tbuckley/cabot-search huggingface dataset:
How a Farmhand Paid for His Cabbage: The Peter/Paul Principle
Authors: Karl Brandspigel
Journal: JAMA (1986)

<h3>To the Editor.—</h3> A 53-year-old man underwent coronary artery bypass graft surgery after his second myocardial infarction. The surgery was elective, recommended because of high-risk lesions on cardiac catherization, and was funded by the state vocational rehabilitation program. His subsequent course was uneventful. Two months after surgery he returned to his primary physicians, reported no cardiac symptoms, and asked if he could return to work. For the previous two years he had done farm work, and it was assumed that his intention was to return to this, so he was advised that he could return to work with the usual precautions. Exuberant, he left the office volunteering, "Don't worry, doc! Now you will get your money." Two days later we noted on the front page of the local newspaper that our patient had indeed resumed an earlier occupation—bank robbery. Critics of coronary artery bypass graft surgery or vocational rehabilitation programs
Trends in Cardiovascular Complications of Diabetes
Authors: Caroline S. Fox
Journal: JAMA (2004)

Despite reductions in cardiovascular disease (CVD) mortality over the past few decades, it is unclear whether adults with and without diabetes have experienced similar declines in CVD risk.To determine whether adults with and without diabetes experienced similar declines in incident CVD in 1950-1995.Participants aged 45-64 years from the Framingham Heart Study original and offspring cohorts who attended examinations in 1950-1966 ("earlier" time period; 4118 participants, 113 with diabetes) and 1977-1995 ("later" time period; 4063 participants, 317 with diabetes). Incidence rates of CVD among those with and without diabetes were compared between the earlier and later periods.Myocardial infarction, coronary heart disease death, and stroke.Among participants with diabetes, the age- and sex-adjusted CVD incidence rate was 286.4 per 10,000 person-years in the earlier period and 146.9 per 10,000 in the later period, a 49.3% (95% confidence interval [CI], 16.7%-69.4%) decline. Among participants without diabetes, the age- and sex-adjusted incidence rate was 84.6 per 10,000 person-years in the earlier period and 54.3 per 10,000 person-years in the later period, a 35.4% (95% CI, 25.3%-45.4%) decline. Hazard ratios for diabetes as a predictor of incident CVD were not different in the earlier vs later periods.We report a 50% reduction in the rate of incident CVD events among adults with diabetes, although the absolute risk of CVD is 2-fold greater than among persons without diabetes. Adults with and without diabetes have benefited similarly during the decline in CVD rates over the last several decades. More aggressive treatment of CVD risk factors and further research on diabetes-specific factors contributing to CVD risk are needed to further reduce the high absolute risk of CVD still experienced by persons with diabetes.
Diminished Protection?: Early Childhood PCB Exposure and Reduced Immune Response to Vaccinations
Authors: Julia R. Barrett
Journal: Environmental Health Perspectives (2010)

Sprawling Cities Have the Most Very Hot DaysThe urban heat island effect, the phenomenon in which a city has higher temperatures than surrounding countryside, is known to contribute to higher rates of heat-related mortality in summer months when temperatures soar.Although extreme heat events have become more common in large U.S. cities, a new study indicates that sprawling cities experience more than double the rate of extreme heat events in the summer compared with more compact urban areas [EHP 118( 10):1425-1428; Stone et al.].The authors considered 53 U.S. metropolitan areas for which data were available on sprawl and extreme heat event.Sprawl had been assessed in a 2003 study using an index based on land use data from the 2000 census along with measures of population density, average street block size, proximity of homes to businesses, and land use mix.Extreme heat events were defined as days on which the minimum, maximum, or average temperature exceeded the 85th percentile of a base period of 1961-1990.The authors compared the extent of sprawl for each metropolitan area with that area's average annual rate of extreme heat events from 1956 through 2005.Over the 50 years examined,
PRESCRIPTION REPETITION AND ITS DANGERS.
Authors: WILLIAM C. ALPERS
Journal: JAMA (1903)

