tbuckley/cabot-search huggingface dataset:
Please bypass the PORT
Authors: T A Sheldon
Journal: BMJ (1994)

Struggling to contain health care costs, the United States has devoted considerable attention to health technology assessment, producing clinical guidelines and measures of appropriateness, organising consensus conferences, and carrying out studies of practice variation and “outcomes research.” Serious reservations have been expressed about the scientific validity of some of these approaches. Controversy focuses particularly on the use of routine health records to assess the effectiveness of treatments. Such studies conflict with the British tradition of using randomised controlled trials. Last year the New York Academy of Sciences brought together the exponents of different approaches to evaluating health care. The results have now been published in a book, which also provides edited accounts of the often heated discussion.1

When Congress created the Agency for Health Care Policy and Research in 1989 it was anxious for quick results, assuming that analysis of databases would provide technical solutions to the United States' health care crisis.2 Fifteen patient outcomes research teams (PORTs) with a planned budget of …
Abstract 5469: Detection of deoxyguanosine adducts in the oral tissues of mice treated with the environmental carcinogen dibenzo[a, l]pyrene by LC-MS/MS
Authors: Shang-Min Zhang, Kun-Ming Chen, Cesar Aliaga, Krishnegowda Gowdahalli, Shantu Amin, Karam El-Bayoumy
Journal: Cancer Research (2012)

Abstract Oral cancer is the major form of head and neck squamous cell carcinoma, which is the fifth most common cancer worldwide. Tobacco smoking is one of the leading causes of oral cancer. Dibenzo[a, l]pyrene (DB[a, l]P) is the most potent carcinogenic polycyclic aromatic hydrocarbon found in tobacco smoke. Our laboratory had developed a mouse model of oral cancer induced by DB[a, l]P. Our working hypothesis is that the stereochemical course of DB[a, l]P metabolism, the conformations of the DNA adducts formed and their removal by mammalian DNA repair enzymes, and their mutagenic properties if not removed in an error-free manner, all play critical roles during the induction of oral carcinogenesis. As an initial study to test our hypothesis, we have previously developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to detect and quantify DB[a, l]PDE-N6-dA adducts in oral tissues of mice treated with DB[a, l]P. We have shown that (-)-anti-cis- and (-)-anti-trans-DB[a, l]PDE-N6-dA adducts were detected from oral tissues of mice treated with DB[a, l]P. In the present study, to further test our hypothesis, we report on the development of a LC-MS/MS method to detect DB[a, l]PDE-N2-dG adducts in vivo. (±)-anti-[15N5]-DB[a, l]PDE-N2-dG adducts were synthesized as internal standards. The stereochemistry of adducts were characterized. Following the addition of internal standards, DNA isolated from oral tissues of mice treated with DB[a, l]P or DB[a, l]PDE was enzymatically hydrolyzed to 2′-deoxyribonucleosides and partially purified by solid-phase extraction. The LC-MS/MS analysis was carried out by monitoring transitions m/z 620 [M+H]+→ m/z 504 [(M+H)+−2′-deoxyribose] for DB[a, l]PDE-N2-dG adducts and m/z 625α m/z 509 for the internal standards. We have detected two N2-dG adducts from oral tissues of mice treated with DB[a, l]P, and four N2-dG adducts from oral tissues of mice treated with (±)-anti-DB[a, l]PDE. Collectively, the in vivo detection of dA and dG adducts indicated that DB[a, l]P is predominantly metabolized to (-)-anti-DB[a, l]PDE in oral tissues of mice. This sensitive LC-MS/MS method, is capable of simultaneously detecting both dA and dG adducts derived from anti-DB[a, l]PDE. Our results indicated that levels of dA adducts are significantly higher than dG adducts in vivo, which are consistent with those reported in literature in organs other than oral tissues, demonstrating that fjord region diol epoxide of DB[a, l]P predominantly form dA adducts than dG adducts. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5469. doi:1538-7445.AM2012-5469
The MKSAP Program and Recertification
Authors: MYRON LEWIS
Journal: Annals of Internal Medicine (1979)

