tbuckley/cabot-search huggingface dataset:
Developing a Therapeutic Range of Adalimumab Serum Concentrations in Management of Psoriasis
Authors: Stef P. Menting, Emma Coussens, Mieke F. Pouw, Juul M. P. A. van den Reek, Linda Temmerman, Hugo Boonen, Elke M. G. J. de Jong, Phyllis I. Spuls, Jo Lambert
Journal: JAMA Dermatology (2015)

<h3>Importance</h3> Adalimumab has proven to be effective in suppressing psoriasis disease activity and is administered in a standard dose. <h3>Objective</h3> To establish a therapeutic range for adalimumab trough levels in the treatment of plaque-type psoriasis, leading to a more personalized treatment. <h3>Design, Setting, and Participants</h3> A multicenter, prospective, observational, daily practice cohort study conducted at an academic hospital with affiliated secondary care hospitals in Belgium (cohort 1) and 2 academic hospitals in the Netherlands (cohort 2). Both cohorts included adult patients treated with adalimumab for plaque-type psoriasis. Cohort 1 comprised 73 patients who were being treated with adalimumab for more than 24 weeks until 401 weeks. In cohort 2 (n = 62), serum samples were obtained between weeks 24 and 52 of treatment. <h3>Interventions</h3> Before the start of adalimumab therapy and at time of serum sampling, Psoriasis Area and Severity Index (PASI) scores were determined. <h3>Main Outcomes and Measures</h3> Adalimumab trough level and PASI score at the time of serum sampling to determine the receiver-operator characteristics analyses and concentration effect curve. <h3>Results</h3> By means of receiver-operator characteristics analyses with an area under the curve of 0.756 (SD, 0.046; 95% CI, 0.666-0.847) and a sensitivity of 78% and a specificity of 70%, 3.51 mg/L was established as the lower margin for the therapeutic range. By means of a concentration effect curve, 7 mg/L was established as the upper margin. One-third of patients had an adalimumab trough concentration exceeding 7 mg/L. <h3>Conclusions and Relevance</h3> A therapeutic range of adalimumab trough levels of 3.51 mg/L to 7.00 mg/L, which corresponds to an optimal clinical effect, was identified. In one-third of patients, it was observed that trough concentrations exceeded the therapeutic window. Based on the established range, a therapeutic algorithm for adalimumab treatment for patients with psoriasis can be developed and validated in a prospective patient cohort. By identifying this range, a step has been taken toward a more rational use of biological therapy in psoriasis. Developing a therapeutic algorithm may lead to less overtreatment of patients and cost savings.
A PECULIAR CRYSTALLINE PROTEIN IN HUMAN URINE
Authors: LUDVIG HEKTOEN
Journal: JAMA (1924)

<h3>REPORT OF CASE</h3> A man, aged 57, an engineer; admitted to the hospital in January, 1924, had typhoid fever twenty-five years before, and when young had had gonorrhea, from which he recovered without complications. His wife was living, and had never been pregnant. The chief complaints were nocturia, dysuria, backache, a small, weak stream, pallor and drowsiness, nervousness, swelling of the eyelids, and one attack of complete retention of urine. This illness began four years before admission, when he had complete retention of urine. His physician catheterized him twice a day for a week, when sounds were passed, after which he was able himself to empty the bladder. The urinary trouble became worse again a few weeks before entering the hospital following a cold, and the patient urinated every hour or hour and a half during the day, and arose from three to four times at night. He had some
A new method for the analysis of cohort studies: implications of the multistage theory of carcinogenesis applied to occupational arsenic exposure.
Authors: C C Brown, K C Chu
Journal: Environmental Health Perspectives (1983)

Implications of the multistage theory of carcinogenesis for evaluating the effect of exposure to carcinogens in the workplace are described. This theory predicts different patterns of excess risk related to duration of exposure, age at initial exposure, and follow-up time since exposure stopped, depending upon which stage of the carcinogenic process is affected by the carcinogen, i.e., action at an early stage or a late stage. New statistical methodologies are proposed to examine these patterns and are applied to the lung cancer mortality experience from a cohort study of smelter workers exposed to arsenic. Under this multistage hypothesis, the results indicate that arsenic exerts a definite late stage effect though an additional effect at the initial stage cannot be ruled out. The possibilities of biased conclusions resulting from incomplete exposure histories and lack of smoking information are also discussed as well as implications of these results to experimental animal studies.
Anomalous origin of the right coronary artery with aortopulmonary window: functional and surgical considerations.
Authors: S V Luisi, M H Ashraf, G Gula, R Radley-Smith, M Yacoub
Journal: Thorax (1980)

