tbuckley/cabot-search huggingface dataset:
Blood Lead Changes during Pregnancy and Postpartum with Calcium Supplementation
Authors: Brian L. Gulson, Karen J. Mizon, Jacqueline M. Palmer, Michael J. Korsch, Alan J. Taylor, Kathryn R. Mahaffey
Journal: Environmental Health Perspectives (2004)

Pregnancy and lactation are times of physiologic stress during which bone turnover is accelerated. Previous studies have demonstrated that there is increased mobilization of lead from the maternal skeleton at this time and that calcium supplementation may have a protective effect. Ten immigrants to Australia were provided with either calcium carbonate or a complex calcium supplement (approximately 1 g/day) during pregnancy and for 6 months postpartum. Two immigrant subjects who did not conceive acted as controls. Sampling involved monthly venous blood samples throughout pregnancy and every 2 months postpartum, and quarterly environmental samples and 6-day duplicate diets. The geometric mean blood lead at the time of first sampling was 2.4 microg/dL (range, 1.4-6.5). Increases in blood lead during the third trimester, corrected for hematocrit, compared with the minimum value observed, varied from 10 to 50%, with a geometric mean of 25%. The increases generally occurred at 6-8 months gestation, in contrast with that found for a previous cohort, characterized by very low calcium intakes, where the increases occurred at 3-6 months. Large increases in blood lead concentration were found during the postpartum period compared with those during pregnancy; blood lead concentrations increased by between 30 and 95% (geometric mean 65%; n = 8) from the minimum value observed during late pregnancy. From late pregnancy through postpartum, there were significant increases in the lead isotopic ratios from the minimum value observed during late pregnancy for 3 of 8 subjects (p < 0.01). The observed changes are considered to reflect increases in mobilization of lead from the skeleton despite calcium supplementation. The identical isotopic ratios in maternal and cord blood provide further confirmation of placental transfer of lead. The extra flux released from bone during late pregnancy and postpartum varies from 50 to 380 microg lead (geometric mean, 145 microg lead) compared with 330 microg lead in the previous cohort. For subjects replete in calcium, the delay in increase in blood lead and halving of the extra flux released from bone during late pregnancy and postpartum may provide less lead exposure to the developing fetus and newly born infant. Nevertheless, as shown in several other studies on calcium relationships with bone turnover, calcium supplementation appears to provide limited benefit for lead toxicity during lactation.
Phospholipase Cγ1 is essential for T cell development, activation, and tolerance
Authors: Guoping Fu, Yuhong Chen, Mei Yu, Andy Podd, James Schuman, Yinghong He, Lie Di, Maryam Yassai, Dipica Haribhai, Paula E. North, Jack Gorski, Calvin B. Williams, Demin Wang, Renren Wen
Journal: The Journal of Experimental Medicine (2010)

Phospholipase Cγ1 (PLCγ1) is an important signaling effector of T cell receptor (TCR). To investigate the role of PLCγ1 in T cell biology, we generated and examined mice with T cell–specific deletion of PLCγ1. We demonstrate that PLCγ1 deficiency affects positive and negative selection, significantly reduces single-positive thymocytes and peripheral T cells, and impairs TCR-induced proliferation and cytokine production, and the activation of ERK, JNK, AP-1, NFAT, and NF-κB. Importantly, PLCγ1 deficiency impairs the development and function of FoxP3+ regulatory T cells, causing inflammatory/autoimmune symptoms. Therefore, PLCγ1 is essential for T cell development, activation, and tolerance.
Consultant cleared after writing misleading reference
Authors: O. Dyer
Journal: BMJ (2002)

A consultant accused of writing a misleading reference to help a previously suspended surgeon find work was last week cleared of serious professional misconduct by the General Medical Council.

David Osborne, consultant urologist at Basildon and Thurrock General Hospital, was called before the professional conduct committee for failing to mention that former colleague Willem Bijl had been suspended and was under investigation when he resigned from his post as consultant urologist at the hospital.

