tbuckley/cabot-search huggingface dataset:
Modulation of tumor necrosis factor α in advanced heart failure with cachexia is associated with anabolic effects
Authors: Richard V. Milani, Stefan Endres, Mandeep R. Mehra, Julia Cook, Andreas Eigler, Frank W. Smart, Carl J. Lavie, Joseph P. Murgo, Hector O. Ventura
Journal: Journal of the American College of Cardiology (1996)
Putting Adverse Drug Events Into Perspective
Authors: Jerry Avorn
Journal: JAMA (1997)

We have become all too familiar with the dark side of the industrial model of medicine in which physicians become vendors, patients are covered lives generating revenue streams, and providing care for the sick is described in terms of "medical loss ratios." However, the 3 articles in this issue of<i>JAMA</i>that deal with the prevention of adverse drug events (ADEs)<sup>1-3</sup>illustrate that a "systems" approach to thinking about health care services can also be used for nobler purposes. See also pp 301, 307, and 312. Traditionally, hospital care has been seen as a series of separate and unrelated interactions between health care professionals and individual patients. Viewed from the perspective of the physician (as things once were), "the health care professional" was usually the doctor, with the importance of other actors such as nurses and pharmacists rarely appreciated. The industrial vision of medicine has brought with it, along
Acute Colitis Following Colonoscopy
Authors: R. Caprilli, A. Viscido, G. Frieri, G. Latella
Journal: Endoscopy (1998)

Colitis following colonoscopy is an acute, self-limited condition characterized by tenesmus and bloody diarrhea appearing within 48 hours of colonoscopy or sigmoidoscopy. Glutaraldehyde used for disinfection of the endoscopes is considered to be the main etiological agent. Three cases of severe acute self-limited colitis are described in this report. All three were observed within one week, and showed the typical anamnestic, clinical, endoscopic, histological, and radiological features of glutaraldehyde-induced colitis. The main characteristics in these cases were the time relationship with colonoscopy and the severity of the clinical presentation, with symptoms of systemic reaction and intense and diffuse edema of the colonic mucosa. The clinical and morphological features may mimic those of colonic ischemia. All three patients recovered completely within a few days, one spontaneously and two after treatment with steroids, antibiotics, and mesalazine.
Early atrial fibrillation during evolving myocardial infarction: a consequence of impaired left atrial perfusion.
Authors: H Hod, A S Lew, M Keltai, B Cercek, I L Geft, P K Shah, W Ganz
Journal: Circulation (1987)

Seven of 214 patients (3%) with acute myocardial infarction (120 inferior and 94 anterior) developed atrial fibrillation within 3 hr of the onset of chest pain. All seven patients had an inferior infarction and in all seven the left circumflex artery was occluded proximal to the origin of its left atrial circumflex branch. In five patients this occlusion was acute and was the cause of inferior infarction and in the remaining two patients the occlusion was old and the inferior infarction was due to an acute occlusion of the right coronary artery that also supplied extensive collaterals to the previously occluded left circumflex artery. All seven patients also had impaired perfusion to the atrioventricular nodal artery, as evidenced by total occlusion proximal to its origin or by stenosis proximal to its origin associated with second- or third-degree atrioventricular block. In contrast, early atrial fibrillation did not occur in any of the 18 patients with inferior myocardial infarction due to acute occlusion of the distal left circumflex artery or in any of the five patients with inferior infarction due to acute occlusion of the proximal left circumflex artery if perfusion to the atrioventricular nodal artery was not impaired. Early atrial fibrillation did not occur in any of the 90 patients with inferior infarction due to acute occlusion of the right coronary artery, including 12 patients with occlusion proximal to the sinus nodal artery, but without coexistent occlusion of the left circumflex artery.(ABSTRACT TRUNCATED AT 250 WORDS)
Prognostic Impact of CD204-Positive Macrophages in Lung Squamous Cell Carcinoma: Possible Contribution of Cd204-Positive Macrophages to the Tumor-Promoting Microenvironment
Authors: Shunki Hirayama, Genichiro Ishii, Kanji Nagai, Shotaro Ono, Motohiro Kojima, Chisako Yamauchi, Keiju Aokage, Tomoyuki Hishida, Junji Yoshida, Kenji Suzuki, Atsushi Ochiai
Journal: Journal of Thoracic Oncology (2012)
Community care compared with hospital outpatient care for hypertensive patients
Authors: R. Jones
Journal: BMJ (1982)

