tbuckley/cabot-search huggingface dataset:
Adherence to Prescribed Explicit Criteria During Utilization Review
Authors: Lawrence C. Kleinman
Journal: JAMA (1997)

Utilization review (UR) seeks to improve quality and cost-efficiency of health care. However, how well the process works in practice has not been assessed.To describe the outcomes of a sample of physician reviews in terms of the explicit criteria that the UR was designed to implement.Retrospective analysis of transcripts of precertification reviews.California physicians employed by a UR firm conducted 96 interviews from April 1990 to July 1991 with attending physicians who had proposed to insert tympanostomy tubes on a patient younger than 16 years and whose proposals had been found to be inappropriate on an initial screen.The appropriateness rating assigned to each case by the physician-reviewer and by the investigators using explicit criteria. Logistic regression identified factors associated with the reviewers' recommendations to perform surgery and with recommendations at variance from the criteria.The reviewers recommended 78% of cases for surgery, of which only 29% were supported by the criteria or had extenuating circumstances. The criteria concurred with all 30 of the reviewers' recommendations against surgery. Two factors, female sex (odds ratio [OR], 8.2; 95% confidence interval [CI], 1.2-53.8) and previous tympanostomy tube insertion (OR, 30.9; 95% CI, 2.4-394.8) were associated with reviewer recommendations in favor of surgery that were at variance from the criteria, despite the lack of evidence for either as a mitigating circumstance.Physician reviewers were more lenient than the explicit criteria that the reviews were designed to implement. In no cases did the reviewers depart from the criteria's recommendations in favor of surgery.
WASTED TWIST INDEX: A NOVEL INDEX TO QUANTIFY AND EXPLAIN DECREASED STROKE VOLUME IN PATIENTS WITH ISCHEMIC CARDIOMYOPATHY
Authors: Mirza Nubair Ahmad, Haroon Yousaf, Bijoy K. Khandheria, Timothy E. Paterick, A. Jamil Tajik, Khawaja Afzal Ammar
Journal: Journal of the American College of Cardiology (2014)
Abstract 4078: Over-expression of FOXM1 is associated with cell migration/invasion in ovarian cancer
Authors: Gabriel Tm Lok, David W. Chan, Vincent Ws Liu, Hextan Ys Ngan
Journal: Cancer Research (2010)

Abstract FOXM1 is a typical transcription factor regulating the S- and M-phase progression in cell cycle. It is frequently over-expressed and is associated with tumor stages in numerous human cancers. The influence of FOXM1 expression on cell proliferation has been well studied, yet its impact on other tumor characteristics in ovarian cancer, like cell migration/invasion remains unclear. In the present study, we demonstrated that FOXM1 was significantly up-regulated in ovarian cancer cell lines at both RNA and protein level by semi-quantitative RT- PCR and Western blot analyses. Immunohistochemical analysis showed that FOXM1 was highly correlated with the high-grade ovarian cancer. To examine the effect of FOXM1 on ovarian cancer cell motility, the FOXM1 specific inhibitor, thiostrepton, was used to reduce FOXM1 expression in OVCA433 cells. The FOXM1 reduced OVCA433 cells, as a result, showed a significant decrease in cell migration using wound healing assay. By using MEK specific inhibitor, U0126, we demonstrated that the inhibition of ERK activity caused a reduction of FOXM1 level in a time dependent manner and significant reduction of cell migration rate in the wound healing assay in OVCA433. In sum, FOXM1 is over-expressed and regulated by constitutive activated ERK activity in ovarian cancer cells. Our data also suggested that the ERK /FOXM1 signaling axis is crucial in regulating migration/invasion of ovarian cancer cells. Further studies on the molecular mechanism of FOXM1 in the regulation of ovarian cancer cell migration/invasion are warranted. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4078.
Long Noncoding RNA Arid2-IR Is a Novel Therapeutic Target for Renal Inflammation
Authors: Qin Zhou, Xiao R Huang, Jianwen Yu, Xueqing Yu, Hui Y Lan
Journal: Molecular Therapy (2015)

