tbuckley/cabot-search huggingface dataset:
<i>Chlamydia Pneumoniae</i> , Cytomegalovirus, and Herpes Simplex Virus in Atherosclerosis of the Carotid Artery
Authors: B. Chiu, E. Viira, W. Tucker, I.W. Fong
Journal: Circulation (1997)

Chlamydia pneumoniae and the herpes viruses cytomegalovirus (CMV) and herpes simplex virus type 1 (HSV-1) have been associated with human atherosclerosis in seroepidemiological and separate histopathological studies. We investigated the concurrent presence of these microorganisms in patients undergoing carotid endarterectomy.Endarterectomy specimens from 76 patients with carotid artery stenosis were stained for C. pneumoniae, CMV, and HSV-1 particles with specific IgG monoclonal antibodies by the avidin-biotin-peroxidase method. IgG antibodies to CMV and C. pneumoniae were also measured in the serum. These were correlated with plaque morphology and the presence of the microorganisms in the atherosclerotic plaques. C. pneumoniae was detected in 54 (71%) (95% confidence interval [CI], 59.5% to 80.9%), CMV was detected in 27 (35.5%) (CI, 24.9% to 47.3%), and HSV-1 was detected in 8 (10.5%) (CI, 4.7% to 19.7%) versus none of 20 (0%) control normal carotid artery and aortic tissue (autopsy) specimens (CI, 0% to 16.8%) (P<.001 for CMV and C. pneumoniae). At least one microorganism was detected in 59 of the specimens (77.6%) (CI, 66.6% to 86.4%), with a single microorganism present only in 35 (46%), two microorganisms present in 18 (23.7%) (CI, 14.7% to 34.8%), and all three present in 6 (7.9%) (CI, 3.0% to 16.4%). Atherosclerotic plaques with thrombosis were more likely to have C. pneumoniae (80.4%) or CMV (57.8%) than were plaques without thrombosis (56.7% and 16.7%, respectively; P=.04 and .007). There was no correlation between the presence of CMV and C. pneumoniae in the atherosclerotic vessels and serum antibody titers.C. pneumoniae and CMV are commonly detected in atherosclerotic plaques of the carotid arteries, but their presence cannot be predicted by measuring serum antibodies. The presence of these microorganisms may predispose to a greater risk of thrombosis in the plaques, but further studies are needed to confirm this observation.
Patterns of Absolute Risk of Lung Cancer Mortality in Former Smokers
Authors: M. T. Halpern, B. W. Gillespie, K. E. Warner
Journal: JNCI Journal of the National Cancer Institute (1993)

It is well known that the relative risk (RR) of lung cancer mortality decreases following smoking cessation compared with the risk in persons who continue to smoke. However, changes in the absolute risk of lung cancer death following smoking cessation are not well documented. Further, few studies have examined the effect of age at smoking cessation on subsequent lung cancer death risk.The purpose of this study was to examine and compare absolute and relative lung cancer death risks in former smokers as a function of age at cessation.Using the American Cancer Society's Cancer Prevention Study II, a prospective cohort study with 6 years of follow-up, we modeled absolute risk of lung cancer mortality in individuals who had never smoked and in current and former smokers. The model was fit with the use of person-years logistic regression analysis.Similar patterns of absolute risk of lung cancer death by age were found for all ages of smoking cessation up to the mid-60s. Lower lung cancer death risk was observed for those quitting earlier in life, and the risk for all former smokers was significantly lower than that for current smokers. For those quitting between ages 30 and 49, lung cancer death risk rose gradually with age at a rate slightly greater than that for those who had never smoked. Lung cancer death risk for former smokers quitting between ages 50 and 64 leveled off near the risk attained at the time of quitting until around age 75, when it rose sharply. At age 75, the RR for former smokers compared with current smokers was approximately 45% for those quitting in their early 60s, approximately 20% for those quitting in their early 50s, and less than 10% for those quitting in their 30s. For those who had never smoked, the RR at age 75 is less than 5%.In terms of reduced risk of lung cancer mortality, smoking cessation is beneficial at any age, with much greater benefits accruing to those quitting at younger ages. Unlike previous research, which has primarily examined the effects of cessation as a function of years since quitting, our results demonstrate that age at cessation has a major impact on subsequent lung cancer risks.Smokers of all ages should be encouraged to quit because cessation at any age decreases lung cancer risk relative to that of current smokers.
The UK is a net exporter of patients
Authors: J. Hanefeld, R. Smith, N. Lunt, D. Horsfall
Journal: BMJ (2013)

