tbuckley/cabot-search huggingface dataset:
Moving to a Highly Walkable Neighborhood and Incidence of Hypertension: A Propensity-Score Matched Cohort Study
Authors: Maria Chiu, Mohammad-Reza Rezai, Laura C. Maclagan, Peter C. Austin, Baiju R. Shah, Donald A. Redelmeier, Jack V. Tu
Journal: Environmental Health Perspectives (2015)

The impact of moving to a neighborhood more conducive to utilitarian walking on the risk of incident hypertension is uncertain.Our study aimed to examine the effect of moving to a highly walkable neighborhood on the risk of incident hypertension.A population-based propensity-score matched cohort study design was used based on the Ontario population from the Canadian Community Health Survey (2001-2010). Participants were adults ≥ 20 years of age who moved from a low-walkability neighborhood (defined as any neighborhood with a Walk Score < 90) to either a high- (Walk Score ≥ 90) or another low-walkability neighborhood. The incidence of hypertension was assessed by linking the cohort to administrative health databases using a validated algorithm. Propensity-score matched Cox proportional hazard models were used. Annual health examination was used as a control event.Among the 1,057 propensity-score matched pairs there was a significantly lower risk of incident hypertension in the low to high vs. the low to low-walkability groups [hazard ratio = 0.46; 95% CI, 0.26, 0.81, p < 0.01]. The crude hypertension incidence rates were 18.0 per 1,000 person-years (95% CI: 11.6, 24.8) among the low- to low-walkability movers compared with 8.6 per 1,000 person-years (95% CI: 5.3, 12.7) among the low- to high-walkability movers (p < 0.001). There were no significant differences in the hazard of annual health examination between the two mover groups.Moving to a highly walkable neighborhood was associated with a significantly lower risk of incident hypertension. Future research should assess whether specific attributes of walkable neighborhoods (e.g., amenities, density, land-use mix) may be driving this relationship.Chiu M, Rezai MR, Maclagan LC, Austin PC, Shah BR, Redelmeier DA, Tu JV. 2016. Moving to a highly walkable neighborhood and incidence of hypertension: a propensity-score matched cohort study. Environ Health Perspect 124:754-760; http://dx.doi.org/10.1289/ehp.1510425.
Haemoglobin E in Burmese
Authors: H. Lehmann, P. Story, H. Thein
Journal: BMJ (1956)

A case of sensory radicular neuropathy is described in a boy of 8 years, who has been so deaf from early infancy that he had never acquired speech.He had impaired pain sense at the age of 15 months.There is no family history of the condition.He presented with painless ulceration of the toes, symmetrical loss of deep reflexes, the axon reflex, and impaired sensation to pain and temperature over the periphery of the limbs: proprioception, touch, vasomotor responses, and sweating remaining intact.Histological examination of the peri- pheral sensory nerve showed demyelination.This case is compared with cases previously reported and the mechanism of symptomatology briefly discussed.I am greatly indebted to Dr. P.
Parity of esteem for mental and physical healthcare in England: a hundred years war?
Authors: Claire Hilton
Journal: Journal of the Royal Society of Medicine (2015)

‘Parity of esteem’ means ensuring that society provides equitably for mental and physical illness, but evidence indicates that parity is far from being achieved. Mental illness accounts for 23% of the total burden of disease, yet despite the existence of cost-effective treatments, it receives only 13% of National Health Service expenditure.1 Mental illness has the same effect on life expectancy as smoking, and more than obesity. Improved mental health has many benefits, including fewer physical illness symptoms and less demand for physical healthcare, increased employment of adults of working age and greater independence for elderly frail people. Thus, as well as individual benefit, appropriate treatment can also reduce expenditure in various government departments.

According to the Chief Medical Officer, about three-quarters of people with mental disorders fall into the ‘treatment gap’, that is, they have a mental disorder, as defined by international diagnostic criteria, but they are ‘not currently referred for or receiving treatment from services (including primary care mental healthcare)’.2 The Chief Medical Officer also commented that stigma and discrimination towards people with mental illness are common. The cycle of stigma means that personal stigmatisation links to institutional decisions which then affect the individual and so on. Stigma for the individual is associated with exclusion from education and employment, victimisation, poverty and homelessness. In the Chief Medical Officer's words, these are also ‘driving factors in maintaining the status quo of poor access to [mental] healthcare’, influencing National Health Service priorities and provision. This premise was apparent in measures introduced in March 2014 by National Health Service England, cutting spending on hospital services for physical illness by 1.5%, but reducing expenditure on community healthcare, which includes mental health, by 1.8% – a 20% difference.3

