tbuckley/cabot-search huggingface dataset:
Postlicensure Safety Surveillance for 7-Valent Pneumococcal Conjugate Vaccine
Authors: Robert P. Wise
Journal: JAMA (2004)

Clinical trials evaluate a vaccine's safety before approval, but some risks may escape detection or adequate characterization until larger population exposures occur after licensure.To summarize reports of events occurring after vaccination with 7-valent pneumococcal conjugate vaccine (PCV), including those that may warrant further investigation to assess possible causation by PCV.Descriptive epidemiology of reports submitted to the Vaccine Adverse Event Reporting System (VAERS), a national passive surveillance database.United States during first 2 years after licensure of PCV (February 2000 through February 2002). Reports studied were for children younger than 18 years and vaccinated with PCV.Numbers and proportional distributions of reports.A total of 4154 reports of events following PCV were submitted to VAERS, for a rate of 13.2 reports per 100,000 doses distributed. Multiple vaccines were given in 74.3% of reports. The most frequently reported symptoms and signs included fever, injection site reactions, fussiness, rashes, and urticaria. Serious events were described in 14.6% of reports. There were 117 deaths, 23 reports of positive rechallenges, and 34 cases of invasive pneumococcal infections possibly representing vaccine failure. Immune-mediated events occurred in 31.3% of reports. All 14 patients with anaphylactic or anaphylactoid reactions survived. Thrombocytopenia developed in 14 patients and serum sickness in 6 others. Neurologic symptoms occurred in 38% of reports. Seizures described in 393 reports included 94 febrile seizures.The majority of reports to VAERS in the first 2 years after licensure of PCV described generally minor adverse events previously identified in clinical trials. The proportion of reports portraying serious events was similar to that for other vaccines. Although there are important limitations in passive surveillance data, and caution in their interpretation is necessary, symptoms experienced by a few children more than once after successive PCV doses, including allergic reactions, prolonged or abnormal crying, fussiness, dyspnea, and gastrointestinal distress, warrant continued surveillance, as do reports of rare but potentially serious events, such as seizures, anaphylactic or anaphylactoid reactions, serum sickness, and thrombocytopenia.
SPONTANEOUS PNEUMOTHORAX SUPERIMPOSED ON ARTIFICIAL PNEUMOTHORAX
Authors: H. G. Garland
Journal: BMJ (1928)

Medical Research Council, as the result of an investigation, specially emphlasized that large quantities of emetin, lbismuitlh iodidle aire essenitial, and total doses of nlot less tlhai 30 to 40 grainis, in daily doses of 3 to 4 girainis, welre advised.A wariniiig should, I think, be issued with,regard to tlhe treatmenlt of scliistosomiasis in chliildren.Not onily slhould the dose he earefully -r-educed in proportion to .age,hubit the possibility of an accumulative effect slhould be safeguarded aigainst by watclhing the general condition of the patienlt hiiid by examiiining thie urinie with an alkaloidal reagent to see that proper elimination is proceeding.-Iam, etc.,
The Dum-dum Bullet
Authors: A. E. Barker
Journal: BMJ (1898)

<h3>Objective</h3> Psychosocial and economic (socioeconomic) barriers, including poverty, stigma and catastrophic costs, impede access to tuberculosis (TB) services in low-income countries. We aimed to characterise the socioeconomic barriers and facilitators of accessing TB services in Nepal to inform the design of a locally appropriate socioeconomic support intervention for TB-affected households. <h3>Design</h3> From August 2018 to July 2019, we conducted an exploratory qualitative study consisting of semistructured focus group discussions (FGDs) with purposively selected multisectoral stakeholders. The data were managed in NVivo V.12, coded by consensus and analysed thematically. <h3>Setting</h3> The study was conducted in four districts, Makwanpur, Chitwan, Dhanusha and Mahottari, which have a high prevalence of poverty and TB. <h3>Participants</h3> Seven FGDs were conducted with 54 in-country stakeholders, grouped by stakeholders, including people with TB (n=21), community stakeholders (n=13) and multidisciplinary TB healthcare professionals (n=20) from the National TB Programme. <h3>Results</h3> The perceived socioeconomic barriers to accessing TB services were: inadequate TB knowledge and advocacy; high food and transportation costs; income loss and stigma. The perceived facilitators to accessing TB care and services were: enhanced championing and awareness-raising about TB and TB services; social protection including health insurance; cash, vouchers and/or nutritional allowance to cover food and travel costs; and psychosocial support and counselling integrated with existing adherence counselling from the National TB Programme. <h3>Conclusion</h3> These results suggest that support interventions that integrate TB education, psychosocial counselling and expand on existing cash transfer schemes would be locally appropriate and could address the socioeconomic barriers to accessing and engaging with TB services faced by TB-affected households in Nepal. The findings have been used to inform the design of a socioeconomic support intervention for TB-affected households. The acceptability, feasibility and impact of this intervention on TB-related costs, stigma and TB treatment outcomes, is now being evaluated in a pilot implementation study in Nepal.
Exercise and Heart Rate
Authors: Walt F. Weaver
Journal: JAMA (1980)

