tbuckley/cabot-search huggingface dataset:
Informed Consent for Population-Based Research Involving Genetics
Authors: Laura M. Beskow, Wylie Burke, Jon F. Merz, Patricia A. Barr, Sharon Terry, Victor B. Penchaszadeh, Lawrence O. Gostin, Marta Gwinn, Muin J. Khoury
Journal: JAMA (2001)

Bridging the gap between gene discovery and our ability to use genetic information to benefit health requires population-based knowledge about the contribution of common gene variants and gene-environment interactions to the risk of disease. The risks and benefits associated with population-based research involving genetics, especially lower-penetrance gene variants, can differ in nature from those associated with family-based research. In response to the urgent need for appropriate guidelines, the Centers for Disease Control and Prevention formed a multidisciplinary group to develop an informed consent approach for integrating genetic variation into population-based research. The group used expert opinion and federal regulations, the National Bioethics Advisory Commission's report on research involving human biological materials, existing consent forms, and literature on informed consent to create suggested language for informed consent documents and a supplemental brochure. This language reflects the premise that the probability and magnitude of harm, as well as possible personal benefits, are directly related to the meaning of the results for the health of the participant and that appropriate disclosures and processes for obtaining consent should be based on an assessment at the outset of the likelihood that the results will generate information that could lead directly to an evidence-based intervention. This informed consent approach is proposed to promote discussion about how best to enable potential participants to make informed decisions about population-based research involving genetics and to suggest issues for consideration by research sponsors, institutional review boards, and investigators.
Prevalence of Carpal Tunnel Syndrome in a General Population
Authors: Isam Atroshi, Christina Gummesson, Ragnar Johnsson, Ewald Ornstein, Jonas Ranstam, Ingmar Rosén
Journal: JAMA (1999)

Carpal tunnel syndrome (CTS) is a cause of pain, numbness, and tingling in the hands and is an important cause of work disability. Although high prevalence rates of CTS in certain occupations have been reported, little is known about its prevalence in the general population.To estimate the prevalence of CTS in a general population.General health mail survey sent in February 1997, inquiring about symptoms of pain, numbness, and tingling in any part of the body, followed 2 months later by clinical examination and nerve conduction testing of responders reporting symptoms in the median nerve distribution in the hands, as well as of a sample of those not reporting these symptoms (controls).A region in southern Sweden with a population of 170000.A sex- and age-stratified sample of 3000 subjects (age range, 25-74 years) was randomly selected from the general population register and sent the survey, with a response rate of 83% (n = 2466; 46% men). Of the symptomatic responders, 81% underwent clinical examination.Population prevalence rates, calculated as the number of symptomatic responders diagnosed on examination as having clinically certain CTS and/or electrophysiological median neuropathy divided by the total number of responders.Of the 2466 responders, 354 reported pain, numbness, and/or tingling in the median nerve distribution in the hands (prevalence, 14.4%; 95% confidence interval [CI], 13.0%-15.8%). On clinical examination, 94 symptomatic subjects were diagnosed as having clinically certain CTS (prevalence, 3.8%; 95% CI, 3.1%-4.6%). Nerve conduction testing showed median neuropathy at the carpal tunnel in 120 symptomatic subjects (prevalence, 4.9%; 95% CI, 4.1%-5.8%). Sixty-six symptomatic subjects had clinically and electrophysiologically confirmed CTS (prevalence, 2.7%; 95% CI, 2.1%-3.4%). Of 125 control subjects clinically examined, electrophysiological median neuropathy was found in 23 (18.4%; 95% CI, 12.0%-26.3%).Symptoms of pain, numbness, and tingling in the hands are common in the general population. Based on our data, 1 in 5 symptomatic subjects would be expected to have CTS based on clinical examination and electrophysiologic testing.
Changing Intravenous Tubing Containing Burettes-Reply
Authors: David R. Snydman
Journal: JAMA (1985)

