tbuckley/cabot-search huggingface dataset:
Insulin Resistance, the Metabolic Syndrome, and Risk of Incident Cardiovascular Disease in Nondiabetic American Indians
Authors: Helaine E. Resnick, Kristina Jones, Giacomo Ruotolo, Arvind K. Jain, Jeffrey Henderson, Weiquan Lu, Barbara V. Howard
Journal: Diabetes Care (2003)

OBJECTIVE—Insulin resistance (IR) and the metabolic syndrome (MS) are associated with type 2 diabetes and adverse cardiovascular disease (CVD) risk factor profiles. Whether IR and MS predict CVD independently of diabetes and other CVD risk factors is not known. This study examines whether IR and/or presence of MS are independently associated with CVD in nondiabetic American Indians (AI). RESEARCH DESIGN AND METHODS—We examined 2,283 nondiabetic AI who were free of CVD at the baseline examination of the Strong Heart Study (SHS). CVD risk factors were measured, IR was quantified using the homeostasis model assessment (HOMA), and MS as defined by the National Cholesterol Education Program Adult Treatment Panel (ATP III) was assessed for each participant. Incident CVD and diabetes were ascertained during follow-up. RESULTS—MS was present in 798 individuals (35%), and 181 participants (7.9%) developed CVD over 7.6 ± 1.8 years of follow-up. Age, BMI, waist circumference, and triglyceride levels increased and HDL cholesterol decreased across tertiles of HOMA-IR. Risk of diabetes increased as a function of baseline HOMA-IR (6.3, 14.6, and 30.1%; P &amp;lt; 0.001) and MS (12.8 vs. 24.5%). In Cox models adjusted for CVD risk factors, risk of CVD did not increase either as a function of baseline HOMA-IR or MS, but individual CVD risk factors predicted subsequent CVD. CONCLUSIONS—Among nondiabetic AI in the SHS, HOMA-IR and MS both predict diabetes, but neither predicts CVD independently of other established CVD risk factors.
Changes in Mortality After Massachusetts Health Care Reform
Authors: Benjamin D. Sommers, Sharon K. Long, Katherine Baicker
Journal: Annals of Internal Medicine (2014)

The Massachusetts 2006 health care reform has been called a model for the Affordable Care Act. The law attained near-universal insurance coverage and increased access to care. Its effect on population health is less clear.To determine whether the Massachusetts reform was associated with changes in all-cause mortality and mortality from causes amenable to health care.Comparison of mortality rates before and after reform in Massachusetts versus a control group with similar demographics and economic conditions.Changes in mortality rates for adults in Massachusetts counties from 2001 to 2005 (prereform) and 2007 to 2010 (postreform) were compared with changes in a propensity score-defined control group of counties in other states.Adults aged 20 to 64 years in Massachusetts and control group counties.Annual county-level all-cause mortality in age-, sex-, and race-specific cells (n = 146,825) from the Centers for Disease Control and Prevention's Compressed Mortality File. Secondary outcomes were deaths from causes amenable to health care, insurance coverage, access to care, and self-reported health.Reform in Massachusetts was associated with a significant decrease in all-cause mortality compared with the control group (-2.9%; P = 0.003, or an absolute decrease of 8.2 deaths per 100,000 adults). Deaths from causes amenable to health care also significantly decreased (-4.5%; P < 0.001). Changes were larger in counties with lower household incomes and higher prereform uninsured rates. Secondary analyses showed significant gains in coverage, access to care, and self-reported health. The number needed to treat was approximately 830 adults gaining health insurance to prevent 1 death per year.Nonrandomized design subject to unmeasured confounders. Massachusetts results may not generalize to other states.Health reform in Massachusetts was associated with significant reductions in all-cause mortality and deaths from causes amenable to health care.None.
Physician Reporting of Driver Impairment
Authors: Lee N. Hames
Journal: JAMA (1975)

They [physicians] can see the handwriting on the wall. They know that sooner or later their active cooperation with licensing agencies in identifying and controlling medically impaired drivers will be expected,<i>or demanded</i>, in every state. THIS STATEMENT was made by Richard H. Austin, Michigan Secretary of State, last February at a physician reporting conference in Atlanta sponsored by the American Medical Association and the American Association of Motor Vehicle Administrators. If the words "or demanded" are not sufficient to frighten or at least interest physicians, here is how the above quotation continues: They know that either way, their involvement will mean more paperwork, another area of knowledge in which to stay current, more responsibility, more time with certain patients, and, probably, somewhat higher malpractice insurance rates. To put this problem in proper perspective, it must be pointed out that the laws of most states<i>already require</i>licensing agencies to
Disulfiram Hypersensitivity Hepatitis
Authors: Alexander A. Fisher
Journal: JAMA (1975)