If there is any part in the physician's vocation where ethics and commercialism may conflict it is in the writing, dispensing and renewing of prescriptions. The prescription forms a bridge from the one to the other and, after leaving the office, is apt to remind the writer that pure ethics are good theory but sometimes poor practice. The piece of paper that the patient receives has a positive value; it may be negotiable and bring success or failure. It may be a source of profit to the pharmacist, a fountain of relief and comfort or disaster to the patient, and a means of building up a new reputation or shattering an old one to the physician. It is therefore natural that all three, the physician, the pharmacist and the public, should largely be interested in the prescription, and each one watch over it in his own way. The question who
Raised plasma intact parathyroid hormone concentrations in young people with mildly raised blood pressure
Authors: D E Grobbee, W H L Hackeng, J C Birkenhager, A Hofman
Journal: BMJ (1988)

To study the role of parathyroid gland activity in early primary hypertension plasma concentrations of intact parathyroid hormone were measured in 90 untreated young subjects, aged 16-29, with stable midly raised blood pressure and in 40 normotensive control subjects selected from the same population in Zoetermeer, The Netherlands. Intact parathyroid hormone concentration was significantly higher in the hypertensive than the normotensive group (2.34 (SE 0.11) pmol/l v 1.47 (0.13) pmol/l, respectively; difference 0.87 pmol/l; 95% confidence interval 0.55 to 1.21; p less than 0.0001). Serum total calcium concentration was 2.36 (0.01) mmol/l in the hypertensive group and 2.42 (0.01) mmol/l in the normotensive group (difference 0.06 mmol/l; 95% confidence interval 0.02 to 0.09; p = 0.02). Urinary calcium excretion over 24 hours did not differ significantly between the two groups (4.17 (0.28) mmol/24 h in the hypertensive group and 3.89 (0.39) mmol/24 h in the normotensive group; difference 0.28 mmol/24 h; 95% confidence interval -0.66 to 1.22). In the hypertensive group both systolic and diastolic blood pressures increased slightly though significantly with intact parathyroid hormone concentrations. No obvious associations between serum calcium concentration and blood pressure were observed. These findings support the view that enhanced activity of the parathyroid gland may play a part in the early stage of primary hypertension.
Epidemic Cat-Transmitted Sporotrichosis
Authors: Armando O. Schubach, Tânia M.P. Schubach, Mônica B.L. Barros
Journal: New England Journal of Medicine (2005)

symptoms such as substance abuse, depression, or signs of excessive stress can be identified, help is available.A physician health program will intervene, rapidly if necessary, and offer treatment, relieving colleagues of this responsibility.Recognition of early warning signs and prompt referral to the local program for help may prevent the ultimate tragedy of suicide.
Developments in Cervical and Ovarian Cancer Screening: Implications for Current Practice
Authors: Gina Rollins
Journal: Annals of Internal Medicine (2000)

Current Clinical Issues19 December 2000Developments in Cervical and Ovarian Cancer Screening: Implications for Current PracticeGina RollinsGina RollinsSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-12-200012190-00101 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Like the diseases themselves, the models of screening for cervical and ovarian cancer are distinct. Recent research involving these conditions, however, may suggest changes in future screening approaches. Evidence about the standard testing model for cervical cancer is being revisited, and although ovarian cancer screening is still nascent, with no definitive recommended course of action, researchers are moving closer to conclusions. The evolving bodies of evidence, combined with the fact that the at-risk populations for each disease are similar, have distinct implications for internal medicine practice.Cervical CancerThe Papanicolaou (Pap) test has had a striking impact on the risk ... Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByFemale GenitaliaCompetency-based learning 19 December 2000Volume 133, Issue 12Page: 1021-1024KeywordsCancer screeningCervical cancerGenetic testingHuman papillomavirusMedical risk factorsOvarian cancerOvarian cancer screeningPopulation statisticsSpecificityUltrasound imaging ePublished: 19 December 2000 Issue Published: 19 December 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.Loading ...
Understanding controlled trials: What are pragmatic trials?
Authors: M. Roland, D. J Torgerson
Journal: BMJ (1998)

Trials of healthcare interventions are often described as either explanatory or pragmatic. Explanatory trials generally measure efficacy-the benefit a treatment produces under ideal conditions, often using carefully defined subjects in a research clinic. Pragmatic trials measure effectiveness-the benefit the treatment produces in routine clinical practice.

