tbuckley/cabot-search huggingface dataset:
Are Low-Income Elderly Patients at Risk for Poor Diabetes Care?
Authors: Daniel T. McCall, Angela Sauaia, Richard F. Hamman, Jane E. Reusch, Phoebe Barton
Journal: Diabetes Care (2004)

OBJECTIVE—Diabetes is common among low-income elderly, dual-eligible (DE) Medicare/Medicaid patients resulting in significant morbidity, mortality, and cost. However, the quality of diabetes care delivered to these patients has not been evaluated. The aims of this study were to describe the quality of diabetes care provided to DE patients and compare it with non-DE patients. RESEARCH DESIGN AND METHODS—This was a cross-sectional analysis of administrative claims from 1 January 1997 through 31 December 1998. A total of 9,453 patients aged 65–75 years with diabetes participated in the study. These were Colorado Medicare fee-for-service (FFS) outpatients. The main outcome measures consisted of a proportion of patients receiving an annual hemoglobin A1c test, biennial eye examination, biennial lipid test, and all three of these care processes. RESULTS—The mean patient age was 71 ± 2.8 years. Over 22% of patients were identified as dual eligible, and they were significantly more likely to be younger, female, and of minority race/ethnicity; reside in a rural location; and have comorbid conditions compared with the non-DE population. DE patients had more visits to primary care physicians, emergency departments, and hospitalizations but were less likely to visit endocrinologists. DE patients were significantly less likely to receive an annual A1c test (73 vs. 81%; P &amp;lt; 0.0001), biennial ophthalmologic examination (63 vs. 75%; P &amp;lt; 0.0001), and biennial lipid testing (43 vs. 57%; P &amp;lt; 0.0001). The adjusted odds ratio of urban DE patients receiving all three care measures was 0.60 (95% CI 0.52–0.69) compared with urban non-DE patients. Minority race/ethnicity and emergency department use were significantly associated with not receiving diabetes care, whereas endocrinology visits were associated with an increased odds of receiving diabetes care. CONCLUSIONS—DE Medicare/Medicaid status was independently associated with not receiving diabetes care, especially among those in urban areas.
WHO pulls two generic AIDS drugs from approved list
Authors: Fiona Fleck
Journal: BMJ (2004)

In a move that could dent confidence in the generic drugs industry, the World Health Organization (WHO) withdrew two anti-AIDS drugs, lamivudine and zidovudine, from its list of approved medicines after laboratory tests failed to prove they have the same chemical make up as their patented equivalents, Epivir and Retrovir, both made by GlaxoSmithKline.

The WHO said that withdrawing the 150 mg lamivudine and 300mg zidovudine tablets, contained in blister packs of 10 tablets, from the WHO's recommended list was not the same as pulling …
Risk for Incident Diabetes Mellitus Following Initiation of Second-Generation Antipsychotics Among Medicaid-Enrolled Youths
Authors: David M. Rubin, Amanda R. Kreider, Meredith Matone, Yuan-Shung Huang, Chris Feudtner, Michelle E. Ross, A. Russell Localio
Journal: JAMA Pediatrics (2015)

Second-generation antipsychotics (SGAs) have increasingly been prescribed to Medicaid-enrolled children, either singly or in a medication combination. Although metabolic adverse effects have been linked to SGA use in youths, estimating the risk for type 2 diabetes mellitus, a rarer outcome, has been challenging.To determine whether SGA initiation was associated with an increased risk for incident type 2 diabetes mellitus. Secondary analyses examined the risk associated with multiple-drug regimens, including stimulants and antidepressants, as well as individual SGAs.Retrospective national cohort study of Medicaid-enrolled youths between January 2003 and December 2007. In this observational study using national Medicaid Analytic eXtract data files, initiators and noninitiators of SGAs were identified in each month. Included in this study were US youths aged 10 to 18 years with a mental health diagnosis and enrolled in a Medicaid fee-for-service arrangement during the study. Those with chronic steroid exposure, a diagnosis of diabetes mellitus, or SGA use during a 1-year look-back period were ineligible. The mean follow-up time for all participants was 17.2 months. Youths were followed up until diagnosis of diabetes mellitus or end of follow-up owing to censoring caused by the transition into a Medicaid managed care arrangement or Medicaid ineligibility (the end of available data). Propensity weights were developed to balance observed demographic and clinical characteristics between exposure groups. Discrete failure time models were fitted using weighted logistic regression to estimate the risk for incident diabetes mellitus between initiators and noninitiators.A filled SGA prescription.Incident type 2 diabetes mellitus identified through visit and pharmacy claims during the observation period.Among 107,551 SGA initiators and 1,221,434 noninitiators, the risk for incident diabetes mellitus was increased among initiators (odds ratio [OR], 1.51; 95% CI, 1.35-1.69; P < .001). Compared with youths initiating only SGAs, the risk was higher among SGA initiators who used antidepressants concomitantly at the time of SGA initiation (OR, 1.54; 95% CI, 1.17-2.03; P = .002) but was not significantly different for SGA initiators who were concomitantly using stimulants. As compared with a reference group of risperidone initiators, the risk was higher among those initiating ziprasidone (OR, 1.61; 95% CI, 0.99-2.64; P = .06) and aripiprazole (OR, 1.58; 95% CI, 1.21-2.07; P = .001) but not quetiapine fumarate or olanzapine.The risk for incident type 2 diabetes mellitus was increased among youths initiating SGAs and was highest in those concomitantly using antidepressants. Compared with risperidone, newer antipsychotics were not associated with decreased risk.
Evaluation of a Self-Calibrating Blood Glucose Monitor
Authors: G Rayman, P D Spencer, C R Tillyer, P H Wise
Journal: Diabetes Care (1984)

