tbuckley/cabot-search huggingface dataset:
Use of Tactile Techniques for Self-Monitoring of Blood Glucose in Visually Impaired Patients with Diabetes Mellitus
Authors: Jerilynn C Prior, Nenita C Alojado, John A Hunt, Iain S Begg
Journal: Diabetes Care (1984)

Twenty-eight patients with type I diabetes mellitus, legally blind as a result of proliferative retinopathy, were recruited into a program designed to teach and evaluate tactile methods for self-monitoring of blood glucose (SMBG). Vision ranged from “blind” to “able to read large print.” Techniques with wipe-off strips (Chemstrip bG or BM Test BG, Boehringer-Mannheim, Canada Ltd., Dorval, Quebec, Canada) use the opposite hand as a guide, operation of timing devices by touch, and special methods forlabeling and storing strips. Methods with wash-off strips (Dextrostix, Ames Division, Miles Laboratories, Rexdale, Ontario, Canada) employ the fingers as a guide in directing thewash water. The accuracy of tactile methods was documented. Clinical parameters of glucose control improved in patients with adequate data after 6 mo of tactile SMBG. Glycosylated hemoglobin in 17 patients decreased from 11.3 ± 2.1% to 9.4 ± 1.5% (P = 0.005). Patients experienced significantly fewer reactions and low blood sugar readings as well as lowering of mean blood glucose values from158 ± 56 to 141 ± 51 (P = 0.025).
Integrated care: a Danish perspective
Authors: A. Rudkjobing, M. Olejaz, H. O. Birk, A. J. Nielsen, C. Hernandez-Quevedo, A. Krasnik
Journal: BMJ (2012)

Despite three decades of reform Denmark's health sector is still struggling to provide coordinated care for an ageing population with a high burden of chronic disease. <b>Andreas Rudkjøbing and colleagues </b>describe recent initiatives to improve continuity of care
Contribution to the History of Public Medicine
Authors: J. I. Ikin
Journal: BMJ (1873)

THE BRITISH MEDICAL 7OURNAL.57 use of the remedies last mentioned, he soon got quite well, and, I be- lieve, remains so.It will be seen from the remarks which have been made that I have employed the blister-treatment both as a means of cure, as ordinarily understood, and of relief.In many of the two former classes of cases it may be regarded as essentially curative, though the cure may be assisted by the employment of constitutional remedies.In the latter cases it can only be considered alleviative, and as an adjuvant, though a very important one, to the cure by constitutional means.
Parental Stress Increases the Detrimental Effect of Traffic Exposure on Children's Lung Function
Authors: Talat Islam, Robert Urman, W. James Gauderman, Joel Milam, Fred Lurmann, Ketan Shankardass, Ed Avol, Frank Gilliland, Rob McConnell
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

Emerging evidence indicates that psychosocial stress enhances the effect of traffic exposure on the development of asthma.We hypothesized that psychosocial stress would also modify the effect of traffic exposure on lung function deficits.We studied 1,399 participants in the Southern California Children's Health Study undergoing lung function testing (mean age, 11.2 yr). We used hierarchical mixed models to assess the joint effect of traffic-related air pollution and stress on lung function.Psychosocial stress in each child's household was assessed based on parental response to the perceived stress scale (range, 0-16) at study entry. Exposures to nitric oxide, nitrogen dioxide, and total oxides of nitrogen (NOx), surrogates of the traffic-related pollution mixture, were estimated at schools and residences based on a land-use regression model. Among children from high-stress households (parental perceived stress scale > 4) deficits in FEV1 of 4.5 (95% confidence interval, -6.5 to -2.4) and of 2.8% (-5.7 to 0.3) were associated with each 21.8 ppb increase in NOx at homes and schools, respectively. These pollutant effects were significantly larger in the high-stress compared with lower-stress households (interaction P value 0.007 and 0.05 for residential and school NOx, respectively). No significant NOx effects were observed in children from low-stress households. A similar pattern of association was observed for FVC. The observed associations for FEV1 and FVC remained after adjusting for sociodemographic factors and after restricting the analysis to children who do not have asthma.A high-stress home environment is associated with increased susceptibility to lung function effects of air pollution both at home and at school.
Suppression of the Immune Response in Tumor-Bearing Mice. II. Characterization of Adherent Suppressor Cells<xref ref-type="fn" rid="FN2">2</xref>
Authors: J A Bluestone, C Lopez
Journal: JNCI Journal of the National Cancer Institute (1979)

