tbuckley/cabot-search huggingface dataset:
S73 Healthcare costs associated with lung cancer diagnosed at emergency hospitalisation
Authors: MPT Kennedy, PS Hall, MEJ Callister
Journal: Thorax (2015)

<h3>Introduction</h3> The diagnosis of lung cancer at emergency presentation with hospital admission is a poor patient experience and is likely to incur significant cost. Reducing the proportion of patients diagnosed by this route has been identified as a priority by policy makers. The full health-economic impact of this route to diagnosis is not known. <h3>Aim</h3> To measure the excess healthcare costs attributable to emergency hospital admission in patients diagnosed with lung cancer. <h3>Methods</h3> Retrospective review of an electronic database of lung cancer patients from 2008–2013. Secondary care costs were acquired from the local NHS Patient Level Information and Costing System (PLICS) with adjustment for inflation. To adjust for survival differences, secondary analyses looked at average costs incurred only while patients remained alive. <h3>Results</h3> 3,274 consecutively diagnosed patients were included. Mean one and twelve-month costs were £2,400 (95% CI £2,313-£2,493) and £10,009 (95% CI £9,725-£10,285). One month mean costs for patients with emergency admission were higher than for those diagnosed by other routes (£3,499 (95% CI £3,332-£3,667) vs £1,899 (95% CI £1,810-£1,999)). Twelve month mean costs for emergency admissions were lower than for other routes (£8,123 (95% CI £7,704-£8,552) vs £10,870 (95% CI £10,511-£11,211)), but this analysis is heavily influenced by excess mortality within the emergency admission group (1 year survival 14% vs 50% respectively). Mean costs for survival, only considering costs per patient alive in that month, are shown in Figure 1. Emergency admission was associated with increased mean alive costs compared to other routes at both one month (£3,499 vs £1,899) and 12 months (£15,063 vs £13,233). Adjusted costs accrued between one and twelve months following diagnosis were similar between the two groups (£11,565 vs £11,334). <h3>Conclusion</h3> Patients diagnosed with lung cancer during an emergency admission incur greater healthcare costs during the first month following diagnosis. Lower longer term costs in these patients seem to be entirely due to the lower survival rates in this poor prognosis group. In addition to improving patient experience and outcome, strategies to increase earlier diagnosis of lung cancer may reduce the additional healthcare costs associated with this route to diagnosis.
A Cluster of Legionella Sternal-Wound Infections Due to Postoperative Topical Exposure to Contaminated Tap Water
Authors: Philip W. Lowry, Rosalind J. Blankenship, Wilma Gridley, Nancy J. Troup, Lucy S. Tompkins
Journal: New England Journal of Medicine (1991)

LEGIONELLA is generally regarded as a pulmonary pathogen and has been responsible for numerous outbreaks of pneumonia in both community and hospital settings.1 2 3 4 5 6 7 Although isolated cases of extrapulmonary legionella infection have been reported,8 9 10 11 12 13 14 15 16 17 nosocomial clusters are very rare. We have previously described seven cases of legionella endocarditis occurring at Stanford University Medical Center,18 but the route of transmission was never established. We now describe three cases of sternal-wound infection with legionella, together with evidence that the infections may have arisen after direct inoculation of legionella into fresh sternal wounds during bathing of patients or dressing changes. Methods Background Since 1985, . . .
Pornographic imagery and prevalence of paraphilia
Authors: P E Dietz, B Evans
Journal: American Journal of Psychiatry (1982)

The authors classified 1,760 heterosexual pornographic magazines according to the imagery of the cover photographs. Covers depicting only a woman posed alone predominated in 1970 but constituted only 10.7% of the covers in 1981. Bondage and domination imagery was the most prevalent nonormative imagery and was featured in 17.2% of the magazines. Smaller proportions of material were devoted to group sexual activity (9.8%), tranvestism and transsexualism (4.4%), and other nonnormative imagery. The authors suggest that pornographic imagery is an unobtrusive measure of the relative prevalence of those paraphilias associated with preferences for specific types of visual imagery and for which better data are lacking.
Recognition of Bla g T Cell Antigens Varies As a Function of Allergic Asthma Versus Rhinitis
Authors: Alessandro Sette, Myles B. Dillon, Véronique M. Schulten, Carla Oseroff, Laura Dullanty, April Frazier, Xavier Belles, Maria-Dolors Piulachs, Cynthia Visness, Leonard B. Bacharier, Gordon R. Bloomberg, Paula J. Busse, John Sidney, Bjoern Peters
Journal: Journal of Allergy and Clinical Immunology (2016)
Cardiac anthracycline risk: Prognostic value of troponin I (TnI) and B-natriuretic peptide (BNP)
Authors: A. S. Bertolini, A. Croce, O. Fusco, E. Berardi, F. Malugani, M. Fiumanò, P. Deligiannis, E. Menatti
Journal: Journal of Clinical Oncology (2009)

