tbuckley/cabot-search huggingface dataset:
Organophosphorus Poisoning in the Kashmir Valley, 1994 to 1997
Authors: G.M. Malik, M. Mubarik, G.J. Romshoo
Journal: New England Journal of Medicine (1998)

To the Editor: An estimated 1 million serious accidental poisonings and 2 million suicide attempts involving organophosphorus compounds occur each year worldwide.1 India ranks second in Asia in annual pesticide consumption.2 We prospectively studied 164 patients (age range, 14 to 58 years) from different districts of the Kashmir valley, who were seen in the casualty department of SMHS Hospital, Srinagar, India, with a history of exposure to organophosphorus compounds between April 1994 and July 1997 (Table 1). Most of the patients (74.4 percent) had consumed these agents to attempt suicide. Phosphamidon was the agent most frequently ingested. Two thirds of . . .
Inhalation of Ultrafine Particles Alters Blood Leukocyte Expression of Adhesion Molecules in Humans
Authors: Mark W. Frampton, Judith C. Stewart, Günter Oberdörster, Paul E. Morrow, David Chalupa, Anthony P. Pietropaoli, Lauren M. Frasier, Donna M. Speers, Christopher Cox, Li-Shan Huang, Mark J. Utell
Journal: Environmental Health Perspectives (2005)

Ultrafine particles (UFPs; aerodynamic diameter < 100 nm) may contribute to the respiratory and cardiovascular morbidity and mortality associated with particulate air pollution. We tested the hypothesis that inhalation of carbon UFPs has vascular effects in healthy and asthmatic subjects, detectable as alterations in blood leukocyte expression of adhesion molecules. Healthy subjects inhaled filtered air and freshly generated elemental carbon particles (count median diameter approximately 25nm, geometric standard deviation approximately 1.6), for 2 hr, in three separate protocols: 10 microg/m3 at rest, 10 and 25 microg/m3 with exercise, and 50 microg/m3 with exercise. In a fourth protocol, subjects with asthma inhaled air and 10 microg/m3 UFPs with exercise. Peripheral venous blood was obtained before and at intervals after exposure, and leukocyte expression of surface markers was quantitated using multiparameter flow cytometry. In healthy subjects, particle exposure with exercise reduced expression of adhesion molecules CD54 and CD18 on monocytes and CD18 and CD49d on granulocytes. There were also concentration-related reductions in blood monocytes, basophils, and eosinophils and increased lymphocyte expression of the activation marker CD25. In subjects with asthma, exposure with exercise to 10 microg/m3 UFPs reduced expression of CD11b on monocytes and eosinophils and CD54 on granulocytes. Particle exposure also reduced the percentage of CD4+ T cells, basophils, and eosinophils. Inhalation of elemental carbon UFPs alters peripheral blood leukocyte distribution and expression of adhesion molecules, in a pattern consistent with increased retention of leukocytes in the pulmonary vascular bed.
Screening and Brief Intervention for Drug Use in Primary Care
Authors: Richard Saitz, Tibor P. A. Palfai, Debbie M. Cheng, Daniel P. Alford, Judith A. Bernstein, Christine A. Lloyd-Travaglini, Seville M. Meli, Christine E. Chaisson, Jeffrey H. Samet
Journal: JAMA (2014)

