tbuckley/cabot-search huggingface dataset:
Menstrual cyclicity of finger joint size and grip strength in patients with rheumatoid arthritis.
Authors: S R Rudge, I C Kowanko, P L Drury
Journal: Annals of the Rheumatic Diseases (1983)

Daily measurements of finger joint size, grip strength, and body weight have been made throughout 2 complete menstrual cycles in 7 female patients with rheumatoid arthritis and 6 healthy female controls. Sine wave analysis showed significant individual cyclical rhythms (p less than 0.05) for finger joint size (5 patients, 4 controls), nude weight (5 patients, 3 controls), and grip strength (4 patients, 3 controls). In addition analysis of group data, on the assumption of a 28-day cycle, showed a significant cycle for grip strength in the rheumatoid patients, with a nadir at 28 days. In the normal subjects much of the cyclical variation in finger joint size could be explained by changes in weight (median 49.5%), but this was not so in patients with rheumatoid arthritis (median 2.8%). These findings suggest the existence of a cyclical variation in disease activity in rheumatoid arthritis.
Quality of Care, Process, and Outcomes in Elderly Patients With Pneumonia
Authors: Thomas P. Meehan
Journal: JAMA (1997)

Pneumonia is a frequent cause of hospitalization and death among elderly patients, but the relationships between processes of care for pneumonia and outcomes are uncertain, making quality improvement a challenge.To assess quality of care for Medicare patients hospitalized with pneumonia and to determine whether process of care performance is associated with lower 30-day mortality.Multicenter retrospective cohort study with medical record review.A total of 3555 acute care hospitals throughout the United States.A total of 14069 patients at least 65 years old hospitalized with pneumonia.Four processes of care: time from hospital arrival to initial antibiotic administration; blood culture collection before initial hospital antibiotics; blood culture collection within 24 hours of hospital arrival; and oxygenation assessment within 24 hours of hospital arrival. Associations between processes of care and 30-day mortality were determined with logistic regression analysis.National estimates of process-of-care performance were antibiotic administration within 8 hours of hospital arrival, 75.5% (95% confidence interval [CI], 73.1-77.9); blood cultures before antibiotics, 57.3% (95% CI, 54.5-60.1); initial blood culture collection, 68.7% (95% CI, 66.2-71.2); and initial oxygenation assessment, 89.3% (95% CI, 87.5-90.9). Lower 30-day mortality was associated with antibiotic administration within 8 hours of hospital arrival (odds ratio [OR], 0.85; 95% CI, 0.75-0.96) and blood culture collection within 24 hours of arrival (OR, 0.90; 95% CI, 0.81-1.00). State and territory performance estimates varied from 49.0% to 89.7% for antibiotics given within 8 hours and from 45.6% to 82.6% for blood cultures drawn within 24 hours.Administering antibiotics within 8 hours of hospital arrival and collecting blood cultures within 24 hours were associated with improved survival. The fact that states varied widely in the performance of these measures suggests that opportunities exist to improve hospital care of elderly patients with pneumonia.
Comparison of Insulin Degludec/Insulin Aspart and Biphasic Insulin Aspart 30 in Uncontrolled, Insulin-Treated Type 2 Diabetes: A Phase 3a, Randomized, Treat-to-Target Trial
Authors: Gregory R. Fulcher, Jens Sandahl Christiansen, Ganapathi Bantwal, Miroslawa Polaszewska-Muszynska, Henriette Mersebach, Thomas H. Andersen, Leo K. Niskanen
Journal: Diabetes Care (2014)

