tbuckley/cabot-search huggingface dataset:
Excretion of arsenic in urine as a function of exposure to arsenic in drinking water.
Authors: R L Calderon, E Hudgens, X C Le, D Schreinemachers, D J Thomas
Journal: Environmental Health Perspectives (1999)

Urinary arsenic (As) concentrations were evaluated as a biomarker of exposure in a U.S. population chronically exposed to inorganic As (InAs) in their drinking water. Ninety-six individuals who consumed drinking water with As concentrations of 8-620 microg/L provided first morning urine voids for up to 5 consecutive days. The study population was 56% male, and 44% was younger than 18 years of age. On one day of the study period, all voided urines were collected over a 24-hr period. Arsenic intake from drinking water was estimated from daily food diaries. Comparison between the concentration of As in individual urine voids with that in the 24-hr urine collection indicated that the concentration of As in urine was stable throughout the day. Comparison of the concentration of As in each first morning urine void over the 5-day study period indicated that there was little day-to-day variation in the concentration of As in urine. The concentration of As in drinking water was a better predictor of the concentration of As in urine than was the estimated intake of As from drinking water. The concentration of As in urine did not vary by gender. An age-dependent difference in the concentration of As in urine may be attributed to the higher As dosage rate per unit body weight in children than in adults. These findings suggest that the analysis of a small number of urine samples may be adequate to estimate an individual's exposure to InAs from drinking water and that the determination of the concentration of InAs in a drinking water supply may be a useful surrogate for estimating exposure to this metalloid.
SCURVY WITH REFERENCE ESPECIALLY TO ADULTS
Authors: GEORGE C. SHATTUCK
Journal: JAMA (1928)

The first case of scurvy in an adult that I remember having seen was shown me in 1922 at the Massachusetts General Hospital. It was a typical case in an American youth, aged 22, who gave a clear history of dietary eccentricity. A second case in an elderly man was diagnosed soon after at the same hospital. During the following year (1923) at the Boston City Hospital, the Service for Tropical Diseases was asked to make an examination for intestinal parasites in a woman, aged 63, who had been born in Sweden. She had a profound anemia and extensive ecchymoses on the legs. A diagnosis of pernicious anemia was being considered. When the search for intestinal parasites had proved fruitless, the diagnosis of scurvy was suggested and was at once accepted by the physician in charge. He kindly consented to transfer the patient to the service for Tropical Diseases (case
ABC of colorectal diseases. Rectal prolapse and associated conditions.
Authors: N. J. Andrews, D. J. Jones
Journal: BMJ (1992)

Prolapse of the rectum is a distressing condition which causes discomfort during bowel action.Occasionally it is surprisingly well tolerated for many years.There are three main types of rectal prolapse: Complete prolapse-The full thickness of the rectum prolapses through the anus-that s, two layers of rectum with an intervening peritoneal sac, which may contain small bowel.Incomplete prolapse-The prolapse is limited to two layers of mucosa.Concealed prolapse-There is an internal intussusception of the upper rectum into the lower rectum, which does not emerge through Complete rectal prolapse.Incomplete rectal prolapse.the anus.Aetiology Causes of rectal prolapse Incomplete prolapse Children -Excessive straining -Constipation -Cystic fibrosis The exact aetiology of rectal prolapse is uncertain.In children incomplete Adults -Haemorrhoids prolapse is related to excessive straining at stool, constipation, and cystic -After anal surgery fibrosis.Mucosal prolapse may occur in adults with large haemorrhoids and -Atony of anal sphincters weak anal sphincters.Complete prolapse Adult -Idiopathic intussusception of rectum -Lack of fixation of rectum to sacrum -Weak pelvic and anal musculatureComplete rectal prolapse probably starts as a 0 -0 -0; > .000..s0 concealed internal intussusception of the upper rectum, which ultimately prolapses through the ~t'~'9~n us.Patients have a floppy redundant sigmoid colon, a deep rectovaginal or rectovesical pouch, ~> and poor fixity of the rectum to the pelvis with weak anal sphincters and levator ani muscles.They often have a decending per ineum.It is unclear whether these factors are causal or secondary.-~~0_Rectal prolapse is six times more common in women than in men but is not associated with 7 77 childbirth or parity.Nearly all elderly patients Probable evolution of rectal prolapse.Internal prolapse of upper rectum into with rectal prolapse have a history of constipation lower rectum (left) ultimately becomes a complete prolapse of the rectum and prolonged strainng at stool, which stretch through the anus (right).the pelvic floor and anal sphincter mechanism.
Reducing the time from soup to nuts
Authors: Nicholas Timmins
Journal: BMJ (2005)

