tbuckley/cabot-search huggingface dataset:
ASN End-Stage Renal Disease Task Force
Authors: John R. Sedor, Suzanne Watnick, Uptal D. Patel, Alfred Cheung, William Harmon, Jonathan Himmelfarb, Thomas H. Hostetter, Jula K. Inrig, Rajnish Mehrotra, Emily Robinson, Paul C. Smedberg, Rachel N. Shaffer
Journal: Journal of the American Society of Nephrology (2010)

For the first time in nearly 30 years, the Centers for Medicare and Medicaid Services (CMS) will implement a new payment system for dialysis patients. Since 1983, Medicare has reimbursed each dialysis session with a prospective payment—known as the composite rate—designed to cover the cost of center or home dialysis.1 Since implementation of the composite rate, however, new therapies—including erythropoietin, vitamin D, and iron—have emerged as new additional costs for standard dialysis care. These therapies are reimbursed separately from the composite rate and now compose approximately 40% of the total Medicare payment for each dialysis treatment.2

To improve the efficiency and flexibility of the ESRD Program, the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 mandated implementation of a comprehensive, case mix–adjusted, bundled-rate payment system for ESRD that includes therapies currently reimbursed outside the composite rate.3 The ESRD Prospective Payment System will be phased in on January 1, 2011, and fully implemented by 2014. Although MIPPA outlines the basic approach to bundling, the legislation grants CMS authority to finalize the components of the bundle and generate a detailed implementation plan. In September 2009, CMS released for public comment a proposed rule on ESRD bundling and is expected to issue a final rule on ESRD bundling in 2010. In addition, CMS is projected to release a proposed rule on a quality improvement program for ESRD care.

Given the monumental significance of the new payment system, the American Society of Nephrology (ASN) formed an ESRD task force to assess and respond comprehensively to the proposed rule changes. Eight ASN members from diverse specialties and practice settings served on this task force, including early-career and established nephrologists as well as ASN policy staff. ASN's foremost concerns relate to preservation of patient access to optimal dialysis care and related …
* Dysphagia in patients with the joint hypermobility syndrome
Authors: A. Fikree, Q. Aziz, J. Jafari, R. Grahame, D. Sifrim
Journal: Gut (2011)

<h3>Introduction</h3> The Joint Hypermobility Syndrome (JHS) is a relatively frequent inherited connective tissue disorder characterised by marked joint hyperextensibility and extra-articular manifestations. Recent work suggests that gastrointestinal (GI) symptom prevalence may be as high as 86%1 in these patients, and that many of them have evidence of GI dysmotility.2 Dysphagia is a symptom which is not uncommon in these patients, but which has never been formally studied. In general terms, dysphagia is either due to a structural abnormality of the oesophagus or a motility problem. <h3>Methods</h3> A single-centre retrospective observational study was carried out to characterise the cause of non-structural dysphagia in patients with JHS. JHS patients who were referred to the upper GI physiology unit and who complained of dysphagia were identified. Their HRM and 24-h pH-metry traces were analysed to characterise oesophageal motility, presence of a hiatus hernia, lower oesophageal sphincter (LOS) pressure and presence of gastro-oesophageal reflux (GOR). <h3>Results</h3> 17 patients with JHS and dysphagia were referred by the rheumatologists to our unit in 1 year: 76% female; age range: 12–58. None had evidence of a structural cause for the dysphagia on either gastroscopy or barium studies. 10 (59%) had an oesophageal dysmotility to account for their dysphagia – out of these one had achalasia; the other 9 (53%) had oesophageal hypomotility with 7 having frequent hypotensive peristalsis and 2 having intermittent hypotensive peristalsis. 33% of those with hypomotility had a normal Multiple Rapid Swallow test (MRS). 7 of the 17 patients (41%) had normal oesophageal motility and 6 of these had reflux studies: 50% had GOR, 17% had a hypersensitive oesophagus and the remaining 33% had normal studies. Only 2 patients (12%) had hiatus hernias and both of these had oesophageal hypomotility and no GOR. <h3>Conclusion</h3> This is the first study of upper GI physiology in patients with JHS and non-structural dysphagia. Oesophageal hypomotility is common in these patients and those patients with normal MRS are likely to show the best response to prokinetics. 50% of those with normal motility had pathological GOR and would benefit from high dose proton pump inhibitor therapy. The remainder had normal studies, suggesting hypersensitivity which may respond to treatment with neuromodulators such as amitriptyline. Only 12% of patients had a hiatus hernia, which is in contrast to previous studies.3 Further prospective studies are required to understand the pathophysiology and management options for dysphagia in JHS.
Effect of near normoglycaemia for two years on progression of early diabetic retinopathy, nephropathy, and neuropathy: the Oslo study.
Authors: K Dahl-Jorgensen, O Brinchmann-Hansen, K F Hanssen, T Ganes, P Kierulf, E Smeland, L Sandvik, O Aagenaes
Journal: BMJ (1986)

