tbuckley/cabot-search huggingface dataset:
P1-10-04: Cost-Utility of the 21-Gene Breast Cancer Assay (Oncotype DX®) in the Irish Healthcare Setting.
Authors: L Lacey, R Chien, J Hornberger
Journal: Cancer Research (2011)

Abstract Objective: The Oncotype DX® Breast Cancer Test is a validated 21-gene assay that predicts the likelihood of benefit from adjuvant chemotherapy in early-stage, node-negative and up to 3-node-positive, ER+ breast cancer as well as the likelihood of distant recurrence at 10-years. Study objective was to investigate the cost-utility (incremental cost per QALY gained) of using Oncotype DX® in early stage, node-negative, ER+ breast cancer patients, from the perspective of the Irish Healthcare system. Methods: A cost-utility analysis was performed over the lifetime of the patient using a state transition model (Markov), which simulated the costs and quality-adjusted survival associated with and without the use of Oncotype DX® to inform adjuvant chemotherapy decisions. The model included 3 health states: no recurrence, recurrence and death. Transition probabilities between health states, utility scores associated with each of the health state, patient cohort characteristics and impact of Oncotype DX® on chemotherapy decisions data were derived from published sources. Direct medical costs associated with chemotherapy were collected from a representative panel of 5 hospitals in Ireland. Costs and outcomes were discounted at 4% per annum and the analysis was conducted over 30 years (lifetime horizon). Probabilistic and one-way sensitivity analyses were conducted. Results: Costs associated with adjuvant chemotherapy (4 cycles of TC) included the following costs: drug (€1,002); administration and monitoring (€1,646); adverse event prevention (€3,561) and adverse event management (€756). The average total cost of chemotherapy across hospitals therefore summed up to €6,965. The base case incremental cost per QALY gained with ODX testing was estimated to be €9,462. There was a 74% chance for ODX to be cost-effective at a willingness to pay threshold of €20,000. Conclusions: Using Oncotype DX® as a decision tool to inform adjuvant chemotherapy in node-negative, ER+ breast cancer patients, is likely to be cost-effective in the Irish healthcare setting. This estimate is probably conservative as the cost and disutility associated with long-term impact of chemotherapy related adverse events (i.e. such as cardiotoxicity, secondary leukaemia and potential cognitive impairment) have not been considered. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-10-04.
Evaluation prospective de l'histoire naturelle des TIPMP des canaux secondaires non opérées et sans signe de dégénérescence
Authors: B Bournet, S Kirzin, P Otal, B Suc, N Carrere, G Portier, B Pradère, F Lazorthes, J Moreau, G Fourtanier, J Escourrou, L Buscail
Journal: Endoscopy (2008)

Introduction: Les tumeurs intracanalaires papillaires et mucineuses du pancréas ou TIPMP sont des tumeurs rares mais à potentiel dégénératif connu avec présence d'un carcinome in situ ou invasif dans 40 à 50% des cas. Le risque de dégénérescence est moindre en cas d'atteinte isolée des canaux secondaires par rapport aux formes atteignant le canal principal ou les formes mixtes. Le but de cette étude était de suivre à long terme l'évolution des patients atteint de TIPMP portant sur un canal secondaire et non opérées afin d'évaluer le devenir morphologique et symptomatique.
Exacerbation of Hypercalcemia after Needle Biopsy of a Parathyroid Cyst
Authors: Akira Kobayashi, Kanji Kuma, Fumio Matsuzuka, Masahiro Sugawara
Journal: Annals of Internal Medicine (1989)

