tbuckley/cabot-search huggingface dataset:
Measuring Health Care Quality
Authors: Roy M. Poses
Journal: JAMA (1993)

<h3>To the Editor.</h3> —Drs Jencks and Wilensky<sup>1</sup>say that a reason to develop their Health Care Quality Improvement Initiative was the finding that practice variation cannot be attributed to "known variations in patient sickness" and, hence, presumably may represent poor quality care. In fact, there are few data to support this statement. The studies usually cited in support of it actually compared the general health of a population sample with the rates of performance of specific procedures in the geographic area from which the sample was drawn. For example, Roos and Roos<sup>2</sup>showed that the socioeconomic characteristics and health status of samples of aged populations in different areas did not correlate with rates of specific surgical procedures in these areas. Similarly, Wennberg and Fowler<sup>3</sup>showed no relationship between population characteristics and procedure rates. Both studies surveyed the general population, not patients with particular problems who might have
P2-073: High insulin-like growth factor 1 receptor (IGF1R) expression is associated with poor survival in surgically treated patients with non-small cell lung cancer (NSCLC)
Authors: Rafal Dziadziuszko, Daniel T. Merrick, Barbara Szostakiewicz, Amelia Szymanowska, Witold Rzyman, Ewa Jassem, Kazimierz Jaskiewicz, Jacek Jassem, Paul A. Bunn, Fred R. Hirsch
Journal: Journal of Thoracic Oncology (2007)
PET Versus PET-CT in Patient With Suspicion of Non-Hodgkin Lymphoma Recurrence
Authors: Gerard Moulin-Romsee, Luc Mortelmans
Journal: Clinical Nuclear Medicine (2007)

We present the case of a 62-year-old patient with a history of non-Hodgkin lymphoma (stage III) in complete remission after 6 cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone with rituximab (CHOP-R) in 2006. The patient was referred for a PET-CT scan because of suspicion of recurrence. On PET there were multiple lung lesions, a submandibular lesion (right side) and an impressive retroperitoneal mass with a hypermetabolic wall, and central necrosis invading all retroperitoneal structures (aorta). There was also an additional lesion in the anterior abdominal wall below the liver. It was concluded that it was recurrent non-Hodgkin lymphoma (stage IV). Contrast enhanced CT demonstrated a large, rupturing abdominal aortic aneurysm (AAA) with saccular ectasia of the posterior wall compatible with a mycotic aneurysm. The other sites of hypermetabolism corresponded to metastatic infectious lesions. Histopathology confirmed the mycotic infection. The patient underwent urgent surgery including bilateral axillofemoral stenting and removing a clot from the AAA twice. Intravenous antibiotics were started. This case clearly denotes the importance of contrast enhanced hybrid PET-CT systems in which the CT information is relevant for PET interpretation and not only for anatomic repair. With PET alone, the diagnosis would have been completely different.
Antivirally protective cytotoxic T cell memory to lymphocytic choriomeningitis virus is governed by persisting antigen.
Authors: S Oehen, H Waldner, T M Kündig, H Hengartner, R M Zinkernagel
Journal: The Journal of Experimental Medicine (1992)

The basis of antiviral protection by memory cytotoxic T lymphocytes (CTL) was investigated in vivo and in vitro using lymphocytic choriomeningitis virus (LCMV) and recombinant vaccinia viruses expressing the LCMV-glycoprotein (vacc-GP) or -nucleoprotein (vacc-NP). The widely replicating LCMV with a tendency to persist induced solid long-term protective memory. The poorly replicating vaccinia recombinant viruses revealed in the vaccinated host that the antiviral capacity of the secondary immune T cell response and the protection against lethal LCM was dependent upon the immunizing antigen and its dose. Protection against lethal choriomeningitis is less sensitive to assess memory because it depends upon high levels of CTL precursors (p) and/or on an activated state of memory CTL. In contrast, antiviral protection measured as the capacity of the primed host to reduce virus titers after challenge infection correlated with elevated CTLp frequencies after immunization with live LCMV or recombinant vaccinia virus-expressing the major LCMV epitope. CTLp frequencies were constantly increased up to 70 d for LCMV immune mice, but rapidly decreased a few weeks after immunization with low dose vaccinia recombinant virus. For example, mice primed with 2 x 10(6) plaque-forming units (PFU) of vacc-NP, or 2 x 10(2) PFU, or 2 x 10(6) PFU of vacc-GP were antivirally protected on day 7 but not after day 30 when CTLp could not be measured any longer in vitro. However, greater priming doses of vacc-NP (10(4) or 2 x 10(6) PFU) as well as LCMV (2 x 10(2) PFU) induced elevated levels of CTLp and antiviral protection for 60 d or longer. Adoptive transfer experiments of immune spleen cells into syngeneic recipients without addition of antigen demonstrated that maintenance of the antiviral protective capacity of the transferred cells depended on the presence of viral antigen. Thus, antiviral protection by memory CTL may be rather short-lived since it is based on activated T cells continuously stimulated by persisting antigen. This is best achieved by high immunizing antigen doses yielded either by widely replicating viruses or high doses of poorly replicating recombinant vaccines.
Optimized design and data analysis of tag-based cytosine methylation assays
Authors: Masako Suzuki, Qiang Jing, Daniel Lia, Marién Pascual, Andrew McLellan, John M Greally
Journal: Genome biology (2010)

