tbuckley/cabot-search huggingface dataset:
Effect of Triple Therapy (Antibiotics plus Bismuth) on Duodenal Ulcer Healing
Authors: David Y. Graham, Ginger M. Lew, Dolores G. Evans, Doyle J. Evans, Peter D. Klein
Journal: Annals of Internal Medicine (1991)

To determine whether antimicrobial therapy for Helicobacter pylori infection accelerates the healing of duodenal ulcers.Single-blind, randomized, controlled trial.Veterans Affairs hospital.One hundred and five patients with endoscopically verified duodenal ulcers.Patients received either ranitidine, 300 mg/d, or ranitidine, 300 mg/d, plus "triple therapy" (2 g/d of tetracycline, 750 mg/d of metronidazole, and 5 or 8 bismuth subsalicylate tablets per day). Triple therapy was administered for only the first 2 weeks of ulcer treatment.Videoendoscopic assessment of ulcer status was done until ulcer healing was complete. Evaluations were done after 2, 4, 8, 12, and 16 weeks of therapy.Ulcer healing was more rapid in patients receiving ranitidine plus triple therapy than in patients receiving ranitidine alone (P less than 0.01). The cumulative percentages of patients with healed ulcers in the group receiving ranitidine plus triple therapy and in the group receiving ranitidine alone were as follows: 37% and 18% after week 2; 74% and 53% after week 4; 84% and 68% after week 8; 96% and 80% after week 12; and 98% and 84% after week 16.Combined therapy with anti-H. pylori agents and ranitidine was superior to ranitidine alone for duodenal ulcer healing. Our results indicate that H. pylori plays a role in duodenal ulcer disease.
Comparison of the Extent and Severity of Myocardial Perfusion Defects Measured by CT Coronary Angiography and SPECT Myocardial Perfusion Imaging
Authors: Balaji K. Tamarappoo, Damini Dey, Ryo Nakazato, Haim Shmilovich, Thomas Smith, Victor Y. Cheng, Louise E.J. Thomson, Sean W. Hayes, John D. Friedman, Guido Germano, Piotr J. Slomka, Daniel S. Berman
Journal: JACC. Cardiovascular imaging (2010)
Characterization of Electrograms Associated With Termination of Chronic Atrial Fibrillation by Catheter Ablation
Authors: Yoshihide Takahashi, Mark D. O’Neill, Mélèze Hocini, Rémi Dubois, Seiichiro Matsuo, Sébastien Knecht, Srijoy Mahapatra, Kang-Teng Lim, Pierre Jaïs, Anders Jonsson, Frédéric Sacher, Prashanthan Sanders, Thomas Rostock, Pierre Bordachar, Jacques Clémenty, George J. Klein, Michel Haïssaguerre
Journal: Journal of the American College of Cardiology (2008)
Doctor who prescribed Viagra for himself is struck off
Authors: C. Dyer
Journal: BMJ (2014)

A doctor who stole prescription forms from the hospital where he worked and used them to obtain sildenafil (Viagra) because he was too embarrassed to ask his GP has been struck off by a fitness to practise panel at the Medical Practitioners Tribunal Service in Manchester.

Mansoor Mohammed Kassim, 37, who qualified in India, had worked for the NHS for eight years when he took up a post with Aneurin Bevan University Health Board in Wales as a trauma and orthopaedic clinical fellow in February 2013.

He stole his first prescription pad on …
Increased neutrophil function induced by bile duct ligation in a rat model
Authors: Rachel Levy, Francisc Schlaeffer, Arie Keynan, Ofra Nagauker, Arie Yaari, Emanuel Sikuler
Journal: Hepatology (1993)

Neutrophil function was studied in rats with common bile duct ligation. Superoxide production stimulated by phorbol myristate acetate, opsonized zymosan or formyl-methionyl-leucyl-phenylalanine; phagocytosis; and chemotaxis were significantly greater in neutrophils from rats with common bile duct ligation than in sham-operated control rats. Enhanced neutrophil activity was observed within 12 hr of bile duct ligation; it remained increased during the 15-day study. Preincubation of neutrophils from control rats with sera of rats with common bile duct ligation did not increase superoxide generation. This suggests that the high superoxide production observed in neutrophils of rats with common bile duct ligation was not an immediate effect of the serum. Neutrophils of rats with portal vein ligation exhibited normal activity, indicating that portal systemic shunting per se is not the underlying mechanism for increased activity. The elevated levels of AST and alkaline phosphatase, indicating liver damage, that appeared within 12 hr of bile duct ligation correlated with the increased superoxide generation.
Noninvasive Manifestations of Abnormal Left Ventricular Contraction in Patients with the Syndrome of Midsystolic Click and Late Systolic Murmur.
Authors: Alberto Benchimol
Journal: Annals of Internal Medicine (1973)

