tbuckley/cabot-search huggingface dataset:
THE STABILIZATION OF SERUM LIPID EMULSIONS BY SERUM PHOSPHOLIPIDS
Authors: Edward H. Ahrens, Henry G. Kunkel
Journal: The Journal of Experimental Medicine (1949)

Clarity of high lipid sera is closely correlated with elevated proportions of serum phospholipids, and lipemia (milkiness) with low proportions of phospholipids. Clear high lipid sera occur uniquely in obstructive jaundice, both intra- and extrahepatic in origin. Destruction of the polar nature of serum "lecithin" by enzymatic hydrolysis, using Cl. welchii lecithinase, results in a degree of lipemia which is linearly proportional to total lipid content in clear or lipemic high lipid or normal lipid sera. Even in grossly lipemic sera, a significant proportion of the serum lipids is masked in particles of invisible size. Enzymatic removal of the stabilizing properties of serum "lecithin" unmasks this hitherto invisible fraction. The concentration of serum phospholipids available for complex formation with serum proteins appears to be an important factor in determining particle size of serum lipids and hence of their occurrence in serum as masked or as visible particles. The implications of these findings for studies of the genesis of atheromatosis are discussed.
The Renin–Angiotensin–Aldosterone System and Autosomal Dominant Polycystic Kidney Disease
Authors: Arlene B. Chapman, Ann Johnson, Patricia A. Gabow, Robert W. Schrier
Journal: New England Journal of Medicine (1990)

A high incidence of hypertension (50 to 75 percent) occurs early in the course of autosomal dominant polycystic kidney disease. Cyst enlargement, causing bilateral renal ischemia and subsequent release of renin, is proposed as the cause of this form of hypertension.To investigate this hypothesis, we measured plasma renin activity and aldosterone concentrations during short-term and long-term converting-enzyme inhibition in 14 patients with hypertension due to polycystic kidney disease, 9 patients with essential hypertension, 11 normotensive patients with polycystic kidney disease, and 13 normal subjects. The groups were comparable with respect to age, sex, body-surface area, degree of hypertension, sodium excretion, and renal function.During the short-term study, the mean (+/- SE) plasma renin activity was significantly higher in the hypertensive patients with polycystic kidney disease than in the patients with essential hypertension, in the supine (0.36 +/- 0.06 vs. 0.22 +/- 0.06 ng per liter.second, P = 0.05) and upright positions (1.03 +/- 0.14 vs. 0.61 +/- 0.08 ng per liter.second, P less than 0.03) and after converting-enzyme inhibition (1.97 +/- 0.28 vs. 0.67 +/- 0.17 ng per liter.second, P less than 0.0006). The mean arterial pressures measured in the supine and upright positions and the plasma aldosterone concentrations measured in the upright position were significantly higher in the normotensive patients with polycystic kidney disease than in the normal subjects. After six weeks of converting-enzyme inhibition, renal plasma flow increased (P less than 0.005), and both renal vascular resistance (P less than 0.007) and the filtration fraction (P less than 0.02) decreased significantly in the hypertensive patients with polycystic kidney disease but not in the patients with essential hypertension.The renin-angiotensin-aldosterone system is stimulated significantly more in hypertensive patients with polycystic kidney disease than in comparable patients with essential hypertension. The increased renin release, perhaps due to renal ischemia caused by cyst expansion, probably contributes to the early development of hypertension in polycystic kidney disease.
Molecular phylogeny of the major arthropod groups indicates polyphyly of crustaceans and a new hypothesis for the origin of hexapods
Authors: J. C. Regier, J. W. Shultz
Journal: Molecular Biology and Evolution (1997)

A phylogeny of the arthropods was inferred from analyses of amino acid sequences derived from the nuclear genes encoding elongation factor-1 alpha and the largest subunit of RNA polymerase II using maximum-parsimony, neighbor-joining, and maximum-likelihood methods. Analyses of elongation factor-1 alpha from 17 arthropods and 4 outgroup taxa recovered many arthropod clades supported by previous morphological studies, including Diplopoda, Myriapoda, Insecta, Hexapoda, Branchiopoda (Crustacea), Araneae, Tetrapulmonata, Arachnida, Chelicerata, and Malacostraca (Crustacea). However, counter to previous studies, elongation factor-1 alpha placed Malacostraca as sister group to the other arthropods. Branchiopod crustaceans were found to be more closely related to hexapods and myriapods than to malacostracan crustaceans. Sequences for RNA polymerase II were obtained from 11 arthropod taxa and were analyzed separately and in combination with elongation factor-1 alpha. Results from these analyses were concordant with those derived from elongation factor-1 alpha alone and provided support for a Hexapoda/Branchiopoda clade, thus arguing against the monophyly of the traditionally defined Atelocerata (Hexapoda + Myriapoda).
Controlled trial of pyrogastrone and cimetidine in the treatment of reflux oesophagitis.
Authors: D G Maxton, J Heald, P J Whorwell, N Y Haboubi
Journal: Gut (1990)

