tbuckley/cabot-search huggingface dataset:
Measuring Quality of Care
Authors: Robert H. Brook, Elizabeth A. McGlynn, Paul D. Cleary
Journal: New England Journal of Medicine (1996)

Until recently, we relied primarily on professional judgment to ensure that patients received high-quality medical care. Hospitals routinely monitored poor outcomes, such as deaths or infections, to identify ways to improve the quality of care. In rare cases, medical societies reviewed the performance of physicians. However, monitoring of and improvement in quality were generally left to individual clinicians.This situation has changed dramatically. We have learned that practice patterns and the quality of medical care vary much more than many people had realized, our ability to measure the quality of care has advanced considerably, and clinicians are increasingly interested in . . .
Needed: A New Strategy for Health Promotion
Authors: Greer Williams
Journal: New England Journal of Medicine (1968)

DEATH, health workers note with a touch of irony, is the most valid index to a change in health. If so, this is a good reason, in addition to the normal will to live, for citing death rates in discussions of health progress. Nevertheless, the health communicators do borrow trouble in using death as a measure of results in governmental medical programs. The trouble comes when they try to justify efforts that do not produce evidence of significant reductions in mortality.This danger has been so repeatedly overlooked in Washington that, at least in the eyes of the health-care cognoscenti . . .
Brazil and India clash with EU over seizure of generic drugs
Authors: J. Zarocostas
Journal: BMJ (2009)

Brazil and India clashed with the European Union in the World Trade Organization (WTO) last week because of the detention by Dutch customs authorities of a shipment of a generic drug. The seizure has renewed concerns from poor nations that rich nations are resorting to harsh enforcement measures and hindering access to cheaper, life savings drugs.

“The decision to impede the transit of a cargo of generic medicines which was not headed for the Dutch market is unacceptable and sets a dangerous precedent,” said Roberto Azevedo, Brazil’s ambassador to the WTO, at a session of the agency’s ruling general council on 3 February.

The action that triggered the latest showdown was the detention in December of a 500 kg shipment of losartan potassium, a generic version of the active ingredient for the brand drug Cozaar, developed by Merck and Dupont, which …
RADIUM TREATMENT OF CANCER OF THE LIP
Authors: J. N. Scott
Journal: JAMA (1918)

<h3>To the Editor:</h3> —In the article by Dr. Henry H. Janeway on the treatment of cancer of the lip by radium (The Journal, April 13, p. 1051), he describes the method of treating cancer of the lip by emanation of radium in glass tubes instead of radium element in flat applicators and after reporting his splendid results states: "The superior adaptability of radium emanation for the treatment of cancer makes the use of the element itself obsolete, and for the vast majority of cases it is inefficient." I believe the use of radium element of the required strength scattered over a flat applicator 1 c.c. square is much more accurate and scientific than the use of emanation in glass tubes in treating lip cancer, as the flat applicator fits evenly over the region on the lip. It gives off a uniform quantity of rays and dose from different applicators so
The anti-tumor immune response generated by radiation therapy may be limited by tumor cell adaptive resistance and can be circumvented by PD-L1 blockade
Authors: Simon Dovedi, Amy Adlard, Grazyna Lipowska-Bhalla, Conor McKenna, Sherrie Jones, Eleanor Cheadle, Ian Stratford, Edmund Poon, Michelle Morrow, Ross Stewart, Hazel Jones, Robert W Wilkinson, Jamie Honeychurch, Tim Illidge
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Radiation therapy (RT) plays a definitive part of anti-cancer therapy for the majority of common cancers but for many patients, metastatic disease and local recurrence are common and the outlook remains poor. New more effective RT combination approaches are urgently required that
Trial of atenolol and chlorthalidone for hypertension in black South Africans.
Authors: Y K Seedat
Journal: BMJ (1980)

