tbuckley/cabot-search huggingface dataset:
Delayed Access to Health Care: Risk Factors, Reasons, and Consequences
Authors: Joel S. Weissman, Robert Stern, Stephen L. Fielding, Arnold M. Epstein
Journal: Annals of Internal Medicine (1991)

Objective: To determine characteristics of patients reporting delays in care before hospitalization and the reasons for those delays. Design: Survey; personal interviews. Setting: Five hospitals in Massachusetts. Patients: Subjects were drawn from a consecutive sample of all adult patients (excluding obstetrics or psychiatry patients) hospitalized during the first 6 months of 1987 as part of a larger study of hospital costs. For the current study, if patients were re-admitted, we included in our analysis only data on the first admission during the study period. We obtained usable survey data from 12 068 of 17 231 eligible patients. Results: Delays in care were reported by 16% of patients. The odds of reporting delays in care among patients who were black, poor, uninsured, or without a regular physician were 40% to 80% greater than those for other patients (P < 0.01). Most patients who reported delays thought that their problem was not serious (64%). Cost was an important factor in delaying care for patients in lower socioeconomic positions; the odds of delaying care because of cost for patients who were both poor and uninsured were 12 times greater than the odds for other patients (P < 0.0¼1). After controllingfor diagnosis-related groups (DRGs) and severity, patients who reported delays had 9% longer hospital stays compared with others (P < 0.001). Conclusions: Patients generally thought to be disadvantaged are at especially high risk for delaying care for conditions that eventually lead to hospitalization. Because these delays are associated with longer hospital stays and potentially poorer health outcomes, interventions that reduce delays seem especially important.
SOME ASPECTS OF THE MEDICAL CURRICULUM OF TO-DAY AND OF TO-MORROW
Authors: A. W. MEYER
Journal: JAMA (1910)

That he who makes a prophecy risks his reputation, is an old adage. I accept its truth. However, only he who hath can lose. Moreover, it is not my purpose to suggest or to forecast an ideal curriculum, but simply to discuss certain aspects of present-day curricula in our stronger medical schools, and to call attention to changes which may be anticipated, or perhaps found advisable, even now. Others may be necessitated in the future— likely in the near future—while some have already been incorporated by a few of the leading medical schools of the country. It is indeed to be regretted that there is such a distance between the vanguard and the rear-guard of our medical schools, and that the curricula of many of them have undergone so few transitions outside of those necessitated by the very recent changes in requirements for admission. To be sure, change does not
Regulation of high density lipoprotein receptor activity in cultured human skin fibroblasts and human arterial smooth muscle cells.
Authors: J F Oram, E A Brinton, E L Bierman
Journal: Journal of Clinical Investigation (1983)

Cultured human skin fibroblasts and human arterial smooth muscle cells possess high-affinity binding sites specific for high density lipoproteins (HDL). Results from the present study demonstrate that binding of HDL to these sites is up-regulated in response to cholesterol loading of cells. When fibroblasts or smooth muscle cells were preincubated with nonlipoprotein cholesterol, cellular binding of 125I-HDL3 was enhanced severalfold. This enhancement was sustained in the presence of cholesterol but was readily reversed when cells were exposed to cholesterol-free medium. The stimulatory effect of cholesterol treatment was prevented by cycloheximide, suggesting the involvement of protein synthesis. Kinetic analysis of HDL3 binding showed that prior exposure to cholesterol led to an induction of high-affinity binding sites on the cell surface. In the up-regulated state, the apparent dissociation constant (Kd) of these sites was approximately 2 micrograms protein/ml. Competition studies indicated that the HDL binding sites recognized either HDL3 or HDL2 but interacted weakly with low density lipoprotein (LDL). Exposure of cells to lipoprotein cholesterol in the form of LDL also enhanced HDL binding by a process related to delivery of sterol into cells via the LDL receptor pathway. Enhancement of HDL binding to fibroblasts by either nonlipoprotein cholesterol or LDL was associated with an increased cell cholesterol content, a suppressed rate of cholesterol synthesis, decreased LDL receptor activity, and an enhanced rate of cholesterol ester formation. A comparison of HDL3 binding with the effects of HDL3 on cholesterol transport from cells revealed similar saturation profiles, implying a link between the two processes. Thus, cultured human fibroblasts and human arterial smooth muscle cells appear to possess specific receptors for HDL that may function to facilitate cholesterol removal from cells.
Methylenetetrahydrofolate reductase (MTHFR) gene 677C&gt;T and 1298A&gt;C polymorphisms are associated with differential apoptosis of leukemic B cells in vitro and disease progression in chronic lymphocytic leukemia
Authors: H Nückel, U H Frey, J Dürig, U Dührsen, W Siffert
Journal: Leukemia (2004)
The Lung and Its Disorders in the Newborn Infant
Authors: Robert H. High
Journal: JAMA (1965)

