tbuckley/cabot-search huggingface dataset:
Encouraging Primary Care Physicians To Help Smokers Quit
Authors: Stuart J. Cohen
Journal: Annals of Internal Medicine (1989)

Study Objective: To increase the effect that primary care physicians have on their patients who smoke. Design: Randomized, controlled trial with 112 general internists and their patients who smoke. Patients: Sample of 1420 patients from a general medicine clinic of a city-county teaching hospital, who smoke at least one cigarette a day and were recruited regardless of their interest in quitting smoking. Interventions: Physicians were randomly assigned to one of four groups: participants who received a protocol for smoking management and a lecture on the consequences and management of smoking (control); in addition, had nicotine gum freely available to patients (gum); had stickers attached to their smokers' charts (reminder); or had both gum and reminders (both). Measurements and Main Results: The percentage of patients with a return visit at 6 months who quit smoking (alveolar carbon monoxide of less than nine parts per million) was 1. 3% (control), 7.7% (gum), 7.0% (reminders), and 6.3% (both). At 1 year the percentages were 2.7%, 8.8%, 15.0%, and 9.6%, respectively. Subsequent pairwise comparisons showed that the three intervention groups were not significantly different, but that each was significantly different from the control group (P < 0.05). Physicians in all three intervention groups spent significantly more time than did the physicians in the control group counseling their patients about smoking. Conclusions: The availability of nicotine gum or labeling the charts of smokers can help primary care physicians increase their success rates two- to six-fold in helping patients quit smoking. If all primary care physicians used these procedures, they could help an additional 2 million smokers quit.
Thrombotic Microangiopathic Glomerulopathy in Human Decay Accelerating Factor–Transgenic Swine-to-Baboon Kidney Xenografts
Authors: Akira Shimizu, Kazuhiko Yamada, Shin Yamamoto, John M. Lavelle, Rolf N. Barth, Simon C. Robson, David H. Sachs, Robert B. Colvin
Journal: Journal of the American Society of Nephrology (2005)

Models of pig-to-baboon xenografting were examined to identify the mechanisms and pathologic characteristics of acute humoral xenograft rejection (AHXR). Thymus and kidney (composite thymokidney) from human decay accelerating factor-transgenic swine were transplanted into baboons (n = 16) that were treated with an immunosuppressive regimen that included extracorporeal immunoadsorption of anti-alphaGal antibody and inhibition of complement activation. Morphologic and immunohistochemical studies were performed on protocol biopsies and graftectomy samples. All renal xenografts avoided hyperacute rejection. However, graft rejection coincided with the increase of anti-alphaGal antibody in the recipient's circulation. The 16 xenografts studied were divided into two groups dependent on the rapid return (group 1) or gradual return (group 2) of anti-alphaGal antibody after immunoadsorption. In group 1 (n = 6), grafts were rejected to day 27 with development of typical AHXR, characterized by marked interstitial hemorrhage and thrombotic microangiopathy in the renal vasculature. In group 2 (n = 10), grafts also developed thrombotic microangiopathy affecting mainly the glomeruli by day 30 but also showed minimal evidence of interstitial injury and hemorrhage. In the injured glomeruli, IgM and C4d deposition, subsequent endothelial cell death and activation with upregulation of von Willebrand factor and tissue factor, and a decrease of CD39 expression developed with the formation of fibrin-platelet multiple microthrombi. In this model, the kidney xenografts, from human decay accelerating factor-transgenic swine, in baboons undergo AHXR. In slowly evolving AHXR, graft loss is associated with the development of thrombotic microangiopathic glomerulopathy. Also, anti-alphaGal IgM deposition and subsequent complement activation play an important role in the mechanism of glomerular endothelial injury and activation and the formation of multiple microthrombi.
Short Cuts to Nursing.
Authors: Lavin[ill] Dock
Journal: JAMA (1902)

New York City, June 23, 1902. <h3>To the Editor:</h3> Dr. Helen C. Putnam's article on "Attendants and Nursemaids," inThe Journal, opens up to the consideration of the medical profession a large subject which trained nurses have been discussing for some time. Naturally, from the limitations of their professional initiative there is little that nurses can do in the matter of new fields of training, but I would be grateful for the privilege of presenting their views on this subject toThe Journaland through its pages to the medical profession, who have not only influence (which we earnestly desire to see used for what we feel to be the best good of our work) but also direct initiatory power which we sometimes are forced to think they use, in nursing matters, in ways which we feel to be detrimental not to us only, but ultimately to the safety of
Cardiac Infarction and Peptic Ulcer
Authors: P. S. Elias
Journal: BMJ (1954)