Meeting Abstracts1 May 1973Noninvasive Manifestations of Abnormal Left Ventricular Contraction in Patients with the Syndrome of Midsystolic Click and Late Systolic Murmur.Alberto Benchimol, M.D., F.A.C.P., Steven D. Promisloff, M.D., Kenneth B. Desser, M.D.Alberto Benchimol, M.D., F.A.C.P.Search for more papers by this author, Steven D. Promisloff, M.D.Search for more papers by this author, Kenneth B. Desser, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-5-819_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEleven patients (ages from 28 to 59 years) with the auscultatory syndrome of midsystolic click and late systolic murmur were studied by left ventriculography, selective coronary arteriography, phonocardiography, and multiple external carotid arterial and apexcardiographic recordings. Aortic subvalvular and valvular gradients were measured during isoproterenol infusion and after catheter-provoked ventricular premature contractions. Coronary arteriography was normal in all patients, and there was no evidence of subaortic pressure gradient during isoproterenol infusion and postextrasystole-pressure measurement. Left ventriculography showed mitral regurgitation in 11 patients. Eight patients had left ventricular contraction rings and inferoapical dyskinesis; they all had abnormalities of the external carotid... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Alberto Benchimol, M.D., F.A.C.P.; Steven D. Promisloff, M.D.; Kenneth B. Desser, M.D.Affiliations: Phoenix, Arizona PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byApexcardiographic-Echocardiographic Correlation in Mitral Valve Prolapse 1 May 1973Volume 78, Issue 5Page: 819-819KeywordsAngiographyIsoproterenolMitral insufficiencyStable coronary artery diseaseSystolic ejection murmur ePublished: 1 December 2008 Issue Published: 1 May 1973 PDF downloadLoading ...
Can Pay-for-Performance Improve Quality and Reduce Health Disparities?
Authors: Katie Coleman, Richard Hamblin
Journal: PLoS Medicine (2007)

Pay-for-performance programs have been embraced by United States and United Kingdom policy makers and payors (those who pay for health-care services) as a means to improve the quality of health care. In fact, since the Institute of Medicine's 2001 report Crossing the Quality Chasm suggested realigning incentives to improve care [1], the UK's National Health Service (NHS) introduced pay-for-performance (P4P) contracts for all family practitioners. In the US, more than half of commercial health maintenance organizations have started using such contracts, and recent legislation requires that the Centers for Medicare and Medicaid Services do the same for Medicare [2].

Despite growing enthusiasm for P4P programs in the policy and commercial sectors, the evidence to support their effectiveness is weak. Only a handful of studies have directly examined the impact of financial incentives on improving health-care processes and outcomes, and the results of those studies are mixed (K. Coleman, K. L. Reiter, D. Fulwiler, unpublished data). Generally, studies show that modest improvements can be achieved on the measures that are explicitly incentivized, at least over the short term [3]. However, it is unclear whether the improvements are a result of the financial incentives themselves rather than simply the increased focus on services resulting from measurement of performance and publication of data [4].

In addition to the lack of evidence supporting P4P programs, there are also concerns about the possible unintended consequences of implementing P4P. For example, in their evaluation of the NHS P4P program, Doran and colleagues found that the strongest predictor of high achievement (i.e., where a family practice successfully met a number of pre-specified quality targets) was exception reporting—a practice where physicians can exempt certain patients from being included in their performance data due to medical or other reasons [5]. Exception reporting rates for physician practices ranged from 0% to 85.8%, with a median of 6%. In addition to creating incentives for dishonest reporting of data, or gaming, we are starting to see evidence that P4P may undermine other important quality initiatives such as reducing health disparities. In the NHS program, family practices with a high proportion of patients who were living in single-parent or low-income households were less likely to meet the quality targets [5].

