tbuckley/cabot-search huggingface dataset:
The effect of aspirin desensitization on urinary leukotriene E4 concentrations in aspirin-sensitive asthma.
Authors: S M Nasser, M Patel, G S Bell, T H Lee
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Patients with aspirin sensitive asthma (ASA) can be desensitized to aspirin but the mechanisms by which this happens are unknown. To test the hypothesis that there may be a reduction in aspirin-induced leukotriene release following aspirin desensitization, we studied nine patients with ASA, 37 +/- 2.3 yr of age (mean +/- SEM) with a baseline FEV1 of 94 +/- 3.5%. Urinary leukotriene E4 (LTE4) and FEV1 were measured before and after ingestion of a threshold dose of aspirin leading to a 15% decrease in FEV1, and then at intervals following desensitization, when a maintenance dose of 600 mg aspirin was ingested. Prior to desensitization, the maximum decrease in FEV1 following ingestion of a threshold dose of aspirin was 15.3 +/- 3.9%, and urinary LTE4 rose from a baseline value of 235 +/- 79.4 pg/mg creatinine to 1,714 +/- 783 pg/mg creatinine at 3 h. Immediately after acute desensitization, which was performed over several days, 600 mg aspirin provoked a maximum decrease in FEV1 of only 3.3 +/- 2.4%, and urinary LTE4 increased from a baseline of 645 +/- 223 pg/mg creatinine to 1,256 +/- 456 pg/mg creatinine. Following ingestion of 600 mg aspirin for 9 +/- 3.2 mo (n = 5; chronic desensitization), urinary LTE4 rose from a basal level of 432 +/- 127 pg/mg creatinine to 749 +/- 257 pg/mg creatinine at 3 h after 600 mg aspirin, and this was accompanied by a maximum decrease in FEV1 of 7.4 +/- 4.5%. Although there was significantly less aspirin-induced LTE4 excretion after acute desensitization, substantial amounts of LTE4 were still produced without any significant change in lung function.(ABSTRACT TRUNCATED AT 250 WORDS)
Enhancement of Clinicians' Diagnostic Reasoning by Computer-Based Consultation
Authors: Charles P. Friedman, Arthur S. Elstein, Fredric M. Wolf, Gwendolyn C. Murphy, Timothy M. Franz, Paul S. Heckerling, Paul L. Fine, Thomas M. Miller, Vijoy Abraham
Journal: JAMA (1999)

ContextComputer-based diagnostic decision support systems (DSSs) were developed to improve health care quality by providing accurate, useful, and timely diagnostic information to clinicians. However, most studies have emphasized the accuracy of the computer system alone, without placing clinicians in the role of direct users.ObjectiveTo explore the extent to which consultations with DSSs improve clinicians' diagnostic hypotheses in a set of diagnostically challenging cases.DesignPartially randomized controlled trial conducted in a laboratory setting, using a prospective balanced experimental design in 1995-1998.SettingThree academic medical centers, none of which were involved in the development of the DSSs.ParticipantsA total of 216 physicians: 72 at each site, including 24 internal medicine faculty members, 24 senior residents, and 24 fourth-year medical students. One physician's data were lost to analysis.InterventionTwo DSSs, ILIAD (version 4.2) and Quick Medical Reference (QMR; version 3.7.1), were used by participants for diagnostic evaluation of a total of 36 cases based on actual patients. After training, each subject evaluated 9 of the 36 cases, first without and then using a DSS, and suggested an ordered list of diagnostic hypotheses after each evaluation.Main Outcome MeasureDiagnostic accuracy, measured as the presence of the correct diagnosis on the hypothesis list and also using a derived diagnostic quality score, before and after consultation with the DSSs.ResultsCorrect diagnoses appeared in subjects' hypothesis lists for 39.5% of cases prior to consultation and 45.4% of cases after consultation. Subjects' mean diagnostic quality scores increased from 5.7 (95% confidence interval [CI], 5.5-5.9) to 6.1 (95% CI, 5.9-6.3) (effect size: Cohen d = 0.32; 95% CI, 0.23-0.41; P<.001). Larger increases (P = .048) were observed for students than for residents and faculty. Effect size varied significantly (P<.02) by DSS (Cohen d = 0.20; 95% CI, 0.08-0.32 for ILIAD vs Cohen d = 0.45; 95% CI, 0.31-0.59 for QMR).ConclusionsOur study supports the idea that "hands-on" use of diagnostic DSSs can influence diagnostic reasoning of clinicians. The larger effect for students suggests a possible educational role for these systems.
Is the private finance initiative dead?
Authors: Rifat A Atun, Martin McKee
Journal: BMJ (2005)