e20726 Background: In patients with cancer who are undergoing to high-dose chemotherapy (HDC), even minimal elevation of TnI is associated with late left ventricular dysfunction. A TnI increase soon after HDC is a strong predictor of poor cardiological outcome. BNP elevation seems to have same prognostic value. Patients treated by standard Anthracycline-based chemotherapy (ADM-CT) doses could not have benefit from TnI/BNP evaluation; on the contrary the method could adsorb too much resources and may not be rational. Methods: To evaluate cardio toxicity trend we studied TnI and BNP in plasma samples of 28 breast cancer pts (female, adjuvant setting, mean age 50), treated with ADM-CT. The samples were detected before (a) one hour (b) and ten days (c) after each course. TnI was considered positive for values ≥ 0.044 ng/mL; BNP for values ≥ 100pg/mL .Comparison between TnI and BNP values were made with the ANOVA method. A probability value &lt; 0.05 was considered statistically significant. Each patient was followed also with LVEF (basal &amp; 3 months after). Results: At present we observed 135 events, mean TnI: (a) 0,00672, (b) 0,006512, (c) 0,005791; BNP (a) 33.8, (b) 36.4, (c) 35.2. We performed 405 detections for both tests; costs: 8.707$ BNP, 10.327$ TnI. No significant difference in test values has been observed between the different time periods. We can't indicate a trend referring to therapy or a particular time period. No patients had LVEF variation. Conclusions: TnI and BNP release pattern after ADM-CT doesn't identify patients at different risk of cardiac events. The program appears useful for HDC treatments, while in normal chemotherapy the data are ongoing and expensive. No significant financial relationships to disclose.
Recent Advances in the Treatment of Non-Hodgkin’s Lymphomas
Authors: Jeremy S Abramson, Andrew D Zelenetz
Journal: Journal of the National Comprehensive Cancer Network (2013)

Non-Hodgkin’s lymphomas (NHL) represent a diverse set of diseases, with different treatment pathways based on the stage and type of hematologic cancer. In their presentation at the NCCN 18th Annual Conference, Dr. Jeremy Abramson and Dr. Andrew D. Zelenetz discuss 3 specific B-cell NHLs: follicular lymphoma, mantle cell lymphoma, and chronic lymphocytic leukemia. They provided an overview of the treatment strategies for patients with these hematologic malignancies, and offered highlights from recent clinical trials supporting these recommendations.
Markers of Neoplastic Transformation in Epithelial Cell Lines Derived From Human Carcinomas
Authors: C. J. Marshall, L. M. Franks, A. W. Carbonell
Journal: JNCI Journal of the National Cancer Institute (1977)

Journal Article Markers of Neoplastic Transformation in Epithelial Cell Lines Derived From Human Carcinomas Get access C. J. Marshall, C. J. Marshall Search for other works by this author on: Oxford Academic PubMed Google Scholar L. M. Franks, L. M. Franks Search for other works by this author on: Oxford Academic PubMed Google Scholar A. W. Carbonell A. W. Carbonell Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 58, Issue 6, June 1977, Pages 1743–1751, https://doi.org/10.1093/jnci/58.6.1743 Published: 01 June 1977 Article history Received: 25 August 1976 Accepted: 11 November 1976 Published: 01 June 1977
Antibodies against Recombinant Human Erythropoietin in a Patient with Erythropoietin-Resistant Anemia
Authors: Ramón Peces, Miguel de la Torre, Roberto Alcázar, José M. Urra
Journal: New England Journal of Medicine (1996)

