tbuckley/cabot-search huggingface dataset:
Clinical Outcomes and Cost-Effectiveness of Coronary Computed Tomography Angiography in the Evaluation of Patients With Chest Pain
Authors: Joseph A. Ladapo, Farouc A. Jaffer, Udo Hoffmann, Carey C. Thomson, Fabian Bamberg, William Dec, David M. Cutler, Milton C. Weinstein, G. Scott Gazelle
Journal: Journal of the American College of Cardiology (2009)

The aim of this study was to project clinical outcomes, health care costs, and cost-effectiveness of coronary computed tomography angiography (CCTA), as compared with conventional diagnostic technologies, in the evaluation of patients with stable chest pain and suspected coronary artery disease (CAD). CCTA has recently been found to be effective in the evaluation of patients with suspected CAD, but investigators have raised concerns related to radiation exposure, incidental findings, and nondiagnostic exams. With published data, we developed a computer simulation model to project clinical outcomes, health care costs, and cost-effectiveness of CCTA, compared with conventional testing modalities, in the diagnosis of CAD. Our target population included 55-year-old patients who present to their primary care physicians with stable chest pain. All diagnostic strategies yielded similar health outcomes, but performing CCTA—with or without stress testing or performing stress single-photon emission computed tomography—marginally minimized adverse events and maximized longevity and quality-adjusted life-years (QALYs). Health outcomes associated with these strategies were comparable, with CCTA in men and women yielding the greatest QALYs but only by modest margins. Overall differences were small, and performing the most effective test—compared with the least effective—decreased adverse event rates by 3% in men and women. Comparable increases in longevity and QALYs were 2 months and 0.1 QALYs in men and 1 month and 0.03 QALYs in women. CCTA raised overall costs, partly through the follow-up of incidental findings, and when performed with stress testing, its incremental cost-effectiveness ratio ranged from $26,200/QALY in men to $35,000/QALY in women. Health outcomes were marginally less favorable in women when radiation risks were considered. CCTA is comparable to other diagnostic studies and might hold good clinical value, but large randomized controlled trials are needed to guide policy.
From Chocolate to Morphine: Everything You Need to Know About Mind-Altering Drugs
Authors: Donald W. Goodwin
Journal: JAMA (1994)

The message of this book is that if you must use drugs, use them responsibly. Drugs include any substance that gives pleasure, including sugar and chocolate, but the book is mainly about illicit drugs and inappropriate use of drugs, covering alcohol, marijuana, opiates, stimulants, downers, hallucinogens, and other pharmacologic attractions.
Noises in the Neck
Authors: J. Willis Hurst, Linton C. Hopkins, Robert B. Smith
Journal: New England Journal of Medicine (1980)

The interesting follow-up study of patients with asymptomatic carotid bruits reported by Heyman et al. in this issue again calls attention to the common and perplexing problem of vascular noises in the neck. What kinds of noises are heard, what do they mean, and what should be done about them?The Cervical Venous Hum1 The murmur of a venous hum is continuous and is usually heard above the medial end of the clavicles and along the anterior border of the sternocleidomastoid muscle. According to Fowler and Gause, a venous hum can be heard or produced in 75 per cent of . . .
Thymic Malignancies: From Clinical Management to Targeted Therapies
Authors: Ronan J. Kelly, Iacopo Petrini, Arun Rajan, Yisong Wang, Giuseppe Giaccone
Journal: Journal of Clinical Oncology (2011)

A key challenge in the treatment of thymoma and thymic carcinoma (TC) is in improving our understanding of the molecular biology of these relatively rare tumors. In recent years, significant efforts have been made to dissect the molecular pathways involved in their carcinogenesis. Here we discuss the results of large-scale genomic analyses conducted to date and review the most active chemotherapies and targeted treatments.
Relief of Pain in Midwifery
Authors: J. A. Chalmers
Journal: BMJ (1948)

