tbuckley/cabot-search huggingface dataset:
US health spending grew more slowly in 2005, but it's not all good news
Authors: Janice Hopkins Tanne
Journal: BMJ (2007)

Doctors from more than a third of accident and emergency departments in hospitals in England said they were not reaching the government's target of dealing with patients within four hours.The main reason for this finding, from a survey published this week, was a shortage of available hospital beds, making it difficult for patients to be admitted.Only 49% of the nearly 500 members of the British Association for Emergency Medicine-all consultants and middle grade doctors-responding to the survey reported that their departments met the emergency access target for 98% of all patients to be seen, treated, admitted, or discharged within four hours.Although only 49% considered that their department actually met the emergency access target, 67% said that the figures reported by their department indicated that the target had been met.Respondents' comments on what had happened in their departments included, "Middle managers revising figures before being submitted," "Minor injury unit figures used to help achieve department's 96.9% target," and "Patients often 'moved' on the computer tracking but still kept in department to meet targets."Forty one per cent said that their depart- Lack of beds leads to missed government targetsment did not reach this target."Not enough available in-patient beds" was the main reason given for departments not meeting the emergency access target, and 88% of respondents reported it as a major contributory factor.Don MacKechnie, chairman of the BMA's emergency subcommittee and a consultant in emergency medicine at Pennine Acute Hospitals NHS Trust, said that financial problems in the NHS had meant that the availability of hospital beds for patients needing admission from accident and emergency departments was an important problem.He said, "In certain trusts, financial recovery measures have included closing beds previously used as 'safety valves' before, such as beds in rehabilitation wards.This has a knock-on effect to A&E [accident and emergency departments], with recovering patients that might have previously been moved remaining in acute beds."Mr MacKechnie said it was important that emergency access targets were seen as having broader application than simply affecting accident and emergency departments."Sometimes, other specialties forget that this is not just an A&E target.It is an emergency access target, with a responsibility from all specialties in an acute trust to ensure that the four hour target can be met."He said this meant ensuring that sufficient beds were available to admit patients from emergency departments and ensuring that doctors on call in each specialty are free to see patients in accident and emergency departments within the target of one hour after being referred.
Allergen‐specific conjunctival challenge in children with allergic asthma: a clinical tool
Authors: G. Ciprandi, M. A. Tosca, L. Fasce, G. W. Canonica
Journal: Allergy (1994)

Ciprandi G, Tosca MA, Fasce L, Canonica GW. Allergen‐specific conjunctival challenge in children with allergic asthma: a clinical tool.
Abstract 3718: Taxane-induced hedgehog activation promotes stemness of breast cancer cells.
Authors: Lynn Opdenaker, Jennifer Sims-Mourtada
Journal: Cancer Research (2013)

Abstract Recurrence of breast cancer after chemotherapy is thought to arise from resistant breast cancer stem cells which are eventually able to repopulate the tumor. The hedgehog (HH) signaling pathway has been shown to regulate the proliferation and survival of breast cancer stem cells, and has been shown to promote resistance to chemotherapy through the activation of multi-drug resistance and prosurvival pathways. Here we report that exposure of heterogenous breast cancer cell lines (T47D and SKBr3) to low doses (1-10nM) of docetaxel resulted in activation of HH signaling. Increased levels of sonic HH were detected in supernatants of breast cancer cells at 6- hours post-treatment. This release was accompanied by increased expression and nuclear translocation of Gli-1, peaking at 24 hours after exposure. Additionally, increased expression of the PTCH receptor was observed by western blotting in these cells 24 hours after treatment, indicating activation of a Gli-1 induced negative feeback loop. Increased mammosphere formation was observed in cells after preincubation with low dose docetaxel. Secondary sphere forming efficiency (SFE) was also increased in pretreated cells. The increase in SFE was similar to that of cell lines cultured in the presence of recombinant SHH. Additionally, the increase in SFE observed after docetaxel treatment could be blocked by the addition of sublethal doses of the hedgehog inhibitor cyclopamine. These results suggest that hedgehog pathway activation induced by docetaxel treatment could result in increased stemness of breast cancer cell lines. We propose that chemotherapy may activate stem cell signaling pathways, resulting in expansion of cancer stem cells and increased drug resistance. Citation Format: Lynn Opdenaker, Jennifer Sims-Mourtada. Taxane-induced hedgehog activation promotes stemness of breast cancer cells. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3718. doi:10.1158/1538-7445.AM2013-3718
Progressive fetal axillary cystic lymphangioma with coexistent naevus flammeus
Authors: C.-P. CHEN, H.-C. CHEN, F.-f. LIU, S.-W. JAN, S.-P. LIN, J.-C. SHEU, B.-F. CHEN
Journal: British Journal of Dermatology (1997)

