tbuckley/cabot-search huggingface dataset:
The UK needs an Institute of Medicine
Authors: R Minhas, K C R Patel, A S Wierzbicki
Journal: BMJ (2008)

The permanent revolution within the NHS aims to ensure fiscal balance and the provision of patient centred care while maintaining the support of the medical profession. The fiscal and care aspects have received most attention at the expense of engagement with clinicians, and the policy focus has now moved to the “quality of care” at a time when the word deprofessionalisation captures well the current zeitgeist within the medical profession. Professionalism requires a high level of performance, and so improving standards is fundamental to medical practice; now the issue is how to apply this ethic to the delivery of health care itself. The physician’s primary duty to the patient must be held above other loyalties (institutional, specialist or financial), as this ensures the public’s trust in the profession. However, care in the NHS has to be delivered not only to individuals but also to populations, and this consideration, traditionally confined to public health medicine, must now assume a central position within the wider profession too.

Quality, defined as “the degree to which health services increase the likelihood of desired health outcomes given current knowledge,”1 2 …
Ga-67 Scan as a Prognostic Indicator in Primary Lung Carcinoma
Authors: TOMOMITSU HIGASHI, KOH NAKAMURA, SHINJI SUZUKI, JACK R ALLISON, HIROMI WAKAO
Journal: Clinical Nuclear Medicine (1982)

GA-67 scintigraphy was performed on 74 patients with a variety of histologic types of untreated primary lung carcinoma. Ga-67 uptake was determined, allowing for differences in tumor size. Ga-67 uptake was compared with the response to the incidence of metastases, and to host survival in the 74 patients. From these results, it is suggested that the greater the Ga-67 accumulation in the tumor, the higher the incidence of metastases and the shorter the host survival. Ga-67 scintigraphy appears to be a valuable tool in indicating the prognosis following radiation therapy in patients with primary lung carcinoma.
Access to Substance Abuse Treatment Services Under the Oregon Health Plan
Authors: Dennis D. Deck
Journal: JAMA (2000)

HE IMPLEMENTATION OF MAN-aged care has raised numerous concerns about access to health services. 1The American Society for Addiction Medicine has suggested that chemical dependency treatment programs have experienced a greater impact from managed care than other sectors of the health care industry.For example, an American Society for Addiction Medicine working group reported a 75% reduction in the value of addiction insurance coverage from 1988 to 1998 for mid-size to largesize companies. 2,35][6][7] A key question concerns the impact of these trends on access to publicly funded chemical dependency treatment.Although these developments are under way in the larger health care sector, states have been converting their Medicaid programs from fee-for-service to managed care. 8Most Medicaid recipients are now enrolled in managed care systems. 8At least 48 states have federal waivers allowing them to replace feefor-service Medicaid with managed care. 6,9Chang et al 10 suggested that, at least in some states, these changes have decreased access to chemical dependency treatment services for Medicaid recipients.However, few quantitative data are available.Although comparison between feefor-service and managed care Medicaid is of great theoretical interest, a return to unmanaged Medicaid seems unlikely. 3A more practical question concerns the difference in access among various types of managed care systems, such as the contrast between "integrated" health care systems (which provide both medical-surgical and behavioral health care) and "carve out" programs (in which behavioral health services are delivered by agencies distinct from the systems that provide medical-surgical care). 11Tightly integrated systems may facilitate the referral of patients with substance abuse disorders from primary care to treatment programs, but integrated systems might direct funds intended for substance abuse treatment into medical-surgical services.Other dimensions of interest include the mechanism used to reim-
Temperature Curve Complexity Predicts Survival in Critically Ill Patients
Authors: Manuel Varela, Juan Churruca, Ana Gonzalez, Alfredo Martin, Jesus Ode, Pedro Galdos
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Temperature curve complexity is inversely related to clinical status in critically ill patients.To study if temperature curve complexity analysis predicts clinical outcome and how this test compares to other well-established conventional measures.Temperature was continuously recorded in 50 patients with multiple organ failure. Time-series complexity was analyzed using hourly approximate entropy (ApEn) and detrended fluctuation analysis (DFA) values. Sequential Organ Failure Assessment (SOFA) score was obtained every other day, and correlation between complexity and SOFA values was evaluated. Differences in complexity between nonsurviving and surviving patients were likewise analyzed. Logistic regression models were calculated to predict outcome, and receiver operating characteristic (ROC) curves were plotted to compare the predictive power of complexity values versus SOFA.There was good correlation between complexity results and clinical scores for each patient. Nonsurvivors exhibited lower complexity values than survivors (minimum ApEn = 0.230 vs. 0.378; maximum DFA = 1.636 vs. 1.507; mean ApEn = 0.459 vs. 0.596; mean DFA = 1.376 vs. 1.288; p < 0.001 for all comparisons). In the logistic regression model, a change of 0.1 in the minimum complexity resulted in severe increases in the odds ratio of dying (7.6-fold for ApEn, 5.4-fold for DFA). In terms of predicting outcome, there were no significant differences in the areas under the ROC curves for complexity values versus SOFA scores.Low levels of complexity in the temperature curve are indicators of poor prognosis in patients with multiple organ failure. The predictive ability of temperature curve complexity is similar to that of the SOFA score.
Drugs Five Years Later
Authors: RICHARD QUINTILIANI
Journal: Annals of Internal Medicine (1978)