Eighty patients with reflux oesophagitis were randomised to receive either Pyrogastrone five tablets daily or cimetidine 400 mg twice daily for six weeks, extended to 12 if necessary. At six weeks, 49% of the Pyrogastrone treated subjects and 37% of the cimetidine treated subjects were healed. After 12 weeks the cumulative healing rates were 64% for Pyrogastrone and 66% for cimetidine. Compared with baseline both drugs achieved similarly significant improvements in symptom score, endoscopic and histological grading even in those who did not heal completely. Response was not related to length of symptoms or initial severity of oesophagitis. Eleven of 25 (44%) patients healed with Pyrogastrone relapsed within one year compared with 15 of 27 (56%) healed with cimetidine. Although this trend in favour of Pyrogastrone was not significant at one year the early relapse rate was significantly greater in cimetidine treated subjects. At six weeks, five cimetidine treated subjects had relapsed compared with none in the Pyrogastrone group (p = 0.05). This study shows that Pyrogastrone and cimetidine are equally effective in the healing of oesophagitis and raises the possibility that Pyrogastrone has marginal benefits in terms of time to relapse.
Money can't buy you satisfaction
Authors: Chris Ham
Journal: BMJ (2005)

US and UK health care: a special relationship? Money can't buy you satisfaction Chris HamOrganisational differences between the US and UK healthcare systems mean that ideas have to be adapted through learning partnerships rather than simply copiedThe NHS performs as well as or better than the US healthcare system on many objective indicators.Yet the United Kingdom shows greater interest in learning from the United States than vice versa.Is this paradox a consequence of American insularity, British credulity, or some other factor?And is there any prospect of the balance of trade in health policy ideas being reversed?If so, what aspects of health care in the United Kingdom should the United States be studying and seeking to learn from? Comparing the two systemsTake the facts first.The United States spends almost 15% of gross domestic product on health care 1 compared with less than 8% in the United Kingdom. 2 Population health as measured by infant mortality and life expectancy are broadly comparable in the two countries and lag behind those achieved in high performing systems like Japan and Sweden. 3lthough the majority of the public in both the United Kingdom and United States express dissatisfaction with their healthcare systems, a higher proportion of the British population think their system works well, and a lower proportion believe the system needs to be rebuilt completely, than in the United States. 4round 45 million Americans under the age of 65 lack health insurance cover, and far more US citizens than UK citizens report that the cost of health care is a barrier to access.In a five nation survey that included Britain and the United States, Britain performed best in offering health care that was equitable, even though waiting times for treatment were the longest. 5A study of the quality of medical care in different countries found the United States performing relatively well, although the authors noted that in view of the much higher levels of expenditure "it is difficult to conclude that it is getting good value for its medical dollar." 6An overall assessment made by the World Health Organization in its hotly contested ranking of countries in terms of health system performance placed the United Kingdom 18th and the United States 37th out of 191 countries studied. 7his suggests that as a system the achievements of the United States do not match those of the United Kingdom, even though the United States contains many examples of clinical excellence and provides highly responsive care to people who are insured.
The Bradshaw Lecture on Bacteriology in its Relations to Surgery
Authors: H. Power
Journal: BMJ (1886)

determine to honour the me!mory of the deceased with a garland which he shall receive who has done the most for the art and in the art of statuary.The beloved Master has often praised the sniith as the author of their great suiecess, and they finally decide to award the garland to him." Well," answers the smith, " I consent.You are many, and among you are clever people.I am but a single man.You assert that f singly have been of service to many of you, and that many places,teem with sculptors who decked the temples with divine statues, which, without the tools that I have given you, would have been very imperfectly fashioned.
Whither Scientific Deliberation in Health Policy Recommendations? — Alice in the Wonderland of Breast-Cancer Screening
Authors: S W Fletcher
Journal: New England Journal of Medicine (1997)

