tbuckley/cabot-search huggingface dataset:
The economic impact of esophageal variceal hemorrhage: Cost-effectiveness implications of endoscopic therapy
Authors: Ian M. Gralnek, Dennis M. Jensen, Thomas O. Kovacs, Rome Jutabha, Gustavo A. Machicado, Jeffrey Gornbein, Joy King, Susie Cheng, Mary Ellen Jensen
Journal: Hepatology (1999)

Esophageal variceal hemorrhage (EVH) is a serious and expensive sequela of chronic liver disease, leading to increased utilization of resources. Today, endoscopic sclerotherapy (ES) and endoscopic ligation (EL) are the accepted, community standards of endoscopic treatment of patients with EVH. However, there are no published studies comparing the economic costs of treating EVH using these interventions. As part of a prospective, randomized trial comparing ES and EL for the treatment of EVH, we estimated the direct costs of health care utilization and cost–effectiveness for the prevention of variceal rebleeding and patient survival at 1–year follow–up. Treatment groups were similar in incidence of variceal rebleeding (41.9% vs. 42.9%), variceal obliteration (41.9% vs. 40.0%), hospital days, blood transfusions, shunt requirements, and survival (71.0% vs. 60.0%). There were significantly more treatment failures for active bleeding using EL (42% vs. 0%; P = .027) and esophageal stricture formation in the ES–treated patients (19.4% vs. 2.9%; P = 0.03). Median total direct cost outcomes were similar between groups (EL = $9,696 and ES = $13,197; P = .46). EL and ES had similar cost/variceal rebleeding prevented ($28,678 vs. $29,093) and cost/survival ($27,313 vs. $23,804). In the subgroup of active bleeders, ES had a substantially lower cost/survival ($28,523 vs. $51,696). We conclude that resource utilization was similar between treatment groups and that the choice of endoscopic therapy for EVH must still rely on clinical grounds. Further studies comparing costs and resource utilization in this patient population are needed.
The Heart and the Law: A Practical Guide to Medicolegal Cardiology
Authors: George E. Hall
Journal: JAMA (1968)

Although published contemporaneously with the vast publicity being received by heart transplantations, this book contains nothing about such operations. This is no oversight, however—the book was researched and written before the first transplant was attempted. Nor does the omission detract at all from the value of the book. The text is almost equally divided between law and medicine. The legal material, designed for the nonlegally trained physician, will greatly aid the lawyer handling his first cardiac claim. The medical material, designed for the non-medically trained lawyer, will aid the physician preparing to testify in court. The legal portion covers all areas of possible cardiac litigation (medical malpractice; workmen's compensation; insurance and employment contracts; social security; cardiac arrest; licensing of motor vehicle operators and airplane pilots; maritime law; criminal law; general tort actions and federal employer's liability act) and then discusses causation, rules of evidence, use of documentary material (hospital records,
Smoking habits in professional football.
Authors: D R Hutchinson, N J Mountain, G R McLatchie
Journal: British Journal of Sports Medicine (1986)

In a questionnaire study of 1,559 English professional footballers, the incidence of cigarette smoking was found to be much lower than the national average. Of those surveyed only 5% admitted to cigarette smoking. Smoking was much lower in First Division Clubs (3.2%), and higher in Fourth Division Clubs (6.9%). It is suggested that these figures could be used in a national campaign to promote non-smoking amongst young people who follow football.
Cancer Neurology in Clinical Practice
Authors: Jerzy Hildebrand
Journal: Neuro-Oncology (2003)

In the introduction to this book, Jerome Posner asks the question, "Why another book on neuro-oncology?"One of his answers is that the field is evolving and the literature needs to be updated.The volume edited by Schiff and Wen certainly fulfills that purpose.All the chapters are carefully written by experts currently active in the field, and all provide abundant and recent references.The book is divided into several sections, or parts, that take different approaches to the neuro-oncological subject matter.Of most interest to me are Parts II and VII.Part II describes the physiopathogenesis and clinical presentation of some major manifestations encountered in neuro-oncology, such as seizures, headaches, confusion and delirium, and pain.The section also considers the management of all these conditions, including the use of corticosteroids.In Part VII, the neurological complications are classified according to the nature of the primary tumor: lung and breast cancers, genitourinary malignancies, melanoma, leukemias, lymphomas, plasma cell dyscrasias, female reproductive tract cancers, gastrointestinal cancers, sarcomas, head and neck cancers, and cancers of childhood.This approach will be particularly useful for physicians without specific training in neuro-oncology.Most of the chapters in the other sections, such as those on direct or indirect (remote) complications of cancer and complications of cancer therapies, are excellent.However, several have been published fairly recently in other books, reviews, and postgraduate courses, thus giving one a feeling of déjà lu.
The benefits of restraint: a pivotal role for IL-13 in hepatic glucose homeostasis
Authors: Mariana Verdelho Machado, Yiping Yang, Anna Mae Diehl
Journal: Journal of Clinical Investigation (2012)

