tbuckley/cabot-search huggingface dataset:
Surgical management of metastatic inguinal lymphadenopathy: Authors' reply
Authors: Marc C Swan, Dominic Furniss, Oliver C S Cassell
Journal: BMJ (2005)

Electronic data protection: procedures need drastic improvementEditor-Gulena et al are correct to challenge overzealous interpretation of data protection law in their questionnaire survey of patients' and visitors' views about having their names displayed in hospital. 1Measures taken by doctors to safeguard patient confidentiality, especially electronic records, are, however, severely deficient and fuel the concerns of those entrusted to police data security.We invited 32 surgical trainees to complete a questionnaire regarding their Data Protection Act registration and electronic data confidentiality practices.Of 29 responders, 26 trainees regularly computerised and stored patients' data.One person was registered with the Data Protection Act.Only three of 14 desktops, eight of 19 laptops, and three of 14 handheld computers forced a password logon.Sixteen of 29 trainees used the same password for all machines, and 25 of 27 passwords were less than eight characters long.All desktops, 16 of 19 laptops, and five of 14 handhelds were routinely connected to the internet, and half of these had not had their online security settings adjusted.Of 29 trainees, 28 did not encrypt their sensitive data files.Ten trainees had sent patients' data unencrypted over the internet, using a non-secure server.Electronic data confidentiality practices among surgical trainees are unsafe, and this is unlikely to be confined to our study population.A breach in confidentiality would have widespread implications for public trust.][4] Existing passwords should be improved, and biometric logon systems (fingerprint scanning) considered.Files containing sensitive data should be routinely encrypted.Magnetic and solid state computer storage devices (including hard disks, floppy disks, CD Roms, DVD Roms, and memory sticks) should undergo routine physical or electronic data shredding after their final use. 5 We are implementing medical information technology security training for this particu-lar group of doctors and would urge others to initiate similar programmes before a serious breach occurs.
Adeboye Oluwole Ogunmekan
Authors: D. A. Ogunmekan
Journal: BMJ (2012)

Adeboye Oluwole Ogunmekan started his career by doing house jobs in South Shields and also in Lagos University Teaching Hospital. He obtained the FRCP of Edinburgh in 1984, of Glasgow in 1984, and of London in 1987. He trained as a paediatric neurologist …
THE EFFECT OF A GLYCOSIDE OF MONO AND DIGLYCEROL (GOPO<sup>®</sup>) SUPPLEMENTATION ON PASSIVE KNEE JOINT FORCES AND SUBJECTIVE ASSESSMENT OF PAIN IN A NON-ARTHRITIC POPULATION
Authors: R Scaife
Journal: British Journal of Sports Medicine (2013)

We investigated whether ingesting a supplement containing GOPO ® has an effect on the passive forces during flexion/extension of the knee and self-reported pain in active non-arthritic participants. Thirty physically active male participants between the ages of 35–60 were randomly allocated to either placebo or active supplement groups. Measurements of body composition, hydration, physical activity, subjective aches/pains and passive lower leg forces were recorded at baseline and 2, 6 and 12 weeks, using a Biodex System 3 isokinetic dynamometer at 5, 60, 90, and 120 degrees per second. Both groups reported a drop in mean perceived aches and pains between baseline and 12 weeks, the decrease was greater for the active group 14% compared to 8% in the placebo group. At the slower speed (5° per second) there was a mean decrease in passive total work during knee flexion and extension of 8.4% and 13.7% respectively in the active group after 12 weeks when compared to baseline. The placebo group showed no such reduction (0.5% decrease in flexion and 0.7% decrease in extension). The decrease in passive torque observed at the slower speeds following 12 weeks of supplement ingestion showed promising trends that warrant further investigation. A general reduction in passive torque might indicate a change in the compliancy of the series and parallel elastic components or a change in cartilage compliance which might in the long term reduce joint degeneration.
Artificial Organs and Cardiopulmonary Support Systems
Authors: John J. Bergan
Journal: JAMA (1972)

A wide experience in development of the artificial kidney, lung, and heart for clinical application is gathered together in this slim volume. Its 23 papers and wise summation by John Merrill give a needed interpretation of the field of artificial organs as viewed at the end of 1971. Lasting value is enclosed in the views of Belding Scribner at the beginning and Merrill's closing remarks at the end. Scribner draws upon his vast experience to detail a precise past relationship and future applicability of renal dialysis and kidney transplantation in treating patients with kidney failure. His prophetic remarks show clearly how institution of early treatment, avoidance of blood transfusions, and adherence to a life plan for each patient allow individualization of care without blind acceptance of renal dialysis or of transplantation for total renal failure. He is able to elucidate clearly the controversial problems of contraindications to transplantation and limitations
Depolarization-Repolarization Inhomogeneity After Repair of Tetralogy of Fallot
Authors: Michael A. Gatzoulis, Jan A. Till, Andrew N. Redington
Journal: Circulation (1997)

