tbuckley/cabot-search huggingface dataset:
Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries
Authors: Jack A Ginsburg, Robert B Doherty, J Fred Ralston, Naomi Senkeeto, Molly Cooke, Charles Cutler, David A Fleming, Brian P Freeman, Robert A Gluckman, Mark Liebow, Robert M McLean, Kenneth A Musana, Patrick M Nichols, Mark W Purtle, P Preston Reynolds, Kathleen M Weaver, David C Dale, Joel S Levine, Joseph W Stubbs
Journal: Annals of Internal Medicine (2008)

This position paper concerns improving health care in the United States. Unlike previous highly focused policy papers by the American College of Physicians, this article takes a comprehensive approach to improving access, quality, and efficiency of care. The first part describes health care in the United States. The second compares it with health care in other countries. The concluding section proposes lessons that the United States can learn from these countries and recommendations for achieving a high-performance health care system in the United States. The articles are based on a position paper developed by the American College of Physicians' Health and Public Policy Committee. This policy paper (not included in this article) also provides a detailed analysis of health care systems in 12 other industrialized countries. Although we can learn much from other health systems, the College recognizes that our political and social culture, demographics, and form of government will shape any solution for the United States. This caution notwithstanding, we have identified several approaches that have worked well for countries like ours and could probably be adapted to the unique circumstances in the United States.
ELECTROCARDIOGRAPHIC EVIDENCE OF MYOCARDIAL INVOLVEMENT IN RHEUMATIC FEVER
Authors: Alfred E. Cohn, Homer F. Swift
Journal: The Journal of Experimental Medicine (1924)

These observations then show that in one way or the other the heart was affected in 35 of 37 cases of rheumatic fever. The evidence was of three sorts; first, the duration of auriculoventricular conduction was increased, though not always, and usually not to the degree of causing heart block; second, alteration in the ventricular complex of the electrocardiogram affecting in certain instances the Q R S complex and in others either the interval between R wave and T wave, or the T wave itself; and third, the occurrence of numerous irregularities in cardiac rhythm. These signs are characteristic of cardiac involvement, but are not specific for rheumatic fever; that is to say, from their presence rheumatic fever cannot be diagnosticated; all of them express merely derangement of the heart. They are signs which are, however, to be taken as evidence that the heart is affected by the rheumatic process even though an inference cannot be drawn as to the nature or the permanence of the injury. This may be slight and altogether transient even if the sign appears to be of advanced degree. The facts brought forward show that it is possible during the course of the disease to know whether the heart is involved in the general process. When sufficient data have been accumulated over a sufficiently long period of time, the usefulness for prognosis of observations like these will become established.
Effect of Hysterectomy vs Medical Treatment on Health-Related Quality of Life and Sexual Functioning
Authors: Miriam Kuppermann, R. Edward Varner, Robert L. Summitt, Jr, Lee A. Learman, Christine Ireland, Eric Vittinghoff, Anita L. Stewart, Feng Lin, Holly E. Richter, Jonathan Showstack, Stephen B. Hulley, A. Eugene Washington, None for the Ms Research Group
Journal: JAMA (2004)