In response to feeding, insulin promotes the uptake of sugar in peripheral tissues and suppresses the production of sugar, a process called gluconeogenesis, in the liver. Recent research has shown that chronic inflammation promotes insulin resistance, and in turn, chronically high glucose levels can drive inflammation. In this issue of the JCI, Stanya et al. investigate the connection between inflammation and glucose homeostasis by analyzing the effect of the antiinflammatory cytokine IL-13. Their results suggest that IL-13 plays an unexpected role in the regulation of glucose homeostasis by modulating gluconeogenesis and may be a useful therapeutic target for treatment of diabetes and metabolic syndrome.
Symphysiotomies are important option in developing world
Authors: D A A Verkuyl
Journal: BMJ (2001)

EDITOR—Payne mentions possible legal action by women who had a “barbaric” symphysiotomy in Ireland.1 Many symphysiotomies were done in Roman Catholic countries, because contraception was illegal, even for medical indications, and women might have many caesarean sections with all the inherent risks.

In poor areas of the world thousands of women die or are maimed for life because they cannot obtain a symphysiotomy. The money, staff, and political stability to give all women in need access to a caesarean section are often not available. …
Up to 1bn of Better Care Fund will be spent on NHS services
Authors: I. Torjesen
Journal: BMJ (2014)

The government has announced that up to £1bn of the Better Care Fund will be held back to pay for NHS services in England, after concerns that the initiative’s estimated savings would not be made quickly enough because the required cuts to emergency admissions were overambitious.

The NHS in England was told in June last year that £1.9bn (€2.4bn; $3.3bn) of funds would be top sliced from NHS commissioning budgets from April 2015 and transferred to local authorities to form part of the £3.8bn Better Care Fund. This fund will be used to improve care in the community through programmes jointly agreed by the NHS and local authorities. The government argued that it would save money by reducing the strain on hospitals and cutting admissions.

However, the health policy …
Treatment of acne with topical antibiotics: lessons from clinical studies
Authors: T. Simonart, M. Dramaix
Journal: British Journal of Dermatology (2005)

Over the past 20 years, major concerns have been repeatedly expressed over antibiotic-resistant acne in Europe and in the U.S.A. However, the clinical significance of these resistance patterns is poorly defined so that topical antibiotics remain one of the cornerstones of acne management.To determine whether we are facing decreased efficacy of topical formulations of erythromycin and clindamycin in clinical trials of therapeutic interventions for acne.To review systematically the results of the clinical trials investigating topical formulations of erythromycin and clindamycin for the treatment of inflammatory acne and to establish whether or not there is a decrease in the efficacy of these topical antibiotic formulations since their widespread introduction in the mid 1970s.Of the 50 eligible controlled trials identified using a systematic electronic database search strategy, 45 (90%) incorporated a lesion count, making comparison across trials possible. Analysis of clinical studies investigating the effect of topical erythromycin in acne patients indicates a significant decrease in the effect of this antibiotic on inflammatory and noninflammatory lesion count over time (r = -2.140, P = 0.001 and r = -2.032, P = 0.001, respectively). Efficacy of topical clindamycin remained stable during the study period.There is a gradual decrease in the efficacy of topical erythromycin in clinical trials of therapeutic intervention for acne, which is probably related to the development of antibiotic-resistant propionibacteria.
Antiarrhythmic efficacy, clinical electrophysiology, and pharmacokinetics of 3-methoxy-O-desmethyl encainide (MODE) in patients with inducible ventricular tachycardia or fibrillation.
Authors: D M Roden, J T Lee, R L Woosley, D S Echt
Journal: Circulation (1989)

