tbuckley/cabot-search huggingface dataset:
Length of Stay in the Intensive Care Unit
Authors: Kim A. Eagle
Journal: JAMA (1990)

We developed consensus management guidelines for patients admitted with chest pain, pulmonary edema, and syncope and used these guidelines to examine practice variation and the effects of physician feedback on decision making in 1145 consecutive admissions to three medical intensive care units. Data collection included a 6-month baseline period and two 6-month physician feedback periods. Hospital length of stay fell from 8.34 days to 7.41 and 7.14 days during feedback; intensive care unit length of stay fell from 2.45 days to 2.23 and 2.07 days. Feedback was associated with an increase in the percentage of patients conforming to the management guidelines. Multiple linear regression showed that feedback correlated with reductions of 0.79 days (confidence interval, 0.12 to 1.46) in hospital length of stay and 0.21 days (confidence interval 0.05 to 0.37) in intensive care unit length of stay. This effect was most apparent in patients not requiring any intervention, but with a major complication. During the 6-month follow-up, mortality, readmission, and urgent readmission rates were similar for patients admitted in baseline and feedback periods.
Upregulation of apoptosis with dietary restriction: implications for carcinogenesis and aging.
Authors: S J James, L Muskhelishvili, D W Gaylor, A Turturro, R Hart
Journal: Environmental Health Perspectives (1998)

The maintenance of cell number homeostasis in normal tissues reflects a highly regulated balance between the rates of cell proliferation and cell death. Under pathologic conditions such as exposure to cytotoxic, genotoxic, or nongenotoxic agents, an imbalance in these rates may indicate subsequent risk of carcinogenesis. Apoptotic cell death, as opposed to necrotic cell death, provides a protective mechanism by selective elimination of senescent, preneoplastic, or superfluous cells that could negatively affect normal function and/or promote cell transformation. The relative efficiency or dysfunction of the cell death program could therefore have a direct impact on the risk of degenerative or neoplastic disease. Dietary restriction of rodents is a noninvasive intervention that has been reproducibly shown to retard tumor development and most physiologic indices of aging relative to ad libitum-fed animals. As such, it provides a powerful model in which to study common mechanistic processes associated with both aging and cancer. In a recent study we established that chronic dietary restriction (DR) induces an increase in spontaneous apoptotic rate and a decrease in cell proliferation rate in hepatocytes of 12-month-old B6C3F1 DR mice relative to ad libitum (AL)-fed mice. This diet-induced shift in cell death/proliferation rates was associated with a marked reduction in subsequent development of spontaneous hepatoma and a marked increase in disease-free life span in DR relative to AL-fed mice. These results suggest that total caloric intake may modulate the rates of cell death and proliferation in a direction consistent with a cancer-protective effect in DR mice and a cancer-promoting effect in AL mice. To determine whether the increase in spontaneous apoptotic rate was maintained over the life span of DR mice, apoptotic rates were quantified in 12-, 18-, 24- and 30-month-old DR and AL mice. The rate of apoptosis was elevated with age in both diet groups; however, the rate of apoptosis was significantly and consistently higher in DR mice regardless of age. In double-labeling experiments, an age-associated increase in the glutathione S-transferase-II expression in putative preneoplastic hepatocytes in AL mice was rapidly reduced by apoptosis upon initiation of DR. Thus, intervention that promote a low-level increase in apoptotic cell death may be expected to protect genotypic and phenotypic stability with age. If during tumor promotion an adaptive increase in apoptosis effectively balances the dysregulated increase proliferation, the risk of permanent genetic error and carcinogenesis would be minimized.
Combination immunotherapy with a CpG oligonucleotide (1018 ISS) and rituximab in patients with non-Hodgkin lymphoma: increased interferon-α/β–inducible gene expression, without significant toxicity
Authors: Jonathan W. Friedberg, Helen Kim, Mary McCauley, Edith M. Hessel, Paul Sims, David C. Fisher, Lee M. Nadler, Robert L. Coffman, Arnold S. Freedman
Journal: Blood (2004)
1244 THE PHARMACOKINETIC INTERACTION BETWEEN METHADONE AND THE INVESTIGATIONAL HCV PROTEASE INHIBITOR TELAPREVIR
Authors: R. van Heeswijk, A. Vandevoorde, P. Verboven, G. Boogaerts, E. De Paepe, R. van Solingen-Ristea, V. Garg, M. Beumont
Journal: Journal of Hepatology (2011)
New-onset and idiopathic thrombotic thrombocytopenic purpura: Incidence, diagnostic validity, and potential risk factors
Authors: Stephanie D. Schech, Allen Brinker, Deborah Shatin, Margaret Burgess
Journal: American Journal of Hematology (2006)

