tbuckley/cabot-search huggingface dataset:
End-Stage Renal Disease: Better Treatment at Lower Cost
Authors: BENJAMIN T. BURTON
Journal: Annals of Internal Medicine (1978)

Editorials1 April 1978End-Stage Renal Disease: Better Treatment at Lower CostBENJAMIN T. BURTON, PH. D.BENJAMIN T. BURTON, PH. D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-4-567 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn Chinese folklore he who saves another person's life is responsible for him for the rest of his existence. Ever since the enactment of Public Law 92-603 in 1972 the Federal Government might be regarded as being in the same position as the proverbial Chinese good Samaritan who becomes the moral prisoner of his altruistic deed. In the United States each year approximately 52 000 patients approach terminal renal failure. The only alternative to their death is treatment by maintenance dialysis or renal transplantation. Maintenance dialysis must be continued for the rest of the life of the patient; it has... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: National Institute of Arthritis, Metabolism, and Digestive Diseases National Institutes of Health Bethesda, Maryland PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByOutpatient Cycler Peritoneal Dialysis for Home Failure, Hemodialysis Failure, AV Access Failure, and Cardiovascular InstabilityTreatment Bias in the Management of End-Stage Renal DiseaseIndikation zur NierentransplantationDialytic Therapy for Irreversible Uremia 1 April 1978Volume 88, Issue 4Page: 567-568KeywordsMedical dialysisRenal failureRenal transplantation Issue Published: 1 April 1978 PDF DownloadLoading ...
Lenalidomide, melphalan, prednisone and thalidomide (RMPT) for relapsed/refractory multiple myeloma
Authors: A Palumbo, A Larocca, P Falco, G Sanpaolo, A P Falcone, V Federico, L Canepa, M Crugnola, M Genuardi, V Magarotto, M T Petrucci, M Boccadoro
Journal: Leukemia (2010)
Substitution of another opioid for morphine may be useful for pain control
Authors: P. Murray
Journal: BMJ (1998)

EDITOR—In their article on the principles of palliative care and pain control O'Neill and Fallon rightly emphasise the primacy of morphine among strong opioid analgesics in the management of cancer pain.1 Although morphine is generally well tolerated and effective, some patients have pain that is relatively resistant to it. Increasing the dose in these circumstances may lead to …
Liver-specific inactivation of<i>Notch2</i>, but not<i>Notch1</i>, compromises intrahepatic bile duct development in mice
Authors: Fabian Geisler, Florian Nagl, Pawel K. Mazur, Marcel Lee, Ursula Zimber-Strobl, Lothar J. Strobl, Freddy Radtke, Roland M. Schmid, Jens T. Siveke
Journal: Hepatology (2008)

The Notch pathway is an evolutionary conserved, intercellular signaling pathway that plays an important role in cell fate specification and the embryonic development of many organs, including the liver. In humans, mutations in the Notch receptor ligand Jagged1 gene result in defective intrahepatic bile duct (IHBD) development in Alagille syndrome. Developmental abnormalities of IHBD in mice doubly heterozygous for Jagged1 and Notch2 mutations propose that interactions of Jagged1 and its receptor Notch2 are crucial for normal IHBD development. Because different cell types in the liver are involved in IHBD development and morphogenesis, the cell-specific role of Notch signaling is not entirely understood. We investigated the effect of combined or single targeted disruption of Notch1 and Notch2 specifically in hepatoblasts and hepatoblast-derived lineage cells on liver development using AlbCre transgenic mice. Hepatocyte differentiation and homeostasis were not impaired in mice after combined deletion of Notch1 and Notch2 (N1N2(F/F)AlbCre). However, we detected irregular ductal plate structures in N1N2(F/F)AlbCre newborns, and further postnatal development of IHBD was severely impaired characterized by disorganized ductular structures accompanied by portal inflammation, portal fibrosis, and foci of hepatocyte feathery degeneration in adulthood. Further characterization of mutant mice with single deletion of Notch1 (N1(F/F)AlbCre) or Notch2 (N2(F/F)AlbCre) showed that Notch2 but not Notch1 is indispensable for normal perinatal and postnatal IHBD development. Further reduction of Notch2 gene dosage in Notch2 conditional/mutant (N2(F/LacZ)AlbCre) animals further enhanced IHBD abnormalities and concomitant liver pathology.Notch2 is required for proper IHBD development and morphogenesis.
Evaluation of Tuberculosis Control Policies Using Computer Simulation
Authors: Timothy F. Brewer
Journal: JAMA (1996)