<h3>In Reply.—</h3> The statement by Ms Josephson that the 24-hour specimen results in the 48-hour group do not contribute to the determination of safety at 48 hours is incorrect. We were unwilling to make that assumption. In fact, some burettes in the 48-hour group were contaminated at 24 hours but not at 48 hours. Therefore, contamination of the burette at 24 hours clearly could contribute to the determination of safety in the 48-hour group. Since any contamination might lead to bacteremia, we felt that all contamination was an appropriate end point used to determine safety. Furthermore, the risk of contamination of the patient may be time dependent. To compare comparable time intervals, successive 24-hour cultures in the 24-hour group were compared with successive 24-hour cultures in the 48-hour group. It just so happens that the study design allowed one group (the 48-hour one) to have their burette remain the same.
The nursing profession's coming of age: A team effort required?
Authors: Mark Davies
Journal: BMJ (2006)

The nursing profession's coming of age The end of medicine as a professionEditor-Young describes the coming of age of the nursing profession. 1 All professions and occupations are human creations and therefore are subject to change.With the widening of roles of many professions, it becomes harder to define what a doctor can do that can't be done by an appropriately trained member of another profession.Perhaps major surgery and certifying cause of death are all that remains.With the increasing difficulty of getting junior doctors to do anything that may be regarded as work (rather than education) we doctors may be engineering the abolition of our profession, and we may move from distinct professions to practitioners from varied backgrounds being trained for a particular function.
Death at the pool
Authors: R. Millar
Journal: BMJ (1995)

I had welcomed the chance to ponder, while swimming with mindless determination at the leisure centre, on the diagnostic signals of thoracic or abdominal scars. For it was only six months since I had given my final anaesthetic in an American hospital--and resuscitated my last patient. After 43 years, this, now, was retirement in Surrey.

The man's age, I had guessed, was early 70s, and a heart valve replacement or a coronary bypass could be assumed …
SPONTANEOUS FRACTURE OF THE POSTERIOR CLINOIDS
Authors: Robert L. Pitfield
Journal: JAMA (1928)

Fracture of the clinoids has been observed by several physicians but is a rare occurrence. The case here reported is of interest because of the excellent demonstration of the lesion by means of the roentgen ray and because of the typical history. W. B., a young Irish-American, who had for years exhibited signs of constitutional inferiority, having a small, meager frame, long, slender hands and feet, high arched palate, adherent ear lobes and small irregular skull, was in many ways abnormal mentally, in that he was intractable and would not submit to much medical supervision and care. He was admitted to the hospital because of excruciating bitemporal headaches. These were so severe that he was unable to work. During a more than severe encephalalgia he was suddenly relieved of all pain. A roentgenogram the following day revealed a small sella turcica and fracture of the posterior clinoid processes of the
Interleukin-10 suppresses hepatic ischemia/reperfusion injury in mice: Implications of a central role for nuclear factor ?B
Authors: Hiroyuki Yoshidome, Atsushi Kato, Michael J. Edwards, Alex B. Lentsch
Journal: Hepatology (1999)

Ischemia/reperfusion injury of the liver requires the participation of proinflammatory cytokines, chemokines, and adhesion molecules, many of which are regulated by the transcription factor nuclear factor κB (NFκB). The anti-inflammatory cytokine, interleukin-10 (IL-10) affects inflammatory reactions, at least in part, through inhibitory effects on the transcription factor, NFκB. The objective of the current study was to determine whether IL-10 could suppress hepatic ischemia/reperfusion-induced NFκB activation and the ensuing inflammatory liver injury. C57BL/6 mice underwent partial hepatic ischemia and reperfusion with or without intravenous injections of recombinant murine IL-10. Hepatic NFκB activation was induced in a time-dependent fashion. IL-10 suppressed NFκB activation as well as messenger RNA expression of tumor necrosis factor-α (TNF-α) and macrophage inflammatory protein-2 (MIP-2). In addition, IL-10 reduced serum levels of TNF-α and MIP-2. Hepatic neutrophil recruitment, liver edema, and hepatocellular injury were all significantly reduced by IL-10. The data suggest that IL-10 protects against hepatic ischemia/reperfusion injury by suppressing NFκB activation and subsequent expression of proinflammatory mediators.
Botulinum Toxin A in the Early Treatment of Sixth Nerve Palsy-Induced Diplopia in Type 2 Diabetes
Authors: Anna Broniarczyk-Loba, Leszek Czupryniak, Olimpia Nowakowska, Jerzy Loba
Journal: Diabetes Care (2004)