Abstract Objective: The aim of this study was to determine the incidence rate for new‐onset and idiopathic thrombotic thrombocytopenic purpura (TTP) among adults 20–64 years old, the validity of diagnostic criteria, and potential risk factors for TTP. Methods: This retrospective observational study analyzed automated administrative data from 11 geographically dispersed U.S. health plans. Cases of TTP were identified based on the presence of an inpatient hospital claim for TTP (ICD‐9‐CM 446.6) between 1/1/97 and 12/31/01 and confirmed by medical record review. Pharmacy and medical claims were used to evaluate outpatient drug exposure and comorbidities preceding hospitalization for TTP. Cases and the base population were screened so as to result in an incidence rate for idiopathic TTP. Results: We confirmed new‐onset and idiopathic TTP in 9 of 15 presumptive cases for an incidence density of 1.4 per million person‐years (95% CI: 0.6–2.6). The rate increased to 1.8 per million person‐years after projection and age‐standardization. The highest incidence rate of TTP was found in patients 50–64 years old (2.8 per million person‐years; 95% CI: 0.8–7.1). These 9 patients had no apparent risk factors for TTP based on claims and medical record data. Conclusions: In a general U.S. population, the incidence rate of confirmed new‐onset and idiopathic TTP was lower than previously reported, but appears to be on the rise. Our findings suggest that administrative claims data are useful for identifying outpatient drug exposures and comorbidities potentially associated with TTP. Am. J. Hematol., 2006. Published 2006 Wiley‐Liss, Inc.
Comparative study of tibial (single) and tibiofemoral (double) osteotomy for osteoarthrosis and rheumatoid arthritis.
Authors: J M Iveson, E B Longton, V Wright
Journal: Annals of the Rheumatic Diseases (1977)

Osteotomies on 101 knees in 79 patients were assessed either prospectively or retrospectively. High tibial osteotomy was performed in 54 knees (27 with rheumatoid arthritis (RA) and 27 with osteoarthrosis (OA)) and double (tibiofemoral) osteotomy in 47 knees (25 RA and 22 OA), and were assessed prospectively in 46 and retrospectively in 55. Using a subjective assessment, 65% showed some improvement--70% of the single and 60% of the double osteotomies. Of the four groups (OA single or double, RA single or double), OA knees having a single osteotomy improved most frequently (74%), and OA knees having a double osteotomy least frequently (50%). Significant improvements in pain score and angular deformity were recorded. The mean range of movement of the operated knee was significantly reduced, and was particularly evident in those knees having a double osteotomy. We conclude that double osteotomies tend to have a higher incidence of complications, including impaired movement, and are not more efficient in relieving pain than single osteotomies in either OA or RA.
A CASE OF ACUTE LUPUS ERYTHEMATOSUS
Authors: F. Beetham, F. W. Eurich
Journal: BMJ (1909)

