tbuckley/cabot-search huggingface dataset:
Cost-Effectiveness of Screening for Carotid Stenosis in Asymptomatic Persons
Authors: Tina T. Lee
Journal: Annals of Internal Medicine (1997)

Background: The Asymptomatic Carotid Atherosclerosis Study (ACAS) showed that carotid endarterectomy was beneficial for symptom-free patients with carotid stenosis of 60% or more. This finding raises the question of whether widespread screening to identify cases of asymptomatic carotid stenosis should be implemented. Objective: To determine whether a screening program to identify cases of asymptomatic carotid stenosis would be a cost-effective strategy for stroke prevention. Design: Cost-effectiveness analysis using published data from clinical trials. Setting: General population of asymptomatic 65-year-old men. Intervention: Patients who were screened for carotid disease with duplex Doppler ultrasonography were compared with patients who were not screened. If ultrasonography found significant carotid stenosis (≥ 60%), disease was confirmed by angiography before carotid endarterectomy was done. Measurements: Quality-adjusted life-years, costs, and marginal cost-effectiveness ratios. Results: When the conditions and results of ACAS were modeled and it was assumed that the survival advantage produced by endarterectomy would last for 30 years, the lifetime marginal cost-effectiveness of screening relative to no screening was $120 000 per quality-adjusted life-year. Sensitivity analysis showed that marginal cost-effectiveness decreased to $50 000 or less per quality-adjusted life-year only under implausible conditions (for example, if a free screening instrument with perfect test characteristics was used or an asymptomatic population with a 40% prevalence of carotid stenosis was found). Conclusions: Surgery offers a real but modest absolute reduction in the rate of stroke at a substantial cost. A program to identify candidates for endarterectomy by screening asymptomatic populations for carotid stenosis costs more per quality-adjusted life-year than is usually considered acceptable.
ACTIVATION OF T AND B LYMPHOCYTES IN VITRO
Authors: Dieter Armerding, David H. Katz
Journal: The Journal of Experimental Medicine (1974)

The studies presented herein have focused on the biological and biochemical properties of a nonspecific mediator produced by populations of activated T lymphocytes during short-term in vitro reactions with foreign alloantigens. We have analyzed the activity of the unseparated and of chromatographically separated fractions of the supernatants from such cultures on the in vitro responses of mouse lymphocytes to soluble and macrophage-bound DNP-carrier conjugates and also to particulate heterologous erythrocytes. The results demonstrate that a highly active protein moiety, termed allogeneic effect factors (AEF), in the mol wt range of 30,000-40,000, is capable of acting directly on B lymphocytes, in the presence of antigen, probably to effect triggering and subsequent differentiation and proliferation to antibody-forming cells in vitro. The active molecule, although not manifesting specificity for antigen, does exhibit some strain-specific properties suggesting a possible relationship to cell surface antigens or other gene products coded in the major histocompatibility gene complex.
Lions in the Way: A Discursive History of the Oslers
Authors: William B. Bean
Journal: JAMA (1961)

Devotees and apostles of William Osler may not be aware that a delightful family sketch of the Oslers was published some time ago by Anne Wilkinson, Osler's grandniece. This is a family chronicle, charmingly written. Not only does Anne Wilkinson weave the documents together skillfully, but her sometimes wry and rueful comments reveal that she does not let her poetic faculties becloud her clear understanding of family foibles or family fame. The title of what she calls "A Discursive History of the Oslers" came from a letter that Ellen Osler, William Osler's mother, wrote to him when she was over 90. In it she says: "There are often 'Lions in the Way' when I write a note—but neither lions nor dim sight hinder loving thoughts toward those who are absent." The world's image of William Osler, especially for those who did not know him personally, is largely that determined by
Liver Biopsy in Hemophilia A
Authors: HENRY R. LESESNE
Journal: Annals of Internal Medicine (1977)

