tbuckley/cabot-search huggingface dataset:
How the internet affects patients' experience of cancer: a qualitative study
Authors: Sue Ziebland, Alison Chapple, Carol Dumelow, Julie Evans, Suman Prinjha, Linda Rozmovits
Journal: BMJ (2004)

<b>Objective</b> To explore how men and women with cancer talk about using the internet. <b>Design</b> Qualitative study using semistructured interviews collected by maximum variation sampling. <b>Setting</b> Respondents recruited throughout the United Kingdom during 2001-2. <b>Participants</b> 175 men and women aged 19-83 years, with one of five cancers (prostate, testicular, breast, cervical, or bowel) diagnosed since 1992 and selected to include different stages of treatment and follow up. <b>Results</b> Internet use, either directly or via friend or family, was widespread and reported by patients at all stages of cancer care, from early investigations to follow up after treatment. Patients used the internet to find second opinions, seek support and experiential information from other patients, interpret symptoms, seek information about tests and treatments, help interpret consultations, identify questions for doctors, make anonymous private inquiries, and raise awareness of the cancer. Patients also used it to check their doctors9 advice covertly and to develop an expertise in their cancer. This expertise, reflecting familiarity with computer technology and medical terms, enabled patients to present a new type of “social fitness.” <b>Conclusion</b> Cancer patients used the internet for a wide range of information and support needs, many of which are unlikely to be met through conventional health care. Serious illness often undermines people9s self image as a competent member of society. Cancer patients may use the internet to acquire expertise to display competence in the face of serious illness.
Introductory Address on Puerperal Fever a Preventable Disease: a Plea for the More General Adoption of Antiseptics in Midwifery Practice
Authors: C. J. Cullingworth
Journal: BMJ (1888)

THE subject I have chosen for to-day's lecture is the preventability. of puerperal fever.'Childbirth is not uncommonly regarded as a simple physio- logical process; painful certainly, but, with a few rare-exceptions, natural and safe.Unless your attention has been specially directed to the subject it will probably not have occurred to you to consider how far this popular notion is correct.As a matter of fact, it is very incorrect.In the latest report of the Registrar- General 3,877 deaths are stated to have occurred from childbirth in England and Wales in the year 1886, including 479 in the single registration district of London.The numbers for the previous year (1885) were still larger.These figures are suffi- ciently startling, but they do not represent the whole truth.A great many deaths from childbirth are not returned as such, but appear under entirely different headings.It often happens that a woman dies from some puerperal disease, say, peritonitis, and on the death-certificate the name of the disease appears without any mention of its connection with childbirth.This is due partly to carelessness, partly to the reluctance of medical men to create alarm in the public mind, and partly also to the uncer- tainty that occasionally arises in the mind of the medical attendant as. to whether the fatal disease was attributable to childbirth or to some independent cause.The fact that many of the returns are inaccurate in the direction here indicated is well known to the authorities.Ever since the year 1881 letters of inquiry, asking for further particulars, have been issued from the office of the Registrar-General to medical men who had given certificates in which the causes of death were imperfectly stated.In one year alone (1881) the result of sending out these letters was the discovery of 330 additional deaths due to childbirtl.This question of childbirth mortality was made the subject of a most thorough and painstaking inquiry some years ago by Dr. Matthews Duncan.He arrived at the conclusion that " not fewer than 1 in every 120 women, delivered at or near the full time, die within the four weeks of childbed."This statement was received with astonishment and incredulity.The late Dr. Farr, of the Registrar-General's office, who had, in 1856, declared the mortality of childbed in England and Wales to be 1 in 189, denounced Dr.Duncan in good round terms as an alarmist.Before his death, however, he came so nearly to accepting Dr. Duncan's estimate as to allow that one woman
Rubella Vaccine Trial in Children
Authors: I. B. Hillary, P. N. Meenan, A. H. Griffith, C. C. Draper, G. D. Laurence
Journal: BMJ (1969)

