tbuckley/cabot-search huggingface dataset:
Frequent attenders are getting poor care
Authors: D. Spence
Journal: BMJ (2014)

Shocking headlines have revealed that a small number of patients attend emergency departments as many as 50 times a year.1 This was suggested to be a waste of resources and a failure of primary care. Perhaps reporters should ask the same questions of general practice. Our waiting rooms are full of familiar faces, who wave as we walk by, some attending more than 50 times a year. GPs are criticised for having appointments that last only 10 minutes, but we spend hours each year in the company of some patients. What leads patients to …
Willingness of Hong Kong healthcare workers to accept pre-pandemic influenza vaccination at different WHO alert levels: two questionnaire surveys
Authors: J. S Y Chor, K. L. Ngai, W. B Goggins, M. C S Wong, S. Y S Wong, N. Lee, T.-f. Leung, T. H Rainer, S. Griffiths, P. K S Chan
Journal: BMJ (2009)

<b>Objective </b>To assess the acceptability of pre-pandemic influenza vaccination among healthcare workers in public hospitals in Hong Kong and the effect of escalation in the World Health Organization’s alert level for an influenza pandemic. <b>Design </b>Repeated cross sectional studies using self administered, anonymous questionnaires <b>Setting </b>Surveys at 31 hospital departments of internal medicine, paediatrics, and emergency medicine under the Hong Kong Hospital Authority from January to March 2009 and in May 2009 <b>Participants </b>2255 healthcare workers completed the questionnaires in the two studies. They were doctors, nurses, or allied health professionals working in the public hospital system. <b>Main outcome measures </b>Stated willingness to accept pre-pandemic influenza vaccination (influenza A subtypes H5N1 or H1N1) and its associating factors. <b>Results </b>The overall willingness to accept pre-pandemic H5N1 vaccine was only 28.4% in the first survey, conducted at WHO influenza pandemic alert phase 3. No significant changes in the level of willingness to accept pre-pandemic H5N1 vaccine were observed despite the escalation to alert phase 5. The willingness to accept pre-pandemic H1N1 vaccine was 47.9% among healthcare workers when the WHO alert level was at phase 5. The most common reasons for an intention to accept were “wish to be protected” and “following health authority’s advice.” The major barriers identified were fear of side effects and doubts about efficacy. More than half of the respondents thought nurses should be the first priority group to receive the vaccines. The strongest positive associating factors were history of seasonal influenza vaccination and perceived risk of contracting the infection. <b>Conclusions </b>The willingness to accept pre-pandemic influenza vaccination was low, and no significant effect was observed with the change in WHO alert level. Further studies are required to elucidate the root cause of the low intention to accept pre-pandemic vaccination.
Oxidative Metabolism in Cirrhotic Patients With and Without Hepatocellular Carcinoma: Effects of Malnutrition
Authors: Francesco William Guglielmi, Tecla Mastronuzzi, Maria de Marco, Lucia Laddaga, Carmine Panella, Antonio Francavilla
Journal: Hepatology (1992)

Progressive degrees of metabolic alterations are frequent in cirrhosis impairing peripheral tissue and body composition. Hepatocellular carcinoma worsens protein wasting and malnutrition. A normal energy production rate and an abnormal substrate oxidation rate are well-known findings in cirrhosis; however, no data are available on cirrhotic patients with hepatocellular carcinoma. The aim of this study was to measure oxidative metabolism in cirrhotic patients with and without hepatocellular carcinoma and to investigate the correlation between energy production rate, respiratory quotient and nutritional state. Thirteen male cirrhotic patients with hepatocellular carcinoma (8 well-nourished and 5 malnourished) were compared with 17 cirrhotic patients without hepatocellular carcinoma (11 well-nourished and 6 malnourished) and six controls who were age and sex matched. A diagnosis of malnutrition was made if the fat mass percentage was reduced to less than 20% of the patient's body weight. Indirect calorimetry was performed between 8 and 10 AM, after a 12-hr fast, for 30 min (with a 10-min steady-state period), and measured energy production rate was calculated according to Weir's formula. Body composition was assessed by means of the Durnin and Womersley formula. Anthropometry and bioelectric impedance analysis showed no variations in kilograms of fat-free mass in our malnourished patients. Our data show that, when the energy production rate is measured while the patient is at rest and corrected for fat-free mass, the energy requirements of cirrhotic patients and cirrhotic patients with hepatocellular carcinoma matched that of the controls, regardless of nutritional state.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetogenic effect of cyclosporin.
Authors: J J Bending, C S Ogg, G C Viberti
Journal: BMJ (1987)