Twenty-four black patients (Zulus) with hypertension participated in a double-blind, placebo-controlled cross-over trial of the efficacy of a beta-blocking agent (atenolol) 100 mg once daily as compared with chlorthalidone 25 mg once daily. The two drugs were also given combined at these doses and the effects compared with those of the drugs given alone. Atenolol as sole treatment had no appreciable effect on blood pressure as compared with placebo. Chlorthalidone produced a small decrease, but this was not statistically significant. Combining the two drugs, however, produced a significant reduction in blood pressure (mean lying blood pressure p &lt; 0.001; mean standing blood pressure p &lt; 0.0002). These findings suggest that beta-blockers should not be regarded as baseline treatment of hypertension in blacks.
Transtracheal Delivery of Oxygen
Authors: Ralph F. Huller, Roy J. Moser
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 March 1988Transtracheal Delivery of OxygenRALPH F. HULLER JR, M.D., ROY J. MOSER III, M.D.RALPH F. HULLER JR, M.D.Search for more papers by this author, ROY J. MOSER III, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-3-487_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The experience of Christopher and coworkers (1) using long-term oxygen therapy in 100 patients adds further credibility to the efficacy and safety of transtracheal oxygen delivery. An enhanced self image may not be as significant as the improvement in poor patient compliance with chronic oxygen therapy. Bloom and associates have actually shown an increase in oxygen utilization per month with transtracheal oxygen compared to nasal cannula, despite a 50% reduction in oxygen flow per minute (Blood BS, Daniel J, Kissick WL, Knorr RS, Wiseman M. Transtracheal oxygen in chronic obstructive pulmonary disease. Presented at the World Congress...References1. CHRISTOPHERSPOFFORDPETRUNMCCARTYGOODMANPETTY KBMDJT. A program for transtracheal oxygen delivery: assessment of safety and efficacy. Ann Intern Med. 1987;107:802-8. LinkGoogle Scholar2. . Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Ann Intern Med. 1980;93:391-8. LinkGoogle Scholar3. HEIMLICHCARR HG. Transtracheal catheter technique for pulmonary rehabilitation. Ann Otol Rhinol Laryngol. 1985;94(5 pt 1):502-4. CrossrefMedlineGoogle Scholar4. HOFFMANDAUBERFERSONOPENBRIERZULLO LJPDT. Patient response to transtracheal oxygen delivery. Am Rev Respir Dis. 1987;135:153-6. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1988Volume 108, Issue 3Page: 487-487KeywordsBloodChronic obstructive pulmonary diseaseOxygenSafety Issue Published: 1 March 1988 PDF DownloadLoading ...
Sarcomatoid hepatocellular carcinoma with mixed osteoclast-like giant cells and chondroid differentiation
Authors: Kyoung-Bun Lee
Journal: Clinical and Molecular Hepatology (2014)

The sarcomatoid variant of hepatocellular carcinoma (HCC) is a rare histologic variant comprising malignant spindle cells and typical HCC. The proportion of the spindle cell component varies; when the tumor fully consists of malignant spindle cells, it is difficult to distinguish from various primary sarcomas. The 2010 World Health Organization classification of gastrointestinal tract tumors classifies sarcomatoid HCC under the special HCC types with fibrolamellar carcinoma, scirrhous HCC, undifferentiated carcinoma, and lymphoepithelioma-like carcinoma.1 Carcinosarcoma, which is synonymously used with sarcomatoid carcinoma, is separately described under malignancies of mixed or uncertain origin of the liver encompassing calcifying nested epithelial stromal tumor, combined hepatocellular-cholangiocarcinoma, hepatoblastoma, mixed epithelial-mesenchymal type, and malignant rhabdoid tumor. Here a recent case of sarcomatoid HCC is reported and relevant literature is reviewed.
A SPECIFIC TREATMENT FOR NEUROVEGETATIVE DYSTONIA
Authors: FRANK CERULLI
Journal: American Journal of Psychiatry (1952)

1. One can conclude from such a study that great care in interviewing individuals should be taken. Individuals from unstable backgrounds, i.e., alcoholic families, split families, religious conflicts, or orphans, should be interviewed with care. There is a tendency for these individuals to overcompensate for their poor start in life. By careful screening acute military reactions can be avoided. 2. Combined reactions are mainly a manifestation of the instinct of self-preservation. Individuals who have to struggle from the beginning have a greater drive for self-preservation as an overcompensating mechanism. 3. Functional or psychosomatic ills probably occur as an accumulation of all the stresses and strains in the patient's past history. In the treatment of our patients, Bellergal has proved to be an excellent adjunct in psychotherapy. The symptoms referable to all the organs of the body can be greatly alleviated by the judicious use of this therapeutic agent. By reducing the acute symptoms, the patient is not as aware of his bodily functions and is in a better frame of mind to respond to psychotherapy.
GALLSTONES AND GALL-BLADDER DISEASES FROM THE STANDPOINT OF THE PHYSICIAN.
Authors: NORMAN BRIDGE
Journal: JAMA (1906)

