tbuckley/cabot-search huggingface dataset:
College calls for major overhaul of the delivery of care
Authors: N. Hawkes
Journal: BMJ (2013)

The way hospital doctors work needs to be transformed, to repair the types of failure of care revealed by a series of reports over the past few years, the Royal College of Physicians has said.

It calls for barriers between hospital and community care to be abolished. The idea that hospitals are there to provide a brief period of acute care before discharging cured patients back to the community is no longer valid, particularly in the case of frail, elderly patients and those with dementia, says a new report from the college’s Future Hospital Commission.1

It calls for seamless care without physical or professional barriers, delivered wherever is best for the patient, not the medical team. Care should come to the …
Long-term Amikacin Use
Authors: Marcia M. Moody
Journal: JAMA (1982)

Amikacin sulfate was first used sparingly at our cancer center in 1976; since 1979, it has been the only aminoglycoside used for systemic cancer therapy for patients with granulocytopenia. As the development of resistance has been correlated with antibiotic use over time, we wished to determine if prolonged use of amikacin in our patients had led to increased amikacin resistance. A total of 1,129 strains were recovered from 315 patients during a 13-month period. Each species isolated per patient was considered once. Seven percent of the patients had amikacin-resistant strains (2.7% of isolates), and 10% of patients had gentamicin-resistant strains (4% of isolates). Amikacin resistance was significantly less than in an earlier study. Unrestricted use of amikacin has not led to a concomitant increase in amikacin resistance in gram-negative bacilli. (<i>JAMA</i>1982;248:1199-1202)
PRIMARY HYPERTROPHY OF THE GUMS
Authors: S. D. RUGGLES
Journal: JAMA (1925)

A diligent search of our own and foreign language publications reveals but few reported cases of this disease, and of these only a few compare in extent to the cases to be reported at this time. Hypertrophies commonly seen by the stomatologist arise from broken down roots, irritations resulting from faulty dentistry, deposits of calculus, malocclusion, etc. The condition under consideration is not the result of these agencies and bears little or no resemblance to them.<sup>1</sup> Well authenticated cases show heredity,<sup>2</sup>the disease having been traced through three generations,<sup>3</sup>with several cases in the same family,<sup>4</sup>while in a family of five only a single case developed.<sup>5</sup>Males and females are about equally affected, with possibly a slight preponderance of cases among females. All cases reported since 1839 are of the various members of the Caucasian race. The disease is undoubtedly congenital in some cases,
Life Extension: A Practical Scientific Approach
Authors: Frederick J. Stare
Journal: JAMA (1983)

It is important for physicians to be aware of the contents of<i>Life Extension</i>in order to properly counsel their patients who have bought this best sellers' list book. Unusual symptoms, requests for extensive laboratory testing, and appeals for unrequired prescription drugs should alert physicians that their patients may be under the dangerous illusion that long life and good health can be achieved simply by swallowing the unsound advice of "Durk and Sandy." The jacket photograph of the two authors of this 858-page tome is designed so that prospective buyers will believe that the young, long-haired, unconventional-looking duo have combined laboratory and ultramodern technology skills (Durk is holding a beaker in an arm swathed in Indian jewelry, Sandy is holding a computer printout, and the screen on their home computer module is aglow with figures) to come up with the way to "enjoy the pleasure and stamina, the vitality and
Phenotypic Correction of Hemophilia A by Ectopic Expression of Activated Factor VII in Platelets
Authors: Tsukasa Ohmori, Akira Ishiwata, Yuji Kashiwakura, Seiji Madoiwa, Katsuyuki Mitomo, Hidenori Suzuki, Mamoru Hasegawa, Jun Mimuro, Yoichi Sakata
Journal: Molecular Therapy (2008)

Platelets are receiving much attention as novel target cells to secrete a coagulation factor for hemophilia gene therapy. In order to extend the application of platelet-directed gene therapy, we examined whether ectopic expression of activated factor VII (FVIIa) in platelets would result in an efficient bypass therapy to induce sufficient thrombin generation on platelet surfaces in mice with hemophilia A. Transduction of bone marrow cells with a simian immunodeficiency virus (SIV)-based lentiviral vector harboring the platelet-specific GPIb alpha promoter resulted in efficient transgene expression in platelets. FVIIa antigen was expressed in platelets by this SIV system; FVII transgene products were found to localize in the cytoplasm and translocate toward the sub-membrane zone and cell surface after activation. Although FVII antigen levels in platelets did not reach the therapeutic levels seen with FVIIa infusion therapy, whole-blood coagulation, as assessed by thromboelastography, was significantly improved in mice with hemophilia A. Further, we observed correction of the bleeding phenotype in mice with hemophilia A after transplantation, even in the presence of FVIII-neutralizing antibodies. Our results demonstrate that FVIIa-expressing platelets can strengthen hemostatic function and may be useful in treating hemophilia and other inherited bleeding disorders. These findings are comparable to the proven therapeutic effects of FVIIa infusion.
Arthritis in Flemish paintings
Authors: J C W Edwards
Journal: BMJ (1977)

