tbuckley/cabot-search huggingface dataset:
Patients' and carers' preferences in two models of care for acute exacerbations of COPD: results of a randomised controlled trial
Authors: J C Ojoo
Journal: Thorax (2002)

Background: Patients with an acute exacerbation of chronic obstructive pulmonary disease (COPD) were randomised to either hospital at home (HaH) or inpatient management, and patient and carer preferred site of management and satisfaction with care received in the two arms was determined. Methods: Emergency admissions with an acute exacerbation of COPD were randomised to inpatient care or HaH care. After discharge an independent observer administered a questionnaire to both patients and carers on the preferred site of care and scored satisfaction with the care received. Results: Of 60 patients recruited, 30 were randomised to receive HaH care. Retrospective patient preference for HaH care was 96.3% in the domiciliary arm and 59.3% in the conventional arm; carer preference figures were 85.7% and 42.9%, respectively. There was a higher preference for domiciliary care by both patients and carers in the HaH arm than in the inpatient arm (p=0.001 and p=0.01, respectively). Patients recorded equal satisfaction with care in the two arms (88.1% in the conventional arm, 91.7% in the domiciliary arm); carer scores were 91.3% and 91.9%, respectively. Conclusions: The results of this study show that both patients and carers were significantly more likely to prefer domiciliary care if they were in the HaH arm. Since patients had to be willing to be looked after at home, both patients9 and carers9 perceptions of the benefits of HaH care were reinforced by their experience. HaH care of acute exacerbations of COPD is the preferred option in suitable patients.
Some specifics about generalization
Authors: Joshua B. Tenenbaum, Thomas L. Griffiths
Journal: Behavioral and Brain Sciences (2001)

We address two kinds of criticisms of our Bayesian framework for generalization: those that question the correctness or the coverage of our analysis, and those that question its intrinsic value. Speaking to the first set, we clarify the origins and scope of our size principle for weighting hypotheses or features, focusing on its potential status as a cognitive universal; outline several variants of our framework to address additional phenomena of generalization raised in the commentaries; and discuss the subtleties of our claims about the relationship between similarity and generalization. Speaking to the second set, we identify the unique contributions that a rational statistical approach to generalization offers over traditional models that focus on mental representation and cognitive processes.
Human insulin: study of safety and efficacy in man.
Authors: D R Owens, M K Jones, T M Hayes, L G Heding, K G Alberti, P D Home, J M Burrin, R G Newcombe
Journal: BMJ (1981)

The safety and efficacy of a new highly purified neutral soluble human insulin produced by conversion of porcine insulin was compared with a highly purified neutral soluble porcine insulin in six normal men. The insulins were administered by subcutaneous injection at a dose of 0.075 U/kg body weight. Somatostatin was infused during the experiment to suppress endogenous insulin secretin. No difference was found in the plasma glucose, insulin, or metabolite responses. Thus the potency, onset, and duration of effect were identical with the two insulins. No short-term side effects to either insulin were observed. Highly purified, semi-synthetic human insulin offers a safe and effective means to explore the possible advantages of homologous human insulin in the management of diabetes mellitus.
Clinical risks for development of the acute respiratory distress syndrome.
Authors: L D Hudson, J A Milberg, D Anardi, R J Maunder
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

To further understanding of the epidemiology of acute respiratory distress syndrome (ARDS), we prospectively identified 695 patients admitted to our intensive care units from 1983 through 1985 meeting criteria for seven clinical risks, and followed them for development of ARDS and eventual outcome. ARDS occurred in 179 of the 695 patients (26%). The highest incidence of ARDS occurred in patients with sepsis syndrome (75 of 176; 43%) and those with multiple emergency transfusions (> or = 15 units in 24 h) (46 of 115; 40%). Of patients with multiple trauma, 69 of 271 (25%) developed ARDS. If any two clinical risks for trauma were present, the incidence of ARDS was 23 of 57, or 40%. During the study period, we identified 48 patients with ARDS who did not have one of the defined clinical risks, yielding a sensitivity of 79% (179 of 227). Secondary factors associated with increased risk for ARDS in clinical risk subgroups include an elevated Acute Physiologic and Chronic Health Evaluation II (APACHE II) score in patients with sepsis and increased APACHE II and Injury Severity Scores (ISS) in trauma victims. Mortality was threefold higher when ARDS was present (62%) than among patients with clinical risks who did not develop ARDS (19%; p < 0.05). The difference in mortality if ARDS developed was particularly striking in patients with trauma (56% versus 13%), but less in those with sepsis (69% versus 49%). The mortality data should be interpreted with caution, since the fatality rate in ARDS patients appears to have decreased in our institution from the time that these data were collected.(ABSTRACT TRUNCATED AT 250 WORDS)
Radionuclide Evaluation of a Patient with Neonatal Presentation of Pompe??s Disease
Authors: AVRAHAM LORBER, RUTH HARDOFF, AVI FRONT
Journal: Clinical Nuclear Medicine (1987)

