tbuckley/cabot-search huggingface dataset:
Public health in the aftermath of disasters
Authors: Eric K Noji
Journal: BMJ (2005)

In the aftermath of disasters, public health services must address the effects of civil strife, armed conflict, population migration, economic collapse, and famine. In modern conflicts civilians are targeted deliberately, and affected populations may face severe public health consequences, even without displacement from their homes. For displaced people, damage to health, sanitation, water supplies, housing, and agriculture may lead to a rapid increase in malnutrition and communicable diseases. Fortunately, the provision of adequate clean water and sanitation, timely measles immunisation, simple treatment of dehydration from diarrhoea, supplementary feeding for the malnourished, micronutrient supplements, and the establishment of an adequate public health surveillance system greatly reduces the health risks associated with the harsh environments of refugee camps. ![][1]</img> ### Environmental health Overcrowding, inadequate hygiene and sanitation, and the resulting poor water supplies increase the incidence of diarrhoea, malaria, respiratory infections, measles, and other communicable diseases. A good system of water supply and excreta disposal must be put in place quickly. No amount of curative health measures can offset the harmful effects of poor environmental health planning for communities in emergency settlements. Where camps are unavoidable, appropriate site location and layout and spacing and type of shelter can mitigate the conditions that lead to the spread of disease. View this table: Table 1 Priorities for a coordinated health programme for emergency settlements #### Water supply and sanitation Adequate sources of potable water and sanitation (collection, disposal, and treatment of excreta and other liquid and solid wastes) must be equally accessible for all camp residents. This is achieved by installing an appropriate number of suitably located waste disposal facilities (toilets, latrines, defecation fields, or solid waste pick-up points), water distribution points, availability of soap and bathing and washing facilities, and effective health education. The United Nations High Commissioner for Refugees (UNHCR) recommends … [1]: /embed/graphic-1.gif
Colonic Perforation after Exchange Transfusion
Authors: J. F. Lucey
Journal: New England Journal of Medicine (1969)

WHEN a "new" complication of an "old" procedure is reported, one cannot help wondering whether it is really "new" or just previously overlooked. Recently, there were two reports of 10 cases of colonic perforation and peritonitis in newborn infants following exchange transfusion.1 , 2 Two similar cases have been observed in Canada.3 Sporadic cases had previously been reported, but the association with exchange transfusion has not received much attention. It must be a rare complication. Its appearance now, however, may be due to subtle changes in the technic of exchange transfusion that have occurred over the years. For example, it is now . . .
Risk stratification with low-level exercise testing 2 weeks after acute myocardial infarction.
Authors: F M Weld, K L Chu, J T Bigger, L M Rolnitzky
Journal: Circulation (1981)

We enrolled 250 patients with acute myocardial infarction after they had been discharged from the cardiac intensive care unit. Among 236 patients who performed a low-level exercise test just before hospital discharge, 52 (22%) had exercise-induced ST depression of at least 0.1 mV in ECG lead V5, 102 (43%) had ventricular arrhythmias, and 121 (51%) had an exercise capacity of shorter than 6 minutes. We used multiple logistic regression analysis to investigate the association of exercise variables with 1-year cardiac mortality. Exercise duration and ventricular premature depolarizations (VPDs) were significantly associated with 1-year mortality after acute myocardial infarction, both with and without control of the influence of other exercise variables statistically; the association of exercise-induced ST depression with 1-year cardiac mortality was not statistically significant. Standardized regression coefficients showed that the variables ranked in the following order in terms of predictive value: exercise duration, VPD frequency and ST depression. Jackknife techniques showed that multiple logistic regression using the three exercise variables was highly accurate in predicting 1-year mortality.
Regulation of alpha 1 proteinase inhibitor function by rabbit alveolar macrophages. Evidence for proteolytic rather than oxidative inactivation.
Authors: M J Banda, E J Clark, Z Werb
Journal: Journal of Clinical Investigation (1985)

