tbuckley/cabot-search huggingface dataset:
AMA fights for improvements in Aborigines' health
Authors: C Zinn
Journal: BMJ (1994)

The Australian Medical Association (AMA) is pushing for a radical programme to improve Aborigines' health. The initiative comes from federal president Dr Brendan Nelson.

After a visit to Aboriginal communities in the Northern Territory Dr Nelson said that Aboriginal health was the “number one public health problem in Australia. I am determined to ensure that the AMA does all it can to support Aboriginal people and those at the cutting edge of Aboriginal health,” …
Current Concepts of Parenteral Fat Nutrition.
Authors: G. H. Becker
Journal: Annals of Internal Medicine (1961)

s1 May 1961Current Concepts of Parenteral Fat Nutrition.G. H. Becker, M.D., (Assoc.)G. H. Becker, M.D., (Assoc.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-54-5-1042_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe development of a suitable fat emulsion for intravenous use has helped solve the problem of caloric deficiency which frequently exists in patients with inadequate oral nutrition. The use of intravenous fat has also provided an opportunity to study certain aspects of fat metabolism in various disease entities including diabetes mellitus and renal failure.Intravenous fat tolerance tests were performed in 148 chronically ill patients infused with a 15% cottonseed oil emulsion in doses of 1 gm./Kg. over a 3½ hour period. Total lipid, triglyceride, nonesterified fatty acids, and electrolyte levels were determined during and following the infusion. A consistent... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Ill. (CI) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byClinical Toxicology of Common Drugs and Chemicals: Colon*Colonic Toxicity of Administered Drugs and ChemicalsDrug-Induced Gastrointestinal DisordersDrug-induced gastrointestinal disease 1 May 1961Volume 54, Issue 5Page: 1042-1043KeywordsDiabetes mellitusFatsFatty acidsLipidsNutritionOilsRenal failure ePublished: 1 December 2008 Issue Published: 1 May 1961 PDF downloadLoading ...
Calcium and colorectal epithelial cell proliferation.
Authors: J H Kleibeuker, N H Mulder, A Cats, R van der Meer, E G de Vries
Journal: Gut (1996)

2000, Synectics) is currently the best method to measure DGR quantitatively31 in the fast- ing and postprandial state, during day and night.This technique was not available when we carried out our study, and it is still under investigation and standardisation.3We also agree with the comment that 'normal' subjects have various degrees of DGR, but studies of 'normal' subjects have not discriminated H pylon positive and negative persons.'4 However, it has recently been shown that patients with type B gastritis have a high incidence of DGR.5 This study lends support to the results of our experiments, where we have shown that significantly more patients who had DGR were H pylori positive (91 v 44%, p=001) and that DGR is reduced after successful H pylon eradication.These evidences justify our statement that 'H pylon may induce DGR'.
Donor conceived children shouldn't have right to be told of their origins, says Nuffield Council
Authors: I. Torjesen
Journal: BMJ (2013)

Children conceived from donated sperm or eggs should not have an automatic right to be told about their conception, recommends a report from the Nuffield Council on Bioethics.1

It should be up to the child’s legal parents to decide whether to make the child aware that he or she was donor conceived, says the report. It adds, however, that parents need more support to help them make and follow through on this difficult decision.

The report says that the state has an ethical responsibility to ensure that appropriate support is provided to donor conceived people, their families, and donors at all stages. It says that this support could come from a variety of sources, including fertility clinics, which should increase the level of counselling offered to prospective parents, new parents, and potential donors. Support services should also be available to donor conceived people who contact the Human Fertilisation and Embryology Authority to find …
Gastric Acid Secretion in Chronic Uraemia and after Renal Transplantation
Authors: J. C. Gingell, G. P. Burns, G. D. Chisholm
Journal: BMJ (1968)