A new reflectance blood glucose meter designed for hospital use, the Reflocheck (Boehringer-Mannheim, West Germany), was evaluated. The instrument showed excellent correlation with a routine laboratory method (r = 0.996), and the coefficients of variation at high, medium, and low glucose levels were less than 4%.
Patterns of Meaning in Psychiatric Patients: Semantic Differential Responses in Obsessives and Psychopaths
Authors: Marjorie C. Meehan
Journal: JAMA (1966)

<b>The Recognition of Mental Illness in London: A Study of the Social Processes Determining Compulsory Admission to an Observation Unit in a London Hospital</b>, by Annette R. L. Lawson, Institute of Psychiatry Maudsley Monographs, No. 15; 123 pp, $10.50, London and New York: Oxford University Press, 1966. <b>Physiological Measures, Sedative Drugs, and Morbid Anxiety</b>, by M. H. Lader and Lorna Wing, Institute of Psychiatry Maudsley Monographs, No. 14; 179 pp, $11.50, London and New York: Oxford University Press, 1966. These three most recent Maudsley Monographs describe research projects carefully carried out, with extensive review of relevant literature, detailed explanation of purpose and method, complete record of findings, and limited discussion and interpretation. The investigations were probably worth doing and reporting, but was it necessary to publish three whole books, to sell for a total of $35? By careful summarizing and editing, each of these research projects could have been adequately
Functional p75 interleukin‐2 receptor expression on the fresh blast cells in childhood acute lymphoblastic leukemia with natural killer cell properties
Authors: Motoki Ichikawa, Hiroshi Kawai, Atsushi Komiyama, Mitsuru Tsudo, Masayuki Miyasaka, Akitoshi Kinoshita, Shinpei Nakazawa
Journal: American Journal of Hematology (1991)

Abstract Neoplastic cells of childhood acute lymphoblastic leukemia (ALL) with natural killer (NK) cell properties were studied for the expression of p75 interleukin‐2 receptors (IL‐2R) and the receptor functions. Freshly prepared blast cells from a patient with ALL had NK cell properties: (1) the phenotype such as CD56 + , CD2 + , E‐rosette + , CD3 − , and CD19 − ; and (2) the presence of spontaneous cytotoxicity against NK‐sensitive K562 target cells. Although p55 Tac antigen was not detectable, there was the expression of p75 IL‐2R on the freshly prepared blast cells: 70% of the cells reacted with Mik‐β1 monoclonal antibody against p75 IL‐2R as determined by flow cytometry. Two‐color flow cytometry revealed that the blast cells expressed both p75 IL‐2R and NKH‐1. NK activity of the blast cells was augmented by their treatment with 1,000 U/ml recombinant IL‐2 (rIL‐2): the cytotoxicity level as percentage lysis increased to 38.7% from 22.0% when the normal lymphocyte value increased to 62.1% from 46.2%. Although the blast cells possessed no apparent level of proliferative capacity, the addition of 1,000 U/ml rlL‐2 yielded a 2.7‐fold increase in their thymidine uptake. These results demonstrate the expression of functional p75 IL‐2R on the patient's blast cells with NK cell properties.
Did MONICA really say that?
Authors: H. Tunstall-Pedoe
Journal: BMJ (1998)

Can I have a fag and a chip butty now? Some journalists have claimed, on the basis of the results of the MONICA project, that coronary risk factors no longer matter. Hugh Tunstall-Pedoe, who was involved in the study, explains how the original story was metamorphosed by the media.