A young woman given a renal allograft for polycystic kidney disease developed insulin dependent diabetes mellitus 25 days after transplantation. There was no family history of diabetes, plasma glucose concentrations had been normal at presentation and on five subsequent occasions, and at no time were islet cell antibodies detectable. Plasma C peptide concentrations, however, were greatly suppressed after transplantation and remained so for up to six months. The immunosuppressive regimen had included cyclosporin A, which had been difficult to regulate and caused definite signs of toxicity in the patient. By virtue of its reported toxicity for beta cells and the reversal of the diabetes several months after the dose was reduced cyclosporin was incriminated as the probable causative agent. Dose related beta cell toxicity of cyclosporin A may be a risk in recipients of this drug and warrants careful monitoring of drug and glucose concentrations.
A novel type of congenital hypochromic anemia associated with a nonsense mutation in the STEAP3/TSAP6 gene
Authors: Bernard Grandchamp, Gilles Hetet, Caroline Kannengiesser, Claire Oudin, Carole Beaumont, Sylvie Rodrigues-Ferreira, Robert Amson, Adam Telerman, Peter Nielsen, Elisabeth Kohne, Christina Balser, Hermann Heimpel
Journal: Blood (2011)
ROENTGEN-RAY STUDIES OF THE APPENDIX, CECUM AND ASCENDING COLON
Authors: B. H. ORNDOFF
Journal: JAMA (1926)

My purpose in this paper is to emphasize the importance of the roentgenologic examination of the appendix, cecum and ascending colon. That surgical intervention of chronic appendicitis has been instituted too liberally is proved by the large proportion of patients in our clinics who have failed to secure desired relief following appendectomies. It is quite generally accepted that a pathologic appendix is frequently only a part of a more general pathologic condition which involves the cecum, ascending colon and often other organs. As the roentgenologist can secure visible results while the organ is being palpated or is exercising its function or is under motion from the rotation or change of posture of the patient, it becomes both a duty and a necessity that he should analyze what he has found and endeavor to render correct clinical interpretation. Many pathologists maintain that the cecum, proximal colon and appendix are nearly always
AN EXPERIENCE WITH ANTITOXIN WITH INSTRUCTIVE RESULTS.
Authors: JOSEPH WM. STICKLER
Journal: JAMA (1896)

I will quote but two cases, types of others, to call attention to points which seem to me to be of importance in connection with the administration of antitoxin. <h3>Case 1.</h3> —Some time ago I was asked by Dr. Simmons of Orange, N. J., to see a boy about 7 years of age, who was suffering from some form of laryngeal stenosis. At the time he requested me to consult with him he could not discover by the ordinary method of examining the throat (with tongue depressor) any membrane. When I arrived at the house the child was sitting upon his mother's lap, presenting the appearance of a child in the advanced stage of so-called membranous croup, i.e., laryngeal diphtheria. The breathing was however fairly easy, at times losing its marked stridulous character. When the respirations were not markedly quickened and labored the skin was normal in appearance and the
Interactions between MDM2 and TP53 Genetic Alterations, and Their Impact on Response to MDM2 Inhibitors and Other Chemotherapeutic Drugs in Cancer Cells
Authors: Wanqing Liu, Lijun He, Jacqueline Ramírez, Mark J. Ratain
Journal: Clinical Cancer Research (2009)

Abstract Purpose: MDM2 is a key negative regulator of the p53 signaling pathway. We aimed to evaluate the inter-relationships between MDM2 SNP309, mRNA expression, amplification, and TP53 mutations, as well as their correlations with responsiveness to MDM2 inhibitors and other commonly used cytotoxic drugs tested in the NCI-60 cancer cell panel. Experimental Design: SNP309 was genotyped in the NCI-60 cancer cell lines. MDM2 mRNA levels and gene copy number were measured using real-time PCR. We assessed the inter-relationship between MDM2 genetic alterations, TP53 mutations, and the cytotoxicity of two MDM2 inhibitors (RITA and Nutlin-3) as well as 111 other drugs with known mechanisms of action. Results: In the overall NCI-60 cell panel, MDM2 mRNA levels were not associated with SNP309 but with increased gene copy number. However, SNP309 strongly determined the MDM2 mRNA expression in cancer cells with wild-type TP53. Cancer cells with wild-type TP53 also had significantly higher MDM2 copies. In the overall panel, MDM2 copy number was independently correlated with increased sensitivity to commonly used alkylating agents and topoisomerase I and II inhibitors. SNP309 was significantly associated with increased sensitivity to alkylating agents and topoisomerase I inhibitors in the cells with wild-type TP53. In addition, TP53 mutations were the only factor significantly associated with cellular resistance to the MDM2 inhibitor RITA. Conclusions: Our results suggest that MDM2 copy number and SNP309 may predict for response to alkylating agents and topoisomerase inhibitors. These markers should be tested further, particularly in combination with other putative predictive biomarkers. (Clin Cancer Res 2009;15(24):7602–7)
ETIOLOGY AND TREATMENT OF RHEUMATOID ARTHRITIS AND ALLIED DISEASES
Authors: S. G. Billington, S. Crabbe
Journal: BMJ (1924)