Summary: We describe a case of the “tilted-disk” syndrome in a patient with a bitemporal field depression (a pseudohemianopia). CT and MR imaging showed thinning and prolapse of the nasal sectors of the posterior walls of the globes and flattening of the temporal portion of the globes.
The Outstanding Jet Pilot
Authors: ROGER F. REINHARDT
Journal: American Journal of Psychiatry (1970)

A study of 105 superior jet pilots aged 20 to 40 years revealed that most were firstborn children with unusually close father-son relationships. They were self-confident, showed a great desire for challenge and success, were not introspective, and tended toward inter-personal and emotional distance. The author cites implications for population control and small families. He feels that we should give more attention to the significance of birth order and specific parental influence in regard to other groups.
Underreporting of pedestrian accidents.
Authors: P. J. Morrison
Journal: BMJ (1992)

whether any otorrhoea had occurred.No attempt was made to correlate the otorrhoea to swimming activity or upper respiratory infection.We studied 210 children (mean age 6 years).At the beginning of the summer the tubes had been in place for a mean of six months (range one to 24 months).Purulent discharge developed in 40 patients, 20 of whom had not been swimming.The incidence of otorrhoea was lower in the 142 children who had swum during the summer (13'S,) than in the 68 children who had not (31 %) (p=0-005, X2 test).The incidence of infection in the group who had not swum was not significantly different from that in the 27 children who had swum one to five times (33%) but was significantly higher than that in the 41 children who had gone swimming six to 20 times (12%, p=0 01) and in the 71 children who had gone swimming more than 20 times (7%, p<0-001).Our conclusions are the same as those ofPringle': children with grommets should be allowed to swim.Penetration of water into the ear canal is not the main factor leading to otorrhoea in patients with grommets.
Comparison of Presenting Complaint vs Discharge Diagnosis for Identifying “ Nonemergency” Emergency Department Visits
Authors: Maria C. Raven, Robert A. Lowe, Judith Maselli, Renee Y. Hsia
Journal: JAMA (2013)

<h3>Importance</h3>Reduction in emergency department (ED) use is frequently viewed as a potential source for cost savings. One consideration has been to deny payment if the patient's diagnosis upon ED discharge appears to reflect a “nonemergency” condition. This approach does not incorporate other clinical factors such as chief complaint that may inform necessity for ED care.<h3>Objective</h3>To determine whether ED presenting complaint and ED discharge diagnosis correspond sufficiently to support use of discharge diagnosis as the basis for policies discouraging ED use.<h3>Design, Setting, and Participants</h3>The New York University emergency department algorithm has been commonly used to identify nonemergency ED visits. We applied the algorithm to publicly available ED visit data from the 2009 National Hospital Ambulatory Medical Care Survey (NHAMCS) for the purpose of identifying all “primary care–treatable” visits. The 2009 NHAMCS data set contains 34 942 records, each representing a unique ED visit. For each visit with a discharge diagnosis classified as primary care treatable, we identified the chief complaint. To determine whether these chief complaints correspond to nonemergency ED visits, we then examined all ED visits with this same group of chief complaints to ascertain the ED course, final disposition, and discharge diagnoses.<h3>Main Outcomes and Measures</h3>Patient demographics, clinical characteristics, and disposition associated with chief complaints related to nonemergency ED visits.<h3>Results</h3>Although only 6.3% (95% CI, 5.8%-6.7%) of visits were determined to have primary care–treatable diagnoses based on discharge diagnosis and our modification of the algorithm, the chief complaints reported for these ED visits with primary care–treatable ED discharge diagnoses were the same chief complaints reported for 88.7% (95% CI, 88.1%-89.4%) of all ED visits. Of these visits, 11.1% (95% CI, 9.3%-13.0%) were identified at ED triage as needing immediate or emergency care; 12.5% (95% CI, 11.8%-14.3%) required hospital admission; and 3.4% (95% CI, 2.5%-4.3%) of admitted patients went directly from the ED to the operating room.<h3>Conclusions and Relevance</h3>Among ED visits with the same presenting complaint as those ultimately given a primary care–treatable diagnosis based on ED discharge diagnosis, a substantial proportion required immediate emergency care or hospital admission. The limited concordance between presenting complaints and ED discharge diagnoses suggests that these discharge diagnoses are unable to accurately identify nonemergency ED visits.
Of saving children
Authors: I. Loefler
Journal: Journal of the Royal Society of Medicine (2007)

