tbuckley/cabot-search huggingface dataset:
The Medicare-HMO Revolving Door — The Healthy Go in and the Sick Go Out
Authors: Robert O. Morgan, Beth A. Virnig, Carolee A. DeVito, Nancy A. Persily
Journal: New England Journal of Medicine (1997)

Enrollment in Medicare health maintenance organizations (HMOs) is encouraged because of the expectation that HMOs can help slow the growth of Medicare costs. However, Medicare HMOs, which are paid 95 percent of average yearly fee-for-service Medicare expenditures, are increasingly believed to benefit from the selective enrollment of healthier Medicare recipients. Furthermore, whether sicker patients are more likely to disenroll from Medicare HMOs, thus raising average fee-for-service costs, is not clear.
Acanthosis Nigricans and Autoimmune Reactivity
Authors: Raymond A. Sturner, Stephen Denning, Patricia Marchase
Journal: JAMA (1981)

Acanthosis nigricans has been associated with malignant diseases and endocrinopathy. One of the cases reported herein and a review of 12 others suggest that the onset of acanthosis nigricans may predate a variety of classic autoimmune diseases. The other case being reported now, along with a literature review of 22 cases, suggests that acanthosis nigricans also may be associated with disordered immunoreactivity not fitting any clinically recognizable syndrome. (<i>JAMA</i>1981;246:763-765)
Treating the Patient, Not Just the Cancer
Authors: Ian F. Tannock
Journal: New England Journal of Medicine (1987)

Progress in chemotherapy has produced cures in advanced Hodgkin's disease and other lymphomas, metastatic testicular cancer, and several childhood cancers. These cures are obtained at the price of considerable toxicity, but both patients and their physicians are willing to accept a high risk of toxicity if there is a definite chance of cure. Unfortunately, most of the common solid tumors of adults cannot as yet be cured once they have metastasized to other sites. Anticancer drugs may kill a proportion of the malignant cells in many of these cancers, leading to a shrinkage of tumor masses that is often referred . . .
THE ASSOCIATION BETWEEN FALSE LUMEN THROMBOSIS AND AORTIC DIAMETER IN TYPE B AORTIC DISSECTIONS IN A LARGE COMMUNITY BASED COHORT
Authors: Keith Thompson, Armen Chalian, Ryan Clare, Yuh-Jer Shen, Michael Jorgensen, Colin Watanabe, Raymond Chen, William Gray, Ajay Kirtane, Somjot Brar, Kaiser Permanente
Journal: Journal of the American College of Cardiology (2014)
A truncated T cell receptor repertoire reveals underlying immunogenicity of an antigenic determinant.
Authors: N K Nanda, E Sercarz
Journal: The Journal of Experimental Medicine (1996)

Induction of T cell responses to an antigenic peptide that is known to bind a major histocompatibility complex molecule is a function of either the T cell receptor (TCR) repertoire or regulatory influences by CD8 or CD4 regulatory T cells. We have tested the hypothesis that a lack of 10 TCR V beta gene segments in V beta a mice may result in an incomplete repertoire of regulatory T cells involved in maintaining peripheral tolerance. Such a hole in the repertoire of regulatory cells could result in expression of T cell responses to antigenic determinants that normally remain undetected in mice with a wild-type repertoire of TCR V beta gene segments. We show here that H-2d mice respond to the peptide 74-96 of hen egg-white lysozyme (HEL) when they are of V beta a haplotype at their TCR locus. The wild-type (V beta b) H-2d mice with their complete set of 20 TCR V beta gene segments fail to respond to HEL 74-96. The 74-96-specific T cell responsiveness was revealed in the wild-type (V beta b) mice when they were treated in vivo with anti-CD8 antibody, implicating the existence of regulatory cells that prevent expression of T cell responses specific for peptide 74-96. This is a demonstration that holes in the regulatory T cell repertoire can, in certain circumstances, become beneficial to the host, for example, in susceptibility against pathogens.
Differential effects of two doses of aspirin on platelets-vessel wall introduction in vivo.
Authors: K K Wu, Y C Chen, E Fordham, C H Ts'Ao, G Rayudu, D Matayoshi
Journal: Journal of Clinical Investigation (1981)

