tbuckley/cabot-search huggingface dataset:
Diabetes and automobile crashes in the elderly. A population-based case-control study.
Authors: G McGwin, R V Sims, L Pulley, J M Roseman
Journal: Diabetes Care (1999)

The aim of this study was to estimate the association between diabetes and its complications and at-fault automobile crashes among older drivers.This was a population-based case-control study. Case subjects were drivers aged > or = 65 years who had been involved in a crash during 1996 in which they were at fault. Two control groups were selected: 1) crash-involved not-at-fault subjects and 2) non-crash-involved subjects. Telephone interviewers collected information on demographic characteristics, driving habits, diabetes sequelae and treatment, other chronic medical conditions, and visual function.Overall, there was no association between diabetes and at-fault crash involvement. The adjusted odds ratio (OR) for diabetes was 1.1 (CI 0.7-1.9) when case subjects were compared with either control group. However, the adjusted OR for diabetes was 2.5 (0.9-7.2) among subjects who had been involved in a crash in the 4 years preceding 1996, while it was only 0.9 (0.5-1.7) among those who had not. There was no evidence of an association between treatment modalities and at-fault crash involvement. Case subjects were, although not significantly (P = 0.25), more likely (OR 2.4) to report neuropathy compared with both control groups, and retinopathy was not associated with increased crash risk.This study provides no evidence that older drivers with diabetes are at increased risk for automobile crashes. There remains the possibility that those with diabetes who have more severe disease or have had multiple crashes are at increased risk.
As influenza season progresses, experts look ahead to 1990 season
Authors: C. Marwick
Journal: JAMA (1989)

EVEN AS the number of reported cases of influenza is rising rapidly in the United States, the first steps toward combating next year's outbreaks were being taken by an advisory group to the Food and Drug Administration.  After reviewing influenza viruses currently in circulation throughout the world—data provided by experts from the Centers for Disease Control, Atlanta, Ga—the group, chaired by Floyd Denny, MD, University of North Carolina, Chapel Hill, recommended:   Keeping the present H1N1 type A virus (isolated in 1986 in Taiwan) in next year's vaccine.  Consideration of substituting a slightly different representative of H3N2(known as Shanghai/11/87, isolated during the 1987 and 1988 influenza season) for Sichuan/2/87, the antigen in the present vaccine.  Giving serious thought to replacing the present B strain with a new type B strain isolated last year in Japan.   The final decision on which variants of the H3N2 and B strains to put into the
Biological characterisation of vascular grafts cultured in a bioreactor
Authors: Paula Engbers-Buijtenhuijs, Laura Buttafoco, Andre A. Poot, Piet J. Dijkstra, Rob A.I. de Vos, Lotus M.Th. Sterk, Rob H. Geelkerken, Istvan Vermes, Jan Feijen
Journal: Biomaterials (2005)
The Cost-Effectiveness of Preventing Diabetes
Authors: Steven Teutsch
Journal: Diabetes Care (2003)

There are many hurdles in the adoption of preventive programs. The first is efficacy, demonstrating that an intervention can work, at least in optimal settings. The breakthrough Diabetes Prevention Program (DPP) easily cleared this hurdle (1). The next step is to show that it is effective, proving that the results can be achieved in usual-care settings with their resource constraints and often broader cross section of patients. The final quantitative hurdle is cost-effectiveness, showing that the intervention is worth its cost (2).

The economic evaluation by the DPP Research Group (3) in this issue of Diabetes Care is an excellent example of a well-done, within-trial, cost-efficacy study. Building on the group’s earlier cost analysis (4), they use the numbers needed to treat (NNT) and utility analysis results from the trial to determine cost-effectiveness from societal and payer viewpoints. Within-trial analyses such as this one have several strengths. Costs and outcomes can be ascertained with a high degree of accuracy. Few assumptions and extrapolations are required. Yet within-trial analyses have limitations as well. Because of their limited time frames, important long-term costs and outcomes cannot be ascertained. We can only speculate about how well patients adhere to the regimens in the long term, whether the reductions in …
Tacrine in Alzheimer's Disease-Reply
Authors: M. Farlow, L. A. Hershey, C. H. Sadowsky, S. I. Gracon, K. W. Lewis, J. Dolan-Ureno
Journal: JAMA (1993)