The law of diminishing returns, first described by economists to explain why, beyond a certain point, additional inputs produce smaller and smaller outputs, offers insight into many situations encountered in clinical medicine. For example, when the risk of an adverse event can be reduced in several different ways, the impact of each intervention can generally be shown mathematically to be reduced by the previous ones. The diminishing value of successive interventions is further reduced by adverse consequences (eg, drug-drug, drug-disease, and drug-nutrient interactions), as well as by the total expenditures of time, energy, and resources, which increase with each additional intervention. It is therefore important to try to prioritize interventions based on patient-centered goals and the relative impact and acceptability of the interventions. We believe that this has implications for clinical practice, research, and policy.
Environmental factors as disease accelerators during chronic hepatitis C
Authors: Ariane Mallat, Christophe Hezode, Sophie Lotersztajn
Journal: Journal of Hepatology (2008)

Progression of chronic hepatitis is highly variable among individuals, as the result of several host, viral and environmental factors. The latter have been extensively investigated in order to ameliorate hepatitis C outcome, particularly in difficult-to-treat patients. Over the last decade, several studies have shown that a combination of HCV infection and high levels of alcohol abuse results in synergistic acceleration of liver fibrogenesis. In addition, recent data indicate that light alcohol intake may also exacerbate fibrosis progression. It has also been suggested that cigarette smoking may enhance activity grade in patients with chronic hepatitis C, thereby increasing progression of fibrosis. This assumption mostly relies on epidemiological evidences in the absence of pathogenic studies. Finally, cannabis use is increasingly emerging as a novel co-morbidity in patients with chronic hepatitis C. Indeed, regular cannabis smoking is an independent predictor of both fibrosis and steatosis severity in infected patients. In addition, experimental studies have shown that cannabinoid CB1 receptors enhance liver fibrogenesis and steatogenesis by distinct mechanisms, therefore strongly supporting epidemiological findings. Altogether, patients should be informed of the deleterious impact of alcohol, tobacco and cannabis use and should be offered appropriate support to achieve abstinence.
Sexuality — The Experience and Anxieties of Medical Students
Authors: John W. Mudd, Richard J. Siegel
Journal: New England Journal of Medicine (1969)

Abstract In a study of the medical student's sexuality as it relates to his total medical-school experience, 397 male medical students at the University of Pennsylvania were found to be more experienced sexually than college-educated men studied by Kinsey. Nevertheless, the average student has strong desires for sex education both for his personal edification and to equip him to counsel patients. An important component of the anxiety that he experiences in physician-patient relations is due to sexual conflict. However, his personal sex experience or sense of confidence is not related to his propensity to these sexual conflicts and anxieties. There is strong evidence that his anxieties appreciably inhibit professional objectivity. These anxieties were more marked during the earlier than the later years of medical-school experience. The student's sexuality fits into a constellation of emotional factors that determines the integrated quality of his personality, and it is this overall quality that facilitates or inhibits optimal physician-patient interactions and communication.
Glycoengineered Acid α-Glucosidase With Improved Efficacy at Correcting the Metabolic Aberrations and Motor Function Deficits in a Mouse Model of Pompe Disease
Authors: Yunxiang Zhu, Ji-Lei Jiang, Nathan K Gumlaw, Jinhua Zhang, Scott D Bercury, Robin J Ziegler, Karen Lee, Mariko Kudo, William M Canfield, Timothy Edmunds, Canwen Jiang, Robert J Mattaliano, Seng H Cheng
Journal: Molecular Therapy (2009)

