tbuckley/cabot-search huggingface dataset:
The Joint Commission Looks to the Future
Authors: Dennis S. O'Leary
Journal: JAMA (1987)

Since early in this century, the medical profession has provided firm leadership in promoting high-quality patient care in the nation's hospitals. During the past two decades, this effort has steadily spread to involve a wide spectrum of organized health care settings. In this issue of the<i>Journal</i>, Roberts and colleagues<sup>1</sup>describe the historical evolution of the Joint Commission on Accreditation of Hospitals and its role in effecting this professional mandate. While the achievements of the Joint Commission are note-worthy, there is little basis for self-satisfaction in the current health care climate. In today's altered environment for patient care, resource limitation, changing and sometimes perverse reimbursement incentives, the professional liability crisis, and increased competition for patients have led to the elevation of quality of care to the status of a major public policy issue in this country. Public and professional concerns about the potential adverse impacts of these forces on
When Is Measuring Sensitivity and Specificity Sufficient To Evaluate a Diagnostic Test, and When Do We Need Randomized Trials?
Authors: Sarah J. Lord, Les Irwig, R. John Simes
Journal: Annals of Internal Medicine (2006)

The clinical value of using a new diagnostic test depends on whether it improves patient outcomes beyond the outcomes achieved using an old diagnostic test. When can studies of diagnostic test accuracy provide sufficient information to infer clinical value, and when do clinicians need to wait for results from randomized trials? The authors argue that accuracy studies suffice if a new diagnostic test is safer or more specific than, but of similar sensitivity to, an old test. However, if a new test is more sensitive than an old test, it leads to the detection of extra cases of disease. Results from treatment trials that enrolled only patients detected by the old test may not apply to these extra cases. Clinicians need to wait for results from randomized trials assessing treatment efficacy in cases detected by the new diagnostic test, unless they can be satisfied that the new test detects the same spectrum and subtype of disease as the old test or that treatment response is similar across the spectrum of disease.
A Phase I study of NLG919 for adult patients with recurrent advanced solid tumors
Authors: Asha Nayak, Zhonglin Hao, Ramses Sadek, Nicholas Vahanian, W Ramsey, Eugene Kennedy, Mario Mautino, Charles Link, Pamela Bourbo, Robin Dobbins, Kelly Adams, Allison Diamond, Lisa Marshall, David H Munn, John Janik, Samir N Khleif
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Clinical Trial Registration Number: [NCT02048709][1] The enzyme Indoleamine 2,3-dioxygenase (IDO1) catalyzes the cleavage of L-tryptophan, resulting in the production of kynurenine. Tryptophan depletion and kynurenine metabolites enhance the number and function of Tregs (
250 Sub-cellular expression of Ape1/Ref1 in hepatocellular carcinoma at different stages: Possible prognostic significance
Authors: V. Di Maso, L.S. Crocè, C. Avellini, G. Tell, V. Del Mistro, S. Intini, E. Cattin, E. Sasso, C. Tiribelli
Journal: Journal of Hepatology (2006)
Renal tubular acidosis and autoimmune liver disease
Authors: P. L. Golding, A. S. M. Mason
Journal: Gut (1971)

Forty-two patients with autoimmune liver disease have been investigated. Renal tubular acidosis was detected in 60% of the patients with primary biliary cirrhosis, in 30% with active chronic hepatitis, and in one out of seven cases with cryptogenic cirrhosis. The presence of the defect of renal acidification was not related to the level of plasma potassium, copper, or total globulin, nor to the pattern of immunological abnormalities detected in the serum. It is suggested that autoimmune liver disease and renal tubular acidosis may be part of a systemic disorder in the pathogenesis of which immunological mechanisms are involved.
Maternal obesity, gestational weight gain, and risk of asthma and atopic disease in offspring: A study within the Danish National Birth Cohort
Authors: Maria C. Harpsøe, Saima Basit, Peter Bager, Jan Wohlfahrt, Christine Stabell Benn, Ellen A. Nøhr, Allan Linneberg, Tine Jess
Journal: Journal of Allergy and Clinical Immunology (2012)
Diagnosis and treatment of malaria in Britain.
Authors: M Molyneux, R Fox
Journal: BMJ (1993)