This monograph, the first in a series planned to survey problems in clinical pediatrics, has been prepared by a clinician and investigator well known in the field of pediatrics. It is to be hoped that subsequent volumes achieve the excellent qualities of this first one.  The book has three major sections, of which the first, comprising about 25% of the volume, deals with normal development and physiology of the fetal and neonatal lung. Much of this section discusses pulmonary function in newborn infants. Attention is given to various methods of determining pulmonary function and to the limitations of these methods.  The second part, about one half of the entire monograph, deals with disorders of respiration in the newborn period. The common as well as uncommon problems are described, and these descriptions are often supplemented by tables, illustrations, and roentgenograms. Major emphasis is directed to hyaline membrane disease, the leading cause
Jacopone da Todi's mystical pathology.
Authors: L J Bruce-Chwatt
Journal: BMJ (1982)

With St Francis of Assisi (1181-1226) a new element entered into the spirit of the Catholic church. It took the form of an experience of divine presence and gave rise to a wave of Fran? ciscan mysticism, with its dramatic sense of mystery, its desire for a union with the Infinite, its relation to all living things, and, above all, its emphasis on humility and poverty. Mysticism, in the sense of a direct communion with God and in the conviction that all things in the universe are manifestations of the eternal being, reflects the ancient ideas of Buddhism and Hinduism. It found its European sources in Plato and in Plotinus, the founder of Neoplatonism. According to this philosophy, various forces including the human soul, shape the matter, and man should return to the union with God by rejecting from his life all that is worldly before reaching the final exaltation of spiritual fulfilment. The early Christian mystics headed by St Paul and St Augustine took the example from the Judaic tradition of Isaiah and Ezekiel. Among the disciples and followers of St Francis the group known as Franciscan Tertiaries was remarkable.1 They willingly accepted the rule of voluntary poverty and became, like the master, twice-born souls. One of them, Jacopone da Todi, holds a special place, not only in the Catholic hagiography but also in the history of Italian literature.2 3 To a medical historian some aspects of his life and work are of particular interest because of the extraordinary morbid streak of his penitence, through sickness and pain, before the dissolu? tion of his bodily form in the metaphysical absolute. Jacopone da Todi (Jacopo de Benedetti) was born in Todi, Umbria, in 1230 into a noble family. He was a successful and ambitious lawyer, married to the young and beautiful Lady Vanna. The two led the gay and carefree life of the rich con? temporary society until a tragic accident, when a wooden platform collapsed under the dancing crowd and Vanna was killed. On his wife's dead body Jacopone discovered under the elegant gown a penitent's hairshirt. This event led to Jacopone's conversion and changed his whole life. He devoted his remaining
The Septic Tank.
Authors: W. J. McGuigan
Journal: JAMA (1901)

Vancouver, B. C., Sept. 14, 1901. <h3>To the Editor:</h3> —In your issue of August 24, you refer to the sewage disposal at Stratford, Ont., which I understand is by means of the septic-tank system. Your remark that this is the only system of its kind in Ontario, and probably in Canada, is not quite correct, for I am sure that the city of Vancouver, B. C., was the first to introduce it into the Dominion. The septic-tank system has been in operation in Vancouver for six months and is giving the very best satisfaction. The neighboring city of Victoria is also installing it, and Seattle, Wash., is observing its operations closely with the view of adopting it in the near future, if in further time its success is fully demonstrative, which I thing is certain. So many inquiries have been made at the City Hall here about the workings of
Chronic pelvic pain in women
Authors: J. P. Daniels, K. S. Khan
Journal: BMJ (2010)

#### Summary points

Chronic pelvic pain in women is a debilitating condition that impairs quality of life. Studies using various definitions estimated that its prevalence ranges from 2.1% to 24% of the female population worldwide.1 It is a common presentation in UK primary care, with 38 per 1000 women affected annually—a rate comparable to those of asthma (37 per 1000) and back pain (41 per 1000).2 Because pelvic pain is associated with conditions such as endometriosis and interstitial cystitis, a diagnosis is often difficult to establish, leading to a delay in appropriate treatment. Social and psychological factors are strongly associated with chronic pelvic pain, so tailored, effective treatment can be challenging to provide.

