tbuckley/cabot-search huggingface dataset:
No Evidence for a Role of Alcohol or Other Psychoactive Drugs in Accelerating Immunodeficiency in HIV-1—Positive Individuals
Authors: Richard A. Kaslow, William C. Blackwelder, David G. Ostrow, Diane Yerg, John Palenicek, Anne H. Coulson, Ronald O. Valdiserri
Journal: JAMA (1989)

In a multicenter cohort study of homosexual men, the proportion of seropositives at enrollment who developed the acquired immunodeficiency syndrome (AIDS) during the following 18 months ranged from 5.5% to 8.2% in 1597 alcohol drinkers vs 9.2% in 109 nondrinkers with no clear trend according to use, and from 6.3% to 9.6% for 1662 users vs 7.2% for 83 nonusers of psychoactive drugs prior to enrollment. Among seropositive men with low initial T helper lymphocyte counts, those who continued to use drugs showed no significantly higher 18-month risk of AIDS than nonusers (13% vs 10%); the corresponding risks were 13% and 15%, respectively, for continued heavier vs continued lighter consumption of alcohol. No other manifestations of immunodeficiency were positively associated with substance use prior to enrollment. Prior use was not associated with low mean T helper cell counts at enrollment, and continued drug or alcohol use after enrollment was not associated with greater subsequent decline in counts. As used in a large cohort of homosexual men, psychoactive substances did not enhance the progression of human immunodeficiency virus infection. (<i>JAMA</i>. 1989;261:3424-3429)
Health gap between rich and poor in London widens
Authors: Zosia Kmietowicz
Journal: BMJ (2001)

The health gap between the rich and the poor across London is getting wider despite government targets to stamp out inequalities in health, a report has shown.

People living just a few miles apart have widely varying life expectancies—a pattern that is likely to be repeated throughout England and Wales, says the document from the recently established London Health Observatory, one of eight regional public health observatories around England.

Figures collected by the London Health Observatory for 1997 to 1999 showed that a baby boy born in Westminster, one of London's richest boroughs, is likely to outlive …
Multiple Calcified Pulmonary Nodules in an Elderly Man
Authors: Joseph Panella
Journal: JAMA (1980)

<h3>History</h3> A 76-year-old man had been treated for carcinoma of the prostate for approximately two years with radiation, bilateral orchiectomy, and chemotherapy. The patient had numerous previous roentgenograms of the chest, but the most recent examination of the chest was one year before the current examination, at which time no notable abnormality was noted. The posteroanterior chest roentgenogram shown in Fig 1 demonstrates multiple pulmonary nodules distributed widely throughout both lungs. The nodules showed variation in size and are sharply outlined. A close-up view shows punctate calcifications present in most of the nodules (Fig 2). <h3>Diagnosis</h3> Prostatic adenocarcinoma with metastatic pulmonary nodules containing calcification. <h3>Comment</h3> The patient underwent a fluoroscopically guided transthoracic needle biopsy, using a Chiba needle. The cytological study showed clusters of atypical glandular cells that were moderately well differentiated and compatible with prostatic adenocarcinoma. The original diagnosis had been established by aspiration of the prostate. The presence
What Is Cystic Fibrosis?
Authors: Michael R Knowles, Peter R Durie
Journal: New England Journal of Medicine (2002)

Cystic fibrosis is a heterogeneous recessive genetic disorder with pathobiologic features that reflect mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Classic cystic fibrosis reflects two loss-of-function mutations in the CFTR gene and is characterized by chronic bacterial infection of the airways and sinuses, fat maldigestion due to pancreatic exocrine insufficiency, infertility in males due to obstructive azoospermia, and elevated concentrations of chloride in sweat (Figure 1).1 Patients with nonclassic cystic fibrosis have at least one copy of a mutant gene that confers partial function of the CFTR protein, and such patients usually have no overt . . .
Previous Aspirin Use May Attenuate the Severity of the Manifestation of Acute Ischemic Syndromes
Authors: David Garcia-Dorado, Pierre Théroux, Pilar Tornos, Antonia Sambola, Juan Oliveras, Maite Santos, J. Soler Soler
Journal: Circulation (1995)