Letters and Corrections15 February 1989Exacerbation of Hypercalcemia after Needle Biopsy of a Parathyroid CystAkira Kobayashi, MD, Kanji Kuma, MD, Fumio Matsuzuka, MD, Masahiro Sugawara, MDAkira Kobayashi, MDSearch for more papers by this author, Kanji Kuma, MDSearch for more papers by this author, Fumio Matsuzuka, MDSearch for more papers by this author, Masahiro Sugawara, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-4-326 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The parathyroid cyst or cystic parathyroid adenoma is a rare cause of primary hyperparathyroidism (1-5). We report a case of primary hyperparathyroidism caused by cystic parathyroid adenoma in a patient who developed hypercalcemic crisis after a fine-needle aspiration biopsy of the cyst. This fineneedle aspiration biopsy introduced a new complication, the exacerbation of hypercalcemia.A 57-year-old man visited us because of weight loss. Physical examination showed a 3.5 X 2.0-cm firm mass in the left lower neck. A fine-needle aspiration biopsy of the neck mass was done using a 22-gauge needle, and approximately 9 mL of colorless,...References1. AlbertsonMarshallJarman DRW. Hypercalcemic crisis secondary to a functioning parathyroid cyst. Am J Surg. 1981;141:175-77. CrossrefMedlineGoogle Scholar2. NaruseKoiekeAriyoshi TAH. Huge cystic parathyroid adenoma with hypercalcemic crisis: a case report. Hormn To Rinsho (Japan). 1982;30:53-6. MedlineGoogle Scholar3. FerraraHazellParkerRutland BSTE. Parathyroid cyst. South Med J. 1985;78:528-32. CrossrefMedlineGoogle Scholar4. PaciniAntonelliaGasperiniBaschieriPinchera FALLA. Unsuspected parathyroid cysts diagnosed by measurement of thyroglobulin and parathyroid hormone concentration in fluid aspirates. Ann Intern Med. 1985;102:793-4. LinkGoogle Scholar5. Ramos-GabatinMalletteBringhurstDraper ALFM. Functional mediastinal parathyroid cyst: dynamics of parathyroid hormone secretion during cyst aspirations and surgery. Am J Med. 1985;79:633-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTwo Cases of Non-functional Parathyroid CystsCystic Parathyroid LesionsA CASE OF INTRATHYROIDAL PARATHYROID CYST IN A PATIENT WITH SCHIZOPHRENIAA CASE OF PRIMARY HYPERPARATHYROIDISM OF HYPERPLASIA WITH CYSTIC CHANGE 15 February 1989Volume 110, Issue 4Page: 326-327KeywordsBiopsyHypercalcemiaHyperparathyroidismParathyroidParathyroid tumorsWeight loss Issue Published: 15 February 1989 PDF downloadLoading ...
Psychiatric Consultations in a Children's Hospital
Authors: EDWARD P. MONNELLY, BENJAMIN M. IANZITO, MARK A. STEWART
Journal: American Journal of Psychiatry (1973)

The psychiatric consultations done in a children's hospital over an 11-month period were analyzed. Major reasons for referral included a symptom of unknown etiology (possibly psychosomatic), suspected depression, and behavior problems on the ward. Hysteria was the most common psychiatric disorder found on consultation; one-third of the girls had this diagnosis. The other most frequent diagnoses were hyperactive child syndrome, depression, and organic brain syndrome.
Freeze-dried poly(d,l-lactic acid) macroporous guidance scaffolds impregnated with brain-derived neurotrophic factor in the transected adult rat thoracic spinal cord
Authors: Carla M. Patist, Mascha Borgerhoff Mulder, Sandrine E. Gautier, Véronique Maquet, Robert Jérôme, Martin Oudega
Journal: Biomaterials (2003)
TERMINAL QRS DISTORTION ON PREHOSPITAL ECG AFFECTS THE IMPACT OF SYMPTOM-TO-BALLOON TIME ON SALVAGE IN STEMI PATIENTS TREATED WITH PRIMARY PCI
Authors: Michael Ringborn, Yochai Birnbaum, Søren Steen Nielsen, Olle Pahlm, Galen S. Wagner, Christian Juhl Terkelsen, Pyotr G. Platonov
Journal: Journal of the American College of Cardiology (2013)
Health-related quality of life among dialysis patients on three continents: The Dialysis Outcomes and Practice Patterns Study
Authors: Shunichi Fukuhara, Antonio Alberto Lopes, Jennifer L. Bragg-Gresham, Kiyoshi Kurokawa, Donna L. Mapes, Tadao Akizawa, Jürgen Bommer, Bernard J. Canaud, Friedrich K. Port, Philip J. Held, None for the Worldwide Dopps
Journal: Kidney International (2003)
Effects of calcitonin gene-related peptide on normal and atheromatous vessels and on resistance vessels in the coronary circulation in humans.
Authors: P F Ludman, A Maseri, P Clark, G J Davies
Journal: Circulation (1991)

