tbuckley/cabot-search huggingface dataset:
HOSPITAL COSTS FOR PEDIATRIC HEART SURGERY VARY WIDELY ACROSS INSTITUTIONS
Authors: Sara K. Pasquali, Xia He, Marshall Jacobs, Samir Shah, Eric D. Peterson, Matthew Hall, J. William Gaynor, Kevin D. Hill, Karl F. Welke, John E. Mayer, Jeffrey P. Jacobs, Jennifer S. Li
Journal: Journal of the American College of Cardiology (2013)
The Twenty-Minute Hour: An Experiment in Medical Education
Authors: Pietro Castelnuovo-Tedesco
Journal: New England Journal of Medicine (1962)

The life so short, the craft so long to learn. Hippocrates, Aphorisms, I (translated by Chaucer).TIME, its exigencies and in particular the pressure of crowded schedules are sure to be points for discussion whenever someone wonders aloud why internists and general practitioners do not more often treat their anxious, emotionally disturbed patients with psychotherapy. Over the past several years I have raised the question a good number of times, often informally across the lunch table in the hospital dining room, and almost invariably the colleague on the other side of the table has made time the central issue of . . .
Evaluation of Clinical Efficacy of Antimicrobials in Complicated Urinary Tract Infections
Authors: Y. Kawada, S.E. Lee, C. Chen, B.M. Limson, P. Chan, A. Kongkanand, S. Wudhikarn, K.H. Tung, P. Rahardjo, I. Saito, T. Doi
Journal: Drugs (1995)
Acute Leukemia Following Cytotoxic Chemotherapy
Authors: Martin Perlman
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Recent attention has been directed to acute leukemia in patients treated with cytotoxic agents (219:75, 1972). We recently have had the opportunity to see a 65-year-old white woman who had unexplained anemia. The patient had had a mastectomy 18 months previously for carcinoma of the breast. She had received thiotepa as adjunctive therapy on a weekly basis since the original diagnosis. When seen by us, the patient had thrombocytopenia, anemia, and leukopenia. There was no evidence of recurrent breast carcinoma. The bone marrow was found to be dysplastic with megaloblastic changes. The patient was treated with both cyanocobalamin and folic acid despite normal Schilling test. Repeated bone marrow examination showed no change. There was no evidence on bone marrow biopsy of metastatic disease. Slides were reviewed by Dr. Richard Gams who concurred with our diagnosis of acute myelogenous leukemia. The patient was treated with the COAP program
Evidence for a dominant gene that suppresses hypercholesterolemia in a family with defective low density lipoprotein receptors.
Authors: H H Hobbs, E Leitersdorf, C C Leffert, D R Cryer, M S Brown, J L Goldstein
Journal: Journal of Clinical Investigation (1989)

This paper describes an unusual kindred with familial hypercholesterolemia in which one-third of the relatives with a mutant LDL receptor gene have normal plasma cholesterol concentrations. The proband, a 9-yr-old boy with a plasma cholesterol value greater than 500 mg/dl, is homozygous for a point mutation that changes Ser156 to Leu in the LDL receptor. This substitution in the fourth repeat of the ligand binding domain slows the transport of the protein to the cell surface. The defective receptor cannot bind LDL, which contains apo B-100, but it does bind beta-migrating VLDL, which contains apo E in addition to apo B-100. Although the mother is heterozygous for this mutation, her LDL-cholesterol concentration is consistently in the 28th percentile for the population. Through direct examination of genomic DNA, we identified the mutant gene in heterozygous form in 17 of the mother's relatives, five of whom had normal LDL-cholesterol values. The pedigree was consistent with dominant transmission of a single gene that ameliorates or suppresses the hypercholesterolemic effect of the LDL receptor mutation. Through linkage analysis, we excluded the possibility that this suppressor gene was an allele at the LDL receptor locus. We also excluded the genes for the two ligands for the LDL receptor, apo B-100 and apo E. The existence of this putative suppressor gene may explain the occasional observation of normal LDL-cholesterol concentrations in heterozygotes for LDL receptor mutations.
Bladder Hernia Simulating Metastatic Lesion on FDG PET Study
Authors: Anne-Sophie Pirson, Bruno Krug, Marc Lacrosse, Delphine Luyx, Annelore Barbeaux, Thierry Vander Borght
Journal: Clinical Nuclear Medicine (2004)

