tbuckley/cabot-search huggingface dataset:
Estimated GFR reporting is associated with decreased nonsteroidal anti-inflammatory drug prescribing and increased renal function
Authors: Li Wei, Thomas M. MacDonald, Claudine Jennings, Xia Sheng, Robert W. Flynn, Michael J. Murphy
Journal: Kidney International (2013)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used; however, they are also nephrotoxic with both acute and chronic effects on kidney function. Here we determined NSAID prescribing before and after estimated GFR (eGFR) reporting and evaluate renal function in patients who used NSAIDs but stopped these after their first eGFR report. A population-based longitudinal analysis using a record-linkage database was conducted with the GFR estimated using the four-variable equation from the MDRD study and analyzed by trend test, paired t-test, and logistic regression modeling. Prescriptions for NSAIDs significantly decreased from 39,459 to 35,415 after implementation of eGFR reporting from the second quarter of 2005 compared with the first quarter of 2007. Reporting eGFR was associated with reduced NSAID prescriptions (adjusted odds ratio, 0.78). NSAID prescription rates in the 6 months before April 2006 were 18.8, 15.4, and 7.0% in patients with CKD stages 3, 4, and 5 and 15.5, 10.7, and 6.3%, respectively, after eGFR reporting commenced. In patients who stopped NSAID treatment, eGFR significantly increased from 45.9 to 46.9, 23.9 to 27.1, and 12.4 to 26.4 ml/min per 1.73 m(2) in 1340 stage 3 patients, 162 stage 4 patients, and 9 stage 5 patients, respectively. Thus, NSAID prescribing decreased after the implementation of eGFR reporting, and there were significant improvements in estimated renal function in patients who stopped taking NSAIDs. Hence, eGFR reporting may result in safer prescribing.
Belt-Positioning Booster Seats and Reduction in Risk of Injury Among Children in Vehicle Crashes
Authors: Dennis R. Durbin, Michael R. Elliott, Flaura K. Winston
Journal: JAMA (2003)

Context Although more than a dozen states have ratified laws that require booster seats for children older than 4 years, most states continue to have child restraint laws that only cover children through age 4 years. Lack of booster seat effectiveness data may be a barrier to passage of stronger child restraint laws. Objectives To quantify the association of belt-positioning booster seats compared with seat belts alone and risk of injury among 4- to 7-year-old children and to assess patterns of injury among children in booster seats vs seat belts. Design, Setting, and Population Cross-sectional study of children aged 4 to 7 years in crashes of insured vehicles in 15 states, with data collected via insurance claims records and a telephone survey. A probability sample of 3616 crashes involving 4243 children, weighted to represent 56 593 children in 48 257 crashes was collected between December 1, 1998, and May 31, 2002. Main Outcome Measure Parent report of clinically significant injuries. Results Injuries occurred among 1.81% of all 4- to 7-year-olds, including 1.95% of those in seat belts and 0.77% of those in belt-positioning booster seats. The odds of injury, adjusting for child, driver, crash, and vehicle characteristics, were 59% lower for children aged 4 to 7 years in belt-positioning boosters than in seat belts (odds ratio, 0.41; 95% confidence interval, 0.20-0.86). Children in belt-positioning booster seats had no injuries to the abdomen, neck/spine/back, or lower extremities, while children in seat belts alone had injuries to all body regions. Conclusion Belt-positioning booster seats were associated with added safety benefits compared with seat belts to children through age 7 years, including reduction of injuries classically associated with improper seat belt fit in children.
Experts question proposals to use private sector in India's health reforms
Authors: G. Mudur
Journal: BMJ (2012)

India’s most influential government think tank has agreed to revise a draft document for healthcare reform after some experts claimed that it reflected an intent to hand over virtually all clinical services to the private sector.

The document from India’s Planning Commission, which outlines health priorities for the period 2012 to 2017, has proposed new initiatives to reduce the amount that Indians contribute personally to healthcare, from the current level of 71% to 50% of total health spending.

The document suggests that the government would fund and deliver services such as ambulance transport, obstetric and newborn care, immunisation, and the management of tuberculosis and malaria. The government would also pay for but “not necessarily directly provide” other clinical services that would be available through public and private sector healthcare providers, leaving the choice to patients and their families, it said.