rescission of the basic salary will be sufficient in itself to main- tain essential freedom.While this proviso may perhaps provide escape from the State salaried service in name and title it is very far from doing so in effect and in fact, as these innocents would very quickly find if the Government became the sole owner and patron of their practices-which Heaven forbid.It is by no means appreciated how great is the value to the public of continuity of practice.A doctor who buys a general practice purchases, as it were, a stake in the locality.Almost invariably he settles down for a term of years, and not infrequently for the whole of his working life.In the way that only time can give he gains a real knowledge of his patients, their characters, their interests, their antecedents, indeed almost everything about them.To him they are individuals, not numbers.Frequently and in a very real sense he is a father of his people.In due course he may be succeeded by his son.Now consider what might well happen under Government patronage, the doctor being appointed to his living.There is no incentive to like the place or to care for the people, there is no incentive to remain, and indeed much inducement to keep moving.Thus he becomes no more than a temporary resident, or.more aptly, the equivalent of the political " carpet-bagger."Those who are wavering or weak in the faith, and those who are casting anxious eyes at their compensation, should try to look into the future of ten, twenty, or thirty years hence, when their sons and successors will be practising, and should always remember that they themselves are but custodians, that the science of medicine is a heritage common to the past, the present.and the future.It is worth hazard or sacrifice, especially of personal position and amenity, if thereby that heritage can be passed on in all the greatness of freedom.-Iam, etc.. Wirksworth.Derby.
Glycosylated fetal haemoglobin.
Authors: M N Cauchi, A Balloch
Journal: BMJ (1982)

Twenty patients out of 38 (52 60' ) who had undergone haemodialysis for one to 80 months (mean 28 1 months) were found to have eosinophilia (eosinophils > 400/mm3) in a random examination (December 1980) in the first unit, while 16 out of 31 patients (51 6%) whose dialysis had lasted from three to 68 months (mean 29-7 months) had eosinophilia in the second unit.Thirty patients from the latter unit who had received dialysis for 20-72 months, who had eosinophil counts at least once a month, were included in this study also.Sixteen out of 30 of these (5333%) never developed eosinophilia during the observation period, six (20%) developed constant eosino- philia, and eight (26 7%) developed transient eosinophilia.This study also shows that during the first two years there is a progressive increase in the mean eosinophil count of the patients, which remains almost constant during the following years (figure).No correlation was found with 4.00 300-Mean eosinophil count/mm¾3 SE 200 - n= 18 100 Before 1 2 3 4 dialysis Years on dialysisEosinophil counts in patients undergoing dialysis.
Fibrin-polylactide-based tissue-engineered vascular graft in the arterial circulation
Authors: Sabine Koch, Thomas C. Flanagan, Joerg S. Sachweh, Fadwa Tanios, Heike Schnoering, Thorsten Deichmann, Ville Ellä, Minna Kellomäki, Nina Gronloh, Thomas Gries, René Tolba, Thomas Schmitz-Rode, Stefan Jockenhoevel
Journal: Biomaterials (2010)
New insights into disease pathogenesis in crusted (Norwegian) scabies: the skin immune response in crusted scabies
Authors: S.F. Walton, D. Beroukas, P. Roberts-Thomson, B.J. Currie
Journal: British Journal of Dermatology (2008)

Crusted scabies is a rare and severely debilitating disease characterized by infestation of the skin with up to millions of Sarcoptes scabiei mites, high total IgG levels, extremely high total IgE levels, and the development of hyperkeratotic skin crusts that may be loose, scaly and flaky or thick and adherent.To describe crusted scabies skin pathogenesis and identify markers associated with an inappropriate immune response leading to disease progression.Serial sections from skin biopsies obtained from two patients with severe crusted scabies were examined by immunohistochemistry for cell surface markers and inflammatory and regulatory cytokines. Concurrent levels of total B- and T-cell subsets and IgE, IgA, IgM, IgG and IgG subclasses were analysed in the blood. In addition antibody levels were recorded in a further 33 patients with crusted scabies and 14 patients with ordinary scabies.A predomination of infiltrating CD8+ T lymphocytes in the dermis was observed compared with minimal helper T lymphocytes (CD4+) and the absence of any B cells. The proportion of T and B lymphocytes and T-cell subsets in the blood of these patients were within normal ranges, indicating a selective movement of CD8+ T cells into the dermis. Furthermore, strong staining for the inflammatory cytokine interleukin-1 beta and anti-inflammatory cytokine transforming growth factor-beta1 was observed. Elevated levels of IgE, IgG, IgG1, IgG3 and IgG4 were recorded.Skin-homing cytotoxic T cells contribute to an imbalanced inflammatory response in the dermis of crusted scabies lesional skin. This, in combination with the lack of B cells, is contributing to the failure of the skin immune system to mount an effective response resulting in uncontrolled growth of the parasite.
Pain and the Neurosurgeon: A 40-Year Experience
Authors: Oscar Sugar
Journal: JAMA (1969)