In most patients, the clinical effects of therapy with encainide are mediated by the generation of the active metabolites O-desmethyl encainide and 3-methoxy-O-desmethyl encainide (MODE). Data from in vitro and animal studies have indicated that MODE has electrophysiologic and pharmacokinetic features that make its further evaluation desirable; in earlier studies, we found that MODE suppressed chronic high-frequency nonsustained ventricular arrhythmias at plasma concentrations of 50-160 ng/ml. We now report the clinical electrophysiology, antiarrhythmic activity, and pharmacokinetics of MODE in 17 patients with inducible ventricular tachyarrhythmias (VTs) in whom programmed electrical stimulation was performed before drug administration and after one or two sequences of loading and maintenance infusions of MODE. Because the relation between plasma concentration and effect had been incompletely defined, a dose-titration approach was adopted: available pharmacokinetic data were used to construct loading and maintenance infusion regimens that were predicted to attain low plasma concentrations in initial patients while higher infusion rates were evaluated in subsequent patients. MODE prevented VT induction in three of 17 patients and VT cycle length was increased by greater than or equal to 100 msec in a further seven of 17; most responses to MODE occurred at plasma concentrations greater than 556 ng/ml (greater than 1 SD above mean plasma MODE during encainide therapy). Response to MODE did not predict subsequent response to oral therapy with encainide. MODE increased intracardiac conduction times, QT intervals during atrial and ventricular pacing, and right ventricular effective refractory periods (RVERP); changes in RVERP were most prominent at rapid pacing rates, while changes in intracardiac conduction were rate-independent at cycle lengths between 400 and 600 msec. Plasma MODE concentrations measured during electrophysiology study correlated well with those predicted by the pharmacokinetic simulations (r = 0.91, p less than 0.001). Serial plasma sampling after programmed electrical stimulation indicated a minimum MODE elimination half-life of 8.2 +/- 5.4 hours. Side effects were confined to three instances of asymptomatic conduction system depression in subjects with latent conduction system disturbances. We conclude that MODE slows intracardiac conduction, delays repolarization, and can suppress or substantially modify inducible VT. Moreover, it was only with the adoption of the dose-titration strategy that we were able to safely demonstrate that plasma MODE concentrations higher than those routinely observed during encainide therapy were required to substantially alter cardiac electrophysiology.
The genetics of human cancer: implications for ecotoxicology.
Authors: G McMahon
Journal: Environmental Health Perspectives (1994)

The study of human cancers has provided evidence that malignant progression is associated with genetic change. It has been suggested that some genetic alterations in tumors may be the result of direct or indirect processes related to environmental chemical exposure. This hypothesis has been supported by genetic evidence in liver tumors which has associated aflatoxin B1 exposure with the detection of inactivating DNA mutations within the human p53 tumor suppressor gene. The detection of activating ras oncogene mutations at high frequency in liver tumors of feral fish suggest that the survey of mutations in genes, such as p53 or other genes, might provide a genetic signature for specific chemical exposure in tissues of aquatic animals derived from environmentally damaged sites.
The Prognostic Value of Cellular and Serologic Markers in Infection with Human Immunodeficiency Virus Type 1
Authors: John L. Fahey, Jeremy M.G. Taylor, Roger Detels, Bo Hofmann, Raphael Melmed, Pari Nishanian, Janis V. Giorgi
Journal: New England Journal of Medicine (1990)

We evaluated three cellular and five serologic markers that are affected by infection with the human immunodeficiency virus type 1 (HIV-1 ) for their ability to predict the progression to clinical acquired immunodeficiency syndrome (AIDS). The cellular markers were the number of CD4+ T cells, the number of CD8+ T cells, and the ratio of CD4+ T cells to CD8+ T cells. The serologic markers were the serum levels of neopterin (a product of stimulated macrophages), beta2-microglobulin, soluble interleukin-2 receptors, IgA, and HIV p24 antigen. We evaluated the usefulness of these measures as markers of the progression to AIDS prospectively, over four years, in a cohort of 395 HIV-seropositive homosexual men who were initially free of AIDS.
Chronic fatigue syndrome and neurally mediated hypotension
Authors: R. Baschetti
Journal: JAMA (1996)