We report the rare occurrence of a progressive fetal axillary cystic lymphangioma coexistent with an overlying naevus flammeus. The fetus at 22 weeks' gestation was found to have a 37 x 35 mm left axillary multiloculated mass without colour-flow imaging. Amniocentesis showed a normal 46,XX karyotype. Multiple fine-needle aspirations of the mass in the second and third trimesters obtained blood-stained chocolate-coloured fluid containing numerous erythrocytes and lymphocytes but proved ineffective in lessening the progressive growth of the mass. The mother underwent caesarean delivery and a healthy neonate was born with a 141 x 81 mm left axillary cystic lymphangioma and a 50 x 35 mm coexistent naevus flammeus. The neonate was well after simple excision of the lesions. Although cystic lymphangiomas arising in the axilla enlarge progressively during fetal life, our case suggests a good prognosis and except for genetic evaluation, no prenatal intervention is required.
Steatorrhoea in Progressive Systemic Sclerosis (Scleroderma)
Authors: D. J. McBrien, H. E. L. Mummery
Journal: BMJ (1962)

fall into grades I and II, and 20% into grade III.Only one patient of the 110 interviewed said that he was worse after the operation, and the sole patient with an TABLE III Visick grading I II III IV No. of patients .. 35 (31-8%) 51 (46 5%) 22 (19-9%) 2 (1-8%)anastomotic ulcer has also been placed in Grade IV.Even the 20% with a relatively unsatisfactory result were all of the opinion that they were far better than in the days of their ulcer.Summary A review is given of 128 patients with duodenal ulcers treated during 1950-4 by a limited Polya gastrectomy; 110 (86%) patients were interviewed.Only half the stomach was removed.The importance of ligating the vasa brevia to reduce the gastric acidity is emphasized.Only one patient (0.8%) developed an anastomotic ulcer.The incidence of the dumping syndrome was much lower than with the standard three-quarters gastrectomy.Bile vomiting occurred in 23% of the series, but was severe in only one woman.Iron-deficiency anaemia was present in 65% of the men.Loss of weight occurred in 92% of the patients.There was no correlation between the result of the operation and the amount of weight lost.We are grateful to Miss Turner, M.A., the senior almoner, without whose help and ingenuity it would have been impossible to trace many of the patients.We are also indebted to the general practitioners of Oxford who also went to great trouble in helping us to find the patients.
Screening Panels in Malpractice Cases: Some Disturbing Progress Reports
Authors: William J. Curran
Journal: New England Journal of Medicine (1980)

AMONG the major reforms in recent years in the field of medical malpractice has been the establishment of interprofessional screening panels designed to review and eliminate frivolous and unsupportable claims. Before the insurance crisis of 1975, only a few states had experimented with review panels.1 Most of the panels were informal, and their decisions nonbinding. Twenty-one states now have screening systems of various types. Most can make binding decisions, at least to the degree of requiring plaintiffs to present their cases to the panels before a court trial can be obtained. The panel's determination is not controlling, but its finding . . .
Echocardiography-Guided Ethanol Septal Reduction for Hypertrophic Obstructive Cardiomyopathy
Authors: Nasser M. Lakkis, Sherif F. Nagueh, Neal S. Kleiman, Donna Killip, Zuo-Xiang He, Mario S. Verani, Robert Roberts, William H. Spencer
Journal: Circulation (1998)