It may have failed in the United Kingdom, but that won't stop it being exported 

F or health professionals working in hospitals that had been starved of investment for decades, often in buildings that were crumbling around them, the United Kingdom's private finance initiative (PFI) must have seemed like a dream come true. Rather than finding the money up front to rebuild hospitals, managers could enter into a contract with a private company or a consortium to finance the building and guarantee that the facilities would be maintained long into the future. In turn the hospital trust would pay an annual fee to cover the costs of financing the project (adjusted for the risk assumed by the private company) and of maintenance. Suddenly it became possible to escape the constraints imposed by buildings that, in many cases, had been designed to meet the needs of the population a century earlier.

The initial enthusiasm by many hospital boards was easy to understand, as the Department of Health made it clear that this was the only way to fund big capital developments. Yet from the inception of this initiative in the NHS there have been …
The carboxy-terminal propeptide of type I procollagen in serum as a marker of bone formation: The effect of nandrolone decanoate and female sex hormones
Authors: C. Hassager, L.T. Jensen, J.S. Johansen, B.J. Riis, J. Melkko, J. Pødenphant, L. Risteli, C. Christiansen, J. Risteli
Journal: Metabolism (1991)
Plans for information collection from NHS put doctors in "impossible position"
Authors: M. Cross
Journal: BMJ (2011)

Provisions in the Health and Social Care Bill to improve the collection of information in the NHS in England could harm the confidentiality of GP-patient relationships, doctors have warned. 

The concerns centre on the role of the NHS Information Centre, headquartered in Leeds, which under the bill’s proposals is to become the central point for collecting and disseminating information about NHS and social care for “secondary purposes” beyond the care setting.

Critics say that the bill’s powers to create “a national repository of health, public health and social care information” are unnecessarily far reaching. Paul Cundy, a London GP who is joint chairman of the joint IT committee of …
Abstract P5-18-06: Trastuzumab emtansine in HER2-positive metastatic breast cancer: pooled safety analysis from seven studies
Authors: V Diéras, N Harbeck, GT Budd, JK Greenson, E Guardino, M Samant, N Chernyukhin, M Smitt, IE Krop
Journal: Cancer Research (2012)

Abstract Background: The antibody-drug conjugate (ADC) trastuzumab emtansine (T-DM1) combines the antitumor activities of trastuzumab with intracellular delivery of the cytotoxic agent DM1 and represents a new approach to therapy for HER2-positive MBC. Recently, the first phase 3 data have been reported with significant improvements in PFS (9.6 vs 6.4 months; HR=0.650; P&amp;lt;0.0001) and lower incidence of grade ≥3 adverse events (AEs) (57% vs 41%) vs capecitabine + lapatinib (Blackwell 2012). This pooled analysis reports the overall safety profile of T-DM1 3.6 mg/kg q3w in 882 patients treated with T-DM1. Methods: Data were included from treated patients in 7 studies of single-agent T-DM1 3.6 mg/kg q3w: 1 phase 1 study in previously treated MBC (TDM3569g, Krop 2010, n=15 treated at 3.6 mg/kg q3w); 3 phase 2 single-arm studies in previously treated MBC (TDM4258g, Burris 2011, N=112; TDM4374g, Krop 2012, N=110; TDM4688g, Gupta 2011, n=51); 1 randomized phase 2 study in previously untreated MBC (Hurvitz 2011, TDM4450g/BO21976, n=69); 1 extension study (TDM4529/BO25430, n=43 from parent studies); and 1 phase 3 study in MBC previously treated with trastuzumab and a taxane (EMILIA, Blackwell 2012, n=490). Data were analyzed in 4 groups: (1) all T-DM1-treated pts (7 studies, N=882), (2) pts originally enrolled in single-arm studies (n = 288), (3) T-DM1 pts from TDM4450g (n = 69), and (4) T-DM1 pts from EMILIA (n = 490). Results: Among all pts (N = 882), median age was 53 years (range 25–85 years); 52.7% had ≥3 metastatic sites; 81.7% had received prior treatment for MBC; and the median number of prior non-endocrine agents for MBC was 3.0 (range 0–19). All-grade AEs occurring in ≥25% of patients were fatigue (45.4%), nausea (42.3%), headache (28.7%), thrombocytopenia (28.7%), and constipation (25.5%). Grade ≥3 AEs occurring in ≥2% were thrombocytopenia, increased AST, increased ALT, fatigue, hypokalemia, and anemia. Table 1 describes the grade ≥3 incidence of these AEs, as well as selected AEs with known association to T-DM1 or potential risk based on the components of T-DM1 or on preclinical data. Conclusions: The safety profile of T-DM1 3.6 mg/kg q3w was consistent across the studies and the different patient populations with HER2-positive MBC. Additional analyses on hepatic transaminase increases and those exploring potential associations between thrombocytopenia and hemorrhage will be presented. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-18-06.
Lymphadenopathy Associated With Severe Hypertriglyceridemia
Authors: David A. Leaf
Journal: JAMA (1990)