Everything in the Labour party's plan for the NHS is subordinate to the need to increase capacity and to bring down the waiting time between seeing a GP and having an operation. Nick Timmins reports 

At election time some people (probably, in truth, a small and rather sad minority) pore over the parties' manifestos. They are often a pretty poor guide to the future. No one could possibly have gleaned from the Conservative manifesto for health in 1987, for example, that by 1992 the NHS would be operating an internal market. The big financial crisis late in 1987 that triggered the Conservatives' NHS review was just about visible; its outcome, to all but clairvoyants and those now granted the gift of hindsight, was not.

Equally, a newly landed Martian reading Labour's 1997 manifesto and looking at the NHS today would be entitled to wonder how on earth we got from there to here. That manifesto contained, for example, no mention of the National Institute for Clinical Excellence or the creation of an NHS inspectorate and a social care inspectorate, a clinical assessment authority, or a patient safety agency. A party that was later to introduce more central targets and a tougher performance management regime than any of its predecessors promised not to return to the “top down management of …
Cost-benefit analysis of long-term haemodialysis for chronic renal failure.
Authors: M J Buxton, R R West
Journal: BMJ (1975)

A cost-benefit analysis of long-term maintenance haemodialysis indicates that there is a large gulf between the cost of the service and "economic" benefit. The difference may be considered to represent one estimate of the price society is prepared to pay to maintain life. Using "best estimates" from available data we found the implicit social value of maintaining a patient on haemodialysis to be approximately pounds 4720 per annum in hospital or pounds 2600 at home. The analysis would suggest that society must look carefully at alternative uses for health expenditure before extending indiscriminately to large sections of the population these treatment programmes or other similarly expensive.
Child mortality is falling but some developing regions will miss millennium targets
Authors: S. Mayor
Journal: BMJ (2012)

Deaths in children under 5 years are continuing to fall but huge variations in the rate of reduction between countries mean that developing regions will not achieve millennium development goals, according to United Nations figures published in the open access journal PLOS Medicine .1

The figures showed that between 1990 and 2010 the global mortality rate for children under 5 fell from 88 to 57 per 1000 live births. The number of deaths in this age group each year fell by 37% from 12 million to 7.6 million over this period.

But figures for each country …
Relationship of infectious murine leukemia virus and virus-related antigens in genetic crosses between AKR and the Fv-1 compatible strain C57L.
Authors: H Ikeda, W P Rowe, E A Boyse, E Stockert, H Sato, S Jacobs
Journal: The Journal of Experimental Medicine (1976)

In a further genetic study of murine leukemia virus (MuLV) and its components we examined the backcross C57L X (C57L X AKR). This population was selected because strains AKR and C57L are both Fv-1n, and the restriction which the Fu-1b allele imposes on the output of virus was thereby obviated. The segregants were scored for three characters: (a) infectious Gross-AKR-type MuLV (V), in the tail; (b) group-specific antigen indicative of p30 internal viral protein, in spleen; and (c) GIX antigen, now thought to be indicative of gp69/71 viral envelope glycoprotein, on thymocytes. Our conclusions are: (a) It is confirmed that the AKR mouse has two unlinked chromosomal genes, Akv-1 and Akv-2, each of which can independently give rise to the life-long high output of MuLV that is characteristic of AKR mice. (b) Of the eight phenotypes that could possibly be derived from segregation of the three pairs of independent alternative traits, seven were observed, but on progeny testing only three were shown to reflect stably heritable genotypes; these were V+p30+GIX+ and V-p30-GIX- (the parental types) and V-p30+GIX+. A third, newly identified AKR gene, designated Akvp, segregating independently of Akv-1 and Akv-2, also determines expression of p30 and GIX but in this case independently of XC-detectable MuLV. (c) The four remaining observed phenotypes, which did not breed true on progeny testing, involved mostly antigen-negative parents yielding antigen-positive progeny; it is likely that these discrepancies represented suppression of phenotype by a maternal resistance factor.
The era of NHS “flying blind” is coming to an end, says commission
Authors: Zosia Kmietowicz
Journal: BMJ (2008)