Acute transverse myelopathy in a young person may be due to infection, postinfective or inflammatory demyelination, or vascular causes. Rarely, a completely reversible cause of acute transverse myelopathy may be seen, as described here in our case of transverse myelopathy due to extramedullary haematopoiesis (EMH). An 18-year-old man who had a history of a lone blood transfusion at age of 7 years presented with paraplegia. MRI showed multiple epidural space masses of EMH compressing the spinal cord. He was detected to have thalassaemia intermedia and was treated with blood transfusions, steroids and radiotherapy to the involved paraspinal areas. He recovered fully over 15 days and remained symptom free at 6 months.
A Response to “Holding GUSTO Up to the Light”
Authors: Paul M. Ridker
Journal: Annals of Internal Medicine (1994)

Open and informed evaluation of study results is essential to advancing scientific understanding, particularly in large-scale trials (such as the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries [GUSTO] trial), which may affect clinical treatment and public health. In this article, we discuss alternative interpretations of the GUSTO findings, the problems inherent in any unblinded trial, and the need for more complete analysis and reporting of data so that the four different thrombolytic regimens tested in GUSTO can be adequately compared with one another.We conclude that, based on all the available evidence, any differences among individual drugs in terms of efficacy or safety are small and are less clinically important than is the wider use and more rapid delivery of thrombolytic therapy with any of the available agents.
Improving Prescribing Patterns for the Elderly Through an Online Drug Utilization Review Intervention
Authors: Mark Monane, Dipika M. Matthias, Becky A. Nagle, Miriam A. Kelly
Journal: JAMA (1998)

Pharmacotherapy is among the most powerful interventions to improve health outcomes in the elderly. However, since some medications are less appropriate for older patients, systems approaches to improving pharmacy care may be an effective way to reduce inappropriate medication use.To determine whether a computerized drug utilization review (DUR) database linked to a telepharmacy intervention can improve suboptimal medication use in the elderly.Population-based cohort design, April 1, 1996, through March 31, 1997.Ambulatory care.A total of 23269 patients aged 65 years and older throughout the United States receiving prescription drug benefits from a large pharmaceutical benefits manager during a 12-month period.Evaluation of provider prescribing through a computerized online DUR database using explicit criteria to identify potentially inappropriate drug use in the elderly. Computer alerts triggered telephone calls to physicians by pharmacists with training in geriatrics, whereby principles of geriatric pharmacology were discussed along with therapeutic substitution options.Contact rate with physicians and change rate to suggested drug regimen.A total of 43007 alerts were triggered. From a total of 43007 telepharmacy calls generated by the alerts, we were able to reach 19368 physicians regarding 24 266 alerts (56%). Rate of change to a more appropriate therapeutic agent was 24% (5860), but ranged from 40% for long half-life benzodiazepines to 2% to 7% for drugs that theoretically were contraindicated by patients' self-reported history. Except for rate of change of beta-blockers in patients with chronic obstructive pulmonary disease, all rates of change were significantly greater than the expected baseline 2% rate of change.Using a system integrating computers, pharmacists, and physicians, our large-scale intervention improved prescribing patterns and quality of care and thus provides a population-based approach to advance geriatric clinical pharmacology. Future research should focus on the demonstration of improved health outcomes resulting from improved prescribing choices for the elderly.
In-Home Particle Concentrations and Childhood Asthma Morbidity
Authors: Meredith C. McCormack, Patrick N. Breysse, Elizabeth C. Matsui, Nadia N. Hansel, D’Ann Williams, Jean Curtin-Brosnan, Peyton Eggleston, Gregory B. Diette
Journal: Environmental Health Perspectives (2008)