We have previously shown that QRS prolongation (> or = 180 ms) is a risk marker for sustained ventricular tachycardia (VT) late after repair of tetralogy of Fallot (rTOF). We have now examined the dispersion of QT and its components QRS and JT, in an attempt to determine whether any association exists between these measurements and the presence of VT in these patients.QRS duration and QT/QRS/JT dispersion were measured manually from standard ECGs in 10 syncopal rTOF patients (21.4 +/- 4.6 years after repair; group 1) with QRS > or = 180 ms and with documented VT and were compared with 9 rTOF patients with QRS > or = 180 ms and no VT (group 2), 40 rTOF patients with QRS < 180 ms and no clinical arrhythmias (group 3), and 40 nontetralogy control subjects (20 with right bundle-branch block [group 4] and 20 with normal ECG patterns [group 5]). Mean QT dispersion (62 +/- 36 ms) in the tetralogy patients was greater than in the nontetralogy control subjects (34 +/- 10 ms, P < .001). There were significant differences in all measured parameters between groups 1 and 3 and more importantly between groups 1 and 2. QRS dispersion in group 1 also correlated with QRS duration but not with JT dispersion.Our data suggest that both depolarization and repolarization abnormalities are associated with VT after rTOF. Furthermore, increased QT, QRS, and JT dispersions, combined with a QRS > or = 180 ms, refine risk stratification for VT in these patients.
Sulfasalazine and Folate Deficiency
Authors: Enrique Spindel
Journal: JAMA (1983)

<h3>To the Editor.—</h3> The letter entitled "Sulfasalazine and Folate Deficiency" (1983;249:729) describes an interesting case of ulcerative colitis and severe anemia with associated direct Coombs' test positivity and folate deficiency. The conclusions of the author about the relationship between sulfasalazine and folate deficiency may be misleading and have thus prompted this letter. Although sulfasalazine inhibits folate absorption, anemia caused by folate deficiency is not common in patients with ulcerative colitis and adequate dietary intake of folate. Macrocytic anemia caused by folate deficiency has been documented to occur in only 2.5% of patients with ulcerative colitis.<sup>1</sup>Furthermore, folate deficiency in this small number of patients may have other causes such as celiac disease, nutritional deficiencies, and hemolysis.<sup>1</sup> Folate deficiency can occur because of chronic hemolysis of any cause and may have occurred in the patient described by Dr Goldberg. In addition, the fact that the patient suffered from ulcerative
Community, Context, and the Contrasting Roles of Clinicians and Researchers: Challenges Raised by Statutory Rape
Authors: Stuart G. Finder, Stanley Korenman
Journal: The American Journal of Bioethics (2014)

Click to increase image sizeClick to decrease image size FUNDINGThis commentary was supported by the National Center for Advancing Translational Sciences (UL1 TR000124). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Evaluating the Quality of Research into a Single Prognostic Biomarker: A Systematic Review and Meta-analysis of 83 Studies of C-Reactive Protein in Stable Coronary Artery Disease
Authors: Harry Hemingway, Peter Philipson, Ruoling Chen, Natalie K. Fitzpatrick, Jacqueline Damant, Martin Shipley, Keith R. Abrams, Santiago Moreno, Kate S. L. McAllister, Stephen Palmer, Juan Carlos Kaski, Adam D. Timmis, Aroon D. Hingorani
Journal: PLoS Medicine (2010)

