tbuckley/cabot-search huggingface dataset:
Measuring Quality of Hospital Care
Authors: Edwin D. Huff
Journal: JAMA (1995)

To the Editor.  —The key finding recently reported by Dr Miller and colleagues1and featured as an Original Contribution was previously described.2However, the previous interpretation was very different.  The significant inverse relationship between likelihood of hospitalization and all-cause, 30-day, postadmission-modeled mortality (the hospital sample standardized mortality ratio for 30 days [HSMR30]) suggested to me that states with indications of easier access to care (higher likelihood of admission) were associated with lower-than-expected mortality rates. That inverse pattern also held for disease-specific admissions for congestive heart failure, pneumonia, and stroke.2These findings were interpreted by me as evidence that hospitalization may actually confer survival benefit, in contrast to the underlying assumption of most small-area utilization analyses that hospitalization necessarily puts people at risk.  The interpretation of Miller et al of this finding, that it is evidence of modeling bias, is argued primarily through use of econometric theory. Secondarily,
The Nail in Health and Disease
Authors: William P. Coleman
Journal: JAMA (1990)

This is an even more complete and satisfying text than the excellent first edition. Dr Zaias has devoted much of his dermatologic career to understanding the anatomy and physiology of the nail. His familiarity with all aspects of nail disease resounds throughout. This text is particularly strong in the basic science of the nail as well as the multiple disorders. But it is primarily a medical dermatology textbook. Only 13 pages (5%) of the book are devoted to surgical procedures. Although most commonly used nail procedures are covered, there is a lack of detail that will disappoint dermatologic surgeons. You will have to look elsewhere for a more thorough treatise of nail surgery. The chapters on anatomy and physiology are excellent and well referenced. The embryology presented is well done but lacking in references. There are excellent chapters on nail regeneration and kinetics. Those who like syndromes need not look
Letter: Escherichia coli O148 and diarrhoea in adults.
Authors: B Rowe
Journal: BMJ (1974)

sense in 1942.1This was that "a medical practitioner who knows that a death has occurred in circumstances which would put a coroner on inquiry under the Coroners (Amendment) Act, 1926, owes a common- law duty to report the death to the coroner, quite apart from his duty of certifying the death to the registrar under the Registration Acts."In these esoteric matters, in the absence of a judicial decision, there must be room for more than one view.-Iam, etc.,
Nonpigmented Serratia marcescens
Authors: Edwin Clayton
Journal: JAMA (1966)

One hundred and eighty-one isolations of nonpigmented<i>Serratia marcescens</i>from 104 patients were made during a one-year period, most of them from urines and sputa. Patients with positive cultures had either a preexisting local disease, a history of instrumentation (catheterization, treatment with an intermittent positive pressure breathing device) or operation, or both. Other contributing factors were impaired general resistance and preceding antibiotic treatment. An evaluation of the role of Serratia in the course of each case proved difficult. However, the virulence of our strains seemed to be low. Few symptoms could be attributed exclusively to Serratia infections. Emergence after antibiotic treatment, resistance to many antibiotics, prevalence in hospital patients, and typical ward epidemics suggest that Serratia is a predominantly hospital-acquired organism. It may constitute a potential danger to debilitated patients, and its finding should not be dismissed as meaningless.
Occult Foreign-Body Aspiration in Adults
Authors: Norman Wolkove
Journal: JAMA (1982)

Foreign-body aspiration in the adult commonly results in proximal airway obstruction and acute life-threatening asphyxia. However, small foreign bodies that traverse the larynx are often asymptomatic initially and result in respiratory symptoms for weeks to years before diagnosis. We describe three patients in whom clinically important pulmonary sequelae developed after unrecognized foreign-body aspiration. (<i>JAMA</i>1982;248:1350-1352)
Genotype-phenotype assessment in autosomal recessive arrhythmogenic right ventricular cardiomyopathy (Naxos disease) caused by a deletion in plakoglobin
Authors: Nikos Protonotarios, Adalena Tsatsopoulou, Aris Anastasakis, Elias Sevdalis, Godfrina McKoy, Kostas Stratos, Kostas Gatzoulis, Kostas Tentolouris, Chara Spiliopoulou, Demos Panagiotakos, William McKenna, Paulos Toutouzas
Journal: Journal of the American College of Cardiology (2001)
Decreased serum group-specific component protein levels and complexes with actin in fulminant hepatic necrosis
Authors: William M. Lee, David L. Emerson, Phillip A.M. Werner, Philippe Arnaud, Pascal Goldschmidt-Clermont, Robert M. Galbraith
Journal: Hepatology (1985)