Platelet cyclooxygenase appears to be more sensitive to aspirin than the arterial endothelial cell cyclooxygenase. To investigate the dose-related effects of aspirin on platelet-vessel wall interaction in acute vascular injury, male New Zealand White rabbits were treated with either (a) aspirin (150 mg/kg body wt; n = 6), (b) aspirin (30 mg/kg; n = 6), or (c) vehicle (n = 10). After treatment, autologous 111In-platelets were injected and deendothelialization of a 10-cm long segment of abdominal aorta was induced by a balloon catheter. Rabbits were killed 3 h after injury and radioactive counts and percentages of injected radioactivity per gram dry weight of tissue or blood were determined. The 30 mg aspirin group had a significantly lower radioactive count (62.13 +/- SD 6.07 x 10(3) cpm) and percentage of injected radioactivity (0.024 +/- 0.003%) per gram dry weight of damaged aortic tissue than the control (1,167.82 +/- 212.31 x 10(3) cpm/g tissue and 0.435 +/- 0.079%, respectively). By contrast, the 150-mg aspirin group had an elevation of radioactive counts (4,343.12 +/- 556.98 cpm) and percentage (1.632 +/- 0.246%) per gram dry weight of damaged tissue. Infusion of exogenous PGI2 was associated with reduction of lesion radioactivity. These findings were supported by ultrastructural findings. Examined under transmission electron microscopy, the injured aortic wall of 30-mg group was covered throughout the segment by a single layer of platelets without detectable platelet aggregates, while that of the 150-mg group was diffusely packed with multiple layers of platelets. The findings demonstrate that aspirin (30 mg/kg) prevents platelet aggregate formation at the injured arterial wall, whereas 150 mg/kg promotes platelet thrombus formation.
THE TECHNIC OF WOUNDS INCIDENT TO LAPAROTOMY.
Authors: HENRY O. MARCY
Journal: JAMA (1904)

The currents and counter-currents of surgical opinion have nowhere better illustration than in the treatment of wounds. Through the warp and the woof of history there are continually appearing and disappearing, in the experience of the ages, many truths which have their demonstration only in this later day of crucial science. The Egyptians, the Greeks, the Romans, all used antiseptics, in varying degree of value. This we recognize in the balsams, vinous preparations, terebinthinates and mineral oils. More or less obscurely they also recognized the value of drainage and cleanliness in wounds. After amputations, the application of boiling oil or the actual cautery served an admirable purpose for primary disinfection. To my mind, one of the greatest evidences of the genius and power of Ambroise Parélies quite as much in his overcoming of conservative prejudice against the introduction of the ligature as a hemostatic as to the value of the
The Effusion That Would Not Go Away
Authors: Petham Muthuswamy, Morufu Alausa, Brendan Reilly
Journal: New England Journal of Medicine (2001)

A 36-year-old man who was undergoing long-term hemodialysis was hospitalized with a two-day history of increasing dyspnea on exertion. He stated that he did not have cough, orthopnea, or night sweats.On examination, he was found to be in mild respiratory distress, with a blood pressure of 156/68 mm Hg, a respiratory rate of 22, a pulse of 80 per minute, and a temperature of 38.3°C (100.9°F). The site of entry of a right subclavian dialysis catheter appeared unremarkable. There was edema of the left hand and an audible bruit over an arteriovenous shunt in the left forearm. . . .
Anticoagulation Rebound after Hemodialysis
Authors: Constantine L. Hampers, M. Donald Blaufox, John P. Merrill
Journal: New England Journal of Medicine (1966)

REGIONAL heparinization has been a useful adjunct to hemodialysis since its introduction several years ago.1 Experience with the procedure, as reported by several authors,2 , 3 has generally been satisfactory. In principle, regional heparinization involves the constant infusion of heparin into the arterial arm of the dialyzer and neutralization of the heparin by protamine on the venous side. If the heparin-to-protamine ratio is properly adjusted only neutralized heparin enters the patient, and theoretically this should not affect his coagulation parameters. This technic allows anticoagulation of the artificial kidney without anticoagulation of the patient and its attendant risks.Some time ago, we noted . . .
An Outbreak of Bullous Impetigo Neonatorum
Authors: T. H. C. Benians
Journal: BMJ (1943)

Outbreaks of impetigo neonatorum apparently due to staphylococcal infection were undoubtedly much more frequent than usual during the autumn and winter of 1941, more especially in maternity hospitals and homes.It is possible that staphylococcal infections in general were increased, as is shown in the following comparative figures of in-patients operated on in a large general hospital in London.
Relation Between Sensitivity to Thiopentone, Sulphonamides, and Sunlight
Authors: F. Evans, J. Gould
Journal: BMJ (1952)