An explanatory approach recruits as homogeneous a population as possible and aims primarily to further scientific knowledge. By contrast, the design of a pragmatic trial reflects variations between patients that occur in real clinical practice and aims to inform choices between treatments. To ensure generalisability pragmatic trials should, so far as possible, represent the patients to whom the treatment will be applied. The need for purchasers and providers of health care to use …
Counterpoint: Selective Screening for Gestational Diabetes Mellitus
Authors: Howard Berger, Mathew Sermer
Journal: Diabetes Care (2009)

Gestational diabetes mellitus (GDM), defined as carbohydrate intolerance first diagnosed during pregnancy (1), is a common medical complication of pregnancy, affecting 1.1–14.3% of pregnant women depending on the ethnic and clinical characteristics of the population and the diagnostic test employed (2). Ever since O'Sullivan and Mahan (3) published their criteria for diagnosis of GDM using a 100-g oral glucose tolerance test (GTT), clinicians worldwide have been struggling to determine whether screening for GDM should be offered routinely in pregnancy and, if so, the optimal method of screening. There have been no adequately designed randomized controlled trials to answer the question of whether screening for GDM is both beneficial and cost effective, leading to a wide variance in screening practices worldwide. The Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS), a multicenter randomized controlled trial of GDM treatment versus routine prenatal care, found a reduction in a composite of severe perinatal outcomes in the treatment group compared with a control group receiving routine prenatal care (4). Although it was not a trial of screening, its results have convinced many practitioners to adopt some type of screening for GDM because logically, in order to treat GDM (an asymptomatic entity), one must first screen for it. Recently, the U.S. Preventive Services Task Force (USPSTF), in an update to its policy statement on screening for GDM, recognized that treatment of GDM after 24 weeks of gestation improves some maternal and neonatal outcomes but, conversely, also stated that there is still insufficient evidence to support screening of all pregnant women either before or after 24 weeks of gestation (5). Despite this, most clinicians use some method of screening for GDM.

Ideally, the chosen screening protocol should identify subjects at maximal risk of adverse pregnancy outcomes who would most benefit from intensified management and surveillance, while …
A Three‐Year‐Survey of Microfungi in the Air of Copenhagen 1977–79
Authors: Lisbeth Suldrup Larsen
Journal: Allergy (1981)

The presence and prevalence of common saprophytic airborne microfungi has been studied. Since August 1977 culturable microfungi in the outdoor air of Copenhagen have been monitored. The method used is a volumetric analysis by means of a Biap Slit‐Sampler. The microfungal flora was dominated by very few genera, thus Cladosporium, Alternaria, Penicillium and Aspergillus make up 86.8% of the organisms collected. The mere number of microfungal spores might be misleading as a guide to the relative importance of atmospheric allergens. An alternative or a supplementary parameter could be the spore substance expressed as cubic spore substance/m 3 of air, as suggested by Hyde (20). Most fungi show a seasonal dependence as well as fluctuations from year to year. The high season for living microfungi is found to be from June until October. The microfungi thus constitute a prolongation of the pollen season, a fact of importance in relation to patients suffering from inhalation‐allergy.
Meeting hears of health consequences of rape and violence in war zones
Authors: Peter Moszynski
Journal: BMJ (2006)

Sexual violence in areas of conflict is increasingly recognised as a fundamental violation of human rights, a development issue, and a global public health problem. That was the message given at a symposium in Brussels last week that heard that a growing body of research confirms that sexual violence has “grave consequences for women's physical, sexual, and mental health, as well as implications for the health and wellbeing of families and communities.”

