tbuckley/cabot-search huggingface dataset:
Association of Race and Age With Survival Among Patients Undergoing Dialysis
Authors: Lauren M. Kucirka, Morgan E. Grams, Justin Lessler, Erin Carlyle Hall, Nathan James, Allan B. Massie, Robert A. Montgomery, Dorry L. Segev
Journal: JAMA (2011)

Many studies have reported that black individuals undergoing dialysis survive longer than those who are white. This observation is paradoxical given racial disparities in access to and quality of care, and is inconsistent with observed lower survival among black patients with chronic kidney disease. We hypothesized that age and the competing risk of transplantation modify survival differences by race.To estimate death among dialysis patients by race, accounting for age as an effect modifier and kidney transplantation as a competing risk.An observational cohort study of 1,330,007 incident end-stage renal disease patients as captured in the United States Renal Data System between January 1, 1995, and September 28, 2009 (median potential follow-up time, 6.7 years; range, 1 day-14.8 years). Multivariate age-stratified Cox proportional hazards and competing risk models were constructed to examine death in patients who receive dialysis.Death in black vs white patients who receive dialysis.Similar to previous studies, black patients undergoing dialysis had a lower death rate compared with white patients (232,361 deaths [57.1% mortality] vs 585,792 deaths [63.5% mortality], respectively; adjusted hazard ratio [aHR], 0.84; 95% confidence interval [CI], 0.83-0.84; P <.001). However, when stratifying by age and treating kidney transplantation as a competing risk, black patients had significantly higher mortality than their white counterparts at ages 18 to 30 years (27.6% mortality vs 14.2%; aHR, 1.93; 95% CI, 1.84-2.03), 31 to 40 years (37.4% mortality vs 26.8%; aHR, 1.46; 95% CI, 1.41-1.50), and 41 to 50 years (44.8% mortality vs 38.0%; aHR, 1.12; 95% CI, 1.10-1.14; P <.001 for interaction terms between race and each aforementioned age category), as opposed to patients aged 51 to 60 years (51.5% vs 50.9%; aHR, 0.93; 95% CI, 0.92-0.94), 61 to 70 years (64.9% vs 67.2%; aHR, 0.87; 95% CI, 0.86-0.88), 71 to 80 years (76.1% vs 79.7%; aHR, 0.85; 95% CI, 0.84-0.86), and older than 80 years (82.4% vs 83.6%; aHR, 0.87; 95% CI, 0.85-0.88).Overall, among dialysis patients in the United States, there was a lower risk of death for black patients compared with their white counterparts. However, the commonly cited survival advantage for black dialysis patients applies only to older adults, and those younger than 50 years have a higher risk of death.
Metformin and Thiazolidinedione Use in Medicare Patients With Heart Failure
Authors: Frederick A. Masoudi, Yongfei Wang, Silvio E. Inzucchi, John F. Setaro, Edward P. Havranek, JoAnne M. Foody, Harlan M. Krumholz
Journal: JAMA (2003)

According to package inserts, metformin is contraindicated in diabetic patients receiving drug treatment for heart failure therapy, and thiazolidinediones are not recommended in diabetic patients with symptoms of advanced heart failure. Little is known about patterns of use of these antihyperglycemic drugs in diabetic patients with heart failure.To determine the proportions of patients hospitalized with heart failure and concomitant diabetes treated with metformin or thiazolidinediones.Serial cross-sectional measurements using data from retrospective medical record abstraction.Nongovernmental acute care hospitals in the United States.Two nationally representative samples of Medicare beneficiaries hospitalized with the primary diagnosis of heart failure and concomitant diabetes between April 1998 and March 1999 and between July 2000 and June 2001.The prescription of either metformin or a thiazolidinedione at hospital discharge.In the 1998-1999 sample (n = 12 505), 7.1% of patients were discharged with a prescription for metformin, 7.2% with a prescription for a thiazolidinedione, and 13.5% with a prescription for either drug. In the 2000-2001 sample (n = 13 158), metformin use increased to 11.2%, thiazolidinedione use to 16.1%, and use of either drug to 24.4% (P<.001 for all comparisons). Similar increases were seen among patients of all age groups, all races, and both sexes.The use of metformin and thiazolidinediones is common and has increased rapidly in Medicare beneficiaries with diabetes and heart failure in direct contrast with explicit warnings against this practice by the Food and Drug Administration. Further studies to establish the safety and effectiveness of this practice are needed to ensure optimal care of patients with diabetes and heart failure.
INEFFECTIVENESS OF "KREBIOZEN" THERAPY ON TRANSPLANTED MOUSE LEUKEMIA AND LYMPHOSARCOMA
Authors: John B. Loefer
Journal: JAMA (1952)

