tbuckley/cabot-search huggingface dataset:
Toxicological and epidemiological evidence for health risks from inhaled engine emissions.
Authors: J L Mauderly
Journal: Environmental Health Perspectives (1994)

Information from toxicological and epidemiological studies of the cancer and noncancer health risks from inhaled diesel engine exhaust (DE) and gasoline engine exhaust (GE) was reviewed. The toxicological database is more extensive for DE than for GE. Animal studies have shown that heavy, chronic exposures to both DE and GE can cause lung pathology and associated physiological effects. Inhaled GE has not been shown to be carcinogenic in animals. Chronically inhaled DE at high concentrations is a pulmonary carcinogen in rats, but the response is questionable in mice and negative in Syrian hamsters. The response in rats is probably not attributable to the DE soot-associated organic compounds, as previously assumed, and the usefulness of the rat data for predicting risk in humans is uncertain. Experimental human exposures to DE show that lung inflammatory and other cellular effects can occur after single exposures, and sparse data suggest that occupational exposures might affect respiratory function and symptoms. Epidemiology suggests that heavy occupational exposures to exhaust probably increase the risks for mortality from both lung cancer and noncancer pulmonary disease. The small magnitudes of the increases in these risks make the studies very sensitive to confounding factors and uncertainties of exposure; thus, it may not be possible to resolve exposure-response relationships conclusively by epidemiology. Our present knowledge suggests that heavy occupational exposures to DE and GE are hazardous but does not allow quantitative estimates of risk with a high degree of certainty.
A Multicenter Randomized Trial Comparing Amphilimus- With Paclitaxel-Eluting Stents in De Novo Native Coronary Artery Lesions
Authors: Didier Carrié, Jacques Berland, Stefan Verheye, Karl Eugen Hauptmann, Mathias Vrolix, Roberto Violini, Alain Dibie, Sergio Berti, Eric Maupas, David Antoniucci, Joachim Schofer
Journal: Journal of the American College of Cardiology (2012)
Child Psychiatric Units: At the Crossroads
Authors: A. Hall
Journal: BMJ (1996)

Ed Rosemary Chesson, Douglas Chisholm Jessica Kingsley, pounds sterling16.95, pp 278 ISBN 1 85302 329 9

Inpatient psychiatric units for children are under threat. Despite a 50% increase in psychiatric admissions of 10-14 year olds recorded by the Department of Health recently, the number of beds in the United Kingdom is falling and many units are offering only five day or day patient care. Although the absolute numbers of highly disturbed children remains relatively small, such children have a grossly disproportionate impact on outpatient mental health services and social services. Vast amounts of precious professional time can …
Hastening slowly: Mr Dobson plays a waiting game
Authors: R. Klein
Journal: BMJ (1997)

Britain's new government is at present engaged in a curious policy striptease, with more tease than strip. Hardly a day passes without the unveiling of some new initiative or the announcement of yet another working party to review specific aspects of the NHS. But we are still left waiting for the promised series of green and white papers translating the government's general aspirations into specific proposals for the NHS and public health. In this respect, the speech by Frank Dobson, the Secretary of State for Health, at the recent Labour party conference proved unrevealing.1 There was a dribble of specifics. But the government's overall strategy remains veiled. Nor is this surprising.

