tbuckley/cabot-search huggingface dataset:
Mercury sphygmomanometers: disposal has far reaching consequences
Authors: P. Saunders, A. Rouse, S. Ali
Journal: BMJ (2001)

Mercury sphygmomanometers: disposal has far reaching consequencesEditor-The papers by O'Brien and Beevers et al have documented the trend away from the use of the mercury sphygmomanometer. 1 2 But the ethical, legal, economic, and public health consequences associated with their disposal have not been so well documented.This lack of advice is surprising since mercury has well known toxic properties.Haphazard disposal of mercury inevitably leads to environmental recycling and bioconcentration, with ecological damage at best and human poisoning at worst. 3 The Special Waste Regulations 1996 classify mercury and waste material containing more than 3% mercury as special waste and require extensive documented control of, and the use of approved contractors for, each stage of the disposal process.Noncompliance can result in a major fine, together with a custodial sentence.Although technically only the mercury component is special, it would not be safe for staff to break sphygmomanometers open to access the mercury in uncontrolled conditions.In addition, we considered it likely that standard mercury containing sphygmomanometers used in general prac-tice in England and Wales would contain more than 3% mercury and should therefore be considered special waste.We obtained four intact mercury sphygmomanometers from a general practitioner's surgery and drained and weighed the mercury under laboratory conditions.Each contained more than 3% mercury (average 6.5%).The NHS must develop a policy for the storage and ultimate disposal of retired mercury sphygmomanometers that accords with the Special Waste Regulations 1996.Data from Birmingham health authority show that more than 30 000 mercury sphygmomanometers are still in active use by general practitioners in the UK.If plans are not made to dispose of these sphygmomanometers safely, some 1800 kg of mercury could enter the environment.The contamination that would result from the haphazard disposal of all mercury sphygmomanometers used in the NHS would be much greater, and the volumes involved suggest that collection and recycling may be commercially viable.What should general practitioners, hospitals, and other NHS trusts do?Expecting each to negotiate a suitable system of collection and disposal would be burdensome, inefficient, and impractical, although it is their legal responsibility to do so.We are working with the environment agency in our region to develop an approved scheme that will reduce the bureaucratic demands on individual practices while protecting them from statutory action and, at the same time, provide a safe, efficient, and cost effective storage, transport, and disposal service.
Glomerulonephritis in Africans in Uganda
Authors: H. M. Leather
Journal: BMJ (1960)

Nephritis is a common disease in the African (Gelfand, 1957) and is a common cause of death from hyper- tensive heart failure.Becker (1946), from Johannes- burg, found that out of a total of 3,000 necropsies hypertensive heart failure was present in 247 cases and that 85 of these were due to glomerulonephritis, the great majority being in the chronic phase of the disease.Uys (1954), again from necropsy studies, found glomerulonephritis to be the commonest cause of secondary hypertension.In Uganda, Davies (1949) found " some form of nephritis " to be present in 301 out of 2,994 necropsies, and, in these, congestive heart failure was the commonest single mode of death.Raper (1953), however, reporting on " nephritis and allied lesions in Central Africans," found only 23 cases of nephritis among 92 necropsies in which advanced renal disease had been present.No comprehensive clinical studies of gloinerulonephritis have been made on the African native in his home environment, the only recorded study being an analysis by Furman (1955) from Johannesburg of the case-records of European and Bantu patients suffering from nephritis.The present study was therefore made in order to learn more of the clinical features, the biochemical and histological findings, and, if possible, the course of glomerulonephritis in the Bantu.Material and Method.-BetweenJanuary, 1956, and February, 1957, all patients admitted to the wards of a medical unit, Mulago Hospital, in whom clinical evidence of renal disease was present, or who were otherwise hypertensive, were studied.An exception was made in the case of patients in whom transient albuminuria wal present during the course of another illness-for example, pneumococcal pneumonia.,Patients who were found on investigation to be suffering -from renal disease other than glomerulonephritisfor example, pyelonephritis, amyloidosis, or essential hypertension-have been excluded from the present series and are reported elsewhere (Leather, 1959; and ,awaiting publication).The details of the method used in this study are also -recorded elsewhere (Leather, awaiting publication).Findings.-Glomerulonephritis was found in 33 of the 67 patients in the entire study.It was the com- monest cause of renal disease in each of the first four decades, and was present in 12 of the 13 children studied.It was not always possible to tell which stage in the natural history of the disease process a particular patient had reached.Classification, which was there- fore difficult, has been made from a combination of clinical and histological findings and is as follows: I. Glomerulonephritis in childhood II.Glomerulonephritis in adults .. " Acute " nephritis Rapidly progressive "acute " nephritis Subacute nephritis Latent nephritis " Intermediate" nephritis Chronic nephritis 12 cases 21 3 cases 3 ,, 1 case 1 ,, 3 cases 10 .-I.-
Prevalence of serious eye disease and visual impairment in a north London population: population based, cross sectional study
Authors: A Reidy, D C Minassian, G Vafidis, J Joseph, S Farrow, J Wu, P Desai, A Connolly
Journal: BMJ (1998)