Letters and Corrections1 April 1979The MKSAP Program and RecertificationMYRON LEWIS, M.D.MYRON LEWIS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-90-4-724_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Burg, Grosse, and Kay have reviewed in the January issue (1) the MKSAP-IV examination developed during 1975 and 1976. I did have the privilege and pleasure of participating in a review course on this material and of taking the recertification test in October 1977.I believe that the authors have misinterpreted the purpose of the postgraduate courses and the mechanism of recertification. They point out that these courses should not be concerned with the 80 multiple-choice questions. Certainly anyone taking the recertification test should at least have available to them not only the opinion of the so-called...Reference1. BURGGROSSEKAY FMC: A national self-assessment program in internal medicine. Ann Intern Med 90:100-107, 1979 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Medical Center Plaza Memphis, TN 38103 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1979Volume 90, Issue 4Page: 724-724 Issue Published: 1 April 1979 PDF DownloadLoading ...
Abstract 92: Odonogenic Ameloblast Associated Protein (ODAM) moderates cell growth and invasion in the human breast cancer line MDA-MB-231 in part through the TGF-β signaling pathway
Authors: Jonathan E. Phipps, James S. Foster, John Bell, Alan Solomon, Daniel P. Kestler
Journal: Cancer Research (2012)

Abstract Breast neoplasms are the second leading cause of cancer deaths of women in the United States. Recently, it has been shown by immunohistochemical staining of tumor biopsy tissue that nuclear localization of the odontogenic ameloblast associated protein (ODAM) correlated with staging and increased survival in patients, leading to the proposal of this protein as a novel biomarker in breast cancer. Further, ectopic expression of recombinant ODAM protein in the invasive breast carcinoma line MDA-MB-231 (231-ODAM) was shown to slow cell growth to 30-50% of that seen in control 231 cells, increase apoptosis, effect developmental change, and decrease the ability of cells to migrate or invade through extracellular matrix in transwell barrier assays. Further, this expression reduced the ability of these cells to form solid tumors by greater than 10-fold in immunodeficient mice, or establish tumor colonization of the lungs after tail vein injection. Herein, we show results of microarray and qRT-PCR data collected from 231-ODAM and control cells revealing effects of ODAM on the expression of a number of genes which have been reported to be affected by or active in the TGF-β pathway including TGF-β I-II, HAS2, Gli-2, SMADs 2, 3 and 7, PLAU and others. This suggests that ODAM interacts in part with the TGF-β pathway. When challenged with neutralizing antibodies to block TGF-β activity we observed an increase in 231-ODAM cell growth which was approximately 80% that of the 231-control line. In addition, antibody blockade of TGF-β signaling restored the ability of 231-ODAM cells to invade and migrate through matrigel-coated barriers to that of the 231-control line. Taken together, these results and others suggest that ODAM acts in part through the TGF-β pathway, which has been implicated with invasion and metastasis in breast cancer and other malignancies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 92. doi:1538-7445.AM2012-92
Are psoriatic patients at risk of heat intolerance?
Authors: E. LEIBOWITZ, D.S. SEIDMAN, A. LAOR, Y. SHAPIRO, Y. EPSTEIN
Journal: British Journal of Dermatology (1991)

Sixteen young male subjects with psoriasis (mean of 4.9% of skin surface area involvement) and 10 healthy controls underwent a heat exercise test (40 °C, 40% r.h.) for 2 h. Rectal temperature (Tr). mean skin temperature (Tsk), heart rate (HR) and heat storage (dS) were measured and calculated. A sharper rise was found for all parameters in the psoriatic patients as compared with controls. Statistically significant differences were found in Tr after 60 min (37.9 ± 0.1°C and 37.5 ± 0.1°C in patients and controls, respectively) and at termination of the exercise (38.3 ± 0.1°C and 37.5 ± 0.1°C). Heat storage at the end of the first hour was 78 ± 9 and 30 ± 7 kcal in patients and controls, respectively. At the end of 120 min. heat storage in the study group increased to 87 ± 14 kcal. while the control group stored only 30 ± 7 kcal. Sweat rate was lower in the psoriatic patients (590 ± 49 g/h) than in controls (691 ± 42 g/h). even when corrected for healthy skin area (337 ± 26 g/h/m2 compared with 370 ± 24 g/h/m2). It is suggested that psoriatic patients have a reduced ability to dissipate extra heat during exposure to exercise in the heat. Psoriasis should therefore be considered as a risk factor for heat intolerance.
Quantitative Analysis of Liver Function in Percutaneous Transhepatic Biliary Drainage Patients
Authors: MICHAEL G. VELCHIK, WARREN SCHWARTZ, JACK W. LONDON, P. TODD MAKLER, ABASS ALAVI
Journal: Clinical Nuclear Medicine (1985)

