Peptide
Authors: Faquan Liang, Jessica O’Rear, Ute Schellenberger, Lungkuo Tai, Michael Lasecki, George F. Schreiner, Fred S. Apple, Alan S. Maisel, N. Stephen Pollitt, Andrew A. Protter
Journal: Journal of the American College of Cardiology (2007)
Expression of dystrophin driven by the 1.35-kb MCK promoter ameliorates muscular dystrophy in fast, but not in slow muscles of transgenic mdx mice
Authors: Patrick Dunant, Nancy Larochelle, Christian Thirion, Rolf Stucka, Daniel Ursu, Basil J Petrof, Eckhard Wolf, Hanns Lochmüller
Journal: Molecular Therapy (2003)

Successful gene therapy of Duchenne muscular dystrophy may require the lifelong expression of a therapeutic gene in all affected muscles. The most promising gene delivery vehicles, viral vectors, suffer from several limitations, including immunogenicity, loss of therapeutic gene expression, and a limited packaging capacity. Therefore, various efforts were previously undertaken to use small therapeutic genes and to place them under the control of a strong and muscle-specific promoter. Here we report the effects of a minidystrophin (6.3 kb) under the control of a short muscle-specific promoter (MCK 1.35 kb) over most of the lifetime (4-20 months) of a transgenic mouse model. Dystrophin expression remained stable and muscle-specific at all ages. The dystrophic phenotype was greatly ameliorated and, most importantly, muscle function in limb muscles was significantly improved not only in young adult but also in aged mice compared to nontransgenic littermates. Dystrophin expression was strong in fast-twitch skeletal muscles such as tibialis anterior and extensor digitorum longus, but weak or absent in heart, diaphragm, and slow-twitch muscles. Additionally, expression was strong in glycolytic but weak in oxidative fibers of fast-twitch muscles. This study may have important implications for the design of future gene therapy trials for muscular dystrophy.
Effect of bisphenol A on murine immune function: modulation of interferon-gamma, IgG2a, and disease symptoms in NZB X NZW F1 mice.
Authors: Catherine Sawai, Katherine Anderson, Debby Walser-Kuntz
Journal: Environmental Health Perspectives (2003)

To investigate the effects of the estrogen receptor-binding molecule bisphenol A (BPA) on murine immune function in vivo, we fed a low dose of 2.5 micro g BPA/kg body weight/day to both normal C57BL/6 and lupus-prone NZB X NZW F(1) (NZB/NZW) 5-week-old mice for 1 week. Analysis of concanavalin A (ConA)-stimulated splenic mononuclear cells by ELISA demonstrated that BPA-fed C57BL/6 males produced, on average, 40% less interferon-gamma (IFN-gamma; p < 0.01) and C57BL/6 females 28% less IFN-gamma (p < 0.05) compared with controls. Treated female NZB/NZW mice were monitored for lupus disease symptoms, defined as proteinuria (> 100 mg/dL albumin in urine for 2 consecutive weeks). Before the development of proteinuria, BPA-fed NZB/NZW mice produced significantly less ConA-stimulated IFN-gamma than did controls and displayed an average reduction of 50% in immunoglobulin G2a (IgG2a) antibody production from lipopolysaccharide (LPS)-stimulated splenocytes (p < 0.05). It is striking that 5-week-old female NZB/NZW mice fed a 7-day low-dose course of BPA developed proteinuria an average of 7 weeks later than did controls. Once proteinuria developed, splenocytes were stimulated with ConA for cytokine analysis. The BPA-fed mice showed a dramatic reduction of 64% in IFN-gamma production and a 32% reduction in ConA-stimulated interleukin-10 (p < 0.05). The long-lasting effects of BPA on IFN-gamma and IgG2a production likely contributed to the increased symptom-free period of the NZB/NZW mice.
Poor economy means more Americans have trouble paying medical bills
Authors: J. H. Tanne
Journal: BMJ (2008)

A selected germplasm of whiplash pappusgrass (<i>Pappophorum vaginatum</i> Buckley [Poaceae]) has been released for rangeland seeding, saline soil revegetation, and wildlife habitat restoration plantings in south Texas. Webb Germplasm whiplash pappusgrass is a blend of 3 accessions selected from an evaluation at multiple sites in the intended area of use. Selections were made based on visual evaluations of plant characteristics and germination tests of seed collected from each location. Following selection, components of the germplasm were increased in isolation and blended following harvest to ensure inclusion of seed of each selected accession. Accessions included in the blend originate from 3 counties and distinct soil types. This germplasm represents the first commercial release of a whiplash pappusgrass ecotype originating from south Texas.
Toxic Shock Syndrome Associated With Surgical Wound Infections
Authors: Paul Bartlett
Journal: JAMA (1982)