Background The present study was designed to investigate whether the prior use of aspirin could influence the severity of the manifestation of acute coronary artery syndromes, given the well-documented observations that aspirin can prevent myocardial infarction, stroke, and death in cardiovascular disease. Methods and Results A series of 539 consecutive patients admitted to the Coronary Care Unit of a General Hospital was carefully characterized in a study with an ambidirectional design, with regard to previous medical history, aspirin use, and subsequent hospital diagnosis. Among the 214 patients previously taking aspirin, the hospital diagnosis was myocardial infarction in 24% and unstable angina in 76% compared with 54% and 46%, respectively, among the 325 not taking aspirin ( P &lt;.0001), for a reduction in the odds ratio of myocardial infarction with aspirin of 72% (95% CI, 59% to 90%). The decrease in odds was homogeneous in all subsets studied and independent of age, sex, previous angina, or previous myocardial infarction. The myocardial infarction was of a Q-wave type in 62% of aspirin users compared with 76% of nonusers ( P &lt;.05). By multivariate analysis, previous aspirin use was a strong predictor of unstable angina versus myocardial infarction and the only independent predictor of non–Q-wave versus Q-wave myocardial infarction. Conclusions This study, thus, suggests a shift to less severe manifestation of acute coronary syndromes with aspirin use, implying that the failure of the drug in many patients with an acute coronary syndrome is only partial and that aspirin has the potential of attenuating the severity of the underlying acute thrombotic disease process.
It's my time to change
Authors: S. Dawlatly
Journal: BMJ (2009)

In January 2009 the national “Time to Change” campaign was launched ( BMJ 2009;338:b309, doi:10.1136/bmj.b309). Aimed at ending discrimination against people with mental health problems, it calls on doctors to support such patients who may have been discriminated against. The campaign states that 1 in 10 people you work with has a mental illness. I am certain that less than a tenth of my colleagues know about my own severe enduring mental illness. In fact it is such a guarded secret (until now) that I instructed my GP not to link my summary care record to the “spine,” the national system for making data available to NHS organisations. My fear was that other colleagues and potential employers could find out about my diagnosis. Perhaps I’m being paranoid, perhaps not—but that’s an argument for another day.

However, how can I encourage my patients to be open about their mental health problems and support them in any battles against discrimination if I am not also as open? Surely I would be a hypocrite? Currently the only people …
Care of the Dying Child
Authors: J Goodall
Journal: BMJ (1994)

Oxford University Press, pounds sterling 16.50, pp 214 ISBN 0-19-261983-7.

To say that the needs of dying children have been neglected is only partly true. Most doctors who care for them struggle hard to save their lives. Advances in technology mean that there is always one more thing to try. One of the first needs of the irreversibly dying child may be for all concerned to agree to change the goal to one of symptom control rather than hoping still for total cure.

Two major problems have hitherto thwarted this transition. The first is the instinctive denial …
Medical Problems of Old Age
Authors: Robert T. Monroe
Journal: New England Journal of Medicine (1949)

EIGHT years ago, a geriatric clinic was established in the Out-Door Department of the Peter Bent Brigham Hospital in Boston. Its purpose was to study old people from a fresh point of view in an academic atmosphere. It sought to define the medical problems imposed by age. Are diseases in old people different from the same diseases in younger ones? Are diagnostic problems altered by age? Can useful therapeutic measures and programs be devised? In short, is there a place for geriatrics as a distinct discipline in the medical arts and sciences? This paper is the first report of progress . . .
Recombinant human insulin-like growth factor-I accelerates recovery and reduces catabolism in rats with ischemic acute renal failure.
Authors: H Ding, J D Kopple, A Cohen, R Hirschberg
Journal: Journal of Clinical Investigation (1993)