The diagnostic usefulness of Tc-99m DISIDA cholescintigraphy as a predictor of eventual catheter and hepatic function in patients who have undergone percutaneous transhepatic biliary drainage (PTBD) for extrahepatic biliary obstruction was evaluated. Twentynine cholescintigrams were performed in 14 patients. The examinations were divided into two groups: Group A (N=17), in which the patient's clinical status deteriorated within two to three days post-PTBD, and Group B (N=12), in which the patients did well clinically post- PTBD. No significant difference between the two groups was demonstrated by visual analysis of the analog images or by analysis of serum bilirubin levels. A computer program, developed by the authors, quantitates several parameters of DISIDA kinetics, reflecting hepatic function based upon compartmental analysis. A significant difference (P<.001) was demonstrated between the mean transport constants (blood clearance constant=k1; hepatic clearance constant=k2) for the two groups. It is concluded that serum bilirubin levels and visual inspection of analog images are inadequate independent predictors of hepatic function in patients post PTBD. The transport constants k1, and k2 are quantitative parameters of hepatic function that may be of prognostic value in patients post PTBD.
Proteoglycan form of macrophage colony-stimulating factor binds low density lipoprotein.
Authors: S Suzu, T Inaba, N Yanai, T Kawashima, N Yamada, T Oka, R Machinami, T Ohtsuki, F Kimura, S Kondo
Journal: Journal of Clinical Investigation (1994)

We recently isolated a proteoglycan form of macrophage colony-stimulating factor (PG-M-CSF) that carries a chondroitin sulfate glycosaminoglycan chain. Here, we examined the interaction of PG-M-CSF with low density lipoprotein (LDL). When LDL preincubated with PG-M-CSF was fractionated by molecular size sieving chromatography, it was eluted earlier than untreated LDL. When LDL was preincubated with chondroitin sulfate-free 85-kD M-CSF instead of PG-M-CSF, the elution profile of LDL remained unchanged, indicating specific interaction between PG-M-CSF and LDL. The level of PG-M-CSF binding in the wells of a plastic microtitration plate precoated with LDL was significant, this binding being completely abolished by pretreatment of PG-M-CSF with chondroitinase AC, which degrades chondroitin sulfate. The addition of exogenous chondroitin sulfate or apolipoprotein B inhibited the binding of PG-M-CSF to LDL in a dose-dependent manner, indicating that the interaction between PG-M-CSF and LDL was mediated by the binding of the chondroitin sulfate chain of PG-M-CSF to LDL apolipoprotein B. PG-M-CSF was also demonstrated in the arterial wall, and there were increased amounts of PG-M-CSF in atherosclerotic lesions. The in vitro interaction between PG-M-CSF and LDL thus appears to have physiological significance.
Principles of Cardiac Arrhythmias
Authors: David H. Spodick
Journal: JAMA (1971)

Readers familiar with Dr. Chung's many instructive, scholarly, well-illustrated, and eminently readable articles will be grateful to him for combining all these qualities in a book. This clinically oriented treatise on arrhythmias transcends its title (<i>Principles</i>) by including treatment, additional practical considerations in diagnosis such as arrhythmias during myocardial infarction and digitalis excess, pseudoarrhythmias, and quasiarrhythmias. No aspect of rhythm disturbances is ignored, including mention of tenable alternate explanations where the mechanism of an arrhythmia is undecided, and the author is appropriately skeptical of explanations based on mere intuition. While, for example, Dr. Chung chooses to retain the familiar term "A-V nodal" (instead of "junctional") rhythms, this is by choice and their junctional-tissue origin is repeatedly cited. Clarity and completeness are Dr. Chung's hallmarks, making it hard to choose among 19 masterly chapters. "Atrial Arrhythmias" is both succinct and detailed. "A-V Dissociation," "Electrical Alternans," and "Aberrant Conduction" are self-contained classics.
99mTc-Methylene Diphosphonate Concentration in Soft Tissue Malignant Fibrous Histiocytoma
Authors: LEONARD ROSENTHALL
Journal: Clinical Nuclear Medicine (1978)