Abstract Using the type III restriction-modification enzyme EcoP15I, we isolated sequences flanking sites digested by the methylation-sensitive HpaII enzyme or its methylation-insensitive MspI isoschizomer for massively parallel sequencing. A novel data transformation allows us to normalise HpaII by MspI counts, resulting in more accurate quantification of methylation at &gt;1.8 million loci in the human genome. This HELP-tagging assay is not sensitive to sequence polymorphism or base composition and allows exploration of both CG-rich and depleted genomic contexts.
Sickened: The True Story of a Lost Childhood
Authors: Sean A Spence
Journal: BMJ (2004)

O ne variety of child abuse name-checked in the British media right now is Munchausen's syndrome by proxy (MBP): the infliction of suffering, symptoms, and signs upon a child by its “carer,” facilitating some need that the latter may have to interact with doctors. Children may be maimed and murdered by their kith and kin, and all in the pursuit of medical interventions. Raised in Ohio, in the American Midwest, Julie Gregory survived such an upbringing as the proxy for her mother, a truly damaged woman, who put her daughter through the mill. …
Prospective evaluation of the macroscopic types and location of early Barrett’s neoplasia in 380 lesions
Authors: O. Pech, L. Gossner, H. Manner, A. May, T. Rabenstein, A. Behrens, M. Berres, J. Huijsmans, M. Vieth, M. Stolte, C. Ell
Journal: Endoscopy (2007)

See also: Commentaire de travail de O. Pech et al., pp. 588Endoscopy 2007; 39(07): 757-757DOI: 10.1055/s-0032-1306949
Science for evil: the scientist's dilemma
Authors: M. Atiyah
Journal: BMJ (1999)

You are a scientist. You see your science being put to evil purposes, with disaster looming ahead. What do you do? This was the dilemma that confronted nuclear physicists in 1945 after the atomic bomb had been exploded over Japan. The search to understand the ultimate nature of matter, driven by intellectual curiosity and carried out in an abstruse mathematical framework, had produced the ultimate weapon of war.

Whether the development and use of these first atomic bombs was morally justified is today deeply disputed, but the problem that confronted the scientists at the end of the war was how to control the genie that had escaped from the bottle. They had produced a weapon that threatened the future of humankind. Their collective responsibility (or guilt) was unambiguous, but what should they do?

This was the genesis of the Pugwash organisation, an informal group of scientists who saw it as their responsibility to prevent the catastrophe of nuclear war in the future. From the beginning they were international, including, crucially, scientists from both sides of the Iron Curtain; they were experts, in both scientific and military spheres; and they conducted their discussions out of the limelight. The aim was to bring calm academic thinking to the complex scientific, military, and political issues involved.