To the Editor: Casadevall et al. (March 7 issue)1 described the development of autoantibodies against erythropoietin in a patient with pure red-cell aplasia. The authors report the presence of IgG ...
Variability in response definition and confirmation practices in randomized phase II and III trials in colorectal cancer
Authors: K. Y. Chung, L. B. Saltz, L. H. Schwartz
Journal: Journal of Clinical Oncology (2004)

3594 Background: Tumor response, as measured by several adopted criteria such as WHO or RECIST, is a common clinical trial endpoint. Investigator-reported response rates (RR) are frequently found to be different (higher or lower) from externally reviewed RR. External review of response has recently become an expected practice. Methodologies used in independent review, however, may vary considerably. Methods: We reviewed the methodology of response verification in all randomized studies in colorectal cancer published in The Journal of Clinical Oncology (JCO). Results: A search using the JCO website search engine for the key words “colorectal” and “randomized” in the title identified 49 manuscripts. Dates of publication ranged between January of 1987 and April 2003. One meta-analysis, 3 trials lacking radiologic endpoints, and 2 breast cancer trials were excluded. 15 of the remaining 43 studies (35%) report external verification of RR. Thus, 65% of randomized colorectal studies published in JCO thus far report only investigator-determined RR. Within the 15 studies with external review, wide variation was found in review methodology. Often the exact details of methodology are lacking. We have identified 5 different review strategies, the results of which may not be inter-comparable: 1) confirmation of responses only; 2&3) review of all films by one radiologist unblinded, or blinded to investigator's determination; 4&5) review of responses by an independent panel with or without access to clinical data. Method of scan comparison (i.e., whether baseline and follow-up scans are individually interpreted or compared together) is virtually never reported. Conclusion: Independent review of response data from randomized studies in CRC is a relatively recent practice. Methodology is variable and often poorly defined in manuscripts. The standards for rigor in confirmation are intensifying with time, making comparison of RR with historical controls less valid. Clinical trials manuscripts should specify the response verification strategies employed. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Bristol-Myers Squibb; Genentech; Pfizer; Roche Pfizer
Soundings: What crisis?
Authors: Colin Douglas
Journal: BMJ (2000)

Here in Auchendreich we take pride in being prepared. We believe our emergency planning systems are second to none: a happy legacy of our frontline role in the cold war, when a top secret bunker, 200 feet beneath a local pig farm, offered shelter to key members of the Scottish civil and military establishment for as long as the nuclear holocaust might necessitate it.

Recent years have not blunted our preparedness for whatever may befall. As usual, the planning group for the annual winter bed crisis held its first meeting in June, just as the impact of last year's crisis was beginning to recede.

July and August meetings are traditionally devoted to analysis of the previous crisis and full discussion of the lessons learnt. In the event both had to be cancelled.

As usual, the September meeting was reasonably well attended, but as a result of a major trust reconfiguration exercise there was a distressing lack of continuity among the various representatives. And, sadly, the main business of the meeting—a controversial proposal from the board to merge the functions of the Twenty Fifth Annual Winter Bed Crisis Planning Group with that of the Millennium Planning Group—led to an acrimonious and inconclusive debate which significantly depleted the rather limited reserves of goodwill towards our three directors of planning.

Eventually, a chairman for the amalgamated planning group was identified; work began in earnest with the usual flurry of faxes in late December.

Then it occurred to someone that much needed extra beds might be found by reopening two wards of the old Royal Dreich Asylum, so just before Christmas a dozen people—from personnel, catering, patient transport, laundry, portering, and pest control—were summoned to a meeting.

A plan was agreed with remarkable speed and a commendable effort by all concerned ensured that within four days about 40 bewildered elderly patients could be whisked from our hard pressed acute beds to the comparative safety of a spacious old asylum.