In the tropics malaria is a major killer, especially of young children in areas of intense transmission of Plasmodium fakiparum: there may be a million or more such deaths in Africa every year.'In parts of the world with no transmission of malaria (fig 1) returning travellers and visitors, infected elsewhere, continue to develop the illness.Twelve patients died of malaria in Britain in 1991; IO died in 1992.Of the four species of plasmodium that commonly cause human infections, one-P falciparum-is responsible for nearly all malaria deaths.The others-P vivax, P ovale, and P malariae-cause febrile illnesses that are troublesome but rarely fatal.The increased incidence of "imported" malaria in Britain since the 1970s has been due largely to a steady increase in the incidence ofPfakiparum infections (fig 2).Several factors have combined to increase the problem of imported malaria in Britain and other industrial nations: increased travel (more malaria infections); increasing resistance of Pfalcipanum,2 and recently of P vivax,3 to chemoprophylactic drugs (more infections progressing to disease); inadequate or neglected travel advice (more infections and disease); and delayed diagnosis and treatment (progression of falciparum malaria to life threatening disease).
Isolation of malignant cells from human bone marrow using a discontinuous percoll gradient
Authors: S. D. Macfarlane, G. P. Tauro, K. Rendall, J. J. Welch, H. Ekert
Journal: American Journal of Hematology (1986)

A technique for examining relatively large volumes of bone marrow for involvement by malignancy is described. The use of discontinuous Percoll gradients offers no advantage over conventional methods in the diagnosis of hematological malignancy. Its usefulness in detecting infiltration by solid tumor is uncertain. Complete exclusion of malignancy from the fraction containing hematologic stem cells in three patients raises the possibility that this technique is a useful adjunct to other methods of marrow purging before autologous marrow rescue in malignant disease.
The dead zones: oxygen-starved coastal waters.
Authors: S Joyce
Journal: Environmental Health Perspectives (2000)

After the great Mississippi River flood of 1993, the hypoxic (or low-oxygen) "dead zone" in the Gulf of Mexico more than doubled its size, reaching an all-time high of over 7,700 square miles in July of 1999. Scientists attribute the Gulf of Mexico dead zone largely to nutrient runoff from agriculture in the Mississippi River basin. During the warm months, these nutrients fuel eutrophication, or high organic production, causing large algal blooms. When the algae decay, the result is hypoxia. Reports of such hypoxic events around the world have been increasing since the mid 1960s. Eutrophication and hypoxia have resulted in mortality of bottom-dwelling life in dozens of marine ecosystems and have stressed fisheries worldwide. Some algal blooms can alter the function of coastal ecosystems or, potentially, threaten human health. Anthropogenic nutrient loading from sources such as agriculture, fossil fuel emissions, and climate events is believed to be related to the global increase in frequency, size, and duration of certain algal blooms.
Evaluation of thrombolytic and systemic effects of the novel recombinant plasminogen activator BM 06.022 compared with alteplase, anistreplase, streptokinase and urokinase in a canine model of coronary artery thrombosis
Authors: Ulrich Martin, Gisbert Sponer, Klaus Strein
Journal: Journal of the American College of Cardiology (1992)
Roentgenographic Studies in Necrotizing Fasciitis
Authors: J. Gray
Journal: JAMA (1979)

<h3>To the Editor.—</h3> Fisher et al (241:803, 1979) recently drew attention to the importance of roentgenographic studies in the diagnosis of necrotizing fasciitis. We would like to add an additional report to their series. <h3>Report of a Case.—</h3> A 78-year-old woman was admitted to the Victoria General Hospital because of dyspnea and chest discomfort. She cited a three-week history of "flu," characterized by dull pain in both hips, knees, and calves. She denied any localized pain and had had no fever or chills reported by the staff of the nursing home where she lived. The patient was not diabetic. Physical examination showed an extremely obese lady in mild respiratory distress. Pulse rate was 100 beats per minute, with a temperature of 37 °C. Pedal pulses were absent. There was notable intertrigo in both groin areas, under the breasts, and beneath the abdominal pannus. Calf and thigh measurements were equal bilaterally.
Comprehensive Textbook of Psychiatry
Authors: Frank J. Ayd
Journal: JAMA (1967)