Insulin degludec/insulin aspart (IDegAsp) is the first combination of a basal insulin with an ultralong duration of action, and a rapid-acting insulin in a single injection. This trial compared IDegAsp with biphasic insulin aspart 30 (BIAsp 30) in adults with type 2 diabetes inadequately controlled with once- or twice-daily (OD or BID) pre- or self-mixed insulin with or without oral antidiabetic drugs.In this 26-week, randomized, open-label, multinational, treat-to-target trial, participants (mean age 58.7 years, duration of diabetes 13 years, BMI 29.3 kg/m(2), and HbA1c 8.4% [68 mmol/mol]) were exposed (1:1) to BID injections of IDegAsp (n = 224) or BIAsp 30 (n = 222), administered with breakfast and the main evening meal and dose titrated to a self-measured premeal plasma glucose (PG) target of 4.0-5.0 mmol/L.After 26 weeks, mean HbA1c was 7.1% (54 mmol/mol) for both groups, with IDegAsp achieving the prespecified noninferiority margin for mean change in HbA1c (estimated treatment difference [ETD] -0.03% points [95% CI -0.18 to 0.13]). Treatment with IDegAsp was superior in lowering fasting PG (ETD -1.14 mmol/L [95% CI -1.53 to -0.76], P < 0.001) and had a significantly lower final mean daily insulin dose (estimated rate ratio 0.89 [95% CI 0.83-0.96], P = 0.002). Fewer confirmed, nocturnal confirmed, and severe hypoglycemia episodes were reported for IDegAsp compared with BIAsp 30.IDegAsp BID effectively improves HbA1c and fasting PG levels with fewer hypoglycemia episodes versus BIAsp 30 in patients with uncontrolled type 2 diabetes previously treated with once- or twice-daily pre- or self-mixed insulin.
Abstract P1-09-08: Survival, Health Care Cost and Utilization of Patients with Triple Negative Breast Cancer in a U.S. Managed Care Setting
Authors: O Baser, W Wei, HJ Henk, L Xie, A. Teitelbaum
Journal: Cancer Research (2010)

Abstract Objectives: Triple negative breast cancer (TNBC), a subtype of breast cancer characterized by its unique molecular profile and aggressive clinical behavior, lacks satisfactory standard therapies. Little is known about survival and economic cost of patients with TNBC. This study was conducted to compare the survival, health care cost and utilization of patients with TNBC versus patients with breast cancer that is not triple negative. Methods: Analyses were conducted using Impact Intelligence Oncology Management (IIOM) (2002-2009) linked with United Health administrative claims. Patients were followed from the time of initial breast cancer diagnosis until death, disenrollment or end of the observation period. Continuous enrollment was required during the observation period. Staging and estrogen and progesterone receptors (ER/PR) and HER2 status were obtained at time of initial diagnosis. Patients’ age, region, cancer stage, comorbid conditions, health care costs and utilization prior to the initial diagnosis were controlled for risk-adjusted comparison. Cox regression was used for survival analysis. Health care resource use during the follow-up after initial diagnosis, such as number of hospitalizations, emergency room (ER) visits, office visits, outpatient visits and oncologist visits, were modeled with negative binomial regression. Since variable length of follow-up is allowed in the study design, we used inverse probability weight adjusted generalized linear models to estimate risk-adjusted annual total health care costs. Using a similar approach, we compared adjusted inpatient, pharmacy, office, outpatient, emergency and other costs between both groups. Results: The study included 450 patients with TNBC and 1,807 patients without TNBC. At time of diagnosis, TNBC patients were younger (54 vs. 57, P&amp;lt;0.001) than patients with no TNBC. After controlling with baseline differences, overall mortality risk rate for TNBC patients were over two times higher (HR: 2.15, P&amp;lt;0.002). Stratified Kaplan-Meier (KM) analysis showed that the best survival rates were for stage I-III non-TNBC patients, followed by stage IV non-TNBC patients and stage I-III TNBC patients. The highest death rates occurred for stage IV TNBC patients. Adjusted comparison showed that patients with TNBC had significantly more annual number of hospitalizations, hospitalization days and number of ER visits relative to non-TNBC patients (1.28 vs. 0.95 P&amp;lt;0.001, 10.20 vs. 6.07 P&amp;lt;0.001, 1.30 vs. 0.93, P&amp;lt;0.003). Although similar in annual total health cost, total adjusted inpatient costs for TNBC patients were almost 50% higher ($9,581 vs. $6,506, P&amp;lt;0.001). Conclusions: The economic and clinical burden of patients with TNBC is significant versus patients with breast cancer that are not triple negative. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-09-08.
Coxsackie and Adenovirus Receptor Promotes Adenocarcinoma Cell Survival and Is Expressionally Activated after Transition from Preneoplastic Precursor Lesions to Invasive Adenocarcinomas
Authors: Ansgar Brüning, Elmar Stickeler, Daniel Diederich, Lioba Walz, Hendrik Rohleder, Klaus Friese, Ingo B. Runnebaum
Journal: Clinical Cancer Research (2005)