<h3>Importance</h3> The United States has invested substantially in screening and brief intervention for illicit drug use and prescription drug misuse, based in part on evidence of efficacy for unhealthy alcohol use. However, it is not a recommended universal preventive service in primary care because of lack of evidence of efficacy. <h3>Objective</h3> To test the efficacy of 2 brief counseling interventions for unhealthy drug use (any illicit drug use or prescription drug misuse)—a brief negotiated interview (BNI) and an adaptation of motivational interviewing (MOTIV)—compared with no brief intervention. <h3>Design, Setting, and Participants</h3> This 3-group randomized trial took place at an urban hospital-based primary care internal medicine practice; 528 adult primary care patients with drug use (Alcohol, Smoking, and Substance Involvement Screening Test [ASSIST] substance-specific scores of ≥4) were identified by screening between June 2009 and January 2012 in Boston, Massachusetts. <h3>Interventions</h3> Two interventions were tested: the BNI is a 10- to 15-minute structured interview conducted by health educators; the MOTIV is a 30- to 45-minute intervention based on motivational interviewing with a 20- to 30-minute booster conducted by master's-level counselors. All study participants received a written list of substance use disorder treatment and mutual help resources. <h3>Main Outcomes and Measures</h3> Primary outcome was number of days of use in the past 30 days of the self-identified main drug as determined by a validated calendar method at 6 months. Secondary outcomes included other self-reported measures of drug use, drug use according to hair testing, ASSIST scores (severity), drug use consequences, unsafe sex, mutual help meeting attendance, and health care utilization. <h3>Results</h3> At baseline, 63% of participants reported their main drug was marijuana, 19% cocaine, and 17% opioids. At 6 months, 98% completed follow-up. Mean adjusted number of days using the main drug at 6 months was 12 for no brief intervention vs 11 for the BNI group (incidence rate ratio [IRR], 0.97; 95% CI, 0.77-1.22) and 12 for the MOTIV group (IRR, 1.05; 95% CI, 0.84-1.32;<i>P</i> = .81 for both comparisons vs no brief intervention). There were also no significant effects of BNI or MOTIV on any other outcome or in analyses stratified by main drug or drug use severity. <h3>Conclusions and Relevance</h3> Brief intervention did not have efficacy for decreasing unhealthy drug use in primary care patients identified by screening. These results do not support widespread implementation of illicit drug use and prescription drug misuse screening and brief intervention. <h3>Trial Registration</h3> clinicaltrials.gov Identifier:NCT00876941
Intestinal Obstruction caused by Faecalith
Authors: A. L. Goodall
Journal: BMJ (1948)

MEDICAL MEMORANDA BRITISCIwas withdrawn.In a third aspiration, on June 1, a further 3 pints 15 oz.(2.13 litres) was drained, making a total of 11 pints 13 oz.(6.62 litres) removed in three weekly sessions.By that time the patient was very well and fit to be discharged from hospital.The foetal heart sounds could now be heard distinctly, although it was not possible to distinguish between two separate hearts.During the remainder of the pregnancy the woman was seen regularly in the antenatal clinic.She remained in good health, and there was no recurrence of the hydramnios.It was, however, noticed (and confirmed by x-ray examination) that one foetus failed to grow while the other seemed to develop normally.Spontaneous delivery of uniovular twins occurred at full term on Aug. 22: the first was a living female child weighing 6 lb.6 oz.(2.89 kg.) (vertex delivery) and the second a foetus papyraceus, 12 in.(30 cm.) long and weighing 11 oz.(312 g.)There was one large placenta, about a
PATERNITY TESTS BY BLOOD GROUPING
Authors: Alexander S. Wiener
Journal: JAMA (1941)

<h3>To the Editor:—</h3> In the Report of the Committee on Medicolegal Blood Grouping Tests, recommendation was made that the use of blood grouping tests for the exclusion of paternity be accepted by the courts throughout this country. It was pointed out, however, that it is essential that the person performing the tests should be properly qualified, as the tests are of a highly specialized nature. Unfortunately this warning has not been followed, and a number of blunders have resulted in addition to those mentioned in the report of the committee. Aside from the mistakes made by totally unqualified persons who presumed to undertake the examinations, errors have been made by four physicians who are outstanding in their own chosen fields. It seems trite to remark that a person who is experienced in one field does not qualify to perform work in a field in which he has no experience. In
CCR7-mediated physiological lymphocyte homing involves activation of a tyrosine kinase pathway
Authors: Jens V. Stein, Silvia F. Soriano, Christine M'rini, César Nombela-Arrieta, Gonzalo González de Buitrago, José Miguel Rodrı́guez-Frade, Mario Mellado, Jean-Philippe Girard, Carlos Martı́nez-A.
Journal: Blood (2002)
TCT-844 Active Versus Passive Anchoring Vascular Closure Devices: A Safety and Efficacy Comparative Analysis
Authors: Nevin C. Baker, Michael J. Lipinski, Ricardo O. Escarcega, Marco A. Magalhaes, Sa'ar Minha, Thibault Lhermusier, Hideaki Ota, lakshmana Pendyala, Lowell F. Satler, Augusto Pichard, William O. Suddath, Rebecca Torguson, Ron Waksman
Journal: Journal of the American College of Cardiology (2014)
Metabolic and immunologic effects of insulin lispro in gestational diabetes.
Authors: L Jovanovic, S Ilic, D J Pettitt, K Hugo, M Gutierrez, R R Bowsher, E J Bastyr
Journal: Diabetes Care (1999)