To the Editor:—   a substance obtained from the serum of treated horses, has been reported as possessing possible therapeutic value for human malignant tumors (Ivy, A. C., and others: Krebiozen: An Agent for the Treatment of Malignant Tumors, Chicago, Champlin-Shealy Co., 1951, pp. 1-106). The tests also indicated that it had no effect on a spontaneously occurring carcinoma in C3H mice nor on several transplanted tumors, including the C3HBA mammary carcinoma in C3H mice and the Jensen and Walker tumors in rats. No experimental details were given in the original publication, and, although a number of communications have since appeared (A Status Report on  report of the Council on Pharmacy and Chemistry, J. A. M. A.  147 :864-873 [Oct. 27] 1951. Ivy, A. C.: Krebiozen, Science  114 :286, 1951. Rhoads, C. P.: Krebiozen, ibid. 114 :285-286, 1951) no detailed reports concerning the effect of krebiozen on mouse neoplasms
Observations on the Treatment of Rheumatoid Arthritis by Transfusions of Blood from Pregnant Women
Authors: C. Josephs
Journal: BMJ (1954)

The persistence of the duodenal cap deformity three months later, in the absence of further signs and symptoms, indicated that the ulcer had healed, leaving a considerable degree of scarring.This scarring, together with its inter- ference with the normal growth of the duodenum, may lead to the development of pyloric stenosis in the future. Summary and ConclusionsA case of Curling's ulcer in a child aged 4 years with 25% body surface burns is described.From the third day onwards for six weeks, severe attacks of melaena and haematemesis occurred, during which time a total of 131 pints (7.7 litres) of blood was given.After two grafting operations, with resultant healing of the burns, the ulcer symptoms subsided and the child improved rapidly.The prognosis in cases of Curling's ulcer is poor, especially in children, death occurring most often from haemorrhage or perforation.This case illustrates that if conservative treatment of the ulcer and its complica- tions can be maintained until the burns have healed, then the ulcer will heal spontaneously.My thanks are due to Mr.
Safe limits of drinking: patients' views
Authors: P. Anderson, P. Wallace
Journal: BMJ (1988)

<h3>Abstract</h3> While inflammation has been implicated in psychopathology, relationships between immune-suppressing processes and psychiatric constructs remain elusive. This study sought to assess whether β<sub>2</sub>-agonist clenbuterol (CBL) would attenuate immune activation in adolescents with mood and anxiety symptoms following <i>ex vivo</i> exposure of whole blood to lipopolysaccharide (LPS). Our focus on adolescents aimed to target a critical developmental period when psychiatric conditions often emerge and prior to chronicity effects. To capture a diverse range of immunologic and symptomatologic phenotypes, we included 97 psychotropic-medication free adolescents with mood and anxiety symptoms and 33 healthy controls. All participants had comprehensive evaluations and dimensional assessments of psychiatric symptoms. Fasting whole-blood samples were collected and stimulated with LPS in the presence and absence of CBL for 6 hours, then analyzed for 41 cytokines, chemokines, and hematopoietic growth factors. Comparison analyses used Bonferroni-corrected nonparametric tests. Levels of nine immune biomarkers—including IL-1RA, IL-1β, IL-6, IP-10, MCP-1, MIP-1α, MIP-1β, TGF-α, and TNF-α—were significantly reduced by CBL treatment compared to LPS alone. Exploratory factor analysis reduced 41 analytes into 5 immune factors in each experimental condition, and their relationships with psychiatric symptoms were examined as a secondary aim. CBL+LPS Factor 4—comprising EGF, PDGF-AA, PDGF-AB/BB, sCD40L, and GRO—significantly correlated with anticipatory and consummatory anhedonia, even after controlling for depression severity. This study supports the possible inhibitory effect of CBL on immune activation. Using a data-driven method, distinctive relationships between CBL-affected immune biomarkers and dimensional anhedonia were reported, further elucidating the role of β<sub>2</sub>-agonism in adolescent affective symptomatology.
Complete regression of advanced HCC with long acting octreotide
Authors: J T Siveke
Journal: Gut (2003)