Mr Bijl was struck off by the professional conduct committee in November 2000, over a 1996 operation in which he …
Comparison of Arm and Leg Blood-pressures in Aortic Insufficiency: an Appraisal of Hill's Sign
Authors: E. F. Pascarelli, C. A. Bertrand
Journal: BMJ (1965)

Hill and Flack (1909) reported that indirectly measured leg systolic pressures were considerably higher than arm systolic pressures in subjects with aortic insufficiency. Further studies (Hill et al., 1909 ; Hill and Rowlands, 1911-12) described this phenomenon in hyperthyroidism after vigorous exercise and in old age. Cuffs were placed below the knee, and by palpation of the posterior tibial or dorsalis pedis arteries the systolic pressures were measured. In several of their cases differences of 100 mm. Hg were noted. In one case a difference of 150 mm. Hg was reported. The usual difference is thought to be between 60 and 100 mm. Hg (Friedberg, 1956). Hill's sign, or the Hill-Flack sign, was also labelled disproportionate femoral systolic hypertension in aortic insufficiency (Friedberg, 1956), even though it was the popliteal artery and its branches which were compressed. The validity of this sign has been challenged by intra arterial studies. Leiner and Wachstein (1937) used a mercury column and optical system on four persons with aortic insuffi ciency, and found no significant directly recorded arm-leg pressure difference. Kotte et al. (1944) used the Hamilton manometer to study 10 persons with aortic insufficiency, and found great variability in consecutively recorded compared brachial and femoral systolic pressures. In some instances brachial systolic pressures were actually found to be higher than femoral pressures. Because of the small number of cases no definite conclusions were reached.
Diabetes Complications in Youth
Authors: Lisa M. Buckloh, Amanda S. Lochrie, Holly Antal, Amy Milkes, J. Atilio Canas, Sally Hutchinson, Tim Wysocki
Journal: Diabetes Care (2008)

Youth with type 1 diabetes face long-term risks of health complications of the disease. Little is known about patients' and parents' knowledge, acquisition of information, and family communication regarding these complications. This paper reports qualitative analyses of parental focus-group discussions of this topic.A total of 47 participants (30 mothers, 14 fathers, and 3 others) representing 33 children between the ages of 8 and 18 years with type 1 diabetes participated in 1 of 13 focus groups. Open-ended questions focused on the type and amount of information about long-term complications presented to parents by health care professionals at different time points, as well as the way that information was presented. Questions also elicited details about parent-child communication and exposure to misconceptions about diabetes complications.Qualitative analysis of the transcribed focus groups revealed that participants experienced significant anxiety about diabetes complications, with a shift from concern about daily management tasks to concern about long-term complications over time. Participants desired a flexible, collaborative educational approach, especially regarding the timing and type of information, relative to the child's age and duration of diabetes. Many parents wanted more sensitive communication and emotional support from health care providers. Motivating children appeared to be a particular challenge; family burnout with regard to diabetes care over time was reported. Knowledge was gained in many ways, yet misinformation was uncommon.Obtaining information about long-term complications is an important process that changes over the course of the disease and with the child's developmental level. More research is needed, especially regarding youth knowledge, learning, and beliefs about diabetes complications.
Idiopathic Hypoproteinemia in Twins
Authors: James Lock
Journal: JAMA (1974)

<h3>To the Editor.—</h3> Since the report of an edema-anemia-hypoproteinemia symptom complex in infants with cystic fibrosis (by Billie and Vahlquist<i>Acta Pediatr</i>44:435, 1955), several articles have been published similar to that of Lee et al (228:585, 1974). We have also participated in the care of identical male twins with this interesting symptom complex and would like to comment on them. <h3>Report of Cases.—Case 1.—</h3> A 2,724-gm (6-lb) boy was born to unrelated parents following an uncomplicated 39-week gestation. Neonatal course was uncomplicated, and he was breast-fed without difficulty. Following the institution of milk supplementation, however, a diffuse, macular, erythematous rash appeared and a soy formula was given. One week later, he was "swollen and pale," and oral iron therapy was started. He did not improve, however, and at 4 weeks of age was pale and edematous. Vital signs were normal for age except for the marked pallor, edema,
Chance, coincidence, serendipity.
Authors: B W Hackman
Journal: BMJ (1979)

TIA patients should simply be given daily aspirin, we would urge general practitioners or others who see any TIA patients over the next few years to refer them to one of the neurologists collaborating in the UK TIA aspirin trial, so that reliable information will eventually emerge.We would be pleased to supply inquirers with the name of a nearby collaborator.
Sensitivity to Folic Acid
Authors: I. Chanarin, J. C. B. Fenton, D. L. Mollin
Journal: BMJ (1957)