ABSTRACT To the Editor.— In The Journal (243:466, 1980), a small philosophical comment entitled One Small Step for Mankind caught my eye. The comments are lighthearted and do not deserve any harsh scientific rebuttal, but I would like to reply in the same light vein of thought to the oft-quoted concept, We are all born with a certain number of heart-beats; only a fool would use them up jogging.If in the 1,440 minutes of each day the seasoned jogger's heart rate is at least ten beats per minute slower than his sedentary peer because of training effect, he accumulates a credit of 1,440×10 or 14,440 beats per 24 hours. If he jogs for a full hour and elevates his heart rate 90 beats per minute above his basal rate, he still has wasted only 90×60 or 5,400 beats by his one hour of jogging. Thus, even by conservative estimates he
Randomised controlled trial to evaluate early discharge scheme for patients with stroke
Authors: A. G Rudd, C. D A Wolfe, K. Tilling, R. Beech
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To assess the clinical effectiveness of an early discharge policy for patients with stroke by using a community based rehabilitation team. <b>Design:</b> Randomised controlled trial to compare conventional care with an early discharge policy. <b>Setting:</b> Two teaching hospitals in inner London. <b>Subjects:</b> 331 medically stable patients with stroke (mean age 71) who lived alone and were able to transfer independently or who lived with a resident carer and were able to transfer with help. <b>Interventions:</b> 167 patients received specialist community rehabilitation for up to 3 months after randomisation. 164 patients continued with conventional hospital and community care. <b>Main outcome measures:</b> Barthel score at 12 months. Secondary outcomes measured impairment with motoricity index, minimental state examination, and Frenchay aphasia screening test; disability with the Rivermead activity of daily living scales, hospital anxiety and depression scale, and 5 m walk; handicap with the Nottingham health profile; carer stress with caregiver strain index and patient and carer satisfaction. The main process measure was length of stay after randomisation. <b>Results:</b> One year after randomisation no significant differences in clinical outcomes were found apart from increased satisfaction with hospital care in the community therapy group. Length of stay after randomisation in the community therapy group was significantly reduced (12 <i>v</i> 18 days; P&lt;0.0001). Patients with impairments were more likely to receive treatment in the community therapy group. <b>Conclusions:</b> Early discharge with specialist community rehabilitation after stroke is feasible, as clinically effective as conventional care, and acceptable to patients. Considerable reductions in use of hospital beds are achievable. <h3>Key messages</h3> Early discharge from hospital after stroke with specialist rehabilitation at home is feasible without an increase in readmission rates or stress to carers This randomised controlled trial shows this method to be as effective as conventional care when assessed with a range of measures of impairment, disability, handicap, carer stress, and patient and carer satisfaction at 1 year Significant reductions in bed usage can be achieved by the provision of a community rehabilitation team with no significant increase in rehabilitation services
Endothelin-1 transgenic mice develop glomerulosclerosis, interstitial fibrosis, and renal cysts but not hypertension.
Authors: B Hocher, C Thöne-Reineke, P Rohmeiss, F Schmager, T Slowinski, V Burst, F Siegmund, T Quertermous, C Bauer, H H Neumayer, W D Schleuning, F Theuring
Journal: Journal of Clinical Investigation (1997)

