tbuckley/cabot-search huggingface dataset:
Exposure of U.S. Children to Residential Dust Lead, 1999–2004: II. The Contribution of Lead-Contaminated Dust to Children’s Blood Lead Levels
Authors: Sherry L. Dixon, Joanna M. Gaitens, David E. Jacobs, Warren Strauss, Jyothi Nagaraja, Tim Pivetz, Jonathan W. Wilson, Peter J. Ashley
Journal: Environmental Health Perspectives (2008)

BackgroundThe U.S. Centers for Disease Control and Prevention collected health, housing, and environmental data in a single integrated national survey for the first time in the United States in 1999–2004.ObjectivesWe aimed to determine how floor dust lead (PbD) loadings and other housing factors influence childhood blood lead (PbB) levels and lead poisoning.MethodsWe analyzed data from the 1999–2004 National Health and Nutrition Examination Survey (NHANES), including 2,155 children 12–60 months of age with PbB and PbD measurements. We used linear and logistic regression models to predict log-transformed PbB and the odds that PbB was ≥ 5 and ≥ 10 μg/dL at a range of floor PbD.ResultsThe population-weighted geometric mean (GM) PbB was 2.0 μg/dL (geometric standard error = 1.0). Age of child, race/ethnicity, serum cotinine concentration, poverty-to-income ratio, country of birth, year of building construction, floor PbD by floor surface and condition, windowsill PbD, presence of deteriorated paint, home-apartment type, smoking in the home, and recent renovation were significant predictors in either the linear model [the proportion of variability in the dependent variable accounted for by the model (R2) = 40%] or logistic model for 10 μg/dL (R2 = 5%). At floor PbD = 12 μg/ft2, the models predict that 4.6% of children living in homes constructed before 1978 have PbB ≥ 10 μg/dL, 27% have PbB ≥ 5 μg/dL, and the GM PbB is 3.9 μg/dL.ConclusionsLowering the floor PbD standard below the current standard of 40 μg/ft2 would protect more children from elevated PbB.
Conversion to open cholecystectomy is decreasing
Authors: A. Harris, F. D. Franco, S. Gergely
Journal: BMJ (2014)

We were surprised to read the assertion by Gurusamy and Davidson in their excellent review of gallstones that there was no difference in rates of conversion to open cholecystectomy after a laparoscopic cholecystectomy between early versus delayed cholecystectomy for acute cholecystitis, being 20% …
Damage Compounded: Disparities, Distrust, and Disparate Impact in End-of-Life Conflict Resolution Policies
Authors: Mary Ellen Wojtasiewicz
Journal: The American Journal of Bioethics (2006)

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients (or their proxies) over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based on the well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed “medically inappropriate” will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. Keywords: disparitiesdisparate impacttrustconflict-resolution policiesmedically inappropriate care ACKNOWLEDGMENT The author thanks Kenneth A. DeVille and John C. Moskop for their review of and helpful comments on this manuscript.
Spondylolysis in fast bowlers: principles of prevention and a survey of awareness among cricket coaches.
Authors: P A Bell
Journal: British Journal of Sports Medicine (1992)

Back injury in general, and spondylolysis in particular, represents a serious threat to the fast bowler. Hereditary factors, poor technique, overuse, and poor preparation for fast bowling may combine to produce the 'at risk' bowler. Three first-class county coaches were interviewed to establish a level of awareness of the lesion, with an emphasis on preparation of fast bowlers and the roles of technique alteration and bowling prescription in reducing the risk of back injury.
Lymphocytic Enterocolitis in Patients With 'Refractory Sprue'
Authors: Raymond N. DuBois
Journal: JAMA (1989)

