tbuckley/cabot-search huggingface dataset:
QALYs: Their Ethical Implications-Reply
Authors: John La Puma
Journal: JAMA (1990)

<h3>In Reply.—</h3> Like Dr Danford, we believe that outcome assessment should be important in determining how resources are allocated. We do not believe, however, that such numbers tell the whole story. Much of medical practice is process—listening, encouraging, reassuring, and advising. Valid, reliable assessments of clinical process are also needed. Effective, beneficial clinical processes should be identified, studied, and taught. Drs Kaplan and Ganiats fail to identify the genuine ethical concerns QALYs raise. Our colleagues doubt that physicians act as patient advocates when they make clinical decisions. They believe that "patients want treatments that produce QALY benefits." It is easy to miss the ethical concerns that QALYs raise. Some of them are these: "quality of life can be accurately measured and used, utilitarianism is acceptable, equity and efficiency are compatible, projections of community preferences can substitute for individual patient preferences, the old have less 'capacity to benefit' than the
Measurement of data
Authors: P. Sedgwick
Journal: BMJ (2010)

A randomised controlled trial evaluated the effectiveness of an integrated care programme compared with usual care in facilitating the return to work for patients with chronic low back pain.1 The integrated care programme was a combined patient and workplace directed intervention. The trial participants were 134 adults aged 18-65 years who had had low back pain for more than 12 weeks, were in paid work, and had been absent or partially absent from work.

Variables measured at baseline included patient’s sex, age, and level of education. Level of education was classified as low (preschool or primary school), intermediate (secondary school), and high (tertiary, university, or postgraduate). Trial participants were followed for 12 months. The primary outcome was duration of time off work after randomisation until a fully sustained return …
Changing Eating Habits for the Medical Profession
Authors: Lenard I. Lesser, Deborah A. Cohen, Robert H. Brook
Journal: JAMA (2012)

Health professionals spend a great deal of time at meetings. Grand rounds, noon seminars, research meetings, and medical conferences are part of the life of a health professional. At many of these activities, food is available. Although some members of the health professional community have called for changes to the food environment in the community in which they live, they have paid less attention to the quality of food served at hospitals, physician offices, and at conferences.
Survival After Reconstructive Surgery for Hypoplastic Left Heart Syndrome : A 15-Year Experience From a Single Institution
Authors: W. T. Mahle, T. L. Spray, G. Wernovsky, J. W. Gaynor, B. J. Clark
Journal: Circulation (2000)

There are limited data regarding the long-term survival of patients who have undergone reconstructive surgery for hypoplastic left heart syndrome (HLHS). We reviewed the 15-year experience at our institution to examine survival in the context of continued improvements in early operative results.Between 1984 and 1999, 840 patients underwent stage I surgery for HLHS. From review of medical records and direct patient contact, survival status was determined. The 1-, 2-, 5-, 10-, and 15-year survival for the entire cohort was 51%, 43%, 40%, 39%, and 39%, respectively. Late death occurred in 14 of the 291 patients discharged to home after the Fontan procedure, although only 1 patient has died beyond 5 years of age. Heart transplantation after stage I reconstruction was performed in 5 patients. Later era of stage I surgery was associated with significantly improved survival (P:<0.001). Three-year survival for patients undergoing stage I reconstruction from 1995 to 1998 was 66% versus 28% for those patients undergoing surgery from 1984 to 1988. Age >14 days at stage I and weight <2.5 kg at stage I were also associated with higher mortality (P:=0.004 and P:=0.01, respectively). Other variables, including anatomic subtype, heterotaxia, and age at subsequent staging procedures, were not associated with survival.Over the 15-year course of this study, early- and intermediate-term survival for patients with HLHS undergoing staged palliation increased significantly. Late death and the need for cardiac transplantation were uncommon.
Forward and backward waves in the arterial system
Authors: N. WESTERHOF, P. SIPKEMA, G. C. V. D. BOS, G. ELZINGA
Journal: Cardiovascular Research (1972)