<h3>In Reply.</h3> —Our tacrine study was designed to support preliminary results from a preceding enrichment trial<sup>1</sup>and to define dose-response characteristics using doses from 20 to 80 mg/d. The a priori hypothesis (as indicated on page 2525) addressed whether tacrine improves patient response on the Alzheimer's Disease Assessment Scale (ADAS) cognitive and the clinician-rated Clinical Global Impression of Change (CGIC). The ADAS cognitive has been validated in Alzheimer's disease and demonstrated sensitivity to modest drug effects and cognitive deterioration over time.<sup>2</sup>However, the clinician-rated CGIC had not been validated in this patient population.<sup>3</sup>Therefore, our primary focus on ADAS cognitive reflected uncertainty in use of the CGIC when the study was designed. The sample size was set to provide sufficient power to detect ADAS cognitive effects based on previous studies of tacrine.<sup>1</sup> Primary analyses based on "evaluable completers" were most appropriately presented in the original publication.
Bilateral Deep-Brain Stimulation of the Globus Pallidus in Primary Generalized Dystonia
Authors: Marie Vidailhet, Laurent Vercueil, Jean-Luc Houeto, Pierre Krystkowiak, Alim-Louis Benabid, Philippe Cornu, Christelle Lagrange, Sophie Tézenas du Montcel, Didier Dormont, Sylvie Grand, Serge Blond, Olivier Detante, Bernard Pillon, Claire Ardouin, Yves Agid, Alain Destée, Pierre Pollak
Journal: New England Journal of Medicine (2005)

Severe forms of dystonia respond poorly to medical treatment. Deep-brain stimulation is a reversible neurosurgical procedure that has been used for the treatment of dystonia, but assessment of its efficacy has been limited to open studies.We performed a prospective, controlled, multicenter study assessing the efficacy and safety of bilateral pallidal stimulation in 22 patients with primary generalized dystonia. The severity of dystonia was evaluated before surgery and 3, 6, and 12 months postoperatively during neurostimulation, with the use of the movement and disability subscores of the Burke-Fahn-Marsden Dystonia Scale (range, 0 to 120 and 0 to 30, respectively, with higher scores indicating greater impairment). Movement scores were assessed by a review of videotaped sessions performed by an observer who was unaware of treatment status. At three months, patients underwent a double-blind evaluation in the presence and absence of neurostimulation. We also assessed the patients' quality of life, cognition, and mood at baseline and 12 months.The dystonia movement score improved from a mean (+/-SD) of 46.3+/-21.3 before surgery to 21.0+/-14.1 at 12 months (P<0.001). The disability score improved from 11.6+/-5.5 before surgery to 6.5+/-4.9 at 12 months (P<0.001). General health and physical functioning were significantly improved at month 12; there were no significant changes in measures of mood and cognition. At the three-month evaluation, dystonia movement scores were significantly better with neurostimulation than without neurostimulation (24.6+/-17.7 vs. 34.6+/-12.3, P<0.001). There were five adverse events (in three patients); all resolved without permanent sequelae.These findings support the efficacy and safety of the use of bilateral stimulation of the internal globus pallidus in selected patients with primary generalized dystonia.
The Probability of Closure in Aortocoronary Vein Bypass Grafts
Authors: Alfred A. Rimm, Steven Blumlein, Joseph J. Barboriak, Alfred J. Anderson, John A. Walker, W. Dudley Johnson
Journal: JAMA (1976)

A study of 540 patients who had the aortocoronary vein bypass operation (from several transplant teams) showed that grafts within a patient closed independently of one another during the first-two year postoperative period. For patients with a single vein graft, there was a 23% chance of closure during the first two year postoperative period. The chance that all grafts would close during this period for patients with two grafts was 5%, and it was 1% for patients with three grafts. The knowledge of these closure probabilities may be used by the surgeon when planning the optimal surgical maneuver.
PUBLIC PROVISION FOR INCIPIENT CASES OF TUBERCULOSIS, SANATORIA AND DISPENSARIES.
Authors: CHARLES C. BROWNING
Journal: JAMA (1907)

