tbuckley/cabot-search huggingface dataset:
Multi-modality imaging of N-methyl-N-nitrosourea-induced mammary tumors by MRI and small animal PET.
Authors: KI Shoghi, J He, Y Su, Y Yan, D Rowland, J Garbow, RH Mach, RA Lubet, M You
Journal: Cancer Research (2009)

Abstract Abstract #6008 Background: We evaluated the use of high resolution Magnetic Resonance Imaging (MRI) and small animal Positron Emission Tomography (PET) imaging in assessing tumor proliferation and response to therapy in N-methyl-N-nitrosourea (MNU)-induced mammary tumors.&amp;#x2028; Materials and Methods: The study comprised of 30 untreated MNU rats, 6 Targretin-treated MNU rats, and 6 Vorozole-treated MNU rats. Rats received a baseline imaging session when they developed their first palpable mammary tumor and were subsequently randomized into a control group or a treatment group with either Targretin (220mg/kg in the diet) or Vorozole (1.25mg/kg body weight by gavage). Treatment lasted for 8 weeks following the baseline imaging session. Each rat was imaged for 10-weeks at 2-week intervals with a) FDG to assess the metabolic state of tumors, b) MRI to monitor tumor volume, and c) [18F]ISO-1, a Sigma-2 radiolabeled ligand, to assess the proliferative status of MNU-induced tumors. Static images (10-minute) were obtained 60-minutes post-injection of FDG and [18F]ISO-1. In untreated tumors, a minimum of 40 PET outcome measures were assessed for their ability to predict changes in MRI-derived volume measurements between consecutive imaging sessions. In addition, regression analysis was performed to assess the correlation (R) between the measures. In treated tumors, the time-course of changes in PET outcome measures relative to baseline was evaluated to assess the efficacy of Targretin and Vorozole, in particular in characterizing short-term response (initial 2-weeks) and response to treatment withdrawal (weeks 8-10).&amp;#x2028; Results: An index characterizing a MRI-normalized [18F]ISO-1 uptake significantly correlated (R=0.7, P&amp;lt;0.0003) with changes in tumor volume between consecutive imaging sessions in untreated tumors. In contrast, there was no correlation between FDG outcome measures and changes in tumor volume. Targretin had the strongest short-term efficacy with a reduction in tumor load, on average, by as much as 60% compared with Vorozole's 20% reduction in tumor load. We observed higher rate of tumor resurgence in rats treated with Vorozole compared with Targretin, suggesting a residual effect of Targretin. In general, PET outcome measures of both FDG and [18F]ISO-1 delineated short-term response to treatment and non-responding tumors. [18F]ISO-1 was more sensitive than FDG in capturing tumor growth following treatment withdrawal at week 8.&amp;#x2028; Conclusion: MRI and small animal PET provide a platform to assess MNU-induced tumor proliferation and the efficacy of therapeutic interventions non-invasively, as demonstrated in this work. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6008.
Danger of Traction During Radiography for Cervical Trauma
Authors: Howard H. Kaufman
Journal: JAMA (1982)

To the Editor.—  Adequate radiological visualization of the lower cervical vertebrae in the lateral projection frequently requires that cephalad traction be applied to the patient's head while the shoulders are pulled caudally by traction applied directly to the upper extremities. However, in patients with possible neck injuries, this maneuver should not be used unless the lateral initial roentgenogram is inadequate and there is a low degree of suspicion (ie, the patient is awake without neck pain) because certain types of injuries, notably a bilateral interfacetal dislocation and a flexion teardrop fracture, are associated with complete ligamentous disruption. Such distraction may lead to, or aggravate, injury to the spinal cord or vertebral arteries.  Report of a Case.—  A 34-year-old man was injured in a motor vehicle accident, which caused a brief loss of consciousness and respiratory problems that required intubation. He rapidly recovered a normal level of consciousness, and the only
Sodium glucose cotransport-2 inhibition and intrarenal RAS activity in people with type 1 diabetes
Authors: David Z.I. Cherney, Bruce A. Perkins, Nima Soleymanlou, Fengxia Xiao, Joseph Zimpelmann, Hans-Juergen Woerle, Odd E Johansen, Uli C. Broedl, Maximilian von Eynatten, Kevin D. Burns
Journal: Kidney International (2014)
Unusual Cause of ??Obstructed?? Appearance on Diuretic Tc-99m DTP A Renal Scan
Authors: MARSHA JURAVSKY, JOHN E. POWE, ALBER A. DREDGER
Journal: Clinical Nuclear Medicine (1990)

