tbuckley/cabot-search huggingface dataset:
ABC of labour care: Relief of pain
Authors: I. Findley, G. Chamberlain
Journal: BMJ (1999)

Labour is usually painful. Exceptionally, a very few women may not feel pain; others can control their response so as to reduce pain. Most women think that pain is going to be a major part of giving birth. Professionals can help to reduce women's fears by giving precise, accurate, and relevant information beforehand and explaining what pain relief will be available at the place where the woman will be in labour. If a women has plans about the sort of pain relief she wants, these should be discussed in advance with the woman and her partner.

### Causes of labour pain

View this table:

Percentages of women using pain relief (based on the reports of the National Birthday Trust surveys)



The National Birthday Trust has performed nationwide surveys since the second world war, and the table shows the proportions of women going through labour using various methods of analgesia. Chloroform and trilene are no longer used; pethidine achieved a popularity that is now waning;nitrous oxide is a mainstay; and epidural and spinal methods are increasing in use.



Equipment for self administration of nitrous oxide and oxygen (Entonox) with a mouth piece (top) and a face mask (bottom



The trust's 1990 report, Pain Relief in Labour , is based on the experiences of over 10 000 women who delivered in the United Kingdom during one week. It is the best source of national statistics on both pharmacological and non-pharmacological analgesics. Much of this article is based on the report; some practices may have changed in the years since the survey—for example, the increased use of epidural and spinal anaesthesia for caesarean section.

### Nitrous oxide

Premixed nitrous oxide and oxygen is now provided …
Sanitising horror for the public good
Authors: J. Rozenberg
Journal: BMJ (1996)

All journalists want their work to be noticed: that's why they write for a living. Commonly enough their work is ignored, but those of us covering the trial of Rosemary West this autumn discovered an entirely new phenomenon. Our work was not simply ignored, but shunned—readers and viewers told us they simply did not want to know about the evidence against Mrs West, which led to her conviction on 10 counts of murder.

After the main prosecution statements at the committal proceedings earlier in the year, we had warned our editors about the nature of the evidence we expected, and most newspapers and broadcasters had decided how much detail their audiences could take.

At the BBC we set our own limits. These were never spelt out in detail, but there was broad agreement among everyone responsible for our coverage. At one point in the trial we announced on air that we would not be …
Intimate Partner Violence and Incident Depressive Symptoms and Suicide Attempts: A Systematic Review of Longitudinal Studies
Authors: Karen M. Devries, Joelle Y. Mak, Loraine J. Bacchus, Jennifer C. Child, Gail Falder, Max Petzold, Jill Astbury, Charlotte H. Watts
Journal: PLoS Medicine (2013)

Karen Devries and colleagues conduct a systematic review of longitudinal studies to evaluate the direction of association between symptoms of depression and intimate partner violence. Please see later in the article for the Editors' Summary
Do Older Men Benefit From Curative Therapy of Localized Prostate Cancer?
Authors: Shabbir M.H. Alibhai, Gary Naglie, Robert Nam, John Trachtenberg, Murray D. Krahn
Journal: Journal of Clinical Oncology (2003)

Prior decision-analytic models are based on outdated or suboptimal efficacy, patient preference, and comorbidity data. We estimated life expectancy (LE) and quality-adjusted life expectancy (QALE) associated with available treatments for localized prostate cancer in men aged >/= 65 years, adjusting for Gleason score, patient preferences, and comorbidity.We evaluated three treatments, using a decision-analytic Markov model: radical prostatectomy (RP), external beam radiotherapy (EBRT), and watchful waiting (WW). Rates of treatment complications and pretreatment incontinence and impotence were derived from published studies. We estimated treatment efficacy using three data sources: cancer registry cohort data, pooled case series, and modern radiotherapy studies. Utilities were obtained from 141 prostate cancer patients and from published studies.For men with well-differentiated tumors and few comorbidities, potentially curative therapy (RP or EBRT) prolonged LE up to age 75 years but did not improve QALE at any age. For moderately differentiated cancers, potentially curative therapy resulted in LE and QALE gains up to age 75 years. For poorly differentiated disease, potentially curative therapy resulted in LE and QALE gains up to age 80 years. Benefits of potentially curative therapy were restricted to men with no worse than mild comorbidity. When cohort and pooled case series data were used, RP was preferred over EBRT in all groups but was comparable to modern radiotherapy.Potentially curative therapy results in significantly improved LE and QALE for older men with few comorbidities and moderately or poorly differentiated localized prostate cancer. Age should not be a barrier to treatment in this group.
Relatively Benign Sickle-cell Anaemia in 60 Patients Aged Over 30 in the West Indies
Authors: G. R. Serjeant, R. Richards, P. R. H. Barbor, P. F. Milner
Journal: BMJ (1968)