Pompe's disease (glycogen storage disease type IIA) is a rare autosomal recessive metabolic disorder involving skeletal and heart muscle. A neonate in whom the diagnosis of Pompe's disease was suspected, was evaluated using Tc-99m RBC and TI-201 scintigraphy. A skeletal muscle biopsy specimen that showed lack of lysosomal alpha 1,4 glycosidase confirmed the diagnosis. To the best of the authors' knowledge, this is the youngest patient with Pompe's disease in whom radionuclide evaluation was performed.
TCT-238 Low Event Rates At Long-term Follow-up In The Randomized Myocardial Infarction XAMI Trial Comparing First And Second Generation Drug Eluting Stents
Authors: S.H. Hofma, Pieter C. Smits, Arnoud van't Hof, M.A. Velders, A.J. van Boven
Journal: Journal of the American College of Cardiology (2013)
Angiotensin II stimulates endothelin-1 secretion in cultured rat mesangial cells
Authors: Masakazu Kohno, Takeshi Horio, Miwako Ikeda, Koji Yokokawa, Toshiki Fukui, Kenichi Yasunari, Naotsugu Kurihara, Tadanao Takeda, Machiko Johchi
Journal: Kidney International (1992)
Altered solid and liquid gastric emptying in patients with duodenal ulcer disease.
Authors: G J Maddern, M Horowitz, D J Hetzel, G G Jamieson
Journal: Gut (1985)

Alteration in gastric emptying has been implicated in duodenal ulcer disease. The precise abnormalities remain controversial. We have used a radionuclide technique to assess solid and liquid gastric emptying in 14 patients with endoscopically proven duodenal ulcer and 22 healthy controls. Solid gastric emptying values for the patient group fell within the normal range. The median time taken for 50% (T50) of the liquid marker to empty from the stomach was 12 minutes (range 6-23 minutes) which was significantly faster (p less than .005) than controls (median 18 minutes, range 11-35). In 10 of the 14 patients, however, the rate of liquid emptying was within the normal range. There was no significant difference in the T50 for gastric emptying of solids between the groups, but in duodenal ulcer patients food left the stomach significantly earlier than in controls (p less than .05). After this, however, the linear rate at which duodenal ulcer patients emptied solid food from the stomach was a median 0.75%/minutes (range 0.5-1.4 minutes), which was slower (p less than .0005) than controls, median 1.25/minutes (range 0.7-2.3). These results show that the pattern of gastric emptying of digestible solids and liquids in patients with duodenal ulcer disease, as a group, is significantly altered.
Work can damage your health.
Authors: R I McCallum
Journal: BMJ (1991)

Software for screening to assess risk of Down's syndrome SIR,-The brief reference to screening for Down's syndrome in the ABC of antenatal care' is perhaps indicative of the few centres currently offering screening to assess the risk of Down's syndrome despite the considerable benefits that the screen offers.The delays in introducing the screen are possibly due to uncertainty about the analytes required to perform an effective screen.a Feto- protein and human chorionic gonadotrophin are well established, but there is still dispute over whether unconjugated oestriol should be included.2'Furthermore, other potential screen- ing variables have been suggested, including preg- nancy specific f1 glycoprotein (SP-1),4 ratio of biparietal diameter to length of femur,s and maternal urea resistant neutrophil alkaline phosphatase activity.6A further cause of delay in introducing the screen is the poor availability of commercial software to calculate the risk.In Gwent and South Glamorgan screening using a fetoprotein and human chorionic gonadotrophin has been offered with considerable success for the past 16 months.
Pulmonary Arterial Hypertension in Patients Treated by Dasatinib
Authors: David Montani, Emmanuel Bergot, Sven Günther, Laurent Savale, Anne Bergeron, Arnaud Bourdin, Helene Bouvaist, Matthieu Canuet, Christophe Pison, Margareth Macro, Patrice Poubeau, Barbara Girerd, Delphine Natali, Christophe Guignabert, Frédéric Perros, Dermot S. O'Callaghan, Xavier Jaïs, Pascale Tubert-Bitter, Gérard Zalcman, Olivier Sitbon, Gérald Simonneau, Marc Humbert
Journal: Circulation (2012)

