tbuckley/cabot-search huggingface dataset:
Treatment of Agranulocytosis during Pregnancy with Antibiotics, ACTH and Cortisone
Authors: Oliver H. Durand, Curtis M. Flory, Woodhull S. Hall
Journal: New England Journal of Medicine (1955)

SEVEN cases of agranulocytosis treated with ACTH or cortisone have been reported in the literature.1 2 3 4 Of these patients 6 recovered, and 1 died. The report of an additional case so treated follows.Case ReportA 32-year-old housewife was admitted to the hospital with an illness of 4 days' duration characterized by low fever, increasing pharyngitis and severe malaise.On physical examination the throat was severely inflamed, with many scattered patches of adherent membrane. She was extremely hoarse and coughing, and there was respiratory stridor. Throat smear and culture showed only a nondescript mixture of Streptococcus viridans, nonhemolytic streptococcus and yeast . . .
Tumor Growth Rate as Diagnostic Test for Lung Cancer
Authors: M. H. Nathan
Journal: JAMA (1974)

<h3>To the Editor. —</h3> Contrary to K. Moser's editorial (227:1167, 1974), I think the management decisions in these cases are not easy, but evaluation of<i>all</i>available information will be helpful, and "statistics" in this situation should not be considered a dirty word. K. Moser states that my "comments about 'unnecessary surgery' based on statistics alone become inappropriate (if not frankly erroneous) when applied to management of the individual patient," but Dr. Moser will be unable to find in my article any such indication that decisions for or against surgery are based on statistics alone. Dr. Moser's misleading statement that my survival data concern "metastatic, not primary, lesions of the lung" is assumed to be the result of careless reading rather than an effort to discredit the paper. The same is true of some of his other statements: he takes out of context my inclusion of all forms of bronchogenic
Osteogenic differentiation of rabbit mesenchymal stem cells in thermo-reversible hydrogel constructs containing hydroxyapatite and bone morphogenic protein-2 (BMP-2)
Authors: Kun Na, Sung won Kim, Bo Kyung Sun, Dae Gyun Woo, Han Na Yang, Hyung Min Chung, Keun Hong Park
Journal: Biomaterials (2007)
Rates of Progression in Diabetic Retinopathy During Different Time Periods
Authors: Tien Y. Wong, Mkaya Mwamburi, Ronald Klein, Michael Larsen, Harry Flynn, Marisol Hernandez-Medina, Gayatri Ranganathan, Barbara Wirostko, Andreas Pleil, Paul Mitchell
Journal: Diabetes Care (2009)

This meta-analysis reviews rates of progression of diabetic retinopathy to proliferative diabetic retinopathy (PDR) and/or severe visual loss (SVL) and temporal trends.This systematic literature review and meta-analysis of prospective studies assesses progression of retinopathy among diabetic patients without treatment for retinopathy at baseline. Studies published between 1975 to February 2008 were identified. Outcomes of interest were rates of progression to PDR and/or SVL. Pooled baseline characteristics and outcome measures were summarized using weighted averages of counts and means. Baseline characteristics and outcomes were compared between two periods: 1975-1985 and 1986-2008.A total of 28 studies comprising 27,120 diabetic patients (mean age 49.8 years) were included. After 4 years, pooled incidence rates for PDR and SVL were 11.0 and 7.2%, respectively. Rates were lower among participants in 1986-2008 than in 1975-1985. After 10 years, similar patterns were observed. Participants in 1986-2008 studies had lower proportions of PDR and non-PDR at all time points than participants in 1975-1985 studies.Since 1985, diabetic patients have lower rates of progression to PDR and SVL. These findings may reflect an increased awareness of retinopathy risk factors; earlier identification and initiation of care for patients with retinopathy; and improved medical management of glucose, blood pressure, and serum lipids. Differences in baseline characteristics, particularly in the prevalence and severity of retinopathy, could also have contributed to these temporal differences.
NCS-1 in the Dentate Gyrus Promotes Exploration, Synaptic Plasticity, and Rapid Acquisition of Spatial Memory
Authors: Bechara J. Saab, John Georgiou, Arup Nath, Frank J.S. Lee, Min Wang, Aubin Michalon, Fang Liu, Isabelle M. Mansuy, John C. Roder
Journal: Neuron (2009)
Tenure in Medical Schools
Authors: Charles L. Witte
Journal: JAMA (1984)

