tbuckley/cabot-search huggingface dataset:
Cost effectiveness and cost utility model of public place defibrillators in improving survival after prehospital cardiopulmonary arrest
Authors: A. Walker
Journal: BMJ (2003)

<b>Objective</b> To determine the cost effectiveness and cost utility of locating defibrillators in all major airports, railway stations, and bus stations throughout Scotland. <b>Design</b> Economic modelling exercise with data from Heartstart (Scotland). Parameters used in economic model included direct costs derived for increased accident and emergency attendances, increased hospital bed days, purchase and maintenance of defibrillators, and training in their use; life years gained calculated from increased discharges from hospital and mean survival after discharge; utility (quality of life) obtained from published data. Sensitivity analyses tested the robustness of model. Future gains discounted at 1.5% a year and future costs at 6%. <b>Setting</b> Whole of Scotland. <b>Subjects</b> Records of all prehospital cardiac arrests due to presumed heart disease that occurred in a major airport, railway, or bus station between May 1991 and March 1998 and were not witnessed by ambulance or medical staff. <b>Main outcome measures</b> Observed survival to hospital admission and observed survival to discharge. Predicted survival calculated by applying observed survival in patients attended by ambulance staff within three minutes to those who waited longer. <b>Results</b> The total discounted direct costs were £18 325 a year. The cost per life year gained was £29 625 ($49 625, €;43 151) and the cost per quality adjusted life year (QALY) gained was £41 146 ($68 924, €;59 932). More widespread provision of public place defibrillators would increase these figures. <b>Conclusions</b> The cost per QALY calculated for public place defibrillators represents poorer value for money than some alternative strategies for improving survival after prehospital cardiopulmonary arrest, such as the use of other trained first responders. The figure exceeds the commonly discussed cut off levels for funding in the United Kingdom and United States of £30 000 and $50 000 per QALY, respectively.
The specific binding of Listeria monocytogenes-immune T lymphocytes to macrophages. I. Quantitation and role of H-2 gene products.
Authors: K Ziegler, E R Unanue
Journal: The Journal of Experimental Medicine (1979)

A system was developed to study the binding of Listeria monocytogenes-specific T cells to L. monocytogenes-pulsed macrophages as an analogue of the initial phase of T-cell activation: antigen recognition. Specific binding, demonstrable after a brief (1 h) contact, was quantitated by the depletion of L. monocytogenes-specific T-cell activity in the cells nonadherent to L. monocytogenes-pulsed macrophage monolayers. L. monocytogenes-specific T-cell function was measured by its ability to activate L. monocytogenes-pulsed macrophages, both to secrete a protein mitogenic for thymocytes and to effect nonspecific tumoricidal activity. These manifestations of T-cell function are known to be regulated by products of I region of the H-2 gene complex. Studies designed to determine the role of H-2 gene products in specific T-cell-macrophage binding have revealed the following. T cells bind specifically to syngeneic macrophages and poorly to allogeneic macrophages. The binding ability appears to map to the K end of the H-2 gene complex (K through I-E). At least two distinct populations of B6AF1 T cells with binding avidity for L. monocytogenes presented on parental macrophages can be identified. Finally, the binding of a given parental-reactive B6AF1 T-cell clone can be specifically inhibited by pretreatment of the antigen-pulsed B6AF1 binding macrophage with anti-H-2 (anti-Ia) antibodies reactive with the appropriate parental haplotype. These results strongly suggest that H-2 gene products play a direct role in mediating the specific binding of T cells to macrophages and imply that the antigen-dependent physical interaction between T cells and macrophages is the initial, and determining, event in some forms of H-2 gene control of immune reactivity.
Treatment of Colorectal Peritoneal Carcinomatosis With Systemic Chemotherapy: A Pooled Analysis of North Central Cancer Treatment Group Phase III Trials N9741 and N9841
Authors: Jan Franko, Qian Shi, Charles D. Goldman, Barbara A. Pockaj, Garth D. Nelson, Richard M. Goldberg, Henry C. Pitot, Axel Grothey, Steven R. Alberts, Daniel J. Sargent
Journal: Journal of Clinical Oncology (2011)