Background —Left ventricular outflow tract (LVOT) obstruction is frequently responsible for symptoms in hypertrophic obstructive cardiomyopathy (HOCM). Medical therapy is often not sufficient to control these symptoms, and surgical myotomy-myomectomy is required. Methods and Results —We enrolled 33 symptomatic patients with HOCM and obstruction (≥40 mm Hg gradient at rest or ≥60 mm Hg dobutamine-provoked). By contrast echocardiography, the bulging septum was localized and infarcted by injection of 2 to 5 mL of absolute ethanol into the septal artery(ies) supplying the hypertrophied area. Baseline echocardiograms with Doppler, myocardial perfusion tomograms, and treadmill exercise or pharmacological testing were compared with those at 6 weeks and 6 months. The mean rise in creatine kinase was 1964±796 U. All patients experienced symptomatic relief; NYHA class decreased from 3.0±0.5 to 0.9±0.6 ( P &lt;0.001). Exercise time increased from 286±193 to 421±181 seconds ( P =0.03). The resting and dobutamine-provoked gradient decreased from 49±33 and 96±34 mm Hg to 9±19 ( P &lt;0.001) and 24±31 mm Hg ( P &lt;0.001), respectively. Echocardiograms repeated at 6 weeks after the procedure showed a 28% reduction in septal thickness and 17% reduction in left ventricular mass. Myocardial perfusion imaging showed a “septal amputation pattern,” with scarring in the upper and middle septal areas. Complete heart block developed in 11 patients, who then required permanent pacemaker implantation. Conclusions —Echocardiography-guided ethanol septal reduction in patients with HOCM is a safe, minimally invasive procedure that provides symptomatic relief with improved hemodynamic and left ventricular parameters.
PSA Screening and Prostate Cancer Incidence
Authors: George G. Rhoads
Journal: JAMA (1996)

To the Editor.  —The report by Dr Jacobsen and colleagues 1 on the changing incidence of prostate cancer with the introduction of prostate-specific antigen (PSA) screening may lead the unwary reader to conclude that there are early signs that screening will reduce prostate cancer morbidity and mortality. The article contains no indication that this is the case. It is well known that many older men have occult prostate cancer and that serum PSA is elevated in at least some patients with organ-confined disease. Given widespread PSA screening, it would be surprising not to find an increase in incidence, especially of cases in early stages.  The authors' assertion that this increase should be transient warrants comment. If an active screening program leads to the identification of an increased proportion of many small prostate cancers that are known to be present at autopsy, a long-term elevation in observed incidence should be expected
Peace Corps Physician Volunteers
Authors: Robert Sargent Shriver
Journal: JAMA (1962)

<h3>To the Editor:—</h3> The Peace Corps is receiving requests for medical manpower assistance from developing countries of Africa, Asia, and Latin America. Our ability to respond to these requests will depend in great measure on the support of American physicians. I am hopeful that you will help us inform physicians that the Peace Corps offers them the opportunity to volunteer their services. Health authorities of developing nations are acutely aware of their health needs and are making great efforts to meet them. They face tremendous tasks in the clinical care of patients, the application of preventive health measures, and the training of medical personnel. The health measures needed for the treatment and control of such diseases as smallpox, malaria, schistosomiasis, leprosy, tuberculosis, and numerous other parasitic, communicable, and nutritional diseases are enormous. Besides these and many other conditions, which I am told physicians in this country face only rarely or
Use of thallium-201 redistribution scintigraphy in the preoperative differentiation of reversible and nonreversible myocardial asynergy.
Authors: A Rozanski, D S Berman, R Gray, R Levy, M Raymond, J Maddahi, N Pantaleo, A D Waxman, H J Swan, J Matloff
Journal: Circulation (1981)

Thallium-201 (201Tl) redistribution scintigraphy might differentiate reversibly from nonreversibly asynergic myocardial segments and thus predict the response of these segments to coronary artery bypass grafting (CABG). To test this hypothesis, 25 consecutive patients undergoing CABG, preoperative stress-redistribution 201Tl scintigraphy, and both pre- and postoperative resting equilibrium radionuclide ventriculography were evaluated. For both types of scintigraphic study, each patient was imaged in the same three views. Because of the effects of CABG on septal motion, this region was considered separately. Postoperative improvement was noted in 54% of 72 preoperative asynergic segments. Improvement was common not only in hypokinetic but also in akinetic and dyskinetic segments, and occurred in a similar proportion of studies performed early (less than 2 weeks) or late (3-6 months) after CABG. Thallium-201 redistribution scintigraphy was highly predictive of the pattern of postoperative asynergy: The redistribution pattern was normal in 90% of segments with reversible asynergy and abnormal in 76% of segments with nonreversible asynergy. The presence or absence of pathologic Q waves was less sensitive in this differentiation. Septal segments, however, frequently demonstrated abnormal wall motion postoperatively, despite normal 201Tl redistribution scintigraphy. Resting left ventricular ejection fraction (LVEF) was generally unchanged postoperatively, but in some patients with multiple areas of reversible asynergy it did improve. Thus, 201Tl redistribution scintigraphy appears to reliably distinguish viable from nonviable asynergic myocardial zones, and predicts the response of these segments to CABG.
The relationship between enzymatic and histologic estimates of the extent of myocardial infarction in conscious dogs with permanent coronary occlusion.
Authors: C R Roe, F R Cobb, C F Starmer
Journal: Circulation (1977)