OBJECTIVE: To compare the immunologic response to insulin lispro with that to regular human insulin, thereby assuring its safety for use in women with gestational diabetes, and to verify that it is effective. RESEARCH DESIGN AND METHODS: We compared the metabolic and immunologic effects of insulin lispro and regular human insulin in 42 women &amp;gt;18 years of age diagnosed with gestational diabetes by oral glucose tolerance testing at 14-32 weeks of gestation. Patients were randomized to receive regular human insulin or insulin lispro before consuming a test meal. Serum insulin, blood glucose, and C-peptide concentrations were measured. Throughout the remainder of gestation, patients received premeal insulin lispro or regular human insulin combined with basal insulin and performed blood glucose self-monitoring before and after each meal. Insulin antibodies and HbA1c were determined at enrollment and 6 weeks later. In addition, 10 patients received continuous intravenous insulin (4 lispro, 6 regular human insulin) and dextrose infusions intrapartum to assess placental insulin transfer. RESULTS: Anti-insulin antibody levels were similar in the two groups. Insulin lispro was not detectable in the cord blood. During a meal test, areas under the curve for glucose, insulin, and C-peptide were significantly lower in the lispro group. Mean fasting and postprandial glucose concentrations and end point HbA1c were similar in the two groups. The lispro group demonstrated fewer hypoglycemic episodes (symptoms and blood glucose concentrations &amp;lt;55 mg/dl). No fetal or neonatal abnormalities were noted in either treatment group. CONCLUSIONS: Insulin lispro may be considered a treatment option for women with gestational diabetes.
Suppurative Pericarditis Treated by Cartilage Resection, Incision, and Drainage: Broncho-Pneumonia: Death
Authors: H. B. Robinson
Journal: BMJ (1898)

THE cases of suppurative pericarditis treated by incision alnd drainage-are still, according to our medical records, very few and far between.This is no doubt due to the misfortune of only successful cases generally being published, and partly explains the favourable statistics to be drawn from tlhem, as shown in my paper in the Clinical Society's Transactions, vol.xxx.The following case, although unsuccessful, is another contribution towards this very limited list: J. W., aged 4, was admitted into the East London hlospital for Childreni, Shadwell, on January I3th, I898, under the care of my colleague, Dr. Coutts.He had been well up to three weeks before, when lie took cold and complained of pain in his chest, particularly on the right side.He had a very bad cough, and there was con- siderable difficulty in expectorating.One week before ad- mission he became much worse, his breathing being very rapid, with profuse sweating at night.
Large-Core Needle Biopsy of Nonpalpable Breast Lesions
Authors: Jack E. Meyer
Journal: JAMA (1999)

An increasing number of nonpalpable abnormalities requiring breast biopsy are being identified due to the widespread use of screening mammography. Large-core needle biopsy (LCNB) has become an alternative to surgical excision.To determine whether LCNB is a safe and accurate technique to evaluate nonpalpable abnormalities found on breast imaging studies.Case series at an institutional referral center from August 1, 1991, to December 31, 1997.A total of 1643 women with 1 or more suspicious breast abnormalities received LCNBs (n = 1836 lesions).The LCNB of the breast uses a 14- or 11-gauge needle with stereotactic localization or ultrasound guidance.Utility and potential limitations of LCNB compared with the criterion standard, surgical excision after wire localization.Of the 1836 breast lesions sampled, 444 (24%) were found to be malignant. A total of 412 (22%) were found to be malignant on the initial LCNB and 202 repeat biopsies yielded 32 additional malignancies. Complications were infrequent: 1 patient experienced a superficial infection and 1 developed a pneumothorax after LCNB.Image-guided LCNB is a reliable diagnostic alternative to surgical excision of suspicious nonpalpable breast abnormalities.
British court allows terminally ill baby to die
Authors: C. Dyer
Journal: BMJ (1997)

Doctors caring for a terminally ill 16 month old British girl were last week given permission to let her die despite the objections of her parents.