Background Systematic evaluations of the quality of research on a single prognostic biomarker are rare. We sought to evaluate the quality of prognostic research evidence for the association of C-reactive protein (CRP) with fatal and nonfatal events among patients with stable coronary disease. Methods and Findings We searched MEDLINE (1966 to 2009) and EMBASE (1980 to 2009) and selected prospective studies of patients with stable coronary disease, reporting a relative risk for the association of CRP with death and nonfatal cardiovascular events. We included 83 studies, reporting 61,684 patients and 6,485 outcome events. No study reported a prespecified statistical analysis protocol; only two studies reported the time elapsed (in months or years) between initial presentation of symptomatic coronary disease and inclusion in the study. Studies reported a median of seven items (of 17) from the REMARK reporting guidelines, with no evidence of change over time. The pooled relative risk for the top versus bottom third of CRP distribution was 1.97 (95% confidence interval [CI] 1.78–2.17), with substantial heterogeneity (I2 = 79.5). Only 13 studies adjusted for conventional risk factors (age, sex, smoking, obesity, diabetes, and low-density lipoprotein [LDL] cholesterol) and these had a relative risk of 1.65 (95% CI 1.39–1.96), I2 = 33.7. Studies reported ten different ways of comparing CRP values, with weaker relative risks for those based on continuous measures. Adjusting for publication bias (for which there was strong evidence, Egger's p<0.001) using a validated method reduced the relative risk to 1.19 (95% CI 1.13–1.25). Only two studies reported a measure of discrimination (c-statistic). In 20 studies the detection rate for subsequent events could be calculated and was 31% for a 10% false positive rate, and the calculated pooled c-statistic was 0.61 (0.57–0.66). Conclusion Multiple types of reporting bias, and publication bias, make the magnitude of any independent association between CRP and prognosis among patients with stable coronary disease sufficiently uncertain that no clinical practice recommendations can be made. Publication of prespecified statistical analytic protocols and prospective registration of studies, among other measures, might help improve the quality of prognostic biomarker research. Please see later in the article for the Editors' Summary
PWE-107 Osteoporosis in Crohn’S Disease Patients Expressing an Autophagy-Related Atg16L1 Gene Variant: Abstract PWE-107 Table
Authors: N Azzopardi, P Ellul, C Saliba, G Laferla, G Grech
Journal: Gut (2013)

<h3>Introduction</h3> Osteoporosis is common in Crohn’s disease patients.<sup>1</sup> Autophagy genes have so far never being studied as potential risk factors for osteoporosis in Crohn›s disease. <h3>Methods</h3> We have analysed the risk for osteoporosis among Crohn’s disease patients expressing the rs2241880 polymorphism of the ATG16L1 gene. Patients diagnosed with Crohn’s disase through histological, radiological and endoscopic findings were recruited. A blood sample for genotyping was taken and a DEXA Bone Density scan was performed in each patient. Genotyping for this variant involved: – DNA extraction – Gradient Polymerase Chain Reaction (PCR) – Quantitative PCR and High Resolution Melt (HRM) – Restriction Fragment Length Polymorphism (RFLP) of PCR product <h3>Results</h3> 83 Crohn’s patients were included in the study. Following genotyping, 33 patients were found to have no mutation (wild type), 44 were heterozygous and 6 were homozygous for the rs2241880 variant of the ATG16L1 gene. The table below shows the mean T and Z scores at the hip and spine of patients with the wild type, heterozygous and homozygous variants. Patients Homozygous for the rs2241880 variant had lower mean T and Z scores at the hip than those Heterozygous or Wild Type. Using t-test, there was no statistical difference between the Homozygous, Heterozygous and Wild Type patients’ hip T scores (<i>p</i>:<i>0.314),</i> Z scores (<i>p</i>:<i>0.441</i>), and spine T scores (<i>p</i>:<i>0.751)</i> and Z scores (<i>p</i>:<i>0.822)</i>. Using χ<sup>2</sup> test, the relationship between the 3 different variants (homozygous, heterozygous and wild type) and the risk of osteoporosis (T score &lt; –2.5), osteopoenia (T score: –1.0 to –2.5) and normal (Tscore &gt; –1.0) was not statistically significant (<i>p</i>:<i>0.978</i>). <h3>Conclusion</h3> We found no significant difference between the T and Z scores of patients with ATG16L1 Homozygous, Heterozygous and Wild Type alleles. However, there is a trend in the mean T and Z scores at the hip with lower scores in patients with Heterozygous/Homozygous alleles. Such a trend is not present in the spine. While the authors can offer no explanation for this difference, studies on larger populations are needed to better investigate the relationship between ATG16L1 mutations and the risk of osteoporosis. <h3>Disclosure of Interest</h3> None Declared. <h3>Reference</h3> Lewis NR, Scott BB. British Society Guidelines for osteoporosis in inflammatory bowel disease and celiac diseas. BSG guidelines in Gastroenterology. June 2007; 1–12.
Spinal Subdural Hematoma
Authors: David Dunn
Journal: JAMA (1979)

