tbuckley/cabot-search huggingface dataset:
Improving clinical effectiveness in the NHS
Authors: R. R Harrod
Journal: BMJ (1989)

impression left by the white paper that the only objective for such budgets is to exert "down- ward pressure on expenditure on drugs."Other ministerial comments have, however, suggested that cost effectiveness-rather than mere cost containment-might be the broader aim.If this could be more openly confirmed, and if it could be backed up by some fairly simple actions consistent with this aim, there should be more general support for the government's proposals.For example, though there is undoubtedly some irrational or excessive prescribing, an international comparison of prescribing volumes and costs suggests that this is not a major problem in Britain.Though everyone would nevertheless agree that overprescribing should be eliminated where possible, at least as potentially damaging and expensive is underprescribing.So far no official attention seems to have been paid to this deter- mining the future workings of budgets.To take only one disease as an example, the underdiagnosis and undertreatment of, say, asthma have been
iNGR-modified PEG-PLGA nanoparticles that recognize tumor vasculature and penetrate gliomas
Authors: Ting Kang, Xiaoling Gao, Quanyin Hu, Di Jiang, Xingye Feng, Xue Zhang, Qingxiang Song, Lei Yao, Meng Huang, Xinguo Jiang, Zhiqing Pang, Hongzhuan Chen, Jun Chen
Journal: Biomaterials (2014)
The Neglected Disease: An Update
Authors: Theodore C. Doege
Journal: JAMA (1986)

Seventeen years ago the National Academy of Sciences focused attention on "accidental death and disability,"<sup>1</sup>a "neglected disease" that received little attention from society except, perhaps, for an occasional catastrophe or spectacular incident. Has there been any progress with the problem? Is there a better understanding of why and how disabling injuries occur? Death rates in the United States involving all major categories of unintentional injuries have fallen steadily since World War II. Fatal crashes on highways constitute the most important component. In terms of deaths per 10,000 registered vehicles, there has been a steady decline since the mid-1930s.<sup>2,3</sup>In 1982 there were 46,300 deaths in vehicle-related crashes, the lowest number since 1963; in 1982 the US population was 24% greater than in 1963. Thus, it is apparent there has been progress. A landmark report of the US Surgeon General,<i> Healthy Peopl</i>e, in 1979 called for progress
Unusual Length of a Plasmodium ovale Infection
Authors: N. S. Dixit
Journal: BMJ (1958)

MEDICAL MEMORANDA BICJOU was unable to give details.Salicylates are known very rarely to cause thrombocytopenic purpura.It is assumed that in this case a mild inhibition of red-cell production also occurred and accounted for the anaemia.Although no studies of haemolysis or liver function were made, the case seems worthy of a brief report so that prompt action may be taken in similar cases before platelet counts are reduced to such dangerous levels.
Exercise Testing in Hypertensive Patients-Reply
Authors: Albert J. Miller
Journal: JAMA (1984)

<h3>In Reply.—</h3> We appreciate the thoughtful comments of Dr Prichard and colleagues. Their group has had extensive experience in the treatment of hypertension and has pioneered the use of β-blockers for its treatment. The simple exercise test described by them certainly makes sense, although it does not allow for checking the blood pressure<i>during</i>exercise and is probably a less effective research method than the simple three minutes on a treadmill at zero elevation and 3-mph speed that we described. The important conclusion from the experience of both of our groups is the same: exercise is an important test of the effectiveness of blood pressure control in hypertensive patients.
Hyperparathyroidism and Pancreatitis-Reply
Authors: Anthony J. Edis
Journal: JAMA (1980)

<h3>In Reply.—</h3> We would agree with Dr Clark that anecdotal reports and collective reviews gathered from the medical literature attesting to an association between hyperparathyroidism and pancreatitis cannot be construed as providing sound evidence of a cause-and-effect relationship. Certainly, pancreatitis can develop in the presence of hypercalcemia, but this appears to be a rare phenomenon, and no satisfactory explanation for a possible causal mechanism has yet been proposed. Our principal purpose in publishing this experience was not to tilt at shibboleths but simply to remind physicians that pancreatitis in the presence of hypercalcemia may have another cause.
Transfusion Malaria in the United States, 1972-1981
Authors: ISABEL C. GUERRERO
Journal: Annals of Internal Medicine (1983)

Twenty-six cases of transfusion-induced malaria were reported in the United States from 1972 through 1981. In nine patients malaria was due to Plasmodium malariae; eight, P. falciparum; eight, P. vivax; and one, P. ovale. Four patients died. The estimated rate of transfusion malaria for this period was 0.25 cases per million donor units collected. Of the 18 cases in which a specific infective blood donor could be identified, at least nine of the donors should have been rejected for blood donation because of recent residence or travel to a malarious area. Among 17 patients for whom the national origin of the implicated blood donor was reported, 12 were born in malarious countries. We propose minor changes in donor procedures and standards, including stricter criteria for donors born in malarious countries. Potential donors should be deferred for 3 years after an unexplained febrile illness occurring 1 year after exposure to malaria.
Pyoderma gangrenosum of the penis
Authors: None Farrell, None Black, None Bracka, None Bunker
Journal: British Journal of Dermatology (1998)