Relationships between enzyme estimates (EE) and histologic measurements of infarct size (HIS) were analyzed in 14 conscious dogs with permanent occlusion of the circumflex coronary artery. EE were derived from serial CPK, CPK-MM, CPK-MB, and CPK-BB. Estimates were obtained using methods of Shell et al., Norris et al., and Roberts et al. HIS was determined from multiple histologic sections 5-6 days after infarction. In 14 animals, HIS ranged from 0.1-26.6 grams. Regression analysis demonstrated poor correlation (r2 less than 0.06) between EE by each method and HIS. Using the Shell method and restricting the analysis to HIS of less than 13 grams, improved the correlation (r2 = 0.42). Correlation in this subgroup could be further improved by using CPK-MM and MB data, elimination of animals with high background values, or limiting analysis to the portion of the curve where LDH isoenzymes indicated a cardiac zone. When the analysis was restricted to animals with HIS of less than 13 grams, Norris and Roberts modifications as compared to Shell's method improved correlation with CPK-MB but reduced correlation using CPK and CPK-MM data. In this subgroup, each method overestimated extent of HIS; Shell greater than Norris greater than Roberts. In this study it was not possible to distinguish small from large HIS by serum enzyme measurements.
Comparing Asthma in America (AIA) and Asthma Insight and Management (AIM) Surveys - Did Asthma Burden and Management Improve in the United States Between 1998 and 2009?
Authors: R.A. Nathan, S.W. Stoloff, M. Blaiss, E.O. Meltzer, D.E. Doherty, K.R. Murphy
Journal: Journal of Allergy and Clinical Immunology (2011)
Effect of the Hyde Amendment
Authors: Dennis B. Smith
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The article by Willard Cates, Jr, MD, "The Hyde Amendment in Action" (1981; 246:1109), represents a common misuse of statistical analysis and abuse of scientific "objectivity" to support a clearly political position. To his credit there is no misstatement of fact in the article, but there is a subtle distortion of data presentation that facilitates a misleading conclusion. Given the data as presented, it is easy to follow Cates' conclusion that the Hyde Amendment has had only a "minor impact on Medicaid-eligible women who wanted to terminate their pregnancies." Dr Cates has based his conclusion on an analysis of the total population of Medicaid-eligible women with unwanted pregnancies. However, 85% of these women were unaffected by the Hyde Amendment because they lived in states that continued to provide funding for abortion. If, as Cates did, one includes these women with the 15% who did not have access
Time until Relapse in Tuberculosis Treatment Trials: Implication for Phase 3 Trial Design
Authors: John L. Johnson, Bonnie A. Thiel
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

To the Editor:

The number of new drugs and combinations for tuberculosis treatment that require testing has increased during the past 5 years; however, the number of trial sites in high-burden countries capable of conducting registration-quality trials is limited. The primary endpoint for response to treatment in most earlier phase 3 trials was relapse at least 24 months after completion of therapy. Coupled with the large number of patients required and the challenge of following up patients in resource-constrained settings, the long length of follow-up has meant that such trials require upwards of 5 years to enroll and complete. If the length of follow-up could be shortened without missing a substantial number of relapses, the time and resources necessary to complete such trials could be reduced.