Various therapeutic approaches for unresectable hepatocellular carcinoma (HCC) have been suggested in recent years. However, major advances concerning tumour regression or patient survival were not achieved. A few trials have assessed the effect of the somatostatin analogue octreotide in advanced HCC with divergent results.1,2 The latter might be due to expression of somatostatin receptor type 2 (SSTR2) in some but not all patients with HCC.3,4 Herein we describe a patient with advanced HCC who was treated with long acting octreotide, which resulted in complete and prolonged regression of the tumour.

The patient was diagnosed with HCC after a suspect nodule …
The Proper Perineal Prostatectomy Incision.
Authors: Jas. H. Nicoll
Journal: JAMA (1903)

Glasgow, Aug. 29, 1903. <h3>To the Editor:</h3> —The incision in question is undoubtedly the inverted Y, as advocated by Professor Senn inThe Journal, August 15, and there can be little doubt that its more general acceptance will be hastened by the support its practice has just secured at the hands of an authority so widely accepted as Professor Senn's. The inverted Y incision I have practiced and taught for years as the proper incision for perineal prostatectomy. Among the earliest of my references to it may be noted a description of it in a paper on prostatectomy in the<i>Lancet</i>, April 14, 1894, and in a discussion in the New York Academy of Medicine (reported in the<i>Medical News</i>, 1898) it was subjected to just such unfavorable criticism as Professor Senn now seeks to disarm, and which, though coming from other quarters as well, has never affected my belief
Retaliatory Actions in Malpractice: Doctors against Lawyers and Patients
Authors: William J. Curran
Journal: New England Journal of Medicine (1981)

ONE of the results of the increasing numbers of medical-malpractice actions in American courts has been more aggressive retaliation by physicians who believe the actions to be unfounded or improperly brought against them. National surveys have not found any large number of unmeritorious claims annually, but there are undoubtedly some actions filed that are improper or unjustified on any reasonable basis. These types of claims are the ones most resented by the medical profession. In this column I will examine some recent aspects of medical retaliatory efforts and an unusual, if not bizarre, counteraction by some patients in Kansas.The . . .
Abstract 3776: Third follow-up of a Dutch cohort occupationally exposed to chlorophenoxy herbicides, chlorophenols and dioxins
Authors: Daisy Boers, Lutzen Portengen, Bas Bueno-de-Mesquita, Dick Heederik, Roel Vermeulen
Journal: Cancer Research (2010)

Abstract A retrospective cohort study of workers exposed to phenoxy herbicides, chlorophenols, and contaminants (2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and other polychlorinated dioxins and furans) has been conducted in two chemical factories in the Netherlands. TCDD levels at time of presumed last exposure were estimated based on back-extrapolation of predictive models derived from a cross-sectional survey on a sub-population of the full cohort. Analyses were done using Cox proportional hazard models, using attained age as the time-scale. In analyses relating exposure to phenoxy herbicides to cancer mortality the previously reported increased risks for respiratory cancer, and non-Hodgkin's lymphoma in factory A could not be confirmed. However, increased risks were observed for all cancers in both factory A (HR=1.31; 95% CI 0.86-2.01) and factory B (HR=1.54; 95% CI 1.00-2.37). Increased risks for urinary cancers (HR=4.2; 95% CI 0.99-17.89) and genital cancers (HR=2.93; 95% CI 0.61-14.15) were observed in factory A, consistent with earlier reported results in this population. More detailed analyses showed that this increased risk for urinary and genital cancers in exposed workers was not due to selection of healthy controls and could not be attributed to specific products or departments. The results of this study showed only slight increases in cancer mortality risk among phenoxy herbicide exposed workers. Analyses using estimated (back-extrapolated) TCDD are currently in progress. Preliminary analyses suggest an increased risk for non-Hodgkin lymphoma in TCDD exposed factory A compared to B. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3776.
Epstein-Barr Virus Antibodies and Risk of Multiple Sclerosis
Authors: Alberto Ascherio, Kassandra L. Munger, Evelyne T. Lennette, Donna Spiegelman, Miguel A. Hernán, Michael J. Olek, Susan E. Hankinson, David J. Hunter
Journal: JAMA (2001)