The clinical recognition of diffuse lymphadenopathy generates a variety of important differential diagnostic considerations. We describe a woman with severe hypertriglyceridemia (type V hyperlipidemia) associated with diffuse lymphadenopathy. This association has not been described previously and should be included in the differential diagnosis of diffuse lymphadenopathy.
Culyer reforms will create new opportunities for research
Authors: C. Lewis
Journal: BMJ (1998)

EDITOR—The role of director of research and development in a teaching hospital is a challenging one, particularly during the introduction of the Culyer reforms. It does not include discouraging clinical staff who are industrious in their service work, enjoy teaching, and are active in research from continuing to develop evidence that can lead to improved clinical practice.1 Trusts that wanted to obtain money from the levy fund that was established to support research and development had to satisfy the NHS Executive that they would, firstly, implement …
Oversight of Fast-Track Drug Approval by FDA Stuck in Low Gear, Critics Say
Authors: Mike Mitka
Journal: JAMA (2010)

dren with SCID may die from infections without being diagnosed. The screening results will also facilitate study of these immune conditions and how best to treat them. Puck noted that the National Institute of Allergy and Infectious Diseases and the National Institutes of Health’s Office of Rare Diseases have established a network of centers that study rare immune deficiencies. She said the consortium’s work should allow clinicians to determine which treatments are best for patients based on the gene variants underlying the condition. Additionally, these efforts may lead to new insights about which genes and pathways are crucial for proper immune function. “It will show us the nonredundant pathways in immunity,” she said.
ASSOCIATION OF LEFT VENTRICULAR WALL THICKNESS AND MYOCARDIAL FIBROSIS/SCAR WITH ADVERSE EVENTS IN HYPERTROPHIC CARDIOMYOPATHY: INTERACTION OF MAXIMAL WALL THICKNESS AND LATE GADOLINIUM ENHANCEMENT BY CARDIAC MAGNETIC RESONANCE
Authors: Aya Kino, James Carr, Robert Bonow, Lubna Choudhury
Journal: Journal of the American College of Cardiology (2012)
SPECT Brain Imaging Abnormalities in Attention Deficit Hyperactivity Disorder
Authors: KARL G. SIEG, GARY R. GAFFNEY, DAVID F. PRESTON, JESSICA A. HELLINGS
Journal: Clinical Nuclear Medicine (1995)

SPECT using N-Isopropyl I-123 IMP was performed, as part of a neuropsychiatric evaluation, on 10 patients with the DSM III-R diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and 6 patients from a non-ADHD mixed psychiatric group used as controls for comparison. Mean regional I-123 IMP SPECT region of interest (ROI) count ratios (left to right) demonstrated that the ADHD patients had greater overall hemispheric I-123 IMP uptake asymmetry with less activity in the left frontal and left parietal regions in comparison to control patients. Both groups demonstrated similar I-123 IMP uptake asymmetry in the temporal regions. These findings are consistent with previous studies of brain physiology in ADHD implicating regional cortical perfusion and metabolism abnormalities in areas which are involved in the control of attentional processes.
Oxygen Consumption of the Thoracic Aorta of Normal and Hypercholesteremic Rats
Authors: F. J. LOOMEIJER, J. P. OSTENDORF
Journal: Circulation Research (1959)

