tbuckley/cabot-search huggingface dataset:
Cost effectiveness of shortening screening interval or extending age range of NHS breast screening programme: computer simulation study
Authors: R. Boer, H. de Koning, A. Threlfall, P. Warmerdam, A. Street, E. Friedman, C. Woodman
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objective</b> : To compare the cost effectiveness of two possible modifications to the current UK screening programme: shortening the screening interval from three to two years and extending the age of invitation to a final screen from 64 to 69. <b>Design</b> : Computer simulation model which first simulates life histories for women in the absence of a screening programme for breast cancer and then assesses how these life histories would be changed by introducing different screening policies. The model was informed by screening and cost data from the NHS breast screening programme. <b>Setting</b> : North West region of England. <b>Main outcome measures</b> : Numbers of deaths prevented, life years gained, and costs. <b>Results</b> : Compared with the current breast screening programme both modifications would increase the number of deaths prevented and the number of life years saved. The current screening policy costs £2522 per life year gained; extending the age range of the programme would cost £2612 and shortening the interval £2709 per life year gained. The marginal cost per life year gained of extending the age range of the screening programme is £2990 and of shortening the screening interval is £3545. <b>Conclusions</b> : If the budget for the NHS breast screening programme were to allow for two more invitations per woman, substantial mortality reductions would follow from extending the age range screened or reducing the screening interval. The difference between the two policies is so small that either could be chosen.
Proinflammatory cytokines in hypersensitivity pneumonitis.
Authors: M Denis
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

We examined the synthesis and release of the proinflammatory cytokines macrophage inflammatory protein-1 alpha (MIP-1 alpha) and interleukin-8 (IL-8) in the context of subjects with hypersensitivity pneumonitis (HP). Subjects with acute HP were found to have alveolar macrophages that released high levels of MIP-1 alpha and IL-8, whereas control subjects had cells that released low levels of these factors. Bronchoalveolar lavage fluid from HP subjects contained low but significant levels of MIP-1 alpha and IL-8. Immunohistochemistry revealed that macrophages from acute HP subjects expressed MIP-1 alpha and IL-8 at high levels. Treatment of acute HP subjects by contact avoidance or by corticosteroids reduced the synthesis of both cytokines. Supernatants of alveolar macrophages from subjects with HP were shown to attract activated CD8+ T lymphocytes, and this activity was significantly inhibited by anti-MIP-1 alpha. MIP-1 alpha and IL-8 may be important inflammatory cytokines in the development of HP via their capacity to attract inflammatory cells (activated CD8+ T lymphocytes and neutrophils, respectively) into the airways of subjects with HP.
Regional 99m technetium diphosphonate uptake in experimental dog heart infarcts: relation to duration and severity of ischaemia
Authors: T. PETER, R. M. NORRIS, M. K. HENG, N. L. SAMMEL
Journal: Cardiovascular Research (1979)

Regional uptake of 99mTechnetium diphosphonate was compared with regional myocardial blood flow 6, 12, and 24 h after the onset of myocardial infarction in dogs, and with regional creatine kinase depletion 24 h after the onset. Uptake of the imaging agent increased from 6 to 24 h, but no consistent relationship could be demonstrated between regional myocardial blood flow and regional uptake of the diphosphonate nor between uptake and regional creatine kinase depletion at the centre or border of the infarct. In addition, inappropriately high levels of 99m Technetium uptake could be demonstrated in the epicardial layer of the normal tissue surrounding the infarct. We conclude that diphosphonate uptake is not quantitatively related to the severity of ischaemia, and that use of this substance for imaging may over-estimate myocardial infarct size.
Introduction to the social security system.
Authors: S Ennals
Journal: BMJ (1990)

better.That's how America came to spend 12% of gross domestic product to produce a medical system that is no better than anyone else's.It even has some rather serious deficiencies.If we were to introduce a true market-even insurance based-we would produce very well paid doctors and a very expensive system, but I doubt we'd produce any more quality.General practitioners and health authorities are much more informed customers of services than any patient, whether here or in the States.JR: What's your vision for 10 or 20 years from now? KC: That we've retained the principle of universal access to the highest possible quality care.How high we can get depends on politicians, doctors, administra- tors, and others in the service.I don't imagine the system I introduced will be permanent.Nothing is, of course.I do believe that nobody will go back on things like clinical audit, measurement of quality, better resource management.These are tools to discovering better ways of doing things.
New ideas in asthma and allergy research: creating a multidisciplinary graduate school
Authors: Bengt Björkstén, Göran Graninger, Gunilla Jacobsson Ekman
Journal: Journal of Clinical Investigation (2003)