<h3>Objective.</h3> —To develop more effective methods to assess tuberculosis (TB) control strategies so we can meet national goals for the elimination of TB in the United States. <h3>Design.</h3> —Using a semi-Markov model that divided the US population into 3 age groups and 18 clinical states based on disease status and risk for TB and human immunodeficiency virus (HIV) infection, we measured the effects of 5 changes in TB policy, introduced singly and in combination: (1) increased coverage and (2) improved efficacy of preventive therapy, (3) increased coverage and (4) improved efficacy of treatment, and (5) introduction of BCG vaccination. <h3>Results.</h3> —A BCG vaccination program that reached 10% of eligible children and 1% of eligible adults each year would produce a 17% reduction in cases and an 11% decline in deaths over 10 years. Preventive therapy programs among the general population would have little effect on the number of TB cases, but a program targeting HIV-infected patients would reduce HIV-associated TB cases and deaths 14% to 20%. A 10% improvement in the coverage and efficacy of both preventive therapy and treatment, coupled with the BCG vaccination program, would lead to a 47% decline in TB cases and a 50% decline in TB deaths relative to baseline over 10 years. <h3>Conclusions.</h3> —Improvements in treatment coverage or effectiveness alone are unlikely to reach established national goals for the elimination of TB. These goals can be achieved through a combination of improvements in current programs with targeted preventive therapy and BCG vaccination programs.
The Emerging Epidemic of Melanoma and Squamous Cell Skin Cancer
Authors: Andrew G. Glass
Journal: JAMA (1989)

Squamous cell skin cancer, though common, remains largely unreported and unstudied, with little known about its incidence and time trends. We have used a unique resource—a continuous population-based registry of cases of squamous cell skin cancer within a single prepaid health plan—to describe basic epidemiologic features of this malignancy and compare it with the more widely studied melanoma. Both malignancies are considerably more common in this population than we expected based on previous reports from the general population. From the 1960s to the 1980s, the incidence of squamous cell skin cancer increased 2.6 times in men and 3.1 times in women, while incidence of melanoma rose 3.5-fold and 4.6-fold in men and women, respectively. Skin cancers of both types involving the head and neck or the extremities increased essentially in parallel over these 27 years. Melanomas of the trunk, however, appeared to increase at a faster rate in both sexes. These observations are consistent with the impression that the rising incidence of both malignancies may be attributable to increased voluntary exposure to the sun over an extended period. (<i>JAMA</i>. 1989;262:2097-2100)
Haemodynamics and left ventricular function in heart failure patients: Comparison of awake versus intra‐operative conditions
Authors: Ellen A. ten Brinke, Robert J. Klautz, Sven A. Tulner, Frank H. Engbers, Harriette F. Verwey, Douwe E. Atsma, Martin J. Schalij, Ernst E. van der Wall, Jeroen J. Bax, Hein Putter, Robert A. Dion, Paul Steendijk
Journal: European Journal of Heart Failure (2008)
801-1 In women with symptoms of ischemic heart disease, global and regional myocardial perfusion status by magnetic resonance imaging better assigns risk: Results from the National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation (WISE)
Authors: Mark Doyle, Gerald M Pohost, Eduardo Kortright, Leslee J Shaw, Delia B Johnson, William J Rogers, Anthon Fuisz, Steven E Reis, Barry L Sharaf, Carl J Pepine, Noel Bairey-Merz, Sunil Mankad, Diane A Vido, Sheryl F Kelsey, Marian B Olson, Robert W.W Biederman
Journal: Journal of the American College of Cardiology (2004)
Meeting Report: The 11th International Conference on Differentiation Therapy and Innovative Therapeutics in Oncology
Authors: Laurent Delva, Arthur Zelent, Tomoki Naoe, Pierre Fenaux, Samuel Waxman, Laurent Degos, Christine Chomienne
Journal: Cancer Research (2007)

The International Conference on Differentiation Therapy group of clinicians and researchers has met for more than 20 years and the most recent meeting in 2005 was held in Shanghai, China ( [1][1]). This group fostered the required networks to translate these novel strategies to clinical practice, as
Developmental Immunology: Clinical Problems and Aging
Authors: Sonya Naryshkin
Journal: JAMA (1983)