To the Editor.  —Dr Bou-Holaigah and colleagues1observed that nearly half of patients treated with fludrocortisone reported complete or nearly complete resolution of CFS symptoms. Although partial, this response represents good success, if we consider that no previously tried therapy, except licorice,2,3has been reported to be consistently effective.  Fludrocortisone is the typical mineralocorticoid supplementation for Addison's disease,4which also has been treated with licorice.5Both this common therapeutic effectiveness and the recently confirmed hypocortisolism in CFS patients6suggest that the NMH that occurs in CFS is a mere consequence of an underlying atypical adrenal insufficiency. Therefore, the failure of fludrocortisone, which has only mineralocorticoid activity,4to resolve symptoms in approximately half of patients who received it in the study by Bou-Holaigah et al1simply reflects its lack of glucocorticoid potency. Intuitively, fludrocortisone plus hydrocortisone would have been more effective. In fact, for
Excision Repair Cross Complementing-1 and Topoisomerase IIα Gene Expression in Small-Cell Lung Cancer Patients Treated with Platinum and Etoposide: A Retrospective Study
Authors: Paolo Ceppi, Marina Longo, Marco Volante, Silvia Novello, Susanna Cappia, Elisa Bacillo, Giovanni Selvaggi, Silvia Saviozzi, Raffaele Calogero, Mauro Papotti, Giorgio V. Scagliotti
Journal: Journal of Thoracic Oncology (2008)
Gender Differences in Procedure-Related Adverse Events in Patients Receiving Implantable Cardioverter-Defibrillator Therapy
Authors: Pamela N. Peterson, Stacie L. Daugherty, Yongfei Wang, Humberto J. Vidaillet, Paul A. Heidenreich, Jeptha P. Curtis, Frederick A. Masoudi
Journal: Circulation (2009)

Background— Women are at higher risk than men for adverse events with certain invasive cardiac procedures. Our objective was to compare rates of in-hospital adverse events in men and women receiving implantable cardioverter- defibrillator (ICD) therapy in community practice. Methods and Results— Using the National Cardiovascular Data Registry ICD Registry, we identified patients undergoing first-time ICD implantation between January 2006 and December 2007. Outcomes included in-hospital adverse events after ICD implantation. Multivariable analysis assessed the association between gender and in-hospital adverse events, with adjustment for demographic, clinical, procedural, physician, and hospital characteristics. Of 161 470 patients, 73% were male, and 27% were female. Women were more likely to have a history of heart failure (81% versus 77%, P &lt;0.01), worse New York Heart Association functional status (57% versus 50% in class III and IV, P &lt;0.01), and nonischemic cardiomyopathy (44% versus 27%, P &lt;0.01) and were more likely to receive biventricular ICDs (39% versus 34%, P &lt;0.01). In unadjusted analyses, women were more likely to experience any adverse event (4.4% versus 3.3%, P &lt;0.001) and major adverse events (2.0% versus 1.1%, P &lt;0.001). In multivariable models, women had a significantly higher risk of any adverse event (OR 1.32, 95% CI 1.24 to 1.39) and major adverse events (OR 1.71, 95% CI 1.57 to 1.86). Conclusions— Women are more likely than men to have in-hospital adverse events related to ICD implantation. Efforts are needed to understand the reasons for higher ICD implantation–related adverse event rates in women and to develop strategies to reduce the risk of these events.
A bee in the bonnet about honey and healing
Authors: R. Ferner
Journal: BMJ (2013)

The editor’s advice to authors can be forthright: “We can assure [him] that we are doing him infinite service by recommending him to restrain his too fluent pen. He is only compromising his position and losing his friends by rushing into fiery print on every possible occasion.”1 The object of this reproach was not me (or Des Spence), but the redoubtable Birmingham surgeon Joseph Sampson Gamgee.2 His tirades were sometimes well directed, as when he condemned the army’s punishment for desertion: branding …
SEPTICEMIA FOLLOWING PASSAGE OF CALCULUS THROUGH URETHRA
Authors: Abraham Nelken
Journal: JAMA (1923)