The spring term of 2001 saw the start of a new, unique graduate research training program at the Centre for Allergy Research at the Karolinska Institutet in Stockholm, Sweden. The program was created to bridge the gaps between basic, clinical, social, and behavioral sciences and to establish a global approach to the study of asthma and allergy. A reflection, two years on, discusses the strategies that are key to this model’s success and the challenges in introducing a multidisciplinary research program.
Colestipol-Niacin Therapy and Coronary Atherosclerosis-Reply
Authors: David H. Blankenhorn
Journal: JAMA (1987)

ABSTRACT In Reply.— In response to Dr Mann, 719 patients were screened at a first clinic visit and 346 were excluded before the prerandomization drug trial. Among the 373 patients who entered the drug pretrial, 19% chose not to continue in the study because of medication-related symptoms, 9% were excluded because of an insufficient drop in cholesterol level, and 3% found the medication routine too burdensome. Multiple reasons for exclusion were frequent; the percentages given indicate major reasons.We believe that weight loss was unlikely to have contributed to change in atherosclerosis except as it contributed to change in blood lipid and lipoprotein levels, because an analysis that considered all patients showed no significant association between weight loss and global change score. Following Dr Mann's suggestion, we tested for a weight loss effect, comparing patients with a 2.25-kg or greater weight loss vs all other patients (all patients combined and also
A Mental Health Intervention for Schoolchildren Exposed to Violence
Authors: Bradley D. Stein, Lisa H. Jaycox, Sheryl H. Kataoka, Marleen Wong, Wenli Tu, Marc N. Elliott, Arlene Fink
Journal: JAMA (2003)

No randomized controlled studies have been conducted to date on the effectiveness of psychological interventions for children with symptoms of posttraumatic stress disorder (PTSD) that has resulted from personally witnessing or being personally exposed to violence.To evaluate the effectiveness of a collaboratively designed school-based intervention for reducing children's symptoms of PTSD and depression that has resulted from exposure to violence.A randomized controlled trial conducted during the 2001-2002 academic year.Sixth-grade students at 2 large middle schools in Los Angeles who reported exposure to violence and had clinical levels of symptoms of PTSD.Students were randomly assigned to a 10-session standardized cognitive-behavioral therapy (the Cognitive-Behavioral Intervention for Trauma in Schools) early intervention group (n = 61) or to a wait-list delayed intervention comparison group (n = 65) conducted by trained school mental health clinicians.Students were assessed before the intervention and 3 months after the intervention on measures assessing child-reported symptoms of PTSD (Child PTSD Symptom Scale; range, 0-51 points) and depression (Child Depression Inventory; range, 0-52 points), parent-reported psychosocial dysfunction (Pediatric Symptom Checklist; range, 0-70 points), and teacher-reported classroom problems using the Teacher-Child Rating Scale (acting out, shyness/anxiousness, and learning problems; range of subscales, 6-30 points).Compared with the wait-list delayed intervention group (no intervention), after 3 months of intervention students who were randomly assigned to the early intervention group had significantly lower scores on symptoms of PTSD (8.9 vs 15.5, adjusted mean difference, - 7.0; 95% confidence interval [CI], - 10.8 to - 3.2), depression (9.4 vs 12.7, adjusted mean difference, - 3.4; 95% CI, - 6.5 to - 0.4), and psychosocial dysfunction (12.5 vs 16.5, adjusted mean difference, - 6.4; 95% CI, -10.4 to -2.3). Adjusted mean differences between the 2 groups at 3 months did not show significant differences for teacher-reported classroom problems in acting out (-1.0; 95% CI, -2.5 to 0.5), shyness/anxiousness (0.1; 95% CI, -1.5 to 1.7), and learning (-1.1, 95% CI, -2.9 to 0.8). At 6 months, after both groups had received the intervention, the differences between the 2 groups were not significantly different for symptoms of PTSD and depression; showed similar ratings for psychosocial function; and teachers did not report significant differences in classroom behaviors.A standardized 10-session cognitive-behavioral group intervention can significantly decrease symptoms of PTSD and depression in students who are exposed to violence and can be effectively delivered on school campuses by trained school-based mental health clinicians.
Reduction of Mortality in General Medical In-patients by Low-Dose Heparin Prophylaxis
Authors: HILLEL HALKIN
Journal: Annals of Internal Medicine (1982)