The French pulmonary hypertension (PH) registry allows the survey of epidemiological trends. Isolated cases of precapillary PH have been reported in patients who have chronic myelogenous leukemia treated with the tyrosine kinase inhibitor dasatinib.This study was designed to describe incident cases of dasatinib-associated PH reported in the French PH registry. From the approval of dasatinib (November 2006) to September 30, 2010, 9 incident cases treated by dasatinib at the time of PH diagnosis were identified. At diagnosis, patients had moderate to severe precapillary PH with functional and hemodynamic impairment. No other incident PH cases were exposed to other tyrosine kinase inhibitors at the time of PH diagnosis. Clinical, functional, or hemodynamic improvements were observed within 4 months of dasatinib discontinuation in all but 1 patient. Three patients required PH treatment with endothelin receptor antagonist (n=2) or calcium channel blocker (n=1). After a median follow-up of 9 months (min-max 3-36), the majority of patients did not demonstrate complete clinical and hemodynamic recovery, and no patients reached a normal value of mean pulmonary artery pressure (≤20 mm Hg). Two patients (22%) died at follow-up (1 of unexplained sudden death and 1 of cardiac failure in the context of septicemia, respectively, 8 and 12 months after dasatinib withdrawal). The lowest estimate of incident PH occurring in patients exposed to dasatinib in France was 0.45%.Dasatinib may induce severe precapillary PH fulfilling the criteria of pulmonary arterial hypertension, thus suggesting a direct and specific effect of dasatinib on pulmonary vessels. Improvement is usually observed after withdrawal of dasatinib.
Glomerular and vascular atrial natriuretic factor receptors in saralasin-sensitive and -resistant two-kidney, one-clip hypertensive rats.
Authors: R Garcia, G Gauquelin, M Cantin, E L Schiffrin
Journal: Circulation Research (1988)

We have investigated whether there is a relation between renin dependency of two-kidney, one-clip (2K1C) hypertensive rats and the density of renal glomerular and vascular atrial natriuretic factor (ANF) receptors. Conscious 2K1C rats with blood pressure of 150 mm Hg or higher were classified according to their sensitivity to the blood pressure-lowering effect of the angiotensin II antagonist saralasin. Both hypertension groups had lower body weights and greater relative heart weights than normotensive controls. Hematocrit was lower and plasma volume higher in saralasin-resistant animals than in either saralasin-sensitive or control rats. Plasma renin activity was higher in the saralasin-sensitive group than in the resistant rats. Plasma ANF concentration was greater in saralasin-resistant than in either normotensive or saralasin-sensitive animals. ANF was reduced in both atria of saralasin-resistant 2K1C animals but only in the left atrium of the sensitive group. Both hypertensive groups showed an increased ventricular ANF concentration. The number of glomerular ANF binding sites was significantly lower in the clipped kidney of both hypertensive groups. This lower density of binding sites was accompanied by an increased affinity. In saralasin-sensitive rats, the density of glomerular ANF receptors in the nonclipped kidney was significantly higher than in the controls. Saralasin-resistant rats exhibited a decreased number of vascular ANF binding sites in both mesenteric arteries and aorta. We conclude that through modulation of its glomerular and vascular receptors, ANF may contribute to the differential sodium handling of saralasin-sensitive and -resistant 2K1C hypertensive rats and to the reduced vascular responsiveness to ANF observed in the saralasin-resistant hypertensive rats.
Zafirlukast Improves Asthma Control in Patients Receiving High-Dose Inhaled Corticosteroids
Authors: J. CHRISTIAN VIRCHOW, ANTJE PRASSE, IAN NAYA, LINDA SUMMERTON, ALLAN HARRIS
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Not all asthma can be adequately controlled, despite the use of high-dose inhaled corticosteroids. Because cysteinyl-leukotrienes (Cys-LT) have been implicated in the pathogenesis of asthma, we hypothesized that the leukotriene receptor antagonist zafirlukast, in combination with high-doses of inhaled corticosteroids, might be efficacious in severe asthma. In a double-blind, parallel group study, 368 chronic adult asthmatic patients treated with inhaled corticosteroids (1,000 to 4,000 μ g/d), who had a predefined level of asthma symptoms during the run in period of the study, were randomly assigned to receive additional treatment with a high dose of zafirlukast (80 mg twice daily) (n = 180) or placebo (n = 188) for 6 wk. Compared with placebo, zafirlukast produced a significant improvement over baseline in the primary study endpoint of mean morning peak expiratory flow rate (PEFR) (18.7 L/min versus 1.5 L/min, p < 0.001), as well as in evening PEFR (p < 0.01), FEV1 (p < 0.05), daytime symptom score (p < 0.001), and β2-agonist use (p < 0.001). Furthermore, zafirlukast significantly reduced the risk of an exacerbation of asthma (odds ratio [OR]: 0.61; 95% confidence interval [CI]: 0.38 to 0.99) and the risk of patients requiring a further increase in asthma controller therapy (OR: 0.4; 95% CI: 0.2 to 0.8). In conclusion, in patients taking high-dose inhaled corticosteroids, zafirlukast improves pulmonary function and asthma symptoms, and reduces the risk of an asthma exacerbation, suggesting that the contribution of leukotrienes to asthma symptoms and exacerbations is not adequately controlled by high-dose inhaled corticosteroids.
Effect of digoxin and diuretics on high altitude left ventricular dysfunction.
Authors: V Balasubramanian, A Behl, G S Das, A K Wadhwa, O P Mathew, R S Hoon
Journal: Circulation (1978)