This fine book contains the proceedings of the 1981 UCLA Forum in Medical Sciences Symposium. The purpose of the symposium was to gather experts to explore, in depth, selected areas of the field of developmental immunology and to relate these topics to disease processes and to aging. The five areas concentrated upon are immunoglobulin genes, immunorecognition and evolution of receptors, ontogeny and stem cells, immunopathology of the immune system, and aging of the immune system. The introductory section contains a lively and imaginative explanation of how and why the mammalian immune system developed, pointing out the consequences of immunological foresight and reasons for the development of the major histocompatibility complex (MHC). The immune capabilities of various organisms throughout the phylogenetic tree are compared, and the role of the MHC in those responses is discussed. Researchers and students of molecular genetics will find the next section stimulating. Here, the focus is
A walk down memory lane
Authors: D. Spence
Journal: BMJ (2009)

I graduated from university, swam on the Great Barrier Reef, looked upon Krakatoa, played roulette in Caesar’s Palace, and saw my children born. I value the memories of my youth. But our world gathers speed with age. Mid-life mugs you on the way home from your 40th birthday party wielding the knife of your own mortality. Terrified, we take up running, buy AC/DC tickets, wear inappropriate clothes, dye our hair, or grow silly facial hair. But the harder we cling to youth, …
Predictors of efficacy of amiodarone and characteristics of recurrence of arrhythmia in patients with sustained ventricular tachycardia and coronary artery disease.
Authors: J Zhu, D E Haines, B B Lerman, J P DiMarco
Journal: Circulation (1987)

The value of serial electropharmacologic testing during long-term oral amiodarone therapy for prediction of long-term drug efficacy as well as characteristics of arrhythmia recurrence is controversial. One-hundred four consecutive patients with coronary artery disease and sustained ventricular tachyarrhythmias (VT) underwent initial electrophysiologic (EP) evaluation in the drug-free state and again after an amiodarone loading period of 25 +/- 14 days (mean +/- SD). Twenty-six patients (25%) had no inducible ventricular tachyarrhythmia during therapy with amiodarone (VT control group), whereas arrhythmia inducibility persisted in the remaining 78 patients (VT noncontrol group). During 17.4 +/- 13.7 months of follow-up, two patients in the VT control group either had VT recurrence or died suddenly compared with 21 VT recurrences and eight sudden cardiac deaths in the VT noncontrol group (actuarial event rates at 36 months of 0.11 and 0.56, respectively, p = .0065). The cycle lengths of recurrent VT in these 21 patients in the VT noncontrol group were compared with those observed at final EP testing. A significant linear correlation was demonstrated (r = .76, p = .0001). Subgroup analysis of patients in the VT noncontrol group showed no EP predictors of outcome, including cycle length of induced VT. However, patients dying suddenly during the follow-up period had a higher prevalence of new or worsening congestive heart failure (75%) compared with patients with VT recurrence (19%) or those with no arrhythmic event (29%) (p less than .02).2off
Abstract P3-10-31: Epithelial Proliferation (Ki67) Is Not an Independent Variable for Breast Cancer Relapse in Symptomatic or Screen Detected Breast Cancers (SDBC)
Authors: NJ Bundred, WF Knox, A Cramer, M Wilson, R Prasad, J Morris
Journal: Cancer Research (2010)

Abstract Background: UK screen detected breast cancers (SDBC) (aged 50-65 years) have an overall 97.2% 5 year relative survival compared to 77.6% for symptomatic cancers. Epithelial proliferation has been used to determine therapy in the St. Gallen guidelines (Ki67 ≥30% indicates the need for chemotherapy). Methods: To determine the value of Ki67 in post-menopausal breast cancer in women aged 50-65 years, we have studied Ki67 in 1270 women aged 50-65 years (mean 57 years) with either symptomatic cancers (n=412) or SDBC (n=858) with a 10 year follow up. Results: Ki67 predicted relapse and death in both symptomatic and SDBC. Mode of detection, size, grade, node status and oestrogen receptor (ER) were independently predictive of breast cancer mortality and Ki67 was not an independent variable. In small size ≤15mm ER positive SDBC (n=248) or symptomatic cancers (n=146), Ki67 was not prognostic (p=0.13 and 0.59 respectively). Twelve per cent of symptomatic and 2% of SDBC had died within 5 years. Mean Ki67 in SDBC was 21.4 (SD 10.3) and 34.2 (SD 16.2) in symptomatic cancers (p=≤0.001). ER positive cancers had lower Ki67 levels (p=0.002). For each 10 unit increase in Ki67, increases in distant relapse occurred (RR 1.43:95%CI;1.32-1.55). Ten Year Survival According to Ki67 and Mode of Presentation Discussion: Epithelial proliferation is prognostic in breast cancer but its value is predominantly in large size (≥15mm) symptomatic tumours and Ki67 alone cannot be used to determine therapy. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-31.
Protein permeability in the adult respiratory distress syndrome. Loss of size selectivity of the alveolar epithelium.
Authors: J F Holter, J E Weiland, E R Pacht, J E Gadek, W B Davis
Journal: Journal of Clinical Investigation (1986)