however, should be protected by four or five mattrass sutures of linen or silk.In irreducible ileocecal or other intussusceptions the procedure of Mikulicz and Jessett, which is a modifica- tion of the Mounsell method, may be employed.After reducing as much of the intussusception as possible, an incision is made through the containing wall of the in- vesting colon and the entire gangrenous mass lifted out, amputated and sutured from the mucous side.After the stump is returned, a few sutures of linen or silk protect the serous surface.The working incision in the colon is separately closed.RESECTION OF THE TRANSVERSE COLON.In resecting part of the transverse colon it should not be forgotten that in four cases out of five the middle colic artery is the sole blood supply, and unless these vessels are involved they should be preserved, else the whole transverse colon will become devitalized.End- to-end or lateral anastomosis may be performed, as the parts are amply surrounded by peritoneum and invested in the folds of the omentum, so that the certainty of union is very great.The contents of the transverse .colon are semi-fluid, which is a most favorable circum- stance.The suture method, however, should be adopted, preferably the two-row with the holding clamps.The Murphy button should be avoided, as there may be fecal masses of sufficient size to obstruct the button lumen.RESECTION OF THE SPLENIC FLEXURE, DESCENDING COLON AND SIGMOID.The colonic fecal container begins at the splenic flex- ure of the colon and extends to the upper border of the rectum.The splenic flexure and the upper part of the descending colon under normal conditions are empty, acting rather as a connecting link or passage-way to the sigmoid, which is the true fecal reservoir.That por-
Reduced final height and indications for insulin resistance in 20 year olds born small for gestational age: regional cohort study
Authors: J. Leger, C. Levy-Marchal, J. Bloch, A. Pinet, D. Chevenne, D. Porquet, D. Collin, P. Czernichow
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To investigate whether the association between low birth weight and increased risk of developing impaired glucose tolerance, insulin resistance, hypertriglyceridaemia, and hypertension in middle age is apparent by the age of 20 in people born small for gestational age. <b>Design:</b> Regional cohort study. <b>Setting:</b> Maternity registry, Haguenau, France. <b>Subjects:</b> 236 full term singleton babies born small for gestational age (birth weight or length, or both, below third centile) during 1971-8 and 281 with normal birth weight (between 25th and 75th centile). All subjects were contacted and evaluated at a mean (SD) age of 20.6 (2.1) years. <b>Main outcome measures:</b> Adult height; concentrations of glucose, insulin, and proinsulin during an oral glucose tolerance test; lipid and fibrinogen concentrations; and blood pressure. <b>Results:</b> After sex and target height were adjusted for, subjects who had been born small for gestational age were significantly shorter at age 20 than those with a normal birth weight (men 4.5 cm shorter (95% confidence interval 6.0 to 3.0 cm); women 3.94 cm shorter (5.2 to 2.7 cm). After sex and body mass index were adjusted for, mean plasma glucose concentration 30 minutes after a glucose load, fasting insulin concentration (in women), and insulin and proinsulin concentrations 30 and 120 minutes after a glucose load were significantly higher in subjects who had been born small for gestational age than in those with a normal birth weight. Mean lipid and fibrinogen concentrations and blood pressure were not different between the two groups. <b>Conclusions:</b> Intrauterine growth retardation has long term consequences such as reduced final height. Raised insulin and proinsulin concentrations are present in young adults born small for gestational age and could be markers of early changes in insulin sensitivity. <h3>Key messages</h3> An inverse relation between birth weight and increased risk of developing impaired glucose tolerance, insulin resistance, hypertriglyceridaemia, and hypertension (syndrome X) in middle age has been reported In this study reduced final height and raised serum insulin and proinsulin concentrations during oral glucose tolerance testing were found in young adults born small for gestational age compared with young adults with an appropriate birth weight for gestational age Reduced fetal growth was not associated with impaired glucose tolerance, higher blood pressure, or abnormalities in lipid and fibrinogen concentrations Further longitudinal studies are required to examine the risk of developing the other elements of syndrome X later in life
Legs that swell and ache: volume changes during the day in health young adults.
Authors: L Hands, J Collin
Journal: BMJ (1984)

injury are probably due to increased intracranial pressure,3 but there was no question of this in our patient either symptomatically or on computed tomography.The most logical explanation for the haematoma in our patient was shearing injury to the blood vessels supplying the lower midbrain and upper pons with no damage to brain stem tissue, which might explain why he remained alert and conscious.'Crompton MR.Brainstem lesions due to closed head injury.
Effects of coronary occlusion on high-frequency content of the epicardial electrogram and body surface electrocardiogram.
Authors: V Mor-Avi, B Shargorodsky, S Abboud, S Laniado, S Akselrod
Journal: Circulation (1987)