We describe a patient with refractory sprue with malabsorption, a flat small-bowel biopsy specimen unresponsive to a gluten-free diet, and colonic biopsy specimens consistent with lymphocytic (microscopic) colitis. To investigate further the relation between celiac disease and lymphocytic or collagenous colitis (a similar and possibly related entity), we examined colorectal and small-bowel biopsy specimens in patients indexed histologically as having celiac disease who have been seen at The Johns Hopkins Hospital since 1958. Of 135 indexed patients, 21 had colorectal biopsies. Colorectal biopsy specimens were abnormal in 7 of the 21 patients. Four patients had biopsy specimens resembling lymphocytic colitis, 2 patients had acute colitis, and another patient had both lymphocytic and acute colitis. No patients had collagenous colitis. Three of the patients with lymphocytic colitis and celiac-like changes of the small bowel never responded to a gluten-free diet and may represent a distinctive panintestinal disease for which the term "lymphocytic enterocolitis" with malabsorption is proposed.
Abstract 1242: Expression of steroid receptor coactivators and HER-2/neu in normal and malignant breast tissue in controls and tamoxifen treated tumors
Authors: Line H. Moi, Marianne H. Flaageng, Sara Gandini, Aliana Guerrieri-Gonzaga, Bernardo Bonanni, Matteo Lazzeroni, Jennifer Gjerde, Ernst Lien, Andrea Decensi, Gunnar Mellgren
Journal: Cancer Research (2010)

Abstract The complex agonist/antagonist effects of tamoxifen may partly be explained by changes in nuclear receptor coactivator expression and activity. In addition, overexpression of the epidermal growth factor receptor HER-2/neu is associated with poor prognosis and tamoxifen resistance in conjunction with coactivator SRC-3/AIB1. In this study, 64 patients with ER positive breast cancer were randomly treated with 20, 5 or 1 mg tamoxifen/day for 4 week preoperatively. 28 ER positive patients were included as not-treated controls. Specimens at the time of surgery were collected from tumor tissue and normal breast tissue below 1 cm from the tumor. Real-time PCR analyses were performed to measure mRNA expression of the members of the steroid receptor coactivator (SRC) family; SRC-1, SRC-2/TIF-2, SRC-3/AIB1 and the receptor HER-2/neu. The mRNA levels were analyzed with the focus on effects of tamoxifen dose, tissue type, as well as potential correlation to the plasma levels of the biomarkers IGF-I, SHBG and immunohistochemical expression of Ki-67. The mRNA-levels of SRC-1, SRC-2/TIF-2, SRC-3/AIB1 and HER-2/neu were all significantly higher in tumors compared to normal tissue (P &amp;lt; 0.001). Tamoxifen significantly increased mRNA expression level of the coactivators in a dose-independent manner in both tissue-types, with the clearest effect for SRC-3/AIB1 (P &amp;lt; 0.001). There was no difference in HER-2/neu mRNA levels in tamoxifen treated samples compared to controls. We observed no significant correlation between mRNA levels of the coactivators and HER-2/neu with IGF-1, SHBG or Ki-67. In conclusion, nuclear receptor coactivators were significantly higher both in breast tumors and normal tissue after tamoxifen treatment; however there was no difference in mRNA levels between the tamoxifen doses of 1, 5 or 20 mg/day. Whether such an increase in expression of coactivators could be a sign of effective endocrine treatment or an attempt of the cells to shift back to a more estrogen sensitive state, remains to be elucidated. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1242.
Surface Coatings that Promote Rapid Release of Peptide‐Based AgrC Inhibitors for Attenuation of Quorum Sensing in <i>Staphylococcus aureus</i>
Authors: Adam H. Broderick, Danielle M. Stacy, Yftah Tal‐Gan, Michael J. Kratochvil, Helen E. Blackwell, David M. Lynn
Journal: Advanced Healthcare Materials (2013)