The respiratory activity of the thoracic aorta wall of hypercholesteremic rats was shown to be 30 to 40 per cent higher than in normal animals. The addition, in vitro, of serum of different cholesterol content did not affect the oxygen consumption.
Hdac2 regulates the cardiac hypertrophic response by modulating Gsk3β activity
Authors: Chinmay M Trivedi, Yang Luo, Zhan Yin, Maozhen Zhang, Wenting Zhu, Tao Wang, Thomas Floss, Martin Goettlicher, Patricia Ruiz Noppinger, Wolfgang Wurst, Victor A Ferrari, Charles S Abrams, Peter J Gruber, Jonathan A Epstein
Journal: Nature Medicine (2007)
Stratum corneum lipid profile and maturation pattern of corneocytes in the outermost layer of fresh scars: the presence of immature corneocytes plays a much more important role in the barrier dysfunction than do changes in intercellular lipids
Authors: T. Kunii, T. Hirao, K. Kikuchi, H. Tagami
Journal: British Journal of Dermatology (2003)

Background The functional characteristics of the stratum corneum (SC) of fresh scars as well as keloids and hypertrophic scars are characterized by elevated transepidermal water loss (TEWL) and increased SC hydration. Objectives To study the composition of the intercellular lipids and maturation properties of the cornified envelope (CE) of the SC, as these are the most important components for the SC barrier function in fresh scars. Methods SC lipids were extracted from the donor site for split-thickness skin grafting soon after re-epithelialization using a cup method, and were analysed with high-performance thin-layer chromatography. CEs, which were prepared from superficial layers of the SC, were double stained with Nile red and anti-involucrin. Results We found a significant decrease in the proportion of ceramide (CER) in the SC lipids of fresh scars. We also observed changes in the SC CER profile that consisted of an increase in CER 4 and CER 7 and a decrease in CER 3, without any significant change in the proportion of CER 1. These changes were insufficient to explain the remarkably high TEWL recorded in the early stage of fresh scars. In contrast, with double staining of CE with Nile red and anti-involucrin, we detected the presence of numerous immature and less hydrophobic corneocytes in the outermost layer of the SC of fresh scars. Scanning electron microscopy of such corneocytes revealed numerous fine wrinkles on their enlarged surface area. Most of all, we found a closely similar, time-dependent, exponential decrease in the ratio of immature corneocytes with a poorly hydrophobic CE and in the recorded TEWL values in fresh scars. There was a highly significant positive correlation between the proportion of immature corneocytes in the outermost layer of the SC and TEWL values. Conclusions These results suggest that the SC barrier dysfunction of the fresh scars is attributable to the presence of immature corneocytes with a less hydrophobic CE, rather than to the changes in SC lipid composition.
84th Annual Report on Medical Education in the United States Executive Summary
Authors: Anne E. Crowley
Journal: JAMA (1984)

This EDUCATION ISSUE of<i>JAMA</i>is the 84th Annual Report on Medical Education in the United States. The first such report was published in the Sept 21, 1901, issue ofThe Journal. The current EDUCATION ISSUE provides information on educational programs leading to the MD degree, the financial operation of medical schools, residency training programs, educational programs for physicians in medical practice, programs for the training of allied health care professionals, and government-sponsored medical educational programs. <h3>Items of Special Interest</h3> Section I is a review of events and issues that have or will have an impact on US medical education. The purpose of Section I is to call attention to some of the current issues in medical education and the efforts of medical educators to improve and maintain the quality of American medical education. Concern about the financing of medical education programs has been accentuated by several factors. Both federal
ASSESSMENT OF CHANGE IN CLINICAL PRACTICE USING THE UPDATED 2009 AMERICAN COLLEGE OF CARDIOLOGY/ AMERICAN SOCIETY OF NUCLEAR CARDIOLOGY FOR APPROPRIATENESS CRITERIA SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY MYOCARDIAL PERFUSION IMAGING
Authors: Abdul Moiz Hafiz, Jonathan Kahan, Vijayapraveena Paruchuri, Daniel Zakhary, Todd Kerwin, Melissa Fazzari, Joshua DeLeon, Kevin Marzo, Juan Gaztanaga
Journal: Journal of the American College of Cardiology (2014)
684. Viral Gene Therapy in Tendon Healing: Adeno-Associated Virus-2 but Not Other Serotypes Effectively Transduces Intrasynovial Tenocytes with Persistent Expression of the Transgene
Authors: Xiao Tian Wang, Paul Y. Liu, Jin Bo Tang
Journal: Molecular Therapy (2005)