The proposals have evoked sharp reactions …
Sole abnormalities of chromosome 7 in myeloid malignancies: Spectrum, histopathologic correlates, and prognostic implications
Authors: Fareeda Taher Nazer Hussain, Edward P. Nguyen, Sania Raza, Ryan Knudson, Animesh Pardanani, Curtis A. Hanson, Daniel Van Dyke, Ayalew Tefferi
Journal: American Journal of Hematology (2012)

Among 6,565 consecutive abnormal cytogenetic reports at our institution, 3,192 (49%) constituted sole abnormalities, of which 230 (7%) involved chromosome 7: monosomy 7 (n = 98), 7q- (n = 51), der(1;7)(q10;p10) (n = 44), balanced translocations (n = 15), ring 7 (n = 13), and 7p- (n = 9). The most frequent histopathologic correlates were myelodysplastic syndromes (MDS; 28%), acute myeloid leukemia (AML; 17%), secondary or therapy-related MDS/AML (13%), primary myelofibrosis (PMF; 7%), and chronic myelomonocytic leukemia (6%). Monosomy 7 was the most frequent in each one of these disease categories except PMF where 7q- was more frequent. In primary MDS, patients with der(1;7)(q10;p10) (n = 13), compared to those with monosomy 7 (n = 30) or 7q- (n = 15), were less likely (P = 0.04) to display excess blasts or multilineage dysplasia but overall and leukemia-free survival adjusted for these variables revealed no significant difference between the three groups (P = 0.57 and 0.81, respectively). The current study does not prognostically distinguish monosomy 7 from 7q- or der(1;7), in MDS.
Whole-Body Counters
Authors: Alexander P. Remenchik
Journal: JAMA (1966)

Whole-body counters are sensitive radiation-detecting and measuring instruments developed by radiation physicists for determining the amount of radioactivity present in man. Quickly and painlessly they enable the investigator to determine the kinds and amounts of radioactive substances in the body which have accumulated from natural sources, manmade fallout, industrial and laboratory sources, or from tracer isotopes given for medical purposes. This is done by counting emissions from the radioactive material in the body. From a physical point of view these devices do not differ materially from the instruments most physicians are familiar with that are used to assay for radioactivity in body fluids and tissues. They differ from these devices only by their large size, their heavy shielding, and their sensitivity to very low levels of radioactivity. Two principal types of wholebody counters have been developed. One uses a sodium iodide crystal as a radiation detector, and in the other
Protective effects of non-peptide endothelin receptor antagonist bosentan on myocardial ischaemic and reperfusion injury in the pig
Authors: Q.-D. Wang, X.-S. Li, J. M Lundberg, J. Pernow
Journal: Cardiovascular Research (1995)

The aim was to investigate the effects of the non-peptide endothelin receptor antagonist bosentan (Ro 47-0203) on haemodynamic variables, infarct size, myocardial overflow, and tissue content of endothelin-like immunoreactivity (ET-LI) during ischaemia and reperfusion in anaesthetised pigs, and to study the inhibitory effect of bosentan on ET-1 induced coronary constriction in vitro.Ischaemia was induced by ligation of the left anterior descending coronary artery for 45 min, followed by 4 h of reperfusion. Bosentan was given either intravenously (5 mg.kg-1) 15 min before ischaemia or as a 25 min local coronary venous retroinfusion (10(-4) M) starting at 30 min of ischaemia. ET-LI was analysed in myocardial tissue and in plasma from the anterior interventricular coronary vein and aorta. The effect of bosentan on endothelin-1 induced vasoconstriction was evaluated in isolated diagonal branches of left anterior descending coronary artery.Intravenous bosentan slightly reduced arterial blood pressure (P < 0.05) but did not affect basal coronary vascular resistance. Local retroinfusion of bosentan did not change blood pressure. Intravenous and retroinfused bosentan significantly reduced infarct size by 58% and 48% respectively (P < 0.01) and enhanced the recovery of coronary blood flow by 65-90% compared to vehicle treated controls at the end of 4 h reperfusion. The basal plasma levels of ET-LI and the myocardial overflow of ET-LI during reperfusion increased twofold after bosentan. A threefold increase in the concentration of ET-LI was observed in the ischaemic/reperfused myocardium and this enhancement was significantly attenuated by bosentan. Bosentan effectively antagonised the endothelin-1 induced but not the serotonin induced, contractions of isolated coronary arteries and reversed the established contraction induced by endothelin-1.The non-peptide endothelin receptor antagonist bosentan markedly protects the myocardium from ischaemia/reperfusion injury and improves blood flow to the reperfused area, indicating the involvement of endogenous endothelin-1 and the therapeutic value of bosentan in the treatment of ischaemia/reperfusion injury.
The generation of fibrinopeptide A in clinical blood samples: evidence for thrombin activity.
Authors: H L Nossel, M Ti, K L Kaplan, K Spanondis, T Soland, V P Butler
Journal: Journal of Clinical Investigation (1976)

