tbuckley/cabot-search huggingface dataset:
The cost of hepatitis A infections in American adolescents and adults in 1997
Authors: Jeremy J. Berge, David P. Drennan, Jake R. Jacobs, Alan Jakins, Allen S. Meyerhoff, Wayne Stubblefield, Melvyn Weinberg
Journal: Hepatology (2000)

The incidence of hepatitis A has declined in the United States for several decades, leading to an increased number of susceptible adolescents and adults. Because clinical severity increases with age, hepatitis A infections in older individuals cause greater morbidity, mortality, and treatment costs. Because the economic burden of hepatitis A has not been well described, we estimated its costs, from the societal perspective, for patients infected at distinct ages. A case-series study described treatment patterns, work loss, and symptom duration. Disease outcomes were estimated by an expert panel. Economic losses were calculated by applying normative data reflecting treatment charges, employee compensation, and the value of housekeeping services. In the case-series study, mean treatment charges were $740 for nonhospitalized patients versus $6,914 for hospitalized patients ( P &lt; .001). Symptom duration (67.8 vs. 34.4 days, P &lt; .001) and work loss (33.2 vs. 15.5 days, P &lt; .01) were also greater for those hospitalized. Nationally, we estimate 63,363 symptomatic hepatitis A infections occurred among adolescents and adults during 1997, resulting in 8,403 hospital admissions and 255 deaths. Nearly 2.5 million days of symptomatic illness and 829,000 work-loss days resulted, and 7,466 years of life were lost. Under base-case assumptions, annual hepatitis A costs were estimated at $488.8 million. In sensitivity analyses, this estimate varied from $332.4 to $579.9 million. These costs may be reduced by regionally targeted vaccination of children, as recommended by the Advisory Committee on Immunization Practices, although the cost effectiveness of this policy has not yet been established.
Impaired ketogenesis is a major mechanism for disturbed hepatic fatty acid metabolism in rats with long-term cholestasis and after relief of biliary obstruction
Authors: Corinne Lang, Simona Berardi, Markus Schäfer, Dolors Serra, Fausto G Hegardt, Lukas Krähenbühl, Stephan Krähenbühl
Journal: Journal of Hepatology (2002)
Tinnitus as an Indication of Therapeutic Serum Salicylate Levels
Authors: Edward Mongan
Journal: JAMA (1973)

The clinical adage, "Push to tinnitus, then back off slightly," has been used to regulate aspirin dosage for intensive salicylate therapy. Its value in subjects with normal hearing was demonstrated in a study of seven healthy volunteers and 67 patients with rheumatoid arthritis. The dose of buffered aspirin was gradually increased until tinnitus was noted. In 59 subjects experiencing tinnitus, the serum salicylate level was invariably greater than 19.6 mg/100 ml (average, 30.4 mg/100 ml), although their aspirin dose varied from 12 to 36 standard 300-mg tablets daily. However, tinnitus was not a reliable guide in 22 patients with preexisting hearing loss, as 15 of them did not experience it despite an average serum salicylate level of 43.1 mg/100 ml. Aspirin dosage should be increased with caution and monitored with serum determinations in this predominantly elderly group.
Multivariate analysis of prognostic factors in patients with refractory and relapsed acute myeloid leukemia undergoing sequential high-dose cytosine arabinoside and mitoxantrone (S-HAM) salvage therapy: relevance of cytogenetic abnormalities
Authors: W Kern, C Schoch, T Haferlach, J Braess, M Unterhalt, B Wörmann, T Büchner, W Hiddemann
Journal: Leukemia (2000)
My choice of words
Authors: I. W. Seetho
Journal: BMJ (2012)

On our ward round we visited a patient with a raised body mass index. As we stood at the end of the patient’s bed discussing the need for computed tomography (CT), I broached the question of the possible weight restriction of the hospital CT table. On hearing this, the patient’s demeanour immediately changed—for the worse. I had obviously hurt the patient’s feelings when …
Lipid-Lowering Therapy in Persons With Chronic Kidney Disease
Authors: Ashish Upadhyay, Amy Earley, Jenny L. Lamont, Shana Haynes, Christoph Wanner, Ethan M. Balk
Journal: Annals of Internal Medicine (2012)

