tbuckley/cabot-search huggingface dataset:
Organisations question EC changes on drug information for patients
Authors: R. Watson
Journal: BMJ (2009)

Medical and consumer organisations are raising concerns about plans by the European Commission to allow drug companies to provide information on prescription only drugs directly to the public. The drug industry is also questioning how the system would work in practice.

The initial reactions to measures that would allow drug companies to supply factual information on prescription only drugs to the public emerged last week at a conference in Brussels organised by the European Commission and the Organisation for Professionals in Regulatory Affairs.

The draft legislation, tabled last December, …
All Africa conference on tobacco control
Authors: S Chapman, D Yach, Y Saloojee, D Simpson
Journal: BMJ (1994)

Although the health hazards of smoking are now generally accepted in most Western countries, the arguments have not had much impact on poorer nations. A conference on tobacco control held in Harare, Zimbabwe, in November last year was the largest to tackle this problem. The conference heard how threats of epidemics of tobacco related disease in the distant future held little weight with governments of countries that often already had massive public health problems. More immediate effects needed to be emphasised. Speakers gave three cogent arguments; firstly, the loss of capacity for foreign trade in essential goods, since most African countries are net importers of tobacco; secondly, the extensive deforestation which is occurring to fuel the flue curing of tobacco; thirdly, evidence from Papua New Guinea that raising taxation on tobacco provides governments with increased income for many years before a decrease begins.
Mortality Among Low-Income African Americans and Whites With Diabetes
Authors: Baqiyyah N. Conway, Michael E. May, William J. Blot
Journal: Diabetes Care (2012)

To estimate mortality rates and risk factors for mortality in a low-socioeconomic status (SES) population of African Americans and whites with diabetes.We determined mortality among African Americans and whites aged 40-79 years with (n = 12,498) and without (n = 49,914) diabetes at entry into a cohort of participants recruited from government-funded community health centers. Multivariable Cox analysis was used to estimate mortality hazard ratios (HRs) (95% CI) among those with versus those without diabetes and among those with diabetes according to patient characteristics.During follow-up (mean 5.9 years), 13.5% of those with and 7.3% of those without diabetes died. All-cause mortality risk was higher among those with versus without diabetes for both African Americans (HR 1.84 [95% CI 1.71-1.99]) and whites (1.80 [1.58-2.04]), although among those with diabetes, mortality was lower among African Americans than whites (0.78 [0.69-0.87]). Mortality risk increased with duration of diabetes and was greater among patients on insulin therapy and reporting histories of cardiovascular disease (CVD), hypertension, and stroke. The HRs associated with these multiple risk factors tended to be similar by sex and race, with the exception of a differentially higher impact of prevalent CVD on mortality among African Americans (interaction P value = 0.03), despite a lower baseline prevalence of CVD.In this population with similarly low SES and access to health care, strong and generally similar predictors of mortality were identified for African Americans and whites with diabetes, with African Americans at a moderately but significantly lower mortality risk.
Air Pressure Stethoscope
Authors: Alfons R. Bacon
Journal: JAMA (1965)

<h3>To the Editor:—</h3> I wish to report on the use of increased air pressure to augment sounds in the stethoscope. At first this new principle was tried out on a stethoscope designed to let mothers hear fetal heart tones (as described in the November, 1964, issue of<i>Obstetrics and Gynecology</i>[<b>24</b>:800] ), and recently I have been trying the technique in normal stethoscopes for heart and lung examinations. An inflating bulb is attached by a Y-connector to the stethoscope tubing. The pressure usually used amounts to about 20 mm Hg and is without discomfort to the ears. The most pronounced feature is the reduction of background noises. Even though we are not aware of it, most of the time we are bombarded by noises from the air conditioning cr ventilation openings, the hum of fluorescent lamps and electric clocks, background music, remote conversations, and outside noises. Everyone has at some
Effect of BRCA Mutations on Metastatic Relapse and Cause-specific Survival After Radical Treatment for Localised Prostate Cancer
Authors: Elena Castro, Chee Goh, Daniel Leongamornlert, Ed Saunders, Malgorzata Tymrakiewicz, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Steve Ellis, Debra Frost, Elizabeth Bancroft, Trevor Cole, Marc Tischkowitz, M John Kennedy, Jacqueline Eason, Carole Brewer, D Gareth Evans, Rosemarie Davidson, Diana Eccles, Mary E Porteous, Fiona Douglas, Julian Adlard, Alan Donaldson, Antonis C Antoniou, Zsofia Kote-Jarai, Douglas F Easton, David Olmos, Rosalind Eeles
Journal: European Urology (2014)
Neutrophil dysfunction in alcoholic hepatitis superimposed on cirrhosis is reversible and predicts the outcome
Authors: Rajeshwar P. Mookerjee, Vanessa Stadlbauer, Sukhwinderjit Lidder, Gavin A.K. Wright, Stephen J. Hodges, Nathan A. Davies, Rajiv Jalan
Journal: Hepatology (2007)

