tbuckley/cabot-search huggingface dataset:
Some guidelines on the use of cost effectiveness league tables.
Authors: J Mason, M Drummond, G Torrance
Journal: BMJ (1993)

Decisions to allocate resources in health care are increasingly influenced by relative cost effectiveness. To warn decision makers of some of the pitfalls currently found in cost effectiveness league tables and to suggest how meaningful comparisons may be made between health care technologies a published league table was scrutinised by examining its sources. This showed some of the methodological problems surrounding such tables and how such difficulties could be reduced in future. The source studies in the table featured different years of origin, discount rates, health state evaluations, settings, and types of comparison programmes; all of these differences may raise problems for meaningful comparison. Decision makers need to assess the relative value for money of competing health care interventions. In the absence of systematic comparisons such assessments are likely to take place informally. This will probably have a worse risk-benefit trade off than the formalized use of league tables.
Polyclonal immune activation and marrow plasmacytosis in multiple myeloma patients receiving long-term lenalidomide therapy: incidence and prognostic significance
Authors: D Zamarin, S M Devlin, M E Arcila, H Landau, A Lesokhin, N Lendvai, D J Chung, D Chimento, J Weltz, D Babu, S Giralt, H Hassoun
Journal: Leukemia (2013)
If I ruled the world
Authors: G. Dunea
Journal: BMJ (2002)

In the first year of my dictatorship I will ban sugar coated doughnuts, atonal music, phenylbutazone, and hospital public relations departments. With the ruthlessness of irrational dictators I will outlaw multivitamin pills, ties with horizontal stripes, malpractice lawyers, useless expensive drugs, and hot and cold water taps that turn in opposite directions.

Handsome women will not chew gum with their mouths open, petty bureaucrats will not notify their 500 employees of their …
Progress Toward Human Gene Therapy
Authors: Manal A. Morsy
Journal: JAMA (1993)

THE TECHNOLOGY of gene transfer has evolved over nearly 50 years since studies of DNA-mediated bacterial transformation reported by Avery et al in 1944.<sup>1</sup>These earliest gene transfer experiments explored "the chemical nature of the substance inducing transformation of pneumococcal types."1 More than two decades later, mammalian cells were transformed with SV40 and polyoma papovavirus DNA by calcium phosphate—mediated cellular uptake.<sup>2-4</sup>In 1971, the first workshop on gene therapy was held.<sup>5</sup>Recombinant DNA technology provided the first approaches for cell transfer of disease-related genes (ie, β-globin [hemoglobinopathies] and hypoxanthine guanine phosphoribosyltransferase [Lesch-Nyhan syndrome]).<sup>6-10</sup>The Human Genome Project, with its high rate of heritable disease and cancer gene discoveries, fuels the opportunities for gene transfer therapy. Replication-defective viral vectors are essential vehicles for gene transfer. Safe viral vectors were developed in the laboratories of Mulligan, Verma, Miller, and Gilboa based on the basic research on the life
Carers face poverty and isolation, report says
Authors: J. Seymour
Journal: BMJ (2001)

Caring for a relative or partner can leave people isolated and on a low income, a report launched this week concluded. Carers are also more likely to face ill health themselves.

In a report drawing together recent evidence about the United Kingdom's 5.7 million carers, the Child Poverty Action Group and Carers UK said that many carers live in poverty as nearly …
Pavlovian Psychiatry: A New Synthesis
Authors: Samuel Friedman
Journal: JAMA (1966)

This monograph, one of a series known as American Lectures in Objective Psychiatry, offers a bird'seye view of some of the recent work in conditional reflex studies. In a brief foreword, the author affirms his intention of presenting "basic conditional reflex research and its implications for psychiatry." Unfortunately, the presentation is far too brief and cursory for the reader who is unsophisticated in this field. Much of this slim volume consists merely of short summaries of published articles, without adequate interpretation of the material. Frequently, multiple references (64 in one instance) follow a statement, serving to confuse rather than to clarify the problem. The section on psychopharmacological aspects of conditioning constitutes the most pertinent and practical material for the psychiatrist. The reviewer agrees fully with the conclusions drawn here. For example, the author's results with ataractic drugs in schizophrenia indicate that chronic, deteriorated patients derive relatively little benefit, whereas those
Macrophage-induced inhibition of nitric oxide production in primary rat hepatocyte cultures via prostaglandin E2 release
Authors: B�n�dicte Griffon, Josiane Cillard, Martine Chevanne, Isabelle Morel, Pierre Cillard, Odile Sergent
Journal: Hepatology (1998)