BACKGROUND Calcitonin gene-related peptide (CGRP) is a potent dilator of normal epicardial coronary vessels in humans, but its effects on myocardial blood flow and atheromatous coronary vessel diameter are unknown. METHODS AND RESULTS Seven patients were entered for study of the effects of CGRP on coronary blood flow and 13 for the comparison of its effects on normal and atheromatous coronary arteries. In the first seven patients, left anterior descending artery (LAD) diameter at an angiographically normal site, coronary sinus oxygen saturation (CSO2S), systemic blood pressure, and heart rate were measured during intracoronary infusion of increasing concentrations of CGRP (up to 200 ng/ml at 2 ml/min) followed by intracoronary adenosine (0.267 micrograms/ml at 2 ml/min) and finally intracoronary glyceryl trinitrate (GTN) (5 micrograms/ml at 2 ml/min). CGRP dilated the normal segment of the LAD by 22.6 +/- 8% (mean +/- 95% confidence interval), p less than 0.001, with only a small increase in CSO2S from 40.1 +/- 2.7% to 47.3 +/- 2.7%, p less than 0.001. Adenosine, a potent dilator of myocardial resistance vessels, caused no further increase in LAD diameter but caused a rise in CSO2S from 47.3 +/- 2.7% to 76.0 +/- 2.7%, p less than 0.001. GTN caused no further increase in LAD diameter. As heart rate-blood pressure product remained unchanged throughout the study, the increase of CSO2S indicated only a small increase in myocardial blood flow after CGRP infusion. In 13 patients with atheromatous coronary artery disease, the effects of intracoronary CGRP at angiographically normal sites, stenoses, angiographically normal sites immediately adjacent to stenoses, and sites of coronary artery wall irregularity were compared after intracoronary infusion of a single dose of CGRP (200 ng/ml at 2 ml/min) followed by intracoronary GTN (5 micrograms/ml at 2 ml/min). At these four sites, CGRP resulted in dilatation by 17.0 +/- 5.6%, 15.3 +/- 12.1% (NS), 7.6 +/- 5.4% (NS), and 15.9 +/- 7.8%, respectively. There was no significant further dilatation after GTN at any of the four sites. CONCLUSIONS These data indicate that CGRP has little effect in humans at rest on coronary resistance vessels in nonischemic myocardium but causes marked dilatation of normal arteries and variable dilatation of atheromatous epicardial arteries.
THE CLINICAL IMPORTANCE OF THE CEREBRO-SPINAL FLUID
Authors: W. Boyd
Journal: BMJ (1914)

LMTEDRIEJOIN 96rthrombosis aiA sclerosis, fdllowed.by.s;-bhilitic meningitis, but in the absence of a p)ost-rnurtein examinatioIn I admit it is at least as likely that the terminal infection was tuberculous.
Review and Control of Antimicrobial Usage in Hospitalized Patients
Authors: George W. Counts
Journal: JAMA (1977)

THE 1976 Hospital Accreditation Standards on Infection Control established by the Joint Commission on the Accreditation of Hospitals (JCAH) now requires involvement of physicians in a review of antimicrobial usage in hospitalized patients. As stated, the hospital's infection control program is to "include the regular review of the clinical usage of antibiotics." In recent years, attention has been focused on antibiotic prescribing and the magnitude of the problem of inappropriate usage of antibiotics by physicians. Several factors have contributed to the call for scrutiny of physician antibiotic-prescribing patterns. In 1970, Scheckler and Bennett<sup>1</sup>from the Center for Disease Control reported that 62% of patients receiving antibiotics in seven community hospitals had no evidence of infection. Similar findings concerning possible inappropriate use of antibiotics have been reported by others.<sup>2-4</sup>In 1974, Simmons and Stolley<sup>5</sup>presented a strongly worded commentary on physician misuse of antibiotics. They suggested that "hundreds
Heart rate and force-frequency effects on diastolic function of the left ventricle in exercising dogs.
Authors: T Miura, S Miyazaki, B D Guth, C Indolfi, J Ross
Journal: Circulation (1994)

BACKGROUND Previous studies from our laboratory have shown pronounced augmentation of the force-frequency relation on myocardial contraction during exercise, but the influence of this effect on diastole has not been investigated. METHODS AND RESULTS Accordingly, the effect of changing heart rate on left ventricular (LV) relaxation, filling dynamics, and pressure-volume relations during exercise was studied in eight conscious dogs. The exercise heart rate was slowed from 208 +/- 21 (SD) to 163 +/- 11 beats per minute by injection of a specific sinus node inhibitor (UL-FS 49, or zatebradine, 0.6 mg/kg) during continuous exercise. Heart rate was then abruptly restored to the predrug level by atrial pacing during continued exercise. LV volume was calculated by use of implanted ultrasonic crystals, and LV pressure was determine with an implanted micromanometer. Comparing conditions after pacing back to a heart rate of 210 beats per minute with those obtained when the heart rate was slowed by atrial pacing, LV dP/dtmax was increased by 27% at the higher rate (P &lt; .01), despite a marked decrease in LV end-diastolic pressure (24 +/- 4 versus 10 +/- 5 mm Hg, P &lt; .01) and the time constant of isovolumic LV pressure decay (tau) was significantly shortened (19 +/- 5 versus 14 +/- 4 milliseconds, P &lt; .01). The peak rapid filling rate in early diastole (PFR) was not significantly changed by increasing the heart rate, since it was maintained at the slower rate. During exercise, at the slowed heart rate the early portion of the diastolic pressure-volume curve was significantly shifted upward and to the right compared with that at the physiological heart rate, but the late portion of the curve was unchanged. CONCLUSIONS These data indicate that the negative inotropic effect of the force-frequency relation when heart rate was slowed during exercise caused pronounced impairment of LV relaxation and early filling dynamics. Conversely, an important component of the pronounced improvement of diastolic ventricular function during normal exercise was shown to result from exercise-induced enhancement of the positive inotropic effects of the force-frequency relation on myocardial contraction and relaxation.
The Paradox of Appropriate Care
Authors: John E. Wennberg
Journal: JAMA (1987)