Adherent spleen cells from late (≥18 days post inoculation) tumor-bearing BALB/c mice suppressed lymphoproliferatlve and effector immunity as evaluated by the mixed leukocyte culture and ceil-mediated lympholysls assays. Procedures that eliminated T-cells or B-cells while enriching for macrophage populations significantly augmented the suppression, whereas removal of phagocytic and adherent cells abrogated the suppressive effect. We concluded that the cells responsible for suppression of ceil-mediated immune responses in late tumor-bearing mice were of the monocyte-macrophage series. Furthermore, the suppressive influence was not due merely to the increased number of macrophages in tumor-bearing animals. Experiments clearly showed that the splenic macrophages, even at low concentrations, demonstrated a suppressive function.
Oxaliplatin and capecitabine in patients with metastatic adenocarcinoma of the esophagus, gastroesophageal junction and gastric cardia: a phase II study from the North Central Cancer Treatment Group
Authors: A. Jatoi, B.R. Murphy, N.R. Foster, D.A. Nikcevich, S.R. Alberts, J.A. Knost, T.R. Fitch, K.M. Rowland
Journal: Annals of Oncology (2005)
The Importation of Hematogenous Precursors by the Thymus Is a Gated Phenomenon in Normal Adult Mice
Authors: Deborah L. Foss, Elina Donskoy, Irving Goldschneider
Journal: The Journal of Experimental Medicine (2001)

Hematogenous precursors repopulate the thymus of normal adult mice, but it is not known whether this process is continuous or intermittent. Here, two approaches were used to demonstrate that the importation of prothymocytes in adult life is a gated phenomenon. In the first, age-dependent receptivity to thymic chimerism was studied in nonirradiated Ly 5 congenic mice by quantitative intrathymic and intravenous bone marrow (BM) adoptive transfer assays. In the second, the kinetics of importation of blood-borne prothymocytes was determined by timed separation of parabiotic mice. The results showed that >60% of 3-18-wk-old mice developed thymic chimerism after intrathymic injection of BM cells, and that the levels of chimerism (range, 5-90% donor-origin cells) varied cyclically (periodicity, 3 to 5 wk). In contrast, only 11-14% of intravenously injected recipients became chimeric, and chimerism occurred intermittently (receptive period approximately 1 wk; refractory period approximately 3 wk). In the intravenously injected mice, chimerism occurred simultaneously in both thymic lobes; gate opening occurred only after most intrathymic niches for prothymocytes had emptied; and the ensuing wave of thymocytopoiesis encompassed two periods of gating. These kinetics were confirmed in parabiotic mice, and in cohorts of mice in whom gating was synchronized by an initial intrathymic injection of BM cells. In addition, a protocol was developed by which sequential intravenous injections of BM cells over a 3 to 4 wk period routinely induces thymic chimerism in the apparent absence of stem cell chimerism. Hence, the results not only provide a new paradigm for the regulation of prothymocyte importation during adult life, but may also have applied implications for the selective induction of thymocytopoiesis in nonmyeloablated hosts.
Plasma Interleukin-18 Concentrations Are Elevated in Type 2 Diabetes
Authors: Katherine Esposito, Raffaele Marfella, Dario Giugliano
Journal: Diabetes Care (2004)