Monomeric G-actin has recently been shown to form high-affinity complexes with group-specific component protein (Gc), and this process might be expected to occur in vivo when hepatocyte necrosis with release of actin takes place. We therefore measured serum Gc levels and searched for evidence of actin-containing complexes of Gc in 147 sera from 21 normal subjects and 126 patients with acute and chronic liver diseases. Sera were examined for Gc concentration using an ELISA with purified Gc as standard. Gc levels were greatly diminished (less than 10 mg per dl) in 5 of 37 patients with acute hepatitis and 1 of 3 patients with subacute hepatic necrosis, and the mean values for these groups overall as well as those for chronic active hepatitis patients were significantly less than that observed in the normal controls (mean, 35.5 mg per dl). No significant alteration in Gc level was observed in the chronic disease categories studied. In contrast, Gc concentrations less than 10 mg per dl were found in 12 of 14 patients with fulminant hepatic necrosis, and the mean for this group (9.7) was significantly reduced (p less than 0.001). Sequential studies in 12 patients with acute hepatitis of moderate to marked severity but without a fulminant phase showed significant diminutions in initial Gc levels when these were compared with Gc levels obtained during recovery. Using analytical isoelectric focusing with print immunofixation, variable amounts of Gc:G-actin complexes could be demonstrated in virtually all sera examined, but the proportion of total Gc present as complex with G-actin appeared greater in fulminant hepatic necrosis sera.(ABSTRACT TRUNCATED AT 250 WORDS)
Chemical nature and immunotoxicological properties of arachidonic acid degradation products formed by exposure to ozone.
Authors: M C Madden, M Friedman, N Hanley, E Siegler, J Quay, S Becker, R Devlin, H S Koren
Journal: Environmental Health Perspectives (1993)

Ozone (O3) exposure in vivo has been reported to degrade arachidonic acid (AA) in the lungs of rodents. The O3-degraded AA products may play a role in the responses to this toxicant. To study the chemical nature and biological activity of O3-exposed AA, we exposed AA in a cell-free, aqueous environment to air, 0.1 ppm O3, or 1.0 ppm O3 for 30-120 min. AA exposed to air was not degraded. All O3 exposures degraded > 98% of the AA to more polar products, which were predominantly aldehydic substances (as determined by reactivity with 2,4-dinitrophenylhydrazine and subsequent separation by HPLC) and hydrogen peroxide. The type and amount of aldehydic substances formed depended on the O3 concentration and exposure duration. A human bronchial epithelial cell line (BEAS-2B, S6 subclone) exposed in vitro to either 0.1 ppm or 1.0 ppm O3 for 1 hr produced AA-derived aldehydic substances, some of which eluted with similar retention times as the aldehydic substances derived from O3 degradation of AA in the cell-free system. In vitro, O3-degraded AA induced an increase in human peripheral blood polymorphonuclear leukocyte (PMN) polarization, decreased human peripheral blood T-lymphocyte proliferation in response to mitogens, and decreased human peripheral blood natural killer cell lysis of K562 target cells. The aldehydic substances, but not hydrogen peroxide, appeared to be the principal active agents responsible for the observed effects. O3-degraded AA may play a role in the PMN influx into lungs and in decreased T-lymphocyte mitogenesis and natural killer cell activity observed in humans and rodents exposed to O3.
Medical Economics — Student Health — London Fog
Authors: John Lister
Journal: New England Journal of Medicine (1953)

ALTHOUGH in a special article reviewing the subject of medical economics the Times asserted that public and private medical care in Britain probably takes a smaller share of the national income than in the United States, the problem of financing the National Health Service has recently attracted much attention in both the lay and the medical press.It was Sir Stafford Cripps who, in 1950, insisted that there must be an upper limit to spending from taxation. He fixed on the arbitrary annual figure of £400 m. (about £8 per head of population), and this ceiling has since been maintained. . . .
Cost of out of hours care was 22% higher than predicted in England
Authors: Adrian O'Dowd
Journal: BMJ (2006)

The £392m (€570m; $730m) cost of providing out of hours primary care last year in England was 22% higher than anticipated by the government, a report has shown.

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The cost and quality of out of hours care since GPs opted out of their 24 hour responsibility have been questioned in a report published last week by the government's spending watchdog, the National Audit Office.