Objective: To estimate the magnitude of serious eye disorders and of visual impairment in a defined elderly population of a typical metropolitan area in England, and to assess the frequency they were in touch with, or known to, the eye care services. Design: Cross sectional survey using two stage cluster random sampling. Setting: General practices in north London. Subjects: Random sample of people aged 65 and older, drawn from a defined population of elderly people registered with 17 general practice groups. Main outcome measures: Proportions and population prevalence estimates were determined for visual acuity, assessed with the person's own spectacles (if any), classified into four categories: prevalence of cataract, age related macular degeneration, and refractive error causing visual impairment and of definite primary open angle glaucoma; and status of contact with eye services. Results: 1547 of 1840 (84%) eligible people were examined. The population prevalence of bilateral visual impairment (visual acuity <6/12) was 30%, of which 72% was potentially remediable. 92 of these 448 cases (21%) had visual acuity <6/60 ("blindness") in one or both eyes. Prevalence of cataract causing visual impairment was 30%; 88% of these people were not in touch with the eye services. The prevalence of vision impairing, age related macular degeneration was 8% and of glaucoma (definite cases) was 3%. Three quarters of the people with definite glaucoma were not known to the eye services. Conclusions: Untreated visual impairment and eye disorders affect a substantial proportion of people aged 65 years and older. These findings should contribute to the setting up of future strategies for preservation of sight and eye health services in general. #### Key messages
Microsatellite Instability in Sporadic Endometrial Carcinoma
Authors: B. D. Duggan, J. C. Felix, L. l. Muderspach, D. Tourgeman, J. Zheng, D. Shibata
Journal: JNCI Journal of the National Cancer Institute (1994)

Recent studies have demonstrated ubiquitous somatic microsatellite mutations in some cancers of the colon, endometrium, stomach, and pancreas.Our purpose was to characterize the frequency and nature of this replication error (RER) or mutator phenotype in sporadic endometrial carcinoma.Formalin-fixed, paraffin-embedded normal and tumor tissues from 45 patients with sporadic endometrial cancer were screened for the RER phenotype at three microsatellite loci. To further characterize when these alterations were acquired relative to clonal expansion, the sizes of the altered microsatellites in different tumor and normal regions were determined using selective UV radiation fractionation. Approximately 150-300 histologically defined cells on stained tissue sections were covered with small ink dots, and UV irradiation was used to destroy the DNA of cells not covered by ink. Undamaged DNA from seven to 25 spots per section were extracted, then analyzed at the Mfd27, Mfd41, and Mfd47 microsatellite loci and also at the c-K-ras gene locus with individual polymerase chain reactions. Radioactively labeled amplified DNAs were analyzed by electrophoresis and autoradiography. Fisher's exact test and the logrank test were used for statistical analysis.The RER positive (RER+) phenotype was detected in nine (20%) of 45 sporadic endometrial carcinomas. The topographic tissue distributions of the altered microsatellites revealed clues to their pathogenesis. The RER+ phenotype was homogeneously present in the primary tumors and their metastases and was absent from adjacent normal and hyperplastic endometrium. The altered microsatellites were predominantly the same sizes throughout five tumors but demonstrated greater intratumor heterogeneity in three tumors. In one case, the primary tumor was stable but its metastasis was unstable. Mutant c-K-ras alleles were significantly more frequent in RER+ (56%) than in RER negative (RER-) (14%) tumors (P = .0165) and appeared to be acquired after the RER+ phenotype in one tumor. There were no significant clinical differences between the RER+ and RER- tumors.The RER+ phenotype is frequently present in sporadic endometrial cancers and is expressed before and during clonal expansion. The underlying mutator mutations are probably heterogeneous, since the RER+ phenotypes were diverse. The absence of altered microsatellites in adjacent normal endometrium demonstrates that the expression of the RER+ phenotype is limited to neoplastic tissue. The bulk of the microsatellite alterations appeared to be acquired prior to clonal expansion, suggesting that expression of the underlying genomic instability contributes to, and is not a consequence of, transformation.
Elevated growth differentiation factor 15 expression in patients with congenital dyserythropoietic anemia type I
Authors: Hannah Tamary, Hanna Shalev, Galit Perez-Avraham, Meira Zoldan, Itai Levi, Dorine W. Swinkels, Toshihiko Tanno, Jeffery L. Miller
Journal: Blood (2008)
Psychosocial Factors in the Adjustment of Patients with Permanently Implanted Cardiac Pacemakers
Authors: William A. Greene, Arthur J. Moss
Journal: Annals of Internal Medicine (1969)