e read with interest the article by Aso et al. (1) showing greater plasma concentrations of interleukin-18 (IL-18) in type 2 diabetic patients compared with matched control subjects.While the authors found no significant associations between fasting levels of IL-18 and homeostasis model assessment, a measure of insulin resistance, they found associations between IL-18 and C-reactive protein concentrations.Moreover, carotid intima-media thickness, a validated surrogate measure of atherosclerosis, was greater in diabetic patients with high IL-18 than in those with normal IL-18.As a whole, these data add to the mounting evidence that diabetes may be regarded as a chronic lowgrade inflammatory state.However, we disagree with the authors' conclusions that "the present study demonstrated for the first time that plasma IL-18 concentrations were significantly higher in type 2 diabetic patients than in age-matched control subjects" because we have reported similar findings in Diabetes Care (2).In that study, we demonstrated that 30 newly diagnosed, slightly overweight (BMI 26.9 Ϯ 1.2 kg/m 2 , means Ϯ SD) type 2 diabetic patients without clinical or instrumental evidence of micro-and macrovascular complications presented higher circulating concentrations of IL-18 compared with nondiabetic subjects matched for sex, age, and body weight (205 Ϯ 39 vs. 120 Ϯ 25 pg/ml, P Ͻ 0.01).It is reassuring to see that the fasting values of IL-18 in the Japanese diabetic patients studied by Aso et al. (1) were quite similar (203 Ϯ 153 pg/ml) to those of our Caucasian diabetic patients and that the relation between fasting plasma glucose and IL-18 concentrations was present in both studies (r ϭ 0.31, P Ͻ 0.05; r ϭ 0.24, P Ͻ 0.02, respectively).These results suggest that ethnicity does not to play a major role in these associations.IL-18 is a potent proinflammatory cy-tokine reported to play a role in plaque destabilization (3) and predict cardiovascular death in patients with coronary artery disease (4).Although IL-18 is produced mainly by monocyte/macrophages, a contribution from adipose tissue has recently been suggested (5).In the light of the evidence that IL-18 circulating levels are higher in type 2 diabetic patients than matched nondiabetic subjects and correlate with fasting glucose levels, it does not seem hazardous to hypothesize that IL-18 may play a role in acute coronary syndromes through plaque destabilization ( 6).This working hypothesis, which deserves further investigation, also finds support in the observation that acute hyperglycemia may increase circulation levels of IL-18 in both normal subjects and patients with impaired glucose tolerance (7).
Predictive Value of Brachial Flow-Mediated Dilation for Incident Cardiovascular Events in a Population-Based Study
Authors: Joseph Yeboah, Aaron R. Folsom, Gregory L. Burke, Craig Johnson, Joseph F. Polak, Wendy Post, Joao A. Lima, John R. Crouse, David M. Herrington
Journal: Circulation (2009)

Background— Although brachial artery flow-mediated dilation (FMD) predicts recurrent cardiovascular events, its predictive value for incident cardiovascular disease (CVD) events in adults free of CVD is not well established. We assessed the predictive value of FMD for incident CVD events in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods and Results— Brachial artery FMD was measured in a nested case-cohort sample of 3026 of 6814 subjects (mean±SD age, 61.2±9.9 years) in MESA, a population-based cohort study of adults free of clinical CVD at baseline recruited at 6 clinic sites in the United States. The sample included 50.2% female, 34.3% white, 19.7% Chinese, 20.8% black, and 25.1% Hispanic subjects. Probability-weighted Cox proportional hazards analysis was used to examine the association between FMD and 5 years of adjudicated incident CVD events, including incident myocardial infarction, definite angina, coronary revascularization (coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, or other revascularization), stroke, resuscitated cardiac arrest, and CVD death. Mean (SD) FMD of the cohort was 4.4% (2.8). In probability-weighted Cox models, FMD/unit SD was significantly associated with incident cardiovascular events in the univariate model (adjusted for age and sex) (hazard ratio, 0.79; 95% confidence interval, 0.65 to 0.97; P =0.01), after adjustment for the Framingham Risk Score (FRS) (hazard ratio, 0.80; 95% confidence interval, 0.62 to 0.97; P =0.025), and in the multivariable model (hazard ratio, 0.84; 95% confidence interval, 0.71 to 0.99; P =0.04) after adjustment for age, sex, diabetes mellitus, cigarette smoking status, systolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, heart rate, statin use, and blood pressure medication use. The c statistic (area under the curve) values of FMD, FRS, and FRS+FMD were 0.65, 0.74, and 0.74, respectively. Compared with the FRS alone, the addition of FMD to the FRS net correctly reclassifies 52% of subjects with no incident CVD event but net incorrectly reclassifies 23% of subjects with an incident CVD event, an overall net correct reclassification of 29% ( P &lt;0.001). Conclusions— Brachial FMD is a predictor of incident cardiovascular events in population-based adults. Even though the addition of FMD to the FRS did not improve discrimination of subjects at risk of CVD events in receiver operating characteristic analysis, it improved the classification of subjects as low, intermediate, and high CVD risk compared with the FRS.
FreeStyle Navigator Continuous Glucose Monitoring System Use in Children With Type 1 Diabetes Using Glargine-Based Multiple Daily Dose Regimens
Authors: Stuart Weinzimer, Dongyuan Xing, Michael Tansey, Rosanna Fiallo-Scharer, Nelly Mauras, Tim Wysocki, Roy Beck, William Tamborlane, Katrina Ruedy
Journal: Diabetes Care (2008)

In a previous pilot study of the FreeStyle Navigator Continuous Glucose Monitoring System, hereafter referred to as “Navigator,” in 30 children and adolescents with type 1 diabetes using insulin pumps, we found that Navigator use averaged >130 h per week over 13 weeks and mean A1C level dropped from 7.1 ± 0.6 to 6.8 ± 0.7% ( P = 0.02) (1). The current study evaluated whether the Navigator was similarly tolerated over 13 weeks in 27 children aged 4–17 years with type 1 diabetes using glargine-based, multiple daily injection(MDI) insulin regimens. Subjects averaged >100 h/week of Navigator use. Mean A1C level fell from 7.9 ± 1.0% at baseline to 7.3 ± 0.9% at 13 weeks ( P = 0.004). High satisfaction with the Navigator was reported on the Continuous Glucose Monitor Satisfaction Scale. These encouraging pilot study results support the inclusion of MDI users in longer-term randomized clinical trials of continuous glucose monitors.