Although a quarter of US women undergo elective hysterectomy before menopause, controlled trials that evaluate the benefits and harms are lacking.To compare the effect of hysterectomy vs expanded medical treatment on health-related quality of life.A multicenter, randomized controlled trial (August 1997-December 2000) of 63 premenopausal women, aged 30 to 50 years, with abnormal uterine bleeding for a median of 4 years who were dissatisfied with medical treatments, including medroxyprogesterone acetate. The participants, who were patients at gynecology clinics and affiliated practices of 4 US academic medical centers, were followed up for 2 years.Participants were randomly assigned to undergo hysterectomy or expanded medical treatment with estrogen and/or progesterone and/or a prostaglandin synthetase inhibitor. The hysterectomy route and medical regimen were determined by the participating gynecologist.The primary outcome was mental health measured by the Mental Component Summary (MCS) of the 36-Item Short-Form Health Survey (SF-36). Secondary outcomes included physical health measured by the Physical Component Summary (PCS), symptom resolution and satisfaction, body image, and sexual functioning, as well as other aspects of mental health and general health perceptions.At 6 months, women in the hysterectomy group had greater improvement in MCS scores than women in the medicine group (8 vs 2, P =.04). They also had greater improvement in symptom resolution (75 vs 29, P<.001), symptom satisfaction (44 vs 7, P<.001), interference with sex (41 vs 22, P =.003), sexual desire (21 vs 3, P =.01), health distress (33 vs 13, P =.009), sleep problems (13 vs 1, P =.03), overall health (12 vs 2, P =.006), and satisfaction with health (31 vs 14, P =.01). By the end of the study, 17 (53%) of the women in the medicine group had requested and received hysterectomy, and these women reported improvements in quality-of-life outcomes during the 2 years that were similar to those reported by women randomized to the hysterectomy group. Women who continued medical treatment also reported some improvements (P<.001 for within-group change in many outcomes), with the result that most differences between randomized groups at the end of the study were no longer statistically significant in the intention-to-treat analysis.Among women with abnormal uterine bleeding and dissatisfaction with medroxyprogesterone, hysterectomy was superior to expanded medical treatment for improving health-related quality-of-life after 6 months. With longer follow-up, half the women randomized to medicine elected to undergo hysterectomy, with similar and lasting quality-of-life improvements; those who continued medical treatment also reported some improvements.
Adalimumab improves joint-related and skin-related functional impairment in patients with psoriatic arthritis: patient-reported outcomes of the Adalimumab Effectiveness in Psoriatic Arthritis Trial
Authors: D D Gladman, P J Mease, M A Cifaldi, R J Perdok, E Sasso, J Medich
Journal: Annals of the Rheumatic Diseases (2006)

To evaluate the effects of adalimumab on patient-reported outcomes of joint-related and skin-related functional impairment, health-related quality of life, fatigue and pain in patients with psoriatic arthritis (PsA).Patients with moderately- to severely- active PsA were treated with adalimumab, 40 mg, every other week, or placebo, in this 24-week, randomised, controlled trial. Patient-reported outcomes included the Health Assessment Questionnaire Disability Index (HAQ DI), Short-Form 36 Health Survey (SF-36), the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Scale and the Dermatology Life Quality Index (DLQI).Adalimumab (n = 151) and placebo (n = 162) groups were comparable with respect to baseline demographics and disease severity. Significant changes from baseline in HAQ DI were reported for adalimumab v placebo (-0.4 v -0.1, p<0.001) at both 12 and 24 weeks. At week 24, significant improvements in the SF-36 domains of physical functioning, role-physical, bodily pain, general health, vitality and social functioning, as well as the physical component summary score, were observed for adalimumab versus placebo (p<0.01). These reported changes in HAQ DI and SF-36 were also clinically important. Significantly more patients treated with adalimumab had complete resolution of functional loss (HAQ DI = 0) and dermatological-related functional limitations (DLQI = 0) compared with placebo at weeks 12 and 24 (p< or =0.001). Adalimumab led to significantly greater improvements in FACIT-Fatigue scores, pain scores, and disease activity measures versus placebo at 12 and 24 weeks (p<0.001 for all).Adalimumab improved physical-related and dermatological-related functional limitations, HRQOL, fatigue and pain in patients with PsA treated for 24 weeks.
Vitamin D Treatment Is Protective Of Inhalant Organic Dust-Induced Bone Loss
Authors: Jill A. Poole, Anand Dusad, Todd Wyatt, Angela Gleason, Michael Duryee, Elizabeth Klein, Christopher Bauer, Lynell Klassen, Ted Mikuls, William West, Debra Romberger, Geoffrey Thiele
Journal: Journal of Allergy and Clinical Immunology (2014)
Benzodiazepines and hip fractures in elderly people: case-control study
Authors: C. Pierfitte
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objective:</b> To determine whether benzodiazepines are associated with an increased risk of hip fracture. <b>Design:</b> Case-control study. <b>Participants:</b> All incident cases of hip fracture not related to traffic accidents or cancer in patients over 65 years of age. 245 cases were matched to 817 controls. <b>Setting:</b> Emergency department of a university hospital. <b>Main outcome measures:</b> Exposure to benzodiazepines and other potential risk or protective factors or lifestyle items. <b>Results:</b> The use of benzodiazepines as determined from questionnaires, medical records, or plasma samples at admission to hospital was not associated with an increased risk of hip fracture (odds ratio 0.9, 95% confidence interval 0.5 to 1.5). Hip fracture was, however, associated with the use of two or more benzodiazepines, as determined from questionnaires or medical records but not from plasma samples. Of the individual drugs, only lorazepam was significantly associated with an increased risk of hip fracture (1.8, 1.1 to 3.1). <b>Conclusion:</b> Except for lorazepam, the presence of benzodiazepines in plasma was not associated with an increased risk of hip fracture. The method used to ascertain exposure could influence the results of case-control studies.
Mechanisms of depressed conduction from long-term amiodarone therapy in canine myocardium.
Authors: J H Levine, E N Moore, A H Kadish, H F Weisman, C W Balke, R F Hanich, J F Spear
Journal: Circulation (1988)