These diseases are common, and they usually come first to the knowledge of the physician. He first prescribes for them and sometimes studies them; frequently he makes a diagnosis. Whether or not he appreciates their character, he has for them a large measure of responsibility which he can not escape. If he believes a given case has become a subject for surgery, he is responsible to the patient that the consultant shall be capable, that he has the skill in surgical technic to do successfully the several steps of an operation; and, far more important, that he has the knowledge of pathology that fits one to deal with unexpected surgical conditions. The physician may recall cases in which a surgeon has found such conditions and, never having considered their possibility, has blundered in a nonchalant sort of way, to the harm of the patient and the regret of all concerned.
Food, Nutrition and Diet Therapy
Authors: Therese Mondeika
Journal: JAMA (1961)

This book relates the role of the student nurse in the field of nutrition and dietetics. The nurse is a vital member of the team in feeding the sick, for the acceptance or rejection of a diet, in many instances, depends on the nurse's knowledge of nutrition and her attitude toward it. The book is divided into 4 sections. The first deals with basic information on the principles of nutrition and discusses it on a world-wide basis. Food fadism and fallacies that are prevalent in the field of nutrition today are discussed, and ways of combating them are suggested. Section 2 on diet therapy contains all the most recent methods of dietary treatment in the prevention and treatment of disease; it emphasizes the fact that to be effective a diet must be followed, and to be followed it must be acceptable. Individual variations are taken into account. Section 3 covers
Bone-specific alkaline phosphatase concentrations are less variable than those of parathyroid hormone in stable hemodialysis patients
Authors: Sunita Sardiwal, Clare Gardham, Adrian E. Coleman, Paul E. Stevens, Michael P. Delaney, Edmund J. Lamb
Journal: Kidney International (2012)

Abnormalities of bone mineral metabolism and vascular calcification are prevalent in patients with kidney failure. Clinical management is based on biochemical targets, in particular parathyroid hormone (PTH) concentrations, but this has many limitations including high biological variation. A possible alternative is bone-specific alkaline phosphatase (ALP); therefore, we evaluated the biological variation of this marker in patients undergoing hemodialysis. Bone ALP was measured in non-fasting serum samples taken twice a week over a 6-week period in 22 stable hemodialysis patients and 12 healthy volunteers. The within-individual coefficients of variance were calculated and used to derive the critical difference required to be certain that an observed change was significant. The coefficient of variance for bone ALP was significantly higher in hemodialysis patients compared to healthy individuals. Seven samples were required to estimate the homeostatic set point of bone ALP, within 10%, in a hemodialysis patient. The concentration of serial bone ALP measurements would need to change by 36% between any two measurements before it can be considered a significant change. Since the biological variation of bone ALP is less than half that reported for PTH, our study provides further support for the use of bone ALP as an alternative marker of bone mineral metabolism in the setting of chronic kidney disease-mineral and bone disorder.
The Limitations of the G1-S Checkpoint
Authors: Dorothee Deckbar, Thomas Stiff, Barbara Koch, Caroline Reis, Markus Löbrich, Penny A. Jeggo
Journal: Cancer Research (2010)

