tbuckley/cabot-search huggingface dataset:
Variation in Patient-Sharing Networks of Physicians Across the United States
Authors: Bruce E. Landon, Nancy L. Keating, Michael L. Barnett, Jukka-Pekka Onnela, Sudeshna Paul, A. James O’Malley, Thomas Keegan, Nicholas A. Christakis
Journal: JAMA (2012)

Physicians are embedded in informal networks that result from their sharing of patients, information, and behaviors.To identify professional networks among physicians, examine how such networks vary across geographic regions, and determine factors associated with physician connections.Using methods adopted from social network analysis, Medicare administrative data from 2006 were used to study 4,586,044 Medicare beneficiaries seen by 68,288 physicians practicing in 51 hospital referral regions (HRRs). Distinct networks depicting connections between physicians (defined based on shared patients) were constructed for each of the 51 HRRs.Variation in network characteristics across HRRs and factors associated with physicians being connected.The number of physicians per HRR ranged from 135 in Minot, North Dakota, to 8197 in Boston, Massachusetts. There was substantial variation in network characteristics across HRRs. For example, the mean (SD) adjusted degree (number of other physicians each physician was connected to per 100 Medicare beneficiaries) across all HRRs was 27.3 (range, 11.7-54.4); also, primary care physician relative centrality (how central primary care physicians were in the network relative to other physicians) ranged from 0.19 to 1.06, suggesting that primary care physicians were more than 5 times more central in some markets than in others. Physicians with ties to each other were far more likely to be based at the same hospital (69.2% of unconnected physician pairs vs 96.0% of connected physician pairs; adjusted rate ratio, 0.12 [95% CI, 0.12-0.12]; P < .001), and were in closer geographic proximity (mean office distance of 21.1 km for those with connections vs 38.7 km for those without connections, P < .001). Connected physicians also had more similar patient panels in terms of the race or illness burden than unconnected physicians. For instance, connected physician pairs had an average difference of 8.8 points in the percentage of black patients in their 2 patient panels compared with a difference of 14.0 percentage points for unconnected physician pairs (P < .001).Network characteristics vary across geographic areas. Physicians tend to share patients with other physicians with similar physician-level and patient-panel characteristics.
Endoscopic ultrasound-guided application of a new internally gas-cooled radiofrequency ablation probe in the liver and spleen of an animal model: a preliminary study
Authors: S. Carrara, P. Arcidiacono, L. Albarello, A. Addis, M. Enderle, C. Boemo, A. Neugebauer, M. Campagnol, C. Doglioni, P. Testoni
Journal: Endoscopy (2008)

See also: Commentaire de travail de S. Carrara et al., pp. 759Endoscopy 2008; 40(09): 969-970DOI: 10.1055/s-0032-1306877
The haemodynamic impact of portal overflow in a small-for-size liver pig-model
Authors: C. Hillert, L. Mueller, K. Helmke, A. Koops, C. Wilms, A. Paetz, K. Schroeder, W. Notarp, G. Krupski, D.C. Broering, X. Rogiers
Journal: Journal of Hepatology (2003)
Monozygotic twins discordant for intermittent allergic rhinitis differ in <scp>mRNA</scp> and protein levels
Authors: A.‐K. M. Sjogren, F. Barrenas, A. Muraro, M. Gustafsson, P. Sætrom, H. Wang, M. Benson
Journal: Allergy (2012)

Abstract Monozygotic ( MZ ) twins discordant for complex diseases may help to find disease mechanisms that are not due to genetic variants. Intermittent allergic rhinitis ( IAR ) is an optimal disease model because it occurs at defined time points each year, owing to known external antigens. We hypothesized that MZ twins discordant for IAR could help to find gene expression differences that are not dependent on genetic variants. We collected blood outside of the season from MZ twins discordant for IAR , challenged their peripheral blood mononuclear cells ( PBMC ) with pollen allergen in vitro , collected supernatants and isolated CD 4+ T cells. We identified disease‐relevant mRNA s and proteins that differed between the discordant MZ twins. By contrast, no differences in micro RNA expression were found. Our results indicate that MZ twins discordant for IAR is an optimal model to identify disease mechanisms that are not due to genetic variants.
Studies of Illness in the Aged
Authors: Sidney Katz
Journal: JAMA (1963)

