tbuckley/cabot-search huggingface dataset:
Comparison of two utility instruments, the EQ-5D and the 15D, in the critical care setting
Authors: Tarja Vainiola, Ville Pettilä, Risto P. Roine, Pirjo Räsänen, Anne M. Rissanen, Harri Sintonen
Journal: Intensive Care Medicine (2010)

Reliable measures are required for proper cost-utility analysis after critical care. No gold standard is available, but the EQ-5D health-related quality of life instrument (HRQoL) has been proposed. Our aim was to compare the EQ-5D with another utility measure, the 15D, after critical illness.A total of 929 patients filled in both the EQ-5D and 15D HRQoL instruments 6 and 12 months after treatment at an intensive care or high-dependency unit. The difference in the medians and distributions of the scores of the instruments was tested with Wilcoxon signed-rank test and their association with Spearman rank correlation. Discriminatory power was compared by the ceiling effect and agreement between the instruments regarding the direction of the minimal clinically important change in the HRQoL scores between 6 and 12 months was tested with the McNemar-Bowker test and Cohen's kappa.The utility scores produced by the instruments and their distributions were different. Agreement between the instruments was only moderate. The 15D appeared more sensitive than the EQ-5D both in terms of discriminatory power and responsiveness to clinically important change.The agreement between the two utility measures was only moderate. The choice of the instrument may have a substantial effect on cost-utility results. Our results suggest that the 15D performs well after critical illness, but further large cohort studies comparing different utility instruments in this patient population are warranted before the gold standard for utility measurement can be announced.
ABC of ENT: difficulty in swallowing.
Authors: H Ludman
Journal: BMJ (1981)

The commonest causes of acute dysphagia are inflammatory disorders and 0 (g / foreign bodies, which are discussed in other articles.When dysphagia is chronic the doctor must first identify the stage of swallowing that is ) \ 1 ;, / affected.Difficulty with the first two stages of swallowing-passing the bolus to the back of the throat and initiating the swallowing reflex-is (~l ; K.).-:caused by neuromuscular disorders and is relatively rare.Dysphagia after the initiation of the involuntary swallowing reflex is much more common and is usually caused by lesions within the laryngopharynx and oesophagus, though, rarely, the oesophageal lumen may be compressed externally or * 2Qderanged by diseases of its wall as in scleroderma.The neuromuscular / / 8 1 disorders that disrupt the first two stages of swallowing include motor v ~r3) 1 l \Waneurone disease, multiple sclerosis, paralysis of the lower bulbar nerves after posterior cranial fossa operations or infarction of the medulla, and infection of the bulbar neurones in acute anterior poliomyelitis.* ,/ \ ] development of malignant neoplasia is preceded for some years by the X *2 % formation of a fibrous postcricoid web, immediately under atrophic 111 Pr tcricoid postcricoid mucosa.In the early stages, before neoplasia develops, the PostcnricOmd patient must be treated by restoring serum iron concentrations to normal and maintaining them.Postcricoid webs may be dilated through an endoscope.
Molecular cloning of an immunodominant antigen of Onchocerca volvulus.
Authors: R Lucius, N Erondu, A Kern, J E Donelson
Journal: The Journal of Experimental Medicine (1988)

We have cloned and characterized the gene for an immunodominant antigen of O. volvulus that is recognized by the sera of 96% of patients with onchocerciasis. Its 1.2-kb mRNA constitutes 0.3% of adult worm poly(A)+ RNA and its cDNA sequence reveals that it is not a highly conserved structural protein such as actin or tubulin. Similar but not identical genes occur in the genomes of related filarie, Brugia malayi and Dirofilaria immitis. The recombinant antigen has both immunodiagnostic and immunoprophylactic significance.
Dowling-Degos disease and Kitamura's reticulate acropigmentation: support for the concept of a single disease
Authors: N.H. COX, E. LONG
Journal: British Journal of Dermatology (1991)

Journal Article Dowling‐Degos disease and Kitamura's reticulate acropigmentation: support for the concept of a single disease Get access N.H. COX, N.H. COX Department of Dermatology, Cumberland Infirmary, Carlisle, Cumbria CA2 7HY. U.K. Dr N.H.Cox. Search for other works by this author on: Oxford Academic Google Scholar E. LONG E. LONG Department of Pathology, Cumberland Infirmary, Carlisle, Cumbria CA2 7HY. U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 125, Issue 2, 1 August 1991, Pages 169–171, https://doi.org/10.1111/j.1365-2133.1991.tb06065.x Published: 01 August 1991
Screening for Down's syndrome
Authors: S Vyas
Journal: BMJ (1994)

