tbuckley/cabot-search huggingface dataset:
Risk Factors for Coronary Artery Disease in Healthy Persons with Hyperinsulinemia and Normal Glucose Tolerance
Authors: I Zavaroni, E Bonora, M Pagliara, E Dall'Aglio, L Luchetti, G Buonanno, P A Bonati, M Bergonzani, L Gnudi, M Passeri
Journal: New England Journal of Medicine (1989)

We studied the relation of serum insulin levels to plasma lipid levels and blood pressure in two groups drawn from among 247 healthy, normotensive nonobese subjects with normal glucose tolerance. One group of 32 subjects was defined as having hyperinsulinemia (serum insulin, greater than 2 SD above the mean) and then compared with 32 normoinsulinemic subjects (serum insulin within 1 SD of the mean) matched for age (mean, 39 years), sex (22 men and 10 women), and body-mass index (24.7). The two groups had similar patterns of smoking, drinking, and physical exercise. Plasma glucose levels after an oral glucose challenge were significantly higher (P less than 0.05) in the hyperinsulinemic group. In addition, the mean (+/- SEM) fasting plasma triglyceride levels in subjects with hyperinsulinemia were significantly higher (1.73 +/- 0.2 vs. 1.24 +/- 0.1 mmol per liter) and the plasma high-density lipoprotein cholesterol concentrations were lower (1.21 +/- 0.06 vs. 1.43 +/- 0.06 mmol per liter) than in subjects with normoinsulinemia. Both systolic (126 vs. 119 mm Hg; P less than 0.05) and diastolic (85 vs. 78 mm Hg; P less than 0.01) blood pressures were significantly elevated in the group with hyperinsulinemia. We conclude that healthy persons with hyperinsulinemia and normal glucose tolerance have an increase in risk factors for coronary artery disease, as compared with a well-matched group of healthy subjects with normal insulin levels.
Managed care: Disease management
Authors: D. J Hunter, G. Fairfield
Journal: BMJ (1997)

The disease management approach to patient care seeks to coordinate resources across the healthcare delivery system. The growing interest in evidence based medicine and outcomes, and a commitment to integrated care across the primary, secondary, and community care sectors, all contribute to making disease management an attractive idea. A combination of patient education, provider use of practice guidelines, appropriate consultation, and supplies of drugs and ancillary services all come together in the disease management process. But its effectiveness is largely untested, so evaluation is essential.
Estrogen Receptor Assay in the Differential Diagnosis of Adenocarcinomas
Authors: David T. Kiang
Journal: JAMA (1977)

Estrogen receptor determination by the sucrose gradient method was applied to 295 tumor tissues of various origins. Estrogen receptor of the 8 S type was found only in adenocarcinoma of the breast, uterus, and ovary. Of 19 patients with metastatic carcinoma of unknown origin, four benefited from estrogen receptor study (ie, appropriate therapy could be initiated) and one was helped retrospectively on the clinical diagnosis. Estrogen receptor assays may also be useful in determining whether bilateral breast involvement represents two primary lesions or metastasis. Estrogen receptor studies should be included in evaluating cancers of unknown origin in female patients. (<i>JAMA</i>238:32-34, 1977)
Aminocaproic acid. Use in control of hemorrhage in patients with amegakaryocytic thrombocytopenia
Authors: F. H. Gardner
Journal: JAMA (1980)

The bleeding complications of some forms of thrombocytopenia are difficult to control. Many patients become refractory to platelet transfusions even when HLA-matched. We have successfully used aminocaproic acid to control bleeding in 13 patients with amegakaryocytic thrombocytopenia. Four patients receiving long-term therapy with this drug had striking reductions in the number of platelet transfusions required for capillary bleeding. No adverse effects have been noted save for orthostatic hypotension, which is ameliorated by a reduction in dosage. Quantitative platelet function changes have been impossible to demonstrate, but no changes were noted in four patients with normal platelet counts who were receiving high-dose aminocaproic acid for treatment of subarachnoid hemorrhage. Aminocaproic acid has proved to be a valuable agent in the management of patients with amegakaryocytic thrombocytopenia, especially in decreasing the need for platelet transfusions.
212 Management of digestive bleeding related to portal hypertension in cirrhotic subjects: Impact of the paris consensus statement
Authors: C. Charpigno, F. Oberti, P. Bernard, E. Bartoli, A. Pauwels, P. Renard, J.E. Cadranel, B. Bernard Chabert, J.C. Barbare, I. Ingrand, P. Ingrand, M. Beauchant
Journal: Journal of Hepatology (2006)
No Longer Patient: Feminist Ethics and Health Care
Authors: Bruce D. Weinstein
Journal: JAMA (1992)