Two cases of pyoderma gangrenosum involving the penis are presented. Treatment was difficult in both cases despite the use of high doses of prednisolone. In one case, the addition of thalidomide proved successful, whereas in the other, minocycline effected a cure.
P2-280: Gemcitabine and Oxaliplatin as second and third line therapy of advanced and metastatic non-small cell lung cancer (NSCLC): evidence of clinical activity and improvement in quality of life.
Authors: Gilberto Lopes, Alvaro Alencar, Marcelo Blaya, Luis Raez, Nancy Farfan, Gail Walker, Aurea Flores, Jessica Macyntire, Caio Rocha Lima
Journal: Journal of Thoracic Oncology (2007)
Acute fulminant non-A, non-B hepatitis leading to chronic active hepatitis after treatment with cryoprecipitate.
Authors: C A Lee, P B Kernoff, P Karayiannis, H C Thomas
Journal: Gut (1985)

This report describes a carrier of haemophilia A who developed fulminant non-A, non-B hepatitis after transfusion with cryoprecipitate. She survived, but developed chronic active hepatitis.
Abstract P3-15-01: Primary G-CSF Prophylaxis during the First Two Cycles Only or Throughout All Chemotherapy Cycles in Breast Cancer Patients at Risk of Febrile Neutropenia: Final Results from a Phase III Trial of the Dutch Breast Cancer Trialists Group (BOOG)
Authors: MJB Aarts, FPJ Peters, WMW Dercksen, CMPW Mandigers, J Stouthard, HWR Nortier, YJL Kamm, LJC van Warmerdam, CCD van der Rijt, S van Gastel, M Joore, A Kessels, VCG. Tjan-Heijnen
Journal: Cancer Research (2010)

Abstract Background: In patients at risk of febrile neutropenia (FN), the highest incidence of FN is seen during the first chemotherapy cycles. This observation questions the effectiveness of continued G-CSF prophylaxis during later chemotherapy cycles. Methods: We conducted a multicenter phase III study in breast cancer. Patients were randomized to primary G-CSF prophylaxis during the first two chemotherapy cycles only (experimental arm) or to primary G-CSF prophylaxis throughout all chemotherapy cycles (standard arm). Patients were eligible if treated with 3-weekly chemotherapy, being at risk of FN according to criteria of international guidelines. This was an equivalence study, aimed to include 230 patients, with FN as primary endpoint. Results: An independent Data Safety Monitoring Board recommended premature closure of the study because of an unacceptable increase in FN rate in the experimental arm. In total, 85 patients enrolled the experimental arm and 84 patients the standard arm till 15 th December 2009. Baseline characteristics were well belanced: age ≥65years in 93% versus 95%, ECOG PS of zero in 82% versus 88%, treated with docetaxel containing chemotherapy in (neo)-adjuvant setting in 97% versus 100%, respectively. At least one episode of FN was seen in 27 (32%) patients of the experimental arm compared with 4 (5%) patients in the standard arm (P&amp;lt;0.0001). Notably, in the experimental arm FN occurred predominantly in the third cycle, whereas in the standard arm FN was seen throughout all cycles. Fever, infection and/or mucositis led to serious adverse events in 31 (36%) patients in the experimental arm versus in 11 (13%) patients in the standard arm (P&amp;lt;0.001). In both arms, 5% of patients stopped or changed treatment because of toxicity. Most patients experienced only one FN episode. In these, chemotherapy was mostly given as planned, but in 61 % of patients with secondary G-CSF prophylaxis and in 21% of patients with secondary antibiotic prophylaxis (in the experimental arm). Conclusion: We conclude that in patients at risk of FN, primary G-CSF prophylaxis cannot be limited to the first chemotherapy cycles, despite the well known increased FN incidence in the first cycles without prophylaxis. With only 2 cycles protected, FN risk is increased in the third cycle. Support: The Netherlands organization for health research and development (ZonMw) and sanofi-aventis Netherlands B.V. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-15-01.
Aspirin after Myocardial Infarction in the Elderly
Authors: Bruce L. Ring
Journal: Annals of Internal Medicine (1996)

