tbuckley/cabot-search huggingface dataset:
Hospitalization-Associated Disability
Authors: Kenneth E. Covinsky, Edgar Pierluissi, C. Bree Johnston
Journal: JAMA (2011)

In older patients, acute medical illness that requires hospitalization is a sentinel event that often precipitates disability. This results in the subsequent inability to live independently and complete basic activities of daily living (ADLs). This hospitalization-associated disability occurs in approximately one-third of patients older than 70 years of age and may be triggered even when the illness that necessitated the hospitalization is successfully treated. In this article, we describe risk factors and risk stratification tools that identify older adults at highest risk of hospitalization-associated disability. We describe hospital processes that may promote hospitalization-associated disability and models of care that have been developed to prevent it. Since recognition of functional status problems is an essential prerequisite to preventing and managing disability, we also describe a pragmatic approach toward functional status assessment in the hospital focused on evaluation of ADLs, mobility, and cognition. Based on studies of acute geriatric units, we describe interventions hospitals and clinicians can consider to prevent hospitalization-associated disability in patients. Finally, we describe approaches clinicians can implement to improve the quality of life of older adults who develop hospitalization-associated disability and that of their caregivers.
Alternatives to hospital for older people must be found, says NHS chief
Authors: N. Hawkes
Journal: BMJ (2013)

Hospitals are “very bad places for old, frail people,” the chief executive of the NHS Commissioning Board, David Nicholson, believes. Hospitals’ focus on getting a diagnosis, referring the patient to the right place, and getting treatment is unsuited to a patient population, 40% of whom will have some form of dementia, he told the Independent newspaper in an interview.1

“We need to find alternatives,” he said. “We need to put as much focus on that as we do on telling nurses to be more compassionate.” Nicholson used the example of people with dementia to emphasise the drive to take “large amounts” of care out of hospitals and into the community. He warned that hospitals would face a double challenge, losing services as a result of concentrating specialist care in fewer centres and of shifting services into the community. “How we manage that is going to be quite tricky,” he admitted.

Responding to Nicholson’s remarks, the Alzheimer’s Society …
The Role of Glucagon Hypersecretion in the Pathogenesis of Hyperglycemia Following Acute Myocardial Infarction
Authors: SHLOMO LANIADO, PESACH SEGAL, BARRY ESRIG
Journal: Circulation (1973)

In a group of nondiabetic patients, postinfarction hyperglycemia was found to be closely associated with high levels of plasma immunoreactive glucagon (IRG). It is proposed that, in certain cases, hyperglycemia following acute myocardial infarction may be related to a temporary and uninhibited rise in plasma glucagon levels, probably stimulated by the major stress of acute myocardial infarction.
Mutations in different components of FGF signaling in LADD syndrome
Authors: Edyta Rohmann, Han G Brunner, Hülya Kayserili, Oya Uyguner, Gudrun Nürnberg, Erin D Lew, Angus Dobbie, Veraragavan P Eswarakumar, Abdullah Uzumcu, Melike Ulubil-Emeroglu, Jules G Leroy, Yun Li, Christian Becker, Kai Lehnerdt, Cor W R J Cremers, Memnune Yüksel-Apak, Peter Nürnberg, Christian Kubisch, Joseph Schlessinger, Hans van Bokhoven, Bernd Wollnik
Journal: Nature Genetics (2006)
Abstract LB-349: ZO1 gene represents a chemosensitivity gene in multiple myeloma
Authors: Lin Yang, Robert Orlowski, Xingding Zhang, Huimin Meng, Gangli An, Hua Wang
Journal: Cancer Research (2012)