Sir Stephen Brown, president of the High Court's family division, approved the doctors' plans to withdraw artificial ventilation from the girl, who has spinal muscular atrophy type 1, and not to resuscitate her if, as expected, she stops breathing. …
Psychological Mechanisms in Hypochondriasis: Attention-Induced Physical Symptoms without Sensory Stimulation
Authors: Anton J.M. Schmidt, Dorien J. Wolfs-Takens, Jaap Oosterlaan, Marcel A. van den Hout
Journal: Psychotherapy and Psychosomatics (1994)

Attention and expectancy have, in previous research, been demonstrated to influence symptom reporting and these findings can be relevant for understanding hypochondriasis. Earlier attention/expectancy effects on symptom reporting were studied when subjects were physically stimulated by the experimenter. If attention or expectancy produced symptom reporting, which plays a role in hypochondriasis, one expects that attention/expectancy will also produce symptoms in the absence of any deliberate physical stimulation. Eighty healthy volunteers were allocated to one of four groups: attention, expectancy, attention plus expectancy or a control condition. Compared to the control condition there was much higher symptom reporting in the 3 experimental groups. The experimental groups did not differ. It is argued that the effects of expectancy are obtained via increased attention. The relevance of the findings for understanding hypochondriasis is discussed.
Brief Communication: Clinical Implications of Short-Term Variability in Liver Function Test Results
Authors: Mariana Lazo, Elizabeth Selvin, Jeanne M. Clark
Journal: Annals of Internal Medicine (2008)

Background: Clinicians sometimes order liver tests as part of a screening examination or general work-up. Current guidelines do not recommend routine retesting of abnormal results in asymptomatic patients. Objective: To characterize the magnitude of intraindividual variability of liver test results and determine the proportion of adults with persistently elevated levels after 1 positive test. Design: Reliability study. Setting: The NHANES (National Health and Nutrition Examination Survey) III First and Second Examinations (1988 to 1994). Participants: 1864 men and women age 18 years or older living in the United States. Measurements: Repeated measurements (mean, 17.5 days apart) of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, γ-glutamyltransferase, and bilirubin. Results: Using NHANES III cutoffs for normal levels, 38% of adults with initially elevated bilirubin levels had normal levels at the second examination. These proportions were 36%, 31%, 17%, and 12% for AST, ALT, alkaline phosphatase, and γ-glutamyltranferase, respectively. More than 95% of initially normal results remained normal. The results did not differ by alcohol consumption; hepatitis A, B, or C serologic status; recent infection; body mass index; or sociodemographic characteristics. Intraindividual variability was significantly higher for bilirubin (coefficient of variation, 23.4%) and ALT (coefficient of variation, 20.4%) than for AST (coefficient of variation, 13.9%), γ-glutamyltransferase (coefficient of variation, 13.8%), and alkaline phosphatase (coefficient of variation, 6.7%). Limitations: Only 2 measurements were available. Complete liver disease history was lacking. Conclusion: If retested, more than 30% of adults with elevated AST, ALT, or bilirubin levels would be reclassified as normal. Clinicians should be aware of the high intraindividual variability in common liver tests, and practice guidelines should explicitly recommend retesting of asymptomatic individuals with abnormal liver test results.
Sperm morphology assessment: historical review in relation to fertility
Authors: W Ombelet
Journal: Human Reproduction Update (1995)

Journal Article Sperm morphology assessment: historical review in relation to fertility Get access W. Ombelet, W. Ombelet 4 1Genk Institute for Fertility TechnologySt.–Jansziekenhuis, Schiepse Bose 2, 3600 Genk, Belgium 4 To whom correspondence should be addressed, Tel:(32) 89 32 57 51; Fax: (32) 89 32 56 91 Search for other works by this author on: Oxford Academic PubMed Google Scholar R. Menkveld, R. Menkveld 2Andrology and IVF Units, Department of Obsteries and Gynaecology, Tygerberg HospitalTygerberg, South Africa Search for other works by this author on: Oxford Academic PubMed Google Scholar T.F. Kruger, T.F. Kruger 2Andrology and IVF Units, Department of Obsteries and Gynaecology, Tygerberg HospitalTygerberg, South Africa Search for other works by this author on: Oxford Academic PubMed Google Scholar O. Steeno O. Steeno 2Andrology and IVF Units, Department of Obsteries and Gynaecology, Tygerberg HospitalTygerberg, South Africa Search for other works by this author on: Oxford Academic PubMed Google Scholar Human Reproduction Update, Volume 1, Issue 6, 1 January 1995, Pages 543–557, https://doi.org/10.1093/humupd/1.6.543 Published: 01 November 1995
The primacy of primary health care
Authors: J R Hampton
Journal: BMJ (1998)