Daily stool weights in this community average over 400 g.Whereas appendicitis and diabetes have been postulated to result from two different aspects of food refining, diverticular disease and varicose veins have both been attributed to changes in faecal viscosity and volume which not only cause increased intracolonic pressure but also increased intra-abdominal pressure during straining a stool.A positive correlation between these two diseases has been reported in individual patients.'Professor Corridan and his colleagues are to be congratulated on their study for it is just such a search for associations between diseases in individuals which can be so informative and which is so neglected.It is hoped that others will follow their commendable example and look for other disease correlations.
Sandoz and the Monitoring of Patients Receiving Clozapine
Authors: Owen D. Benton
Journal: JAMA (1991)

<h3>To the Editor.—</h3> The Medical News and Perspectives article by Kleinerman<sup>1</sup>explores the issues surrounding the clozapine (Clozaril) controversy. As with most social conflict, each protagonist voices a meritorious principle on which to base argument. The medical profession asserts its rights and responsibilities regarding clinical management. Public interest groups decry inordinate expense. Politicians are happily embroiling themselves in the controversy and offering their usual nonsolutions. The key to solving the dilemma lies in understanding its root cause, which has not been directly addressed. Sandoz' clozapine program director hints that the US Department of Veterans Affairs' proposal, which included monitoring its own patients, might have been acceptable had it indemnified Sandoz against liability. If product liability fears are the basis for Sandoz' position, it becomes apparent why the meritorious arguments of others have been rebuffed by Sandoz. While the Sandoz monitoring system does not provide absolute legal protection, it would
Sjögren's Syndrome—Newer Aspects of Research, Diagnosis, and Therapy
Authors: NORMAN A. CUMMINGS
Journal: Annals of Internal Medicine (1971)

Recent advances in the study of Sjögren's syndrome include detection of antisalivary duct antibody (ASDA) in patients' sera, development of sensitive techniques to evaluate salivary glandular function by scintigraphy, classification of salivary glands obtained from lip biopsies according to the extent of lymphoid infiltration, and demonstration that these lymphoid cells actively synthesize significant amounts of IgG and especially of IgM, including rheumatoid factor. The syndrome presents against a broad spectrum of lymphoproliferation, from benign disease, through nonmalignant extraglandular lymphoproliferation ("pseudolymphoma"), to frankly malignant disease, either macroglobulinemia or lymphomas. The relationships between scintigraphic and histologic classification, the presence of ASDA, serum levels, and lip biopsy synthesis of IgM and rheumatoid factor, and the clinical course are discussed. Implications for therapy with immunosuppressive drugs are briefly explored. Possible mechanisms are pointed out that may help explain the pathogenesis as genetic factors leading to an immunologic imbalance between cellular and serologic response, with viral antigens playing a role.
Abnormal binding of an anti-amnion antibody to epidermal basement membrane provides a novel diagnostic probe for junctional epidermolysis bullosa
Authors: A.R. KENNEDY, A.H.M. HEAGERTY, J-P. ORTONNE, B-L. HSI, C-J.G. YEH, R.A.J. EADY
Journal: British Journal of Dermatology (1985)

AA3 is a novel antibody raised against human amnion, which reacts with the basement membrane of various epithelia of ectodermal origin. We use AA3 to examine the epidermal basement membrane zone in normal skin and different genetically determined types of epidermolysis bullosa (EB), by indirect immunofluorescence. AA3 staining was normal in dystrophic and simplex EB, but was markedly reduced in lesional and non‐blistered skin in severe forms of junctional EB. In non‐lethal junctional EB, the intensity of staining was variable and appeared to be inversely associated with disease severity, but did not correlate with demonstrable abnormalities of hemidesmosomes. AA3 binding was not reduced in pemphigoid lesions or normal suction blisters. It appeared to localize to the lamina lucida, but with different characteristics compared with antibodies to laminin and bullous pemphigoid antigen. These findings suggest that AA3 recognizes an antigen (or antigens) which may be involved in a primary biochemical defect in junctional EB. Moreover, this antibody may act as a new probe for this potentially lethal mechano‐bullous disease.
Anatomic Stereotactic Catheter Ablation on Three-Dimensional Magnetic Resonance Images in Real Time
Authors: Timm Dickfeld, Hugh Calkins, Muz Zviman, Ritsushi Kato, Glenn Meininger, Lars Lickfett, Ron Berger, Henry Halperin, Stephen B. Solomon
Journal: Circulation (2003)