In 45 patients with chronic uraemia the basal acid output was the same as in 22 controls. Maximal acid output in uraemic patients was less than in the controls but not significantly so. In uraemia the maximal acid output was directly related to the duration of uraemia and inversely related to both haemoglobin level and age; it was not related to the height of the blood urea. Neutralization of gastric acid by ammonia probably occurred in the basal juice, but not when acid secretion was maximally stimulated. The presence of secondary hyperparathyroidism was associated with a 50% increase in the maximal acid output, but the increase may have been due to the younger age of this group.Successful renal transplantation was followed in two out of seven patients by a considerable increase in acid output and both patients showed evidence of peptic ulceration.
Pregnancy in patients with β-thalassemia intermedia: Outcome of mothers and newborns
Authors: Anwar H. Nassar, Ihab M. Usta, Johnny B. Rechdan, Suzanne Koussa, Adlette Inati, Ali T. Taher
Journal: American Journal of Hematology (2006)

Little is known about the outcome of pregnancy in women with beta-thalassemia intermedia (TI). Over 10 years, maternal and neonatal outcomes of women with TI followed at a single thalassemia center were reviewed. Nine spontaneous pregnancies in five women with TI were studied. Six pregnancies resulted in live newborns; two were complicated by first-trimester abortions and one by an unexplained intrauterine fetal death at 36 weeks' gestation. Two patients had splenectomy before pregnancy: one required cesarean delivery and splenectomy at 31(2/7) weeks' gestation for worsening hemolytic anemia and thrombocytopenia and another had splenectomy 8 weeks postpartum for symptomatic hypersplenism. Two patients had received transfusions before pregnancy, and two required them for the first time during pregnancy and developed antibodies, which contributed to worsening of their anemia and repeated transfusions. The mean number of transfusions received during pregnancy was 8.0 +/- 5.2 units. The mean lowest hemoglobin level in pregnancy was 5.2 +/- 2.0 g/dl. Cesarean delivery was performed in 42.9% of cases. Mean gestational age at delivery was 36.7+/- 3.1 weeks with intrauterine growth restriction (IUGR) complicating 57.1% of cases. In conclusion, IUGR complicates more than half of pregnancies with TI. Transfusions are needed in most cases, even in non-transfusion-dependent patients. Postpartum splenectomy might be necessary in some patients.
Nearly half of over 40s in US would be candidates for statins under new guidance
Authors: M. McCarthy
Journal: BMJ (2014)

Implementation of the most recent guidelines on treating high cholesterol from the American College of Cardiology and the American Heart Association would make 48.6% of US adults aged 40 to 75 years candidates for treatment with statins, a new analysis finds.1

That would be 12.8 million more people than under the preceding established recommendations of the Third Adult Treatment Panel (ATP III) of the National Cholesterol Education Program.2 3

The analysis was published online this week by the New England Journal of Medicine . Michael J Pencina of the Duke Clinical Research Institute at Duke University in Durham, North Carolina, is the paper’s lead author.

Under the older guidelines, statin treatment was recommended for patients with …
Percutaneous Transluminal Dilatation for Renovascular Hypertension
Authors: DAVID A. MCCARRON
Journal: Annals of Internal Medicine (1980)

Letters and Corrections1 June 1980Percutaneous Transluminal Dilatation for Renovascular HypertensionDAVID A. MCCARRON, M.D.DAVID A. MCCARRON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-92-6-865_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article by Kuhlmann and colleagues (1) and the accompanying editorial in the January 1980 (2) issue both point out the need for long-term follow-up data on patients with renovascular hypertension treated by percutaneous transluminal dilatation. Two aspects of the article concern me: First, why did the authors choose to report only subjects with unilateral disease involving the left side; second, a number of cases seem to be the same ones that the authors described at the 51st Scientific Session of the American Heart Association (3) in November 1978. If the abstract was submitted by the deadline...References1. KUHLMANN U, VETTER W, FURRER J, LÜTOLF U, SIEGENTHALER W, and GRÜNTZIG A. Renovascular hypertension: treatment by percutaneous transluminal dilatation. Ann Intern Med. 1980;92:1-6. LinkGoogle Scholar2. GRIM C, YUNE H, WEINBERGER M, KLATTE E, and RYAN M. Balloon dilatation for renal artery stenosis causing hypertension: criteria, concerns, and cautions. Ann Intern Med. 1980;92:117-9. Editorial. LinkGoogle Scholar3. GRUNTZIG A, KUHLMANN U, VETTER W, and FURRER J. Percutaneous transluminal dilatation of atherosclerotic renal artery stenosis. Circulation. 1978;58(suppl II):II-213. Abstract. Google Scholar1. KUHLMANN U, VETTER W, FURRER J, LÜTOLF U, SIEGENTHALER W, and GRÜNTZIG A. Renovascular hypertension: treatment by percutaneous transluminal dilatation. Ann Intern Med. 1980;92:1-6. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DAVID A. MCCARRON, M.D.Affiliations: University of Oregon Health Sciences Center Portland, OR 97201 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1980Volume 92, Issue 6Page: 865-866KeywordsCardiovascular therapyHeart diseasesHypertension ePublished: 1 December 2008 Issue Published: 1 June 1980 PDF downloadLoading ...
Female sexual dysfunction
Authors: Vivian Lewis
Journal: BMJ (2005)