Is paternalism justified? Who ought to control access to new reproductive technologies? What position should the good society take on the issue of abortion? These issues have been the staple of the medical ethics literature for the past twenty years. Susan Sherwin's book makes an important addition to this literature by using a feminist perspective to consider them. The book is divided into three parts, which reflect the task Sherwin takes to be essential to a feminist approach to bioethics. The first provides a theoretical framework for considering ethical problems in health care. Here the author explains what feminism is, the relationship between ethics as traditionally understood and feminist ethics, and what a feminist ethics of health care might be like. The second part explores four traditional problems in health care ethics: abortion, new reproductive technologies, paternalism, and research. The third part expands the bioethics landscape by presenting three issues
The Aggravation of Dementia by Pilocarpine
Authors: F. T. Fraunfelder, Ron Morgan
Journal: JAMA (1994)

<h3>To the Editor.</h3> —It has been previously reported that topical ocular pilocarpine may induce or aggravate dementia of the Alzheimer type. Patients experience memory loss, hallucinations, lability of affect, confusion, and agitation possibly attributable to an effect of pilocarpine on the central nervous system.<sup>1</sup>The National Registry of Drug-Induced Ocular Side Effects (Casey Eye Institute, Oregon Health Sciences University, Portland) has received eight reports (Table) along with four additional unsubstantiated cases from the World Health Organization Collaborating Centre for International Drug Monitoring (Uppsala, Sweden) of altering of mental status associated with topical ocular pilocarpine. Topical ocular pilocarpine in dosages from 1% to 6% administered two to four times daily was associated with confusion, difficulty of cognitive tasks, and/or bizarre behavior usually occurring within 1 to 3 days after starting the medication. In all cases, recovery occurred or the patients significantly improved when topical ocular pilocarpine was discontinued. For example,
Increased Vertebral Artery Tortuosity Index Is Associated With Adverse Outcomes in Children and Young Adults With Connective Tissue Disorders
Authors: Shaine A. Morris, Darren B. Orbach, Tal Geva, Michael N. Singh, Kimberlee Gauvreau, Ronald V. Lacro
Journal: Circulation (2011)

Arterial tortuosity is described as a common and distinctive feature of Loeys-Dietz syndrome (LDS), yet reports on arterial tortuosity are based on qualitative observations and none have investigated an association between tortuosity and cardiovascular outcomes in LDS or other connective tissue disorders.We performed a retrospective analysis of 90 patients ≤50 years of age with Marfan syndrome, LDS, Ehlers-Danlos syndrome, or nonspecific connective tissue disorder who underwent thoracic contrast-enhanced magnetic resonance angiography. Controls (n=30) underwent magnetic resonance imaging to exclude arrhythmogenic right ventricular dysplasia. Using a volume-rendered angiogram, vertebral arteries were measured along the curvature of the vessel (actual length) and linearly (straight length), and distance factor was calculated: [(actual/straight length-1)×100]. Each subject's maximum distance factor was designated the Vertebral Tortuosity Index (VTI). The VTI was compared among diagnostic groups and among patients with cardiac surgery, dissection, and death. Median age at magnetic resonance imaging was 19.6 years (range 0.2 to 50.1). VTI interrater reliability was excellent (intraclass correlation coefficient =0.987). The VTI was higher in Marfan syndrome (n=57, median 26; interquartile range 10 to 49) and LDS (n=13, median 58; interquartile range 18 to 92) compared with controls (median 4.5; interquartile range 3 to 6; P<0.001 for both). Higher VTI was associated with younger age at surgery even when controlling for root size (adjusted P=0.002). Vertebral tortuosity index ≥50 was associated with earlier age at dissection and death compared with VTI <50 (P=0.001 versus P<0.001). We found no difference in age at surgery, dissection, or death in Marfan syndrome compared with LDS.Arterial tortuosity measured by magnetic resonance angiography is a reproducible marker of adverse cardiovascular outcomes in connective tissue disorders.
Eighteen month follow up of Helicobacter pylori positive children treated with amoxycillin and tinidazole.
Authors: G Oderda, D Vaira, C Ainley, J Holton, J Osborn, F Altare, N Ansaldi
Journal: Gut (1992)