Making Parity a Reality4 was the Royal College of Psychiatrists’ manifesto for the 2015 General Election. It stated that treatment for people with mental disorders has ‘long been underfunded and undervalued … Fortunately, this is beginning to change.’ Unfortunately, that is what our psychiatric forbears thought a century ago. The need for parity has been reiterated intermittently since then. This paper explores parity from a historical perspective.
Clinical efficacy and safety of a novel controlled-release morphine suppository and subcutaneous morphine in cancer pain: a randomized evaluation.
Authors: E Bruera, R Fainsinger, K Spachynski, N Babul, Z Harsanyi, A C Darke
Journal: Journal of Clinical Oncology (1995)

PURPOSE A significant number of cancer patients will require an alternate route of morphine administration at some point during their illness. This study compared the clinical efficacy and safety of a novel morphine sulfate controlled-release suppository (MS-CRS) and subcutaneous (SC) morphine in patients with cancer pain. METHODS Thirty patients with cancer pain were randomized in a double-blind crossover study to MS-CRS every 12 hours or SC morphine every 4 hours for 4 days each, using a 2.5:1 analgesic equivalence ratio. Pain intensity was assessed using a visual analog scale (VAS) and the Present Pain Intensity Index of the McGill Pain Questionnaire. Nausea and sedation were also assessed with a VAS. Evaluations were made by the patient at 8 AM, noon, 4 PM, and 8 PM and rescue morphine consumption recorded. RESULTS Twenty-three patients completed the study (13 men and 10 women; mean age, 64.0 +/- 2.0 years) and were treated with mean daily MS-CRS and SC morphine doses of 326 +/- 69 mg and 138 +/- 28 mg, respectively. There was a small but significant difference in overall ordinal pain-intensity scores in favor of MS-CRS (0.7 +/- 0.1 v 0.9 +/- 0.1, P = .0459). There were no significant differences between MS-CRS and SC morphine in overall VAS scores for pain intensity (13 +/- 3 v 13 +/- 3 mm), sedation (23 +/- 3 v 25 +/- 4 mm), and nausea (8 +/- 2 v 9 +/- 2 mm). The mean daily rescue analgesic consumption during MS-CRS and SC morphine did not differ significantly (1.2 +/- 0.4 v 1.2 +/- 0.4 doses/d). CONCLUSION MS-CRS, administered every 12 hours, provides analgesia comparable to SC morphine and represents a reliable, noninvasive alternative method of pain control for patients unable to take oral morphine.
Two thirds of families in Maharashtra’s “free” health scheme pay for treatment
Authors: Sanjeet Bagcchi
Journal: BMJ (2015)

Nearly two thirds of families enrolled in a scheme that entitled them to free health services in Maharashtra paid substantial out-of-pocket expenses when they needed hospital treatment, a study has found.

The state of Maharashtra launched a health insurance scheme called Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) in 2012 to improve access to medical care for poor people in the state. It entitles people with an annual income of up to Rs100<thin000 (£1000; €1400; $1500) to free health services from accredited healthcare centres, …
Incidence and predictors for cardiovascular events in patients with psoriatic arthritis
Authors: Lihi Eder, Ying Wu, Vinod Chandran, Richard Cook, Dafna D Gladman
Journal: Annals of the Rheumatic Diseases (2015)

Objective To assess the incidence and risk factors of cardiovascular events in patients with psoriatic arthritis (PsA). Methods A cohort analysis was conducted involving patients recruited and followed over the period from 1978 to 2013 in a large PsA clinic. The participants were assessed at 6 to 12-month intervals according to a standard protocol. The collected information included demographics, lifestyle habits, medical history, medications use and PsA-related outcomes. The primary outcome was a composite major cardiovascular end point comprising myocardial infarction, ischaemic stroke, revascularisation or cardiovascular death. The association between the features of disease activity and the occurrence of cardiovascular events was assessed using Cox proportional hazard models. Results A total of 1091 patients with PsA were analysed. During the follow-up period, 104 cardiovascular events occurred. A considerable proportion of patients developed a cardiovascular event (19.8% of the patients by the age of 70 years and 30.1% of patient by the age of 80 years). No trend in the risk of developing cardiovascular events was observed over the decades from 1978 to 2013 (p=0.73). In multivariate analysis, the following variables were independent predictors of major cardiovascular events: hypertension (relative risk (RR) 1.81, p=0.015), diabetes (RR 2.72, p&lt;0.001) and the number of dactylitic digits (RR 1.20, p&lt;0.001). Sedimentation rate was a significant predictor only among women (RR 1.83, p=0.02). Conclusion A significant proportion of patients with PsA develop cardiovascular events during the course of their disease. Increased cardiovascular risk is associated with a combination of traditional cardiovascular risk factors and disease activity.
Combining miR-10b–Targeted Nanotherapy with Low-Dose Doxorubicin Elicits Durable Regressions of Metastatic Breast Cancer
Authors: Byunghee Yoo, Amol Kavishwar, Alana Ross, Ping Wang, Doris P. Tabassum, Kornelia Polyak, Natalia Barteneva, Victoria Petkova, Pamela Pantazopoulos, Aseda Tena, Anna Moore, Zdravka Medarova
Journal: Cancer Research (2015)