A common clinical problem 

In this issue (p 138), Ray Moynihan argues that female sexual dysfunction is essentially an invention of big pharmaceutical companies. He accuses Procter and Gamble of aggressively marketing awareness of a type of sexual dysfunction—female hypoactive desire disorder—to create a need for its new drug, transdermal testosterone (Intrinsa), which recently failed to gain FDA approval. Moynihan further calls for less influence of marketing on decisions about this condition and its treatment. Clearly, we are well served as physicians and patients by maintaining our objectivity and seeking unbiased sources of health information. But I disagree with Moynihan about the diagnosis of female sexual dysfunction.

The most widely cited prevalence rate of 43% for female sexual dysfunction was actually derived through indirect means.1 Laumann et al applied a statistical technique (latent class analysis) to data from a survey of 1749 women and 1410 men. Far from being a big pharma initiative, this study was funded by the National Institutes of Health (NIH) and the Ford Foundation. The proportion of women who described lack of interest in sex was 27-32%, depending on their age group.1 A …
A surgeon's hands
Authors: M. Rostom
Journal: BMJ (2014)

I remember when I was a young and budding doctor; people would look admiringly at my hands, smile knowingly, and say “you have the hands of a surgeon.” This was a wonderful compliment­; it generally meant you had elegant hands, long nimble fingers, and soft, unblemished skin. They were not heavy labourer’s hands—surgeon’s hands were for delicate work, they were for making art . . . or so I thought.

Yesterday, five years later, after …
As the world grows: contraception in the 21st century
Authors: R. John Aitken, Mark A. Baker, Gustavo F. Doncel, Martin M. Matzuk, Christine K. Mauck, Michael J.K. Harper
Journal: Journal of Clinical Investigation (2008)

Contraceptives that are readily available and acceptable are required in many poorer countries to reduce population growth and in all countries to prevent maternal morbidity and mortality arising from unintended pregnancies. Most available methods use hormonal steroids or are variations of barrier methods. Reports from several fora over the last 12 years have emphasized the number of unwanted pregnancies and resultant abortions, which indicate an unmet need for safe, acceptable, and inexpensive contraceptive methods. This unmet need can be assuaged, in part, by development of new nonhormonal contraceptive methods. This Review addresses the contribution that the "omic" revolution can make to the identification of novel contraceptive targets, as well as the progress that has been made for different target molecules under development.
Fetal Glucocorticoid-regulated Pathways Are Not Affected by Inhaled Corticosteroid Use for Asthma during Pregnancy
Authors: Nicolette A. Hodyl, Michael J. Stark, Annette Osei-Kumah, Maria Bowman, Peter Gibson, Vicki L. Clifton
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Rationale: Inhaled corticosteroids (ICS) are currently advised for the control of asthma during pregnancy, despite the lack of evidence regarding potential systemic effects on maternal, placental, and fetal systems.Objectives: To determine maternal plasma concentrations of cortisol, estriol, osteocalcin, and corticotropin-releasing hormone in pregnant women with asthma (n = 156) and without asthma (n = 51).Methods: During each trimester of pregnancy, the use and dose of ICS was recorded and blood samples were collected. Ultrasound was performed at 18 and 30 weeks' gestation, and birth weight and fetal sex were recorded at delivery.Measurements and Main Results: Maternal hormone concentrations were not affected by the presence of asthma; however, they were inhibited by ICS use in a dose-dependent manner. This was dependent on fetal sex: in pregnancies with a female, ICS was inversely associated with maternal cortisol in first trimester and inversely associated with maternal osteocalcin in second and third trimester. When pregnant with a male, no effect of ICS dose was observed on maternal cortisol, estriol, or osteocalcin levels, whereas corticotropin-releasing hormone levels were increased with ICS use only in the first trimester.Conclusions: Maternal glucocorticoid-regulated systems appeared susceptible to ICS only when pregnant with a female. Fetal adrenal function appeared unaffected by ICS in pregnancies of both males and females. This provides clinically important information suggesting that ICS do not exert effects on glucocorticoid-regulated pathways in the fetus, and therefore are unlikely to contribute to adverse effects on fetal growth and development.
Strategies to Minimize Risks and Exploitation in Phase One Trials on Healthy Subjects*
Authors: Adil E. Shamoo, David B. Resnik
Journal: The American Journal of Bioethics (2006)

