tbuckley/cabot-search huggingface dataset:
Promoting cancer screening within the patient centered medical home
Authors: Mona Sarfaty, Richard Wender, Robert Smith
Journal: CA A Cancer Journal for Clinicians (2011)

Abstract While consensus has grown that primary care is the essential access point in a high‐performing health care system, the current model of primary care underperforms in both chronic disease management and prevention. The Patient Centered Medical Home model (PCMH) is at the center of efforts to reinvent primary care practice, and is regarded as the most promising approach to addressing the burden of chronic disease, improving health outcomes, and reducing health spending. However, the potential for the medical home to improve the delivery of cancer screening (and preventive services in general) has received limited attention in both conceptualization and practice. Medical home demonstrations to date have included few evidence‐based preventive services in their outcome measures, and few have evaluated the effect of different payment models. Decreasing use of hospitals and emergency rooms and an emphasis on improving chronic care represent improvements in effective delivery of healthcare, but leave opportunities for reducing the burden of cancer untouched. Data confirm that what does or does not happen in the primary care setting has a substantial impact on cancer outcomes. Insofar as cancer is the leading cause of death before age 80, the PCMH model must prioritize adherence to cancer screening according to recommended guidelines, and systems, financial incentives, and reimbursements must be aligned to achieve that goal. This article explores capacities that are needed in the medical home model to facilitate the integration of cancer screening and other preventive services. These capacities include improved patient access and communication, health risk assessments, periodic preventive health exams, use of registries that store cancer risk information and screening history, ability to track and follow up on tests and referrals, feedback on performance, and payment models that reward cancer screening. CA Cancer J Clin 2011. © 2011 American Cancer Society.
How to improve care in outpatients with cirrhosis and ascites: A new model of care coordination by consultant hepatologists
Authors: Filippo Morando, Giulio Maresio, Salvatore Piano, Silvano Fasolato, Marta Cavallin, Antonietta Romano, Silvia Rosi, Elisabetta Gola, Anna Chiara Frigo, Marialuisa Stanco, Carla Destro, Giampietro Rupolo, Domenico Mantoan, Angelo Gatta, Paolo Angeli
Journal: Journal of Hepatology (2013)
USEFULNESS OF A TRANS-STENT FRACTIONAL FLOW RESERVE GRADIENT FOR ASSESSING THE RESULTS OF DRUG-ELUTING STENT IMPLANTATION
Authors: Hong-Seok Lim, Seung-Jea Tahk, Hyoung-Mo Yang, Myeong-Ho Yoon, Byoung-Joo Choi, So-Yeon Choi, Jin-Sun Park, Gyo-Seung Hwang, Joon-Han Shin
Journal: Journal of the American College of Cardiology (2011)
<i>Retracted</i>: Outcome and immune reconstitution of HBV-specific immunity in patients with reactivation of occult HBV infection after alemtuzumab-containing chemotherapy regimen
Authors: Chee-Kin Hui, Winnie W. Cheung, Kar-Wai Leung, Vincent C. C. Cheng, Bone S. F. Tang, Iris W. S. Li, John M. Luk, Nikki P. Lee, Yok-Lam Kwong, Wing-Yan Au, Kwok-Yung Yuen, George K. Lau, Raymond Liang
Journal: Hepatology (2008)