<h3>To the Editor.—</h3> In their article, "Disulfiram Hypersensitivity Hepatitis" (230:435, 1974), the authors describe two episodes of acute hepatitis that "were temporarily related to the administration of disulfiram." The second episode included "the presence of urticaria." Since there was no actual proof that the patient was allergic to disulfiram, it might be helpful to give him a patch test with 1% disulfiram in petrolatum. Occasionally, systemic "immediate" reactions such as urticaria are associated with the delayed type of contact sensitivity that may be proved by a positive patch-test reaction.<sup>1-3</sup>A positive patch-test reaction would reenforce the possibility of an allergic mechanism for the urticaria and possibly the hepatitis.
Effectiveness of home care programmes for patients with incurable cancer on their quality of life and time spent in hospital: systematic review
Authors: F. W J M Smeenk, J. C M van Haastregt, L. P de Witte, H. F J M Crebolder
Journal: BMJ (1998)

To investigate whether for patients with incurable cancer comprehensive home care programmes are more effective than standard care in maintaining the patients' quality of life and reducing their "readmission time" (percentage of days spent in hospital from start of care till death).Systematic review.A computer aided search was conducted using the databases of Medline, Embase, CancerLit, and PsychLit. The search for studies and the assessment of the methodological quality of the relevant studies were performed by two investigators, blinded from each other. Prospective, controlled studies investigating the effects of a home care intervention programme on patients' quality of life or on readmission time were included in the analyses.Only 9 prospective controlled studies were found; eight were performed in the United States and 1 in the United Kingdom. Their methodological quality was judged to be moderate (median rating 62 on a 100 point scale). None of the studies showed a negative influence of home care interventions on quality of life. A significantly positive influence on the outcome measures was seen in 2 out of the 5 studies measuring patients' satisfaction with care, in 3/7 studies measuring physical dimensions of quality of life, in 1/6 studies measuring psychosocial dimensions, and in 2/5 studies measuring readmission time. The incorporation of team members' visits to patients at home or regular multidisciplinary team meetings into the intervention programme seemed to be related to positive results.The effectiveness of comprehensive home care programmes remains unclear. Given the enormity of the problems faced by society in caring for patients with terminal cancer, further research is urgently needed.
The Effect of Air Pollution on Spatial Dispersion of Myocardial Repolarization in Healthy Human Volunteers
Authors: Gopal Sivagangabalan, Danna Spears, Stephane Masse, Bruce Urch, Robert D. Brook, Frances Silverman, Diane R. Gold, Karl Z. Lukic, Mary Speck, Marjan Kusha, Talha Farid, Kwaku Poku, Evelyn Shi, John Floras, Kumaraswamy Nanthakumar
Journal: Journal of the American College of Cardiology (2011)
Abstract 3171: Expression of PKC iota in breast cancer
Authors: Judith Paget, Manijeh Daneshmand, Md. Shahrier Amin, Shahidul Islam, Ian Lorimer
Journal: Cancer Research (2010)