This study evaluated whether recombinant human insulin-like growth factor-I (rhIGF-I) enhances recovery of renal function and reduces catabolism in rats with ischemic acute renal failure (ARF). ARF and sham rats received subcutaneous injections of either rhIGF-I or vehicle three times daily starting 5 h after surgery. Serum creatinine and urea, which initially rose similarly in the ARF+vehicle and ARF+rhIGF-I rats, increased more slowly after commencing the rhIGF-I injections. 72 h after surgery, the ARF+rhIGF-I rats, in comparison with ARF+vehicle animals, showed significantly greater renal plasma flow and filtration fraction, a fivefold higher glomerular filtration rate, greater renal cortical IGF-I levels, increased proliferating cell nuclear antigen expression in proximal tubule nuclei and enhanced DNA synthesis in the renal cortex, corticomedullary junction, glomeruli, and tubules as demonstrated by [3H]thymidine incorporation and in corticomedullary junction tubules as determined by autoradiography. Estimated total nitrogen output (ETNO) was greater in ARF+vehicle than in ARF+rhIGF-I or sham rats throughout the study. ETNO in ARF+rhIGF-I rats returned to sham values by the second day after surgery. 72 h after surgery, protein degradation was increased and protein synthesis reduced in the epitrochlearis muscle of ARF+vehicle as compared with ARF+rhIGF-I or sham+vehicle rats. Thus, treatment with rhIGF-I starting 5 h after inducing ischemic ARF in rats increases recovery of renal function, enhances formation of new renal tubular cells, lowers protein degradation, and increases protein synthesis in skeletal muscle and reduces net catabolism.
Hiccups, Compulsive Water Drinking, and Hyponatremia
Authors: Francisco C. Ramirez, David Y. Graham
Journal: Annals of Internal Medicine (1993)

Letters15 April 1993Hiccups, Compulsive Water Drinking, and HyponatremiaFrancisco C. Ramirez, MD and David Y. Graham, MDFrancisco C. Ramirez, MDSearch for more papers by this author and David Y. Graham, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-8-199304150-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We report the use of the -aminobutyric acid analog baclofen in the prevention of symptomatic hyponatremia caused by compulsive water drinking associated with intractable hiccup.A 58-year-old man developed hiccup in 1982. In 1985, he began to drink large volumes of water with the aim of stopping his hiccup. By October 1989, he was drinking 2 to 3 gallons of water a day, at which time he was hospitalized with a serum sodium concentration of 111 mmol/L and appropriately low urinary osmolarities. Over the next 9 months, he was admitted seven times for symptomatic hyponatremia; the median ...References1. Cronin RE. Psychogenic polydipsia with hyponatremia: report of eleven cases. Am J Kidney Dis. 1987; 9:410-6. Google Scholar2. Burke AM, White AB, Brill N. Baclofen for intractable hiccups. N Engl J Med. 1988; 319:1354. Google Scholar3. Lance JW, Bassil GT. Familial intractable hiccup relieved by baclofen. Lancet. 1989; 2:276-7. Google Scholar4. Yaqoob M, Prahbu P, Ahmad R. Baclofen for intractable hiccups. Lancet. 1989; 2:562-3. Google Scholar5. Ramirez FC, Graham DY. Treatment of intractable hiccup with baclofen. Results of a double-blind randomized, controlled, cross-over study. Am J Gastroenterol. 1992; 87:1789-91. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPersistent Hiccups Because of Water Intoxication by Colonic Irrigation With Tap WaterChronic HiccupsEffects of the GABAB receptor agonist baclofen on primary drinking in rats 15 April 1993Volume 118, Issue 8Page: 649KeywordsAttentionHyponatremiaNeurotransmittersSodium Issue Published: 15 April 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Burden of Cardiovascular Risk Factors, Subclinical Atherosclerosis, and Incident Cardiovascular Events Across Dimensions of Religiosity: The Multi-Ethnic Study of Atherosclerosis
Authors: Matthew Feinstein, Kiang Liu, Hongyan Ning, George Fitchett, Donald M. Lloyd-Jones
Journal: Circulation (2010)