The report found shortcomings in the setting up in 2004 of new arrangements to provide out of hours care. And although no evidence was found that …

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Effect of chloroquine on insulin and glucose homoeostasis in normal subjects and patients with non-insulin dependent diabetes mellitus
Authors: A. Peiris, A. H Kissebah
Journal: BMJ (1987)

alone.Four weeks later she was discharged from hospital taking 62 IU daily.The chloroquine dose was gradually reduced, and she remained respon- sive to subcutaneous insulin.The rarityoftrue subcutaneous insulin resistance has been emphasised.3The patient reported on by Blazaretalhad accelerated insulin degradation in subcutaneous fat but also showed severe resistance to intravenous insulin.2There is evidence that, in addition to its action on hepatocyte receptors and receptor mediated degradation, chloroquine also inhibits lysosomal degradation in human skeletal muscle4 and fibroblasts5 and that it inhibits adipocyte insulin degradation in vivo.6 Chloro- quine's action may help to explain the pathogenesis of this rare syndrome as well as being useful in its management.
Pulmonary Langerhans'-Cell Granulomatosis (Histiocytosis X)
Authors: Raanan Arens, Sandra S. Kramer
Journal: New England Journal of Medicine (2000)

Figure 1. A previously healthy 16-year-old girl presented with a three-day history of progressive pain on the left side of her chest. A chest x-ray film showed a large left-sided pneumothorax with bilateral cystic radiolucencies, and a chest tube was inserted. A high-resolution computed tomographic scan demonstrated the pneumothorax and multiple thin-walled cysts throughout the lungs, especially in the upper lobes (Panel A). Diagnostic thoracoscopy, with the endoscope inserted in the space around the chest tube, showed multiple subpleural cysts (Panel B). A thoracoscopic wedge-biopsy specimen was obtained. Histologic evaluation demonstrated nodular aggregates of Langerhans' cells (arrows in Panel C) . . .
Evolutionary aspects of lipoxygenases and genetic diversity of human leukotriene signaling
Authors: Thomas Horn, Susan Adel, Ralf Schumann, Saubashya Sur, Kumar Reddy Kakularam, Aparoy Polamarasetty, Pallu Redanna, Hartmut Kuhn, Dagmar Heydeck
Journal: Progress in Lipid Research (2014)
The first inborn error of manganese metabolism caused by mutations in SLC30A10, a newly identified manganese transporter
Authors: K Tuschl, PT Clayton, SM Gospe, G Shamshad, S Ibrahim, P Singhi, RT Ribeiro, MS Zaki, M Luz del Rosario, S Dyack, V Price, RA Wevers, PB Mills
Journal: The Lancet (2013)
From genes to channels: normal mechanisms
Authors: D Roden
Journal: Cardiovascular Research (1999)

Electrophysiologic remodeling is a process whereby heart disease alters the electrophysiologic properties of cardiac tissue. These alterations, in turn, can cause or exacerbate disease-related arrhythmias. Ion channels are the fundamental molecular units underlying cardiac electrophysiology, and it therefore follows that electrophysiologic remodeling represents alterations in the function or expression of genes encoding ion channels or other proteins crucial for cardiac electrophysiologic activity. This review will describe the mechanisms whereby normal function of these proteins arises from the processes of gene transcription, mRNA processing, and protein transport, post-translational modification, assembly with other proteins, and degradation. Identification of entirely novel targets for drug intervention should result from further understanding of the fundamental mechanisms underlying remodeling.
Detection of Insulitis by Pancreatic Scintigraphy With 99mTc-Labeled IL-2 and MRI in Patients With LADA (Action LADA 10)
Authors: Alberto Signore, Gabriela Capriotti, Marco Chianelli, Elena Bonanno, Filippo Galli, Carlo Catalano, Ana M. Quintero, Giorgio De Toma, Silvia Manfrini, Paolo Pozzilli
Journal: Diabetes Care (2015)

