tbuckley/cabot-search huggingface dataset:
S94 Tumour Necrosis Factor receptor 1 inhibition using a novel inhaled human antibody reduces inflammation in a human model of lung injury induced by inhaled lipopolysaccharide; a randomised placebo-controlled clinical trial: Abstract S94 Table 1.
Authors: CM O'Kane, A Bayliffe, A Serone, P Bareille, S Smith, U Hamid, V Brown, T Wright, Y Chen, R Wilson, JS Elborn, DF McAuley
Journal: Thorax (2013)

<h3>Introduction and Objectives</h3> Tumour Necrosis Factor receptor 1 (TNFR1) transduces the pro-inflammatory activity of TNF-α, whereas signalling through TNFR2 may contribute to tissue repair. Attenuation of TNFR1 signalling, whilst simultaneously preserving the effects of TNFR2 signalling, may be beneficial in management of acute lung injury (ALI). GSK1995057 is a novel, fully human antibody fragment (domain antibody) that selectively binds TNFR1 and antagonises signalling of TNF-α via TNFR1. The aim of this clinical study was to investigate the effect of nebulised GSK1995057 on pulmonary and systemic inflammation and cell injury in an <i><i>in vivo</i></i> human model of lung injury induced by inhaled lipopolysaccharide (LPS). <h3>Methods</h3> Healthy subjects were enrolled in a double-blind, placebo-controlled study and randomised to nebulised GSK1995057 or placebo (1:1) administered 1 hour prior to LPS inhalation. Measurements were performed in bronchoalveolar lavage (BAL) fluid obtained at 6 hours after LPS challenge (7 hours after dosing) and in serum obtained over 24 hours post dosing of GSK1995057. The primary endpoint was BAL neutrophil count at 6 hours post LPS exposure. Data are geometric mean (95% CI). <h3>Results</h3> Thirty-seven healthy subjects were enrolled. One subject in the placebo group was excluded from the analysis of BAL markers as the BAL was technically poor. Pre-treatment with inhaled GSK1995057 significantly reduced pulmonary and systemic markers of inflammation. In addition, there was a reduction in pulmonary vWF reflecting reduced endothelial cell injury/activation (Table 1). The prevalence of LPS-induced clinical symptoms (e.g. fever, nausea) was also lower in GSK1995057 treated subjects compared with placebo treated subjects. There were no serious adverse events related to study drug. <h3>Conclusion</h3> This is the first report that inhalation of a novel human antibody fragment directed against the TNFR1 receptor attenuates mechanisms implicated in the pathophysiology of ALI. GSK1995057 may be a potential therapy for ALI. ClinicalTrials.gov identifier: NCT01587807. This work was funded by GlaxoSmithKline.
Dangers of tinted glasses for driving.
Authors: M J Gilkes
Journal: BMJ (1976)

suggested by Mr Pearson and Miss Weaver, record many fewer movements per unit time than when they record for shorter periods.Presumably this is an effect of fatigue and reduced alertness.Recording during meals, conversation, reading, listening to music, etc, is not reliable.We instruct the women to assess and record each fetal movement for periods of 30-60 min three times a day.If the number of movements is less than three per hour the recording is continued for 6-12 hours in the day.From the sum of the movements recorded the rate per 12 hours-daily fetal movement recording (DFMR)-is calculated.Employing this method for a total of 1 5-3 hours a day the computed DFMR in 114 women with a normal outcome varied between 4 and 1440 per 12 hours.The majority of DFMRs were between 200 and 600 per 12 hours.In addition, the number of fetal movements recorded by an electromagnetic device' varied between 25 and 235 per hour.The patients recorded 87'. of
Immune response to type III group B streptococcal polysaccharide-tetanus toxoid conjugate vaccine.
Authors: D L Kasper, L C Paoletti, M R Wessels, H K Guttormsen, V J Carey, H J Jennings, C J Baker
Journal: Journal of Clinical Investigation (1996)

