tbuckley/cabot-search huggingface dataset:
New Technology and Health Care Costs — The Case of Robot-Assisted Surgery
Authors: Gabriel I. Barbash, Sherry A. Glied
Journal: New England Journal of Medicine (2010)

Technological innovation in health care is an important driver of cost growth. Doctors and patients often embrace new modes of treatment before their merits and weaknesses are fully understood. These technologies can lead to increases in costs, either because they are simply more expensive than previous treatments or because their introduction leads to an expansion in the types and numbers of patients treated. We examined these patterns as they apply to the case of robot-assisted surgery.Robotic surgical devices allow a surgeon at a console to operate remote-controlled robotic arms, which may facilitate the performance of laparoscopic procedures. Laparoscopic surgery, . . .
788 INTERMEDIATE STAGE HEPATOCELLULAR CARCINOMA (HCC): TO TACE OR NOT TO TACE?
Authors: F. Farinati, A. Giacomin, P. Tartaro, V. Vanin, A. Sergio, P. Burra, U. Cillo, M.A. Di Nolfo, P. Del Poggio, L. Benvegnù, M. Zoli, F. Borzio, E.G. Giannini, E. Caturelli, F. Trevisani
Journal: Journal of Hepatology (2009)
TACI deficiency enhances antibody avidity and clearance of an intestinal pathogen
Authors: Shoichiro Tsuji, Lucas Stein, Nobuhiko Kamada, Gabriel Nuñez, Richard Bram, Bruce A. Vallance, Ana E. Sousa, Jeffrey L. Platt, Marilia Cascalho
Journal: Journal of Clinical Investigation (2014)

The transmembrane activator and calcium-modulating cyclophilin ligand interactor (TACI) controls differentiation of long-lived plasma cells, and almost 10% of individuals with common variable immunodeficiency (CVID) express either the C104R or A181E variants of TACI. These variants impair TACI function, and TACI-deficient mice exhibit a CVID-like disease. However, 1%-2% of normal individuals harbor the C140R or A181E TACI variants and have no outward signs of CVID, and it is not clear why TACI deficiency in this group does not cause disease. Here, we determined that TACI-deficient mice have low baseline levels of Ig in the blood but retain the ability to mutate Ig-associated genes that encode antigen-specific antibodies. The antigen-specific antibodies in TACI-deficient mice were produced in bursts and had higher avidity than those of WT animals. Moreover, mice lacking TACI were able to clear Citrobacter rodentium, a model pathogen for severe human enteritis, more rapidly than did WT mice. These findings suggest that the high prevalence of TACI deficiency in humans might reflect enhanced host defense against enteritis, which is more severe in those with acquired or inherited immunodeficiencies.
Dawn Phenomenon: Its Frequency in Non-Insulin-Dependent Diabetic Patients on Conventional Therapy
Authors: Jameel A Atiea, Robert R J Ryder, Jiten Vora, David R Owens, Stephen D Luzio, Sheila Williams, Tom M Hayes
Journal: Diabetes Care (1987)

The frequency of the dawn phenomenon has been studied in non-insulin-dependent diabetic (NIDDM) patients while they continued with their conventional therapy. Plasma glucose (PG) and immunoreactive insulin (IRI) were estimated hourly from 0300 to 0900 h in 19 NIDDM patients; 9 patients were treated by diet alone (group 1), and 10 patients were treated by diet and oral hypoglycemic agents (group 2). The dawn rise of plasma glucose was demonstrated in 17 (89.5%) of the 19 patients with mean +/- SE plasma glucose at 0300 h of 7.0 +/- 0.5 mM and at 0800 h of 8.4 +/- 0.6 (P less than .01). IRI in all patients rose from 14.7 +/- 1.3 microU/ml at 0500 h to 18.1 +/- 1.8 microU/ml at 0700 h (P less than .05). The changes in IRI levels at any time from 0300 to 0800 h in groups 1 and 2 when considered separately were insignificant. Thus, the dawn phenomenon occurs commonly in NIDDM patients taking their conventional therapy.
Cholecystographic Modifications to Improve Initial Study Opacification
Authors: Charles E. Shopfner
Journal: JAMA (1975)