Forty five insulin dependent diabetics were randomised to treatment with continuous subcutaneous insulin infusion (CSII), multiple insulin injections (five or six daily), or conventional twice daily insulin injections. Near normoglycaemia was obtained with CSII and multiple injections but not with conventional treatment (p less than 0.01). Hypoglycaemic coma was observed less frequently with CSII than with multiple injections and conventional treatment (p less than 0.001), but blood glucose concentrations below 2.5 mmol/l (45 mg/100 ml) were more common. After two years fewer retinal microaneurysms and haemorrhages had developed in the patients given CSII and multiple injections compared with those given conventional treatment, in whom the number had increased significantly (p less than 0.01). Motor nerve conduction velocity deteriorated in the patients given conventional treatment; in those given CSII it was unchanged during the first year but had improved after two years (p less than 0.01). Glomerular hyperfiltration was reduced with CSII, but no change occurred in urine albumin excretion rates. Long term near normoglycaemia may prevent the progression of early stages of late diabetic complications.
Heterogeneity in the Management and Outcomes of Patients With Acute Myocardial Infarction Complicated by Heart Failure
Authors: Frederick A. Spencer, Theo E. Meyer, Joel M. Gore, Robert J. Goldberg
Journal: Circulation (2002)

Heart failure (HF) is an important predictor of poor outcome after acute myocardial infarction (AMI). However, limited data exist about the clinical significance of HF in the coronary reperfusion era and the impact of its timing on hospital outcomes. The objective of this study was to determine the clinical impact of HF complicating AMI in the National Registry of Myocardial Infarction (NRMI). A secondary objective was to determine differences in demographic and clinical characteristics, treatment, and hospital death rates in patients presenting with HF compared with those developing HF after presentation.The study sample consisted of patients with AMI and without a history of HF included in the NRMI. Of 606 500 cases included from July 1, 1994 to June 30, 2000, 123 938 (20.4%) patients had HF at the time of hospital presentation and 52 220 (8.6%) developed HF thereafter. Patients with HF were older, more likely female, had more comorbidities, and were less likely to receive effective cardiac medications compared with patients without HF. The multivariable adjusted odds for in-hospital death were higher for patients with HF at presentation and thereafter (3.1 and 5.5, respectively) than those without HF.Results from this nationwide registry suggest that the incidence and hospital death rates associated with HF complicating AMI remain high. Patients developing HF after hospital admission are at even greater risk than those presenting with HF. Effective cardiac therapies remain underutilized in these patients, and the reasons for this underutilization need to be explored.
Letter: Oestrogens as a cause of endometrial carcinoma.
Authors: I D Cooke
Journal: BMJ (1976)

Various studies on the carcinogenic risks of estrogens and estrone sulphate in the treatment of postmenopausal women are criticized. Criticism is directed against the method by which patient data were collected and matched control groups selected, and against the biochemical arguments made against estrone. Further study, especially well-controlled prospective studies, are needed to fully assess the carcinogenic risks of estrogen-replacement therapy.
Comparison of ischaemic preconditioning in blood perfused and buffer perfused isolated heart models
Authors: R. Sandhu, R. J Diaz, G. J Wilson
Journal: Cardiovascular Research (1993)