Abstract Chemotherapy agents are extremely important in the treatment of liquid malignancies, such as multiple myeloma (MM). Unfortunately, chemotherapy resistance in MM therapy is the most significant cause of treatment failure. The ability to predict, treat, or circumvent resistance is extremely likely to improve clinical outcomes. Thus, identification of novel genes that play a crucial role in MM progression and chemosensitivity is necessary to understand this disease better at the molecular level. Moreover, these genes and their products may serve as new therapeutic targets for MM, whose expression could improve patient outcomes or served as a predictor for chemotherapy outcome. To identify potential chemosensitivity genes, establishing a high-throughput method for validation of targets becomes urgently needed. Toward this purpose, we have successfully developed a high-throughput siRNA based functional target validation approach and identified a group of potential chemosensitivity genes. Our preliminary studies focusing on one of the candidate gene, ZO1 (zonula occludens 1), suggested that targeting ZO1 led to tumor cell resistant to several chemotherapy agents, including doxorubicin (Dox), cisplatin (Cis), methotrexate (MTX), and bortezomib. Further analysis with 264 bortezomib treated MM patients indicated that expression level of ZO1 correlated with patient response to bortezomib treatment. Two clones and pooled RPMI 8226 MM cell line, which were developed against bortezomib treatment in our lab, showed loss of ZO1 expression, suggesting a role of ZO1 may play in bortezomib resistance development. More importantly, ZO1 targeting in myeloma cells resulted in cell resistance to bortezomib treatment. Taken together, our studies reveal a novel chemosensitivity gene, which may lay the foundation for further clinical studies. Moreover, in the clinical arena, it may form a basis for algorithms to help predict chemosensitivity based on baseline gene expression profiles in the future, and may provide the strategies aimed at enhancing chemosensitivity by increasing expression of target genes of interest.[[Unsupported Character - &amp;#8194;]] Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-349. doi:1538-7445.AM2012-LB-349
Computed Tomography in Neurologic Diagnosis
Authors: A G Osborn
Journal: Annual Review of Medicine (1979)

The instant, universal acceptance of computed tomography (CT) in the evaluation of a wide spectrum of intracranial lesions attests to its great value in neurologic diagnosis. The reliability of CT in demonstrating a broad range of intracerebral disorders has been well established (1). CT has been said to provide more diagnostic information on the general spectrum of intracranial disease than any other single neuroradiologic examination (2) and for the first time permits direct visualization of important but formerly obscure areas such as the orbit and posterior fossa. This report reviews the basic physical principles of CT scanning, then briefly discusses the utility, economics and efficacy, limitations, and new developments in cranial CT as an adjunct to neurologic diagnosis.
Chemotherapy of Malaria and Trypanosomiasis
Authors: L. G. Goodwin
Journal: BMJ (1953)

Summary Twoimportant bacillary infections intheTropics are bacillary dysentery andcholera. Chemotherapy hasnot proved ofbenefit incholera; itmaybethatitwill not dosointhefuture inviewoftheextraordinary acutenessofthecondition. Inthebacillary dysenteries sulphaguanidine andits successors, succinylsulphathiazole andphthalylsulphathiazole, areeffective and arenotpronetocause crystalluria andrenal blockage. Theabsorbable sulphonamides, especially sulphadiazine, arealsoveryeffective, butrenal obstruction mayoccurfromtheir use. Treatment ofEntamoeba histolytica infection isdiscussed. Thedrugsaccepted asbeing specifically amoebicidal include thealkaloids emetine andconessine, certain arsenicals, andtheiodo-quinolines. Trials of aureomycin andterramycin showthatthese antibiotics areuseful additions totherangeofamoebicidal drugs. Their outstanding valueappears tolieintheir capacity, whengiventogether withthese drugs, toeradicate the extremely refractory infections occasionally metwith. REFERENCES
Three more polio workers are killed in Pakistan
Authors: A. Gulland
Journal: BMJ (2014)

Three polio vaccination workers in Karachi, Pakistan, were shot and killed last week, raising concerns about the level of protection that aid workers receive.

Media reports stated that health workers in the city refused to continue with their work after the killings of two female workers and one male worker on 21 January, all of whom were Pakistani nationals. However, the polio vaccination campaign in the city has now resumed, said the World Health Organization.

Dr Elias Durry, WHO Senior Polio Emergency Coordinator in Pakistan, said that Karachi was a city with significant security problems.

“It’s not just polio workers that are …
Prediction of Long-Term Mortality After Percutaneous Coronary Intervention in Older Adults
Authors: William S. Weintraub, Maria V. Grau-Sepulveda, Jocelyn M. Weiss, Elizabeth R. DeLong, Eric D. Peterson, Sean M. O'Brien, Paul Kolm, Lloyd W. Klein, Richard E. Shaw, Charles McKay, Laura L. Ritzenthaler, Jeffrey J. Popma, John C. Messenger, David M. Shahian, Frederick L. Grover, John E. Mayer, Kirk N. Garratt, Issam D. Moussa, Fred H. Edwards, George D. Dangas
Journal: Circulation (2012)

