tbuckley/cabot-search huggingface dataset:
Treatment of postnatal depression
Authors: V. Hendrick
Journal: BMJ (2003)

Effective interventions are available, but the condition remains underdiagnosed 

Major depressive episodes after childbirth are referred to as postnatal depression or, in the United States, as postpartum depression. During the first six months after delivery the prevalence of major depression is estimated at 12-13%.w1 The precise time frame for defining postnatal depression has varied across studies, typically from one month to one year after childbirth. In an effort to standardise the terminology, the Diagnostic and Statistical Manual of Mental Disorders , fourth edition, restricted the specifier of postpartum onset to depressive episodes occurring within four weeks of delivery. However, most studies of postnatal depression have continued to use wider time frames, in part because epidemiological studies show that women's heightened vulnerability to depression continues for at least the first six months after childbirth. Postnatal depression must be distinguished from postnatal blues (“baby blues”), a common experience following childbirth, in which new mothers experience lability of mood and tearfulness. This mild and self limiting condition typically disappears two weeks after delivery.

Unfortunately postnatal depression is often overlooked in primary care clinics. In a study of 214 women who brought their children to a general paediatric clinic, 86 reported high levels of depressive symptoms on the psychiatric symptom index. Of these women, only 29% were identified as depressed by the paediatricians.1 The mother's suffering, coupled with the burden that her depression …
Organ donors and transplantations decrease in Spain, the leading country in both
Authors: M. d. Lago
Journal: BMJ (2011)

The number of organ donors and transplantations fell last year in Spain, the country that leads the ranking in both and whose transplantations model was recently adopted by the EU. 

The decline—which signals a break in the increase seen in recent years—was caused largely by a sharp reduction in deaths from traffic incidents. Improved management of cerebral infarctions and a small increase in the refusal rate to donate organs among families whose relative has died have also contributed to the fall. The reluctance to donate is particularly widespread among the immigrant population.

The …
Structure and Function of Mucosal Antibodies
Authors: T B Tomasi
Journal: Annual Review of Medicine (1970)

Justification for considering the secretory system as more or less distinct from that responsible for the formation of circulating antibody (systemic sys­ tem) stems from a number of lines of evidence. First, studies in the older medical and veterinary literature [for reviews see Tomasi & Bienenstock, (1); and Pierce (2) I suggest that the titers of specific antibodies present in external secretions vary independently from serum titers, indicating that secretory antibodies are not derived from serum, at least by simple transudation. Sec­ ond, in certain cases, titers of antibodies in external secretions are better cor­ related with resistance to and recovery from infection than are those of se­ rum. Third, more recent observations indicate that many external secretions contain antibodies primarily of the IgA type, whereas this immunoglobulin is a minor constituent of serum. The finding of a predominance of IgA-type plasma cells locally in secretory organs, and the observation that antibodies of the IgA type may be produced by local immunization, support the concept of local synthesis of secretory antibodies. Although most experimental work has thus far focused on IgA, which is present in highest concentrations in external fluids, other immunoglobulins including IgG and IgM are often detectable in significant amounts, particu­ larly when inflammation is present. Very little work has been done with these immunoglobulins. However, evidence is accumulating that both IgG and IgM and, more recently, IgE may be produced locally in small amounts. In this review, emphasis will be placed on secretory IgA which is the predomin­ ant species of antibody. It should be pointed out that the role of these other immunoglobulins, as well as immunoglobulin fragments, may be of consider­ able importance and deserves more attention in future studies.
THE EFFECT OF CLOPIDOGREL LOW-RESPONSIVENESS ASSESSED BY VERIFYNOW P2Y12 ASSAY ON THROMBOTIC EVENTS AFTER IMPLANTATION OF DRUG-ELUTING STENT
Authors: Joong Kyung Sung, Young Jin Yoon, Nam Seok Lee, Jun Won Lee, Jang-Young Kim, Seung Hwan Lee, Junghan Yoon, Kyung-Hoon Choe
Journal: Journal of the American College of Cardiology (2010)
Prevention of Venous Thrombosis in Knee Arthroplasty
Authors: Jacques R. Leclerc
Journal: Annals of Internal Medicine (1997)