A Bostonian is about twice as likely to undergo a carotid endarterectomy as a New Havenite; for coronary bypass operations the risk is the reverse.<sup>1</sup>New Haven residents experience substantially higher rates for hysterectomies and back surgery, while the rates for knee and hip replacements are much greater for Bostonians. Across a wide spectrum of common acute and chronic conditions such as back pain, gastroenteritis, pneumonia, and diabetes, the incidence of hospitalization is much greater for residents of Boston than for those of New Haven, even though the populations are very similar in demographic characteristics related to the need for care. These overall differences in utilization translate into large differences in expense to third-party insurers. For example, in 1982, the Medicare program's outlays were $2647 per enrollee for Boston residents while the average expenditure in New Haven county was $1561. As recently emphasized by Secretary of the Department of
PTU-028 First Human Series Of Magnet Assisted Capsule Endoscopy (mace) In The Upper Gi Tract Using The Novel Mirocam-navi System: Abstract PTU-028 Table 1
Authors: I Rahman, M Pioche, C Shim, I Sung, J-C Saurin, P Patel
Journal: Gut (2014)

<h3>Introduction</h3> Attempts in employing a simple technique of capsule endoscopy for visualisation of the upper GI tract has, thus far, been experimental, cumbersome and potentially expensive. We describe the first human series for comprehensive visualisation of the upper GI tract using the simple Intromedic MiroCam-Navi system. Our aim was to demonstrate the manoeuvrability of this magnetic capsule and evaluate its ability to completely visualise and maintain views in the upper GI tract. <h3>Methods</h3> 26 volunteers observed a 12 hr overnight fast. 30 mins before the examination volunteers drank a preparation mixture of 20 mg of maxalon syrup with simethicone and pronase. After capsule ingestion, volunteers were allowed sips of water during the procedure. The MiroCam-Navi magnet was placed at strategic points on the body surface and rotated to hold and manoeuvre the capsule. Control was assessed by moving and holding the capsule for 1 min to visualise each of the following stations: lower oesophagus, cardia, fundus, body, incisura, antrum and pylorus and also by traversing across the stomach and through the pylorus. Total procedure time was taken from the moment of ingestion of the capsule to either reaching the duodenum, or after attempting a maximum of 10mins to traverse the pylorus. All volunteers subsequently underwent a standard upper GI endoscopy within 3 days. <h3>Results</h3> Volunteers' median age was 38 yrs (range 26–45), median BMI 24.1 (range 19.4–38.2), median volume of water consumed 800 mls (range 200 mls–1500 mls) and median procedure time 24 min (range 12–39 min). Table 1 shows the success of clear visualisation of landmarks The capsule could be held in the lower oesophagus, cardia, fundus, body and antrum in 92%, 88%, 92%, 88% and 81% occasions respectively. The capsule could be moved from the fundus to the antrum in all cases and traverse the pylorus in 50% (n = 13). Age ≥40 was associated with successful pyloric traversing (p = 0.04). There was positive concordance for 8 out of 9 minor pathological findings with standard upper GI endoscopy. A small 4 mm submucosal lesion was missed by capsule endoscopy in the cardia of one volunteer where views were obscured. <h3>Conclusion</h3> This is the first convincing demonstration of the potential value of MACE in the upper GI tract. There is a high degree of visualisation and control, with some improvement required for optimising fundal views and traversing the pylorus. <h3>Disclosure of Interest</h3> None Declared.
Objective measurement of nasal continuous positive airway pressure use. Ethical considerations.
Authors: D F Dinges, N B Kribbs, A R Schwartz, P L Smith, A I Pack
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