In the next five years patients, doctors, and health service commissioners ought to be able to compare how effective various NHS interventions are in improving health, says a report from the Office of Health Economics.

Collecting data on outcomes to measure the effect of treatment on patients’ health should become a routine part of NHS work across a large part of the health service by 2013, says the report from the office’s Commission on NHS Outcomes, Performance and Productivity. 

The commission, which was established in autumn 2006 to look at the feasibility of collecting data on outcomes of treatment in the NHS, says that at the moment health service productivity is measured in terms of the numbers of patients …
Epidural morphine for outpatients with severe anginal pain.
Authors: S E Clemensen, P Thayssen, P Hole
Journal: BMJ (1987)

<h3>Objectives</h3> To describe the benefits and limitations of using individual and combinations of linked English electronic health data to identify incident cancers. <h3>Design and setting</h3> Our descriptive study uses linked English Clinical Practice Research Datalink primary care; cancer registration; hospitalisation and death registration data. <h3>Participants and measures</h3> We implemented case definitions to identify first site-specific cancers at the 20 most common sites, based on the first ever cancer diagnosis recorded in each individual or commonly used combination of data sources between 2000 and 2014. We calculated positive predictive values and sensitivities of each definition, compared with a gold standard algorithm that used information from all linked data sets to identify first cancers. We described completeness of grade and stage information in the cancer registration data set. <h3>Results</h3> 165 953 gold standard cancers were identified. Positive predictive values of all case definitions were ≥80% and ≥94% for the four most common cancers (breast, lung, colorectal and prostate). Sensitivity for case definitions that used cancer registration alone or in combination was ≥92% for the four most common cancers and ≥80% across all cancer sites except bladder cancer (65% using cancer registration alone). For case definitions using linked primary care, hospitalisation and death registration data, sensitivity was ≥89% for the four most common cancers, and ≥80% for all cancer sites except kidney (69%), oral cavity (76%) and ovarian cancer (78%). When primary care or hospitalisation data were used alone, sensitivities were generally lower and diagnosis dates were delayed. Completeness of staging data in cancer registration data was high from 2012 (minimum 76.0% in 2012 and 86.4% in 2014 for the four most common cancers). <h3>Conclusions</h3> Ascertainment of incident cancers was good when using cancer registration data alone or in combination with other data sets, and for the majority of cancers when using a combination of primary care, hospitalisation and death registration data.
Hyperinsulinemia, Hyperglycemia, and Impaired Hemostasis
Authors: J B Meigs, M A Mittleman, D M Nathan, G H Tofler, D E Singer, P M Murphy-Sheehy, I Lipinska, R B D'Agostino, P W Wilson
Journal: JAMA (2000)

