tbuckley/cabot-search huggingface dataset:
Quality of Care: Do We Care?
Authors: R H Brook
Journal: Annals of Internal Medicine (1991)

The quality of U.S. health care must improve. Practicing physicians need to become involved in generating new knowledge about what does and does not work in medical practice. Physicians might, for example, participate in building national databases on chronic and acute conditions using data from their patients or might help to enroll patients in cohort studies or experimental trials. Furthermore, our knowledge is now sufficient to support a substantial investment of funds in improving what physicians now do in medical practice and in developing publicly available standards of medical practice. Such standards or guidelines could be used by both physicians and patients as part of an explicit process to assess the medical appropriateness of expensive or dangerous procedures before they are done. In addition, the competence with which care is delivered also needs to be measured. Both of these assessments should be used prospectively by physicians to help patients choose the referral source that will maximize their preferences.
Serum aminotransferase activity and mortality risk
Authors: Daniele Prati, Agostino Colli, Laura Porretti
Journal: Hepatology (2008)

We read with interest the article by Dr. Tae Hoon Lee and colleagues,1 which demonstrates that aminotransferase activity can predict mortality in U.S. community residents. We think that the data collected by Dr. Lee and colleagues will be even more informative and clinically useful if supplemental analyses will be conducted. The authors document that the risk of death from all causes increases as aminotransferase levels increase even within the normal range, but do not provide an estimate of the best thresholds to predict mortality. Survival analyses were performed after categorizing subjects in four subgroups, according to alanine aminotransferase (ALT) levels. Instead, we suggest the analysis of ALT as a continuous variable, using a receiver operating characteristic curve analysis. We believe this approach would be very helpful in clinical practice. As correctly underscored by the authors, we previously identified "healthy" or "desirable" ranges for ALT values, that is, the values expected in individuals at lowest risk for liver disease.2 Although these ranges were associated with lower mortality rates among Korean men,3 the optimal thresholds in Western populations remain to be assessed. There is growing evidence that high aminotransferase values are associated with future mortality for both hepatic and nonhepatic causes. In this regard, ALT activity can be viewed not only as an indicator of liver disease, but also as a gauge of general health.4 Therefore, we fully agree with Dr. Lee and colleagues that aminotransferase measurement could have an important role as a preventive screening test, particularly in individuals at risk. It is time to provide clinicians with validated thresholds, defined according to different clinical outcomes. Daniele Prati M.D.*, Agostino Colli M.D.*, Laura Porretti D.Sc. , * Ospedale Alessandro Manzoni, Lecco, Italy, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
710-4 The Dimorphic Pathology of Vein Graft Lesions Effects Acute Procedural and Late Angiographic Outcomes
Authors: Gary S. Mintz, Jeffrey J. Popma, Augusto D. Pichard, Kenneth M. Kent, Lowell F. Satler, S. Chiu Wong, Mun K. Hong, Jack A. Painter, Julie Mackenzie, Martin B. Leon
Journal: Journal of the American College of Cardiology (1995)
Response to Letter Regarding Article “Atherosclerosis 2005: Recent Discoveries and Novel Hypotheses”
Authors: Pascal J. Goldschmidt-Clermont, Gregory K.W. Lam, Victor J. Dzau, Chunming Dong, Joanne Kurtzberg, Mark A. Creager, Douglas W. Losordo, Momtaz Wassef
Journal: Circulation (2006)
Use of the Inactivated Intranasal Influenza Vaccine and the Risk of Bell's Palsy in Switzerland
Authors: Margot Mutsch, Weigong Zhou, Philip Rhodes, Matthias Bopp, Robert T. Chen, Thomas Linder, Christian Spyr, Robert Steffen
Journal: New England Journal of Medicine (2004)