Abstract One in nine (11%) women is expected to develop breast cancer during their lifetime. Abnormal activation of the PI3K signaling cascade is common in breast cancer. The p110α catalytic subunit of PI3K is mutated in 20-40% of breast cancers. The two most common mutations are E545K in the helical domain and H1047R in the kinase domain; these mutations render PI3K constitutively active. PKC iota is a member of atypical class of PKC family serine/threonine kinases and a downstream effector in the PI3K signaling pathway. PKC iota has been implicated in carcinogenesis and oncogenic signaling in lung, colon and ovarian carcinomas but its role in breast cancer progression is unknown. Using immunohistochemistry (IHC), we have evaluated PKCι expression and localization in breast cancer tissue microarrays (TMA). Weak PKCι staining was detected in normal breast tissue. PKCι was over-expressed in subset of breast cancers with no staining in the surrounding stroma. Positive tumor staining was mainly cytoplasmic with nuclear staining in some cases. There was no significant correlation of positive PKCι staining with tumour type. PKCι overexpression was also seen in a subset of ductal carcinoma in situ samples. In vitro, we have also shown that PKCι is over-expressed and has higher levels of phosphorylation in a subset of breast cancer cell lines when compared to mammary epithelial cell lines. Stable cell lines expressing E545K or H1047R mutations were generated in the mammary myoepithelial cell line MCF-10A by retroviral transduction. Using Western blotting, we have shown that these mutations are sufficient to increase PKCι expression and activation. These results suggest a possible mechanism for the PKCι overexpression previously demonstrated by IHC. Two structurally independent PI3K inhibitors, Wortmannin and LY294-002, inhibited PKCι phosphorylation and activation in mutant PI3K expressing cells, confirming that the PKCι activation is PI3K-dependent. These inhibitors did not inhibit the low level of PKCι activation seen in MCF10A cells expressing wild-type PI3K control, suggesting that this activation occurs by a PI3K-independent mechanism. These results demonstrate that PKCι is overexpressed in some breast cancers, and that PI3KCA mutations may drive this overexpression. These results also indicate a potential role for PKCι in breast carcinogenesis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3171.
Radiofrequency catheter ablation of ventricular tachycardia in patients with coronary artery disease.
Authors: F Morady, M Harvey, S J Kalbfleisch, R el-Atassi, H Calkins, J J Langberg
Journal: Circulation (1993)

Radiofrequency (RF) ablation of idiopathic ventricular tachycardia (VT) has been demonstrated to be highly efficacious, but the efficacy of RF ablation of VT in patients with coronary artery disease has been unknown. Therefore, the purpose of this study was to determine the feasibility of RF ablation of VT in patients with coronary artery disease.Fifteen consecutive patients with coronary artery disease and a history of myocardial infarction underwent an attempt at RF ablation of 16 hemodynamically stable monomorphic VTs that had been documented clinically on a 12-lead ECG and that had not been successfully managed by pharmacological or device therapy. One VT was incessant, five occurred more than 25 times, and the remainder occurred two to 20 times. An additional four VTs that had not been documented clinically also were targeted for ablation. The mean age of the patients was 68 +/- 7 years (+/- SD), and their mean left ventricular ejection fraction was 0.27 +/- 0.08. The mean cycle length of the 20 VTs targeted for ablation was 438 +/- 82 msec. Ablation sites were selected based on endocardial activation mapping, pace mapping, identification of an isolated mid-diastolic potential, or concealed entrainment. Sixteen of the 20 VTs (80%) were successfully ablated in 11 of 15 patients (73%), using a mean of 4.2 +/- 3 applications of RF energy, and no recurrences of the ablated VTs occurred during 9.1 +/- 3.3 months of follow-up. The mean duration of the ablation procedures was 128 +/- 30 minutes. No complications occurred in any of the patients.The results of this study demonstrate that RF ablation of hemodynamically stable VT is feasible as adjunctive therapy in selected patients with coronary artery disease.
Induction of central tolerance by intrathymic inoculation of adenoviral antigens into the host thymus permits long-term gene therapy in Gunn rats.
Authors: Y Ilan, P Attavar, M Takahashi, A Davidson, M S Horwitz, J Guida, N R Chowdhury, J R Chowdhury
Journal: Journal of Clinical Investigation (1996)