The total amount of reflection in the arterial system of the dog is evaluated during control, high, and low peripheral resistance, and an occluded descending aorta. Pressure, as measured in the ascending aorta, may be separated into a (composite) wave travelling from the heart towards the periphery, the forward wave, and a (composite) wave that travels in the opposite direction, the backward wave. This is also true for aortic flow. One may distinguish between reflections at bifurcations of the large vessels and reflections at the arteriolar part of the arterial tree. The former contribute a small, rather constant amount to the returning wave, while the latter reflects a strongly variable amount.
PBB homologs in sera of Michigan dairy farmers and Michigan chemical workers.
Authors: M S Wolff, B Aubrey
Journal: Environmental Health Perspectives (1978)

In November, 1976 the Environmental Sciences Laboratory of the Mount Sinai School of Medicine, examined 1029 persons in Michigan for the potential health effects of exposure to PBB. Included in this group were 55 persons from Michigan Chemical Corporation and 237 farming families. Blood serum was analyzed for PBB. FireMaster FF-1 contains several bromobiphenyl components, the major constituent being approximately 60% 2,4,4,2'4'4'-hexabromobiphenyl. Other PBB homologs identifiable as peaks by gas chromatography--mass spectrometry include two pentabromobiphenyl peaks, three additional hexabromobiphenyl peaks, and two heptabromobiphenyl peaks. The relative concentrations, with respect to the major hexabromobiphenyl peak, of these minor constituents (1--20%) of PBB were different for persons from Michigan Chemical Corporation and for farmers. Penta-, hexa-, and hepta-bromobiphenyl components in serum samples analyzed from farming families from Michigan Chemical Corporation employees were compared with relative concentrations of these homologs in FireMaster mixture and in tissue and blood samples from rats fed FireMaster FF-1. Varying concentrations of these PBB components are attributed to different routes of exposure and the relative ease of metabolism and excretion of one pentabromobiphenyl component.
Radioimmunoassay of anabolic steroids: an evaluation of three antisera for the detection of anabolic steroids in biological fluids.
Authors: R. Dugal, C. Dupuis, M. J. Bertrand
Journal: British Journal of Sports Medicine (1977)

Recently developed radioimmunoassays (RIA) for the analysis of anabolic steroids and their metabolites in biological fluids were tested for cross-reactivity with other types of steroids. Results show that the degree of desirable cross-reactivity within the two classes or orally active anabolic steroids vary widely and that the antiserum for 19-Nortestosterone (the active principle of intramuscular preparations) has a very high degree of undesirable cross-reactivity with components of oral contraceptives. Single and multiple dose studies in human volunteers demonstrate that the detection level and degree of retrospectivity are likewise variable but that the test easily detects most anabolic steroids during treatment. At the present time, the combination of the three antisera for the assay of a sample appears to be a relatively rapid and economic method for screening large numbers of samples in situations where doping control of anabolic steroids is required. The importance of utilizing physico-chemical means for identification of RIA potential positives is emphasized.
LEAD ENCEPHALOPATHY, WITH A REPORT OF A CASE.
Authors: ALBERT E. ROUSSEL
Journal: JAMA (1895)

R. H., age 35 years, an artist by profession, first consulted me March 3, 1890. The patient, a wellnourished and intelligent man of good habits, had never been sick from childhood, and reported a remarkably good family history. For some time previous he had noticed a gradual deterioration of health, as manifested by persistent insomnia, coated tongue, loss of appetite, mental and physical lassitude and an increasing tendency to constipation. A careful physical examination gave no clue to the cause of the above symptoms, save visual evidences of a rather pronounced anemia. Examination of the blood gave 2,500,000 red corpuscles to the c. m., while the hemoglobin remained about normal, 85 per cent. Some slight accentuation of the movements of the heart was discernible. The urine was concentrated, reddish in color, specific gravity 1018, with absence of both albumin and sugar. Three days later (March 6) I was hastily summoned
The Medical Education Project in Vietnam An Obituary
Authors: Ira Singer
Journal: JAMA (1975)