Mortality in patients with alcoholic hepatitis (AH) remains high, and although corticosteroids are widely used for treatment, the results vary considerably. In AH, neutrophils are primed and infiltrate the liver to produce injury, but paradoxically, the main cause of death in such patients is infection. Our prospective study addressed this paradox of primed neutrophils on the one hand and increased risk of infection on the other. We hypothesized that the full activation of neutrophils by a humoral factor such as endotoxin renders them unable to respond to further bacterial challenge. We analyzed neutrophil oxidative burst and phagocytosis in whole blood by fluorescence-activated cell sorting analysis in 63 alcoholic patients with cirrhosis and patients with cirrhosis with superimposed AH (cirrhosis+AH). In 16 patients, ex vivo studies determined whether the removal of endotoxin restored neutrophil function. A resting burst greater than or equal to 5%, indicating neutrophil activation and a reduced phagocytic capacity lower than 42%, was associated with significantly greater risk of infection, organ failure, and mortality. This defective neutrophil function was transmissible through patients' plasma to normal neutrophils, and patients' neutrophil function could be restored by normal plasma. The ex vivo removal of endotoxin from patients' plasma decreased the resting burst and increased the phagocytic function. Conclusions: Our study provides the rationale for a goal-directed approach to the management of patients with cirrhosis and AH, in which the assessment of neutrophil function may be an important biomarker to select patients for immunosuppressive therapy. The neutrophil dysfunction in cirrhosis and AH is reversible, with endotoxin-removal strategies providing new targets for intervention. (Hepatology 2007.)
Dry powders based on PLGA nanoparticles for pulmonary delivery of antibiotics: Modulation of encapsulation efficiency, release rate and lung deposition pattern by hydrophilic polymers
Authors: Francesca Ungaro, Ivana d'Angelo, Ciro Coletta, Roberta d'Emmanuele di Villa Bianca, Raffaella Sorrentino, Brunella Perfetto, Maria Antonietta Tufano, Agnese Miro, Maria Immacolata La Rotonda, Fabiana Quaglia
Journal: Journal of Controlled Release (2011)
The Human Factor: Revolutionizing the Way People Live with Technology
Authors: Chris Ham
Journal: BMJ (2004)

W hat do the Chernobyl nuclear disaster and the painting of flies on men's urinals have in common? According to Kim Vicente, both are examples of the way in which technology and people interact to create more or less desirable outcomes.

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Kim Vicente

Routledge, $27.95, pp 352 ISBN 0 415 97064 4 http://www.routledge-ny.com/

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In the case of Chernobyl, the designers of the nuclear power plant developed a technology that outstripped the ability of the operators to use it safely. The tragic consequence was an explosion that resulted in death or serious illness to thousands of people, with reverberations around the world.

By contrast, the strategic location of painted flies on men's urinals minimised the risk of “splash back” by making it easy for the users to do what comes naturally. In this case, the technology in question (the painted flies) appealed to the desire of men to aim in a direction that avoided an adverse outcome (trouser stains).

Both examples illustrate the …

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Magnetic Resonance Imaging to Assess the Hemodynamic Effects of Pulmonary Valve Replacement in Adults Late After Repair of Tetralogy of Fallot
Authors: Hubert W. Vliegen, Alexander van Straten, Albert de Roos, Arno A.W. Roest, Paul H. Schoof, Aeilko H. Zwinderman, Jaap Ottenkamp, Ernst E. van der Wall, Mark G. Hazekamp
Journal: Circulation (2002)

