tbuckley/cabot-search huggingface dataset:
Cost-effectiveness of Vaccination Against Pneumococcal Bacteremia Among Elderly People
Authors: Jane E. Sisk
Journal: JAMA (1997)

Clinical, epidemiologic, and policy considerations support updating the cost-effectiveness of pneumococcal vaccination for elderly people and targeting the evaluation only to prevention of pneumococcal bacteremia.To assess the implications for medical costs and health effects of vaccination against pneumococcal bacteremia in elderly people.Cost-effectiveness analysis of pneumococcal vaccination compared with no vaccination, from a societal perspective.The elderly population aged 65 years and older in the United States in 3 geographic areas: metropolitan Atlanta, Ga; Franklin County, Ohio; and Monroe County, New York.Incremental medical costs and health effects, expressed in quality-adjusted life-years per person vaccinated.Vaccination was cost saving, ie, it both reduced medical expenses and improved health, for all age groups and geographic areas analyzed in the base case. For people aged 65 years and older, vaccination saved $8.27 and gained 1.21 quality-adjusted days of life per person vaccinated. Vaccination of the 23 million elderly people unvaccinated in 1993 would have gained about 78000 years of healthy life and saved $194 million. In univariate sensitivity analysis, the results remained cost saving except for doubling vaccination costs, including future medical costs of survivors, and lowering vaccination effectiveness. With assumptions most unfavorable to vaccination, cost per quality-adjusted life-year ranged from $35 822 for ages 65 to 74 years to $598 487 for ages 85 years and older. In probabilistic sensitivity analysis, probability intervals were more narrow, with less than 5% probability that the ratio for ages 85 years and older would exceed $100000.Pneumococcal vaccination saves costs in the prevention of bacteremia alone and is greatly underused among the elderly population, on both health and economic grounds. These results support recent recommendations of the Advisory Committee on Immunization Practices and public and private efforts under way to improve vaccination rates.
Placebo Response in Antipsychotic Clinical Trials
Authors: Bret R. Rutherford, Emily Pott, Jane M. Tandler, Melanie M. Wall, Steven P. Roose, Jeffrey A. Lieberman
Journal: JAMA Psychiatry (2014)

Because increasing placebo response rates decrease drug-placebo differences and increase the number of failed trials, it is imperative to determine what is causing this trend.To investigate the relationship between antipsychotic medication and placebo response by publication year, and to identify associated study design and implementation variables.MEDLINE, PsycINFO, and PubMed were searched to identify randomized clinical trials of antipsychotic medications published from 1960 to July 2013.Included were randomized clinical trials lasting 4 to 24 weeks, contrasting antipsychotic medication with placebo or an active comparator, and enrolling patients 18 years of age or older with schizophrenia or schizoaffective disorder.Standardized mean change scores were calculated for each treatment arm, plotted against publication year, and tested with Spearman rank correlation coefficients. Hierarchical linear modeling identified factors associated with the standardized mean change across medication and placebo treatment arms.We hypothesized that the mean change in placebo-treated patients would significantly increase from 1960 to the present, that a greater change would be observed in active comparator vs placebo-controlled trials, and that more protocol visits would increase the symptom change observed.In the 105 trials examined, the mean change observed in placebo arms increased significantly with year of publication (n=39, r=0.52, P=.001), while the mean change in effective dose medication arms decreased significantly (n=208, r=-0.26, P<.001). Significant interactions were found between assignment to effective dose medication and publication year (t260=-5.55, P<.001), baseline severity (t260=5.08, P<.001), and study duration (t260=-3.76, P<.001), indicating that the average drug-placebo difference significantly decreased over time, with decreasing baseline severity and with increasing study duration. Medication treatment in comparator studies was associated with significantly more improvement than medication treatment in placebo-controlled trials (t93=2.73, P=.008).The average treatment change associated with placebo treatment in antipsychotic trials increased since 1960, while the change associated with medication treatment decreased. Changes in randomized clinical trials leading to inflation of baseline scores, enrollment of less severely ill participants, and higher expectations of patients may all be responsible.
Is the tube in the trachea?
Authors: S Mehta
Journal: BMJ (1987)