Amiodarone therapy leads to a significant impairment in myocardial conduction, yet it causes only a modest decrease in the maximum rate of depolarization of the action potential (dV/dT). To determine whether the decrease in dV/dT solely accounts for the impaired myocardial conduction or whether passive membrane properties may also be involved, we studied 21 ventricular epicardial tissues from 14 beagles; six dogs received long-term treatment (3-6 weeks) of amiodarone orally, and the remaining dogs served as controls. Amiodarone therapy was associated with a decrease in conduction velocity (0.41 +/- 0.15 vs. 0.56 +/- 0.05 m/sec; p less than 0.01). There was a trend toward a decrease in dV/dT and a significant decrease in the space constant (0.69 +/- 0.27 vs. 1.05 +/- 0.25 mm; p = 0.01), of which the latter correlated closely with the decrease in conduction velocity measured in the amiodarone-treated tissues (r = 0.85, p less than 0.05). These data indicate that the decrease in myocardial conduction velocity caused by amiodarone is primarily due to effects on overall resistance to passive current flow rather than effects on the inward sodium current.
Clinical Features of Nipah Virus Encephalitis among Pig Farmers in Malaysia
Authors: Khean Jin Goh, Chong Tin Tan, Nee Kong Chew, Patrick Seow Koon Tan, Adeeba Kamarulzaman, Sazilah Ahmad Sarji, Kum Thong Wong, Basri Johan Jeet Abdullah, Kaw Bing Chua, Sai Kit Lam
Journal: New England Journal of Medicine (2000)

Between September 1998 and June 1999, there was an outbreak of severe viral encephalitis due to Nipah virus, a newly discovered paramyxovirus, in Malaysia.We studied the clinical features of the patients with Nipah virus encephalitis who were admitted to a medical center in Kuala Lumpur. The case definition was based on epidemiologic, clinical, cerebrospinal fluid, and neuroimaging findings.Ninety-four patients with Nipah virus infection were seen from February to June 1999 (mean age, 37 years; ratio of male patients to female patients, 4.5 to 1). Ninety-three percent had had direct contact with pigs, usually in the two weeks before the onset of illness, suggesting that there was direct viral transmission from pigs to humans and a short incubation period. The main presenting features were fever, headache, dizziness, and vomiting. Fifty-two patients (55 percent) had a reduced level of consciousness and prominent brain-stem dysfunction. Distinctive clinical signs included segmental myoclonus, areflexia and hypotonia, hypertension, and tachycardia and thus suggest the involvement of the brain stem and the upper cervical spinal cord. The initial cerebrospinal fluid findings were abnormal in 75 percent of patients. Antibodies against Hendra virus were detected in serum or cerebrospinal fluid in 76 percent of 83 patients tested. Thirty patients (32 percent) died after rapid deterioration in their condition. An abnormal doll's-eye reflex and tachycardia were factors associated with a poor prognosis. Death was probably due to severe brain-stem involvement. Neurologic relapse occurred after initially mild disease in three patients. Fifty patients (53 percent) recovered fully, and 14 (15 percent) had persistent neurologic deficits.Nipah virus causes a severe, rapidly progressive encephalitis with a high mortality rate and features that suggest involvement of the brain stem. The infection is associated with recent contact with pigs.
Combination Therapy with Pulse Cyclophosphamide plus Pulse Methylprednisolone Improves Long-Term Renal Outcome without Adding Toxicity in Patients with Lupus Nephritis
Authors: Gabor G. Illei, Howard A. Austin, Marianna Crane, Lee Collins, Mark F. Gourley, Cheryl H. Yarboro, Ellen M. Vaughan, Takashi Kuroiwa, Carol L. Danning, Alfred D. Steinberg, John H. Klippel, James E. Balow, Dimitrios T. Boumpas
Journal: Annals of Internal Medicine (2001)