Background— Pulmonary regurgitation (PR) late after total correction for tetralogy of Fallot may lead to progressive right ventricular (RV) dilatation and an increased incidence of severe arrhythmias and sudden death. Timing of pulmonary valve replacement (PVR) is subject to discussion, because the effect of PVR on RV function in adults is unclear. In this study, MRI was used to assess the effect of PVR on RV function and PR. Clinical improvement was established by means of the NYHA classification. Methods and Results— Twenty-six adult patients were included. Cardiac MRI was performed at a median of 5.1±3.4 months before and 7.4± 2.4 months after PVR. Mean preoperative PR was 46±10% (range, 25% to 64%). After PVR, 20 of 26 patients (77%) showed no residual PR, 5 patients showed mild residual PR, and 1 patient showed moderate PR. RV end-diastolic volume (RV-EDV) decreased from 305±87 to 210±62 mL ( P &lt;0.001), and RV end-systolic volume (RV-ESV) decreased from 181±67 to 121±58 mL ( P &lt;0.001). No significant change was found in RV-EF (42% versus 42%). However, RVEF corrected for regurgitations and shunting increased from 25.2±8.0% to 43.3±13.7% ( P &lt;0.001). Mean validity class improved from 2.0 to 1.3 ( P &lt;0.001). Conclusions— In adult patients with PR and RV dilatation, late after total correction of tetralogy of Fallot, MRI measurements show remarkable hemodynamic improvement of RV function after PVR and improvement of validity. We therefore advocate a less restrictive management concerning PVR in these patients.
Local Delivery of Protease-Resistant Stromal Cell Derived Factor-1 for Stem Cell Recruitment After Myocardial Infarction
Authors: Vincent F.M. Segers, Tomotake Tokunou, Luke J. Higgins, Catherine MacGillivray, Joseph Gannon, Richard T. Lee
Journal: Circulation (2007)

Background— Local delivery of chemotactic factors represents a novel approach to tissue regeneration. However, successful chemokine protein delivery is challenged by barriers including the rapid diffusion of chemokines and cleavage of chemokines by proteases that are activated in injured tissues. Stromal cell–derived factor-1 (SDF-1) is a well-characterized chemokine for attracting stem cells and thus a strong candidate for promoting regeneration. However, SDF-1 is cleaved by exopeptidases and matrix metalloproteinase-2, generating a neurotoxin implicated in some forms of dementia. Methods and Results— We designed a new chemokine called S-SDF-1(S4V) that is resistant to matrix metalloproteinase-2 and exopeptidase cleavage but retains chemotactic bioactivity, reducing the neurotoxic potential of native SDF-1. To deliver S-SDF-1(S4V), we expressed and purified fusion proteins to tether the chemokine to self-assembling peptides, which form nanofibers and allow local delivery. Intramyocardial delivery of S-SDF-1(S4V) after myocardial infarction recruited CXCR4 + /c-Kit + stem cells (46±7 to 119±18 cells per section) and increased capillary density (from 169±42 to 283±27 per 1 mm 2 ). Furthermore, in a randomized, blinded study of 176 rats with myocardial infarction, nanofiber delivery of the protease-resistant S-SDF-1(S4V) improved cardiac function (ejection fraction increased from 34.0±2.5% to 50.7±3.1%), whereas native SDF-1 had no beneficial effects. Conclusions— The combined advances of a new, protease-resistant SDF-1 and nanofiber-mediated delivery promoted recruitment of stem cells and improved cardiac function after myocardial infarction. These data demonstrate that driving chemotaxis of stem cells by local chemokine delivery is a promising new strategy for tissue regeneration.
Trends in the Black-White Life Expectancy Gap in the United States, 1983-2003
Authors: Sam Harper, John Lynch, Scott Burris, George Davey Smith
Journal: JAMA (2007)

