tbuckley/cabot-search huggingface dataset:
Valuing the effects of sildenafil in erectile dysfunction
Authors: N. Freemantle
Journal: BMJ (2000)

Papers p 1165 

Sildenafil is a true breakthrough drug in the sense that it provides a potential treatment for a condition for which there was no existing acceptable alternative. This complicates any attempt to describe the cost effectiveness of sildenafil in erectile dysfunction, such as that by Stolk et al in this week's BMJ (p 1165).1 They compare sildenafil with papaverine-phentolamine injections, which they argue are rationed on “medical grounds” and will not achieve the population benefits that might be achieved by sildenafil. More controversially, they argue that “the incremental cost-effectiveness of sildenafil lies at the favourable end of the scale when compared with interventions in health care for other diseases.”

The comparator therapy Stolk et al refer to, papaverine-phentolamine injections, seems not to have been rigorously evaluated and is not widely used. They used a cost utility approach in which a representative sample of the general population were asked to value the effects of treatment (for a condition that they did not have) to generate a cost per quality adjusted life year (QALY). Why might we question the validity of these findings?

Generating values for …
Relationship of Regional Adiposity to Insulin Resistance in Nonobese Japanese Type 2 Diabetic Patients
Authors: Ataru Taniguchi, Yoshikatsu Nakai, Masahiko Sakai, Satoru Yoshii, Masaru Hayashi, Kazukiyo Nishitani, Daizaburo Hamanaka, Shigeo Nakaishi, Takayuki Kamamoto, Itaru Nagata, Takahide Okumura, Hiroyuki Kishimoto, Mitsuo Fukushima
Journal: Diabetes Care (2001)

Type 2 diabetes is a heterogeneous disorder characterized by insulin resistance and/or defective insulin secretion (1,2). The mechanisms underlying insulin resistance in type 2 diabetes are not fully understood, but the numerous studies in nondiabetic populations have addressed the importance of upper body fat distribution. A study by Vague (3) was the first to show that upper body fat distribution has particularly adverse metabolic abnormalities. Higher concentrations of plasma glucose, insulin, and triglycerides have been shown to be associated with increasing abdominal body fat in nondiabetic subjects (4567). However, in diabetic patients, very little has been reported on the associations between insulin resistance and body fat distribution.

Banerji et al. (8) recently disclosed that visceral but not subcutaneous abdominal fat volume is associated with insulin resistance in black subjects with type 2 diabetes. In contrast, Abate et al. (9) recently demonstrated that subcutaneous but not intraperitoneal nor retroperitoneal fat volume is associated with insulin resistance in non-Hispanic whites with type 2 diabetes. The reason for the discrepant result between the two groups is unknown, but it can be speculated that there may be an ethnic difference in the relationship between insulin resistance and body fat distribution in type 2 diabetes.

Nonobese Japanese type 2 diabetic patients are unique in that they are divided into two variants: those with insulin resistance and those with normal insulin sensitivity (101112). However, to the best of our knowledge, the relationship between insulin resistance and body fat distribution has not been investigated in nonobese Japanese type 2 diabetic populations. Thus, the aim of the present study was to investigate the relationships among insulin resistance and subcutaneous or visceral fat area in nonobese Japanese type 2 diabetic patients.

A total of 75 nonobese Japanese type 2 diabetic patients at …
Hyperzincuria in IDDM Women: Relationship to Measures of Glycemic Control, Renal Function, and Tissue Catabolism
Authors: Carla C Heise, Janet C King, Francoise M Costa, John L Kitzmiller
Journal: Diabetes Care (1988)

Eighteen women with insulin-dependent diabetes mellitus (IDDM) and 15 nondiabetic women participated in a study of the relationship of zincuria to measures of glycemic control, renal function, and tissue catabolism. In the IDDM women, mean +/- SE glycosylated hemoglobin was 9.8 +/- 0.5%, and fasting plasma glucose was 189 +/- 19 mg/dl; duration of diabetes averaged 15 yr. In comparison with control women, the IDDM women excreted four times as much zinc in the urine. However, the total plasma zinc concentration was significantly higher in the IDDM than in the control women (14.7 vs. 13.4 microM). The increased urinary zinc loss in the IDDM women was not related to urine volume, urinary glucose excretion, fasting plasma glucose concentration, percent glycosylated hemoglobin, or an increased glomerular filtration rate. Total urinary protein losses were four times higher in the IDDM women than in the control women, and these urinary protein losses correlated with the urinary zinc losses (P less than .007). There was no relationship between urinary zinc and the excretion of any of the amino acids, urea, or ammonia. The results of this study show that hyperzincuria in diabetes is not associated with lower plasma zinc levels. An increased zinc absorption, decreased intestinal zinc excretion, or increased tissue catabolism may support higher plasma zinc levels.
Numerical representation, math skills, memory, and decision-making
Authors: Ellen Peters, Alan Castel
Journal: Behavioral and Brain Sciences (2009)