A study in Jamaica of 60 patients with sickle-cell anaemia over the age of 30 years showed that most of them were in full-time employment. Pains in the bones or joints, leg ulceration, and jaundice were the most frequent types of presentation, but only two patients had a haemoglobin level consistently below 6 g./ 100 ml. Most of the patients were well developed and of average height, and, though the development of secondary sexual characteristics was delayed, there was an average of 2.6 pregnancies per patient. These findings suggest that the course is more benign than has been realized.
Immunologic effects of dioxin: new results from Seveso and comparison with other studies.
Authors: Andrea Baccarelli, Paolo Mocarelli, Donald G Patterson, Matteo Bonzini, Angela C Pesatori, Neil Caporaso, Maria Teresa Landi
Journal: Environmental Health Perspectives (2002)

Animal studies indicate that the immune system is one of the most sensitive targets of the toxic effects of 2,3,7,8-tetrachloro-p-dibenzodioxin (TCDD). TCDD inhibits immunoglobulin secretion and decreases resistance to bacterial, viral, and parasitic infections in exposed animals. Nearly 20 years after the Seveso, Italy, accident, we measured immunoglobulin and complement plasma levels in a random sample of the population in the most highly exposed zones (n = 62) and in the surrounding noncontaminated area (n = 58). Plasma IgG levels decreased with increasing TCDD plasma concentration (r = -0.35, p = 0.0002). Median IgG concentration decreased from 1,526 mg/dL in the group with the lowest (< 3.5 ppt) TCDD levels to 1,163 mg/dL in the group with the highest (20.1-89.9 ppt) TCDD levels (p = 0.002). The association was significant (p = 0.0004) after adjusting for age, sex, smoking, and consumption of domestic livestock and poultry in multiple regression analysis and persisted after exclusion of subjects with inflammatory diseases and those using antibiotics or nonsteroidal anti-inflammatory drugs. IgM, IgA, C3, and C4 plasma concentrations did not exhibit any consistent association with TCDD levels. We performed a systematic review of all the articles published between 1966 and 2001 on human subjects exposed to TCDD reporting information on circulating levels of immunoglobulins and/or complement components. The literature indicates that the evidence for effects of TCDD on humoral immunity is sparse. Methodologic issues, results, and possible sources of variation between studies are discussed. The possible long-term immunologic effects of TCDD exhibited by the participants of the present study, coupled with the increased incidence of lymphatic tumors in the area of the accident, warrant further investigation.
1403 ASSOCIATION OF VITAMIN D BINDING PROTEIN GENE POLYMORPHISM rs 222020 AND THERAPEUTIC OUTCOME IN ASIAN PATIENTS WITH CHRONIC HEPATITIS C INFECTION
Authors: K. Thanapirom, S. Suksawatamnuay, P. Tangkijvanich, S. Treeprasertsuk, Y. Poovorawan, S. Akkarathamrongsin, P. Komolmit
Journal: Journal of Hepatology (2013)
Ferritin in Serum
Authors: A. Jacobs, M. Worwood
Journal: New England Journal of Medicine (1975)

FERRITIN is the major iron storage protein in the body. Although it is found in all tissues there is little quantitative information about its distribution. Measurements of non-heme iron concentrations indicate a particularly large amount in the liver, spleen and bone marrow. Each ferritin molecule is thought to consist of a spherical protein shell of molecular weight about 450,000 made up of 24 subunits with a variable amount of iron as a crystalline core of ferric-oxide-phosphate. The study of tissue ferritins has shown that each molecule may accumulate up to about 4000 atoms of iron, and the fully saturated protein . . .
Blood Transfusion in Clinical Medicine
Authors: F. K. Widmann
Journal: JAMA (1967)