Hepatitis is a significant complication of the treatment of hemophilia A with factor VIII concentrates. Chronic liver disease in these patients is infrequently documented in the literature. The results of percutaneous liver biopsy, under the coverage of glycine-precipitated factor VIII, in six patients with hemophilia A who had the persistence of abnormal liver-function tests for at least 6 months, are described. Three patients had chronic active hepatitis, and three had chronic persistent hepatitis. No complications were encountered as a result of the biopsy procedure. These results suggest that percutaneous liver biopsy should be considered in patients with hemophilia A with continuously abnormal liver-function tests to establish a histologic diagnosis and to guide further therapy.
THE TREATMENT OF PTERYGIA WITH THE GALVANO-CAUTERY.Read in the Section on Ophthalmology, at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: ARTHUR G. HOBBS
Journal: JAMA (1894)

I shall not presume that it is necessary in describing this method of operating on pterygia to even enumerate the many already in vogue. I should rather ask your forbearance for merely suggesting to you that yet another method is to be added to the list already, perhaps, too long; still it may be true that each of these operations has served its purpose in turn in the process of evolution. Since it is the cardinal point in making a pterygium operation to prevent two raw surfaces from remaining in apposition after the operation, which necessarily results in the relapses which we too frequently see, why not then convert each of the raw surfaces into an eschar at once to avoid such failures, provided we are able to demonstrate practically that this means will bring about that desired result? For some years the galvano-cautery point has been resorted to in
Effects of Di(2-ethylhexyl) Phthalate (DEHP) on Female Fertility and Adipogenesis in C3H/N Mice
Authors: Juliane-Susanne Schmidt, Kristina Schaedlich, Nadia Fiandanese, Paola Pocar, Bernd Fischer
Journal: Environmental Health Perspectives (2012)

Di(2-ethylhexyl) phthalate (DEHP) and its metabolites are known to affect lipid metabolism and adipogenesis, mainly by activation of peroxisome proliferator-activated receptors (PPARs). Exposure to DEHP has been linked with testicular impairment and male subfertility. However, the effects of DEHP on female reproductive health and metabolism have not been studied in detail.
A Novel Device.
Authors: Wm. H. De Witt
Journal: JAMA (1899)

Cincinnati, June 16, 1899. <h3>To the Editor:</h3> —The following is a novel device for securing a small quantity of the contents of stomach for examination; Take the long end of a largest-size empty capsule, into this crowd or condense as much as possible of fine sponge, to which is attached a fine silk thread of sufficient length. The capsule is then closed and the patient allowed to swallow the same. After sufficient time has elapsed for the capsule to dissolve, the sponge is removed by the string. The sponge will be found to have absorbed a sufficient amount of gastric contents for all practical purposes. In this way tests can be made for free hydrochloric acid or, indeed, for anything else that may have been taken into the stomach. This method is original with me; I do not know whether others have used the same device or not. It will,
Childhood Immunization Procedures-Reply
Authors: Samuel L. Katz
Journal: JAMA (1977)

Dr Nitzkin is quite correct in his approach. Those children whose attendance in health facilities is so sporadic and unreliable that one visit may be their only appearance certainly may receive simultaneously DTP, TOPV, measles, rubella, and mumps vaccine. This is certainly not ideal because the anticipated febrile and other possible responses from each may be additive, and, if there is any illness in the subsequent several days, it is further confusing to delineate its cause—from the vaccines or some intercurrent infection. However, one must be pragmatic, and the ideal can certainly be compromised to meet reality. There is no concern about the antigens interfering with one another in such a mass single administration schedule. The only caution relates to the surveillance of reactions.
Interleukin 27 limits autoimmune encephalomyelitis by suppressing the development of interleukin 17–producing T cells
Authors: Marcel Batten, Ji Li, Sothy Yi, Noelyn M Kljavin, Dimitry M Danilenko, Sophie Lucas, James Lee, Frederic J de Sauvage, Nico Ghilardi
Journal: Nature Immunology (2006)
Patient, Doctor, Drug and Bug
Authors: Ernest Jawetz
Journal: New England Journal of Medicine (1958)