Group B Streptococcus (GBS) is an important perinatal pathogen. Because transplacentally acquired maternal antibodies to the GBS capsular polysaccharides (CPS) confer protection, prevention of infant disease may be possible after immunization of women. Unfortunately, the purified CPS of GBS are only variably immunogenic in adults; therefore to enhance immunogenicity we have designed and developed a CPS-protein conjugate vaccine. The lability of a conformationally dependent epitope on the III CPS containing a critical sialic acid residue was important to consider in vaccine design. 100 women were randomized to receive GBS type III CPS-tetanus toxoid conjugate (III-TT) vaccine at one of three doses; unconjugated GBS type III CPS; or saline. Serum samples were obtained before immunization and 2, 4, 8, and 26 wk thereafter, and specific antibody to type III CPS was measured. Vaccines were well tolerated. In sera from recipients of the highest dose of III-TT, CPS-specific IgG levels rose from a geometric mean of 0.09 microg/ml before immunization to 4.53 microg/ml 8 wk later, whereas levels in recipients of unconjugated type III CPS rose from 0.21 microg/ml to 1.41 microg/ml. Lower doses resulted in lower antibody levels. A > or = 4-fold rise in antibody concentration was achieved in 90% of recipients of III-TT compared with 50% of those that received III CPS (P = 0.0015). Antibodies evoked by the conjugate vaccine recognized a conformationally dependent epitope of the III-CPS, promoted opsonophagocytosis and killing of GBS, and, after maternal immunization, protected neonatal mice from lethal challenge with type III GBS. We conclude that directed coupling of type III GBS polysaccharide to a carrier protein yielded a conjugate vaccine with preserved expression of a highly labile conformational epitope involving sialic acid and enhanced immunogenicity compared with uncoupled CPS.
Cost-Effectiveness of Radiofrequency Ablation for Supraventricular Tachycardia
Authors: Carol H.F. Cheng, Gillian D. Sanders, Mark A. Hlatky, Paul Heidenreich, Kathryn M. McDonald, Byron K. Lee, Mary S. Larson, Douglas K. Owens
Journal: Annals of Internal Medicine (2000)

Background: Radiofrequency ablation is an established but expensive treatment option for many forms of supraventricular tachycardia. Most cases of supraventricular tachycardia are not life-threatening; the goal of therapy is therefore to improve the patient's quality of life. Objective: To compare the cost-effectiveness of radiofrequency ablation with that of medical management of supraventricular tachycardia. Design: Markov model. Data Sources: Costs were estimated from a major academic hospital and the literature, and treatment efficacy was estimated from reports from clinical studies at major medical centers. Probabilities of clinical outcomes were estimated from the literature. To account for the effect of radiofrequency ablation on quality of life, assessments by patients who had undergone the procedure were used. Target Population: Cohort of symptomatic patients who experienced 4.6 unscheduled visits per year to an emergency department or a physician's office while receiving long-term drug therapy for supraventricular tachycardia. Time Horizon: Patient lifetime. Perspective: Societal. Interventions: Initial radiofrequency ablation, long-term antiarrhythmic drug therapy, and treatment of acute episodes of arrhythmia with antiarrhythmic drugs. Outcome Measures: Costs, quality-adjusted life-years, life-years, and marginal cost-effectiveness ratios. Results of Base-Case Analysis: Among patients who have monthly episodes of supraventricular tachycardia, radiofrequency ablation was the most effective and least expensive therapy and therefore dominated the drug therapy options. Radiofrequency ablation improved quality-adjusted life expectancy by 3.10 quality-adjusted life-years and reduced lifetime medical expenditures by $27 900 compared with long-term drug therapy. Long-term drug therapy was more effective and had lower costs than episodic drug therapy. Results of Sensitivity Analysis: The findings were highly robust over substantial variations in assumptions about the efficacy and complication rate of radiofrequency ablation, including analyses in which the complication rate was tripled and efficacy was decreased substantially. Conclusions: Radiofrequency ablation substantially improves quality of life and reduces costs when it is used to treat highly symptomatic patients. Although the benefit of radiofrequency ablation has not been studied in less symptomatic patients, a small improvement in quality of life is sufficient to give preference to radiofrequency ablation over drug therapy.
Regenerative Medicine: Additively Manufactured Device for Dynamic Culture of Large Arrays of 3D Tissue Engineered Constructs (Adv. Healthcare Mater. 6/2015)
Authors: Pedro F. Costa, Dietmar W. Hutmacher, Christina Theodoropoulos, Manuela E. Gomes, Rui L. Reis, Cédryck Vaquette
Journal: Advanced Healthcare Materials (2015)