Background: Lipid-lowering therapy is not widely used in persons with chronic kidney disease (CKD) despite a high burden of dyslipidemia and cardiovascular disease in this population. Purpose: To synthesize evidence examining the effect of lipid-lowering therapy on clinical outcomes in persons with CKD. Data Sources: MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from January 2000 through November 2011. Study Selection: Randomized, controlled trials (RCTs) comparing lipid-lowering therapy with control treatment in persons with CKD, including subgroup analyses of trials in the general population. Data Extraction: Abstracts were screened and data were extracted on study methodology, population, interventions, cardiovascular and kidney outcomes, and adverse events. Data were extracted by one author and confirmed by another. Study quality was determined by consensus. Random-effects model meta-analyses were performed. Data Synthesis: 18 RCTs, all in adults, met the eligibility criteria. Five RCTs involved CKD populations, and 13 were CKD subgroup analyses from trials in the general population. Sixteen RCTs examined statins, and 2 examined statins plus ezetimibe. Lipid-lowering therapy does not improve kidney outcomes but decreases the risk for cardiac mortality (pooled risk ratio [RR] from 6 trials, 0.82 [95% CI, 0.74 to 0.91]; P < 0.001), cardiovascular events (including revascularization) (pooled RR from 9 trials, 0.78 [CI, 0.71 to 0.86]; P < 0.001), and myocardial infarction (pooled RR from 9 trials, 0.74 [CI, 0.67 to 0.81]; P < 0.001). Significant benefit was also seen for all-cause mortality but was limited by a high degree of heterogeneity. No benefit was found for other cardiovascular outcomes. Rates of adverse events were similar between intervention and comparator groups. Limitations: Lack of data in children, heterogeneity among reviewed studies, and the possibility of selective reporting of outcomes and adverse events. Conclusion: Lipid-lowering therapy decreases cardiac death and atherosclerosis-mediated cardiovascular events in persons with CKD. Primary Funding Source: Kidney Diseases: Improving Global Outcomes.
Failure of Attenuated Viral Vaccine in Prevention of Atypical Measles
Authors: Manju Chatterji
Journal: JAMA (1977)

ATYPICAL illness on exposure to wild measles virus has been described in children previously immunized with inactivated measles vaccine<sup>1</sup>as well as in children who received one dose of live vaccine shortly after receiving killed vaccines (KKL group). The American Academy of Pediatrics, however, recommends administration of live attenuated measles vaccine in children immunized previously with killed vaccine to prevent atypical illness on exposure to wild virus.<sup>1</sup>We report the case of a child in whom atypical measles developed despite the fact that she had received live vaccine several years after receiving killed vaccine. <h3>Report of a Case</h3> A 12-year-old girl was in excellent health until May 20, 1975, when she complained of headache and myalgia. Three days later a severe headache and high fever developed. A maculopapular rash was observed on both knees two days after the onset of fever. In the next 48 hours, the rash
Detecting fabricated or induced illness in children
Authors: William Lewis
Journal: BMJ (2005)

Improving surveillance of MRSA bacteraemiaData from north west England support Oxfordshire findings Editor-Wyllie et al conclude that admission cultures accounted for 24% of total hospital methicillin resistant Staphylococcus aureus (MRSA) bacteraemia episodes over seven years to March 2004. 1 Data collected from five district general hospitals and one university hospital in Cheshire and Merseyside and one district general hospital in greater Manchester support this view.This group of hospitals has collected enhanced MRSA bacteraemia surveillance data using published case definitions from the Department of Health since April 2004.Anonymised data are collected on paper forms and analysed using the FORMIC data capture system.In all, 534 cases of S aureus bacteraemia were identified between April 2004 and March 2005, 334 being methicillin sensitive S aureus bacteraemia and 200 MRSA bacteraemia.Sixty six of the MRSA bacteraemia cases occurred within 48 hours of arrival in hospital, 16 being related to a previous hospital admission, 25 in patients known to have been colonised with MRSA, and 13 in patients admitted from nursing or residential homes.Thirty five cases were admitted as medical specialties, 25 of them in patients over 65.Our results support the suggestion by Wyllie et al that anti-MRSA treatment should be considered for patients with possible staphylococcal sepsis who have previously been admitted or known to be colonised with MRSA.In a predominantly district general hospital setting, anti-MRSA treatment should also be considered for possible staphylococcal sepsis in elderly medical admissions and admissions from nursing homes.
Intracardiac electrography in endocardial cushion defects.
Authors: J R Jacobsen, P C Gillette, B N Corbett, M Rabinovitch, D G McNamara
Journal: Circulation (1976)