A RARE, but serious, complication of lumbar puncture is the production of a spinal subdural hematoma with resulting damage to the cord and roots. The importance of thrombocytopenia, usually associated with malignancy, in the formation of these hematomas was emphasized in a recent review in which it was present in nine of 12 patients.<sup>1</sup>Alcoholism, a common problem, can cause thrombocytopenia,<sup>2</sup>and in a chronic alcoholic can be an unsuspected hazard of lumbar puncture, as in the patient described in this report. <h3>Report of a Case</h3> A severely debilitated, 37-year-old female alcoholic was admitted to the hospital because of fever, heart murmur, tetany, and tremulousness. No history or clinical evidence of a blood dyscrasia was noted. The prothrombin time and the partial thromboplastin time were normal. After admission, she had a cardiac arrest but was successfully resuscitated. She was lethargic and disoriented, and because of the possibility of
RISK-TREATMENT-PARADOX IN STEMI WITH IMPAIRED RENAL FUNCTION IN CLINICAL PRACTICE IN EUROPE: LESSONS FROM THE EURO HEART SURVEY ACS REGISTRY
Authors: Anselm K. Gitt, Frank Towae, Ralf Zahn, Hugo Katus, Alexander Pakhomenko, Francois Schiele, Jean-Pierre Bassand
Journal: Journal of the American College of Cardiology (2010)
Reducing High Blood Cholesterol Levels With Drugs
Authors: Judith D. Bentkover
Journal: JAMA (1991)

To the Editor.—  In their cost-effectiveness analysis of alternative pharmaceutical therapies for high blood cholesterol levels, Schulman et al1do a good job of summarizing the literature relevant to a major national health goal, lowering total cholesterol and low-density lipoprotein cholesterol levels of 5% to 10% of middle-aged men in the United States plus an unidentified percentage of older men and women. However, one must be careful fully to understand the limitations of their methods before leaping to a position of advocacy concerning any programmatic policy measures that are alleged to reduce costs.  First, as the authors point out in the first section of their article, serum cholesterol is used as a proxy for coronary heart disease (CHD) morbidity and mortality. Although there is no disagreement that high cholesterol levels put one at risk for an adverse CHD outcome, there is some variation in the relationship between unit or
Electrophysiologic and antiarrhythmic effects of sotalol in patients with life-threatening ventricular tachyarrhythmias.
Authors: K Nademanee, G Feld, J Hendrickson, P N Singh, B N Singh
Journal: Circulation (1985)

Sotalol is a unique beta-blocker that lengthens cardiac repolarization and effective refractory period (ERP). Its efficacy after intravenous (1.5 mg/kg) and oral (160 to 480 mg bid) administration was therefore evaluated in 37 patients with refractory recurrent ventricular tachycardia/fibrillation (VT/VF). Thirty-five patients, 33 with inducible VT/VF, underwent electrophysiologic testing. Intravenous sotalol lengthened the ERP in the atrium (+24.6%, p less than .01), atrioventricular node (+24.9%, p less than .01), and ventricle (+14.9%, p less than .01). It also significantly lengthened sinus node recovery time, corrected QT interval (QTc), and the AH interval, but not the HV interval. Sotalol prevented reinduction of VT/VF in 15 patients (45.5%). Twenty-five of the 33 patients (15 with positive results of electrophysiologic tests; 10 with negative results) were given oral sotalol. The drug was ineffective in seven (26.9%) and aggravated arrhythmia in one (3.8%). In four patients sotalol was withdrawn because of side effects; arrhythmias recurred late in two (7.7%). Eleven patients (42.3%) have continued on oral sotalol over a mean follow-up period of 9.2 +/- 8.6 months. Sotalol reduced (n = 21) total premature ventricular complex (PVC) count on the Holter electrocardiogram by 73% (p less than .01), paired PVCs by 89% (p less than .01), and beats of ventricular tachycardia by 95% (p less than .01). In 52% (n = 11), total reduction in PVCs was at least 85%, and incidence of paired and tachycardiac beats was reduced at least 90% (group A). In the remainder (n = 10), PVC suppression was not significant (group B). Group A included nine patients with nonreinducible VT/VF and two in whom it was reinducible; in group B, eight of 10 patients had reinducible VT/VF. The difference between the two groups (Fisher exact test) was significant (p less than .01). The prevention of reinduction of VT/VF by intravenous sotalol and suppression of spontaneously occurring arrhythmias by the oral drug were both predictive of long-term drug efficacy. Sotalol is a significant advance in the short- and long-term management of life-threatening ventricular tachyarrhythmias.
Characterization of the UDP-glucose receptor (re-named here the P2Y14 receptor) adds diversity to the P2Y receptor family
Authors: Maria P Abbracchio, Jean-Marie Boeynaems, Eric A Barnard, José L Boyer, Charles Kennedy, Maria Teresa Miras-Portugal, Brian F King, Christian Gachet, Kenneth A Jacobson, Gary A Weisman, Geoffrey Burnstock
Journal: Trends in Pharmacological Sciences (2003)
Vulnerability-Based Spatial Sampling Stratification for the National Children’s Study, Worcester County, Massachusetts: Capturing Health-Relevant Environmental and Sociodemographic Variability
Authors: Timothy J. Downs, Yelena Ogneva-Himmelberger, Onesky Aupont, Yangyang Wang, Ann Raj, Paula Zimmerman, Robert Goble, Octavia Taylor, Linda Churchill, Celeste Lemay, Thomas McLaughlin, Marianne Felice
Journal: Environmental Health Perspectives (2010)