The ability to test large arrays of cell/biomaterial combinations in 3D environments is still rather limited. On page 864 D. W. Hutmacher and co-workers present a method and device combining additive manufacturing and bioreactor technologies which enable the generation and culture of arrays of 3D tissue engineered constructs in a highly automated and reproducible way.
Marxism, the Theory of Complementarity, and Medical Care
Authors: Bernard S. Bloom
Journal: Annals of Internal Medicine (1988)

Editorials15 September 1988Marxism, the Theory of Complementarity, and Medical CareBernard S. Bloom, PhD, William L. Kissick, MD, DrPHBernard S. Bloom, PhDSearch for more papers by this author, William L. Kissick, MD, DrPHSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-6-446 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptNiels Bohr, the Danish 1922 Nobel Laureate in Physics, advanced the theory of complementarity to explain light as a wave or a pulse. Although theories of physics are tested by precise instrumentation, social theories are more subjectively evaluated.Medicine is usually perceived as a biological science that uses rigorous methods. As we move beyond homeostasis, the double helix, and the principles of the autoimmune system, where do we turn for guidance with economic, political, social, cultural, and techno-scientific parameters of the health care enterprise? Quality, cost, equity, and access become predominant issues in the domain of the soft sciences.Drs....References1. HimmelsteinWoolhandler DS. The corporate compromise: a marxist view of health maintenance organizations and prospective payment. Ann Intern Med. 1988;109:494-501. LinkGoogle Scholar2. BlendanAltman RD. Public attitudes about health care costs. New Eng J Med. 1984;311:613-6. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Bernard S. Bloom, PhD; William L. Kissick, MD, DrPHAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBohr's Principle of ComplementarityStephen J. Clark, MDPhysicians and the Economics of PracticeCharles E. Andrews Jr., MD 15 September 1988Volume 109, Issue 6Page: 446-448KeywordsHealth careHealth economicsHeart rate ePublished: 1 December 2008 Issue Published: 15 September 1988 PDF downloadLoading ...
John Kenneth Wright
Authors: B. Peach
Journal: BMJ (2003)

Consultant orthopaedic surgeon Fylde 1956-78 (b Haslingden 1918; q Manchester 1942), d 19 March 2003.​2003.




Figure 1




Ken completed his house jobs at Manchester Royal Infirmary, before joining the Royal Air Force early in 1943. For a time he was a medical officer in a squadron that was part of the famous “Dam Busters.” In late 1943 he was posted to India and Burma, returning home in 1946. He became a lecturer in orthopaedics before being appointed to the Fylde. A great raconteur and wit with an impish sense of humour, he enjoyed many varied hobbies, including shooting, fishing, and patenting engineering inventions. He leaves a wife, Vicky; two children; and seven grandchildren.
Balance between oxidative damage and proliferative potential in an experimental rat model of CCl4-induced cirrhosis: Protective role of adenosine administration
Authors: R Hernandez-Munoz, M Diaz-Munoz, V Lopez, F Lopez-Barrera, L Yanez, S Vidrio, A Aranda-Fraustro, V C de Sanchez
Journal: Hepatology (1997)

Oxidative stress and its consequent lipid peroxidation (LP) exert harmful effects, which have been currently involved in the generation of carbon tetrachloride-induced cirrhosis. However, the recent report that “physiological” LP can be associated with liver regeneration (LR) makes it necessary to discriminate between oxidative stress-induced and LR-associated LP. In rats rendered cirrhotic by continuous CCl 4 administration for 4 weeks, moderate cell necrosis and fine fatty infiltration were found. The histological abnormalities were accompanied by increased LP, mainly accounted for by the microsomal and cytosolic fractions and evidence of oxidative stress (decreased hepatic glutathione content and changes in xanthine oxidase and pentose phosphate pathway activities). After 8 weeks, a micronodular cirrhosis developed, but oxidative stress was greatly attenuated, only persisting in the enhanced LP confined to microsomes. Simultaneous administration of adenosine, a reliable hepatoprotector that readily prevents the onset of liver fibrosis, was able to block the oxidative stress induced by the long-term CCl 4 treatment but elicited a selective subcellular distribution of increased LP, similar to that found during LR. The adenosine-induced changes in liver LP (mainly in the nuclear fraction) correlated with an increased activity of thymidine kinase. Therefore, data suggest that adenosine-mediated preservation of energy availability and mitochondrial function could participate in preventing the onset of oxidative stress in cirrhotic rats. The latter could induce a successful liver recovery, curtailing the sequence of events leading to fibrogenesis.
The Wisdom and Justice of Not Paying for “Preventable Complications”
Authors: Peter J. Pronovost
Journal: JAMA (2008)