MEDICAL JOURN4ALwere cured, and in fact the results have proved so disappointing that it has been reluctantly decided to abandon the trial.Further work might show whether aminitrozole is effec- tive in eliminating trichomonads in the female urinary tract and in the male, but the results so far suggest that it is not suitable alone for vaginal infections.There may be a place for it in conjunction with an effective tricho- monicide, used locally in the vagina, especially in chronic cases, but its use without such treatment does not give sufficiently good results to make it a practical method.We acknowledge our indebtedness to Ortho Pharmaceutical Limited for their generous support of this investigation.This has included help with the technical side and supplies of tritheon, aci-jel, and materials for the culture medium.This help has been given without prejudice to any results that might be obtained.We also thank Mr. D.
Polyunsaturated fatty acids and colchicine in multiple sclerosis
Authors: A G Hassam, M A Crawford
Journal: BMJ (1979)

does not form calcium complexes in bone- forming tissue.Brucellosis, also mentioned by Brock and Roach, is fortunately uncommon within the British Isles3; but co-trimoxazole,4 either alone or in combination with streptomycin, offers highly effective chemotherapy.In this vulnerable group of patients, if a tetracycline is thought to be obligatory, doxycycline would be the least toxic of the group, as its affinity for calcium has been shown to be less than that of the other tetra- cyclines.5However, even this agent is potentially dangerous in childhood and during pregnancy, and must be avoided if at all possible.
Independent and Combined Effects of Exercise Training and Metformin on Insulin Sensitivity in Individuals With Prediabetes
Authors: Steven K. Malin, Robert Gerber, Stuart R. Chipkin, Barry Braun
Journal: Diabetes Care (2011)

Physical activity or metformin enhances insulin sensitivity and opposes the progression from prediabetes to type 2 diabetes. The combination may be more effective because each treatment stimulates AMP-activated protein kinase activity in skeletal muscle. We evaluated the effects of exercise training plus metformin on insulin sensitivity in men and women with prediabetes, compared with each treatment alone.For 12 weeks, men and women with prediabetes were assigned to the following groups: placebo (P), 2,000 mg/day metformin (M), exercise training with placebo (EP), or exercise training with metformin (EM) (n = 8 per group). Before and after the intervention, insulin sensitivity was measured by euglycemic hyperinsulinemic (80 mU/m(2)/min) clamp enriched with [6,6-(2)H]glucose. Changes due to intervention were compared across groups by repeated-measures ANOVA.All three interventions increased insulin sensitivity (P < 0.05) relative to the control group. The mean rise was 25-30% higher after EP than after either EM or M, but this difference was not significant.Insulin sensitivity was considerably higher after 12 weeks of exercise training and/or metformin in men and women with prediabetes. Subtle differences among condition means suggest that adding metformin blunted the full effect of exercise training.
Pressure mounts for inquiry into MMR furore
Authors: Clare Dyer
Journal: BMJ (2004)

<h3>Background</h3> Coronary sinus blood flow (CSBF) is reduced in coronary artery disease (CAD). <h3>Objective</h3> To evaluate the usefulness of transthoracic echocardiography (TTE) in assessing CSBF in patients with CAD. <h3>Methods and results</h3> 232 patients with CAD, including 28 patients with acute myocardial infarction (AMI) (thrombolysed), 80 patients with unstable angina and delayed presentation MI, 80 patients admitted for coronary angiography (CAG) and 44 patients awaiting percutaneous transluminal coronary angioplasty (PTCA) were evaluated with TTE to obtain CSBF values; results were compared with those of controls. In the CAG group, the correlation between CSBF and lesion severity was assessed while in the thrombolysis and PTCA groups, CSBF levels before and after treatment were evaluated. The control group had a coronary sinus diameter of 8.73±2.08 mm and mean CSBF of 441±172 mL/min. Both the diameter and mean CSBF levels were reduced in patients with CAD. In the AMI group, patients with anterior wall myocardial infarction (AWMI) showed a greater percentage increase in CSBF after thrombolysis than patients with inferior wall myocardial infarction (IWMI). In the CAG group, patients with lower CSBF values (&lt;300 mL/min) had more multivessel involvement, especially in patients with AWMI than in those with IWMI. In the PTCA group, patients with AWMI with initial CSBF levels &lt;300 mL/min had a greater percentage increase in CSBF levels after stenting than patients with AWMI with CSBF values &gt;300 mL/min. <h3>Conclusions</h3> Non-invasive assessment of CSBF by TTE is a simple, cost-effective, imaging modality in patients with CAD, especially for risk stratification and assessing therapeutic success.
Why do adults sexually abuse children?
Authors: A Bentovim
Journal: BMJ (1993)

