tbuckley/cabot-search huggingface dataset:
Screening Adults for Pre-Diabetes and Diabetes May Be Cost-Saving
Authors: Ranee Chatterjee, K.M. Venkat Narayan, Joseph Lipscomb, Lawrence S. Phillips
Journal: Diabetes Care (2010)

OBJECTIVE The economic costs of hyperglycemia are substantial. Early detection would allow management to prevent or delay development of diabetes and diabetes-related complications. We investigated the economic justification for screening for pre-diabetes/diabetes. RESEARCH DESIGN AND METHODS We projected health system and societal costs over 3 years for 1,259 adults, comparing costs associated with five opportunistic screening tests. All subjects had measurements taken of random plasma and capillary glucose (RPG and RCG), A1C, and plasma and capillary glucose 1 h after a 50 g oral glucose challenge test without prior fasting (GCT-pl and GCT-cap), and a subsequent diagnostic 75 g oral glucose tolerance test (OGTT). RESULTS Assuming 70% specificity screening cutoffs, Medicare costs for testing, retail costs for generic metformin, and costs for false negatives as 10% of reported costs associated with pre-diabetes/diabetes, health system costs over 3 years for the different screening tests would be GCT-pl $180,635; GCT-cap $182,980; RPG $182,780; RCG $186,090; and A1C $192,261; all lower than costs for no screening, which would be $205,966. Under varying assumptions, projected health system costs for screening and treatment with metformin or lifestyle modification would be less than costs for no screening as long as disease prevalence is at least 70% of that of our population and false-negative costs are at least 10% of disease costs. Societal costs would equal or exceed costs of no screening depending on treatment type. CONCLUSIONS Screening appears to be cost-saving compared to no screening from a health system perspective, and potentially cost-neutral from a societal perspective. These data suggest that strong consideration should be given to screening—with preventive management—and that use of GCTs may be cost-effective.
The Alpine Cure: Les Avants, a Winter Resort
Authors: M. H. Feeny
Journal: BMJ (1887)

tfieatment" at these places, are skating, sleighing, tobog-ganing`&nd snow-shoeing, besides the ordinary exercise of walking, sitting-out in the open air and in shelters, sketching, reading, etc. Indoor a'muse- ments are the usual ones of music, dancing, amateur and other con- certs, theatricals, and various social gatherings.In the Eugadine a day may bee 'spent thas: At 8.30 or 9 A.M., breakfast ;as soon as the sun appears on the snow a walk is taken, or the skates put on an4d the ice-rink visited.Some sit in shelters or on the ice watchaing the skaters, protected from the glaring sun by smoked-glass spectacles and parasols.About 12 30 P.m. lunch is taken.Those desirous of getting as much open air exposure as possible have their lunch sent to .them on the ice or in the wooden sheds constructed for.these purposes'After lunch the skates can be changed for' the toboggan, or a sleighdrive taken to some villAge or place of interest.A snow-shoeing party may be got up, and a small excursion made to the inaccessible nooks of the woods and side valleys, all of which are rendered easy of ex- ploration by the Canadian snow-shoe.Picnics, too, are dften under- taken in this way or by sleigh, combine;d with -a irnLn down a slo;ping.Dnration ~~~Diminution Duain Weight Weight i.Rmrs NTo.Condition of Patient.4ge'. of Gained.Lost, rate.Residence, ' '1s.lbs.'lbs. 1 Congestion of right apex .264j knonths 13 _ None Remark-able improvement.2 Congestion of right apex 29 1 4i ,, 2t -None Great improvemzut.3 Consolidation and catarrh of right lung after pleurisy 24 A ,, --16 Improvedc 4 Consolidation of upper lobe of left lung 49 7' >. _ .1 None Slight improvernetit. 5 Cavity of left apex communicating with the pleura, after empyema and excision of portions of Jthree ribs; sinus still open 28 4A *, 4 _ 4 General improvement.
Trimethoprim-induced linear fixed drug eruption
Authors: E. ÖZkaya-Bayazit, C. Baykal
Journal: British Journal of Dermatology (1997)