Pain is perhaps the most common reason for seeking medical assistance. All doctors treat pain—by medication, removal of offending organs, and so on. The neurosurgeon has two roles to play: first, to relieve pain produced by a disorder of the nervous system, such as tumor, neuralgia, injury, and the like; and second, to relieve pain by interfering with neural pathways, when the source of pain cannot be attacked by medication, injection, or operation. This book by White and Sweet details their experience in treating painful conditions in some 1,700 humans with intractable pain, and provides follow-up over many years. The first half, on treatment of specific painful conditions, is oriented toward anyone interested in peripheral neuralgias, trigeminal and other cephalic neuralgias, pain of spinal origin, and pain from malignant disease anywhere below the neck. The second half of the book gives the authors' observations on how to carry out the
Improving survival for patients with atrial fibrillation and advanced heart failure
Authors: William G. Stevenson, Lynne W. Stevenson, Holly R. Middlekauff, Gregg C. Fonarow, Michelle A. Hamilton, Mary A. Woo, Leslie A. Saxon, Paul D. Natterson, Anthony Steimle, Julie A. Walden, Jan H. Tillisch
Journal: Journal of the American College of Cardiology (1996)
A Short Pulse of IL-4 Delivered by DCs Electroporated With Modified mRNA Can Both Prevent and Treat Autoimmune Diabetes in NOD Mice
Authors: Rémi J Creusot, Pearl Chang, Don G Healey, Irina Y Tcherepanova, Charles A Nicolette, C Garrison Fathman
Journal: Molecular Therapy (2010)

Bone marrow-derived dendritic cells (DCs) are cells of the immune system that have been used as a tool to boost, modulate, or dampen immune responses. In the context of autoimmunity, DCs can be modified to express immunoregulatory products encoded by transgenes, and used therapeutically in adoptive cellular therapy. DCs that were lentivirally transduced (lt) to express interleukin 4 (IL-4) can significantly delay or prevent the onset of autoimmune diabetes in nonobese diabetic (NOD) mice. However, modifying cells using viral vectors carries the dual risk of oncogenicity or immunogenicity. This study demonstrates that NOD DCs, electroporated with "translationally enhanced" IL-4 mRNA (eDC/IL-4), can be equally efficient therapeutically, despite the reduced amount and shorter duration of IL-4 secretion. Moreover, a single injection of eDC/IL-4 in NOD mice shortly after the onset of hyperglycemia was able to maintain stable glycemia for up to several months in a significant fraction of treated mice. Treatment with eDC/IL-4 boosted regulatory T (Tregs) cell functions and modulated T helper responses to reduce pathogenicity. Thus, treatment with DCs, electroporated with modified IL-4 mRNA to express IL-4 for up to 24 hours, constitutes a viable cellular therapy approach for the regulation of autoimmune diabetes, as a preferred alternative to the use of viral vectors. Bone marrow-derived dendritic cells (DCs) are cells of the immune system that have been used as a tool to boost, modulate, or dampen immune responses. In the context of autoimmunity, DCs can be modified to express immunoregulatory products encoded by transgenes, and used therapeutically in adoptive cellular therapy. DCs that were lentivirally transduced (lt) to express interleukin 4 (IL-4) can significantly delay or prevent the onset of autoimmune diabetes in nonobese diabetic (NOD) mice. However, modifying cells using viral vectors carries the dual risk of oncogenicity or immunogenicity. This study demonstrates that NOD DCs, electroporated with "translationally enhanced" IL-4 mRNA (eDC/IL-4), can be equally efficient therapeutically, despite the reduced amount and shorter duration of IL-4 secretion. Moreover, a single injection of eDC/IL-4 in NOD mice shortly after the onset of hyperglycemia was able to maintain stable glycemia for up to several months in a significant fraction of treated mice. Treatment with eDC/IL-4 boosted regulatory T (Tregs) cell functions and modulated T helper responses to reduce pathogenicity. Thus, treatment with DCs, electroporated with modified IL-4 mRNA to express IL-4 for up to 24 hours, constitutes a viable cellular therapy approach for the regulation of autoimmune diabetes, as a preferred alternative to the use of viral vectors.
Some Properties of a Cardioactive Substance Isolated From Human Plasma
Authors: WINIFRED G. NAYLER, PETER G. C. ROBERTSON, JOCELYN M. PRICE, THOMAS E. LOWE
Journal: Circulation Research (1965)

