tbuckley/cabot-search huggingface dataset:
Prognosis by Calculation
Authors: Howard L. Bleich
Journal: New England Journal of Medicine (1971)

Assessment of prognosis in patients who have serious illness is an important and often difficult problem. Many attributes are customarily monitored, but the results of these measurements are related to survival with adjectives and adverbs rather than with quantitative data. With the recent publication of mathematical expressions for the likelihood that a patient with a myocardial infarction will survive acutely1 and chronically,2 medicine took a large step forward in replacing verbal with quantitative description. The authors of these papers evaluated the contribution of each measurement to the assessment of prognosis, and, focusing on measurements that had an important influence on . . .
Selection of antigen receptors in splenic marginal-zone lymphoma: further support from the analysis of the immunoglobulin light-chain gene repertoire
Authors: V. Bikos, E. Stalika, P. Baliakas, Nikos Darzentas, Z. Davis, A. Traverse-Glehen, A. Dagklis, G. Kanellis, A. Anagnostopoulos, A. Tsaftaris, M. Ponzoni, F. Berger, P. Felman, P. Ghia, T. Papadaki, D. Oscier, C. Belessi, K. Stamatopoulos
Journal: Leukemia (2012)
Assessment of adrenocortical reserve in stable patients with cirrhosis
Authors: Giuseppe Fede, Luisa Spadaro, Tania Tomaselli, Graziella Privitera, Salvatore Piro, Agata Maria Rabuazzo, Alexander Sigalas, Elias Xirouchakis, James O’Beirne, Matteo Garcovich, Emmanuel Tsochatzis, Francesco Purrello, Andrew Kenneth Burroughs
Journal: Journal of Hepatology (2010)
Tobacco-specific nitrosamine adducts: studies in laboratory animals and humans.
Authors: S S Hecht, S G Carmella, P G Foiles, S E Murphy, L A Peterson
Journal: Environmental Health Perspectives (1993)

This paper describes quantitation of human hemoglobin and DNA adducts of the carcinogenic tobacco-specific nitrosamines 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and N'-nitrosonornicotine (NNN). NNK and NNN are believed to be involved in cancers of the lung, esophagus, oral cavity, and pancreas in people who use tobacco products. The adduct dosimetry method employs GC-MS for quantitation of 4-hydroxy-1-(3-pyridyl)-1-butanone (HPB) released by mild base hydrolysis of hemoglobin or acid hydrolysis of DNA as a biochemical marker of the pyridyloxobutylation metabolic activation pathway. Approximately 22% of smokers (n = 101) had elevated levels of HPB released from hemoglobin (range, 200-1600 fmole/g Hb). Adduct levels in snuff dippers ranged from 200-1800 fmole/g Hb. HPB levels in nonsmokers were generally below the detection limit. Acid hydrolysis of lung and tracheal DNA obtained at autopsy and analysis for released HPB revealed levels ranging up to 50 fmole/mg DNA in smokers; the adduct was not detected in nonsmokers. These findings are consistent with data generated in studies of adduct formation by NNK in rats. The biological significance of the HPB-releasing DNA pyridyloxobutylation pathway was compared to that of the DNA methylation pathway in the A/J mouse. These studies demonstrated that the persistence of O6-methylguanine in lung DNA is critical for tumorigenesis by NNK and that pyridyloxobutylation enhances both persistence of O6-methylguanine and tumorigenesis by acetoxymethylmethylnitrosamine. In the rat, the relative roles of methylation and pyridyloxobutylation in lung tumorigenesis by NNK are not as clearly defined.(ABSTRACT TRUNCATED AT 250 WORDS)
Effects of S-nitroso-glutathione in the human forearm circulation: evidence for selective inhibition of platelet activation
Authors: A. J d. Belder, R. MacAllister, M. W Radomski, S. Moncada, P. J T Vallance
Journal: Cardiovascular Research (1994)