After 5 years of use, cefazolin can be considered similar to cephalothin as a therapeutic agent and in its potential for adverse reactions. When cefazolin and cephalothin are compared by appropriately designed clinical trials, neither cefazolin's slightly greater in-vitro susceptibility to staphylococcal beta-lactamase inactivation, nor its slightly greater microbiologic activity for some enterobacteraciae has been shown to result in any readily apparent therapeutic differences. The important differences between cefazolin and cephalothin—and this is also probably true with respect to cephapirin and cephradine—are not in therapeutic effectiveness, microbiologic activity, or toxicity but rather in pharmacokinetics and cost-effectiveness.
Chromobox Protein Homologue 7 Protein, with Decreased Expression in Human Carcinomas, Positively Regulates E-Cadherin Expression by Interacting with the Histone Deacetylase 2 Protein
Authors: Antonella Federico, Pierlorenzo Pallante, Mimma Bianco, Angelo Ferraro, Francesco Esposito, Maria Monti, Marianna Cozzolino, Simona Keller, Monica Fedele, Vincenza Leone, Giancarlo Troncone, Lorenzo Chiariotti, Piero Pucci, Alfredo Fusco
Journal: Cancer Research (2009)

Chromobox protein homologue 7 (CBX7) is a chromobox family protein encoding a novel polycomb protein, the expression of which shows a progressive reduction, well related with the malignant grade of the thyroid neoplasias. Indeed, CBX7 protein levels decreased in an increasing percentage of cases going from benign adenomas to papillary, follicular, and anaplastic thyroid carcinomas. To elucidate the function of CBX7 in carcinogenesis, we searched for CBX7 interacting proteins by a proteomic analysis. By this approach, we identified several proteins. Among these proteins, we selected histone deacetylase 2 (HDAC2), which is well known to play a key role in neoplastic cell transformation and down-regulation of E-cadherin expression, the loss of which is a critical event in the epithelial-to-mesenchymal transition. We confirmed by coimmunoprecipitation that CBX7 physically interacts with the HDAC2 protein and is able to inhibit its activity. Then, we showed that both these proteins bind the E-cadherin promoter and that CBX7 up-regulates E-cadherin expression. Consistent with these data, we found a positive statistical correlation between CBX7 and E-cadherin expression in human thyroid carcinomas. Finally, we showed that the expression of CBX7 increases the acetylation status of the histones H3 and H4 on the E-cadherin promoter. Therefore, the ability of CBX7 to positively regulate E-cadherin expression by interacting with HDAC2 and inhibiting its activity on the E-cadherin promoter would account for the correlation between the loss of CBX7 expression and a highly malignant phenotype.
Aortic Dilatation and Dissection in Turner Syndrome
Authors: Lea Ann Matura, Vincent B. Ho, Douglas R. Rosing, Carolyn A. Bondy
Journal: Circulation (2007)