#### Sources and selection criteria

We searched EMBASE and Medline for articles with titles that included the keywords “chronic pelvic pain” with the limits “meta-analysis, review and randomised controlled trial”. We restricted the search to articles published in English in the past five years. We identified all systematic reviews and trial citations in the Cochrane Library under the MeSH terms pelvic pain and dysmenorrhoea. Articles of interest cited in these papers were identified. Finally we reviewed published clinical guidelines from international pain associations and gynaecological societies and searched the National Guidelines Clearing House.

Chronic …
Abstract 100: The effect of synergic anti-proliferation of DNA methyltransferase inhibitor binding to anti-cancer drugs in gastric cancer
Authors: Kazuya Muguruma, Masakazu Yashiro, Hiroaki Tanaka, Kenjirou Kimura, Hisashi Nagahara, Ryousuke Amano, Eiji Noda, Naoshi Kubo, Nobuya Yamada, Kiyoshi Maeda, Masaichi Ohira, Tetsurou Ishikawa, Kosei Hirakawa
Journal: Cancer Research (2011)

Abstract Epigenetic alterations of DNA methylation play an important role in the regulation of gene expression associated with chemosensitivity of gastric carcinomas. With the aim of improving the chemotherapeutic efficacy of gastric carcinoma, the effect of DNA methyltransferase inhibitor, 5-aza-2′-deoxycytidine, on the chemosensitivity of five anti-cancer drugs was investigated. Human gastric cancer cell lines, OCUM-2M and MKN-74, and five anti-cancer drugs, 5-fluorouracil, paclitaxel, oxaliplatin, irinotecan, and gemcitabine, were used. In both gastric cancer cell lines, a synergistic anti-proliferative effect by a combination of 5-aza-2′-deoxycytidine at 5μ M was found in irinotecan or gemcitabine. 5-Aza-2′-deoxycytidine at 5μM increased apoptosis induced by irinotecan and gemcitabine in both cell lines. 5-Aza-2′-deoxycytidine increases the expression of DAPK-2 and DAPK-3, RASSF1, and THBS1 gene in both OCUM-2M and MKN-74 cells, but not that of hMLH1, p16, MGMT, E-cadherin, and p53 genes. These findings suggest that 5-aza-2′-deoxycytidine is a promising chemotherapeutical agent for gastric carcinomas in combination with anti-cancer drugs of irinotecan and gemcitabine in apoptosis signaling. The up-regulation of DAPK-2 and DAPK-3, RASSF1, and THBS1 genes by 5-aza-2′-deoxycytidine might be associated with the synergistic effect. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 100. doi:10.1158/1538-7445.AM2011-100
Small or Large Isolation Areas Around the Pulmonary Veins for the Treatment of Atrial Fibrillation?
Authors: Thomas Arentz, Reinhold Weber, Gerd Bürkle, Claudia Herrera, Thomas Blum, Jochem Stockinger, Jan Minners, Franz Josef Neumann, Dietrich Kalusche
Journal: Circulation (2007)

Pulmonary vein (PV) isolation is a promising new treatment for atrial fibrillation (AF). We hypothesized that isolation of large areas around both ipsilateral PVs with verification of conduction block is more effective than the isolation of each individual PV.A total of 110 patients, 67 with paroxysmal AF and 43 with persistent AF, were randomly assigned to undergo either isolation of each individual PV or isolation of large areas around both ipsilateral PVs. The isolation of each individual PV was an electrophysiologically guided, ostial segmental ablation with a 64-pole basket catheter or a 20-pole circular mapping catheter (group I). Isolation of large areas was performed around the 2 ipsilateral veins with a nonfluoroscopic navigation system and a circular 20-pole mapping catheter for verification of conduction block (group II). In both groups, an irrigated-tip ablation catheter (25 to 35 W) was used to achieve complete isolation. Procedure and ablation times were longer in group II, whereas fluoroscopic time was significantly shorter (P < or = 0.001). After a follow-up period of 15+/-4 months, 27 patients in group I (49%) and 37 patients in group II (67%) remained free of symptoms of AF and had no AF or atrial flutter during repetitive Holter monitoring without antiarrhythmic drug treatment after a single procedure (P < or = 0.05).The rate of success was significantly higher and fluoroscopy times were significantly lower in the group with large isolation areas around both ipsilateral PVs than in those who underwent individual PV isolation.
Interleukin-17-targeted treatment of alcoholic liver disease
Authors: Enzo Emanuele, Marco Bertona
Journal: Hepatology (2009)