The very high-frequency content (150 to 250 Hz) of epicardial electrogram waveforms was studied in 19 anesthetized dogs subjected to occlusion of left anterior descending coronary artery. Computer techniques of digital averaging and digital band-pass filtering were applied. Signals were obtained from epicardial electrodes placed in the ischemic left ventricular region and on the noninjured right ventricular surface, and from the body surface electrocardiogram. All recordings were made simultaneously before, during, and after coronary occlusion and subjected to the same analysis. The waveforms obtained from the ischemic left ventricular region showed a considerable decrease in high-frequency content, while those obtained from the noninjured right ventricular surface remained unchanged. The results correlated with the appearance of a zone of reduced amplitude in the body surface high-frequency QRS complex. Therefore, this macroscopic phenomenon measured noninvasively from the body surface is explained by local reduction of high-frequency activity in the ischemic region of the myocardium.
Abstract LB-125: A novel telomerase inhibitor.
Authors: Ilgen Mender, Sergei Gryaznov, Zeliha Gunnur Dikmen, Woodring Wright, Jerry Shay
Journal: Cancer Research (2013)

Abstract Telomeres are highly specialized structures that are found at the very ends of linear chromosomes. Normal human somatic cells progressively lose their telomeres with each cell division due to the end replication problem. Unlike most normal somatic cells, the vast majority of advanced cancers have telomerase activity, which overcomes the end replication problem by adding multiple TTAGGG sequences to the end of linear chromosomes. Because of the selective expression of this enzyme in cancer cells, it is an almost universal target for antitumor drug development. However, there are surprisingly few telomerase inhibitors in clinical trials. We have modified a chemotherapeutic antimetabolite agent, 6-thioguanine (6-thio-G) so that this newly synthesized compound targets telomeres while retaining its antimetabolite activity. 6-thio-dG is a nucleoside analogue that is recognized by telomerase and is incorporated into telomeres. Telomeric incorporation results in structurally modified telomeres, functionally uncapping the shelterin protective complex, resulting in telomere associated DNA damage foci. Here, we report that 6-thio-dG causes progressive telomere shortening independent from inhibition of telomerase activity and induces telomere dysfunction in HCT116 human colon cancer cell line. Combination of the telomerase inhibitor GRN163L, which is in advanced clinical trials, and 6-thio-dG have additive effects on telomere shortening in HCT116 cells. 6-thio-dG treatment altered HCT116 cellular morphology and killed most of these cells within 1 week. Normal BJ fibroblast cells, which are telomerase silent, were not affected by 6-thio-dG in either cell morphology after 1 week or in enhanced telomere shortening after long-term treatment. These results show that 6-thio-dG is a novel anti-cancer inhibitor and a potential therapeutic agent targeting both telomeres and general DNA damage. Citation Format: Ilgen Mender, Sergei Gryaznov, Zeliha Gunnur Dikmen, Woodring Wright, Jerry Shay. A novel telomerase inhibitor. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr LB-125. doi:10.1158/1538-7445.AM2013-LB-125
Stabbing: data support public perception
Authors: Tom König, Charles H Knowles, Alison West, Alastair Wilson, Frank Cross
Journal: BMJ (2006)