The therapeutic promise of microRNA (miRNA) in cancer has yet to be realized. In this study, we identified and therapeutically exploited a new role for miR-10b at the metastatic site, which links its overexpression to tumor cell viability and proliferation. In the protocol developed, we combined a miR-10b-inhibitory nanodrug with low-dose anthracycline to achieve complete durable regressions of metastatic disease in a murine model of metastatic breast cancer. Mechanistic investigations suggested a potent antiproliferative, proapoptotic effect of the nanodrug in the metastatic cells, potentiated by a cell-cycle arrest produced by administration of the low-dose anthracycline. miR-10b was overexpressed specifically in cells with high metastatic potential, suggesting a role for this miRNA as a metastasis-specific therapeutic target. Taken together, our results implied the existence of pathways that regulate the viability and proliferation of tumor cells only after they have acquired the ability to grow at distant metastatic sites. As illustrated by miR-10b targeting, such metastasis-dependent apoptotic pathways would offer attractive targets for further therapeutic exploration.
Ongoing somatic mutations and clonal expansions after cure of Helicobacter pylori infection in gastric mucosa-associated lymphoid tissue B-cell lymphoma.
Authors: C Thiede, B Alpen, A Morgner, M Schmidt, M Ritter, G Ehninger, M Stolte, E Bayerdörffer, A Neubauer
Journal: Journal of Clinical Oncology (1998)

PURPOSE Although most patients with primary gastric low-grade mucosa-associated lymphoid tissue (MALT) B-cell lymphoma experience complete endoscopic and histologic remission after the cure of Helicobacter pylori infection, in many patients, the polymerase chain reaction (PCR) still detects monoclonal B cells in the gastric mucosa. The present study asked whether the lymphoma immunoglobulin VH (IgVH) sequences remained stable in patients with gastric MALT lymphoma after H pylori eradication. PATIENTS AND METHODS Eight patients with stage EI disease treated with H pylori eradication were analyzed before and at different time points after the cure of the infection. After the amplification of IgVH genes from DNA extracted from gastric biopsy specimens, monoclonal PCR products were cloned and multiple clones (43 to 105) were sequenced per patient. RESULTS Mutations were detected in all lymphoma VH sequences, which suggested germinal center or postgerminal center origin of the lymphoma B cells. In five of the eight patients, clonal heterogeneity was observed at diagnosis or during follow-up. Genealogical analysis of shared and unshared mutations showed that the process of somatic mutations was ongoing after H pylori eradication in four of the five patients who showed clonal instability. Ongoing mutations were observed in three of the four patients who completely responded to H pylori eradication, but in only one of the four patients who did not respond or who partially responded. CONCLUSION In low-grade gastric MALT lymphomas, an ongoing process of somatic hypermutation and antigen selection can be detected after the therapeutic removal of the underlying stimulus H pylori. These data point to the relevance of yet unknown antigens that drive this disease. In addition, they challenge the view that these lymphomas may be cured solely by the eradication of H pylori.
Treatment of metastatic renal cell carcinoma with coumarin (1,2-benzopyrone) and cimetidine: a pilot study.
Authors: M E Marshall, L Mendelsohn, K Butler, L Riley, J Cantrell, C Wiseman, R Taylor, J S Macdonald
Journal: Journal of Clinical Oncology (1987)