LUPUS ASYTHEMATOBUS.[Nov.13, 19. and its duration being left out of account.The modifications and improvements that it has undergone since it was first put forward dimnish, but do not remove, the defect.The wide adoption of this anatomical classification, whether modified or not, seems to me to be responsible for a somewhat mechanical view; of the disease, to the comparative disregard of its constitutional aspect.Trudeau divides his cases into: (1) Incipient, (2) Ad- vanced, (3) Far Advanced.In this classification the combination of local conditions and constitutional dis- turbance is recognized.Nearly all the great clinicians-British, American, French, and German-of the past as well as of the present generation have classified cases as Acute and Chronic, with Subdivisions based on the pathological con- dition, the pathological condition corresponding fairly well to the intensity.Thus in the chief classifications of recent years the extent of the disease, its intensity, and its duration have served as principles of division.Alone, each principle of division can yield, only distorted or inadequate results.While, as a joint principle of division, extent and intensity, not running parallel courses in pulmonary tuiberculosis, must be forced somewhat in order to yield the rather rigid combination at present in vogue.In the following classification I believe I have succeeded in allowing full value to each of the three aspects in question-Extent, Intensity, Duration-at the same time preserving their independence.This classification, while fuller and more exact, is also, I think, easier to apply than any previous scheme.In addition, I may say that it embodies a large amount of clinical experience.The plan is to estimate numerically, according to the definitions presently to be given, the Extent, the Intensity, and the Duration of the disease, from 1, the lowest grade, to 5, the highest, except that the highest grade of Intensity must be taken to range from 5 to 10, so as to include excessively acute or fulminating cases.The sum of these
The Synthesis of Glycosaminoglycans by Cultures of Corneal Stromal Cells from Patients with Keratoconus
Authors: Beatrice Y. J. T. Yue, Jules L. Baum, Jeremiah E. Silbert
Journal: Journal of Clinical Investigation (1979)

Keratoconus is a disease that results in thinning and ectasia of the central cornea. Cultures of corneal stromal cells from patients with keratoconus were established and the synthesis of glycosaminoglycans compared with the synthesis of glycosaminoglycans by normal human corneal stromal cells in culture.
ASPIRIN VERSUS CLOPIDOGREL FOLLOWING DUAL ANTIPLATELET THERAPY ON THE ERA OF DRUG-ELUTING STENTS
Authors: Taek Kyu Park, Young Bin Song, Hye Bin Gwag, Woo Jin Jang, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon
Journal: Journal of the American College of Cardiology (2014)
Effects of carbon tetrachloride on albumin synthesis
Authors: Marcus A. Rothschild, Murray Oratz, Sidney S. Schreiber
Journal: Journal of Clinical Investigation (1972)

The effects of CCl4 on albumin synthesis were studied employing the isolated perfused liver. Carbonate-14C was used to measure newly synthesized albumin. 2.5 ml of CCl4 was administered by stomach tube 2 hr before perfusion. Albumin synthesis decreased from 36 to 5 mg following the ingestion of CCl4. Preperfusing the livers for 1 hr before measuring albumin synthesis resulted in an increase to 12 mg, and the addition of tryptophan to a final concentration of 10 mM resulted in a further increase to 19 mg. Cortisone did not protect against the toxic effects of CCl4 when administered to the donor rabbits. Fasting resulted in an increased sensitivity to CCl4 and an antioxidant was not effective in protecting against the toxic manifestations of CCl4.
Treatment of seasonal allergic rhinitis: Desensitisation for hay fever works
Authors: S. R Durham
Journal: BMJ (2003)

Editor—Desensitisation for hay fever, using conventional high dose extracts, does work1 and does modify allergy, as reflected by long term remission of disease for at least three years after treatment, and data indicating reduced progression of hay fever to asthma in children.2,3 On the other hand, the negative results of the study by Radcliffe et al concerning enzyme-potentiated desensitisation using low dose extracts are convincing and seriously question the use of this alternative treatment.4 ​




Figure 1




It is unfortunate that your journal cover banner heading did not distinguish the two forms of treatment, with the likely result that general practitioners will be discouraged from referring the small but significant proportion of patients with severe hay fever, unresponsive to nasal corticosteroids and antihistamines, to NHS allergy clinics for consideration of high dose desensitisation.