Abstract Staphylococcus aureus is a major human pathogen responsible for a variety of life‐threatening infections. The pathogenicity of this organism is attributed to its ability to produce a range of virulence factors and toxins, including the superantigen toxic shock syndrome toxin‐1 (TSST‐1). While many S. aureus infections can be treated using conventional antibiotics, strains resistant to these bactericidal agents have emerged. Approaches that suppress pathogenicity through mechanisms that are nonbactericidal (i.e., antivirulence approaches) could provide new options for treating infections, including those caused by resistant strains. Here, we report a nonbactericidal approach to suppressing pathogenicity based on the release of macrocyclic peptides ( 1 and 2 ) that inhibit the agr quorum sensing (QS) circuit in group‐III S. aureus . It is demonstrated that these peptides can be immobilized on planar and complex objects (on glass slides, nonwoven meshes, or within absorbent tampons) using the rapidly dissolving polymer carboxymethylcellulose (CMC). Peptide‐loaded CMC films released peptide rapidly (&lt;5 min) and promoted strong (&gt;95%) inhibition of the agr QS circuit without inducing cell death when incubated in the presence of a group‐III S. aureus gfp‐reporter strain. Peptide 1 is among the most potent inhibitors of QS in S. aureus reported to date, and the group‐III QS circuit regulates production of TSST‐1, the primary cause of toxic shock syndrome (TSS). These results thus suggest approaches to treat the outer covers of tampons, wound dressings, or other objects to suppress toxin production and reduce the severity of TSS in clinical and personal care contexts. Because peptide 1 also inhibits QS in S. aureus groups‐I, ‐II, and ‐IV, this approach could also provide a pathway for attenuation of QS and associated virulence phenotypes in a broader range of contexts.
Does the Effect of PM <sub>10</sub> on Mortality Depend on PM Nickel and Vanadium Content? A Reanalysis of the NMMAPS Data
Authors: Francesca Dominici, Roger D. Peng, Keita Ebisu, Scott L. Zeger, Jonathan M. Samet, Michelle L. Bell
Journal: Environmental Health Perspectives (2007)

Lack of knowledge regarding particulate matter (PM) characteristics associated with toxicity is a crucial research gap. Short-term effects of PM can vary by location, possibly reflecting regional differences in mixtures. A report by Lippmann et al. [Lippmann et al., Environ Health Perspect 114:1662-1669 (2006)] analyzed mortality effect estimates from the National Morbidity, Mortality, and Air Pollution Study (NMMAPS) for 1987-1994. They found that average concentrations of nickel or vanadium in PM2.5 (PM with aerodynamic diameter < 2.5 microm) positively modified the lag-1 day association between PM10 and all-cause mortality.We reestimated the relationship between county-specific lag-1 PM10 (PM with aerodynamic diameter < 10 microm) effects on mortality and county-specific nickel or vanadium PM2.5 average concentrations using 1987-2000 effect estimates. We explored whether such modification is sensitive to outliers.We estimated long-term average county-level nickel and vanadium PM2.5 concentrations for 2000-2005 for 72 U.S. counties representing 69 communities. We fitted Bayesian hierarchical regression models to investigate whether county-specific short-term effects of PM10 on mortality are modified by long-term county-specific nickel or vanadium PM2.5 concentrations. We conducted sensitivity analyses by excluding individual communities and considering log-transformed data.Our results were consistent with those of Lippmann et al. However, we found that when counties included in the NMMAPS New York community were excluded from the sensitivity analysis, the evidence of effect modification of nickel or vanadium on the short-term effects of PM10 mortality was much weaker and no longer statistically significant.Our analysis does not contradict the hypothesis that nickel or vanadium may increase the risk of PM to human health, but it highlights the sensitivity of findings to particularly influential observations.
Preventing food poisoning by bacterial toxins.
Authors: N D Noah, D Roberts
Journal: BMJ (1981)

a score of 7 or more, the homes were providing care for practically the same number of heavily dependent old people as were found in the geriatric wards.It therefore seemed safe to assume that the 25(,, who scored 5 or more were in need of nursing care, and this was reinforced by the statement that a quarter were incontinent during the previous week.The use of staff assessments as an indicator of need masks the severity of the problem, for an untrained staff may accept responsibility while not recognising mismanagement.For example, the nursing and medical problems are greatest with those who are immobile but they are not seen to be a problem, while wandering patients often are.' The trend in Leicestershire to appoint trained nursing staff is welcome, but Andrews3 drew attention to the fact that it is the apparent intention of the DHSS to reduce the amount of nursing in the homes.-ED,BM7.
Regulating nursing homes: Residential nursing facilities in the United States
Authors: C. Harrington
Journal: BMJ (2001)