Some effects of a relatively low molecular weight substance, isolated from human plasma, on isolated amphibian and mammalian cardiac muscle and on intact rabbits have been studied. This cardioactive plasma substance elicited a positive inotropic response from isolated isometrically contracting papillary muscle of rabbits, dogs, and monkeys, from trabeculae carneae of rats, and from ventricular muscle of toads. Its positive inotropic activity was associated with a shortened duration of action potentials. Studies on intact animals showed that the intravenous injection of this substance raised systemic pressures, raised right and left ventricular systolic pressures, and increased cardiac output. Adrenergic blocking drugs failed to block the inotropic and pressor effects of freshly isolated cardioactive plasma substance.
Pernicious anaemia and intestinal malabsorption: spinal cord degeneration developing during vitamin B 12 treatment.
Authors: C. G. Riley
Journal: BMJ (1967)

calcification.By 1963 Punsar and Somer were able to review 33 reported cases of irreversible renal failure due to prolonged excessive intake of absorbable alkali, associated in most but not all instances with excessive milk consumption.Rifkind et al. (1960) reported the only previous British case that we have been able to find with the principal features of the chronic milk-alkali syndrome.Their patient was a woman of 48 who had taken 30 Rennies tablets daily for 10 years with- out excessive milk intake.Besides uraemia and nephrocalcin- osis there were calcium deposits in the corneae and sclerae, aorta, and abdominal lymph nodes and there was generalized osteosclerosis, whereas our patient had radiologically normal bones.Our case, like theirs, had an excessive intake of calcium and absorbable alkali derived from Rennies tablets.In our patient the rapid fall in the serum calcium level with subsequent improvement in the general state of health and fall in blood urea after stopping the Rennies tablets indicates that they were the cause of the hypercalcaemia and nephrocalcinosis.The absence of further deterioration of renal function almost three years after stopping the tablets is noteworthy.Both our patient and that of Rifkind et at.took large quantities of Rennies tablets because they had developed a liking for them.It seems improbable that any patient would take so many antacid tablets solely to relieve dyspepsia.
Resistance training may concomitantly benefit body composition, blood pressure and muscle MMP-2 activity on the left ventricle of high-fat fed diet rats
Authors: Richard Diego Leite, Rita de Cássia Marqueti Durigan, Anderson Diogo de Souza Lino, Markus Vinicius de Souza Campos, Maria das Graças Souza, Heloisa Silvestre Selistre-de-Araújo, Eliete Bouskela, Luiz Guilherme Kraemer-Aguiar
Journal: Metabolism (2013)
Pregnancy and Fertility Following Bariatric Surgery
Authors: Melinda A. Maggard, Irina Yermilov, Zhaoping Li, Margaret Maglione, Sydne Newberry, Marika Suttorp, Lara Hilton, Heena P. Santry, John M. Morton, Edward H. Livingston, Paul G. Shekelle
Journal: JAMA (2008)