Letters15 January 1997Prevention of Venous Thrombosis in Knee ArthroplastyJacques R. Leclerc, MDJacques R. Leclerc, MDLilly Corporate Center, Indianapolis, IN 46285Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-2-199701150-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Basskin and Jacobson raise important points about our study. Investigators in one contemporary trial, which compared enoxaparin with placebo after major knee surgery, obtained a 60% rate of total deep venous thrombosis in patients who received placebo [1]. These results indicate that deep venous thrombosis is an ongoing problem despite improved surgical care and early patient ambulation.Compliance with enoxaparin was not a major issue in our trial because enoxaparin was administered by the nursing staff during hospitalization.We did not do subgroup analyses for age, mobility status, or other variables. Most of our patients were able ...References1. Leclerc JR, Geerts WH, Desjardins L, Jobin F, Laroche F, Delorme F, et al. Prevention of deep vein thrombosis after major knee surgery-a randomized, double-blind trial comparing a low molecular weight heparin fragment (enoxaparin) to placebo. Thromb Haemost. 1992; 67:417-23. Google Scholar2. O'Brien B, Anderson D, Goree R. Cost-effectiveness of enoxaparin versus warfarin prophylaxis against deep vein thrombosis after total hip replacement. Can Med Assoc J. 1994; 150:1083-90. Google Scholar3. RD heparin compared with warfarin for prevention of venous thromboembolic disease following total hip or knee arthroplasty. The RD Heparin Arthroplasty Group. J Bone Joint Surg Am. 1994; 76:1174-85. Google Scholar Author, Article, and Disclosure InformationAuthors: Jacques R. Leclerc, MDAffiliations: Lilly Corporate Center, Indianapolis, IN 46285 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 1997Volume 126, Issue 2Page: 173KeywordsAnesthesiaArthroplastyDeep vein thrombosisHemorrhageHeparinKneesLow molecular weight heparinProphylaxisSurgeryWalking ePublished: 15 August 2000 Issue Published: 15 January 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Biomedical research funding can save lives.
Authors: S Ballin, C Louis
Journal: Circulation (1993)

He ealth care reform is a top priority of the Clinton administration.However, biomedical research does not appear on the White House radar screen.If the American Heart Association (AHA) has its way, biomedical research and preventive care will be key components in any health care system.As reported in "Political News for Physicians/Scientists" in the July Cardiovascular News, the AHA is actively advocating the adoption of five health care principles by Members of Congress and the Clinton administration, including coverage for preventive care and biomedical and clinical research.AHA Board Member Charles Francis, MD, testified recently before the House Ways and Means Subcommittee on Health about the importance of mak- ing prevention and biomedical research integral parts of health care reform.In addition to the lack of focus on research in health care reform, the Clinton budget for fiscal year 1994, submitted to Congress on April 8, fails to recognize the importance of research and prevention activities at the National Institutes of Health (NIH).The Clinton ad- ministration's budget would slash funding for 9 of the 19 research institutes at the NIH and hold 5 of the other 10 institutes to increases of approximately 1% or less.Priority areas in the budget include women's health, minority health, AIDS, and cancer.The overall increase for the NIH would be about 3.2% over the fiscal year 1993 appropriation, below the 4.2% estimated inflation for biomedical research.Of particular concern to the AHA, the Clinton budget calls for a 1.3% cut for the National Heart, Lung, and Blood Institute (NHLBI) and a 1.6% cut for the National Institute of Neurological Disorders and Stroke (NINDS).The effective impact of these pro- posed reductions would be a 6% cut for each institute, taking into account the estimated inflation for biomed- ical research.New and competing research project
The Passing of the Red-Light Treatment of Smallpox.
Authors: Jay F. Schamberg
Journal: JAMA (1904)