Already the operation has been acclaimed as a triumph, mainly because not so much as a whisper of any crisis has reached either local or national media. And already our delighted trust chief executives are seeking out potential members of the Twenty Sixth Annual Winter Bed Crisis Planning Group.
Silent and Masquerading Intrathoracic Lesions
Authors: Richard H. Overholt, Norman J. Wilson
Journal: New England Journal of Medicine (1946)

MILLIONS of persons have recently had their chests x-rayed in the mass surveys of large segments of the population now under way. The program at induction centers and in the armed forces, industrial plants and schools is well known. In addition, some form of radiologic screening of the chest is becoming a routine procedure in many clinics and hospitals and in the private practice of many physicians. Thousands of pathologic lesions have been discovered in apparently healthy persons, a large percentage being in the minimal stage, when treatment offers the best chance of cure.Of this group, the patient who . . .
The Evolution of Intercapillary Glomerulosclerosis
Authors: Harry A. Derow, Monroe J. Schlesinger
Journal: New England Journal of Medicine (1949)

IN 1936, Kimmelstiel and Wilson1 described a diffuse, microscopic lesion in the kidneys of 8 middle-aged and elderly diabetic patients with hypertension, profuse albuminuria and generalized edema. The abnormality was termed "intercapillary glomerulosclerosis" and consisted of striking changes in the intercapillary tissue characterized by large hyaline masses confined to the centers of the glomeruli or glomerular lobules. Less severe degrees of this hyalinization were also reported. These observations have been confirmed and extended by many authors,2 3 4 5 6 7 8 and the subject has recently been reviewed by Kimmelstiel and Porter.9 The available published data are inconclusive concerning the period necessary for the evolution . . .
AB1082 Specific Sonographic Measures of Effusion Associate with Pain but not Response to Intra-Articular Steroid Injection in Knee Osteoarthritis: Table 1
Authors: R. Klocke, G. Hirsch, G. Kitas
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Valid and readily available imaging biomarkers in knee osteoarthritis (OA) are still lacking. Previous sonographic studies of effusion and synovial thickening in relation to pain and response to intra-articular corticosteroid injection (IACI) have been negative or inconclusive, often using binary criteria for effusion/synovial thickening for analysis, and/or uncertain definitions of scanning technique. <h3>Objectives</h3> To investigate the association between measures of sonographic effusion/synovial thickening at specific sites of the supra-patellar pouch (SPP) and knee pain and change of knee pain following IACI in knee OA. <h3>Methods</h3> In a prospective secondary-care based, observational study, 105 subjects with knee OA (mean age 63.6 years, 59% female, median symptom duration 36 months) underwent baseline sonographic measurement in triplicates of maximal effusion and synovial layer thickness [mm] at the medial (transverse), mid (longitudinal)and lateral (transverse) SPP (as defined by patellar margins), of the maximally extended, relaxed knee. Knee pain was assessed by WOMAC questionnaire [0-500mm] at baseline and 3 weeks after IACI of 40 mg triamcinolone plus lignocaine injected by a separate clinician, using anatomical landmarks. <h3>Results</h3> Mean WOMAC pain at baseline was 265.7 (SD 95.5) and 148.8 (133.5) at 3 weeks. Effusion and synovial thickness was maximal at the lateral SPP (Table 1). Univariate linear regression with baseline pain/percentage pain change as dependent variable returned a significant r for medial, lateral and mean SPP effusion with baseline pain, but not percentage pain change. The variance of baseline pain explained by lateral and mean SPP effusion was very similar at 6.6 and 6.7%, respectively. Interrater-ICC coefficient on a sub-sample was 0.92. Synovial thickness showed no significant correlation with pain or pain change. Mean SPP effusion thickness showed a significant correlation with high-sensitivity CRP at baseline (Pearson9s r 0.273, p=0.009). <h3>Conclusions</h3> This study suggests that targeted sonographic measurement of effusion thickness at the lateral supra-patellar pouch may predict some of the pain in knee OA, but not response to IACI. The correlation of mean effusion thickness and hsCRP also indicates that effusion in knee OA may represent a measure of inflammation. <h3>Disclosure of Interest</h3> None declared
Occupational Dermatoses: Disability and Compensation
Authors: C. Guy Lane
Journal: New England Journal of Medicine (1945)

DISEASES of the skin comprise 65 per cent of all occupational disease. There is, however, surprisingly little material indicating the actual amount of disability that occurs in these cases, the expense in terms of compensation paid or the medical costs involved. Compensation laws have been enacted in almost all the states, and it can be expected that such studies will be available later. These laws and the progress made since the original compensation act passed in Wisconsin in 1911 have been discussed by Foerster.1 He points out that within fourteen years there occurred in that state three times as many . . .
Pneumocystic Abscesses of the Spleen
Authors: Kim Eagle, Michael Landor
Journal: New England Journal of Medicine (1993)

