tbuckley/cabot-search huggingface dataset:
Evidence-Based to Value-Based Medicine
Authors: Amit K. Ghosh
Journal: Annals of Internal Medicine (2005)

Medical Writings: Book Notes7 June 2005Evidence-Based to Value-Based MedicineAmit K. Ghosh, MDAmit K. Ghosh, MDFrom Mayo Clinic, Rochester, Minnesota.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-11-200506070-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Brown MM, Brown GC, Sharma S, eds. 339 pages. Chicago: AMA; 2005. $64.95. ISBN 1579476252. Order at www.amapress.com.Field of medicine: Evidence-based medicine and value-based medicine.Format: Softcover book.Audience: Physicians, health care researchers, health policymakers, managers, and payers of health care.Purpose: To provide physicians with information on value-based medicine to help them understand quality-of-life variables, deliver high-quality care, integrate patient values with best evidence, and estimate clinical outcomes using health care economics.Content: The book consists of 21 chapters divided into 4 parts. Part 1 (chapters 1 through 3) provides background information, defines value-based medicine, and includes information ... Author, Article, and Disclosure InformationAffiliations: From Mayo Clinic, Rochester, Minnesota. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEvaluating the Effectiveness of Repricing for Market Expansion in the Japanese Drug Pricing System 7 June 2005Volume 142, Issue 11Page: 952KeywordsDecision analysisEvidence based medicineHealth careHealth economicsHealth information technologyPatientsPharmacoeconomicsQuality of lifeSoftware tools ePublished: 7 June 2005 Issue Published: 7 June 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
EVIL RESULTS OF OVERSTUDY IN THE YOUNG.
Authors: W. THORNTON PARKER
Journal: JAMA (1896)

In the early days of our Republic, it was the unwritten law that the youth must work first, and study afterward. The children of the wealthy could be sent to school or college, but for the average American book learning formed a small part of life. The picture of Abraham Lincoln lying on his stomach, in front of the open fire, with a piece of charcoal ciphering on a broad wooden shovel, represents the man who afterward became President of the United States. This is not an extraordinary picture in early American life. Garfield, as well as hundreds of other prominent men, won his education by a struggle. And up to the present moment, there are countless young men throughout our country who are earning their way through college, just as there are many other young men who are squandering their way through. These two classes suffer from the evil
Is It 'Oldtimer's Disease' or Just Growing Old?
Authors: Teri Randall
Journal: JAMA (1991)

The genetic underpinnings of Alzheimer's  have begun to emerge in recent years, only to reveal that the  is far more complex, the responsible genes far more elusive, than was hoped. Statistical analyses of pedigrees affected by the  suggest that at least two chromosomes play a role. The actual genes on these chromosomes, however, are still hidden in stretches of DNA 5 to 10 million base pairs long—a virtual universe left to search.  Also emerging is a new way of thinking about the disease. Many experts now suggest that what is called Alzheimer's  may not be a disease at all, but a natural part of the aging process.  The theory stems in part from the observation that the brains of elderly persons who are unaffected by Alzheimer's  also display the hallmark plaque deposits and neurofibrillary tangles found in the brains of patients with Alzheimer's disease, but
Synergistic activity of imatinib and 17-AAG in imatinib-resistant CML cells overexpressing BCR-ABL – Inhibition of P-glycoprotein function by 17-AAG
Authors: A Radujkovic, M Schad, J Topaly, M R Veldwijk, S Laufs, B S Schultheis, A Jauch, J V Melo, S Fruehauf, W J Zeller
Journal: Leukemia (2005)
The revised WHO diagnostic criteria for Ph-negative myeloproliferative diseases are not appropriate for the diagnostic screening of childhood polycythemia vera and essential thrombocythemia
Authors: Luciana Teofili, Fiorina Giona, Maurizio Martini, Tonia Cenci, Francesco Guidi, Lorenza Torti, Giovanna Palumbo, Angela Amendola, Giuseppe Leone, Robin Foà, Luigi M. Larocca
Journal: Blood (2007)
Antigen‐Induced Bronchial Anaphylaxis in Actively Sensitized SD Rats
Authors: M. Dahlbåuck, R. Brattsand
Journal: Allergy (1986)