This is the second in a series of three articles 

Poor quality care has been an enduring feature of many of the 16 500 residential nursing facilities that provide care to 1.6 million people in the United States.1 Despite three decades of public concern, government surveys and data collected by the federal government continue to show that residents of nursing homes experience problems in their care (figure). In 1998 and 1999, 25-33% of nursing homes had serious or potentially life threatening problems in delivering care and were harming residents. 3 4 In 1999, state inspectors found that 26% of the nation's nursing facilities had poor food hygiene; 21% provided care that was inadequate; 19% had environments that contributed to injuries in residents; and in 18% pressure sores were treated improperly. The eight most common deficiencies identified in 1999 are shown in the box.2 About 77% of facilities that were performing poorly had problems in subsequent surveys conducted by state licensing and certification agencies.2



Violations of care standards in nursing homes in the United States, 1991-92



#### Summary points

Poor quality care for the 1.6 million people in nursing homes in the United States has existed for 25 years

Care in as many as one third of nursing homes jeopardises the health and safety of residents

The largely profit making nursing home industry provides fewer nurses and poorer quality of care than non-profit homes and government run nursing homes

A fundamental cause of poor care is the low number of nurses and other staff required by law

Monitoring and enforcement of quality standards, which has been devolved to the states, has been weak because standards are lax

The US government has failed to hold the nursing home industry accountable for how government funds are spent and to protect residents from …
Treatment of Rectal Carcinoma
Authors: W. B. Gabriel
Journal: BMJ (1941)

<h3>Abstract</h3> The position weight matrix (PWM) has long been a useful tool for describing variation in the composition of regions of DNA such as transcription factor (TF) binding sites. It is difficult, however, to relate the sequence-based representation of a DNA motif to the biological features of the interaction of a TF with its binding site. Here we present an alternative strategy for representing DNA motifs – called Structural Motif (StruM) – that can easily represent different sets of structural features. Structural features are inferred from dinucleotide properties listed in the Dinucleotide Property Database. StruMs are able to specifically model TF binding sites, using an encoding strategy that is distinct from sequence-based models. This difference in encoding strategies makes StruMs complementary to sequence-based methods of TF binding site identification.
Detection of c-Ki-ras mutations in faecal samples from sporadic colorectal cancer patients.
Authors: J Smith-Ravin, J England, I C Talbot, W Bodmer
Journal: Gut (1995)

Colonic exfoliated epithelial cells in faecal material provide a source of human DNA which has been analysed for the presence of the tumour marker ras, in order to detect early tumour cells. The stool samples were subjected to a preliminary sample preparation step followed by centrifugation. DNA was extracted from both the centrifugation pellet and supernatant fractions, as well as from endoscopy washings, using a conventional phenol chloroform extraction method and was then purified on glass milk or spin columns. The purified DNA was amplified using mitochondrial primers and analysed for ras mutations using a non-radioactive, allele specific mismatch method. Corresponding tumour DNA was analysed for mutations using the same method. The results show that approximately 50% of the faecal samples analysed exhibited the presence of ras mutations which were also observed in the corresponding tumours. A double mutation was detected in one supernatant. Our findings represent an important stage in the development of a diagnostic test for the early detection of colorectal cancer.
The Future of Medical Care-Reply
Authors: Norbert Gleicher
Journal: JAMA (1991)

<h3>In Reply.</h3> —I appreciate the interest in my article expressed by Drs Morfesis and Manthous. I attempted to make the point that it is neither medically necessary nor economically realistic to believe that medical coverage to the uninsured and underinsured of this country can be extended based on a further increase in overall national health care expenditures. It is quite apparent that Morfesis does not agree with many of my comments when he suggests that they are typical of the thinking that has led to the present-day crisis. I would argue otherwise since I do not believe that society sees good medical care as a "privilege" but as a "right." I can also not accept the notion that the quality of medical care should vary between individuals of different means and hope that this is not what he considers as the "inflexibility" of the system. My article was not meant
Genetic correction of dystrophin deficiency and skeletal muscle remodeling in adult MDX mouse via transplantation of retroviral producer cells.
Authors: A Fassati, D J Wells, P A Sgro Serpente, F S Walsh, S C Brown, P N Strong, G Dickson
Journal: Journal of Clinical Investigation (1997)