The Index of ADL was developed to study results of treatment and prognosis in the elderly and chronically ill. Grades of the Index summarize over-all performance in bathing, dressing, going to toilet, transferring, continence, and feeding. More than 2,000 evaluations of 1,001 individuals demonstrated use of the Index as a survey instrument, as an objective guide to the course of chronic illness, as a tool for studying the aging process, and as an aid in rehabilitation teaching. Of theoretical interest is the observation that the order of recovery of Index functions in disabled patients is remarkably similar to the order of development of primary functions in children. This parallelism, and similarity to the behavior of primitive peoples, suggests that the Index is based on primary biological and psychosocial function, reflecting the adequacy of organized neurological and locomotor response.
Measurements of morning and evening airflow grossly underestimate the circadian variability of FEV1 and peak expiratory flow rate in asthma.
Authors: G E D'Alonzo, V W Steinijans, A Keller
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Peak expiratory flow rate (PEF) or forced expiratory volume in 1 s (FEV1) monitoring is an important clinical tool to assess the degree of 24-h variation (circadian) in lung function, which correlates with the degree of airway hyperresponsiveness. Ideally, PEF measurements should be taken frequently during the 24-h period to reflect the true variability. In practice, however, measurements are generally taken twice daily, usually upon arising and in the evening before bedtime. The effect of reducing the frequency of lung function measurement on the reported 24-h time average (mesor) and the circadian variability were evaluated. Four measurements taken 8 h apart and two measurements derived upon arising and the other, either 12 h later or before retiring, were compared with the full 24-h lung function profile, which included thirteen 2-hourly measurements. Based on the data from a 24-h lung function study in 20 adult patients with asthma, the corresponding values were separately compared at baseline and under two theophylline treatments, one being administered twice daily and the other once daily. The results are as follows: Whereas the 24-h time average (mesor) is hardly effected by the reduced measurements schemes, variability was grossly underestimated. Only 60 to 80% of the actual variability is picked up in the case of the four 8-hourly measurements, and only 20 to 45% in the case of the two measurements. The loss of accuracy in assessing 24-h airflow variability has potentially important implications on clinical practice and the investigation of therapeutics in asthma.(ABSTRACT TRUNCATED AT 250 WORDS)
Cigarette smoke facilitates allergen penetration across respiratory epithelium
Authors: K. Gangl, R. Reininger, D. Bernhard, R. Campana, I. Pree, J. Reisinger, M. Kneidinger, M. Kundi, H. Dolznig, D. Thurnher, P. Valent, K.‐W. Chen, S. Vrtala, S. Spitzauer, R. Valenta, V. Niederberger
Journal: Allergy (2008)

The association between cigarette smoke exposure and allergic airway disease is a matter for debate. We sought to investigate in an in vitro system whether active smoking reduces the integrity and barrier function of the respiratory epithelium and thus facilitates allergen penetration.We cultured the human bronchial epithelial cell line 16HBE14o- in a transwell culture system as a surrogate for the intact respiratory epithelium. The cell monolayer was exposed to standardized cigarette smoke extract (CSE). The extent and effects of trans-epithelial allergen penetration were measured using 125I-labelled purified major respiratory allergens (rBet v 1, rPhl p 5 and rDer p 2) and histamine release experiments.Exposure of cells to concentrations of CSE similar to those found in smokers induced the development of para-cellular gaps and a decrease in trans-epithelial resistance. CSE exposure induced a more than threefold increase in allergen penetration. Increased subepithelial allergen concentrations provoked a substantial augmentation of histamine release from sensitized basophils.Our results indicate that cigarette smoke is a potent factor capable of reducing the barrier function of the respiratory epithelium for allergens and may contribute to increased allergic inflammation, exacerbation of allergic disease and boosting of IgE memory.
Trends in incidence of anal cancer in Denmark.
Authors: M Frisch, M Melbye, H Moller
Journal: BMJ (1993)