Ministers face a dilemma. The frustrating reality of a financially constrained NHS struggling to cope with competing expectations has somehow to be reconciled with the rhetoric of transformation that swept ministers into office. In these circumstances the best that can be hoped for is incremental change, which, …
Efferocytosis Is an Innate Antibacterial Mechanism
Authors: Constance J. Martin, Matthew G. Booty, Tracy R. Rosebrock, Cláudio Nunes-Alves, Danielle M. Desjardins, Iris Keren, Sarah M. Fortune, Heinz G. Remold, Samuel M. Behar
Journal: Cell Host & Microbe (2012)
Increased Mitochondrial DNA Copy Number in Occupations Associated with Low-Dose Benzene Exposure
Authors: Michele Carugno, Angela Cecilia Pesatori, Laura Dioni, Mirjam Hoxha, Valentina Bollati, Benedetta Albetti, Hyang-Min Byun, Matteo Bonzini, Silvia Fustinoni, Pierluigi Cocco, Giannina Satta, Mariagrazia Zucca, Domenico Franco Merlo, Massimo Cipolla, Pier Alberto Bertazzi, Andrea Baccarelli
Journal: Environmental Health Perspectives (2011)

Benzene is an established leukemogen at high exposure levels. Although low-level benzene exposure is widespread and may induce oxidative damage, no mechanistic biomarkers are available to detect biological dysfunction at low doses.Our goals were to determine in a large multicenter cross-sectional study whether low-level benzene is associated with increased blood mitochondrial DNA copy number (mtDNAcn, a biological oxidative response to mitochondrial DNA damage and dysfunction) and to explore potential links between mtDNAcn and leukemia-related epigenetic markers.We measured blood relative mtDNAcn by real-time polymerase chain reaction in 341 individuals selected from various occupational groups with low-level benzene exposures (> 100 times lower than the Occupational Safety and Health Administration/European Union standards) and 178 referents from three Italian cities (Genoa, Milan, Cagliari).In each city, benzene-exposed participants showed higher mtDNAcn than referents: mtDNAcn was 0.90 relative units in Genoa bus drivers and 0.75 in referents (p = 0.019); 0.90 in Milan gas station attendants, 1.10 in police officers, and 0.75 in referents (p-trend = 0.008); 1.63 in Cagliari petrochemical plant workers, 1.25 in referents close to the plant, and 0.90 in referents farther from the plant (p-trend = 0.046). Using covariate-adjusted regression models, we estimated that an interquartile range increase in personal airborne benzene was associated with percent increases in mtDNAcn equal to 10.5% in Genoa (p = 0.014), 8.2% (p = 0.008) in Milan, 7.5% in Cagliari (p = 0.22), and 10.3% in all cities combined (p < 0.001). Using methylation data available for the Milan participants, we found that mtDNAcn was associated with LINE-1 hypomethylation (-2.41%; p = 0.007) and p15 hypermethylation (+15.95%, p = 0.008).Blood MtDNAcn was increased in persons exposed to low benzene levels, potentially reflecting mitochondrial DNA damage and dysfunction.
Severe Metabolic Alkalosis Caused by Administration of Plasma Protein Fraction in End-Stage Renal Failure
Authors: G. Thomas Rahilly, Tomas Berl
Journal: New England Journal of Medicine (1979)

THE impairment in acid excretion that accompanies decreases in renal function makes patients with renal insufficiency prone to the development of a metabolic acidosis.1 However, we have recently observed several patients with limited or no renal function in whom metabolic alkalosis developed instead. Such a disturbance ensued when the electrolytes and protein losses caused by lymph drainage from their thoracic duct (an apparently useful form of immunosuppression in preparation for or after renal transplantation2) were replaced by one of several preparations of human plasma protein fraction. The potential of these commonly used parenteral solutions, when administered in large quantities, . . .
1081-48 Latin America small vessel randomized study in diabetic patients (LASMAL II): Clinical and angiographic follow-up data
Authors: Alfredo E Rodriguez, Maximo Rodriguez Alemparte, Carlos Fernandez Pereira, Victor Bernardi, Cesar F Vigo, Claudio Llaurado, Alberto Sampaolessi, Rocha Loures Bueno
Journal: Journal of the American College of Cardiology (2004)
General Principles of Treatment of Air-raid Casualties
Authors: P. H. Mitchiner
Journal: BMJ (1941)

~~~~~~~~~~~~~~~~~~~~~~~~~~EIA JOURNAL_ _ be found.Some of these symptoms may be biologicallY puLrposive, but they are of a type which cannot be imitated voluntarily, have acquired a certain autonomy of their own which cannot be abruptly terminated by changes in the environment, and, as some might say, are outside the patient's control.To suLppose that all affective reactions (i.e., states of anxiety and depression) are of an " escape " type and
Frequency of Hematoma Expansion After Spontaneous Intracerebral Hemorrhage in Children
Authors: Lauren A. Beslow, Rebecca N. Ichord, Melissa C. Gindville, Jonathan T. Kleinman, Rachel A. Bastian, Sabrina E. Smith, Daniel J. Licht, Argye E. Hillis, Lori C. Jordan
Journal: JAMA Neurology (2013)