Abstract The consideration of deliberate versus automatic processing of numeric representations is important to math education, memory for numbers, and decision-making. In this commentary, we address the possible roles for numeric representations in such higher-level cognitive processes. Current evidence is consistent with important roles for both automatic and deliberative processing of the representations.
GW25-e4113 A randomized clinical study comparing using a single MAC guiding catheter with conventional approach via radial artery for coronary angiography and intervention in patients with ST elevation myocardial infarction
Authors: Guo Jincheng, Guozhong Wang, Fuli Zhu, Yuping Wang, Guowang Gao, Jianchun Wang, Jincheng Guo
Journal: Journal of the American College of Cardiology (2014)
Treating pressure sores.
Authors: M A Nasar
Journal: BMJ (1978)

data).Under these circumstances the usual effects of noradrenaline, causing marked reductions in heart rate and cardiac output, do not occur.Thus atropine, alone or after beta-blockers, can raise blood pressure and heart rate while maintaining cardiac output.From these observations therefore we would endorse the use of atropine in doses of at least 3 mg as bolus injections.Furthermore, as an alternative to isoprenaline in patients still hypotensive we would recommend graded infusions of noradrenaline to restore blood pressure provided atropine has been given previously.Under these circumstances heart rate and cardiac output are likely to be satisfactorily maintained and blood pressure restored.
Apoptosis as a mechanism of keratinocyte death in toxic epidermal necrolysis
Authors: C. PAUL, P. WOLKENSTEIN, H. ADLE, J. WECHSLER, H.J. GARCHON, J. REVUZ, J.C. ROUJEAU
Journal: British Journal of Dermatology (1996)

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are life-threatening diseases characterized by extensive epidermal destruction. The aim of our study was to investigate apoptosis in keratinocytes of patients with TEN and TEN/SJS overlap syndrome. Keratinocytes from TEN patients were found to undergo extensive apoptosis. These results suggest that cell destruction in TEN occurs as a result of apoptosis. Our findings suggest that apoptosis inhibitory agents may play an important part in the therapeutic strategy of TEN.
Oral contraceptive use and mortality after 36 years of follow-up in the Nurses' Health Study: prospective cohort study
Authors: B. M. Charlton, J. W. Rich-Edwards, G. A. Colditz, S. A. Missmer, B. A. Rosner, S. E. Hankinson, F. E. Speizer, K. B. Michels
Journal: BMJ (2014)

Objective To determine whether use of oral contraceptives is associated with all cause and cause specific mortality. Design Prospective cohort study. Setting Nurses’ Health Study, data collected between 1976 and 2012. Population 121 701 participants were prospectively followed for 36 years; lifetime oral contraceptive use was recorded biennially from 1976 to 1982. Main outcome measures Overall and cause specific mortality, assessed throughout follow-up until 2012. Cox proportional hazards models were used to calculate the relative risks of all cause and cause specific mortality associated with use of oral contraceptives. Results In our population of 121 577 women with information on oral contraceptive use, 63 626 were never users (52%) and 57 951 were ever users (48%). After 3.6 million person years, we recorded 31 286 deaths. No association was observed between ever use of oral contraceptives and all cause mortality. However, violent or accidental deaths were more common among ever users (hazard ratio 1.20, 95% confidence interval 1.04 to 1.37). Longer duration of use was more strongly associated with certain causes of death, including premature mortality due to breast cancer (test for trend P<0.0001) and decreased mortality rates of ovarian cancer (P=0.002). Longer time since last use was also associated with certain outcomes, including a positive association with violent or accidental deaths (P=0.005). Conclusions All cause mortality did not differ significantly between women who had ever used oral contraceptives and never users. Oral contraceptive use was associated with certain causes of death, including increased rates of violent or accidental death and deaths due to breast cancer, whereas deaths due to ovarian cancer were less common among women who used oral contraceptives. These results pertain to earlier oral contraceptive formulations with higher hormone doses rather than the now more commonly used third and fourth generation formulations with lower estrogen doses.
A Long-Term Prognostic Value of CT Angiography and Exercise ECG in Patients With Suspected CAD
Authors: Gianluca Pontone, Daniele Andreini, Antonio L. Bartorelli, Erika Bertella, Sarah Cortinovis, Saima Mushtaq, Claudia Foti, Andrea Annoni, Alberto Formenti, Andrea Baggiano, Edoardo Conte, Francesca Bovis, Fabrizio Veglia, Giovanni Ballerini, Cesare Fiorentini, Piergiuseppe Agostoni, Mauro Pepi
Journal: JACC. Cardiovascular imaging (2013)
Synovial Sarcoma of Childhood and Adolescence: A Multicenter, Multivariate Analysis of Outcome
Authors: Mehmet Fatih Okcu, Mark Munsell, Joern Treuner, Adrian Mattke, Alberto Pappo, Alvida Cain, Andrea Ferrari, Michela Casanova, Alp Ozkan, Beverly Raney
Journal: Journal of Clinical Oncology (2003)