Most of the literature on phase one trials has focused on ethical and safety issues in research on patients with advanced cancer, but this article focuses on healthy, adult subjects. The article makes six specific recommendations for protecting the rights and welfare of healthy subjects in phase one trials: 1) because phase one trials are short in duration (usually 1 to 3 months), researchers should gather more data on the short-term and long-term risks of participation in phase one studies by healthy subjects; 2) researchers should develop strict inclusion/exclusion criteria that exclude unhealthy or vulnerable subjects, such as decisionally impaired people, in phase one studies; 3) subjects should not participate in more than one phase one study at the same time and should wait at least 30 days between participating in different studies; 4) researchers should develop a database to keep track of phase one participants; 5) subjects should be guaranteed a minimum wage equivalent to the equivalent type of unskilled labor, but there should be no upper limits on wages; and 6) subjects should be allowed to engage in collective bargaining with research sponsors.
Issues in the risk assessment of chromium.
Authors: R E Albert
Journal: Environmental Health Perspectives (1991)

Although hexavalent chromium is well established as a human carcinogen by the inhalation route, there are significant uncertainties in the quantitative estimation of cancer risk. One of the important uncertainties is the assumption that the carcinogenic potency, determined under conditions of occupational exposure where most workers were cigarette smokers, applies to the nonsmoking individual in the general population. There is substantial evidence that carcinogenicity is a function of the rate of cell turnover in the target tissue. The chromate worker would be expected to have a relatively high rate of cell proliferation in the bronchial mucosa due to airborne irritants and smoking. The potency of chromium might therefore be relatively high under conditions of occupational exposure. This problem in quantitative risk assessment applies equally well to another important indoor pollutant, radon.
Case Report: High Prenatal Bisphenol A Exposure and Infant Neonatal Neurobehavior
Authors: Sheela Sathyanarayana, Joe M. Braun, Kimberly Yolton, Stacey Liddy, Bruce P. Lanphear
Journal: Environmental Health Perspectives (2011)

Most of the U.S. population is exposed to the high-production-volume chemical bisphenol A (BPA), but targetable sources of exposure remain to be determined. Animal studies and one human study suggest that BPA is a neurotoxicant.
Anti–protamine-heparin antibodies: incidence, clinical relevance, and pathogenesis
Authors: Tamam Bakchoul, Heike Zöllner, Jean Amiral, Simon Panzer, Sixten Selleng, Thomas Kohlmann, Sven Brandt, Mihaela Delcea, Theodore E. Warkentin, Ulrich J. Sachs, Andreas Greinacher
Journal: Blood (2013)
Neighborhood Socioeconomic Context and Long-Term Survival After Myocardial Infarction
Authors: Yariv Gerber, Yael Benyamini, Uri Goldbourt, Yaacov Drory
Journal: Circulation (2010)