Sixty three children with dyspepsia (mean age 12 years, range one to 18, M/F 41/22) were Helicobacter pylori positive by histology of gastric antral biopsy specimens and were treated with a six week course of amoxycillin (50 mg/kg) and tinidazole (20 mg/kg). The endoscopic diagnoses were: normal (16), nodular gastritis (19), oesophagitis (four), duodenal ulcer (13), and gastric ulcer (11). H pylori was eradicated in 54 (87%) and histological gastritis resolved in 51 and was improved in the other three. Repeat investigation was offered at six monthly intervals. Reinfection was found in three of 34 (9%) at six months, in none of 22 at 12 months, and in two of 18 (11%) at 18 months, yielding an 18 month cumulative relapse rate of 20%. Children with persisting infection despite treatment remained positive during follow up. Serum H pylori IgG concentrations fell after treatment (p &lt; 0.001), and for individual children during follow up there was a progressive decline, but an increased concentration indicated recurrence. After eradication of H pylori by combined amoxycillin and tinidazole treatment, only a minority of children relapse during the ensuing 18 months.
A Rare Case of Non–Small Cell Lung Cancer Metastasizing to the Pituitary Gland
Authors: Krishan Kant Agarwal, Punit Sharma, Suhas Singla, Sudhir Suman KC, Chandrasekhar Bal, Rakesh Kumar
Journal: Clinical Nuclear Medicine (2013)

Metastases to the pituitary gland are rare. We here present a case of a 52-year-old man with non-small cell lung cancer where pituitary metastasis was detected on staging F-FDG PET-CT, characterized with MRI and confirmed at histopathology. By demonstrating such rare site of metastasis, F-FDG PET-CT can have significant impact on management of cancer patients.
5-fluorouracil induces vasoconstriction of vascular smooth muscle in vitro: Evidence that vasospasm is the basis for cardiovascular and cerebrovascular ischemic complications of 5-fluorouracil
Authors: Morris Mosseri, Howard Fingert, Saurabh K. Chokshi, Dov Gal, Jeffrey M. Isner
Journal: Journal of the American College of Cardiology (1991)
Nomogram to Predict Postoperative Readmission in Patients Who Undergo General Surgery
Authors: Sarah E. Tevis, Sharon M. Weber, K. Craig Kent, Gregory D. Kennedy
Journal: JAMA Surgery (2015)

The Centers for Medicare and Medicaid Services have implemented penalties for hospitals with above-average readmission rates under the Hospital Readmissions Reductions Program. These changes will likely be extended to affect postoperative readmissions in the future.To identify variables that place patients at risk for readmission, develop a predictive nomogram, and validate this nomogram.Retrospective review and prospective validation of a predictive nomogram. A predictive nomogram was developed with the linear predictor method using the American College of Surgeons National Surgical Quality Improvement Program database paired with institutional billing data for patients who underwent nonemergent inpatient general surgery procedures. The nomogram was developed from August 1, 2006, through December 31, 2011, in 2799 patients and prospectively validated from November 1, 2013, through December 19, 2013, in 255 patients at a single academic institution. Area under the curve and positive and negative predictive values were calculated.The outcome of interest was readmission within 30 days of discharge following an index hospitalization for a surgical procedure.Bleeding disorder (odds ratio, 2.549; 95% CI, 1.464-4.440), long operative time (odds ratio, 1.601; 95% CI, 1.186-2.160), in-hospital complications (odds ratio, 16.273; 95% CI, 12.028-22.016), dependent functional status, and the need for a higher level of care at discharge (odds ratio, 1.937; 95% CI, 1.176-3.190) were independently associated with readmission. The nomogram accurately predicted readmission (C statistic = 0.756) in a prospective evaluation. The negative predictive value was 97.9% in the prospective validation, while the positive predictive value was 11.1%.Development of an online calculator using this predictive model will allow us to identify patients who are at high risk for readmission at the time of discharge. Patients with increased risk may benefit from more intensive postoperative follow-up in the outpatient setting.
Abstract P1-14-04: Long- term outcome after neoadjuvant radiochemotherapy in locally advanced non-inflammatory breast cancer and predictive factors for a pathologic complete remission; results of a multi-variate analysis
Authors: C Matuschek, E Boelke, S Roth, H Bojar, W Audretsch, JW Janni, C Nestle-Kraemling, R Sauer, V Speer, W Budach
Journal: Cancer Research (2012)