Purpose: To identify prognostic factors related to outcome in 219 children and adolescents with synovial sarcoma. Patients and Methods: We combined the experiences of the four following research groups: Cooperative Weichteilsarkomastudie Group, Germany (n = 95); St. Jude Children’s Research Hospital, Memphis, TN (n = 49); Istituto Nazionale dei Tumori, Milan, Italy (n = 33); and The University of Texas M.D. Anderson Cancer Center, Houston, TX (n = 42). Kaplan-Meier and Cox proportional hazard analyses were performed. Results: The median age at diagnosis was 13 years (range, 1 to 20 years), and the median follow-up was 6.6 years (range, 0.5 to 30.7 years). The estimated 5-year overall survival and event-free survival rates for the entire group were 80% ± 3% (SE) and 72% ± 3%, respectively. A previously unreported interaction between tumor size and invasiveness was observed that statistically significantly related to outcome. In multivarible analysis, patients with T1B and T2B disease (hazard ratio [HR] = 5.6, 95% confidence interval (CI), 1.9 to 16.2; and HR = 5.9, 95% CI, 2.1 to 16.4, respectively) or Intergroup Rhabdomyosarcoma Study (IRS) Clinical Group III and IV disease (HR = 2.7, 95% CI, 1.2 to 6.5; and HR = 14.1, 95% CI, 4.3 to 31.3, respectively) had poor overall survival. Treatment with radiotherapy was related to improved overall survival (HR = 0.4; 95% CI, 0.2 to 0.7). In IRS Group III patients, objective response to chemotherapy (18 of 30, 60%) correlated with improved survival. Conclusion: Clinical group, tumor size, and invasiveness are important prognostic factors. Multicenter randomized clinical trials are needed to determine both the effect of chemotherapy on survival and the necessity of local radiotherapy in patients with completely resected tumors.
Synergetic Effects of Cigarette Smoking, Systolic Blood Pressure, and Psychosocial Risk Factors for Lung Cancer, Cardiac Infarct and Apoplexy Cerebri
Authors: Ronald Grossarth-Maticek
Journal: Psychotherapy and Psychosomatics (1980)

With 1,353 inhabitants of a Yugoslavian town, a prospective investigation was carried out during the years 1965–1975. At the beginning, physical and psychosocial risk factors for cancer and other internal diseases were determined; during the next 10 years the incidence of these diseases was recorded. The strongest physical and psychosocial risk factors for lung cancer, cardiac infarct, and apoplexia cerebri were investigated with respect to 'synergetic' effects (interaction nonlinearities), i.e., a dependence of the effect of one variable upon the value of another. They were always present, and the efficacy of physical risk factors was always wholly dependent upon the presence of psychosocial risk factors, while the latter were sometimes quite effective even in the absence of physical ones.
Low Bone Mineral Density in Young Children with Cystic Fibrosis
Authors: Isabelle Sermet-Gaudelus, Jean Claude Souberbielle, Jean Charles Ruiz, Stephanie Vrielynck, Blandine Heuillon, Imrana Azhar, Aline Cazenave, Ethel Lawson-Body, Frédérique Chedevergne, Gérard Lenoir
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Rationale: Low bone mineral density (BMD) is a frequent problem for adult patients with cystic fibrosis (CF). Only limited information is available for young patients.Objectives: The aim of this study was to evaluate BMD of children with CF younger than 6 years.Methods: BMD was measured at the lumbar spine (LS) after adjustment for height, sex, and pubertal status in 25 children with CF younger than 6 years, 53 prepubertal children aged 6 to 10 years, and 36 adolescents aged 11 to 18 years. Nutritional status, body composition, pulmonary disease severity, corticosteroid usage, dietary calcium, caloric intake, and vitamin D status were evaluated as potential correlates of BMD.Measurements and Main Results: The mean LS z score in the youngest group was significantly lower than normal (−0.96; SEM, 0.3). It did not differ significantly from that of children aged 6 to 10 years (−0.91; SEM, 0.2) or adolescents (-1.4; SEM, 0.2). LS z score was positively correlated with fat-free mass in multiple regression analysis. LS z score was less than −1 in 34% of the patients with mild pulmonary disease and normal nutritional status.Conclusions: These data suggest that the origin of CF bone disease in early childhood may be independent of nutritional status or disease severity.
Violence and Threats of Violence Experienced by Public Health Field-Workers
Authors: Joann M. Schulte
Journal: JAMA (1998)