Philadelphia, Nov. 16, 1904. <h3>To the Editor:</h3> —In May, 1903, I published inThe Journal<sup>1</sup>an article in which the value of the red-light treatment of smallpox so stoutly championed by Finsen, was questioned. The theoretical objections to the acceptance of Finsen's claim were discussed in detail and the unfavorable results of the treatment of two cases of smallpox in a well-equipped red-light room were given. Finsen replied to this article and criticised the methods employed and the deductions drawn. Since this time Dr. Nelson D. Brayton<sup>2</sup>of Indianapolis published the absolutely negative results obtained in the treatment of 300 cases of smallpox in red-light wards. In the<i>London Lancet</i>, July 30, 1904, there appears an article<sup>3</sup>on "The Red-Light Treatment of Smallpox," by Dr. T. F. Ricketts, medical superintendent of the Smallpox Hospital of the Metropolitan Asylums Board, and J. B. Byles, assistant medical officer of
LONGITUDINAL EFFECT OF LATE AORTIC INSUFFICIENCY UNDER CONTINUOUS FLOW LEFT VENTRICULAR ASSIST DEVICE SUPPORT
Authors: Arudo Hiraoka, Pavan Atluri, James Kirkpatrick, Yasuhiro Shudo, John W. MacArthur, Jeffrey E. Cohen, Alexander S. Fairman, Y. Woo
Journal: Journal of the American College of Cardiology (2013)
Cardiorespiratory Fitness, Glycemic Status, and Mortality Risk in Men
Authors: Harold W Kohl, Neil F Gordon, Jesús A Villegas, Steven N Blair
Journal: Diabetes Care (1992)

Objective — To determine the association of baseline cardiorespiratory fitness to all-cause mortality across the range of blood glucose levels. Research Design And Methods — Data from a prospective study of 8715 men (average age 42 yr), followed for an average of 8.2 yr (range 1-15 yr), were analyzed. Cardiorespiratory fitness was assessed by maximal-exercise treadmill testing. Men with evidence of clinical vascular disease or who did not achieve 85% of their age-predicted maximum heart rate during exercise testing were excluded from analyses. Results — Age-adjusted death rates increased with higher levels, of fasting blood glucose. Regardless of glycemic status, fit men had lower age-adjusted all-cause death rates than their less fit counterparts. For men with fasting blood glucose ≥ 7.8 mM or physician-diagnosed non-insulin-dependent diabetes mellitus (NIDDM), the age-adjusted death rates per 10,000 person-yr of follow-up in unfit and fit subjects were 82.5 and 45.9, respectively. The age-adjusted relative risk of death due to all causes was significantly elevated in the lower-fitness group within each of three glycemic status levels: fasting blood glucose &amp;lt;6.4 mM; relative risk (RR) = 1.93 (95% confidence interval [95% CI] 1.15-3.26); fasting blood glucose 6.4-7.8 mM; RR = 3.42 (95% CI 2.27-5.15); and fasting blood glucose ≥ 7.8 mM or with NIDDM, RR = 1.80 (95% CI = 1.25-2.58). Multivariate analyses, controlling for risk factors of mortality (age, resting systolic blood pressure, serum cholesterol, body mass index, family history of heart disease, follow-up interval, and smoking habit) showed a higher risk of death due to all causes for unfit compared with fit men. Multivariate risks of death associated with low fitness, compared with higher fitness (RR), in the three glycemic status groups were: fasting blood glucose &amp;lt;6.4 mM, RR = 1.38 (95% CI 1.09-1.74); fasting blood glucose 6.4-7.8 mM, RR = 1.61 (95% CI 0.91-2.86); and fasting blood glucose ≥7.8 mM or with NIDDM, RR = 1.92 (95% CI 0.75-4.90). Conclusions — These data suggest that risk of death increases with lessfavorable glycemic status, and that cardiorespiratory fitness may attenuate the forces of impaired carbohydrate metabolism on mortality from any cause.
HTLV-III/LAV Antibody and Immune Status of Household Contacts and Sexual Partners of Persons With Hemophilia
Authors: Janine M. Jason
Journal: JAMA (1986)

We evaluated the human T-cell lymphotropic virus type III/Iymphadenopathy-associated virus (HTLV-III/LAV) antibody and immune status of 88 persons living with and/or sexual partners of 43 hemophiliacs, 12 of whom had AIDS, five of whom had AIDS-related complex (ARC), 17 of whom were clinically well but HTLV-III/LAV antibody positive, and nine of whom were well and HTLV-III/LAV antibody negative. No nonhemophilic household contacts (0/50) of healthy hemophiliacs were HTLV-III/LAV antibody positive; two of 33 nonhemophilic AIDS/ARC contacts were positive. One was a spouse and one a sexual partner of a hemophiliac. One of these antibody-positive contacts herself had AIDS, and one had ARC. Antibody-negative, nonhemophilic contacts of AIDS/ARC and of antibody-positive hemophiliacs had significantly lower numbers of lymphocytes, T helper lymphocytes, and T suppressor lymphocytes than did contacts of antibody-negative hemophiliacs. We conclude that risk of HTLV-III/LAV transmission may exist for spouses and/or sexual contacts of hemophiliacs with AIDS/ARC, but we cannot now determine the risk for contacts of asymptomatic hemophiliacs. (<i>JAMA</i>1986;255:212-215)
Poliovirus proves IRES-istible in vivo
Authors: Bert L. Semler
Journal: Journal of Clinical Investigation (2004)