The human endothelin-1 (ET-1) gene under the control of its natural promoter was transferred into the germline of mice. The transgene was expressed predominantly in the brain, lung, and kidney. Transgene expression was associated with a pathological phenotype manifested by signs such as age-dependent development of renal cysts, interstitial fibrosis of the kidneys, and glomerulosclerosis leading to a progressive decrease in glomerular filtration rate. This pathology developed in spite of only slightly elevated plasma and tissue ET-1 concentrations. Blood pressure was not affected even after the development of an impaired glomerular filtration rate. Therefore, these transgenic lines provide a new blood pressure-independent animal model of ET-1-induced renal pathology leading to renal fibrosis and fatal kidney disease.
Effect of Acute Carbon Monoxide Poisoning on Work Capacity
Authors: G. H. Apthorp, D. V. Bates, R. Marshall, D. Mendel
Journal: BMJ (1958)

Donald and Paton in 1955 reviewed the theoretical and historical aspects of the administration of gases during artificial respiration.They paid particular attention to the treatment of severe carbon monoxide poisoning with respiratory depression, and emphasized the importance of immediate artificial respiration and the administra- tion of oxygen.They condemned the use of 5% carbon dioxide in oxygen (carbogen) in such patients on the grounds that a patient with respiratory depression must already have excessive amounts of carbon dioxide in his blood, and further administration of carbon dioxide can do no good and might well do harm, since a very high carbon dioxide level in the blood depresses the respiratory centre and may cause death.Their argu- ment.sappear conclusive.The arguments for and against the use of carbogen are not so clear-cut in cases of lesser severity in which respiratory depression has either not occurred or has improved after effective artificial respiration.Min. MI.Blood Vol.Cleared, I. /min.min.
Glucose Intolerance and Aging
Authors: Ralph A DeFronzo
Journal: Diabetes Care (1981)

Glucose tolerance is known to decrease with advancing age. This decline begins in the third or fourth decade of life and is progressive throughout the entire adult life span. The primary cause of this age-related impairment in glucose metabolism results from tissue unresponsiveness to insulin. The plasma insulin response to glucose shows little change with age. Several factors, including decreased physical activity and decreased lean body mass, probably contribute to the insulin resistance. The aging process per se, however, appears to have its own deleterious effect on tissue sensitivity to insulin.
A phase 2 study of eliglustat tartrate (Genz-112638), an oral substrate reduction therapy for Gaucher disease type 1
Authors: Elena Lukina, Nora Watman, Elsa Avila Arreguin, Maryam Banikazemi, Marta Dragosky, Marcelo Iastrebner, Hanna Rosenbaum, Mici Phillips, Gregory M. Pastores, Daniel I. Rosenthal, Mathilde Kaper, Tejdip Singh, Ana Cristina Puga, Peter L. Bonate, M. Judith Peterschmitt
Journal: Blood (2010)
How to Build a Theory About Empirical Bioethics: Acknowledging the Limitations of Empirical Research
Authors: Craig L. Fry
Journal: The American Journal of Bioethics (2009)

Click to increase image sizeClick to decrease image size Acknowledgment This work is supported by an NHMRC Australian Public Health Training Fellowship #519556, the Murdoch Children's Research Institute (Children's Bioethics Centre), and University of Melbourne (Centre for Applied Philosophy & Public Ethics). Comments from the Editors improved the focus of this commentary.
Number of organ donations to strangers trebled last year
Authors: M. Limb
Journal: BMJ (2013)

<h3>Introduction</h3> Reliably and accurately establishing injury and illness epidemiology in biathletes will provide insight into seasonal changes, provide potential to better embed innovative prevention strategies and advance sports medicine through the provision of effective healthcare to biathletes. The main objective of the Biathlon Injury and Illness Study (BIIS) is to provide the first comprehensive epidemiological profile of injury and illness in biathlon athletes during two consecutive Biathlon World Cup seasons over 2-years. <h3>Methods</h3> The BIIS study methodology is established in line with the International Olympic Committee (IOC) injury and illness surveillance protocols using a biathlon-specific injury and illness report form. Team medical staff will provide weekly data using injury and illness definitions of any injury or illness that receives medical attention regardless of time loss. Injuries or illness must be diagnosed and reported by a qualified medical professional (eg, team physician, physiotherapist) to ensure accurate and reliable diagnoses. Descriptive statistics will be used to identify the type, body region and nature of the injury or illness and athlete demographics such as age and gender. Summary measures of injury and illnesses per 1000 athlete-days will be calculated whereby the total number of athletes will be multiplied by the number of days in the season to calculate athlete-days. <h3>Ethics and Dissemination</h3> This study has been approved by the Bellbery Human Research Ethics Committee (HREC reference: 2017-10-757). Results will be published irrespective of negative or positive outcomes and disseminated through different platforms to reach a wide range of stakeholders.
Aiming high in skin photography
Authors: S.E. Brown
Journal: British Journal of Dermatology (1985)