Improving the delivery of therapeutics to disease-affected tissues can increase their efficacy and safety. Here, we show that chemical conjugation of a synthetic oligosaccharide harboring mannose 6-phosphate (M6P) residues onto recombinant human acid α-glucosidase (rhGAA) via oxime chemistry significantly improved its affinity for the cation-independent mannose 6-phosphate receptor (CI-MPR) and subsequent uptake by muscle cells. Administration of the carbohydrate-remodeled enzyme (oxime-neo-rhGAA) into Pompe mice resulted in an approximately fivefold higher clearance of lysosomal glycogen in muscles when compared to the unmodified counterpart. Importantly, treatment of immunotolerized Pompe mice with oxime-neo-rhGAA translated to greater improvements in muscle function and strength. Treating older, symptomatic Pompe mice also reduced tissue glycogen levels but provided only modest improvements in motor function. Examination of the muscle pathology suggested that the poor response in the older animals might have been due to a reduced regenerative capacity of the skeletal muscles. These findings lend support to early therapeutic intervention with a targeted enzyme as important considerations in the management of Pompe disease. Improving the delivery of therapeutics to disease-affected tissues can increase their efficacy and safety. Here, we show that chemical conjugation of a synthetic oligosaccharide harboring mannose 6-phosphate (M6P) residues onto recombinant human acid α-glucosidase (rhGAA) via oxime chemistry significantly improved its affinity for the cation-independent mannose 6-phosphate receptor (CI-MPR) and subsequent uptake by muscle cells. Administration of the carbohydrate-remodeled enzyme (oxime-neo-rhGAA) into Pompe mice resulted in an approximately fivefold higher clearance of lysosomal glycogen in muscles when compared to the unmodified counterpart. Importantly, treatment of immunotolerized Pompe mice with oxime-neo-rhGAA translated to greater improvements in muscle function and strength. Treating older, symptomatic Pompe mice also reduced tissue glycogen levels but provided only modest improvements in motor function. Examination of the muscle pathology suggested that the poor response in the older animals might have been due to a reduced regenerative capacity of the skeletal muscles. These findings lend support to early therapeutic intervention with a targeted enzyme as important considerations in the management of Pompe disease.
TCTAP C-205 “Iliac Vein Stenting Alone” Strategy for Iliac Vein Compression Syndrome Complicated with Arteriovenous Malformation
Authors: Yoshiya Yamamoto, Osami Kawarada, Shingo Sakamoto, Koichiro Harada, Teruo Noguchi, Hisao Ogawa, Satoshi Yasuda
Journal: Journal of the American College of Cardiology (2015)
The relationship between glycemic control and plasma vascular endothelial growth factor and endothelin-1 concentration in diabetic patients
Authors: Hiroaki Kakizawa, Mitsuyasu Itoh, Yasutoshi Itoh, Shigeo Imamura, Yoko Ishiwata, Takashi Matsumoto, Keiko Yamamoto, Taiya Kato, Yasunaga Ono, Mutsuko Nagata, Nobuki Hayakawa, Atsushi Suzuki, Yoshie Goto, Naohisa Oda
Journal: Metabolism (2004)
Essential Sciences for Clinicians
Authors: J. William Hollingsworth
Journal: JAMA (1982)

This book seems small but actually contains 500 pages, and initial perusal suggested that it was another compilation of second-year medical student "bridge" course material, of the sort called pathobiology or clinical-pathophysiologic correlates. All the contributors are from the University of Manchester in England, a fact that further suggests such an orientation to the textbook. The preface, however, indicates that it represents lectures from something that must be uniquely British: a basic science dayrelease course. Apparently the course has been going on annually in Manchester for a decade, "to ensure that the needs of doctors intending to specialize in surgery, anaesthesia, pathology, and obstetrics and gynecology are fully catered for." The catering job did not seem to meet any of the usual nutritional requirements of courses with which I am familiar in American medical pedagogy. This reviewer does not claim to have read all 21 sections, but those that I
Acetylsalicylic Acid and HL-A Antigens
Authors: A. S. RUSSELL
Journal: Annals of Internal Medicine (1972)