The new edition of Mollison is out. This unadorned statement is enough to send all blood-bankers rushing to their booksellers. To admirers of the third edition (1961) it will be no surprise that the fourth edition is lucidly written, sensibly organized, admirably compendious, and has an astonishing bibliography. Readers not yet familiar with<i>Blood Transfusion in Clinical Medicine</i>should lose no time in acquiring it. Within the broad field of blood transfusion are subjects which affect clinicians of every variety, physiologists, pathologists, biochemists, computer experts, and refrigeration engineers, and there is something in this edition for all of them. The emphasis remains on the clinical applications of immunohematology, but a concise section on "immunologic aspects" covers the newer work on immunoglobulins, complement, and the biochemical nature of antigens. Experimental work in red blood cell preservation is described briefly, and advances in leukocyte and platelet grouping are discussed. Described in detail
Mutations affecting components of the SWI/SNF complex cause Coffin-Siris syndrome
Authors: Yoshinori Tsurusaki, Nobuhiko Okamoto, Hirofumi Ohashi, Tomoki Kosho, Yoko Imai, Yumiko Hibi-Ko, Tadashi Kaname, Kenji Naritomi, Hiroshi Kawame, Keiko Wakui, Yoshimitsu Fukushima, Tomomi Homma, Mitsuhiro Kato, Yoko Hiraki, Takanori Yamagata, Shoji Yano, Seiji Mizuno, Satoru Sakazume, Takuma Ishii, Toshiro Nagai, Masaaki Shiina, Kazuhiro Ogata, Tohru Ohta, Norio Niikawa, Satoko Miyatake, Ippei Okada, Takeshi Mizuguchi, Hiroshi Doi, Hirotomo Saitsu, Noriko Miyake, Naomichi Matsumoto
Journal: Nature Genetics (2012)
Abstract 3077: Nek3/Vav2 modulation of the expression of genes involved in breast cancer pathogenesis
Authors: Christine Ratajczak, Charles Clevenger
Journal: Cancer Research (2012)

Abstract The pituitary hormone prolactin (PRL) is generally recognized for its role in breast growth and differentiation; however, a role for PRL in the pathogenesis of breast cancer has emerged from epidemiological studies and basic science research using both human breast cancer cells and animal models. Activation of the prolactin receptor (PRLr) by PRL contributes to the growth, survival, and motility of human breast cancer cells. PRLr stimulation by PRL results in the activation of multiple signaling complexes including serine/threonine kinase Nek3 and guanine nucleotide exchange factor Vav2. Nek3 is necessary for the activation of Vav2, and Nek3 knockdown results in decreased cytoskeletal re-organization, cell motility, and cell invasion in PRL-stimulated human breast cancer cells. The overexpression of a kinase inactive form of Nek3 in human breast cancer cells results in increased apoptosis, indicating a pro-survival function for Nek3. Furthermore, Nek3 expression is increased in malignant vs. normal human breast tissue. These data make the Nek3/Vav2 complex an interesting target for novel breast cancer therapeutics. To this end, a greater understanding of the role of Nek3/Vav2 in breast cancer pathogenesis is necessary. We hypothesized that the Nek3/Vav2 complex modulates PRL-driven expression of genes involved in the pathogenesis of breast cancer. In these studies, luciferase assays and quantitative PCR were used to evaluate the effects of gain- or loss-of-function of Nek3/Vav2 on the expression of CISH (cytokine-inducible SH2-containing protein). Gain- or loss-of-function of Nek3/Vav2 was found to alter the expression of CISH in response to PRL in both MCF7 and T47D human breast cancer cell lines. The CISH promoter has 4 binding sites for the transcription factor Stat5, which is known to contribute to malignant transformation and tumor growth in breast cancer. Luciferase assay showed that gain- or loss-of-function of Nek3 was also found to alter the activation of a reporter construct containing the lactogenic hormone response element which consists of six tandem Stat5 DNA-binding elements. This suggests that Nek3/Vav2 modulates the PRL-driven expression of CISH by regulating activity of the transcription factor Stat5. Gain- or loss-of-function of Nek3/Vav2 was not found to alter the subcellular localization of Stat5 in response to PRL. Ongoing studies are examining the mechanism of Nek3/Vav2 modulation of PRL-responsive gene expression in breast cancer cells. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3077. doi:1538-7445.AM2012-3077
Hemopexin Therapy Improves Cardiovascular Function by Preventing Heme-Induced Endothelial Toxicity in Mouse Models of Hemolytic Diseases
Authors: Francesca Vinchi, Lucia De Franceschi, Alessandra Ghigo, Tim Townes, James Cimino, Lorenzo Silengo, Emilio Hirsch, Fiorella Altruda, Emanuela Tolosano
Journal: Circulation (2013)