Four cases of non-calcifying soft tissue malignant fibrous histiocytoma are presented which showed concentration of 99mTc-methylene diphosphonate. Angiography was performed in one of the patients and it featured hypervascularity, tumor staining and early draining veins indicative of arteriovenous shunting. As with other extraskeletal non-calcifying entities which exhibit enhanced uptake of 99mTc-phosphate complex, the mechanism of concentration is largely conjectural. Malignant fibrous histiocytoma can be added to the expanding list of conditions which may portray an avidity for 99mTc-phosphate complex.
Long-Term Results of Endoscopic and Percutaneous Transhepatic Treatment of Benign Biliary Strictures
Authors: None Born, None Rösch, None Brühl, None Sandschin, None Allescher, None Frimberger, None Classen
Journal: Endoscopy (1999)

Background and Study Aims: Benign biliary strictures, mostly associated with biliary surgery, are of growing importance for the therapeutic endoscopist. In the short term, endoscopic therapy has success rates similar to those of surgery. With regard to the long-term results, fewer data are available, particularly concerning forms of treatment including percutaneous transhepatic biliary drainage (PTBD) as an additional tool. The present study was aimed at allowing evaluation of the short and long-term results of endoscopic and percutaneous treatment in patients with benign biliary strictures.
Report shows causes of maternal deaths in India
Authors: S. Baggchi
Journal: BMJ (2014)

<h3>Background</h3> A range of policies aim to reduce salt intake; however, their relative effects remain unclear. We undertook a narrative synthesis of existing evidence to determine the most promising approaches. <h3>Methods</h3> We searched for systematic reviews, then empirical and modelling studies of salt reduction policies in six electronic databases. Reference lists of retrieved articles were screened and key informants were asked to identify further reviews and empirical/modelling studies. Items were assessed for inclusion and data were extracted into predesigned forms. Results were categorised using a modified version of the marketing four P’s framework: Price, Product, Place and Promotion. <h3>Results</h3> <i>Price</i>: A US sodium excise tax may reduce sodium intake (by 6%), systolic blood pressure (by 0.9mmHg), stroke (by 10%) and myocardial infarction (by 5%) over the lifetime of those aged 40 – 85 years.<i> (One modelling study)</i> <i>Product:</i> Voluntary US salt limits might achieve lifetime reductions in sodium intake (-9.5%), blood pressure (-1.25mmHg), myocardial infarction (-5%) and stroke (-10%). In Australia, mandatory salt limits could reduce cardiovascular disease (by 18%) but only by 1% with voluntary intervention. <i>(Two modelling studies)</i> <i>Promotion:</i> Intensive advice, support and encouragement to restrict dietary sodium intake led to significant long term reductions in urinary sodium excretion, systolic blood pressure (-1.1mmHg) and disease burden (-0.5%.) Interventions involving advertising/marketing/labelling have only been evaluated within multi-component interventions. <i>(One systematic review.)</i> <i>Place:</i> Place-based interventions (targeting schools, workplaces and community settings) have only been evaluated within multi-component interventions. <i>Multi-component interventions:</i> The UK FSA product and promotion-based initiatives reduced salt intake by approximately 10%. Two modelling studies estimate that similar interventions in low- and middle-income countries might achieve a 15% reduction in salt consumption, globally averting perhaps 1 million deaths and 21 million disability-adjusted life years annually. Modelling estimates from Norway suggest that combining taxes and subsidies with product and price interventions might reduce daily salt intake by 6g. Survey data reveal that in Finland between 1979 – 2002, a comprehensive and mandatory nutrition intervention (using regulations targeting price, product, place and promotion) reduced urinary sodium excretion from 13 to 10 g/day in men and from 10.5 to 7.5g/day in women. <i>(Two empirical studies and three modelling studies)</i> <h3>Conclusion</h3> There is patchy evidence on the effectiveness of policy actions to reduce dietary salt intake. Dietary advice can achieve modest benefits. Modelling suggests taxes and reformulation may be effective (particularly when mandatory). Empirical and modelling studies indicate multi-component interventions could be particularly powerful.
Effects of Hydroxychloroquine on Immune Activation and Disease Progression Among HIV-Infected Patients Not Receiving Antiretroviral Therapy
Authors: Nicholas I. Paton, Ruth L. Goodall, David T. Dunn, Samuel Franzen, Yolanda Collaco-Moraes, Brian G. Gazzard, Ian G. Williams, Martin J. Fisher, Alan Winston, Julie Fox, Chloe Orkin, Elbushra A. Herieka, Jonathan G. Ainsworth, Frank A. Post, Mark Wansbrough-Jones, Peter Kelleher, for the Hydroxychloroquine Trial Team
Journal: JAMA (2012)