Down's syndrome (trisomy 21) is the commonest cause of mental retardation and is also associated with major structural anomalies of the heart and gastrointestinal system and an increased risk of leukaemia. Early mortality is high, mainly due to congenital heart defects, but between infancy and 40 years of age mortality is similar to the norm. Most surviving adults go on to develop brain abnormalities that are typical of Alzheimer's disease.

At birth the incidence of the syndrome is 1.3 per 1000, with the risk rising with increasing maternal age. Until recently screening was confined to women over an arbitrary age limit of 35 to 37 and entailed amniocentesis or chorionic villus sampling. These procedures carry a small but important rate of miscarriage. On this basis, one in 20 pregnant women would be offered screening, and the risk of giving birth to a baby with Down's syndrome would be comparable to the risk of miscarriage due to the procedure. This screening programme was based on …
Variability in Bone Mass Measurement
Authors: Pekka Kannus
Journal: JAMA (1993)

<h3>To the Editor.</h3> —We read with great interest the recent article by Recker et al.<sup>1</sup>The authors concluded that gain in bone mass occurs in healthy young women during the third decade of life, with the median gain (expressed as a percentage per decade) ranging from 4.8% (forearm) to 12.5% (total body). They used median values instead of means because "the distributions for rates of change in bone mineral were not gaussian." However, a closer look at their Table 2, which presents the percentage changes in bone mineral per decade, makes the conclusion questionable. Namely, the 95% confidence intervals (CIs) for these median gains in bone mineral are extremely large, including very high negative values. For example, the CI for the 4.8% median gain in the forearm bone mineral density was from —25.7% to 25.6%, indicating that in the population the actual change can be anything from very high
Medical Education and Medical Research — An Interaction
Authors: Stanley E. Bradley
Journal: New England Journal of Medicine (1963)

THE modern era has witnessed a truly remarkable transformation in medical education and practice that has resulted directly from the brilliant successes of scientific investigation and the research approach. In the schools scholarship in medical science has proved increasingly a touchstone to academic success and a paradigm for practice. In the public view medical research and education are unquestionably inseparable, but within the profession, the new dispensation has been accepted with some reservation. No one denies the immeasurable benefits conferred by medical science or the need to keep pace with the steadily accelerating expansion of knowledge. What is in question . . .
Coexpression of C-myc and transforming growth factor alfa in the liver promotes early replicative senescence and diminishes regenerative capacity after partial hepatectomy in transgenic mice
Authors: V M Factor, M R Jensen, S S Thorgeirsson
Journal: Hepatology (1997)

We have recently shown that overexpression of c-myc and transforming growth factor alpha (TGF-alpha) in the liver of double-transgenic mice results in severe DNA damage, aberrant hepatic growth, and development of tumors at a much younger age than that observed in c-myc single-transgenic mice. We now report that double-transgenic TGF-alpha/c-myc hepatocytes rapidly lose their ability to proliferate upon mitogenic stimulation following partial hepatectomy (PH). At 4 weeks of age, the overall rate of bromodeoxyuridine (BrdU) incorporation following PH was comparable in c-myc and TGF-alpha/c-myc livers and exceeded that seen in wild-type (WT) mice. However, by 10 weeks of age, c-myc single-transgenic hepatocytes showed proliferative advantages over the WT cells, whereas TGF-alpha/c-myc double-transgenic hepatocytes had a decreased capacity to proliferate upon mitogenic stimulation. This decreased proliferative response was accompanied by a reduction in the total fraction of proliferating hepatocytes, as well as by a decline in the induction of cyclin A, cyclin B, and cdc2 gene expression. These data show that constitutive coexpression of c-myc and TGF-alpha accelerates age-related loss in the regenerative potential following PH, and suggest that early replicative senescence of differentiated hepatocytes may have a role in providing a selective growth advantage to initiated cell populations in this model.
Adjuvant Chemotherapy in Colorectal Cancer: Mournful, Hopeful Perpetual Motion Machine Heads to Dim Light at End of Tunnel
Authors: Howard W. Bruckner
Journal: JAMA (1989)