Letters1 December 1996Aspirin after Myocardial Infarction in the ElderlyBruce L. Ring, MDBruce L. Ring, MDGoddard Medical Associates, PC, Brockton, MA 02401.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-11-199612010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their article, Krumholz and colleagues [1] stated that aspirin was not prescribed at discharge for 24% of elderly patients who did not have a contraindication to aspirin after they had been hospitalized for acute myocardial infarction. Because daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) is common in this population, and because these drugs (except for nonacetylated agents) have significant antiplatelet activity [2, 3], it may be reasonable and preferable not to add aspirin to the regimen of patients taking other NSAIDs. How many patients in the nonaspirin group were taking NSAIDs regularly?References1. Krumholz HM, Radford MJ, Ellerbeck EF, Hennen J, Meehan TP, Petrillo M, et al. Aspirin for secondary prevention after acute myocardial infarction in the elderly: prescribed use and outcomes. Ann Intern Med. 1996; 124:292-8. Google Scholar2. Rajah SM, Nair V, Rees M, Saunders M, Walker D, Williams G, et al. Effects of antiplatelet therapy with indobufen or aspirin—dipyridamole on graft patency one year after coronary artery bypass grafting. J Thorac Cardiovasc Surg. 1994; 10:1146-53. Google Scholar3. Brochier ML. Evaluation of flurbiprofen for prevention of reinfarction and reocclusion after successful thrombolysis or angioplasty in acute myocardial infarction. The Flurbiprofen French Trial. Eur Heart J. 1993; 14:951-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: Goddard Medical Associates, PC, Brockton, MA 02401. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1996Volume 125, Issue 11Page: 938KeywordsAcute myocardial infarctionAspirinDrugsElderlyMyocardial infarctionNSAIDs Issue Published: 1 December 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Incidental Discovery of Asplenia Syndrome, with Situs Inversus and a Normal Heart by Radionuclide Biliary Imaging A Case Report
Authors: GABRIEL L. HAUSER, CARLOS SILBERMAN
Journal: Clinical Nuclear Medicine (1982)

Tc-99m biliary imaging was performed on a 34-year-old woman who was being investigated for suspected cholelithiasis. A left-sided liver was detected. On subsequent radionuclide imaging, partial visceral situs inversus and asplenia were demonstrated. Extensive roentgenographic investigation, ECG, echocardiogram, and laparotomy confirmed the radionuclide findings. Asplenia syndrome may exist without cardiovascular abnormalities and thus be undiscovered. Radionuclide imaging is important in the diagnosis of this syndrome.
Notes on Three Years' Ovariotomy Work in the Samaritan Free Hospital: Eighty-Two Cases without a Death
Authors: G. G. Bantock
Journal: BMJ (1888)

teresting example of ophitlhalmoplegia externa, for wlhlich no cause could be assigned.The patient was a florid, healtly-lookiing lady, aged 33.lier features, teeth, and complexion were as far as pessible removed from those suggestive of inherited syphilis.Shle was single, and there was not the slightest reason for suspecting that she had ever suffered froum the acquired disease. 1 [er fatleer came with her, and in answer to a direct question assured me that he had never lad nny suspicious disease.l1e had a large, healthy family.Miss --'8 symptoms were remarkable for their symmetr and evenness.Botlh eyelids drooped so as to almost cover the pAipils.She could move botlh eyeballs a very little in all (lirect ions anti almost equally in all.It was exceedingly little.I could not detect any squint, and she had seldom or never been troubled with diplopia.A very remarkable point was that her pupils acted fairly vell, aLnd that she could still use her accommodation.lier pul)ils were of normal size and equal.As she was myopic there was a fallacy as to the accommodation, but with glasses wlich enabled her to see well in the distance she could still see to read.I lha not time to test this in detail.She was accustomedl to read a goo(d deal, and was able to see downwards well in spite of the drooping lids.Two photograpls produced showed that the ptosis was commencing three years ago, and that it was qtuite absent ten years ago.Slhe believed that from girlhood she had been accustomed to turn her head when others would turin their eyes.It had been, she said, a matter of remark by her companions.1ler fatlher (lid not, how- ever, know anything of this.Miss --had no other symptoms of nervous disorder.Dr.MIoxon informed me that her -nee-jttmp was good.She had never had any lightning pains.The only ailment which she would confess to was occasional very severe headaches.To these slhe had been liable from childhood, and was sometimes laid up for a day by them, Ido not think that I have ever seen a syphilitic case of oplhthalmop'Legia externa in which the symptoms were so regular.Almost always one or more of the ocular muscles escapes paralysis to a large extent.(I know nothing as to the sequel of this case.I never saw one quite like it, and should be very glad to know the result if any of my readers can give the information.)
Rapidly Evolving Genes of Drosophila: Differing Levels of Selective Pressure in Testis, Ovary, and Head Tissues Between Sibling Species
Authors: Santosh Jagadeeshan, Rama S. Singh
Journal: Molecular Biology and Evolution (2005)