Context.—Public health workers may work with clients whose behaviors are risks for both infectious disease and violence.Objective.—To assess frequency of violent threats and incidents experienced by public health workers and risk factors associated with incidents.Design.—Anonymous, self-administered questionnaires.Setting.—Texas sexually transmitted disease (STD), human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS), and tuberculosis (TB) programs.Participants.—Questionnaires were completed by 364 (95.5%) of 381 public health workers assigned to the programs. The STD program employed 131 workers (36%), the HIV/AIDS program, 121 workers (33%), and the TB program, 112 workers (31%).Main Outcome Measures.—The frequencies with which workers had ever experienced (while on the job) verbal threats, weapon threats, physical attacks, and rape, and risk factors associated with those outcomes.Results.—A total of 139 (38%) of 364 workers reported 611 violent incidents. Verbal threats were reported by 136 workers (37%), weapon threats by 45 (12%), physical attacks by 14 (4%), and rape by 3 (1%). Five workers (1%) carried guns and/or knives while working. In multiple logistic regression, receipt of verbal threats was associated with worker's male sex (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.5-4.0), white ethnicity (OR, 2.4; 95% CI, 1.4-4.1), experience of 5 years or longer (OR, 2.2; 95% CI, 1.3-3.8), weekend work (OR, 1.8; 95% CI, 1.1-3.1), and sexual remarks made to the worker by clients (OR, 2.0; 95% CI, 1.2-3.5). Receipt of weapon threats was associated with worker's male sex (OR, 5.7; 95% CI, 2.4-15.3), white ethnicity (OR, 4.0; 95% CI, 1.8-9.3), age of 40 years or older (OR, 2.5; 95% CI, 1.1-5.8), work experience of 5 years or longer (OR, 2.7; 95% CI, 1.2-6.0), rural work (OR, 3.6; 95% CI, 1.3-10.1), being alone with the opposite sex (OR, 3.7; 95% CI, 1.6-9.7), and interaction with homeless clients (OR, 5.2; 95% CI, 1.7-18.8). Physical attacks were associated with sexual remarks made to the worker by clients (OR, 4.2; 95% CI, 1.4-13.9). No risk factors predicting rape were identified.Conclusions.—Violence directed toward public field-workers is a common occupational hazard. An assessment of what situations, clients, and locations pose the risk of violence to public health workers is needed.
THE DIAGNOSIS AND TREATMENT OF ADDISON'S DISEASE
Authors: GEORGE A. HARROP
Journal: JAMA (1933)

During the past two and one-half years we have treated thirteen cases of Addison's disease by means of the suprarenal cortical extract made according to the method of Swingle and Pfiffner. The diagnosis of each of these cases we have regarded as unequivocal. We have had seven deaths (table 1), and six of our patients are now living (table 2). All of the seven fatal cases have come to autopsy, and the clinical diagnosis of Addison's disease has in each been proved correct. Four were due to cortical atrophy. Of the three due to tuberculosis, case 1 (table 1) was the first one in which treatment was given, and in the light of our later experience, adequate amounts of extract were not administered. The other two patients had advanced tuberculous lesions elsewhere in the body which probably caused death. An earlier report appeared inThe Journala year ago.<sup>1</sup>
10 YEARS OF INFECTIVE ENDOCARDITIS AT ST. BARTHOLOMEW'S HOSPITAL: ANALYSIS OF CLINICAL FEATURES AND TREATMENT IN RELATION TO PROGNOSIS AND MORTALITY
Authors: J.A. Lowes, G. Williams, S. Tabaqchali, I.M. Hill, J. Hamer, E. Houang, E.J. Shaw, G.M. Rees
Journal: The Lancet (1980)
Surgeon has 19 conditions placed on his practice
Authors: C. Dyer
Journal: BMJ (2013)

An orthopaedic surgeon in private practice—whose “inadequate” surgery had “serious far reaching consequences” for nine patients—has been allowed to continue practising, subject to 19 conditions.