Context Since the early 1980s, the black-white gap in life expectancy at birth increased sharply and subsequently declined, but the causes of these changes have not been investigated.Objective To determine the contribution of specific age groups and causes of death contributing to the changes in the black-white life expectancy gap from 1983-2003.Design and Setting US vital statistics data from the US National Vital Statistics System, maintained by the National Center for Health Statistics.Standard life table techniques were used to decompose the change in the black-white life expectancy gap by combining absolute changes in age-specific mortality with relative changes in the distribution of causes of death. Main Outcome MeasureThe gap in life expectancy at birth between blacks and whites. ResultsAmong females, the black-white life expectancy gap increased 0.5 years in the period 1983-1993, primarily due to increased mortality from human immunodeficiency virus (HIV) (0.4 years) and slower declines in heart disease (0.1 years), which were somewhat offset by relative improvements in stroke (-0.1 years).The gap among males increased by 2 years in the period 1983-1993, principally because of adverse changes in HIV (1.1 years), homicide (0.5 years), and heart disease (0.3 years).Between 1993 and 2003, the female gap decreased by 1 year (from 5.59 to 4.54 years).Half of the total narrowing of the gap among females was due to relative mortality improvement among blacks in heart disease (-0.2 years), homicide (-0.2 years), and unintentional injuries (-0.1 years).The decline in the life expectancy gap was larger among males, declining by 25% (from 8.44 to 6.33 years).Nearly all of the 2.1-year decline among males was due to relative mortality improvement among blacks at ages 15 to 49 years (-2.0 years).Three causes of death accounted for 71% of the narrowing of the gap among males (homicide [-0.6 years], HIV [-0.6 years], and unintentional injuries [-0.3 years]), and lack of improvement in heart disease at older ages kept the gap from narrowing further.Conclusions After widening during the late 1980s, the black-white life expectancy gap has declined because of relative mortality improvements in homicide, HIV, unintentional injuries, and, among females, heart disease.Further narrowing of the gap will require concerted efforts in public health and health care to address the major causes of the remaining gap from cardiovascular diseases, homicide, HIV, and infant mortality.
ON THE SIZE OF THE TOXIC PARTICLE PASSING THE INTESTINAL BARRIER IN BOTULISM
Authors: Robert J. Heckly, G. J. Hildebrand, Carl Lamanna
Journal: The Journal of Experimental Medicine (1960)

On the basis of toxicity assays using partition centrifugation cells it was established that the sedimentation coefficient of type A botulinum toxin appearing in the lymph of orally poisoned rats was 7.9 x 10–18 cm. per dyne sec. with 95 per cent confidence limits of 4.4 to 11.4 x 10–13 cm. per dyne sec. This is a significantly lower value than that obtained for crystalline toxin but is well within the range of size for proteins. Exposure of crystalline toxin for 2 hours to digestive processes in a section of the duodenum of living rats did not significantly reduce the sedimentation coefficient of the toxin. The S20 of crystalline toxin employed in the present study ranged between 12 and 21 with a mean value of 17.9. While it was observed that both botulinum toxin and albumin sedimented from lymph in glycerol gradient tubes to essentially the same level no evidence was developed to indicate association between toxin in lymph and serum albumin. The electrophoretic mobility of toxin in lymph is like that of crystalline toxin and not albumin. Dialysis of toxic lymph against serum albumin does not result in the appearance of toxin in the dialysate.
Routine quantification of rheumatoid factor by rate nephelometry.
Authors: P J Roberts-Thomson, R McEvoy, T Langhans, J Bradley
Journal: Annals of the Rheumatic Diseases (1985)

In a cross-sectional study of over 3000 consecutive serum specimens the levels of rheumatoid factor (RF) measured by rate nephelometry (Beckman ICS II) were compared with values obtained by the more traditional methods of sheep cell agglutination (Rose-Waaler) and latex agglutination. Similar values for sensitivity and specificity were found for all three methods for rheumatoid arthritis, with nephelometry giving slightly higher levels of sensitivity for other rheumatic disorders. A significant correlation (r = 0.46, p less than 0.01) was found between the nephelometric and Rose-Waaler method for 147 consecutive seropositive specimens. Of interest, however, several disparate results were observed, and explanations for these were sought. Longitudinal studies of RF were performed in 49 seropositive patients over a two-year period. The nephelometric method was considered superior compared with the other techniques because of its ability to detect changes in absolute levels at earlier stages and its low interassay coefficient of variance (11%). We conclude that the nephelometric technique appears suitable for routine diagnostic use, offers several advantages compared with more traditional methods, and is no more expensive per test specimen than the Rose-Waaler technique.
Oesophageal and gastric motility disorders in patients categorised as having primary anorexia nervosa.
Authors: G Stacher, A Kiss, S Wiesnagrotzki, H Bergmann, J Hobart, C Schneider
Journal: Gut (1986)