Letters, Comments, and Corrections1 August 1972Acetylsalicylic Acid and HL-A AntigensA. S. RUSSELL, M.D., C. R. STILLER, M.D, J. B. DOSSETER, M.D.A. S. RUSSELL, M.D.Search for more papers by this author, C. R. STILLER, M.DSearch for more papers by this author, J. B. DOSSETER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-77-2-321 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Butler and Rossen (1) recently reported a major alteration in the detected HL-A antigens of lymphocytes in three of four patients taking therapeutic acetylsalicylic acid. They suggested that this may be related to the apparent association of some HL-A antigens with systemic lupus erythematosus. In addition, it could clearly invalidate tissue typing of patients awaiting renal transplants, who may be receiving a variety of drugs; we therefore thought it important to assess this result promptly.After initial HL-A typing, with the microlymphocytotoxicity test of Terasaki, four volunteers were given acetylsalicylic acid in a dose of 3.6 to...Reference1. BUTLER W and ROSSEN R: Aspirin induced changes in histocompatibility antigen (HL-A) typing of lymphocytes. Fed Proc 31:737, 1972 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: A. S. RUSSELL, M.D.; C. R. STILLER, M.D; J. B. DOSSETER, M.D.Affiliations: Rheumatic Disease Unit Department of Medicine The University of Alberta Edmonton, Alberta, Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHL-A antigens: Association with diseaseRheumatoid Arthritis, 1970-1972JOHN S. JOHNSON, M.D., JOHN H. VAUGHAN, M.D., F.A.C.P., P. KAHLER HENCH, M.D., STEPHEN E. BLOMGREN, M.D., F.A.C.P. 1 August 1972Volume 77, Issue 2 Page: 321-322 Keywords Antigens Drugs Lupus erythematosus Lymphocytes Renal transplantation ePublished: 1 December 2008 Issue Published: 1 August 1972 PDF downloadLoading ...
Letter: Toxoplasmosis and embryopathy.
Authors: D G Fleck
Journal: BMJ (1974)

Lastly, we must point out that when hyperthermia is given together with cytotoxic drugs, as is current practice in Edinburgh, the combined treatment is associated with a definite mortality.It therefore appears to us that further controlled studies and consid_rably more data are required before hyperthermia can be accepted as having a significant role to play in cancer management.-We are, etc.,
Cytogenetic Effects of LSD 25 Therapy in Man
Authors: David A. Hungerford
Journal: JAMA (1968)

Chromosomes have been studied in leukocytes cultured from patients undergoing experimental therapy with lysergic acid diethylamide (LSD 25). Aberration frequencies prior to therapy were established for three of the four patients; these were comparable to frequencies in control subjects. Following each of three doses given intravenously (usually 200μg per dose), each patient's chromosomes were reexamined. Some increase in aberration frequency was observed, along with the appearance of some types of aberration not present before treatment. However, a return to control levels occurred in follow-up samples taken one to six months after the final dose was administered. We feel therefore that continued experimental therapy is not strongly contraindicated. On the other hand, these results can not be construed to minimize the possible cytogenetic hazards suggested by other studies concerned primarily with drug abuse.
Abstract LB-167: Prepubertal or lifetime genistein intake reduces risk of tamoxifen resistance in rats
Authors: Xiyuan Zhang, Anni Warri, Idalia M. Cruz, Katherine Cook, Robert Clarke, Leena Hilakivi-Clarke
Journal: Cancer Research (2012)

Abstract Using a preclinical model, we studied whether consumption of soy isoflavone genistein (GEN) during childhood modifies the effect of adult GEN intake on the ability of tamoxifen (TAM) to inhibit mammary tumor growth. Female rats were fed AIN93G control diet supplemented with 0 or 500 ppm genistein between postnatal days (PND) 15 and 30 (prepubertal exposure); on PND30 both groups received control diet. They were then exposed on PND50 to DMBA, and on PND57 divided to four dietary groups (n=20-40 per group) (see Table). Most rats in all four groups developed mammary tumors, but tumor latency was longer in the prepubertally GEN fed G-G (P&amp;lt;0.003) and G-C groups (p&amp;lt;0.095), compared to controls. TAM treatment (338 ppm in the diet) was started when tumor reached a size of 1.4 cm, and rats were followed for 18 weeks. The response to TAM was determined as complete response (CR), partial response (PR), or as being resistant. Adding GEN to the diet when TAM treatment started increased TAM resistance by 48%, compared to rats which were never fed GEN. Adult GEN intake (C-G group) further reduced CR. However, protein levels in the tumors of genes involved in unfolded-protein response and associated with TAM resistance (IRE1a, BIP, ATF4, BECLIN1, CHOP, ER), were not affected. Prepubertal GEN intake in G-C and G-G groups significantly increased the rate of CR and inhibited TAM resistance. Total tumor burden, which reflects the response of all tumors per rat to TAM, including those appearing during TAM treatment (de novo TAM resistant) was significantly higher in the rats which received GEN as adults, compared to the other three groups (p&amp;lt;0.001); lowest tumor burden was seen in the rats which consumed GEN both during prepuberty and as adults. Our findings suggest that prepubertally GEN fed rats, also when they continue to consume GEN in adulthood, are at low risk of developing TAM resistance. In contrast, adult only GEN consumption significantly impaired response to TAM. Mechanisms explaining these data are currently being investigated. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-167. doi:1538-7445.AM2012-LB-167
Identification of Patients at Increased Risk of First Unheralded Acute Myocardial Infarction by Electron-Beam Computed Tomography
Authors: Paolo Raggi, Tracy Q. Callister, Bruce Cooil, Zuo-Xiang He, Nicholas J. Lippolis, Donald J. Russo, Alan Zelinger, John J. Mahmarian
Journal: Circulation (2000)

