tbuckley/cabot-search huggingface dataset:
Association Between Availability of a Price Transparency Tool and Outpatient Spending
Authors: Sunita Desai, Laura A. Hatfield, Andrew L. Hicks, Michael E. Chernew, Ateev Mehrotra
Journal: JAMA (2016)

There is increasing interest in using price transparency tools to decrease health care spending.To measure the association between offering a health care price transparency tool and outpatient spending.Two large employers represented in multiple market areas across the United States offered an online health care price transparency tool to their employees. One introduced it on April 1, 2011, and the other on January 1, 2012. The tool provided users information about what they would pay out of pocket for services from different physicians, hospitals, or other clinical sites. Using a matched difference-in-differences design, outpatient spending among employees offered the tool (n=148,655) was compared with that among employees from other companies not offered the tool (n=295,983) in the year before and after it was introduced.Availability of a price transparency tool.Annual outpatient spending, outpatient out-of-pocket spending, use rates of the tool.Mean outpatient spending among employees offered the tool was $2021 in the year before the tool was introduced and $2233 in the year after. In comparison, among controls, mean outpatient spending changed from $1985 to $2138. After adjusting for demographic and health characteristics, being offered the tool was associated with a mean $59 (95% CI, $25-$93) increase in outpatient spending. Mean outpatient out-of-pocket spending among those offered the tool was $507 in the year before introduction of the tool and $555 in the year after. Among the comparison group, mean outpatient out-of-pocket spending changed from $490 to $520. Being offered the price transparency tool was associated with a mean $18 (95% CI, $12-$25) increase in out-of-pocket spending after adjusting for relevant factors. In the first 12 months, 10% of employees who were offered the tool used it at least once.Among employees at 2 large companies, offering a price transparency tool was not associated with lower health care spending. The tool was used by only a small percentage of eligible employees.
Hemophagocytic Lymphohistiocytosis Associated with NK Cell Dysfunction and Disseminated Herpesvirus Infection in GATA2 Deficiency/Monomac Syndrome
Authors: Michael A. Spinner, Camila Odio, Katherine R. Calvo, Amy P Hsu, Christa S. Zerbe, Jennifer Cuellar-Rodriguez, Jennifer P. Ker, Charles J. Stoudenmire, Oluwole Fadare, Arunima Ghosh, Emily M. Mace, Jordan S. Orange, Dennis D. Hickstein, Steven M. Holland
Journal: Blood (2014)
Prognostic factors in uterine sarcoma: A clinicopathologic and immunohistochemical (IHC) study of 30 cases
Authors: F. Al-Safi, A. Al Kushi, S. Ameeri, N. Al Merri
Journal: Journal of Clinical Oncology (2007)

16071 Background: The objective of this study is to examine the prognostic relevance of traditional clinical, pathological and IHC features of uterine sarcoma (US). Methods: The study population consisted of thirty cases of US treated at our institute. Twenty- two cases are HGS (11 leiomyosarcoma, and 11 carcinosarcoma) and eight cases are LGS (5 mullerian adenosarcoma and 3 low grade endometrial stromal sarcoma). Clinical and pathological data including patient's age, parity, menopausal status, tumor cell type, lymphovascular invasion, nuclear grade, stage and mitotic index. Serial sections were immunostained with antibodies for p53, bcl-2, estrogen receptor (ER), Her2 and c-kit. The clinicopathological and IHC features were analysed by using Kaplan-Meier method for constructing survival curves, and log-rank statistic for survival curves comparison. Multivariate analysis was performed using Cox regression modeling. Results: The mean follow-up period of patients is 32 months (range 1- 120). Twelve (55%) patients with HGS died of the disease and none of the LGS group. In the HGS group, stage (p=0.01), myometrial invasion in early stage tumor (p=0.04), and lymphovascular invasion (p=0.043) were significant predicators of patient outcome in univariate analysis. Similarly, tumor cell type, ER, p53 and bcl-2 expression showed statistical significant correlation with tumor-specific survival (p=0.0039, p=0.001, p=0.03, and p=0.04, respectively). ER and bcl-2 expression were associated with better outcome and the opposite for p53 expression. In a multivariate analysis, only the tumor stage and cell type had independent statistical significance (p=0.04, and p=0.035, respectively). Overexpression of p53 and Her2 were observed in 40% and 60% of carcinosracomas respectively and not seen in any of the other tumors. The c-kit immunostain showed focal and weak staining in 40% of carcinosarcoma and only in 33% of leiomyosarcoma. None of LGS had this marker. The ER was expressed only in the LGS group. Conclusions: This study demonstrates that stage and tumor cell type are the most important prognostic indicators of patient outcome in US. IHC markers such as ER, p53, c-kit, and Her2 can be useful ancillary tools to discriminate between HGS and LGS in difficult cases. No significant financial relationships to disclose.
Parasitic helminth infections and the control of human allergic and autoimmune disorders
Authors: R.M. Maizels
Journal: Clinical Microbiology and Infection (2016)