Targets for radiofrequency (RF) ablation of atrial fibrillation, atrial flutter, and nonidiopathic ventricular tachycardia are increasingly being selected on the basis of anatomic considerations. Because fluoroscopy provides only limited information about the relationship between catheter positions and cardiac structures and is associated with radiation risk, other approaches to mapping may be beneficial.An electromagnetic catheter positioning system was superimposed on 3D MR images using fiducial markers. This allowed the dynamic display of the catheter position on the true anatomy of previously acquired MR images in real time. In vitro accuracy and precision during catheter navigation were assessed in a phantom model and were 1.11+/-0.06 and 0.30+/-0.07 mm (mean+/-SEM), respectively. Left and right heart catheterization was performed in 7 swine without the use of fluoroscopy, yielding an in vivo accuracy and precision of 2.74+/-0.52 and 1.97+/-0.44 mm, respectively. To assess the reproducibility of RF ablation, RF lesions were created repeatedly at the identical anatomic site in the right atrium (n=8 swine). Average distance of the repeated right atrial ablations was 3.92+/-0.5 mm. Straight 3-point lines were created in the right and left ventricles to determine the ability to facilitate complex ablation procedures (n=6 swine). The ventricular lesions deviated 1.70+/-0.24 mm from a straight line, and the point distance differed by 2.25+/-0.63 mm from the pathological specimen.Real-time display of the catheter position on 3D MRI allows accurate and precise RF ablation guided by the true anatomy. This may facilitate anatomically based ablation procedures in, for instance, atrial fibrillation or nonidiopathic ventricular tachycardia and decrease radiation times.
Brucella endocarditis, a report of 14 cases (1991–2009)
Authors: Maryam Keshtkar-Jahromi, Mohammadali Boroumand, Seyed-Mostafa Razavi, Sharareh Gholamin, Babak Haghighat, Mohammad-Jafar Hashemi, Mohammad Khani, Marzieh Keshtkar-Jahromi, Behrooz Naghili
Journal: Journal of Infection (2010)
A Spatial Vector Analyzer for the Conventional Electrocardiogram
Authors: ERNST SIMONSON, JACK ROSS
Journal: Circulation (1953)

Present methods of spatial vector analysis are descriptive rather than quantitative, or require lengthy calculations. With the spatial vector analyzer, the spatial vector is constructed from the conventional electrocardiogram, with only minor modifications of electrocardiographic routine. The method is simple, can be applied to mean and instantaneous vectors, and a quantitative characterization of any vector in terms of a horizontal angle, vertical angle, and magnitude can be obtained in about three minutes. It may be expected that the description of any deflection in simple, quantitative terms will improve the electrocardiographic interpretation by eliminating distortion resulting from the limitation to one (frontal) plane.
A diabetes-susceptible HLA haplotype is best defined by a combination of HLA-DR and -DQ alleles.
Authors: M J Sheehy, S J Scharf, J R Rowe, M H Neme de Gimenez, L M Meske, H A Erlich, B S Nepom
Journal: Journal of Clinical Investigation (1989)