<h3>To the Editor.—</h3> Petersdorf's sweeping attack on tenure is both misguided and dangerous. Tenure, when shorn of elitist and grandiose overtones, simply entitles faculty members to review by a disinterested tribunal before adverse job decisions are rendered final—a protection routinely afforded physicians before dismissal from hospital practice privileges. Even then, administrative hearings are nonbinding on the president or board, who may and often do overrule "in-house" recommendations. No matter how polemics may cloud the issue, elimination of the fair-play doctrine of tenure permits unfettered administrative power to hire and fire and, with it, a chilling effect on free expression. Not only does Petersdorf underplay the need to protect medical faculty from external influences (politics), but he also fails to address the more pernicious issue of intimidation from within. Authoritarianism traditionally permeates medical thinking and practice, and the huge sums of money concentrated in modern academic health centers makes the pressure
Addict died after rapid opiate detoxification
Authors: C. Dyer
Journal: BMJ (1998)

A heroin addict who survived the IRA bus bombing in London last year died as a result of ‘inadequate care’ after rapid opiate detoxification treatment at a private hospital, an inquest jury decided last week. But the jury delivered a verdict of ‘misadventure.’

Addiction specialists called for a review of the controversial treatment after the death of Brendan Woolhead, …
Insulin and Hypertension: Lessons from Obesity
Authors: Lewis Landsberg
Journal: New England Journal of Medicine (1987)

Hyperinsulinemia is a well-recognized if incompletely understood concomitant of obesity. Diminished sensitivity to the effects of insulin on glucose uptake and metabolism in skeletal muscle, commonly referred to as "insulin resistance," is known to contribute to the hyperinsulinemia of obesity by evoking an increase in pancreatic insulin secretion in order to maintain euglycemia. Decreased hepatic extraction of insulin in obese persons appears to be involved as well, as a consequence of increased levels of free fatty acids in the portal blood.1 A primary increase in insulin secretion mediated by the pancreatic nerves, and a secondary increase in response to excessive . . .
One‐Step Photo Synthesis of Protein–Drug Nanoassemblies for Drug Delivery
Authors: Jinbing Xie, Yi Cao, Mao Xia, Xiang Gao, Meng Qin, Jiwu Wei, Wei Wang
Journal: Advanced Healthcare Materials (2013)

Upon controlled UV illumination, disulfide bonds in bovine α-lactalbumin (BLA) are selectively broken, leading to self-assembly of the BLA and doxorubicin (DOX) molecules into nanoparticles via hydrophobic interactions and intermolecular disulfide bonds. Such protein–drug nanoparticles have synergistic anticancer activity in vitro and tumor-homing specificity in vivo, which are of great potential for systemic drug delivery in cancer therapy. As a service to our authors and readers, this journal provides supporting information supplied by the authors. Such materials are peer reviewed and may be re-organized for online delivery, but are not copy-edited or typeset. Technical support issues arising from supporting information (other than missing files) should be addressed to the authors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Localized arterial wall drug delivery from a polymer-coated removable metallic stent. Kinetics, distribution, and bioactivity of forskolin.
Authors: T L Lambert, V Dev, E Rechavia, J S Forrester, F Litvack, N L Eigler
Journal: Circulation (1994)