At the meeting, which was hosted by the Belgian government, the European Commission, and the United Nations Population Fund, representatives from countries affected by conflict discussed plans …
Embryonic Growth-Associated Protein Is One Subunit of a Novel N-Terminal Acetyltransferase Complex Essential for Embryonic Vascular Development
Authors: Janet M. Wenzlau, Pamela J. Garl, Peter Simpson, Kurt R. Stenmark, James West, Kristin B. Artinger, Raphael A. Nemenoff, Mary C.M. Weiser-Evans
Journal: Circulation Research (2006)

N-terminal protein acetylation, catalyzed by N-terminal acetyltransferases (NATs) recognizing distinct N-terminal sequences, is gaining recognition as an essential regulator of normal cell function, but little is known of its role in vertebrate development. We previously cloned a novel gene, embryonic growth-associated protein (EGAP), the expression of which is associated with rapid vascular smooth muscle cell proliferation during development. We show herein EGAP is the mammalian/zebrafish homologue of yeast Mak10p, one subunit of the yeast NatC complex, and describe the cloning of its binding partners Mak3 and Mak31. The EGAP NAT forms a functional complex in mammalian cells, is evolutionarily conserved, and developmentally regulated. It is widely but not ubiquitously expressed during early zebrafish development but undetectable in later developmental stages. We demonstrate EGAP- and Mak3-deficient zebrafish fail to develop because of, in part, decreased cell proliferation, increased apoptosis, and poor blood vessel formation contributing to embryonic lethality. We examined the role of target of rapamycin (TOR), a highly conserved protein kinase controlling cell growth, as a physiological target of EGAP NAT acetylation. Compared with controls, TOR expression and signaling is significantly reduced in EGAP morphants. Pharmacological inhibition of TOR with rapamycin phenocopied the EGAP morpholino oligonucleotide-induced growth and vessel defects. Overexpression of constitutively active TOR rescued EGAP morphants, suggesting TOR is a direct or indirect endogenous substrate of the EGAP NAT complex. These data suggest the EGAP NAT complex is an essential regulatory enzyme controlling the function of a subset of proteins required for embryonic growth control and vessel development.
SR1-2: Breast Cancer and the Environment: A Life Course Approach - Report Release from an IOM Committee.
Authors: RA Hiatt
Journal: Cancer Research (2011)

Abstract In response to a request from Susan G. Komen for the Cure®, an Institute of Medicine (IOM) committee was convened to review and assess the strength of the science base regarding the relationship between breast cancer and the environment. As part of their charge, the committee members reviewed the evidentiary standards for identifying and measuring cancer risk factors and the methodological challenges involved in conducting research on breast cancer and the environment. They also considered the potential interaction between genetic and environmental risk factors. The committee's report notes evidence-based actions that women could take to reduce their risk of breast cancer and offers recommendations for future research on breast cancer and the environment. The results of this IOM committee's work will be presented. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr SR1-2.
UK patients are given advice on private screening
Authors: A. Cole
Journal: BMJ (2010)

The UK National Screening Committee has issued new guidance on the pros and cons of private health tests, after growing concern among doctors about the number of tests being offered to the public.

The committee’s director of programmes, Anne Mackie, said that patients were increasingly turning to private screening companies. “We want to make sure that people are fully aware of the tests that are offered to them on the NHS before they pay private companies for screening that may cause unnecessary anxiety and could lead to further unnecessary investigations.”

Private companies currently offer a wide range of heath checks from blood …
A CK2-dependent mechanism for activation of the JAK-STAT signaling pathway
Authors: Ying Zheng, Hongwei Qin, Stuart J. Frank, Luqin Deng, David W. Litchfield, Ayalew Tefferi, Animesh Pardanani, Fang-Tsyr Lin, Jingzhi Li, Bingdong Sha, Etty N. Benveniste
Journal: Blood (2011)
Relationship Between ARIA and ISAAC Questionnaires Regarding to the Classification and Severity of Rhinitis in School Children
Authors: Yuichi Adachi, Koichi Yoshida, Toshiko Itazawa, Yukihiro Ohya, Hiroshi Odajima, Akira Akasawa, Toshio Miyawaki
Journal: Journal of Allergy and Clinical Immunology (2013)
Systemically derived large intestinal CD4+ Th2 cells play a central role in STAT6-mediated allergic diarrhea
Authors: Mi-Na Kweon, Masafumi Yamamoto, Masahiro Kajiki, Ichiro Takahashi, Hiroshi Kiyono
Journal: Journal of Clinical Investigation (2000)