Abstract Purpose: The cell adhesion protein, coxsackie and adenovirus receptor (CAR), is differentially expressed in various human adenocarcinomas. We analyzed the role of differential CAR expression during tumorigenesis and in cell survival of adenocarcinomas. Experimental Design: In a murine mammary cancer model, a syngenic preneoplastic mammary tissue was implanted into the mammary fat pads of syngenic female BALB/c mice. CAR expression was determined by semiquantitative reverse transcription-PCR in the preneoplastic noninvasive precursor lesions and the developing invasive adenocarcinomas. Cell clones overexpressing CAR were generated and tested for their response to apoptotic factors and for the expression of apoptosis relevant proteins by reverse transcription-PCR and Western blot analysis. Results: In comparison of preneoplastic precursor lesions with established adenocarcinomas, CAR expression was enhanced 2- to 5-fold in all six tissues which had survived and transformed into invasive adenocarcinomas. When stable CAR-overexpressing cell clones of the human cancer cell lines HeLa, CaSki, and A2780 were compared with the parental cell lines, 1.5- to 6-fold more cells survived application of tumor necrosis factor–related apoptosis-inducing ligand or growth factor withdrawal. CAR-enhanced cell survival was accompanied by reduced activation of caspase 3 and enhanced expression of bcl-2 or bcl-XL, depending on the cell type tested. Up-regulation of bcl-2 was found in all CAR-expressing adenocarcinomas of the murine cancer model. Conclusions: CAR expression is enhanced after transition from preneoplastic precursor lesions to neoplastic mammary cancer outgrowths. Enhanced CAR expression can promote cancer cell survival. These data suggest differential expression of CAR as a new factor in tumorigenesis.
Drowning, Near-Drowning, and Ice-Water Drowning
Authors: James P. Orlowski
Journal: JAMA (1988)

Drowning has become an accident of affluence. As pointed out in the article by O'Carroll et AL<sup>1</sup>in this issue ofTHE JOURNAL, close to 50% of all drowning accidents in Los Angeles County occur in swimming pools. Drowning is now the second leading cause of accidental death in children and the second leading cause of years of potential life lost. For all causes of death in children, drowning is exceeded only by motor vehicle accidents and cancer.<sup>2</sup>As impressive as these figures are, mortality data fail to reflect the large toll in morbidity from anoxic brain damage caused by near-drowning accidents. It is estimated that one third of all survivors are moderately to severely neurologically damaged.<sup>3</sup>Hospitalization for near-drowning occurs five times more frequently than for drownings, and near-drowning accidents are estimated to be 500 to 600 times more common than their fatal counterpart. The vast
Necrobacillosis (Lemmiere's syndrome): a rare cause of necrotizing pneumonia
Authors: RS Dykhuizen, ES Olson, S Clive, JG Douglas
Journal: European Respiratory Journal (1994)

The cases of four young and previously healthy patients with necrobacillosis are reported. All four patients presented with acute pharyngotonsillitis and pulmonary infiltrates due to metastatic abscesses, and had neutrophil leucocytosis and hypoalbuminaemia. Blood cultures grew Fusobacterium necrophorum and each patient responded to metronidazole.
Subacute Fluorosis
Authors: Philip J. Klemmer, Nortin M. Hadler
Journal: Annals of Internal Medicine (1978)

A young woman presented with a novel multisystem disease: painful periostitis, osteosclerosis, hypertension, and renal dysfunction. The similarity of some of this clinical picture to fluoride intoxication led to the discovery of massively elevated fluoride levels in serum, urine, and bone. Although initially an enigma, the source of fluoride was later found to be the illicit use of an anesthetic agent, methoxyflurane. This agent is one of a class of organofluorides that, by virtue of biotransformation, is a known cause of inorganic fluoride exposure. Though the drug is potentially nephrotoxic as generally used, exposure to it is transient and has not previously led to discernible bone disease.
A response to the LENT score
Authors: James Murray, Richard Turner, Graham H Bothamley, Angshu Bhowmik
Journal: Thorax (2014)