A study with RA 27/3 attenuated rubella virus vaccine (Plotkin strain) showed that this produced a significant antibody response in all of twenty-one vaccinated non-immune children without any appreciable marked clinical reactions. Serological examination of 53 non-immune and 29 immune siblings living in the same households failed to show any evidence of transmission of infection.
Towards rational prescribing
Authors: J Gilley
Journal: BMJ (1994)

One tenth of the NHS's budget (pounds sterling 3.6 billion in England and Wales in 1992-3) goes on drugs prescribed by general practitioners. This drug bill grew by 14% last year, making it a target for Treasury efforts to find politically acceptable ways of limiting NHS spending. Despite recent headlines of “GPs' wasteful drug habits” British general practitioners prescribe fewer drugs than their counterparts in many developed countries and are usually described as “conservative prescribers.”1 But, according to the Audit Commission's recent report A Prescription for Improvement: Towards More Rational Prescribing in General Practice, they should become even more conservative.2,3

Based on studies of 10 family health services authorities and interviews with 54 practices, the report details examples of “best practice.” The authors insist that what they want is rational prescribing - that is, prescribing that takes account of efficiency, safety, appropriateness, and economy - not cheaper prescribing. In some cases, rational prescribing could even increase the drug bill - for example, if all general practitioners prescribed half as many inhaled steroids as they do bronchodilators then drug costs would rise by pounds sterling 75m. But deaths would fall, and the total cost to the NHS of patients with asthma would fall because of fewer hospital admissions.4

The report claims that substantial savings would result from less overprescribing (which would save pounds sterling 275m), …
Association between Urinary Polycyclic Aromatic Hydrocarbon Metabolites and Sperm DNA Damage: A Population Study in Chongqing, China
Authors: Xue Han, Niya Zhou, Zhihong Cui, Mingfu Ma, Lianbing Li, Min Cai, Yafei Li, Hui Lin, Ying Li, Lin Ao, Jinyi Liu, Jia Cao
Journal: Environmental Health Perspectives (2010)

Polycyclic aromatic hydrocarbons (PAHs), a class of the most ubiquitous environmental contaminants, may reduce male reproductive functions, but the data from human population studies are very limited.We designed this study to determine whether environmental exposure to PAHs contributes to the alteration in semen quality, sperm DNA damage, and apoptosis in the general male human population.We measured urinary levels of four PAH metabolites and assessed semen quality, sperm apoptotic markers with Annexin V assay, and sperm DNA damage with comet assay in 232 men from Chongqing, China.We found that increased urinary 2-hydroxynaphthalene (2-OHNa) levels were associated with increased comet parameters, including the percentage of DNA in the tail (tail%) [β coefficient = 13.26% per log unit 2-OHNa (micrograms per gram creatinine); 95% confidence interval (CI), 7.97-18.55]; tail length (12.25; 95% CI, 0.01-24.52), and tail distribution (7.55; 95% CI, 1.28-18.83). The urinary level of 1-hydroxypyrene was associated only with increased tail% (5.32; 95% CI, 0.47-10.17). Additionally, the increased levels of four urinary PAH metabolites were significantly associated with decreased vital Annexin V negative sperm counts. However, there was no significant association between urinary PAH metabolite levels and human semen parameters or morphology of the sperm samples.Our data indicate that the environmental level of PAH exposure is associated with increased sperm DNA damage but not with semen quality. These findings suggest that exposure to PAHs may disrupt sperm DNA and thereby interfere with human male fertility.
STUDIES ON X-RAY EFFECTS
Authors: Herbert D. Taylor, William D. Witherbee, James B. Murphy
Journal: The Journal of Experimental Medicine (1919)