IMPORTANCE Hematoma expansion is the only modifiable predictor of outcome in adult intracerebral hemorrhage; however, the frequency and clinical significance of hematoma expansion after childhood intracerebral hemorrhage are unknown.OBJECTIVE To assess the frequency and extent of hematoma expansion in children with nontraumatic intracerebral hemorrhage. DESIGN, SETTING, AND PARTICIPANTSProspective observational cohort study at 3 tertiary care pediatric hospitals.Children (Ն37 weeks' gestation to 18 years) with nontraumatic intracerebral hemorrhage were enrolled in a study from 2007 to 2012 focused on predictors of outcome.For this planned substudy of hematoma expansion, neonates 28 days or younger and participants with isolated intraventricular hemorrhage were excluded.Children with 2 head computed tomography (CT) scans within 48 hours were evaluated for hematoma expansion and were compared with children with only 1 head CT scan.Consent for the primary cohort was obtained from 73 of 87 eligible participants (84%); 41 of 73 children enrolled in the primary cohort met all inclusion/exclusion criteria for this substudy, in whom 22 had 2 head CT scans obtained within 48 hours that could be evaluated for hematoma expansion.Within our substudy cohort, 21 of 41 (51%) were male, 25 of 41 (61%) were white, 16 of 41 (39%) were black, and median age was 7.7 years (interquartile range, 2.0-13.4years). MAIN OUTCOME AND MEASURE Primary outcome was prevalence of hematoma expansion.RESULTS Of 73 children, 41 (56%) met inclusion criteria, and 22 (30%) had 2 head CT scans to evaluate expansion.Among these 22 children, median time from symptom onset to first CT was 2 hours (interquartile range, 1.3-6.5 hours).Median baseline hemorrhage volume was 19.5 mL, 1.6% of brain volume.Hematoma expansion occurred in 7 of 22 (32%).Median expansion was 4 mL (interquartile range, 1-11 mL).Three children had significant (>33%) expansion; 2 required urgent hematoma evacuation.Expansion was not associated with poorer outcome.Compared with children with only 1 head CT scan within 48 hours, children with 2 head CT scans had larger baseline hemorrhage volumes (P = .05)and were more likely to receive treatment for elevated intracranial pressure (P < .001).CONCLUSIONS AND RELEVANCE Hematoma expansion occurs in children with intracerebral hemorrhage and may require urgent treatment.Repeat CT should be considered in children with either large hemorrhage or increased intracranial pressure.
Tight Glycemic Control and Use of Hypoglycemic Medications in Older Veterans With Type 2 Diabetes and Comorbid Dementia
Authors: Carolyn T. Thorpe, Walid F. Gellad, Chester B. Good, Sijian Zhang, Xinhua Zhao, Maria Mor, Michael J. Fine
Journal: Diabetes Care (2015)

OBJECTIVE Older adults with diabetes and dementia are at increased risk for hypoglycemia and other adverse events associated with tight glycemic control and are unlikely to experience long-term benefits. We examined risk factors for tight glycemic control in this population and use of medications associated with a high risk of hypoglycemia in the subset with tight control. RESEARCH DESIGN AND METHODS This retrospective cohort study of national Veterans Affairs (VA) administrative/clinical data and Medicare claims for fiscal years (FYs) 2008–2009 included 15,880 veterans aged ≥65 years with type 2 diabetes and dementia and prescribed antidiabetic medication. Multivariable regression analyses were used to identify sociodemographic and clinical predictors of hemoglobin A1c (HbA1c) control (tight, moderate, poor, or not monitored) and, in patients with tight control, subsequent use of medication associated with a high risk of hypoglycemia (sulfonylureas, insulin). RESULTS Fifty-two percent of patients had tight glycemic control (HbA1c &amp;lt;7% [53 mmol/mol]). Specific comorbidities, older age, and recent weight loss were associated with greater odds of tight versus moderate control, whereas Hispanic ethnicity and obesity were associated with lower odds of tight control. Among tightly controlled patients, 75% used sulfonylureas and/or insulin, with higher odds in patients who were male, black, or aged ≥75 years; had a hospital or nursing home stay in FY2008; or had congestive heart failure, renal failure, or peripheral vascular disease. CONCLUSIONS Many older veterans with diabetes and dementia are at high risk for hypoglycemia associated with intense diabetes treatment and may be candidates for deintensification or alteration of diabetes medications.
Intracellular metabolism and effects of circulating cadmium-metallothionein in the kidney.
Authors: K S Squibb, B A Fowler
Journal: Environmental Health Perspectives (1984)

The mechanism of cadmium-metallothionein (CdMT)-mediated nephrotoxicity is being studied in rats using an acute dose regimen. Results of metabolism studies have shown that injected CdMT is rapidly degraded by the kidney with the release of Cd2+ into the cell cytoplasm. Ultrastructural studies indicate that an increase in the number of small lysosomes is the first measurable effect of CdMT in the kidney at 1 hr. This is followed by an increase in the number of small vesicles at 4 hr. It is proposed that these effects are the result of decreased primary lysosome formation and an inhibition of the fusion of pinocytotic vesicles with cell lysosomes by Cd. Functional alterations measured 8 hr after CdMT injection include an increase in urine volume and increased excretion of the low molecular weight protein, RNAase. Prior induction of renal MT by Zn pretreatment prevents the induction of polyuria and low molecular weight proteinuria by CdMT. These data provide further evidence that CdMT nephrotoxicity occurs as a result of Cd2+ toxicity within the cell.