Institutional review boards at each of the Diabetes Research in Children Network (DirecNet) centers approved the study protocol and consent/assent forms. Research methods were virtually identical to those employed in our previous Navigator (Abbott Diabetes Care; Alameda, CA) study (1) except that all subjects were treated with glargine-based MDI treatment. Other eligibility requirements were as follows: subjects must 1 ) be aged 3–17 years, 2 ) have type 1 diabetes for a duration ≥1 year, 3 ) have access to a home computer equipped with E-mail, and 4 ) have a parent/older subject who comprehended English. Subjects were excluded for asthma, cystic fibrosis, psychiatric disorder, and use of glucocorticoids. Subjects were selected for participation from the existing patient population at each center.

There was a 1-week run-in period during which Navigator use was blinded to collect baseline glucose data, followed by unblinded home use for 3 months. To blind subjects to the results …
Mortality associated with delay in operation after hip fracture: observational study
Authors: Alex Bottle, Paul Aylin
Journal: BMJ (2006)

<h3>Abstract</h3> <b>Objective</b> To estimate the number of deaths and readmissions associated with delay in operation after femoral fracture. <b>Design</b> Analysis of inpatient hospital episode statistics. <b>Setting</b> NHS hospital trusts in England with at least 100 admissions for fractured neck of femur during the study period. <b>Patients</b> People aged ≥ 65 admitted from home with fractured neck of femur and discharged between April 2001 and March 2004. <b>Main outcome measures</b> In hospital mortality and emergency readmission within 28 days. <b>Results</b> There were 129 522 admissions for fractured neck of femur in 151 trusts with 18 508 deaths in hospital (14.3%). Delay in operation was associated with an increased risk of death in hospital, which was reduced but persisted after adjustment for comorbidity. For all deaths in hospital, the odds ratio for more than one day9s delay relative to one day or less was 1.27 (95% confidence interval 1.23 to 1.32) after adjustment for comorbidity. The proportion with more than two days9 delay ranged from 1.1% to 62.4% between trusts. If death rates in patients with at most one day9s delay had been repeated throughout all 151 trusts in this study, there would have been an average of 581 (478 to 683) fewer total deaths per year (9.4% of the total). There was little evidence of an association between delay and emergency readmission. <b>Conclusions</b> Delay in operation is associated with an increased risk of death but not readmission after a fractured neck of femur, even with adjustment for comorbidity, and there is wide variation between trusts.
Lead Exposure, B Vitamins, and Plasma Homocysteine in Men 55 Years of Age and Older: The VA Normative Aging Study
Authors: Kelly M. Bakulski, Sung Kyun Park, Marc G. Weisskopf, Katherine L. Tucker, David Sparrow, Avron Spiro, Pantel S. Vokonas, Linda Huiling Nie, Howard Hu, Jennifer Weuve
Journal: Environmental Health Perspectives (2014)