Investigators have reexamined the timing of relapse in earlier studies to inform regulatory authorities and guide the design of future trials. In a reanalysis of trials conducted from 1970 to 1983 by the British Medical Research Council, 78% of relapses occurred within 6 months of stopping treatment and 91% occurred within 12 months (1). To add to this information, we examined data from a recent phase 3 randomized trial of shortening treatment from 6 to 4 months in adults with drug-susceptible tuberculosis (TB) done in Brazil, Uganda, and the Philippines (2). Subjects were followed with sputum cultures monthly during treatment and every 3 months thereafter for a total of 30 months after beginning treatment. Eighteen of 370 patients developed recurrent TB. Two recurrences due to exogenous reinfection were excluded. The mean time after treatment until relapse was 7 ± 4.4 months. Of the 16 relapses, 11 (69%) occurred within the first 6 months after stopping treatment, 13 (81%) occurred within 12 months, and 15 (94%) occurred within 18 months. The timing of relapse did not differ between sites. Our results support reconsideration of the follow-up time required after treatment in phase 3 registration trials of new TB drugs and regimens for drug-susceptible TB.
Art of Medicine — Achievement or Security? — Influence of Television
Authors: John Lister
Journal: New England Journal of Medicine (1954)

FINE words are spoken and high ideals are set as each new academic year begins. Men of eminence address the students of medical schools and define for them the principles of the profession. Many of those who have spoken to students this year have stressed the fact that medicine remains an art even though it has been caught up in the rapidly advancing social and scientific resolutions of the day.Lord Dawson of Penn once said that medicine was an art based on many sciences. Recalling this in a speech at the Royal Free Hospital, Mr. A. N. Gilkes, high . . .
Cervico-oculo-acoustic dysplasia.
Authors: D A Primrose
Journal: BMJ (1970)

from severe vomiting of late pregnancy.She was given intravenous fluids via the right cephalic vein using an Intracath Bard Davol catheter.Later the drip was leaking, therefore the catheter was withdrawn and adjusted.As this was still unsatisfactory a second infusion was set up.The first catheter was removed and found to be incomplete.X-rays were taken which showed the missing portion to have migrated through the superior vena cava into the right atrium.She was transferred to Hammersmith Hospital and treated firstly with intravenous fluid, anticoagulants, and antibiotics.
The reasons why clinical cardiologists disregard reperfusion arrhythmias
Authors: J T Lie
Journal: Cardiovascular Research (1993)

Journal Article The reasons why clinical cardiologists disregard reperfusion arrhythmias Get access J T Lie J T Lie UC Davis Medical Center (PAT-1), 2315 Stockton Boulevard, Sacramento, CA 95817, USA: Professor J T Lie. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 27, Issue 11, November 1993, Page 1906, https://doi.org/10.1093/cvr/27.11.1906 Published: 01 November 1993
Toxic Shock Syndrome: A Critique of the 1980 Wisconsin Case-Control Study
Authors: JEFFREY P. DAVIS
Journal: Annals of Internal Medicine (1982)

Seven cases of toxic shock syndrome has been reported to the Wisconsin Division of Health by 6 January 1980; all seven cases were in female patients, six of whom had onset of illness during active menstruation. Through passive reporting of cases by physicians and patients themselves, a total of 38 patients with confirmed cases of toxic shock syndrome had been identified by the Division of Health by 30 June 1980. Thirty-five patients with menstrual toxic shock syndrome were each age-matched to three menstruating control subjects as part of a case-control study to identify potential risk factors associated with menstrual toxic shock syndrome. Statistically significant findings included increased tampon usage by patients as compared with controls, and fewer patients than controls were using any method of birth control. Numerous other health and hygiene variables were examined and found not to be statistically significant. We critically review the potential biases inherent to the study design. The conclusions and experience gained in this study were crucial to the designing of later case-control studies.
Erratum: Corrigendum: Abnormal cerebellar development and axonal decussation due to mutations in AHI1 in Joubert syndrome
Authors: R J Ferland, W Eyaid, R V Collura, L D Tully, R S Hill, D Al-Nouri, A Al-Rumayyan, M Topcu, G Gascon, A Bodell, Y Y Shugart, M Ruvolo, C A Walsh
Journal: Nature Genetics (2004)
Hemochromatosis C282Y mutation and histological fibrosis in patients with C virus chronic hepatitis
Authors: Christophe Hézode, Cécile Cazeneuve, Olivier Coué, Françoise Roudot-Thoraval, Jean-Michel Pawlotsky, Elie-Serge Zafrani, Serge Amselem, Daniel Dhumeaux
Journal: Hepatology (1999)