Kupffer cells and other macrophages play an important role in pathogenesis of toxicants in the liver. The aim of this study was to evaluate the effect of macrophages on hepatocyte production of nitric oxide (NO), which has been previously reported to be protective toward oxidative stress induced in primary rat hepatocytes. For this purpose, RAW 264.7 macrophages were added to primary rat hepatocytes at various ratios between macrophages and hepatocytes. These cocultures were supplemented with lipopolysaccharide (LPS) and interferon gamma (IFN-γ) for 23 hours to induce NO synthase and trigger NO production. NO production was followed by quantification of nitrites in culture medium and dinitrosyl iron complexes (DNIC) in intact hepatocytes after separation from macrophages. In cocultured hepatocytes incubated with LPS and IFN-γ, DNIC and nitrite levels decreased compared with those observed in hepatocytes cultured without macrophages in the same conditions. Moreover, inhibition of NO production in hepatocyte cocultures was macrophage-number–dependent. Macrophage-conditioned medium also inhibited NO production in hepatocytes, suggesting that the effect of macrophages was mediated by soluble factors. Among the soluble factors known to decrease NO levels are some cytokines, growth factors, reactive oxygen species, and prostaglandins. Ultrafiltration of macrophage-conditioned medium through a 500-d membrane to rule out higher-molecular-weight molecules, such as anti-inflammatory cytokines and growth factors, failed to restore NO production. In the same way, the use of superoxide dismutase (SOD) and catalase (CAT) to eliminate reactive oxygen species produced by macrophages did not lead to recovery of NO levels in hepatocytes. However, when NO synthesis was inhibited in macrophages by NG-monomethyl-l -arginine (l -NMMA), hepatocytes recovered the capacity to produce NO. A net decrease of prostaglandin E2 (PGE2) release by macrophages was concomitantly observed. Moreover, inhibition of PGE2 production in macrophages by indomethacin led to restoration of NO levels. Taken together, our observations suggest that NO synthesized by macrophages can decrease NO production in hepatocytes via PGE2 release. Because of the protective role of NO toward many liver injuries, it may be postulated that macrophages contribute through this mechanism to liver damage.
Megaloblastic Anemia in China
Authors: VICTOR HERBERT
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 July 1982Megaloblastic Anemia in ChinaVICTOR HERBERT, M.D., J.D.VICTOR HERBERT, M.D., J.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-1-139_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article, "Hematology in the People's Republic of China" (1), states that "megaloblastic anemias, and, in particular, pernicious anemia are said to be virtually unknown except for occasional cases of childhood folate deficiency."I would like to dispute that. In October 1979, I visited the People's Republic of China with a group of physicians (Dr. Richard Silver of Cornell Medical College and I were the two hematologists with the group). We visited with colleagues at medical schools and hospitals in Beijing (Peking), Chengchow, Wuhan, Shanghai, and Kwangchow (Canton), as discussed in an article entitled "Chinese Medicine Turns...References1. RASSIGAFINCHENGLISH ACE. Hematology in the People's Republic of China. Ann Intern Med. 1982;96:524-5. LinkGoogle Scholar2. KENNEDY A. Chinese medicine turns to U.S. again. Med World News. 1979;20(25):11-22. MedlineGoogle Scholar3. HERBERT V. The nutritional anemias. Hosp Pract. 1980;15(3):65-89. CrossrefMedlineGoogle Scholar4. HERBERT V. Diagnosing megaloblastic anemia. Med Times. 1982; 110(4):63-70. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1982Volume 97, Issue 1Page: 139-140KeywordsChinese peopleFolate deficiencyHematology and oncologyHospital medicineMegaloblastic anemiaPernicious anemia Issue Published: 1 July 1982 PDF DownloadLoading ...
Prognostic Significance of Heart Rate Variability in Post–Myocardial Infarction Patients in the Fibrinolytic Era
Authors: Giulio Zuanetti, James M.M. Neilson, Roberto Latini, Eugenio Santoro, Aldo P. Maggioni, David J. Ewing
Journal: Circulation (1996)