The effect of prophylactic low-dose heparin on mortality was tested in 1358 consecutive patients admitted to the medical wards of an acute care hospital. Eligibility for treatment or exclusion was ascertained on admission by predefined contraindications. Eligible patients with even-number hospital records were assigned to treatment (5000 U twice daily), those with odd-number records served as controls. Because determination of eligibility was open to bias, evaluation of treatment was based on comparison of the total even-number group (669 patients, of which 411 were treated with heparin), and the total odd-number group (689 patients, none treated with heparin). Mortality was significantly lower in the even-number group-7.8% (52 of 669 patients) versus 10.9% (75 of 689 patients) in the odd-number group; the difference increased consistently with length of hospitalization (p = 0.025). The estimated reduction in mortality attributable to heparin was 31.1%. We believe that low-dose heparin prophylaxis is appropriate in all immobilized medical patients who are not at risk of bleeding.
558 RESTORATION OF VIRUS SPECIFIC T CELL MEMORY IN CHRONIC HBV INFECTION: IMPLICATIONS FOR OPTIMIZATION OF ANTIVIRAL-THERAPY
Authors: C. Boni, D. Tola, D. Laccabue, A. Zerbini, A. Penna, T. Giuberti, V. Precone, G.B. Gaeta, G. Missale, C. Ferrari
Journal: Journal of Hepatology (2009)
The study of sequence configuration and functional impact of the (AC)<i><sub>n</sub></i>(AT)<i><sub>x</sub></i>T<i><sub>y</sub></i> motif in human β‐globin gene promoter
Authors: P.K. Chan, E.S.K. Ma, S. Philipsen, K.C. Tan‐Un
Journal: American Journal of Hematology (2006)

Abstract In this report we examine the (AC) n (AT) x T y motif residing −530 bp 5′ upstream of the β‐globin gene in Chinese thalassaemic patients. This motif is a putative binding site for a repressor protein, termed beta protein 1 (BP1) (Berg et al., Nucleic Acids Res 1989;17:8833–8852). Variations in the (AC) n (AT) x T y repeats affect the binding affinity of BP1, thereby altering the expression of the β‐globin gene. Eight different configurations of this repeat motif are identified in our population of Chinese β‐thalassaemia patients. A (AC) 3 (AT) 7 T 5 motif was identified among these thalassaemia patients and its influence in β‐globin gene expression was studied using stable transfection assay in murine erythroleukemia (MEL) cells. Our data demonstrated that the (AC) 3 (AT) 7 T 5 motif has a moderately strong repressor effect on the expression of the cis‐linked β‐globin gene. The high affinity of BP1 for this motif may result in the suppression of the transcription of the β‐globin gene (Berg et al., Am J Hematol 1991;36:42–47). We postulate that silencer elements in the β‐globin promoter play an important role in modifying the clinical presentation of the disease. Am. J. Hematol., 2007. © 2006 Wiley‐Liss, Inc.
Implementation of the Essentials of Approved Internships and Residencies
Authors: George H. Reifenstein
Journal: JAMA (1965)

The "Essentials of Approved Internship" and the "Essentials of Approved Residencies"<sup>1</sup>are offered as guides to the staffs of hospitals conducting intern and resident programs and are the bases on which their training potential is evaluated. These are minimum standards which should apply wherever there is an approved program. The question has been raised whether there should be a different set of essentials for so-called community teaching hospitals. In those hospitals where there may not be a large full-time faculty, where the majority of patients used in teaching may be private, and where university affiliations are tenuous, it is more important that the essentials be implemented or fortified, rather than revised, particu larly to illustrate ways in which educational goals beyond a minimum may be obtained. <h3>Selection of Teaching Staff</h3> A successful internship or residency program cannot be developed if the teaching staff is not deliberately selected. Members should
Effects of Antibiotic Therapy on Outcomes of Patients With Coronary Artery Disease
Authors: Richard Andraws, Jeffrey S. Berger, David L. Brown
Journal: JAMA (2005)