1. X-rays in large doses affect the lymphocytes before any of the other circulating cells. 2. There is a sharp fall in the total number of circulating lymphocytes, which is complete 48 hours after x-ray treatment. 3. Following the immediate decrease in the circulating lymphocytes there is a primary rise, followed by another fall, which in turn is followed by a permanent rise of these cells to normal. 4. The effect of the x-rays on different species of animals varies considerably, but in those studied, cat, monkey, guinea pig, rabbit, rat, mouse, and pony, the selective action on the lymphocytes was in all instances apparent. 5. When several animals of the same species are given the same dose of x-rays, the effect on the circulating lymphocytes seems to be quantitatively parallel, when determined by blood counts. 6. The polymorphonuclear neutrophilic leucocytes, when affected at all, increase in number immediately after the administration of the x-rays and then tend to decrease below their normal level. This decrease is followed by a return to normal many days before the lymphocytes reach their original level. 7. The other cells of the blood follow the neutrophilic curve. 8. Percentage figures, as determined by differential blood counts, do not give an accurate indication of the effect of the x-rays. It is only when these are multiplied by the total white blood count that a figure, representing the total number of cells of the series per c. mm. of blood, is obtained, which varies to the stimulus in a constant manner, the variations being practically quantitative.
Estrogen improves arterial stiffness in postmenopausal diabetic women
Authors: Amit Nussbacher, Claudia Sztejnsznajd, Elizabeth Silva, Otavio C. Gebara, João B. Serro-Azul, Humberto Pierri, Silvia Lage, Giuseppe Rosano, Mauricio Wajngarten, JoséAntonio F. Ramires
Journal: Journal of the American College of Cardiology (2002)
Expression, Genomic Organization, and Transcription of the Mouse Angiotensin II Type 2 Receptor Gene
Authors: Toshihiro Ichiki, Tadashi Inagami
Journal: Circulation Research (1995)

Abstract Although the rat angiotensin II type 2 receptor (AT 2 ) was cloned and shown to be a member of the seven transmembrane domain–type receptor family, its signaling mechanism and biological roles have not been established. To acquire additional information on the structure and functions of AT 2 genomic DNA, we cloned the mouse AT 2 gene and examined its expression, transcription, and genomic organization. The amino acid sequence of the mouse AT 2 cDNA showed a 98.5% sequence identity with the rat AT 2 . In mouse fetus, mRNA of the AT 2 was highly expressed in the eviscerated carcass and brain. This expression decreased rapidly after birth. In 10-week-old mice, mRNA of the AT 2 could be detected in the brain by Northern blot analysis. However, reverse transcription–polymerase chain reaction showed that mRNA of the AT 2 was expressed in all organs examined, indicating that the AT 2 is expressed at a low level in other organs. Southern blot analysis of the genomic DNA of the mouse liver digested with Bam HI, Eco RI, and Hin dIII resulted in single bands, indicating that the AT 2 gene probably exists at a single locus in the mouse genome. The nucleotide sequence of the AT 2 gene (4.5 kb of the Eco RI fragment) revealed the presence of three exons. An entire coding sequence was included in the third exon. Primer extension experiments showed the presence of two transcription initiation sites in the mouse AT 2 gene. A DNA segment of about 1.5 kb of the promoter region (−1497 to +56 bp) of the mouse AT 2 gene was fused to a luciferase reporter gene. This promoter-luciferase construct was functional as a promoter when transfected into R3T3 cells. The promoter region contains several transcription cis elements, such as AP1 and C/EBP, in the −1497- to −874-bp segment of the promoter region. Deletion analysis showed that this segment of the DNA accounted for 70% of the promoter activity. The shortest deletion segment (−47 to +56 bp), which contains the TATA box, contributed about 15% of the promoter activity. These results clarified several functional features of the mouse AT 2 gene at a molecular level.
Bufale Spotting, part 5: Assessing a website
Authors: Tom Jefferson, Lucia Zarra
Journal: Journal of the Royal Society of Medicine (2007)

If your selected website presents data (e.g. on the incidence of the disease or condition in question), look for a background and methods sections which should tell you how the data are gathered, who funded the site and any conflicts of interest. If you cannot find one, look for another site. If you have more time and you want to have a go at finding out who is behind the website, go to http:// www.register.it/ (or http://allwhois.com) and type in the URL of the site you are interested in. If you try and register with the same URL you will be told that it is not possible but you may be able find out who registered the URL. If it is a government department this should be clearly indicated, but private concerns may use internet agencies as gobetweens. Some sites have quality certification like the HON Code awarded by the Health on the Net Foundation (http:// www.hon.ch/). However, this is a self-awarded label with rather disappointing minimum requirements (a signature and a list of information provided with a date). If the site is quoting data from elsewhere it is worth carrying out one more level of checks, by looking at one of the references at random. One more pointer is the presence of a Digital Object Identifier (DOI) next to each item. This suggests that the webmaster is planning to update the information and make it traceable in the future. It suggests accountability, which is good.
Lentigo maligna melanoma yields to radiotherapy
Authors: M. Korcok
Journal: JAMA (1983)