Background— Religious involvement has been associated with improved health practices and outcomes; however, no ethnically diverse community-based study has examined differences in cardiac risk factors, subclinical cardiovascular disease, and cardiovascular disease (CVD) events across levels of religiosity. Methods and Results— We included 5474 white, black, Hispanic, and Chinese participants who attended examination 2 of the National Heart, Lung, and Blood Institute’s Multi-Ethnic Study of Atherosclerosis (MESA). We compared cross-sectional differences in cardiac risk factors and subclinical CVD and longitudinal CVD event rates across self-reported levels of religious participation, prayer/meditation, and spirituality. Multivariable-adjusted regression models were fitted to assess associations of measures of religiosity with risk factors, subclinical CVD, and CVD events. MESA participants (52.4% female; mean age, 63) with greater levels of religious participation were more likely to be female and black. After adjustment for demographic covariates, participants who attended services daily, compared with never, were significantly more likely to be obese (adjusted odds ratio 1.57, 95% confidence interval [CI] 1.12 to 1.72) but less likely to smoke (adjusted odds ratio 0.39, 95% CI 0.26 to 0.58). Results were similar for those with frequent prayer/meditation or high levels of spirituality. There were no consistent patterns of association observed between measures of religiosity and presence/extent of subclinical CVD at baseline or incident CVD events during longitudinal follow-up in the course of 4 years. Conclusions— Our results do not confirm those of previous studies associating greater religiosity with overall better health risks and status, at least with regard to CVD. There was no reduction in risk for CVD events associated with greater religiosity.
The Effects of Mindfulness-Based Stress Reduction Program on the Mental Health of Family Caregivers: A Randomized Controlled Trial
Authors: Rebecca Jing Hou, Samuel Yeung-Shan Wong, Benjamin Hon-Kei Yip, Anchor T.F. Hung, Herman Hay-Ming Lo, Peter H.S. Chan, Cola S.L. Lo, Timothy Chi-Yui Kwok, Wai Kwong Tang, Winnie W.S. Mak, Stewart W. Mercer, S. Helen Ma
Journal: Psychotherapy and Psychosomatics (2013)

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Caregivers of people with chronic conditions are more likely than non-caregivers to have depression and emotional problems. Few studies have examined the effectiveness of mindfulness-based stress reduction (MBSR) in improving their mental well-being. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Caregivers of persons with chronic conditions who scored 7 or above in the Caregiver Strain Index were randomly assigned to the 8-week MBSR group (n = 70) or the self-help control group (n = 71). Validated instruments were used to assess the changes in depressive and anxiety symptoms, quality of life, self-efficacy, self-compassion and mindfulness. Assessments were conducted at baseline, post-intervention and at the 3-month follow-up. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Compared to the participants in the control group, participants in the MBSR group had a significantly greater decrease in depressive symptoms at post-intervention and at 3 months post-intervention (p &lt; 0.01). The improvement in state anxiety symptoms was significantly greater among participants in the MBSR group than those of the control group at post-intervention (p = 0.007), although this difference was not statistically significant at 3 months post-intervention (p = 0.084). There was also a statistically significant larger increase in self-efficacy (controlling negative thoughts; p = 0.041) and mindfulness (p = 0.001) among participants in the MBSR group at the 3-month follow-up compared to the participants in the control group. No statistically significant group effects (MBSR vs. control) were found in perceived stress, quality of life or self-compassion. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; MBSR appears to be a feasible and acceptable intervention to improve mental health among family caregivers with significant care burden, although further studies that include an active control group are needed to make the findings more conclusive.
A somatic component to myocardial infarction.
Authors: A S Nicholas, D A DeBias, W Ehrenfeuchter, K M England, R W England, C H Greene, D Heilig, M Kirschbaum
Journal: BMJ (1985)