Sixty patients were studied for adjustments with and to permanent pacemakers implanted 6 years to 1 month. Their median age was 72 years. Most patients make an excellent psychological adjustment to cardiac pacemakers with a rejuvenating lease on life; only a small minority exhibit anxiety about the pacemaker. The patient's individual adjustment appears to be a function of his physical status, duration of symptoms, his available object relations, his adjustments to previous prosthetic devices, his personality style, and the adequacy of pacemaker function. Age, sex, and socioeconomic status do not appear to be important factors in patient adjustment. Psychological illness per se is not compounded by the use of pacemakers. In this older age group the pacemaker and the associated physician seem to provide a more concrete basis on which to depend than the nebulous fate of old age.
UK death rates in children's heart surgery have almost halved over past decade
Authors: Z. Kmietowicz
Journal: BMJ (2015)

More children survived for at least 30 days after heart surgery at the end of the past decade than at the start, an analysis has found. The death rate fell from 4.3% to 2.6% of cases.

The findings have prompted the researchers to call for a shift away from scrutinising short term survival to looking at the longer term effects of heart surgery in children, such as measures of ill health and the effect on functional capacity.

Researchers …
Neglect of Occupational Disease
Authors: DAVID C. CHRISTIANI
Journal: Annals of Internal Medicine (1976)

Comments1 October 1976Neglect of Occupational DiseaseDAVID C. CHRISTIANI, M.D.DAVID C. CHRISTIANI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-85-4-542_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The June NIH Conference on vinyl chloride-associated liver disease (Ann Intern Med84:717-731, is a valuable scientific treatment of this grave problem. The official estimates of all occupational illness and injuries are frightening: government figures state that more than 14 000 workers are killed each year in work accidents, and more than 2.2 million more are either permanently or temporarily disabled as a result of work accidents and occupational disease (1). In addition to on-the-job accidents, almost 500 000 more workers develop "official" occupational diseases each year (2). These figures are unoccupational derestimates, and a 1971 study...References1. : Environmental Health Problems. Washington, D.C., Government Printing Office, 1970 Google Scholar2. See Reference 1 Google Scholar3. GORDON J: Industrial Safety Statistics: A Re-examination; A Critical Report Prepared for the Department of Labor. New York, Praeger Publishers, 1971 Google Scholar4. BRAUNDRUCKMAN PE (editors): Vinyl chloride: can the worker be protected? N Engl J Med 294:655, 1976 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1976Volume 85, Issue 4Page: 542-542KeywordsLiver diseases ePublished: 1 December 2008 Issue Published: 1 October 1976 PDF downloadLoading ...
Case 37-1966
Authors: Alan C. Aisenberg, Richard B. Cohen
Journal: New England Journal of Medicine (1966)

Presentation of Case First admission. An eighty-year-old man entered the hospital because of swelling of the parotid gland.He had been well until three weeks previously, when he noticed a swelling in the area of the left parotid gland and the left side of the neck. A sialographic examination in the clinic revealed slight irregularity of the main parotid duct and stretching of the posterior radicles by a mass situated deep to the ductal system. He was admitted to the hospital for further evaluation. A prostatectomy had been performed thirty years earlier.Physical examination revealed an elderly man who . . .
Testosterone Therapy for the Pruritus of Obstructive Jaundice
Authors: H. G. L. Lloyd-Thomas, S. Sherlock
Journal: BMJ (1952)