Small amounts of plasma protein normally reach the alveolar epithelial surface by a size-selective process that restricts the passage of very large molecules. Size selectivity may be compromised in the lungs of patients with the adult respiratory distress syndrome (ARDS). To assess this question, bronchoalveolar lavage fluid (BALF) from normal volunteers (n = 11), cardiac edema patients (n = 3), and ARDS patients (n = 8) was compared. Mean total protein in ARDS BALF was greater than 12 times the levels in normals or cardiac edema patients. BALF/plasma total protein ratios and measurements of epithelial lining fluid protein also separated the patients groups. The large proteins IgM and alpha 2-macroglobulin were found in ARDS BALF at greater than 90 times the concentrations of normal or cardiac edema fluid. The relationship of distribution coefficient vs. log molecular weight for seven proteins (54,000-900,000 mol wt) hyperbolically increased in normals but was flat in ARDS patients. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed a paucity of high molecular weight proteins in normal and cardiac edema BALF, but demonstrated the full spectrum of plasma proteins in ARDS BALF. We conclude that normal size selectivity is preserved in cardiac edema but is destroyed by the alveolar-capillary injury of ARDS.
A Simple Procedure for Early Detection of Hypofibrinogenaemia
Authors: G. L. Bourne, J. A. Riedel
Journal: BMJ (1958)

A Simple Procedure for Early Detection of HypofibrinogenaemiaFor the diagnosis of hypofibrinogenaemia or afibrinogen- aemia the Kjeldahl or simpler " fibrindex " (Ortho) method is most frequently used.Weiner et al. (1953) suggested a " bedside " method, the so-called " clot-observation test."In cases suspected of afibrinogenaemia blood is withdrawn into a test-tube.If clotting has not occurred in 10 minutes, disturbance of the fibrinogen level can be assumed.One of
TOXICITY OF DINITROPHENOL
Authors: Henry H. Haft
Journal: JAMA (1933)

<h3>To the Editor:</h3> —It was to be expected, following the article on the "Actions and Uses of Dinitrophenol" by Drs. Cutting, Mehrtens and Tainter (The Journal, July 15) and general newspaper and magazine comment throughout the country, that it would attract a great deal of public interest and inquiry as to its therapeutic application. A university professor, who is much overweight and who had been on a great many reducing diets with indifferent results, consulted me, with the purpose in mind of using this drug. The dangers of the drug were pointed out to him, and he read the article inThe Journaland the editorial comment in the same issue carefully but still evinced a strong desire to use this substance. He stated that he realized the possibility of body damage and our present incomplete knowledge of the pharmacology of the drug, but in a spirit of "heroism"(?) he
Points: Fees for cervical smears
Authors: J. Slome
Journal: BMJ (1982)

August, p 444) the treatment with adrenaline referred to in the 17th edition of Manson's Tropical Diseases for cerebral malaria dates from the days when quinine was the only drug used in the treat- ment of severe falciparum malaria before the days of 4'amino-quinolines.Its value was based on hearsay and practice in conditions away from laboratory facilities.After the war quinine was no longer used, but with the appearance of chloroquine-resistant malaria rapidly assumed its former value.The more modern assessments of the results of traditional treatments and the general use of quinine by intravenous infusion, which has removed the danger of hypotensive collapse, have led to a reassessment of the practice.
Comparison of Metabolic Control in a Cross-Sectional Study of 2,873 Children and Adolescents With IDDM from 18 Countries
Authors: Henrik B Mortensen, Philip Hougaard
Journal: Diabetes Care (1997)