Increasing evidence shows that microRNAs play an important role in kidney disease. However, functions of long noncoding RNAs (lncRNAs) in kidney diseases remain undefined. We have previously shown that TGF-β1 plays a diverse role in renal inflammation and fibrosis and Smad3 is a key mediator in this process. In this study, we used RNA-sequencing to identify lncRNAs related to renal inflammation and fibrosis in obstructive nephropathy induced in Smad3 wild-type and knockout mice. We found that Arid2-IR was a Smad3-associated lncRNA as a Smad3 binding site was found in the promoter region of Arid2-IR and deletion of Smad3 abolished upregulation of Arid2-IR in the diseased kidney. In vitro knockdown of Arid2-IR from tubular epithelial cells produced no effect on TGF-β-induced Smad3 signaling and fibrosis but inhibited interleukin-1β-stimulated NF-κB-dependent inflammatory response. In contrast, overexpression of Arid2-IR promoted interleukin-1β-induced NF-κB signaling and inflammatory cytokine expression without alteration of TGF-β1-induced fibrotic response. Furthermore, treatment of obstructed kidney with Arid2-IR shRNA blunted NF-κB-driven renal inflammation without effect on TGF-β/Smad3-mediated renal fibrosis. Thus, Arid2-IR is a novel lncRNA that functions to promote NF-κB-dependent renal inflammation. Blockade of Arid2-IR may represent a novel and specific therapy for renal inflammatory disease. Increasing evidence shows that microRNAs play an important role in kidney disease. However, functions of long noncoding RNAs (lncRNAs) in kidney diseases remain undefined. We have previously shown that TGF-β1 plays a diverse role in renal inflammation and fibrosis and Smad3 is a key mediator in this process. In this study, we used RNA-sequencing to identify lncRNAs related to renal inflammation and fibrosis in obstructive nephropathy induced in Smad3 wild-type and knockout mice. We found that Arid2-IR was a Smad3-associated lncRNA as a Smad3 binding site was found in the promoter region of Arid2-IR and deletion of Smad3 abolished upregulation of Arid2-IR in the diseased kidney. In vitro knockdown of Arid2-IR from tubular epithelial cells produced no effect on TGF-β-induced Smad3 signaling and fibrosis but inhibited interleukin-1β-stimulated NF-κB-dependent inflammatory response. In contrast, overexpression of Arid2-IR promoted interleukin-1β-induced NF-κB signaling and inflammatory cytokine expression without alteration of TGF-β1-induced fibrotic response. Furthermore, treatment of obstructed kidney with Arid2-IR shRNA blunted NF-κB-driven renal inflammation without effect on TGF-β/Smad3-mediated renal fibrosis. Thus, Arid2-IR is a novel lncRNA that functions to promote NF-κB-dependent renal inflammation. Blockade of Arid2-IR may represent a novel and specific therapy for renal inflammatory disease.
Cigarettes, Cough, and Cancer of the Lung
Authors: Katharine R. Boucot
Journal: JAMA (1966)

The increasing incidence of primary lung cancer has made it important to delineate the natural history of this grave disease so that improved detection techniques may be developed and populations at greatest risk may be pinpointed for intensive study. With this goal in mind, the Philadelphia Pulmonary Neoplasm Research Project was begun in December 1951. A total of 6,137 men 45 years of age or older volunteered to report semiannually over a ten-year period for x-ray examination of the chest and questioning about symptoms, smoking habits, etc.<sup>1</sup>The men were recruited over a fouryear period and the study has now drawn to a close. At the start of the project, in considering the symptoms which might be associated with lung cancer, the first one which came to mind was cough, long recognized as a symptom of lower-respiratorytract disease. The prevalence of cough increases with increasing age and increasing degrees
Incidence of Dumping after Truncal and Selective Vagotomy with Pyloroplasty and Highly Selective Vagotomy without Drainage Procedure
Authors: C. S. Humphrey, D. Johnston, B. E. Walker, C. N. Pulvertaft, J. C. Goligher
Journal: BMJ (1972)

The incidence of dumping after truncal or selective vagotomy with pyloroplasty and highly selective vagotomy without a drainage procedure was assessed both clinically and experimentally. At a gastric follow-up clinic dumping was found to be significantly less frequent in patients who had undergone highly selective vagotomy without a drainage procedure than in patients who had undergone truncal or selective vagotomy with pyloroplasty (P &lt; 0·05 or &lt; 0·001, respectively). Hypertonic glucose given by mouth provoked the onset of dumping in 20% of patients with duodenal ulcer before operation, in 73% after truncal vagotomy and pyloroplasty, in 80% after selective vagotomy and pyloroplasty, and in 47% after highly selective vagotomy. The test meal also produced significantly greater decreases in blood pressure and increases in pulse rate in patients who had undergone vagotomy with pyloroplasty than in patients who had undergone highly selective vagotomy.
Famciclovir for the Suppression of Symptomatic and Asymptomatic Herpes Simplex Virus Reactivation in HIV-Infected Persons: A Double-Blind, Placebo-Controlled Trial
Authors: Timothy Schacker, Hui Lin Hu, David M. Koelle, Judith Zeh, Robin Saltzman, Ron Boon, Mary Shaughnessy, Gail Barnum, Lawrence Corey
Journal: Annals of Internal Medicine (1998)