Equally upsetting was the depiction of a “stargazer,” I presume a type of lily, as a cause of hay fever. Hay fever is caused by wind pollinated plants, which include grasses, trees, and weeds. Lilies are insect pollinated. They look nice and smell nice, and they attract insects, but they don't cause hay fever.
Post Pulmonary Embolism Pericarditis
Authors: IZAK GARTY, REUVEN MADER, SHLOMO SCHONFELD
Journal: Clinical Nuclear Medicine (1994)

A patient is described in whom pericarditis appeared a few days after pulmonary embolism. Prompt improvement was noted following corticosteroid therapy. The possibility of pericarditis appearing following pulmonary embolism should be kept in mind, considering that both entities present with similar clinical manifestations but require different therapeutic approaches. The combination of ventilation and perfusion lung scanning and plain chest radiographs for the prompt and early diagnosis of post pulmonary embolism pericarditis, is illustrated.
The Ethics of Human Gene Therapy
Authors: L. S. Rothenberg
Journal: JAMA (1997)

Over 100 years ago Sir William Osler reminded us that "[e]verywhere the old order changes and happy they who can change with it" (<i>The Principles and Practice of Medicine</i>[1895]). Physicians have not always been good guessers, however, when it comes to the future direction of clinical practice and therapy. Thirty-two years ago,<i>JAMA</i>published a news story about a conference at the University of Pennsylvania at which physicians, scientists, and educators gave their predictions about the state of medicine in the year 2000.<sup>1</sup>Such recorded predictions as "the practical elimination of the cancer problem in most parts of the world" and "a good supply of spare [body] parts, either human or mechanical" suggest the risks inherent in accurate crystal gazing. Thus, with the appropriate caveats invoked, one can offer the prophecy that within the next three decades, techniques of human gene transfer and manipulation will
Telangiectatic adenoma: An entity associated with increased body mass index and inflammation
Authors: Valérie Paradis, Axelle Champault, Maxime Ronot, Lydia Deschamps, Dominique-Charles Valla, Dominique Vidaud, Valérie Vilgrain, Jacques Belghiti, Pierre Bedossa
Journal: Hepatology (2007)

What were previously called telangiectatic focal nodular hyperplasias are in fact true adenomas with telangiectatic features (TAs) without overt characterized genetic abnormalities. The aim of our study was to review a surgical series of TAs in order to describe clinical, biological, and radiological findings of these lesions and to evaluate their outcomes. From January 1996 to November 2005, 284 patients with benign hepatocellular nodules underwent surgical resection at Beaujon Hospital. Among them, 32 TAs from 27 patients were diagnosed. Ninety-two percent of the patients were women. Mean age was 38 years (range 17-63). Mean body mass index was 28 (range 18-49), with 16 patients being overweight. Symptoms revealed lesions in 10 patients. In 13 patients, TA was associated with another benign liver lesion. Mean size of the TAs was 5 cm (range 1-17 cm). Histological analysis showed cellular atypias in 6 cases (19%), steatosis in 17 cases (53%), vascular changes in 19 cases (59%), and significant inflammatory infiltrate in 29 cases (91%). In 1 case, the TA had foci of well-differentiated hepatocellular carcinoma. In 18 of the 26 cases (69%), adjacent liver showed significant steatosis. Serum biomarkers of inflammation were increased in 90% of patients (19 of 22). After surgical resection, inflammatory marker levels returned to normal values in all patients tested.This study has shown that TAs occur in a characteristic background of overweight patients and are often associated with a biological inflammatory syndrome. Moreover, a TA may progress to malignancy.
Abolishing Mammography Screening Programs? A View from the Swiss Medical Board
Authors: Nikola Biller-Andorno, Peter Jüni
Journal: New England Journal of Medicine (2014)