We studied the effects of anti-asthmatic and anti-inflammatory drugs on antigen-induced bronchial anaphylactic reactions (BAR) in Sprague Dawley (SD) rats immunized with ovalbumin (OA) and alum. The animals were treated locally (intratracheal instillation (i.t.) or by aerosol) with terbutaline (TERB), disodium cromoglycate (DSCG), theophylline (THEO), the xanthine derivative 3,7-dihydro-1,8-dimethyl-3-phenyl-1H-purine-2,6-dione (D4026), budesonide (BUD) or dexamethasone (DEX) at various times before intravenous (i.v.) challenge with OA. The BAR was elicited by giving a low dose of OA. When the response to that challenge had levelled an additional high dose of antigen was given. Previous work had shown that TERB, DSCG, and D4026 given systemically (i.v.) at a suboptimal dose, had a better inhibitory efficacy when the animals were challenged with a low antigen dose late (6 weeks) than when challenged early (2-3 weeks) after immunization. We show here that such a difference in efficacy is not recorded after local treatment. Moreover, each of the drugs inhibited BAR to the same extent after i.t. as after i.v. treatment. Potent drugs like TERB and D4026 seemed to show similar efficacy when given either i.t. or by aerosol, whereas less potent drugs like DSCG and THEO were less effective when given by aerosol. In a previous study, we showed that the inhibitory capacity of glucocorticoids (GCS) on the BAR did not vary with sensitization conditions of the rats, BUD and DEX showed the same inhibitory capacity after intraperitoneal (i.p.) treatment as after i.t. treatment. In the present study, DEX showed increased whereas BUD showed decreased inhibitory capacity when given by aerosol 18-24 h before challenge. The duration of the anti-anaphylactic activity after inhalation was longer for DEX than for BUD.
Human Plague in the United States 1900-1966
Authors: Joseph L. Caten
Journal: JAMA (1968)

One or two cases of human plague occur on the average in the United States each year. The occurrence of seven cases in 1965 and five in 1966 led to this review of the available records. A total of 547 cases of human plague with 349 deaths was reported in the continental United States from 1900 to 1966. Epidemics, following epizootics in urban rats, account for 432 of the cases with 284 deaths, all prior to 1925. From 1908 to 1966, contact with wild-rodent sources caused an additional 115 cases with 65 deaths.
Toothpick Perforation Of the Bowel
Authors: Aaron M. Lefkovitz
Journal: JAMA (1966)

<h3>To the Editor:—</h3> The use of the toothpick as an aid to good dental and oral hygiene goes back to antiquity. According to Weinberger,<sup>1</sup>the Chinese were among the earliest people, if not the first, to make use of the chew stick or fiber pencil either as a toothpick or as a toothbrush. The earliest records relating to toothpicks can be traced to about 3500 BC. Excavations at the site of Ningal Temple at Ur by C. Leonard Woolley unearthed a toilet set consisting of silver or gold tweezers, ear scoops, and toothpicks. The custom of placing such items in the grave with the dead suggests that those people believed that toothpicks might be useful in the future world. Greek and Roman writers recommended the use of toothpicks. Pliny advocated the use of a bone of a hare, sharp as a needle, as a toothpick to prevent mouth odors.
CASE OF SPINAL ANTERIOR SUBACUTE GENERAL PARALYSIS.
Authors: C. EUGENE RIGGS
Journal: JAMA (1900)

was taken to the hospital, and within a reasonable time, I think possibly four months after I first saw him, he died, and the post-mortem, so much as could be made, revealed a typical case of anterior poliomyelitis.It is the only typical case with a post-mortem that has been reported at all in the adult; the complete report of the case still remains in abeyance.Dr. Augustus A. Eshner, Philadelphia-An alteration in any portion of the peripheral sensory neuron, or of the per- ipheral motor neuron, might readily give rise to the symptoms present in these two cases and similar ones.Nor need we conceive that alterations of this sort are necessarily dependent on any one single toxic influence.There are a variety of agencies, some of bacterial origin, as the infectious diseases, some of toxic, as from poison introduced from without, or generated within, the body, as alcohol, mercury, lead, gout, diabetes, uremia, that are capable of affecting the peripheral motor or sensory neurons, and at times it is exceedingly diffi- cult to make the differentiation.Dr. P. Savary Pearce, Philadelphia-Dr.Sterne, in saying that malarial intoxication was a probable cause of the par- alysis, reminds me of a case of locomotor ataxia which I re- ported last year, in which, so far as I could trace the etiology, the tabes was due to acute malarial intoxication.The case
Hypothesis: a Unifying Mechanism for Nutrition and Chemicals as Lifelong Modulators of DNA Hypomethylation
Authors: Duk-Hee Lee, David R. Jacobs, Miquel Porta
Journal: Environmental Health Perspectives (2009)