After the introduction of an inactivated intranasal influenza vaccine that was used only in Switzerland, 46 cases of Bell's palsy were reported.We conducted a matched case-control study and a case-series analysis. All primary care physicians, ear, nose, and throat specialists, and neurologists in German-speaking regions of Switzerland were requested to identify cases of Bell's palsy diagnosed in adults between October 1, 2000, and April 30, 2001. Each physician was invited to select three control patients for each patient with Bell's palsy, with matching according to age, date of the clinic visit, and physician. Vaccination information was provided by the physicians.A total of 773 patients with Bell's palsy were identified. Of the 412 (53.3 percent) who could be evaluated, 250 (60.7 percent) were enrolled and matched with 722 control patients; the other 162 patients had no controls. In the case-control study, we found that 68 patients with Bell's palsy (27.2 percent) and 8 controls (1.1 percent) had received the intranasal vaccine (P<0.001). In contrast to parenteral vaccines, the intranasal vaccine significantly increased the risk of Bell's palsy (adjusted odds ratio, 84.0; 95 percent confidence interval, 20.1 to 351.9). Even according to conservative assumptions, the relative risk of Bell's palsy was estimated to be 19 times the risk in the controls, corresponding to 13 excess cases per 10,000 vaccinees within 1 to 91 days after vaccination. In the case-series analysis, the period of highest risk was 31 to 60 days after vaccination.This study suggests a strong association between the inactivated intranasal influenza vaccine used in Switzerland and Bell's palsy. This vaccine is no longer in clinical use.
B cell homeostasis in chronic hepatitis C virus-related mixed cryoglobulinemia is maintained through naïve B cell apoptosis
Authors: Lauren E. Holz, Joo Chun Yoon, Sukanya Raghuraman, Susan Moir, Michael C. Sneller, Barbara Rehermann
Journal: Hepatology (2012)

Mixed cryoglobulinemia (MC) is the most common extrahepatic manifestation of chronic hepatitis C virus (HCV) infection. Although the formation of inflammation-triggering immune complexes is driven by clonal expansions of autoreactive B cells, we found total B cell numbers paradoxically reduced in HCV-infected patients with MC. HCV patients with MC (n = 17) also displayed a reduced number and a reduced frequency of naïve B cells compared with HCV-infected patients without MC (n = 19), hepatitis B virus-infected patients (n = 10), and uninfected controls (n = 50). This was due to an increased sensitivity of naïve B cells to apoptosis resulting in a reduction in the size of the naïve B cell subset. In addition, 4-fold expansion and skewing (lower T1/T2-ratio) of the immature B cell subset was noted in MC patients, suggesting that apoptosis of naïve B cells triggered the release of B cell precursors from bone marrow in an attempt to maintain normal B cell numbers. Following treatment of MC with the B cell-depleting antibody rituximab, the size of all B cell subsets, the T1/T2-ratio, and the cyroglobulin levels all normalized. Cryoglobulin levels correlated with in vivo proliferation of T2 B cells, suggesting a link between the skewing of the T1/T2 ratio and the formation of immune complexes.This study provides insight into the mechanisms maintaining B cell homeostasis in HCV-induced MC and the ability of rituximab therapy to restore normal B cell compartments. (HEPATOLOGY 2012;56:1602-1610).
MORPHINISM FROM THE STANDPOINT OF THE GENERAL PRACTITIONER.
Authors: T. J. HAPPEL
Journal: JAMA (1900)

A practitioner of medicine in a large city, as a rule, has not as intimate a knowledge of his patients and patrons as his confrère in the small country town of two or three thousand inhabitants. In the cities, unless it be an exceptional case, the statement of the patient must be accepted as our basis upon which to draw conclusions; but in the smaller towns, nearly every one is personally known to the physician, who may have had, in a long life, a personal knowledge of three generations. It has been my own experience in several cases to have had a knowledge of as many as four generations of several of the families for whom I have practiced, and in cases referred to in the subsequent portions of this article, frequently three generations have been my intimate acquaintances. It is just such a condition as this that will make
Renal Papillary Necrosis and Pyelonephritis Accompanying Fenoprofen Therapy
Authors: Fred E. Husserl
Journal: JAMA (1979)

Renal papillary necrosis occurred after fenoprofen calcium administration in a patient with systemic lupus erythematosus and urinary tract infection. Possible mechanisms of renal damage may be hypersensitivity, decreased blood flow, and decreased production of a prostaglandin E-like substance.
Short-, Intermediate-, and Long-Term Quality of Life After Laparoscopic Radical Prostatectomy—Does the Learning Curve of LRP Have a Negative Impact on Patients’ Quality of Life?
Authors: Stephen F. Wyler, Robin Ruszat, Urs Straumann, Thomas H. Forster, Maurizio Provenzano, Tullio Sulser, Thomas C. Gasser, Alexander Bachmann
Journal: European Urology (2006)
Generalized Exfoliative Dermatitis Due to Penicillin
Authors: J. Ordie Shaffer
Journal: New England Journal of Medicine (1948)