Abstract Background: An earlier published series of neoadjuvant radio-chemotherapy (NRT-CHX) in locally advanced non-inflammatory breast cancer (LABC) has now been updated with a follow up of more than 15 years. Long- term outcome data and predictive factors for pathologic complete response (PCR) were analyzed. Patients and Methods: 315 LABC patients (cT1-cT4/cN0-N1) were treated during 1991–1998 with NRT-CHX. Preoperative radiotherapy (RT) consisted of external beam radiation therapy (EBRT) of 50 Gy (5 × 2 Gy/week) to the breast and the supra-/infraclavicular lymph nodes combined with an electron boost in 214 cases afterwards or – in case of breast conservation – an 10-Gy interstitial boost with 192Ir afterloading before EBRT. Chemotherapy was administered prior to RT in 192 patients, and concomitantly in 113; 10 patients received no chemotherapy. The update of all follow up ended in November 2011. Age, tumor grade, nodal status, hormone receptor status, simultaneous vs. sequential CHX and the time interval between end of RT and surgery were examined in multivariate terms with as endpoint pCR and overall survival. Results: The total PCR rate after neoadjuvant RT-CHX reached 29.2 % with LABC breast conservation becoming possible in 50.8%. In initially node-positive cases (cN+), a complete nodal response (pN0) after NRT-CHX was observed in 56% (89/159). The multivariate analysis revealed that a longer time interval to surgery increased the probability for a pCR (HR 1,17 [95% CI 1,05-1,31], p &amp;lt; 0,01). However, in large tumors (T3-T4) a significantly reduced pCR rate (HR 0.89 [95% CI 0.80 to 0.99], p = 0.03) could be obtained. Importantly, a pCR was the strongest prognostic factor for long term survival (HR 0.28 [95% CI 0.19–0.56], p &amp;lt; 0.001). Conclusions: A PCR identifies patients with a significant better prognosis for long-term survival. However, a long time interval to surgery (&amp;gt; 2 months) increases the probability of a pCR after NRT-CHX. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-14-04.
Product of Hemoglobin and Left Ventricular Ejection Fraction as a New Predictor of Contrast Induced Nephropathy in Patients with Acute Coronary Syndrome
Authors: Murat Uğur, Mehmet Bozbay, Gökhan Çiçek, Gurkan Karaca, Bayram Köroğlu, Eyyüp Tusun, Ahmet Murat, Burak Turan, Ahmet Lutfu Orhan
Journal: Journal of the American College of Cardiology (2013)
Life Support and Maternal Brain Death During Pregnancy
Authors: William P. Dillon
Journal: JAMA (1982)

The authors are physicians affiliated with the State University of New York at Buffalo and the Children's Hospital of Buffalo. They describe the clinical management of two brain-dead pregnant women and suggest guidelines to help physicians decide whether to treat such women. Based on the dramatically increasing chances for fetal survival from the 24th to the 27th weeks of gestation, they recommend vigorous life support during this period to permit fetal viability and prognosis to be assessed. Fetuses of 28 weeks should be delivered by cesarean section as soon as practicable after confirmation of maternal brain death.
The nature of cell death in piecemeal necrosis: Is order emerging from chaos?
Authors: Lawrie W. Powell
Journal: Hepatology (1987)

Electron microscopic studies of acidophilic or Councilman-like bodies in the liver show that they are manifestations of apoptosis. The morphology and biochemistry of apoptosis suggest a process of active cellular self-destruction rather than degeneration. The incidence of apoptosis indicates that it is normally involved in the regulation of organ size and, in addition, may be triggered by specific pathological stimuli. Cell death produced in vitro by various types of cell-mediated immune injury occurs by apoptosis The occurence of apoptosis in hepatic disease is illustrated and discussed. That it constitutes the only clearly identifiable mode of cell death in most types of acute and chronic hepatitis and in primary biliary cirrhosis is in accord with current concepts of the pathogenesis of these conditions. Furthermore, the morphological features of apoptosis may explain long-standing enigmas in the histology of hepatitis–-the cryptic nature of the cell death in piecemeal "necrosis" and the apparent drop-out of large numbers of hepatocytes in many cases of acute hepatitis without overt evidence of necrosis. Apoptosis represents rapid budding of a cell to form numerous globules, the largest of which appear to be acidophilic bodies. All apoptotic fragments are quickly removed by adjacent cells without evident inflammation, permitting the process to occur inconspicuously.
India pledges free drugs for all citizens through public hospitals
Authors: G. Mudur
Journal: BMJ (2012)

The Indian government has said that it will make available free drugs in public hospitals in a bid to reduce the amount that patients spend out of their own pockets, which is tipping tens of thousands of households across the country into debt or poverty each year.