Rabbit alveolar macrophages were cultured in an environment conducive to the secretion of both reactive oxygen and proteinases, so that the relative importance of proteolytic and oxidative inactivation of alpha 1-proteinase inhibitor by alveolar macrophages could be evaluated. The inactivation of alpha 1-proteinase inhibitor was proportional to its proteolysis, and there was no detectable inactivation in the absence of proteolysis. Although the live macrophages were capable of secreting reactive oxygen, they did not inactivate alpha 1-proteinase inhibitor by oxidation. The inactivation of alpha 1-proteinase inhibitor by proteolysis was proportional to the secretion of elastinolytic activity by the alveolar macrophages. The inability of the alveolar macrophages to oxidize alpha 1-proteinase inhibitor was attributed to the methionine in the macrophages, in secreted proteins, and in the culture medium competing for oxidants. The data suggest that proteolytic inactivation of alpha 1-proteinase inhibitor may be important in vivo and that the methionine concentration in vivo may protect alpha 1-proteinase inhibitor from significant oxidative inactivation.
Paradoxical reduction of atherosclerosis in apoE-deficient mice with obesity-related type 2 diabetes
Authors: L G Lyngdorf, S Gregersen, A Daugherty, E Falk
Journal: Cardiovascular Research (2003)

The effect of obesity and insulin resistance on the development of atherosclerosis was evaluated in apoE-deficient (ApoE(-/-)) mice. A previously described obesity model, in which the hypothalamic satiety center can be destroyed by a single gold thioglucose (GTG) injection, was used. To evaluate the effect of starvation on atherosclerosis ApoE(-/-) mice were food-restricted with 25% less chow than ad libitum-fed control mice.Sixty-eight ApoE(-/-) mice were allocated into a control group (n=20), a GTG-injected group (n=28), and a food-restricted group (n=20). The control and food-restricted mice were injected with saline instead of GTG. The control and GTG-injected mice had free access to food, and all mice had free access to water during the study period.After 4 months, the GTG-injected mice were significantly overweight (mean body weight (g): 33 +/- 2.11 vs. 23 +/- 0.24 and 17 +/- 0.31 in control and food-restricted mice, respectively), obese, hypertriglyceridemic, insulin-resistant, hyperinsulinemic (mean plasma insulin (ng/ml): 2.45 and 0.43 in obese and control mice, respectively), and hyperglycemic (mean plasma glucose (mmol/l): 11.03 and 7.80 in obese and control mice, respectively). Unexpectedly, these obese and diabetic mice developed significantly less atherosclerosis compared with lean non-diabetic control mice. Food-restricted mice also developed less atherosclerosis compared to control mice.These findings may question the usefulness of mouse models in studying the relation of obesity-related type 2 diabetes to atherosclerosis and also the relevance of results obtained in apoE(-/-) mice with reduced weight gain during intervention.
Strongyloidiasis in Allied ex-prisoners of war in south-east Asia
Authors: D I Grove
Journal: BMJ (1980)

One hundred and sixty ex-servicemen who had been prisoners of war in south-east Asia during 1942-5 were investigated for infection with Strongyloides stercoralis. Larvae were found in 44 (27.5%) of the men, who had therefore been infected for 34-37 years. Direct microscopy of the faeces was the most successful diagnostic method, giving a positive result in 37 cases (84%); multiple examinations were often necessary. Faecal culture was positive in 30 cases (68%), but examination of duodenal fluid obtained with the string test gave a positive result in only 17 (39%). The mean blood eosinophil count and mean serum IgE concentration were higher in the infected men, though normal values were often found in individual cases. Clinical manifestations of isolated strongyloides infection were analysed by comparing the infected men with control groups of ex-prisoners in south-east Asia without proved strongyloidiasis and ex-prisoners in Europe. Twenty-nine infected men (66%) complained of non-specific urticaria, and 13 (30%) had pathognomonic larva currens. Gastrointestinal symptoms significantly more common in the infected group were diarrhoea, indigestion, lower abdominal pain, pruritus ani, and weight loss (p <0.05-p <0.0005).The study group was thought to be reasonably representative of Allied ex-servicemen imprisoned in south-east Asia during the second world war. Probably there are many thousands of infected persons in several countries. The worm has an unusual ability to multiply, and larvae may spread throughout the body in immunosuppressed subjects.
Rat mesangial cell hypertrophy in response to transforming growth factor-β1
Authors: Mary E. Choi, Eung-Gook Kim, Qi Huang, Barbara J. Ballermann
Journal: Kidney International (1993)