The profile of global health today presents a striking reciprocal distribution between parasitic diseases in many of the world's lower-income countries, and ever-increasing levels of inflammatory disorders such as allergy, autoimmunity and inflammatory bowel diseases in the more affluent societies. Attention is particularly focused on helminth worm parasites, which are associated with protection from allergy and inflammation in both epidemiologic and laboratory settings. One mechanistic explanation of this is that helminths drive the regulatory arm of the immune system, abrogating the ability of the host to expel the parasites, while also dampening reactivity to many bystander specificities. Interest has therefore heightened into whether helminth parasites, or their products, hold therapeutic potential for immunologic disorders of the developed world. In this narrative review, progress across a range of trials is discussed, together with prospects for isolating individual molecular mediators from helminths that may offer defined new therapies for inflammatory conditions.
Abstract 16936: Vitamin D Supplementation Lowers Blood Pressure and Improves Control Rates in a Predominantly African American Hypertensive Cohort
Authors: Brian A Ference, Samar A Nasser, Phillip D Levy, Shiling Zhang, Manmeet Singh, Lowell A Hedquist, John M Flack
Journal: Circulation (2011)

Background: Vitamin D deficiency, highly prevalent in African Americans, has been associated with elevated blood pressure (BP) and hypertension in epidemiological studies. However, vitamin D supplementation has not been shown to consistently lower BP. Methods: Six hundred forty eight hypertensive patients with vitamin D blood levels and BP above JNC goal levels, with at least one follow-up visit, were followed a median of 10.6 months (5 clinic visits). At baseline, mean age was 56.5 years, mean BP 156/92 mm Hg, (mean of 22.3/8.8 mm Hg above JNC BP goal), mean vitamin D level 17.6 ng/ml; 67.2% were women and 87.7% were African American. Mixed effects general linear models were used to estimate longitudinal BP changes. Cox proportional hazards models were used to estimate the impact of vitamin D supplementation on first attainment of JNC goal BP. Repeated event proportional hazards analysis was utilized to determine the incremental (per 1 category higher of vitamin D supplementation) likelihood of attainment of JNC goal BP during follow-up. Models were adjusted for age, sex, initial BP level, baseline vitamin D level (&lt; 15, &gt; 15 ng/ml), antihypertensive drug therapeutic intensity, and vitamin D supplementation (0 = no vitamin D, 1 = &lt; 2000 IU/d, 2 = &gt; 2000 IU/d); the latter two variables were entered into the models as time-varying covariates. Results: Relative to no vitamin D supplementation, longitudinal SBP change was - 3.9 (p = 0.0089) and - 10.7 mm Hg (p = 0.0003) greater at incrementally higher vitamin D supplementation; DBP change was -2.5 (p = 0.0042) and - 7.0 mm Hg (p &lt; 0.0001) greater. Per 1 category higher vitamin D supplementation, there was no effect on first attainment of goal SBP HR = 1.15, 95% CI 0.94 - 1.39. However, first time DBP control was favorably impacted - HR = 1.28, 95% CI 1.09 - 1.50. Repeated events proportional hazards analysis showed greater BP control per 1 category higher vitamin D supplementation (SBP goal HR = 1.32, 95% CI 1.21 - 1.44; DBP goal HR =1.30, 95% CI 1.20 - 1.41). Conclusion: Vitamin D supplementation appears to lower BP and improve BP control rates independent of the intensity of antihypertensive treatment in a dose-dependent manner. The BP lowering effect is, however, most pronounced at &gt; 2000 IU/d.
Seven procedures account for 80% of emergency general surgery operations, deaths, and complications, US study finds
Authors: Michael McCarthy
Journal: BMJ (2016)

Each year more than half a million patients in the United States undergo urgent or emergency general surgery at an annual cost of more than $6bn (£4.1bn; €5.2bn), but just seven procedures account for 80% of these operations and related deaths, surgical complications, and costs, a new study has found.