An unusual case is presented in which a 58-year-old man with a known history of chronic left ureteropelvic junction obstruction, for which surgery was done in the remote past, was investigated in follow-up. A Foley catheter was in place. A diuretic renogram revealed a suboptimal response to furosemide. At the end of the study, it was noted that the Foley catheter drainage bag was full and on emptying it and reimaging, the “obstructed” pattern promptly disappeared. This would appear to be a case of an acute iatrogenic obstruction with subsequent acute relief of the obstruction.
Gonadal Dysgenesis Intersex With XO/XY Mosaicism
Authors: Robert B. Greenblatt, Hernan Dominguez, Virendra B. Mahesh, Robert Demos
Journal: JAMA (1964)

Individuals with gonadal dysgenesis (Turner's syndrome) have been considered pseudofemales because of the presence of only 45 chromosomes with a single X sex chromosome. Male pseudohermaphrodites usually have 46 chromosomes with an XY sex chromosome pattern. The missing sex chromosome in Turner's syndrome may be either an X or a Y. The finding of phenotypic females with an XO/XY chromosomal sex pattern having gonadal dysgenesis and a contralateral testis provides a link between gonadal dysgenesis and male pseudohermaphroditism. The suggestion is made that in many instances patients with Turner's syndrome, particularly those with androgenic manifestations, may well be atypical cases of male pseudohermaphrodit
Medical Malpractice and Legal Resolution Systems in Japan
Authors: Kazue Nakajima
Journal: JAMA (2001)

Medical malpractice claims and dispute resolution systems have been examined in Western societies for their impact on the quality of care and efficient compensation for injured patients. However, little is known about the Japanese malpractice environment because claim information has been closely guarded. Based on data from the Japanese Supreme Court, the Ministry of Health, Labor, and Welfare (formerly the Ministry of Health and Welfare), and the Japan Medical Association (JMA), which provides malpractice insurance to 43.5% of Japan's 250 000 physicians, we review Japanese malpractice liability systems and the frequency of claims during the last 30 years. Annual premiums for physician professional liability insurance are relatively low ($454-$491). Although the frequency of claims in Japan is lower than that reported in the United States, England, and Germany, the number of claims is increasing in Japan. According to publicly available data from the Japanese Supreme Court, the annual number of medical malpractice suits filed in district courts has increased from 102 in 1970 to 629 in 1998 (from 0.09 to 0.25 per 100 physicians). The proportion of awards greater than $89 300 increased from 13.6% in 1976 to 65.4% in 1987. Among JMA members, claims increased 31% from 1987 to 1999, but the frequency of claims has remained at approximately 0.3 per 100 JMA members. The JMA's professional liability program offers a nonbinding out-of-court review of claims that is faster and less expensive than judicial resolution (a few months with no attorney required vs 35 months and attorney fees), but is a poor means of deterrence or discipline. Since JMA data represent only 43.5% of Japanese physicians, generalizations cannot be made about all Japanese physicians and institutions. The lack of data on all claims hinders adequate evaluation of dispute resolution methods, development of appropriate risk management activities, and proactive education for Japanese physicians.
Sleep Quality in Older Adults: Effects of Exercise Training and Influence of Sunlight Exposure-Reply
Authors: Abby C. King
Journal: JAMA (1997)

In Reply.  —Drs O'Connor and Youngstedt raise some interesting issues with respect to the potential role that exposure to sunlight accompanying increases in outdoor physical activity could have on improvements in sleep quality. We agree that the mechanisms through which increases in physical activity affect rated sleep quality remain to be elucidated.  Although it is conceivable that light exposure could have been a factor in producing the study results, there are several aspects of our study that raise doubts that change in light exposure was an important mediator of the sleep-quality changes observed. First, there was no evidence of any shifts in the time of night at which study subjects went to bed following the 16-week exercise training program. This suggests no circadian phase shift, as was posited by the authors. Even if there were a shift in reported bedtime, this would not prove that light was the crucial factor. For instance,
Dr Wendy Orr and the Health of Detainees in South Africa-Reply
Authors: Halton Cheadle
Journal: JAMA (1987)