Central features of progressive glomerular sclerosis are initial glomerular hypertrophy and subsequent accumulation of extracellular matrix proteins. Since TGF-beta 1 may play a key role in this glomerular response to injury, the present study sought to explore further TGF-beta 1 actions and regulated expression of its receptor in rat mesangial cells. The rat TGF-beta type II receptor (TGF-beta RII) homolog was cloned by screening a rat kidney cDNA library with a human TGF-beta RII cDNA probe, and sequenced. Expression of this receptor subtype in rat mesangial cells was then demonstrated by RNase protection assay, and by Northern blot analysis of poly (A)+ RNA, TGF-beta RII expression was down-regulated in cells treated with exogenous TGF-beta 1. Affinity cross linking studies demonstrated presence of this receptor on cell surface. Rat mesangial cells also expressed TGF-beta 1 and autoinduction by TGF-beta 1 was observed in the same cells, suggesting that this polypeptide may act in an autocrine fashion on mesangial cells, and that it may stimulate a positive autoamplification loop. TGF-beta 1 inhibited mesangial cell proliferation and stimulated significant overall protein and collagen production. Furthermore, mesangial cell size increased in response to chronic TGF-beta 1 treatment. These findings demonstrate that rat mesangial cells express key components of the TGF-beta system and raise the intriguing possibility that in the glomerular mesangium, TGF-beta 1 may not only induce extracellular matrix synthesis, but may also participate in the process of glomerular hypertrophy in response to injury.
Sustained Hyperglycaemia in Pregnancy
Authors: N. Oakley
Journal: BMJ (1972)

All patients gave "informed consent to the procedure."It is with diffidence and regret, as a former colleague of some of the authors and the consultants under whose care these patients were, that I write to ask to whom this consent was given, and in what terms one explains to a diabetic mother that her doctors wish to perform a procedure which may cause the precise danger to her fetus which for the previous three months they have striven to prevent.And does one obtain informed consent from her husband, and if so, how?-I am, etc., T. W. I.
Proteinuria and structural alterations in rat glomerular basement membranes induced by intravenously injected anti-laminin immunoglobulin G.
Authors: D R Abrahamson, J P Caulfield
Journal: The Journal of Experimental Medicine (1982)

Antibodies against laminin, which is a defined glycoprotein of basement membranes, were produced in sheep and affinity purified by immunoadsorption on laminin-Sepharose (S alpha L). When injected intravenously into rats, S alpha L rapidly bound in a linear pattern to the glomerular basement membrane (GBM) in the peripheral and mesangial regions of all glomeruli, and, when greater than 0.5 mg S alpha L was injected, to some tubular BM as well. 1-2 h after the injection of conjugates of horseradish peroxidase (HRP) and S alpha L, HRP reaction product was present throughout the full thickness of the GBM and mesangial matrix. [125I]S alpha L binding to the kidney in vivo increased linearly over the dose range of 40-950 micrograms of IgG and accounted for approximately 2% of the injected dose/g kidney. When 4 mg of [125I]S alpha L was injected, 1.5% or 62 micrograms/g kidney was bound. Proteinuria did not develop within 7 wk of injection in rats that received 0.5-1.6 mg of S alpha L. In contrast, all animals that received injections of 4 mg of S alpha L gradually became proteinuric within 3-6 wk. Thickening, reduplication, and flocculent subendothelial deposits were observed in the GBM of these animals. In addition, mononuclear cells adhered to the GBM and infiltrated beneath the endothelium. However, the deposition of rat C3 was infrequently observed, and rat IgG was not seen in the glomeruli of any rat that received S alpha L. 10 wk after injection, much greater amounts of S alpha L appeared within the mesangium than the peripheral GBM. These results demonstrate that the interaction of S alpha L with the GBM, possibly in concert with infiltrating mononuclear cells, gradually altered the structure and permeability characteristics of the glomerulus independent of a host anti-S alpha L humoral response.
Predictors of new renal dialysis after percutaneous coronary intervention
Authors: Beth A. Bartholomew, Srinivas Dukkipati, Kishore J. Harjai, Judith A. Boura, Datinder Deo, Michael W. Yerkey, H. Mehrdad Sadeghi, William W. O'Neill, Joel K. Kahn
Journal: Journal of the American College of Cardiology (2003)
Australian army infected troops and internees in second world war
Authors: G. Kenyon
Journal: BMJ (1999)

An investigation has found that the Australian army deliberately infected Australian troops and Italian and German internees with malaria and dengue fever at the end of the second world war as part of a drug trial. Many of the men and women who participated in the trials are now questioning the validity of the informed consent procedures and are complaining of subsequent health problems. They are also requesting war service pensions.