We read with interest the article by Lemmers and colleagues recently published in HEPATOLOGY elegantly demonstrating that interleukin-17 (IL-17) may be pathogenically important in human alcoholic liver disease (ALD).1 The authors reported that IL-17 plasma levels were markedly raised in patients with alcoholic hepatitis and that peripheral blood cells disclosed an IL-17–secreting phenotype in this clinical entity. Additionally, liver infiltration with IL-17–secreting cell infiltrates seems to be a pathological hallmark of patients with ALD.1 Although the cornerstone for therapy for ALD remains lifestyle modification, the interesting question raised by the study of Lemmers et al. is whether targeting IL-17 might be a potential therapeutic strategy in alcoholic hepatitis. Here, we put forward a few possibilities that might be explored in this research area. First, a potential approach to inhibiting IL-17 signaling may be represented by the stimulation of retinoic acid receptor α, using all-trans retinoic acid (ATRA).2 Accordingly, animal studies have shown that ATRA can inhibit the differentiation of the effector T cell lineage Th-17 by promoting transforming growth factor-β signaling.3 Of note, ATRA has been already proven to be potentially useful for treatment of chronic hepatitis C,4 but no data are not yet available for its use in ALD. An alternative approach might be represented by supplementation with essential omega-3 fatty acids, which have a demonstrated IL-17–decreasing effect5 and whose potential usefulness to slow down liver injury has been already suggested.6 Of interest is also the observation that some therapies currently used in ALD are also capable of acting on the IL-17 pathway. In this regard, corticosteroids, which are effective in selected patients with alcoholic hepatitis,7 have been shown to reduce IL-17 expression.8 Additionally, anti–tumor necrosis factor-α therapy, which has been suggested for some patients with ALD,7 can exert significant IL-17–decreasing effects.5 In summary, the authors are to be congratulated for having performed an interesting study that might stimulate research in IL-17–targeted treatment of ALD. Hopefully this can ultimately improve the quality of life of these patients and, in some cases, even decrease short-term mortality. Enzo Emanuele*, Marco Bertona*, * Interdepartmental Center for Research in Molecular Medicine (CIRMC), University of Pavia, Pavia, Italy.
Randomized trial of the effect of drug presentation on asthma outcomes: The American Lung Association Asthma Clinical Research Centers
Authors: Robert A. Wise, Susan J. Bartlett, Ellen D. Brown, Mario Castro, Rubin Cohen, Janet T. Holbrook, Charles G. Irvin, Cynthia S. Rand, Marianna M. Sockrider, Elizabeth A. Sugar
Journal: Journal of Allergy and Clinical Immunology (2009)
[570] MUTATIONS IN THE NATURAL STRAINS OF NS3 PROTEASE DOMAIN THAT CONFER RESISTANCE TO ANTI-HCV PROTEASE INHIBITORS IN HIV/HCV COINFECTED PATIENTS
Authors: S. Bagaglio, C. Uberti-Foppa, L. Alagna, C. Lodrini, G. Gallotta, L. Galli, S. Dispinseri, A. Lazzarin, G. Morsica
Journal: Journal of Hepatology (2007)
Diversity of autoantibodies in avian scleroderma. An inherited fibrotic disease of White Leghorn chickens.
Authors: D C Haynes, M E Gershwin
Journal: Journal of Clinical Investigation (1984)