OBJECTIVE Pancreatic scintigraphy with interleukin-2 radiolabeled with 99mTc (99mTc-IL-2) is a technique used to image chronic inflammatory-mediated disorders. We used this method to detect a signal consistent with the presence of insulitis in patients with autoimmune diabetes. Positive and negative controls (patients with pancreatic carcinoma and type 2 diabetes, respectively) also were studied. RESEARCH DESIGN AND METHODS We examined 25 patients with autoimmune diabetes (16 with recently diagnosed type 1 diabetes, 9 with latent autoimmune diabetes in adults [LADA]), 6 with type 2 diabetes, and 7 with pancreatic carcinoma (the latter two groups were used as negative and positive controls, respectively). All patients underwent 99mTc-IL-2 scintigraphy and contrast-enhanced MRI of the pancreas. To validate positive controls, samples were taken from patients with pancreatic carcinoma during surgery for histological and immunohistochemical investigations. RESULTS Pancreatic accumulation of 99mTc-IL-2 was detected in patients with autoimmune diabetes (61% positive) and, notably, in 6 of 9 patients with LADA; semiquantitative evaluation of pancreatic uptake of 99mTc-IL-2 showed higher values in patients with autoimmune diabetes (both childhood and LADA) and pancreatic carcinoma than in those with type 2 diabetes (4.45 ± 1.99, 4.79 ± 1.1, and 4.54 ± 1.62 vs. 2.81 ± 0.63; P = 0.06, P = 0.01, and P = 0.04, respectively). In patients with pancreatic carcinoma, pancreatic interleukin-2 receptor expression correlated with pancreatic 99mTc-IL-2 uptake (r = 0.8; P = 0.01). In patients with LADA, 99mTc-IL-2 uptake inversely correlated with duration of disease (r = 0.7; P = 0.03). CONCLUSIONS Autoimmune diabetes in adults is associated with increased pancreatic 99mTc-IL-2 uptake, indicating the presence of insulitis, particularly within 1 year of the beginning of insulin therapy, similar to type 1 diabetes at diagnosis.
Beta-Cell Deficiency, Insulin Resistance, or Both?
Authors: George F. Cahill
Journal: New England Journal of Medicine (1988)

Non-insulin-dependent diabetes (Type II, or maturity-onset diabetes) remains a popular topic in biomedical science because of its prevalence, morbidity, and undefined pathophysiologic aspects. Several general facts about the disorder have been known for decades, but have recently been underscored again in studies of the homogeneous population of Pima Indians by members of the National Institute of Diabetes and Digestive and Kidney Diseases in their unit in Phoenix, Arizona.1 One general observation is that obesity and overeating play very important parts; another, more important one, is that there is a correlation between the disease and increasing age.Numerous studies around the . . .
Abstract 5216: The Effect of Erythropoietin on Restenosis in Patients With Acute Myocardial Infarction Undergoing PCI
Authors: Ilka Ott, Stefanie Schulz, Julinda Mehilli, Stefanie Fichtner, Martin Hadmamitzky, Tareq Ibrahim, Steffan Martinoff, Josef Dirschinger, Adnan Kastrati, Albert Schömig
Journal: Circulation (2009)

Background: In experimental models erythropoietin not only improves myocardial function in acute myocardial infarction but also enhances reendothelialization after vessel wall injury and reduces neointima generation. Aim of this study was to analyze the angiographic restenosis in patients from the randomized, controlled Regeneration of Vital Myocardium in ST-Segment Elevation Myocardial Infarction by Erythropoietin (REVIVAL-3) study. Methods and Results: Patients with STEMI treated with primary percutaneous coronary intervention (PCI) were randomly assigned to receive epoetin beta (3.33×10 4 U, n=68) or placebo (n=70) immediately, at 24 and 48 hours after PCI. Angiographic follow-up was performed after 6 months. Quantitative coronary angiography at follow-up revealed a binary restenosis rate of 12% in the erythropoietin group and 7% in the placebo group (P=0.298). In segment diameter stenosis was 32±9% in the erythropoietin group versus 26±14% in the placebo group (P=0.046). Accordingly in segment minimal lumen diameter was 2.1±0.7mm after erythropoietin as compared to 2.3±0.6 in the placebo group P=0.070). Conclusion: In contrast to experimental findings, erythropoietin use in patients with STEMI treated with primary PCI is associated with a certain risk increase of lumen renarrowing.
A novel lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections: a prospective cohort study
Authors: Daisy Walter, Uwe Will, Andres Sanchez-Yague, Dirk Brenke, Jochen Hampe, Helge Wollny, Jose López-Jamar, Gertrud Jechart, Peter Vilmann, Joan Gornals, Sebastian Ullrich, Martin Fähndrich, Alberto de Tejada, Félix Junquera, Ferran Gonzalez-Huix, Peter Siersema, Frank Vleggaar
Journal: Endoscopy (2014)