Hemolytic diseases are characterized by enhanced intravascular hemolysis resulting in heme-catalyzed reactive oxygen species generation, which leads to endothelial dysfunction and oxidative damage. Hemopexin (Hx) is a plasma heme scavenger able to prevent endothelial damage and tissue congestion in a model of heme overload. Here, we tested whether Hx could be used as a therapeutic tool to counteract heme toxic effects on the cardiovascular system in hemolytic diseases.By using a model of heme overload in Hx-null mice, we demonstrated that heme excess in plasma, if not bound to Hx, promoted the production of reactive oxygen species and the induction of adhesion molecules and caused the reduction of nitric oxide availability. Then, we used β-thalassemia and sickle cell disease mice as models of hemolytic diseases to evaluate the efficacy of an Hx-based therapy in the treatment of vascular dysfunction related to heme overload. Our data demonstrated that Hx prevented heme-iron loading in the cardiovascular system, thus limiting the production of reactive oxygen species, the induction of adhesion molecules, and the oxidative inactivation of nitric oxide synthase/nitric oxide, and promoted heme recovery and detoxification by the liver mainly through the induction of heme oxygenase activity. Moreover, we showed that in sickle cell disease mice, endothelial activation and oxidation were associated with increased blood pressure and altered cardiac function, and the administration of exogenous Hx was found to almost completely normalize these parameters.Hemopexin treatment is a promising novel therapy to protect against heme-induced cardiovascular dysfunction in hemolytic disorders.
FcγIIB and Cardiovascular Inflammatory Disease
Authors: Chiharu Kishimoto, Keisuke Shioji, Zuyi Yuan
Journal: Circulation Research (2006)

We read with great interest the article by Mineo and colleagues 1 exploring the role of Fc␥IIB, an inhibitory receptor of Fc␥IIs, on C-reactive protein (CRP)-mediated endothelial dysfunction.Mineo et al examined the mechanisms of CRP actions on endothelium by testing the hypothesis that CRP attenuates endothelial NO synthase (eNOS) activation in vitro.The investigators found that CRPinduced declines in NO production promote monocyte adhesion to endothelium.They further investigated the role of Fc␥ receptors, which display high affinity for CRP and modulate CRP actions.They found that, in Fc␥RIIB ϩ/ϩ mice, CRP blunts acetylcholine-induced increases in carotid artery vascular conductance, and that, in contrast, CRP enhances acetylcholine responses in Fc␥RIIB Ϫ/Ϫ mice.They concluded that Fc␥RIIB mediates CRP inhibition of eNOS.At first glance, their results appear to be contradictory to previous reports by our own group 2,3 and by Gill et al. 4 In our study, not only Fc␥RIIB-mediated inhibitory effect on experimental autoimmune myocarditis in rats 2 but Fc␥RIIB-mediated antiatherosclerotic effect in apolipoprotein E-deficient mice 3 were demonstrated, using immunoglobulin preparations.Gill et al 4 demonstrated the targeting effect of immunoglobulin on adhesion molecules using ischemiareperfusion model in cats, suggesting the downregulation of adhesion molecules via Fc receptors.3][4] The precise effect of Fc␥RIIB on cardiovascular inflammatory cascades may depend on experimental models.Such opposite activatory and inhibitory actions of Fc␥RIIB against inflammation may occur, depending on the dose used and the experimental conditions.In fact, there are Fc␥RIIA, an activatory receptor, and Fc␥RIIB, an inhibitory receptor, in humans, but only Fc␥RIIB has been identified in mice. 5ineo et al 1 also explored the fact that Fc␥RIIB is expressed in human endothelial cells and in mouse endothelium.It is well known that CRP levels are strongly correlated with increased risk for cardiovascular inflammatory diseases. 6,7Taken together, they proposed a CRP-modulating novel therapy by Fc␥RIIB for preventing cardiovascular complications in multiple inflammatory and autoimmune disorders.We agree with their proposal, because of the great pathogenetic contribution of Fc␥IIs in cardiovascular inflammatory diseases.
Statistical coronary motion models for 2D+t/3D registration of X-ray coronary angiography and CTA
Authors: N. Baka, C.T. Metz, C. Schultz, L. Neefjes, R.J. van Geuns, B.P.F. Lelieveldt, W.J. Niessen, T. van Walsum, M. de Bruijne
Journal: Medical Image Analysis (2013)
We've Come a Long Way—Thanks to Peer Review
Authors: Martha J. Carney
Journal: JAMA (1987)