I AM honored to have been chosen by the program committee to deliver the first William Randall lecture. Much of Dr. Randall's professional life was dedicated to the attainment of objective measurement in the new and complex field of antibiotics. It might be a fitting tribute to his memory if I attempted to examine some relations and interactions of the four main participants in the daily drama: patient, doctor, drug and bug.At the outset it must be stated that, on the whole, the position of each participant is quite satisfactory. A large majority of bacterial infections can be treated . . .
Exposure to Asbestos-Containing Vermiculite Ore and Respiratory Symptoms among Individuals Who Were Children While the Mine Was Active in Libby, Montana
Authors: Lisa C. Vinikoor, Theodore C. Larson, Thomas F. Bateson, Linda Birnbaum
Journal: Environmental Health Perspectives (2010)

Libby, Montana, was home to the largest vermiculite ore mine in the United States. The processing, use, and transport of the ore, which was contaminated with amphibole asbestos, led to generalized contamination of the community. The mine closed in 1990.We examined the prevalence of respiratory symptoms in 2000-2001 and their association with history of vermiculite exposure among people who were < or = 18 years of age when the mine closed.Information on respiratory symptoms and exposure history was collected by questionnaire in 2000-2001, at which time participants were 10-29 years old. Logistic regression was used to model the associations between exposures and outcomes adjusted for age, sex, and tobacco smoke exposure.Of the 1,003 individuals included in the study, 10.8% reported usually having a cough, 14.5% reported experiencing shortness of breath when walking up a slight hill or hurrying on level ground, and 5.9% reported having coughed up bloody phlegm in the past year. These respiratory symptoms were positively associated with frequently handling vermiculite insulation compared with never handling vermiculite insulation. We found no association between vermiculite insulation in the house and respiratory symptoms. Respiratory symptoms were associated with other vermiculite exposures as well, and the number and frequency of these activities showed a positive trend with usually having a cough. We found no association between any of the activities and abnormal spirometry.These data suggest that residents of Libby, Montana, who were children when the mine closed experienced some respiratory symptoms associated with asbestos-contaminated vermiculite exposure.
Abstract LB-291: Novel germline G660D mutation in HER2 gene detected by whole-exome sequencing can predispose a patient to developing familial lung adenocarcinoma
Authors: Hiromasa Yamamoto, Koichiro Higasa, Masakiyo Sakaguchi, Kazuhiko Shien, Junichi Soh, Koichi Ichimura, Masashi Furukawa, Shinsuke Hashida, Kazunori Tsukuda, Nagio Takigawa, Keitaro Matsuo, Katsuyuki Kiura, Sinichiro Miyoshi, Fumihiko Matsuda, Shinichi Toyooka
Journal: Cancer Research (2014)

Abstract Familial cancers arising from several organs are often reported including breast and colon cancers, although familial lung cancers are few reported. We encountered a family of Japanese descent in which multiple members developed lung adenocarcinomas. Using whole-exome sequencing, we identified a novel germline mutation in the transmembrane domain of the human epidermal growth factor receptor 2 (HER2) gene (G660D). A novel somatic mutation (V659E) was also detected in the same transmembrane domain of HER2 in one of 253 sporadic lung adenocarcinomas. Because the transmembrane domain of HER2 is considered to be responsible for the dimerization and subsequent activation of the HER family and downstream signaling pathways, we performed functional analyses of these HER2 mutants. Mutant HER2 G660D and V659E proteins were more stable than wild-type protein. Both the G660D and V659E mutants activated Akt, an effector kinase regarding to cell survival. In addition, they activated the other kinase, p38 at a remarkable level, which is thought to promote critically cell proliferation in lung adenocarcinoma. Coupling experiments revealed that mutant HER2 avidly dimerized with EGFR, HER3 and HER4 in the same manner to those with wild type HER2. The formation of mutant HER2 homodimers was also observed, whereas we less detected homodimers of wild type HER2. Our findings strongly suggest that mutations in the transmembrane domain of HER2 are oncogenic, causing hereditary and sporadic lung adenocarcinomas. Citation Format: Hiromasa Yamamoto, Koichiro Higasa, Masakiyo Sakaguchi, Kazuhiko Shien, Junichi Soh, Koichi Ichimura, Masashi Furukawa, Shinsuke Hashida, Kazunori Tsukuda, Nagio Takigawa, Keitaro Matsuo, Katsuyuki Kiura, Sinichiro Miyoshi, Fumihiko Matsuda, Shinichi Toyooka. Novel germline G660D mutation in HER2 gene detected by whole-exome sequencing can predispose a patient to developing familial lung adenocarcinoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-291. doi:10.1158/1538-7445.AM2014-LB-291
The Sounds of the Hospital
Authors: Mitchell H. Katz, Steven A. Schroeder
Journal: New England Journal of Medicine (1988)