Journal Article Trimethoprim‐induced linear fixed drug eruption Get access E. ÖZkaya‐Bayazit, E. ÖZkaya‐Bayazit I.Ü. Istanbul Tip Fakültesi, Dermatoloji Anabilim Dali, 34390 Çapa‐Istanbul, Turkey Email: bayazit@turk.net Search for other works by this author on: Oxford Academic Google Scholar C. Baykal C. Baykal I.Ü. Istanbul Tip Fakültesi, Dermatoloji Anabilim Dali, 34390 Çapa‐Istanbul, Turkey Email: bayazit@turk.net Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 137, Issue 6, 1 December 1997, Pages 1028–1029, https://doi.org/10.1111/j.1365-2133.1997.tb01584.x Published: 01 December 1997
Autoregulatory Mechanisms of Phosphorylation of Checkpoint Kinase 1
Authors: Jingna Wang, Xiangzi Han, Youwei Zhang
Journal: Cancer Research (2012)

Abstract Checkpoint kinase 1 (Chk1), a serine/threonine protein kinase, is centrally involved in cell-cycle checkpoints and cellular response to DNA damage. Phosphorylation of Chk1 at 2 Ser/Gln (SQ) sites, Ser-317 and Ser-345, by the upstream kinase ATR is critical for checkpoint activation. However, the precise molecular mechanisms controlling Chk1 phosphorylation and subsequent checkpoint activation are not well understood. Here, we report unique autoregulatory mechanisms that control protein phosphorylation of human Chk1, as well as checkpoint activation and cell viability. Phosphorylation of Ser-317 is required, but not sufficient, for maximal phosphorylation at Ser-345. The N-terminal kinase domain of Chk1 prevents Chk1 phosphorylation at the C-terminus by ATR in the absence of DNA damage. Loss of the inhibitory effect imposed by the N-terminus causes constitutive phosphorylation of Chk1 by ATR under normal growth conditions, which in turn triggers artificial checkpoints that suppress the S-phase progression. Furthermore, two point mutations were identified that rendered Chk1 constitutively active, and expression of the constitutively active mutant form of Chk1 inhibited cancer cell proliferation. Our findings therefore reveal unique regulatory mechanisms of Chk1 phosphorylation and suggest that expression of constitutively active Chk1 may represent a novel strategy to suppress tumor growth. Cancer Res; 72(15); 3786–94. ©2012 AACR.
The prevalence of positive reactions in the atopy patch test with aeroallergens and food allergens in subjects with atopic eczema: a European multicenter study
Authors: U. Darsow, J. Laifaoui, K. Kerschenlohr, A. Wollenberg, B. Przybilla, B. Wuthrich, S. Borelli, F. Giusti, S. Seidenari, K. Drzimalla, D. Simon, R. Disch, S. Borelli, A. C. A. Devillers, A. P. Oranje, L. De Raeve, J.-P. Hachem, C. Dangoisse, A. Blondeel, M. Song, K. Breuer, A. Wulf, T. Werfel, S. Roul, A. Taieb, S. Bolhaar, C. Bruijnzeel-Koomen, M. Bronnimann, L. R. Braathen, A. Didierlaurent, C. Andre, J. Ring
Journal: Allergy (2004)

Background: The atopy patch test (APT) was proposed to evaluate IgE-mediated sensitizations in patients with atopic eczema (AE). Objective: The prevalence and agreement with clinical history and specific IgE (sIgE) of positive APT reactions was investigated in six European countries using a standardized method. Methods: A total of 314 patients with AE in remission were tested in 12 study centers on clinically uninvolved, non-abraded back skin with 200 index of reactivity (IR)/g of house dust mite Dermatophagoides pteronyssinus, cat dander, grass, and birch pollen allergen extracts with defined major allergen contents in petrolatum. Extracts of egg white, celery and wheat flour with defined protein content were also patch tested. APT values were evaluated at 24, 48, and 72 h according to the European Task Force on Atopic Dermatitis (ETFAD) guidelines. In addition, skin-prick test (SPT) and sIgE and a detailed history on allergen-induced eczema flares were obtained. Results: Previous eczema flares, after contact with specific allergens, were reported in 1% (celery) to 34% (D. pteronyssinus) of patients. The frequency of clear-cut positive APT reactions ranged from 39% with D. pteronyssinus to 9% with celery. All ETFAD intensities occured after 48 and 72 h. Positive SPT (16–57%) and elevated sIgE (19–59%) results were more frequent. Clear-cut positive APT with all SPT and sIgE testing negative was seen in 7% of the patients, whereas a positive APT without SPT or sIgE for the respective allergen was seen in 17% of the patients. APT, SPT and sIgE results showed significant agreement with history for grass pollen and egg white (two-sided Pr > |Z| ≤ 0.01). In addition, SPT and sIgE showed significant agreement with history for the other aeroallergens. With regard to clinical history, the APT had a higher specificity (64–91% depending on the allergen) than SPT (50–85%) or sIgE (52–85%). Positive APT were associated with longer duration of eczema flares and showed regional differences. In 10 non-atopic controls, no positive APT reaction was seen. Conclusion: Aeroallergens and food allergens are able to elicit eczematous skin reactions after epicutaneous application. As no gold standard for aeroallergen provocation in AE exists, the relevance of aeroallergens for AE flares may be evaluated by APT in addition to SPT and sIgE. The data may contribute to the international standardization of the APT.
Pharmacological Management to Reduce Exacerbations in Adults With Asthma
Authors: Don D. Sin, Jonathan Man, Heather Sharpe, Wen Qi Gan, S. F. Paul Man
Journal: JAMA (2004)