OBJECTIVE--To study long term trends in incidence of anal cancer in a well monitored, unselected population. DESIGN--Descriptive epidemiological study based on data from the Danish Cancer Registry. SETTING--Denmark, 1943-87. MAIN OUTCOME MEASURES--Time related changes in anal cancer incidence according to sex, age, birth cohort, urban or rural residence, and marital status. RESULTS--The incidence of anal cancer remained fairly constant in the period 1943-57 and was similar for men and women, but it increased 1.5-fold among men and nearly tripled among women thereafter. Among men the incidence increased from 0.25 per 100,000 population (world standardised) in 1958-62 to 0.38 in 1983-7 (p = 0.01) and among women from 0.28 to 0.74 (p &lt; 0.01). The greatest increase was among residents of the capital (Copenhagen). During 1943-87 age specific trends increased in young and middle aged men and in all age groups among women. Men with anal cancer were significantly more likely throughout the study period to be unmarried than were patients with cancer of the colon (adjusted odds ratio 2.7; 95% confidence interval 2.0 to 3.6) and stomach (2.1; 1.5 to 2.8), but no association with marital status was found among women. CONCLUSIONS--The distribution and incidence of anal cancer have changed appreciably since around 1960, especially among women, which indicates important aetiological changes. Changes in sexual behaviour may have facilitated the spread of a transmittable agent of aetiological importance. It has recently been suggested that cigarette smoking promotes anal cancer, and this finds indirect support in the synchronism between changes in anal cancer incidence and heavy smoking behaviour. Factors associated with homosexuality are likely to explain some of the cases among men.
Turning round NHS deficits: …is more difficult for PCTs
Authors: Hilary G Pickles
Journal: BMJ (2006)

EDITOR—Ham believes that the turnaround teams from the private sector will find it difficult to deal with NHS deficits.1 The solution he describes entails reducing spare capacity, increasing performance, and fully engaging clinicians. These measures, aspects of the failure regime for hospitals,2 have some chance of success in provider organisations. The position for primary care trusts (PCTs) in deficit is even more difficult …
Potential Impact of Magnetic Resonance Cholangiopancreatography on Endoscopic Retrograde Cholangiopancreatography Workload and Complication Rate in Patients Referred Because of Abdominal Pain
Authors: R. J. Farrell, N. Noonan, N. Mahmud, M. M. Morrin, D. Kelleher, P. W. Keeling
Journal: Endoscopy (2001)

Endoscopic retrograde cholangiopancreatography (ERCP) has a significant mortality, morbidity, and failed cannulation rate. Magnetic resonance cholangiopancreatography (MRCP) is a safer, noninvasive method of imaging the pancreaticobiliary tree. A substantial number of patients are referred for ERCP because of abdominal pain, a high proportion of whom have normal ducts or pathology not requiring interventional ERCP. The aim was to assess the potential impact of MRCP on overall ERCP workload and patient outcome if MRCP were the primary investigation in patients referred for ERCP because of abdominal pain.1758 consecutive ERCPs performed in 1148 patients over a 3-year period in a single tertiary referral center in the pre-MRCP era were reviewed. Cannulation failure, ERCP findings, need for follow-up ERCP and all 30-day major complication rates were analyzed with regard to clinical indications.The overall workload comprised 1108 (63 %) successful initial ERCPs, 188 (11 %) failed cannulation attempts and 462 (26 %) follow-up ERCPs. Of the patients, 299 (27 %) had normal ERCP findings, 331 (30 %) had choledocholithiasis and 246 (22 %) had strictures. lf MRCP had been used as the primary imaging investigation in the 451 patients (39 %) referred for ERCP because of abdominal pain, we estimate that 197 patients (44 %) would have avoided ERCP, and the overall ERCP workload would have been reduced by 13 %. Initial MRCP in suspected gallstone pancreatitis and certain miscellaneous groups, it was estimated, would have further decreased ERCP workload by 9 %. Four of 40 major ERCP-related complications (3.5 %) and one of four ERCP-related deaths (0.35 %) would potentially have been avoided.Initial MRCP in patients referred with abdominal pain would potentially have avoided ERCP in 44 % of cases, reduced ERCP workload by 13 % and significantly reduced patient morbidity and mortality. The relatively small reduction in ERCP workload among these patients reflects the fact that over half of them had probable sphincter dysfunction, a significant proportion of whom might have benefited from biliary manometry and/or endoscopic intervention despite a normal MRCP. Furthermore, a small number of patients with calculi and subtle biliary and pancreatic strictures would be missed by this approach.
35 HEPATITIS E AS A ZOONOSIS AND THE RELEVANCE FOR LIVER TRANSPLANT RECIPIENTS
Authors: S. Pischke, C. Baechlein, P.V. Suneetha, R. Raupach, J. Schlue, J.U. Becker, A. Heim, C.P. Strassburg, M.P. Manns, B. Grummer, H. Wedemeyer
Journal: Journal of Hepatology (2009)
Tumor Localization and Image Registration of F-18 FDG Coincidence Detection Scans with Computed Tomographic Scans
Authors: CANDICE L. AITKEN, FAAIZA MAHMOUD, GEORGEANN McGUINNESS, ELISSA L. KRAMER, GERALD Q. MAGUIRE, MARILYN E. NOZ
Journal: Clinical Nuclear Medicine (2002)