Duchenne muscular dystrophy (DMD) is an X-linked, lethal disease caused by mutations of the dystrophin gene. No effective therapy is available, but dystrophin gene transfer to skeletal muscle has been proposed as a treatment for DMD. We have developed a strategy for efficient in vivo gene transfer of dystrophin cDNA into regenerating skeletal muscle. Retroviral producer cells, which release a vector carrying the therapeutically active dystrophin minigene, were mitotically inactivated and transplanted in adult nude/mdx mice. Transplantation of 3 x 10(6) producer cells in a single site of the tibialis anterior muscle resulted in the transduction of between 5.5 and 18% total muscle fibers. The same procedure proved also feasible in immunocompetent mdx mice under short-term pharmacological immunosuppression. Minidystrophin expression was stable for up to 6 mo and led to alpha-sarcoglycan reexpression. Muscle stem cells could be transduced in vivo using this procedure. Transduced dystrophic skeletal muscle showed evidence of active remodeling reminiscent of the genetic normalization process which takes place in female DMD carriers. Overall, these results demonstrate that retroviral-mediated dystrophin gene transfer via transplantation of producer cells is a valid approach towards the long-term goal of gene therapy of DMD.
Mushroom Poisoning Case Registry
Authors: Kenneth W. Cochran
Journal: JAMA (1984)

<h3>To the Editor.—</h3> The recently reported unfortunate experience of two physicians with a species of mushroom frequently identified as nonpoisonous,<i>Tricholomopsis platyphylla</i>, sometimes known as the "Platterful Mushroom," emphasizes the unknown toxicity of many species of mushrooms.<sup>1</sup>This was also noted earlier inThe Journalin a review of mushroom poisoning.<sup>2</sup>Since many cases of mushroom poisoning may be handled on the telephone, in the physician's office, or even informally in consultation along the trail, they remain unreported, and potentially useful information is lost. The North American Mycological Association has established a Mushroom Poisoning Case Registry, and we invite reports of all instances of mushroom poisoning of any degree.
Waterborne Legionella bozemanii and Nosocomial Pneumonia in Immunosuppressed Patients
Authors: MICHAEL F. PARRY
Journal: Annals of Internal Medicine (1985)

From October 1983 to February 1984, five episodes of nosocomial pneumonia caused by Legionella bozemanii occurred in immunosuppressed patients at a 300-bed community hospital. Pulmonary infiltrates were predominantly patchy and present in multiple lobes and bilaterally; cavitation occurred in one patient. Patients responded promptly and completely to treatment with erythromycin and rifampin. Epidemiologic studies showed that all patients had been continuously or recently hospitalized at the same institution. Legionella bozemanii was cultured from four of the five infected patients, from tapwater in patient care areas, from the hospital's hot-water holding tank, and from soil in an area of excavation and new construction on hospital property. Chlorination and heat sterilization of the tank eliminated L. bozemanii from the water and no further cases were seen. This outbreak reaffirms that excavation and construction are risk factors for the outbreak of nosocomial legionella pneumonia and is the first description of nosocomial infection due to L. bozemanii.
"The Long-Range Alternative to Socialized Medicine Is Academic Medicine"
Authors: E. Grey Dimond
Journal: JAMA (1964)

The ancient oath of Hippocrates, an often claimed fundamental of the medical profession includes these words: "I will look upon him who taught me this art as my brother and I will teach his sons." The tenuous relationship between the claims of any group (political, religious, professional) and its real behavior, is appreciated. However, titles and oaths can, on occasion, be believed and there is a period in the career of each physician when he does believe and does aspire to these ancient traditions. The period may have been brief and buried deep in the last years of premedicine or the first one or two years of medical school. At a varying point in the sophomore, junior, or senior year, the fires cool and the realistic limitations of a physician's life become understood. This does not mean that the practicing physician is without ideals or without a sense of devotion