Recombinant adenoviruses are highly efficient at transferring foreign genes in vivo. However, duration of gene expression is limited by the host antiviral immune response which precludes expression upon viral readministration. We tested the feasibility of prolonging gene expression by induction of central tolerance to adenoviral antigens in bilirubin-UDP-glucuronosyltransferase-1 (BUGT1)-deficient Gunn rats. Tolerance was induced by intraperitoneal injection of antilymphocyte serum, followed by intrathymic inoculation of one of the following: a recombinant adenovirus (Ad), adenovirus human UDP-glucuronosyltransferase (Ad-hBUGT1) carrying the hBUGT1 gene; a protein extract of the same virus; or viral infected hepatocytes. Controls received intrathymic injections of normal saline. After 12 d all groups were injected intravenously with 5 x 10(9) pfu of either Ad-hBUGT1 or adenovirus beta-galactosidase (Ad-LacZ) (expressing the Escherichia coli beta-galactosidase [LacZ] gene). In all three groups of tolerized rats, hBUGT1 was expressed in the liver after administration of Ad-hBUGT1, with glucuronidation of biliary bilirubin of above 95%. Serum bilirubin levels decreased from 7.2 to 1.8 mg/dl within 1 wk and remained low for 7 wk. Similar findings were observed following repeat injections given on days 45 and 112. In control rats serum bilirubin levels were reduced for only 4 wk, and viral readministration was ineffective. In all tolerized groups, but not in controls, there was a marked inhibition of appearance of neutralizing antibodies and cytotoxic lymphocytes against the recombinant adenovirus. Injection of wild type adenovirus-5 (Ad5) into the tolerized rats elicited a wild type-specific cytotoxic lymphocyte response. This is the first demonstration of Ad-directed long-term correction of an inherited metabolic disease following central tolerization with thymic antigen.
Antibody deficiency in patients with ataxia telangiectasia is caused by disturbed B- and T-cell homeostasis and reduced immune repertoire diversity
Authors: Gertjan J. Driessen, Hanna IJspeert, Corry M.R. Weemaes, Ásgeir Haraldsson, Margreet Trip, Adilia Warris, Michiel van der Flier, Nico Wulffraat, Mijke M.M. Verhagen, Malcolm A. Taylor, Menno C. van Zelm, Jacques J.M. van Dongen, Marcel van Deuren, Mirjam van der Burg
Journal: Journal of Allergy and Clinical Immunology (2013)
Nervous System Involvement in Ankylosing Spondylitis
Authors: D. J. Thomas, M. J. Kendall, A. G. W. Whitfield
Journal: BMJ (1974)

In a review of 45 patients with ankylosing spondylitis 10 had neurological symptoms and signs and three of them had two separate neuropathological disorders. The neurological profiles fell into five main categories-multiple sclerosis, the cauda equina syndrome, focal epilepsy, vertebrobasilar insufficiency, and peripheral nerve lesions. An association between ankylosing spondylitis and multiple sclerosis is suggested, possibly due to an immunological defect or to one being a complication of the other.
Self-Reactive B Lymphocytes Overexpressing Bcl-xL Escape Negative Selection and Are Tolerized by Clonal Anergy and Receptor Editing
Authors: Wei Fang, Bennett C. Weintraub, Brenda Dunlap, Paul Garside, Kathy A. Pape, Marc K. Jenkins, Christopher C. Goodnow, Daniel L. Mueller, Timothy W. Behrens
Journal: Immunity (1998)
Mefenamic Acid for Dysmenorrhea
Authors: Paul F. Souney
Journal: JAMA (1979)

<h3>To the Editor.—</h3> Penny W. Budoff, MD (241:2713, 1979), has suggested that mefenamic acid, by virtue of its ability to inhibit prostaglandin activity, in addition to its ability to inhibit prostaglandin synthesis, may offer the advantage of allowing initiation of therapy for primary dysmenorrhea on the day of initial menstrual flow rather than beginning therapy one to two days before expected menses, as has been advocated for other inhibitors of prostaglandin synthesis (ie, naproxen, or indomethacin). This approach eliminates risk of exposing a fetus to these drugs if conception occurred during the cycle. Lundström<sup>1</sup>compared the pain-relieving effect of indomethacin and naproxen in regard to the day of the menstrual cycle on which treatment was started. Patients who received prostaglandin synthetase inhibitors one to five days before the onset of their menstrual flow were compared with those treated from the first day of bleeding. The overall results indicated that
Infection control in hospitals sink or swim?
Authors: K. F Barker
Journal: BMJ (1997)

It is questionable how many newly appointed consultant microbiologists relish the prospect of also acquiring the role of infection control doctor for their trusts. Recognised outbreaks are only a small proportion of hospital acquired infection but inevitably attract more attention. Indeed it was two major outbreaks and associated deaths in the mid-1980s and the adverse publicity concerning the hospital management that provided the impetus for the 1988 guidance, which was revised in 1995. As a result, the concept of an infection control doctor, usually a medical microbiologist, and infection control nurse is now well established. Published standards for infection control in hospitals exist, and yet it is estimated that still around one in 10 hospital patients will acquire an infection.