<h3>To the Editor.—</h3> An editorial inThe Journal(232:642, 1975) discussed the problem of nonopacification of the gallbladder with a single 3-gm dose of iopanoic acid (Telepaque). It pointed out that an estimated 15 million Americans are afflicted with gallbladder disease, and hence, are potential candidates for cholecystography. Nonopacified gallbladders occur in 25% of patients with a single 3-gm dose, but the second dose of 3 gm of iopanoic acid causes opacification in 70%. Eighty percent of patients in whom opacification is obtained with reinforcement have normal gallbladders. A recommendation for the sake of economy was therefore made that all patients routinely receive 3 gm of iopanoic acid 40 to 42 hours before roentgenography and a second dose of 3 gm at 14 to 16 hours before. Assuming that 15 million cholecystograms are to be done, this recommendation means that 11,250,000 patients receive the double dose unnecessarily and suffer the
Immunologic Abnormalities Induced by Postperfusion Cytomegalovirus Infection
Authors: GARY L. KANTOR
Journal: Annals of Internal Medicine (1970)

Clinical and immunologic features in ten patients with cytomegalovirus-induced postperfusion syndrome were studied. Fever, hepatosplenomegaly, and lymphocytosis were the most frequent clinical manifestations. In addition, lymphocytic leukemoid reactions were present in two patients, glomerulitis in one, and transient anemia in five. In three anemic subjects erythrocyte autoantibodies were found. Immunologic aberrations including rheumatoid factor, antinuclear antibodies, cold agglutinins, and cryoglobulins were detected in 9 of the 10 patients. The immunologic abnormalities appeared during the cytomegalovirus infection, disappeared when the mononucleosis-like syndrome resolved, and were not present in a control group consisting of 29 patients who had undergone cardiopulmonary bypass without developing cytomegalovirus infection. These observations indicate that cytomegalovirus infection can induce a variety of clinical and immunologic abnormalities in postperfusion patients.
Mitochondria-Targeted Drugs Synergize with 2-Deoxyglucose to Trigger Breast Cancer Cell Death
Authors: Gang Cheng, Jacek Zielonka, Brian P. Dranka, Donna McAllister, A. Craig Mackinnon, Joy Joseph, Balaraman Kalyanaraman
Journal: Cancer Research (2012)

Cancer cells are long known to exhibit increased aerobic glycolysis, but glycolytic inhibition has not offered a viable chemotherapeutic strategy in part because of the systemic toxicity of antiglycolytic agents. However, recent studies suggest that a combined inhibition of glycolysis and mitochondrial function may help overcome this issue. In this study, we investigated the chemotherapeutic efficacies of mitochondria-targeted drugs (MTD) in combination with 2-deoxy-d-glucose (2-DG), a compound that inhibits glycolysis. Using the MTDs, termed Mito-CP and Mito-Q, we evaluated relative cytotoxic effects and mitochondrial bioenergetic changes in vitro. Interestingly, both Mito-CP and Mito-Q synergized with 2-DG to decrease ATP levels in two cell lines. However, with time, the cellular bioenergetic function and clonogenic survival were largely restored in some cells. In a xenograft model of human breast cancer, combined treatment of Mito-CP and 2-DG led to significant tumor regression in the absence of significant morphologic changes in kidney, liver, or heart. Collectively, our findings suggest that dual targeting of mitochondrial bioenergetic metabolism with MTDs and glycolytic inhibitors such as 2-DG may offer a promising chemotherapeutic strategy.
ASSOCIATION BETWEEN NON-INVASIVE ARTERIAL PULSE VOLUME RECORDINGS AND EXTENT OF CORONARY ARTERY DISEASE
Authors: Ashish Parikh, Shailja V. Parikh, Sandeep Das, Tayo Addo, Shoaib Saya, Sondra Rolator, Tamra Cooper, Elizabeth Holper
Journal: Journal of the American College of Cardiology (2010)
Administration of truncated secretory leukoprotease inhibitor ameliorates bleomycin-induced pulmonary fibrosis in hamsters.
Authors: H Mitsuhashi, S Asano, T Nonaka, I Hamamura, K Masuda, M Kiyoki
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

