tbuckley/cabot-search huggingface dataset:
Inequities in Health Services among Insured Americans
Authors: Rodney A. Hayward, Martin F. Shapiro, Howard E. Freeman, Christopher R. Corey
Journal: New England Journal of Medicine (1988)

Abstract To determine whether groups other than the elderly and the uninsured have difficulty obtaining access to medical care, we studied 7633 adults nationwide. As we expected, the insured had much greater access than the uninsured, but among the insured there were substantial disparities in access to care. Insured adults of working age were 3.5 times as likely (95 percent confidence interval, 2.7 to 4.4) as the elderly to have needed supportive medical services (including medications and supplies) but not to have received them, and 3.4 times (2.3 to 4.4) as likely to have had major financial difficulties because of illness. Among insured, working-age adults, the poor were 4.4 times (3.5 to 5.3) as likely as those who were not poor to have needed supportive services but not to have received them, and 5.2 times (3.6 to 6.8) as likely to have had major financial problems because of illness. Apart from insurance status and income, blacks were 1.7 times (1.1 to 2.2) as likely as whites to have needed supportive services but not to have received them. Hispanics with a medical illness were 2.2 times (1.3 to 3.2) as likely as whites not to have seen a physician within the past year. We conclude that insured, working-age adults have less access to medical care than the elderly, and that poor, black, or Hispanic persons in this group are at risk for even greater problems with access to care. Current policy strategies are unlikely to improve the ability of these groups to obtain care. (N Engl J Med 1988; 318:1507–12.)
Osteogenesis imperfecta in the differential diagnosis of child abuse.
Authors: C. R. Paterson, S. J. McAllion
Journal: BMJ (1989)

The pharmaceutical industry may be very useful here.Of course, it helps if the research fellow works in a specialty in which there is a lot of industry interest.In our view this is a legitimate activity, although some will disagree.Make initial approaches through the relevant local representatives as chances of obtaining funding are often enhanced if the representative is pushing the case.Turn down the offer to discuss this or that product over lunch but tactfully suggest that help towards the travel costs of the next European meeting would be a more worthwhile way to spend the budget.Make the most of the money raised Advance programmes for many international scientific meetings provide the facility for booking convenient hotel accommodation beforehand.Furthermore, members of particular specialty associations receive, unsolicited, details of "package" deals to attend forthcoming major meetings.We have never availed ourselves of these opportunities, believing that good, cheaper alternatives are often possible.This does not apply to national meetings when adequate and cheaper accommodation is to be had in university halls of residence.The traditional "bucket shops" which deal in the "unsold stocks" of airline tickets have been heavily criticised because of financial losses and nonarrival of tickets.But some of these outlets are good and efficient: the difficulty lies in knowing which fall into this category.If you want to deliver your talk to your colleagues at the meeting rather than to other stranded passengers at the airport it is best to use travel agents bonded to the Association of British Travel Agents (ABTA) or the International Air Transport Association (IATA) whenever possible.Planning ahead is the most important consideration in obtaining the best deals.Cheaper excursion flights (stay includes a compulsory Saturday night) have to be booked at least two weeks ahead for most European flights and three weeks for those further afield.Consider charter flights and accommodation packages, such as City Breaks, which can be very good value, especially if you share a room with a colleague.Choosing an unpopular flight time (early morning, late night) may enable cheaper tickets to be obtained.For Europe it is worth considering rail travel, and for a small group travelling together driving may prove much cheaper.We know of some colleagues who actually camped out near one European city and travelled in daily for the meeting.For those not so hardy there are now plenty of available guides which detail cheap and clean basic accommodation in most cities.
The early recognition of right ventricular infarction: diagnostic accuracy of the electrocardiographic V4R lead.
Authors: H O Klein, T Tordjman, R Ninio, P Sareli, V Oren, R Lang, J Gefen, C Pauzner, E Di Segni, D David, E Kaplinsky
Journal: Circulation (1983)