<h3>Abstract</h3> Excitatory synaptic transmission in many neurons is mediated by two coexpressed ionotropic glutamate receptor subtypes, AMPA and NMDA receptors, that differ in kinetics, ion selectivity, and voltage-sensitivity. AMPA receptors have fast kinetics and are voltage-insensitive, while NMDA receptors have slower kinetics and increased conductance at depolarized membrane potentials. Here, we report that the voltage dependency and kinetics of NMDA receptors act synergistically to stabilize synaptic integration of EPSPs across spatial and voltage domains. Simulations of synaptic integration in simplified and morphologically realistic dendritic trees revealed that the combined presence of AMPA and NMDA conductances reduce the variability of somatic responses to spatiotemporal patterns of excitatory synaptic input presented at different initial membrane potentials and/or in different dendritic domains. This moderating effect of the NMDA conductance on synaptic integration was robust across a wide range of AMPA-to-NMDA ratios, and results from synergistic interaction of NMDA kinetics (which reduces variability across membrane potential) and voltage dependence (which favors stabilization across dendritic location). When combined with AMPA conductance, the NMDA conductance compensates for voltage-dependent and impedance-dependent changes in synaptic driving force, and distance-dependent attenuation of synaptic potentials arriving at the axon, to increase the fidelity of synaptic integration and EPSP-spike coupling across both neuron state (i.e., initial membrane potential) and dendritic location of synaptic input. Thus, synaptic NMDA receptors convey advantages for synaptic integration that are independent of, but fully compatible with, their importance for coincidence detection and synaptic plasticity.
Streptococcal Pharyngitis in Children-Reply
Authors: James W. Bass
Journal: JAMA (1976)

As Dr Gillette points out in the first paragraph of his letter, we referenced two previous studies in our article and confirmed, with our own work, that the addition of penicillin G procaine to penicillin G benzathine significantly alters the high incidence and severity of local reactions compared to that seen when the latter is given alone. The second paragraph of Dr Gillette's letter cautions that it would be unwise to infer that our treatment regimen containing 900,000 units of penicillin G benzathine and 300,000 units of penicillin G procaine in a 2-ml injection offered any other advantages. We made no such inferences. We clearly stated in our summary that (1) "although the procaine component does not hasten the resolution of signs and symptoms when compared to the benzathine component alone," (2) "it clears the throat of streptococci more rapidly," (3) "greatly decreases the incidences and severity of
Inducible Carboxypeptidase Activity
Authors: Alexander Redlitz, Francesca A. Nicolini, Janis L. Malycky, Eric J. Topol, Edward F. Plow
Journal: Circulation (1996)

Background An inducible carboxypeptidase activity in human plasma delays tissue-type plasminogen activator (TPA)–induced clot lysis in vitro. We investigated whether carboxypeptidase activity is induced in vivo during thrombosis and thrombolytic therapy in a canine model of myocardial infarction. Methods and Results By use of synthetic substrate assays, dog plasma was shown to contain an inducible carboxypeptidase activity that is efficiently inhibited by potato carboxypeptidase inhibitor. This inhibitor accelerates TPA-mediated clot lysis in vitro by an average of 27% (n=5, P =.046). Analysis of the inducible carboxypeptidase activity in plasma samples of dogs with electrically induced thrombosis of the circumflex coronary artery treated with TPA revealed that (1) inducible carboxypeptidase activity is increased during thrombosis (8.7±2.0 U/L, P &lt;.013) and thrombolytic therapy (9.9±1.8 U/L, P &lt;.024) compared with baseline (3.2±2.0 U/L); (2) thrombosis is a prerequisite of carboxypeptidase induction during and after TPA infusion, since carboxypeptidase levels were lower in dogs without a coronary thrombus; and (3) a significant positive correlation ( r =.6, P &lt;.0069) of carboxypeptidase activity with time to restoration of blood flow was observed. Conclusions These data indicate that carboxypeptidase activity is induced in vivo and may influence thrombolysis.
THE STRAUSS REACTION FOR THE DIAGNOSIS OF GLANDERS
Authors: B. L. ARMS
Journal: JAMA (1910)