The genetic basis for the attenuation of polio vaccines has been known since the 1980s. Changes in the internal ribosome entry site, within the 5′ noncoding region of genomic RNAs, were presumed to reduce translation in certain target organs, leading to the conclusion that attenuation is mediated at the level of translation. A report in this issue of the JCI reveals that poliovirus tropism is, in part, determined after internal ribosome entry.
Estrogen Use and All-Cause Mortality
Authors: Trudy L. Bush
Journal: JAMA (1983)

The association of exogenous estrogen use and hysterectomy status with all-cause mortality was examined in 2,269 white women, aged 40 to 69 years, who had been followed up for an average of 5.6 years in the Lipid Research Clinics Program Follow-up Study. A total of 72 deaths occurred during this period. The relative risk of death in estrogen users compared with nonusers was 0.54 in gynecologically intact women, 0.34 in hysterectomized women, and 0.12 in bilaterally oophorectomized women. The risk of death in estrogen users, irrespective of hysterectomy status, was 0.37 times that in nonusers (3.4/1,000 v 9.3/1,000). The significant negative association of estrogen use with mortality persisted after multivariate adjustment for confounding factors. Hysterectomy status alone was not a significant predictor of death. Some, but not all, of the lower risk of mortality in estrogen users can be accounted for by increased levels of high-density lipoprotein cholesterol. (<i>JAMA</i>1983;249:903-906)
Research in high-performance sports medicine: from the bench, to the bedside...to the podium
Authors: C A Speed, S A Ingham
Journal: British Journal of Sports Medicine (2010)

High-performance sports medicine (HPSM) is an area of medicine that deals with individuals who can be unique and complex. They can represent the extreme of the spectrum of normality in relation to their physiological, psychological and behavioural characteristics, and can be exposed to extreme stresses in a range of environments.

When sport and exercise medicine (SEM) started as a discipline in Greco-Roman times, so too did interest develop in the effects of exercise on the human body.1 However, it was not until the 20th century that the field of exercise physiology really evolved. In the 21st century, ‘exercise sciences’ have expanded far into the reaches of metabolic and molecular sciences. Sport- and exercise-related research has become a vast field, ranging from biomechanics, all areas of clinical medicine and applied sciences, through to genetics, psychology, behavioural and neurosciences and technology. Nevertheless, our understanding of high-performance athletes (HPAs) remains limited. The field is rich in opportunities in research. There is the potential to enhance our understanding of adaptations and responses to extreme stimuli. Research can enhance the delivery of medical care to our athletes, and assist with the safe optimisation of human performance. Research in this field can also provide valuable insights into models of health and disease.

This article provides an overview of the framework of research models and methods. We outline some of the challenges of research in HPSM and discuss opportunities in developing the field. Some of the issues raised can relate to SEM as a whole.

Medical research can be broadly classified as basic, applied or translational. Basic …
Survival of Outpatients with Alzheimer-type Dementia
Authors: John S. Walsh
Journal: Annals of Internal Medicine (1990)