Although both nutrition and chemicals are important environmental factors modulating epigenetic changes, they are commonly studied separately by researchers in different fields. However, these two environmental factors cannot be separated from each other in the real world because a number of chemical agents contaminate food chains.We propose a unifying mechanism that can link epigenetic alterations in relation to DNA hypomethylation due to chemical agents and to nutrient deficiency or imbalance, emphasizing the importance of an integrative approach in the field of environmental epidemiology.Methyl groups from S-adenosylmethionine (SAM) are needed for DNA methylation. Diets low in sources of methyl groups can lead to global DNA hypomethylation by impairing synthesis of SAM. However, even without nutritional deficiency, enhanced need to synthesize glutathi-one (GSH) can impair synthesis of SAM and perturb DNA methylation, because the methylation cycle and the GSH synthesis pathways are biochemically linked. Exposure to environmental chemicals is a common situation in which the need for GSH synthesis is enhanced, because GSH is consumed to conjugate diverse chemicals. Given that GSH conjugation happens at any chemical dose, this hypothesis is relevant even at exposures below the high doses that cause toxicologic responses.At present, general populations are exposed to a large number of chemicals, each at a very low dose. Thus, DNA hypomethylation due to chemical exposure may be common in modern societies and can synergistically interact with nutrition-induced DNA hypomethylation.
Teaching of Medical Ethics
Authors: Stuart Farber
Journal: JAMA (1978)

<h3>To the Editor.—</h3> I read Mark Siegler's article with great interest. His discussion certainly struck harmonic chords in my own experience as a medical student, resident, and now medical educator. One area that I found particularly important was his discussion of the unprepared student—who finds it difficult to deal with the "softer" subject of medical ethics. He goes on to recommend preliminary training in the "philosophical and ethical principles on which bedside decisions are based." An unmentioned conclusion seems to be that premedical education should require as firm a grounding in the humanities (eg, philosophy, English, religion) as it does in the sciences (eg, chemistry, biology, physics). Of the 104 students who began medical school with me in 1970, only ten were in nonscience majors. I doubt if the figures have changed much since then. By requiring a background in the humanities, medical schools can achieve at least three goals:
MELIOIDOSIS: PATHOGENESIS AND IMMUNITY IN MICE AND HAMSTERS
Authors: Arthur M. Dannenberg, Eva M. Scott
Journal: The Journal of Experimental Medicine (1958)

The pathogenesis of acute respiratory melioidosis mice and hamsters is described. Inhaled organisms giving rise to lesions seemed to be first engulfed by the mononuclear alveolar phagocytes, but in less than 1 day polymorphonuclear cells made their appearance. In spite of this defense reaction, the bacteria continued to multiply and their products caused focal necrosis. These foci enlarged and gave rise to septicemia, toxemia, and eventually death, which usually occurred in 3 to 10 days depending on the dose. Melioidosis, is, therefore, an acute septicotoxemic disease resembling plague and anthrax in this respect. In hamsters the disease process developed more rapidly than in mice and death occurred sooner. The course of the disease in hamsters was sometimes complicated by intraglomerular deposits resembling "fibrinoid," which were similar to those of the generalized Shwartzman phenomenon. This phenomenon may have been an indirect cause of both the perifocal hemorrhage and the extremely large number of bacteria in some of the hamster lesions. When low infecting doses of organisms were employed, mice, but not hamsters, developed a chronic type of disease, lasting 2 to 8 weeks. This was characterized by large abscesses in the spleen or lung, marked proliferation of mononuclear phagocytes and plasma cells, and increased immunity against reinfection (about 40-fold against respiratory challenge). When mice and hamsters inhaled high infecting doses of organisms, a peracute disease resulted with death in 1 to 3 days. Increased numbers of bacteria were observed in the lesions, and the histological changes in the spleen resembled those following the intravenous injection of Malleomyces pseudomallei toxin or the intramuscular injection of large doses of cortisone. These changes were characterized by a swelling of the phagocytes of the white pulp with nuclear debris. The peracute, the acute, and the chronic forms of melioidosis in mice are similar to analogous clinical forms found in man.
Lactational Exposure to Polybrominated Diphenyl Ethers and Its Relation to Social and Emotional Development among Toddlers
Authors: Kate Hoffman, Margaret Adgent, Barbara Davis Goldman, Andreas Sjödin, Julie L. Daniels
Journal: Environmental Health Perspectives (2012)