Journal Article Comparison of ischaemic preconditioning in blood perfused and buffer perfused isolated heart models Get access Reena Sandhu, Reena Sandhu Division of Cardiovascular Research, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada: R Sandhu, R J Diaz, G J Wilson. Correspondence to Dr Sandhu at: CCRW1-885, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4. Search for other works by this author on: Oxford Academic PubMed Google Scholar Roberto J Diaz, Roberto J Diaz Division of Cardiovascular Research, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada: R Sandhu, R J Diaz, G J Wilson. Search for other works by this author on: Oxford Academic PubMed Google Scholar Gregory J Wilson Gregory J Wilson Division of Cardiovascular Research, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada: R Sandhu, R J Diaz, G J Wilson. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 27, Issue 4, April 1993, Pages 602–607, https://doi.org/10.1093/cvr/27.4.602 Published: 01 April 1993 Article history Received: 07 October 1992 Accepted: 05 February 1993 Published: 01 April 1993
Abstract 299: Modulation of the leptin receptor in pancreatic cancer cells mediates tumor growth
Authors: Alisha Mendonsa, Madeleine Chalfant, Nagaraj Nagathihalli, Nipun Merchant, Lee Gorden, Michael N. VanSaun
Journal: Cancer Research (2012)

Abstract Background: Pancreatic cancer is the fourth leading cause of cancer death with a five year survival rate around 5%, which has not changed in 30 years. Obesity and increased abdominal adipose tissue independently correlate with an increased relative risk for the development of pancreatic cancer. These conditions have been associated with altered levels of adipokines, or adipose secreted cytokines. Circulating serum levels of the adipokine leptin are increasesddramatically in obese patients as well as in high fat diet induced obese mice. Leptin has been shown to induce oncogenic signaling in breast and prostate cancer. We have previously shown an increase in orthotopic pancreatic tumor size in high fat diet induced obese mice compared with regular diet control mice. We hypothesize that leptin signaling mediates pancreatic tumorigenesis. Methods: Leptin receptor status was determined in human as well as murine pancreatic cell lines. Leptin stimulated cell proliferation was determined using a modified BrdU assay. Leptin receptor levels were knocked down in human and murine pancreatic tumor cells using a shRNAmir approach. Leptin receptor shRNA Panc02 knockdown cells were injected orthotopically into the pancreas of C57/Bl6J mice on regular or high fat diet to determine the contribution of leptin to pancreatic tumor growth. Results: We have detected the long form of the leptin receptor in five human and four murine pancreatic cancer cell lines. In vitro administration of leptin stimulated proliferation of Panc1 and CFPAC1 cell lines, which was abrogated with co-incubation of a leptin antagonist. To better understand the mechanism of leptin-mediated signaling, we studied downstream targets and identified a significant increase in phosphorylation of STAT3 in Panc1, BXPC3 and CFPAC1 cell lines after leptin treatment. Orhtotopic injection of leptin receptor shRNA Panc02 cells into normal and obese mice showed a markedly diminished tumor growth in obese mice when compared to the nonsilencing control Panc02 cell growth in obese mice. Conclusion: These results implicate leptin as a mediator of pancreatic tumorigenesis and suggest that leptin activation is mediated in part through STAT3 signaling. Knockdown of the leptin receptor results in inhibition of high fat diet associated tumor growth in vivo. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 299. doi:1538-7445.AM2012-299
C[unk] inactivator inhibition by plasmin
Authors: Peter C. Harpel
Journal: Journal of Clinical Investigation (1970)