The purpose of this study was to develop a long-term model to predict mortality after percutaneous coronary intervention in both patients with ST-segment elevation myocardial infarction and those with more stable coronary disease.
Decrease in sarcoglycans and dystrophin in failing heart following acute myocardial infarction
Authors: H YOSHIDA, M TAKAHASHI, M KOSHIMIZU, K TANONAKA, R OIKAWA, T TOYOOKA, S TAKEO
Journal: Cardiovascular Research (2003)

Genetic defects in several sarcoglycans (SGs) and dystrophin (Dys) play a critical role in cardiomyopathy. The present study was designed to determine whether changes in SGs and Dys might occur in animals with chronic heart failure (CHF) induced by acute myocardial infarction (AMI), which have no genetic defects.AMI was induced by the left coronary artery ligation (CAL) in rats. The hemodynamic parameters of the 2- and 8-week CAL (2w- and 8w-CAL) rats were measured and the myocardial SGs, Dys, calpain, and calpastatin levels were determined by the Western blot method. Myocardial calpain-like protease activity was evaluated as caseinolysis activity.Increases in left ventricular end-diastolic pressure (LVEDP) and right ventricular systolic pressure, and a decrease in +/-dP/dt were observed at the 2nd week, whereas cardiac output index (COI) was preserved. In contrast, the 8w-CAL rats showed a further increment in LVEDP with low COI. alpha-SG of the viable left ventricle (LV), and septum (Sep) of the 8w-CAL rat decreased (60-70% of the control). The alpha- and beta-SGs of the right ventricle (RV) of the 2w- and 8w-CAL rats were reduced, while gamma- and delta-SGs in the three regions did not change significantly. Dys in the viable LV and RV of the 8w-CAL rat decreased (75% of the control). The amount of m-calpain in the three regions of the 2w- and 8w-CAL rats increased (140-200% of the control), whereas the endogenous calpain inhibitor, calpastatin, did not change significantly. The in vitro degradation studies using purified m-calpain or cytosolic fractions of the 8w-CAL rat heart suggested a reduction in SGs and Dys by calpain.The results suggest that a decrease in SGs and Dys may play an important role in the pathophysiology of CHF following AMI.
A Randomized Controlled Trial to Prevent Post-Operative Atrial Fibrillation by Antioxidant Reinforcement
Authors: Ramón Rodrigo, Panagiotis Korantzopoulos, Mauricio Cereceda, René Asenjo, Jaime Zamorano, Eli Villalabeitia, Cristián Baeza, Rubén Aguayo, Rodrigo Castillo, Rodrigo Carrasco, Juan G. Gormaz
Journal: Journal of the American College of Cardiology (2013)
Reporting and analysis of trials using stratified randomisation in leading medical journals: review and reanalysis
Authors: B. C. Kahan, T. P. Morris
Journal: BMJ (2012)

To assess how often stratified randomisation is used, whether analysis adjusted for all balancing variables, and whether the method of randomisation was adequately reported, and to reanalyse a previously reported trial to assess the impact of ignoring balancing factors in the analysis.Review of published trials and reanalysis of a previously reported trial.Four leading general medical journals (BMJ, Journal of the American Medical Association, Lancet, and New England Journal of Medicine) and the second Multicenter Intrapleural Sepsis Trial (MIST2).258 trials published in 2010 in the four journals. Cluster randomised, crossover, non-randomised, single arm, and phase I or II trials were excluded, as were trials reporting secondary analyses, interim analyses, or results that had been previously published in 2010.Whether the method of randomisation was adequately reported, how often balanced randomisation was used, and whether balancing factors were adjusted for in the analysis.Reanalysis of MIST2 showed that an unadjusted analysis led to larger P values and a loss of power. The review of published trials showed that balanced randomisation was common, with 163 trials (63%) using at least one balancing variable. The most common methods of balancing were stratified permuted blocks (n=85) and minimisation (n=27). The method of randomisation was unclear in 37% of trials. Most trials that balanced on centre or prognostic factors were not adequately analysed; only 26% of trials adjusted for all balancing factors in their primary analysis. Trials that did not adjust for balancing factors in their analysis were less likely to show a statistically significant result (unadjusted 57% v adjusted 78%, P=0.02).Balancing on centre or prognostic factors is common in trials but often poorly described, and the implications of balancing are poorly understood. Trialists should adjust their primary analysis for balancing factors to obtain correct P values and confidence intervals and to avoid an unnecessary loss in power.
Environmental Medicine: From the Concert Hall to the Barracks
Authors: M. J. Brenner
Journal: JAMA (1999)