Purpose Symptoms and complications of metastatic colorectal cancer (mCRC) differ by metastatic sites. There is a paucity of prospective survival data for patients with peritoneal carcinomatosis colorectal cancer (pcCRC). We characterized outcomes of patients with pcCRC enrolled onto two prospective randomized trials of chemotherapy and contrasted that with other manifestations of mCRC (non-pcCRC). Methods A total of 2,095 patients enrolled onto two prospective randomized trials were evaluated for overall survival (OS) and progression-free survival (PFS). A Cox proportional hazard model was used to assess the adjusted associations. Results The characteristics of the pcCRC group (n = 364) were similar to those of the non-pcCRC patients in median age (63 v 61 years, P = .23), sex (57% males v 61%, P = .23), and performance status (Eastern Cooperative Oncology Group performance status 0 or 1 94% v 96%, P = .06), but differed in frequency of liver (63% v 82%, P &lt; .001) and lung metastases (27% v 34%, P = .01). Median OS (12.7 v 17.6 months, hazard ratio [HR] = 1.3; 95% CI, 1.2 to 1.5; P &lt; .001) and PFS (5.8 v 7.2 months, HR = 1.2; 95% CI, 1.1 to 1.3; P = .001) were shorter for pcCRC versus non-pcCRC. The unfavorable prognostic influence of pcCRC remained after adjusting for age, PS, liver metastases, and other factors (OS: HR = 1.3, P &lt; .001; PFS: HR = 1.1, P = .02). Infusional fluorouracil, leucovorin, and oxaliplatin was superior to irinotecan, leucovorin, and fluorouracil as a first-line treatment among pcCRC (HR for OS = 0.62, P = .005) and non-pcCRC patients (HR = 0.66, P &lt; .001). Conclusion pcCRC is associated with a significantly shorter OS and PFS as compared with other manifestations of mCRC. Future trials for mCRC should consider stratifying on the basis of pcCRC status.
Volume ejected in early systole. A sensitive index of left ventricular performance in coronary artery disease.
Authors: L L Johnson, K Ellis, D Schmidt, M B Weiss, P J Cannon
Journal: Circulation (1975)

Indices based on early systolic ejection rates are theoretically more sensitive to ventricular performance than indices based on the entire systolic ejection (SE) period (mean ejection phase indices-MEPI): mean systolic ejection rate (MSER), mean normalized systolic ejection rate (MNSER) and mean velocity of circumferential fiber shortening (MVcf). The volume ejected in early systole is an indicator of the early rate of ejection. Accordingly, ventricular volume changes were determined by ventriculographic analysis for each thrid of SE in ml/sec (SER), as normalized systolic ejection rate (NSER), and as percent of stroke volume (PSV). In ten normal controls all these indices were higher in the first third compared to the other thirds of SE. Seven patients with diffuse ventricular disease had depressed values in the first third of SE. Despite "normal ventriculograms and normal MEPI, eight patients with left anterior descending coronary artery stenoses (greater than 60%) also had definitely depressed ejection indices during first third of systole. Detailed wall motion analysis in this group showed anteroapical hypokinesis isolated to the first third of SE. These data show that indices based on early SER are more sensitive than MEPI (MVcf, MNSER) for detecting abnormalities in ventricular performance in coronary artery disease;
Mode of regulation of natural killer cell activity by interferon
Authors: N Minato, L Reid, H Cantor, P Lengyel, BR Bloom
Journal: The Journal of Experimental Medicine (1980)

Whereas xenogeneic tumors such as baby hamster kidney or HeLa cells grow in nude mice, the same cells persistently infected with a variety of viruses are rejected. Spleen cells from normal nude mice were found to be induced to produce interferon and to exert natural killer (NK) activity on virus persistently infected (PI) tumor cells, and not on uninfected parental cells in vitro. The phenotype of the interferon-producing cells and the NK effector cells was found to be the same namely, Qa 5(+), Ly 5(+), ganglio-N- tetraosylceramide, with 35 percent of the NK cells also expressing Thy 1.2. NK activity against virus PI tumor cell lines could be nonspecifically augmented both in vivo and in vitro by prior contact with virus PI tumor cells. It was unambiguously demonstrated with chemically homogeneous mouse interferon that interferon, and not a contaminant, was responsible for the augmentation of NK activity in vitro. Studies on the mode of interferon action in augmenting NK activity revealed that the target cell for interferon action was serologically distinct from the NK effector cell. Anti-Ly 5 + complement (C)-treated spleen cells were depleted of NK activity and the ability to produce interferon, but, upon incubation with interferon for 1-3 h, regained both NK activity and susceptibility to anti-Ly 5 + C. Treatment with anti-Qa 5 + C eliminated NK activity, which could not be restored by the addition of interferon. We conclude that interferon produced by Ly 5(+) cells in response to virus PI tumor cells acts on Ly 5(-) precursor cells and induces their differentiation into functional Ly 5(+) NK effector cells.
A lipoprotein characterizing obstructive jaundice. II. Isolation and partial characterization of the protein moieties of low density lipoproteins
Authors: D. Seidel, P. Alaupovic, R. H. Furman, W. J. McConathy
Journal: Journal of Clinical Investigation (1970)