Over the last 2 decades, many new pharmacological agents have been introduced to reduce the growing morbidity associated with asthma, but the long-term effects of these agents on exacerbations are unclear.To systematically review and quantitatively synthesize the long-term effects of inhaled corticosteroids, long-acting beta2 agonists, leukotriene pathway modifiers/receptor antagonists, and anti-IgE therapies on clinical outcomes and particular clinically relevant exacerbations in adult patients with chronic asthma.MEDLINE, EMBASE, and Cochrane databases were searched to identify relevant randomized controlled trials and systematic reviews published from January 1, 1980, to April 30, 2004. We identified additional studies by searching bibliographies of retrieved articles and contacting experts in the field.Included trials were double-blind, had follow-up periods of at least 3 months, and contained data on exacerbations and/or forced expiratory volume in 1 second. The effects of interventions were compared with placebo, short-acting beta2 agonists, or each other.Inhaled corticosteroids were most effective, reducing exacerbations by nearly 55% compared with placebo or short-acting beta2 agonists (relative risk [RR], 0.46; 95% confidence interval [CI], 0.34-0.62; P<.001 for heterogeneity). Compared with placebo, the use of long-acting beta2 agonists was associated with 25% fewer exacerbations (RR, 0.75; 95% CI, 0.64-0.88; P =.43 for heterogeneity); when added to inhaled corticosteroids, there was a 26% reduction above that achieved by steroid monotherapy (RR, 0.74; 95% CI, 0.61-0.91; P =.07 for heterogeneity). Combination therapy was associated with fewer exacerbations than was increasing the dose of inhaled corticosteroids (RR, 0.86; 95% CI, 0.76-0.96; P =.65 for heterogeneity). Compared with placebo, leukotriene modifiers/receptor antagonists reduced exacerbations by 41% (RR, 0.59; 95% CI, 0.49-0.71; P =.44 for heterogeneity) but were less effective than inhaled corticosteroids (RR, 1.72; 95% CI, 1.28-2.31; P =.91 for heterogeneity). Use of monoclonal anti-IgE antibodies with concomitant inhaled corticosteroid therapy was associated with 45% fewer exacerbations (RR, 0.55; 95% CI, 0.45-0.66; P =.15 for heterogeneity).Inhaled corticosteroids are the single most effective therapy for adult patients with asthma. However, for those unable or unwilling to take corticosteroids, the use of leukotriene modifiers/receptor agonists appears reasonable. Long-acting beta2 agonists may be added to corticosteroids for those who remain symptomatic despite low-dose steroid therapy. Anti-IgE therapy may be considered as adjunctive therapy for young adults with asthma who have clear evidence of allergies and elevated serum IgE levels.
Abstract 5456: Potential role of nitric oxide in chromium-induced lung carcinogenesis
Authors: Thomas A. Forbes, Lauren Hopkins, Brent Schneider, Lindsay Lazarus, David Leitenberg, Stephanie Constant, Arnold Schwartz, Steven Patierno, Susan Ceryak
Journal: Cancer Research (2012)