J. L., aged 39, a native of Finland, admitted to the urological service of Touro Infirmary, Feb. 2, 1923, had been sick for ten weeks with an attack diagnosed as dengue, the symptoms of which were severe pain in the right lumbar region, accompanied by fever. Following cessation of pain, the patient developed urinary frequency, voiding as often as thirty or forty times in twenty-four hours. This continued for two weeks. Then he had difficulty in urinating, and, after two weeks more of suffering, he applied at the Touro outclinic for relief. The morning he first was seen, he had not been able to urinate for twenty-four hours. Catheterization was made without difficulty, and gave immediate relief. For the next two weeks, he visited the clinic daily, with the exception of two days, but until the day of his admission, he did not again have retention. My assistants in the
Effects of terlipressin on systemic and regional haemodynamics in catecholamine-treated hyperkinetic septic shock
Authors: Andrea Morelli, Monica Rocco, Giorgio Conti, Alessandra Orecchioni, Andrea De Gaetano, Giuliana Cortese, Flaminia Coluzzi, Enrico Vernaglione, Paolo Pelaia, Paolo Pietropaoli
Journal: Intensive Care Medicine (2003)
High-dose cyclophosphamide without stem cell rescue in scleroderma
Authors: C V Tehlirian, L K Hummers, B White, R A Brodsky, F M Wigley
Journal: Annals of the Rheumatic Diseases (2007)

To investigate the safety and tolerability of high-dose cyclophosphamide without stem cell rescue in scleroderma.An open-label, single-site, uncontrolled study design entered patients with active diffuse cutaneous scleroderma. Patients were treated with cyclophosphamide (50 mg/kg) intravenously daily for 4 consecutive days (total 200 mg/kg) followed by granulocyte colony-stimulating factor (5 microg/kg/day). The primary clinical efficacy end point was the modified Rodnan skin score (mRSS). Secondary end points included the Health Assessment Questionnaire-Disability Index (HAQ-DI), physician global assessment (PGA) and pulmonary function tests.Six patients (4 men, 2 women) aged 19-60 years were entered into the study. One patients died early in the protocol, thus five patients had follow-up data. The percentage reduction of the mRSS in these five evaluable patients within 1 month of treatment was 60%, 55%, 41%, 31% and 0%. The patient with no decline in skin score at 1 month showed a decrease in skin score from 41 to 26 by the 3-month visit, a 37% improvement. Three patients sustained the improvement after treatment for 24, 12 and 12 months. Two patients relapsed at 12 and 6 months after treatment. The PGA and HAQ-DI scores improved in five of the six patients by 72% and 79% respectively at 3 months. The only serious adverse event was a death that occurred owing to infection after neutrophil count recovery.High-dose cyclophosphamide without stem cell rescue can lead to a clinically significant improvement in skin score and measures of disease severity in patients with diffuse cutaneous scleroderma.
1098 MODELLING HEPATIC OSTEODYSTROPHY: BALB-ABCB4 KNOCKOUT MICE LACKING THE HEPATOBILIARY PHOSPHOLIPID TRANSPORTER DISPLAY DECREASED 25-OH-VITAMIN D3 SERUM LEVELS AND BONE MINERAL CONTENTS
Authors: K. Hochrath, M. Krawczyk, B. Rathkolb, K. Micklich, W. Hans, T. Adler, Y. Wang, H. Fuchs, V. Gailus-Durner, D.H. Busch, E. Wolf, M. Hrabé de Angelis, F. Lammert
Journal: Journal of Hepatology (2010)
A FURTHER STUDY ON THE BIOLOGIC CLASSIFICATION OF PNEUMOCOCCI
Authors: Oswald T. Avery
Journal: The Journal of Experimental Medicine (1915)

1. At least three subgroups of Pneumococcus Type II may be recognized by specific immune reactions. They have been called Subgroups II A, II B, and II X. 2. That the organisms of these three subgroups are biologically related to Pneumococcus Type II is shown by the following facts: (a) Agglutination with Antipneumococcus Serum II. (b) Protection with Antipneumococcus Serum II, except Subgroup II X. (c) Absorption of Antipneumococcus Serum II with typical Type II pneumococcus removes the antibodies for all subgroups, (d) Absorption of Antipneumococcus Serum II with a member of Subgroups II A or II B removes only the antibodies for the homologous subgroup. Absorption of Antipneumococcus Serum II with any given member of Subgroup II X removes the antibodies for that particular strain only. 3. That the three subgroups, although biologically related to Pneumococcus Type II, possess, nevertheless, specific differential characterswhich separate them one from another, is evidenced by thefollowing facts: (a) The organisms of any subgroup are not agglutinated bythe antisera of the other two subgroups. (b) They are not protected against by the sera of the other subgroups. (c) They do not absorb from Antipneumococcus Serum II the specific immune bodies of the other subgroups. 4. Subgroups II A and II B are characterized by immunity reactions identical within the respective group. 5. Subgroup II X consists of heterogeneous strains which do not cross in their immunity reaction with each other or with Subgroups II A or II B.