Plasmin incubated with partially purified C[unk] inactivator produced a decrease in inhibitory activity which was related to the time of incubation and to the concentration of plasmin. This effect of plasmin was not influenced by the purity of the inhibitor preparations. Soybean trypsin inhibitor and tosyl arginine methyl ester (TAMe), substances which block the active enzymic center of plasmin, prevented the plasmin-induced inactivation. Double diffusion analysis of the functionally deficient, plasmin-treated C[unk] inactivator using a specific antibody, showed a reaction of identity with the untreated inhibitor. Agarose and acrylamide gel immunoelectrophoresis of a plasmin, inhibitor mixture showed the appearance of an additional precipitin band with immunologic reactivity similar to that of the untreated inhibitor. These results demonstrate that plasmin alters both the functional and immunoelectrophoretic properties of C[unk] inactivator, and that the active proteolytic site of plasmin is necessary for this interaction. Since C[unk] inactivator has been shown to inhibit several different proteolytic enzymes including C[unk], kallikrein, PF/Dil, and plasmin, this investigation provides a theoretical relationship between the fibrinolytic, kallikrein, and complement systems which may have pathophysiologic relevance to various human disease states.
Polymorphisms in the Cholinergic Receptor, Muscarinic 1 (CHRM1) Gene Confer Susceptibility to Asthma in Japanese
Authors: Y. Maeda, N. Hizawa, E. Jinushi, D. Takahashi, Y. Fukui, S. Konno, E. Yamaguchi, M. Nishimura
Journal: Journal of Allergy and Clinical Immunology (2006)
Gastrin and somatostatin in Helicobacter pylori infected antral mucosa.
Authors: L Odum, H D Petersen, I B Andersen, B F Hansen, J F Rehfeld
Journal: Gut (1994)

Helicobacter pylori infection is associated with increased meal stimulated gastrin secretion, but the reason for this is unknown. Sequence specific radioimmunoassays were used to measure the concentration of alpha-amidated gastrin, the total progastrin product, and somatostatin in biopsy specimens of human antral mucosa. The antral concentrations of alpha-amidated gastrin and of total progastrin products were significantly higher in H pylori infected patients than in those not infected by this organism. In contrast, the antral somatostatin concentration was significantly decreased in infected patients. Progastrin processing, determined by gel chromatography, seemed unaffected by H pylori infection. The results suggest that the finding of increased gastrin secretion from the antral G cells in H pylori infected patients may be a result of reduced inhibition of G-cell secretion by somatostatin.
Withdrawal of food supplement judged as misconduct
Authors: C. Dyer
Journal: BMJ (1999)

A GP in the United Kingdom who ordered nurses to withdraw a high protein food supplement from an elderly patient who had had a stroke was found guilty of serious professional misconduct by the General Medical Council (GMC) last week but escaped being removed from the medical register.

Dr Ken Taylor, aged 51, was suspended from practice for six months despite strong statements of support from 85 year old Mary Ormerod's family and many testimonials from patients. Dr Taylor, a former nurse, gave instructions that Mrs Ormerod, …
Field epidemiologic studies of populations exposed to waste dumps.
Authors: C W Heath
Journal: Environmental Health Perspectives (1983)

Epidemiologic studies are required for assessing health risks related to toxic waste exposure. Since the settings in which such studies must be performed are extremely diverse, epidemiologic approaches must be versatile. For any particular study, three fundamental requirements are to assess what toxic materials are present, understand how human exposure may occur, and objectively measure possible biologic effects. In assessing links between exposure and disease, epidemiologists must be particularly aware of: expected disease frequencies in relation to the size of populations studied, implications of long or varied disease latencies for study design and competing causes of disease and associated confounding variables. These concepts are illustrated by discussion of epidemiologic studies related to the Love Canal toxic waste dump site in Niagara Falls, NY.
Prevention of spread of hepatitis C
Authors: Miriam J. Alter
Journal: Hepatology (2002)

Hepatitis C virus (HCV) is transmitted by percutaneous or permucosal exposure to infectious blood or blood-derived body fluids. Based on the results of cohort and acute case control studies, risk factors associated with acquiring HCV infection in the United States have included transfusion of blood and blood products and transplantation of solid organs from infected donors, injecting drug use, occupational exposure to blood (primarily contaminated needle sticks), birth to an infected mother, sex with an infected partner, and multiple heterosexual partners. Nosocomial and iatrogenic transmission of HCV primarily are recognized in the context of outbreaks, and primarily have resulted from unsafe injection practices. Transmission from HCV-infected health care workers to patients is rare. Transfusions and transplants have been virtually eliminated as sources for transmission, and most (68%) newly acquired cases of hepatitis C are related to injecting drug use. The primary prevention of illegal drug injecting will eliminate the greatest risk factor for HCV infection in the United States. Other prevention strategies that need to be widely implemented include risk reduction counseling and services and review and improvement of infection control practices in all types of health care settings. Testing for HCV infection should be routinely performed for persons at high risk for infection or who require postexposure management. There are no recommendations for routine restriction of professional activities for HCV-infected health care workers, and persons should not be excluded from work, school, play, and child care or other settings on the basis of their HCV infection status.
Philosophical medical ethics
Authors: R. Gillon
Journal: BMJ (1985)