Whether preemptive anti- hepatitis B virus (HBV) therapy should be considered in all hepatitis B surface antigen (HBsAg)-negative patients with occult HBV infection receiving alemtuzumab containing chemotherapy is uncertain. We determined the outcome and effect on HBV-specific immunity of an alemtuzumab-containing chemotherapy regimen in occult HBV-infected patients. Twenty-one consecutive occult HBV-infected patients treated with an alemtuzumab containing chemotherapy regimen were studied. T cell reactivity to HBV antigens and -peptides were quantified by ELISpot and the T cell subset by flow cytometry. Six of the 21 patients (28.6%) developed HBsAg seroreversion. The median (range) time to development of HBsAg seroreversion after the end of chemotherapy was 1.8 months (0.2-2.3 months). Direct sequencing showed that the occult HBV infection of all six patients (100%) was reactivated. These six patients developed severe HBV-related hepatitis. At the end of follow-up, four of these six patients (66.7%) had become negative for HBsAg again. Recovery of CD4+ T cell count and CD4+T cell reactivity against hepatitis B core antigen (HBcAg) occurred 9 months after the end of chemotherapy. Loss of HBsAg occurred after recovery of the CD4+T cell count and increased CD4+T cell reactivity against HBcAg 9 months after the end of chemotherapy.An alemtuzumab-containing chemotherapy regimen is associated with a high risk of reactivation of occult HBV infection. Suppression of HBV immunity by an alemtuzumab-containing chemotherapy regimen would persist until 9 months after the end of chemotherapy. In occult HBV-infected patients receiving an alemtuzumab-containing chemotherapy regimen, preemptive anti-HBV therapy should be continued until 9 months after the end of chemotherapy, when recovery of HBV immunity has occurred.
Regulating medical apps: which ones and how much?
Authors: D. Kamerow
Journal: BMJ (2013)

The FDA has issued sensible guidance



Close to 100 000 health related apps for smartphones are now available on the two major mobile device software platforms, Apple’s iOS and Google’s Android. Medical apps have generated more than three million US downloads on iOS alone.1 By 2015 an estimated 500 million smartphone users worldwide will use some type of medical app,2 and the global market for mobile health apps may reach $26bn (£16bn; €19bn) by 2017.1

Early apps related to health were designed simply to track exercise or weight loss or to provide instruction on diet or smoking cessation. More recently, though, designers have begun linking smartphones’ computing and display power with custom designed hardware to create functioning portable medical devices. Around 15% of these apps are designed for healthcare professionals, but most are being marketed to patients to gather, track, analyze, and transmit medical data.1

For example, you can now buy an AliveCor device for $199 that slips over your iPhone and records and transmits a one channel electrocardiogram with its app. For …
Upregulation of CTLA-4 by HIV-specific CD4+ T cells correlates with disease progression and defines a reversible immune dysfunction
Authors: Daniel E Kaufmann, Daniel G Kavanagh, Florencia Pereyra, John J Zaunders, Elizabeth W Mackey, Toshiyuki Miura, Sarah Palmer, Mark Brockman, Almas Rathod, Alicja Piechocka-Trocha, Brett Baker, Baogong Zhu, Sylvie Le Gall, Michael T Waring, Ryan Ahern, Kristin Moss, Anthony D Kelleher, John M Coffin, Gordon J Freeman, Eric S Rosenberg, Bruce D Walker
Journal: Nature Immunology (2007)
LV remodelling and LVH regression are related to ambulatory (not casual) BP control in hypertension
Authors: Vivienne-E Smith, Yaga Szlachcic, Barry Massie, Julio Tubau, Katherine Ascah, William Feeney, Brian Gilbert, Franz Messerli, Terrence Ruddy, Kiran Sagar, Jay Sullivan, Orysia Tresnewsky, Terry Flanagan
Journal: Journal of the American College of Cardiology (1996)
Critical Pathways as a Strategy for Improving Care: Problems and Potential
Authors: Steven D. Pearson
Journal: Annals of Internal Medicine (1995)

In an era of increasing competition in medical care, critical pathway guidelines have emerged as one of the most popular new initiatives intended to reduce costs while maintaining or even improving the quality of care.Developed primarily for high-volume hospital diagnoses, critical pathways display goals for patients and provide the corresponding ideal sequence and timing of staff actions for achieving those goals with optimal efficiency. Despite the rapid dissemination of critical pathway programs in hospitals throughout the United States, many uncertainties remain about their development, implementation, and evaluation.In addition, serious concerns have been raised about their effect on patient outcomes and satisfaction with care, physician autonomy, malpractice risks, and the teaching and research missions of many hospitals. Underlying these concerns is the absence of data from controlled trials to evaluate the effects of critical pathways. Physicians should understand the potential benefits and problems associated with critical pathways because physicians are increasingly being asked to provide leadership for pathway programs.Physicians and other health service investigators should also develop methods to study pathways in evolving health care settings. Although the promise of reduced costs and improved quality is enticing, the gaps in our knowledge about critical pathways are extensive; therefore, like any new health care technology, pathway programs should be fully evaluated in order to understand the conditions under which that promise may be fulfilled.
Altitude, Low Birth Weight, and Infant Mortality in Colorado
Authors: Cynthia Unger
Journal: JAMA (1988)