Abstract It has been proposed that the G1-S checkpoint is the critical regulator of genomic stability, preventing the cell cycle progression of cells with a single DNA double-strand break. Using fluorescence-activated cell sorting analysis of asynchronous cells and microscopic analysis of asynchronous and synchronized cells, we show that full blockage of S-phase entry is only observed &amp;gt;4 hours after irradiation. The process is ataxia-telangiectasia mutated (ATM) dependent and Chk1/2 independent and can be activated throughout G1 phase. By monitoring S-phase entry of irradiated synchronized cells, we show that the duration of arrest is dose dependent, with S-phase entry recommencing after arrest with kinetics similar to that observed in unirradiated cells. Thus, G1-S checkpoint arrest is not always permanent. Following exposure to higher doses (≥2 Gy), G1-S arrest is inefficiently maintained, allowing progression of G1-phase cells into G2 with elevated γH2AX foci and chromosome breaks. At early times after irradiation (≤4 h), G1-S checkpoint arrest is not established but cells enter S phase at a reduced rate. This early slowing in S-phase entry is ATM and Chk2 dependent and detectable after 100 mGy, showing a novel and sensitive damage response. However, the time needed to establish G1-S checkpoint arrest provides a window when cells can progress to G2 and form chromosome breaks. Our findings detail the efficacy of the G1-S checkpoint and define two significant limitations: At early times after IR, the activated checkpoint fails to efficiently prevent S-phase entry, and at later times, the checkpoint is inefficiently maintained. Cancer Res; 70(11); 4412–21. ©2010 AACR.
Lifitegrast Ophthalmic Solution 5.0% for Treatment of Dry Eye Disease
Authors: John D. Sheppard, Gail L. Torkildsen, John D. Lonsdale, Francis A. D'Ambrosio, Eugene B. McLaurin, Richard A. Eiferman, Kathryn S. Kennedy, Charles P. Semba
Journal: Ophthalmology (2013)
Tolerogenic Dendritic Cells Induce the Differentiation of CD4+CD25+Foxp3+ T Regulatory Cells from CD4+CD25−Foxp3− T Effectors cells and Reverse Asthma Phenotype Responses in an IL-10-dependent Fashion
Authors: H. Huang, X. Zhang, J. Town, J.R. Gordon
Journal: Journal of Allergy and Clinical Immunology (2009)
Plastic Surgery: New Methods and Refinements
Authors: Bradford Cannon
Journal: JAMA (1975)

The title Plastic Surgery for this elaborately illustrated 500-page book suggests an all-inclusive text. Actually, the author has concentrated on areas in which he has made important contributions and innovations recognized by his colleagues throughout the world.  The book is divided into two sections, the first of which concerns congenital facial clefts. Skoog has not yet accepted the factor of mesodermal deficiency in cleft morphogenesis, recognizing that some disagreement still exists. He stresses the principles of repair, with emphasis on minimal interference with growth potential and delay in the primary repair until the age of 3 months. Each step in his handling of the alveolar cleft with the associated single cleft lip repair he illustrates with serial photographs and drawings. The mobilization of musculature to ensure symmetrical mobility and provide support for the floor of the nose is considered an essential part of the lip repair.  Skoog prefers the two-stage
Inguinal Hernia: A Handicapping Condition?
Authors: Stanley D. Berliner
Journal: JAMA (1983)

<h3>To the Editor.—</h3> The remarks by T. Forrest Fisher, MD (1982;247:1407) concerning inguinal hernias and employability deserve comment. He wrote that "the decision on waiving restrictions for the employee or the applicant for employment with a definite inguinal hernia and a moderate-sized defect rests with the examining physician, who should be guided by company guidelines." It has been my experience with more than 2,000 inguinal hernia operations that the patient may have a small to moderate-sized hernia on the opposite side that is not symptomatic and does not require surgery. Since my postoperative follow-up is for ten years, I have had the opportunity to observe the clinical course of the side that was not operated on. Many of these hernias remain stationary in size and continue asymptomatic, despite the fact that the patient may be engaged in heavy manual labor. It would seem desirable for the Occupational Medical Practice Committee
Identification of Ki23819, a highly potent inhibitor of kinase activity of mutant FLT3 receptor tyrosine kinase
Authors: Y Komeno, M Kurokawa, Y Imai, M Takeshita, T Matsumura, K Kubo, T Yoshino, U Nishiyama, T Kuwaki, K Kubo, T Osawa, S Ogawa, S Chiba, A Miwa, H Hirai
Journal: Leukemia (2005)
THE TREATMENT AND MANAGEMENT OF DISEASES DUE TO DEFICIENCY OF DIET: SCURVY AND BERI-BERI
Authors: W. H. Willcox
Journal: BMJ (1920)