Americans' inability to explain their decline in coronary disease spawned the World Health Organisation's MONICA project (MONItoring CArdiovascular disease) in the 1980s. This 10 year study of trends in disease and risk factors recruited 38 populations in 21 countries. Preliminary results were presented at the European Congress of Cardiology in Vienna in August 1998 but individual centres had previously published results.

I drafted the press release accompanying this presentation; it emphasised the value of the data on trends collected from the 38 populations and listed findings for coronary disease rates, 28 day case fatality, smoking, blood pressure, cholesterol, and obesity. Then came the surprises. Although some centres had previously reported no change in case fatality during the revolution in treatment of myocardial infarction of the …
Prevalence and Prognostic Significance of Short QT Interval in a Middle-Aged Finnish Population
Authors: O. Anttonen, M.J. Junttila, H. Rissanen, A. Reunanen, M. Viitasalo, H.V. Huikuri
Journal: Circulation (2007)

Short-QT syndrome is an inherited disorder characterized by a short QT interval and an increased risk of sudden cardiac death. The clinical significance of a short QT interval observed in a randomly recorded ECG is not known. Therefore, we assessed the prevalence and prognostic significance of a short QT interval in a general population.QT intervals were measured from the 12-lead ECGs of 10 822 randomly selected middle-aged subjects (5658 males, mean age 44+/-8.4 years) enrolled in a population study and followed up for 29+/-10 years. The end points were all-cause and cardiovascular mortality. In addition to Bazett's method (corrected QT interval, or QTc), the Fridericia (QTfc) and nomogram (QTnc) methods were used to correct the QT interval for heart rate. The cutoff values for short QT intervals were defined as 320 ms (very short) and 340 ms (short). The prevalence of QT interval <320 ms based on QTc, QTfc, and QTnc was 0.10%, 0.08%, and 0.06%, and the prevalence of QT interval <340 ms was 0.4%, 0.3%, and 0.3%, respectively. The majority of subjects with short QT intervals were males. All-cause or cardiovascular mortality did not differ between subjects with a very short or short QT interval and those with normal QT intervals (360 to 450 ms). There were no sudden cardiac deaths, aborted sudden cardiac deaths, or documented ventricular tachyarrhythmias among subjects with a QTfc <340 ms.A short QT interval does not appear to indicate an increased risk for all-cause or cardiovascular mortality in middle-aged nonreferral, community-based individuals.
699. Correction of Glycogen Storage Disease Type II (GSD II) with an Adeno-Associated Virus 8 (AAV2/8) Vector
Authors: Luis M. Franco, Baodong Sun, Andrew Bird, Haoyue Zhang, Andrea Amalfitano, Y.-T. Chen, Dwight D. Koeberl
Journal: Molecular Therapy (2004)

Glycogen storage disease type II (GSD II; Pompe disease; MIM 232300) is an autosomal recessive disorder caused by a deficiency in the activity of the lysosomal enzyme alpha-glucosidase (GAA; acid maltase; EC 3.2.1.20). The disease is characterized by massive accumulation of glycogen in the lysosomes and cytoplasm of striated muscle, with a subsequent disruption of cellular functions. Clinically, the disease spectrum varies in severity and age of onset, and the manifestations include muscle weakness, hypotonia, hypertrophic cardiomyopathy and respiratory failure. Intravenous administration of adenovirus vectors encoding GAA previously demonstrated generalized correction of glycogen storage in the GAA-knockout (GAA-KO) mouse model, although GAA secretion stopped and glycogen content increased coincident with appearance of anti-GAA antibodies. Tissue-specific expression of an introduced therapeutic protein has prevented the formation of neutralizing antibodies in other models, but not in GAA-KO mice. Consequently, an AAV2/8 vector containing a liver-specific promoter (LSP) to drive GAA expression (AAV-LSPGAApA) was administered (1 x 10E11 particles intravenously) in 3 month-old immunocompetent GAA-KO mice. A second group of age-matched GAA-KO mice was injected with a similar dose of an AAV2/8 vector containing hGAA under the control of the CMV enhancer/chicken |[beta]|-actin (CB) promoter for comparison (AAV-CBGAApA). High-level hGAA was detectable by Western blot in plasma for longer than 6 weeks with AAV-LSPGAApA in GAA-KO mice, in contrast to AAV-CBGAApA which produced low-level hGAA in the plasma only during the first week. The latter vector has produced sustained, high-level hGAA in plasma in immunodeficient (GAA-KO/SCID) mice, indicating the significance of the immune response to hGAA secretion. ELISA performed at 1, 3, and 6 weeks following vector administration demonstrated no detectable anti-GAA antibodies in response to liver-specific hGAA expression in GAA-KO mice ( 1:800) at the 6 week time point. The level of hGAA activity in plasma with AAV-LSPGAApA (>1000 nmol/hr/ml) has previously corrected glycogen storage in the heart of tolerant GAA-KO mice. This combined approach to liver-targeted gene therapy of GSD II with a liver-directed AAV serotype and a liver-specific promoter provides a substantially greater and more sustained level of hGAA expression in vivo than has previously been reported. Further work will be carried out to determine the implications of this sustained, high-level expression of the enzyme on disease phenotype. Thus, use of a liver-specific promoter prevented neutralizing antibody formation in GSD II mice and will enhance the development of gene therapy in Pompe disease.
Immunologic Aspects of Vasculitis and Cardiovascular Disease
Authors: Dennis K. Ledford
Journal: JAMA (1997)