cell count is of no value in such situations in evaluating the probability of acute bacterial infection, as in a proportion of patients with infectious mononucleosis the first change evi- dent is a neutrophil leucocytosis.'To put my point in the language of clinical epidemiology, the positive predictive value of a neutrophil leucocytosis in diagnosing bacterial throat infection is low when the prevalence of infectious mononucleosis is high.This has obvious implications for those who care for young populations.Secondly, since this study was presumably designed to emphasise the importance of rational therapy of sore throats, I would like to ponder on the possible importance of irrational therapy in the dramatic reduction in poststreptococcal glomerulonephritis and rheu- matic fever which has taken place in the last three decades.Did wholesale prescription of antibiotics when they were available have a valuable role to play in the virtual dis- appearance of these diseases ?Is it only now that we can afford the luxury of a sophisticated rational therapy ?
Conditioning prepulse of biphasic defibrillator waveforms enhances refractoriness to fibrillation wavefronts.
Authors: J F Swartz, J L Jones, R E Jones, R Fletcher
Journal: Circulation Research (1991)

The mechanism of biphasic waveform defibrillation threshold reduction is unknown. We tested the hypothesis that, during refractory period stimulation, sarcolemmal hyperpolarization by the first pulse of biphasic waveforms facilitates excitation channel recovery, which enhances graded responses produced by the second depolarizing pulse. This prolongs cellular refractoriness to fibrillation wavefronts when compared with a monophasic depolarizing stimulus. Monophasic (10 msec, rectangular wave) or symmetrical biphasic (10 msec, each pulse) current injection S2 stimuli at 1.5 and two times S1 threshold were used to scan the S1 action potential refractory period (S1 cycle length, 600 msec) in myocardial cell aggregates. S2 waveforms were delivered with normal and reversed polarity to test the hyperpolarizing action of biphasic waveforms. Responses to an S3 stimulus, which simulated a potential incoming fibrillation wavefront, were also determined. Results showed that biphasic S2 waveforms produced longer graded responses during and immediately after the S1 refractory period than did corresponding monophasic S2 waveforms. The maximum difference in response duration produced by the biphasic and monophasic waveforms was 58.6 +/- 10.0 msec (p less than 0.001). This maximum difference occurred 10 msec before the end of the S1 refractory period. The longer response durations produced by biphasic S2 also produced longer refractoriness to the S3 stimulus. The maximum difference in total refractoriness to S3 of 51.8 +/- 2.8 msec (p less than 0.002) occurred at the same S1S2 coupling interval as the maximum difference in S2 response duration. Prolonged refractoriness may protect ventricular cells from refibrillation wavefronts and act as the cellular basis for greater biphasic waveform defibrillation efficacy.
An Unusual False-Positive Scan in a Patient With Pericardial Effusion
Authors: ONELIO GEATTI, BRAHM SHAPIRO, PIER GIUSEPPE ORSOLON, RENATA MIROLO, ANTONIO DI DONNA
Journal: Clinical Nuclear Medicine (1994)

Uptake of I-131 in the pericardial area is described in an asymptomatic patient who underwent total body scan for recurrent papillary thyroid cancer. Ultrasonography demonstrated a small pericardial effusion that persisted after 1-thyroxlne therapy was reinstituted. Two 1–131 therapeutic doses were given, and follow-up total body scans were performed during the next 6 years. Although tracer accumulation in the neck was eliminated and the serum thyroglobulin level was not elevated, 1–131 uptake persisted in pericardial effusion. Despite diligent study, no neoplastic, infectious, or autoimmune etiology could be demonstrated, and we thus classified it as idiopathic pericardial effusion. This phenomenon should be considered when interpreting 1–131 scans that show 1–131 uptake in the region of the heart.
Ophthalmologic Care for Persons With Diabetes
Authors: Steve R. Witkin
Journal: JAMA (1984)