Sixth (abducent) cranial nerve palsy is a typical yet infrequent mononeuropathic complication of diabetes. It usually causes considerable diplopia, which can be debilitating and significantly impair the everyday and professional activity of afflicted individuals. In most cases, nerve function restores itself, although it usually takes several months or even over a year for the symptoms to resolve (1). No specific treatment of nerve palsy-induced diplopia in diabetic patients has been established (2,3). We report the successful use of botulinum toxin A in the early treatment of diplopia caused by sixth nerve palsy in two type 2 diabetic patients. In both patients, diplopia made it impossible for them to continue with their professional activities.

The first patient (female, computer operator, aged 52 years, with a 15-year history of type …
Treatment of Certain Side-effects of Morphine
Authors: G. Christie, S. Gershon, R. Gray, F. H. Shaw, I. McCance, D. W. Bruce
Journal: BMJ (1958)

EPILEPSY AS A SOCIAL PROBLEM 1BRnisH 675 social aspects of their patient's problem.But it is grati- fying that in recent years there is an increasing aware- ness that the queries which epilepsy raises are not concerned solely with accurate diagnosis of the cause and with instituting the best treatment of the fits, but also with ens!iring that the epileptic is given the fullest opportunities to take his place as a full and active member of the community in which he lives.
Exercise Left Ventricular Performance in Patients with Chest Pain, Ischemic-Appearing Exercise Electrocardiograms, and Angiographically Normal Coronary Arteries
Authors: HARVEY J. BERGER
Journal: Annals of Internal Medicine (1981)

Left ventricular performance was evaluated using first-pass radionuclide angiocardiography in 31 patients with chest pain, an ischemic-appearing exercise electrocardiogram, and angiographically normal coronary arteries at rest and during maximal upright bicycle exercise. Thallium-201 (201TI) imaging was done in all patients after treadmill exercise and in selected patients after ergonovine provocation. Resting left ventricular performance was normal in all patients. An abnormal ejection fraction response to exercise was detected in 12 of 31 patients. Regional dysfunction was present during exercise in four patients, all of whom also had abnormal global responses. Three of these 12 patients and two additional patients had exercise-induced 201TI perfusion defects. In all nine patients who underwent ergonovine testing, there was no suggestion of coronary arterial spasm. Thus, left ventricular dysfunction during exercise, in the presence of normal resting performance, was found in a substantial number of patients with chest pain, an ischemic-appearing exercise electrocardiogram, and normal coronary arteries.
N-Terminal Probrain Natriuretic Peptide Is a Stronger Predictor of Cardiovascular Mortality Than C-Reactive Protein and Albumin Excretion Rate in Elderly Patients With Type 2 Diabetes
Authors: Graziella Bruno, Andrea Landi, Federica Barutta, Giuseppe Ghezzo, Claudio Baldin, Laura Spadafora, Andrea Schimmenti, Tania Prinzis, Paolo Cavallo Perin, Gabriella Gruden
Journal: Diabetes Care (2013)

To study whether N-terminal probrain natriuretic peptide (NT-proBNP) is a short-term independent predictor of both all-cause and cardiovascular (CV) mortality in type 2 diabetic patients and to establish whether albuminuria and C-reactive protein (CRP) affect this relationship.The prospective study included 1,825 type 2 diabetic patients from the population-based cohort of the Casale Monferrato study. CV risk factors, preexisting CVD, and NT-proBNP levels were evaluated at baseline. All-cause and CV mortality were assessed 5.5 years after baseline examination. Multivariate Cox proportional hazards modeling was used to estimate mortality hazard ratios (HRs).During the follow-up period, 390 people died (175 for CVD) out of 9,101 person-years of observations. A significantly increased mortality risk by quartiles of NT-proBNP was observed (test for trend, P < 0.001). NT-proBN P values >91 pg/mL conferred HRs of 2.05 (95% CI 1.47-2.86) for all-cause and 4.47 (2.38-8.39) for CV mortality, independently of CV risk factors, including CRP and albumin excretion rate (AER). The association was also significant for modest rises in NT-proBNP levels and in patients without microalbuminuria and CVD at baseline (upper quartiles HRs 3.82 [95% CI 1.24-13.75]) and 3.14 [1.00-9.94]). Albuminuria and NT-proBNP had an additive effect on mortality, though the association was stronger for NT-proBNP.NT-proBNP is a strong independent predictor of short-term CV mortality risk in elderly people with type 2 diabetes, including those without preexisting CVD. This association is evident even in people with slightly increased values, is not modified by CRP, and is additive to that provided by AER.
Urethral syndrome: a self limiting illness.
Authors: T C O'Dowd, C D Ribeiro, J Munro, R R West, C H Howells, R H Davis
Journal: BMJ (1984)