Background: Controlled trials in lupus nephritis have demonstrated that cyclophosphamide therapy is superior to corticosteroid therapy alone. The long-term effectiveness and side-effect profiles of pulse immunosuppressive regimens warrant further study. Objective: To define the long-term risk and benefit of monthly treatment with boluses of methylprednisolone, cyclophosphamide, or both. Design: Extended follow-up (median, 11 years) of a randomized, controlled trial. Setting: U.S. government research hospital. Patients: 82 patients with proliferative lupus nephritis. Measurements: Rates of treatment failure (defined as need for supplemental immunosuppressive therapy or doubling of serum creatinine concentration, or death) and adverse events. Results: In an intention-to-treat survival analysis, the likelihood of treatment failure was significantly lower in the cyclophosphamide (P = 0.04) and combination therapy (P = 0.002) groups than in the methylprednisolone group. Combination therapy and cyclophosphamide therapy alone did not differ statistically in terms of effectiveness or adverse events. Of patients who completed the protocol (n = 65), the proportion of patients who had doubling of serum creatinine concentration was significantly lower in the combination group than in the cyclophosphamide group (relative risk, 0.095 [95% CI, 0.01 to 0.842]). Conclusion: With extended follow-up, pulse cyclophosphamide continued to show superior efficacy over pulse methylprednisolone alone for treatment of lupus nephritis. The combination of pulse cyclophosphamide and methylprednisolone appears to provide additional benefit over pulse cyclophosphamide alone and does not confer additional risk for adverse events.
The place of ethics in a unified behavioral science
Authors: Peter Danielson
Journal: Behavioral and Brain Sciences (2007)

Behavioral science, unified in the way Gintis proposes, should affect ethics, which also finds itself in “disarray,” in three ways. First, it raises the standards. Second, it removes the easy targets of economic and sociobiological selfishness. Third, it provides methods, in particular the close coupling of theory and experiments, to construct a better ethics.
Salmeterol versus formoterol in patients with moderately severe asthma: onset and duration of action
Authors: JA van Noord, JJ Smeets, JA Raaijmakers, AM Bommer, FP Maesen
Journal: European Respiratory Journal (1996)

We evaluated the profile of the bronchodilatory effect of three inhaled beta2-agonists, 24 microg formoterol, 50 microg salmeterol and 200 microg salbutamol, in patients with stable, moderately severe asthma. Thirty asthmatics (mean+/-SD age 54+/-8 yrs; forced expiratory volume in one second (FEV1) 58+/-12% predicted; reversibility of FEV1 21+/-8% from baseline) participated in a single-centre, double-blind, randomized, single-dose, cross-over study. FEV1 was obtained in baseline condition and 10, 20, 30, 60 min, and every hour up to 12 h after inhalation of the trial drug. Specific airway conductance (sGaw) was measured at baseline condition and 1, 3, 5, 7, 10, 20, 30, 60 min, and every hour up to 12 h after inhalation. Formoterol produced a mean increase in sGaw (as % of baseline) of 44% after 1 min, maximal (135%) after 2 h, and 56% after 12 h. The mean increase in FEV1 was maximal (27%) after 2h, and 10% after 12 h. After salmeterol, mean increase in sGaw amounted to 16% after 3 min, maximal (111%) after 2-4 h, and 58% after 12 h. The mean increase in FEV1 was maximally 25% after 3h, being 11% after 12 h. After salbutamol, mean increase in sGaw was 44% after 1 min and maximal (100%) after 30 min. The peak increase in FEV1 was 25%. We conclude that formoterol (24 microg) and salmeterol (50 microg) had an equal bronchodilatory capacity, which was similar to that of 200 microg salbutamol and lasted for at least 12 h in patients with asthma. However, formoterol had a more rapid onset of action than salmeterol, equal to that of salbutamol.
Safety and efficacy of long-term statin treatment for cardiovascular events in patients with coronary heart disease and abnormal liver tests in the Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) Study: a post-hoc analysis
Authors: Vasilios G Athyros, Konstantinos Tziomalos, Thomas D Gossios, Theodora Griva, Panagiotis Anagnostis, Konstantinos Kargiotis, Efstathios D Pagourelias, Eleni Theocharidou, Asterios Karagiannis, Dimitri P Mikhailidis
Journal: The Lancet (2010)
Antigenic conservation and immunogenicity of the HIV coreceptor binding site
Authors: Julie M. Decker, Frederic Bibollet-Ruche, Xiping Wei, Shuyi Wang, David N. Levy, Wenquan Wang, Eric Delaporte, Martine Peeters, Cynthia A. Derdeyn, Susan Allen, Eric Hunter, Michael S. Saag, James A. Hoxie, Beatrice H. Hahn, Peter D. Kwong, James E. Robinson, George M. Shaw
Journal: The Journal of Experimental Medicine (2005)