The immunologic cardiovascular diseases are a heterogeneous group of conditions. Many of these entities are associated with serious morbidity and mortality resulting from cardiac impairment, ischemic complications, or organ dysfunction, particularly of the kidneys, lung, and nervous system. The systemic nature of these conditions, coupled with vague symptoms and nonspecific initial physical findings, makes the differential diagnosis complicated. Research has identified specific mediators and primary origins in some conditions, with infections often being responsible. Immunosuppressive therapy, despite the potential complications, has improved the prognosis of some of the more serious immunologic cardiovascular diseases. Improvement in the treatment of immunologic cardiovascular diseases awaits identification of additional causes, improved definition of host factors that predispose an individual to develop these conditions, and better understanding of the immune dysregulation responsible for the progression of disease. The potential pathophysiologic role of immunologic mechanisms in common disorders such as congestive heart failure and atherosclerosis is intriguing and offers the possibility of novel therapies in these prevalent conditions.
Efficacy of mizolastine, a new antihistamine, compared with placebo in the treatment of chronic idiopathic urticaria
Authors: J. Brostoff, P. Fitzharris, C. Dunmore, M. Theron, P. Blondin
Journal: Allergy (1996)

A two-centre, double-blind, randomized, placebo (P)-controlled, parallel-group study was conducted in the UK to examine the efficacy and safety of mizolastine (M), a new H1-receptor antagonist, as a once-daily 10-mg dose in chronic idiopathic urticaria. Fifty-six outpatients (M: n = 28; P: n = 28) with a mean age of 38 +/- 15 years, a duration of disease of more than 3 years, and symptoms of urticaria at least twice a week in the absence of treatment were recruited. After a single-blind placebo run-in period, patients were allocated to one of two treatment groups and were evaluated after 7 and 28 days. The main characteristics (age, duration of disease, number of urticarial episodes, and total score) of the two groups were comparable at inclusion. Mizolastine was shown to improve the urticaria symptoms: at the end of the study, mizolastine produced a significantly greater decrease in the global symptom score comprising itch, wheals, and erythema (M: 2.1 +/- 2.1 vs P: 0.4 +/- 2.0; P = 0.002). The patient-rated global discomfort from symptoms measured by visual analog scale was significantly improved with mizolastine (M: 31.4 +/- 36.7) compared to placebo (P: 5.4 +/- 27.6; P = 0.003), with respectively more M responders (74.1%) than P responders (28.6%, P = 0.001), a responder being a patient with a > or = 50% decrease in VAS. Premature dropouts due to lack of efficacy and loss to follow-up mainly occurred at the first evaluation (day 7) and were more often observed in patients in the placebo group (n = 17) than in the mizolastine group (n = 8) (P = 0.031). No serious adverse events were recorded. Somnolence was reported in two mizolastine patients, one of whom discontinued the study. Thus, mizolastine may be considered a new treatment option for the symptoms of chronic urticaria.
USE OF SILICONE OILS IN MAINTAINING SURGICAL INSTRUMENTS
Authors: Frank W. Crowe
Journal: JAMA (1952)