For years there has been a need for a collation and implementation of modern psychiatric theories and therapies in a book which would be comprehensive, eclectic, and authoritative. The British have theirs in Clinical Psychiatry , by Mayer-Gross, Slater, and Roth, but this excellent book has been outdated by the advances in psychiatry and neurology in the past decade. Comprehensive Textbook of Psychiatry satisfies this need admirably. This is an encyclopedic coverage of all aspects of psychiatry, neurology, and related areas by 174 American experts. It is well-organized and remarkably well-written and edited. There are so many competent contributions that it is impossible to cite any one for special praise. Because of my particular interest in the physical methods of treatment in psychiatry, especially pharmacotherapy, I can testify that the coverage of these areas is of very high quality. From a holistic view, this tome is clear, instructive, constructively critical, and
Effects of inhaled acids on respiratory tract defense mechanisms.
Authors: R B Schlesinger
Journal: Environmental Health Perspectives (1985)

The respiratory tract is endowed with an interlocking array of nonspecific and specific defense mechanisms which protect it from the effects of inhaled microbes and toxicants, and reduce the risk of absorption of materials into the bloodstream, with subsequent systemic translocation. Ambient acids may compromise these defenses, perhaps providing a link between exposure and development of chronic and acute pulmonary disease. This paper reviews the effects of inhaled acids upon the nonspecific clearance system of the lungs.
Intrathecal Chloramphenicol in Staphylococcal Meningitis Resistant to Penicillin and Streptomycin
Authors: K. F. Anderson, F. G. Ellis
Journal: BMJ (1951)

Chloramphenicol, an antibiotic first isolated from Streptomyces venezuelae (Ehrlich et al., 1948), has recently been prepared synthetically (Olive, 1949).It is a crystalline chemical substance with a wide therapeutic range.It is soluble in water to a concentration of 2.5 mg. per ml. at 250 C., and solutions withstand boiling for five hours without measurable loss of potency.The antibiotic shows considerably more activity against Gram-negative organisms than against Gram-positive and acid-fast species.It is seven to thirty times as active as penicillin against tested Gram-negative species, but much less active against
1163 EDA-STREPTAVIDIN FUSION PROTEIN CONJUGATED TO BIOTINYLATED HCV-NS3 PROTEIN INDUCES STRONG T CELL IMMUNE RESPONSES AGAINST NS3
Authors: L. Arribillaga, M. Martinez, L. Villanueva, M. Gorraiz, M. Durantez, F. Rudilla, N. Casares, T. Lozano, B.-C. Francisco, P. Sarobe, J. Prieto, J. Lasarte
Journal: Journal of Hepatology (2013)
When Throughout the Year Is Coronary Death Most Likely to Occur?
Authors: Robert A. Kloner, W. Kenneth Poole, Rebecca L. Perritt
Journal: Circulation (1999)

Previous studies have suggested that there is an increase in cardiac events in the morning. Fewer data relate cardiac events to months of the year and season.We analyzed all monthly death certificate data from Los Angeles County, California, for death caused by coronary artery disease from 1985 through 1996 (n=222 265). The mean number of deaths was highest in December at 1808 and January at 1925; the lowest rates were in June, July, August, and September at 1402, 1424, 1418, and 1371, respectively. December and January had significantly higher rates than would be expected from a uniform distribution of monthly deaths (P=0.00001). The percent of yearly coronary deaths was defined by the quadratic U-shaped equation [percent=13.1198-1.5238(month)+0. 0952(month(2)), where January=1, February=2, etc]. When monthly deaths were plotted by year, there was a decrease from 1985 through 1996. Monthly mortality correlated inversely with temperature. During the months with the highest frequency of death (December, January), however, there was an increase in deaths that peaked around the holiday season and then fell, which could not be explained solely on the basis of the daily temperature change.Even in the mild climate of Los Angeles County, there are seasonal variations in the development of coronary artery death, with approximately 33% more deaths occurring in December and January than in June through September. Although cooler temperatures may play a role, other factors such as overindulgence or the stress of the holidays might also contribute to excess deaths during these peak times.
A multiparameter panel method for outcome prediction following aneurysmal subarachnoid hemorrhage
Authors: Natacha Turck, Laszlo Vutskits, Paola Sanchez-Pena, Xavier Robin, Alexandre Hainard, Marianne Gex-Fabry, Catherine Fouda, Hadiji Bassem, Markus Mueller, Frédérique Lisacek, Louis Puybasset, Jean-Charles Sanchez
Journal: Intensive Care Medicine (2009)
Podocyte protection by darbepoetin: preservation of the cytoskeleton and nephrin expression
Authors: N. Eto, T. Wada, R. Inagi, H. Takano, A. Shimizu, H. Kato, H. Kurihara, H. Kawachi, S.J. Shankland, T. Fujita, M. Nangaku
Journal: Kidney International (2007)
Prospectively Randomized Evaluation of Stented Xenograft Hemodynamic Function in the Aortic Position
Authors: Thomas Walther, Sven Lehmann, Volkmar Falk, Sebastian Metz, Nicolas Doll, Ardawan Rastan, Marika Viehweg, Markus Richter, Jan Gummert, Friedrich W. Mohr
Journal: Circulation (2004)