Neighborhood of residence has been suggested to affect cardiovascular risk above and beyond personal socioeconomic status (SES). However, such data are currently lacking for patients with myocardial infarction (MI). We examined all-cause and cardiac mortality according to neighborhood SES in a cohort of MI patients.Consecutive patients < or =65 years of age discharged from 8 hospitals in central Israel after incident MI in 1992 to 1993 were followed up through 2005. Individual data were obtained at study entry, including education, income, and employment. Neighborhood SES was estimated through a composite census-derived index developed by the Israel Central Bureau of Statistics. During follow-up, 326 deaths occurred in 1179 patients. Patients residing in disadvantaged neighborhoods had higher mortality rates, with 13-year survival estimates of 61%, 74%, and 82% in increasing tertiles (P(trend)<0.001). After adjustment for sociodemographic variables, traditional risk factors, MI severity indexes, and individual SES measures, the hazard ratios for death associated with neighborhood SES were 1.47 (95% confidence interval, 1.05 to 2.06) in the lower and 1.19 (95% confidence interval, 0.86 to 1.63) in the middle tertiles compared with the upper tertile (P(trend)=0.02). The respective hazard ratios were even stronger for cardiac death (1.63; 95% confidence interval, 1.09 to 2.25; and 1.41; 95% confidence interval, 0.96 to 2.07). In the final models, neighborhood context and several individual SES measures were concurrently associated with all-cause and cardiac mortality.Neighborhood SES is strongly associated with long-term survival after MI. The association is partly, but not entirely, attributable to individual SES and clinical characteristics. These data support a multidimensional relationship between SES and MI outcome.
A72: Predicting Progression From Oligoarticular to Polyarticular Juvenile Arthritis
Authors: Dax Rumsey, Elham Rezaei, Chandima Karunanayake, Kiem Oen, Alan M. Rosenberg, Natalie Shiff
Journal: Arthritis & Rheumatology (2014)

Background/Purpose:

It has been previously shown that early involvement of wrist and ankle are risk factors for extension of oligoarticular onset juvenile arthritis (oligoJA). Our objective was to determine whether early wrist, ankle, upper limb, or lower limb involvement are risk factors for extension to a polyarticular course in a cohort of paediatric patients with oligoJA.



Methods:

This is a retrospective cohort study of children with oligoJA presenting to paediatric rheumatology clinics at the two Canadian paediatric centres from 1981 to 2010. OligoJA was defined as ≤4 joints at the first and 6 month visits. Risk factors for extension from oligoJA to polyarthritis (>5 joints) by 2 and 5 years after diagnosis were modelled using logistic regression while controlling for sex, ever having used DMARDs, or intraarticular corticosteroid injections. Time to extension was assessed using Cox proportional hazard analysis.



Results:

420 patients met eligibility criteria. 56% were female. The median time from disease onset to diagnosis was 136 days (IQR 55.5 days, 365.0 days); 15 patients in the logistic regression models extended by 2 years (n=280, of which 5.4% extended) and 27 by 5 years (n=339, of which 8.0% extended). At 2 years after diagnosis the odds of extension was 6.1 times higher (95% CI 1.9, 24.3) in those with initial wrist involvement than in those without, and at 5 years it was 3.1 times higher (95% CI 1.0, 8.0). The OR of extension in those with initial upper limb involvement versus those without was 7.0 (95% C.I. 2.3, 21.6) at 2 years and 6.3 (95% C.I. 2.5, 15.8) at 5 years. Cox proportional hazard modelling showed a HR of 2.3 (95% CI 1.2, 4.5) in patients with upper limb involvement compared to without upper limb involvement indicating that extension was 2.3 times more likely to occur in the former group. The likelihood ratio was 68.7, p value < 0.0001, degrees of freedom (d.f) = 4, and events per variable = 9.8.



Conclusion:

This study independently confirms previous published findings that wrist and upper limb arthritis in the first 6 months after diagnosis of oligoJA is a risk factor for extension. Unlike previous reports, we did not find an increased probability of extension in patients with early ankle arthritis. Patients with upper limb arthritis in the first 6 months after diagnosis were more likely to extend sooner than those without early upper limb arthritis.
Nuffield Trust praises ambitious NHS plans but calls for better monitoring
Authors: A. Ferriman
Journal: BMJ (2003)

The Nuffield Trust this week praised the government for its comprehensive effort to improve the quality of care in the NHS but also called for the setting up of a centre to provide regular independent reports of NHS performance.



Based on an 18 month research project, the report summarises what the Labour government has achieved since it came to power in 1997.



Professor Sheila Leatherman, one of the authors and research professor at the School of Public Health at the University of North Carolina, said: “We believe this …