THE increasing frequency of reactions to penicillin warrants wider recognition of the dangers of the local application of penicillin, and more reliance placed on less sensitizing methods of administration, such as the intramuscular, intravenous and intra-arterial routes.1 , 2 Although the direct toxic action of penicillin is negligible,3 aside from the irritating effect when the drug is applied to the central nervous system,4 the delayed or acquired sensitivity reactions may be severe or fatal. Wile5 noted that severe allergic reactions involving edema of the pharynx, larynx and lungs complicating penicillin therapy are serious and may result in fatal complications. Numerous other authors . . .
CD4+ T-Cell Recognition of Mutated B-RAF in Melanoma Patients Harboring the V599E Mutation
Authors: Melinda S. Sharkey, Gregory Lizée, Monica I. Gonzales, Sima Patel, Suzanne L. Topalian
Journal: Cancer Research (2004)

Abstract The potential of antigen-directed cancer immunotherapy has not been fully realized, perhaps because many commonly targeted tumor associated proteins are not essential to maintaining the malignant cell phenotype. A constitutively activating mutation in the signaling molecule BRAF is expressed frequently in melanomas and may play an important role in the biology of this disease. A 29-mer B-Raf peptide incorporating the V599E mutation was used for in vitro stimulation of lymphocytes derived from melanoma patients, generating MHC class II-restricted CD4+ T cells specific for this peptide as well as for melanoma cells expressing B-Raf V599E. Mutated B-Raf exemplifies targets that may be ideal for immunotherapy.
Vasectomy for contraception
Authors: P. H. Addison
Journal: BMJ (1967)

Correspondenc'method described in my first paper (8 May, 1965(8 May, , p. 1209)).The first tube contained urine alone, the second had 10 mg./100 ml.glucose added.The difference in the extinc- tiot.rfdings represented 10 mg./100 ml.-glucose, whatever the glucose loss, which in any case rarely exceeds 20%.This loss, incidentally, is partly due to charcoal .adsocptionand partly to residual antienzyme
Fluctuations of anticardiolipin antibody levels in patients with systemic lupus erythematosus: a prospective study.
Authors: H J Out, P G de Groot, P Hasselaar, M dan Vliet, R H Derksen
Journal: Annals of the Rheumatic Diseases (1989)

In 53 patients with systemic lupus erythematosus sequential blood samples obtained during a four year period (range 6-47 months) were screened for anticardiolipin antibodies (ACAs). Disease activity and treatment with prednisone were also assessed and related to ACA concentrations. During follow up only 21 patients for ACA IgG (40%) and 25 for ACA IgM (47%) remained in the ACA category (negative, low positive, high positive) found at the first sample taken at entrance. Marked increases from negative to high positive concentrations were sometimes seen and were not accompanied by typical events such as thrombosis or thrombocytopenia (the ACA syndrome). Shifts in ACA concentrations could not always be explained by changes in prednisone dose. Also, in patients with low dose prednisone treatment or none at all (n = 22) 10 patients (45%) changed ACA IgG category and 12 patients (55%) fluctuated in ACA IgM categories during follow up. As a consequence of the variability in ACA titres relations of ACAs with the ACA syndrome depended on the blood sample studied. In the second sample, randomly taken half way through follow up, no significant relations with the ACA syndrome could be found. Anticardiolipin antibody IgG was significantly associated with disease activity in 11/47 patients (23%) and in the group as a whole. During remission ACA IgG was significantly associated with the ACA syndrome, whereas during moderate/severe disease activity in the same patients that correlation was not significant. Anticardiolipin antibody IgM was much less influenced by disease activity, and in only 4/47 patients (9%) could a significant relation with disease activity be shown. Associations of ACA IgM with the ACA syndrome were significant during both lupus flares and remission.
How well do physicians recognize melanoma and other problem lesions?
Authors: Barrie R. Cassileth, Wallace H. Clark, Edward J. Lusk, Beth E. Frederick, C. Jean Thompson, William P. Walsh
Journal: Journal of the American Academy of Dermatology (1986)