The purposes of this study were to investigate the effect of our recently developed truncated secretory leukoprotease inhibitor (SLPI) on bleomycin (BLM)-induced lung injury and fibrosis in hamsters, which is widely used as a model of interstitial pulmonary fibrosis, and to assess the possible involvement of neutrophil elastase in the pathogenesis of pulmonary fibrosis. The fibrosis model was prepared by administration of BLM (10 mg/kg) intratracheally to hamsters. The truncated SLPI was administered at a dose 5 or 15 mg/kg intraperitoneally twice a day only for 10 d starting from the time of BLM administration. BLM administration resulted in decreases in body weight and survival rate. Elastase activity in the supernatant of bronchoalveolar lavage (BAL) fluids was increased at 3 and 7 d after BLM administration in parallel with the increase in the number of neutrophils in the fluids. Histopathologically, at 14 and 28 d after BLM administration, diffuse thickening and fibrosis of alveolar walls with marked cell infiltration and severe distortion of alveolar structure, including honeycomb lung, were observed to have occurred. In this model, the decreases in body weight and survival rate and the increase in elastase activity were inhibited by the truncated SLPI dose-dependently, and pulmonary fibrosis was significantly ameliorated by the administration of this shortened form of SLPI. These results suggest that neutrophil elastase may be implicated in the pathogenesis of BLM-induced pulmonary fibrosis and that the truncated SLPI might be a promising therapeutic in the treatment of interstitial pulmonary fibrosis.
Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981-22981/CE.3
Authors: Thierry Gorlia, Martin J van den Bent, Monika E Hegi, René O Mirimanoff, Michael Weller, J Gregory Cairncross, Elizabeth Eisenhauer, Karl Belanger, Alba A Brandes, Anouk Allgeier, Denis Lacombe, Roger Stupp
Journal: The Lancet Oncology (2007)
Does this patient have appendicitis?
Authors: A. Alvarado
Journal: JAMA (1997)

To the Editor.  —The meta-analysis presented by Dr Wagner and colleagues 1 provides a good picture of the clinical signs and symptoms of acute appendicitis. Most of the studies on this subject indicate that the most reliable signs in the diagnosis of acute appendicitis are those with a high likelihood ratio, providing that these signs are present on each individual patient. I agree with the statement that the routine history and physical examination remain the most effective and practical tools to make the  Nevertheless, we cannot ignore the fact that a white blood cell count with a differential cell count is also an important tool in the evaluation, but this is not mentioned by the authors in their article.  I also agree with their assertion that clinicians often do not collect enough clinical details for accurate and precise diagnosis. It is for this reason that I would like to emphasize that the
THE EPIDEMIOLOGY OF FOWL CHOLERA
Authors: I. W. Pritchett, T. P. Hughes
Journal: The Journal of Experimental Medicine (1932)

1. Strains of-P. avicida from "spontaneous epidemics" of fowl cholera, when introduced intranasally in fixed doses into specially bred chickens, induced fatal fowl cholera in about 40 per cent but did not survive in the nasal clefts of resistant birds nor spread to normal contacts. 2. Strains of P. avicida from "spontaneous endemics" of fowl cholera, when introduced similarly into chickens, failed to kill but did survive in the nasal clefts of inoculated birds and spread readily to normal contacts. 3. "Laboratory" variants of the epidemic strains of P. avicida failed to kill or survive in the test birds and did not spread to contacts.
Heparin-induced thrombocytopenia type II: Successful use of Orgaran (ORG 10172) in intensive care patients
Authors: U. Burkhard-Meier, D. Söhngen, A. Heyll, W. Schneider, H. -P. Schultheiss, B. Schwartzkopff, M. Vogt, A. Greinacher
Journal: Intensive Care Medicine (1995)
Signal regulatory protein α is associated with tumor-polarized macrophages phenotype switch and plays a pivotal role in tumor progression
Authors: Yu-fei Pan, Ye-xiong Tan, Min Wang, Jian Zhang, Bo Zhang, Chun Yang, Zhi-wen Ding, Li-wei Dong, Hong-yang Wang
Journal: Hepatology (2013)

Macrophages (Mψ) are the major component of infiltrating leukocytes in tumors and exhibit distinct phenotypes according to the microenvironment. We have recently found that signal regulatory protein α (SIRPα), the inhibitory molecule expressed on myeloid cells, plays a critical role in controlling innate immune activation. Here, we identify that SIRPα is down-regulated on monocytes/Mψ isolated from peritumoral areas of hepatocellular carcinoma (HCC) samples, while its level is moderately recovered in intratumor Mψ. In vitro assays demonstrate that SIRPα expression is significantly reduced on Mψ when cocultured with hepatoma cells. This reduction is partly due to the soluble factors in the tumor microenvironment. Knockdown (KD) of SIRPα prolongs activation of nuclear factor kappa B (NF-κB) and PI3K-Akt pathways as Mψ encounter tumor cells, leading to an increased capacity of Mψ for migration, survival, and proinflammatory cytokine production. Enhanced Stat3 and impaired Stat1 phosphorylation are also observed in tumor-exposed SIRPα-KD Mψ. Adoptive transfer with SIRPα-KD Mψ accelerates mouse hepatoma cells growth in vivo by remolding the inflammatory microenvironment and promoting angiogenesis. SIRPα accomplishes this partly through its sequestration of the signal transducer Src homology 2-containing phosphotyrosine phosphatase (SHP2) from IκB kinase β (IKKβ) and PI3K regulatory subunit p85 (PI3Kp85). Conclusion : These findings suggest that SIRPα functions as an important modulator of tumor-polarized Mψ in hepatoma, and the reduction of SIRPα is a novel strategy used by tumor cells to benefit their behavior. Therefore, SIRPα could be utilized as a potential target for HCC therapy. (Hepatology 2013;58:680–691)
Serum selenium concentrations in rheumatoid arthritis.
Authors: J R O'Dell, S Lemley-Gillespie, W R Palmer, A L Weaver, G F Moore, L W Klassen
Journal: Annals of the Rheumatic Diseases (1991)