HLA-DR4 is associated with insulin-dependent diabetes mellitus (IDDM) in many populations. Many recent studies suggest that the DR4 effect is really due to DQ3.2, an allele of the nearby DQB1 locus. We used T cell clones, MAb, and allele-specific oligonucleotides to test IDDM and control subjects for DR4 subtypes (Dw4, Dw10, Dw13, and Dw14) and for DR4-associated DQB1 alleles (DQ3.1 and DQ3.2). We find that (a) IDDM is approximately equally associated with alleles of the DRB1 locus (Dw4 and Dw10, combined relative risk, RR = 6.4) and the DQB1 locus (DQ3.2, RR = 5.9); and (b) there is significant interaction, in a statistical sense, between these DR and DQ alleles in IDDM. The only IDDM-associated DR4 haplotypes were those carrying the IDDM-associated alleles at both loci (RR = 12.1); haplotypes with Dw4 or 10 but not DQ3.2, or vice versa, had a RR less than 1. Alternative explanations include: (a) that susceptibility requires specific allelic products of both DR and DQ loci; (b) that the combination of certain DR and DQ alleles marks haplotypes with the true susceptibility allele at a third locus; or (c) that Dw4 and 10 mark haplotypes with an allele at another locus that interacts with DQ3.2. As discussed, this third locus is unlikely to be DQA1 (DQ alpha). The data thus are not easily reconciled with an exclusive effect of HLA-DQ. This information increases our ability to predict IDDM by genetic typing: in the population studied, heterozygotes DR3/[DQ3.2, Dw4] or DR3/[DQ3.2, Dw10] had a relative risk of 38.0 and an absolute risk of 1 in 15.
Modification of hypertension and hypercholesterolaemia in patients with systemic lupus erythematosus: a quality improvement study
Authors: M B Urowitz
Journal: Annals of the Rheumatic Diseases (2005)

Hypercholesterolaemia and hypertension are risk factors for coronary artery disease in patients with systemic lupus erythematosus (SLE).To examine the recognition and management of hypercholesterolaemia and hypertension in patients with SLE before and after a quality improvement study.Patients with SLE have been followed up prospectively at the University of Toronto Lupus Clinic since 1970. The charts of all patients who entered the clinic since 1990 were reviewed to ensure completeness of data on anti-hypertensive treatment (AHT) and lipid lowering agents (LLA). Recognition and management of hypercholesterolaemia and hypertension were evaluated for the periods 1990-1995 and 1996-2001.Comparison of treatment between time periods showed that during 1990-1995 204/559 (36%) patients seen were hypertensive, of whom 180 (88%) were receiving AHT, and during 1996-2001 241/576 (42%) patients seen were hypertensive, of whom 232 (96%) were receiving AHT (p = 0.0013). A comparison of treatment for hypercholesterolaemia showed that 21/236 (9%) hypercholesterolaemic patients were being treated with LLA in the earlier period compared with 74/261 (28%) in the later period (p<0.0001).Treatment for hypertension and hyperlipidaemia has increased in the past 6 years compared with the previous 6 years, but a number of patients eligible for these treatments remain untreated.
VIPoma: A Rare Cause of a Pancreatic Mass
Authors: Ilias Drivas, Robert Mansberg, John M. Roberts
Journal: Clinical Nuclear Medicine (2004)

Vasoactive intestinal polypeptide secreting tumor (VIPoma) is a rare neuroendocrine tumor belonging to a group of cancers called pancreatic endocrine tumors (PETs). The incidence is 1 in 10 million. It has previously been described as Verner-Morrison syndrome, watery diarrhea, hypokalemia, and achlorhydria (WDHA) and pancreatic cholera. Patients usually present with chronic diarrhea and are diagnosed late because it is slow growing. Imaging of VIPomas when they are small is difficult and they are easily missed. A 34-year-old man with a 7-year history of diarrhea who had a normal abdominal ultrasound early in the course of his disease but was subsequently found to have a mass in the pancreas 4 years later, is presented.
The Canadian National Breast Screening Study-1: Breast Cancer Mortality after 11 to 16 Years of Follow-up: A Randomized Screening Trial of Mammography in Women Age 40 to 49 Years
Authors: Anthony B. Miller
Journal: Annals of Internal Medicine (2002)

The efficacy of breast cancer screening in women age 40 to 49 years remains controversial.To compare breast cancer mortality in 40- to 49-year-old women who received either 1) screening with annual mammography, breast physical examination, and instruction on breast self-examination on 4 or 5 occasions or 2) community care after a single breast physical examination and instruction on breast self-examination.Individually randomized, controlled trial.15 Canadian centers.50 430 volunteers age 40 to 49 years, recruited from January 1980 to March 1985, who were not pregnant, had no previous breast cancer diagnosis, and had not had mammography in the preceding 12 months.Breast physical examination and instruction on breast self-examination preceded random assignment of 25 214 women to receive mammography and annual mammography, breast physical examination, and breast self-examination and 25 216 women to receive usual community care with annual follow-up.Verified breast cancer incidence and cohort mortality through 31 December 1993 and deaths from breast cancer through 30 June 1996.The 105 breast cancer deaths in the mammography group and 108 breast cancer deaths in the usual care group yielded a cumulative rate ratio, adjusted for mammography done outside the study, of 1.06 (95% CI, 0.80 to 1.40). A total of 592 cases of invasive breast cancer and 71 cases of in situ breast cancer were diagnosed by 31 December 1993 in the mammography group compared with 552 and 29 cases, respectively, in the usual care group. The expected proportions of nonpalpable and small invasive tumors were detected on mammography.After 11 to 16 years of follow-up, four or five annual screenings with mammography, breast physical examination, and breast self-examination had not reduced breast cancer mortality compared with usual community care after a single breast physical examination and instruction on breast self-examination. The study data show that true effects of 20% or greater are unlikely.
Thalidomide versus bortezomib based regimens as first‐line therapy for patients with multiple myeloma: A systematic review
Authors: Ambuj Kumar, Iztok Hozo, Keath Wheatley, Benjamin Djulbegovic
Journal: American Journal of Hematology (2010)