Objective: Nitric oxide (NO) is a vasodilator and inhibitor of platelet function. The clinical use of NO donors as inhibitors of platelet activation is limited by their concomitant hypotensive effect. S-nitroso-glutathione (GSNO) has a significant antiplatelet effect at doses that cause only a small decrease in blood pressure in rats. The aim of this study was to examine the antiplatelet and vasodilator properties of this nitrosothiol in the human forearm. Methods: Forearm blood flow was measured by forearm occlusion plethysmography in five healthy males. Ex vivo platelet aggregation to ADP was performed in a platelet ionised calcium lumi-aggregometer. Results: Intra-arterial infusion of GSNO (0.2, 1, and 5 nmol·min−1) resulted in inhibition of ADP (1-10 μM) induced platelet aggregation. This inhibition was submaximal for 0.2 and maximal for 1 and 5 nmol·min−1. However, the antiaggregatory effect observed at the lowest dose of GSNO was accompanied only by a threshold increase in forearm blood flow. Conclusions: These results show that GSNO is more effective as an inhibitor of platelet activation than as a vasodilator, suggesting that it is possible to achieve selective antiplatelet and potentially antithrombotic effects with NO donors. Cardiovascular Research 1994;28:691-694
Primary Cardiac Lymphoma
Authors: Gabriel Pérez Baztarrica, Norma Nieva, Luis Gariglio, Flavio Salvaggio, Rafael Porcile
Journal: Circulation (2010)

H uman immunodeficiency virus can cause pericarditis, myocarditis, cardiomyopathies, endocarditis, other valvular compromises, cardiac involvement by neoplasm, pulmonary hypertension, arrhythmia, and thromboembolic disease.Myocardial involvement by tumors has been reported in rare cases, with Kaposi sarcoma and non-Hodgkin lymphomas being the most frequent tumor types.In this case, we introduce a 51-year-old man who presented with a febrile syndrome lasting for 30 days.He had just been on a 7-day course of azithromycin prescribed for a respiratory infection.On day 10 after he completed the antibiotic course, fever recurred without evidence of an identifiable infectious focus.Because of the aforementioned clinical presentation and to rule out infectious endocarditis, an echocardiogram was performed on the patient, which showed an image in the right atrium that could correspond to a vegetation.On physical examination, heart rate was 100 bpm, blood pressure 120/ 75 mm Hg, and jugular distention 3/3 without inspiratory change.Laboratory data were as follows: white blood cells 12 300/mm 3 , C-reactive protein ϩϩϩ, and erythrocyte sed-
Diagnosis of Hypertension of Adrenal and Renal Origin
Authors: Reginald H. Smithwick
Journal: JAMA (1960)

Among a series of patients with hypertension, between 1942 and 1959, there were 54 whose cases were classified as adrenal or renal and considered amenable to surgery. There were 22 patients with pheochromocytomas or paragangliomas, 15 with unilateral renal disease, 10 with primary aldosteronism, and 7 with adrenal cortical hyperfunction. Diagnostic criteria included certain physical characteristics, postural hypotension, urine of low specific gravity and high pH, low serum potassium levels, and functional disparities between the two kidneys. The diagnostic tests generally afforded a satisfactory basis for choosing between medical and surgical treatment, and in this series the results of surgery were gratifying.
Effect of selective bowel decontamination with norfloxacin on spontaneous bacterial peritonitis, translocation, and survival in an animal model of cirrhosis*1
Authors: Bruce A. Runyon, Mauro Borzio, Sharon Young, Susan U. Squier, Carlos Guarner, Michelle A. Runyon
Journal: Hepatology (1995)

Selective bowel decontamination with the orally administered quinolone antibiotic, norfloxacin, has been shown to suppress gut gram-negative bacteria and help prevent gram-negative infections in cirrhotic patients who are at high risk of bacterial infection. Because this drug does not eradicate gram-positive organisms, it is conceivable that gram-positives could replace the suppressed gram-negatives in the gut and lead to subsequent infection. Also the effect of norfloxacin on translocation (as defined by culture positivity of mesenteric lymph nodes) has received little attention. In this study, the effect of oral norfloxacin on translocation, bacterial peritonitis, and survival was investigated in an animal model of carbon tetrachloride-induced cirrhosis and ascites. Treated rats received daily doses of orally administered norfloxacin from the onset of cirrhosis until they died or were killed. Controls received no antibiotic. Norfloxacin led to a reduction in bacterial peritonitis from 70% in untreated cirrhotic controls to 28% in treated cirrhotic rats; these data were statistically significant (P = .012). There was no effect on overall translocation rate (28% with norfloxacin vs. 50% without norfloxacin) (P > .1). Gram-positives were isolated in 100% of the bacterial peritonitis episodes and in 71.4% of culture-positive mesenteric lymph nodes in treated animals compared with only 25% of peritonitis episodes and 10% of culture-positive mesenteric lymph nodes of untreated cirrhotic controls (P < .01 for peritonitis and P < .05 for translocation). The survival rate was not different between groups (P > .1).(ABSTRACT TRUNCATED AT 250 WORDS)
Field Epidemiology Training Programs
Authors: Stanley I. Music
Journal: JAMA (1990)