A 67-year-old man with a cerebral metastasis underwent an FDG PET study to search for the primary tumor. Colonic adenocarcinoma without liver metastases was found. An unsuspected inguinal focus, simulating a metastasis, was urinary activity in a vesical hernia. Vesical hernias are not so uncommon, accounting for 0.4–3% of all inguinal hernias, but massive bladder hernias at the inguinoscrotal level are rare. They affect mainly men older than 50 years and may be responsible for misdiagnosis when radiopharmaceuticals with main urinary excretion are used.
Primary ventricular fibrillation and resumption of work, sexual activity, and driving after first acute myocardial infarction.
Authors: B Kushnir, K M Fox, I W Tomlinson, R W Portal, C P Aber
Journal: BMJ (1975)

The resumption of work, sexual activity, and driving were studied in 32 patients who had suffered primary ventricular fibrillation after their first myocardial infarction. They were compared with 95 patients whose myocardial infarction was not so complicated. Though initially slowing rehabilitation, primary ventricular fibrillation did not affect ultimately either the return to work or the resumption of normal sexual activity and driving.
Watching the doctor-watchers. How well do peer review organization methods detect hospital care quality problems?
Authors: H. R. Rubin
Journal: JAMA (1992)

To determine how well one state's peer review organization (PRO) judged the quality of hospital care compared with an independent, credible judgment of quality of care.Retrospective study comparing a PRO's review, including initial screening, physician review, and final judgments, with an independent "study judgment" based on blinded, structured, implicit reviews of hospital records.One state's medical and surgical Medicare hospitalizations during 1985 through 1987 audited randomly by the state's PRO.Stratified random sampling of records: 62 records that passed the PRO initial screening process and were not referred for PRO physician review; 50 records that failed the PRO screen and then were confirmed by PRO physicians to be "quality problems."None.A study judgment of below standard or standard or above based on the mean of overall ratings by five internists for records in medical diagnosis related groups (DRGs) and by five internists and five surgeons for surgical DRGs. Each step in the PRO review was evaluated for how many records passing or failing that step were judged standard or above or below standard in the study (positive and negative predictive value) and how well that step classified records that the study judged below standard or standard or above (sensitivity and specificity).An estimated 18% of records reviewed by the PRO were below standard according to the study judgment, compared with 6.3% quality problems according to the PRO's final judgment (difference, 12%; 95% confidence interval, 1 to 23). The PRO's initial screening process failed to detect and refer for PRO physician review two of three records that the study judged below standard. In addition, only one of three of the records that PRO physicians judged to be quality problems were judged below standard by the study judgment. Therefore, the PRO's final quality of care judgment and the study judgment agreed little more than expected by chance, especially about poor quality of care. Although the PRO correctly classified 95% of the records that the study judged standard or above, it detected only 11% of records judged below standard by the study.Most of all, this PRO review process would be improved by additional preliminary screens to identify the 67% of records that the study judged below standard but that passed its initial screening. The screening process also must be more accurate in order to be cost-effective, as it was only slightly better than random sampling at correctly identifying below standard care. More reproducible physician review is also needed and might be accomplished through improved reviewer selection and training, a structured review method, and more physician reviewers per record.
Lack of Mutagenicity of Acrolein-Induced DNA Adducts in Mouse and Human Cells
Authors: Sang-in Kim, Gerd P. Pfeifer, Ahmad Besaratinia
Journal: Cancer Research (2007)

Abstract Acrolein is an endogenous metabolite and a ubiquitous environmental pollutant. Recently, it has been suggested that acrolein is a major etiologic agent for tobacco smoking–related lung cancer. Despite the known DNA-damaging effects of acrolein, its mutagenicity to mammalian cells remains uncertain. We have investigated acrolein-induced DNA damage in relation to mutagenesis, with special focus on DNA repair, in mouse and human cells. We mapped the formation of acrolein-induced DNA adducts and the kinetics of repair of the induced lesions in the cII transgene, the mutational target, in acrolein-treated transgenic mouse fibroblasts. Acrolein-DNA adducts were formed preferentially at specific nucleotide positions, mainly at G:C base pairs, along the cII transgene. The induced acrolein-DNA adducts were moderately resistant to DNA repair. Quantification of cII mutant frequency in acrolein-treated cells, however, revealed that acrolein was not mutagenic to these cells at doses sufficient to produce DNA adducts. Determination of supF mutant frequency in DNA repair–proficient and DNA repair–deficient human fibroblasts transfected with acrolein-treated plasmids confirmed a lack of acrolein mutagenicity. Because CpG methylation may intensify acrolein-DNA adduction, we examined whether the extent of CpG methylation in the supF gene can determine acrolein-induced mutagenesis in human cells. Enhancement of acrolein-DNA adduction by methylating CpGs in the supF sequence did not elicit a mutagenic response in human fibroblasts, however. We conclude that acrolein is not mutagenic to mouse and human fibroblasts, regardless of DNA repair capacity or methylation status of CpGs, possibly because of a highly accurate replication bypass of the induced lesions. [Cancer Res 2007;67(24):11640–7]
Is the FXR the Fix for Cholesterol Gallstone Disease? *
Authors: Brian D. Juran, Konstantinos N. Lazaridis
Journal: Hepatology (2005)