immunisation.This difference was significant (p= <0 005, x2 analysis).While it is assumed that half of those women might have a live birth after numerous additional abortions, these abortions may be prevented by immunotherapy.Moreover, women who have had one spontaneous abortion who have their immune response altered by immunotherapy seem to have second subsequently successful pregnancies.(This has occurred in all five patients who have become pregnant a second time in our series.)Though such women have spontaneously successful pregnancies, however, they seem to revert to their tendency to abort afterwards.Nine patients in our series had two or more abortions after a spontaneously successful pregnancy.Only one patient had two subsequently successful pregnancies after one spontaneous abortion.We therefore consider immunotherapy to be a most effective form of treatment for women who have had missed abortions, and the results of Drs Vlaanderen and Treffers do not convince us other- wise.
Lethal Postoperative Infections Following Cardiac Surgery
Authors: RICHARD M. ENGELMAN, RANDOLPH M. CHASE, ARTHUR D. BOYD, GEORGE E. REED
Journal: Circulation (1973)

Seventeen of 1,494 patients (1.1%) succumbed to infection following open-heart operations at New York University Hospital between January, 1968 and December, 1971. All but two of these patients had Starr-Edwards ball-valve prostheses inserted. One had repair of a tetralogy of Fallot, and one had aortic commissurotomy and a double coronary bypass graft. The sites of infection were pulmonary (15 patients), urinary tract (14), mediastinum or pleura (10), and blood (15). Pulmonary infection appeared as the source of endocarditis in 13 patients and as a source of pleural or mediastinal infection in nine. Candida species infection was directly responsible for the deaths of 10 of the 17 patients, being the sole organism isolated in 5 of the 10. Predisposing factors to infection were preoperative bacterial endocarditis 2 patients, prolonged cardiopulmonary bypass (&gt;3½ hours) 6 patients, a "low output" state following operation 12 patients, postoperative cerebral dysfunction 6 patients, and postoperative disseminated intravascular coagulation 4 patients. The debilitated state of the patients, multiple sites of infection, degree of tissue destruction, and the variety and resistance of the organisms involved all combined to produce treatment failure. Removal of the infected valvular prosthesis coupled with antimicrobial therapy is considered the treatment of choice in instances of bacterial endocarditis when chemotherapy fails and in all cases of established fungal endocarditis.
1048. Engineering and Development of I-AniI Homing Endonucleases for Gene Correction Applications
Authors: Andrew M. Scharenberg, David J. Rawlings, Raymond J. Monnat, Barry L. Stoddard
Journal: Molecular Therapy (2005)

Induction of a double strand break in DNA results in a large increase in the frequency of homologous recombination in the vicinity of the double strand break, raising the possibility of targeted gene correction if reagents were available for the simultaneous introduction of a site specific double strand break and a correcting DNA fragment. Structural and molecular studies of homing endonucleases (HE's) suggest that HE's possess significant potential for engineering of their cut site specificities to diverse target sequences. Here we discuss preliminary work on the I-AniI endonuclease with regards to its application to targeted gene correction of primary immune deficiencies. Work to be discussed will focus on the engineering hurdles to be faced in applying I-AniI as a site specific DSB-inducing tool, and the development of model systems for the evaluation and benchmarking of HE's and other DSB-inducing reagents in practical gene correction methods.
Groups Potentially at Risk for Making Poorly Informed Decisions About Entry into Clinical Trials for Childhood Cancer
Authors: Christian Simon, Stephen J. Zyzanski, Michelle Eder, Pauline Raiz, Eric D. Kodish, Laura A. Siminoff
Journal: Journal of Clinical Oncology (2003)