A decrease in birth weight occurs at high altitude, but its relationship to infant mortality is unclear. We examined Colorado vital statistics recorded from 1979 through 1982 to determine whether high altitude increased infant mortality and whether decreased birth weight contributed to the mortality observed. Retardation of intrauterine growth reduced birth weight and doubled the frequency of low-birth-weight infants from the lowest (915 to 1523 m [3000 to 4999 ft]) to the highest (≥2744 m [≥9000 ft]) altitude in the state. Low birth weight increased mortality risk, but the mortality risk of low birth weight was decreased at high compared with low altitudes, resulting in similar infant mortality rates throughout the state. This finding differed from that of 1969 through 1973 when infant mortality doubled at high altitude. A 46% infant mortality reduction had occurred statewide over the ten years due chiefly to decreased mortality risk for preterm low-birth-weight infants. This reduction, particularly pronounced at high altitude, might have been due to better identification and transport of high-risk pregnancies to hospitals with tertiary neonatal treatment centers. (<i>JAMA</i>1988;259:3427-3432)
The Acute Cardiac Emergency: Diagnosis and Management
Authors: Thomas Killip
Journal: JAMA (1973)

This slender volume is a compendium from a symposium on the cardiac emergencies, held in 1972, and consists of a series of normal papers and selected edited discussions. The foreword states, "This book compiles practical information which the physician requires in the detection and management of victims of the acute cardiopulmonary emergency..." that will serve as a "readable, comprehensive and practical guide...." The book covers a wide variety of topics including pathophysiology of sudden death, myocardial infarction, electrophysiology, hemodynamics, radiology, recent advances in antiarrhythmic drugs, cardiogenic shock, rupture of the heart, pacemakers, management of drowning, lightning stroke and electric shock, and community planning. As is so often true with multiauthored books, the pace is uneven. The chapters on antiarrhythmic drugs and cardiogenic shock by Dean T. Mason and coauthors are especially good. Other chapters providing background information are less impressive and the material is more easily obtained in greater depth
Scintigraphic Findings of Multiple Osteochondromas
Authors: WEI-JEN SHIH, CHRISTINE N. RILEY, PEGGY A. DOMSTAD, FRANK H. DeLAND
Journal: Clinical Nuclear Medicine (1986)

Multiple osteochondromas (hereditary multiple exostoses, diaphyseal aclasis, cartilagenous exostoses) are anomalies of bone development in which multiple cartilagenous exostoses grow out from the cortical surface, mainly involving ends of the long bones. While radiographic characteristics of multiple osteochondromas have been well documented, there is little information concerning the place of bone imaging in this disease. A patient with multiple osteochondromas whose skeletal scintigrams correlate with the concurrent radiographs is presented. Although there is no specific pattern scintigraphically, the abnormal, irregular increase in radioactivity at the end of the long bones may raise a possibility of this disease entity.
Varicella and Herpes Zoster
Authors: Lawrence S. Ross
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In the editorial, "Disseminated Herpes Zoster" (<i>JAMA</i><b>188</b>:749 [May 25] 1964), it is stated that a "clinical syndrome develops which closely resembles varicella." It is surprising to find herpes zoster regarded as being only similar to varicella, rather than as another manifestation of the latter. Numerous case reports have linked varicella outbreaks with herpes zoster, and vice versa. In Rivers' textbook on virology, the viruses causing the two diseases are described as being identical. I have seen four children with herpes zoster, all of whom had had chickenpox during infancy, or a mild case in the second year of life. In one youngster a generalized varicelliform lesion developed simultaneously which was much milder than the average case of chickenpox. In three cases, chickenpox developed in the patients' susceptible contacts, including, in two cases, the mothers, who had never had chickenpox. The appearance of zoster in children
The Colored Proteins — Blood Brothers
Authors: Thomas G. Gabuzda
Journal: New England Journal of Medicine (1971)