Abstract Certain hexavalent chromium [Cr(VI)] compounds are well established human respiratory toxins and carcinogens of occupational and environmental relevance. Our recent studies have shown that intranasal (IN) exposure of Balb/c mice to particulate zinc Cr(VI) compounds leads to pronounced innate inflammation in the lung, which we postulate plays a significant role in pulmonary tumorigenesis. Nitric oxide (NO) has been shown to be induced via inflammatory response mediators, and has been implicated in the progression of different cancers, including lung. Moreover, NO-induced tumor invasiveness has been correlated with enhanced matrix metalloproteinase (MMP) expression in lung tumor cell lines. Of particular relevance to the present study is the finding that in vitro exposure of human lung cells to Cr(VI) in culture led to increased NO production. The aim of the present study was to explore the role of NO in chromium-induced lung tumorigenesis. BALB/c mice received weekly IN delivery of either saline or 10 ug particulate basic zinc chromate, which is an intermediately water soluble chromate typically encountered in mining/chromate production facilities and which is also present as an environmental atmospheric contaminant in urban areas surrounding ferrochrome production facilities. After 9 weeks, immune cells, cytokines, NO, MMPs and pathologic features of lung injury and inflammation were measured in airway lavage fluid and lung tissue, at both 24h after the final Cr(VI) dose, as well as 1 week later. As previously shown, repetitive Cr(VI) exposure induced a neutrophilic inflammatory airway response 24h after treatment. Neutrophils were subsequently replaced by increasing numbers of macrophages 1 week after treatment. Peribronchiolar inflammation was observed in chromate-exposed mice, and was accompanied by a 100-fold increase in pro-MMP9 release into the airways. Notably, airway NO was significantly increased ∼ 1.9 fold in Cr(VI)-exposed mice as compared to their saline-treated counterparts at both time points following final exposure. Moreover, immunoreactivity of induced nitric oxide synthase (iNOS) was markedly increased in airways exposed to Cr(VI), with staining localized to infiltrating immune cells. In conclusion, repetitive exposure to particulate chromate induces an inflammatory environment in the lung, accompanied by enhanced NO production, which we postulate may promote Cr(VI) carcinogenesis. Supported by NIH grants CA107972 and ES017334 to SC and ES017307 to SRP. 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 5456. doi:1538-7445.AM2012-5456
Exaggerated hyperkalaemia in acute myeloid leukaemia.
Authors: D O Ho-Yen
Journal: BMJ (1981)

people with this high genetic risk of renal cell carcinoma may not confer any practical therapeutic advantage as only bilateral neph- rectomy would reduce the risk to zero.However, the diagnosis of this predisposition to renal cell carcinoma could be made in the fetus by cytogenetic analysis of amniotic cells, thus allowing decisions to be made concerning termination of the pregnancy and elimination of this chromosomal aberration and its consequences for the pedigree.
Commentary: The government has mismanaged cases of HIV infected health care workers
Authors: C. Swinhoe
Journal: BMJ (1996)

Pell and colleagues' account of their three cases raises several issues: firstly, the risk to patients; secondly, the management of a case of a health care worker becoming infected; and, thirdly, the duty of a health care worker whose lifestyle puts himself or herself at risk of HIV infection.

Quantifying the risk to patients of treatment by an infected health care worker …
A Comparative Evaluation of Culdoscopy and Laparoscopy in Gynecology
Authors: E. Kastendieck, M. Ghani, E. Majewski
Journal: Endoscopy (1975)

213 culdoscopies and 325 laparoscopies were analysed with regard to indication, the quality of endoscopic view, the possibility of performing additional operations, the extent to which complications occur and the extent to which diagnostic failure or errors take place. Indications calling for laparoscopy had a wider range. Examination per vaginam is impossible in instances involving fixed uterine retroversion, vaginal agenesis, condition after hysterectomy and tumors in the cul-de-sac. Additional operations are further indications for laparoscopy. Laparoscopy also gives a better view of the pelvic organs and also makes it possible to check other organs of the abdominal cavity. The view was limited half as often in laparoscopy as in culdoscopy. As a result diagnostic failures or errors occurred to a greater extent in culdoscopy. This was proved by subsequent laparotomies. Adhesions were, in both methods, the main cause of a limited view. They occurred mainly in patients who had had previous gynecological operations. In laparoscopy the view into the pelvic cavity was obstructed mainly by omental adhesions. In culdoscopy a limited view was caused by inflammatory or by postoperative adhesions at the adnexa or the cul-de-sac. Complications occurred to the same extent in both methods. (1.9% of all culdoscopies and 1.8% of all laparoscopies led to complications.) There were no lethal complications. Guldoscopy is the quicker operation, requires less equipment and is the easier and safer technique when dealing with obesity. It also gives perhaps better results than does laparoscopy, when omental adhesions are present. Laparoscopy has the advantage that it provides a better view of the pelvic cavity, makes it easier to perform additional operations, has a wider range of indications, provides better conditions for anaesthesia and requires less personnel than does culdoscopy. Abdominal examination is, therefore, advisable. Investigation per vaginam is an important additional method in cases involving obesity or postoperative adhesions.
Fibrous Dysplasia of Bone and Primary Hyperparathyroidism
Authors: ULRICH EHRIG
Journal: Annals of Internal Medicine (1972)