Context Epidemiological studies suggest an association between infection with Epstein-Barr virus (EBV) and risk of multiple sclerosis (MS).Objective To determine whether elevation in serum antibody titers to EBV viral capsid antigen (VCA), nuclear antigens (EBNA, EBNA-1, and EBNA-2), and diffuse and restricted early antigen (EA-D and EA-R) as well as to cytomegalovirus (CMV) precede the occurrence of MS.Design, Setting, and Subjects Prospective, nested case-control study.Of 62439 women participating in the Nurses' Health Study (aged 30-55 years in 1976) and Nurses' Health Study II (aged 25-42 years in 1989) who gave blood samples in 1989-1990 and 1996-1999, respectively, and were followed up through 1999, 144 women with definite or probable MS and 288 healthy age-matched controls were included in the analysis.Main Outcome Measure Serum antibody titers to the specific EBV and CMV antigens, compared between cases and controls. ResultsWe documented 18 cases of MS with blood collected before disease onset.Compared with their matched controls, these women had higher serum geometric mean titers (GMTs) of antibodies to EBV but not CMV.Elevations were significant for antibodies to EBNA-1 (GMT, 515 vs 203; P=.03), EBNA-2 (GMT, 91 vs 40; P=.01), and EA-D (15.9 vs 5.9; P=.04).The strongest association was found for antibodies to EBNA-2; a 4-fold difference in titers was associated with a relative risk (RR) of MS of 3.9 (95% confidence interval [CI], 1.1-13.7).The corresponding RRs were 1.6 (95% CI, 0.7-3.7)for VCA, 2.5 (95% CI, 1.0-6.3)for EBNA, 1.8 (95% CI, 1.0-3.1)for EA-D, and 1.0 (95% CI, 0.6-1.7)for CMV.Significant but generally weaker elevations in anti-EBV antibodies were also found in analyses of 126 cases of MS with blood collected after disease onset and their matched controls.Conclusions Our results support a role of EBV in the etiology of MS.
Natural Killer Cells Are Required for Extramedullary Hematopoiesis following Murine Cytomegalovirus Infection
Authors: Stefan Jordan, Zsolt Ruzsics, Maja Mitrović, Thomas Baranek, Jurica Arapović, Astrid Krmpotić, Eric Vivier, Marc Dalod, Stipan Jonjić, Lars Dölken, Ulrich H. Koszinowski
Journal: Cell Host & Microbe (2013)
Acquired Haemolytic Anaemia
Authors: W. Weiner, J. P. Whitehead, W. J. Walkden
Journal: BMJ (1956)

Before delivery, posterior pituitary extract should be used with great care.Certain criteria for the relatively safe employment of this substance are indicated.High multiparity provides certain problems, one of which is the possibility of spontaneous rupture of the uterus.The causes of dystocia in the multipara are summarized.Brow presentation should always be considered when the foetal head fails to descend in the second stage of labour, especially in the mn lltipara.Precipitate labotur max cauLse serious trauma to mother and foetus.Women who have had plastic cervical and vaginal operations should be delivered in hospital.Spontaneous rupture of the vaginal and supravaginal cervix with extension into the broad ligament is de- scribed, with illustrative cases.Four clinical varieties of rupture are described.The "qliet" and "delayed " varieties are easily missed.Stress is laid upon early diagnosis.Treatment is summarized.The value of transfusion is stressed.The incidence of ruLpture and perforation of the uterus in aissociation with pregnancy was 1 in 1,200 of all deliveries in the service of the two hospitals.BIBLIOGRAPIIY
Access to Information — Physicians' Credentials and Where You Can't Find Them
Authors: J M Reade, R M Ratzan
Journal: New England Journal of Medicine (1989)

WE recently tried to verify the credentials of physicians who advertise in the Yellow Pages of the telephone directory, and were dismayed to discover that we could not get the information we needed about their training.1 We were consequently unable to answer certain questions — e.g., how many years of specialty training did each physician have — and were forced to look only at board certification as a measure of specialty training. While trying to ascertain how physicians' credentials corresponded to those they listed for themselves in the Yellow Pages, we encountered a veritable obstacle course of inconsistent and illogical . . .
The aim should be a drug free society
Authors: K F Gunning
Journal: BMJ (1996)