EPIDEMIOLOGY, the basic science of preventive medicine, is the scientific process of assembling facts about health problems and the groups in which these health problems occur so that inferences can be made that lead to their control and prevention. Epidemiologic techniques, properly applied, are powerful tools to improve the health of nations. Epidemiologic methods can measure the health status of populations, measure the prevalence of risk factors within populations, identify new disease threats within populations and from one population to another (especially threats from emerging organisms), determine and quantify the utilization of health services and health resources, and determine the impact of health-promoting and disease-preventing interventions. By communicating properly analyzed and interpreted epidemiologic information in a timely manner to policymakers and planners, relevant health policies can be formulated, implemented, and monitored. <h3>THE ROLE OF EPIDEMIOLOGY IN NATIONAL HEALTH PROGRAMS</h3> The well-known adage that "an ounce of prevention is worth a
Alcohol accounts for high proportion of cancer deaths in central and eastern Europe
Authors: Roger Dobson
Journal: BMJ (2006)

Around 400 000 cases of cancer a year worldwide are due to drinking alcohol, new research shows.

One in 30 deaths from cancer each year—or around 233 000—can be attributed to alcohol consumption, says a report of the study, which was published online ahead of print publication on 23 March in the International Journal of Cancer (www3.interscience.wiley.com, doi 10.1002/ijc.21903).

“Despite the importance of alcohol as a human carcinogen, a detailed estimate of the global burden of alcohol related cancers is lacking,” write the authors, from the International Agency for Research on Cancer, the …
Efficiency and Cost of Primary Care by Nurses and Physician Assistants
Authors: Sheldon Greenfield, Anthony L. Komaroff, Theodore M. Pass, Hjalmar Anderson, Sharon Nessim
Journal: New England Journal of Medicine (1978)

We conducted a prospective study in a prepaid primary-care practice (health-maintenance organization) of a system in which nurses and physician assistants used protocols, and compared the efficiency and costs of this "new-health-practitioner" protocol system to a physician-only nonprotocol system. In five months, we studied 472 patients with any of four common acute complaints--respiratory infections, urinary and vaginal infections, headache, and abdominal pain; a subset of 203 patients was randomly allocated between the two systems. In the new-health-practitioner system physician time per patient was reduced by 92 per cent, from 11.8 to 0.9 minutes, and average visit costs--including practitioner time and charges for laboratory tests and medications--were 20 per cent less (P = 0.01). We conclude that this protocol system saves physician time and reduces costs.
Wilson's Disease in The Merck Manual: Corrections
Authors: Robert Berkow
Journal: JAMA (1988)

<h3>To the Editor.</h3> —It has been brought to our attention that there is incorrect information about Wilson's disease in the new 15th edition of<i>The Merck Manual</i>(pp 947 to 949), particularly regarding diagnosis and treatment. Wilson's disease, transmitted in an autosomal recessive fashion, is always fatal unless it is diagnosed and an appropriate lifelong therapeutic regimen instituted before progressive and irreversible pathology of the liver or brain develops.<sup>1</sup> Concerning diagnosis,<i>a normal ceruloplasmin level is 200 to 500 mg/L (20 to 50 mg/dL)</i>, not 150 to 400 mg/L (15 to 40 mg/dL). A concentration of hepatic copper greater than 250 μg/g<i>dry weight</i>(not &gt;250 μg/g wet weight) is absolutely diagnostic if, and only if, the serum ceruloplasmin concentration is less than 200 mg/L (&lt;20 mg/dL). About 4% of patients with Wilson's disease have ceruloplasmin concentrations greater than 200 mg/L (&gt;20 mg/dL). Diagnosing Wilson's disease in these patients
Policy Space Areas and Properties of Benefit-Cost/Utility Analysis
Authors: John P. Anderson
Journal: JAMA (1986)

STEINBACH and Hardison<sup>1</sup>are correct when they state that the simple benefit-cost/utility (BCU) ratio must be refined for many practical decision situations, including the ones they describe. Because it did not affect the analysis of parasite screening among Indochinese refugees, the issue was not discussed in detail. But it is important, and bears directly on the General Health Policy Model's scope of applicability. This reply draws from the nonclinical literature where program or treatment interdependencies and nonlinear constraints have been studied in greater detail.<sup>2-5</sup> A two-dimensional health policy space (Figure), where costs are subtracted from benefits (to establish consistency in signs), provides a useful analytic framework for considering resource allocation problems. Net dollar returns per person, where returns equals benefits minus costs, are plotted on the x axis, and well-years gained or lost per person (Y) are plotted on the<i>y</i>axis. Any alternative action (whether treatment, program,
Dissociation between airway responsiveness to methacholine and responsiveness to antigen
Authors: A. Kamachi, Y. Nasuhara, M. Nishimura, T. Takahashi, Y. Homma, Y. Ohtsuka, M. Munakata
Journal: European Respiratory Journal (2002)