<h3>In reply.—</h3> Dr Retief's apologia calls for correction: His assertion that the case was withdrawn is false. The case was never withdrawn. The injunction against the police could not be extended in June 1986 because all the detainees protected by the original injunction had been released from detention. The fact that the temporary injunction lapsed, however, did not dispose of the case. In South African law, the winning party is generally awarded its legal costs. This meant that notwithstanding the fact that the applicants were no longer in need of protection, the Supreme Court still had to decide which party was entitled to its legal costs. This would have entailed the court hearing evidence and investigating the merits of the applicants' allegations. Had the police not tendered to pay the applicants' costs, the case would have been heard in open court. The legal costs amounted to 420 000 rand (approximately $250 000
Estimation of retinal blood flow by measurement of the mean circulation time
Authors: C. J. Bulpitt, C. T. Dollery
Journal: Cardiovascular Research (1971)

A method is described for measuring the segmental mean circulation time and estimating the segmental flow in the human retina. Serial retinal photographs were taken after intravenous fluorescein injection and the relative concentration of fluorescein in the superior temporal artery and vein calculated from measurements of the optical density of the vessel images. Arterial and venous time-concentration curves were constructed and the mean circulation time calculated. In normal subjects the mean circulation time in the superior temporal segment varied from 1·39 to 6·85 sec. This variation was largely explained by variations in the volume of the vascular bed which was taken to be related to the sum of the square of the arterial and venous diameters. Volume flow showed less than a two-fold variation in normal subjects, mean 55 ± SD 11 units/sec. Similar results for volume flow were found in hypertensive subjects, although flow was more variable in these patients, mean 54 ± SD 18 units/sec. Some anaemic patients showed a marked increase in volume flow, and there was a significant relationship between packed cell volume and retinal volume flow (R = 0·65, P = 0·01).
Environmental toxicants in developing countries.
Authors: P Ostrosky-Wegman, M E Gonsebatt
Journal: Environmental Health Perspectives (1996)

Health effects from environmental toxicants may be a more serious problem in developing countries compared with developed countries because the problem is potentiated by other factors: a) the lack of or failure to enforce regulations, which allows human exposures to genotoxic agents; b) undernourishment of the lower economic and social classes that comprise the most exposed populations from industrial and agricultural activities; and c) parasitic infections that afflict a wide range of populations in both urban and rural areas. Data on the genotoxic effects of different types of exposures, including environmental exposes (natural and industrial), occupational exposures, and infections and medical treatments, are presented and discussed with the point of view that all these factors must be taken into account with respect to regulation and the protection of human health. Occupational exposures in developing countries are higher than in developed countries due to lack of stringent regulations, lack of knowledge of the risks involved, and the negligence of workers. General pollution is another important issue since developed countries have established strict regulations and risky industrial processes are being exported to developing countries, along with banned substances and dangerous industrial wastes. It should be emphasized that stringent regulations in developed countries will not prevent exposures in the long term because toxic substances that are released into the environment will ultimately reach all our future generations.
Informed participation in screening is essential
Authors: A E Raffle
Journal: BMJ (1997)

Editor—A paradox with early detection is that its popularity bears little relation to the magnitude of its benefits and harms. Sarah Stewart-Brown and Andrew Farmer's editorial about screening could therefore be dismissed by some people as public health negativism.1 There is sparse evidence that subjects suffer psychological morbidity, so why worry?

Consider what happens when we screen 250 000 women for cervical cancer. The aim is to help a subset of the 40 or so women who would die annually of cervical cancer among this …
Health staff know where savings can be made, says US "zero harm" expert
Authors: Z. Kmietowicz
Journal: BMJ (2013)

Plenty of opportunities exist to cut UK healthcare costs without reducing the quality of care, or even improving it, but health service leaders need to embrace change to deliver them, a leading authority on delivering better healthcare has said.