The left eyelids and conjunctiva were very oedematous.The left cheek, over the parotid region, was red and swollen.All the affected parts were somewhat tender.Temperature and pulse were normal; the tongue was very coated; the pupils were equal and active.All other reflexes were normal.On the chest and abdomen there was a rash, which had been present about twenty-four hours.The clinical features of this rash, throughout its duration, were those of varicella, but, in the light of subsequent events, the question arises whether the rash was due to varicella or to larval infection.Within forty-eight hours the swelling of eye and cheek had completely subsided, the tongue was clean, and the child was asking for food.He remained quite well until March 14th, wlhen the right eyelids and cheek became swollen and red.There were also several circumscribed swellings-one the size of a chestnut on the right side of the forehead just above the outer canthus, one the size of a hazel-nut behind the left ear, one the size of a walnut over the right parietal region of the scalp, and two small ones over tbe left parietal region.The swelling on the right side of
Di Guglielmo's Syndrome after Polycythemia
Authors: Arthur Bank, P. Reed Larsen, H. M. Anderson
Journal: New England Journal of Medicine (1966)

IN a review of all the cases of erythroleukemia reported up to 19631 there was none in which this disease was associated with polycythemia vera. Recently, however, 2 cases of acute erythroleukemia (Di Guglielmo's syndrome) developing in patients with polycythemia vera have been reported.2 , 3 We present here a third case of this unusual association.Case ReportJ.M. (PH-138–93–97), a 67-year old construction superintendent, was admitted to the Medical Service on October 13, 1964, with a chief complaint of weakness and fever of 2 days' duration. He had first been seen in September, 1958, when he was noted to be polycythemic . . .
The abscopal effect: efficacy of radiotherapy in patients on progression after treatment with ipilimumab 3 mg/kg
Authors: Antonio M Grimaldi, Ester Simeone, Diana Giannarelli, Marco Palla, Paolo Muto, Sara Falivene, Fabio Sandomenico, Antonella Petrillo, Marcello Curvietto, Assunta Esposito, Miriam Paone, Corrado Caracò, Gennaro Ciliberto, Nicola Mozzillo, Paolo A Ascierto
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts After more than 30 years, Ipilimumab was the first agent which showed a survival benefit for the treatment of metastatic melanoma. However, only about the 20% of patients have a long-term survival benefit. The combination of ipilimumab with other therapies might improve its
Global Dynamic Coupling of Activation and Repolarization in the Human Ventricle
Authors: Arthur M. Yue, Tim R. Betts, Paul R. Roberts, John M. Morgan
Journal: Circulation (2005)

Background— The ability to determine spatial and dynamic changes in ventricular repolarization may help to understand arrhythmogenic mechanisms in humans. We hypothesized that noncontact mapping could be used to investigate global activation-repolarization coupling in the human ventricle during steady state and premature extrastimulation. Methods and Results— Activation-recovery intervals (ARIs) determined from reconstructed unipolar electrograms by the Ensite system were analyzed during sinus rhythm, constant pacing, spontaneous ventricular ectopic beats, and premature stimulation at intermediate and short coupling intervals in the left or right ventricle of 13 patients (6 female; mean age, 48 years) without structural myocardial disease. ARIs were measured from 32 sites in each ventricle with the use of a method validated with monophasic action potential recordings and unipolar contact electrograms. Global T-wave distribution was displayed on a 3-dimensional geometry of the ventricle, with polarities opposite to the direction of activation during steady state and premature stimulation. There was a significant inverse correlation between activation times and ARIs during sinus rhythm, ventricular ectopy, and premature stimulation ( r =0.72, slope=−0.76, P &lt;0.001). Premature stimuli at short coupling intervals flattened the regression slope compared with sinus rhythm (−0.61 versus −0.81; P =0.05), but the global pattern of repolarization was preserved. In comparison to our method, the Wyatt method of ARI measurement failed to demonstrate significant coupling between activation and repolarization ( r =0.34, slope=0.19). Conclusions— Global, dynamic repolarization mapping of the human ventricle is feasible. An inverse coupling of activation and repolarization during steady state and premature stimulation may preserve electric stability in the normal ventricle.
Determinants of Diabetes-Attributable Non–Blood Glucose–Lowering Medication Costs in Type 2 Diabetes
Authors: Wendy A. Davis, Matthew W. Knuiman, Delia Hendrie, Timothy M.E. Davis
Journal: Diabetes Care (2005)