The sensitivity and specificity of ST-segment elevation in the right precordial lead V4R as an early indicator of right ventricular infarction were examined in a consecutive series of 110 patients admitted for acute inferior myocardial infarction. The sensitivity was 82.7%, the specificity 76.9% and the positive predictive value 70% in 58 patients with right ventricular infarction documented by autopsy or a combination of radionuclide ventriculography and one or more of the following tests: echocardiography, technetium-99m pyrophosphate scintigraphy and hemodynamic monitoring. The negative predictive value was 87.7%. Because of its simplicity and its high sensitivity and specificity, recording of V4R should be an intrinsic part of the early evaluation and electrocardiographic examination of acute inferior wall infarction.
Editorial: Lesions about the junction of medulla and spinal cord
Authors: C. D. Azing
Journal: JAMA (1974)

TO ERR in the diagnosis of a relievable disorder is a tragedy. A readily missed and usually eminently relievable lesion of the nervous system is one about the junction of the medulla and cervical spinal cord (a junction lesion). Here, the arrangement of nervous structures and their blood supply<sup>1</sup>is such as to result in a multiplicity and variance of symptoms and signs from patient to patient, signs that may come and go. A recent leading article in<i>The Lancet'</i><sup>2</sup>called attention to missed foramen magnum tumors. Aneurysms and subarachnoid cysts in this locale, characterized by remission and exacerbation, test diagnostic acumen. The most common mistake in diagnosis has been to call these troubles "multiple sclerosis," and perhaps next most common, "cervical spondylosis." A sign of multiple sclerosis, the tingling shock that occurs on first flexing the neck (Lhermitte sign) has been found in junction lesions. Also, horizontal
Timing chromosomal abnormalities using mutation data
Authors: Steffen Durinck, Christine Ho, Nicholas J Wang, Wilson Liao, Lakshmi R Jakkula, Eric A Collisson, Jennifer Pons, Sai-Wing Chan, Ernest T Lam, Catherine Chu, Kyunghee Park, Sung-woo Hong, Joe S Hur, Nam Huh, Isaac M Neuhaus, Siegrid S Yu, Roy C Grekin, Theodora M Mauro, James E Cleaver, Pui-Yan Kwok, Philip E LeBoit, Gad Getz, Kristian Cibulskis, Jon C Aster, Haiyan Huang, Elizabeth Purdom, Jian Li, Lars Bolund, Sarah T Arron, Joe W Gray, Paul T Spellman, Raymond J Cho
Journal: Genome biology (2011)
Clinical and prognostic significance of cytokine receptor expression in adult acute lymphoblastic leukemia: interleukin-2 receptor α-chain predicts a poor prognosis
Authors: K Nakase, K Kita, H Miwa, K Nishii, M Shikami, I Tanaka, H Tsutani, T Ueda, K Nasu, T Kyo, H Dohy, H Shiku, N Katayama
Journal: Leukemia (2007)
Abstract 123: miR-145 function as a tumor suppressor targeting multiple oncogenes in prostate cancer
Authors: Miki Fuse, Nijiro Nohata, Muradil Mutallip, Naoko Kikkawa, Shinichi Sakamoto, Satoko Kojima, Takeshi Chiyomaru, Kazumori Kawakami, Hideki Enokida, Masayuki Nakagawa, Tomohiko Ichikawa, Naohiko Seki
Journal: Cancer Research (2011)

Abstract Prostate cancer remains one of the most prevalent cancers and a major cause of morbidity and mortality in the western world. Disease progression and the development of hormone refractory disease remain major causes of cancer-related death. The understanding of the new molecular pathways of hormone refractory would be helpful in improving diagnosis and therapy of the disease. microRNAs (miRNAs) are small, non-coding RNAs with a length of approximately 22 nucleotides. They regulate gene expression by promoting mRNA cleavage and at the posttranscriptional level by translational suppression. They play important roles in various biological and metabolic processes, including development, differentiation, signal transduction, cell maintenance, and cancer. Bioinformatic predictions indicate that miRNAs regulate more than 30% of the protein coding genes. It is estimated that approximately 1,000 miRNAs exist in the vertebrate genome. An important role for miRNAs in the development of cancer has emerged in recent years. miRNAs are aberrantly expressed in many human cancers, and they may function as oncogenes or tumor suppressors. Up-regulated miRNAs could function as oncogenes by negatively regulating tumor suppressor genes, while down-regulated miRNAs could act as tumor suppressors, inhibiting cancers by regulating oncogenes. Down-regulation of miR-145 has been reported in many types of human cancer, including prostate cancer, suggesting that miR-145 function as a tumor suppressor. In this study, we focused on target identification of miR-145 in prostate cancer, based on gene-wide gene expression analysis of miR-145 transfection cells. According to our expression analysis showed that down-regulated genes (FSCN1, UNG and EIF4EBP2) were identified. Loss-of-function assays revealed that FSCN1 inhibited cell proliferation, migration, and invasion in PC3 and DU145 cells, suggesting FSCN1 function as an oncogene. The identification of tumor suppressive miRNA and their target genes could provide new insights into potential mechanisms of prostate carcinogenesis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 123. doi:10.1158/1538-7445.AM2011-123
SOME REMARKS ON THE OPERATIVE METHODS IN THE TREATMENT OF ADENOID GROWTHS.Read in the Section on Laryngology and Otology, at the Forty-fourth Annual Meeting of the American Medical Association.
Authors: C. W. RICHARDSON
Journal: JAMA (1893)