The plasma low density lipoproteins (LDL) in biliary obstruction are characterized almost exclusively by the presence of the immunochemically distinct lipoprotein families, lipoprotein B (LP-B) and lipoprotein X (LP-X). It is suggested that LP-X, with its uniquely high content of unesterified cholesterol and phospholipid, is primarily responsible for the unusual lipid composition of LDL and the abnormal plasma lipid composition in obstructive jaundice. To show their protein moieties, we isolated LP-X and LP-B from the LDL in plasma obtained from patients with obstructive jaundice. A separation procedure was employed which combines ultracentrifugation, heparin precipitation, and ethanol fractionation. Whereas LP-B was characterized by the presence of apolipoprotein B (ApoB), intact LP-X contained a protein moiety of unique composition consisting of a mixture of albumin (approximately 40%) and the specific apolipoprotein, ApoX (60%). These two protein moieties were separated by preparative ultracentrifugation at d 1.21 g/ml of a solution of partially delipidized LP-X. LP-X thus comprises an albumin-lipoprotein complex in which the masked antigenic site of albumin can be revealed by partial or total delipidization. Apolipoprotein X, the characteristic nonalbumin protein moiety of intact or partially delipidized LP-X, was immunochemically different from ApoA, ApoB, albumin, gamma-globulins, and other serum proteins. The results of analytical ultracentrifugation and the immunochemical and electrophoretic properties of ApoX indicated it to be a complex protein consisting possibly of several nonidentical polypeptides. ApoX was characterized by its amino acid composition, and by serine and threonine as the major N-terminal and alanine as the major C-terminal amino acids. It has been suggested that ApoX is similar to, if not identical with, apolipoprotein C.
Reprogramming the Chromatin Landscape: Interplay of the Estrogen and Glucocorticoid Receptors at the Genomic Level
Authors: Tina B. Miranda, Ty C. Voss, Myong-Hee Sung, Songjoon Baek, Sam John, Mary Hawkins, Lars Grøntved, R. Louis Schiltz, Gordon L. Hager
Journal: Cancer Research (2013)

Abstract Cross-talk between estrogen receptors (ER) and glucocorticoid receptors (GR) has been shown to contribute to the development and progression of breast cancer. Importantly, the ER and GR status in breast cancer cells is a significant factor in determining the outcome of the disease. However, mechanistic details defining the cellular interactions between ER and GR are poorly understood. We investigated genome-wide binding profiles for ER and GR upon coactivation and characterized the status of the chromatin landscape. We describe a novel mechanism dictating the molecular interplay between ER and GR. Upon induction, GR modulates access of ER to specific sites in the genome by reorganization of the chromatin configuration for these elements. Binding to these newly accessible sites occurs either by direct recognition of ER response elements or indirectly through interactions with other factors. The unveiling of this mechanism is important for understanding cellular interactions between ER and GR and may represent a general mechanism for cross-talk between nuclear receptors in human disease. Cancer Res; 73(16); 5130–9. ©2013 AACR.
Health effects of daily indoor nitrogen dioxide exposure in people with asthma
Authors: B.J. Smith, M. Nitschke, L.S. Pilotto, R.E. Ruffin, D.L. Pisaniello, K.J. Willson
Journal: European Respiratory Journal (2000)

Household gas appliances produce nitrogen dioxide (NO2), which may be associated with an increase in symptoms in asthmatics. The relationship between indoor NO2 exposure, and respiratory symptoms in people with asthma was evaluated. Self-reported asthmatics (n=125) wore lapel badges that measured NO2 daily over 6 weeks at home. Outdoor pollutants, spores and meteorological parameters were measured daily, in addition to smoking status and demographic factors. Seven asthma symptoms were recorded in diaries, for analysis by same day and also with 1 day lag exposures, using a generalized estimating equation. Significant interactions were demonstrated between NO2 at age &lt; or =14 yrs, with respect to the symptoms of chest tightness on the same day (odds ratio (OR): 1.29, 95% confidence interval (CI): 1.16-1.43) and with a 1 day lag (OR: 1.29, 95% CI: 1.14-1.46), breathlessness on exertion with a 1 day lag (OR: 1.13, 95% CI: 1.00-1.28), daytime asthma attacks on the same day (OR: 1.13, 95% CI: 1.02-1.26) night asthma attacks on the same day (OR: 1.16, 95% CI:1.03-1.30) and with a 1 day lag (OR: 1.15, 95% CI; 1.03-1.29) after adjustment for potential confounders. A significant interaction between NO2 and age 35-49 yrs was demonstrated for coughs with a 1 day lag (OR: 1.15, 95% CI: 1.01-1.31). Daily personal exposures to NO2 are associated with asthmatic symptoms in children.
Effect of pleural effusion on respiratory mechanics, and the influence of deep inflation, in dogs
Authors: G Dechman, J Sato, JH Bates
Journal: European Respiratory Journal (1993)