It was an American study, now 20 years old, that showed a strong association between the establishment of intensive infection surveillance and control programmes and reduction of the rates of hospital acquired infection over a five year period. Most studies, however, accept that even with optimal infection control procedures there is an irreducible, but unfortunately often undefined, minimum number of infections associated with, for example, mechanical ventilation, …
Bayer’s Response to “Potential for Conflict of Interest in the Evaluation of Suspected Adverse Drug Reactions: Use of Cerivastatin and Risk of Rhabdomyolysis”
Authors: Joseph D. Piorkowski
Journal: JAMA (2004)

JAMA has invited this response from Bayer Corporation to the article authored by Psaty et al (the “Article”), which appears on page 2622 in this issue. Although the Article is presented as a scientific review of facts, sections are copied verbatim from a report submitted by the lead author in a US lawsuit in which he served as a paid expert for the plaintiff. Moreover, the Article’s conclusions are based upon selected exhibits from another lawsuit in which another author (Dr Ray) submitted a report for plaintiffs. Bayer won that court case (as well as the only other cerivastatin cases that have gone to trial). At least 2 of the authors continue to participate in lawsuits against Bayer. This response presents a more complete picture of the information available in the public record. It is submitted on Bayer’s behalf by one of its outside counsel because Bayer views the Article as the publication of a disputed position taken in ongoing litigation.
Routine ultrasound scanning in pregnancy: Link with left handedness not established
Authors: A. Davis
Journal: BMJ (1993)

Data quoted by McGavock and colleagues are sometimes misleading.They quote relapse rates for peptic ulceration of 30% after bismuth chelate treatment.However, the references they quote indicated relapse rates of 61% and 47% in patients treated with bismuth chelate alone.45To obtain the quoted improved rates of relapse with, for example, bismuth chelate and tinidazole would incur additional net NHS costs of about C69 per patient for tinidazole.Such discrepancies in quoted data further weaken the conclusions of the paper.Consideration of crude prescribing figures without regard to morbidity data, secular trends, and emerging evidence of efficacy is an insecure foundation for the criticisms which the authors make of general practitioners in Northern Ireland and, by extension, the pharmaceutical industry.Neither general practitioners nor administrators should act on the conclusions drawn from such inadequate data.
Removal of Right or Left Frontal Lobes in Man
Authors: G. Jefferson
Journal: BMJ (1937)

In the early days of the neurological renaissance that followed the discovery of localized function in the cerebral hemispheres the frontal lobes seemed to select them- selves as the seats of the intelligence by a process of exclusion.Once the motor, the sensory, the visual, the auditory, and the olfactory areas had been roughed out upon the, cortex and the tracts coming to and from them plotted with gradually increasing certainty (a task to this day unc'ompleted), it was but natural that speculation should 'be busy with those large areas still remaining which were unresponsive to stimulation and often, but not always, curiously " silent" to destructive or disease processes in man.Those of us who " teethed" in study twenty-five years ago did so on the cortical maps of Flechsig, Elliot Smith, Campbell, Brodmann, and the Vogts, and learned that the grey matter consisted of numerous areas with different developmental histories and with different histological s:ructures.This was true not only of the projection areas but also of the various association areas, and it was demonstrable that the frontal lobes, like other parts, had not one single homogeneous structure, but were sub- divisible again into several cantonments, the most posterior of which formed the motor cortex.The work of Ferrier, of Horsley, and of Sherrington in particular, allotted definite functions to the different parts of that latter area, though our knowledge even of the apparently simple motor cortex is not yet complete (see, for example, the revival of interest excited by J. F. Fulton (1932), then by F. M. R. Walshe (1935), and more recently by D. E.
"The History of Medicine, Etc.," by William Hamilton.
Authors: J. S. Shields
Journal: JAMA (1897)

Milledgeville, Ind., March 11, 1897. <h3>To the Editor:</h3> —Could you tell me where a copy of "The History of Medicine, Surgery and Anatomy from the Creation to the Commencement of the Nineteenth Century," by Wm. Hamilton, could be found? and oblige <h3>Answer.</h3> —This work was published in London, 1831, by H. Colburn and R. Bentley. You will doubtless have to procure it through your dealer at second hand.
Active Transport of Sodium and Potassium Ions
Authors: Kathleen J. Sweadner, Stanley M. Goldin
Journal: New England Journal of Medicine (1980)

Much of the metabolic energy produced by the body is used to establish high intracellular concentrations of potassium (K+) and low concentrations of sodium (Na+), the reverse of the relative concentrations of these ions in the extracellular fluids. The extrusion of sodium requires its movement against a gradient of concentration (higher outside than inside) and electrical potential (inside about 70 mV more negative than outside); work is therefore needed to overcome this electrochemical gradient. The transmembrane pumping of sodium and potassium that establishes these gradients has been studied intensively and is among the best understood membrane transport processes. . . .