In cooperation with the Agency for International Development, the AMA Division of Medical Education has for the past nine years supported the Faculty of Medicine of the University of Saigon in its efforts to strengthen the educational process and resources of that institution. This was possible with the participation of 19 different departments in 16 American medical schools. The Vietnamese faculty proved to be highly dedicated in their quest to improve the education process. To achieve this, about 124 faculty studied and trained in the United States for various periods while others labored to modernize curriculum and reassess objectives. This activity was brought to an abrupt close during late April of this year because of the drastic political and military changes that occurred in the Republic of Vietnam. Through the years, almost 250 Americans representing the AMA and cooperating institutions have given their time, intellect, emotion, ideas, and ideals to
Flow-dependent coronary artery dilatation in humans.
Authors: H Drexler, A M Zeiher, H Wollschläger, T Meinertz, H Just, T Bonzel
Journal: Circulation (1989)

To determine the role of endothelium-mediated flow-dependent coronary dilatation in humans, we studied the coronary dilatation exerted by maximal pharmacologic increase of coronary flow in 14 patients with normal coronary arteries. Biplane views of the circumflex (Cx) and left anterior descending (LAD) coronary arteries were obtained before and 80 seconds after inducing a maximal increase in flow selectively in the Cx by injecting 7 mg papaverine through a 2F infusion catheter in the midportion of the Cx (n = 10). The diameter of the proximal Cx segment (exposed to increased flow but not to papaverine directly) increased with papaverine by 11.1 +/- 4% (range, 5.2-16.4%, p less than 0.001 vs. control), whereas the LAD diameter did not change. LAD and Cx diameters increased by 18.3% and 21.2% after nitroglycerin given into the left main artery, which showed the preserved capability of the LAD to dilate. In four patients with normal coronary arteries and six patients with coronary artery disease (CAD, non-flow-limiting stenosis), a similar protocol was applied with the LAD for the assessment of flow-dependent dilatation. Simultaneously, intracoronary blood flow velocity was measured by an intracoronary Doppler catheter. Papaverine-induced coronary flow reserve (peak/resting velocity ratio) in the LAD was 4 +/- 0.7 (range, 3.5-5) in normal arteries and was 3.5 +/- 0.6 (range, 2.7-4.4) in CAD.(ABSTRACT TRUNCATED AT 250 WORDS)
Diffusely Infiltrating Central Nervous System Lymphoma Involving the Brainstem in an Immune-Competent Patient
Authors: Khalid Alsherbini, Brad Beinlich, M. Shahriar Salamat
Journal: JAMA Neurology (2013)

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Pressure Measurements in Oesophageal Varices: First Comparison of Two Techniques
Authors: M. Staritz, Ph. Gertsch
Journal: Endoscopy (1986)

See also: Endoscopic Non-aggressive Assessment of Oesophageal Variceal Pressure Compared with Wedged Hepatic Venous Pressure in Alcoholic Liver CirrhosisEndoscopy 1983; 15(03): 101-103DOI: 10.1055/s-2007-1021478
Cellular and Hormonal Disruption of Fetal Testis Development in Sheep Reared on Pasture Treated with Sewage Sludge
Authors: Catriona Paul, Stewart M. Rhind, Carol E. Kyle, Hayley Scott, Chris McKinnell, Richard M. Sharpe
Journal: Environmental Health Perspectives (2005)

The purpose of this study was to evaluate whether experimental exposure of pregnant sheep to a mixture of environmental chemicals added to pasture as sewage sludge (n = 9 treated animals) exerted effects on fetal testis development or function; application of sewage sludge was undertaken so as to maximize exposure of the ewes to its contents. Control ewes (n = 9) were reared on pasture treated with an equivalent amount of inorganic nitrogenous fertilizer. Treatment had no effect on body weight of ewes, but it reduced body weight by 12–15% in male (n = 12) and female (n = 8) fetuses on gestation day 110. In treated male fetuses (n = 11), testis weight was significantly reduced (32%), as were the numbers of Sertoli cells (34% reduction), Leydig cells (37% reduction), and gonocytes (44% reduction), compared with control fetuses (n = 8). Fetal blood levels of testosterone and inhibin A were also reduced (36% and 38%, respectively) in treated compared with control fetuses, whereas blood levels of luteinizing hormone and follicle-stimulating hormone were unchanged. Based on immunoexpression of anti-Müllerian hormone, cytochrome P450 side chain cleavage enzyme, and Leydig cell cytoplasmic volume, we conclude that the hormone changes in treated male fetuses probably result from the reduction in somatic cell numbers. This reduction could result from fetal growth restriction in male fetuses and/or from the lowered testosterone action; reduced immunoexpression of α-smooth muscle actin in peritubular cells and of androgen receptor in testes of treated animals supports the latter possibility. These findings indicate that exposure of the developing male sheep fetus to real-world mixtures of environmental chemicals can result in major attenuation of testicular development and hormonal function, which may have consequences in adulthood.
Neuropathy associated with leflunomide: a case series
Authors: K Martin
Journal: Annals of the Rheumatic Diseases (2005)