Selenium is a trace element and an essential part of the enzyme glutathione peroxidase, which protects cells from oxidative damage. Selenium has been shown to have antiproliferative, anti-inflammatory, antiviral, and immune altering effects. Serum selenium concentrations in 101 patients with seropositive rheumatoid arthritis were found to be significantly lower than those in 29 normal, healthy controls (mean (SD) 148 (42) v 160 (25) micrograms/l) and also lower than those in eight patients with fibrositis (148 (42) v 166 (25) micrograms/l). It is speculated that serum selenium concentrations may modulate the effect of viral or other infections in subjects with the appropriate genetic background and in this way enhance the development or progression of rheumatoid arthritis.
Ontogeny-related changes in proliferative potential of human hematopoietic cells.
Authors: P M Lansdorp, W Dragowska, H Mayani
Journal: The Journal of Experimental Medicine (1993)

Blood cells originate from hematopoietic stem cells that are located at different sites during ontogeny. Production of human stem cells and their progeny in culture is expected to have important implications for experimental therapeutic strategies involving gene transfer and transplantation. Here we report striking differences between primitive hematopoietic cells purified from adult bone marrow, umbilical cord blood, and fetal liver in cytokine-supplemented, serum-free cultures. In such cultures both the fraction of responding cells and their ability to produce CD34+ progenitor cells decreased markedly with the age of the cell donor. These results document extensive, ontogeny-related functional differences between primitive hematopoietic cells.
Stringent V beta requirement for the development of NK1.1+ T cell receptor-alpha/beta+ cells in mouse liver.
Authors: T Ohteki, H R MacDonald
Journal: The Journal of Experimental Medicine (1996)

The liver of C57BL/6 mice contains a major subset of CD4+8- and CD4-8- T cell receptor (TCR)-alpha/beta+ cells expressing the polymorphic natural killer NK1.1 surface marker. Liver NK1.1+TCR-alpha/beta+ (NK1+ T) cells require interaction with beta2-microglobulin-associated, major histocompatibility complex I-like molecules on hematopoietic cells for their development and have a TCR repertoire that is highly skewed to Vbeta8.2, Vbeta7, and Vbeta2. We show here that congenic C57BL/6.Vbeta(a) mice, which lack Vbeta8- expressing T cells owing to a genomic deletion at the Vbeta locus, maintain normal levels of liver NK1+ T cells owing to a dramatic increase in the proportion of cells expressing Vbeta7 and Vbeta2 (but not other Vbetas). Moreover, in C57BL/6 congenic TCR-V Vbeta3 and -Vbeta8.1 transgenic mice (which in theory should not express other Vbeta, owing to allelic exclusion at the TCR-beta locus), endogenous TCR-Vbeta8.2, Vbeta7, and Vbeta2 (but not other Vbetas) are frequently expressed on liver NK1+T cells but absent on lymph node T cells. Finally, when endogenous V beta expression is prevented in TCR-Vbeta3 and Vbeta8.1 transgenic mice (by introduction of a null allele at the C beta locus), the development of liver NK1+T cells is totally abrogated. Collectively, our data indicate that liver NK1+T cells have a stringent requirement for expression of TCR-Vbeta8.2, Vbeta7, or Vbeta2 for their development.
Idiopathic bronchiolitis obliterans organizing pneumonia with multiple cavitary lung nodules
Authors: M Haro, M Vizcaya, A Texido, X Aguilar, M Arevalo
Journal: European Respiratory Journal (1995)