Cholesterol gallstone disease is characterized by several events, including cholesterol precipitation in bile, increased bile salt hydrophobicity and gallbladder inflammation. Here, we describe the same phenotype in mice lacking the bile acid receptor, FXR. Furthermore, in susceptible wild-type mice that recapitulate human cholesterol gallstone disease, treatment with a synthetic FXR agonist prevented sequelae of the disease. These effects were mediated by FXR-dependent increases in biliary bile salt and phospholipid concentrations, which restored cholesterol solubility and thereby prevented gallstone formation. Taken together, these results indicate that FXR is a promising therapeutic target for treating or preventing cholesterol gallstone disease.
Validation of Memorial Sloan–Kettering Cancer Center nomogram for prediction of non-sentinel lymph node metastasis in sentinel lymph node positive breast cancer patients an international comparison
Authors: Yao-Lung Kuo, Wen-Chung Chen, Wei-Jen Yao, Lili Cheng, Hui-Ping Hsu, Hung-Wen Lai, Shou-Jen Kuo, Dar-Ren Chen, Tsai-Wang Chang
Journal: International Journal of Surgery (2013)
Allergy to Iprindole (Prondole) with Hepatotoxicity
Authors: H. E. Amos
Journal: BMJ (1970)

MDICBLOUNAL 681 be expected in patients with folic acid deficiency (clinical or subclinical).The find- ings of Kaimis, Sumrnerly, and Giles (per- sonal cormmunication to Marks and Shuster, 12 September, p. 618) and the demon- stration of malabsorption in the proximnal small bowel' which is the site of absorption of folic acid, would seem to indicate that, in addition to an increased demand, there may be malabsorption of folic acid in these patients which would further exacerbate folate deficiency.As correctable malabsorption of vitamin B12 has been described in patients with folic acid deficiency,9"0 it would seem likely that the malabsorption of vitamin B12 in patients with various skin diseases is also due to folic acid deficiency.I wonder whether the authors have repeated the study after a course of folic acid.It would also be interesting to see whether the small bowel dysfunction in dermatogenic enteropathy reverts to normal on folic acid therapy alone without local treatment of the rash.If it does (as I suspect) in addition to the local treatment of dermatosis early folic acid therapy would seem to be indicated in patients with enteropathy, even when there are no obvious haematological changes.Similar explanation probably holds true in enteropathy associated with various chronic debilitating illnesses and also in conditions where increased cellular proliferation is a predomiunant feature.-Iam, etc.,
Assessment of elderly people in hospital. Use clinically relevant assessment tool.
Authors: C Cooper, P Crome
Journal: BMJ (1993)