To obtain an estimate of the current level of metabolic control in children and adolescents with IDDM, the Hvidøre Study Group on Childhood Diabetes decided to establish a formal collaboration among countries to gather and exchange data for comparative purposes.This cross-sectional non-population-based survey involved 22 pediatric departments from 18 countries in Europe, Japan, and North America. Blood samples and information were collected from March through August 1995 on 2,873 children who were born in 1977 or later and seen in the outpatient clinics. HbA1c levels were determined once and analyzed centrally (normal range, 4.4-6.3%; mean, 5.4%). Year of birth, sex, duration of diabetes, height, body weight, insulin regimen, and number of episodes of severe hypoglycemia during the past 3 months were recorded.Average HbA1c was 8.6 +/- 1.7%, but varied significantly (P < 0.0001) between centers. Hypoglycemia resulting in unconsciousness and/or seizures was related to younger age (0-8 years) and lower HbA1c level. The incidence, based on the 3-month period, was 22 per 100 patient-years. Sixty percent of the children (n = 1,707) had two injections daily, while 37% (n = 1,071) were on three or more. HbA1c increased during maturation for both sexes. No difference in glycemic control was found among adolescents treated with two, three, and four or more daily injections. Adolescents on four or more injections received significantly (P < 0.001) more insulin. Girls on four or more injections had significantly (P < 0.01) higher BMI than girls on twice-daily insulin.In the participating centers with a multidisciplinary team, only one third of the patients had an HbA1c level of < 8%.
The increasing number of older patients with renal disease
Authors: R J A Sims
Journal: BMJ (2003)

Trainees in nephrology should enhance their skills in geriatrics 

“Are my kidneys going to wear out before the rest of me?” is a valid question for older patients with hypertension and a raised serum creatinine concentration. The extent of the problem is illustrated by a study in an inner London primary healthcare setting.1 In the age group 50-75 years, the prevalence of renal impairment (serum creatinine higher than 120 μmol/l) was 6.1% in patients known to have hypertension, 12.6% in those known to have diabetes, and 16.9% in those with both.1 Many of these patients will progress to end stage renal failure. Of the one million patients who need chronic dialysis worldwide, more than half are over 65 years, as are approximately 10% of patients waiting for cadaveric transplants. www.uktransplant.org.uk The renal registry report for the United Kingdom for 2002 indicates the acceptance rate for dialysis for patients over 65 is approaching 300 patients per 1 000 000 population, compared with 72 per 1 000 000 population in those aged 18-64 years.2

Many of these patients will progress to end stage renal failure. Of the one million patients who need chronic dialysis worldwide, more than half are over 65 years, as are approximately 10% of patients waiting for cadaveric transplants.2 The renal …
Abstract 650: <i>IGSF4</i> methylation is an independent marker of HPV positive OPSCC.
Authors: Kang Mei Chen, Josena K. Stephen, Meredith Mahan, Shaleta Havard, George Divine, Glendon Gardner, Vanessa P. Schweitzer, Maria J. Worsham
Journal: Cancer Research (2013)

Abstract Human papilloma virus (HPV) is a known causative agent for oropharyngeal squamous cell cancer (OPSCC). The goal of our study was to determine the relationship of HPV type 16 (HPV16) infection and methylation status in an OPSCC cohort. HPV16 was detected using real-time quantitative PCR (qPCR) in a retrospective cohort of 111 primary OPSCC. A 24 tumor suppressor gene candidate panel was assessed for methylation using the methylation specific-multiplex ligation-dependent probe amplification (MS-MLPA) assay. Univariate associations with HPV and gene methylation, age, gender, race and smoking were analyzed using Fisher's exact tests and logistic regression. A final multiple logistic regression model, to include patient characteristics and genes significant on univariate analysis, was built using backwards selection of genes. Statistical significance was set at p&amp;lt;0.05 and all analyses were done using SAS 9.2. In univariate analyses, Caucasian American (CA) OPSCC were more likely to be HPV positive as compared to African American (AA) OPSCC (OR=3.01, 95% CI 1.28, 7.07, p=0.011). Also, smoking (never vs current) [OR=3.60 (1.06, 12.24), p=0.04], and TIMP3, DAPK1, ESR1, and IGSF4 were associated with HPV positive status (OR=5.03, p=0.021; OR=3.71, p=0.04; OR=5.03, p=0.021; OR=7.68, p=0.012, respectively). The final model, after controlling for patient characteristics and after backward elimination of genes, indicated IGSF4 methylation is an independent predictor of HPV positive status [OR=7.07 (1.22, 40.79), p=0.029]. HPV infection status is independently associated with methylation of IGSF4, indicating interplay of DNA methylation and HPV in OPSCC pathogenesis. Citation Format: Kang Mei Chen, Josena K. Stephen, Meredith Mahan, Shaleta Havard, George Divine, Glendon Gardner, Vanessa P. Schweitzer, Maria J. Worsham. IGSF4 methylation is an independent marker of HPV positive OPSCC. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 650. doi:10.1158/1538-7445.AM2013-650