The seven most costly emergency general surgery procedures identified by the study were partial colectomy, small bowel resection, cholecystectomy, operative management of peptic ulcer disease, lysis of peritoneal adhesions, appendectomy, and laparotomy. “These first 7 procedure groups accounted for 80.0% of all procedures, 80.3% of all deaths, 78.9% of all …
MOPP after two decades.
Authors: S A Rosenberg
Journal: Journal of Clinical Oncology (1986)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1986.4.9.1289 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3755754 MOPP after two decades. S A RosenbergxS A RosenbergSearch for articles by this author https://doi.org/10.1200/JCO.1986.4.9.1289 PDF "MOPP after two decades.." Journal of Clinical Oncology, 4(9), pp. 1289–1290© 1986 by American Society of Clinical Oncology
Attenuating effect of PS341 for MDR1 in multidrug resistant breast cancer
Authors: T. Fujita, H. Doihara, K. Washio, D. Takabatake, H. Takahashi, S. Yoshitomi, Y. Ishibe, Y. Ogasawara, N. Shimizu
Journal: Journal of Clinical Oncology (2005)

2087 Background: Over-expression of P-gp has been associated with the resistance to a wide range of anti-cancer drugs. Doxorubicin and paclitaxel are substrate of this transporter system and have important role for the various human malignancies, especially in the treatment of breast cancer. Here we demonstrate that proteasome inhibitors could remarkably enhance drug sensitivities for MDR1 overexpressed multidrug resistant breast cancer and analyzed the estimated pathways involved in it Methods: Drug sensitive MCF7 and multidrug resistant MCF7/ADR (characterized by overexpression of P-gp) human breast cancer cell lines were used as an experimental model. And two proteasome inhibitors;PS341 and MG132 were used as treatment drugs. Results: PS341 and MG132, proteasome inhibitors, reduced the degree of the multidrug resistance in MCF7/ADR cells. This phenomenon was accompanied by a decrease in the IC50 value of doxorubicin and paclitaxel from 55.9±3.46 to 0.60±0.08 uM, and from 17.61±1.77 to 0.59±0.12 uM. The IC50 value of sensitive cells for doxorubicin and paclitaxel were about 0.42 uM and 0.83 uM. The effect of PS341 and MG132 on MCF7/ADR cells was associated with significantly decreased both protein and gene levels of P-gp expression. Moreover, regard with the expression of possible signal transduction pathways of MAP kinase related to the activation of mdr1, proteasome inhibitors did significantly influence the activation of these proteins. Western blot analysis revealed that 24hr exposure of multidrug resistant MCF7/ADR cells with proteasome inhibitors did remarkably decreased levels of cytosolic NF-kappaB, ERK1/2, c-Jun and p-c-Jun. Conclusions: Proteasome inhibitors (especially PS341) attenuate the resistance of MCF7/ADR cells for P-gp substrate drugs of doxorubicin and paclitaxel. Several proteins are supposed to be associated with the re-sensitization of the cells to conventional cytotoxic drugs, although decreased activity of P-gp is at least involved in the proteasome inhibitor-related re-sensitization. And influence with signal transduction pathways, which have been reported to be associated with the regulation of P-gp, might be contributed to the re-sensitization brought by proteasome inhibitors. No significant financial relationships to disclose.
Erratum: Corrigendum: The ciliopathy-associated CPLANE proteins direct basal body recruitment of intraflagellar transport machinery
Authors: Michinori Toriyama, Chanjae Lee, S Paige Taylor, Ivan Duran, Daniel H Cohn, Ange-Line Bruel, Jacqueline M Tabler, Kevin Drew, Marcus R Kelly, Sukyoung Kim, Tae Joo Park, Daniela A Braun, Ghislaine Pierquin, Armand Biver, Kerstin Wagner, Anne Malfroot, Inusha Panigrahi, Brunella Franco, Hadeel Adel Al-lami, Yvonne Yeung, Yeon Ja Choi, Yannis Duffourd, Laurence Faivre, Jean-Baptiste Rivière, Jiang Chen, Karen J Liu, Edward M Marcotte, Friedhelm Hildebrandt, Christel Thauvin-Robinet, Deborah Krakow, Peter K Jackson, John B Wallingford
Journal: Nature Genetics (2016)
Annual Report on the Results of Treatment in Carcinoma of the Uterus and Vagina, Vol. 13 (Statements of Results Obtained in 1948 to 1957). H. F. Kottmeier (ed.). Published under the Patronage of the International Federation of Gynecology and Obstetrics, Stockholm, Sweden, 1966. 372 pp.
Authors: Marvin A. Schneiderman
Journal: Cancer Research (1967)
Our future: a Lancet commission on adolescent health and wellbeing
Authors: George C Patton, Susan M Sawyer, John S Santelli, David A Ross, Rima Afifi, Nicholas B Allen, Monika Arora, Peter Azzopardi, Wendy Baldwin, Christopher Bonell, Ritsuko Kakuma, Elissa Kennedy, Jaqueline Mahon, Terry McGovern, Ali H Mokdad, Vikram Patel, Suzanne Petroni, Nicola Reavley, Kikelomo Taiwo, Jane Waldfogel, Dakshitha Wickremarathne, Carmen Barroso, Zulfiqar Bhutta, Adesegun O Fatusi, Amitabh Mattoo, Judith Diers, Jing Fang, Jane Ferguson, Frederick Ssewamala, Russell M Viner
Journal: The Lancet (2016)
Dementia patients in care homes get a second class NHS service, charity says
Authors: Ingrid Torjesen
Journal: BMJ (2016)