Although outdoor particulate matter (PM) has been linked to mortality and asthma morbidity, the impact of indoor PM on asthma has not been well established.This study was designed to investigate the effect of in-home PM on asthma morbidity.For a cohort of 150 asthmatic children (2-6 years of age) from Baltimore, Maryland, a technician deployed environmental monitoring equipment in the children's bedrooms for 3-day intervals at baseline and at 3 and 6 months. Caregivers completed questionnaires and daily diaries during air sampling. Longitudinal data analyses included regression models with generalized estimating equations.Children were primarily African Americans (91%) from lower socioeconomic backgrounds and spent most of their time in the home. Mean (+/- SD) indoor PM(2.5-10) (PM with aerodynamic diameter 2.5-10 microm) and PM(2.5) (aerodynamic diameter < 2.5 microm) concentrations were 17.4 +/- 21.0 and 40.3 +/- 35.4 microg/m(3). In adjusted models, 10-microg/m(3) increases in indoor PM(2.5-10) and PM(2.5) were associated with increased incidences of asthma symptoms: 6% [95% confidence interval (CI), 1 to 12%] and 3% (95% CI, -1 to 7%), respectively; symptoms causing children to slow down: 8% (95% CI, 2 to 14%) and 4% (95% CI, 0 to 9%), respectively; nocturnal symptoms: 8% (95% CI, 1 to 14%) and 6% (95% CI, 1 to 10%), respectively; wheezing that limited speech: 11% (95% CI, 3 to 19%) and 7% (95% CI, 0 to 14%), respectively; and use of rescue medication: 6% (95% CI, 1 to 10%) and 4% (95% CI, 1 to 8%), respectively. Increases of 10 microg/m(3) in indoor and ambient PM(2.5) were associated with 7% (95% CI, 2 to 11%) and 26% (95% CI, 1 to 52%) increases in exercise-related symptoms, respectively.Among preschool asthmatic children in Baltimore, increases in in-home PM(2.5-10) and PM(2.5) were associated with respiratory symptoms and rescue medication use. Increases in in-home and ambient PM(2.5) were associated with exercise-related symptoms. Although reducing PM outdoors may decrease asthma morbidity, reducing PM indoors, especially in homes of inner-city children, may lead to improved asthma health.
Doctors should be allowed to offer patients a simplified form of consent, expert says
Authors: Jeremy Davies
Journal: BMJ (2005)

Patients should be able to choose between two different types of giving consent when agreeing to NHS treatment, a leading expert on medical ethics has proposed.

John Harris, professor of bioethics at Manchester University and joint editor in chief of the Journal of Medical Ethics , told a public meeting in Manchester last week on the doctor-patient relationship that introducing a two tier system of patient consent could make life easier for doctors and patients—and reduce mounting NHS legal bills.

“Informed consent is a lost cause, a hopeless ideal. We should now offer a choice between simple and informed …
Blackwater fever caused by Plasmodium vivax infection in the acquired immune deficiency syndrome
Authors: E. Katongole-Mbidde, C. Banura, A. Kizito
Journal: BMJ (1988)

Une observation, la premiere publiee due a l'infection par Plasmodium vivax. Une pneumopathie due a Pneumocystis carinii est soupconnee, la malade meurt et l'autopsie est refusee
A Pregnant Surgical Resident? Oh My!
Authors: Emina H. Huang
Journal: JAMA (1991)