General practice is unarguably one of the great strengths of British medicine, but the concept of the primacy of primary health care must be seen for what it is—another attempt at cost containment. The lunatic reorganisation of the NHS by Kenneth Clarke, which aimed to reduce costs by creating fundholding general practitioners and setting one hospital against another in spurious competition, was the primacy of management. It failed because it was manifestly unfair to patients, created strife between hospitals that had no spare capacity for proper competition, and spawned a huge increase in the management culture. The new reorganisation into supreme primary care groups, designed to be independent of hospital trusts, is unlikely to lead to much improvement, for it rests on the same premise—that cost can be controlled only by maintaining the conflict between purchaser and provider. District general hospitals dealing with several primary care groups will have just as many problems as they had when their purchasers comprised a mixture of fundholding practices …
Prevalence of Diabetes in Mexican Americans, Cubans, and Puerto Ricans From the Hispanic Health and Nutrition Examination Survey, 1982–1984
Authors: Katherine M Flegal, Trena M Ezzati, Maureen I Harris, Maureen G Haynes, Rumaldo Z Juarez, William C Knowler, Eliseo J Perez-Stable, Michael P Stern
Journal: Diabetes Care (1991)

The purpose of this study was to estimate the prevalence of diagnosed and undiagnosed diabetes among Mexican Americans, Cubans, and Puerto Ricans in the United States and compare these estimates to data from prior surveys for U.S. non-Hispanic whites and blacks. Data for this study are from the Hispanic Health and Nutrition Examination Survey, a multipurpose cross-sectional survey of three U.S. Hispanic populations conducted in 1982–1984. The interviewed sample of people aged 20–74 yr included 3935 Mexican Americans in the southwest, 1134 Cubans in Florida, and 1519 Puerto Ricans in the New York City area. The diabetes component consisted of interview questions on diabetes diagnosis and treatment and an oral glucose tolerance test administered to a subsample. The prevalence of diabetes was two to three times greater for Mexican Americans and Puerto Ricans than for non-Hispanic whites surveyed in 1976–1980. In Cubans, the prevalence was similar to that for non-Hispanic whites. In men and women 45–74 yr of age, the prevalence of diabetes was extremely high for both Mexican Americans (23.9%) and Puerto Ricans (26.1%) compared with Cubans (15.8%) or non-Hispanic whites (12%). The total prevalence of diabetes was not significantly different for Mexican Americans and Puerto Ricans but was significantly lower for Cubans. The relatively lower prevalence of diabetes among Cubans and the high prevalence in both Mexican Americans and Puerto Ricans may be related to socioeconomic, genetic, behavioral, or environmental factors.
Reforming the New Zealand health reforms
Authors: C. Ham
Journal: BMJ (1997)

In common with several other countries, New Zealand has embarked on a far reaching programme of market oriented reforms in recent years. These reforms involved separating purchaser and provider responsibilities and using contracts and competition in an attempt to increase efficiency and enhance services' responsiveness. The former National government used its parliamentary majority to push these changes through quickly, starting in 1993. The big bang that resulted sent out a series of shock waves, and the effects continue to be felt.

As Hornblow notes in this week's BMJ (p 1892),1 although the reforms have brought some benefits, overall they have failed to produce the improvements in performance that were anticipated. Furthermore, there have been several adverse consequences that have provoked opposition to the direction of change. Notwithstanding the argument that over a longer period the reforms might have worked as intended,2 steps have been taken to address the problems that have arisen and to put in place new policies.

The election of a coalition government last autumn, bringing together the National party and New Zealand First, has already resulted in a commitment to abandon competition in favour of collaboration. The new government's statement on health policy …