Increased risk for cardiovascular disease in persons with glucose intolerance (impaired glucose tolerance and type 2 diabetes mellitus) is not fully explained by concomitant elevations in traditional atherosclerosis risk factors. Hyperinsulinemia associated with glucose intolerance may increase risk directly, or its effect could be mediated through impaired hemostatic function.To evaluate associations between fasting insulin levels and hemostatic factors in subjects with normal and impaired glucose homeostasis.Cross-sectional analysis conducted between January 1991 and June 1995.The population-based Framingham Offspring Study.A total of 1331 men and 1631 women aged 26 to 82 years, without diagnosed diabetes or cardiovascular disease and classified as having normal glucose tolerance (80.2%) or glucose intolerance (impaired glucose tolerance and impaired fasting glucose combined, 15.2%; previously undiagnosed diabetes, 4.7%) using an oral glucose tolerance test.Trends across quintiles of fasting insulin in levels of plasminogen activator inhibitor 1 (PAI-1) antigen, tissue-type plasminogen activator (tPA) antigen, von Willebrand factor (vWF) antigen, factor VII antigen, fibrinogen, and plasma viscosity. We stratified analyses by sex and glucose tolerance status and adjusted hemostatic factor levels for obesity, lipid levels, and traditional cardiovascular disease risk factors.Mean levels of all hemostatic factors (except for fibrinogen in men) increased across fasting insulin quintiles among subjects with normal glucose tolerance (P<.001 for trend). Levels of PAI-1 and tPA antigens, but not other hemostatic factors, were higher comparing subjects with glucose intolerance with those with normal glucose tolerance (P<.001). Among subjects with glucose intolerance, levels of PAI-1 and tPA antigen in men and women (P<.01 for trend) and vWF antigen in men (P<.05 for trend) increased significantly across insulin quintiles, but levels of factor VII antigen, fibrinogen, and plasma viscosity did not increase.Elevated levels of fasting insulin are associated with impaired fibrinolysis and hypercoagulability in subjects with normal glucose tolerance. Hyperinsulinemia is associated primarily with impaired fibrinolysis in subjects with glucose intolerance. Excess risk for cardiovascular disease associated with hyperinsulinemia and glucose intolerance may be mediated in part by enhanced potential for acute thrombosis.
606 Effect of peginterferon alpha-2b and ribavirin on histological lesions in patients with hepatitis C virus (HCV) and HCV/HIV co-infection: An open-label trial
Authors: R. Sarmento e Castro, A. Horta, H. Coelho, O. Vasconcelos, J. Méndez, J. Seabra, A.P. Tavares, O. Fortes, M. Duarte, N. Pires, L. Chaves, J.P. Pires, L. Pinho, E. Carneiro
Journal: Journal of Hepatology (2006)
Generation of lyso-phospholipids from surfactant in acute lung injury is mediated by type-II phospholipase A2 and inhibited by a direct surfactant protein A-phospholipase A2 protein interaction.
Authors: L Arbibe, K Koumanov, D Vial, C Rougeot, G Faure, N Havet, S Longacre, B B Vargaftig, G Béréziat, D R Voelker, C Wolf, L Touqui
Journal: Journal of Clinical Investigation (1998)

Lyso-phospholipids exert a major injurious effect on lung cell membranes during Acute Respiratory Distress Syndrome (ARDS), but the mechanisms leading to their in vivo generation are still unknown. Intratracheal administration of LPS to guinea pigs induced the secretion of type II secretory phospholipase A2 (sPLA2-II) accompanied by a marked increase in fatty acid and lyso-phosphatidylcholine (lyso-PC) levels in the bronchoalveolar lavage fluid (BALF). Administration of LY311727, a specific sPLA2-II inhibitor, reduced by 60% the mass of free fatty acid and lyso-PC content in BALF. Gas chromatography/mass spectrometry analysis revealed that palmitic acid and palmitoyl-2-lyso-PC were the predominant lipid derivatives released in BALF. A similar pattern was observed after the intratracheal administration of recombinant guinea pig (r-GP) sPLA2-II and was accompanied by a 50-60% loss of surfactant phospholipid content, suggesting that surfactant is a major lung target of sPLA2-II. In confirmation, r-GP sPLA2-II was able to hydrolyze surfactant phospholipids in vitro. This hydrolysis was inhibited by surfactant protein A (SP-A) through a direct and selective protein-protein interaction between SP-A and sPLA2-II. Hence, our study reports an in vivo direct causal relationship between sPLA2-II and early surfactant degradation and a new process of regulation for sPLA2-II activity. Anti-sPLA2-II strategy may represent a novel therapeutic approach in lung injury, such as ARDS.
Quality improvement report: Learning from adverse incidents involving medical devices
Authors: J. Amoore
Journal: BMJ (2002)