The risk for aortic dissection is increased among relatively young women with Turner syndrome (TS). It is unknown whether aortic dilatation precedes acute aortic dissection in TS and, if so, what specific diameter predicts impending deterioration.Study subjects included 166 adult volunteers with TS (average age, 36.2 years) who were not selected for cardiovascular disease and 26 healthy female control subjects. Ascending and descending aortic diameters were measured by magnetic resonance imaging at the right pulmonary artery. TS women were on average 20 cm shorter, yet average aortic diameters were identical in the 2 groups. Ascending aortic diameters normalized to body surface area (aortic size index) were significantly greater in TS, and approximately 32% of TS women had values greater than the 95th percentile of 2.0 cm/m2. Ascending diameter/descending diameter ratios also were significantly greater in the TS group. During approximately 3 years of follow-up, aortic dissections occurred in 3 women with TS, for an annualized rate of 618 cases/100,000 woman-years. These 3 subjects had ascending aortic diameters of 3.7 to 4.8 cm and aortic size indices > 2.5 cm/m2.The risk for aortic dissection is greatly increased in young women with TS. Because of their small stature, ascending aortic diameters of < 5 cm may represent significant dilatation; thus, the use of aortic size index is preferred. Individuals with a dilated ascending aorta defined as aortic size index > 2.0 cm/m2 require close cardiovascular surveillance. Those with aortic size index > or = 2.5 cm/m2 are at highest risk for aortic dissection.
Indolent T-cell lymphoproliferative disease of the gastrointestinal tract
Authors: Anamarija M. Perry, Roger A. Warnke, Qinglong Hu, Philippe Gaulard, Christiane Copie-Bergman, Serhan Alkan, Huan-You Wang, Jason X. Cheng, Chris M. Bacon, Jan Delabie, Erik Ranheim, Can Kucuk, XiaoZhou Hu, Dennis D. Weisenburger, Elaine S. Jaffe, Wing C. Chan
Journal: Blood (2013)
Lobectomy for Bronchiectasis in an Infant
Authors: A. W. Fawcett
Journal: BMJ (1941)

Unusual Dislocation of the Carpal BonesIt is thought that the following case is worthy of record owing to its unusual character.CASE REPORT A soldier aged 21 came to hospital on the morning of December 10, 1940, complaining of pain in his right wvrist.Earlier that morning a lorry, wvhilst backing, had compressed his right hand and forearm against a wall.The elbow was flexed at the time so that the force wvas an impacting one, tending to drive the carpus proxirnally.On examination there was considerable radial deviation of the wrist, and the lower end of the ulna was very prominent.Any attempt to move the w%rist passively caused great pain.
Abstract 4143: Bz-423, a novel benzodiazpine, inhibits PI3 kinase signaling in ovarian cancer cells
Authors: Gunjal Garg, Rebecca Liu, Anthony Boitano, Lijun Tan, Roland Kwok, Gary Glick, Anthony Opipari
Journal: Cancer Research (2010)

Abstract Objective: Bz-423 is a 1,4-benzodiazepine with immunomodulatory and cytotoxic properties. The effect of Bz-423 on survival signaling in lymphoid neoplasms predicts activity against similar pathways in ovarian cancer cells. Having previously established the cytotoxic activity of Bz-423 against ovarian cancer, we now characterize the mechanism of action. Methods: Human ovarian cancer cell lines were maintained in culture. Cells were treated with Bz-423 or vehicle control. Cell survival and proliferation were evaluated, along with signaling mechanisms including the PI3-kinase-Akt-mTOR axis. DNA degradation (apoptotic fraction), mitochondrial function and caspase activation were evaluated by flow cytometry. Cytochrome c release and protein kinase activation were analyzed by immunoblotting. Apoptosome complex formation was monitored by gel filtration chromatography. Cellular ultrastructure was determined by electron microscopy (EM). Results: Growth inhibition and apoptosis were observed in all ovarian cell lines following treatment with Bz-423. Caspase-9 and −3 cleavage, along with cytochrome c release were seen, consistent with activation of the intrinsic pathway of apoptosis. Early mitochondrial changes identified by ultrastructural evidence of mitochondrial swelling and the accumulation of superoxide within 1 hr of treatment were seen. Bz-423 induced cell death was associated with inhibition of Akt activation through a oxidant dependent mechanism. Antioxidants blocked Bz-423-induced signaling. Conclusions: Bz-423 is a novel benzodiazepine being developed as a mitochondria targeted therapy, and displays anti-neoplastic activity against ovarian cancer cells in vitro. Results show that by acting on mitochondrial complex V, this compound inhibits PI3-kinase signaling, including the tumor survival factor Akt. PI3-kinase signaling is increasingly recognized as a survival and growth promoting mechanism in ovarian cancer. Since Akt inhibition by Bz-423 is dependent upon cellular bioenergetics and anti-oxidant balance, strategies employing this compound offer a selective new approach to target ovarian cancer cells. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4143.
Cytogenetic studies in lymphocytes of patients with rectal cancer.
Authors: E Gebhart, R Romahn, A Schneider, M Hoffmann, D Rau, H Tittelbach
Journal: Environmental Health Perspectives (1993)