Purpose The aim of this study was to determine the feasibility of registering routine clinical F-18 fluorodeoxyglucose (FDG) coincidence detection (CD) scans with computed tomographic (CT) scans for radiation treatment planning and case management. Methods F-18 FDG CD and chest CT scans, performed in 10 randomly selected patients with confirmed or possible adenocarcinoma of the lung, were evaluated. The quality of the matches was verified by comparisons of the center-to-center distance between a region of interest (ROI) manually drawn on the CT slice and warped onto the CD slice with an ROI drawn manually directly on the CD slice. In addition, the overlap between the two ROIs was calculated. Results All 10 F-18 FDG CD and CT scans were registered with good superimposition of soft tissue density on increased radionuclide activity. The center-to-center distance between the ROIs ranged from 0.29 mm to 8.08 mm, with an average center-to-center distance of 3.89 mm ± 2.42 mm (0.69 pixels ± 0.34 pixels). The ROI overlap ranged from 77% to 99%, with an average of 90% ± 5.6%. Conclusions Although the use of F-18 FDG CD shows great promise for the identification of tumors, it shares the same drawbacks as those associated with radiolabeled monoclonal antibody SPECT and ligand-based positron emission tomographic scans in that anatomic markers are limited. This study shows that image registration is feasible and may improve the clinical relevance of CD images.
Numbers, Especially Lucky Ones
Authors: Hugh H. Hussey
Journal: JAMA (1976)

Ever since men stopped counting objects on their fingers or with sets of pebbles or the like, written numbers have been important in advancing knowledge and causing a certain fascination. Men march by numbers, use them in gambling, play with them in creative delight. Not surprisingly, as with many things that foster special intellectual curiosity, superstitions have surrounded special numbers. For example, 13 emits an air of unluckiness or unease for many persons. Even those who flout triskaidephobia seem superstitious in their own way. In contrast, three is considered a very lucky number except by persons who believe that ills befall in threes or by persons who are involved in what is romantically called the eternal triangle. Although, the origins of the superstitions are unknown, 13 may have a bad odor because of the Scriptures' account of the Last Supper and the events that followed it or because witches "gathered
Note on Certain "Dermoid" Cysts
Authors: G. A. Wright
Journal: BMJ (1896)

MEDICAL JOURNAL of February ist, that he has found it so useful in gthe method of wound treatment there described.Others have not been so favourably impressed with its 'value in cases of major operations; but possibly they have not applied it properly, or have not used a solution of the -right strength.Not being engaged in surgical practice, I -cannot speak of its value as a permanent coating over the incision wounds after surgical operations, but in minor sur- gery and in a number of trivial but troublesome affections of the skin, it is of the greatest service.In the case of cuts, puncture wounds, excoriations, etc., especially of the hanids, it forms a useful, dry, permanent .coatingand dressing.For the deep cracks and fissures in
Fate of Coronary Chronic Total Occlusion Recanalization via Subintimal Tracking With Bioresorbable Vascular Scaffolds: A Temporary Cage for a Permanent New Lumen?
Authors: Alessio La Manna, Yohei Ohno, Guilherme F. Attizzani, Alberto Chisari, Giuseppe Giacchi, Davide Capodanno, Corrado Tamburino
Journal: JACC. Cardiovascular imaging (2014)
The pressure-flow relation in the canine coronary artery: combined effects of critical stenosis and intracoronary thrombosis
Authors: P. R. Belcher, I. Vergroesen, A. J. Drake-Holland, M. I.M. Noble
Journal: Cardiovascular Research (1995)