in unexplained hydrops to detect the rare fetus with anaemia secondary to parvovirus infection or fetomatemal haemor- rhage.Access to blood samples from fetuses led to a wealth of research and important contributions to the understanding of human fetal physiology, metabolism, and disease.Banks of surplus samples from clinically indicated procedures should be maintained as a valuable resource for future research, as ethics committees are unlikely to approve fetal blood sampling solely for research.Blood sampling carries a risk of fetal loss of 1-3%/,7 11 with up to 25% in high risk pregnancies.'3The development of non-invasive or less invasive procedures that provide the same 1 Old JM, Thein SL, Weatherall DJ, Cao A, Loukopoulos D. Prenatal diagnosis of the major
Effect of acute volume alterations on norepinephrine and dopamine-beta-hydroxylase in normotensive and hypertensive subjects.
Authors: C R Lake, M G Ziegler
Journal: Circulation (1978)

Fifty-six patients with essential hypertension and 29 normotensive controls were hospitalized and volume expanded with saline or volume depleted with furosemide. We measured plasma norepinephrine (NE) and dopamine-beta-hydroxylase (DBH) to evaluate their sympathetic nervous activity. NE and DBH levels and their response to volume changes were the same in normal and hypertensive subjects. Volume depletion increased plasma NE in recumbent subjects by 50% and in standing subjects by 75% but did not alter DBH. Volume expansion with 2 liters of normal saline did not generally alter plasma NE, but led to a small decrease in DBH. Hypertensives have normal plasma levels of NE and DBH and normal responses of NE and DBH to alterations in volume and posture. The human sympathetic nervous system increases NE output during volume depletion, but fails to decrease NE during volume expansion.
The Effect of Posture on Hypertension Induced by Sympathomimetic Amines in Man
Authors: A. LITTMAN M.D., R. M. GUNNAR, M. I. GROSSMAN, R. CASAS
Journal: Circulation (1952)

After atropine the hypertension induced by Arterenol in man is abolished by tilting to the vertical position. This does not occur with equipressor doses of Arterenol or with atropine alone. Arterenol and atropine in combination could not be shown to have a blocking action at sympathetic ganglions in animal experiments, nor was there blockade of the carotid sinus reflex pathways. The failure to maintain Arterenol-induced hypertension after atropine was thus unexplained. Further experiments on the clinical implications of this phenomenon were performed.
Misdiagnosis of Hereditary Amyloidosis as AL (Primary) Amyloidosis
Authors: Helen J. Lachmann, David R. Booth, Susanne E. Booth, Alison Bybee, Janet A. Gilbertson, Julian D. Gillmore, Mark B. Pepys, Philip N. Hawkins
Journal: New England Journal of Medicine (2002)

Hereditary, autosomal dominant amyloidosis, caused by mutations in the genes encoding transthyretin, fibrinogen A α-chain, lysozyme, or apolipoprotein A-I, is thought to be extremely rare and is not routinely included in the differential diagnosis of systemic amyloidosis unless there is a family history.
Treatment of Injuries to Athletes
Authors: W. Michael Walsh
Journal: JAMA (1984)

Can you really improve on a classic? I mean, honestly. Could Charles Dickens have done any better with a second edition of<i>A Tale of Two Cities?</i>Such questions must naturally come to mind as one contemplates the new fourth edition of O'Donoghue's<i>Treatment of Injuries to Athletes</i>, a true classic in the sports medicine literature. As the author points out in the preface to this edition, the major changes here have been in the addition of several of Dr O'Donoghue's reconstructive surgical techniques. The first ones encountered in the textbook are in the chapter on shoulder injuries, where in this edition a detailed account of Dr O'Donoghue's preferred procedures for both recurrent anterior dislocation and recurrent posterior dislocation of the shoulder is given. Probably the changes most anticipated by regular readers of earlier editions come in the chapter on knee injuries, where Dr O'Donoghue recapitulates his earlier writing on
The Myth of Heterosexual AIDS
Authors: Virginia M. Anderson
Journal: JAMA (1990)