The alarming increase in the incidence of cutaneous malignant melanoma in the United States emphasizes the importance of its early detection and treatment. Early detection requires accurate clinical recognition of both malignant and precancerous skin lesions (dysplastic nevi). This study presents data on dermatologists' and nondermatologists' ability to diagnose skin lesions. A total of 105 nondermatologist physicians, from first-year residents to practicing physicians, and forty-eight dermatologists were asked to identify color slides or photographs of eleven cutaneous lesions, including malignant melanomas, dysplastic nevi, and innocuous lesions such as seborrheic keratoses and common moles. Diagnosis of cutaneous lesions was generally inaccurate among nondermatologists. Only 38% correctly identified four or more of the six melanomas as melanoma of any type, and 58% were unable to diagnose dysplastic nevi. Only 17% categorized their relevant training as excellent or good. Improved training in the diagnosis of skin lesions for practicing physicians and house staff is required if mortality from malignant melanoma is to be decreased in the United States. The alarming increase in the incidence of cutaneous malignant melanoma in the United States emphasizes the importance of its early detection and treatment. Early detection requires accurate clinical recognition of both malignant and precancerous skin lesions (dysplastic nevi). This study presents data on dermatologists' and nondermatologists' ability to diagnose skin lesions. A total of 105 nondermatologist physicians, from first-year residents to practicing physicians, and forty-eight dermatologists were asked to identify color slides or photographs of eleven cutaneous lesions, including malignant melanomas, dysplastic nevi, and innocuous lesions such as seborrheic keratoses and common moles. Diagnosis of cutaneous lesions was generally inaccurate among nondermatologists. Only 38% correctly identified four or more of the six melanomas as melanoma of any type, and 58% were unable to diagnose dysplastic nevi. Only 17% categorized their relevant training as excellent or good. Improved training in the diagnosis of skin lesions for practicing physicians and house staff is required if mortality from malignant melanoma is to be decreased in the United States.
THE APPENDIX VERMIFORMIS AND CECUM. A COMPARATIVE STUDY. (1814-1901.)
Authors: B. MERRILL RICKETTS
Journal: JAMA (1901)

It will be the province of this paper to deal rather extensively with the comparative study of the appendix vermiformis and cecum of a few of the members of each of the four divisions of the sub-kingdom, Vertebrata. It will be shown that the appendix vermiformis is not found exclusively in the mammals, but is also found in birds, reptiles and fish. <h3>MAMMALS.</h3> The colon is largest in mammals, and its junction with the ileum generally has a single cecum. The anthropomorphous apes, such as Hylobates (gibbons). Simius satyrus (orang), Troglodytes (chimpanzee and gorilla), each possess a cecum, with a processus vermiformis or appendix, while the cynomorphous apes, (dog-like) babboon, and mandril, etc., each have a small cecum without an appendix, as do also the Platyrrhina (flat nose) monkeys. The long-tailed monkey has a cecum of pyramidal form. In the other order of mammals the cecum is generally present, but
Stimulation of Insulin Secretion by Fructose Ingested With Protein in People With Untreated Type 2 Diabetes
Authors: Mary C Gannon, Frank Q Nuttall, Charles T Grant, Sean Ercan-Fang, Nacide Ercan-Fang
Journal: Diabetes Care (1998)

OBJECTIVE Ingested protein provides substrate for gluconeogenesis and strongly stimulates insulin and glucagon secretion, but it has little effect on the glucose concentration in people with type 2 diabetes. Ingested fructose also is a substrate for gluconeogenesis, modestly stimulates insulin and glucagon secretion, and has little effect on the plasma glucose. Therefore we were interested in determining if ingestion of fructose along with protein would result in an additive, greater than additive, or less than additive effect on circulating insulin, glucagon, and glucose concentrations. RESEARCH DESIGN AND METHODS Seven male subjects with untreated type 2 diabetes were fasted overnight and then were given either 25 g fructose, 25 g protein, 25 g fructose plus 25 g protein, or water only at 0800. Subjects also ingested 50 g glucose on two separate occasions. Plasma glucose, insulin, C-peptide, glucagon, α-amino nitrogen, urea nitrogen, nonesterified fatty acids, and triglyceride concentrations were determined over the subsequent 5 h. RESULTS The glucose concentration was only modestly increased and the area responses were similar when protein, fructose, or the combination was ingested. Thus, the glucose response to the combination was less than additive. The insulin area response to protein was 2.5-fold greater than to fructose, and the response to the two nutrients was additive and quantitatively similar to the response to 50 g glucose. The glucagon area response was less than additive, i.e., there was an interaction between the protein and fructose that resulted in a smaller than expected response. CONCLUSIONS When protein and fructose were ingested together, the insulin response was similar to that following ingestion of 50 g glucose. It also was as expected based on the response to the individual nutrients. In contrast, the glucose and glucagon responses were significantly less than expected. These data may be useful in dietary planning for subjects with type 2 diabetes.
EARLY INITIATION OF HIGH-DOSE SIMVASTATIN DURING ST-ELEVATION MYOCARDIAL INFARCTION DECREASES THE INCIDENCE OF CARDIOVASCULAR EVENTS, EVEN IN PATIENTS WITH LOW ADMISSION LDL CHOLESTEROL LEVELS
Authors: Nestor Sales Martins, Luiz Srgio Carvalho, Osrio Luis Rangel de Almeida, Jos Carlos Silva, Khurram Nasir, Michael Blaha, Andrei Sposito
Journal: Journal of the American College of Cardiology (2014)
Abstract 4529: Self-assembled lipid-polymer hybrid nanoparticles for the sustained delivery of siRNA and the treatment of drug-resistant cancers.
Authors: Jinjun Shi, Yingjie Xu, Xiaoyang Xu, Alexander Votruba, Xi Zhu, Eric Pridgen, Zeyu Xiao, Robert Langer, Bruce R. Zetter, Omid C. Farokhzad
Journal: Cancer Research (2013)