BackgroundThe National Children's Study is the most ambitious study ever attempted in the United States to assess how environmental factors impact child health and development. It aims to follow 100,000 children from gestation until 21 years of age. Success requires breaking new interdisciplinary ground, starting with how to select the sample of > 1,000 children in each of 105 study sites; no standardized protocol exists for stratification of the target population by factoring in the diverse environments it inhabits. Worcester County, Massachusetts, like other sites, stratifies according to local conditions and local knowledge, subject to probability sampling rules.ObjectivesWe answer the following questions: How do we divide Worcester County into viable strata that represent its health-relevant environmental and sociodemographic heterogeneity, subject to sampling rules? What potential does our approach have to inform stratification at other sites?ResultsWe developed a multivariable, vulnerability-based method for spatial sampling consisting of two descriptive indices: a hazards/stressors exposure index (comprising three proxy variables), and an adaptive capacity/sociodemographic character index (five variables). Multivariable, health-relevant stratification at the start of the study may improve detection power for environment–child health associations down the line. Eighteen strata capture countywide heterogeneity in the indices and have optimal relative homogeneity within each. They achieve comparable expected birth counts and conform to local concepts of space.ConclusionThe approach offers moderate to high potential to inform other sites, limited by intersite differences in data availability, geodemographics, and technical capacity. Energetic community engagement from the start promotes local stratification coherence, plus vital researcher–community trust and co-ownership for sustainability.
Americans Studying Abroad
Authors: Donald D. Goldberg
Journal: JAMA (1975)

IT IS estimated that there are presently 3,715 American-born students who are forced to leave the United States to study medicine in a foreign country, in a foreign tongue.<sup>1(p912)</sup> These students are highly motivated to study medicine. In many cases, they would have gained admission to a US medical school had there been enough places. Many come from affluent families, as do their brothers in US medical schools. Others scrape or borrow to meet the financial obligations to complete their studies. Depending on the school to which they are admitted, students may have to begin their training at the premedical school level, eg, in Italy, France, and Belgium (some schools), or they may receive one year's credit exemption for the premedical work performed during their four-year US bachelor's program. In many cases, they are helped in their admission to French medical schools by commercial entrepreneurs using a "packaged plan"
790 HEPATITIS C TREATMENT OUTCOMES AND PREDICTORS OF RESPONSE IN TREATMENT-NAIVE PATIENTS TREATED WITH PEGINTERFERON alfa/RIBAVIRIN IN REAL-WORLD ITALIAN CLINICS COMPARED WITH OTHER COUNTRIES: PROPHESYS SUB-ANALYSIS
Authors: A. Ascione, S. Bruno, C. Coppola, A. Mangia, A. Orlandini, M. Schmitz, B. Deodato, M. Puoti
Journal: Journal of Hepatology (2013)
Preventing Sexual Transmission of HIV — New Ideas from Sub-Saharan Africa
Authors: Myron S. Cohen
Journal: New England Journal of Medicine (2000)

When human immunodeficiency virus type 1 (HIV-1) was identified as the cause of AIDS more than 15 years ago, it seemed possible that an end to the epidemic would follow. However, the control of communicable diseases requires far more than the identification of causative pathogens. It also requires an understanding of the ways in which a pathogen is spread; an understanding of the biologic, behavioral, and social requirements for transmission; the development of both biologic and behavioral approaches to prevention; the mobilization of social and political forces; and money. Perhaps no disease has highlighted the importance of these requirements more . . .
Role of hypothalamic Foxo1 in the regulation of food intake and energy homeostasis
Authors: Min-Seon Kim, Youngmi K Pak, Pil-Geum Jang, Cherl Namkoong, Yon-Sik Choi, Jong-Chul Won, Kyung-Sup Kim, Seung-Whan Kim, Hyo-Soo Kim, Joong-Yeol Park, Young-Bum Kim, Ki-Up Lee
Journal: Nature Neuroscience (2006)