Gastrointestinal motor function in patients with primary anorexia nervosa has rarely been investigated. We studied oesophageal motor activity in 30 consecutive patients meeting standard diagnostic criteria for primary anorexia nervosa (Feighner et al; DSM III). Seven were found to suffer from achalasia instead of primary anorexia nervosa, one from diffuse oesophageal spasm and one from severe gastro-oesophageal reflux and upper oesophageal sphincter hypertonicity, while partly non-propulsive and repetitive high amplitude, long duration contractions prevailed in the lower oesophagus of another six. In four patients with oesophageal dysmotility not responding to therapy and in 12 of 15 patients with normal oesophageal manometry, gastric emptying of a semisolid meal was studied. Emptying was normal in only three but markedly delayed in 13 cases (half emptying times 97-330 min, median: 147 min, as compared with 21-119 min, median: 47 min, in 24 healthy controls). In eight patients, the effects of domperidone 10 mg iv and placebo were compared under random double blind conditions. Half emptying times were shortened significantly (p less than 0.01) by domperidone. Conclusions: symptoms of disordered upper gastrointestinal motor activity may be mistaken as indicating primary anorexia nervosa; clinical evaluation of patients with presumed primary anorexia nervosa should rule out the possibility that disordered oesophageal motor activity underlies the symptoms; delayed gastric emptying is a frequent feature in primary anorexia nervosa and might be returned to normal with domperidone.
Acute kidney injury in critically ill patients with 2009 influenza A (H1N1) viral pneumonia: an observational study
Authors: N. Nin, J. A. Lorente, L. Soto, F. Ríos, J. Hurtado, F. Arancibia, S. Ugarte, E. Echevarría, P. Cardinal, F. Saldarini, H. Bagnulo, I. Cortés, G. Bujedo, C. Ortega, F. Frutos, A. Esteban
Journal: Intensive Care Medicine (2011)
Preventing the Heterosexual Spread of AIDS
Authors: Donald P. Francis
Journal: JAMA (1988)

To the Editor.—  We commend Drs Hearst and Hulley 1 for their evaluation of how to prevent the heterosexual spread of acquired immunodeficiency syndrome (AIDS). Their article is useful for academic purposes because it provides a statistical basis for risk assessment. However, from the practical individual-in-the-street vantage, two aspects of the article may cause confusion: (1) the use of a constant infectivity factor in calculations that may be appropriate for population-based studies, but that are less appropriate for assessing individual risk, and (2) stressing the importance of obtaining sexual histories of potential partners, also important in an epidemiologic, population sense but less useful for the individual.  The authors use a constant infectivity rate of 0.002 or less for male-to-female vaginal intercourse, derived in part from our continuing study being conducted throughout California of the female partners of human immunodeficiency virus (HIV)—infected men. Drs Hearst and Hulley acknowledge that if variable infectivity
Effects of Insulin Glargine and Liraglutide Therapy on Liver Fat as Measured by Magnetic Resonance in Patients With Type 2 Diabetes: A Randomized Trial
Authors: An Tang, Rémi Rabasa-Lhoret, Hélène Castel, Claire Wartelle-Bladou, Guillaume Gilbert, Karine Massicotte-Tisluck, Gabriel Chartrand, Damien Olivié, Anne-Sophie Julien, Jacques de Guise, Gilles Soulez, Jean-Louis Chiasson
Journal: Diabetes Care (2015)

OBJECTIVE This study determined the effects of insulin versus liraglutide therapy on liver fat in patients with type 2 diabetes inadequately controlled with oral agents therapy, including metformin. RESEARCH DESIGN AND METHODS Thirty-five patients with type 2 diabetes inadequately controlled on metformin monotherapy or in combination with other oral antidiabetic medications were randomized to receive insulin glargine or liraglutide therapy for 12 weeks. The liver proton density fat fraction (PDFF) was measured by MRS. The mean liver PDFF, the total liver volume, and the total liver fat index were measured by MRI. The Student t test, the Fisher exact test, and repeated-measures ANOVA were used for statistical analysis. RESULTS Insulin treatment was associated with a significant improvement in glycated hemoglobin (7.9% to 7.2% [62.5 to 55.2 mmol/mol], P = 0.005), a trend toward a decrease in MRS-PDFF (12.6% to 9.9%, P = 0.06), and a significant decrease in liver mean MRI-PDFF (13.8% to 10.6%, P = 0.005), liver volume (2,010.6 to 1,858.7 mL, P = 0.01), and the total liver fat index (304.4 vs. 209.3 % ⋅ mL, P = 0.01). Liraglutide treatment was also associated with a significant improvement in glycated hemoglobin (7.6% to 6.7% [59.8 to 50.2 mmol/mol], P &amp;lt; 0.001) but did not change MRS-PDFF (P = 0.80), liver mean MRI-PDFF (P = 0.15), liver volume (P = 0.30), or the total liver fat index (P = 0.39). CONCLUSIONS The administration of insulin glargine therapy reduced the liver fat burden in patients with type 2 diabetes. However, the improvements in the liver fat fraction and glycemia control were not significantly different from those in the liraglutide group.