Since Strauss 1 in 1886 discovered the fact that when material containing virulent B. mallei was inoculated into the peritoneal cavity of male guinea pigs scrotal lesions developed, the method which bears his name has been very generally used.  A positive reaction followed by typical organisms and a typical culture is unfailing evidence of the presence of B. mallei in the material inoculated, while the failure to obtain the reaction is not proof that the horse from which the specimen was taken has not glanders. Hill and Burr, 2 and also Frothingham, 3 in 1901 called attention to the fact that frequently material from a horse which had glanders, as proved by autopsy, failed to give the reaction.  The bacteriologic laboratory of the Boston Board of Health makes free examination for any disease of a bacterial nature which is dangerous to public health. Our tests for glanders during the past
ANTIGEN-ANTIBODY REACTIONS IN ALLERGIC HUMAN TISSUES
Authors: Ben Z. Rappaport
Journal: The Journal of Experimental Medicine (1960)

The skin of atopic patients contains specific reaginic antibodies in all epidermal cells, in unchallenged as well as antigen-challenged areas. The reagins are also present in the epithelial cells of sebaceous glands, sweat glands, hair follicles and also in macrophages and pericytes. Judged by staining characteristics, their immunologic reaction in tissues with antigen is identical with that of rabbit antibodies. Comparison of tissues stained with conjugated reagins and conjugated anti-human globulin antibodies demonstrates the close relationship of reagins and globulins. In antigen-challenged tissues the macrophages and pericytes become enlarged and stain more intensely with toluidine blue. No such changes in morphology or staining are present in histamine-tested or unchallenged atopic tissues.
DARWINISM AND DISEASE.
Authors: WOODS HUTCHINSON
Journal: JAMA (1892)

Before commencing this, to me, extremely interesting subject, I wish to say that I do not appear before you either as a full-fledged Darwinist or an expert pathologist, but as a mere dabbler in both, who has succeeded in raking up, together with much mud, a few oysters which he thinks contain pearls. Only a moiety of the collection displayed is original, but the method of arrangement is entirely so. The subject, of course, is an enormous one and one of which only the merest outlines can be given within the limits of the time allotted. I fear it will seem to some of you that setting two such "dark continents" to illuminate one another is much like calling upon one sphinx to explain another, a sort of "blind leading the blind," but as a matter of fact, even the mere inkling of the relations between the two which we
Sex Differences in Mortality in Children Undergoing Congenital Heart Disease Surgery
Authors: Ariane Marelli, Kimberlee Gauvreau, Mike Landzberg, Kathy Jenkins
Journal: Circulation (2010)

Background— The changing demographics of the adult congenital heart disease (CHD) population requires an understanding of the factors that impact patient survival to adulthood. We sought to investigate sex differences in CHD surgical mortality in children. Methods and Results— Children &lt;18 years old hospitalized for CHD surgery were identified using the Kids’ Inpatient Database in 2000, 2003, and 2006. Demographic, diagnostic, and procedural variables were grouped according to RACHS-1 (Risk Adjustment for Congenital Heart Surgery) method. Logistic regression was used to determine the odds ratio of death in females versus males adjusting for RACHS-1 risk category, age, prematurity, major noncardiac anomalies, and multiple procedures. Analyses were stratified by RACHS-1 risk categories and age. Of 33 848 hospitalizations for CHD surgery, 54.7% were in males. Males were more likely than females to have CHD surgery in infancy, high-risk CHD surgery, and multiple CHD procedures. Females had more major noncardiac structural anomalies and more low-risk procedures. However, the adjusted risk of in-hospital death was higher in females (odds ratio, 1.21; 95% confidence interval, 1.08 to 1.36) on account of the subgroup with high-risk surgeries who were &lt;1 year of age (odds ratio, 1.39; 95% confidence interval, 1.16 to 1.67). Conclusions— In this large US population study, more male children underwent CHD surgery and had high-risk procedures. Female infants who had high-risk procedures were at higher risk for death, but this accounted for a small proportion of females and is therefore unlikely to have a major impact on the changing demographics in adults in CHD.
When I use a word . . .: Crosses and stars
Authors: J. Aronson
Journal: BMJ (1997)

The Red Cross was founded in 1864 in pursuance of the aims of the Geneva Convention, and therefore used the Geneva Cross, a red Greek cross on a white ground, as its symbol. Because of the Christian connotations of the cross, similar organisations in Turkey and then in other Muslim countries were called the Red Crescent. And the equivalent modern Israeli term is Magen David Adom, the Red Shield of David.