To the Editor.—  The meta-analysis of Buyse et al 1 and the accompanying editorial 2 identify a double standard that discriminates against patients with colorectal cancer. The same order of success that created enthusiasm for the adjuvant therapy of breast cancer has failed to create a similar response for analogous patients with colorectal cancer.  The medical community's history of inappropriate responses to promising colorectal cancer trials should cause serious concern. Good controlled trials describing improved survival, based on variants of the now-respectable metaanalysis for adjuvant trials 3 and the dose intensity concept for advanced disease, which doubles the frequency of objective tumor regression, 4 were incorrectly attacked as invalid and trivial. Controlled trials that found that chemotherapy enhanced radiotherapy were largely ignored for years. 5 Combined modality therapy regimens for rectal cancer are still too often disregarded in preference to radiotherapy that has failed consistently in controlled trials and now
Solitary Unicameral Cyst of the Os Calcis
Authors: Charles C. Verstandig
Journal: New England Journal of Medicine (1947)

A REVIEW of the literature reveals a surprisingly low incidence of solitary cysts of the os calcis. The most recent report is that of Copelman et al.1 Only 12 cases are recorded in the literature; of these only 4 were reported by American physicians. The patients in Copelman's cases complained of pain on standing or walking, which was also the complaint in the case presented below. The case described by Smith2 was believed to be either osteitis fibrosa or a peculiar architectural anomaly. Brailsford3 described a lesion of the os calcis that was identical in appearance with that in the . . .
TOXOPLASMOSIS AND PITYRIASIS LICHENOIDES
Authors: N. B. ZLNTKOV, A. C. ANDREEV
Journal: British Journal of Dermatology (1972)

Summary.— Eleven patients with pitryrisis lichenoides have been tested for toxoplasmosis. In 6 of them the complement fixation test, the intradermal test with toxoplasmin and the Sabin-Feldman test were repeatedly strongly positive. The same patients reported continuous occupational animal contact. Both the toxoplasma-positive patients and 3 negative patients were submitted to treatment with pyrimethamine. All 6 toxoplasma-positive patients responded very favourably: 3 were completely cured. 75 clearance of lesions was obtained in 2 and 50 in one. The 3 toxoplasma-negative patients failed to improve. The authors believe that Toxoplasma gondii infection may play an aetiological role in pityriasis lichenoides. More observations are needed in order to corroborate or to reject this supposition.
A2.9 Adherence to therapy and results of treatment in patients with the different ways of spondyloarthritis monitoring
Authors: I Gaydukova, A Akulova, A Aparkina, A Rebrov
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Spondyloarthritis (SpA) are the diseases in which monitoring of disease activity is required. The frequency of the monitoring should be decided on an individual basis depending on course of symptoms, severity and treatment of the disease [1]. <h3>Objective</h3> Is to evaluate the difference in adherence to therapy and results of treatment in patients with the different ways of SpA monitoring. <h3>Methods</h3> 196 patients with SpA were involved (ASAS criteria for axial SpA [2]). Patients with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4 without the treatment with TNFα-inhibitors (n = 168) were randomised on 3 groups. 96 patients were managed in free way by rheumatologist (group 1); 26 patients were managed actively – visited rheumatologist every 12 weeks (group 2); 46 patients were involved in the group of the remote monitoring – monitor called them every 4 weeks and collected data about treatment and disease activity (group 3). At baseline and after 1 year in all groups were collected data about treatment and disease activity (BASDAI, the Ankylosing Spondylitis Disease Activity Score – ASDAS, the patient acceptable symptom state – PASS, and other parameters recommended by ASAS). Patients were asked if they need the rheumatologist’s consultation. In statistical analyses (SPSS17) the results were considered significant for p &lt; 0.05. <h3>Results</h3> Patients of all groups were comparable in age, sex. In group 1 BASDAI at baseline was 5.32 ± 3.2, after one year – 5.17 ± 2.16, ASDAS – 3.45 ± 2.1 and 3.1 ± 1.1, respectively (p &gt; 0.05). In group 3 (remote monitoring) BASDAI at baseline was 5.32 ± 3.2, finally – 3.17 ± 2.12, ASDAS – 3.44 ± 3.1 and 2.6 ± 1.8; in group 2 BASDAI at baseline was 5.21 ± 3.0, in 1 year – 4.77 ± 2.2, ASDAS – 3.42 ± 2.9 and 2.79 ± 2.6, p &lt; 0.05 for difference between final and baseline values and between final values in groups 1 and 3. Positive PASS was achieved in the group 3 in 15 (57.69%, n = 26), in group 2 - in 4 (20%, n = 20), in group 1 – in 0 (0%) of cases. Non-steroid anti-inflammatory drugs intake recommended at baseline was changed arbitrarily by 5 (19.23%, n = 26), 15 (75%, n = 20), 93 (96.87%, n = 96) patients of groups 3, 2 and 1, respectively. After one year of follow up 3 patients of group 3 (11.5%, n = 26), 19 (95%, n = 20) of group 2 and 96 (100%) patients of group 1 considered that they need to visit rheumatologist. <h3>Conclusion</h3> Remote telephone monitoring of SpA every 4 weeks is associated with better adherence to therapy and better treatment outcomes than active monitoring of the disease every 12 weeks or monitoring in free way. <h3>References</h3> Braun J, <i>Ann Rheum Dis</i>. 2011; 70: 896–904. Rudwaleit M. <i>Ann Rheum Dis</i>. 2011 Jan; 70(1):25-31.
Transient Pretreatment With Glucocorticoid Ablates Innate Toxicity of Systemically Delivered Adenoviral Vectors Without Reducing Efficacy
Authors: Sergey S Seregin, Daniel M Appledorn, Aaron J McBride, Nathaniel J Schuldt, Yasser A Aldhamen, Tyler Voss, Junping Wei, Matthew Bujold, William Nance, Sarah Godbehere, Andrea Amalfitano
Journal: Molecular Therapy (2009)