Immunogenic, broadly reactive epitopes of the HIV-1 envelope glycoprotein could serve as important targets of the adaptive humoral immune response in natural infection and, potentially, as components of an acquired immune deficiency syndrome vaccine. However, variability in exposed epitopes and a combination of highly effective envelope-cloaking strategies have made the identification of such epitopes problematic. Here, we show that the chemokine coreceptor binding site of HIV-1 from clade A, B, C, D, F, G, and H and circulating recombinant form (CRF)01, CRF02, and CRF11, elicits high titers of CD4-induced (CD4i) antibody during natural human infection and that these antibodies bind and neutralize viruses as divergent as HIV-2 in the presence of soluble CD4 (sCD4). 178 out of 189 (94%) HIV-1–infected patients had CD4i antibodies that neutralized sCD4-pretreated HIV-2 in titers (50% inhibitory concentration) as high as 1:143,000. CD4i monoclonal antibodies elicited by HIV-1 infection also neutralized HIV-2 pretreated with sCD4, and polyclonal antibodies from HIV-1–infected humans competed specifically with such monoclonal antibodies for binding. In vivo, variants of HIV-1 with spontaneously exposed coreceptor binding surfaces were detected in human plasma; these viruses were neutralized directly by CD4i antibodies. Despite remarkable evolutionary diversity among primate lentiviruses, functional constraints on receptor binding create opportunities for broad humoral immune recognition, which in turn serves to constrain the viral quasispecies.
Effects of Intrauterine Exposure to Synthetic Glucocorticoids on Fetal, Newborn, and Infant Hypothalamic-Pituitary-Adrenal Axis Function in Humans: A Systematic Review
Authors: Marion Tegethoff, Christopher Pryce, Gunther Meinlschmidt
Journal: Endocrine Reviews (2009)

Abstract Background: Synthetic glucocorticoids are commonly used in reproductive medicine. Fetal organ systems are highly sensitive to changes in the intrauterine environment, including overexposure to glucocorticoids. Structural and functional alterations resulting from such changes may persist throughout life and have been associated with diverse diseases. One system that could be particularly sensitive to fetal glucocorticoid overexposure is the hypothalamic-pituitary-adrenal (hpa) axis. Many human studies have investigated this possibility, but a systematic review to identify consistent, emergent findings is lacking. Methods: We systematically review 49 human studies, assessing the effects of intrauterine exposure to synthetic glucocorticoids on fetal, neonate, and infant hpa function. Results: Study quality varied considerably, but the main findings held true after restricting the analyses to higher-quality studies: intrauterine exposure to synthetic glucocorticoids reduces offspring hpa activity under unstimulated conditions after pain but not pharmacological challenge. Although reduced unstimulated hpa function appears to recover within the first 2 wk postpartum, blunted hpa reactivity to pain is likely to persist throughout the first 4 months of life. There is some evidence that the magnitude of the effects is correlated with the total amount of glucocorticoids administered and varies with the time interval between glucocorticoid exposure and hpa assessment. Conclusions: This systematic review has allowed the demonstration of the way in which intrauterine exposure to various regimens of synthetic glucocorticoids affects various forms of hpa function. As such, it guides future studies in terms of which variables need to be focused on in order to further strengthen the understanding of such therapy, whilst continuing to profit from its clinical benefits.