][3][4][5][6][7][8][9][10][11][12][13][14] Rates of surgical weight loss procedures have grown steeply and women account for many of these patients. 15arge numbers of women in their childbearing years may undergo bariatric surgery, which may change fertility following weight loss, alter nutritional requirements during pregnancy, or impact contraception to prevent pregnancy.Our specific goals were to estimate the incidence of bariatric surgery in women aged 18 to 45 years and perform a systematic review to assess associations of bariatric surgery on pregnancy outcomes, including maternal and neonatal outcomes, nutritional adverse events, fertility, contraception, optimal time to delay pregnancy, and surgical complications during pregnancies.
SOLTI-0701: A Multinational Double-Blind, Randomized Phase 2b Study Evaluating the Efficacy and Safety of Sorafenib Compared to Placebo When Administered in Combination with Capecitabine in Patients with Locally Advanced or Metastatic Breast Cancer (BC).
Authors: J. Baselga, H. Roché, F. Costa, J. Getúlio Martins Segalla, H. Pinczowski, E. Ma Ciruelos, S. Cabral Filho, P. Gómez, B. Van Eyll
Journal: Cancer Research (2009)

Abstract INTRODUCTION: Sorafenib (SOR) is a potent multikinase inhibitor with anti-angiogenic and anti-proliferation activity. It is indicated for the treatment of advanced renal cell carcinoma and unresectable hepatocellular carcinoma. As a single agent, SOR has shown modest activity in patients with advanced BC. Here, we report results from one (SOLTI-0701) of four Phase 2b trials of sorafenib in combination with chemotherapy for advanced breast cancer.METHODS: SOLTI-0701 is a multinational, double-blind, randomized, placebo-controlled phase 2b study in patients with locally advanced or metastatic BC. Eligibility criteria included HER-2 negative tumors and &amp;lt;2 prior chemo regimens for advanced/metastatic BC. Patients with active brain metastasis were excluded. Patients were randomized (1:1) to receive CAP (1000 mg/m2, orally, twice daily [BID], for 14 of every 21 days) with placebo (pl) or SOR (400 mg, orally, BID, continuously). Randomization is stratified by metastatic site (visceral vs nonvisceral). The primary endpoint is progression-free survival (PFS), and secondary endpoints include overall survival, time to progression, response rate, response duration, safety, and QoL. Disease assessments occur every 6 weeks for the first 24 weeks of the study and then every 9 weeks thereafter until disease progression. Based on projected event and accrual rates, a sample size of 220 patients has been calculated. We estimate 120 PFS events within 17 months of study initiation. The study is registered at EudraCT (ID 2007-000290-32).RESULTS: Enrollment began in August 2007 and was completed in December 2008 with 229 patients randomized. Study findings demonstrated that the median PFS was extended in patients treated with SOR and CAP compared to patients receiving CAP and PL. These results were statistically significant (p=0.0006). The safety and tolerability of the combination did not show any new or unexpected toxicities. A subset analysis will be presented.CONCLUSION: The SOLTI-0701 study will provide important efficacy and safety data for the use of sorafenib in combination with oral chemotherapy for advanced breast cancer. These data will help us better understand the potential role for sorafenib in BC and if phase III trials are warranted. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 45.
Astrolabe
Authors: Thomas B. Cole
Journal: JAMA (2014)

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Chanson D'Amour
Authors: Steven Goodrick
Journal: The Lancet Neurology (2012)

One way to hold your audience's attention at the very beginning of a film is for the first scene to feature police officers and paramedics breaking down an apartment door only to be faced with a decomposing corpse, festooned with garlands of flowers. Certainly dramatic, but perhaps not what you would expect from Austrian auteur Michael Haneke as the opening to his latest film, Amour, the much-feted winner of the 2012 Palme D'Or. Just as I was starting to wonder whether I had accidentally walked into the wrong screening, the story winds back to before the events that precipitated this dramatic tableau, and the more genteel venue of a Schubert piano recital in Paris.
Acute confusional state with postoperative intravenous cefazolin.
Authors: A. M. Herd, C. A. Ross, S. K. Bhattacharya
Journal: BMJ (1989)

Nevertheless they generally reported less chronic pain after treatment with acyclovir,"'°and this is consistent with other uncontrolled data.4"On balance, therefore, it seems more reasonable to conclude that acyclovir can reduce, though not completely prevent, post-herpetic neuralgia.