Background —There is a clear relationship between absolute calcium scores (CS) and severity of coronary artery disease. However, hard coronary events have been shown to occur across all ranges of CS. Methods and Results —We conducted 2 analyses: in group A, 172 patients underwent electron-beam CT (EBCT) imaging within 60 days of suffering an unheralded myocardial infarction. In group B, 632 patients screened by EBCT were followed up for a mean of 32±7 months for the development of acute myocardial infarction or cardiac death. The mean patient age and prevalence of coronary calcification were similar in the 2 groups (53±8 versus 52±9 years and 96% each). In group B, the annualized event rate was 0.11% for subjects with CS of 0, 2.1% for CS 1 to 99, 4.1% for CS 100 to 400, and 4.8% for CS &gt;400, and only 7% of the patients had CS &gt;400. However, mild, moderate, and extensive absolute CSs were distributed similarly between patients with events in both groups (34%, 35%, and 27%, respectively, in group A and 44%, 30%, and 22% in group B). In contrast, the majority of events in both groups occurred in patients with CS &gt;75th percentile (70% in each group). Conclusions —Coronary calcium is present in most patients who suffer acute coronary events. Although the event rate is greater for patients with high absolute CSs, few patients have this degree of calcification on a screening EBCT. Conversely, the majority of events occur in individuals with high CS percentiles. Hence, CS percentiles constitute a more effective screening method to stratify individuals at risk.
Costs vs Quality in Different Types of Primary Care Settings
Authors: Barbara Starfield
Journal: JAMA (1994)

<h3>Objective.</h3> —To determine the relationship between efficiency in use of resources and quality of care provided by physicians serving as the usual source of care for patients in a state Medicaid program. <h3>Design.</h3> —Retrospective quality-of-care review of 2024 outpatient medical records of 135 providers sampled from system-wide Medicaid claims data in Maryland. <h3>Subjects.</h3> —Providers in three types of practice settings (hospital outpatient clinic, community health center, and physician's office) were stratified into three case mix—adjusted resource use groups (high, medium, and low). A sample of patients with the diagnoses of diabetes, hypertension, asthma, well-child care, or otitis media were identified from Medicaid claims forms from visits during 1988. Case mix was controlled by the application of the ambulatory care groups, a method that characterizes populations according to their burden of morbidity. <h3>Main Outcome Measures.</h3> —Nurses from the local peer review organization audited medical records using explicit criteria for quality of care in several categories: evidence of impaired access, evidence of compromised technical quality, evidence of inappropriate care, outcome of care, and several generic indicators of quality. Well-adult care was assessed for patients with the adult diagnoses. <h3>Results.</h3> —Although there were some systematic differences by type of facility in some aspects of quality of care (more access problems for patients in hospital clinics and more technical quality problems for patients in office-based practice), there were no consistent differences in quality of care overall for patients in different types of settings and no consistent relationships between cost-efficiency and quality of care. However, patients in medium-cost community health centers had the best or second best scores for most of the 21 comparisons of type of quality assessed. <h3>Conclusions.</h3> —Quality of care provided for common conditions in primary care is not associated with costs generated by providers. Policies directed toward the choice of low-cost vs high-cost providers will not necessarily lead to a deterioration in the quality of care. States can both improve quality and lower costs by consistent monitoring of programs over time. The finding of generally higher quality of care for patients in medium-cost community health centers deserves further study. (<i>JAMA</i>. 1994;272:1903-1908)