Abstract To examine the influence of hospital paging systems on residency training, nursing services, and patient care, we asked medical interns (first-year residents) in three teaching hospitals to keep logs of pages they received during a three-day period. Thirty-one logs from 26 interns were completed; a total of 1206 pages were recorded on 91 days (1095 hours). Interns were paged an average of once an hour; on 24 occasions, interns were paged five or more times an hour. The majority of pages (65 percent) occurred when interns were engaged in patient care. Only 34 percent of the pages were judged both to require a response within one hour and to result in a change in patient care. Twenty-four percent were clinically indicated and required a response within one hour but did not result in a change in patient care. Sixteen percent of pages resulted in a change in patient care or were clinically indicated but could have been postponed for more than an hour. An additional 26 percent of pages neither resulted in a change in clinical management nor were clinically indicated. Reducing the number of unnecessary pages and postponing nonurgent ones could result in as much as a 42 percent decrease in disruptions of patient care and more rest for interns. (N Engl J Med 1988; 319:1585–9.)
Transformation of coronary artery aneurysm to obstructive lesion and the role of collateral vessels in myocardial perfusion in patients with Kawasaki disease
Authors: Zenshiro Onouchi, Kenji Hamaoka, Yasutaka Kamiya, Shousei Hayashi, Yutaka Ohmochi, Kouichi Sakata, Isao Shiraishi, Takashi Hayano, Hiroshi Fukumochi
Journal: Journal of the American College of Cardiology (1993)
Effect of C′1 esterase on vascular permeability in man: studies in normal and complement-deficient individuals and in patients with hereditary angioneurotic edema
Authors: Martin R. Klemperer, Virginia H. Donaldson, Fred S. Rosen
Journal: Journal of Clinical Investigation (1968)

When purified human C'1 esterase is injected intradermally in man, increased vascular permeability results. This effect is not blocked by soybean trypsin inhibitor and is not abolished by pretreatment with the antihistamine, pyribenzamine, or by compound 48/80. Thus, the effect is not due to the release of endogenous histamine. The decreased permeability response of individuals with a specific hereditary deficiency of C'2 is evidence for the complement-dependent nature of this reaction. The apparently normal response to intradermal C'1 esterase developed by individuals with an acquired specific deficiency of C'3 suggests that the vasoactive substance may be derived from one of the early reacting complement components. Characteristic attacks of angioedema have been provoked by the intradermal injection of human C'1 esterase in two individuals with hereditary angioneurotic edema. Patients with hereditary angioneurotic edema are unresponsive to intradermal injections of C'1 esterase immediately after attacks.
American Medical Association fights pharmacists who won't dispense contraceptives
Authors: Janice Hopkins Tanne
Journal: BMJ (2005)

A battle is looming in the United States between doctors and the pharmacists who refuse to fill prescriptions for emergency contraception, birth control pills, and other drugs on grounds of conscience. “The [American Medical Association] has called for a meeting with pharmacists and others to get a national consensus about how this problem is to be handled,” Peter Carmel, a paediatric neurosurgeon at the University of Medicine and Dentistry of New Jersey and a trustee of the association, told the BMJ .