<h3>Background</h3> An important factor in worldwide neonatal mortality is the deficiency in neonatal resuscitation skills among trained professionals. ‘Helping Babies Breathe’ (HBB) is a simulation-based training course designed to train healthcare professionals in the initial steps of neonatal resuscitation in low-resource areas. The aim of this systematic review is to provide an overview of the available evidence regarding intrapartum-related stillbirths and neonatal mortality related to the HBB training and resuscitation method. <h3>Data sources</h3> Cochrane, CINAHL, Embase, PubMed and Scopus. <h3>Study eligibility criteria</h3> Conducted in low-resource settings focusing on the effects of HBB on intrapartum-related stillbirths and neonatal mortality. <h3>Study appraisal</h3> Included studies were reviewed independently by two researchers in terms of methodological quality. <h3>Data extraction</h3> Data were extracted by two independent reviewers and crosschecked by one additional reviewer. <h3>Results</h3> Seven studies were included in this systematic review; the selected studies included a total of 230.797 neonates. Significant decreases were found after the implementation of HBB in one of two studies describing perinatal mortality (n=25 108, rate ratio (RR) 0.75; p&lt;0.001), four out of six studies related to intrapartum-related stillbirths (n=125.720, RR 0.31–0.76), in four out of five studies focusing on 1 day neonatal mortality (n=111.289, RR 0.37–0.67), and one out of three studies regarding 7 day neonatal mortality (n=4.390, RR 0.32). No changes were seen in late neonatal mortality after HBB training and resuscitation method. <h3>Limitations</h3> Included studies in were predominantly of moderate quality, therefore no strong recommendations can be made. <h3>Conclusions and implications of key findings</h3> Due to the heterogeneous quality of the studies, this systematic review showed moderate evidence for a decrease in intrapartum-related stillbirth and 1-day neonatal mortality rate after implementing the ‘Helping Babies Breathe’ training and resuscitation method. Further research is required to address the effects of simulation-based team training on morbidity and mortality beyond the initial neonatal period. <h3>PROSPERO registration number</h3> CRD42018081141.
Abstract LB-3: Fully synthetic self-assembling tumor-targeted virus-like nanoparticles .
Authors: Nadya Tarasova, Yuhong Chen, Marzena Dyba, Sergey G. Tarasov
Journal: Cancer Research (2013)

Abstract Virus particles have evolved as highly effective delivery systems. They are able to deliver whole proteins and large nucleic acid molecules to certain types of cells. Genetically engineered virus-like particles (VLPs) have been explored as drug delivery and imaging agents. However, generation of fully synthetic VLPs has not been achieved. We have found that properly derivatized synthetic analogs of transmembrane domains not only inhibit the function of the corresponding receptor, but can self-assemble into virus-like particles with high precision (Proc. Natl. Acad. Sci. U. S. A 108: 9798 (2011). The described particles have intrinsic biological activity of the peptide they are composed of and fuse with cell spontaneously. Particles composed of CXCR4 antagonist fuse spontaneously with cell membrane, inhibit CXCR4 function in vitro and CXCR4-mediated metastasis in vivo. However, the fusion is non-selective. We have now developed the first fully synthetic VLPs that fuse with cells like real viruses, in receptor-mediated manner. Prevention of non-selective fusion was achieved by derivatization of self-assembling peptides with polyethylene glycol. Addition of ligands recognizing receptors over expressed on prostate tumor cells allowed for the particles that fuse selectively with receptor-positive cells. Particles targeting gastrin-releasing peptide receptor (GRPR), luteinizing hormone-releasing hormone (LHRH) receptor and prostate-specific membrane antigen (PSMA) are remarkably stable, more than 99 % homogeneous in size and undergo receptor-mediated fusion with tumor cells expressing corresponding receptor. Whole- animal fluorescence tomography of nude mice injected with fluorescent nanoparticles targeted to PSMA and GRPR revealed that particles rapidly accumulate in tumors and allow for tumor detection as early as two hours after the injection. Development of fully synthetic VLPs establishes a foundation for generation of delivery systems with investigator-defined biophysical properties and targeting ability for a wide range of biomedical applications. Tumor-targeted self-assembling particles represent a new class of agents with dual and triple biological activity for the therapy and detection of tumors. Citation Format: Nadya Tarasova, Yuhong Chen, Marzena Dyba, Sergey G. Tarasov. Fully synthetic self-assembling tumor-targeted virus-like nanoparticles . [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr LB-3. doi:10.1158/1538-7445.AM2013-LB-3
Analysis of side-effects of medium- and low-dose cyclosporin maintenance therapy in psoriasis
Authors: M.A. RIE, M.M.H.M. MEINARDI, J.D. BOS
Journal: British Journal of Dermatology (1990)