Linked Research Article
This Perspective discusses the following new study published in PLoS Medicine:

Millett C, Gray J, Saxena S, Netuveli G, Khunti K, et al. (2007) Ethnic disparities in diabetes management and pay-for-performance in the UK: The Wandsworth Prospective Diabetes Study. PLoS Med 4(6): e191. doi:10.1371/journal.pmed.0040191

Based on a population-based longitudinal survey, Christopher Millett and colleagues concluded that pay-for-performance incentives for UK general practitioners had not addressed disparities in the management and control of diabetes between ethnic groups.
Drug-Related Deaths Among Medical Inpatients
Authors: Jane Porter
Journal: JAMA (1977)

Among 26,462 carefully monitored medical inpatients, 24, or 0.9 per 1,000, were considered to have died as a result of a drug or group of drugs. Most of the patients were seriously ill prior to the event that caused death. Six of the deaths-five from fluid overload and one from excessive potassium therapy-may have been preventable.
Abstract 263: Defective Perinatal Myosin Produces Nemaline Myopathy And Embryonic Lethality
Authors: Konstantinos Charitakis, Luke Kim, Deborah A McDermott, Matthew L Inra, Brooke C Harrison, Leslie Leinwand, Craig T Basson
Journal: Circulation (2007)

Cardiac myxomas, the most common primary cardiac tumor, can occur in a familial disorder referred to as Carney complex (CNC), in which cardiac myxomas occur in the setting of spotty skin pigmentati...
Non-reversible and wide ranging voice changes after treatment with danazol.
Authors: P G Wardle, M I Whitehead, R P Mills
Journal: BMJ (1983)

Prostate-specific membrane antigen (PSMA)–ligand PET is potentially useful for screening of castration-resistant prostate cancer (CRPC) clinical trial target populations. We investigated the impact of PSMA PET on Prostate Cancer Clinical Trials Working Group 3 (PCWG3) clinical subtype classification when compared with conventional imaging (CI). <b>Methods:</b> A multicenter retrospective study enrolled patients who had undergone PSMA PET for CRPC, had prostate-specific antigen values of at least 1 ng/mL, and had undergone CI—that is, CT plus bone scanning or whole-body MRI. The clinical PCWG3 subtype was determined for PET versus CI by 3 masked readers. <b>Results:</b> Sixty-seven patients were included, and PSMA PET led to up-staging in 15% (10/67) of patients; of these, 6 of 10 (60%) had nonmetastatic CRPC on CI. PSMA PET resulted in down-staging in 15% (10/67) of patients. Agreement for PET versus CI PCWG3 clinical subtypes was 0.81 versus 0.51, 0.74 versus 0.47, 0.95 versus 0.72, or 0.59 versus 0.66 for local, nodal, bone, or visceral disease, respectively. <b>Conclusion:</b> Despite 70% concordance with CI, PSMA PET demonstrated superior reproducibility and accuracy especially for non-metastatic CRPC and should be implemented in future clinical trial entry procedures.
Malignant Neoplasm in Peutz-Jeghers Syndrome
Authors: Pierre Major
Journal: JAMA (1978)

<h3>To the Editor.—</h3> In their article entitled "Extensive Metastases in Peutz-Jeghers Syndrome" (239:2268, 1978), Ryo and associates refer to an article by Reid (229:833, 1974) to state that there are 14 known cases of malignant neoplasms developing from the Peutz-Jeghers polyp and that the rate of malignant transformation in these polyps is 2% to 3%. Reid reviewed 14 cases of digestive malignant neoplasms in the Peutz-Jeghers syndrome, and, in fact, in only two of his reviewed cases<sup>1,2</sup>is there acceptable proof that the malignant neoplasm originated from a typical hamartomatous polyp. The 2% to 3% incidence of malignancy in this syndrome as stated by Reid refers to all digestive cancers and not only to those developing in hamartomatous polyps as Ryo et al seem to imply. In fact, besides the two cases in Reid's review and the one reported by Ryo et al, there is only one other case
Understanding Drug Treatment in Mental Health Care
Authors: T. Kendrick
Journal: BMJ (1996)

Alyson J Bond, Malcolm H Lader Wiley, £15.99, pp 235 ISBN 0 471 96171 X

If you must steal something from my medical bag take my stethoscope but leave me my British National Formulary. Since I was a house officer I have rarely allowed myself to be more than a few feet away from a copy of that regularly updated, authoritative manual of therapeutics. Books aimed at improving general practitioners' understanding of drug treatments must offer more than the BNF's succinct background sections yet remain small enough to be read. I have no doubt …
Prognostic value of dobutamine-atropine stress technetium-99m sestamibi perfusion scintigraphy in patients with chest pain
Authors: Marcel L. Geleijnse, Abdou Elhendy, Ron T. van Domburg, Jan H. Cornel, Ambroos E.M. Reijs, Jos R.T.C. Roelandt, Eric P. Krenning, Paolo M. Floretti
Journal: Journal of the American College of Cardiology (1996)
The myxomatous mitral valve and sudden death.
Authors: E Chesler, R A King, J E Edwards
Journal: Circulation (1983)