The provision of ophthalmologic care to diabetic patients was examined in a large, geographically defined population-based study in southern Wisconsin. Of the total of 2,272 patients examined, 902 were taking insulin and were diagnosed before 30 years of age (younger onset) and 1,370 were diagnosed at or after 30 years of age (older onset). Approximately 26% of the younger-onset and 36% of the older-onset diabetic population had never had an ophthalmologic examination. Characteristics of the younger-onset and older-onset population associated with never having had an ophthalmologic examination included living in a nonmetropolitan county, being older at the time of diagnosis, having a shorter duration of diabetes, having fewer years of education, receiving their diabetes care from a family or general practitioner, and having better visual acuity. Eleven percent of younger- and 7% of older-onset persons with Diabetic Retinopathy Study high-risk characteristics for severe visual loss had never been seen or were seen more than two years before the time of the study. Because severe visual loss caused by proliferative diabetic retinopathy may be reduced by timely photocoagulation treatment, this study suggests that a large number of patients who would benefit from ophthalmologic care are currently not receiving it.
ADDITIONAL SAFEGUARD FOR USE IN BRONCHOSCOPY OF TUBERCULOUS PATIENT
Authors: Raymond A. Wetrich
Journal: JAMA (1952)

For some time, a face shield has been used in many hospitals for protection of the physician during bronchoscopy. It has been impractical to use this face guard during the actual application of topical anesthetics to the pharynx and tracheobronchial tree, because a headlight or headmirror could not be readily worn at the same time. This difficulty has been obviated by riveting an ordinary headmirror to the headpiece of the face shield (see figure). The apparatus shown above has been used in this hospital for several months. It has proved satisfactory as a safeguard for the physician during anesthetization of patients, particularly those with tuberculosis.
Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials
Authors: R. D'Amico, S. Pifferi, C. Leonetti, V. Torri, A. Tinazzi, A. Liberati
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objective:</b> To determine whether antibiotic prophylaxis reduces respiratory tract infections and overall mortality in unselected critically ill adult patients. <b>Design:</b> Meta-analysis of randomised controlled trials from 1984 and 1996 that compared different forms of antibiotic prophylaxis used to reduce respiratory tract infections and mortality with aggregate data and, in a subset of trials, data from individual patients. <b>Subjects:</b> Unselected critically ill adult patients; 5727 patients for aggregate data meta-analysis, 4343 for confirmatory meta-analysis with data from individual patients. <b>Main outcome measures:</b> Respiratory tract infections and total mortality. <b>Results:</b> Two categories of eligible trials were defined: topical plus systemic antibiotics versus no treatment and topical preparation with or without a systemic antibiotic versus a systemic agent or placebo. Estimates from aggregate data meta-analysis of 16 trials (3361 patients) that tested combined treatment indicated a strong significant reduction in infection (odds ratio 0.35; 95% confidence interval 0.29 to 0.41) and total mortality (0.80; 0.69 to 0.93). With this treatment five and 23 patients would need to be treated to prevent one infection and one death, respectively. Similar analysis of 17 trials (2366 patients) that tested only topical antibiotics indicated a clear reduction in infection (0.56; 0.46 to 0.68) without a significant effect on total mortality (1.01; 0.84 to 1.22). Analysis of data from individual patients yielded similar results. No significant differences in treatment effect by major subgroups of patients emerged from the analyses. <b>Conclusions:</b> This meta-analysis of 15 years of clinical research suggests that antibiotic prophylaxis with a combination of topical and systemic drugs can reduce respiratory tract infections and overall mortality in critically ill patients. This effect is significant and worth while, and it should be considered when practice guidelines are defined. <h3>Key messages</h3> Over 40% of patients who need ventilation in intensive care develop respiratory tract infections and about 30% may die in the units If the most effective antibiotic prophylaxis (that is, a protocol combining topical and systemic antibiotics) is used the incidence of respiratory tract infections can be reduced by 65% and total mortality by 20% A regimen of topical antibiotics alone reduces respiratory tract infections but does not influence survival The concern that widespread antibiotic use may lead to resistance cannot be confirmed or ruled out by this review. Trials with different design are probably warranted to handle this question This important effect of antibiotic prophylaxis with a combination of topical and systemic antibiotics on survival should be considered by intensivists when treatment policies are designed
Anxiety States in the Navy
Authors: G. V. Stephenson, K. Cameron
Journal: BMJ (1943)