“This is a problem of some urgency. We …
FDG PET-CT Findings in Epiploic Appendagitis
Authors: Nilendu C. Purandare, Sumeet Dua, Sneha Shah, Khushboo Gupta, Anshu Rajnish Sharma, Venkatesh Rangarajan
Journal: Clinical Nuclear Medicine (2009)

Positron emission tomography (PET) using flourodeoxyglucose (FDG) is routinely used for initial staging and restaging of colorectal cancers. However FDG PET studies can suffer from false-positive tracer uptake due to a variety of physiological and inflammatory conditions arising in the abdomen and pelvis. Epiploic appendagitis is one such condition that can give rise to increased glucose concentration on a FDG PET study. We describe the etiology, clinical presentation, computerized tomography scan and FDG PET-computed tomography findings of this unusual inflammatory condition in an operated case of colorectal cancer.
Intimate Partner Violence Against Women
Authors: Angela J. Taft, Kelsey L. Hegarty
Journal: JAMA (2010)

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Nutrition During Pregnancy: Part I, Weight Gain; Part II, Nutrient Supplements
Authors: Barbara Luke
Journal: JAMA (1991)

Twenty years ago, the Food and Nutrition Board issued its landmark report,<i>Maternal Nutrition and the Course and Outcome of Pregnancy</i>. Since that time, both the amount and sophistication of research in maternal nutrition have grown rapidly and have provided clear evidence of the link between perinatal nutrition and pregnacy outcome. During these same years, national attention has turned away from high-technology solutions to the problems of low birth weight and preterm delivery and has focused on the potential therapeutic effects of traditional modalities such as nutrition. The emergence of maternal nutrition as a pivotal factor in the outcome of pregnancy has recently been underscored by the recognition of its central role in the prevention of prenatal mental retardation in patients with maternal phenylketonuria and its potential effect in the prevention of neural tube defects. This latest National Academy of Sciences report provides a balanced and indepth presentation of research
P273 Asthma: Is It as Predictable as the Seasons?
Authors: DH Thakker, P Cullinan, R Hubbard, CJ Smith, SJ MacNeill
Journal: Thorax (2012)

<h3>Background</h3> Current literature shows a distinct peak in asthma exacerbations in September among children, attributing it in part to their return to school and the spread of viral agents accompanying this. There is comparatively little recent research into the trends in adults, however. This study examines seasonal variations in asthma exacerbations in a population of adults with asthma from the community. <h3>Methods</h3> The study population was identified from The Health Improvement Network database of anonymised GP records. Patients were between 16–40 years and had a prescription for asthma treatment during a qualification window of 1998–2000. Current analyses are restricted to patients with at least 5 years of data available pre-qualification. In this instance we defined exacerbations as acute oral prednisolone prescriptions. The daily total number of exacerbations was calculated from 01-01-1999 to 31-12-2003. To explore the potential relationship between exacerbations and co-morbidities, we also explored antibiotic and antiviral prescriptions as well as treatments for seasonal allergic rhinitis in this cohort. <h3>Results</h3> 38,439 patients with current asthma were identified. Prednisolone exacerbations decreased from the beginning of the year until summer, at which point there was a peak in June (Figure: solid line). They then increased in autumn peaking at the end of October, then increasing throughout winter. During the summer there was a similar peak observed in both prednisolone exacerbations and seasonal allergic rhinitis prescriptions in this cohort. From September through to May the trends observed in prednisolone exacerbations were similar to those seen in antiviral and antibiotic prescriptions. <h3>Conclusions</h3> Within the seasonal trends observed, there appears to be some correlation between the summer peak in exacerbations and seasonal allergic rhinitis prescriptions. There are also similarities seen in exacerbations during the beginning and end of the year and antibiotic and antiviral prescriptions. These findings suggest that infections and seasonal allergic rhinitis might be drivers for asthma exacerbations in adults.