Many of the 280 000 people with dementia living in care homes are getting a second rate service from the NHS and having to pay for the privilege, an investigation has found.1

The investigation, which is part of the Fix Dementia Care campaign, was conducted jointly by Alzheimer’s Society and Care England. It involved a survey of over 285 care home managers in England, as well as the testimonies of carers of people with dementia living in care homes.

Almost half of care home managers surveyed said that the NHS wasn’t providing residents with dementia adequate and timely access to vital services such as physiotherapy, continence, …
Ten years of inpatient programs for alcoholic patients
Authors: R A Moore
Journal: American Journal of Psychiatry (1977)

The author reviews the progress made during the past decade in making acute hospital facilities available to the alcoholic patient. He also describes the advances that have been made in the level of care provided by increasingly available detoxification centers. However, he finds that the needs of chronically and permanently disabled alcoholic individuals are still not being met by the mental health system.
Diagnostic value of glutamate with 2-hydroxyglutarate in magnetic resonance spectroscopy for<i>IDH1</i>mutant glioma
Authors: Hiroaki Nagashima, Kazuhiro Tanaka, Takashi Sasayama, Yasuhiro Irino, Naoko Sato, Yukiko Takeuchi, Katsusuke Kyotani, Akitake Mukasa, Katsu Mizukawa, Junichi Sakata, Yusuke Yamamoto, Kohkichi Hosoda, Tomoo Itoh, Ryohei Sasaki, Eiji Kohmura
Journal: Neuro-Oncology (2016)

Mutations in the isocitrate dehydrogenase 1 (IDH1) gene that are frequently observed in low-grade glioma are strongly associated with the accumulation of 2-hydroxyglutarate (2HG), which is a valuable diagnostic and prognostic biomarker of IDH1 mutant glioma. However, conventional MR spectroscopy (MRS)–based noninvasive detection of 2HG is challenging. In this study, we aimed to determine the additional value of other metabolites in predicting IDH1 mutations with conventional MRS. Forty-seven patients with glioma underwent conventional single voxel short echo time MRS prior to surgery. A stereotactic navigation-guided operation was performed to resect tumor tissues in the center of the MRS voxel. MRS-based measurements of metabolites were validated with gas chromatography–mass spectrometry. We also conducted integrated analyses of glioma cell lines and clinical samples to examine the other metabolite levels and molecular findings in IDH1 mutant gliomas. A metabolomic analysis demonstrated higher levels of 2HG in IDH1 mutant glioma cells and surgical tissues. Interestingly, glutamate levels were significantly decreased in IDH1 mutant gliomas. Through an analysis of metabolic enzyme genes in glutamine pathways, it was shown that the expressions of branched-chain amino acid transaminase 1 were reduced and glutamate dehydrogenase levels were elevated in IDH1 mutant gliomas. Conventional MRS detection of glutamate and 2HG resulted in a high diagnostic accuracy (sensitivity 72%, specificity 96%) for IDH1 mutant glioma. IDH1 mutations alter glutamate metabolism. Combining glutamate levels optimizes the 2HG-based monitoring of IDH1 mutations via MRS and represents a reliable clinical application for diagnosing IDH1 mutant gliomas.
Effects of Isoproterenol on Mammary Gland Tumors Induced by &lt;italic&gt;N&lt;/italic&gt;-Nitroso-&lt;italic&gt;N&lt;/italic&gt;-Methylurea and Salivary Gland Tumors Induced by 7,12-Dimethylbenz[&lt;italic&gt;a&lt;/italic&gt;]anthracene&lt;xref ref-type="fn" rid="fn2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="fn3"&gt;3&lt;/xref&gt;
Authors: T Barka
Journal: JNCI Journal of the National Cancer Institute (1982)