Editor-Last year Hern et al published an editorial on knife crime and clearly the problem has not gone away. 1 A quick search of the Times website finds 90 hits on the single search term "stabbing" in the past three months alone.Several recent deaths have fuelled the perception that forensic knife injuries have become an epidemic, resulting in a knife amnesty and government discussion of new punitive measures.An increase in such injuries is supported by data from regional police forces and the Home Office, with 1200 reported attacks in London last year and 30% of homicides caused by knife injury. 2 Crimes defined as "more serious wounding or other act endangering life" almost doubled nationally from 1995 to 2005. 3 We audited forensic knife injuries at this hospital, one of Europe's busiest emergency departments, to establish the size of this problem in a representative urban area (east London).We extracted data on forensic knife injuries (excluding deliberate self harm) from a detailed prospectively recorded database of all trauma calls from July 2004 to June 2006 (these reflecting more severe injuries).Overall there were 309 forensic knife injuries; 259 patients were admitted, 184 were operated on, and eight died.The chest was the most common area injured (183/309 patients, 6/8 deaths).Most patients were men (297/309), and mean age was 28 (range 15-74).To give a measure of changing incidence over a longer time of a greater range of severity of injury, we also performed an audit of all cases coded as "stabbing" on the patient administration system during the 10 year period from July 1997 to June 2006 (figure).Over both periods, the data show an increase in the overall incidence of stabbings.Furthermore, increased need for surgical intervention in the prospective study may reflect increasing severity of injury.These data therefore seem to support the general perception that knife injuries are increasing.
A Deviant Immune Response to Viral Proteins and Transgene Product Is Generated on Subretinal Administration of Adenovirus and Adeno-associated Virus
Authors: Vibha Anand, Bethany Duffy, Zaixin Yang, Nadine S. Dejneka, Albert M. Maguire, Jean Bennett
Journal: Molecular Therapy (2002)

The immune response after ocular exposure to foreign antigens varies substantially from that of a typical systemic response. Anterior chamber associated immune deviation (ACAID) has been well documented. The immune response of the subretinal space has not been studied in as much detail. Here, we characterized the immune response of the subretinal space when it encounters the antigens AdV-GFP and AAV-GFP (recombinant adenovirus or adeno-associated virus, respectively), each delivering the reporter gene encoding green fluorescent protein (GFP). Results indicate that the subretinal space possesses an immune-deviant property similar to ACAID. AdV-elicited immune responses following subretinal injections are significantly reduced compared with systemic responses elicited by intradermal injections of the same virus. Furthermore, subretinal AdV administration results in transduction of retinal pigment epithelial cells (RPE), which are the potential antigen presenting cells of the retina. This subsequently generates a population of immunosuppressive Th2-type, cytokine-secreting, splenic T cells. This response may be advantageous to the development of ocular gene therapy. The immune response after ocular exposure to foreign antigens varies substantially from that of a typical systemic response. Anterior chamber associated immune deviation (ACAID) has been well documented. The immune response of the subretinal space has not been studied in as much detail. Here, we characterized the immune response of the subretinal space when it encounters the antigens AdV-GFP and AAV-GFP (recombinant adenovirus or adeno-associated virus, respectively), each delivering the reporter gene encoding green fluorescent protein (GFP). Results indicate that the subretinal space possesses an immune-deviant property similar to ACAID. AdV-elicited immune responses following subretinal injections are significantly reduced compared with systemic responses elicited by intradermal injections of the same virus. Furthermore, subretinal AdV administration results in transduction of retinal pigment epithelial cells (RPE), which are the potential antigen presenting cells of the retina. This subsequently generates a population of immunosuppressive Th2-type, cytokine-secreting, splenic T cells. This response may be advantageous to the development of ocular gene therapy.
Gross Anatomy in the Practice of Medicine
Authors: John E. Skandalakis
Journal: JAMA (1994)

I slept and dreamt that life was happiness. I awoke and saw that life was service. I served and found that in service happiness is found. Rabindranath Tagore (1861-1941) And I awoke and found another book of anatomy. I'm happy; the queen of basic science is not forgotten. I detect a change in the swing of the pendulum (or perhaps it's my sixth sense telling me). Despite the fight by the cell biologist, anatomy is slowly but surely making a comeback. And my hope is that it will never again be the stepchild of the basic sciences, which I have lamented so many times in previous publications. <i>Gross Anatomy in the Practice of Medicine</i>is a beautiful book of nearly 700 pages with more than 260 black-and-white illustrations and more than 200 full-color ones, which were borrowed from other noted books of anatomy. This book has six sections, with several