Accurate standardised photographs are essential in dermatology, for records and teaching. The techniques involved in obtaining a high standard in terms of colour, size, shape and texture are exacting, and the differences between average and excellent photographs are subtle, being dependent on the skills of the medical photographer. This paper demonstrates these techniques. It includes many clinical photographs, showing how procedures with cameras, lenses and lighting can illustrate a condition to optimum effect.
Serum S100A12 as a new marker for inflammatory bowel disease and its relationship with disease activity
Authors: Marko Brinar, Isabelle Cleynen, Tamara Coopmans, Gert Van Assche, Paul Rutgeerts, Severine Vermeire
Journal: Gut (2010)

We read with interest the work by Foell et al in which the authors report increased serum levels of the protein S100A12, a marker of neutrophil activation, in patients with Crohn's disease and ulcerative colitis in comparison with healthy controls.1 They also demonstrated a correlation between S100A12 in the serum and disease activity as well as a prompt decrease of S100A12 levels in response to infliximab therapy. More recently, the same group showed that faecal S100A12 had even superior sensitivity and specificity than faecal calprotectin in distinguishing active inflammatory bowel disease (IBD) from healthy controls.2 All together, these findings make S100A12 a promising biomarker in IBD.

As both studies included only few patients, we wanted to further investigate the accuracy of serum S100A12 in a larger cohort of patients and controls. In brief, S100A12 was determined in …
Idiopathic Diffuse Muscular Hypertrophy of the Lower Oesophagus
Authors: J. C. Sloper
Journal: Thorax (1954)

There is a curious and little-known pathological change in the oesophagus in which the musculature of the lower half is greatly and diffusely thickened whilst the lumen is of normal diameter.This con- dition was probably described by Matthew Baillie in 1799, but since then has attracted little interest.It seems justifiable to add a further seven cases to the 25 reported in the literature.An attempt will be made to clarify the aetiology of this condition.Attention will also be drawn to the means by which it may be diagnosed in life, for it will be shown that the underlying functional disturbance is probably a diffuse lower oesophageal spasm, a change which has in recent years been recognized with increasing frequency by radiologists, but about the pathology of which little is as yet known.CASE REPORTS CASE 1 (Index number 30351/1923.Medical).-G.H., a man aged 53 years, was admitted to the London Hospital on January 31, 1923.For the past two months he had had a cough with pain in the chest and dyspnoea.He had lost a great deal of weight.His condition deteriorated and he died on March 5, 1923.The patient had no history relevant to the oeso- phagus.Summary of Necropsy (P.M. 121/1923).-Therewas a carcinomatous mass (9 by 6 by 6 cm.) in the hilum of the left lung, with great infiltration of the hilar glands.This growth was composed of solid acini of oat cells and spindle cells, and of tubules lined by cubical and columnar epithelium.There were numerous secondaries in the liver and bones.The lower lobe of the left lung showed broncho- pneumonia.The heart was slightly enlarged (361 g.).Appearance of the Oesophagus.-There was hyper- trophy without dilatation of the oesophagus, gradually increasing from the upper end (0.3 cm.thick) to the lower end (1 cm.thick), but without any additional thickening at the cardia.The mucosa was white and smooth.
How often does Bacteraemia Occur following Endoscopic Retrograde Cholangiopancreatography (ERCP)?
Authors: S. Lam, J. Tsui, P. Chan, K. Wong, G. Ong
Journal: Endoscopy (1977)

In order to determine the risk of bacteraemia from ERCP, we cultured blood specimens from 83 patients before, during and 15 min, 1, 6, 12 and 24 hours after the examination as well as in the subsequent week whenever fever occurred. No bacteraemia was found in the 20 patients who had duodenoscopy only, i.e. in whom ERCP failed. Of the 20 patients with normal biliary and/or pancreatic ducts positive culture was obtained in one patient in whom inadvertent multiple injections of contrast material into the pancreatic duct had resulted in the occurrence of a pyelogram. Four positive cultures were found amongst the 43 patients in whom an obstructive pathology in the biliary or pancreatic system was present. These data support the need of on antibiotic prophylaxis for patients with valvular heart defects.
Different Effects of Estrogen and Progesterone on Experimental Atherosclerosis inFemale Versus Male Rabbits
Authors: Hartmut Hanke, Sybille Hanke, Gerald Finking, Alexandra Muhic-Lohrer, Alfred O. Mu¨ck, Friedrich W. Schmahl, Rainer Haasis, Vinzenz Hombach
Journal: Circulation (1996)