Background: Herpes simplex virus (HSV) infection is one of the most common opportunistic infections in HIV-infected persons. However, most documentation of the effectiveness of antiviral therapy in reducing HSV reactivation is anecdotal. Objective: To evaluate the quantitative effect of antiviral therapy on the frequency of HSV reactivation in HIV-infected persons. Design: Double-blind, placebo-controlled, crossover trial. Setting: Research clinic at a university hospital. Patients: 48 persons (45 men and 3 women) who were HIV positive and HSV seropositive. Intervention: Patients were randomly assigned to receive famciclovir, 500 mg orally twice daily, or placebo for 8 weeks. They then crossed over to receive the other regimen after a 1-week washout period. Measurements: Patients obtained daily cultures of their perirectal, urethral, oral, and genital areas and kept diary records of signs and symptoms of genital and oral-labial herpes. Results: The median CD4 cell count at study entry was 384 cells/mm3. In the intention-to-treat analysis of the first study period, HSV was isolated on 122 of 1114 (11%) placebo days compared with 9 of 1071 (1%) famciclovir days (relative risk, 0.15; P < 0.001). For patients who completed the crossover, the median difference in days with symptoms between placebo and famciclovir was 13.8% of days and the median difference in days on which HSV was isolated was 5.4% of days (P < 0.001 for both). Percentage of days with HSV-2 shedding was reduced from 9.7% to 1.3%. Breakthrough reactivations that occurred while patients were receiving famciclovir were infrequent, short, and often asymptomatic; HSV-2 isolates from these reactivations were susceptible to penciclovir in vitro. Conclusions: Antiviral chemotherapy with famciclovir results in clinically and statistically significant reductions in the symptoms associated with HSV infection and the symptomatic and asymptomatic shedding of HSV among HIV-positive persons.
Prophylactic Granulocyte Transfusions During Chemotherapy of Acute Nonlymphocytic Leukemia
Authors: DREW J. WINSTON
Journal: Annals of Internal Medicine (1981)

Forty-six noninfected patients undergoing induction chemotherapy for acute nonlymphocytic leukemia were randomized to receive (25 patients) or not to receive (21 control patients) prophylactic granulocyte transfusions when their granulocyte count fell below 0.5 x 109/L. Septicemia was less frequent in the patients who received transfusions (two in 25 patients) than in the control patients (five in 21 patients), but this difference was not statistically significant (p = 0.28). Moreover, pneumonia was more frequent among the transfused patients (12 in 25 patients versus two in 21 patients, p = 0.01). There were no significant differences between the two groups in the frequency of other documented infections, the achievement or duration of remission, or survival. Recipients of prophylactic granulocyte transfusions had a higher prevalence of cytomegalovirus infections (13 in 21 patients versus five in 19 patients, p = 0.03). These results suggest that prophylactic granulocyte transfusions have no statistically significant effect on the frequency of septicemia or other infections, do not enhance remission rates or survival, and are associated with an increased risk for pulmonary complications and cytomegalovirus infections.
Hematologic Abnormalities in Children With Congenital Heart Disease
Authors: Stella B. Kontras
Journal: JAMA (1966)

Hematologic studies were done on 145 children with congenital heart disease prior to open-heart surgery. Sixty-five of 111 patients with acyanotic-type disease showed some laboratory evidence of a preexisting hemorrhagic diathesis. Postoperative hemorrhage occurred in 40% of this group as opposed to 15% in the group with no demonstrable abnormality. Twenty-four of the 34 children with cyanotic congenital heart disease had abnormal blood studies and 10 of these had hemorrhage. Increased bleeding time with or without increased capillary fragility was most common in acyanotic types indicating either a microvascular abnormality or a qualitative platelet defect. Circulating fibrinolysin with decreased fibrinogen levels was seen in cyanotic tetralogy of Fallot. Twenty-two of 25 patients showed improvement in the hemorrhagic diathesis after definitive surgery.
Retinol-Binding Protein: The Serum Transport Protein for Vitamin A*
Authors: WILLIAM S. BLANER
Journal: Endocrine Reviews (1989)