Investigations of rapidly evolving sex- and reproduction-related genes are expected to reveal important information about the process of speciation and species divergence. We screened testis, ovary, and head tissues to identify and characterize rapidly evolving genes (REGs) between closely related species. The results show differential patterns of evolution of genes expressed in reproductive and nonreproductive tissues. (1) There is a differential distribution of REGs in the Drosophila genome, with most REGs localized in the testis, followed by ovary, and then head. (2) Sequence analysis indicates that differential selective pressures are driving the rapid evolution of genes expressed in sex and nonsex tissues. Testis REGs from our data, on average, yielded higher rates of nonsynonymous substitutions relative to transcripts in ovary and head, indicating stronger selective pressures on the male reproductive system. (3) We identified REGs in the testis, ovary, as well as in head tissue that show evidence of evolving under positive selection. Identification of rapidly evolving sex genes is important for detailed investigations of cryptic female choice, sexual conflict, and faster male evolution and is pertinent to our understanding of the process of species divergence and speciation.
Facets of Radiotherapy
Authors: I. G. Williams
Journal: BMJ (1967)

<b>Objectives</b> To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom. <b>Design</b> Systematic review and meta-analysis. <b>Data sources and eligibility</b> PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009-10 (n=4729 representing 189.1 million adults without diabetes) and the UK, 2008-12 (n=1932 representing 44.7 million). <b>Synthesis methods</b> Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages. <b>Results</b> Prespecified information was extracted from 17 cohorts (38 253 cases/10 126 754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I<sup>2</sup> for heterogeneity=89%) and 13% (6% to 21%, I<sup>2</sup>=79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I<sup>2</sup>=70%) and 8% (2% to 15%, I<sup>2</sup>=64%); and for fruit juice, 5% (−1% to 11%, I<sup>2</sup>=58%) and 7% (1% to 14%, I<sup>2</sup>=51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity=0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79 000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%). <b>Conclusions</b> Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showd positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.
Surgical Team in South Vietnam
Authors: Richard A. Heimburger
Journal: JAMA (1966)

<h3>To the Editor:—</h3> Life really is not so bad here. We are pretty safe in Cantho. Danger is more of a threat than a reality as long as we stay in the cities. Though there is fighting all around us, most of the towns of any importance are secure. The difficulty lies in the fact that 80% of the population in this country lives in rural areas, knows nothing of strong central government evcept that its people come around once a year to collect taxes and that it owns the planes that bomb their villages. We are part of the large concentrated effort to acquaint the common people with the positive aspect of government. We and others are showing them that their government, with the help of Uncle Sam, is their best bet for a healthy, secure life. Military aid is only about 20% of what these people need, but
Prophylaxis of Restenosis With <sup>186</sup> Re-Labeled Stents in a Rabbit Model
Authors: Gunnar Tepe, Ludger M. Dinkelborg, Ute Brehme, Peter Muschick, Bernhard Noll, Tobias Dietrich, Annette Greschniok, Andreas Baumbach, Claus D. Claussen, Stephan H. Duda
Journal: Circulation (2001)

Intraluminal beta-irradiation has been shown to decrease neointimal proliferation after angioplasty in experimental models. The purpose of this study was to test the technical feasibility and biological effects of (186)Re-labeled stents.Thirty-four New Zealand White rabbits were fed a 0.5% cholesterol diet before balloon angioplasty and insertion of Palmaz stents in the infrarenal aorta. The animals were killed 7 weeks after stent implantation. Two of 34 animals died prematurely (aortic leak, pneumonia). Control stents (n=7) were compared with (186)Re stents (2.6 MBq [n=6], 8.1 MBq [n=5], 16.0 MBq [n=6], and 25.3 MBq [n=8]). Stent application was successful in all cases. No thrombus occlusion was observed. After 7 weeks, neointima formation was 2.2+/-0.2 mm(2) in the control group. In the treatment groups, a dose-dependent neointima reduction was detectable (0.5+/-0.5 mm(2) [2.6 MBq], 0.4+/-0.4 mm(2) [8.1 MBq], and 0 mm(2) [16.0 MBq, 25.3 MBq]). No induction of neointimal formation was observed at the edges of the stents. Radiation resulted in delayed reendothelialization.(186)Re stents were capable of reducing neointima formation in a dose-dependent fashion. (186)Re stents did not cause late thrombosis or neointimal induction at the stent margins in the observation period of 7 weeks.
Assessment of Diabetic Control: A Comparison Between Home and Clinic Blood Glucose Levels
Authors: T M Hayes, Eirlys Hayes
Journal: Diabetes Care (1978)

A comparison between blood glucose levels in patients attending a diabetes clinic and in the same patients leading their normal lives showed that for maturity-onset diabetic patients on oral hypoglycemic therapy, the clinic levels were a poor guide to the patients' usual blood glucose. For insulin-treated patients and for those treated with diet alone, the clinic levels were not significantly different from those taken at home or work.