In November tests were carried out on another group of 19 subjects, all of whom had received 200 mg. of nicotinamide l12 to 3 hours previously.The test times were: Control time, 122-26 Experimental time 1, 117-84; difference, -4-42.Significant ,, ,, 1 2, 115-21; ,,-7-05.Highly significantThe suggestion was made by Dr. Platt that a single dose of nicotinamide should be given at specified times before the experimental tests, and the experiments were carried out in conjunction with him.It is noted that a somewhat different pattern in the results was obtained.Having demonstrated that the effect of a single dose of nicotinamide resulted in a well-marked diminution of the time taken to complete the test and that this effect was most marked 1l to 3 hours after administration of the vitamin, it was essential to ascertain if similar effects would be obtained when tablets were given on six successive days and tests made on the seventh day.This investigation was therefore carried out on 24 I.T.W. subjects at Cambridge in November, and the results
Truth and Consequences — Insurance-Premium Rate Regulation and the ACA
Authors: Ann Mills, Carolyn L. Engelhard, Patricia M. Tereskerz
Journal: New England Journal of Medicine (2010)

Over the past decade, the largest health insurance companies have seen a disproportionate increase in profits of 250%, or 10 times the rate of inflation. During the past year alone, there has been a double-digit increase in health insurance premiums.1 In response to such increases, the new health care reform law, the Patient Protection and Affordable Care Act (“Affordable Care Act,” or ACA), requires the secretary of health and human services, along with individual states, to establish a process for the annual review of unreasonable increases in health insurance premiums. As a result of the new statutory language, the Department . . .
N-Terminal Prohormone Brain Natriuretic Peptide as a Predictor of Cardiovascular Disease and Mortality in Blacks With Hypertensive Kidney Disease
Authors: B.C. Astor, S. Yi, L. Hiremath, T. Corbin, V. Pogue, B. Wilkening, G. Peterson, J. Lewis, J.P. Lash, F. Van Lente, J. Gassman, X. Wang, G. Bakris, L.J. Appel, G. Contreras
Journal: Circulation (2008)

Background— Higher levels of N-terminal prohormone brain-type natriuretic peptide (NT-proBNP) predict cardiovascular disease (CVD) in several disease states, but few data are available in patients with chronic kidney disease or in blacks. Methods and Results— The African American Study of Kidney Disease and Hypertension trial enrolled hypertensive blacks with a glomerular filtration rate of 20 to 65 mL · min −1 · 1.73 m −2 and no other identified cause of kidney disease. NT-proBNP was measured with a sandwich chemiluminescence immunoassay (coefficient of variation 2.9%) in 994 African American Study of Kidney Disease and Hypertension participants. NT-proBNP was categorized as undetectable, low, moderate, or high. Proteinuria was defined as 24-hour urinary protein–creatinine ratio &gt;0.22. A total of 134 first CVD events (CVD death or hospitalization for coronary artery disease, heart failure, or stroke) occurred over a median of 4.3 years. Participants with high NT-proBNP were much more likely to have a CVD event than participants with undetectable NT-proBNP after adjustment (relative hazard 4.0 [95% confidence interval [CI] 2.1 to 7.6]). A doubling of NT-proBNP was associated with a relative hazard of 1.3 (95% CI 1.0 to 1.6) for coronary artery disease, 1.7 (95% CI 1.4 to 2.2) for heart failure, 1.1 (95% CI 0.9 to 1.4) for stroke, and 1.8 (95% CI 1.4 to 2.4) for CVD death. The association of NT-proBNP with CVD events was significantly stronger ( P interaction =0.05) in participants with than in those without proteinuria. Higher NT-proBNP was not associated with renal disease progression. Conclusions— These results suggest that elevated NT-proBNP levels are associated with higher CVD risk among blacks with hypertensive kidney disease. This association may be stronger in individuals with significant proteinuria.
Mitral Valve Disease
Authors: Zoltan G. Turi
Journal: Circulation (2004)

he mitral valve is the most complex of the heart's 4 valves and is the one most commonly associated with disease.There are 3 main conditions that affect the valve: Obstruction (stenosis), leakage (regurgitation), and bulging backward during valve closure (prolapse).Prolapse is the most common, occurring in up to 5% of the population, whereas stenosis is the least common, accounting for less than 1% of cardiac diagnoses in the United States, although it is more frequently seen in developing nations.
OC-051 Microbial, phenotypic and genetic markers of risk: aspects of crohn's disease that are shared by unaffected siblings: Abstract OC-051 Table 1
Authors: C R Hedin, K Taylor, P Louis, F Farquharson, S McCartney, N J Prescott, A J Stagg, J O Lindsay, K Whelan
Journal: Gut (2012)