RDIAisH 1289clouding of consciousness as they do on the presence of an actual focal lesion in the parietal area or elsewhere in the brain. SummaryIn later life, among the reversible toxic and bio- chemical causes apt to provoke confusional symptoms, dehydration, alkalosis, anoxia, and hypoglycaemia de- serve particular emphasis.Anoxia or repeated hypo- glycaemia may lead to ultimate dementia, although as a rule only reversible acute symptoms result.Cerebral tumour in the elderly may be overlooked because the symptoms simply resemble those of growing old, because headache and papilloedema are absent, and because progressive intellectual deterioration may be wrongly attributed to cerebral softening from vascular disease.Parieto-occipital and parieto-temporal vascular lesions especially give rise to clinical pictures resembling post- traumatic psychosis and post-anoxic encephalopathy.The occurrence of so-called parietal signs is closely related to general clouding of consciousness, some indi- cations of which are usually present.
Thrombolysis in Acute Evolving Myocardial Infarction
Authors: H. J. C. Swan
Journal: New England Journal of Medicine (1983)

Acute myocardial infarction is a common manifestation of ischemic heart disease and a leading cause of admission to the acute-care facilities in community and university hospitals. Although the great variations in clinical outcome in this disease are primarily related to the magnitude of acute myocardial loss, medical treatment directed at preservation of jeopardized myocardium has not appeared to result in substantial salvage,1 and the beneficial effects, if any, are probably related to effects on remote — possibly underperfused — myocardium. Myocardial necrosis is a consequence of a profound reduction in regional blood flow sustained for a long enough period to . . .
Alanine aminotransferase isoenzymes: Molecular cloning and quantitative analysis of tissue expression in rats and serum elevation in liver toxicity
Authors: Rong-Ze Yang, Soohyun Park, William J. Reagan, Rick Goldstein, Shao Zhong, Michael Lawton, Francis Rajamohan, Kun Qian, Li Liu, Da-Wei Gong
Journal: Hepatology (2008)

Abstract The elevation of serum alanine aminotransferase (ALT) is regarded as an indicator of liver damage based on the presumption that ALT protein is specifically and abundantly expressed in the liver. However, ALT elevation is also observed in non–liver injury conditions (for example, muscle injury) and in apparently healthy people. Conversely, serum ALT activity is normal in many patients with confirmed liver diseases (for example, cirrhosis and hepatitis C infection). To improve the diagnostic value of the ALT assay and to understand the molecular basis for serum ALT changes in various pathophysiological conditions, we have cloned rat ALT isoenzyme ALT1 and ALT2 complementary DNAs (cDNAs), examined their tissue expressions at the messenger RNA and protein levels, and determined ALT1 and ALT 2 serum levels in response to liver damage in rodents. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis shows that ALT1 messenger RNA is widely distributed and mainly expressed in intestine, liver, fat tissues, colon, muscle, and heart, in the order of high to low expression level, whereas ALT2 gene expression is more restricted, mainly in liver, muscle, brain, and white adipose tissue. The tissue distribution pattern of ALT1 and ALT2 proteins largely agrees with their messenger RNA expression. Interestingly, hepatic ALT2 protein is approximately four times higher in male rats than in female rats. In addition, ALT isoenzymes distribute differentially at the subcellular level in that ALT1 is a cytoplasmic protein and ALT2 a mitochondrial protein, supporting bioinformatic prediction of mitochondrial localization of ALT2. Conclusion: Using animal models of hepatoxicity induced by carbon tetrachloride and acetaminophen, we found that both serum ALT1 and ALT2 protein levels were significantly elevated and correlated with ALT activity, providing, for the first time, the molecular basis for the elevated total serum ALT activity. (Hepatology 2008.)
Diabetes in American Indians and Alaska Natives
Authors: Dorothy Gohdes, Peter H Bennett
Journal: Diabetes Care (1993)