Purpose: Transfer of exogenous growth factor genes to injured tendons is a new and promising method for strengthening tendon repairs. Genes have been delivered to tenocytes through plasmid or adenoviral vectors, but gene transfer through adeno-associated viral (AAV) vectors has not been reported. It is not known whether AAVs can effectively transduce tenocytes and whether transduction rate is different for different AAV serotypes. We explored the efficiency of transduction of intrasynovial tenocytes with 7 serotypes of AAV and the persistency of its expression of a growth factor transgene.
Echocardiographically-guided myocardial lesion application using radiofrequency energy in a porcine model
Authors: Volker Menz, Jian-Fang Ren, John J. Michele, Stephen M. Dillon, David J. Callans, Charles D. Gottlieb, Francis E. Marchlinski, David Schwartzman
Journal: Journal of the American College of Cardiology (1996)
705 HEPATIC VEIN ARRIVAL TIMES USING A MICROBUBBLE CONTRAST ULTRASONOGRAPHY CAN PREDICT DISEASE SEVERITY NON-INVASIVELY IN PATIENTS WITH ALCOHOLIC LIVER DISEASE
Authors: M.Y. Kim, S.K. Baik, M.Y. Cho, S.O. Kwon, D.J. Kim, K.T. Suk, G.J. Cheon, Y.D. Kim, D.H. Choi
Journal: Journal of Hepatology (2013)
The laminate capillary and its wall of multiple basement membranes
Authors: W.B. SHELLEY, E.DORINDA SHELLEY, VERONIKA BURMEISTER
Journal: British Journal of Dermatology (1988)

Cutaneous telangiectatic vessels from two cases of unilateral dermatomal superficial telangiectasia were shown under electron microscopy to be venular capillaries with thick walls composed of multiple basement membranes. We suggest that this special capillary structure, seen in a variety of telangiectatic and disease states, should be called the ‘laminate capillary’.
Structural Variation and the Expanding Genomic Architecture of Parkinson Disease
Authors: Joshua M. Shulman
Journal: JAMA Neurology (2013)

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Plasminogen associates with phosphatidylserine-exposing platelets and contributes to thrombus lysis under flow
Authors: Claire S. Whyte, Frauke Swieringa, Tom G. Mastenbroek, Ausra S. Lionikiene, Marcus D. Lancé, Paola E. J. van der Meijden, Johan W. M. Heemskerk, Nicola J. Mutch
Journal: Blood (2015)
Histopathology of the liver in children with chronic hepatitis C viral infection
Authors: Kamran Badizadegan, Maureen M. Jonas, Mary Jane Ott, Suzanne P. Nelson, Antonio R. Perez-Atayde
Journal: Hepatology (1998)

Although the epidemiology, natural history, and pathological aspects of chronic hepatitis C are well-defined in the adult population, little is known about the characteristics of chronic hepatitis C infection in children. Reports on the histological features and progression of hepatitis C in children are scarce, and consist primarily of multicenter studies in Japanese and European children. Given the geographic variations in viral genotype and the association of pathology with genotype, whether the Japanese and European studies can be extended to the North American populations is unclear. We report the histopathology of the liver in 40 children with chronic hepatitis C infection treated in a single North American institution. The children included 19 males and 21 females ranging in age from 2.0 to 18.6 years at the time of liver biopsy (mean +/- SD: 11.4 +/- 4.3 years). Our findings indicate that the characteristic histopathological lesions of chronic hepatitis C infection, including sinusoidal lymphocytosis, steatosis, portal lymphoid aggregates/follicles, and bile duct epithelial damage, occur with approximately the same frequencies in children as have been reported in adults. Necroinflammatory activity was generally mild. Portal fibrosis was present in 78% of the specimens, including fibrous portal expansion (26%), bridging fibrosis (22%), bridging fibrosis with architectural distortion (22%), and cirrhosis (8%). Centrilobular pericellular fibrosis, which has not been previously reported in the context of chronic hepatitis C infection in adults or children, was also a prominent feature in our series, occurring with a similar frequency as steatosis or portal lymphoid aggregates/follicles. Our data suggest that in spite of mild histological necroinflammatory activity in general, the stage of fibrosis in children can be severe in spite of relatively short duration of infection.