Polybrominated diphenyl ethers (PBDEs) have been widely used as flame retardants and are ubiquitous environmental contaminants. PBDEs have been linked to adverse neurodevelopment in animals and humans.We investigated the association between breast milk PBDE levels and social and emotional development in toddlers.The Pregnancy Infection and Nutrition (PIN) and PIN Babies studies followed a cohort of North Carolina pregnant women and their children through 36 months of age. Breast milk samples obtained at 3 months postpartum were analyzed for PBDEs. The Infant-Toddler Social and Emotional Assessment (ITSEA) was completed by mothers when children were approximately 30 months of age (n = 222). We assessed the relationship between breast milk concentrations of five PBDE congeners-BDEs 28, 47, 99, 100, and 153-and children's social and emotional development, adjusting for other factors.A small, imprecise, yet consistent positive association was apparent between BDEs 47, 99, and 100 and increased externalizing behaviors, specifically activity/impulsivity behaviors. Externalizing domain T-scores ranged from 30 to 87 with a mean of 47.8. Compared with those with BDE-47 concentrations below the median, adjusted externalizing behavior domain scores were 1.6 [95% confidence interval (CI): -1.2, 4.4] and 2.8 (95% CI -0.1, 5.7) points higher for children born to women with breast milk concentrations in the 3rd and 4th quartiles, respectively. PBDEs were not associated with other social and emotional developmental domains.Our results, although imprecise, suggest a subtle association between early-life PBDE exposure and increased activity/impulsivity behaviors in early childhood. Confirmation of these results is needed in other longitudinal studies.
S115 NADPH Oxidase 4 Over-Expression Mediates Epithelial Ciliary Dysfunction in Neutrophilic Asthma
Authors: WYH Wan, L Woodman, R Hirst, K Haldar, E Gomez, A Sutcliffe, D Desai, M Barer, C O’Callaghan, C Brightling
Journal: Thorax (2012)

<h3>Objective</h3> Epithelial ciliary dysfunction is a feature of asthma and contributes to persistent symptoms and recurrent exacerbations. We sought to examine whether its cause is due to an altered airway environment or an intrinsic abnormality. <h3>Methods</h3> Primary epithelial cells were obtained from 46 subjects with asthma and 28 healthy controls for culture. Air-Liquid-Interface (ALI) cultures fully differentiated from human primary airway epithelial cells were stimulated with asthmatic sputum, with or without the presence of antibiotics. Ciliary function was assessed using video-microscopy. Bacterial 16S load in sputum and ALI culture before and after addition of sputum were assessed by qPCR. Oxidative stress was enumerated by 8-oxo-dG expression in bronchial biopsies using immunohistochemiatry in 27 asthmatics and 9 healthy controls, and in basal epithelial cells following hydrogen peroxide (H2O2) stimulation assessed by the DCFDA assay. NADPH oxidase (NOX) subtype 4 mRNA expression was quantified using qPCR. The effect of NOX4 inhibition, using GKT137831, on ciliary dysfunction was evaluated using fresh epithelial strips from 13 asthmatics. <h3>Results</h3> In <i>ex vivo</i> ciliated epithelial ALI cultures ciliary dysfunction did not persist, but was evident in cells from asthmatics following exposure to sputum. Bacterial load increased in the epithelial cultures following exposure to sputum, but were not different between health and disease suggesting that both exposure to an asthmatic environment and a susceptibility to stress is necessary to induce ciliary dysfunction in asthma. <i>In vivo</i> the oxidative stress burden in the bronchial epithelium was heightened and related to airflow obstruction and neutrophilic inflammation. NOX4 mRNA expression was significantly elevated in epithelial cells from neutrophilic asthmatics, and H2O2-induced intracellular reactive oxygen species generation was increased compared to health and attenuated by NOX4 inhibition. Critically, in fresh epithelial cells from asthmatics inhibiting NOX4 markedly improved ciliary function and was related to the intensity of neutrophilic inflammation. <h3>Conclusions</h3> These data suggest that in asthma NOX4 up-regulation promotes the susceptibility of the bronchial epithelium to develop ciliary dysfunction in the presence of an abnormal microenvironment. NOX4 inhibition attenuates ciliary dysfunction. This implicates NOX4 as a potential therapeutic target for asthma, particularly in those with neutrophilic predominant disease.
Identification of a myeloid committed progenitor as the cancer-initiating cell in acute promyelocytic leukemia
Authors: Florence C. Guibal, Meritxell Alberich-Jorda, Hideyo Hirai, Alexander Ebralidze, Elena Levantini, Annalisa Di Ruscio, Pu Zhang, Barbara A. Santana-Lemos, Donna Neuberg, Amy J. Wagers, Eduardo M. Rego, Daniel G. Tenen
Journal: Blood (2009)
Uncovering heart failure in patients with bronchospasm: Rationale for the early use of B-type natriuretic peptide in the emergency department
Authors: Peter A. McCullough, Torbjorn Omland, Catherine W. Knudsen, Philippe Duc, Richard M. Nowak, James McCord, Judd E. Hollander, Marie-Claude Aumont, Philippe Gabriel Steg, Arne Westheim, Alan B. Storrow, William T. Abraham, Sumant Lamba, Alan H. Wu, Alan S. Maisel
Journal: Journal of the American College of Cardiology (2003)
"Antivaccine Lobby" replies to the BMJ
Authors: K. B. Saxena, D. Banerji, I. Qadeer, N. J. Kurian, R. Priya, M. Shiva, J. Puliyel, G. Dabade
Journal: BMJ (2010)