Repeated aerosolized antigen challenges to brown Norway (BN) rats generate nonspecific airway hyperresponsiveness (AHR). On the other hand, some studies have demonstrated that repeated antigen challenge could attenuate antigen-specific AHR in BN rats. The authors questioned whether such dissociation in airway responses actually occurs when assessed in a single study in the same animals. The authors simultaneously measured AHR to methacholine and antigen-specific AHR in rats that were repeatedly exposed to aerosolized ovalbumin (OA) for 1 or 3 months after sensitization. Four days after the last challenge, airway responses to methacholine and OA, morphometry of the airways, the cell profile in bronchoalveolar lavage fluid, and cytokine messenger ribonucleic acid (mRNA) expression in the lungs were evaluated. The two types of AHR were modulated in opposite directions by repeated antigen challenges. The AHR to methacholine was significantly increased in the rats receiving antigen challenges compared with the control rats receiving saline challenges after sensitization; whereas, the antigen-specific AHR was significantly decreased. The number of alveolar macrophages in lavaged fluid and the expression of transforming growth factor-beta1 mRNA in lung tissue was significantly different between the antigen-challenged rats and the control rats. In conclusion, dissociation between nonspecific airway hyperresponsiveness and antigen-specific airway hyperresponsiveness in brown Norway rats after repeated antigen challenges was demonstrated. Sustained airway inflammation with macrophages and/or upregulation of transforming growth factor-beta1 messenger ribonucleic acid in the lung tissue may be responsible for this dissociation.
A PROTEST AGAINST THE USE OF PROPRIETARY REMEDIES.
Authors: DANIEL R. BROWER
Journal: JAMA (1901)

The profession is being overwhelmed by proprietary remedies. The manufacturers who project them copyright the name by which they are to be known, patent the process by which they are made, and patent the resulting product, so that these remedies must remain a monopoly for all time. Coblentz, in his recent edition of "Newer Remedies," gives a succinct account of about two thousand, all introduced during the last few years, and Lehn and Fink, in "Progress in Pharmacy and Therapeutics," enumerate about five hundred more. I have recently had three of the leading dispensing druggists of Chicago, Messrs. Gale &amp; Blocki, Dale &amp; Sempill, and D. R. Dyche &amp; Co., examine the last 1000 prescriptions on their files for the purpose of ascertaining how many of them contained these proprietary remedies, with the result that one firm finds about 20 per cent., another 21 per cent., and the third 26
Verapamil Reduces Tachycardia-Induced Electrical Remodeling of the Atria
Authors: Robert G. Tieleman, Cees D. J. De Langen, Isabelle C. Van Gelder, Pieter J. de Kam, Jan Grandjean, Klaas J. Bel, Maurits C. E. F. Wijffels, Maurits A. Allessie, Harry J. G. M. Crijns
Journal: Circulation (1997)

Background Prolonged periods of atrial fibrillation or rapid atrial pacing induce shortening of the atrial effective refractory period (AERP), which is thought to be related to the lower success rates of various antifibrillatory treatments when the arrhythmia has lasted for a longer period of time. Methods and Results To investigate whether an increase in intracellular calcium could be the stimulus for electrical remodeling, the effects of verapamil on shortening of the AERP in response to 24 hours of rapid atrial pacing (300 bpm) were studied in five chronically instrumented conscious goats during infusion of saline or verapamil. During rapid atrial pacing, the ventricular rate was kept constant by ventricular pacing (150 bpm). The AERP was measured by programmed electrical stimulation at basic cycle lengths of 430, 300, and 200 ms. Verapamil had no effects on the AERP before rapid atrial pacing. However, in the course of 24 hours of rapid atrial pacing, the AERP shortened significantly less (27% to 58%) in the presence of verapamil compared with control (at 430, 300, and 200 ms, P &lt;.001, P &lt;.01, and P &lt;.01, respectively). Also, after cessation of pacing, complete recovery of the AERP during verapamil infusion occurred much sooner than in the control experiments. Despite a significant reduction in electrical remodeling, there was only a minimal reduction in inducibility of atrial fibrillation by verapamil (34% versus 39% in the control experiments, P =.03). Conclusions Electrical remodeling of the atrium during rapid atrial pacing was significantly attenuated by verapamil. This suggests that electrical remodeling of the atrium is triggered by the high calcium influx during rapid atrial pacing rates.
Commentary: Equity in the allocation of resources to general practices will be difficult to achieve
Authors: A. Majeed
Journal: BMJ (1998)