Systemically primed BALB/c mice developed severe diarrhea after repeated oral administration of ovalbumin (OVA). Histological analysis demonstrated that dramatic infiltration of eosinophils and mast cells occurred in the large intestine but not in the small intestine of mice with diarrhea. Interestingly, CD4+ αβ T cells of the large intestine secreted IL-4 and IL-13 at high levels. Identically treated STAT6 gene-disrupted mice failed to develop OVA-induced diarrhea. Further, treatment of BALB/c mice with monoclonal anti–IL-4 antibody prevented the development of allergic diarrhea. An adoptive transfer study showed that systemically primed splenic CD4+ T cells were preferentially recruited into the large intestine upon exposure to oral OVA. These results strongly suggest that systemically derived CD4+ αβ T cells of the large intestine play a critical role in the onset of Th2-mediated intestinal allergic disorders via STAT6 signal transduction.
Metabolic and Cutaneous Events Associated With Hypoglycemia Detected by Sleep Sentry
Authors: William L Clarke, William R Carter, Maria Moll, Daniel J Cox, Linda A Gonder-Frederick, Philip E Cryer
Journal: Diabetes Care (1988)

Eighteen insulin-dependent diabetic subjects [age (mean ± SD) 33.2 ± 10.6 yr] participated in a study designed to determine the metabolic and cutaneous parameters associated with activation of the nocturnal hypoglycemia monitor Sleep Sentry. Plasma glucose, glucagon, epinephrine, norepinephrine, and pancreatic polypeptide concentrations were determined every 10 min during a 2-h constant intravenous insulin infusion (40 mU kg −1 h−1). In addition, skin temperature and electrical conductance were monitored at the same time intervals, and subjects were asked to rate the degree to which they felt cold and/or sweaty. Ten of the subjects (alarmers) activated the device with a mean plasma glucose nadir of 52.8 ± 13.8 mg/dl, whereas eight (nonalarmers) failed to do so despite a mean plasma glucose nadir of 50.5 ± 8.2 mg/dl. There were no significant differences between alarmers and nonalarmers with respect to initial or nadir plasma glucose levels, rate of fall of plasma glucose, or changes in plasma epinephrine, norepinephrine, or pancreatic polypeptide concentrations. In addition, changes in skin temperature and conductance were similar in both groups as were descriptive variables including age, disease duration, gender, and level of glucose control. No subject reported an increase in coldness, whereas 80% of both groups reported an increase in sweatiness. Three subjects studied on more than one occasion over a year failed to exhibit consistent activation of the alarm. This study suggests that it may not be possible to identify patients for whom the Sleep Sentry would be a reliable addition to their self-management regimen and that physicians should exercise caution in recommending its use.
Training of surgical registrars: a regional audit.
Authors: R. T. Diggory
Journal: BMJ (1988)

Though the various functional and organic micturition disorders in children are generally well recognised, there is one fairly uncommon yet quite characteristic feature that seems to have escaped description.We describe this as the daytime frequency syndrome of childhood. PatientsOver four years we saw 17 patients with this condition compared with 253 patients with functional nocturnal and diurnal enuresis seen during the same period.Most (11) were boys, and their ages ranged from 2-10 to 7 2 years (mean 4-2 years).All had been fully toilet trained and had had a normal pattern of micturition but had subsequently developed extreme, unremitting, daytime frequency at intervals varying from five to 20 minutes.There was no polydypsia, and voided volumes were small.Observa- tion of these children in the outpatient department and, in one case, on the ward, indicated that parents were not exaggerating the history.Equally striking was that nocturia was either wholly absent (six cases), occurred only for the first few days (four cases), or took place at intervals (once or twice a night) quite disproportionate to the daytime frequency (seven cases).Two children complained of dysuria for the first few days.None became incontinent by day, but five developed secondary nocturnal enuresis.Bowel habit remained normal.In four cases the disorder followed an upper respiratory tract infection, while in the remainder there were no evident precipitating factors.These children showed no particular similarities of personality and came from varied social backgrounds.Physical examination (including thorough neurological examination) yielded unremarkable results in all cases, urine specimens were free of bacteria, cells, and protein and had a normal pH, and ultrasound examination showed normal upper renal tracts and bladders without thickening of the wall or residual urine.Nine children had received antibiotic treatment without benefit.Spontaneous resolution of symptoms occurred over three to 12 weeks.