Children are treated preferentially.This behaviour evolved, presumably, for it had survival value for the species.In the last sixty years, because of accelerating technological developments, special medical programs for children contributed to population increase and to demographic shifts hampering development and destroying the environment.Could it be that 'Save the Children' programs are contrary to the interests of the species?If so, would it be ethical to try to overcome the urge-wired into the genome in the form of emotions-and cease to practice positive discrimination in favour of children?There seem to be a consensus that in the last decade or so child health and maternal health have deteriorated; WHO has renewed its concern for child and maternal health: new goals have been set by WHO itself and various other organizations.These concerns and activities do not address the fundamental question as to why society should countenance positive discrimination in favour of children.UNICEF, the Save The Children Fund, WHO and a number of agencies and NGOs, both national and international, seem to think that somehow children are more important than adults and that one must, should, and can give preference to themand moreover that the matter is self evident.Occasionally one encounters the argument that investments in children bring important economic rewards, and that healthy children are a prerequisite for productive adults: one should have thought that direct investment in productive adults would make more sense.The fact is that for the last fifty years, as children grew into adults, an increasing number of those adults did not find a role in the production process, had mounting difficulty in procuring essentials, and as their number, as well as the number of unproductive but consuming children, increased throughout the third world, resource depletion, environmental destruction, famines, unrest, insecurity, wars, violence and criminality increased.The entire issue of positive discrimination in favour of children needs to be re-examined.As postmodernism is, as last, drawing to an end, political correctness can be disregarded and questions asked, questions that for decades were taboo and could not be asked.
The structure and dynamics of organizations and groups
Authors: L. Clovis Hirning
Journal: JAMA (1963)

This book deals with social psychiatry, a new psychiatric specialty.In a text of some 200 pages much is encompassed which is important for those interested in the larger implications of group dynamics. A difficulty with this book is that it contains many new and old words in new contexts. A few paragraphs on semantics in the preface and a 14-page glossary do not solve this problem entirely. It includes not only many words from group dynamics literature in general, but also many which seem to be of the author's coinage. The author says on page 79, "Because the terminology of group dynamics has rarely been precise and has become more and more vulgarized, the temptation to coin new words is almost irresistible." The reader soon discovers that Dr. Berne fails repeatedly to resist this temptation. Often he slips into an even graver semantic sin, that of torturing old words into
Venereal Disease Problem in Malaya
Authors: I. D. Gebbie
Journal: BMJ (1939)

Late Maloyavn Medical Service Preliminary examination of available data on the venereal disease problem in the Federated Malay States seemed to suggest that the importance of syphilis and gonorrhoea as causes of death and disability was scarcely realized, nor did it appear that comprehensive material for the reliable assessment of the incidence of venereal diseases in the Federated Malay States had up to the present been assembled.In this mixed community of Malays, Chinese,
Do stem cell markers have significant implication in breast cancer? Immunohistochemical study for CD44 and CD24.
Authors: H Kim, M Kim, S Ahn, B Son, S Kim, K Jung, J Ahn, H Kim, G Gong
Journal: Cancer Research (2009)