Conduction of the sino-atrial impulse from the high right atrium to the ventricles was studied by intracardiac electrography in 21 unoperated patients, age 3 months to 11 years, with endocardial cushion defects (ECD). The high right atrium-to-low right atrium conduction time was prolonged in 15 of 18 subjects (mean 57 +/- 20 msec). The low right atrium-to-His bundle conduction time (LRA-H) was normal in 16 of 17 subjects (mean 82 +/- 30 msec), prolonged in one. The His-to-ventricle conduction time (H-V) was normal in 16 of 17 subjects (mean 37 +/- 8 msec), equivocally short in one. Nine patients with ECD, age 3 to 21 years, were studied postoperatively. One had an acquired complete atrioventricular block in the His bundle. Two had prolonged LRA-H and two prolonged LRA-H and two prolonged H-V. The surface ECG failed to identify accurately either prolonged atrioventricular conduction or the site of prolongation.
Junior doctors and senior managers make plans to collaborate to improve care
Authors: Jacqui Wise
Journal: BMJ (2010)

Junior doctors and senior managers have put together draft recommendations on how to collaborate to improve the quality of care.

Pairs of managers and junior doctors from 100 NHS organisations came up with 10 recommendations during the “Agents for Change—Collaborating for Quality” conference held in London on Wednesday 10 November at the health think tank the King’s Fund. Junior doctors often see ways in which care can be better provided but often believe that they don’t have the means to achieve this.

One recommendation is that a senior manager should …
Sorting out additions to the understanding of cognition during sleep
Authors: William H. Moorcroft
Journal: Behavioral and Brain Sciences (2000)

The target articles by Hobson et al., by Solms, and by Nielsen can be combined to further our understanding of the neurological basis of dreaming during REM and, notably, NREM sleep. Revonsuo adds to our understanding of the function of dreams from the perspective of behavioral biology but overstates its importance. Vertes &amp; Eastman fail in their effort to discount memory enhancement as a function of REM sleep. [Hobson et al.; Nielsen; Revonsuo; Solms; Vertes &amp; Eastman]
Points From Letters: Diagnosis and Treatment of Sprained Ankle
Authors: D. Mackenzie
Journal: BMJ (1963)

<h3>Abstract</h3> <h3>BACKGROUND</h3> The future of the SARS-CoV-2 pandemic hinges on virus evolution and duration of immune protection of natural infection against reinfection. We investigated duration of protection afforded by natural infection, the effect of viral immune evasion on duration of protection, and protection against severe reinfection, in Qatar, between February 28, 2020 and June 5, 2022. <h3>METHODS</h3> Three national, matched, retrospective cohort studies were conducted to compare incidence of SARS-CoV-2 infection and COVID-19 severity among unvaccinated persons with a documented SARS-CoV-2 primary infection, to incidence among those infection-naïve and unvaccinated. Associations were estimated using Cox proportional-hazard regression models. <h3>RESULTS</h3> Effectiveness of pre-Omicron primary infection against pre-Omicron reinfection was 85.5% (95% CI: 84.8-86.2%). Effectiveness peaked at 90.5% (95% CI: 88.4-92.3%) in the 7<sup>th</sup> month after the primary infection, but waned to ∼70% by the 16<sup>th</sup> month. Extrapolating this waning trend using a Gompertz curve suggested an effectiveness of 50% in the 22<sup>nd</sup> month and &lt;10% by the 32<sup>nd</sup> month. Effectiveness of pre-Omicron primary infection against Omicron reinfection was 38.1% (95% CI: 36.3-39.8%) and declined with time since primary infection. A Gompertz curve suggested an effectiveness of &lt;10% by the 15<sup>th</sup> month. Effectiveness of primary infection against severe, critical, or fatal COVID-19 reinfection was 97.3% (95% CI: 94.9- 98.6%), irrespective of the variant of primary infection or reinfection, and with no evidence for waning. Similar results were found in sub-group analyses for those ≥50 years of age. <h3>CONCLUSIONS</h3> Protection of natural infection against reinfection wanes and may diminish within a few years. Viral immune evasion accelerates this waning. Protection against severe reinfection remains very strong, with no evidence for waning, irrespective of variant, for over 14 months after primary infection.
TCT-377 Impact of New-Onset Acute Heart Failure in Patients with Acute Myocardial infarction Underwent Successful Revascularization
Authors: Keun-Ho Park, Myung Ho Jeong, Youngkeun Ahn, Jong Hyun Yoo, Sang Cheol Cho, Young Jo Kim, Seung-Woon Rha, Yang soo Jang
Journal: Journal of the American College of Cardiology (2012)
Abstract 3322: GW4716 selectively targets multiple p53 mutant cancer models.
Authors: Mary Heckler, Christopher Albanese, Rebecca Riggins
Journal: Cancer Research (2013)