Colored proteins are the biochemist's delight. Indeed, perhaps this chemical property, rather than ubiquity or ease of isolation, really explains why both hemoglobin and ferritin — the red and the golden-brown proteins — have been prominent interests of protein chemists for over 30 years. No less are colored proteins the clinician's province. They produce complexions from pallor to plethora — and pathologists have long recognized the dark-brown appearance of ferritin-laden spleens and livers.These two colored proteins, brothers in trade, contain the bulk of the body's iron. Ferritin subserves the important function of hemoglobin formation. The ferritin molecule has a . . .
Deryck Michael Denys Lambert
Authors: J. Lambert
Journal: BMJ (2009)

Deryck Michael Denys Lambert, who died at home in Devon on 16 June 2008 aged 83, was a highly respected general practitioner who practised in Keighley, Yorkshire, and in Runcorn New Town. Throughout his career, he pioneered vocational training and, as an inspirational teacher and mentor, worked energetically to develop the educational dimension of general practice in the pursuit of excellent patient care.

Deryck was born in York in 1924. Having completed his secondary education, he undertook training with Royal Air Force (RAF) flying and navigation schools between 1942 and 1944, including time spent at a navigation training school in Canada. Deryck was subsequently selected to join the legendary Pathfinder Force, part of Bomber Command. During operations over the Ruhr in September 1944, Deryck’s Lancaster was shot down in flames. Deryck and only one other member of the seven man crew survived. For the following eight months he was a prisoner of war, and in the severe cold of early 1945 he undertook the “long march.”

Deryck was profoundly influenced by his wartime experience, especially the extraordinary interdependence, loyalty, trust, mutual respect, and comradeship of being part of a Lancaster Bomber crew. This experience informed his development both as an individual and subsequently as a doctor working in general practice. Respecting and valuing the skills and abilities of colleagues, working towards a common goal, primarily the establishment and development of excellent services for patients and the development of group practice, sometimes in the most challenging or dispiriting of circumstances, characterised his distinguished career in medicine.

After the second world war, demobbed from the RAF, Deryck took up …
The Effect of Low-Nicotine Cigarettes on Angina Pectoris
Authors: WILBERT S. ARONOW
Journal: Annals of Internal Medicine (1969)

Ten subjects with classical exertional angina pectoris were exercised in an upright position with an exercise load of 60 w measured on a bicycle ergometer until the onset of angina pectoris. Exercise was performed four times in a nonsmoking state and four times after smoking a low-nicotine filter cigarette for 5 min. All patients developed angina sooner if they smoked before exercising. The exercise period before angina developed was shortened by an average of 14% after smoking. All subjects developed an increase in the product of systolic blood pressure times heart rate after smoking, indicating an increase in myocardial oxygen consumption. Patients with diseased coronary arteries who exercise after smoking even very low-nicotine cigarettes may be unable to meet the increased demand for myocardial oxygen and may therefore develop angina pectoris sooner.
A Winter Visit to Davos
Authors: E. De La Harpe
Journal: BMJ (1885)

N 1, JL8G64JATl &14Sf\rD'rL TR~L 961 ments-crowded houses, with deficient ventilation and bad drainage.Some will be interestfed to rki,T-if epid6micA 4f aiphtheria and scarla- tina have preceded, or followed close on, these of infectious sore-throat.I cannotSay this has been the case, tthough scarlatina is' frequently presen.tin, the same district in which they occurred.I shall now show you the micro-organisms I have always found in the secretion and miembranous deposit removed from the tonsils in suchcases, and their mode of growth when cultivated artificially in gelatinised meat-infusion.A WINTER VISIT TO DAVOS.
Topical Tretinoin Improves Photoaged Skin
Authors: Jonathan S. Weiss
Journal: JAMA (1988)