Plasma fibrinopeptide A (FPA) concentrations were measured in clinical blood samples incubated in the collecting syringe for different time periods before addition to heparin and Trasylol, and the rate of in vitro generation of FPA was calculated as the mean increment in FPA concentration per minute over the linear portion of the generation curve. 36 normal individuals had a mean plasma FPA level of 0.64 +/- 0.56 pmol/ml and an FPA generation rate of less than 0.5 pmol/ml per min. Clinical samples with elevated plasma FPA levels manifested slow (less than 1 pmol/ml per min) (28 patients) or rapid FPA generation (greater than 1 pmol/ml per min) (33 patients). Slow FPA generation was found in 10/10 patients with venous thrombosis, in 4/4 with aortic aneurysm, and in several patients with acquired hypofibrinogenemia. In one such patient, addition of fibrinogen resulted in rapid FPA generation whereas thrombin addition was without effect. Rapid FPA generation was generally linear, was usually associated with slower fibrinopeptide B generation and was inhibited by parenteral or in vitro heparin. It is thought to reflect increased thrombin activity and was seen in patients with pulmonary embolism, active systemic lupus erythematosus, renal transplant rejection, and after infusion of prothrombin concentrates. The initial rate of FPA cleavage by thrombin at fibrinogen concentrations from 0.05 to 4 mg/ml showed little change between 2 and 4 mg/ml with a Km of 2.99 muM. At a fibrinogen concentration of 2.5 mg/ml the FPA cleavage rate was 49.2 +/- 1.6 nmol/ml per min per U of thrombin. Exogenous thrombin added to normal blood generated 21.7 nmol/ml per U of thrombin FPA in the first minute with a nonlinear pattern reflecting inactivation of thrombin and the presence of alternative substrates. Hence, the thrombin concentration in the blood cannot be calculated from the FPA generation rate. The FPA generation rates in clinical samples with rapid generation (1-28 pmol/ml per min) could be produced by 2 X 10(-5) to 5.6 X 10(-4) thrombin U/ml acting on purified fibrinogen at physiological conditions of pH, ionic strength, and temperature.
THE BREAST FEEDING DEMONSTRATION AND THE PHYSICIAN
Authors: FRANK HOWARD RICHARDSON
Journal: JAMA (1926)

Hand in hand with the reawakening of interest in the possibilities of breast feeding on the part of the medical profession has gone a new development in welfare work; namely, the breast feeding demonstration. For both these movements, the medical and the social, Julius P. Sedgwick deserves undying praise. It was he who worked out the mechanics of the technic of breast feeding that many of us have found most useful in our individual work with mothers and babies; and he it was who established the classic rules for the conduct of the breast feeding demonstration. It would be hard to conceive of doing either line of work, the medical or the social, without hewing to the lines that he laid down.  The two cardinal principles governing the medical handling of a case of breast feeding are too well known to need more than passing mention here. They are, of
Genetic mapping and exome sequencing identify 2 mutations associated with stroke protection in pediatric patients with sickle cell anemia
Authors: Jonathan M. Flanagan, Vivien Sheehan, Heidi Linder, Thad A. Howard, Yong-Dong Wang, Carolyn C. Hoppe, Banu Aygun, Robert J. Adams, Geoffrey A. Neale, Russell E. Ware
Journal: Blood (2013)
Pharmacokinetics in the elderly.
Authors: M Mayersohn
Journal: Environmental Health Perspectives (1994)