<h3>Introduction</h3> Siblings of Crohn9s disease (CD) patients have elevated risk of developing disease which may manifest as raised faecal calprotectin (FC) and increased intestinal permeability. Other features of CD that reflect the at-risk state and their interactions are not well described. <h3>Aim</h3> Identify key facets of the at-risk state and establish their relationships. <h3>Methods</h3> Faecal samples from 22 patients with quiescent CD, 21 siblings and 25 controls were analysed for FC (ELISA) and microbiota (quantitative PCR targeting bacterial 16S ribosomal RNA genes). Genotype RR at 72 known CD risk loci was determined by Illumina Immuno BeadChip, analysed with the REGENT R package. p Values from non-parametric analyses were Bonferroni corrected to adjust for multiple testing. <h3>Results</h3> FC was elevated (&gt;50 μg/g) in 21 (96%) patients, 8 (38%) siblings and 2 (8%) controls. Compared with controls, patients had reduced Bacteroidetes, clostridial cluster IV, <i>Faecalibacterium prausnitzii</i>, <i>Ruminococci</i>, <i>Bifidobacterium adolescentis</i> and <i>Roseburia</i> spp. (Abstract OC-051 table 1). Similarly, in siblings vs controls there was reduced cluster IV clostridia, (specifically <i>F prausnitzii</i>) and <i>Roseburia</i> spp. (Abstract OC-051 table 1). This dysbiosis was evident in siblings with normal FC. Siblings with elevated/high genotype RR (n=4) had normal FC but reduced Bacteroidetes vs controls, (9.2 vs 10.4 log<sub>10</sub>/g, p=0.007). <h3>Conclusion</h3> In addition to enhanced genotypic risk and elevated FC, siblings share aspects of CD dysbiosis, in particular lower butyrate producing bacteria. Reduced Bacteroidetes comparable to that seen in patients, was only found in siblings with increased genotypic risk, raising the possibility of genetic determination. Sibling dysbiosis occurred independently from inflammation. Dysbiosis appears to be an early event in CD pathogenesis and may be an additional marker of CD risk. <h3>Competing interests</h3> C Hedin grant/research support from: clinical research fellow funded by core charity, K Taylor: None declared, P Louis: None declared, F Farquharson: None declared, S McCartney: None declared, N Prescott: None declared, A Stagg: None declared, J Lindsay: None declared, K Whelan: None declared.
Spontaneous Cerebrospinal-fluid Rhinorrhoea
Authors: A. M. Nussey
Journal: BMJ (1966)

By use of a skin-sensitivity test, evidence of infection with toxocariasis has been found in 7 (2.1 %) of 329 apparently healthy persons, in 26 (13.6%) of 191 persons who had had poliomyelitis, and in 26 (7.5 %) of 349 sufferers from epilepsy.It has been confirmed that the reservoir of infection among dogs and cats in the London area is considerable, 21.3% of dogs and 21 % of cats having been found to have ova of T. canis and T. cati respectively in their faeces.It is postulated, and evidence is given to support the view, that larvae of T. canis and T. cati in their migration from the lumen of the alimentary tract to the blood and tissues, may carry with them bacteria, viruses, and other infective agents, and that in this way some patients have been infected with poliomyelitis.The larvae do not usually mature in man, but, after wandering in the tissues, die, and a focus of granulomatous tissue reaction forms around their disintegrating bodies.When larvae reach the brain, as they have been shown to do, this process may cause epilepsy.The toxocaral skin test has been found to be positive four times more frequently in epileptic persons than in healthy controls.It is apparent from this and earlier works that dogs and cats may constitute a considerable public-health hazard.This study was Weiade possible by a grant from the Medical Research Council, to whom we express our thanks.We are grateful to Lord Brain for helpful suggestions,