The NHS is perceived to have a poor record of learning from incidents. Despite efforts of the Medical Devices Agency, which issues safety warnings, adverse incidents with medical devices continue to occur, some of which result in serious injury or death through device failures, user errors, and organisational problems.Introduction of feedback notes on a supportive investigation that seeks to determine latent factors, immediate triggers, causes, and positive actions taken by staff that minimised adverse consequences.Medical physics department providing equipment management services in a major NHS teaching trust.Reduction in repetitions of adverse incidents and improved staff competency in using devices.A feedback note was developed to describe the incident and generic details of the equipment, summarise the investigation (focusing on latent causes and immediate triggers), and describe lessons to be learnt and positive actions by staff.Feedback notes have been used in teaching sessions and given to ward link nurses. Despite being new, the positive supportive approach has encouraged an open reporting culture.Adverse incidents are typically caused by alignment of different factors, but good practice can prevent errors becoming incidents. Careful analysis of incidents reveals both the multifactorial causes and the good practices that can help minimise repetitions.
Protein kinase Cδ mediates cyclic adenosine monophosphate-stimulated translocation of sodium taurocholate cotransporting polypeptide and multidrug resistant associated protein 2 in rat hepatocytes
Authors: Christopher M. Schonhoff, Henry Gillin, Cynthia R. L. Webster, M. Sawkat Anwer
Journal: Hepatology (2008)

Cyclic adenosine monophosphate (cAMP) stimulates translocation of Na+-taurocholate (TC) cotransporting polypeptide (Ntcp) and multidrug resistant associated protein 2 (Mrp2) to the plasma membrane. Because cAMP activates phosphoinositide-3-kinase (PI3K) and protein kinase C (PKC) activation is PI3K-dependent, the aim of the current study was to determine whether cAMP activates conventional and novel PKCs in hepatocytes and whether such activation plays a role in cAMP-stimulated Ntcp and Mrp2 translocation. The effect of cAMP on PKCs, TC uptake, and Ntcp and Mrp2 translocation was studied in isolated rat hepatocytes using a cell-permeable cAMP analog, CPT-cAMP. The activity of PKCs was assessed from membrane translocation of individual PKCs, and phospho-specific antibodies were used to determine PKCδ phosphorylation. TC uptake was determined from time-dependent uptake of 14C-TC, and a cell surface biotinylation method was used to determine Ntcp and Mrp2 translocation. CPT-cAMP stimulated nPKCδ but not cPKCα or nPKCϵ, and induced PI3K-dependent phosphorylation of nPKCδ at Thr505. Rottlerin, an inhibitor of nPKCδ, inhibited cAMP-induced nPKCδ translocation, TC uptake, and Ntcp and Mrp2 translocation. Bistratene A, an activator of nPKCδ, stimulated nPKCδ translocation, TC uptake, and Ntcp and Mrp2 translocation. The effects of cAMP and bistratene A on TC uptake and Ntcp and Mrp2 translocation were not additive. Conclusion: These results suggest that cAMP stimulates Ntcp and Mrp2 translocation, at least in part, by activating nPKCδ via PI3K-dependent phosphorylation at Thr505. (HEPATOLOGY 2008.)
Glass ceiling confirmed in biomedical research
Authors: F. Godlee
Journal: BMJ (1997)

Anyone who has ever said that women have to be twice as good as men to succeed is wrong. In biomedical science they have to be up to four times as good, according to a study from Sweden published last week.

Based on data from Sweden's Medical Research Council-released only after the researchers took legal action under Sweden's freedom of information act-the report shows that successful female applicants for postdoctoral fellowships had published on average two and a half to four times more high impact research than their male counterparts ( Nature 1997;387:341-3).

Sweden's Medical Research Council received 114 applicants for postdoctoral fellowships in 1995. Four fellowships were awarded to women and 16 to men. To see if this was because the women had produced less high quality research than the men, Christine Wenneras and Agnes Wold, both from Gothenburg University, examined the scores …