The effect of isoproterenol (IPR) (20 mg/kg, twice per wk) on mammary gland tumors induced by N-nitroso-N-methylurea (NMU) (40 or 77 mg/kg, iv) was studied. Within 18 weeks 50--60% of the noninbred female Sprague-Dawley rats that received a single injection of NMU developed carcinomas of the mammary gland. In addition, a malignant lymphoma was observed. There was no change in the incidence of tumors if NMU was administered at the time that DNA synthesis was stimulated in the submandibular glands by two injections of IPR (160 mg/kg, ip) given 24 hours apart. Tumors of unequivocal salivary gland origin were not observed, irrespective of whether NMU was given at the peak of stimulated DNA synthesis or without pretreatment with IPR. However, in 10% of the tumor-bearing rats, tumors were found in the neck region. These tumors could be separated from the salivary glands by dissection and were of mammary gland origin. Chronic treatment with IPR caused marked enlargements of the parotid and submandibular glands with hypertrophy of the acinar cells and degeneration of the duct system. Such a treatment caused a high death rate but no change in the incidence of the tumors. The effect of chronic IPR treatment (10 mg/kg twice per wk or 5 mg/kg three times per wk) on submandibular gland tumors induced by 7,12-dimethylbenz[a]anthracene (DMBA) was also studied. With the intraglandular injection of 100 or 200 micrograms of DMBA, the incidences of squamous cell carcinomas in the glands were 6.8 and 38.6%, respectively. Chronic administration of IPR after the instillation of DMBA caused a high death rate but no statistically significant change in the incidence of salivary gland tumors.
Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007–2011: Case-Control Study
Authors: Kelly K. Baker, Ciara E. O’Reilly, Myron M. Levine, Karen L. Kotloff, James P. Nataro, Tracy L. Ayers, Tamer H. Farag, Dilruba Nasrin, William C. Blackwelder, Yukun Wu, Pedro L. Alonso, Robert F. Breiman, Richard Omore, Abu S. G. Faruque, Sumon Kumar Das, Shahnawaz Ahmed, Debasish Saha, Samba O. Sow, Dipika Sur, Anita K. M. Zaidi, Fahreen Quadri, Eric D. Mintz
Journal: PLoS Medicine (2016)

Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal risk in young children, respectively. Little is known about whether the number of households sharing a sanitation facility affects a child's risk of diarrhea. The objective of this study was to describe sanitation and hygiene access across the Global Enteric Multicenter Study (GEMS) sites in Africa and South Asia and to assess sanitation and hygiene exposures, including shared sanitation access, as risk factors for moderate-to-severe diarrhea (MSD) in children less than 5 y of age.The GEMS matched case-control study was conducted between December 1, 2007, and March 3, 2011, at seven sites in Basse, The Gambia; Nyanza Province, Kenya; Bamako, Mali; Manhiça, Mozambique; Mirzapur, Bangladesh; Kolkata, India; and Karachi, Pakistan. Data was collected for 8,592 case children aged <5 y old experiencing MSD and for 12,390 asymptomatic age, gender, and neighborhood-matched controls. An MSD case was defined as a child with a diarrheal illness <7 d duration comprising ≥3 loose stools in 24 h and ≥1 of the following: sunken eyes, skin tenting, dysentery, intravenous (IV) rehydration, or hospitalization. Site-specific conditional logistic regression models were used to explore the association between sanitation and hygiene exposures and MSD. Most households at six sites (>93%) had access to a sanitation facility, while 70% of households in rural Kenya had access to a facility. Practicing open defecation was a risk factor for MSD in children <5 y old in Kenya. Sharing sanitation facilities with 1-2 or ≥3 other households was a statistically significant risk factor for MSD in Kenya, Mali, Mozambique, and Pakistan. Among those with a designated handwashing area near the home, soap or ash were more frequently observed at control households and were significantly protective against MSD in Mozambique and India.This study suggests that sharing a sanitation facility with just one to two other households can increase the risk of MSD in young children, compared to using a private facility. Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of MSD in children. These findings support the current World Health Organization/ United Nations Children's Emergency Fund (UNICEF) system that categorizes shared sanitation as unimproved.