We wished to study how pleural effusion affects dynamic mechanics of the lung and the chest wall. We also determined if these changes could be reversed by deep lung inflations. Pleural effusion was produced by saline infusion into the pleural space. During the infusion and over the following 2 hours, dynamic elastance and resistance of the lungs, the chest wall and the whole respiratory system were recorded. Dynamic elastance and resistance of the lung increased significantly during fluid loading and were partially, and only transiently, reversed by deep inflations. Dynamic elastance and resistance of the chest wall were little affected by these procedures. Thus, pleural effusion can have significant effects on dynamic elastance and resistance of the respiratory system (ERS, RRS). The transient nature of the change in lung parameters after deep inflation suggests that therapies based on periodic lung inflations may be of little benefit to patients with this condition.
Bronchioloalveolar carcinoma: computed tomography findings
Authors: JP Trigaux, PA Gevenois, L Goncette, F Gouat, A Schumaker, P Weynants
Journal: European Respiratory Journal (1996)

The aim of the present study was to investigate the appearance of bronchioloalveolar lung carcinoma on computed tomography (CT) scans, and to determine the frequency of signs suggestive of this diagnosis. CT features of 42 cases with pathologically proven bronchioloalveolar carcinoma were retrospectively analysed for pattern, size, location and secondary signs suggesting the diagnosis. Bronchioloalveolar carcinoma had one of the following patterns: solitary nodule or mass (16), lobar consolidation (10), multilobar consolidations (13) and diffuse nodules (3). The 16 solitary nodules or masses ranged in size from 2.0 to 9.4 cm (mean +/- SD 3.75 +/- 1.7 cm). Eleven of the 16 nodules or masses were peripheral and five were central: Eight of the 16 tumours had pleural tags, seven had spiculated margins, and three had bubblelike lucencies. The consolidations were peripherally distributed in 13 out of 23 cases; cystic airspaces were observed in 19 out of 23 consolidations; bulging of interlobar fissures in 8 out of 23; and the angiogram sign in 7 out of 23. In conclusion, computed tomography findings of bronchioloalveolar carcinoma have a wide spectrum, showing typically a peripheral nodule or consolidation. Computed tomography has a role in the diagnosis of nodular localized versus other forms, with subsequent therapeutic and prognostic implications.
Cooperation between <i>Pik3ca</i> and p53 Mutations in Mouse Mammary Tumor Formation
Authors: Jessica R. Adams, Keli Xu, Jeff C. Liu, Natalia M. Ruiz Agamez, Amanda J. Loch, Ruth G. Wong, Wei Wang, Katherine L. Wright, Timothy F. Lane, Eldad Zacksenhaus, Sean E. Egan
Journal: Cancer Research (2011)