Abstract The TP53 gene is the most commonly mutated gene in all cancers, with over 50% of human cancers harboring an inactivating mutation. Most frequently when p53 is mutated, the mutation occurs as a single nucleotide substitution within the DNA-binding domain. The selective advantage for retaining mutant p53 varies between cancer cells. Mutant p53 can have both gain-of-function and loss-of-function properties. Given the high frequency of p53 mutations in human cancers, understanding mutant p53 function and identifying novel therapies is a clinically relevant and important area of research. We have identified a novel pharmacological approach that selectively targets p53 mutant cancer cells across multiple cancer models using the acyl hydrazone GW4716. We have found cancer cells harboring a mutation in p53, treated with GW4716 for 24h, exhibit significantly greater cell death measured by DNA fragmentation (subG1) than p53 wild-type cells in both breast cancer and glioblastoma models. In contrast, GW4716 has little/no effect on normal (non-transformed) cells Furthermore, the mode of cell death induced by GW4716 differs between p53 wild-type and mutant cells. p53 mutants undergo a G2/M arrest, exhibit characteristics of mitotic catastrophe and ultimately apoptose in response to GW4716. MAPK signaling proteins (p38 and MK2) involved in G2/M checkpoint control, progression through mitosis, and cell death are induced by GW4716 treatment in p53 mutant cells. In contrast, p53 wild-type cells exhibit an induction of cell cycle regulatory proteins (p53 and p21) and the p53-specific autophagy marker DRAM, with a concomitant inhibition of p62 (SQSTM1). This leads us to hypothesize that the cytotoxic effects of GW4716 treatment occur in a p53-dependent manner, and the mode of cell death caused by GW4716 differs depending on p53 status. We hypothesize the loss of functional p53 leads to aberrant mitosis and ultimately apoptosis. We also hypothesize that p53 wild-type cells, which are less sensitive to GW4716, undergo autophagy. With the increasing emphasis on personalized medicine, these data suggest a clinically relevant role for GW4716 in the treatment of multiple p53 mutant cancers. Citation Format: Mary Heckler, Christopher Albanese, Rebecca Riggins. GW4716 selectively targets multiple p53 mutant cancer models. [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 3322. doi:10.1158/1538-7445.AM2013-3322 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.
Randomized Trial of Contrast Media Utilization in High-Risk PTCA
Authors: Charles J. Davidson, Warren K. Laskey, James B. Hermiller, J. Kevin Harrison, William Matthai, Ronald E. Vlietstra, Jeffrey A. Brinker, Dean J. Kereiakes, Joseph B. Muhlestein, Alexandra Lansky, Jeffrey J. Popma, Maurice Buchbinder, John W. Hirshfeld
Journal: Circulation (2000)

Background —Previous in vitro and in vivo studies have suggested an association between thrombus-related events and type of contrast media. Low osmolar contrast agents appear to improve the safety of diagnostic and coronary artery interventional procedures. However, no data are available on PTCA outcomes with an isosmolar contrast agent. Methods and Results —A multicenter prospective randomized double-blind trial was performed in 856 high-risk patients undergoing coronary artery intervention. The objective was to compare the isosmolar nonionic dimer iodixanol (n=405) with the low osmolar ionic agent ioxaglate (n=410). A composite variable of in-hospital major adverse clinical events (MACE) was the primary end point. A secondary objective was to evaluate major angiographic and procedural events during and after PTCA. The composite in-hospital primary end point was less frequent in those receiving iodixanol compared with those receiving ioxaglate (5.4% versus 9.5%, respectively; P =0.027). Core laboratory defined angiographic success was more frequent in patients receiving iodixanol (92.2% versus 85.9% for ioxaglate, P =0.004). There was a trend toward lower total clinical events at 30 days in patients randomized to iodixanol (9.1% versus 13.2% for ioxaglate, P =0.07). Multivariate predictors of in-hospital MACE were use of ioxaglate ( P =0.01) and treatment of a de novo lesion ( P =0.03). Conclusions —In this contemporary prospective multicenter trial of PTCA in the setting of acute coronary syndromes, there was a low incidence of in-hospital clinical events for both treatment groups. The cohort receiving the nonionic dimer iodixanol experienced a 45% reduction in in-hospital MACE when compared with the cohort receiving ioxaglate.
Glomectomy in the Treatment of Chronic Bronchial Asthma
Authors: Maurice S. Segal, Mauricio J. Dulfano
Journal: New England Journal of Medicine (1965)