BACKGROUND Coronary stenting is associated with two major complications: subacute thrombosis and neointimal proliferation resulting in restenosis. Our hypothesis is that the biocompatibility of metallic stents can be improved by coating with a polymer membrane that delivers agents that favorably modify the local arterial microenvironment. This study evaluates the kinetics, distribution, and bioactivity of the model drug forskolin delivered to the local arterial wall by a polyurethane-coated removable metallic stent. METHODS AND RESULTS Stents were used in rabbit carotid arteries (n = 20) for as long as 24 hours. The quantity of forskolin bound to the stent decreased exponentially with a half-life of 5.8 hours. Blood concentrations peaked at 140 +/- 39 pg/microL at 4 hours. The adjacent arterial media contained 60 +/- 39 ng/mg, which was 380- and 460-fold greater than the contralateral carotid media and the systemic blood, respectively (P &lt; .0001). Media forskolin concentrations declined exponentially over time with a tissue half-life of 5.0 hours. Drug distributed throughout the vessel wall with decreasing gradients in the radial and axial dimensions consistent with a diffusion process. Removal of the stent was associated with a 100-fold decline in media forskolin concentration within 2 hours. Forskolin release was associated with a sustained 92% increase in carotid blood flow and a 60% decrease in local arterial resistance compared with coated control stents (P &lt; .005). In another set of rabbits (n = 14) using a carotid crush injury, flow-reduction model, forskolin prolonged the time to flow variation and occlusion by 12-fold compared with the use of bare metal stents and 5-fold compared with the use of polyurethane-coated stents (P &lt; .0001). CONCLUSIONS A polymer-coated metallic stent can deliver forskolin to the local arterial wall in high concentrations relative to the blood or other tissues. High local drug concentrations are dependent on maintaining stent-to-tissue gradients. The delivered drug is biologically active, demonstrating vasodilating and antiplatelet properties.
IL-2 receptor α−/− mice and the development of primary biliary cirrhosis
Authors: Kanji Wakabayashi, Zhe-Xiong Lian, Yuki Moritoki, Ruth Y. Lan, Koichi Tsuneyama, Ya-Hui Chuang, Guo-Xiang Yang, William Ridgway, Yoshiyuki Ueno, Aftab A. Ansari, Ross L. Coppel, Ian R. Mackay, Eric M. Gershwin
Journal: Hepatology (2006)

Recently, we identified a child born with a genetic deficiency of IL-2 receptor α (IL-2Rα, CD25) expression who had several clinical manifestations of primary biliary cirrhosis (PBC). In addition, there has been suggestive evidence in both patients with PBC and their first-degree relatives that a deficiency of regulatory T cells (Tregs) is an integral component for susceptibility to PBC. Based on these observations, we generated IL-2Rα/CD25 deficient (IL-2Rα−/−) mice and wild-type littermate controls and followed them longitudinally for the natural history of liver immunopathology and appearance of antimitochondrial antibodies (AMAs). The analyses included immunohistochemical staining of liver and portal tract infiltrates as well as FACS profiles of lymphoid subpopulations in liver and spleen. In addition, serum cytokine profiles were quantitated. Importantly, IL-2Rα−/−, but not littermate controls, develop portal inflammation and biliary ductular damage similar to human patients with PBC. CD4+ and CD8+ T cells predominate among portal cell infiltrates and sera reflect a Th1 cytokine bias with increased levels of IFN-γ, TNF-α, IL-2 and IL-12p40. Of importance is the finding that the IL-2Rα−/− mice not only develop significantly increased serum levels of IgG and IgA, but they also develop AMAs with specificity for PDC-E2, which maps to the inner lipoyl domain of the autoantigen, all characteristics which are hallmarks of human PBC. In conclusion , the IL-2Rα−/− mice should facilitate studies of the early events in PBC and especially the tantalizing connection between Treg deficiency and autoimmunity specifically directed to mitochondrially located PDC-E2 and subsequent biliary ductular cell damage.
Naked DNA Transfer of Factor VIII Induced Transgene-Specific, Species-Independent Immune Response in Hemophilia A Mice
Authors: Peiqing Ye, Arthur R. Thompson, Rita Sarkar, Zhenping Shen, David P. Lillicrap, Randal J. Kaufman, Hans D. Ochs, David J. Rawlings, Carol H. Miao
Journal: Molecular Therapy (2004)

The development of antibodies to a previously unexpressed protein product may limit the success of human gene therapy approaches. We inserted B-domain-deleted factor VIII (FVIII) cDNA of human, canine, or murine origin into the multiple cloning site of a liver-specific vector, pBS-HCRHPI-A, to yield plasmids pBS-HCRHPI-FVIIIA, pBS-HCRHPI-cFVIIIA, and pBS-HCRHPI-mFVIIIA, respectively. Fifty micrograms of each plasmid in 2 ml of solution was rapidly injected into the tail vein of three groups of hemophilia A mice. Factor VIII levels ranging from 3 to 12 IU/ml were obtained from all three groups (normal is 1 IU/ml in human plasma) 3 days after treatment. These initial very high levels of functional human, canine, or murine factor VIII, however, fell gradually to undetectable levels within 2-3 weeks, and their disappearance correlated with the generation of high-titer, inhibitory anti-FVIII antibodies. Notably, this immune response occurred independent of the species of origin of the exogenous factor VIII. Antibody titers to factor VIII were detected beginning at 2 weeks, reached a plateau and remained at high levels for over 6 months. The majority of anti-hFVIII IgG was IgG1 isotype specific, suggesting a humoral response mediated by Th2-induced signals. Consistent with this idea, in a separate group of mice treated with pBS-HCRHPI-FVIIIA, transient immunosuppression by cyclophosphamide significantly delayed (5/6) or abolished (1/6) inhibitory antibody formation against the transgene.
"Variations" in health
Authors: R. G Wilkinson
Journal: BMJ (1995)