Health authorities will increasingly have to grapple with the problem of how they allocate budgets for hospital care to general practices, whether these practices are fundholders or members of a locality commissioning group. Locality commissioning groups will, in turn, have to monitor the use made of hospital care by their constituent general practices and review differences in referral rates to determine if these are acceptable. Health authorities should find that allocating budgets for hospital care to locality commissioning groups is reasonably straightforward if the populations of these groups are sufficiently large. A revised version of the national resource allocation formula, modified to take local factors into account, could be used to do …
The development of cirrhosis in patients with chronic type B hepatitis: A prospective study
Authors: Yun-Fan Liaw, Dar-In Tai, Chia-Ming Chu, Tong-Jong Chen
Journal: Hepatology (1988)

The incidence and contributing factors of cirrhosis developing in patients with chronic type B hepatitis were assessed prospectively in 684 clinicopathologically verified patients, of which 509 were HBeAg positive and 175 were anti-HBe positive at entry into the study. During an average follow-up period of 35.3 months, cirrhosis occurred 6 to 64 months after entry in 35 HBeAg-positive and 7 anti-HBe positive patients with a calculated annual incidence of 2.4 and 1.3%, respectively (p &gt; 0.05). The incidence increased significantly with the increasing age at entry. Patients who had experienced (a) hepatic decompensation, (b) repeated episodes of severe acute exacerbation (with α-fetoprotein &gt; 100 ng per ml and/or bridging hepatic necrosis), (c) severe acute exacerbation not accompanied by subsequent HBeAg seroconversion and (d) hepatitis B virus reactivation (particularly those with HBeAg reappearance) were found to develop cirrhosis much more frequently (p &lt; 0.001). Contrary to general belief, patients who had hepatitis delta virus superinfection and patients with chronic active hepatitis were not particularly prone to develop cirrhosis. We conclude that in addition to age factor, the extent, severity, duration, frequency and etiology of the hepatic lobular alterations are important factors for the development of cirrhosis in patients with chronic type B hepatitis.
R.S.V. infections and infant deaths.
Authors: G E Urquhart, A A Gibson
Journal: BMJ (1970)

speculating on the pathogenesis in death from respiratory syncytial virus (R.S.V.) infection prompts us to report the following case of infant death with R.S.V. infection.A male child, 4 weeks of age, died three weeks after discharge from a mater- nity hospital.During the three weeks at home he suffered from "chest infections" for which he received two five-day courses of Ampiclox (ampicillin and cloxacillin).Two days before admission to hospital the baby stopped feeding and had a "cold."On examination in hospital he was under- nourished and dehydrated, with a bulging anterior fontanelle.He died less than 24 hours after admission.Postmortem examination showed infarction of the right cerebral hemisphere, the distribution of which suggested extension of a birth injury.There was no evidence of pneumonia or bronchiolitis, but the finding of mucopus in
Adenovirus capsid-display of the retro-oriented human complement inhibitor DAF reduces Ad vector–triggered immune responses in vitro and in vivo
Authors: Sergey S. Seregin, Yasser A. Aldhamen, Daniel M. Appledorn, Zachary C. Hartman, Nathaniel J. Schuldt, Jeannine Scott, Sarah Godbehere, Haixiang Jiang, Michael M. Frank, Andrea Amalfitano
Journal: Blood (2010)
Congenital Abnormalities of Anus and Rectum: Mortality and Function
Authors: F. Cozzi, A. W. Wilkinson
Journal: BMJ (1968)

MEDICALJORAIn summary, methyldopa, provided it is tolerated, produces the best all-round blood pressure control of these three drugs, but 20% of our patients could not tolerate it.Bethanidine was tolerated by all patients, but brought slightly greater postural and exercise hypotension than guanethidine, which, however, produced the largest number of side-effects.We wish to thank Professor D. R. Laurence for his advice in the planning of the trial.We would like to record our appreciation to Dr. J. J. F. Merry, of Merck Sharp and Dohme, for supplies of methyldopa; to Dr. A. D. Munro-Faure, of the Wellcome Foundation, for supplies of bethanidine