Women currently make up 39% of US medical school applicants and 34% of graduates.<sup>1</sup>Almost all graduates enter residency programs, but, until recently, women infrequently chose surgical careers. This has changed dramatically in recent years; in 1982, 875 surgical residents were women, but in 1990, 3709 were women, and this number is increasing each year.<sup>2</sup>Nearly half of the residents in obstetrics and approximately 14% of general surgical residents are women, who are enrolled in programs varying in length from 4 years (basic obstetrics) to 9 years (academic programs in pediatric, thoracic, or vascular surgery). The average age of medical school graduates is 28 years<sup>3</sup>; a typical chief surgical resident is 32 years old. Residencies, especially the lengthy surgical programs, span a vital portion of prime childbearing years for all of these women. Pregnancy during residency, even a surgical residency, can and should be anticipated. What are
Electro-spinning of pure collagen nano-fibres – Just an expensive way to make gelatin?
Authors: Dimitrios I. Zeugolis, Shih T. Khew, Elijah S.Y. Yew, Andrew K. Ekaputra, Yen W. Tong, Lin-Yue L. Yung, Dietmar W. Hutmacher, Colin Sheppard, Michael Raghunath
Journal: Biomaterials (2008)
THE PREFERABLE METHOD OF ANTERIOR FIXATION OF THE UTERUS WHEN THE ABDOMEN IS OPEN.
Authors: H. S. CROSSEN
Journal: JAMA (1907)

There has been too much laudation of particular operations as such and too little consideration of the various conditions found, in the pelvis in operative cases and of how to treat those conditions. No one operation is applicable to all cases. Even narrowing the subject down to those cases in which the abdomen has necessarily been opened, on account of tubal disease or other abnormal condition, the answer to the question as to which operation is preferable still depends on the associated conditions rather than on the displacement itself. Any one with even a moderate experience knows that intrapelvic conditions differ widely and that an operation which in one case cures retrodisplacement, in another case might prove a complete failure. My purpose is not to describe a new operation, nor yet to take up an extended or systematic review of established procedures, but simply to mention certain practical points that
Highly selective vagotomy for duodenal ulcer: do hypersecretors need antrectomy?
Authors: D Johnston, I R Pickford, B E Walker, J C Goligher
Journal: BMJ (1975)

Two to five years after highly selective vagotomy (H.S.V.) for duodenal ulcer the results were similar in patients with high preoperative maximal acid outputs and those with lower acid outputs. Pain of ulcer type was experienced at some time by 6% of patients from each group, but it was mild and transient in some. No patients had recurrent ulceration at endoscopy or laparotomy, while incidence of individual symptoms was about equal in the two groups. Hence H.S.V. is adequate surgical treatment for patients with both duodenal ulceration and high levels of acid secretion. Antrectomy in such patients is not necessary provided that the incidence of incomplete vagotomy can be kept low.
Copper deficiency and sideroblastic anemia associated with zinc ingestion
Authors: Sheryl R. Simon, Richard F. Branda, Barbara H. Tindle, Stanley L. Burns
Journal: American Journal of Hematology (1988)

Abstract Anemia and neutropenia developed in a man who took pharmacologic doses of supplemental zinc. Laboratory investigation showed high zinc level, hypocupremia, low ceruloplasmin level, and ringed sideroblasts. All resolved after withdrawal of zinc. Self‐administered zinc appears to have caused severe copper deficiency, with secondary anemia and neutropenia. Physicians should be aware of this deleterious and completely reversible effect of megadose mineral therapy. Zinc ingestion or exposure should be considered in the differential diagnosis of unexplained anemia, leukopenia, or sideroblastic anemia.
Prevention of Perforation in Submucous Resection of the Nasal Septum
Authors: Albert Bardes
Journal: JAMA (1910)