Systolic time intervals, stroke volume, cardiac output and (dZ/dt)/RZ index were serially estimated in 51 normal healthy volunteers at sea level, for ten days after air induction to 3658 m altitude and on return to sea level. The subjects were divided into three groups and were administered a diuretic, beta methyldigoxin and placebo in a double blind protocol. The group on placebo showed an increase in heart rate, reduction in stroke index and cardiac index during high altitude exposure with normalization on return to sea level. A deterioration in left ventricular function as manifested by prolongation of pre-ejection period, increase in PEP/LVET ratio, reduction in (dZ/dt)/RZ index and left ventricular ejection time was also noted at high altitude. The subjects on digoxin maintained normal stroke/cardiac index and did not show any significant changes in the parameters of myocardial function. The diuretic group showed more deterioration in the parameters than the placebo group. No significant side effects were noted. Left ventricular dysfunction and reduction of stroke index at high altitudes may be causually related; digoxin administration may prevent them from occurring.
APPENDICAL CONCRETIONS SIMULATING URETERAL CALCULI
Authors: Ernest G. Mark
Journal: JAMA (1924)

It is not unusual for the urologist to call the attention of the general surgeon to the numerous cases of ureteritis or ureteral stone in which operations are performed under the diagnosis of appendicitis. The opposite is, I believe, quite uncommon. It is for this reason that I report a case in detail. H. H. M., a man, aged 44, married, an extracting dentist, who came under my observation, Oct. 6, 1923, had been operated on for a right inguinal hernia under local anesthesia, about the middle of the preceding August. Following this operation he developed a retention which required catheterization. On the seventh day after his first catheterization he developed a sudden rise in temperature unaccompanied by chill. There was no infection of the herniotomy wound. This rise in temperature was accompanied by a severe burning sensation in the urethra. The pain continued to become more severe, being referred
Relevance of osteoporosis in women with fracture of the femoral neck
Authors: H Taggart, T R O Beringer
Journal: BMJ (1984)

sion ?If treated with an up to date drug regimen what success is achieved in blood pressure reduction ?We hope to publish results within the next year, and should the MRC trial show benefits from the treatment of mild to moderate hypertension, we will be able to comment on case finding and general practitioner follow up as a practical alternative to an expensive screening technique.This will have important consequences for general practice, for the National Health Service, and, most im- portantly, for the patient.
Effect of Routine Isoniazid Preventive Therapy on Tuberculosis Incidence Among HIV-Infected Men in South Africa
Authors: Alison D. Grant, Salome Charalambous, Katherine L. Fielding, John H. Day, Elizabeth L. Corbett, Richard E. Chaisson, Kevin M. De Cock, Richard J. Hayes, Gavin J. Churchyard
Journal: JAMA (2005)