A response to the LENT scoreWe would like to congratulate Clive et al 1 on their contemporary data on survival in malignant pleural effusion.These data, particularly for lung cancer, will be invaluable for decision-making in cancer multidisciplinary meetings.The LENT prognostic score ( pleural fluid lactate dehydrogenase, Eastern Cooperative Oncology Group (ECOG) performance score (PS), neutrophil-tolymphocyte ratio and tumour type) is applied to unselected patients with malignant pleural effusion.Mesotheliomarelated pleural effusion would not necessarily indicate an advanced disease state, compared with, for example, urological malignancy.Did the authors consider grouping patients by availability of suitable treatments?Oestrogen receptor-positive breast cancer or haematological malignancy would be more likely to benefit from chemotherapy than lung cancer.The authors demonstrate in their receiver operator curve analysis that the area under the curve was higher using the prognostic score than for ECOG performance status alone.If the data on haematological malignancy and mesothelioma are not included then malignant pleural effusion related to lung cancer would account for approximately 50% of the cohort used to develop the LENT score.Have the authors considered comparing the area under the curve for ECOG score and LENT score for lung cancer alone?In our opinion, the most important conclusion from the paper is that the median survival of malignant pleural effusion in lung cancer remains extremely poor.This information should be considered by all oncologists and respiratory physicians encountering the disease and encourage prompt engagement with palliative care services.
Changing view of prognosis of epilepsy.
Authors: E H Reynolds
Journal: BMJ (1990)

Changing view of prognosis of epilepsyGetting better all the time, The older, pessimistic view of the prognosis of epilepsy was based on studies of patients with chronic epilepsy living in institutions or attending hospital clinics.Recently this has given way to a more optimistic perspective, based on studies of newly diagnosed epileptic patients both in the community and in hospital.
Patterns of Orthostatic Blood Pressure Change and Their Clinical Correlates in a Frail, Elderly Population
Authors: Wee Lock Ooi
Journal: JAMA (1997)

To determine patterns of within-day orthostatic blood pressure (BP) changes and clinical factors correlated with them in frail, elderly nursing home residents.Prevalence study of orthostatic BP change.Sample of 45 nursing homes.A total of 911 long-stay residents, aged 60 years or older, able to stand for at least 1 minute.Supine and 1-minute and 3-minute standing BP measurements and heart rates, taken by a random-zero sphygmomanometer before and after breakfast and before and after lunch, symptoms upon standing, medication use, and clinical and functional assessments.Four orthostatic hypotension (OH) groups were defined based on the frequency of a 20 mm Hg or greater orthostatic BP decline during any of 8 postural change measures: no OH group (48.5%); isolated OH group (only once, 18.3%); variable OH group (2-3 times, 19.9%); and persistent OH group (> or =4 times, 13.3%). Orthostatic hypotension was most prevalent before breakfast, especially 1 minute after standing (21.3%), and least prevalent after lunch after 3 minutes of standing (4.9%) (P=.001). A regression approach to repeated measures analysis (method of general estimating equations) showed the following to be significantly associated with OH (P< or =.05): elevated supine systolic BP before breakfast, dizziness/light-headedness on standing, male sex, medication for Parkinson disease, time of day (particularly before breakfast), greater independence in activities of daily living, and low body mass index.Orthostatic hypotension occurs in more than half of frail, elderly nursing home residents, but is highly variable over time. It is most prevalent in the morning when subjects first arise and when supine BP is highest. The relationship of OH with elevated BP, but not antihypertensive medication use, suggests that the treatment of hypertension may improve postural BP regulation.
The von Hippel–Lindau Protein, Vascular Endothelial Growth Factor, and Kidney Cancer
Authors: Daniel J. George, William G. Kaelin
Journal: New England Journal of Medicine (2003)

Early in the 20th century, it was hypothesized that solid tumors secrete factors, now referred to as angiogenic factors, that induce angiogenesis — the formation of new blood vessels — thereby ensuring the delivery of enough blood to support the growth of the tumor. The idea that inhibiting angiogenesis would have an antitumor effect has been borne out by the startling anticancer activity of some antiangiogenic agents in tumor-bearing mice. For these reasons, perhaps no area of cancer research has attracted as much attention, both on Main Street and on Wall Street, as angiogenesis.Unfortunately, the dramatic effects of antiangiogenic . . .
EXPERIMENTAL STUDIES IN ACUTE RENAL FAILURE
Authors: Max G. Menefee, C. Barber Mueller, Tracy B. Miller, Joseph K. Myers, Allen L. Bell
Journal: The Journal of Experimental Medicine (1964)