Despite a widespread belief that lentigo maligna melanoma is a radioresistant tumor, therapeutic radiologists at Toronto's Princess Margaret Hospital are recording better than 90% control of this lesion using conventional orthovoltage (140 to 400 kV) techniques. Reporting this success rate at the recent meeting of the American Society of Therapeutic Radiologists in Orlando, Fla, radiation oncologist Andrew R. Harwood, MB, said that radiation therapy provides an "excellent cosmetic result" and appears to be the treatment of choice for large lesions beyond the scope of surgery. Lentigo maligna (Hutchinson's freckle), which characteristically is seen in old age as a slow-growing, pigmented facial lesion, resembles many benign epidermal lesions. Hence, the lesion frequently is not diagnosed until it is quite large, Harwood told<i>JAMA</i> Untreated, one third to one half of such growths will progress to dermal invasion or lentigo maligna melanoma, and 10% of these invasive tumors will develop regional or
A survey of 90 patients with autoimmune lymphoproliferative syndrome related to TNFRSF6 mutation
Authors: Bénédicte Neven, Aude Magerus-Chatinet, Benoit Florkin, Delphine Gobert, Olivier Lambotte, Lien De Somer, Nina Lanzarotti, Marie-Claude Stolzenberg, Brigitte Bader-Meunier, Nathalie Aladjidi, Christophe Chantrain, Yves Bertrand, Eric Jeziorski, Guy Leverger, Gérard Michel, Felipe Suarez, Eric Oksenhendler, Olivier Hermine, Stéphane Blanche, Capucine Picard, Alain Fischer, Frédéric Rieux-Laucat
Journal: Blood (2011)
Nicotine patches in general practice.
Authors: I A Campbell
Journal: BMJ (1993)

used.5This aims to quantify symptoms reproducibly; some scores include a quality oflife or "bothersome" element.Prostatic obstruction is partly dynamic, resulting from the smooth muscle component ofthe prostatic stroma.This is the therapeutic basis for treatment with a adrenergic blocking drugs6 but also leads to the substantial placebo effect which is such a feature in clinical trials of treatment for benign prostatic hyperplasia.7 Patients in the control groups ex- perience an improvement not only in symptoms but also in objective measurements such as flow rates.Although validating new treatments by controlled studies is relatively easy with medical treatment, true double blind trials are difficult, if not impossible, with mechanical or operative manipulations.Indeed, the sham treatment used by Bdesha and colleagues may not be entirely blind but is probably the best that can be achieved.What we can tell our patients is that no treatment for benign prostatic hyperplasia is as good as surgery.We can reassure them that despite its long history transurethral prostatectomy fulfils the definition of a minimally invasive operation.It is not without its hazards, however, and perhaps the problem caused by the disease in many men does not merit surgery.After all, a hip replacement operation is not the only way of managing arthritis and angina does not always warrant coronary artery surgery.What we must not do is persuade ourselves and our patients that an alternative is effective until it has been tested.Unfortunately, the rigorous standards that are necessary for evaluating drugs are not always adhered to with technological developments.Bdesha and his colleagues are to be congratulated for their attempt to do so.
Treatment of Stone in the Common Bile Duct
Authors: J. Hosford
Journal: BMJ (1957)