Abstract Abstract #5058 Background: We reported that breast cancer expressing CD44+CD24-/low showed a favorable prognosis in contrary to the in vitro/in vivo studies. We further followed this data up to 99 months and analyzed it according to CD44 expression, CD24 expression and hormone expression.&amp;#x2028; Design: immunohistochemical stainings for CD44s and CD24 as well as prognostic markers including estrogen receptor, progesterone receptor, p53, and Her2/neu were done using tissue microarray blocks containing 645 consecutive cases of invasive breast carcinomas from 1993 to 1998. Mean follow up periods were 99.5 months. Cases were categorized into four subgroups (CD44-/CD24+, CD44+/CD24+, CD44-/CD24-, CD44+/CD24-) based on the immunohistochemical staining results and compared them with clinicopathologic parameters. Immunostainings for CD44s and CD24 interpreted as positive if at least 1% of tumor cells show distinct membranous and/or cytoplasmic stainings. In the positive group of CD24, we categorized it as three subgroups according to the degree of positivity.&amp;#x2028; Results: CD44+CD24-/low group showed inversely associated with lymph node metastasis and the tumor stage than other subgroups (p=0.001 and p=0.018, respectively). And CD44+CD24-/low group was showed an increase in disease free survival and overall survival (p=0.003, p=0.002) In the subgroup analysis of CD24 expression (0, grade 1, grade 2, grade 3), the incidence of metastasis and death was more frequently observed in the cases with the higher expression of CD24. (DFS: p=0.03, OS: p=0.001). With respect to the CD44, CD44- group showed frequent metastasis and death (p=0.01, both) however, for the receptor positive groups, not CD44 but CD24 expression resulted negatively to the overall survival significantly(p=0.01, Relative risk=1.90) on multivariate analysis. For the receptor negative groups, especially triple negative group, lack of CD44 expression made overall decreased to 50%(p=0.03, hazard ratio=0.5)&amp;#x2028; Conclusion: In contrast to cell line studies, CD44+CD24-/low phenotype is considered a favorable prognostic subgroup of breast cancer associated with less frequent nodal metastasis, lower tumor stage and infrequent distant metastasis. For receptor positive breast caner, CD24 expression effect DFS, OS significantly, and For receptor negative group, especially triple negative breast cancer, Lack of CD44 expression made and effect OS inversely. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5058.
Medicine and Science — A Commission on Medicines? — Private Practice
Authors: John Lister
Journal: New England Journal of Medicine (1967)

LORD Platt, who was president of the Royal College of Physicians during the years when its beautiful new home was being built in Regents Park, delivered this year's Harveian Oration before the College on October 18. Having spent many years as a professor of clinical medicine, he chose to take as his theme the relation between medicine and science.The scientific revolution of the last few decades had led to a proliferation of chairs of medicine and therapeutics and to a vast increase in the volume of research. But how many of the real therapeutic advances could be attributed to . . .
Passing a nasogastric tube
Authors: F. I Tovey
Journal: BMJ (1980)

A comparison of the combination of antacids and cimetidine with antacids alone (suggested by your leading article) has already been reported in the treatment of patients with established acute mucosal bleeding.8Haemostasis was achieved earlier with cimetidine but it is noteworthy that bleeding stopped within 48 hours in only 330N) of either treatment group.This fact-that established acute gastrointestinal haemorrhage may be difficult to control-and the disastrous results of surgical intervention in the few patients in whom medical treatment is unsuccessful contradict your final sanguine conclusion that "treatment may reasonably be reserved for those in whom bleeding occurs."It is true that prophylaxis should be reserved for high-risk patients-those with severe burns, head injuries or multiple injuries, and major operations, especially when these conditions are complicated by hypotension, jaundice, sepsis, renal failure, or severe respiratory insufficiency.Cimetidine infused slowly intravenously has fewer side effects than antacids, may be used even when the gut is not functioning, and is more convenient.For the most effective prophylaxis intragastric pH should be maintained above 4 and antacids may occasionally need to be added to cimetidine to achieve this.
Blood Groups and Disease
Authors: W. K. Cowan
Journal: BMJ (1962)

TESTING OF EMBRYOTROPIC AGENTS MEDICALROURNALexert their influence only after implantation, we none the less envisage the possibility of the flat-mount technique, when further perfected particularly in its quantitative aspects, becoming a valuable adjunct to other drug- testing and screening procedures, both generally and in relation to pregnancy.We are indebted to Dr. G. F. Somers (The Distillers Co. Ltd.) for gifts of thalidomide and phthaloyl-DL-isoglutamine.
Elucidating the pre- and post-nuclear intracellular processing of 1,4-dihydropyridine based gene delivery carriers
Authors: Zanna Hyvönen, Vesa Hämäläinen, Marika Ruponen, Bart Lucas, Joanna Rejman, Dries Vercauteren, Jo Demeester, Stefaan De Smedt, Kevin Braeckmans
Journal: Journal of Controlled Release (2012)
Prolactin Stimulation by Thyrotropin-Releasing Hormone in a Patient with Isolated Thyrotropin Deficiency
Authors: Richard Sachson, Saul W. Rosen, Pedro Cuatrecasas, Jesse Roth, Andrew G. Frantz
Journal: New England Journal of Medicine (1972)