FAR TOO MANY PATIENTS EXPERIENCE PREVENTABLE HARM from medical care in US hospitals. To promote quality and safety, many employers and insurers are linking financial incentives to clinical performance. These programs, often called pay for performance, use a carrot (pay more for better quality) or a stick (pay less for lower quality). To date, most pay-for-performance programs have encouraged physicians to use evidence-based interventions or improve patient satisfaction. The Centers for Medicare & Medicaid Services (CMS) has taken the lead, with many insurers following, in linking pay for performance to reducing harm. In October 2008, hospitals will no longer derive additional payments they sometimes receive when Medicare patients develop 1 of the following 8 preventable complications: objects (such as surgical instruments or sponges) left in patients after surgery, hospital-acquired urinary tract infections, central line–associated bloodstream infections, administration of incompatible blood products, air embolism, patient falls, mediastinitis after cardiac surgery, and pressure ulcers. In addition, CMS has published that conditions being considered for 2009 expansion of the list include ventilator-associated pneumonia, Staphylococcus aureus septicemia, and deep venous thrombosis or pulmonary embolism. The tacit assumption to the “not paid for preventable complications” approach is that an error occurred in a patient’s care that, if avoided, would have prevented the harm and ensuing costs. For one complication on the CMS list, foreign objects inadvertently left in patients after surgery, this is undeniably true. Linking errors to harm for the remaining complications is more complex. For strategies built around the “not paid for preventable complications” concept to be clinically and morally acceptable and to achieve the policy goal of improving quality of care, it must be certain that preventable complications are important and measurable and truly are preventable. In this Commentary, we discuss the CMS initiative in the context of these metrics. Complications Should Be Important and Measurable
Rwanda after the holocaust
Authors: S Brandon, K Craig
Journal: BMJ (1994)

We were invited by a small charity called Friends in the West to visit Rwanda to advise on a training programme for those dealing with the victims of violence. The slaughter of perhaps one million people in a war lasting only a few weeks has left Rwanda traumatised. Families have been separated as almost everyone was forced to flee, many to refugee camps. Essential services collapsed and diseases were widespread.

The Hutu dominated government fled taking all the convertible assets; it continues to pay its soldiers in refugee camps, where they are fed by the World Food Programme and terrorise refugees who wish to return to Rwanda. The victorious, largely Tutsi Rwandan Patriotic Front has formed a government in Kigali, which is committed to recovery and reconciliation but has limited resources.

* “The centre looked like a prison camp surrounded by security wire.”

Despite all this there is an air of optimism, and the returning refugees, the opening of the markets, and the first signs of rebuilding are beginning to transform the capital. Generators are providing electricity in vital areas and the bodies have been cleared from the streets. The worst of the epidemics have been contained except in the refugee camps.

Thousands of children have lost or been separated from their families. The government refuses to describe them as orphans, preferring the term unaccompained children, and it calls the places where they are being cared for children's centres. Many children have not yet found their …
Mitral Stenosis and Pregnancy.
Authors: J. A. McDonell
Journal: JAMA (1894)

Chicago, Oct. 13, 1894. <h3>To the Editor:</h3> Some years ago there came to my consulting room a young woman, bride of two summers, wife of a prominent criminal lawyer. She was in her third month of utero-gestation, and consulted me regarding an annoying cough, dyspnea and a slight hemoptysis, the latter on the morning of the day she called at my office. From facial landmarks I feared my visitor a tuberculous subject. Her penciled-like eyebrows, long, silken eye-lashes, clear sclerotics, rather prominent cheek bones, and slender tapering fingers all pointing in that direction, but mark you my surprise when I placed a stethoscope over the heart and found I had a pronounced case of mitral stenosis; this told the story of how the sputum came to be tinged with blood We know that the auricle must accommodate for the defect, and if it does so imperfectly, the accumulation of the
Practicing Medicine without a License — The New Intrusions by Congress
Authors: Jerome P. Kassirer
Journal: New England Journal of Medicine (1997)