Although Chlamydia pneumoniae infection has been associated with the initiation and progression of atherosclerosis, results of clinical trials investigating antichlamydial antibiotics as adjuncts to standard therapy in patients with coronary artery disease (CAD) have been inconsistent.To conduct a meta-analysis of clinical trials of antichlamydial antibiotic therapy in patients with CAD.The MEDLINE and Cochrane Central Register of Controlled Trials databases were searched from 1966 to April 2005 for English-language trials of antibiotic therapy in patients with CAD. Bibliographies of retrieved articles were searched for further studies. Presentations at major scientific meetings (2003-2004) were also reviewed. Search terms included antibacterial agents, myocardial infarction, unstable angina, and coronary arteriosclerosis.Eligible studies were prospective, randomized, placebo-controlled trials of antichlamydial antibiotic therapy in patients with CAD that reported all-cause mortality, myocardial infarction, or unstable angina. Of the 110 potentially relevant articles identified, 11 reports enrolling 19,217 patients were included.Included studies were reviewed to determine the number of patients randomized, mean duration of follow-up, and end points. End points of interest included all-cause mortality, myocardial infarction (MI), and a combined end point of MI and unstable angina.Event rates were combined using a random-effects model. Antibiotic therapy had no impact on all-cause mortality among treated vs untreated patients (4.7% vs 4.6%; odds ratio [OR], 1.02; 95% confidence interval [CI], 0.89-1.16; P = .83), on the rates of MI (5.0% vs 5.4%; OR, 0.92; 95% CI, 0.81-1.04; P = .19), or on the combined end point of MI and unstable angina (9.2% vs 9.6%; OR, 0.91; 95% CI, 0.76-1.07; P = .25).Evidence available to date does not demonstrate an overall benefit of antibiotic therapy in reducing mortality or cardiovascular events in patients with CAD.
Acute renal failure and rifampicin: danger of unsuspected intermittent dosage.
Authors: C T Flynn, D J Rainford, E Hope
Journal: BMJ (1974)

1973) and possibly shock hypotension are responsible for the acute oliguria.This may be mediated by an immune reaction, for patients on an intermittent regimen have high levels of circu- lating antirifampicin antibody (Aquinas et al., 1972).The patient's husband confinned her history and we believed that it was authentic.She had been taking rifampicin and sodium aminosalicylate regularly for 16 months and suffered a severe reaction only after taking three intermittent doses of rifampicin.This is apparently the first report of combined hepatic and renal toxicity due to rifampicin, and it also seems to be the first report to incriminate rifampicin taken alone.There have been reports of immediate severe reactions with the first intermittent dose after a previous daily regimen (Kleinknecht et al., 1972).Fortunately both the hepatic and renal toxic effects are re- versible but physicians and patients need to be aware of the hazards of intermittent rifampicin therapy, even after a period of regular therapy. References
WOMEN HAVE A HIGHER COMPLICATION RATE WHEN UNDERGOING ABLATION FOR ATRIAL FIBRILLATION
Authors: Aysha Arshad, Naga Vamsi Garikipati, Vijaya Praveena Paruchuri, Akshay Avula, Suneet Mittal, Jonathan S. Steinberg
Journal: Journal of the American College of Cardiology (2010)
Molecular Etiologies of Schizophrenia: Are We Almost There Yet?
Authors: David Goldman
Journal: American Journal of Psychiatry (2011)

Two articles in this issue of the Journal represent examples of what research is teaching usand not teaching us about the biological basis of schizophrenia.At best, they illustrate how discoveries in genetics and molecular neurobiology converge at the level of neural systems, and they exemplify progress via integrative approaches.At worst, they underline the very complexity of schizophrenia's nature and the failure of findings to always mesh in a simplistically pleasing way or to map against the disease as it is currently defined clinically.Both studies implicate γ-aminobutyric acid (GABA)/glutamate function, which itself has protean effects on activity of the dorsolateral prefrontal cortex and modulation of neurocircuits that have been implicated in schizophrenia (1).
Abstract P1-08-05: The prognostic significance of Ki-67 expression before and after neoadjuvant anthracycline-taxane-based chemotherapy in different biological breast cancer phenotypes
Authors: J Zhang, X Zhang, F Yu, J Liu, S Zhang, X Hao, G Hou
Journal: Cancer Research (2013)