Spontaneous and clastogen-induced chromosomal instability in a high-risk group (i.e, 33 patients with rectal carcinomas) was investigated using peripheral blood lymphocytes as target cells. In addition to the analysis of spontaneous and clastogen-induced chromosome aberrations, this study also included classical karyotype analysis and scoring of sister chromatid exchanges (SCE) in some of the patients. Diepoxybutane (DEB), 4-nitroquinoline-1-oxide (NQO), and bleomycin were used as standard clastogens. Lymphocytes of healthy control individuals were studied in parallel with each cancer patient. While only slight but significant differences could be detected of the average spontaneous, DEB- and bleomycin (G2)-induced chromosome breakage between patient and control lymphocytes, individual patients and two of the control individuals showed a more distinct increase in the frequency of the studied end points. These increases were documented by a variegated mosaicism of karyotypic changes and by an increased breakage rate induced by the clastogens. Neither the bleomycin-exposure in the G1 phase nor SCE was capable of detecting differences between the patients and controls. Of particular interest in the sense of high-risk individuals were seven patients and two control persons whose lymphocytes exhibited increased chromosomal sensitivity under more than one of the studied experimental conditions.
Soluble fas ligand in natural killer cell lymphoma
Authors: Tohru Murayama, Tamio Koizumi, Hiranmoy Das, Yukio Kobayashi, Kazuyoshi Kajimoto, Takeshi Sugimoto, Shion Imoto, Ryuichiro Nishimura, Toshitaro Nakagawa
Journal: American Journal of Hematology (1999)

We measured serum soluble Fas ligand (sFasL) in a patient with natural killer cell lymphoma, and investigated relationship between sFasL and liver dysfunction. An elevated level of sFasL was decreased after local radiation therapy, and liver function improved. When lymphoma relapsed, liver dysfunction reappeared and the level of sFasL increased parallelly. Lymphoma cells expressed mRNA of FasL. This suggested that this liver dysfunction was induced by some remote effectors, and sFasL was one of candidates of these effectors. Am. J. Hematol. 62:253–255, 1999. © 1999 Wiley-Liss, Inc.
Gestational Diabetes, Birth Weight, Sex Ratio, and Cesarian Section
Authors: William H. James
Journal: Diabetes Care (2001)

Knights et al. (1) reported on the sexes of the offspring of 216 women with gestational diabetes (GDM) and 216 control subjects without GDM, all of whom underwent cesarian section. The sex ratio (proportion male) for the control offspring was significantly higher than that for the offspring of the GDM women. The birth weights and gestational ages of the offspring from the two groups of women showed no appreciable differences, even when offspring sex was controlled. These authors claimed that their data do not support the suggestion that the …
CpG Island Hypermethylation in Human Astrocytomas
Authors: Xiwei Wu, Tibor A. Rauch, Xueyan Zhong, William P. Bennett, Farida Latif, Dietmar Krex, Gerd P. Pfeifer
Journal: Cancer Research (2010)

Abstract Astrocytomas are common and lethal human brain tumors. We have analyzed the methylation status of over 28,000 CpG islands and 18,000 promoters in normal human brain and in astrocytomas of various grades using the methylated CpG island recovery assay. We identified 6,000 to 7,000 methylated CpG islands in normal human brain. Approximately 5% of the promoter-associated CpG islands in the normal brain are methylated. Promoter CpG island methylation is inversely correlated whereas intragenic methylation is directly correlated with gene expression levels in brain tissue. In astrocytomas, several hundred CpG islands undergo specific hypermethylation relative to normal brain with 428 methylation peaks common to more than 25% of the tumors. Genes involved in brain development and neuronal differentiation, such as BMP4, POU4F3, GDNF, OTX2, NEFM, CNTN4, OTP, SIM1, FYN, EN1, CHAT, GSX2, NKX6-1, PAX6, RAX, and DLX2, were strongly enriched among genes frequently methylated in tumors. There was an overrepresentation of homeobox genes and 31% of the most commonly methylated genes represent targets of the Polycomb complex. We identified several chromosomal loci in which many (sometimes more than 20) consecutive CpG islands were hypermethylated in tumors. Seven such loci were near homeobox genes, including the HOXC and HOXD clusters, and the BARHL2, DLX1, and PITX2 genes. Two other clusters of hypermethylated islands were at sequences of recent gene duplication events. Our analysis offers mechanistic insights into brain neoplasia suggesting that methylation of the genes involved in neuronal differentiation, in cooperation with other oncogenic events, may shift the balance from regulated differentiation towards gliomagenesis. Cancer Res; 70(7); 2718–27
Mannose-Binding Lectin Variant Alleles and the Risk of Arterial Thrombosis in Systemic Lupus Erythematosus
Authors: Tommy Øhlenschlaeger, Peter Garred, Hans O Madsen, Søren Jacobsen
Journal: New England Journal of Medicine (2004)