THE BACTERIOLOGY OF SPUTUM IN COMMON NON-TUBERCULOUS INFECTIONS OF THE UPPER AND LOWER RESPIRATORY TRACTS, WITH SPECIAL REFERENCE TO LOBAR AND BRONCHO-PNEUMONIA
Authors: Thomas Wood Hastings, Walter L. Niles
Journal: The Journal of Experimental Medicine (1911)

1. In our examinations, only 38 per cent. of the infections of the respiratory tract below the glottis were pure, and this percentage was reached only by carefully following Kitasato's method of handling sputa. 2. Lobar pneumonia may produce sputum free from pneumococci, and may undoubtedly be caused by organisms other than thepneumococcus. 3. There is found a marked yearly variation in the organisms which excite inflammation of the respiratory tract. 4. Micrococcus catarrhalis is usually considered a common secondary invader; but it may, and probably frequently does, assume pathogenic properties.
Doctors form new pressure group to prevent "marketisation" of NHS
Authors: M. Limb
Journal: BMJ (2015)

Consultants and GPs are joining forces ahead of the general election to fight the “marketisation” and “break up of NHS services,” including the feared destruction of primary care.

Clare Gerada, immediate past president of the Royal College of General Practitioners, has urged medical colleagues to support the newly enlarged pressure group, Doctors for the NHS, at the campaign launch on 2 March. She said that the group was needed to prevent, within the next 18 months, the “annihilation of my profession.” She said, “I promise you: general practice is being dismantled.”

The group, Doctors for the NHS (www.nhsca.org.uk), has emerged from the NHS Consultants’ Association, which was founded in 1976 and has some 700 consultant supporters, expanding to include GPs and medical trainees.

The group’s president, Peter Fisher, who led the predecessor organisation for more than 20 years, said it was time for a “united front with the many GPs who we know share our views.” He said, “We changed name, but the ethos remains the same, as do our objectives.”

Fisher said that the new group would put pressure on MPs, directly and “through the force of public opinion,” to convince them …
High-throughput characterization of the ovarian cancer HLA peptidome
Authors: Andrea Patterson, Wilfried Bardet, Curtis McMurtrey, Saghar Kaabinejadian, Ken Jackson, William Hildebrand
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts T cells recognize cancer cells via human leukocyte antigen (HLA)/peptide complexes, and class I HLA-restricted tumor infiltrating T lymphocytes correspond to favorable prognosis in several cancers, including ovarian cancer--the most deadly gynecologic disease [[1][1]]. The
PRELIMINARY NOTE ON THE ACTION OF EHRLICH'S SUBSTANCE 606 ON SPIROCHÆTA PERTENUIS IN ANIMALS
Authors: HENRY J. NICHOLS
Journal: JAMA (1910)

The usual treatment of yaws with potassium iodid or mercury is very tedious, but the encouraging results already obtained in the treatment of other diseases due to spirochetes, namely, syphilis, relapsing fever and fowl spirillosis, by a single injection of Ehrlich's substance 606 1 suggest that his principle of therapia magna sterilisans may be applied also to yaws.  As a preliminary to the use of any new drug on man, its trial on animals is, if possible, of course, strongly indicated on many grounds. Up to the present, the only animal experimentally infected with yaws has been the monkey, various species of which have been infected by Castellani in Ceylon, Ashburn and Craig in the Philippines and Neisser, Halberstadter and Bauerman in Java. A definite lesion results from inoculation, but apparently the reaction is rather superficial, as is indicated by a late weak complement fixation reaction and a relative scarcity of
EFFECT OF CANCER ON LIVER ENZYMES
Authors: Jesse P. Greenstein
Journal: JAMA (1952)

There are two general approaches that the chemical analyst may employ in the study of malignant disease. The first of these is the direct chemical analysis of tumors, and comparison of such findings with those obtained in identical fashion on normal tissues and organs. The second approach is the chemical analysis of the tissues, circulating fluids, secretions, and excreta of cancerous patients, and comparison of such findings with those obtained on the same materials from normal persons. In the former case, it is expected that such information will yield a picture of the chemical processes inherent in the neoplastic transformation of tissues. In the latter case, it is expected that such information will give a description of the systemic effects induced by a tumor on the host that bears it, at a site or sites removed from the tumor, and in a state free of metastatic involvement. It is with