Animals undergo substantial changes in many physiologic and biochemical functions as a natural consequence of aging. In the absence of disease or other pathologic conditions, these changes occur in a gradual manner with time (generally expressed as a fractional or percentage change in that function per year or decade). Furthermore, for any given function and at any given chronologic age, there is large variation in that function among individuals. Given the increase in life expectancy, the substantial increase in the number of elderly (and aged elderly) in the population, and the escalating costs of health care, there is great interest in learning more about the risks associated with aging as a result of toxic exposure. Are the elderly at greater risk than younger adults to the toxic effects of drugs and environmental exposure? Is the elderly population an inherently more sensitive one?
Therapy-Resistant Depressions: Biochemical and Pharmacological Considerations
Authors: K.M. van Praag
Journal: Psychotherapy and Psychosomatics (1974)

Two statements are made: antidepressants increase the amount of MA at the central receptors; antidepressants are effective in some, but quite ineffective in other patients, even if they belong to the same diagnostic category. Three questions arise from these statements: (1) Does a central MA deficiency occur in depressive patients? (2) If so, is this disorder present in only a proportion of the patients? (3) If so, can this explain the apparent selectivity of antidepressants in the sense that MA-deficient patients benefit particularly from this type of therapy? Tentative answers are given to these three questions. In depressive patients the cerebral MA turnover can be diminished. These disorders do not occur in all patients but seem to be confined to certain categories of depression. Diminution or non-diminution of the central MA turnover is a (not the) factor which determines whether antidepressant medication will succeed or fail. The theoretical and practical implications of these answers are discussed.
Positive inotropic effects of epigallocatechin‐3‐gallate (EGCG) involve activation of Na<sup>+</sup>/H<sup>+</sup> and Na<sup>+</sup>/Ca<sup>2+</sup> exchangers
Authors: Mario Lorenz, Niels Hellige, Philipp Rieder, Hans‐Tilmann Kinkel, Christiane Trimpert, Alexander Staudt, Stephan B. Felix, Gert Baumann, Karl Stangl, Verena Stangl
Journal: European Journal of Heart Failure (2008)
Minke whale genome and aquatic adaptation in cetaceans
Authors: Hyung-Soon Yim, Yun Sung Cho, Xuanmin Guang, Sung Gyun Kang, Jae-Yeon Jeong, Sun-Shin Cha, Hyun-Myung Oh, Jae-Hak Lee, Eun Chan Yang, Kae Kyoung Kwon, Yun Jae Kim, Tae Wan Kim, Wonduck Kim, Jeong Ho Jeon, Sang-Jin Kim, Dong Han Choi, Sungwoong Jho, Hak-Min Kim, Junsu Ko, Hyunmin Kim, Young-Ah Shin, Hyun-Ju Jung, Yuan Zheng, Zhuo Wang, Yan Chen, Ming Chen, Awei Jiang, Erli Li, Shu Zhang, Haolong Hou, Tae Hyung Kim, Lili Yu, Sha Liu, Kung Ahn, Jesse Cooper, Sin-Gi Park, Chang Pyo Hong, Wook Jin, Heui-Soo Kim, Chankyu Park, Kyooyeol Lee, Sung Chun, Phillip A Morin, Stephen J O'Brien, Hang Lee, Jumpei Kimura, Dae Yeon Moon, Andrea Manica, Jeremy Edwards, Byung Chul Kim, Sangsoo Kim, Jun Wang, Jong Bhak, Hyun Sook Lee, Jung-Hyun Lee
Journal: Nature Genetics (2013)