Abstract PIK3CA, which codes for the p110α catalytic subunit of phosphatidylinositol 3-kinase, is one of the most frequently mutated genes in human breast cancer. Here, we describe a mouse model for PIK3CA-induced breast cancer by using the ROSA26 (R26) knock-in system, in which targeted Pik3ca alleles can be activated through transgenic expression of Cre recombinase. We mated Pik3caH1047R and Pik3cawt knock-in lines with MMTV-Cre transgenics, which express Cre in mammary epithelium. Starting at approximately 5 months of age, female R26-Pik3caH1047R;MMTV-Cre mice, but not control R26-Pik3cawt;MMTV-Cre mice, developed mammary tumors, as well as lymphoid and skin malignancies. R26-Pik3caH1047R;MMTV-Cre mammary tumors were typically either adenosquamous carcinoma or adenomyoepithelioma. As p53 is the most commonly mutated gene in breast cancer, we tested for genetic interaction between Pik3caH1047R and p53 loss-of-function mutations in R26-Pik3caH1047R;p53loxP/+;MMTV-Cre mice. This led to decreased survival of double-mutant animals, which developed lymphoma and mammary tumors with rapid kinetics. Mammary tumors that formed in p53loxP/+;MMTV-Cre conditional mutants were either poorly differentiated adenocarcinoma or spindle cell/EMT, whereas R26-Pik3caH1047R;p53loxP/+;MMTV-Cre mammary tumors were mostly adenosquamous carcinoma or spindle cell/EMT indicating that double-mutant mice develop a distinct spectrum of mammary tumors. Thus, an oncogenic variant of PIK3CA implicated in multiple human breast cancer subtypes can induce a very diverse spectrum of mammary tumors in mice. Furthermore, Pik3caH1047R shows cooperation with p53, which altered the specific tumors that formed. Thus, the two most frequently mutated genes in human breast cancer show cooperation in mammary tumor formation. Cancer Res; 71(7); 2706–17. ©2011 AACR.
Use of the conjugate of disulphated ursodeoxycholic acid with p-aminobenzoic acid for the detection of intestinal bacteria.
Authors: M Takahashi, T Konishi, Y Maeda, Y Matsugu, F Akazawa, T Eto, M Okajima, K Uchida, Y Masaoka, K Okada
Journal: Gut (1993)

<b>Confocal laser endomicroscopy imaging of lepidic adenocarcinomas is feasible. This technique should be further evaluated as a realtime guiding tool during virtual electromagnetic navigation bronchoscopy for ground-glass opacities</b>https://bit.ly/3uzTcMU
The future for the field of sports medicine
Authors: C Martin
Journal: British Journal of Sports Medicine (2001)

The football club doctor system EDITOR,-I read with interest the paper by Waddington et al 1 highlighting the inadequacies of the football club doctor system in Britain.This paper confirms the situation that many people already knew to exist.Advertisements for club doctors are rarely published in medical journals, doctors normally being appointed on a "who you know" basis.It is also particularly disappointing that, at a time when the specialty of sports and exercise medicine is being established in this country, the majority of doctors working with professional footballers have no qualifications or little experience in the specialty.However, this is not confined to football clubs and probably also applies to rugby clubs and many other sporting associations.One aspect not mentioned in the paper is medical litigation.It is to be hoped that doctors involved with football clubs have arranged medical defence cover, because, if a situation arises in which a player's sporting career is threatened by medical mismanagement and the doctor involved has no professionally recognised sports medicine qualification, he or she could be found guilty of medical negligence.With the amount of money involved in professional football, this could lead to dire consequences for the medical career of the practitioner involved.From a report commissioned by the Football League on the Hillsborough tragedy, the concept of the "crowd doctor" was introduced, meaning that any doctor involved in the medical care of the crowd at a football stadium would be required to possess at least the Diploma in Immediate Medical Care. 2 Before that, the situation was similar to that of the present club doctor system, and few doctors held any recognisable qualifications or training in medical emergencies and resuscitation.A similar recommendation by sports medicine authorities is required to enhance the quality of service provided to football clubs and increase the stature of the specialty.However, it is not a one sided situation.Football clubs must realise the importance of a medical team in looking after their prime assets, the players.Advertising of jobs in medical journals, insisting on experience and qualifications, adequate remuneration, and the provision of job descriptions and contracts should all be implemented.By working together to improve the current situation, a service can be provided in which both professional football players and the medical profession can have confidence.
Phase II Trial of Sorafenib in Patients With Metastatic Breast Cancer Previously Exposed to Anthracyclines or Taxanes: North Central Cancer Treatment Group and Mayo Clinic Trial N0336
Authors: Alvaro Moreno-Aspitia, Roscoe F. Morton, David W. Hillman, Wilma L. Lingle, Kendrith M. Rowland, Martin Wiesenfeld, Patrick J. Flynn, Tom R. Fitch, Edith A. Perez
Journal: Journal of Clinical Oncology (2008)

We conducted a cooperative group phase II study to assess antitumor activity and toxicity of sorafenib in patients with metastatic breast cancer (MBC) who had received prior treatment for their disease.
Race Differences in Long-Term Diabetes Management in an HMO
Authors: Celeste B. Hart
Journal: Diabetes Care (2006)

Adams et al. (1) examined longitudinal differences in HbA1c (A1C) between black and white diabetic members of an HMO. They found a small, but persistent, increase in A1C values in black subjects; however, there is an important omission in their study. There is no indication that the authors considered the potential effect of the presence of variant hemoglobins in the study subjects. Eight percent …