The Royal Society of England first introduced the concept of journal article refereeing around the middle of the 18th century as an attempt to improve the quality of the<i>Philosophical Transactions</i>, the first British medical journal.<sup>1</sup>Nearly 250 years later, we still believe that the intelligent and prudent guidance of peer reviewers is key to maintaining a professional journal of high quality. Rigorous peer review prevents the publication of poor science by applying the most stringent standards when evaluating the validity of research. It often provides the authors with constructive comments to strengthen the content of studies that are ultimately published. Most especially, it prevents both the author and the journal from losing credibility among readers. Circulation and readership figures reveal that many non— peer-reviewed publications are included in the regular reading of physicians. A growing proliferation of such non—primary source periodicals creates severe competition for reader time, especially
Health care rationing
Authors: C. Ham
Journal: BMJ (1995)

The recent decision of Cambridge Health Authority not to fund a second bone marrow transplant operation for a 10 year old girl has brought to public attention what has long been clear to doctors, managers, and politicians. Rationing or priority setting is an inherent feature of decision making in health care. This applies not only to Britain but to health services around the world.1

A recent inquiry by the all party House of Commons health committee has reviewed the experience of purchasers in setting priorities and has made a series of recommendations to the government.2 In its response the government has accepted the broad thrust of the committee's report and has set out how it intends to approach rationing in future.3

Experience in different countries suggests that there are two main approaches to rationing. Firstly, there is what might be described as rationing by exclusion. This is the approach taken in Oregon, where the state health commission drew up a long list of condition-treatment pairs and ranked them in order of priority. With the resources available it has been possible to include 565 out of 696 treatments in the government funded Medicaid programme. The remaining treatments have been excluded from funding thus far, although this may change as the Oregon scheme evolves.

The second approach is to ration by guidelines. This is the approach taken in …
Designing a Research Project: The Basics of Biomedical Research Methodology
Authors: James R. Marshall
Journal: JAMA (1983)

<b>Analyzing Research Data: The Basics of Biomedical Research Methodology</b>, by Ronald G. Marks, 210 pp, with illus, $25, Belmont, CA 94002 (10 Davis Dr), Lifetime Learning Publications, 1982. <i>Designing a Research Project</i>, a text on the conduct of research, will be most useful as a guide to the appreciation of research. The text includes chapters on designing and planning research projects, deciding about the kinds of data to collect, designing data collection instruments, and choosing participants. It is designed to be the first text in a two-text, two-semester sequence. The purpose of the book is to enumerate what must be taken into account in the undertaking of a research project. Planning is emphasized as crucial. The author encourages consultation with statisticians. Unfortunately, the author fails to emphasize the extent to which research builds on the work of others. Most research is designed to build on or amplify the work of
Diphtheria-Tetanus-Pertussis Immunization by Intradermal Jet Injection
Authors: J. P. Stanfield, P. M. Bracken, K. M. Waddell, D. Gall
Journal: BMJ (1972)

An intradermal jet injector was used to administer combined diphtheria, tetanus, and pertussis (D.T.P.) vaccines to infants aged 2 to 12 months. A second dose was given one month after the first and a third six months after the second. Each dose was considerably smaller than the standard intramuscular dose. Blood samples taken one month after the third dose showed a satisfactory diphtheria and tetanus antitoxin response in all but a few cases. The antibody response to the pertussis component was not examined. Reactions were insignificant. Intradermal jet injection is proposed as a cheap, extremely rapid, and effective technique for D.T.P. immunization, especially suitable for use in remote areas where trained staff and facilities are few and many children require immunization.