When purified human globin is injected intravenously into rats it produces acute renal failure characterized by tubular casts and oliguria. The globin is identifiable within vesicles and channels in the cytoplasm of the proximal tubules, through which it passes from lumen to basal side with no apparent serious effect on the cells. When a very minimal amount of globin is taken up by cells of the distal limb of Henle's loop or distal tubules (lower nephron), a markedly deleterious effect is apparent and the cells die within a short time. The mixture of cell debris and precipitated globin forms plugs within the confines of the basement membranes of the former distal limbs and distal tubules. After a number of lower nephrons are plugged a disruption of proximal tubules is found, which apparently results from the effect of back pressure in the obstructed nephrons. We suggest that any amount in excess of a low threshold of globin, either alone or combined with heme or related material, has a toxic effect on lower nephron cells. Once initiated, the toxic effect is not reversible and the resulting plug of debris and precipitate will occlude the lumen. If a sufficient number of nephrons are made non-functional the animal becomes anuric; otherwise it is oliguric. A high rate of urine flow will protect against the excess absorption of material and thus against acute renal failure.
In metformin-treated type 2 diabetes mellitus, weekly dulaglutide was noninferior to daily liraglutide for HbA<sub>1c</sub>levels
Authors: Oscar L. Morey-Vargas, Pankaj Shah
Journal: Annals of Internal Medicine (2014)

Source Citation Dungan KM, Povedano ST, Forst T, et al. Once-weekly dulaglutide versus once-daily liraglutide in metformin-treated patients with type 2 diabetes (AWARD-6): a randomised, open-label, phase 3, non-inferiority trial. Lancet. 2014;384:1349-57. 25018121
Number of Uninsured Continues To Rise
Authors: Linda Gundersen
Journal: Annals of Internal Medicine (1998)

Currents15 September 1998Number of Uninsured Continues To RiseLinda GundersenLinda GundersenSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-6-199809150-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In the United States, 42 million people do not have health insurance. Although insurance is available, its cost is frequently prohibitive, and the situation is becoming worse. Premiums have increased slowly during the past 4 years but are expected to rise an average of 7% in 1999 (in comparison, the consumer inflation rate is 1.4%). This increase is expected for traditional indemnity insurance and for managed care. Kaiser Permanente, the largest managed care company in the United States, plans to ask major employers in its home state of California to pay a 12% premium increase. Aetna-U.S. Healthcare has asked one ... Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSubsidized Health Care: The Hidden System Linda Gundersen Metrics Cited byAcceptance, Universal Patient Acceptance, and Access to Care An UpdateHypertension Outcomes In an Urban Nurse-Managed CenterLiving on the edge: A phenomenological study of medically uninsured working Americans 15 September 1998Volume 129, Issue 6Page: 513-515KeywordsChildrenHealth Insurance Portability and Accountability ActHealth careHealth care qualityHealth insuranceHispanic peopleOphthalmologyPatient advocacyRehabilitation medicineTaxes Issue Published: 15 September 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Treatment of Achalasia with A Pneumatic Dilator Attached to A Gastroscope
Authors: L. Witzel
Journal: Endoscopy (1981)

A pneumatic dilator for the treatment of achalasia of the esophagus is described. An inflatable polyurethane balloon assembly is attached to a small-caliber forward-viewing fiber-optic gastroscope. The balloon is introduced and dilatation carried out under endoscopic visual control. The described method greatly increases the safety and accuracy of the dilatation procedure, even in patients with an extreme degree of megaesophagus. 39 patients have been successfully treated with the dilator with no complications.
The systemic administration of an anti-miRNA oligonucleotide encapsulated pH-sensitive liposome results in reduced level of hepatic microRNA-122 in mice
Authors: Hiroto Hatakeyama, Manami Murata, Yusuke Sato, Mayumi Takahashi, Noriaki Minakawa, Akira Matsuda, Hideyoshi Harashima
Journal: Journal of Controlled Release (2013)