The side-effects of long-term cyclosporin A (CyA) treatment in 26 patients with severe psoriasis were evaluated. These patients had a mean PASI score of 30.2 and were treated with CyA for between 7 and 37 months (mean 19.5 months). There were three groups according to the dose of CyA, less than 2 mg/kg per day, 2-3 mg/kg per day and greater than 3 mg/kg per day. In all three groups, CyA was found to be equally effective. Treatment with CyA was discontinued in 12 of the 26 patients because of nephrotoxicity and/or development of hypertension. One was in the less than 2 mg/kg per day group, three were in the 2-3 mg/kg per day group and eight in the greater than 3 mg/kg per day group. There was no hepatotoxicity with CyA treatment. One patient developed two squamous cell carcinomas of the skin.
The Application of Automated Techniques in Assessing Psychotropic-Drug-Induced Side Effects
Authors: J. M. C. HOLDEN, T. M. ITIL
Journal: American Journal of Psychiatry (1968)

In response to the need for standardization of methodology in assessing the side effects of psychotropic drugs, the authors describe a rating scale, structured for computer optical reading, to measure changes in physical and laboratory data. They feel that the method described, used on patients who are on low drug dosages, will provide predictors of possible abnormalities later when higher dosages are used.
Outbreak of E.C.H.O. Type 9 Infection in a Children's Home
Authors: F. L. Constable, L. F. Howitt
Journal: BMJ (1961)

himself.Like all boundaries, and like this boundary line outside, this parallelism contains the possibilities of friction; but, what is more important, it affords an irreplaceable instrument of discussion and mutual comprehension, which is even more valuable than the tendering of expert advice and technical information.This instrument depends for its effectiveness upon the medical profession inside the Departments being as perfectly as may be in tune with the profession outside and as fully representative and characteristic of the profession's outlook and mind as can be devised.I will not here enter into the various ways in which this condition can be maintained and guaranteed, but will content myself by saying that the politician has good reason to be zealous and grateful for it.Self-analysis is an exercise to be indulged in sparingly, especially in public.This evening I have gone further still, and ventured upon a joint self- analysis of my own profession and another, at least of their points of contact and connexion.I have essayed it only because I believed that such analysis might contribute something to the mutual understanding and co-operation on which the success of the National Health Service is conditional.
Targeting Hypoxia-inducible Factor-1α With Tf–PEI–shRNA Complex via Transferrin Receptor–mediated Endocytosis Inhibits Melanoma Growth
Authors: Yeqiang Liu, Juan Tao, Yan Li, Jing Yang, Yan Yu, Min Wang, Xiaoyuan Xu, Changzheng Huang, Wei Huang, Jing Dong, Li Li, Jing Liu, Guanxin Shen, Yating Tu
Journal: Molecular Therapy (2008)

Malignant melanoma (MM) is a major public health problem. The development of effective, systemic therapies for MM is highly desired. We showed here that the transferrin receptor (TfR) was a suitable surface marker for targeting of gene therapy in MM and that the hypoxia-inducible factor-1alpha (HIF-1alpha) was an attractive therapeutic molecular target in MM. We observed that inhibition of HIF-1alpha blocked cell proliferation and induced cell apoptosis in vitro. We then showed that a transferrin-polyethylenimine-HIF-1alpha-short-hairpin RNA (Tf-PEI-HIF-1alpha-shRNA) complex could target MM specifically and efficiently both in vivo and in vitro, exploiting the high expression of the TfR in MM. The systemic delivery of sequence-specific small-interfering RNA (siRNA) against HIF-1alpha by the Tf- PEI-HIF-1alpha-shRNA complex dramatically inhibited tumor growth in the A375 MM xenograft model. The underlying concept of transfecting a HIF-1alpha shRNA expression vector complexed with Tf-PEI to block HIF-1alpha holds promise as a clinical approach to gene therapy for MM.
Teams vie to find ways to improve care of patients
Authors: J. Smith, F. Moss
Journal: BMJ (2010)

This year’s 28 submissions for the Best Quality Improvement award in the 2010 BMJ Group Awards cover a wide spread of specialties and services from virtually all geographical areas of the United Kingdom, with many good examples of improvement in the effectiveness and safety of patient care.

In the end the shortlist of four emerged easily. Many entries had ruled themselves out because they didn’t meet the criterion of sustaining their change for at least 18 months; we hope that those applicants will apply again next year.

The shortlisted projects come from a primary care trust, a national specialty society, a combined hyperacute and stroke rehabilitation unit, and a hospital team.

The primary care trust NHS County Durham has seen an average 8% rise in its prescribing expenditure since the late 1990s, and in 2007 its drug and therapeutics committee set a series of targets for drugs management within the Quality Outcomes Framework. Each of …