Variations" in healthThe costs ofgovernment timidity From time to time researchers working on health inequalities listen with envy to stories from distant lands about open, all party talks organised by governments wanting to know what can be done to reduce inequalities in health.Last year the British government took its courage in both hands and unbarred the door to admit a small deputation of experts to talk about reducing the health divide.Political safety was ensured by limiting the discussion to what the NHS and the Department of Health could do.Poverty, housing, job insecurity, the inner cities, the rationing of health services, and other embarrassing problems were left outside, and the experts agreed to adopt their hosts' view of political correctness by referring to health "variations" rather than "inequalities." Their report, published this week, is a welcome opening of negotiations.'Although the evidence suggests that health services are not major contributors to health inequalities, the report's recommendations are worth while.As well as saying that health authorities should monitor health variations, target resources, ensure equal access, and evaluate inter- ventions, the report also says a little (not enough) about the responsibilities of the NHS as the country's largest employer and-most crucially-emphasises the Department of Health's responsibility for informing the government of the impact of other aspects ofpolicy on health.
NHS internal market 1991-2: towards a balance sheet.
Authors: R Petchey
Journal: BMJ (1993)

The first year of the internal market in the NHS has been claimed to have resulted in increased efficiency. These claims, however, are hard to substantiate because the systems for operating the market are not fully in place. Examination of data on tax relief for private health insurance premiums for over 60s, general practice fundholding, and implementation and transaction costs suggest that much of the increased efficiency is not due to the reforms but to increased funding. Furthermore, some of the changes seem to be decreasing market forces and reducing efficiency.
Pellagroide Dermatosen an Geisteskranken. Mit besonderem Hinblick auf das Vorkommen solcher bei Schizophrenen und mit Beiträgen zur Beleuchtung gewisser ätiologiscrer und pathogenetischer Verhältnisse bei Dementia Præcox und Pellagra. By<i>Padul J. Reiter</i>and<i>Jakob Jakobsen.</i>(Levin &amp; Munksgaard, Kopenhagen; Georg Thieme Verlag, Leipzig, 1935.)
Authors: J. Notkin
Journal: American Journal of Psychiatry (1936)
A fatal case of low titer anti‐PR cold agglutinin disease
Authors: Steven R. Rousey, Roy E. Smith
Journal: American Journal of Hematology (1990)

Abstract Cold agglutinin disease typically produces a low‐grade hemolytic anemia. We describe herein the unusual occurrence of an anti‐PR cold agglutinin with high thermal amplitude which caused significant and ultimately fatal hemolytic anemia at very low titers.
Non-linear dynamics and chaotic indices in heart rate variability of normal subjects and heart-transplanted patients
Authors: S. Guzzetti, M. G. Signorini, C. Cogliati, S. Mezzetti, A. Porta, S. Cerutti, A. Malliani
Journal: Cardiovascular Research (1996)

Heart rate variability (HRV) is characterised by a variety of linear, non-linear, periodical and non-periodical oscillations. The aim of the present study was mainly to investigate the role played by neural mechanisms in determining non-linear and non-periodical components.Analysis was performed in 7 recently heart transplanted patients and in 7 controls of similar age whose HRV signal was collected during 24 h. Parameters that quantify non-linear dynamic behaviour, in a time series, were calculated. We first assessed the specific non-linear nature of the time series by a test on surrogate data after Fourier phase randomization. Furthermore, the D2 correlation dimension, K2 Kolmogorov entropy, and H self-similarity exponent of the signal were estimated. From this last parameter, the dimension D = 1/H can be obtained. In order to assess whether the dynamics of the system are compatible with chaotic characteristics, the entire spectrum of Lyapunov exponents was calculated. We used return maps to graphically represent the non-linear and non-periodical behaviours in patients and controls.Surrogate data suggest that the HRV time courses have unique non-linear characteristics. D2, K2 and 1/H parameters were significantly lower in transplanted subjects than in controls. Positivity of the first Lyapunov exponent indicates divergence of trajectories in state-space. Furthermore, the display of return maps on projections obtained after Singular Value Decomposition, especially in low-complexity data (as in transplanted patients), shows a structure which is suggestive of a strange attractor. These findings support the hypothesis that chaotic dynamics underlie HRV.These results indicate that non-linear dynamics are likely to be present in HRV control mechanisms, giving rise to complex and qualitatively different behaviours. System complexity decreases in transplanted patients and this may be related to loss of the neural modulation of heart rate.
Conservative Radiation Therapy for Advanced Disease
Authors: Franz Buschke
Journal: JAMA (1973)