THE transport of retinol (vitamin A alcohol) from retinoid (vitamin A and its analogs) stores in the liver to target tissues is accomplished exclusively by means of a specific transport protein, retinol-binding protein (RBP). RBP was first isolated in 1968 by Kanai et al. (1) and subsequently has been extensively studied in humans and rats. RBP is a single polypeptide chain with a molecular weight of about 21,000 and has one binding site for one molecule of all-trans retinol. In the blood, RBP circulates as a 1:1 molar complex with another serum protein, transthyretin (formerly called prealbumin). The formation of the RBP-transthyretin complex is thought to reduce the glomerular filtration and renal catabolism of RBP. Normal levels of RBP in human serum range between approximately 40 to 60 μg/ml. Within individuals, RBP levels are highly regulated and remain constant except in extremes of vitamin A nutriture or in disease. The topic of RBP was comprehensively reviewed by Goodman in 1984 (2). Since the publication of this review, much new information has become available concerning the chemical structure of RBP, the structure of the gene for RBP and its expression, hepatic synthesis and secretion of RBP, and the cellular uptake of retinol from RBP. The present review will focus primarily on the recent advances made in these areas. In addition, brief review of recent advances concerning some possible physiological roles of RBP will be given.
Trade talks on patent protection violate right to health, allege advocacy groups
Authors: J. Zarocostas
Journal: BMJ (2011)

Eleven advocacy groups have filed a complaint with the United Nations’ independent expert on the right to health, alleging that a regional free trade accord being discussed in secret talks by nine countries violates human rights because it threatens to restrict access to cheap generic drugs.

The talks have “clearly ignored” right to health and access to drugs, the groups say, and “threaten to violate the right of hundreds of millions of persons to the enjoyment of the highest attainable standard of health.”

Last month aid agencies and patients’ groups from India and several Asian countries urged the Indian government to reject a free trade agreement it is negotiating with the European Union that they said may undermine India’s capacity to produce generic drugs ( BMJ 2011;342:d1480, doi:10.1136/bmj.d1480).

The talks on a trans-Pacific partnership (TPP) agreement, which …
Specialist training in medicine in Germany
Authors: D. Maclachlan
Journal: BMJ (1997)

The mutual recognition of primary medical qualifications and specialist training within the European Union and the countries of the European Economic Area (which includes Liechtenstein, Norway, and Iceland) theoretically allows specialist training undertaken in one member state to be recognised in another.1 Important differences still exist between the countries, however; this article describes the organisational context in which German doctors train and work and also some of the pitfalls that may arise when doctors attempt to transfer their skills across national boundaries. The German medical student studies at university for a minimum of six years. The curriculum consists of basic medical sciences for the first three years and clinical studies for the final three years, but only the last year involves daily ward work. Te remainder of the clinical course consists of lectures, courses, seminars, and weekly teaching ward rounds. In university holidays the students are required to gain ward experience as a "Famulus." The final year (Praktisches Jahr) involves clinical ward attachments for four months to a medical specialty, a surgical specialty, and a specialty of the student's choice. To qualify the student must pass the Staatsexamen. Most students also undertake either a scientific or literature-based project and complete a short thesis and an oral examination. They are awarded the degree of Dr med, which is not required to practice medicine but is required for being titled "Doctor". Thus a person with basic medical qualifications from the United Kingdom is referred to only as Arzt and not Doctor. #### Practical points about working in Germany
Allergy to storage mites in asthmatic patients and its relation to damp housing conditions
Authors: M. Iversen, R. Dahl
Journal: Allergy (1990)

The relation between allergy to house dust mites and allergy to storage mites was studied in 326 patients with bronchial asthma, A positive RAST to house dust mites was found in 24,5% and to storage mites in 7,4%, There was a close association between a positive RAST to house dust mites and a positive RAST to storage mites, and 91,6% had a positive RAST to both. Only 0,9% with a negative RAST to house dust mites had a positive RAST to storage mites, whereas the frequency was 27,5% in those with a positive RAST to house dust mites. Present occupation with exposure to storage mites was found in 20,8% with a positive RAST to storage mites, A positive RAST to both house dust mites and storage mites was significantly associated with anamnestic indicators of damp housing conditions. The close association between allergy to house dust mites and allergy to storage mites in this study is probably caused by a common environmental factor, i.e, damp housing conditions.
Patients with cardiac chest pain should call emergency services
Authors: Will T Roberts, Adam D Timmis
Journal: BMJ (2007)