Standard stented aortic xenograft valves have not yet been compared regarding their hemodynamic function using a stratified intraoperative randomization protocol.100 patients were prospectively included after intraoperative metric sizing of the decalcified aortic annulus. They received Mosaic (M) or Perimount (P) aortic valve replacement. Patient age was 73+/-5 years, 51 were female, and New York Heart Association (NYHA) functional class was 2.8+/-0.5. The 21-mm annulus group consisted of 5 (M)/7 (P) patients, the 23-mm annulus group of 20 (M)/20 (P), the 25-mm annulus group of 18 (M)/19 (P), and the 27-mm annulus group of 4 (M)/7 (P) patients, respectively. Hemodynamic function was evaluated using transthoracic echocardiography before discharge and at follow-up (438+/-352 days). Surgery was uncomplicated in all patients. Labeled valve sizes were 0.93 (M) and 1.05 (P) mm smaller than the annulus diameters (p=NS). In-hospital mortality was 5%, all nonvalve-related. Transvalvular blood flow velocities and transvalvular pressure gradients were significantly lower in the 25 P versus the 25 M group at baseline and in the 23 P and 25 P groups at follow-up. There was a significant regression of left ventricular mass index in all patients at follow-up. However, left ventricular mass regression was more pronounced after P aortic valve replacement.Labeled sizes of prosthetic heart valves implanted are smaller than the true aortic annulus. Both standard aortic xenografts compared in this prospectively randomized trial provide a sufficient hemodynamic and functional outcome.
ON THE CHARACTER OF THE EVIDENCE AS TO THE INJURIOUSNESS OF ARSENIC AS A DOMESTIC POISON.Read in the Section of Practice of Medicine and Physiology, at the Forty-second Annual Meeting of the American Medical Association, held at Washington, D. C., May 5-8, 1891.
Authors: JAMES J. PUTNAM
Journal: JAMA (1891)

This communication is an attempt to place in as clear a light as possible, the credibility of the evidence that symptoms of arsenical poison may occur as a result of the ordinary exposures, such as are met with in domestic or civic life. I shall not try to indicate the frequency with, which such poisoning occurs, but only the possibility that it may occur; for the question as to frequency can only be satisfactorily answered when a large body of facts have been accumulated, especially those relating to the obscurer forms of chronic poisoning. The first thing to be done, would seem to be to disprove the opinion which has so much weight, even among those who would otherwise credit the evidence of domestic poisoning, that not enough arsenic could possibly reach the tissues to cause serious effects. For this purpose I shall show: first, that urine analyses indicate beyond
Men, muscles, and body image: comparisons of competitive bodybuilders, weight trainers, and athletically active controls
Authors: T C Pickett, R J Lewis, T F Cash
Journal: British Journal of Sports Medicine (2005)

To investigate body image and psychosocial adjustment among competitive bodybuilders, non-competitive weight trainers, and athletically active men.Participants were 40 men in each of the three groups who were assessed on body composition and multiple facets of body image evaluation, investment and anxiety, eating attitudes, and social self esteem.Relative to the other two groups, competitive bodybuilders had greater body mass due to fat-free body mass. Although groups did not differ in their situational body image discomfort, competitive bodybuilders and weight trainers had a more positive global appearance evaluation and were more psychologically invested in their physical appearance. Compared with active controls, men in both weightlifting groups were more satisfied with their upper torso and muscle tone. Competitive bodybuilders reported more mid torso satisfaction than the other two groups. Competitive bodybuilders also wished to be significantly heavier than controls did and reported higher social self esteem but greater eating disturbance.The findings suggest that competitive bodybuilders as a group are not more "muscle dysmorphic" than either non-competitive weight trainers or physically active men who do not train with weights.
Hepatic Iron Overload and Hepatocellular Carcinoma
Authors: Michael C. Kew
Journal: Liver Cancer (2014)