Cardiovascular disease is an important complication in patients with systemic lupus erythematosus (SLE). Variant alleles of the mannose-binding lectin gene are associated with SLE as well as with severe atherosclerosis. We determined whether mannose-binding lectin variant alleles were associated with an increased risk of arterial thrombosis among patients with SLE.Mannose-binding lectin alleles were genotyped by means of a polymerase-chain-reaction assay in 91 Danish patients with SLE. Arterial and venous thromboses occurring after the diagnosis of SLE were assessed in a prospective study. Arterial and venous thromboses were confirmed by appropriate diagnostic methods.Fifty-four patients had no mannose-binding lectin variant alleles (A/A genotype), 30 were heterozygous (A/O genotype), and 7 were homozygous (O/O genotype). During a median follow-up of 9.1 years, arterial thromboses (cerebral or myocardial infarction or leg embolus) developed in 6 of the 7 patients with the O/O genotype, as compared with 18 of the 84 patients with the other two genotypes (hazard ratio, 5.8; 95 percent confidence interval, 2.2 to 15.2; overall incidence, 26 percent). After correction for other known risk factors, the hazard ratio was 7.0 (95 percent confidence interval, 1.9 to 25.4). Venous thromboses, which occurred in 14 patients, were statistically unrelated to the mannose-binding lectin genotype.Among patients with SLE, homozygosity for mannose-binding lectin variant alleles is associated with an increased risk of arterial thrombosis. The risk of venous thrombosis is not increased, indicating that mannose-binding lectin has a specific role in providing protection against arterial thrombosis.
P104Sarcoplasmic reticulum function and energetic metabolism in failing myocardium associated with diabetes mellitus
Authors: D Kondrat′eva, S Afanasiev, M Egorova, B Kozlov, S Popov
Journal: Cardiovascular Research (2014)

Purpose: We studied the sarcoplasmic reticulum function and prevailing type of energy production in failing myocardium associated with diabetes mellitus.
A New Method for Estimating Nonsynonymous Substitutions and Its Applications to Detecting Positive Selection
Authors: Hua Tang, Chung-I Wu
Journal: Molecular Biology and Evolution (2005)

The standard methods for computing the number of nonsynonymous substitutions (Ka) lump all amino acid changes into one single class, even though their rates of substitution vary by at least 10-fold (Tang et al., 2004). Classifying these changes by their physicochemical properties has not been suitably effective in isolating the fastest evolving classes of changes. We now propose to use the Universal index U of Tang et al. (2004) to classify the 75 elementary amino acid changes (codons differing by 1 bp) by their evolutionary exchangeability. Let Ki denote the Ka value of each class (i = 1, …, 75 from the most to the least exchangeable). The cumulative Ki for the top 10 classes, denoted Kh (for high-exchangeability types), has two important properties: (1) Kh usually accounts for 25%–30% of total amino acid changes and (2) when the observed number of amino acid substitutions is large, Kh is predictably twice the value of Ka. This shall be referred to as the twofold approximation. The new method for estimating Kh is applied to the comparisons between human and macaque and between mouse and rat. The twofold approximation holds well in these data sets, and the signature of positive selection can be more easily discerned using the Kh statistic than using Ka. Many genes with Ka/Ks > 0.5 can now be shown to have Kh/Ks > 1 and to have evolved adaptively, at least for the high-exchangeability group of amino acid changes.
840 EFFECT OF THERAPEUTIC DOSES OF ALISPORIVIR (ALV) ON METHADONE PHARMACOKINETICS IN HEALTHY SUBJECTS AND PATIENTS ON STABLE METHADONE MAINTENANCE THERAPY (MMT)
Authors: S.J. Kovacs, J. Ke, A. Barve, Y. Cheng, J. Zhang, R. Maietta, G. Sunkara, D.S. Stein
Journal: Journal of Hepatology (2013)