A novel large-diameter, lumen-apposing, self-expanding metal stent with bilateral flanges was recently developed for endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic pancreatic fluid collections (PFCs). The aim of this study was to evaluate the efficacy and safety of this stent in a large cohort.Patients with a PFC undergoing EUS-guided drainage with this novel stent were prospectively enrolled in this multicenter cohort study.There were 61 patients: 46 patients (75 %) with walled-off necrosis (WON) and 15 (25 %) with a pancreatic pseudocyst. Stent placement was technically successful in 60 patients (98 %, 95 %CI 95 % - 100 %). Clinical success, defined as resolution of clinical symptoms in combination with a decrease in the PFC size to ≤ 2 cm on imaging, was achieved in 93 % of patients with a pancreatic pseudocyst (95 %CI 77 % - 100 %) and in 81 % of patients with WON (95 %CI 69 % - 94 %). Treatment failure occurred in nine patients (16 %, 95 %CI 6 % - 26 %), including four patients who required surgical intervention. Stent removal was performed in 82 % of patients after a median of 32 days (range 2 - 178) and was rated as easy in all but one patient. In 10 patients, endoscopic stent removal was not performed because of stent migration (n = 3), stent dislodgement during necrosectomy (n = 3), stent removal during surgery (n = 2), or refusal by the patient (n = 2). In total, five major complications were reported (9 %, 95 %CI 2 % - 16 %), including PFC infection (n = 4) and perforation (n = 1).EUS-guided drainage using this novel stent is feasible and the clinical results obtained are promising with a low major complication rate.
NATIONWIDE TRENDS IN OUTCOMES OF INFECTIVE ENDOCARDITIS HOSPITALIZATIONS IN THE UNITED STATES FROM 2000–2008
Authors: Karthik Murugiah, Abhishek Deshmukh, Navdeep Gupta, Sadip Pant, Apurva Badheka, Kaustubh Dabhadkar, Gagan Kumar
Journal: Journal of the American College of Cardiology (2013)
Deficiency of Protein-Carboxyl Methylase in Immotile Spermatozoa of Infertile Men
Authors: Claude Gagnon, Richard J. Sherins, David M. Phillips, C. Wayne Bardin
Journal: New England Journal of Medicine (1982)

We studied protein-carboxyl methylase, an enzyme involved in the regulation of cellular locomotion in both bacteria and leukocytes, in semen from 22 normal fertile men, 10 vasectomized volunteers, and nine infertile patients with nonmotile spermatozoa. In normally motile spermatozoa the protein-carboxyl methylase activity was 68.8±5.5 pmol per milligram of protein (mean ±S.E.). On the other hand, the enzyme activity in nonmotile spermatozoa from the infertile patients was low (17.4±3.4 pmol per milligram of protein) and similar to that in the cellular debris from the vasectomized volunteers (10.4±1.3 pmol per milligram of protein). The low enzyme activity in the infertile patients was not caused by the presence of dead spermatozoa or spermatozoa with leaky plasma membranes, since mitochondrial protein synthesis and lactate dehydrogenase activity were normal in these patients. The deficiency of protein-carboxyl methylase activity in nonmotile sperm is probably not due to a primary genetic defect, since the enzyme activity is normal in the red cells of these patients and spontaneous recovery of motility is associated with the return of enzyme activity. (N Engl J Med. 1982; 306:821–5.)
Simple unit for temporary "on demand" pacing.
Authors: S. C. Jordan, L. M. Clarke
Journal: BMJ (1969)

6/18 to no perception of light.Frequent periods of obscured vision occurred in two of these patients and was in most cases due to benign intracranial hypertension.Fluores- cein angiography again demonstrated a typical picture.A very few narrow and threadlike branches to the retinal arteries
Modern Scientific Aspects of Neurology
Authors: Lawrence C. Parish
Journal: JAMA (1960)

An excellent research book has been compiled by the chief editor who has chosen several wellknown European investigators to assist him in the writing. The organization of the contributions is good, and it is most significant that the first chapter is on nucleic acids, reflecting a trend not only general but now more specifically related to neurology. In additional sections is a discussion of nerve endings in striated muscles, lipidoses in the central nervous system, histochemical approach to the study of demyelinating diseases, electron microscopy, x-ray diffraction analysis, glycerophosphatides and spingolipids, esterases, epileptic and convulsive entities, and additional lipid chemistry. The illustrations are outstanding. The printing has been so good that one is actually able to distinguish and to judge with comparative ease the various histochemical stains, which have also been discussed in the text. The references are current, and the index appears suitable for the demands of most physicians.