Legalisation would have to be accompanied by personal responsibility EDrrOR,-Richard Smith argues for the legalisation of those psychoactive substances whose distribution or possession is currently a crime.'The argument is presented in terms of the impossibility of stopping people from wanting to take illicit drugs, the failure of prohibitionist policies, the desirability of a reduction in the costs of enforce- ment, the possibility of education about drugs, the attraction of purer preparations of drugs being manufactured by large companies, and the right of
Most children with vaccine allergies can be revaccinated, US experts say
Authors: J. H. Tanne
Journal: BMJ (2008)

Children who have had allergic reactions to previous vaccinations can usually be safely revaccinated, say new guidelines developed by a multicentre US team of experts in vaccine safety.

When considering revaccinating a child, especially one who has had an immediate reaction, doctors should take a careful history and use skin testing or serum IgE testing, or both, to try to identify the cause of the reaction, advise the authors, led by Robert Wood of the Johns Hopkins Children’s Center, Baltimore.

This is “particularly helpful in assessing risk regarding future immunisation and thereby minimising the risk for anaphylaxis,” they write ( Pediatrics …
Safe Water Treatment and Storage in the Home
Authors: Eric D. Mintz
Journal: JAMA (1995)

In many parts of the developing world, drinking water is collected from unsafe surface sources outside the home and is then held in household storage vessels. Drinking water may be contaminated at the source or during storage; strategies to reduce waterborne disease transmission must safeguard against both events. We describe a two-component prevention strategy, which allows an individual to disinfect drinking water immediately after collection (point-of-use disinfection) and then to store the water in narrow-mouthed, closed vessels designed to prevent recontamination (safe storage). New disinfectant generators and better storage vessel designs make this strategy practical and inexpensive. This approach empowers households and communities that lack potable water to protect themselves against a variety of waterborne pathogens and has the potential to decrease the incidence of waterborne diarrheal disease. (<i>JAMA</i>. 1995;273:948-953)
Primary Cardiac Lymphoma Evaluated With Integration of PET/CT and Contrast-Enhanced CT
Authors: Hung-Yi Su, Han-Luen Huang, Chen-Ming Sun, Shaw-Ming Hou, Meng-Ling Chen
Journal: Clinical Nuclear Medicine (2009)

A 43-year-old man had complete AV block and syncope. Echocardiography revealed a cardiac tumor attaching to the interatrial septum and protruding into the left atrial and right atrial cavities. F-18 FDG-PET/CT was performed and was interpreted with contrast-enhanced CT in similar planes side by side. It revealed remarkably increased glucose metabolism in the right atrium, interatrial septum, left atrium, and in a mass protruding from the posterior aspect of pericardium. Regions with central necrosis were found but there was no evidence of pleural and lymph node involvement. Endometrial biopsy demonstrated diffuse large B cell lymphoma and primary cardiac lymphoma was diagnosed. Integration of PET/CT and contrast-enhanced CT can play an important part in the evaluation of cardiac tumors since it makes differentiation of the intracardiac structures much easier and more precisely.
NICE endorses use of needle exchange scheme to minimise infection risk
Authors: A. Cole
Journal: BMJ (2009)

New guidance from the National Institute for Health and Clinical Excellence (NICE), to be published next week, endorses the use of the needle and syringe exchange scheme and could pave the way for its expansion.

The programmes have been operating in the United Kingdom for the last 20 years with most run by pharmacies and other drug services. They offer sterile injecting equipment to people who inject illicit drugs as well as advice on safer injecting techniques and appropriate disposal.

Around 200 000 people in England and Wales are estimated to inject illegal opiates and stimulants, said Professor Mike Kelly, director …
Performance Differences in Year 1 of Pioneer Accountable Care Organizations
Authors: J. Michael McWilliams, Michael E. Chernew, Bruce E. Landon, Aaron L. Schwartz
Journal: New England Journal of Medicine (2015)

In 2012, a total of 32 organizations entered the Pioneer accountable care organization (ACO) program, in which providers can share savings with Medicare if spending falls below a financial benchmark. Performance differences associated with characteristics of Pioneer ACOs have not been well described.