Objective: To study the clinical course of Alzheimer-type dementia and those factors that might predict or influence the length of survival. Design: A prospective cohort study. Participants: One hundred and twenty-six patients diagnosed with Alzheimer-type dementia were selected from among 200 consecutive outpatients evaluated for suspected dementia from 1980 to 1982. All 126 patients had at least 6 years of follow-up. Setting: All patients were initially seen as outpatients at a university hospital. Measurements and Main Results: Survival analysis was done using Kaplan-Meier estimates and the Cox proportional hazards model. The mean age at symptom onset was 73.9 years and at enrollment in the study, 77.6 years. The median survival from time of enrollment in the study was 5.3 years (range, 0.2 to 7.2+ years) and from symptom onset, 9.3 years (range, 1.8 to 16+ years). Dementia severity, as measured by the Mini-Mental State Examination (MMSE), was strongly associated with survival (P < 0.001); the median survival of patients with scores of 18 or below was 3 years less than that of patients with scores above 18 (relative risk, 2.7; 95% CI, 1.6 to 4.4). Comorbid conditions and symptom duration were not related to survival. A multivariate analysis of age at symptom onset and of historical features showed that the combination of wandering and falling (relative risk, 2.1; 95% CI, 0.9 to 5.2) and the presence of behavioral problems (relative risk, 1.4; 95% CI, 0.7 to 2.9) at the time of evaluation appeared to adversely affect survival. Conclusions: Length of survival in patients with Alzheimer-type dementia is highly variable; severity of disease (not duration), the combination of wandering and falling, and behavioral problems are associated with shorter survival. Our findings, if confirmed, may provide prognostic information for families and professionals and suggest areas in which interventions to improve survival might be focused.
Pneumococcal Vaccination: The Response of Patients with Alcoholic Liver Cirrhosis
Authors: Mauro Pirovino, Eva Lydick, Peter J. Grob, Stephan Arrenbrecht, Josef Altorfer, Martin Schmid
Journal: Hepatology (1984)

Patients with cirrhosis have an increased risk of dying from pneumococcal pneumonia. Their immunological response to pneumococcal vaccination is not known. We compared the antibody response to challenge with a 14-valent purified pneumococcal polysaccharide vaccine in 15 patients with biopsy-proven alcoholic liver cirrhosis, 10 healthy volunteers and 10 patients with chronic obstructive pulmonary disease. Preimmunization levels for Danish type 1 pneumococcal polysaccharide were lower among cirrhotics than patients with chronic obstructive pulmonary disease. Four and 12 weeks after immunization, no significant differences were found in antibody concentrations between the three groups. We conclude that patients with alcoholic cirrhosis can produce an adequate antibody response to pneumococcal polysaccharide antigen.
Stenting increases stroke risk in patients with intracranial stenosis, study shows
Authors: J. Wise
Journal: BMJ (2015)

Intracranial stenting is associated with increased risk of stroke and transient ischaemic attack (TIA) when compared with medical therapy in patients treated for symptomatic intracranial stenosis, show the results of a randomised study1 that was stopped early because of the adverse findings.

The international VISSIT (Vitesse Intracranial Stent Study for Ischemic Therapy) trial, reported in JAMA , randomised 53 patients with symptomatic intracranial stenosis (narrowing ≥70%) to receive …
High-Dimensional Mapping of the Hippocampus in Depression
Authors: Joel A. Posener, Lei Wang, Joseph L. Price, Mokhtar H. Gado, Michael A. Province, Michael I. Miller, Casey M. Babb, John G. Csernansky
Journal: American Journal of Psychiatry (2002)

Abnormalities of the hippocampus may play a role in the pathophysiology of depression, but efforts to identify a structural abnormality in this brain structure among depressed patients have produced mixed results. Previous research may have been limited by exclusive reliance on measures of hippocampal volume. High-dimensional brain mapping is a new analytic method that quantitatively characterizes the shape as well as volume of a brain structure. In this study, high-dimensional brain mapping was used to evaluate hippocampal shape and volume in patients with major depressive disorder and healthy comparison subjects.By using magnetic resonance imaging, brain scans were obtained from 27 patients with major depressive disorder and 42 healthy comparison subjects. High-dimensional brain mapping generated a series of 10 variables (components) that represented hippocampal shape, and hippocampal volumes were also computed. Analysis of variance techniques were used to compare depressed patients and comparison subjects on hippocampal shape and volume.While the depressed patients and comparison subjects did not differ in hippocampal volume, there were highly significant group differences in hippocampal shape. The two groups did not overlap on a discriminant function computed from a model comprising the 10 components. The pattern of hippocampal surface deformation in the depressed patients suggested specific involvement of the subiculum.Patients with major depression may have structural abnormalities of the hippocampus that can be detected by analysis of hippocampal shape but not volume. A specific defect in the subiculum could have widespread effects throughout neurocircuits that appear to be abnormal in depression.
Th1/Th2 cross-regulation and the discovery of IL-10
Authors: Hema Bashyam
Journal: The Journal of Experimental Medicine (2007)

In the late 1980s, Tim Mosmann and colleagues isolated functionally distinct T helper (Th)-1 and Th2 clones, and provided evidence that these two subsets were mutually inhibitory. Knowledge of the inhibition led to the discovery that Th2 cells make IL-10 to suppress Th1 cells.