Partial table of contents: An Introduction to Philosophical Medical Ethics: The Arthur Case. Medical Oaths, Declarations, and Codes. Deontological Foundations for Medical Ethics? Conscience, Good Character, Integrity, and to Hell with Philosophical Medical Ethics? Ita s All Too Subjectivea a : Scepticism about the Possibility or Use of Philosophical Medical Ethics. To What Do We Have Moral Obligations and Why (I)? Rights. Autonomy and the Principle of Respect for Autonomy. Paternalism and Medical Ethics. Beneficence: Doing Good for Others. Justice and Medical Ethics. Justice and Allocation of Medical Resources. Telling the Truth and Medical Ethics. Confidentiality. Consent. Where Respect for Autonomy Is not the Answer. On Sickness and on Health.
Serious Mitral Stenosis with Slight Symptoms: Case for a Purely Objective Assessment for Operation
Authors: P. L. Brunnen, J. K. Finlayson, D. Short
Journal: BMJ (1964)

One of the established principles in the selection of patients for mitral valvotomy is that the symptoms must be disabling enough to warrant the risks of surgery. In practice this is generally taken to mean that there must be at least moderate dyspnoea before operation is recommended. In this paper we present evidence that mitral stenosis may become serious and potentially lethal without causing any definite symptoms.
Effect of Dietary Patterns on Serum Homocysteine
Authors: Lawrence J. Appel, Edgar R. Miller, Sun Ha Jee, Rachael Stolzenberg-Solomon, None RD, Pao-Hwa Lin, Thomas Erlinger, Marie R. Nadeau, Jacob Selhub
Journal: Circulation (2000)

Background —Elevated blood levels of homocysteine are associated with an increased risk of atherosclerotic cardiovascular disease. Although numerous studies have assessed the impact of vitamin supplements on homocysteine, the effect of dietary patterns on homocysteine has not been well studied. Methods and Results —During a 3-week run-in, 118 participants were fed a control diet, low in fruits, vegetables, and dairy products, with a fat content typical of US consumption. During an 8-week intervention phase, participants were then fed 1 of 3 randomly assigned diets: the control diet, a diet rich in fruits and vegetables but otherwise similar to control, or a combination diet rich in fruits, vegetables, and low-fat dairy products and reduced in saturated and total fat. Between the end of run-in and intervention periods, mean change in homocysteine was +0.46 μmol/L in the control diet, +0.21 μmol/L in the fruits and vegetables diet ( P =0.47 compared with control), and −0.34 μmol/L in the combination diet ( P =0.03 compared with control, P =0.12 compared with the fruits and vegetables diet). In multivariable regression models, change in homocysteine was significantly and inversely associated with change in serum folate ( P =0.03) but not with change in serum vitamin B 12 ( P =0.64) or pyridoxal 5′ phosphate, the coenzyme form of vitamin B 6 ( P =0.83). Conclusions —Modification of dietary patterns can have substantial effects on fasting levels of total serum homocysteine. These results provide additional insights into the mechanisms by which diet might influence the occurrence of atherosclerotic cardiovascular disease.
Viscosity of plasma in patients with rheumatoid arthritis.
Authors: M Harreby, B Danneskiold-Samsoe, J Kjer, M Lauritzen
Journal: Annals of the Rheumatic Diseases (1987)

The viscosity of plasma (PV) was investigated in 27 outpatients with classical or definite rheumatoid arthritis (RA) according to the American Rheumatism Association (ARA) criteria. The measurements showed a significantly raised PV in patients with RA (p less than 10(-5)) compared with a control group. There was a positive correlation between the PV and the blood erythrocyte sedimentation rate (B-ESR), and the increase in the PV is largely explained by increased concentrations of the plasma proteins, fibrinogen, and IgG.