Donald Berwick, a paediatrician who cofounded and led the US Institute for Healthcare Improvement for 18 years, said that waste in the US healthcare system had been estimated at between 21% and 47% of expenditure. With annual healthcare costs in the United States in the region of $2.7 trillion (£1.8 trillion; €2.1 trillion), better management could result in savings of up to $1.2 trillion, with the median calculated at 34% of the total, or $910bn, said Berwick.

Although the figures derived from the US healthcare system, Berwick was confident that similar savings could …
Diabetes Care in the Veterans Affairs System and in Managed Care
Authors: Eve A. Kerr, Carol M. Mangione
Journal: Annals of Internal Medicine (2005)

Letters18 January 2005Diabetes Care in the Veterans Affairs System and in Managed CareEve A. Kerr, MD, MPH and Carol M. Mangione, MD, MSPHEve A. Kerr, MD, MPHFrom VA Ann Arbor Healthcare System and the University of Michigan, Ann Arbor, MI 48113-0170; and David Geffen School of Medicine, Los Angeles, CA 90024.Search for more papers by this author and Carol M. Mangione, MD, MSPHFrom VA Ann Arbor Healthcare System and the University of Michigan, Ann Arbor, MI 48113-0170; and David Geffen School of Medicine, Los Angeles, CA 90024.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-2-200501180-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:As we mentioned in our article, the VA's transformation was indeed based on many managed care principles, and as the largest integrated health care system in the United States, it could, as Dr. Patmas suggests, be considered the nation's largest managed care organization. This is precisely what makes the comparison between diabetes care quality in commercial managed care and in the VA so interesting—one can begin to think about the elements unique to the VA that may have further enhanced quality beyond the strategies espoused in the commercial managed care plans. While comparisons between VA and non–managed care ...Reference1. Jha AK, Perlin JB, Kizer KW, Dudley RA. Effect of the transformation of the Veterans Affairs Health Care System on the quality of care. N Engl J Med. 2003;348:2218-27. [PMID: 12773650] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Eve A. Kerr, MD, MPH; Carol M. Mangione, MD, MSPHAffiliations: From VA Ann Arbor Healthcare System and the University of Michigan, Ann Arbor, MI 48113-0170; and David Geffen School of Medicine, Los Angeles, CA 90024. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiabetes Care Quality in the Veterans Affairs Health Care System and Commercial Managed Care: The TRIAD Study Eve A. Kerr , Robert B. Gerzoff , Sarah L. Krein , Joseph V. Selby , John D. Piette , J. David Curb , William H. Herman , David G. Marrero , K.M. Venkat Narayan , Monika M. Safford , Theodore Thompson , and Carol M. Mangione Diabetes Care in the Veterans Affairs System and in Managed Care Michael A. Patmas Metrics 18 January 2005Volume 142, Issue 2Page: 154KeywordsElectronic medical recordsHealth careHealth care qualityHealth services researchResearch quality assessmentVeteran care ePublished: 18 January 2005 Issue Published: 18 January 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Antibiotics and Topical Nasal Steroid for Treatment of Acute Maxillary Sinusitis
Authors: Ian G. Williamson, Kate Rumsby, Sarah Benge, Michael Moore, Peter W. Smith, Martine Cross, Paul Little
Journal: JAMA (2007)