Bronchiolitis obliterans organizing pneumonia (BOOP) is a pulmonary disorder with a wide spectrum of radiological features. We report the case of a 58 year old woman, in whom the radiological appearance was multiple cavitary nodules in both lungs, that responded with a complete resolution after corticosteroid therapy. This finding justifies the inclusion of BOOP in the differential diagnosis of multiple cavitary nodules.
Hemodialysis in the Home
Authors: Angus I. Rae
Journal: JAMA (1968)

Twenty-seven patients with chronic renal failure have been trained in a community hospital for home dialysis. Six patients subsequently received renal homotransplants. The remaining 21 live an average of 230 miles from the training center, the majority in rural communities. Sixteen are cared for entirely by their local physicians. The other five live closer to the center and tend to be more dependent on it. The emphasis of the training is to make the patient as independent as possible relying for his needs on his local medical community. The local physician comes to the center for instruction while his patient is undergoing training. Thereafter, this physician is in contact with the center for advice when necessary. We believe that if dialysis were integrated thus into community medicine, many more patients with renal failure could be saved.
Diagnosing and managing vaginismus
Authors: T. Crowley, D. Goldmeier, J. Hiller
Journal: BMJ (2009)

#### Summary points

Recent consensus defined vaginismus as, “The persistent or recurrent difficulties of the woman to allow vaginal entry of a penis, a finger, and or any object, despite the woman’s expressed wish to do so.”1 The definition also noted that affected women often avoid intercourse; experience involuntary pelvic muscle contraction; and anticipate, fear, or experience pain. However, it can be difficult to diagnose vaginismus. Women with total vaginismus are unable to tolerate penetration of their vagina by any object, but those with partial vaginismus tolerate penetration with difficulty and pain. The condition can be lifelong (primary) or it can occur after sexual function has been normal (secondary). It can also be situational, occurring only with certain partners or in particular circumstances, or it can be global, occurring independent of partner or circumstances. It is thus a clinical syndrome, not a definitive diagnosis, that consists of overlapping elements of hypertonic pelvic floor muscles, pain, anxiety, and difficulty in penetration.

The Diagnostic and Statistical Manual of Mental Disorders , fourth edition (DSM-IV) categorises vaginismus as a sexual pain disorder along with dyspareunia. It describes vaginismus as occurring when “recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina” interferes with intercourse.2 According to this definition, the experience of pain is not necessary for the diagnosis. …
IMPACT OF ANEMIA ON CLINICAL OUTCOME IN PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING PERCUTANEOUS CORONARY INTERVENTION: INSIGHTS FROM THE AFCAS REGISTRY
Authors: Marja Kaarina Puurunen, Tuomas Kiviniemi, Wail Nammas, Axel Schlitt, Andrea Rubboli, Kai Nyman, Pasi Karjalainen, Paulus Kirchhof, Gregory Lip, Juhani Airaksinen
Journal: Journal of the American College of Cardiology (2014)
Sharing decisions with patients: is the information good enough?
Authors: A. Coulter, V. Entwistle, D. Gilbert
Journal: BMJ (1999)

Editorial by Richards and Coulter 

Shared decision making, in which patients and health professionals join in both the process of decision making and ownership of the decision made, is attracting considerable interest as a means by which patients' preferences can be incorporated into clinical decisions.1 When there are several treatment options which may have different effects on the patient's quality of life, there is a strong case for offering patients choice. Their active involvement in decision making may increase the effectiveness of the treatment.

Trials are currently under way to test this hypothesis formally, but there are good grounds for optimism. Patients with hypertension benefit if they are allowed to adopt an active rather than a passive role in treatment, 2 3 patients with breast cancer suffer less depression and anxiety if they are treated by doctors who adopt a participative consultation style,4 and patients who are more actively involved in discussions about the management of their diabetes achieve better blood sugar control.5 Patients whose doctors are ignorant of their values and preferences may receive treatment that is inappropriate to their needs.6–8

Patients cannot express informed preferences unless they are given sufficient and appropriate information, including detailed explanations about their condition and the likely outcomes with and without treatment. Yet many report considerable difficulties in obtaining relevant information.9 There are various reasons for this. Health professionals frequently underestimate patients' desire for and ability to cope with information. Consultation times are limited—there is often insufficient time to explain fully the condition and the treatment choices. Health professionals may themselves lack knowledge of treatment options and their effects. A solution to this problem is to ensure that patients have access to written or audiovisual material, to inform themselves and to use in discussion with health …