FEW FIELDS ARE AS DIVERSE AS ENVIRONMENTAL AND OCCUPATIONAL medicine (EOM), which encompasses health issues at individual, community, and even planetary levels. The estimated disease burden attributed to environmental and occupational medical problems is considerable. Occupational injuries and illnesses in the United States may account for over 46 000 deaths and $171 billion in direct and indirect costs annually. Nonoccupational aspects of environmental medicine have been the subject of a growing body of literature. The World Health Organization now advocates for sustainable health, an approach based on the premise that technological development should not compromise human health or disrupt regional or global ecosystems. The industrialization of the United States during the 19th century marked a time of major development for EOM. As manufacturing became the country’s primary economic activity, the first occupational safety regulations were established. More recent developments in EOM over the past half century were the AMA’s approval in 1955 of certification in occupational medicine and passage in 1970 of the act that created the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health. As the new millennium approaches, many longstanding environmental health issues, such as high lead levels in buildings and hazardous working environments, remain unresolved, and new challenges continue to arise. Eli Merritt comments on the training of US medical students to meet these challenges, with special attention to recent curricular innovations. In his companion piece appearing on the MSJAMA Web site (http://www.ama-assn.org/msjama), Merritt critically examines the emerging field of global environmental medicine. William Clark and Barbara Bohne review the association of noise exposure with auditory injury, reporting on the epidemiology, pathogenesis, and prevention of noise-induced hearing loss. Rosenthal and his colleagues present data on French medical students’ experiences with blood exposure accidents. A piece by Joel Schofer explores the controversial ethical issues surrounding guidelines for obtaining informed medical consent in a wartime environment.
Antiphospholipid antibody tests: spreading the net
Authors: M L Bertolaccini, S Gomez, J F P Pareja, A Theodoridou, G Sanna, G R V Hughes, M A Khamashta
Journal: Annals of the Rheumatic Diseases (2005)

To examine the hypothesis that testing for new antiphospholipid antibody specificities may help to identify the antiphospholipid syndrome (APS) in patients with systemic lupus erythematosus (SLE) with thrombosis who are repeatedly negative for anticardiolipin antibodies (aCL) and/or lupus anticoagulant (LA).Three groups of patients with SLE were studied: (a) SLE/APS (n = 56): 51 female, mean (SD) age 46 (11) years, fulfilling 1999 Sapporo criteria for the APS; (b) SLE/thrombosis (n = 56): 53 female, age 42.6 (12) years, all with a history of thrombosis and persistently negative for aCL and/or LA; (c) SLE only (n = 56): 53 female, age 40 (11) years, without a history of thrombotic events. aCL and LA were retested in all samples. All patients were tested for anti-beta(2)-glycoprotein I (anti-beta(2)GPI) and antiprothrombin antibodies (aPT) by coating prothrombin on irradiated plates or using phosphatidylserine-prothrombin complex as the antigen (aPS-PT).Anti-beta(2)GPI were only present in patients from the SLE/APS group, all of whom were also positive for aCL. aPT and aPS-PT were also more commonly found in SLE/APS than in SLE/thrombosis or SLE only groups (54% v 5%, p<0.0001 or v 16%, p<0.0001 for aPT and 63% v 2%, p<0.0001 or v 11%, p<0.0001 for aPS-PT, respectively). No differences were found between SLE/thrombosis and SLE only groups (p = 1.5 for beta(2)GPI, p = 0.1 for aPT, and p = 0.1 for aPS-PT).Testing for aPT in patients with SLE with thrombosis, but persistently negative for aCL and LA, may be helpful in some selected cases. Anti-beta(2)GPI are not present in patients who are negative for aCL.
Toxicity of Sulphonamide Drugs to Cells in Vitro
Authors: F. Jacoby, P. B. Medawar, E. N. Willmer
Journal: BMJ (1941)