given to it by Neumann is Ibis: It is a synonym of D. retícula- tus as interpreted by Neumann, namely, I), retioulatus of Kurope plus specimens examined by »Mar».I'roni Texas and New .Mexico, plus certain other forms.Two possibilities arc present: (1) If reallv identical with D. retioulatus, the name I), rentistas drops into synonymy and cannot he-used for the spotted-fever lick.(2) 'fhe only way of separating the inline from I), reticttlatiis is by finding the original specimens from Texas or New Mexico and showing that they are not identical with /*.retioulatus.In material recently at my disposal, I hud specimens of the Mars collection labeled Dermaoentor venustus from both Texas and New Mexico.These are the specimens on which Neumann published in 1897, and it is the Texas specimen from sheep which I designated as the type, 'fliese specimens nre clearly distinct from the European />.retioulatus, and they represent the form which I have published ¡is D. rennst us.Mr. Hanks was present at a meeting of the Entomological Society.Jan. 10, 1907, when I showed drawings of the European I), retioulatus, and explained the differences between this and the various American forms.He also visited my lab¬ oratory for the specific purpose of »examining Marx' material, and at Unit time the originals of I), venustus, I), oooidentalis and I), ant/ersoni were placed before him.together with draw¬ ings of the stignuil plates.lie later (1908) published "Dermaoentor venustus n. sp.," admitting that it was Marx'
Erythema Migrans in Lyme Disease: A Correction-Reply
Authors: Richard A. Kaslow
Journal: JAMA (1992)

<h3>In Reply.</h3> —I am most grateful to Dr Berger for pointing out the erroneous attribution of the photograph as well as the precise nature and location of the lesion depicted in my recent article. His contributions to our knowledge of the early cutaneous expression of Lyme borreliosis are much appreciated.
Stretch-induced arrhythmias in the isolated canine ventricle. Evidence for the importance of mechanoelectrical feedback.
Authors: D E Hansen, C S Craig, L M Hondeghem
Journal: Circulation (1990)

Alterations in loading conditions and muscle length influence the electrophysiology of ventricular myocardium and may play a role in arrhythmogenesis in globally dilated or dyskinetic ventricles. To test the hypothesis that stretch can initiate arrhythmias in normal myocardium, the response to graded mechanical stretch was studied in seven isolated blood-perfused canine ventricles. After eight conditioning contractions produced by His bundle pacing (2 Hz), global stretch of the ventricle was produced by a servocontrolled pump that abruptly increased ventricular volume by a precise amount (delta V) during early diastole and then returned ventricular volume to the initial holding volume (Vi). Ventricular premature contractions were readily produced; ventricular couplets and short runs of ventricular tachycardia were occasionally elicited. The probability of a stretch-induced arrhythmia was determined from multiple alternating sequences in which a stretch of known amplitude (delta V) or no stretch was delivered. As delta V was increased, the probability of a stretch-induced arrhythmia was low initially, increased sharply after a threshold was exceeded, and approaching 100% with physiological volumes. With Vi set to a standard value of 20 ml, corresponding to end-diastolic pressure of 5.3 +/- 5.2 mm Hg (mean +/- SD), the delta V resulting in a 50% chance of a stretch-induced arrhythmia (delta V50) was 15.0 +/- 1.6 ml. A decline in delta V50 was consistently observed when Vi was increased. While delta V50 values were remarkably similar (10.7% coefficient of variation), the pressure at the time the ventricular premature depolarization was triggered was highly variable for different ventricles; this finding suggests that myocardial strain is more important than absolute level of wall stress in the initiation of these arrhythmias. These results demonstrate that myocardial stretch predictably initiates arrhythmias and that the susceptibility to stretch-induced arrhythmias is enhanced by ventricular dilatation. Thus, ventricular ectopy in patients with regionally or globally dilated hearts may arise, in part, by a mechanism of myocardial stretch.
PREVENTION OF SCARLET FEVER
Authors: Matthew Molitch
Journal: JAMA (1934)

There is still present, in the minds of many general practitioners, a doubt of the value of immunization against scarlet fever. In the New Jersey State Home for Boys, routine Dick tests are done on every boy admitted and all boys with a positive reaction are treated with Streptococcus scarlet fever toxin prepared according to the Dick method. Five doses, consisting of 500, 2,000, 8,000, 25,000 and 80,000 skin test doses, are given hypodermically at weekly intervals. The accompanying table gives the incidence of positive reactions in 3,025 Dick tests. All the tests during the last nine years were done by Dr. G. F. Leonard of the Biological Laboratories of E. R. Squibb &amp; Sons, which eliminates a possible source of error. An intradermal injection of 0.1 cc. of standard scarlet fever toxin, containing one skin test dose, was given in each case and a reaction of 1 cm. or