It is not my intention in this paper to give a resumé of the operative methods in the treatment of adenoid growths, nor a historical outline of its gradual development and improvement; but simply to describe the operative method I have now employed for several years in the treatment of this condition. In the various steps of the operation I claim nothing original; my originality, if any exists, arises from the manner in which the successive steps are made to interlace. It is with growing interest that I have watched, year by year, the rapid increase in the number and variety of forceps and curettes for the operative removal of these growths, until my interest has become satiated with their multiplicity. Many of these inventors seem to have overlooked the fact that nature has endowed them, not only with the safest and most complete, but also the most sensitive instrument
Gastric adenocarcinoma of the fundic gland type (chief cell predominant type)
Authors: Hiroya Ueyama, Kenshi Matsumoto, Akihito Nagahara, Takuo Hayashi, Takashi Yao, Sumio Watanabe
Journal: Endoscopy (2013)

Gastric adenocarcinoma of the fundic gland (chief cell predominant type, GA-FG-CCP) was recently proposed as a new, rare variant of gastric adenocarcinoma. The aim of the current study was to evaluate the endoscopic features of GA-FG-CCP. A total of 10 GA-FG-CCPs were included and evaluated retrospectively. The endoscopic and clinicopathological features of the lesions were analyzed to provide information of diagnostic value. The GA-FG-CCPs were classified into two categories: submucosal tumor shape (60 %) and flat or depressed type (40 %). Endoscopically, the most common features were submucosal tumor shape (60 %), whitish color (70 %), dilated vessels with branching architecture (50 %), and background mucosa without atrophic change (90 %). GA-FG-CCP has distinct endoscopic characteristics, especially in terms of shape, color, vessels, and background mucosa and may be classified into two categories macroscopically. To diagnose GA-FG-CCP correctly by pathological examination of biopsy specimens, these endoscopic features should be taken into consideration.
Tumor-penetrating peptide fused EGFR single-domain antibody enhances cancer drug penetration into 3D multicellular spheroids and facilitates effective gastric cancer therapy
Authors: Huizi Sha, Zhengyun Zou, Kai Xin, Xinyu Bian, Xueting Cai, Wuguang Lu, Jiao Chen, Gang Chen, Leaf Huang, Andrew M. Blair, Peng Cao, Baorui Liu
Journal: Journal of Controlled Release (2014)
Impact of an informed choice invitation on uptake of screening for diabetes in primary care (DICISION): randomised trial
Authors: T. M. Marteau, E. Mann, A. T. Prevost, J. C. Vasconcelos, I. Kellar, S. Sanderson, M. Parker, S. Griffin, S. Sutton, A. L. Kinmonth
Journal: BMJ (2010)