Diabetes in American Indians and Alaska Natives was the focus of a conference that resulted in a unique interchange among tribal leaders, health-care providers, and medical scientists with particular interests in diabetes mellitus and its complications. The conference, which was held in Mesa, Arizona, 14–17 November 1989, was sponsored by the Indian Health Service: and the National Institute of Diabetes and Digestive and Kidney Diseases, in collaboration with the Intertribal Council of Arizona.
Tumor Cyclooxygenase-2/Prostaglandin E2–Dependent Promotion of FOXP3 Expression and CD4+CD25+ T Regulatory Cell Activities in Lung Cancer
Authors: Sherven Sharma, Seok-Chul Yang, Li Zhu, Karen Reckamp, Brian Gardner, Felicita Baratelli, Min Huang, Raj K. Batra, Steven M. Dubinett
Journal: Cancer Research (2005)

Abstract Cyclooxygenase (COX)-2 and its product prostaglandin (PG) E2 underlie an immunosuppressive network that is important in the pathogenesis of non–small cell lung cancer. CD4+CD25+ T regulatory (Treg) cells play an important role in maintenance of immunologic self-tolerance. CD4+CD25+ Treg cell activities increase in lung cancer and appear to play a role in suppressing antitumor immune responses. Definition of the pathways controlling Treg cell activities will enhance our understanding of limitation of the host antitumor immune responses. Tumor-derived COX-2/PGE2 induced expression of the Treg cell-specific transcription factor, Foxp3, and increased Treg cell activity. Assessment of E-prostanoid (EP) receptor requirements revealed that PGE2-mediated induction of Treg cell Foxp3 gene expression was significantly reduced in the absence of the EP4 receptor and ablated in the absence of the EP2 receptor expression. In vivo, COX-2 inhibition reduced Treg cell frequency and activity, attenuated Foxp3 expression in tumor-infiltrating lymphocytes, and decreased tumor burden. Transfer of Treg cells or administration of PGE2 to mice receiving COX-2 inhibitors reversed these effects. We conclude that inhibition of COX-2/PGE2 suppresses Treg cell activity and enhances antitumor responses.
Environmental influences on uptake of serotonin and other amines.
Authors: A B Fisher, E R Block, G Pietra
Journal: Environmental Health Perspectives (1980)

Lungs accumulate 5-hydroxytryptamine (serotonin, 5-HT) from the perfusate by a sodium-dependent, energy-requiring, saturable process. The rate-limiting step for uptake is the transport of 5-HT and not its subsequent metabolism to 5-hydroxyindoleacetic acid. Autoradiographic studies indicate that the pulmonary endothelium is the cellular site of uptake. The effect of hyperoxia on lung clearance of 5-HT was studied with isolated perfused and ventilated lungs from rats that were previously exposed to hyperoxia. Lungs were perfused with recirculating electrolyte solution and initial [5-HT] of 0.24 microM. The calculated fractional 5-HT clearance (fracion of 5-HT removed in a single pass) ws 0.77 +/- 0.02 (mean +/- SE: n = 44) for control rats. Mean fractional clearance decreased by 20% in rats exposed to 1 atm O2 for 18 hr and 30% after 4 atmospheres absolute (ata) O2 for 1 hr (p < 0.05). The effects of O2 at 4 ata were in part reversed by exposure to air for 3.5 hr and in part prevented by injection of superoxide dismutase (60 nmole/kg body weight). This degree of O2 exposure at either 1 or 4 ata had no effect on lung content of adenine nucleotides or the distribution of 3H-5HT on autoradiography. Rats maintained for 6 weeks on a vitamin E-deficient diet showed an increased effect of hyperoxia on 5-HT clearance and did not show reversal of changes after 24 hr of air breathing. The results indicate that exposure to elevatd po2 results in reversible depression of pulmonary 5-HT clearance that is potentiated by vitamin E deficiency. This suggests alteration of pulmonary endothelial membrane transport properties due to O2 toxicity.
The cooperating mutation or “second hit” determines the immunologic visibility toward MYC-induced murine lymphomas
Authors: Christian Schuster, Angelika Berger, Maria A. Hoelzl, Eva M. Putz, Anna Frenzel, Olivia Simma, Nadine Moritz, Andrea Hoelbl, Boris Kovacic, Michael Freissmuth, Mathias Müller, Andreas Villunger, Leonard Müllauer, Ana-Iris Schmatz, Berthold Streubel, Edit Porpaczy, Ulrich Jäger, Dagmar Stoiber, Veronika Sexl
Journal: Blood (2011)