#### Key points

In acute myocardial infarction, the risk of ventricular fibrillation (and the capacity for external defibrillation or reperfusion therapy to reduce mortality) is highest in the first 12 hours after onset of symptoms. In hospital, reperfusion therapy is now given rapidly in most cases, but the time it takes the patient with chest pain to seek medical help has resisted change.1 This delay accounts for as much as 75% of the total delay to treatment,2 and in patients outside of hospital, ventricular fibrillation …
Garlic-Clove Fibroma
Authors: Howard H. Steel
Journal: JAMA (1965)

RECENTLY three patients presented with lesions of the toe nails and finger nails which closely resemble garlic cloves with the outer skin peeled away. These lesions began, without any history of trauma, as small lumps at the cuticle which grew away from the nail bed; they came to project from the dorsal surface of the nail, loosely attached by a pedicle (Figure). Painless, they did not recur following removal. Histological appearance was of a benign fibroepithelial polyp or irritation fibroma of the nail bed. Microscopic examination of serial sections revealed no foreign body; the appearance was that of a lesion completely covered, except at the base, by a layer of hyperkeratotic stratified squamous epithelium. The granular layer was prominent, with prickle cell and basal layers of normal thickness. The core of the polypoid structure was composed of interlacing bundles of dense collagenous tissue containing capillary channels. <h3>Comment</h3> The lesions described
Bevacizumab reduces VEGF expression in patients with relapsed and refractory acute myeloid leukemia without clinical antileukemic activity
Authors: L Zahiragic, C Schliemann, R Bieker, N H Thoennissen, K Burow, C Kramer, M Zühlsdorf, W E Berdel, R M Mesters
Journal: Leukemia (2007)
Prevent Disaster—Take a History
Authors: Jere W. Lord
Journal: JAMA (1979)

DURING the past 20 years, cardiovascular surgeons have saved many lives and limbs by implanting prostheses into the heart and peripheral vessels. One would hope that following such implants, all would be well forever, but unfortunately this is not so. Serious iatrogenic complications may occur unless a careful and complete history has been taken. Prostheses such as axillofemoral and femorofemoral bypasses used to alleviate aortic and iliac obstruction may be sources of disaster if the urologist or gynecologist boldly incises the abdominal wall. Unless a vascular surgeon is immediately available to replace the divided prosthesis, arterial insufficiency will reappear. A subcutaneous pacemaker is usually obvious, but if surgery is subsequently necessary, care must be taken not to incise the wires leading to the heart. A second serious consideration is positioning patients for hemorrhoidectomy and cystoscopic examination in anything resembling the lithotomy position. One of my patients with early localized gangrene
Measurements and a Simplified Interpretation of Magnetocardiograms from Humans
Authors: DAVID COHEN, LOUIS CHANDLER
Journal: Circulation (1969)

To understand and assess the magnetocardiograph, the magnetic field produced by electrical heart activity was mapped around the torsos of one abnormal and six normal heart subjects, at different times during QRS. The measurements are here presented in the form of instantaneous distributions of vector segments 6 cm from the skin, anteriorly. An electrical model is presented which explains the first-order features of these distributions. This model is a simple, rotating bipole heart source of changing strength which produces the same ion currents as measured with surface electrocardiograms and vectorcardiograms; these currents produce a time-changing magnetic field extending outside the torso. Further analysis of second-order details of the distributions can reveal information not obtainable with various forms of surface electrocardiography.
ISOTROPIC CALCIUM SCORING USING 0.5 MM RECONSTRUCTION MAY BE MORE SENSITIVE THAN STANDARD CONTRAST ENHANCED CT ANGIOGRAPHY IN DETECTING SUBCLINICAL ATHEROSCLEROSIS, USING 320-DETECTOR ROW CT
Authors: Usman Khokhar, Anum Aslam, Ammar Chaudhry, Alexander Abramowicz, Michael Cortegiano, Michael Poon, Szilard Voros
Journal: Journal of the American College of Cardiology (2013)
Activity of Pefloxacin after 2 Yearsʼ Single Dose Therapy for UTI
Authors: P.Y. Allouch, J.C. Alvarez, V. Barthel, M. Benoit, L. By, J.P. Couderc, P. Delavault, A. Dubanchet, A. Dore, D. Mathonnet, B.H. Pangon, J.Y. Roux, J.C. Ghnassia
Journal: Drugs (1993)