Combined hereditary and somatic mutations of replication error repair genes result in rapid onset of ultra-hypermutated cancers
Authors: Adam Shlien, Brittany B Campbell, Richard de Borja, Ludmil B Alexandrov, Daniele Merico, David Wedge, Peter Van Loo, Patrick S Tarpey, Paul Coupland, Sam Behjati, Aaron Pollett, Tatiana Lipman, Abolfazl Heidari, Shriya Deshmukh, Na'ama Avitzur, Bettina Meier, Moritz Gerstung, Ye Hong, Diana M Merino, Manasa Ramakrishna, Marc Remke, Roland Arnold, Gagan B Panigrahi, Neha P Thakkar, Karl P Hodel, Erin E Henninger, A Yasemin Göksenin, Doua Bakry, George S Charames, Harriet Druker, Jordan Lerner-Ellis, Matthew Mistry, Rina Dvir, Ronald Grant, Ronit Elhasid, Roula Farah, Glenn P Taylor, Paul C Nathan, Sarah Alexander, Shay Ben-Shachar, Simon C Ling, Steven Gallinger, Shlomi Constantini, Peter Dirks, Annie Huang, Stephen W Scherer, Richard G Grundy, Carol Durno, Melyssa Aronson, Anton Gartner, M Stephen Meyn, Michael D Taylor, Zachary F Pursell, Christopher E Pearson, David Malkin, P Andrew Futreal, Michael R Stratton, Eric Bouffet, Cynthia Hawkins, Peter J Campbell, Uri Tabori
Journal: Nature Genetics (2015)
Influenza and Cardiovascular Disease
Authors: Mohammad Madjid, Morteza Naghavi, Silvio Litovsky, S. Ward Casscells
Journal: Circulation (2003)

I n the United States, 12 400 000 people live with a history of heart attack, angina pectoris, or both.Of this population, an estimated 1 100 000 will suffer a new or recurrent coronary attack this year. 1 According to the World Health Organization, cardiovascular disease (CVD) will be the leading cause of death worldwide by 2020. 2 How Might Influenza Trigger Acute MI?Infectious agents have different effects on pathophysiology of atherosclerosis and its clinical complications. 23Whereas
Demand exceeds capacity for NHS Direct
Authors: R. Dobson
Journal: BMJ (2003)

NHS Direct is now so popular, with one million contacts a month, that some call centres are facing capacity problems.

According to a report by the health watchdog, the Commission for Health Improvement (CHI), some centres are missing, or close to missing, national targets to answer 90% of telephone calls within 30 seconds and to triage 90% of callers with symptoms within 20 minutes.

The report, the first independent national assessment of the five year old service, …
Twenty-Five-Year Outcome of Pediatric Coronary Artery Bypass Surgery for Kawasaki Disease
Authors: Soichiro Kitamura, Etsuko Tsuda, Junjiro Kobayashi, Hiroyuki Nakajima, Yoshiro Yoshikawa, Toshikatsu Yagihara, Akiko Kada
Journal: Circulation (2009)

The long-term outcome of pediatric coronary artery bypass for patients with severe inflammatory coronary sequelae secondary to Kawasaki disease is unknown.One hundred fourteen children and adolescents ranging in age from 1 to 19 (median, 10) years at operation were followed up for as long as 25 years with a median of 19 years. The number of distal anastomoses was 1.7+/-0.8 per patient, and the internal thoracic artery was used in all but 3, most frequently for left anterior descending artery lesions. Saphenous vein grafts were used in 24 patients, mostly for non-left anterior descending artery lesions. Patients underwent multiple angiograms to evaluate their coronary and graft status. There was no operative or hospital mortality. Both 20- and 25-year survival rates were 95% (95% confidence interval [CI], 88 to 98). Five deaths occurred, all cardiac in origin. Cardiac event-free rates at 20 and 25 years were 67% and 60% (95% CI, 46 to 72), respectively. Percutaneous coronary intervention and reoperation were the most common events. Overall, the 20-year graft patency rate was 87% (95% CI, 78 to 93) for internal thoracic artery grafts (n=154) and 44% (95% CI, 26 to 61) for saphenous vein grafts (n=30) (P<0.001), and the rate for non-left anterior descending artery lesions was also significantly better for arterial grafts (87% [95% CI, 73 to 94]; n=59) than for saphenous vein grafts (42% [95% CI, 23 to 60]; n=27) (P=0.002). Eighty-eight patients (77%) remain on medications, but all 109 survivors are presently symptom free in their daily activities.Although the 25-year survival was excellent after pediatric coronary bypass for Kawasaki disease, the event-free rate declined progressively. This reality mandated continued follow-up. Reinterventions successfully managed most cardiac events. An internal thoracic artery graft was the most favorable for children.