“Let the jury consider their verdict,” the King said, for about the twentieth time that day. “No, no!” said the Queen. “Sentence first — verdict afterwards.” “Stuff and nonsense!” said Alice loudly. “The idea of having the sentence first!” “Hold your tongue!” said the Queen, turning purple. “I won't!” said Alice. “Off with her head!” the Queen shouted at the top of her voice.— Lewis Carroll, Alice's Adventures in Wonderland At 9 a.m. on January 23, 1997, after two days of speeches and presentations at a consensus-development conference sponsored by the National Institutes of Health (NIH), the conference panel . . .
Seasonal variation in arterial blood pressure.
Authors: P J Brennan, G Greenberg, W E Miall, S G Thompson
Journal: BMJ (1982)

Blood pressure measurements recorded during the medical Research Council9s treatment trial for mild hypertension have been analysed according to the calendar month in which the readings were made. For each age, sex, and treatment group systolic and diastolic pressures were higher in winter than in summer. The seasonal variation in blood pressure was greater in older than in younger subjects and was highly significantly related to maximum and minimum daily air temperature measurements but not to rainfall.
Predicted costs of iron‐chelators in myelodysplastic syndromes: A 10‐year analysis based on actual prevalence and red cell transfusion rates
Authors: Senthilkumar Durairaj, Stephen Chew, Ann Hyslop, Norene Keenan, Michael J. Groves, Sudhir Tauro
Journal: American Journal of Hematology (2011)

Consideration of iron-chelation (IC) in transfusion-dependent patients is recommended in most clinical-practice guidelines on myelodysplastic syndromes (MDS). The financial impact of IC on health-care systems is predicted through economic modeling, but an analysis based on actual prevalence is lacking. Here, we have investigated the potential drug-costs and need for IC in a cohort of 189 United Kingdom-based MDS patients diagnosed from 2000 to 2010. Patients with low or intermediate-1 IPSS scores were identified as eligible for IC if ≥24 red cell units (RCU) had been transfused over 12 consecutive months or the transfusion-intensity averaged ≥2 RCU per month. Drug-costs were calculated from the time patients qualified for IC until death or last follow-up. In 159 patients with low/intermediate-1 MDS, survival was superior with a low IPSS score (P = 0.014), age <70 years (P = 0.043), transfusion-independence at diagnosis (P = 0.0056) and transfusion-intensity of <2 RCU per month (P = 0.009). Reflecting the time elapsed since diagnosis, longer survival was observed with a cumulative red cell load of ≥75 U (P = 0.046). By logistic-regression analysis, transfusion-intensity independently predicted survival (P = 0.0035) in low and intermediate-1 risk MDS patients. Forty-one patients fulfilled criteria for consideration of IC. Of these, 6 patients died within 1 month; 35 patients survived for a median of 16 months (range 1-61). Had patients commenced IC, the anticipated drug-costs alone would have been ~$526,880-$2,064,800 over 10 years. The lack of association between cumulative transfusion-load and survival calls for a prospective evaluation of the cost-utility of IC in patients surviving long-term, to enable evidence-based recommendations in MDS management.
In vivo amplification of the androgen receptor gene and progression of human prostate cancer
Authors: Tapio Visakorpi, Eija Hyytinen, Pasi Koivisto, Minna Tanner, Riitta Keinänen, Christian Palmberg, Aarno Palotie, Teuvo Tammela, Jorma Isola, Olli-P. Kallioniemi
Journal: Nature Genetics (1995)
Randomized Controlled Clinical Trial of “Virtual House Calls” for Parkinson Disease
Authors: E. Ray Dorsey, Vinayak Venkataraman, Matthew J. Grana, Michael T. Bull, Benjamin P. George, Cynthia M. Boyd, Christopher A. Beck, Balaraman Rajan, Abraham Seidmann, Kevin M. Biglan
Journal: JAMA Neurology (2013)

The burden of neurological disorders is increasing, but access to care is limited. Providing specialty care to patients via telemedicine could help alleviate this growing problem.To evaluate the feasibility, effectiveness, and economic benefits of using web-based videoconferencing (telemedicine) to provide specialty care to patients with Parkinson disease in their homes.A 7-month, 2-center, randomized controlled clinical trial.Patients' homes and outpatient clinics at 2 academic medical centers.Twenty patients with Parkinson disease with Internet access at home.Care from a specialist delivered remotely at home or in person in the clinic.The primary outcome variable was feasibility, as measured by the percentage of telemedicine visits completed as scheduled. Secondary outcome measures included clinical benefit, as measured by the 39-item Parkinson Disease Questionnaire, and economic value, as measured by time and travel.Twenty participants enrolled in the study and were randomly assigned to telemedicine (n = 9) or in-person care (n = 11). Of the 27 scheduled telemedicine visits, 25 (93%) were completed, and of the 33 scheduled in-person visits, 30 (91%) were completed (P = .99). In this small study, the change in quality of life did not differ for those randomly assigned to telemedicine compared with those randomly assigned to in-person care (4.0-point improvement vs 6.4-point improvement; P = .61). Compared with in-person visits, each telemedicine visit saved participants, on average, 100 miles of travel and 3 hours of time.Using web-based videoconferencing to provide specialty care at home is feasible, provides value to patients, and may offer similar clinical benefit to that of in-person care. Larger studies are needed to determine whether the clinical benefits are indeed comparable to those of in-person care and whether the results observed are generalizable.clinicaltrials.gov Identifier: NCT01476306.
Five Years' Treatment of Parkinson's Disease with Levodopa
Authors: RICHARD D. SWEET
Journal: Annals of Internal Medicine (1975)