In conclusion, infliximab can be used safely in daily clinical practice, but both doctors and patients should be aware of the (infection) risks, especially in patients receiving a higher dose (.3 mg/kg) of infliximab, in order to anticipate and minimise these risks.
Cooperation between Cdk4 and p27kip1 in Tumor Development: A Preclinical Model to Evaluate Cell Cycle Inhibitors with Therapeutic Activity
Authors: Rocío Sotillo, Oliver Renner, Pierre Dubus, Jesús Ruiz-Cabello, Juan Martín-Caballero, Mariano Barbacid, Amancio Carnero, Marcos Malumbres
Journal: Cancer Research (2005)

Abstract Deregulation of the G1-S transition of the cell cycle is a common feature of human cancer. Tumor-associated alterations in this process frequently affect cyclin-dependent kinases (Cdk), their regulators (cyclins, INK4 inhibitors, or p27Kip1), and their substrates (retinoblastoma protein). Although these proteins are generally thought to act in a linear pathway, mutations in different components frequently cooperate in tumor development. Using gene-targeted mouse models, we report in this article that Cdk4 resistance to INK4 inhibitors, due to the Cdk4 R24C mutation, strongly cooperates with p27Kip1 deficiency in tumor development. No such cooperation is observed between Cdk4 R24C and p18INK4c absence, suggesting that the only function of p18INK4c is inhibiting Cdk4 in this model. Cdk4R/R knock in mice, which express the Cdk4 R24C mutant protein, develop pituitary tumors with complete penetrance and short latency in a p27Kip1−/− or p27Kip1+/− background. We have investigated whether this tumor model could be useful to assess the therapeutic activity of cell cycle inhibitors. We show here that exposure to flavopiridol, a wide-spectrum Cdk inhibitor, significantly delays tumor progression and leads to tumor-free survival in a significant percentage of treated mice. These data suggest that genetically engineered tumor models involving key cell cycle regulators are a valuable tool to evaluate drugs with potential therapeutic benefit in human cancer.
Haemophilus Epiglottitis: Nine Recent Cases in Oxford
Authors: M. G. Addy, P. D. M. Ellis, D. C. Turk
Journal: BMJ (1972)

Recent experience of epiglottitis in Oxford confirms the need for doctors in this country-especially family doctors and casualty officers-to be aware of this disease and to be able to recognize it and to take appropriate action immediately. Some important diagnostic and therapeutic implications both of the anatomy of the supraglottic lesion and of the septicaemic component of the illness are discussed.
Reduced Bone Mass in Daughters of Women with Osteoporosis
Authors: Ego Seeman, John L. Hopper, Leon A. Bach, Mark E. Cooper, Elizabeth Parkinson, John McKay, George Jerums
Journal: New England Journal of Medicine (1989)