Leukaemia is a hard nut to crack, and we shall have to wait for further fundamental scientific discoveries before we can greatly modify its frequency and mortality.In the meantime current interest in the incidence of leukaemia and in new forms of therapy can contribute significantly to the welfare of the unfortunate victims of the disease.My experience of therapeutic trials is that they arouse an enthusiasm for treatment which might otherwise be lacking and produce an improvement in results quite apart from the specific remedy.Indeed, as in the famous Hawthorne experiment at the Bell Telephone Works, community studies on the incidence and treatment of disease may sometimes have side-effects which are just as important as the original aim of the investigation. SummaryAcute leukaemia is becoming commoner than chronic leukaemia, and chronic lymphatic leukaemia commoner than chronic myeloid leukaemia.Important factors in the increase in the incidence of leukaemia in Western Europe, North America, and Australasia, and in the higher incidence of leukaemia in these countries than in Asia and Africa, are greater availability of medical care with consequent improvements in diagnosis and ageing of the population, leukaemia being more frequent in later life: It is nevertheless unlikely that these factors account for the whole of the increase, and the search for aetiological factors in leukaemia associated with the rise in the standard of living should continue.Man-made ionizing radiations such as x rays can induce leukaemia, but there is no evidence that they can account for the considerable increase in notifications of leukaemia in the later age groups, which is largely of the chronic lymphatic type, whereas leukaemia after irradiation has so far been predominantly myeloid.The risks of irradiation may be greater in the foetus than in the adult, and stringent precautions should be taken when x-raying pregnant women.These risks should be carefully balanced against the reduction in maternal mortality, stillbirths, and perinatal deaths which can be secured by the intelligent application of radiography.Our recently discovered ability to provoke remissions in acute leukaemia, and the accelerating development of powerful chemotherapeutic remedies and new methods of administering ionizing radiations, have made it essen- tial to organize therapeutic trials in leukaemia.Owing to the spontaneous variations in the course of the disease large numbers of cases are required for valid trials, which must therefore be organized on a co-operative basis.Although we shall have to wait for further funda- mental scientific discoveries before we can greatly modify the frequency and mortality of leukaemia, there is no doubt that current interest in the incidence of leukaemia and in new forms of therapy has contributed materially to the welfare of the unfortunate victims of the disease.
Dexamethasone protection of rat intestinal epithelial cells against oxidant injury is mediated by induction of heat shock protein 72.
Authors: S Urayama, M W Musch, J Retsky, M B Madonna, D Straus, E B Chang
Journal: Journal of Clinical Investigation (1998)

Although the therapeutic actions of glucocorticoids are largely attributed to their anti-inflammatory and immunosuppressive effects, they have been implicated in enhancing tissue and cellular protection. In this study, we demonstrate that dexamethasone significantly enhances viability of IEC-18 rat small intestinal cells against oxidant-induced stress in a dose-dependent fashion. This protective action is mediated by induction of hsp72, the major inducible heat shock protein in intestinal epithelial cells. Dexamethasone stimulates a time- and dose-dependent response in hsp72 protein expression that parallels its effects on cell viability. Furthermore, the induction of hsp72 is tissue dependent, as nonintestinal epithelioid HeLa cells show differential induction of hsp72 expression in response to the same dexamethasone treatment. Antisense hsp72 cDNA transfection of IEC-18 cells abolishes the dexamethasone-induced hsp72 response, without significantly affecting constitutive expression of its homologue, hsc73. Dexamethasone treatment also significantly induces hsp72 protein expression in rat intestinal mucosal cells in vivo. These data demonstrate that glucocorticoids protect intestinal epithelial cells against oxidant-induced stress by inducing hsp72.
Association of Wegener's granulomatosis with HLA antigens and other genetic markers.
Authors: S S Papiha, G E Murty, A Ad'Hia, B T Mains, M Venning
Journal: Annals of the Rheumatic Diseases (1992)

The frequencies of the HLA-A, B, C, DR, DQ antigens and of several other genetic markers in biopsy proved and well characterised patients with Wegener9s granulomatosis were compared with control frequencies of the region. A highly significant increase in HLA-DR1 was found. The percentage combined frequency of DR1-DQw1 was significantly higher in patients than in the controls. Interestingly, association with the red cell enzyme GLOI and complement locus C4B was also seen. As both of these markers are either linked or within the major histocompatibility complex region (MHC) this is further evidence for the involvement of chromosome 6 in the pathogenesis of Wegener9s granulomatosis. To understand the pathology of the disease fully molecular genetic studies of the MHC region are warranted.