Thalidomide (T) or bortezomib (B) in combination with melphalan plus prednisone (MP) is superior to MP as first line therapy for previously untreated myeloma. However, direct head-to-head comparison of Melphalan, Prednisone plus Bortezomib (MPB) versus Melphalan, Prednisone plus Thalidomide (MPT) is lacking. We performed an indirect meta-analysis to assess the treatment effects of MPB versus MPT via common comparator MP using the systematic review and meta-analytical techniques. A comprehensive literature search (MEDLINE and gray literature) was undertaken. Systematic review was performed as per the Cochrane Collaboration recommendations. Initial search yielded 1,013 citations, of which six randomized controlled trials (RCTs) enrolling 2,798 patients met the inclusion criteria. Comparison of MPT versus MP (five RCTs) showed no survival difference [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.64-1.05] but a statistically significant difference in event-free survival favoring MPT (HR 0.66, 95% CI 0.56-0.77) without excessive treatment-related mortality [risk ratio (RR) 1.11, 95% CI 0.64-1.92]. Comparison of MPB vs. MP (one RCT) showed a statistically significant benefit for survival (HR 0.65, 95% CI 0.51-0.84) and event-free survival (HR 0.48, 95% CI 0.37-0.63) without difference in treatment-related mortality (RR 0.42, 95% CI 0.11-1.63) with MPB. The indirect comparison of MPB versus MPT showed no difference between MPB versus MPT for all outcomes but a significant benefit for complete response (RR 2.34, 95% CI 1.12-4.90), and grade III/IV adverse events (RR 0.53, 95% CI 0.38-0.73) favoring MPB. There is an uncertainty about definitive superiority of one type of regimen over the other. Therefore, direct head-to-head comparison between these competing regimens is warranted.
A stiff collar can restrict atlantoaxial instability in rheumatoid cervical spine in selected cases.
Authors: M Kauppi, P Anttila
Journal: Annals of the Rheumatic Diseases (1995)

OBJECTIVE--To study the efficiency of a stiff collar in restricting the instability of anterior atlantoaxial subluxation (AAS). METHODS--Twenty two successive patients with an unstable AAS were studied. Lateral view radiographs were taken of the cervical spine in flexion, extension, and neutral positions without a collar, and in full flexion with a custom made stiff collar. RESULTS--The collar restricted more than 30% of the maximal instability of the AAS in 50% of the patients. These patients had significantly shorter atlantoaxial distance in the neutral position than those in whom the collar was not able to restrict the instability. CONCLUSION--A stiff collar can restrict the atlantoaxial instability in selected rheumatic patients with an unstable AAS. Lateral view radiographs of the cervical spine in a neutral position can be used to identify the patients whom the collar will benefit.
The same tyrosine-based inhibition motif, in the intra-cytoplasmic domain of FcγRIIB, regulates negatively BCR-, TCR-, and FcR-dependent cell activation
Authors: Marc Daëron, Sylvain Latour, Odile Malbec, Eric Espinosa, Patrick Pina, Suzanne Pasmans, Wolf H. Fridman
Journal: Immunity (1995)
Infectious Hepatitis
Authors: James W. Mosley, W. W. Smither
Journal: New England Journal of Medicine (1957)

ALTHOUGH there have been several reports of epidemics of infectious hepatitis due to water-borne spread, only three of these have been from the United States.1 2 3 In view of the large number of cases of the disease occurring in this country each year, this suggests that water-borne transmission is very infrequent here. It is possible, however, that it occurs more often than the paucity of reports implies, and that failure in recognition is due to the difficulties encountered in demonstrating this route to have been the responsible one in any outbreak.During May and June, 1956, an outbreak of infectious hepatitis, . . .