To determine whether premenopausal daughters of women with postmenopausal osteoporosis have lower bone mass than other women of the same age, we measured the bone mineral content of the lumbar spine and femoral neck and midshaft, using dual-photon absorptiometry, in 25 postmenopausal women with osteoporotic compression fractures and in 32 of their premenopausal daughters; we then compared the results with those in normal controls. As compared with normal postmenopausal women, women with osteoporosis had lower bone mineral content in the lumbar spine, femoral neck, and femoral midshaft by 33, 24, and 15 percent, respectively (P<0.001 for each comparison by the one-tailed t-test). As compared with normal premenopausal women, the daughters of women with osteoporosis had lower bone mineral content at these sites by 7, 5, and 3 percent, respectively (P = 0.03, 0.07, and 0.15, respectively, by the one-tailed t-test). In terms of a standardized score, we calculated that the mean (±SEM) relative deficits in bone mineral content in the daughters of women with osteoporosis were 58±18 percent (lumbar spine) and 34±16 percent (femoral neck) of the relative deficits in their mothers. We conclude that daughters of women with osteoporosis have reduced bone mass in the lumbar spine and perhaps in the femoral neck; this reduction in bone mass may put them at increased risk for fractures. We also conclude that postmenopausal osteoporosis may result partly from a relatively low peak bone mass rather than from excessive loss of bone. (N Engl J Med 1989; 320: 554–8.)
Activation of type I IFN signaling by NOD1 mediates mucosal host defense against<i>Helicobacter pylori</i>infection
Authors: Tomohiro Watanabe, Naoki Asano, Atsushi Kitani, Ivan J. Fuss, Tsutomu Chiba, Warren Strober
Journal: Gut Microbes (2011)

Infection of gastric epithelial cells with Helicobacter pylori (H. pylori) induces a complex array of host protective immune responses. The best known are the adaptive T helper type 1 and type 17 responses that are induced in the gastric lamina propria by antigen-presenting cells via presentation of H. pylori antigens to CD4+ T cells. Recently, it has become apparent that innate immune responses are also induced by H.pylori infection, both in epithelial cells and in underlying antigen-presenting cells. One important component of these innate responses involves the activity of NOD1, an intra-cellular sensor of peptides derived from the peptidoglycan component of the bacterial cell wall. In this review, we discuss our recent work showing that the signaling pathway utilized by NOD1 results in the generation of type I interferon and that this cytokine mediates both chemokine and cytokine responses that regulate the severity of gastric H. pylori infection.
The Utility of 12-Lead Holter Monitoring in Patients With Permanent Atrial Fibrillation for the Identification of Nonresponders After Cardiac Resynchronization Therapy
Authors: Ganesh S. Kamath, Delia Cotiga, Jayanthi N. Koneru, Aysha Arshad, Walter Pierce, Emad F. Aziz, Anisha Mandava, Suneet Mittal, Jonathan S. Steinberg
Journal: Journal of the American College of Cardiology (2009)
Identification of a New Cancer/Germline Gene, <i>KK-LC-1</i>, Encoding an Antigen Recognized by Autologous CTL Induced on Human Lung Adenocarcinoma
Authors: Takashi Fukuyama, Takeshi Hanagiri, Mitsuhiro Takenoyama, Yoshinobu Ichiki, Makiko Mizukami, Tetsuya So, Masakazu Sugaya, Tomoko So, Kenji Sugio, Kosei Yasumoto
Journal: Cancer Research (2006)

Abstract The purpose of our present study is to identify a tumor-specific antigen capable of inducing a specific cellular immune response in lung cancer patients. We established a lung adenocarcinoma cell line, designated as F1121L, and induced tumor-specific CTL clone H1 from regional lymph node lymphocytes of patient F1121. CTL clone H1 lysed autologous tumor cells in an HLA-B*1507-restricted manner, but not autologous EBV-B, phytohemagglutinin-blast cells, and K562. The CTL clone also recognized allogeneic HLA-B*1501- or 1507-positive lung cancer cell lines in the HLA-restricted manner. Using the CTL clone, we identified an antigen-coding gene by cDNA expression cloning technique. The gene consisted of 556 bp, including an open reading frame consisted of 113 amino acids, designated as Kita-kyushu lung cancer antigen 1 (KK-LC-1). A 9-mer peptide (KK-LC-176-84; RQKRILVNL) was identified as an epitope peptide. The genomic DNA of this antigen was located in chromosome Xq22. A reverse transcription-PCR analysis revealed that the mRNA of this gene was only expressed in the testis among normal tissues. It was expressed in 9 of 18 (50%) allogeneic non–small-cell lung cancer cell lines and in 40 of 100 (40%) non–small-cell lung cancer tissues. We thus identified a new tumor antigen–coding gene categorized as a cancer/germline gene by an autologous lung cancer and CTL system. The new cancer/germline gene was located in Xq22, which is apparently different from the locations of previously reported cancer/germline genes. (Cancer Res 2006; 66(9): 4922-8)