Colin Mainds told a panel at the Medical Practitioners Tribunal Service in Manchester that by 2009, he was often working seven days a week.

He was the only surgeon at the private BMI Ross Hall Hospital in Glasgow who specialised in lower back spinal surgery, and saw seven of the nine patients as part of an …
Flk1+ cardiac stem/progenitor cells derived from embryonic stem cells improve cardiac function in a dilated cardiomyopathy mouse model
Authors: S BABA, T HEIKE, M YOSHIMOTO, K UMEDA, H DOI, T IWASA, X LIN, S MATSUOKA, M KOMEDA, T NAKAHATA
Journal: Cardiovascular Research (2007)

Flk1(+) cells derived from embryonic stem (ES) cells are known to differentiate into mesodermal lineages such as hematopoietic and endothelial cells. Here we demonstrate that they can develop into cardiomyocytes that support functional recovery in a dilated cardiomyopathy (DCM) C57/BL6 mouse model.Flk1(+) and Flk1(-) cells were sorted at day 4 of differentiation, and cardiomyogenesis was assessed in vitro. Next, we transplanted these cells into the hearts of cardiomyopathy mice to assess improvement in cardiac function.Flk1(+) cells, but not Flk1(-) cells, isolated on day 4 after differentiation were efficiently converted into contractile cardiomyocytes. RT-PCR analysis and immunohistological assays demonstrated that contractile cells derived from Flk1(+) cells in vitro expressed mature cardiac markers on day 10 after differentiation. Transplantation of sorted Flk1(+) cells into DCM model mouse hearts improved cardiac function, as determined by echocardiography and cardiac catheterization. The in vivo differentiated Flk1(+) cells expressed cardiac markers and had gap junctions, as demonstrated by immunohistochemistry. Furthermore, these cells generated ventricular type action potentials similar to those of adult ventricle.These results indicate that Flk1 is a good marker for sorting cardiac stem/progenitor cells which can differentiate into mature cardiomyocytes both in vitro and in vivo.
Radioguided Surgery in Neuroendocrine Tumors Using Ga-68-Labeled Somatostatin Analogs
Authors: Daniel Kaemmerer, Vikas Prasad, Wolfgang Daffner, Sven-Petter Haugvik, Stefan Senftleben, Richard P. Baum, Merten Hommann
Journal: Clinical Nuclear Medicine (2012)

Previous studies of the intraoperative use of a hand-held gamma probe to localize metastases and primary tumors have shown improved assessment of tumor spread and changes in surgical management based on additional information gained by radioguided surgery (RGS).The aim was to test the feasibility and advantages of doing RGS using a gallium-68 labeled with somatostatin receptor analogs in the intraoperative detection of neuroendocrine tumors.Ga-68 somatostatin receptor PET/CT imaging was performed preoperatively in 9 patients with gastroenteropancreatic neuroendocrine tumors. Statistical analyses were performed to find out the correlation between the pathologic size of the tumor lesions and the maximum standardized uptake value on PET/CT as well as the target/nontarget ratio (T/NT) of gamma probe counts. Thereafter, the impact of the planned operation procedure and the lesion-based sensitivity of tumor detection (surgical palpation vs. PET/CT vs. gamma probe) had been observed.Overall, 72 locations in 9 patients were examined intraoperatively using gamma probes. The gamma probe detected 94% of the whole histologically quantified lesions, whereas the PET/CT allocated 69% and surgical palpation, 50%. RGS resulted in change in the operative procedure in 56%. There was a significant correlation between the maximum standardized uptake value and tumor size (0.74; P < 0.005).Hand-held gamma probe surgery using gallium-68-labeled somatostatin analogs is a feasible and an attractive option for real-time detection of small metastases and primaries of neuroendocrine tumors.
Needle-Knife Sphincterotomy as a Precut Procedure: A Retrospective Evaluation of Efficacy and Complications
Authors: W. Bruins Slot, M. N. Schoeman, J. A. Disario, F. Wolters, G. N. J. Tytgat, K. Huibregtse
Journal: Endoscopy (1996)

See also: Needleknife Precut Sphincterotomy: The Devil is in the IndicationsEndoscopy 1997; 29(09): 888-888DOI: 10.1055/s-2007-1004329