India’s health ministry is working with state governments to replicate nationwide a model for the free distribution of essential drugs at public health clinics and hospitals that has been successfully implemented over the past 15 years by the southern state of Tamil Nadu.

The national government will cover 80% of the cost of the programme, which public health experts and health economists estimate will require about 60 billion rupees (£730m; €890m; $1.16bn) a year over the next five years.

Many believe that the free drugs programme will be the easiest to implement component of a set of …
Long-Term Follow-Up of Former Inpatients at the Children's Hospital of the Menninger Clinic
Authors: EDWIN Z. LEVY
Journal: American Journal of Psychiatry (1969)

A follow-up study of 100 children and adolescents treated in a residential setting revealed that about two-thirds had made ordinary or marginal adjustment and about one-half had clearly been helped. Low IQ carried a grim prognostic significance, particularly when coupled with psychosis and violence. The author was struck with the relative ease with which a clinical institution can learn something about its therapeutic effects.
Increased Intestinal Permeability in Crohn Disease
Authors: CHARLES M. GROSSMAN
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 April 1987Increased Intestinal Permeability in Crohn DiseaseCHARLES M. GROSSMAN, M.D.CHARLES M. GROSSMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-4-641_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Figure 1 in Hollander and associates' (1) report on increased intestinal permeability in patients with Crohn disease clearly presents the data and the statistically significant difference of the means. However, their observations show that there may be more than one population and that only subsets of the two groups had higher than control values. The high elevations in three persons with Crohn disease group and approximately half of the relatives are large enough to weight the entire group and give the calculated significant differences. Perhaps the statements should have been qualified in that only some of the...Reference1. HOLLANDERVADHEIMBRETTHOLZPETERSENDELAHUNTYROTTER DCEGTJ. Increased intestinal permeability in patients with Crohn's disease and their relatives: a possible etiologic factor. Ann Intern Med. 1986;105:883-5. LinkGoogle Scholar1. HOLLANDERVADHEIMBRETTHOLZPETERSENDELAHUNTYROTTER DCEGTJ. Increased intestinal permeability in patients with Crohn's disease and their relatives: a possible etiologic factor. Ann Intern Med. 1986;105:833-5. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: CHARLES M. GROSSMAN, M.D.Affiliations: 610 S. W. Alder Street; Portland, OR 97205 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAssessment of the lactulose-mannitol test in Crohn's disease. 1 April 1987Volume 106, Issue 4Page: 641-641KeywordsCrohn's diseaseStatistical data ePublished: 1 December 2008 Issue Published: 1 April 1987 PDF downloadLoading ...
Impaired translational response and increased protein kinase PKR expression in T cells from lupus patients
Authors: Annabelle Grolleau, Mariana J. Kaplan, Samir M. Hanash, Laura Beretta, Bruce Richardson
Journal: Journal of Clinical Investigation (2000)

Activation of peripheral blood T cells results in a rapid and substantial rise in translation rates and proliferation, but proliferation in response to mitogen stimulation is impaired in systemic lupus erythematosus (SLE). We have investigated translation rates and initiation factor activities in T cells from SLE patients in response to activating signals. Activation by PMA plus ionomycin strongly increased protein synthesis in control T cells but not in T cells from SLE patients. The rate of protein synthesis is known to be strongly dependent on the activity of two eukaryotic translation initiation factors, eIF4E and eIF2α. We show that following stimulation, eIF4E expression and phosphorylation increased equivalently in control and SLE T cells. Expression of eIF4E interacting proteins — eIF4G, an inducer, and 4E-BP1 and 4E-BP2, two specific repressors of eIF4E function — and the phosphorylation level of 4E-BP1, were all identical in control and SLE T cells. In contrast, the protein kinase PKR, which is responsible for the phosphorylation and consequent inhibition of eIF2α activity, was specifically overexpressed in activated SLE T cells, correlating with an increase in eIF2α phosphorylation. Therefore, high expression of PKR and subsequent eIF2α phosphorylation is likely responsible, at least in part, for impaired translational and proliferative responses to mitogens in T cells from SLE patients.