Some patients may be at greater risk than others of enrolling on a randomized clinical trial (RCT) without fully understanding the implications. To investigate this possibility, this study poses the question, Do non-English-speaking Latino parents of children with leukemia show differences in their discussion of and understanding of an RCT when compared with English-speaking minority parents and with English-speaking majority (ie, white) parents? This research hypothesizes that factors such as social and educational status and the role of language interpreters may account for significant differences in the discussion and understanding of an RCT among the three groups.A total of 108 parents are reported on, all of whom were observed, interviewed, and audiotaped during informed-consent discussions about participation in an RCT with their child's oncologist. Comparisons among the groups were performed using chi2 tests and a one-way analysis of variance.Problems of consent-related communication and understanding were more frequent among parents of low social status who spoke little or no English than they were in the two other groups. Several factors may have contributed to this disparity, including language interpretation, social status, and prevailing cultural norms.Some patients may be at greater risk than others of enrolling on an RCT without fully understanding the implications of their decision to do so. Numerous factors may contribute to this disparity, including language interpretation, social status, and prevailing cultural norms. Some specific strategies are suggested to help address this disparity.
Medicine in Europe. 1992 and all that.
Authors: T Richards
Journal: BMJ (1991)

prescribe theophylline and I don't monitor anything.DMG: I think the message is that it is much more difficult to attain steady state theophylline concen- trations than can be predicted from published reports or from hospital monitoring.Perhaps the actual blood concentration is not the relevant parameter; it may be the rate of change of blood concentration that is important.There is evidence that withdrawal of Pi ago-
THE EFFECT OF TOPICAL TETRAYNOIC ACID ON THE SEBORKHOEA OF ACNE
Authors: J. L. BURTON, SAM SHUSTER
Journal: British Journal of Dermatology (1972)

SUMMARY.— 2 per cent tetraynoic acid with 20% propylene glycol in ethanol has no effect on the sebum excretion rate when applied topically in acne vulgaris. This contrasts with the slight but definite decrease in sebum excretion rate produced by 2% tetraynoic acid alone.
The use of interferon- -based blood tests for the detection of latent tuberculosis infection
Authors: P. D. O. Davies, F. Drobniewski
Journal: European Respiratory Journal (2006)

As recently as 3 yrs ago, a colleague complained that after 100 yrs the only way to detect tuberculosis (TB) infection was still to measure “bumps on arms”. Now, at last, we have a genuine improved alternative: the ex vivo cellular interferon (IFN)-γ-based blood tests. The crucial questions we need to ask are how good they are at detecting infection with the TB bacterium and whether they are cost-effective? Unfortunately, determining the answers to these questions is not easy.

The new ex vivo cellular IFN-γ assays (CIGAs) have been developed based on the release of IFN-γ from a patient’s T-cells when exposed to mycobacterial antigens. These novel assays rely on the principle that the genes encoding the secretory proteins early secretory antigenic target (ESAT)6/culture filtrate protein (CFP)10 are absent in the bacille Calmette–Guerin (BCG) vaccine strain and most environmental mycobacteria 1. Two commercial cellular immunological assays have been developed in which IFN-γ output from the patient’s whole blood or peripheral blood mononuclear cells are measured following treatment with ESAT6/CFP10 antigens 1.

Different assay formats have been developed. One method relies on the relatively straightforward ELISA detection after a fixed volume of whole blood is incubated in a tube with ESAT6/CFP10 antigens (Quantiferon Gold; Cellestis Limited, Carnegie, Australia). The other method currently available commercially is the T-Spot.TB assay (Oxford Immunotec, Oxford, UK) based on the enzyme-linked immunospot (ELISPOT) principle. The methods appear to be both sensitive and specific. These assays have the potential to change the face of the diagnosis of latent TB infection (LTBI) and active TB at an early stage in the disease process. Their use is also likely to transform the screening of new migrants and other population groups. These tests require only a single blood sample without the repeat visit required for the tuberculin skin …
Complement Factor H and High-Temperature Requirement A-1 Genotypes and Treatment Response of Age-related Macular Degeneration
Authors: Takashi Tsuchihashi, Keisuke Mori, Kuniko Horie-Inoue, Peter L. Gehlbach, Sho Kabasawa, Hiroyasu Takita, Kazuhiro Ueyama, Yasushi Okazaki, Satoshi Inoue, Takuya Awata, Shigehiro Katayama, Shin Yoneya
Journal: Ophthalmology (2010)
Abstract 5400: Targeting the PI3K pathway improves the effect of PARP-1 inhibition in BRCA1-null breast cancer cells
Authors: Siker S. Kimbung, Pontus Berglund, Sofia Gruvberger-Saal, Ingrid A. Hedenfalk
Journal: Cancer Research (2010)