As a result of the reports in the Australian media, in particular in The Age in Melbourne and the Sydney Morning Herald, the minister for veterans' …
Pneumococcal Pneumonia in Hospitalized Patients
Authors: Sharon Ort
Journal: JAMA (1983)

The clinical and radiological features of pneumococcal pneumonia were studied in 94 hospitalized patients. Fifty-seven (61%) had a bronchopneumonic pattern on roentgenogram, and 37 (39%), a lobar pattern. Eighty-two (87%) of the patients in both roentgenographic classifications had one or more underlying disease states. There was no difference in the frequency of heart disease, diabetes, chronic pulmonary disease, or malignancy between the two categories. Sputum Gram's stains were also similar in both patterns. Twenty (54%) of the 37 patients with the lobar pattern were bacteremic compared with only five (9%) of the 57 patients with the bronchopneumonic pattern; all five patients with bronchopneumonia and bacteremia had an associated malignancy. Although a lobar pattern is usually emphasized in the diagnosis of pneumococcal pneumonia, this study showed that the majority of patients hospitalized with pneumococcal pneumonia had a roentgenographic bronchopneumonic pattern rather than the classic lobar pattern. Thus, patients with the bronchopneumonic pneumococcal pneumonia pattern may be underdiagnosed. The implications are important both for treatment and for epidemiologic data used in the selection of pneumococcal types for prophylactic vaccines. (<i>JAMA</i>1983;249:214-218)
Molecular and functional characterization of a natural homozygous Arg67His mutation in the prothrombin gene of a patient with a severe procoagulant defect contrasting with a mild hemorrhagic phenotype
Authors: Sepideh Akhavan, Raimondo De Cristofaro, Flora Peyvandi, Silvia Lavoretano, Raffaele Landolfi, Pier M. Mannucci
Journal: Blood (2002)
General public education.
Authors: A MacFarlane, J Gaffin, R Jones, M Seifert
Journal: Annals of the Rheumatic Diseases (1991)

<h3>Objective</h3> Financial toxicity is a financial burden of cancer care itself, which leads to worse quality of life and higher mortality and is considered an adverse effect. The COmprehensive Score for financial Toxicity (COST) tool is a patient-reported outcome measurement used to evaluate financial toxicity. We aimed to validate the internal consistency and reproducibility of the COST tool in patients with gynecologic cancer. <h3>Methods</h3> In this multicenter study covering the period April 2019 to July 2021, using the COST tool in Japan, patients diagnosed with ovarian, cervical, or endometrial cancer receiving systemic anti-cancer drug therapy for more than 2 months were eligible. Patients with no out-of-pocket costs for direct medical costs were excluded. The patients answered the initial test and a retest, which was completed from 2 to 14 days after the initial test. Internal consistency and reproducibility were assessed using Cronbach’s alpha and intraclass correlation coefficient (ICC), respectively. Cronbach’s alpha ≥0.8 indicates good internal consistency, and ICC ≥0.8 is highly reliable. <h3>Results</h3> A total of 112 patients (ovarian: 50, cervical: 26, endometrial: 36) responded to the initial test, and 89 patients answered the retest from 2 to 14 days after the initial test. The median patient age was 58 (range, 28–78) years. The median COST score was 19. Cronbach’s alpha showed good internal consistency at 0.83 (95% CI 0.78 to 0.87). The ICC at 0.850 (95% CI 0.777 to 0.900) showed high reliability. <h3>Conclusions</h3> The COST tool has good internal consistency and reliable reproducibility in patients with gynecologic cancer in Japan. The COST tool quantifies financial toxicity in the insurance system, where patients have limited out-of-pocket direct medical costs. The results support the use of the COST tool in patients with gynecologic cancer.
Antibody titer to gp210-C terminal peptide as a clinical parameter for monitoring primary biliary cirrhosis
Authors: Minoru Nakamura, Yuki Shimizu-Yoshida, Yasushi Takii, Atsumasa Komori, Terufumi Yokoyama, Toshihito Ueki, Manabu Daikoku, Koji Yano, Takehiro Matsumoto, Kiyoshi Migita, Hiroshi Yatsuhashi, Masahiro Ito, Naohiko Masaki, Hiroshi Adachi, Yukio Watanabe, Yoko Nakamura, Takeo Saoshiro, Takeshi Sodeyama, Michiaki Koga, Shinji Shimoda, Hiromi Ishibashi
Journal: Journal of Hepatology (2004)
Circulating levels of sulphasalazine and its metabolites and their relation to the clinical efficacy of the drug in ulcerative colitis.
Authors: A K Azad Khan, S C Truelove
Journal: Gut (1980)