University of California, Davis line 200 White Leghorn chickens develop an inherited progressive fibrotic disease that includes the appearance of antinuclear antibodies (ANA). To further characterize these ANA, serial aged line 200 birds were studied. Greater than 50% of line 200 birds develop antinuclear and anticytoplasmic antibodies; fluorescent staining patterns included cytoplasmic spider web, most prevalent at 1 mo of age, and fine speckled patterns, characteristic of chickens 6 mo and older. By enzyme-linked immunosorbent assay, 40.4% of line 200 birds were found to have antibodies to single-stranded DNA (ssDNA). In contrast, antibodies to histones, RNA, or poly A . poly U were not detected. Precipitating antibodies to saline extracts from chicken liver were noted in 33.3% of line 200 birds. Saline extracts from turkey, pheasant, and partridge liver but not rat, rabbit, or mouse tissues were also positive in immunodiffusion testing with these line 200 birds. The antigenicity of chicken liver extracts was sensitive to pronase, protease K. and pH variations greater than 10 and less than 5; however, they were resistant to trypsin. DNase. RNase, and incubation at 37 degrees C and 56 degrees C for 1 h. Cell fractionation in conjunction with column chromatographic techniques revealed that several protein antigens with apparent molecular weights in the range of 62,000-290,000 were present in cytoplasm but not in isolated nuclei. Line 200 sera were not reactive against nuclear ribonucleoprotein, Sm, Scl-70, or SS-B/La antigens. Thus, line 200 chickens develop antinuclear and anticytoplasmic antibodies at an early age, which recognize a unique group of protein antigenic determinants found only in avian species. Moreover, and of particular interest, the presence of autoantibodies to saline-extractable antigens correlated with positive ANA, antibodies in ssDNA, and to the clinical expression of disease.
RED CELL STROMA AND HEMOGLOBIN METABOLISM IN ANEMIC DOGS
Authors: G. H. Tishkoff, C. L. Yuile, F. S. Robscheit-Robbins, G. H. Whipple
Journal: The Journal of Experimental Medicine (1955)

Red cell stroma protein and hemoglobin can be labeled by feeding C(14) lysine during periods of active blood regeneration following anemia. Stroma proteins are produced and a maximum concentration of the C(14) label appears 2 to 3 days earlier than with hemoglobin,-which is to say that stroma building precedes hemoglobin construction. The concentration of isotope in stroma protein may exceed its concentration in hemoglobin during regeneration following anemia due to blood loss. Diets favorable for hemoglobin regeneration may force the hemoglobin isotope concentration above that of the stroma protein. In hemolytic anemias great reserves of red cell building material are stored in the body. These stores may modify the curves of isotope concentration in red cells during the recovery periods. When finally formed, the mature red cells show little or no evidence of participation in general body protein metabolism during their life in the circulation.
TCT-230 Instantaneous wave-Free Ratio (iFR) and Gradient (iFG): new promising adenosine-independent alternative to fractional flow reserve. Preliminary results from the FORECAST Study
Authors: Ciro Indolfi, Alberto Polimeni, Annalisa Mongiardo, Carmen Spaccarotella, Sabato Sorrentino, Jolanda Sabatino, Mariella Miceli, Salvatore Giampa, Antonio Curcio, Daniele Torella, Gianluca Caiazzo, Salvatore De Rosa
Journal: Journal of the American College of Cardiology (2012)
Therapeutic concentrations of glucocorticoids suppress the antimicrobial activity of human macrophages without impairing their responsiveness to gamma interferon.
Authors: A Schaffner
Journal: Journal of Clinical Investigation (1985)

By exposing human blood-derived macrophages and alveolar macrophages in vitro to dexamethasone, we showed in these studies that glucocorticoids markedly suppress the antimicrobial activity of macrophages but not macrophage activation by lymphokines. As little as 2.5 X 10(-8) mol/liter of dexamethasone prevented macrophages from inhibiting germination of Aspergillus spores or from eliminating ingested bacteria such as Listeria, Nocardia, or Salmonella. Damage to macrophage function was inhibited by progesterone and appeared to be receptor-mediated. In accordance with in vivo observations, dexamethasone required 24-36 h to suppress antimicrobial activity. While glucocorticoids interfered with base-line activity of macrophages, dexamethasone concentrations comparable to drug levels in patients had no effect on macrophage activation. Proliferating lymphocytes and gamma-interferon thus increased the antimicrobial activity of phagocytes exposed to glucocorticoids over that of control cells. Macrophage activation and correction of the dexamethasone effect by gamma-interferon, however, was dependent on the pathogen. The lymphokine enhanced the antimicrobial activity of dexamethasone-treated macrophages against Listeria and Salmonella but not against Aspergillus or Nocardia. Dexamethasone-induced damage to the antimicrobial activity of human macrophages in vitro parallels observations that glucocorticoids render laboratory animals susceptible to listeriosis and aspergillosis by damaging resident macrophages. Suppression of macrophage antimicrobial activity should thus be considered when treating patients with glucocorticoids; its prevention by gamma-interferon might be beneficial for some but not all pathogens.
"TYPHOID FEVER IN THE UNITED STATES"
Authors: Elizabeth M. Blanton, Sandra Bulens, Christina Polyak, Jazmin Vojdani, Jennifer Stevenson, Felicia Medalla, Ezra Barzilay, Kevin Joyce, Eric Daniel Mintz
Journal: JAMA (1922)

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