Thirty nine adult women who were not pregnant and had the urethral syndrome in a general practice underwent detailed microbiological investigations. Patients monitored their own symptoms, and those with persisting symptoms were entered into a randomised controlled trial of treatment with doxycycline and placebo. Chlamydia trachomatis and Neisseria gonorrhoeae were not isolated and fastidious organisms were not causally associated with the urethral syndrome. Treatment with doxycycline showed no benefit; each episode of the urethral syndrome was short and self limiting and there were no recurrences in a median observation period of 12 months.
PREVALENCE OF QTC INTERVAL PROLONGATION IN PATIENTS ADMITTED TO CARDIAC CRITICAL CARE UNITS AND FREQUENCY OF SUBSEQUENT ADMINISTRATION OF QT INTERVAL PROLONGING DRUGS
Authors: Heather A. Wroblewski, James E. Tisdale, Joanna R. Kingery, Brian R. Overholser, Richard J. Kovacs
Journal: Journal of the American College of Cardiology (2010)
GW25-e1382 The incidence of Congenital Heart Disease in Guangdong province, China: Results of a network study
Authors: Qu Yanji, Nie Zq, Liu Xq, Chen Jm, Pan W, Mai Jz, Gao Xm, Wu Y, Ou Yq, Zhuang Jian
Journal: Journal of the American College of Cardiology (2014)
Management of first trimester spontaneous abortions
Authors: K. Forbes
Journal: BMJ (1995)

Many procedures in obstetrics and gynaecology are ripe for re-evaluation. On the basis of a recent paper,1 surgical evacuation of the uterine contents after all miscarriages in the first trimester may be one of them.

The rationale for curettage as the correct management is based on a series of cases published when parity, general health, and the incidence of criminal abortion differed greatly from now.2 Doctors reported infection (due to retained products of conception after criminal abortion) and bleeding against a background of anaemia, multiparity, and poor nutrition. …
Interferon enhances the susceptibility of virus-infected fibroblasts to cytotoxic T cells.
Authors: J F Bukowski, R M Welsh
Journal: The Journal of Experimental Medicine (1985)

Interferon (IFN) pretreatment of low-passage mouse embryonic fibroblasts (MEF) infected with lymphocytic choriomeningitis virus or vaccinia virus rendered these cells two to three times more susceptible to lysis by H-2 restricted, virus-specific cytotoxic T lymphocytes (CTL) than control, virus-infected MEF. The increased sensitivity to lysis correlated with increased expression of surface H-2 antigens, but not viral antigens. Continuous cell lines already highly sensitive to CTL-mediated lysis and already expressing high levels of surface H-2 antigens were unaffected by IFN pretreatment. These results suggest that IFN treatment, by increasing surface H-2 levels, may result in increased association of surface H-2 and virus antigens, leading to enhanced recognition and lysis by virus-specific CTL.
Resolving the Conundrum of Islet Transplantation by Linking Metabolic Dysregulation, Inflammation, and Immune Regulation
Authors: Xiaolun Huang, Daniel J. Moore, Robert J. Ketchum, Craig S. Nunemaker, Boris Kovatchev, Anthony L. McCall, Kenneth L. Brayman
Journal: Endocrine Reviews (2008)