In 13 cases of toxic shock syndrome (TSS) associated with postoperative wound infections, clinical findings were similar to those observed in cases of TSS in menstruating women. While local signs of a surgical wound infection were minimal,<i>Staphylococcus aureus</i>was recovered from cultures of wounds in 12 of 12 patients; multiple blood cultures were negative for 11 of 11 patients. Toxic shock syndrome due to surgical wound infections accompanied a wide variety of surgical procedures in both men and women and was not necessarily associated with menstruation in women. The median interval between surgery and onset of TSS was two days. Toxic shock syndrome can develop in association with surgical wound infections caused by<i>S aureus</i>and should be considered in the differential diagnosis of postoperative fever and hypotension. (<i>JAMA</i>1982;247:1448-1450)
1277 PDGF-BB induces thrombospondin-1 expression in a SRC-dependent manner leading to activation of latent TGF-β in hepatic stellate cells
Authors: K BREITKOPF, I SAWITZA, A GRESSNER
Journal: Hepatology (2003)

To investigate the impact of radioembolization with yttrium-90 resin microspheres on the regulation of angiogenesis through observation of serial changes in a spectrum of angiogenic markers and other cytokines after therapy.This prospective pilot study enrolled 22 patients with liver-dominant disease deriving from biopsy-proven hepatocellular carcinoma (HCC) (n = 7) or metastatic colorectal carcinoma (mCRC) (n = 15). Circulating angiogenic markers were measured from serum samples drawn at baseline and at time points after therapy ranging from 6 hours to 120 days. Using multiplex enzyme-linked immunosorbent assay, several classic angiogenesis factors (vascular endothelial growth factor [VEGF], angiopoietin-2 [Ang-2], basic fibroblast growth factor [bFGF], platelet-derived growth factor subunit BB [PDGF-BB], thrombospondin-1 [Tsp-1]) and nonclassic factors (follistatin, leptin, interleukin [IL]-8) were evaluated.Increases in cytokine levels ≥ 50% over baseline were observed in more than half of all patients studied for many cytokines, including classic angiogenic factors such as VEGF, Ang-2, and Tsp-1 as well as nonclassic factors IL-8 and follistatin (range, 36%–82% for all cytokines). Baseline cytokine levels in patients with overall survival (OS) < 6 months differed significantly from patients with longer survival for Ang-2 (P = .033) and IL-8 (P = .041). Patients with OS ≤ 6 months exhibited transient increases in VEGF and PDGF-BB after therapy compared with patients with OS > 6 months.Radioembolization is associated with early transient increases in many angiogenic cytokines. In this small sample size, some of these changes were associated with worse OS. This research has important implications for future studies of radioembolization with antiangiogenic therapy performed during and after the procedure.
Regular exercise reduces risk of dementia and Alzheimer's disease
Authors: Susan Mayor
Journal: BMJ (2006)

More evidence for the “use it or lose it” approach to ageing has come from a study published this week showing that older adults who exercised three or more times a week had a significantly lower risk of developing dementia than adults who exercised less ( Annals of Internal Medicine 2006;144: 73-81).

The study included a randomly selected group of 1740 adults aged 65 years or older with normal cognitive function, as assessed by the Cognitive …
STATE MEDICINE IN PENNSYLVANIA AND HOW WE MAY INCREASE ITS EFFICIENCY.
Authors: EUGENE O. BARDWELL
Journal: JAMA (1896)

The State Board of Health and Vital Statistics of Pennsylvania was organized in June, 1885, so that its existence covers a period of a little less than eleven years. The appropriation made for it on its natal day called for $5,000 per year, and the appropriation made ten years later was for $6,000 per year, so you may easily judge that there has been no great development of cerebral matter in the legislature of our good Keystone State during the past ten years. Out of this enormous sum $2,000 is paid to the secretary and executive officer of the board. I understand that the clerk of the board receives $1,500 per year, and this leaves the munificent sum of $2,500, which according to the terms of the act is to be expended, or so much of it as may be necessary, for postage, telegrams, express charges, rent, incidental office expenses,