Forty-five patients with metastatic renal cell carcinoma were treated with coumarin (1,2-benzopyrone) and cimetidine. Patients received coumarin, 100 mg orally daily; cimetidine administration, 300 mg orally four times daily, was initiated on day 15 of therapy, and treatment with both drugs was continued until progression of disease. Three patients are too early to evaluate (on study less than or equal to 2 months with no change in tumor status). Objective responses (greater than or equal to 50% reduction in measurable disease) occurred in 14 of 42 evaluable patients (33.3%) (the 95% confidence interval based on this rate is +/- 14.3%), with three complete responses and 11 partial responses (PR). Complete responses lasted 9.5, 4+, and 9.5+ months. The median duration of response for the PR group was 5 months (range, 4 to 21+ months). Twelve patients experienced stabilization of disease ranging from 4 to 16.5+ months. No response was seen in 16 patients. There was no symptomatic, hematologic, or chemical (organ dysfunction) toxicity among the 45 patients treated. Coumarin and cimetidine appear to be safe and active agents in the treatment of metastatic renal carcinoma. Further studies are required to determine the optimal dose and scheduling of these agents.
Antagonists of Nucleic Acid Derivatives as Medicinal Agents
Authors: G H Hitchings
Journal: The Annual Review of Pharmacology and Toxicology (1992)

Heme oxygenases (HO) catabolize free heme, that is, iron (Fe) protoporphyrin (IX), into equimolar amounts of Fe2+, carbon monoxide (CO), and biliverdin. The stress-responsive HO-1 isoenzyme affords protection against programmed cell death. The mechanism ...Read More
Nonocclusive Mesenteric Ischemia
Authors: L J Brandt, S J Boley
Journal: Annual Review of Medicine (1991)

Intestinal ischemia produces a broad spectrum of disorders, the end result of which depends on many variables, including the mechanism of ischemia (embolus, spasm, or thrombosis), the vessel involved (artery or vein), the onset and duration of the injury (acute or chronic), and the area and length of bowel affected (small intestine or colon). The approximate incidence of the various types of intestinal ischemia at Montefiore Medical Center is as follows:
Phase I study of a combination of recombinant interferon-alpha and recombinant interferon-gamma in cancer patients.
Authors: R Kurzrock, M G Rosenblum, J R Quesada, S A Sherwin, L M Itri, J U Gutterman
Journal: Journal of Clinical Oncology (1986)

Combinations of interferon-alpha and interferon-gamma demonstrate synergistic antiviral and anti-proliferative activity in vitro. Therefore, we initiated a clinical study of combination interferon therapy in humans. Eighteen patients with metastatic solid tumors received daily intramuscular (IM) injections of recombinant interferon-alpha-A (IFN alfa-2a, Roferon-A; Hoffman-LaRoche, Nutley, NJ) and recombinant IFN-gamma (rIFN-gamma) for 6 weeks. The dose levels were 0.5, 1.0, 2.0, and 5.0 X 10(6) U/m2/d of each interferon. A minimum of two patients were entered sequentially at each dose level. Fever, chills, fatigue, and a greater than or equal to 50% drop in granulocyte counts were observed at all doses. Severity of symptoms corresponded to increasing dose levels. In contrast to the tachyphylaxis to these symptoms that usually develops in patients treated with the individual interferons, many patients on this study experienced persistent fever and worsening fatigue over 6 weeks. The maximum tolerated dose was 1 X 10(6) U/m2/d of each interferon. One patient with renal-cell carcinoma achieved a partial remission (duration, 3 months). Enzyme-linked immunoassay analysis in all four patients for whom complete data were available revealed that peak blood levels of IFN alfa-2a on day 22 were about tenfold higher than on day 1. Because of the possibility of cumulative toxicity, the recommended starting dose for further studies is 0.5 X 10(6) U/m2/d of each interferon, with escalation to 1.0 X 10(6) U/m2/d after 1 month if tolerance is acceptable. Phase II investigations to explore the antitumor efficacy of this regimen are planned.
Review of Carl H. Coleman, Jerry A. Menikoff, Jesse A. Goldner, and Nancy Neveloff Dubler (eds.),<i>The Ethics and Regulation of Research with Human Subjects</i>
Authors: Frances H. Miller
Journal: The American Journal of Bioethics (2007)

Click to increase image sizeClick to decrease image size 1Dayton, OH: LexisNexis, 2005. 746 pp. $48.00, hardcover.
Regulation of the Pyruvate Dehydrogenase Multienzyme Complex
Authors: R. H. Behal, D. B. Buxton, J. G. Robertson, M. S. Olson
Journal: Annual Review of Nutrition (1993)

The objective of this review is to provide an overview of intermittent fasting regimens, summarize the evidence on the health benefits of intermittent fasting, and discuss physiological mechanisms by which intermittent fasting might lead to improved ...Read More
The regulation of trophoblast migration across endothelial cells by low shear stress: consequences for vascular remodelling in pregnancy
Authors: Joanna L. James, Judith E. Cartwright, Guy S. Whitley, Darrel R. Greenhill, Andreas Hoppe
Journal: Cardiovascular Research (2011)