More than 300 human clinical trials utilize recombinant adenoviruses (rAds) as a gene transfer vector, confirming that rAds continue to be of high clinical interest. A primary weakness of rAds is their known propensity to trigger an innate, proinflammatory immune response rapidly after high-dose, systemic administration. In this study, we investigated what affects that pre-emptive treatment with anti-inflammatory glucocorticoids might have upon Ad vector-triggered inflammatory immune responses. We found that a simple pretreatment regimen with Dexamethasone (DEX) can significantly reduce most Ad-induced innate immune responses. DEX prevented rAd induction of systemic cytokine/chemokine releases in a dose-dependent fashion, with higher dosages preventing rAd induction of acute thrombocytopenia, endothelial cell activation, proinflammatory gene induction, and leukocyte infiltration into transduced organs. Transient glucocorticoid pretreatment also significantly reduced rAd-induced adaptive immune responses, including a decreased induction of Ad-neutralizing antibodies (NAbs). Importantly, use of DEX did not reduce the efficacy of rAd-mediated gene transduction nor rAd-derived transgene expression. Our results demonstrate that a simple, pre-emptive and transient glucocorticoid pretreatment is a viable approach to reduce rAd-associated acute toxicities that currently limit the use of Ad vectors in systemic clinical applications.
Performance measurement and equity
Authors: Arlene S Bierman, Jocalyn P Clark
Journal: BMJ (2007)

To maximise benefits and minimise harm, equity must be built in from the start

Performance measurement is now a reality for clinicians around the world. It involves measuring and monitoring quality of care using standardised indicators. Shortcomings in the quality of care—the gap between what we know and what we do—are well documented.1 So too are inequities in access, quality, and outcomes linked to gender, ethnic origin, and socioeconomic status.2 Recognition of substandard and uneven quality of care has fuelled calls for providers to be more publicly accountable and for health systems to change. 