The clincopathologic features of 14 cases of sudden death attributable to dysrhythmias associated with the myxomatous mitral valve are described. The patients were 14-59 years old (mean 27 +/- 11 years). Eleven were female and three male. Of the seven ECGs available, none showed prolongation of the QT interval, but two showed repolarization abnormalities. The material was classified according to the degree of prolapse in the pathologic specimen. When obvious prolapse was found, the expected auscultatory findings had been documented. In three cases there was minimal prolapse, casting some doubt on the hypothesis that traction on the papillary muscles or diastolic dumping of the leaflets may be implicated in the pathogenesis of the dysrhythmias. In one of the cases with minimal prolapse there was a strong family history of sudden death. Endocardial friction lesions were present in 11 cases, including two of the three with minimal prolapse. In five cases there was a thrombotic lesion in the angle between the posterior leaflet and the left atrial wall containing fibrin and platelets. These abnormalities may be important in the pathogenesis of the ventricular dysrhythmias.
Specialist liaison nurses
Authors: R. Hobbs, E. T Murray
Journal: BMJ (1999)

General practice p 706 

The number and the roles of clinical nurse specialists continue to increase in many areas of health care, despite limited evidence about their use. Some see the role as a threat to generalist nurses1 or even to primary care physicians. Nevertheless, nurses now lead services, admit and discharge patients, make autonomous clinical decisions, and organise programmes of care.2 What do we know about the use of such nurses and about their effectiveness?

The largest group of specialist nurse roles, in both hospital and community settings, are Macmillan nurses, who provide palliative care, followed by specialist nurses in diabetes, asthma, stoma wound care, infection control, and HIV/AIDS.3 One more recent trend has been for clinical nurse specialists based in hospital to serve as liaison nurses to the community, providing care across organisational boundaries, particularly in chronic disease management. A database maintained at the University of Sheffield …
GATA1-mutant clones are frequent and often unsuspected in babies with Down syndrome: identification of a population at risk of leukemia
Authors: Irene Roberts, Kate Alford, Georgina Hall, Gaetan Juban, Helen Richmond, Alice Norton, Grant Vallance, Kelly Perkins, Emanuele Marchi, Simon McGowan, Anindita Roy, Gillian Cowan, Mark Anthony, Amit Gupta, John Ho, Sabita Uthaya, Anna Curley, Shree Vishna Rasiah, Timothy Watts, Richard Nicholl, Alison Bedford-Russell, Raoul Blumberg, Angela Thomas, Brenda Gibson, Chris Halsey, Pek-Wan Lee, Sunit Godambe, Connor Sweeney, Neha Bhatnagar, Anne Goriely, Peter Campbell, Paresh Vyas
Journal: Blood (2013)
Anti–Cytotoxic T-Cell Lymphocyte Antigen-4–Induced Regression of Spinal Cord Metastases in Association With Renal Failure, Atypical Pneumonia, Vision Loss, and Hearing Loss
Authors: Caroline Voskens, Alexander Cavallaro, Michael Erdmann, Olga Dippel, Eckhart Kaempgen, Gerold Schuler, Beatrice Schuler-Thurner, Lucie Heinzerling
Journal: Journal of Clinical Oncology (2012)
SIRT2 overexpression in hepatocellular carcinoma mediates epithelial to mesenchymal transition by protein kinase B/glycogen synthase kinase-3β/β-catenin signaling
Authors: Juan Chen, Anthony W.H. Chan, Ka-Fai To, Weixian Chen, Zhenzhen Zhang, Jihua Ren, Chunli Song, Yue-Sun Cheung, Paul B.S. Lai, Suk-Hang Cheng, Margaret H.L. Ng, Ailong Huang, Ben C.B. Ko
Journal: Hepatology (2013)

Sirtuin 1 (SIRT1) has been implicated in telomere maintenance and the growth of hepatocellular carcinoma (HCC). Nevertheless, the role of other sirtuins in the pathogenesis of HCC remains elusive. We found that sirtuin 2 (SIRT2), another member of the sirtuin family, also contributes to cell motility and invasiveness of HCC. SIRT2 is up-regulated in HCC cell lines and in a subset of human HCC tissues (23/45). Up-regulations of SIRT2 in primary HCC tumors were significantly correlated with the presence of microscopic vascular invasion (P = 0.001), a more advanced tumor stage (P = 0.004), and shorter overall survival (P = 0.0499). Functional studies by short hairpin RNA-mediated suppression of SIRT2 expression in HCC cell lines revealed significant inhibition of motility and invasiveness. Depletion of SIRT2 also led to the regression of epithelial-mesenchymal transition (EMT) phenotypes, whereas the ectopic expression of SIRT2 in the immortalized hepatocyte cell line L02 promoted cell motility and invasiveness. Mechanistic studies revealed that SIRT2 regulates the deacetylation and activation of protein kinase B, which subsequently impinges on the glycogen synthase kinase-3β/β-catenin signaling pathway to regulate EMT.Our findings have uncovered a novel role for SIRT2 in HCC metastasis, and provide a rationale to explore the use of sirtuin inhibitors in HCC therapy. (HEPATOLOGY 2013;).
Association of Type 1 Diabetes With Month of Birth Among U.S. Youth
Authors: Henry S. Kahn, Timothy M. Morgan, L. Douglas Case, Dana Dabelea, Elizabeth J. Mayer-Davis, Jean M. Lawrence, Santica M. Marcovina, Giuseppina Imperatore
Journal: Diabetes Care (2009)