In early human pregnancy placental trophoblasts migrate along uterine spiral arteries (SAs) and remodel these vessels into wide-bore conduits in a process essential for successful pregnancy. Until 10–12 weeks gestation trophoblasts plug spiral arteries, resulting in slow, high-resistance blood flow. This work examined the consequences of these low shear stress conditions on trophoblast migration, adhesion molecule expression, and attraction to chemotactic factors. Trophoblasts were cultured on fibronectin or human endothelial cells for 6–12 h under 0.5–6 dyne/cm2 shear stress using the BioFlux200 system, and imaged by time-lapse microscopy. Computer-based imaging algorithms were developed to automatically quantify migration. Chemotaxis assays were run using parallel flow. Trophoblasts cultured on fibronectin or endothelial cells did not undergo directional migration in 0.5 and 2 dyne/cm2 cultures; however, in 4 and 6 dyne/cm2 trophoblasts migrated with the direction of flow (n= 4, P< 0.001). Shear stresses did not affect the speed of trophoblast migration, or adhesion molecule expression (E-selectin, α4, β1, and αvβ3 integrin). Trophoblasts cultured on endothelial cells migrated into media containing interleukin-8, macrophage chemoattractant protein-1, or Regulated-upon-Activation-Normal-T-cell-Expressed-and-Secreted (RANTES) (n= 5, P< 0.05). Shear stress increases trophoblast migration in the direction of flow, challenging the idea that trophoblasts migrate down spiral arteries retrograde to flow. This suggests that low shear stresses generated by trophoblast plugging of spiral arteries in the first trimester may favour arterial remodelling by preventing the migration with flow seen at higher shear stresses, allowing trophoblasts to migrate down the arteries in response to alternate stimuli such as uterine or endothelial cell-derived chemotactic factors.
Prophylactic use of low-dose interleukin-2 early post-transplantation: a randomised study
Authors: Xiangyu Zhao, Xiaosu Zhao, Yutong Wang, Ying-Jun Chang, Lan-Ping Xu, Xiao-Hui Zhang, Yu Wang, Yu-Hong Chen, Wei Han, Huan Chen, Chen-Hua Yan, Feng-Rong Wang, Jing-Zhi Wang, Yu-Qian Sun, Fei-Fei Tang, Hai-Xia Fu, Kai-Yan Liu, Xiao-Jun Huang
Journal: The Lancet (2015)
Developmental Aspects of the Hepatic Cytochrome P450 Monooxygenase System
Authors: A H Neims, M Warner, P M Loughnan, J V Aranda
Journal: The Annual Review of Pharmacology and Toxicology (1976)

Due to the massive data sets available for drug candidates, modern drug discovery has advanced to the big data era. Central to this shift is the development of artificial intelligence approaches to implementing innovative modeling based on the dynamic, ...Read More
Changes in Discharge Location and Readmission Rates Under Medicare Bundled Payment
Authors: Lindsay E. Jubelt, Keith S. Goldfeld, Wei-yi Chung, Saul B. Blecker, Leora I. Horwitz
Journal: JAMA Internal Medicine (2015)

Risks Associated With CathetersWhen I was an intern, we frequently placed urinary catheters in hospitalized patients.For some diagnoses, like congestive heart failure, we believed placement of a urinary catheter was almost mandatory to accurately measure fluid output during diuresis.We were well meaning and thought more monitoring of intake and output meant better care.The problem was that we focused more on getting information than how it actually added value to our clinical assessment, and we did not consider the possible and likely complications of catheter placement.In most cases, the risks of catheter placement outweigh any possible benefits.We are familiar with the dramatically increased risk of infection in patients with urinary catheters.But their immobilizing effects are equally serious.Saint et al 1 has described the urinary catheter as a 1-point restraint that renders the hospital patient bedbound.Hospital immobility leads to more weakness and hospital-acquired disability, a syndrome in which older patients leave the hospital with new and often permanent disabilities in their basic activities of daily living, even when their medical diagnoses are successfully treated.This disability renders patients in need of institutional long-term care or care by family or friends.There is emerging evidence that the urinary catheter is an instigator of hospital-acquired disability. 2 It is best to avoid placing urinary catheters.However, when catheters are placed, Leis et al 3 describe a pragmatic and innovative approach to help us remove them as expeditiously as possible.By empowering nurses to remove urinary catheters that are no longer needed, they were able to markedly reduce the number of days patient spent with these cath-eters.This is a promising innovation.We need more teambased interventions that improve patient care and safety.