#### Summary points

The Pugwash organisation was set up by physicists after the building of the atomic bomb to try to contain the malign uses of their science

Since then other scientists have become involved as other sciences have been used for destructive purposes

Pugwash has been involved in various conventions designed to prohibit the use of biological and chemical weapons, though many problems remain in monitoring the use of such weapons

Pugwash also increasingly grapples with wider …
Prevention of autoimmune rheumatic disease: state of the art and future perspectives
Authors: Lars Klareskog, Peter K Gregersen, Tom W J Huizinga
Journal: Annals of the Rheumatic Diseases (2010)

Prevention of disease can in principle be accomplished by identification of environmental and/or lifestyle risk and protective factors followed by public health measures (such as for smoking and lung cancer), or by modification of the individual's reactions to disease-inducing factors (such as in vaccinations against microbes). This review discusses both options based on emerging understanding of aetiologies in inflammatory rheumatic diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The major current opportunity for public health-based prevention lies in avoiding smoking. In RA, recent studies have calculated that, in Sweden (a country characterised by a low frequency of smoking), 20% of all RA cases and 33% of all cases of ACPA-positive RA would not have occurred in a smoke-free society. Smoking is also a major risk factor for SLE but no population attribution is yet available. New avenues for individualised and biology-based prevention are provided by the demonstration that several autoimmune rheumatic diseases are preceded by emergence of subclinical autoimmunity followed by laboratory-based signs of inflammation and finally overt disease. Examples of this process are provided from studies of autoimmunity to citrullinated proteins (in RA), to dsDNA (in SLE in general) and to Ro52 epitopes (in the case of neonatal heart block). The recognition of this sequence of events provides opportunities to intervene specifically and potentially curatively before onset of full-blown disease. Such prevention can be accomplished by modification of inciting antigens (environment), by modification of immunity (more or less specific immunomodulation) or by modification of specific gene functions. In all cases, prevention will be different in different subsets of disease and differ at different time points of disease development. Thus, the road map towards prevention of autoimmune rheumatic diseases includes increased understanding of how genes, environment and immunity interact.
Hemarthrosis Complicating Anticoagulant Therapy
Authors: George E. McLaughlin
Journal: JAMA (1966)

SPONTANEOUS hemarthrosis is an unusual complication of oral anticoagulant therapy. The reported incidence of this type of bleeding varies from 0% to 1.5%.<sup>1-5</sup>Three cases of intra-articular hemorrhage associated with oral anticoagulant therapy are presented herein; pertinent diagnostic and therapeutic points are briefly discussed. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 68-year-old obese white woman was admitted to the Hahnemann Hospital on Oct 28, 1965 for evaluation of pain and swelling in the right knee. She sustained a myocardial infarction in 1957, and subsequently was treated with thiazide diuretics, digitalis, and sodium warfarin (Coumadin). No past history of joint symptomatology was recorded. Arthralgia began suddenly two weeks prior to admission without apparent trauma, and was not associated with any change in therapy. The referring physician made a tentative diagnosis of thiazide-induced gout and phenylbutazone (Butazolidin), 100 mg four times daily, was prescribed. Numerous recent and old cutaneous ecchymoses were noted
Hematologic masquerade of rhabdomyosarcoma
Authors: Avery A. Sandberg, John F. Stone, Lawrence Czarnecki, Jesse D. Cohen
Journal: American Journal of Hematology (2001)

Abstract We present the case of a 12‐year‐old boy admitted with the diagnosis of acute leukemia, but found to have an infiltration of the marrow by an alveolar rhabdomyosarcoma (RMS) as determined by the cytogenetic demonstration of a t(2;13)(q25;q14). A primary tumor could not be found. With this case as a basis, we have tabulated features of all similar cases in the literature and discuss the possible optimal approaches to establishing the correct diagnosis in such patients. Am. J. Hematol. 68:51–57, 2001. © 2001 Wiley‐Liss, Inc.
Information about AIDS
Authors: Roger N. Taylor
Journal: Annals of Internal Medicine (1991)

Letters15 July 1991Information about AIDSRoger N. Taylor, PhDRoger N. Taylor, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-115-2-160_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: We agree with the statements by Veenstra and Gluck (1) that "access to bibliographic citations no longer satisfies medical professionals. They need access to unpublished data and to information on the latest medical trials and experimental drugs." We would add information about laboratory testing and performance evaluation to that list of needs.In addition to the those acquired immunodeficiency syndrome (AIDS)-related computer products discussed in the article, we would like to make you aware of the Laboratory Performance Information Exchange System (LPIES) developed by the Model Performance Evaluation Program, Public Health Practice Program Office, Centers for Disease...Reference1. Veenstra R and Gluck J. Access to information about AIDS. Ann Intern Med. 1991;114:320-4. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Roger N. Taylor, PhDAffiliations: Centers for Disease Control Atlanta, GA 30333 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 July 1991Volume 115, Issue 2Page: 160-160KeywordsAIDSDrugsHealth information technologyPrevention, policy, and public healthResearch laboratoriesSoftware tools ePublished: 1 December 2008 Issue Published: 15 July 1991 PDF downloadLoading ...
Serious errors and neglect in the NHS should be a criminal offence, says safety expert
Authors: N. Hawkes
Journal: BMJ (2013)