Background Studies performed before the introduction of fibrinolysis showed that a low heart rate variability (HRV) is associated with higher mortality in post–myocardial infarction (MI) patients. We evaluated whether HRV adds information relevant to risk stratification in patients treated with fibrinolysis as well. Methods and Results From 24-hour ECG recordings obtained at discharge in patients treated with recombinant tissue-type plasminogen activator or streptokinase, we measured several time-domain indexes of HRV: standard deviation (SDNN), root-mean-square of successive differences (RMSSD), and number of RR interval increases &gt;50 ms (“NN50+”). The prognostic value of HRV for total and cardiovascular mortality was assessed. Of 567 patients with valid recordings, 52 (9.1%) died during the 1000 days of follow-up, 44 (7.8%) of cardiovascular causes. All indexes of low HRV were able to identify patients (16% to 18% of total population) with a higher total mortality (20.8% to 24.2% versus 6.0% to 6.8%, depending on index used). The independent predictive value of low HRV was confirmed by the adjusted analysis with the following relative risks: NN50+, 3.5 (95% CI, 1.9 to 6.7); SDNN, 3.0 (95% CI, 1.55 to 5.9); and RMSSD, 2.8 (95% CI, 1.5 to 5.3). Advanced age, previous MI, Killip class at entry, and use of digitalis were also independent predictors. Similar data were obtained for cardiovascular mortality. Conclusions Time-domain indexes of HRV retain their independent prognostic significance even in post-MI patients of all ages treated with fibrinolysis.
Health costs of the Gulf war.
Authors: I Lee, A Haines
Journal: BMJ (1991)

<h3>ABSTRACT:</h3> A soil conservation economics model (SOILEC) was used to calculate long-run erosion and financial impacts of alternative conservation management systems on 27 Illinois soils. By subtracting annual net income of the best system for achieving the soil loss tolerance (T-value) from the annual net income of the income-maximizing system, an estimate was obtained of the subsidy or payment required to induce a farmer to achieve T-value. Sensitivity of this subsidy to commodity prices and discount rates was analyzed.
Effect of β2-microglobulin adsorption column on dialysis-related amyloidosis
Authors: Takaya Abe, Kazuhiro Uchita, Hikari Orita, Motohiro Kamimura, Minoru Oda, Hirohito Hasegawa, Hirotsugu Kobata, Masaaki Fukunishi, Masami Shimazaki, Tomiya Abe, Tadao Akizawa, Suhail Ahmad
Journal: Kidney International (2003)
Letter by Gómez-Ambrosi et al Regarding Article, “Clinical Assessment and Management of Adult Obesity”
Authors: Javier Gómez-Ambrosi, Javier Salvador, Gema Frühbeck
Journal: Circulation (2013)

1 As stated by the author, the utility of body mass index (BMI) for diagnosing obesity has been demonstrated in many population studies.It has the advantage that a subject's height and weight are easy and inexpensive to measure.However, in spite of being widely used, BMI is only a surrogate measure of body fatness and does not provide an accurate measurement of body composition, 2 which has also been recognized by the author.In this sense, we believe that it is of great clinical value to obtain an accurate idea of the body fat percentage (BF) of patients.This is important because the cardiometabolic risk of some patients may be underestimated or even ignored when using BMI, because it cannot always properly discriminate the risk of chronic disease at the individual level. 3In this sense, our group has recently shown that the determination of BF represents a useful tool for better characterizing individuals who are truly at cardiometabolic risk as a result of excess body fat in spite of exhibiting a normal BMI, thereby identifying those in need of dietary or pharmacological interventions. 2,4The misclassification of obesity by using BMI is not trivial, because up to 29% and 80% of lean and overweight white subjects are actually obese according to real BF. 2 This misclassification affects not only patients with an unusual body habitus, body builders or aged patients, as stated by the author, but also affects normal subjects as evidenced studying >6000 subjects.Our data indicate that a relevant number of at-risk patients with excess adiposity are being underdiagnosed and, therefore, opportunities for adequate treatment are being missed.Kushner also notices that accurate methods for assessing body composition are frequently expensive and not available for routine clinical application, and we agree with this observation.Therefore, given this limitation, we aimed to develop an equation for the estimation of BF that is more precise than BMI, taking into account the age and sex of a given individual in addition to weight and height.We have named this equation CUN-BAE, and its clinical usefulness has been recently validated. 5We suggest that methods for identifying overweight and obesity based on adiposity, such as body composition techniques (or when the possibility of measuring BF is not available, better estimators than BMI) for measuring/estimating BF, should be incorporated to the assessment algorithm to obtain a more realistic view of the potential cardiometabolic risk of a given patient.
US cancer mortality falls for the first time
Authors: Jeanne Lenzer
Journal: BMJ (2006)