The administration of sulphonamide drugs by injection or by mouth for the prevention and treatment of wound infec tion is in many cases giving place to a more direct method, in which the powdered drugs are applied locally to the wound surfaces (Jensen, Johnsrud, and Nelson, 1939; Legroux, 1940; Colebrook, 1940; Hawking and Piercy, 1941 ; Cole brook and Francis, 1941; and others). The first method yields concentrations in the blood and tissue fluids usually ranging from 1: 10,000 to 1:100,000, while the second establishes local concentrations ranging from saturation strength down wards. This second method raises problems concerning the toxicity of sulphonamide drugs to living cells which could hardly be expected to arise in acute form after other methods of treatment. Tissue culture provides one method of studying problems of this sort, because it is capable to some extent of reproducing in vitro the influence of the drugs on the behaviour of the various types of cells which play a part in wound healing. By means of it one should be able not only to rank a series of drugs in the order of their toxicity to living cells, but also to obtain a clear idea of the order of magnitude of the concentrations which are lethal to them. The drugs chosen for investigation were sulphanilamide, sulphathiazole, sulphapyridine, and (in some tests) sulpha diazine; and various aspects of their influence on the behaviour in vitro of cells of three main types-fibroblasts, macrophages, and epithelia-have been put on record. In each case it has been possible to draw an instructive com parison between the action of the sulphonamide drugs and that of proflavine. The method of direct application has been kept con stantly in mind. For instance, a comparison of the drugs at equal or chemically equivalent concentrations alone would be misleading, for their effective toxicity depends largely upon solubility, and on other factors-such as the rate of transport from a site of local application-which them selves largely depend upon solubility. The basic cultiva tion media-adult chicken plasma or serum, in some cases with the addition of chick embryonic extract-are those which have come to be regarded as standard in cultivation work. None of the sulphonamide drugs affects the coagu lation of plasma, and none is notably surface-active. Except with the highest concentrations of sulphanilamide, where a slight but significant osmotic effect must be exerted, the interpretation of experimental results is not therefore complicated by secondary reactions of the reagents employed. Sulphonamide drugs prove, however, to be considerably more soluble in serum than in Tyrode's solution (see table, p. 153).
Design and analysis of multilevel analytic studies with applications to a study of air pollution.
Authors: W Navidi, D Thomas, D Stram, J Peters
Journal: Environmental Health Perspectives (1994)

We discuss a hybrid epidemiologic design that aims to combine two approaches to studying exposure-disease associations. The analytic approach is based on comparisons between individuals, e.g., case-control and cohort studies, and the ecologic approach is based on comparisons between groups. The analytic approach generally provides a stronger basis for inference, in part because of freedom from between-group confounding and better quality data, but the ecologic approach is less susceptible to attenuation bias from measurement error and may provide greater variability in exposure. The design we propose entails selection of a number of groups and enrollment of individuals within each group. Exposures, outcomes, confounders, and modifiers would be assessed on each individual; but additional exposure data might be available on the groups. The analysis would then combine the individual-level and the group-level comparisons, with appropriate adjustments for exposure measurement errors, and would test for compatibility between the two levels of analysis, e.g., to determine whether the associations at the individual level can account for the differences in disease rates between groups. Trade-offs between numbers of groups, numbers of individuals, and the extent of the individual and group measurement protocols are discussed in terms of design efficiency. These issues are illustrated in the context of an on-going study of the health effects of air pollution in southern California, in which 12 communities with different levels and types of pollution have been selected and 3500 school children are being enrolled in a ten-year cohort study.(ABSTRACT TRUNCATED AT 250 WORDS)
Dancing with Antipodes: (Bipolar Illness-in Memory of My Mother)
Authors: Ronald C. Kwon
Journal: Annals of Internal Medicine (1997)

Ad Libitum15 May 1997Dancing with Antipodes: (Bipolar Illness-in Memory of My Mother)Ronald C. Kwon, MDRonald C. Kwon, MDWailuku Maui, HI 96793Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-10-199705150-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Now you are ... Author, Article, and Disclosure InformationAffiliations: Wailuku Maui, HI 96793Corresponding Author: Ronald C. Kwon, MD, 99 South Market Street, Wailuku Maui, HI 96793. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNaphthalen-1-yl-(4-pentyloxynaphthalen-1-yl)methanone: A Potent, Orally Bioavailable Human CB 1 /CB 2 Dual Agonist with Antihyperalgesic Properties and Restricted Central Nervous System Penetration 15 May 1997Volume 126, Issue 10Page: 798KeywordsMemory ePublished: 15 August 2000 Issue Published: 15 May 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...