Jung-Hyun Lee, Jong Bhak and their colleagues report the whole-genome sequencing and de novo assembly of a male minke whale genome, as well as the genome sequences of three additional minke whales, a fin whale, a bottlenose dolphin and a finless porpoise. Their comparative analysis across cetaceans provides insights into adaptation to an aquatic lifestyle. The shift from terrestrial to aquatic life by whales was a substantial evolutionary event. Here we report the whole-genome sequencing and de novo assembly of the minke whale genome, as well as the whole-genome sequences of three minke whales, a fin whale, a bottlenose dolphin and a finless porpoise. Our comparative genomic analysis identified an expansion in the whale lineage of gene families associated with stress-responsive proteins and anaerobic metabolism, whereas gene families related to body hair and sensory receptors were contracted. Our analysis also identified whale-specific mutations in genes encoding antioxidants and enzymes controlling blood pressure and salt concentration. Overall the whale-genome sequences exhibited distinct features that are associated with the physiological and morphological changes needed for life in an aquatic environment, marked by resistance to physiological stresses caused by a lack of oxygen, increased amounts of reactive oxygen species and high salt levels.
The changing face of liver transplantation.
Authors: C Shorrock, J Neuberger
Journal: Gut (1993)

Leading articleThe changing face of liver transplantation It is now 24 years since the first orthotopic liver transplant was carried out in the United Kingdom by Sir Roy Calne in 1968.Much has occurred in the intervening years, not only in practical surgical terms but also as a result of a better understanding of the many facets of transplantation, including selection of patients, timing of the procedure, anaesthetic and other support, improved organ preservation and better management of some of the complications of the procedure.Graft rejection and sepsis are still the major causes of morbidity and mortality' reflecting the difficulties in balancing immunosuppression with the inherent risks of infective complications.Indications for transplantation are changing, particularly with respect to alcoholic liver disease, malignant liver disease and viral hepatitis.In spite of the technical advances made in recent years, increasing demand as indications for transplantation expand only serves to highlight the problem of organ shortage.In this leading article, we review the impact of new immunosuppressive therapies, the changing indications for liver transplantation and highlight attempts to overcome the problems of donor organ shortage.
Low intelligence test scores in 18 year old men and risk of suicide: cohort study
Authors: D Gunnell, P K E Magnusson, F Rasmussen
Journal: BMJ (2004)

To examine the association between intelligence test scores in men, measured at age 18, and subsequent suicide.Record linkage study of the Swedish military service conscription register (1968-94) with the multi-generation register, cause of death register and census data. Four tests were performed at conscription covering logic, language, spatial, and technical skills.Sweden.987 308 Swedish men followed up for 5-26 years.Suicide.2811 suicides occurred during follow up. The risk of suicide was two to three times higher in those with lowest compared with the highest test scores. The strongest associations were seen with the logic test: for each unit increase in test score the risk of suicide decreased by 12% (95% confidence interval 10% to 14%). Associations were only slightly attenuated when we controlled for parents' socioeconomic position. Greatest risks were seen among poorly performing offspring of well educated parents.Performance in intelligence tests is strongly related to subsequent risk of suicide in men. This may be due to the importance of cognitive ability in either the aetiology of serious mental disorder or an individual's capacity to solve problems while going through an acute life crisis or suffering from mental illness.
The nursing profession's coming of age: The death of nursing, the dumbing down of medicine
Authors: Robbie S Coull
Journal: BMJ (2006)

The nursing profession's coming of age The end of medicine as a professionEditor-Young describes the coming of age of the nursing profession. 1 All professions and occupations are human creations and therefore are subject to change.With the widening of roles of many professions, it becomes harder to define what a doctor can do that can't be done by an appropriately trained member of another profession.Perhaps major surgery and certifying cause of death are all that remains.With the increasing difficulty of getting junior doctors to do anything that may be regarded as work (rather than education) we doctors may be engineering the abolition of our profession, and we may move from distinct professions to practitioners from varied backgrounds being trained for a particular function.
Vessel-dependent recruitment of sympathetic axons: looking for innervation in all the right places
Authors: Yoh-suke Mukouyama
Journal: Journal of Clinical Investigation (2014)

Autonomic sympathetic axons extend along and innervate resistance arteries to control vascular tone and participate in blood pressure regulation. In this issue of the JCI, Brunet and colleagues reveal that sympathetic innervation of arteries is facilitated by secretion of the axon guidance molecule netrin-1 by arterial VSMCs. Furthermore, disruption of the signaling cascade induced by netrin-1 through its receptor DCC resulted in defective arterial innervation and sympathetic control of vasoconstriction. This comprehensive study represents a major step forward in our understanding of the coordinated wiring of the vascular and nervous systems in various tissues.