OBJECTIVE Seasonal environment at birth may influence diabetes incidence in later life. We sought evidence for this effect in a large sample of diabetic youth residing in the U.S. RESEARCH DESIGN AND METHODS We compared the distribution of birth months within the SEARCH for Diabetes in Youth Study (SEARCH study) with the monthly distributions in U.S. births tabulated by race for years 1982–2005. SEARCH study participants (9,737 youth with type 1 diabetes and 1,749 with type 2 diabetes) were identified by six collaborating U.S. centers. RESULTS Among type 1 diabetic youth, the percentage of observed to expected births differed across the months (P = 0.0092; decreased in October–February and increased in March–July). Their smoothed birth-month estimates demonstrated a deficit in November–February births and an excess in April–July births (smoothed May versus January relative risk [RR] = 1.06 [95% CI 1.02–1.11]). Stratifications by sex or by three racial groups showed similar patterns relating type 1 diabetes to month of birth. Stratification by geographic regions showed a peak-to-nadir RR of 1.10 [1.04–1.16] in study regions from the northern latitudes (Colorado, western Washington State, and southern Ohio) but no birth-month effect (P &amp;gt; 0.9) in study regions from more southern locations. Among type 2 diabetic youth, associations with birth month were inconclusive. CONCLUSIONS Spring births were associated with increased likelihood of type 1 diabetes but possibly not in all U.S. regions. Causal mechanisms may involve factors dependent on geographic latitude such as solar irradiance, but it is unknown whether they influence prenatal or early postnatal development.
Role of B lymphocytes in cell-mediated immunity. I. Requirement for T cells or T-cell products for antigen-induced B-cell activation.
Authors: S M Wahl, D L Rosenstreich
Journal: The Journal of Experimental Medicine (1976)

Although B lymphocytes can be triggered by B-cell mitogens and by certain other molecules to produce lymphokines, they do not produce lymphokines when stimulated with specific soluble protein antigens. We have investigated whether T-cell help would enable B cells to produce lymphokines when activated by antigens. Addition of small numbers of T cells to B-cell cultures resulted in significant production of a monocyte chemotactic factor. T cells could be replaced by supernates of antigen-stimulated T cells, demonstrating both that the chemotactic factor was B-cell-dervied and that T-cell help was mediated by a soluble factor. Although the T-cell factor was nonantigen specific, B-cell activation required the presence of both antigen and T-cell factor. Thus, it appears that although dependent upon T cells, B lymphocytes may play an important role in amplification of cell-mediated immune responses.
Sickle-cell and altitude.
Authors: F I Konotey-Ahulu
Journal: BMJ (1972)

objectivity in patients' management, so that the doctor might unwittingly be persuaded against a course of action which is ultimiately in the patient's own good.In a practice where it is taken for granted that not only may patients choose a doctor but also the doctor frequently may decide to confer with his colleagues in the presence of the patient, this danger is considerably diminished.So long as all partners are present in one central surgery at most, if not all, consul- ting times, so long as clinical notes are made concisely and clearly, and so long as regular (preferably daily) formal conversations take place between the partners in addition to in- surgery discussions, then we believe that encouraging the patients to consult any of the doctors can only enhance the standard of medical care in general practice.-Weare, etc.,
Diagnosis of Abdominal Cerebrospinal Fluid Pseudocyst by Scintigraphy
Authors: DAVID T. MAI, PANUKORN VASINRAPEE, ROBERT E. COOK
Journal: Clinical Nuclear Medicine (1993)

Abdominal cerebrospinal fluid (CSF) pseudocyst is a rare complication (involving the peritoneal end) of a ventriculoperitoneal shunt procedure. This is a report of a case of a CSF pseudocyst diagnosed by radionuclide shunt patency evaluation. Recognition of CSF pseudocyst formation in patients with predisposing factors will lead to early diagnosis and better management of these patients