OBJECTIVE— To prospectively examine the magnitude and predictors of diabetes-attributable non–blood glucose–lowering (non-BGL) medication costs in type 2 diabetes. RESEARCH DESIGN AND METHODS— Detailed data from 593 community-dwelling patients were available over 4.3 ± 0.4 years. Diabetes-attributable costs (in year 2000 Australian dollars [A$]) were calculated by applying a range of attributable proportions for each complication for which medication was prescribed. RESULTS— Non-BGL medications accounted for 75% of all prescription medication costs over the study period, and one-third were attributable to diabetes. The median annual cost (in A$) of non-BGL medications per patient increased from A$220 to A$429 over 4 years (P &amp;lt; 0.001), whereas the diabetes-attributable contribution increased from A$31 (range 15–40) to A$159 (range 95–219) per patient (P &amp;lt; 0.001). Diabetes-attributable hospital costs remained stable during the study. Diabetes-attributable non-BGL costs were skewed and, therefore, square root transformed before regression analysis. Independent baseline determinants of √cost/year were coronary heart disease, systolic blood pressure, total serum cholesterol, ln(serum triglycerides), ln(albumin-to-creatinine ratio), serum creatinine, education, and, negatively, male sex and fasting plasma glucose (P ≤ 0.043; R2 = 29%). Projected to the Australian population, diabetes-attributable non-BGL medication costs for patients with type 2 diabetes totaled A$79 million/year. CONCLUSIONS— The median annual cost of diabetes-attributable non-BGL medications increased fivefold over 4 years. This increase was predicted by vascular risk factors and complications at baseline. Better-educated patients had higher costs, probably reflecting improved health care access. Men and patients with higher fasting plasma glucose levels had lower costs, suggesting barriers to health care and/or poor self-care. The contemporaneous containment of hospital costs may be due to the beneficial effect of increased medication use.
The JAK2-V617F mutation is frequently present at diagnosis in patients with essential thrombocythemia and polycythemia vera
Authors: Eric Lippert, Marjorie Boissinot, Robert Kralovics, François Girodon, Irène Dobo, Vincent Praloran, Nathalie Boiret-Dupré, Radek C. Skoda, Sylvie Hermouet
Journal: Blood (2006)
Animals in Research
Authors: Dallas Pratt
Journal: JAMA (1988)

To  Editor.—  AsAs a physician, I would like  respond   article entitled Animals in Research by Drs Smith and Hendee. 1 It was addressed  American physicians and scientists, urging them to assume a primary role in defending  use of  for biomedical research.  Unfortunately,  article contains a number of misleading statements and omissions of significant facts. For example, it states that the public has insisted on assurance that  are treated humanely.... The Animal Welfare Act and its amendments as well as Public Health Service policy and regulations put  weight of  law behind such assurances. Rats and mice, which make up  vast majority of experimental animals, have been declared by  Secretary of Agriculture not  be animals with respect  this legislation and receive no protection whatsoever from these laws. Horses, cattle, chickens, and many others are also excluded. Under
Cyclophosphamide Allows for <i>In vivo</i> Dose Reduction of a Potent Oncolytic Virus
Authors: Hirokazu Kambara, Yoshinaga Saeki, E. Antonio Chiocca
Journal: Cancer Research (2005)

Abstract The success of cancer virotherapy depends on its efficacy versus toxicity profile in human clinical trials. Progress towards clinical trials can be hampered by the relatively elevated doses of oncolytic viruses administered in animal models to achieve an anticancer effect and by the even higher doses required in humans to approximate an animal bioequivalent dose. Such elevated doses of injected viral proteins may also lead to undesirable toxicities and are also very difficult to produce in a biotechnological setting. We report that a relatively potent herpes simplex virus type 1 oncolytic virus (rQNestin34.5) produces 45% survivors at a dose of 3 × 104 plaque-forming units (pfu) in a 9-day-old mouse model of human glioma. Unlike our previous findings with less potent oncolytic viruses, though, the preadministration of cyclophosphamide did not enhance this survival or affect oncolytic virus tumor distribution and tumor volume. However, when oncolytic virus doses were reduced (3 × 103 and 3 × 102 pfu), cyclophosphamide significantly enhanced both animal survival and oncolytic virus tumor distribution and also reduced tumor volumes. These findings thus show that cyclophosphamide allows for dose reduction of doses of a relatively potent oncolytic virus, a finding with implications for the development of clinical trials. (Cancer Res 2005; 65(24): 11255-8)
Hydralazine once daily in hypertension.
Authors: J H Silas, L E Ramsay, S Freestone
Journal: BMJ (1982)