AMONG th1e many fascinating and interesting medical pro- blems which presented themselves during the campaign in Mesopotamia those connected with scurvy and beri- beri occupied the foremost place.These two deficiency (liseases occurred to a greater extent in Mesopotamia than in any theatre of war.The enormous wastage caused by scurvy in that campaign can be realized from the statistics available; thus, 11,445 cases occurred in the last six months of 1916.These cases were almost all evacuated to India, since they were quite unfit to undergo the hardships of active service in the field.The c-areful investigations made in connexion witlh these diseases in Mesopotamia, and the results of the manage- ment-tlhat is, the scientific rationing--of the troops, havc most conclusively established that both scurvy and beri- beri are essentially deficiency diseases and are due to a deficiency in the respective vitamines in-the dietary associated with their causation.From the beginning of May, 1916, until the end of Jantary, 1919, as senior consulting physician to the Mesopotamian Expeditionary Force, I made a special study of scurvy and beri-beri from their clinical aspects and from the point of view of prevention and treatment, and acted as special adviser with regard to deficiency diseases.of scurvy amongst Indian troops in the f ront area in Mesopotamia.
Funding the Human Genome Project-Reply
Authors: James D. Watson
Journal: JAMA (1990)

<h3>In Reply.—</h3> Dr Yaes questions the value of the Human Genome Project because he believes the money would be better spent on other research. In response, I want to make several points. The projected funding rate at the National Institutes of Health (NIH) is 25% of approved grants, not 15% or 20% as he suggests. While it is regrettable that more grants cannot be funded, the genome project does fund many investigators who otherwise would be competing for funding from other NIH programs. I believe that the genome project will attract many young investigators to biomedical science rather than discourage them. In fiscal year 1989, twenty-eight percent of genome grants went to young investigators. They recognize that the program will provide them with improved tools for studying genes and their function. The availability of a genetic test for a specific disease can lead to improved and earlier diagnosis as well
20. Targeted Gene Delivery to Embryonic Stem Cells
Authors: Els Henckaerts, Nadja Zeltner, Steven Kattman, Nathalie Dutheil, Peter Ward, Marion Kennedy, Nathalie Clement, Patricia Rebollo, Gordon Keller, R. Michael Linden
Journal: Molecular Therapy (2005)

To date, gene delivery relies on either extrachromosomal persistence or random integration of transgenes within the host nucleus. In addition, the need for safe and efficient gene targeting of ES cells has grown since recent developments in stem cell biology have focused considerable attention on the use of cell-based therapies for the treatment of complex diseases. The success of such an approach, however, will require the ability to genetically modify stem cells ex vivo. Adeno-associated virus has evolved the unique strategy to establish latency by integrating its genome site-specifically into a locus on human chromosome 19 at 19q13.4 (termed AAVS1). We have initiated a study aimed at adapting the underlying mechanism to the development of targeted transgene delivery strategies in ES cells. Differentiation assays of ES cells, both in vitro (embryoid body system) and in vivo (transgenic mice), offer the possibility to investigate whether AAVS1 represents a safe and suitable targeting site. We will discuss the infectivity of different recombinant AAV-based GFP viruses in ES cells. Furthermore, we will present evidence for targeted transgene delivery in these cells and address the safety as determined by differentiation of targeted ES cells into several different lineages. Taken together, our data suggest that a) AAV-mediated targeted gene delivery can be achieved into the mouse AAVS1 ortholog, b) targeted gene delivery to this locus is feasible in ES cells, c) as determined to date, disruption of AAVS1 does not interfere with multilineage in vitro differentiation of ES cells and d) that transgene expression is maintained throughout differentiation.
Challenges posed by the global crisis in the health workforce
Authors: J. Buchan, J. Campbell
Journal: BMJ (2013)

No workforce, no health

In May 2013, the World Health Assembly recognised that renewed attention to the “health workforce crisis” is central to achieving quality healthcare through universal health coverage.1 2 Next month, the Third Global Forum on Human Resources for Health will convene to agree on what can and should be done across all countries to solve the crisis.3 Often oversimplified as a numerical shortage of healthcare workers, the crisis also has management, quality, location, and performance dimensions. These problems have often been recognised (hence the much used phrase “right staff, right place, right time, right skills”) but rarely dealt with effectively.

Although the impact of the health workforce crisis is most evident in emerging economies, advanced economies have not escaped and will have a major role in local, national, regional, and global solutions to the multidimensional challenges. This includes responding to drivers of change, such as financial austerity, and the “double whammy” of an ageing population and ageing health workforce, which present both an opportunity for transformative thinking and a threat to the status quo.

In advanced …