Sixty two patients were randomised to be seen by osteopathic physicians for palpation of the thoracic paravertebral soft tissue, T1-T8. Twenty five patients had clinically confirmed acute myocardial infarction. Of the remainder, 22 without known cardiovascular disease served as controls and 15 were placed in an excluded group because of diagnosed cardiovascular disease other than myocardial infarction. Observations were described in predetermined standard terminology. The control group was found to have a low incidence of palpable changes throughout the thoracic dorsum, and these changes were uniformly distributed from T1 to T8. Examination of the group with myocardial infarction disclosed a significantly higher incidence of soft tissue changes (increased firmness, warmth, ropiness, oedematous changes, heavy musculature), confined almost entirely to the upper four thoracic levels. The 15 patients who were excluded from the experimental group because they had various cardiovascular diseases other than myocardial infarction also showed significantly different changes on palpation compared with the group with myocardial infarction. These findings suggest that myocardial infarction is accompanied by characteristic paravertebral soft tissue changes which are readily detected by palpation.
P51 Interferon-induced fatigue in hepatitis C infected patients is associated with increased expression of indoleamine 2,3-dioxygenase in peripheral blood mononuclear cells
Authors: M. Gess, D. Forton, A. M. Myint
Journal: Gut (2011)

<h3>Introduction</h3> Interferon-α (IFN)-based antiviral therapy for chronic hepatitis C virus (HCV) infection commonly induces fatigue and depression. IFN-induced symptoms may result from the activation of indoleamine 2,3-dioxygenase (IDO), the rate-limiting enzyme, regulating the breakdown of tryptophan (Trp) into L-kynurenine (Kyn), expressed in immune cells and brain. IDO activation might result in Trp and serotonin depletion and accumulation of neurotoxic Kyn metabolites. IFN increases IDO gene expression in vitro and increased serum Kyn/Trp ratios have been reported in IFN-treated patients. However, a consistent relationship between Kyn/Trp and IFN-induced symptoms in HCV has not been shown. <h3>Aim</h3> We sought to determine the relationship between IDO mRNA expression in PBMC, serum Kyn/Trp ratio and IFN-induced symptoms. <h3>Method</h3> Fatigue Impact Scale (FIS) and Hospital Anxiety and Depression (HADS-D) questionnaires were completed by 19 patients at baseline and after 12 weeks treatment with PEGIFN-2a and ribavirin. Blood samples were taken from patients and 14 healthy controls. Total RNA was extracted from Ficoll separated PBMC and IDO mRNA was quantified relative to GAPDH using RT-PCR (Applied Biosystems). Expression at week 12 vs baseline was calculated as fold change using the 2<sup>−ΔΔCt</sup>-method. Serum Kyn/Trp was measured using HPLC/MS/MS. <h3>Results</h3> IDO mRNA expression at baseline was similar in HCV patients and controls (ΔCt=9.76±0.39, ΔCt=9.73±0.28, p=NS). In the whole cohort, there was no change in IDO expression at week 12 vs baseline (ΔCt=10.0±0.23 vs ΔCt=9.76±0.39, p=NS), although serum Kyn/Trp increased significantly (p&lt;0.001). However, patients with IFN-induced fatigue (ΔFIS&gt;20; n=7) showed increased IDO mRNA expression (ΔΔCt= −0.97±0.58; median fold change =2.57) vs those without fatigue (ΔΔCt=0.96±0.53; mfc=0.89; p=0.02). Only modest increases in depression scores were seen (ΔHADS-D ≥5 in 5 patients) but no differences in ΔΔCt were seen compared to those with unchanged HADS-D. Baseline IDO mRNA expression was not predictive of IFN-induced fatigue or depression. There were no associations between baseline or week 12 Kyn/Trp ratios and IFN-induced fatigue or depression. <h3>Conclusion</h3> We show for the first time that peripheral IDO gene expression in HCV patients is similar to healthy controls and IFN-treatment leads to differential induction of IDO mRNA. IFN-induced fatigue is significantly associated with increased peripheral IDO expression but not serum Kyn/Trp. Measurement of PBMC IDO mRNA may mirror CNS changes more accurately than peripheral Trp and Kyn levels. The modest prevalence of depression in this small cohort may explain the lack of association with depression.