PROLACTIN and thyrotropin (TSH) are protein hormones that appear to be produced by different cell populations of the anterior pituitary gland.1 TSH secretion is stimulated by thyrotropin-releasing hormone (TRH), a releasing factor from the hypothalamus whose effects have been well studied in man.2 Prolactin secretion, on the other hand, appears to be under tonic inhibition by a hypothalamic inhibitory factor,1 but studies in animals have suggested an additional hypothalamic stimulating factor as well.3 4 5 Recently, it has been shown in tissue culture6 and intact man7 , 8 that TRH promotes pituitary prolactin secretion in a manner qualitatively and quantitatively similar to its stimulation . . .
Pulmonary Gas Exchange After Foam Sclerotherapy
Authors: Leo Moro, Isaura Rossi Bartoli, Matteo Cesari, Simone Scarlata, Francesco-Maria Serino, Raffaele Antonelli Incalzi
Journal: JAMA Dermatology (2013)

higher in prolonged DRESS (5 of 7 [71%] vs 2 of 25 [8%]; P = .002).Liver enzyme level increase and lymphocyte count were higher at baseline in prolonged DRESS (Table).Likewise, mononucleosis-like atypical lymphocytosis was found in 4 cases of prolonged DRESS (57%), compared with 5 cases in "usual" DRESS (20%) (P = .08).Strikingly, minocycline as a culprit drug was observed in 3 of 7 cases in prolonged DRESS, whereas it was never involved in the other cases (P = .007).There was no evidence of a significant difference between the 2 groups regarding the use of corticosteroids for management of patients with DRESS.Last, no significant difference in viral reactivation frequency was found between the 2 groups.Discussion | Seven of 32 patients (22%) had prolonged evolution lasting more than 90 days, lasting until day 180 (n = 4) and even up to 1 year (n = 3).Comparative analysis showed a predominance of minocycline use in patients of non-European ethnicity, more frequent pustular eruption, more severe hepatic cytolysis, and higher lymphocyte count at baseline in the prolonged evolution group.Several pharmacogenetic studies have shown an association between HLA types, ethnicity, and severe drug reaction, arguing for ethnicity as an additional key factor in the occurrence of adverse drug reactions.In this respect, in a series of minocycline-induced DRESS, 4 all patients were of non-European ethnic origin with Fitzpatrick skin phototypes V and VI, and minocycline was reported to be detected in the plasma and/or skin of some patients up to 17 months after minocycline withdrawal. 4 Drug accumulation in the skin of predisposed patients could explain prolonged evolution of DRESS and in particular the persistence of cutaneous involvement.In a previous study, we showed that drug use was able to reactivate EBV or HHV-6 in vitro. 1,5 Minocycline, although not tested, might also reactivate herpesviruses or unidentified viruses.In addition, a previous report linked HHV-6 reactivation and severity and duration of symptoms, as well as occurrence of flares. 2 In the present study, no difference was found regarding the role of viral reactivation in the persistence of symptoms.However, more pronounced lymphocytosis, presence of mononucleosis, and more severe
Intravenous Nutrition: Fact and Fancy
Authors: Philip Felig
Journal: New England Journal of Medicine (1976)

Thomas Huxley cautioned that "the great tragedy of Science [is] the staying of a beautiful hypothesis by an ugly fact."1 Occasionally, the observations responsible for the initial development of an hypothesis remain undisputed while new facts emerge, making the theory untenable. Such a situation has developed in the field of postoperative parenteral nutrition.After elective surgical procedures or more severe trauma, a period of negative nitrogen balance ensues. Body protein is catabolized at a rate of 75 to 150 g per day, representing losses of 300 to 600 g of lean body mass (primarily muscle), depending in part on the . . .
TCT-246 Characterization of the Actuarial Daily Ischemic Risk in the First Year Following ST-Segment Elevation Myocardial Infarction: Analysis from the HORIZONS-AMI Trial
Authors: Efthymios Deliargyris, Debra Bernstein, Sorin Brener, Philippe Genereux, Ajay J. Kirtane, Roxana Mehran, Jayne Prats, Simona Skerjanec, Gregg W. Stone
Journal: Journal of the American College of Cardiology (2013)