Abstract The development of targeted therapies has greatly improved the prognosis for many women affected by breast cancer. Unfortunately, tumors with a triple-negative, ‘basal-like’ phenotype do not express the targets of these agents and remain a treatment challenge. New approaches to specifically target these groups of breast tumors are in need. The majority of BRCA1 mutated tumors display a triple-negative phenotype and are characterized by homologous recombination defects. They frequently harbor mutations in the PTEN gene leading to activation of the PI3K pathway. The absence of BRCA1 and PTEN expression both confer sensitivity to poly-(ADP-ribose) polymerase 1 (PARP-1) inhibitors whilst the activated PI3K signaling most likely promotes cell survival and resistance to apoptotic cues. The therapeutic effects of PARP-1 inhibitors in BRCA1 deficient cells and tumors have been investigated. Even though pre-clinical and clinical studies show promising results, further ways to improve and broaden the scope of application of this therapeutic approach is warranted. We have investigated the possibility of improving the response of BRCA1 mutated cells to PARP-1 inhibition by co-targeting the PI3K pathway. The BRCA1 and PTEN mutated human breast cancer cell line MDA-MB-436 was treated with the PARP-1 inhibitor AG14361 (1-(4-dimethylaminomethyl-phenyl)-8-9-dihydro-7H-2,7,9a-benzo[cd]azulen-6-one) and the PI3K inhibitor LY294002 (2-(4-morpholinyl)-8-phenyl-chromone), both as single agents and in combination and the effects on cell growth, cell cycle phase distribution and DNA integrity were analyzed. Our results confirm that PARP-1 inhibition alone induces DNA damage conferring a G2/M arrest and a profound decrease in cell growth. LY294002, at the low concentrations used, had less pronounced effects on both cell cycle phase distribution and cell growth. Importantly, combining AG14361 and LY294002 resulted in reduced G2/M accumulation concomitant with an even greater growth inhibition compared to AG14361 alone (p&amp;lt;0.01). These observations could indicate a combination specific upregulation of apoptosis. Our results suggest that the combination of PARP-1 and P13K inhibitors is superior over PARP-1 inhibition alone and may represent an improved selective targeted treatment strategy for triple-negative breast cancers with DNA repair defects and activated PI3K signaling. 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 5400.
Mutations in the gene–encoding SERCA1, the fast–twitch skeletal muscle sarcoplasmic reticulum Ca2+ ATPase, are associated with Brody disease
Authors: Alex Odermatt, Peter E. M. Taschner, Vijay K. Khanna, Herman F. M. Busch, George Karpati, Charles K. Jablecki, Martijn H. Breuning, David H. MacLennan
Journal: Nature Genetics (1996)
Human health effects of exposure to airborne acid.
Authors: L J Folinsbee
Journal: Environmental Health Perspectives (1989)

This paper summarizes and critiques a series of reports on the health effects of acid aerosol exposure, presented at the Symposium on the Health Effects of Acid Aerosols and compares these data to selected previous studies. The role of the two major defenses against acid aerosols, the conversion of acid to the ammonium salts by respiratory ammonia and buffering of acid by airway surface liquid are discussed in relation to airway acid burdens expected from typical inhalation exposures. The roles of particle size and hygroscopicity on airway deposition of aerosol are also included. The major health effects studied were the effects of acid aerosol on mucociliary clearance in healthy individuals and changes in lung function in asthmatics, an important sensitive subpopulation. The broad range of response in asthmatics suggests the need for further study.
Popliteal Artery Entrapment Syndrome
Authors: Victor J. Albertazzi
Journal: JAMA (1969)

ABSTRACT To the Editor:— The report of the case of a 39-year-old man with popliteal entrapment cited in the CLINICAL NOTES (208:692, 1969) serves to familiarize us with the uncommon condition of intermittent claudication found in young people caused by an abnormal course of the popliteal artery and subsequent obstruction. The authors are to be commended for their thorough diagnostic study, excellent photographs, and successful final result with this patient.An article from Angiology (20: 119, 1969) described a 20-year-old male with a similar abnormal course of the popliteal artery and a detailed report of his treatment and progress. I should like to point out that (1) this was the 12th case reported in literature to that date and (2) he appears to be the only patient with this entity treated successfully without arterial thrombectomy or reconstruction.Turner et al deserve the gratitude of the medical community for bringing to our
Quantitative Analysis of Vascular Endothelial Growth Factor in Liver Metastases from Pancreatic Carcinoma as a Predictor of Chemotherapeutic Effect and Prognosis
Authors: Katsunobu Tawada, Takeshi Ishihara, Akitoshi Kobayashi, Taketo Yamaguchi, Toshio Tsuyuguchi, Masato Matsuyama, Osamu Yokosuka
Journal: Clinical Cancer Research (2008)