<h3>Context</h3>Therapies to decrease immune activation might be of benefit in slowing HIV disease progression.<h3>Objective</h3>To determine whether hydroxychloroquine decreases immune activation and slows CD4 cell decline.<h3>Design, Setting, and Patients</h3>Randomized, double-blind, placebo-controlled trial performed at 10 HIV outpatient clinics in the United Kingdom between June 2008 and February 2011. The 83 patients enrolled had asymptomatic HIV infection, were not taking antiretroviral therapy, and had CD4 cell counts greater than 400 cells/μL.<h3>Intervention</h3>Hydroxychloroquine, 400 mg, or matching placebo once daily for 48 weeks.<h3>Main Outcome Measures</h3>The primary outcome measure was change in the proportion of activated CD8 cells (measured by the expression of CD38 and HLA-DR surface markers), with CD4 cell count and HIV viral load as secondary outcomes. Analysis was by intention to treat using mixed linear models.<h3>Results</h3>There was no significant difference in CD8 cell activation between the 2 groups (−4.8% and −4.2% in the hydroxychloroquine and placebo groups, respectively, at week 48; difference, −0.6%; 95% CI, −4.8% to 3.6%; P = .80). Decline in CD4 cell count was greater in the hydroxychloroquine than placebo group (−85 cells/μL vs −23 cells/μL at week 48; difference, −62 cells/μL; 95% CI, −115 to −8; P = .03). Viral load increased in the hydroxychloroquine group compared with placebo (0.61 log<sub>10</sub> copies/mL vs 0.23 log<sub>10</sub> copies/mL at week 48; difference, 0.38 log<sub>10</sub> copies/mL; 95% CI, 0.13 to 0.63; P = .003). Antiretroviral therapy was started in 9 patients in the hydroxychloroquine group and 1 in the placebo group. Trial medication was well tolerated, but more patients reported influenza-like illness in the hydroxychloroquine group compared with the placebo group (29% vs 10%; P = .03).<h3>Conclusion</h3>Among HIV-infected patients not taking antiretroviral therapy, the use of hydroxychloroquine compared with placebo did not reduce CD8 cell activation but did result in a greater decline in CD4 cell count and increased viral replication.<h3>Trial Registration</h3>isrctn.org Identifier: ISRCTN30019040
Two smokers and evidence based medicine
Authors: H A Brewster
Journal: BMJ (2001)

It was the autumn of 1969, and I was in the middle of my first house job. My consultant was lecturing one of his patients, who had pain at rest from peripheral vascular disease, on the importance of stopping smoking immediately. I nodded gravely in the background before we continued our tour of the ward. As soon as we had finished, my consultant lit up a cigarette and walked back up the corridor to Sister's office and then out to the car park. I returned to the ward to finish my post-round tasks and was waved down by the above mentioned patient, known to everyone as “Ginger” because of his red hair and many freckles. “I saw your guv'nor lighting up his fag after telling me not to,” he told me with obvious glee. I was thrown off balance: would …
Court approves sterilisation of man with learning difficulties
Authors: M. Gould
Journal: BMJ (2013)

In a landmark ruling the Court of Protection has agreed that an NHS primary care trust can sterilise a man with profound learning difficulties to prevent him from having further children, because sterilisation was “in his best interests.”

The 37 year old, named only as DE and who lives in the Midlands, has an IQ of 40, which according to an assessment for the court by the independent psychiatrist David Milnes gives him a mental age of between 6 and 9 years. The man has limited speech, cannot use money, and lives with his parents.

DE and his girlfriend, PQ, who also has learning difficulties, had a child in 2010. PQ’s learning disabilities, although not as severe as DE’s, nevertheless meant that she was unable to look after her baby herself. As a result …