The aim of the present study was to compare the effect of estrogen and progesterone on the development of experimental atherosclerosis in female versus male rabbits to assess possible sex-specific differences.A total of 32 female and 32 male New Zealand White rabbits were ovariectomized or castrated. In addition to a 0.5% cholesterol diet, the rabbits received estradiol alone (1 mg/kg body wt [BW] per week), progesterone alone (25 mg/kg BW per week), or combined estradiol-progesterone in these dosages during 12 weeks. Ovariectomized female and castrated male rabbits served as control groups without hormone treatment. Before excision of the vessels, bromodeoxyuridine labeling was performed to determine the extent of cellular proliferation in the atherosclerotic lesions. The aortic arch was analyzed immunohistologically and morphometrically. An inhibitory effect of estrogen on intimal plaque size was found in female rabbits compared with the ovariectomized control group (0.7 +/- 0.5 versus 3.7 +/- 2.5 mm2, P < .002; proliferating cells, 3.1 +/- 1.8% versus 8.5 +/- 2.6%, P < .002). In combination with progesterone, however, estrogen was not able to reduce intimal plaque size or cellular proliferation. In contrast, estradiol in castrated male rabbits was not associated with an inhibitory effect on cellular proliferation or intimal thickening compared with controls (estrogen treatment, 7.6 +/- 2.1% proliferating cells and 2.8 +/- 1.0 mm2 neointima; control group, 7.2 +/- 2.1% cellular proliferation and 2.9 +/- 1.2 mm2 intimal thickening).Our data suggest that the atheroprotective effect of estrogen is probably due to a mechanism that is present in female rabbits only.
Obliterative Aortic Disease in Children in the Tropics
Authors: BRUCE C. PATON, KASARN CHARTIKAVANIJ, PREM BURI, KUMPOL PRACHUABMOH, M. R. BAJARISAN JUMBALA
Journal: Circulation (1965)

Seven cases of obliterative disease of the aorta have been described, all occurring in Thai children. This disease is believed to be a variant of Takayasu's disease and the clinical manifestations, etiology, and treatment have been discussed.
A Quantitative Look at Fluorosis, Fluoride Exposure, and Intake in Children Using a Health Risk Assessment Approach
Authors: Serap Erdal, Susan N. Buchanan
Journal: Environmental Health Perspectives (2004)

The prevalence of dental fluorosis in the United States has increased during the last 30 years. In this study, we used a mathematical model commonly employed by the U.S. Environmental Protection Agency to estimate average daily intake of fluoride via all applicable exposure pathways contributing to fluorosis risk for infants and children living in hypothetical fluoridated and nonfluoridated communities. We also estimated hazard quotients for each exposure pathway and hazard indices for exposure conditions representative of central tendency exposure (CTE) and reasonable maximum exposure (RME) conditions. The exposure pathways considered were uptake of fluoride via fluoridated drinking water, beverages, cow's milk, foods, and fluoride supplements for both age groups. Additionally, consumption of infant formula for infants and inadvertent swallowing of toothpaste while brushing and incidental ingestion of soil for children were also considered. The cumulative daily fluoride intake in fluoridated areas was estimated as 0.20 and 0.11 mg/kg-day for RME and CTE scenarios, respectively, for infants. On the other hand, the RME and CTE estimates for children were 0.23 and 0.06 mg/kg-day, respectively. In areas where municipal water is not fluoridated, our RME and CTE estimates for cumulative daily average intake were, respectively, 0.11 and 0.08 mg/kg-day for infants and 0.21 and 0.06 mg/kg-day for children. Our theoretical estimates are in good agreement with measurement-based estimates reported in the literature. Although CTE estimates were within the optimum range for dental caries prevention, the RME estimates were above the upper tolerable intake limit. This suggests that some children may be at risk for fluorosis.