The Magen David (pronounced Mâ-gen Dâ-veed), a hexagram, a six sided star formed from two equilateral triangles superimposed, is the symbol associated with Judaism; you can see it on the front and back covers of George Steiner's latest …
Passive smoking: Secondhand smoke does cause respiratory disease
Authors: A J Hedley
Journal: BMJ (2003)

Editor–The report by Enstrom and Kabat confirms that exposure to secondhand smoke causes injury to the respiratory system with the finding of a combined increased mortality risk for men and women for chronic obstructive pulmonary disease (relative risk 1.65, 95% confidence interval 1.0 to 2.73).1 This is consistent with other investigations that show the sensitivity of the respiratory system to secondhand smoke at all ages and in different settings. In …
The (Slowly) Vanishing Prescription Pad
Authors: Robert Steinbrook
Journal: New England Journal of Medicine (2008)

The prescription pad, as familiar a medical emblem as the stethoscope or the white coat, is on its way to becoming a historical curiosity. Electronic prescribing — narrowly speaking, the electronic transmission of prescriptions from physician to pharmacy, but generally considered to encompass a broader range of information exchange and connections — is spreading rapidly, propelled by improved technology, expectations of improved care and decreased costs, strong pushes from a variety of advocates (the pharmacy industry, some medical societies, insurers, and the companies that manage pharmacy benefits), and the threat of mandates. As of March 2008, about 7% of the . . .
Mediastinal Lymph Node Examination and Survival in Resected Early-Stage Non–Small-Cell Lung Cancer in the Surveillance, Epidemiology, and End Results Database
Authors: Raymond U. Osarogiagbon, Xinhua Yu
Journal: Journal of Thoracic Oncology (2012)

Pathologic nodal stage is the key prognostic factor in resectable non-small-cell lung cancer (NSCLC). Mediastinal lymph node (MLN) metastasis connotes a poor prognosis. Yet, some NSCLC resections exclude MLN examination.We analyzed U.S. Surveillance, Epidemiology, and End Results program data from 1998 to 2002 to quantify the long-term survival impact of failure to examine MLN in resected NSCLC. We used Kaplan-Meier methods to compare the unadjusted survival difference between patients with, and without, MLN examination, and Cox proportional hazards and competing risk models to serially adjust for the impact of risk factors on survival differences.Sixty-two percent of patients with pathologic N0 or N1 NSCLC had no MLN examined. Overall 5-year survival rates were 52% for those with, versus 47% for those without, MLN examination; lung cancer-specific survival rates were 63% versus 58% respectively (p < 0.001); nonlung cancer mortality was identical between cohorts. Adjusting for potential confounders, MLN examination was associated with a 7% reduction in all-cause mortality (hazard ratio, 0.93; confidence interval, 0.88-0.97; p = 0.002), and 11% reduction in lung cancer-specific mortality (hazard ratio, 0.89; 95% confidence interval, 0.84-0.95; p < 0.001) rates. The excess risk in 1 year's cohort of U.S. lung resections was 3150 lives over 5 years.Failure to examine MLN was a common practice in MLN-negative NSCLC resections, which significantly impaired long-term survival. Efforts to understand the etiology of this quality gap, and measures to eliminate it, are warranted.
P981 MODERN SURGICAL LIVER RESECTIONS OFFER BETTER RESULTS THAN TRANSARTERIAL CHEMOEMBOLIZATION IN CIRRHOTIC PATIENTS WITH B-BCLC STAGE HEPATOCELLULAR CARCINOMA
Authors: R. Ciria, A.B. Gallardo, J. Cabrera, A. Luque, M.D. Ayllón, M. Rodríguez-Perálvarez, J.L. Montero, P. López-Cillero, M. de la Mata, J. Briceno
Journal: Journal of Hepatology (2014)
Surgical Laparoscopy &amp;amp; Endoscopy
Authors: Gary D. Byrd
Journal: JAMA (1993)

It seems inevitable that, in fields expanding as rapidly as endoscopic surgery, new journals will arise. Such journals are created both to respond to the interests of their intended audiences and to be a suitable publishing outlet—for researchers' findings and practitioners' descriptions of new procedures.<i>Surgical Laparoscopy &amp; Endoscopy</i>is likely to address both these needs. Although the journal's first editorial begins by proclaiming that it will be "devoted to all forms of endoscopic surgery," the editor goes on to state that its real focus will be on laparoscopic surgery, because until now there has been only a "limited amount of data published in the medical literature" for laparoscopic surgeons, who have had to rely on "word of mouth, newspaper articles, or... commercial vendors" for information on methodology, indications, and potential complications. There is little question that the articles published to date fill the need for new information on laparoscopic