Interest is growing in performance measurement as a way to drive improvements in health care. In this week's BMJ , McDonald and colleagues describe an ethnographic case study in which two English general practices changed their organisation to achieve high performance scores under the quality and outcomes framework.3 The quality and outcomes framework, and other high profile measurement and reporting efforts such as those in the US Veterans' Health Administration, have met with some early success.4 5 Adding to this enthusiasm is a recent …
Furosemide Absorption Altered in Decompensated Congestive Heart Failure
Authors: M R Vasko, D B Cartwright, J P Knochel, J V Nixon, D C Brater
Journal: Annals of Internal Medicine (1985)

We assessed whether patients with decompensated congestive heart failure had altered absorption of oral furosemide. Pharmacokinetic and pharmacodynamic responses were studied in 11 patients receiving their usual oral dose of furosemide while decompensated, and after attaining normal weight. Seven patients also received 25 g of oral D-xylose to further assess intestinal absorption. A 57% decrease in lag time (p = 0.033), a 27% decrease in time to peak serum concentration (p = 0.041), and a 29% increase in the peak serum furosemide concentration (p = 0.008) were seen in compensated as compared to decompensated patients. No significant change was seen in absorption or elimination half-lives, area under the serum concentration versus time curves for furosemide, or in absorption of D-xylose. Although the pharmacodynamics of furosemide were reduced compared to normal subjects, there was little difference in the compensated and decompensated states. Our results show an alteration in furosemide absorption in decompensated congestive heart failure.
Complete response correlates with long-term progression-free and overall survival in elderly myeloma treated with novel agents: analysis of 1175 patients
Authors: Francesca Gay, Alessandra Larocca, Pierre Wijermans, Federica Cavallo, Davide Rossi, Ron Schaafsma, Mariella Genuardi, Alessandra Romano, Anna Marina Liberati, Agostina Siniscalchi, Maria T. Petrucci, Chiara Nozzoli, Francesca Patriarca, Massimo Offidani, Roberto Ria, Paola Omedè, Benedetto Bruno, Roberto Passera, Pellegrino Musto, Mario Boccadoro, Pieter Sonneveld, Antonio Palumbo
Journal: Blood (2011)
Visual and Eye Movement Functions of the Posterior Parietal Cortex
Authors: R A Andersen
Journal: Annual Review of Neuroscience (1989)

The brain's default mode network consists of discrete, bilateral and symmetrical cortical areas, in the medial and lateral parietal, medial prefrontal, and medial and lateral temporal cortices of the human, nonhuman primate, cat, and rodent brains. Its ...Read More
Innate Defense Mechanism Against Virus Infection Within the Cardiac Myocyte Requiring gp130-STAT3 Signaling
Authors: Toshitaka Yajima, Hideo Yasukawa, Eun-Seok Jeon, Dingding Xiong, Andrea Dorner, Mitsuo Iwatate, Miwako Nara, Hanbing Zhou, Daphne Summers-Torres, Masahiko Hoshijima, Kenneth R. Chien, Akihiko Yoshimura, Kirk U. Knowlton
Journal: Circulation (2006)

Little is known about innate immune mechanisms within the cardiac myocyte that determine susceptibility to enterovirus infection, an important cause of myocarditis and subsequent heart failure. Although interferon (IFN) generally plays a key role in innate immunity, ablation of IFN receptors has little or no effect on acute coxsackievirus B3 infection in the heart. Interestingly, gp130-cytokine-mediated stimulation of neonatal ventricular myocytes has a cytoprotective effect against virus infection in culture that can be inhibited by suppressors of cytokine signaling (SOCS)-3, a physiological inhibitor of gp130 signaling that does not affect IFN signaling. Therefore, we hypothesized that inhibition of gp130 signaling by SOCS3 would change cardiac myocyte susceptibility to virus infection without affecting IFN signaling.We generated cardiac-specific SOCS3 transgenic mice. Despite an intact IFN-mediated antiviral response in adult transgenic myocytes, there was a marked increase in susceptibility to viral infection in the SOCS3 transgenic mouse hearts. This indicated the presence of IFN-independent innate defense mechanisms within the cardiac myocyte. Subsequently, we demonstrated that cardiac-specific gp130-knockout mice also had increased susceptibility to viral infection. Furthermore, we demonstrated that the gp130-mediated increase in survival of infected myocytes occurred through a signal transducers and activators of transcription-3-dependent mechanism that did not affect viral replication. This was accompanied by a persistent expression of full-length dystrophin after coxsackievirus B3 infection. In addition, we found that both SOCS3 transgenic and gp130-deficient mice had a decrease in alpha-sarcoglycan.SOCS3-mediated regulation of gp130 signaling can affect susceptibility to viral infection in the heart. Increased cardiac cell survival through gp130-signal transducers and activators of transcription-3 signaling appears to play an important role in preserving nondividing cardiac myocytes until specific immune responses begin to clear the virus.