Human immunodeficiency virus (HIV) is a lethal infection of both human beings and the entire health care system. As Michael Fumento depicts in this work, concern over the spread of HIV, the agent that causes the acquired immunodeficiency syndrome (AIDS), has infiltrated governmental health care agencies, often at the expense of other health problems. Human immunodeficiency virus infection is spread primarily through anal-receptive sexual intercourse or sharing needles with HIV-infected persons. The heterosexual fear of HIV transmission and AIDS has become a precondition to demanding the superfunding stream that Congress has authorized to fight the HIV epidemic. Four percent of the reported cases in the United States belong to the heterosexual-only category. The HIV has no sexual preference, has an extremely low infectivity rate per exposure, particularly from women to men, and has remained within the original risk groups assigned by the Centers for Disease Control. The AIDS epidemic in
Letter: Skin reactions to practolol.
Authors: R Felix, F A Ive
Journal: BMJ (1974)

looked in the drug addiction film "The Man with the Golden Arm." Then at my outpatient clinic another patient suffering from neurotic depression told me how very ill she felt after stoppng her regimen of phenelzine and haloperidol to go on to lorazepam.The lorazepam made her excessively drowsy and she stopped it after a day or so but then she felt depressed and irritable and also described this feeling of cold and shivering.This last symptom is quite reminiscent of the "cold turkey" reaction to the with- drawal of narcotics from the habituated, and the reaction followed so swiftly the disoon- tinuation of the drug that I wonder if it might not represent a genuine physical res- ponse to deprival of the drug rather than a purely psychological one or the return of the depression.The medical adviser to the manufacturers tells me that no such with- drawal symptoms have previously been re- ported but I wonder if any of your readers can record similar experiences?-Iam, etc., BRICE PI1-rThe London Hospital (St.Clement's) London E.3 Malaria in the United Kingdom SIR,-In your epidemiological report (5 January, p. 43) you mention 84 cases of malaria in immigrants to the U.K. in 1972.The adult populations of countries where malaria is endemic are generally considered to be inmune to malaria in the sense that they do not suffer overt attacks of the disease.It would be valuable to know if there is any record of the proportion of innigrants in whom malaria was considered to be the cause of their illness rather than simply a concomitant finding, the number of adults, and whether any factors were found, such as acute infections or steroid therapy, which might have been responsible for a temporary lowering of resistance to malaria.-Iam, etc.,
A CASE OF ACTINOMYCOSIS (STREPTOTRICHOSIS) OF THE LUNG AND LIVER SUCCESSFULLY TREATED WITH A VACCINE
Authors: W. H. Wynn
Journal: BMJ (1908)

DI&LJoUA'L1ACTINOMYCOSIS OF LUNG. MARCH 7, 190. before bacilli have appeared in the urine.Therapeutic inoculation and open-air ireatment are the best means of dealing with these patients, except in a few cases where a nephrectomy or the removal of a tuberculous testicle may be Indicated.In the former operation, the cystoscope, combined with improved methods of estimating a patient's renal efficiency, minimizes the risk of removing the less diseased of the two kidneys, an occasional surgical tragedy of the past. SUMMARY.I would thus summarize the treatment of these cases of surgical tuberculosis:1.In all cases " opfn-air treatment" should te organized to meet the circumstances and requirements of the particular case.2. The patient's powers of resistance to the diEease should be periodically measured by suitable blcod examination.3.Where the resistance Is found to be low and there Is no evidence of excessive autoinoculation, uee should be mede of inoculations of Koch's new tuberculin, in doses that are accurately controlled, both as regards their amount and repetitions, by examination of the blood.4. For patifnts in whom there is evidence of excessive autoinoculation, abEolute rest, with, in the case of a limb, absolute fixity of the diseased part, should be preseribed.5. In the cases of circamEcribed tuberculosis, efforts ehould be directed to Increase the circulation through the inafected area.I have already indicated the means we have at our disposal to effect this object.6. Operative procedures should be directed to the removal of the inert material, whether caseous glandp, carious bone, or collecticns of pup, and aQlowlng the access to the infected area of healtby lymph.The necessary operations should be conducted with the most scrupulous asepsis.