Abstract Purpose This study was conducted to analyze the Ki-67 expression before and after neoadjuvant chemotherapy and clinical pathology characteristics of different biological breast cancer phenotypes at our center. A correlation study was performed between Ki-67 index change and the prognosis of different biological breast cancer phenotypes and prognosis in Northern China. Methods A regression analysis was performed on 213 patients with invasive breast carcinoma accepted NAC admitted to Tianjin Medical University Cancer Institute and Hospital of Breast Surgery from January 2007 to April 2008. These patients were subtyped by hormone receptor status and HER2 status.The Ki67 index (percentage of Ki67-positive cancer nuclei) were determined immunohistochemically. The prognostic value of the Ki-67 index for different biological breast cancer phenotypes disease-free survival (DFS) and overall survival (OS) was investigated by use of Kaplan–Meier curves and multivariable Cox regression. Results The overall pathologic CR (pCR) rate, defined as no invasive residuals in breast and axilla, was 17.8%. The highest pCR rate of 32.1% was observed in patients with HR-/HER2+ tumors, which is 11.4%, 20.0% and 26.2% in HR+/HER2- HR+/HER2-,HR+/HER2+and HR-/HER2- tumor respectively(P = 0.024).The Ki-67 expression of pre-NAC and post-NAC have prognostic significance in HER2- breast cancer, which have not significance different in HER2+ breast cancer:The best Ki-67 idex cut point of pre-NAC and post-NAC to predict long-term survival was respectively 20% and 10% in HR+/HER2- breast cancer. Moreover, patients with a higher Ki-67 index (&amp;gt; cut-off point) showed significantly lower 5year-DFS/OS rates compared with those whose Ki-67 index were below cut-off point. In addition, Ki-67 index of post-NAC were independent prognostic factors for 5 year disease-free survival of patients with HR+/HER2- breast cancer. Ki-67 change between pre- and post-NAC as an independent prognostic factor independently predict prognosis in the patients who have not achieved pCR, while the best cut-off point was 18%. Conclusion The Ki-67 index of pre- and post-NAC could predict the prognosis in the patients with HER2- breast cancer. Moreover, the Ki-67 change between pre- and post-NAC was an independent prognostic factor in the patients who have not achieved pCR. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-08-05.
Measuring blood pressure in the elderly: Authors' reply
Authors: D Sykes, K Donovan, R Dewar, F Nicklason, K Mohanaruban, D Thomas, D Fisher
Journal: BMJ (1990)

of deterioration and a low risk of surgical compli- cations whether she was or was not taking anti- coagulant drugs.I would have offered burr hole aspiration of the fluid component of the haematoma, and I feel the authors should not be congratulated for the recovery of their patient.It will always be difficult to balance the risks of surgery for intracranial haematomas, particularly in patients receiving anticoagulation, but I hope that their report will not encourage clinicians routinely to manage such haematomas conserva- tively.
Indirect comparisons: a novel approach to assessing the effect of anti-HIV drugs
Authors: J. D Lundgren
Journal: BMJ (2004)

The need to evaluate rapidly and provide access to anti-HIV drugs led, in 1997, to an expedited drug approval process, based on short term trials using viral load and CD4 cell counts as surrogate end points for clinical AIDS. The evidence for efficacy of many drugs is therefore based solely on trials using such end points, but it is useful to evaluate studies using clinical end points where available.

Yazdanpanah and coworkers used an indirect comparison of clinical outcomes from randomised controlled trials to compare the effects of drugs from either the protease inhibitor or the non-nucleoside reverse transcriptase inhibitor (NNRTI) class with two nucleoside reverse transcriptase inhibitors (nucleosides). …
THE ORMATION OF VACUOLES DUE TO BACILLUS TYPHOSUS IN THE CELLS OF TISSUE CULTURES OF THE INTESTINE OF THE CHICK EMBRYO
Authors: Margaret Reed Lewis
Journal: The Journal of Experimental Medicine (1920)

The introduction of Bacillus typhosus into the hanging drop of a tissue culture of the intestine of a chick embryo leads to the rapid vacuolation of the cells of the tissues which comprise the growth of the cultures. The cells of the connective tissue, the endodermal membrane, the mesothelium, and also the clasmatocytes exhibit the ability to ingest Bacillus typhosus in the cultures.