The effects of hydralazine formulation and dose interval were assessed in 20 patients with hypertension well controlled on conventional hydralazine tablets, 100 mg twice daily, in addition to atenolol and a diuretic. The double-blind study used four regimens crossed over in random order at five-week intervals; placebo; conventional hydralazine 100 mg twice daily; conventional hydralazine 200 mg once daily; and slow-release hydralazine 200 mg once daily. Blood pressure and pulse rate were assessed soon after (2.5 +/- 0.9 h) and immediately before taking hydralazine (previous dose: once daily, 26.5 +/- 0.9 h; twice daily, 13.6 +/- 2.0 h). Seventeen patients completed the study. All hydralazine regimens were associated with significant falls in blood pressure. Once-daily treatment with conventional hydralazine was unsatisfactory, as its hypotensive effect waned at 24 h; there was a significant difference between the peak and trough effects on blood pressure and pulse in rapid acetylators. Compared with placebo twice-daily conventional hydralazine and once-daily slow-release hydralazine gave satisfactory control for 24 hours in both rapid and slow acetylators, though the hypotensive effect was larger in the slow acetylators. It is concluded that there is no need to administer hydralazine more than twice daily.
Impaired Lipid and Glucose Homeostasis in Hexabromocyclododecane-Exposed Mice Fed a High-Fat Diet
Authors: Rie Yanagisawa, Eiko Koike, Tin-Tin Win-Shwe, Megumi Yamamoto, Hirohisa Takano
Journal: Environmental Health Perspectives (2014)

Hexabromocyclododecane (HBCD) is an additive flame retardant used in the textile industry and in polystyrene foam manufacturing. Because of its lipophilicity and persistency, HBCD accumulates in adipose tissue and thus has the potential of causing metabolic disorders through disruption of lipid and glucose homeostasis. However, the association between HBCD and obesity remains unclear.We investigated whether exposure to HBCD contributes to initiation and progression of obesity and related metabolic dysfunction in mice fed a normal diet (ND) or a high-fat diet (HFD).Male C57BL/6J mice were fed a HFD (62.2 kcal% fat) or a ND and treated orally with HBCD (0, 1.75, 35, or 700 μg/kg body weight) weekly from 6 to 20 weeks of age. We examined body weight, liver weight, blood biochemistry, histopathological changes, and gene expression profiles in the liver and adipose tissue.In HFD-fed mice, body and liver weight were markedly increased in mice treated with the high (700 μg/kg) and medium (35 μg/kg) doses of HBCD compared with vehicle. This effect was more prominent in the high-dose group. These increases were paralleled by increases in random blood glucose and insulin levels and enhancement of microvesicular steatosis and macrophage accumulation in adipose tissue. HBCD-treated HFD-fed mice also had increased mRNA levels of Pparg (peroxisome proliferator-activated receptor-γ) in the liver and decreased mRNA levels of Glut4 (glucose transporter 4) in adipose tissue compared with vehicle-treated HFD-fed mice.Our findings suggest that HBCD may contribute to enhancement of diet-induced body weight gain and metabolic dysfunction through disruption of lipid and glucose homeostasis, resulting in accelerated progression of obesity.Yanagisawa R, Koike E, Win-Shwe TT, Yamamoto M, Takano H. 2014. Impaired lipid and glucose homeostasis in hexabromocyclododecane-exposed mice fed a high-fat diet. Environ Health Perspect 122:277-283; http://dx.doi.org/10.1289/ehp.1307421.
Concerted expression of eotaxin-1, eotaxin-2, and eotaxin-3 in human bronchial epithelial cells
Authors: A. Komiya, H. Nagase, H. Yamada, T. Sekiya, M. Yamaguchi, Y. Sano, N. Hanai, A. Furuya, K. Ohta, O. Yoshie, K. Yamamoto, K. Hirai
Journal: Journal of Allergy and Clinical Immunology (2003)