<h3>Summary</h3> <h3>Background and objectives</h3> Primary vesicoureteric reflux (VUR) can coexist with reflux nephropathy (RN) and impaired renal function. VUR appears to be an inherited condition and is reported in approximately one third of siblings of index cases. The objective was to establish a DNA collection and clinical database from U.K. families containing affected sibling pairs for future VUR genetics studies. The cohort9s clinical characteristics have been described. <h3>Design, setting, participants, &amp; measurements</h3> Most patients were identified from tertiary pediatric nephrology centers; each family had an index case with cystography-proven primary, nonsyndromic VUR. Affected siblings had radiologically proven VUR and/or radiographically proven RN. <h3>Results</h3> One hundred eighty-nine index cases identified families with an additional 218 affected siblings. More than 90% were &lt;20 years at the study9s end. Blood was collected and leukocyte DNA extracted from all 407 patients and from 189 mothers and 183 fathers. Clinical presentation was established in 122; 92 had urinary tract infections and 16 had abnormal antenatal renal scans. RN was radiologically proven in 223 patients. Four patients had been transplanted; none were on dialysis. In 174 others aged &gt;1 year, estimated GFR (eGFR) was calculated. Five had eGFR 15 to 59 and 48 had eGFR 60 to 89 ml/min per 1.73 m<sup>2</sup>. Values were lower in bilateral RN patients than in those with either unilateral or absent RN. <h3>Conclusions</h3> The large DNA collection from families with VUR and associated RN constitutes a resource for researchers exploring the most likely complex, genetic components predisposing to VUR and RN.
Bone marrow cell transplantation improves cardiac, autonomic, and functional indexes in acute anterior myocardial infarction patients (Cardiac Study)
Authors: Massimo F. Piepoli, Daniele Vallisa, Mariacristina Arbasi, Luigi Cavanna, Luigi Cerri, Monica Mori, Francesco Passerini, Luigi Tommasi, Agostino Rossi, Alessandro Capucci
Journal: European Journal of Heart Failure (2009)
Abstract P1-08-01: Effects Of An Allosteric AKT Inhibitor (MK2206) Administered With Or Without The Aromatase Inhibitor Vorozole In An ER+ Rat Mammary Cancer Model: Preventive And Therapeutic Effects
Authors: RA Lubet, MJ Ellis, CJ Grubbs
Journal: Cancer Research (2012)

Abstract The AKT inhibitors appear to hold some promise with regards to inhibition of ER+ breast cancers which have relapsed. It has been hypothesized that the combination of an aromatase inhibitor plus an AKT inhibitor may be particularly effective. We, therefore, tested whether an allosteric AKT inhibitor (MK2206) alone or together with the aromatase inhibitor vorozole would be effective in a preventive and/or therapeutic setting. Female Sprague-Dawley rats were administered a single IV dose of methylnitrosourea (MNU) at 50 days of age. Beginning 5 days later, rats were administered the AKT inhibitor. In a preliminary study, two treatment regimens were employed: (1) dosing with inhibitor (100 mg/Kg BW/day, 7X/week) or (2) dosing with inhibitor (700 mg/Kg BW, 1X/week). These treatments minimally affected tumor multiplicity, but did significantly decrease tumor weights. We then examined the effects of combining the AKT inhibitor once weekly with a suboptimal dose of vorozole (0.12 mg/Kg BW/day) in a therapeutic setting. In a separate study, rats were treated with MNU and were allowed to develop their first palpable cancer. They were then treated with the combination of vorozole plus the AKT inhibitor or vehicle for 6 weeks. While tumors in vehicle treated rats grew an average of 600%, tumors treated with the inhibitor grew an average of only 95%; and, in fact, 5/12 showed a decrease in tumor size. Finally, we performed a similar combined study in a prevention setting. Dosing was: (a) AKT inhibitor (700 mg/Kg BW, 1X/week), (b) Vorozole (0.12 mg/Kg BW/day, 7X/week), (c) a plus b combined, and (d) vehicle. A, b, and c reduced tumor multiplicity by 26, 48 and 77%, respectively. Thus, combining an AKT inhibitor with an aromatase inhibitor showed synergy in prevention and treatment of ER+ tumors. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-08-01.
P156 Neutrophil and redox dependent proteolysis of bone morphogenetic protein 9: potential role in the pathogenesis of pulmonary arterial hypertension
Authors: W Li, K Hoenderdos, RM Salmon, PD Upton, AM Condliffe, ER Chilvers, NW Morrell
Journal: Thorax (2013)