Background: Lead (Pb) exposure may influence the plasma concentration of homocysteine, a one-carbon metabolite associated with cardiovascular and neurodegenerative diseases. Little is known about the associations between Pb and homocysteine over time, or the potential influence of dietary factors.Objectives: We examined the longitudinal association of recent and cumulative Pb exposure with homocysteine concentrations and the potential modifying effect of dietary nutrients involved in one-carbon metabolism.Methods: In a subcohort of the Veterans Affairs (VA) Normative Aging Study (1,056 men with 2,301 total observations between 1993 and 2011), we used mixed-effects models to estimate differences in repeated measures of total plasma homocysteine across concentrations of Pb in blood and tibia bone, assessing recent and cumulative Pb exposure, respectively. We also assessed effect modification by dietary intake and plasma concentrations of folate, vitamin B6, and vitamin B12.Results: An interquartile range (IQR) increment in blood Pb (3 μg/dL) was associated with a 6.3% higher homocysteine concentration (95% CI: 4.8, 7.8%). An IQR increment in tibia bone Pb (14 μg/g) was associated with a 3.7% higher homocysteine (95% CI: 1.6, 5.6%), which was attenuated to 1.5% (95% CI: –0.5, 3.6%) after adjusting for blood Pb. For comparison, a 5-year increase in time from baseline was associated with a 5.7% increase in homocysteine (95% CI: 4.3, 7.1%). The association between blood Pb and homocysteine was significantly stronger among participants with estimated dietary intakes of vitamin B6 and folate below (vs. above) the study population medians, which were similar to the U.S. recommended dietary allowance intakes.Conclusions: Pb exposure was positively associated with plasma homocysteine concentration. This association was stronger among men with below-median dietary intakes of vitamins B6 and folate. These findings suggest that increasing intake of folate and B6 might reduce Pb-associated increases in homocysteine, a risk factor for cardiovascular disease and neurodegeneration.Citation: Bakulski KM, Park SK, Weisskopf MG, Tucker KL, Sparrow D, Spiro A III, Vokonas PS, Nie LH, Hu H, Weuve J. 2014. Lead exposure, B vitamins, and plasma homocysteine in men 55 years of age and older: the VA Normative Aging Study. Environ Health Perspect 122:1066–1074; http://dx.doi.org/10.1289/ehp.1306931
Precompetition injury and subsequent tournament performance in full-contact taekwondo.
Authors: M Feehan, A E Waller
Journal: British Journal of Sports Medicine (1995)

OBJECTIVE: To determine the pattern of injuries sustained by taekwondo competitors, and how previous injury affects performance in sporting competition. METHODS: Competitors at a major New Zealand full-contact taekwondo tournament were given a comprehensive questionnaire immediately before competition. Self reports of injuries sustained through taekwondo in the previous 12 months were determined. RESULTS: No significant sex differences were found. The injury prevalence was high, but comparatively less than reported for other contact sports such as rugby football. However, one in 20 injuries was a closed head injury. No significant associations between prior injury and tournament outcome were found. CONCLUSIONS: Taekwondo can be a source of disabling injury. However, the fact that prior injury did not appear to be associated with impaired competition performance may militate against acceptance of control and regulation by competitors and coaches.
Genetic requirement for Ras in the transformation of fibroblasts and hematopoietic cells by the Bcr-Abl oncogene.
Authors: C L Sawyers, J McLaughlin, O N Witte
Journal: The Journal of Experimental Medicine (1995)

To determine the functional importance of Ras in transformation by Abl oncogenes, we used a genetic approach to measure the effect of impaired Ras activity on the ability of Bcr-Abl or v-Abl to transform cells. Expression of the catalytic domain of the GTPase activating protein for Ras (Gap C terminus) impaired soft agar colony formation by fibroblasts expressing v-Abl or Bcr-Abl by 70-80%. To test Ras function in a model that more closely resembles clinical diseases involving Bcr-Abl, double gene retroviruses expressing Bcr-Abl paired with the Gap C terminus or dominant negative Ras were introduced into naive mouse bone marrow cells. Transformation by Bcr-Abl was completely blocked in both situations. Coexpression of normal c-H-Ras accelerated the transforming activity of Bcr-Abl. These findings show that Ras activation is essential for the leukemogenic activity of Abl oncogenes in two distinct model systems. The results genetically define a connection between the Bcr-Abl cytoplasmic tyrosine kinase and Ras and add to the accumulating evidence that deregulation of Ras is a central event in the genesis of a number of molecularly distinct forms of human myeloid leukemia.
Cognitive behavior therapy for chronic fatigue syndrome: a randomized controlled trial
Authors: A Deale, T Chalder, I Marks, S Wessely
Journal: American Journal of Psychiatry (1997)

Cognitive behavior therapy for chronic fatigue syndrome was compared with relaxation in a randomized controlled trial.Sixty patients with chronic fatigue syndrome were randomly assigned to 13 sessions of either cognitive behavior therapy (graded activity and cognitive restructuring) or relaxation. Outcome was evaluated by using measures of functional impairment, fatigue, mood, and global improvement.Treatment was completed by 53 patients. Functional impairment and fatigue improved more in the group that received cognitive behavior therapy. At final follow-up, 70% of the completers in the cognitive behavior therapy group achieved good outcomes (substantial improvement in physical functioning) compared with 19% of those in the relaxation group who completed treatment.Cognitive behavior therapy was more effective than a relaxation control in the management of patients with chronic fatigue syndrome. Improvements were sustained over 6 months of follow-up.