We are a group of paediatricians, healthcare activists, teachers in public health, and bureaucrats who have championed universal immunisation in India throughout our working lives, so we were taken aback at being called an “antivaccine lobby” in the BMJ .1

Studies funded by the World Health Organization show that the incidence of Haemophilus influenzae type b (Hib) in India is lower than projected.2 Furthermore, probe studies from Asia show that Hib vaccine does not significantly reduce the burden of disease compared with placebo.3 We discuss the anecdotal evidence and the farcical equity argument used to recommend the pentavalent vaccine (diphtheria, pertussis, tetanus, Hib, hepatitis B) in India4 in our rapid response,5 and concentrate here on the safety issue.

Meta-analysis shows that the combined vaccine is not as effective as single vaccines administered separately6; therefore it is not used widely in the West, where reporting of adverse events is reliable. Pentavalent vaccine was withdrawn in Sri …
ACE Insertion/Deletion Genotypes and Angiotensin II Receptor Blockade in Diabetic Nephropathy
Authors: Steen Andersen, Peter Jacobsen, Hans-Henrik Parving
Journal: Diabetes Care (2003)

Pharmacogenetics is the study of genetic influence on response to drugs. This is an area of increasing attention due to the possibilities of improving overall treatment effects in patients through individual strategies. Mogensen (1) addresses this subject and diabetic renal disease in relation to our study. In the study in question (2), we masked and prospectively investigated the renoprotective effects of angiotensin II receptor blockade (ARB) in hypertensive type 1 diabetic patients with diabetic nephropathy homozygous for …
Mortality among oral contraceptive users
Authors: V Wynn, I F Godsland, J C Stevenson
Journal: BMJ (1990)

Ovarian failure after total body irradiation SIR,-Dr M P Cust and colleagues only touch on the possible long term effects of total body irradia- tion,' but these need to be addressed as increasing numbers of patients are successfully treated.We measured bone mineral content and density in the lumbar spine in 14 women who had premature ovarian failure after treatment for haematological malignancies.On average, 51 months had elapsed since treatment.We used a dual energy x ray absorption technique with a precision of 1%.2The patients' mean vertebral bone density was 0 97 (SD 0 15) g/cm2; that of a control group' of 68 women in the same age range (19 to 45, mean age of both groups 33 years) was 1 07 (0 09) g/cm2 (p=004, Student's t test).The patient with the lowest bone mineral density (0 71 g/cm') had already suffered an atraumatic fracture of a meta- tarsal bone.The loss of almost 10% of bone mineral in this short time implies that these patients are at risk of developing osteoporosis in the future.We support the recommendation of Dr Cust and colleagues that they should be referred to a gynaecologist or endocrinologist to consider hormone replacement therapy.
Use of Throat Cultures
Authors: Nathan Grossman
Journal: JAMA (1984)

To the Editor.—  I read with interest the article by Holmberg and Faich concerning throat culture practices in a recent issue ofThe Journal. I agree with the authors that the misuse of throat cultures is disheartening; however, I would add a cautionary note to their conclusion that promotion of throat culturing by public health laboratories should be reconsidered.  It is true that acute rheumatic fever is not, today, much of a public health problem. The proportion of its declining incidence, owing to improved nutrition and living standards, to widespread antibiotic use, or to decreased rheumatogenicity of group A streptococci, remains a cause for debate. Few would debate, however, that a weakening in surveillance and treatment standards would most probably result in a reversal in the incidence rate of acute rheumatic fever. Therefore, for that proportion of physicians who do use throat cultures correctly and for that even larger proportion