Objective: To characterise the effect of coronary intra-arterial thrombosis upon the downstream vascular bed. Background: The vascular response downstream from a coronary intra-arterial thrombus has not previously been characterised. We postulated that downstream vasoconstriction might result from the presence of endothelial damage with consequent growth of platelet-rich thrombus. Methods: We measured the pressure gradient and flow across, and the pressure/flow ratio distal to, a canine left circumflex artery stenosis with and without endothelial damage causing intracoronary thrombosis. We also observed the effects of transient complete occlusions. Results: At occlusion, the pressure gradient was maximal; relief of occlusion caused a rapid increase flow and distal pressure with a rapid decrease in stenosis pressure gradient and resistance. Subsequently there was a period of stable stenosis resistance with pressure gradient and flow declining; distal pressure therefore increased at this time. Finally in the thrombus group only, stenosis resistance increased again towards re-occlusion. During occlusion, distal pressure averaged 49 ± 18 mmHg in the presence of thrombus vs. 22 ± 4 mmHg in its absence (P < 0.001). Following release of occlusion, the flow increased faster than distal pressure, so that the ratio (distal pressure/flow) fell rapidly. Subsequently, distal pressure continued to increase after flow had reached a peak and begun to decline, suggesting vasoconstriction. In the presence of thrombus, the distal pressure/flow ratio was higher than in the absence of thrombus, both at maximal vasodilatation (P < 0.005) and at maximum vasoconstriction (P < 0.025). Conclusions: During cyclic flow variations the stenosis resistance changes are exactly as expected from thrombus growth and embolisation. The distal pressure/flow ratio showed a time-dependent increase which appeared greater when conditions favoured intracoronary thrombosis.
Effects of Intense and Prolonged Exercise on Insulin Sensitivity and Glycogen Metabolism in Hypertensive Subjects
Authors: Caroline Rhéaume, Paulo-Henrique Waib, N’Guessan Kouamé, André Nadeau, Yves Lacourcière, Denis R. Joanisse, Jean-Aimé Simoneau, Jean Cléroux
Journal: Circulation (2003)

The information that insulin sensitivity and glycogen synthesis are reduced in hypertension arises primarily from studies using insulin infusions. Whether glycogen metabolism is actually altered in a physiological condition, such as during and after prolonged exercise, is currently unknown.To examine this issue, 9 hypertensive and 11 normotensive subjects were evaluated on a rest day and after intense and prolonged exercise on a separate day. Insulin sensitivity and hemodynamic variables were measured on both days. On the exercise day, whole-body substrate utilization was assessed and muscle biopsies were taken in the leg at baseline, immediately after exercise, and 2.5 and 4 hours after exercise. Insulin sensitivity at rest was lower in hypertensive than normotensive subjects (P<0.05) and increased after exercise in normotensive (P<0.01) but not in hypertensive (P=NS) subjects. Leg blood flow increased after exercise in both groups but to a lesser extent in hypertensive than normotensive subjects. Baseline glycogen content and maximal glycogen synthase activity were higher in hypertensive than normotensive subjects (P<0.001). Glycogen concentration decreased relatively less (-35 versus -66%) and returned to baseline levels faster in hypertensive subjects after exercise. Hypertensive subjects used approximately 40% less carbohydrates during exercise (P<0.001) at the expense of greater free fatty acid oxidation.It is concluded that increased intramuscular glycogen storage and resynthesis in hypertension are independent of blood flow and may represent compensatory mechanisms for the reduced insulin sensitivity and carbohydrate metabolism in this condition.
IN VITRO INDUCTION OF TUMOR-SPECIFIC IMMUNITY
Authors: Hermann Wagner, Martin Röllinghoff
Journal: The Journal of Experimental Medicine (1973)

Induction of tumor-specific immunity in vitro was accomplished by cocultivation of cortisone-resistant murine thymocytes or spleen cells with irradiated syngeneic plasma cell tumors (PCT). The cytotoxic activity generated could be detected in a short-term (51)Cr-release assay. Optimal cytotoxic activity against PCT-associated transplantation antigens (TATA) was generated after 7 days in culture. Unlike cytotoxic responses to tumor allografts in which the cytotoxic activity was directed against allogeneic transplantation antigens, the cytotoxic activity obtained in the syngeneic tumor system was specific to the immunizing syngeneic PCT. Similar parameters of induction of cytotoxic responses in in vitro tumor allograft responses and in the syngeneic tumor system suggested that both reactions are cell-mediated cytotoxic immune responses. With regard to the magnitude of cytotoxic responses obtained, allogeneic transplantation antigens induced about a 30-fold higher cytotoxic immune response than plasma cell TATA. The results are consistent with the concept that in vitro tumor allograft responses and in vitro responses against TATA of PCT are similar in quality, but differ in the magnitude of the cytotoxic response provoked.