In pancreatic carcinoma, vascular endothelial growth factor (VEGF) expression at the primary site has been suggested to be a prognostic parameter. We quantitatively analyzed VEGF expression in liver metastases from pancreatic carcinoma and examined the correlation among VEGF expression in liver metastases, clinicopathologic factors, and clinical outcome.The subjects consisted of 23 patients with pancreatic adenocarcinoma who had liver metastases and were treated with S-1 and gemcitabine as the first-line treatment. VEGF expression was quantitated by enzyme immunoassay in biopsy specimens of liver metastases and nontumorous liver tissue, and in plasma. In 10 of the 23 patients, VEGF expression was also quantitated in biopsy specimens of the primary pancreatic tumor. All samples were collected before treatment.The VEGF level in nontumorous liver tissue was 36.6 +/- 10.0 pg/mg protein versus 376.8 +/- 106.1 pg/mg protein in liver metastases (P = 0.0016). Pretreatment VEGF levels in plasma and in primary pancreatic carcinoma did not correlate with VEGF levels in the corresponding liver metastases. The median VEGF level in liver metastases (138.9 pg/mg protein) was used as the cutoff value between high and low VEGF expression in liver metastases. Patients showing high VEGF expression had a significantly longer progression-free survival and overall survival than patients showing low VEGF expression in liver metastases (P = 0.0219 and P = 0.0074, respectively).Evaluation of VEGF levels in liver metastases might be useful in assessing the prognosis of patients with metastatic pancreatic carcinoma who are under systemic chemotherapy.
Hemoglobin H disease and multiple congenital anomalies in a child of Northern European origin
Authors: Brian Hjelle, Samuel Charache, John A. Phillips
Journal: American Journal of Hematology (1982)

Abstract Hemoglobin H (HbH) disease was recently described in three unrelated northern European boys with mental retardation. We have studied a somewhat similar patient, in whom HbH disease was associated with multiple congenital anomalies. Restriction endonuclease analysis of DNA from this proband yielded a pattern consistent with the α‐/– genotype commonly associated with the HbH phenotype in Asians. His parents both carry α thalassemia, in contrast to the previously described families in which only one of the two parents was a carrier.
Jake Walk in Vietnam
Authors: DAVID T. DENNIS
Journal: Annals of Internal Medicine (1977)

Comments and Correction1 May 1977Jake Walk in VietnamDAVID T. DENNIS, M.D.DAVID T. DENNIS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-5-665_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent paper by Morgan and Tuloss, "The Jake Walk Blues" (Ann Intern Med 85:804-808, 1976) on paralytic disease caused by poisoning with triortho-cresyl phosphate, reminded me of tragic outbreaks of this affliction that occurred in the Quang Tri Province of Viet Nam during 1970-71.While serving with a medical assistance team, (Navy MILPHAP N-4), assigned to work within the local health care system in the northernmost province of South Vietnam, I observed small clusters of Vietnamese patients with newly developing spastic quadriplegia. This epidemic paralysis peculiarly attacked family groups. As noted by Morgan and Tuloss, muscle... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTriortho cresyl phosphate “Ginger Jake” disaster—United States,1930sOrganophosphate and Carbamate PoisoningShort-term adverse effects in humans of ingested mineral oils, their additives and possible contaminants–A reviewThe inhibitory effect of neuropathic organophosphate esters on neurite outgrowth in cell cultures: A basis for screening for delayed neurotoxicityIntroduction and historical overviewREFERENCES 1 May 1977Volume 86, Issue 5Page: 665-666KeywordsHealth careMusclesParalysisPhosphates Issue Published: 1 May 1977 PDF downloadLoading ...