The total number of deaths from cancer fell in the United States for the first time since 1930, when nationwide statistics were first compiled, says a new report by the American Cancer Society. The decline occurred in 2003, when 556 902 people died from cancer; the number who died in 2002 was 557 271.

John Seffrin, chief executive officer of the American Cancer Society, said, “For years we've proudly pointed to dropping cancer death rates, even as a growing and aging population meant more actual …
Penicillin-Resistant "Gonorrhea"-Reply
Authors: Alison Ash
Journal: JAMA (1962)

<h3>To the Editor:—</h3> Since "epidemics" of "penicillinresistant gonorrhea" have been occurring among our armed forces overseas, to what is this due? Is it that the actual causative agent is of the tribe Mimeae and is penicillin resistant (<i>JAMA</i><b>177</b>:121 [July 15] 1961), or is it that<i>Neisseria gonorrhea</i>is surrounded by Staphylococcus epidermitis, which, although ordinarily innocuous, puts out enough penicillinase to protect itself plus the gonococcus? (Reported by Arvey C. Sanders to the Society of American Bacteriologists and reprinted in<i>Medical World News</i><b>2</b>:32-33 (June 9) 1961.
Liquid-Filled Balloon Brachytherapy Using <sup>68</sup> Ga Is Effective and Safe Because of the Short 68-Minute Half-Life
Authors: Hans-Peter Stoll, Gary D. Hutchins, Wendy L. Winkle, Anne T. Nguyen, Dongming Hou, C. Robert Appledorn, Bernd Romeike, Keith L. March
Journal: Circulation (2001)

Background —Liquid-filled balloons for coronary brachytherapy provide significant advantages over solid sources in dose homogeneity but carry the risk of life-threatening radiointoxication after balloon rupture and laboratory contamination in case of a spill. We hypothesized that the positron emitter 68 Ga, with a half-life of only 68 minutes, was well suited to overcome these safety obstacles while providing full therapeutic efficacy. Methods and Results —The feasibility, efficacy, and safety of 68 Ga liquid-filled balloon brachytherapy were investigated in the porcine coronary overstretch model. Four groups of 5 balloon-induced coronary lesions were irradiated with 8, 12, 16, and 24 Gy targeted to the adventitia. Ten unirradiated lesions served as controls. Segments treated with 16 or 24 Gy exhibited marked suppression of neointimal proliferation at 28-day follow-up, with quantitative parameters of intraluminal proliferation reduced to &lt;20%. This beneficial effect was not compromised by untoward edge effects. Uninjured but irradiated vessels did not show histological signs of radiation damage. The 68 Ga whole-body dose due to balloon rupture was estimated to be 5 rem/50 mCi treatment activity and compared favorably with that of 188 Re (78 rem/50 mCi). Conclusions — 68 Ga positron radiation suppresses neointimal proliferation at doses of 16 and 24 Gy. This biological efficacy, coupled with the attractive safety profile, suggests the selection of 68 Ga as an attractive isotope for liquid-filled balloon brachytherapy.
Anatomy of the liver: An outline with three levels of complexity – A further step towards tailored territorial liver resections
Authors: Pietro Majno, Gilles Mentha, Christian Toso, Philippe Morel, Heinz O. Peitgen, Jean H.D. Fasel
Journal: Journal of Hepatology (2013)