Tuberculosis preventive therapy reduces tuberculosis incidence among human immunodeficiency virus (HIV)-infected individuals in clinical trials, but implementation has been limited and there are no data on effectiveness under routine conditions.To determine the effect on tuberculosis incidence of a clinic providing isoniazid preventive therapy to HIV-infected adults under routine conditions.Randomized intervention study with a novel incremental recruitment design. Between 1999 and 2001 (before antiretroviral therapy was available), 1655 HIV-infected male employees of a South African gold-mining company (median age, 37 years) were enrolled in the study. Median follow-up was 22.1 months.Employees were invited in random sequence to attend a workplace HIV clinic. Isoniazid, 300 mg/d, was self-administered for 6 months among attendees with no evidence of active tuberculosis.Incidence of tuberculosis (including both first and recurrent episodes) during the periods before and after clinic enrollment.A total of 1016 of 1655 men included in the analysis attended the clinic at least once. Six hundred seventy-nine (97%) of 702 men eligible to start primary isoniazid preventive therapy did so. The tuberculosis incidence rate before vs after clinic enrollment was 11.9 vs 9.0 per 100 person-years, respectively (incidence rate ratio [IRR] after adjustment for calendar period, 0.68; 95% confidence interval [CI], 0.48-0.96). In a multivariable analysis adjusting for calendar period, age, and silicosis grade, the tuberculosis IRR for clinic enrollment was 0.62 (95% CI, 0.43-0.89). In a further analysis excluding individuals with a history of tuberculosis (and, hence, ineligible for isoniazid preventive therapy), the adjusted IRR for clinic enrollment was 0.54 (95% CI, 0.35-0.83).Enrollment in a clinic offering primary isoniazid preventive therapy to HIV-infected adults reduced tuberculosis incidence by 38% overall and by 46% among individuals with no history of tuberculosis prior to the study. Tuberculosis incidence remained high despite isoniazid preventive therapy, and further work is needed to determine how to use additional interventions most effectively to reduce morbidity and mortality due to tuberculosis in HIV-infected persons.
Differences between anti-myeloperoxidase- and anti-proteinase 3-associated renal disease
Authors: Casper F.M. Franssen, Reinold O.B. Gans, Bertjan Arends, Conny Hageluken, Piet M. ter Wee, Paul G.G. Gerlag, Steven J. Hoorntje
Journal: Kidney International (1995)
Medical errors kill almost 100000 Americans a year
Authors: F. Charatan
Journal: BMJ (1999)

An expert panel from the Institute of Medicine, part of the National Academy of Sciences, found that medical errors kill from 44000 to 98000 Americans each year.

The chairman of the 19 member panel, William C Robinson, president of the W K Kellogg Foundation in Battle Creek, Michigan, a private, grant making body, said, “These stunningly high rates of medical errors—resulting in deaths, permanent disability, and unnecessary suffering—are simply unacceptable in a medical system that promises first to ‘do no harm.’”

The panel's report, which was released in November, recommended that a new federal centre for patient safety should be set up in the Public Health Service and should have a budget of about $100m (£63m) a year, which is equivalent to …
Hyperthyroidism With Painless Subacute Thyroiditis in the Elderly
Authors: Michael Gordon
Journal: JAMA (1981)

Six elderly patients experiencing weight loss, palpitations, or depression had the biochemical and clinical features of masked hyperthyroidism due to painless subacute thyroiditis. The syndrome is not commonly recognized in this age group and can be easily misdiagnosed unless appropriate investigations are undertaken. Supportive and symptomatic therapy is sufficient during the hyperthyroid phase of the disorder. (<i>JAMA</i>1981;246:2354-2355)
CORONARY ARTERY CALCIUM PREDICTS INTERMEDIATE-TERM EVENTS IN SUBJECTS WITH A LOW LIFETIME RISK OF CARDIOVASCULAR DISEASE: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA)
Authors: Parag Joshi, Birju Patel, Michael Blaha, Jarett Berry, Ron Blankstein, Matthew Budoff, Nathan Wong, Arthur Agatston, Roger Blumenthal, Khurram Nasir
Journal: Journal of the American College of Cardiology (2013)
Can Someone Own Pneumonia?
Authors: Vincent A. Fulginiti
Journal: JAMA (1976)

<h3>To the Editor.—</h3> I cannot believe it!The Journalpublished a question by "MD, Connecticut" (235:2237, 1976) that is beyond belief. The physician requested consultants' views of his local problem in which his right to discuss pneumonia as a microbiologist was challenged by a pulmonologist who claimed the right of prior approval. My disbelief extends from the fact (1) that consultants would reply, (2) that the inquiry would be published, (3) that a physician would make such a query, and (4) that the event actually happened. I varied between laughter and tears as the implications screamed out from the page. If we, within the confines of each discipline, now claim territoriality for<i>ideas</i>concerning diseases affecting regions of the body as well as the regions themselves, God help us! I almost passed off the inclusion of this query as an ironic twist of the editorial staff ofThe Journal, hearing