In recent years it has become increasingly evident that excess body iron may be complicated by the supervention of hepatocellular carcinoma (HCC). Hereditary hemochromatosis (HH) was the first condition in which hepatic iron overload was shown to predispose to the development of HCC. The inherited predisposition to excessive absorption of dietary iron in HH is almost always the result of homozygosity of the C282Y mutation of the HFE gene, which causes inappropriately low secretion of hepcidin. HCC develops in 8-10% of patients with HH and is responsible for approximately 45% of deaths in the HCC patients. Cirrhosis is almost always present when HCC is diagnosed. Dietary iron overload is a condition which occurs in rural-dwelling Black Africans in southern Africa as a result of the consumption, over time, of large volumes of alcohol home-brewed in iron containers and having, as a consequence, a high iron content. Iron loading of the liver results and may be complicated by malignant transformation of the liver (relative risk of approximately 10.0). Accompanying cirrhosis does occur but is less common than that in HH. The development of HCC as a consequence of increased dietary iron, and the fact that it may develop in the absence of cirrhosis, has been confirmed in an animal model. Drinking water with a high iron content might contribute to the high incidence of HCC in parts of Taiwan. The metabolic syndrome [obesity, insulin resistance type 2 (or diabetes mellitus type 2), non-alcoholic fatty liver or non-alcoholic steatohepatitis] has in recent years become a major public health problem in some resource-rich countries. A link between excess body iron and insulin resistance or the metabolic syndrome has become apparent. The metabolic syndrome may be complicated by the supervention of HCC, and recent evidence suggests that increased body iron may contribute to this complication.
Single-Dose Amoxicillin Therapy for Urinary Tract Infection
Authors: Howard Rubinoff
Journal: JAMA (1981)

<h3>To the Editor.—</h3> Regarding the recent article by Rubin and associates (1980;244:561), "Single-Dose Amoxicillin Therapy for Urinary Tract Infection: Multicenter Trial Using Antibody-Coated Bacteria Localization Technique," I agree fully with these authors on the effectiveness of single-dose therapy for uncomplicated urinary tract infection (UTI). I wonder, however, if the article does not overemphasize the positive fluorescent antibody (FAB) test results. First, the chance of a false-positive test with a lower UTI may be frequent.<sup>1</sup>Second, in my experience, even in patients with asymptomatic bacteriuria, the test result may change from positive to negative over a couple of weeks and back again, even though the same organism is grown in the urine. I would agree with Whitworth and Fairley<sup>2</sup>that "recurrent urinary-tract infection may not always involve the same site even in a single episode of infection, and we consider the clinical value of such tests in an
Conclusions about why doctors change their practice were not supported by the data
Authors: R. M Poses
Journal: BMJ (1997)

Rationing health careAllocating resources only to treating present dangers would ruin preventive health care and jeopardise future livesEditor-In his article on the objectives of the NHS John Harris argues that "there is a good principle that real and present dangers should be met before future and speculative ones." 1 Has he really thought about the implications of this?Immunisation, health promotion, and preventive interventions would all be swept away in favour of curative treatments.As the lives lost by such a shift in resources would be future lives and the people not identifiable beforehand, they would count for nothing.The state's obligation to protect the "citizen against threats to her life and liberty" only applies to immediate threats.Harris argues that the health budget should be larger, as if a larger budget will somehow allocate itself and obviate the need for choosing between competing alternatives.He also claims that health care (and he means curative care) should be afforded a high priority in the state budget.This presents a simple dilemma: should the state spend more on raising the income of impoverished families or on resources to provide more intensive care beds?Since raising the income of poor families has no impact on immediate threats to health, according to Harris we must clearly prefer spending more on providing more intensive care beds.Harris fails to recognise the first problem in identifying healthcare needs.If resources are not the immediate constraint on a healthcare system then rationing takes place on the basis of whether a need (or a want) can be legitimised as a healthcare need.In times of plenty the remit of formal health care expands.Harris seems to desire this process to continue.In wishing for more of our labour to be devoted to financing this end, he can see no cost or opportunity cost to the process.Am I alone in finding this naive?
Tumor-Infiltrating Foxp3+ Regulatory T Cells are Correlated with Cyclooxygenase-2 Expression and are Associated with Recurrence in Resected Non-small Cell Lung Cancer
Authors: Katsuhiko Shimizu, Masao Nakata, Yuji Hirami, Takuro Yukawa, Ai Maeda, Kazuo Tanemoto
Journal: Journal of Thoracic Oncology (2010)