The vascular anatomy of the liver can be described at three different levels of complexity according to the use that the description has to serve. The first--conventional--level corresponds to the traditional 8-segments scheme of Couinaud and serves as a common language between clinicians from different specialties to describe the location of focal hepatic lesions. The second--surgical--level, to be applied to anatomical liver resections and transplantations, takes into account the real branching of the major portal pedicles and of the hepatic veins. Radiological and surgical techniques exist nowadays to make full use of this anatomy, but this requires accepting that the Couinaud scheme is a simplification, and looking at the vascular architecture with an unprejudiced eye. The third--academic--level of complexity concerns the anatomist, and the need to offer a systematization that resolves the apparent contradictions between anatomical literature, radiological imaging, and surgical practice. Based on the real number of second-order portal branches that, although variable averages 20, we submit a system called the "1-2-20 concept", and suggest that it fits best the number of actual--as opposed to idealized--anatomical liver segments.
Sonographic hepatic-renal ratio as indicator of hepatic steatosis: comparison with 1H magnetic resonance spectroscopy
Authors: Marcello Mancini, Anna Prinster, Giovanni Annuzzi, Raffaele Liuzzi, Rosalba Giacco, Carmela Medagli, Matteo Cremone, Gennaro Clemente, Simone Maurea, Gabriele Riccardi, Angela Albarosa Rivellese, Marco Salvatore
Journal: Metabolism (2009)
Renal Rehabilitation — Where Are the Data?
Authors: Drummond Rennie
Journal: New England Journal of Medicine (1981)

WE all have a stake in the billion-dollar End-Stage Renal Disease (ESRD) program, not least because its cost is borne largely by Medicare. We would naturally like to receive frequent, comprehensive, and reliable reports about its progress, along the lines of the articles and newsletters produced until four years ago by Dr. John Bergan and his associates at the Human Renal Transplant Registry, kept by the American College of Surgeons and funded by the National Institutes of Health.1 Unfortunately, since 1977 when the Health Care Financing Administration (HCFA) took over the ESRD program, medical information about it has been woefully . . .
Normal Serum Ferritin in Precirrhotic Hemochromatosis
Authors: William H. Crosby
Journal: New England Journal of Medicine (1977)

After Wands et al.1 reported that some people with precirrhotic hemochromatosis have normal levels of serum ferritin it soon became evident that others had observed the phenomenon without commenting on it.2 , 3 It was a sad development that a test otherwise so nicely reflecting abnormalities of storage iron should remain uninformative in the presence of 5 to 10 g of excess iron in early hemochromatosis.4 Other phenomena already known about hemochromatosis and ferritin may permit an explanation of this paradoxical low value. The monocyte-macrophage in hemochromatosis responds abnormally to the presence of a heavy load of iron in the body. In . . .
Posttransfusion hepatitis after open-heart operations. Incidence after the administration of blood from commercial and volunteer donor populations
Authors: J. H. Walsh
Journal: JAMA (1970)

The incidence of icteric and anicteric hepatitis was determined prospectively in 110 patients undergoing open-heart operations in which cardiopulmonary bypass was used. Patients were supplied with blood from two commercial blood banks (82 patients), or from local volunteer donors (28 patients). Serial determinations of serum transaminase levels were obtained for six months following operation. Hepatitis developed in 51% (42) of the recipients of commercial blood, but the disease did not occur in any patient who received blood from volunteer donors. The hepatitis carrier rate for commercial blood donors was 6.3%, but, for volunteer donors, was less than 0.6%. This difference in carrier rates probably reflects differences in the donor populations.
Host CXCR2-Dependent Regulation of Melanoma Growth, Angiogenesis, and Experimental Lung Metastasis
Authors: Seema Singh, Michelle Varney, Rakesh K. Singh
Journal: Cancer Research (2009)

Abstract Crucial steps in tumor growth and metastasis are proliferation, survival, and neovascularization. Previously, we have shown that receptors for CXCL-8, CXCR1, and CXCR2 are expressed on endothelial cells and CXCR2 has been shown to be a putative receptor for angiogenic chemokines. In this report, we examined whether tumor angiogenesis and growth of CXCL-8–expressing human melanoma cells are regulated in vivo by a host CXCR2–dependent mechanism. We generated mCXCR2−/−, mCXCR2+/−, and wild-type nude mice following crosses between BALB/c mice heterozygous for nude+/− and heterozygous for mCXCR2+/−. We observed a significant inhibition of human melanoma tumor growth and experimental lung metastasis in mCXCR2−/− mice as compared with wild-type nude mice. Inhibition in tumor growth and metastasis was associated with a decrease in melanoma cell proliferation, survival, inflammatory response, and angiogenesis. Together, these studies show the importance of host CXCR2–dependent CXCL-8–mediated angiogenesis in the regulation of melanoma growth and metastasis. [Cancer Res 2009;69(2):411–5]