<h3>Introduction</h3> A critical reduction of bone morphogenetic protein type II receptor (BMPRII) in the pulmonary circulation, either due to the genetic loss-of-function mutations, heightened inflammation or prolonged hypoxia, is one of the major causes behind pulmonary arterial hypertension (PAH), a fatal disease with poor prognosis. BMPRII is highly expressed in the vascular endothelium and undergoes rapid turnover. Bone morphogenetic protein 9 (BMP9), the only active circulating BMP, signals via endothelial BMPRII, inducing BMPRII expression and maintaining endothelial homeostasis. Although BMPRII function has been studied extensively, factors that regulate BMP9 stability and activity remain unclear. <h3>Objective</h3> To investigate how BMP9 activity and stability are regulated and whether this regulation plays a role in pulmonary arterial hypertension. <h3>Results</h3> Two forms of BMP9 dimer could be co-purified, with (D-form) or without (M-form) intermolecular disulphide bond. M- and D-forms BMP9 are interchangeable with redox potential, but have different stability. While the M-form is more susceptible to redox-dependent cleavage and proteases present in serum, the D-form is a preferred substrate for neutrophil elastase. Freshly isolated human peripheral blood neutrophils, when activated by hypoxia or inflammatory stimuli, released elastase that cleaved BMP9 effectively. <h3>Conclusions and Discussions</h3> This study demonstrates a novel proteolytic regulation of BMP9 under physiological and pathological conditions, suggesting neutrophil elastase could be a potential link between inflammation/hypoxia and BMPRII signalling, and the recognised benefits of elastase inhibition in rodent models of PAH may be due in part to reduced degradation of BMP9 and preservation of endothelial BMPR-II signalling.
EXPERIMENTAL ENCEPHALITIS (ST. LOUIS TYPE) IN MICE WITH HIGH INBORN RESISTANCE
Authors: Leslie T. Webster, Anna D. Clow
Journal: The Journal of Experimental Medicine (1936)

1. St. Louis encephalitis virus injected intracerebrally or intraperitoneally in maximum doses in resistant mice is distributed and is effective in a manner generally similar to that in susceptible mice. The minimum infecting dose is at least 1,000 times greater in resistant than susceptible mice and virus injected in the brain tends to remain at a relatively low titre, persist for a few days, and then disappear. 2. Virus dropped in the nares is demonstrable and progresses in the brains of resistant mice as in susceptible mice, but does not increase in titre beyond the 5th day, does not bring about fatal encephalitis, and persists for at least 4 weeks. 3. Lesions in the brains of resistant mice following nasal instillation of virus do not appear until the 8th day, reach a maximum at 40 days, and are still present, though resolving, at 3 months. The changes resemble those seen in the human disease and in other unnamed forms of encephalitis. 4. The quantity of virus drops 1,000-fold when recovered from resistant mice and becomes non-infective by the nasal route. Passage in susceptible mice promptly restores its full titre.
Immunoglobulin E Deficiency in Ataxia-Telangiectasia
Authors: A. J. Ammann, W. A. Cain, K. Ishizaka, R. Hong, R. A. Good
Journal: New England Journal of Medicine (1969)

An IgE deficiency was demonstrated in 11 of 16 patients with ataxia-telangiectasia. No relation to age or to the level of IgG, IgM or IgD was found. Nine out of 11 patients with IgE and IgA deficiency had recurrent sinopulmonary infections of varying degrees. The varying times of onset of recurrent sinopulmonary infection may be a function of immunologic attrition. There may be a delay between the loss of IgE or IgA (or both) and the manifestations of this deficiency. Particular vulnerability to sinopulmonary disease in patients with ataxia-telangiectasia attends the lack of both IgA and IgE.