THE proper management of the patient with chronic recurring bronchial asthma taxes the patience, ingenuity and integrity of the physician. Too often, as with many chronic diseases, the hope of "surgical cures" is brought up. Benefit has been described after a wide variety of surgical procedures, and, indeed, their proponents have "suggested" that these measures are specific.1 Occasionally, brilliant (temporary) results in patients with chronic bronchial asthma have been reported after procedures attacking the sympathetic or parasympathetic (vagal) system or both. This is a functional type of surgery that does not aim at the root of the disorder being treated. . . .
Probe of Heat Wave Deaths Under Way
Authors: Rebecca Voelker
Journal: JAMA (1995)

WHEN FEDERAL epidemiologists arrived in Chicago, Ill, late last month to investigate the city's massive heat-related death toll, Cook County Medical Examiner Edmund Donoghue, MD, made their work a bit easier. He handed over a computer disk containing names, ages, addresses, and the cause of death of hundreds who succumbed during mid-July's record-high temperatures in a city better known for snowscapes and heart-stopping cold. "Usually they just get a story about what happened. This will speed up their analysis," Donoghue said as investigators from the Centers for Disease Control and Prevention (CDC), Atlanta, Ga, sifted through the data. See also page 602. Chicago's heat wave and the CDC study will yield insight into heat-related mortality for some time to come. An initial report on demographics and descriptions of the deaths is in CDC's<i>Morbidity and Mortality Weekly Report</i>. More in-depth reports will focus on identifying risk factors and preventing such
A CASE OF PARTIAL OVARIOTOMY: SURVIVAL OF THE PATIENT DURING FOUR MONTHS
Authors: J. Crouch
Journal: BMJ (1854)

process of ulceration as effectually destroys that process as At of mortification does.There is, however, this difference, that in the latter the poison is expelled altogether from the system; im the former it is, in part at least, carried along the absorbent vessels.In these vessels we find it retaining
Results of publicly funded research should be available to all, says web creator
Authors: Zosia Kmietowicz
Journal: BMJ (2005)

A group of eight UK academics that includes Tim Berners-Lee, who created the world wide web, has called for all publicly funded research to be made freely available on the internet.

In an open letter to the Research Councils UK (RCUK) the group is highly critical of the Association of Learned and Professional Society, which represents non-profit academic publishers and which has opposed such moves to open access. The society claimed that a proposal by RCUK—a strategic partnership of the United Kingdom's eight research councils—that all research papers resulting from its funding should be archived on the internet “will accelerate the move to …
Charles A. Lindbergh: Medical Scientist
Authors: Adolph Meltzer
Journal: JAMA (1976)

<h3>To the Editor.—</h3> Dr Perry Hudson of Hawaii revived some precious memories of my internship days (233:950, 1975). In his discussion of Charles A. Lindbergh, he touched on some controversial areas in the life of this historic American. I believe his contribution to medical science is well worth emphasizing. Historically, Dr Hudson's letter was somewhat "slanted." He mentioned that the physiologist Richard Bing, who had collaborated with Lindbergh and Carrel, joined Prof Alfred Blalock at the Johns Hopkins Medical School and Hospital to augment the scientific team that opened the field of great-vessel surgery. Some younger readers may not be aware of the fact that Lindbergh and the "ingenious Nobel Laureate," Dr Alexis Carrel, did all of their work at The Rockefeller Institute in New York City. It was here that Lindbergh's unusual mechanically oriented mind proved to be such a great help to Carrel in devising his vascular pump
Erythropoiesis and the Effect of Transfusion in Homozygous β-Thalassemia
Authors: Ivor Cavill, Christopher Ricketts, Allan Jacobs, Elizabeth Letsky
Journal: New England Journal of Medicine (1978)

THE erythropoietic abnormality in patients with homozygous β-thalassemia results from a genetically determined defect in globin (β-chain synthesis. Erythroid activity is vastly increased, and estimates of the degree of hyperplasia vary from five to 30-fold.1 , 2 Much of this activity is known to be ineffective, but quantitative assessment of total, effective and ineffective erythropoiesis has not been possible. We have used a recently developed ferrokinetic technic3 , 4 to measure the amount of erythropoiesis and its effectiveness in patients suffering from homozygous β-thalassemia, and this procedure has allowed a preliminary examination of the effect of blood transfusion on erythroid activity. In patients having . . .