Abstract RNA interference (RNAi), which can selectively knockdown target genes, has shown great potential in the treatment of various diseases including cancer. Thus far, numerous nanoparticle (NP) platforms such as lipoplex and polyplex have been developed to facilitate the safe and effective delivery of small interfering RNA (siRNA), which represents a major hurdle for the clinical applications of RNAi. Nevertheless, these NP systems lack the sustained siRNA release property, and thus can only induce transient gene silencing due to the short lifetime of siRNA. Therefore, the delivery of siRNA using controlled-release NPs would be necessary for achieving sustained gene silencing. Herein, we will present a novel NP platform for safe and effective siRNA delivery in a sustained manner, which can be developed through the self-assembly of biodegradable and biocompatible polymers and lipids. The lipid-polymer hybrid NPs show excellent in vitro knockdown efficacy at low doses of siRNA, and promising in vivo results for delivering siRNA to xenograft tumors. More importantly, these NPs can control the temporal release of siRNA, with the half-release time of ∼ 9 days, for sustained silencing of target gene expression. Results demonstrate that the luciferase expression is still less than 25% at day 7 when the lucifrease-expressed HeLa cells were transfected with the NPs containing 40 pmol anti-luciferase siRNA. As a comparison, the luciferase expression is largely recovered (∼ 80%) at day 7, after transfection with lipo2000-siRNA complexes. Furthermore, this NP platform has been applied to deliver anti-drug resistance siRNA (e.g., anti-PHB1) and chemotherapeutic drugs (e.g., taxanes) for the effective treatment of drug resistant cancers. We believe that the lipid-polymer hybrid NP platform with the property of sustained siRNA release could hold potential in both fundamental studies and clinical applications. Citation Format: Jinjun Shi, Yingjie Xu, Xiaoyang Xu, Alexander Votruba, Xi Zhu, Eric Pridgen, Zeyu Xiao, Robert Langer, Bruce R. Zetter, Omid C. Farokhzad. Self-assembled lipid-polymer hybrid nanoparticles for the sustained delivery of siRNA and the treatment of drug-resistant cancers. [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 4529. doi:10.1158/1538-7445.AM2013-4529
Interdependence of AMPK and SIRT1 for Metabolic Adaptation to Fasting and Exercise in Skeletal Muscle
Authors: Carles Cantó, Lake Q. Jiang, Atul S. Deshmukh, Chikage Mataki, Agnes Coste, Marie Lagouge, Juleen R. Zierath, Johan Auwerx
Journal: Cell Metabolism (2010)
The Ledger of Tobacco Control-Reply
Authors: Ronald M. Davis
Journal: JAMA (1996)

<h3>To the Reply.</h3> —In my Editorial, I focused on "assets" and "liabilities" in tobacco control that are national in scope. Coverage of important accomplishments in individual states and communities—such as the 3 state tobacco tax initiatives mentioned by Dr Glantz (and the 1 in Michigan, which he failed to mention)—was not possible in the space available. Nevertheless, these initiatives do represent the most aggressive actions against tobacco use in the United States to date and serve as model policies for adoption by other states and, ideally, by the nation as a whole. Mr O'Malley points out that many smokers receive pleasure from smoking. Of course they do, but 70% of smokers want to give up this pleasure, according to national surveys,<sup>1</sup>yet have not succeeded in quitting because of the addictive nature of smoking. O'Malley also argues that most smokers are aware that smoking is unhealthy. This is true, but large numbers