Abstract Although type 1 diabetes cannot be prevented or reversed, replacement of insulin production by transplantation of the pancreas or pancreatic islets represents a definitive solution. At present, transplantation can restore euglycemia, but this restoration is short-lived, requires islets from multiple donors, and necessitates lifelong immunosuppression. An emerging paradigm in transplantation and autoimmunity indicates that systemic inflammation contributes to tissue injury while disrupting immune tolerance. We identify multiple barriers to successful islet transplantation, each of which either contributes to the inflammatory state or is augmented by it. To optimize islet transplantation for diabetes reversal, we suggest that targeting these interacting barriers and the accompanying inflammation may represent an improved approach to achieve successful clinical islet transplantation by enhancing islet survival, regeneration or neogenesis potential, and tolerance induction. Overall, we consider the proinflammatory effects of important technical, immunological, and metabolic barriers including: 1) islet isolation and transplantation, including selection of implantation site; 2) recurrent autoimmunity, alloimmune rejection, and unique features of the autoimmune-prone immune system; and 3) the deranged metabolism of the islet transplant recipient. Consideration of these themes reveals that each is interrelated to and exacerbated by the other and that this connection is mediated by a systemic inflammatory state. This inflammatory state may form the central barrier to successful islet transplantation. Overall, there remains substantial promise in islet transplantation with several avenues of ongoing promising research. This review focuses on interactions between the technical, immunological, and metabolic barriers that must be overcome to optimize the success of this important therapeutic approach.
SOME RECENT ADVANCES IN CARDIOVASCULAR DISEASE
Authors: C. Wilson
Journal: BMJ (1935)

The cardiovascular system comprises four sections-the heart, the arteries and arterioles, the capillaries, and the veins ; and perhaps the most interesting of all recent advances lies in the conception of the essential unity of this system and of the various mechanisms, nervous and biochemical, which unite and co-ordinate its elaborate activities.The heart is ever varying its output, and it is not too much to say that no two consecutive beats, unless perhaps in tranquil sleep, have quite the same stroke volume.It is well recognized that were all the capillaries dilated at the same time we should bleed to death into them in the course of a minute or two.The control of the capillaries is such that each tissue and every part of it can make a call for blood where needed, and shut down the supply where not.An intermediate mechanism switches pints of blood off and on to the muscles, the brain, or the abdominal organs, necessarily shutting down elsewhere.The co-ordination is elaborate perhaps beyond conception, but we are beginning to understand it.There is no single cell in this whole system which is not under direct nervous control.One implication of this is that nervous disturbance may throw various sections out of gear and suggest serious disease, and the mere notion of this is apt to set up a vicious circle and produce ill-health, which reassurance may be able to dispel.Emotional pallors and blushing deceive no one, but vaso- vagal attacks, the effort syndrome, and many other con- ditions that are not really cardiac at all are often referred to in such unsatisfactory terms as " tired heart," "weak heart," and the like.These are, I think, un- fortunate terms, and although they are frequently used by doctors they are searched for in vain in the index of any treatise on medicine. Blood Pressure and ArteriosclerosisHaving considered very briefly the circulation as a whole we now turn to its constituent parts, and a word on the veins must suffice.Venous pressure has recently received intensive study by some investigators which will lead to important results, while the modern treatment of haemorrhoids and of varix and dependent ulcers has brought untold comfort to countless sufferers.On the arterial side the more general recognition of angiospasm, which accounts for dead fingers, Raynaud's disease, inter- mittent claudication, many transient palsies, and for other as yet less familiar anomalies is of great value, if kept in mind-saving much needless decubitus,; for instance, in cases where organic lesions in the brain are suspected.
Handbook of Aging and the Social Sciences
Authors: Robert L. Kane
Journal: JAMA (1985)

All of those interested in the problems of aging will welcome the appearance of the second edition of the series<i>The Handbooks of Aging</i>. The other two books in the series cover the biology and psychology of aging. This handbook is specifically designed to complement, but not to duplicate, the work of the first edition. It offers a treasure trove of information about the elderly and a vivid demonstration of what the social sciences can offer to our understanding of aging. Carefully crafted and well designed, it serves as an invaluable reference. Each of the chapters is well documented and provides ready access to the literature on the subject covered. It is assuredly not a book to be read at a single sitting or even from cover to cover. Because its primary value is as a reference, it is disappointing to note that the index is not well constructed for