Since the introduction of the organosilicon products into industry in 1943, the potentialities of these compounds appear to be unlimited. Their more recent introduction into cutaneous medicine 1 suggests many uses for their water repellent and lubricating properties in general medicine and surgery.  The physical and chemical differences of the silicones and organic compounds are marked, because the silicones have a quartz-like skeleton consisting of alternating silicon and oxygen atoms rather than the carbon atom framework of the organic compounds. 2 The silicones are water repellent, superior lubricants, which are chemically and physiologically inert and show marked surface adhesiveness. Physical properties 3 are remarkable in that the freezing point for the 500 centistoke (viscosity) DC 200 fluid is —50 C (—58 F). The boiling point for this fluid is 200 C (392 F), and the viscosity-temperature coefficients (viscosity-temperature coefficient equals 1—viscosity at 210 F / viscosity at 100 F)are in the
T cells activate the tumor necrosis factor-α system during hemodialysis, resulting in tachyphylaxis
Authors: Iza C. van Riemsdijk, Carla C. Baan, Elisabeth H.M. Loonen, Christiaan J. Knoop, Gustavo Navarro Betonico, Hubert G.M. Niesters, Robert Zietse, Willem Weimar
Journal: Kidney International (2001)
PROTEIN CONSUMPTION AND THE RESTORATION OF LOST ORGAN TISSUE
Authors: T. Addis, W. Lew
Journal: The Journal of Experimental Medicine (1940)

1. At all levels of immediate protein consumption, from almost none to excessive amounts, the degree of growth of the single kidney, suprarenal, and ovary left after removal of one of each of these organs is the same up to 5 days after the operation. 2. On a 1 per cent protein diet there is no growth of the remaining organs after the first 5 days. 3. On diets containing from 10 per cent to 57 per cent of protein there is no definite relation between the level of protein consumption and the rate and degree of growth from 5 to 40 days after the operation. 4. When rats are given a 1 per cent protein diet for 10 days before the operation a continuation of this diet reduces the initial growth of the remaining organs and leads to a cessation of growth after the first 2 days.
Cellular Effects of Ionizing Radiation
Authors: John B. Little
Journal: New England Journal of Medicine (1968)

Radiation ModifiersA variety of substances have been shown to alter lethal effects when present in cells before or during irradiation. They can be logically thought of in two classes: compounds offering protection against the effects of radiation; and compounds sensitizing cells to irradiation. Oxygen is perhaps the most important example in the latter group. While considering the major groups of modifiers of current interest, I shall not discuss alterations in survival produced by postirradiation treatment of cells; these effects involve either intracellular repair processes or the metabolic development of the initial damage. Examples of such treatments include postirradiation changes . . .
Dialysis outcomes in Colombia (DOC) study: A comparison of patient survival on peritoneal dialysis vs hemodialysis in Colombia
Authors: M. Sanabria, J. Muñoz, C. Trillos, G. Hernández, C. Latorre, C.S. Díaz, S. Murad, K. Rodríguez, Á Rivera, A. Amador, F. Ardila, A. Caicedo, D. Camargo, A. Díaz, J. González, H. Leguizamón, P. Lopera, L. Marín, I. Nieto, E. Vargas
Journal: Kidney International (2008)
Computer Searching of the Medical Literature
Authors: R. BRIAN HAYNES
Journal: Annals of Internal Medicine (1985)

Although clinicians can now search the medical literature electronically from the clinic, bedside, or operating suite, little is known about the performance characteristics of online information services. Fourteen access routes to the MEDLINE database of journal literature were compared for retrieval quantity and quality, user and online search time, and cost for randomly ordered, standardized searches on common clinical problems. All routes produced the articles we judged to be the most definitive on the clinical problem. However, routes differed significantly (< 0.01) for the same searches with respect to online time (range, 5.15 to 18.72 minutes), total search time (8.37 to 20.55 minutes), cost (US$3.38 to $11.62), and proportion of articles relevant to the topic (98% to 75%). "User friendliness" aside, our results showed that the higher the cost, the worse the product. Clinicians should consider these major differences when deciding which search system to use.
Broadening Medical Education: The Transitional Year
Authors: John S. Davis
Journal: JAMA (1991)

To the Editor.—  Dr Stanton 1 laments that a true 'rotating internship' is difficult if not impossible to find through any of the usual sources of graduate medical education. He believes that the future orthopedic resident should be given a more general education than is often provided in the fourth year of medical school or the usual PGY-1 year incorporated into the orthopedic residency.  For Dr Stanton's information, the   is alive and very well, as can be determined by consulting page 134 of the 1990-1991 Directory of Graduate Medical Education Programs  2 (the familiar Green Book known to all medical students) or the NRMP [National Resident Matching Plan] Directory . 3 I refer to the Transitional Year, a broad year of training now much improved from the rotating internship of yore through careful direction by the Accreditation Council of Graduate Medical Education and its Transitional Year Review Committee. The