"Objective measurement of nasal continuous positive airway pressure use. Ethical considerations.." American journal of respiratory and critical care medicine, 149(2), pp. 291–292
Secretory effect of azodisalicylate (azodisal sodium) on the short circuited mucosa of the rat ileum in vitro.
Authors: K J Goerg, R Wanitschke, P H Diehl, K H Meyer zum Buschenfelde
Journal: Gut (1988)

Azodisalicylate (ADS) is one of the newly developed substitutes of sulphasalazine consisting of two molecules of 5-amino-salicylic acid. Azodisalicylate caused diarrhoea in some patients, apparently caused by an antiabsorptive secretagogue action of this compound. The mechanism of this was studied in the short circuited isolated mucosa of the rat ileum. Mucosal addition of ADS increased the potential difference (PD) and short circuit current (Isc) at a concentration of 1.3.10(-4) mol/l (4 mg/dl) with maximal effects at 1.3.10(-3) mol/l (40 mg/dl). Epithelial resistance was only slightly decreased at the higher concentrations of 40 and 100 mg/dl. Serosal ADS had no effect on electrical parameters. The increase of Isc was associated with a change of net chloride absorption into net secretion. Net sodium absorption was only slightly and not significantly decreased. The changes were reversible after rinsing away the ADS. Treatment of the mucosa with furosemide inhibited the ADS induced increase of Isc, suggesting transcellular pathway for the ADS stimulated secretion. Biosynthesis of prostaglandins is not involved in the mechanism of this secretion, as treatment with indomethacin did not alter the effect of ADS on Isc. Results suggest that ADS can be considered as a secretagogue, which stimulates intestinal secretion via a transcellular pathway. Because of the bacterial cleavage of the double molecule into two molecules of the non-secretagogue 5-amino-salicylic acid in the colon, however, diarrhoea may develop only in patients with a decreased absorptive capacity of the colon, or insufficient cleavage of ADS.
Hepatocyte growth factor/hepatopoietin A is expressed in fat-storing cells from rat liver but not myofibroblast-like cells derived from fat-storing cells
Authors: Peter Schirmacher, Albert Geerts, Antonello Pietrangelo, Hans P. Dienes, Charles E. Rogler
Journal: Hepatology (1992)

Hepatocyte growth factor/hepatopoietin A is a complete mitogen for parenchymal liver cells, and its expression is increased as an early response to acute liver injury. To identify the liver cell population responsible for hepatocyte growth factor gene expression, we investigated tissue sections and isolated and purified cell fractions from normal rat liver by in situ and Northern blot hybridization. Hepatocyte growth factor transcripts were present in sinusoidal liver cells, which were preferentially located in the periportal parenchyma. Northern hybridization analysis of RNA isolated from purified liver cell fractions demonstrated that HGF messenger RNA is present only in fat-storing cells. No specific hepatocyte growth factor gene expression was detected in parenchymal cells, endothelial cells and Kupffer cells. Myofibroblast-like transition of fat-storing cells, which is linked to fibrogenesis in chronic liver disease, results in the loss of hepatocyte growth factor expression. Hepatocyte growth factor gene expression in the normal liver, a new function of fat-storing cells, suggests that this growth factor may play a role in the physiological balance between cell death and replacement in the liver and that hepatocyte growth factor may also act in a paracrine manner. Furthermore, loss of hepatocyte growth factor expression in myofibroblast-like cells derived from fat-storing cells may be responsible for reduced parenchymal cell regeneration in chronic liver disease. (Hepatology 1992;15:5-11).
Antiarrhythmic Agents During Pregnancy
Authors: Donald Coustan
Journal: JAMA (1982)

<h3>To the Editor.—</h3> In a recent QUESTIONS AND ANSWERS section (1981;245:2105), the issue of antiarrhythmic agents in pregnancy was discussed. Four "traditional" antiarrhythmic agents were recommended for use during pregnancy (quinidine, procainamide hydrochloride, propranolol hydrochloride, and phenytoin sodium). It was stated that "since they have been available for so long, any substantial teratogenicity in patients using them on a long-term basis probably would have been observed before now." Phenytoin is a well-known teratogen, with the "hydantoin syndrome" being described in human newborns. A statement issued jointly by the American Academy of Pediatrics and the American College of Obstetrics and Gynecology suggests that phenytoins be withdrawn if at all possible before pregnancy. Although women who receive them and who have a proved seizure disorder are advised to continue taking them, it would seem reasonable, for cardiac arrhythmias, to substitute another antiarrhythmic agent if possible. There are concerns about the production of