One hundred and eighty-five patients with ulcerative colitis have been studied serially while receiving regular maintenance treatment with sulphasalazine (SASP) in a dose of 0.5 g four times daily. The circulating levels of the drug and its principal metabolites during remission do not influence the liability to relapse. When relapse does occur, the circulating level of sulphapyridine falls and remains depressed until remission occurs. This fall during a relapse is most pronounced when the patient suffers from universal colitis and is least marked in cases of distal colitis.
PTU-140 Neutrophil lymphocyte ratio in outcome prediction after emergency abdominal surgery in the elderly
Authors: P G Vaughan-Shaw, J R Rees, A T King
Journal: Gut (2012)

<h3>Introduction</h3> Accurate prediction of outcome after emergency surgery in the elderly patient may assist decision making. However, certain scoring systems require post-operative data (eg, P-POSSUM) while others have failed to gain widespread use (eg, Surgical risk score). Recent reports have suggested that C reactive protein (CRP) and the neutrophil lymphocyte (N/L ratio) ratio may predict surgical outcome. <h3>Methods</h3> A retrospective review of consecutive unselected patients aged 80 years or over undergoing emergency abdominal surgery over a 22-month period was performed. Univariate, multivariate and recursive analyses were performed and findings validated using an independent data-set. <h3>Results</h3> 88 patients were identified, median age 84 years. 30-day mortality was 31%, 6-month mortality 43% and 12-month mortality 50%. Univariate analysis revealed age, N/L ratio, CRP, midline laparotomy, ASA and surgical risk score to predict outcome at set time points. Using a recursive approach N/L ratio&gt;22 (p=0.0018) best predicted 30-day outcome. On multivariate analysis, N/L ratio was an independent predictor of 30-day outcome (p=0.004, df=1, χ<sup>2</sup>=8.144) while CRP failed to predict outcome at any time point. In an independent dataset (n=84), N/L ratio was an independent prognostic factor at 30 days (p=0.001, df=2, χ<sup>2</sup>=15.071), 6 months (p&lt;0.001, df=1, χ<sup>2</sup>=12.536) and 12 months (p=0.001, df=1 χ<sup>2</sup>=10.27). <h3>Conclusion</h3> We suggest that N/L is an easily calculable pre-operative measure that may have utility in the prediction of outcome after emergency abdominal surgery in the elderly. Further work to validate this measure in a larger, prospective setting and determine why N/L ratio predicts outcome is necessary. <h3>Competing interests</h3> None declared.
Clinical Aspects of Dementia
Authors: William Thornton
Journal: JAMA (1974)

The authors emphasize that this book is oriented to the clinical aspects of the subject. We found this emphasis to be disappointing. As a helpful, descriptive, and short book intended for the postgraduate student, it is acceptable. The authors appropriately emphasize that the first clinical aspect of dementia is recognition; however, in the second step—differential diagnosis from the psychiatric illnesses—the disappointment begins. The natural history of geriatric mental disorders commonly includes symptoms of dementia (or pseudodementia). Reversible symptoms often consistent with dementia coexist with geriatric mental illnesses, such as retarded depression, anxious depression, paranoid psychosis, and schizophrenias. On the other hand, these same mental pictures evolve secondary to a progressive-deteriorating process of cerebral death. Thus far, Roth (<i>J Mental Sci</i>101:281, 1955) has significantly dealt with this poorly studied differential problem. Pearce and Miller present tables for the essential investigation of treatable organic causes of dementia. The omission of screening
Diffuse panbronchiolitis in an Asian immigrant.
Authors: O. Brugiere, B. Milleron, M. Antoine, M. F. Carette, C. Philippe, C. Mayaud
Journal: Thorax (1996)

Diffuse panbronchiolitis (DPB) is a disease with chronic inflammation exclusively located in the region of the respiratory bronchiole. It is largely restricted geographically to the Far East, and cases in Western countries are exceptional, even among Asian immigrants. A patient of Asian origin with DPB who had been living in France for 10 years is described. Only re-examination of the initial open lung biopsy specimen after an eight year period allowed this rare disease to be diagnosed correctly. The known efficacy of low dose erythromycin in DPB was again confirmed after failure of long term high dose corticosteroid therapy administered before an accurate diagnosis had been made.