Acute sinusitis is a common clinical problem that usually results in a prescription for antibiotics but the role of antibiotics is debated. Anti-inflammatory drugs such as topical steroids may be beneficial but are underresearched.To determine the effectiveness of amoxicillin and topical budesonide in acute maxillary sinusitis.A double-blind, randomized, placebo-controlled factorial trial of 240 adults (aged > or =16 years) with acute nonrecurrent sinusitis (had > or =2 diagnostic criteria: purulent rhinorrhea with unilateral predominance, local pain with unilateral predominance, purulent rhinorrhea bilateral, presence of pus in the nasal cavity) at 58 family practices (74 family physicians) between November 2001 and November 2005. Patients were randomized to 1 of 4 treatment groups: antibiotic and nasal steroid; placebo antibiotic and nasal steroid; antibiotic and placebo nasal steroid; placebo antibiotic and placebo nasal steroid.A dose of 500 mg of amoxicillin 3 times per day for 7 days and 200 mug of budesonide in each nostril once per day for 10 days.Proportion clinically cured at day 10 using patient symptom diaries and the duration and severity of symptoms.The proportions of patients with symptoms lasting 10 or more days were 29 of 100 (29%) for amoxicillin vs 36 of 107 (33.6%) for no amoxicillin (adjusted odds ratio, 0.99; 95% confidence interval, 0.57-1.73). The proportions of patients with symptoms lasting 10 or more days were 32 of 102 (31.4%) for topical budesonide vs 33 of 105 (31.4%) for no budesonide (adjusted odds ratio, 0.93; 95% confidence interval, 0.54-1.62). Secondary analysis suggested that nasal steroids were significantly more effective in patients with less severe symptoms at baseline.Neither an antibiotic nor a topical steroid alone or in combination was effective as a treatment for acute sinusitis in the primary care setting.isrctn.org Identifier: ISRCTN60825437.
RESTING VENTRICULAR-VASCULAR FUNCTION AND EXERCISE CAPACITY IN DIASTOLIC HEART FAILURE (DHF): A RELAX TRIAL ANCILLARY STUDY
Authors: Selma Mohammed, Barry Borlaug, Steven McNulty, Grace Lin, Gregory Lewis, Rosita Zakeri, Marc Semigran, Martin LeWinter, Adrian Hernandez, Eugene Braunwald, Margaret Redfield
Journal: Journal of the American College of Cardiology (2013)
Pyuria and Bacilluria in Children
Authors: J. N. Cumings
Journal: BMJ (1931)

This paper 'consists of two pads, both of which deal primarily with normal children, but some remarks have been added concerning abnormal cases in which the nmethods developed for investigating the former have been employed.Cuthbert Dukes1 has described a method of counting pus cells in' urine by which a definite companson can be made between specimens from several children or between consecutive specimens from one child.He also defines pyuria," limiting the term in adults to those cases which .show more than 100 pus cells per c.mm.He regards-figures between 10 and 100 per c.mm. in adults as indicating " excess of leucocytes" and.figures below 10 per c.mm. as being within normal limits.2He describes a urine as conitaining so many pus cells per c.mm. instead of so many 'cells' per field of a microscope..There can be no doubt that this method, although it involves a little more trouble, is more accurate.It could be adopted FEB.
Common variants associated with general and MMR vaccine–related febrile seizures
Authors: Bjarke Feenstra, Björn Pasternak, Frank Geller, Lisbeth Carstensen, Tongfei Wang, Fen Huang, Jennifer L Eitson, Mads V Hollegaard, Henrik Svanström, Mogens Vestergaard, David M Hougaard, John W Schoggins, Lily Yeh Jan, Mads Melbye, Anders Hviid
Journal: Nature Genetics (2014)
Coding issues at the coalface
Authors: A. E. Livingstone, K. Boomla
Journal: BMJ (2010)

<h3>Abstract</h3> Blood plasma separation is a prerequisite in numerous biomedical assays involving low abundance plasma-borne biomarkers and thus is the fundamental step before many bioanalytical steps. Conventionally, plasma separation is performed using high-capacity refrigerated centrifuges which have the advantage of handling large volume blood samples. These centrifuges are bulky, and prohibitively expensive for low-resource settings, with prices starting from $1,500. Although commercial and existing open-source micro-centrifuges are relatively low-cost, they cannot handle large volume blood samples. Microfluidic blood plasma separation also has been adopted by many researchers to enable low-cost plasma separation, however, these systems still present yield and purity issues for extremely low abundance biomarker detection such as the detection of various fractions of circulating cell-free DNA. To overcome this, we customised the rotor of a commercially available micro-centrifuge ∼$125) using fused filament fabrication to enable centrifugation of large clinical blood samples in resource poor-settings. Our designed adaptor ($15) can hold two 9 mL S-Monovette tubes and maintain the same separation performance (yield, cell count, hemolysis, albumin levels) as the control benchtop refrigerated centrifuge. This low-cost open-source centrifugation system capable of processing clinical blood tubes could be valuable to low-funded laboratories or low-resource settings where centrifugation is required immediately after blood withdrawal for further testing.