In a 16-week randomized, double-blind, vehicle-controlled study of topical tretinoin in the treatment of photoaging, all patients applied topical tretinoin to one forearm and vehicle cream to the other. Half of the patients received tretinoin to the face, and half received vehicle cream. All 30 patients who completed the study showed statistically significant improvement in photoaging on the tretinoin-treated forearms, but not on the vehicle-treated forearms. Fourteen of the 15 patients who received tretinoin to the face had improvement in photoaging, whereas none of the vehicle-treated patients' faces improved, a statistically significant difference in response between the two groups. Statistically significant histologic changes were seen in forearm skin treated with tretinoin, but not with vehicle cream. Side effects were limited to irritation of tretinoin-exposed skin.
Azathioprine treatment in chronic actinic dermatitis: a double-blind controlled trial with monitoring of exposure to ultraviolet radiation
Authors: G.M. MURPHY, P.D.L. MAURICE, P.G. NORRIS, R.W. MORRIS, J.L.M. HAWK
Journal: British Journal of Dermatology (1989)

Oral azathioprine was compared with placebo in a double‐blind controlled trial of therapy in chronic actinic dermatitis (CAD), a rare eczematous photodermatosis. Eighteen severely affected patients were randomly allocated to azathioprine 50 mg t.d.s. or placebo over a 2‐year period. Severity of itch and rash were assessed weekly by each patient on a visual analogue scale and overall clinical status monthly by a medical observer. Monitoring of patient ultraviolet radiation (UVR) exposure was undertaken throughout treatment by polysulphone film lapelbadge dosimetry. Five of 8 patients treated with azathioprine but none of 10 placebo patients achieved remission within 6 months. One patient could not tolerate treatment because of gastrointestinal effects. No haematological or hepatic abnormality was noted. The marked improvement in clinical status of actively treated patients (P < 0·02, Fisher's exact test), led to early termination of the trial. Oral azathioprine therapy is an effective and usually well tolerated treatment in chronic actinic dermatitis.
Care of surgical infections by Médecins Sans Frontières Operations Centre Brussels in 2008–14
Authors: Davina Sharma, Kate Hayman, Barclay T Stewart, Lynette Dominguez, Miguel Trelles, Sanaulhaq Saqeb, Cheride Kasonga, Theophile Kubuya Hangi, Jerome Mupenda, Aamer Naseer, Evan Wong, Adam L Kushner
Journal: The Lancet (2015)
Markers and Tissue Resources for Melanoma: Meeting Report
Authors: Dorothea Becker, Martin C. Mihm, Stephen M. Hewitt, Vernon K. Sondak, Jane W. Fountain, Magdalena Thurin
Journal: Cancer Research (2006)

The Markers and Tissue Resources for Melanoma meeting convened by the Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, Specialized Programs of Research Excellence at the Organ Systems Branch of the National Cancer Institute (NCI), and the Melanoma Research Foundation was held in Gaithersburg, MD on October 2005. The meeting reviewed the current status of biomarkers for early- and advanced-stage melanoma and addressed some of the challenges scientists and clinicians face as they unravel the biology of melanoma and try to apply these findings to patient care. Specifically, the participants focused on molecular changes associated with melanoma progression, potential diagnostic and prognostic markers emerging from molecular profiling studies, and new treatment targets for current and future clinical trials. They also highlighted the ongoing challenges about translational research in melanoma, including availability of tissue resources, and summarized the status of nevus and melanoma tissue microarrays, recently developed as a collaborative project between the melanoma research community and the NCI. The meeting report is intended to provide a perspective on emerging scientific approaches in translational research that can enhance the progress in discovery and validation of markers for melanoma. (Cancer Res 2006; 66(22): 10652-7).
The Clinical Applications of a Systems Approach
Authors: Andrew C Ahn, Muneesh Tewari, Chi-Sang Poon, Russell S Phillips
Journal: PLoS Medicine (2006)

This is the second in a series of two articles that look at the lessons for clinical medicine from systems biology.

In the first article in this series, we examined the reductionist approach that pervades medicine and explained how a systems approach (as advocated by systems biology) may complement it [ 1]. In order for a systems perspective to have any practical clinical significance, we must understand when a systems perspective is or is not helpful, and conversely when a reductionist approach is helpful. In addition, we must be able to envision how a systems perspective can be implemented to appreciate the potential benefits derived from its application. In this article, we address these issues and present a practical discussion of systems application to medicine.