One hundred patients with Parkinson's disease, who started taking levodopa before the end of 1968, have been assessed after 5 years. Forty-seven patients are still being followed on levodopa, and half of them are at least 25% better than at their pretreatment evaluation. However, the average functional rating is returning toward baseline from its remarkable improvement at ½ to 2 years. Abnormal involuntary movements, rapid oscillations in motor performance, postural instability, and dementia have become the major adverse effects. Thirty-two of the 100 patients have died. Life-table analysis shows an excess mortality of 1.9 compared with the U. S. population, a figure that is lower than the 2.9 reported before levodopa's use. Despite its inability to cure Parkinson's disease, levodopa provides symptomatic relief for a prolonged time and it remains the single most effective medication for the illness.
Drinking from the Fire Hose — Statistical Issues in Genomewide Association Studies
Authors: David J. Hunter, Peter Kraft
Journal: New England Journal of Medicine (2007)

The past 3 months have seen the publication of a series of studies examining the inherited genetic underpinnings of common diseases such as prostate cancer, breast cancer, diabetes, and in this issue of the Journal, coronary artery disease (reported by Samani et al., pages 443–453). These genomewide association studies have been able to examine interpatient differences in inherited genetic variability at an unprecedented level of resolution, thanks to the development of microarrays, or chips, capable of assessing more than 500,000 single-nucleotide polymorphisms (SNPs) in a single sample. This "SNP-chip" technology capitalizes on a catalogue of common human genetic variations that . . .
Correlation of peripheral blood OX40+(CD134+) T cells with chronic graft-versus-host disease in patients who underwent allogeneic hematopoietic stem cell transplantation
Authors: Ai Kotani, Takayuki Ishikawa, Yumi Matsumura, Tatsuo Ichinohe, Hitoshi Ohno, Toshiyuki Hori, Takashi Uchiyama
Journal: Blood (2001)
Specialization in Health Care—Reply
Authors: Allan S. Detsky, Stephen R. Gauthier, Victor R. Fuchs
Journal: JAMA (2012)

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Innocent Intramural Gastric Uptake of Gallium-67 in a Case of AIDS
Authors: JEANINE A. McNEILL, JOSEP G. LLAURADO
Journal: Clinical Nuclear Medicine (1986)

In a patient with AIDS, marked uptake of Ga-67 in the stomach walls initially was regarded with a high degree of suspicion for gastric involvement. Results of subsequent intragastric tests, including biopsy and culture, proved negative. Caution should be exercised when considering further costly and/or invasive procedures after gastric visualization on Ga-67 scintigraphy.
ABC of Urology: URINARY STONE DISEASE
Authors: C. Dawson, H. Whitfield
Journal: BMJ (1996)

InvestigationMost patients with urinary stones have microscopic haematuria detected by routine urine analysis.An absence of red cells in the urine suggests an alternative diagnosis.An x ray film of the kidneys, ureters, and bladder shows the position and size of the kidneys as well as the presence of any calculi, which usually obstruct at the pelviureteric junction, the point where the ureter crosses the iliac arteries at the pelvic brim, or the vesicoureteric junction.All patients suspected of having a urinary stone should then have intravenous urography, although renal ultrasonography is acceptable in patients who are either allergic to contrast medium or pregnant.Obstruction may be detected by the delayed appearance or persistence of the nephrogram phase on the intravenous urogram or by the finding of caliceal dilatation in an ultrasound scan.Renography after injection of technetium-99m mercapto acetyltriglycine is not routinely used and is more useful when the urogram suggests obstruction, particularly if the stone does not pass quickly.About two thirds of men presenting with a stone will have recurrent stones.The likelihood of detecting a metabolic abnormality is similar in patients with single and recurrent stones.A compromise for metabolic screening must be reached between the risks of further stone formation on the one hand and the cost of full evaluation on the other.Full metabolic screening should therefore be reserved for high risk groups (such as those with a family history of stones or with recurrent stones).