Interview with Dr. Mette Kalager on the Swiss Medical Board’s recommendation to phase out routine mammography screening. (08:08)Download In February, the Swiss Medical Board recommended that no new systematic mammography screening programs be introduced, that time limits be put on current programs, that screening quality be evaluated, and that women be given clear information regarding benefits and harms.
Diagnosis of ventilator-associated pneumonia: agreement between quantitative cultures of endotracheal aspiration and plugged telescoping catheter
Authors: Souheil Elatrous, Riadh Boukef, Lamia Ouanes Besbes, Soudani Marghli, Sami Nooman, Semir Nouira, Fekri Abroug
Journal: Intensive Care Medicine (2004)
Purification of natural antikeratin autoantibodies from normal human serum and their effect on human keratinocytes cultured in vitro
Authors: C-X. Li, Y-H. Wan, S-M. Chi, G. Wang, L-C. Sun, Y-G. Zhang, X-D. Zhao, T-W. Gao, Y-F. Liu
Journal: British Journal of Dermatology (2001)

Background Antikeratin (AK) autoantibodies, circulating antibodies against epidermal keratins, have been detected in all normal human sera. However, direct evidence on the biological significance of AK autoantibodies is still lacking. Objectives To purify AK autoantibodies from human serum and to make a preliminary study of their biological effects on human keratinocytes. Methods We first extracted keratin polypeptides from human stratum corneum and analysed their purity using sodium dodecyl sulphate–polyacrylamide gel electrophoresis (SDS–PAGE). Next, a keratin affinity column was prepared with the extracted keratins, and AK autoantibodies were purified from pooled normal human serum. Antibodies obtained were identified with SDS–PAGE, enzyme-linked immunosorbent assay, immunoperoxidase staining, immunoelectron microscopy and Western blotting. The biological effect of AK autoantibodies on cultured human keratinocytes was studied using a DNA synthesis assay, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) colorimetric determination and cell cycle analysis. Results On average, 1·83 ± 0·24 mg of antibodies could be purified from 10 mL of pooled human serum. High-titre IgG (about 1 : 70) and low-titre IgM (about 1 : 30) AK autoantibodies were obtained. The DNA synthesis assay and MTT colorimetric determination demonstrated that AK autoantibodies have a significant dose-dependent inhibitory effect on cultured keratinocytes. Correlation coefficients in the two experiments were − 0·583 and − 0·797, respectively. Cell cycle analysis indicated that a small dose of AK autoantibodies leads to inhibition of proliferation of cultured keratinocytes, whereas a large dose of AK autoantibodies causes a visible hypodiploid peak, suggesting apoptosis of keratinocytes. Conclusions The present research lays a solid foundation for further investigation into the biological significance of natural AK autoantibodies.
Smoke-free Legislation and Acute Coronary Syndrome
Authors: Mark D. Eisner
Journal: New England Journal of Medicine (2008)

To the Editor: Pell et al. (July 31 issue) 1 report that smoke-free legislation in Scotland was strongly associated with a decreased risk of the acute coronary syndrome.Nested within their study is a critical and remarkable observation: smokers are also at substantial risk from exposure to secondhand smoke and benefit from its cessation.My group and others have also shown that smokers have adverse respiratory health effects from exposure to secondhand smoke. 2,3Bartenders, whether smokers or nonsmokers, have rapid improvement in their respiratory health after smokefree-workplace legislation is instituted. 4,5This point is important, because most previous research on the health effects of secondhand smoke has excluded smokers on the basis of the assumption that passive smoking is inconsequential as compared with active smoking.We are now learning that secondhand smoke, like other air pollution, affects both smokers and nonsmokers.Research and public health efforts that address exposure to secondhand smoke need a broader focus, to include all persons, regardless of personal smoking status.It is time to clear the air, for smokers and nonsmokers alike.
Chronic Pain and Risk of Falls in Older Adults—Reply
Authors: Suzanne G. Leveille
Journal: JAMA (2010)

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