Something new is happening in Washington: Congress is practicing medicine. In recent months, Congress overwhelmingly passed legislation forcing health plans to pay for 48-hour hospital stays for women delivering babies, passed a resolution promoting mammography for women in their forties, and passed a bill outlawing abortions by intact dilation and extraction (“partial-birth abortions”).On February 4, just weeks after a National Cancer Institute (NCI) Advisory Panel found the value of mammography for women in their forties equivocal, Senator Arlen Specter of Pennsylvania (an attorney), declared that “even though the evidence may be in doubt in the minds of some scientists, . . .
Wedged hepatic venous pressure adequately reflects portal pressure in hepatitis C virus-related cirrhosis
Authors: Àngels Escorsell, Concepció Bru, Rosa Gilabert, Eduardo Moitinho, Juan Carlos García-Pagán, Jaume Bosch
Journal: Hepatology (1999)

Wedged hepatic venous pressure (WHVP) is equivalent to portal venous pressure in patients with alcoholic liver diseases. However, it may underestimate portal pressure in nonalcoholics, which is important because hepatitis C virus (HCV) infection is a frequent cause of chronic liver disease. We investigated the agreement between directly measured portal pressure and WHVP in alcoholic and HCV-related liver diseases. Seventy-one patients with liver disease resulting from HCV infection (n = 32), alcohol (n = 25), or both (n = 14) underwent simultaneous measurements of WHVP (by hepatic vein catheterization) and portal pressure (by direct puncture). In 9 patients, measurements were repeated 20 minutes after acute iv propranolol administration. WHVP showed an excellent agreement with portal pressure in patients with cirrhosis resulting from either HCV, alcohol or both (intraclass correlation coefficient: 0.94, 0.93, and 0.97, respectively; P <.001). A discrepancy of >/=5 mm Hg was observed in 7 cases. WHVP underestimated portal pressure in only 1 case and exceeded portal pressure by >/=5 mm Hg in 6 patients. The WHVP response to propranolol closely and significantly correlated with changes in portal pressure (intraclass correlation coefficient: 0.87; P <.004). The simple and safe measurement of WHVP accurately reflects portal pressure in alcoholic and HCV-related liver disease. This technique also allows us to accurately assess the portal pressure response to propranolol in both alcoholic and HCV-related cirrhosis.
Results and efficiency of programmed ventricular stimulation with four extrastimuli compared with one, two, and three extrastimuli.
Authors: J D Hummel, S A Strickberger, E Daoud, M Niebauer, O Bakr, K C Man, B D Williamson, F Morady
Journal: Circulation (1994)

BACKGROUND Conventional programmed ventricular stimulation protocols are inefficient compared with more recently proposed protocols. The purpose of the present study was to determine if additional efficiency could be derived from a 6-step programmed ventricular stimulation protocol that exclusively uses four extrastimuli. METHODS AND RESULTS The subjects were 209 consecutive patients with coronary artery disease and documented sustained monomorphic ventricular tachycardia, nonsustained ventricular tachycardia, aborted sudden death, or syncope. These patients underwent 159 electrophysiological tests in the absence of antiarrhythmic drug therapy and 105 electrophysiological tests in the presence of antiarrhythmic therapy. Programmed stimulation was performed with two protocols in random order in each patient. Both protocols used an eight-beat drive train, 4-s intertrain pause, and basic drive cycle lengths of 350, 400, and 600 ms. The 6-step protocol started with coupling intervals of 290, 280, 270, and 260 ms, which were shortened simultaneously in 10-ms steps until S2 was refractory. The 18-step protocol used one, two and three extrastimuli in conventional sequential fashion. The end points were 30 s of sustained monomorphic ventricular tachycardia, two episodes of polymorphic ventricular tachycardia requiring cardioversion, or completion of the protocol at two right ventricular sites. There was no significant difference in the yield of sustained monomorphic ventricular tachycardia using the two protocols, regardless of the clinical presentation or treatment with antiarrhythmic drugs. Polymorphic ventricular tachycardia occurred with the 18-step protocol twice as frequently as with the 6-step protocol (6% versus 3%, P &lt; .001). The duration of the 18-step protocol was significantly longer than that of the 6-step protocol in patients with inducible ventricular tachycardia (5.5 +/- 7 versus 2.3 +/- 2 minutes, P &lt; .001), as well as in patients without inducible ventricular tachycardia (25.4 +/- 7 versus 6.9 +/- 2 minutes, P &lt; .001). CONCLUSION A stimulation protocol that exclusively uses four extrastimuli improves the specificity and efficiency of programmed ventricular stimulation without compromising the yield of monomorphic ventricular tachycardia in patients with coronary artery disease.