We radiotherapists are historically conditioned to approach the treatment of neoplasms in a surgical spirit: our standard of success is the five-year "cure", ie, the eradication of unifocal disease. Most of the confusion with regard to the lymphomas, I believe, may be traced to this basic mode of thinking. These lymphomas cannot be viewed this way. They represent systemic diseases (with the possible exception of some lymphosarcomas, eg, tonsil, nasopharynx, stomach, ileocecal region); the approach should not be guided by the surgical aim of cure, but by the internist's aim of providing enjoyable life. The more regular use of sophisticated diagnostic evaluation (lymphogram, abdominal exploration, splenectomy) has shown that the overwhelming majority of patients (70%) are in stage III when first seen, supporting the assumption that Hodgkin's disease is a systemic disease. The treatment of advanced disease thus becomes more and more important from the point of view of prognosis
P173 Ambulatory Management Of Spontaneous Pneumothorax
Authors: K. Thomas, M. Naeem, R. Reddy
Journal: Thorax (2014)

<h3>Introduction</h3> There is no clear consensus on the management of Spontaneous pneumothorax. BTS recommends insertion of chest drain following failure of initial aspiration in large primary spontaneous pneumothorax (PSP) and in all patients with symptomatic/ large secondary spontaneous pneumothorax (SSP). These patients are usually admitted to hospital following chest drain insertion. <h3>Objective</h3> To study the feasibility and safety of early discharge of spontaneous pneumothorax patients requiring chest drain on the ambulatory pathway with a Heimlich valve (pneumostat device). <h3>Methods</h3> Patients were initially managed as per BTS guidelines. Patients who had a chest drain inserted were admitted until review by the respiratory team. All PSP patients and some SSP patients with good performance status (WHO scale 0–1) were eligible for the ambulatory pathway. Those with continuing air leak are fitted with a Heimlich valve and discharged home. They were reassessed every two days with a CXR on arrival in the ambulatory care unit. The chest drain was removed once the air leak stopped for at least 24 h. <h3>Results</h3> 21 episodes of spontaneous pneumothorax in 18 patients (10 PSP and 8 SSP) were treated on the ambulatory pathway between May’13 and June’14. The healthcare usage of patients on ambulatory pathway is listed in the table. The pneumothorax resolved successfully in 82% (17 episodes). There were three recurrences requiring repeat management on the ambulatory pathway. A total of 10 patients were referred to the surgeon including four with continuing air leak and six due to recurrence. Patients with continuing air leak remained in the community until admission for thoracic surgery. Complications included pain in two patients and allergic reaction to the dressing used in one patient. The patient with allergic reaction had accidental dislodgement of chest drain during dressing change necessitating reinsertion of chest drain. <h3>Conclusion</h3> It is feasible for most patients with large PSP and many patients with SSP to be managed on an ambulatory care pathway with a Heimlich valve until their pneumothorax heals or is definitively treated. <h3>Reference</h3> Fanny Voisin <i>et al</i>. Ambulatory management of spontaneous pneumothorax with pigtail catheters. http://dx.doi.org.10.1016/j.annemergmed.2013.12.017
CHI ratings and HSMRs: is there a relation?
Authors: Brian Jarman, Paul Aylin, Alex Bottle
Journal: BMJ (2004)

The measurement of acute hospital performance is an issue of intense political interest. In England, the Department of Health has published star ratings for NHS units based on a range of different indicators. This system, in which higher numbers of stars (up to a maximum of three) are intended to indicate higher quality, has now been extended to cover other NHS organisations. The Commission for Health Improvement (CHI) (now subsumed into the Healthcare Commission) also conducts on-site inspections that give hospitals scores for a variety of issues related to quality of care. 

First we analysed whether there is a relation between the star ratings and hospital standardised mortality …