<b>Objective</b> To compare the effect of an invitation promoting informed choice for screening with a standard invitation on attendance and motivation to engage in preventive action. <b>Design</b> Randomised controlled trial. <b>Setting</b> Four English general practices. <b>Participants</b> 1272 people aged 40-69 years, at risk for diabetes, identified from practice registers using a validated risk score and invited to attend for screening. <b>Intervention</b> Intervention was a previously validated invitation to inform the decision to attend screening, presenting diabetes as a serious potential problem, and providing details of possible costs and benefits of screening and treatment in text and pie charts. This was compared with a brief, standard invitation simply describing diabetes as a serious potential problem. <b>Main outcome measures</b> The primary end point was attendance for screening. The secondary outcome measures were intention to make changes to lifestyle and satisfaction with decisions made among attenders. <b>Results</b> The primary end point was analysed for all 1272 participants. 55.8% (353/633) of those in the informed choice group attended for screening, compared with 57.6% (368/639) in the standard invitation group (mean difference −1.8%, 95% confidence interval −7.3% to 3.6%; P=0.51). Attendance was lower among the more deprived group (most deprived third 47.5% <i>v</i> least deprived third 64.3%; P&lt;0.001). Interaction between deprivation and effect of invitation type on attendance was not significant. Among attenders, intention to change behaviour was strong and unaffected by invitation type. <b>Conclusions</b> Providing information to support choice did not adversely affect attendance for screening for diabetes. Those from more socially deprived groups were, however, less likely to attend, regardless of the type of invitation received. Further attention to invitation content alone is unlikely to achieve equity in uptake of preventive services. <b>Trial registration</b> Current Controlled Trials ISRCTN 73125647.
On the Undiffusion of Established Practices
Authors: Frank Davidoff
Journal: JAMA Internal Medicine (2015)

33. Deyell MW, Buller CE, Miller LH, et al. Impact of National Clinical Guideline recommendations for revascularization of persistently occluded infarct-related arteries on clinical practice in the United States. Arch Intern Med. 2011;171(18): 1636-1643. 34. ShahMR, Hasselblad V, Stevenson LW, et al. Impact of the pulmonary artery catheter in critically ill patients: meta-analysis of randomized clinical trials. JAMA. 2005;294(13):1664-1670.
Deletion of Cardiomyocyte Mineralocorticoid Receptor Ameliorates Adverse Remodeling After Myocardial Infarction
Authors: Daniela Fraccarollo, Stefan Berger, Paolo Galuppo, Susanne Kneitz, Lutz Hein, Günther Schütz, Stefan Frantz, Georg Ertl, Johann Bauersachs
Journal: Circulation (2011)

Background— Mineralocorticoid receptor (MR) blockade improves morbidity and mortality among patients with heart failure; however, the underlying mechanisms are still under investigation. We studied left ventricular remodeling after myocardial infarction in mice with cardiomyocyte-specific inactivation of the MR gene (MR MLCCre ) that were generated with a conditional MR allele (MR flox ) in combination with a transgene expressing Cre recombinase under control of the myosin light-chain (MLC2a) gene promoter. Methods and Results— Control (MR flox/flox , MR flox/wt ) and MR MLCCre mice underwent coronary artery ligation. MR ablation had no detectable baseline effect on cardiac morphology and function. The progressive left ventricular chamber enlargement and functional deterioration in infarcted control mice, detected by echocardiography and conductance catheter analysis during the 8-week observation period, were substantially attenuated in MR MLCCre mice. Chronically infarcted MR MLCCre mice displayed attenuated pulmonary edema, reduced cardiac hypertrophy, increased capillary density, and reduced accumulation of extracellular matrix proteins in the surviving left ventricular myocardium. Moreover, cardiomyocyte-specific MR ablation prevented the increases in myocardial and mitochondrial O 2 ·− production and upregulation of the NADPH oxidase subunits Nox2 and Nox4. At 7 days, MR MLCCre mice exhibited enhanced infarct neovessel formation and collagen structural organization associated with reduced infarct expansion. Mechanistically, cardiomyocytes lacking MR displayed accelerated stress-induced activation and subsequent suppression of nuclear factor-κB and reduced apoptosis early after myocardial infarction. Conclusion— Cardiomyocyte-specific MR deficiency improved infarct healing and prevented progressive adverse cardiac remodeling, contractile dysfunction, and molecular alterations in ischemic heart failure, highlighting the importance of cardiomyocyte MR for heart failure development and progression.
Book: Theater of Disorder: Patients, Doctors, and the Construction of Illness
Authors: S. A Spence
Journal: BMJ (2002)

Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>![Graphic][4]</img> In this bold, intellectual tour de force Brant Wenegrat argues that many of the more exotic neuroses of our time (multiple personality disorder, alien abduction, and recovered memory syndromes) and the transient possession states of “traditional” cultures are really forms of acting—commonly executed by those who are disenfranchised. “The truth is that some psychologists, psychiatrists, and physicians have made their careers directing role enactments,” he says. This critique builds upon “normal” social psychology, demonstrating the extent to which human behaviour can be directed by social cues. More … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif
Diagnosis of Pneumocystis carinii pneumonia in HIV antibody positive patients by simple outpatient assessments.
Authors: R B Nieman, R J Coker, D M Mitchell
Journal: Thorax (1993)

Notification of tuberculosis: how many cases are never reported?Tower Hamlets is not the only London borough to report significant recent under- notification of tuberculosis (27%) (December 1992;47:1015-8).Hickman et alt reported 26% undernotification of non-HIV associated tuberculosis and 60% undemoti- fication of HIV related tuberculosis for the Riverside DHA for the period April 1990 to March 1991.Riverside have tightened procedures to reduce or prevent undemotification and hopefully Tower Hamlets have done so too.Correction of undernotifica- tion from these districts, and possibly others, may be contributing to the recent rise in tuberculosis notifications in England and Wales, particularly since 1989.The use of pathology and microbiology services to supplement notification has been reported.2An integrated and centralised tuberculosis service for a district would overcome many of these problems, but it is easier to implement in a DHA or Trust without multiple units.In the Blackburn, Hyndburn and Ribble Valley DHA, served by two acute hospitals of 400 and 550 beds, there is no undernotification because of our integrated system which has three key components:1.There is agreement that all cases of adult tuberculosis of whatever type are
Biotin Deficiency in an Adult During Home Parenteral Nutrition
Authors: Craig J. McClain
Journal: JAMA (1982)

BIOTIN deficiency in man has been extremely rare, presumably because this vitamin is ubiquitous in the diet and is also produced by the gut flora. Raw egg white contains a protein, avidin, which tightly binds biotin and renders it poorly absorbed. In 1942 Sydenstricker et al<sup>1</sup>induced biotin deficiency in adult volunteers by feeding them a diet to which 200 g of dehydrated egg white had been added. Symptoms of biotin deficiency were produced that reversed with daily injections of 75 to 300 μg of biotin. More recent reports have described infants with inborn errors in the metabolism of biotin-dependent enzymes and signs and symptoms of biotin deficiency.<sup>2,3</sup>One child with short-bowel syndrome has been described in which signs of biotin deficiency appeared in association with parenteral nutrition and antibiotic therapy, and these signs reversed with administration of 10 mg of biotin a day.<sup>4</sup>These investigators presumed this
ABC of mental health: Psychotropic drug treatment
Authors: S. R Pathare, C. Paton
Journal: BMJ (1997)

This article takes a broad view of the factors affecting the choice and effectiveness of common drugs in psychiatric use. Specific treatment issues are dealt with in earlier articles in this series. Decision tree for drug treatment of depression All antidepressants are equally effective in treating depression, and no single drug has been shown to have a more rapid onset of action than another. The choice of antidepressant is dictated by a combination of factors including the clinical presentation, the patient's physical health, the anticipated side effect profile, and the prescriber's preferences. Types of depression —Certain types of depression respond better to particular classes of drugs, such as atypical depressive illness to monoamine oxidase inhibitors or mixed anxiety and depression to selective serotonin reuptake inhibitors. Patients with agitated depression respond well to a sedating tricyclic drug such as amitriptyline. If social withdrawal is prominent, a “stimulating” antidepressant such as imipramine or a selective serotonin reuptake inhibitor such as fluoxetine may help. Suicide risk —Overall, selective serotonin reuptake inhibitors are safer than tricyclics in overdose, with dothiepin having been found to be the most toxic. Since suicide risk in any given patient is extremely difficult to predict, it has been argued that selective serotonin reuptake inhibitors should be the first choice of treatment in all cases of depressive illness. The financial implications of completely abandoning tricyclics in favour of selective serotonin reuptake inhibitors are enormous. However, the cost of drug related morbidity and treatment failure due to poor compliance must also be considered. For the moment, the most effective and economical way to prevent suicide is to