Two patients with monostotic fibrous dysplasia had hyperparathyroidism. One of the patients had frank hypercalcemia; the second patient had hyperparathyroidism with near normal serum calcium values. Both had chief cell adenomas at surgery. Removal of the parathyroid adenomas did not appear to influence the course of fibrous dysplasia. Associated hyperparathyroidism may occur in 5% to 10% of patients with fibrous dysplasia. A similar association has been observed in patients with neurofibromatosis and parathyroid adenomas. The possible mechanisms responsible for the association of hyperparathyroidism and fibrous dysplasia are discussed.
Mouse α-fetoprotein specific DNA-based immunotherapy of hepatocellular carcinoma to tumor regression in mice
Authors: M. Geissler, C.F. Grimm, D. Ortmann, S. Michalak, L. Mohr, T.U. Krohne, S. Meckel, S. Eisele, J. Encke, H.E. Blum
Journal: Journal of Hepatology (2000)
Prevention of Preterm Birth
Authors: Jay Iams
Journal: New England Journal of Medicine (1998)

Advances in the care of preterm infants have blunted what otherwise should have been a constant public outcry about the static rate of preterm birth, the leading cause of perinatal and infant morbidity and mortality in the United States. Why has the problem of prematurity not been solved? For 50 years the reply has been, to quote Eastman, “Only when the factors underlying prematurity are completely understood can any progress toward prevention be made.”1 Despite abundant new knowledge about the factors that underlie preterm birth, 8 to 9 percent of births still occur before 37 weeks' gestation, and the 1 . . .
Gastric exocrine "failure" in critically ill patients: incidence and associated features
Authors: V A Stannard, A Hutchinson, D L Morris, A Byrne
Journal: BMJ (1988)

Following the observation that many critically ill patients cannot maintain their gastric juice pH below 4 without treatment a study was performed to measure the gastric juice pH in such patients and relate it to other clinical data. The case notes of 64 patients who had been admitted to the intensive care unit and taken part in two trials of ranitidine treatment were reviewed. During those trials gastric juice was aspirated hourly and the pH and volume measured. In this study the values recorded during a six hour untreated control phase were used. Data on age, diagnosis, treatment, outcome, episodes of hypoxia, episodes of hypotension, and use of inotropic drugs were also reviewed. Full data were available for 61 patients: 27 had a mean baseline pH of greater than 5 during the control phase and 34 a mean baseline pH of less than 5. Significantly more of those with a high pH suffered hypotension (21/27 v 13/34) and received inotropic drugs (16/27 v 8/34). These findings suggest that hypotension in critically ill patients adversely affects gastric exocrine function; prophylaxis with drugs that can improve gastric mucosal blood flow may be more effective than with antacids.
Pleuropneumonia-like Organisms
Authors: R. Hare
Journal: BMJ (1962)

<h3>Objective</h3> To investigate how Danish citizens evaluate four moral claims related to abortion issues, regarding the moral status of the fetus, autonomy, harm and possible negative consequences of allowing abortion and to explore the association between moral beliefs and attitudes towards abortion for different reasons and at different gestational weeks. <h3>Method</h3> A questionnaire was mailed to 1000 Danish citizens aged 18–45 years randomly drawn from the Danish Central Personal Register. A signiﬁcance level of 0.05 was used for statistical estimations. <h3>Results</h3> Four hundred and sixty-two responded to at least one moral claim. Two hundred and fifty-eight responded to all four claims without using the option ‘neither agree nor disagree’ and were classified as ‘morally engaged responders’. A majority of these had a pro-abortion moral. The general relationship between moral beliefs and attitudes towards abortion was morally sound. Being ‘morally engaged’ did not increase the likelihood of reaching moral judgement on whether requests for abortion should be permitted. Education, religion and parenthood were statistically associated with the investigated issues. <h3>Discussion</h3> The direction of causality is discussed with reference to both moral reasoning and moral intuitions. The relationship between normative social behaviour and abortion attitudes is considered.