Figure 1. Pneumocystic Abscesses of the Spleen. A computed tomographic scan of the spleen in an adult infected with the human immunodeficiency virus, who had a recurrence of Pneumocystis carinii pneumonia despite secondary prophylaxis with aerosolized pentamidine, shows abscesses characteristic of extrapulmonary pneumocystosis. Any type of pyogenic or parasitic abscess can have a similar appearance. Ultrasound-guided needle aspiration of the spleen demonstrated cysts of P. carinii. A second scan, obtained after several months of daily therapy with trimethoprim-sulfamethoxazole, showed marked diminution of the cysts.
Comparison of Direct and Indirect Arterial Pressures in Aortic Regurgitation
Authors: Sidney Goldstein, Thomas Killip
Journal: New England Journal of Medicine (1962)

IN patients with advanced aortic regurgitation Korotkoff sounds may be heard over the brachial artery when the sphygmomanometer cuff has been completely deflated. Diastolic pressures obtained by standard auscultatory methods are therefore commonly recorded as zero – a physiologic impossibility. It has been recommended that both the muffling1 and the disappearance2 of the Korotkoff sounds be used as the auscultatory guide for diastolic pressure. Too few measurements comparing direct and indirect arterial pressures in aortic regurgitation are available to determine which phase of the sound change, if either, is the more reliable index of diastolic pressure.Direct and indirect arterial . . .
Bernard-Soulier syndrome Kagoshima: Ser 444--&gt;stop mutation of glycoprotein (GP) Ib alpha resulting in circulating truncated GPIb alpha and surface expression of GPIb beta and GPIX [see comments]
Authors: S Kunishima, H Miura, H Fukutani, H Yoshida, K Osumi, S Kobayashi, R Ohno, T Naoe
Journal: Blood (1994)
Long-term study of the sleep of insomnia patients with sleep state misperception and other insomnia patients
Authors: R J Salin-Pascual, T A Roehrs, L A Merlotti, F Zorick, T Roth
Journal: American Journal of Psychiatry (1992)

The objectives were 1) to investigate differences among patients with subjective insomnia (sleep state misperception), patients with objective findings of insomnia, and normal volunteers and 2) to assess the consistency of the sleep findings during a 2-month period.Twenty-one subjects were studied. Subjects with sleep state misperception (N = 7) had insomnia complaints for more than 1 year, no objective sleep disturbance, and sleep efficiency of 90% or greater (on the diagnostic screening sleep recording), while subjectively estimating that sleep time was less than 6.5 hours. Subjects with objective insomnia (N = 7) met the same subjective criteria, but objectively sleep efficiency was 85% or less. Normal subjects (N = 7) had no insomnia complaints and objective sleep efficiency of 90% or greater. All subjects were recorded on 2 consecutive nights three times with a 3-week period between each pair of nights (6 standard all-night polysomnographic sessions of 8 hours). A subjective sleep questionnaire was administered after each sleep recording night.Sleep stage variables (percentages) were similar between the two insomnia groups, and both were different from the normal subjects. Sleep continuity variables were disturbed in the objective insomnia group, but they were similar in the sleep state misperception and normal groups. Both insomnia groups rated their sleep as inadequate on the questionnaires and differed from the normal subjects. The distinct sleep patterns of each of the three groups did not vary over the 6 nights of assessment.Sleep state misperception may be a prodromic or transitional state of sleep dysfunction between normal sleep and the sleep pattern of objective insomnia.
Case 19-2011
Authors: Jason B. Harris, Louise C. Ivers, Mary Jane Ferraro
Journal: New England Journal of Medicine (2011)

A 4-year-old Haitian boy was admitted to a hospital because of vomiting and diarrhea. On examination, he was hypovolemic and lethargic. Episodes of diarrhea became too numerous to count. Rehydration was initiated, and a diagnostic test result was received.
Telomere Dysfunction and Senescence-associated Pathways in Bronchiectasis
Authors: Jodie Birch, Stella Victorelli, Dina Rahmatika, Rhys K Anderson, Kasim Jiwa, Elizabeth Moisey, Chris Ward, Andrew J. Fisher, Anthony De Soyza, João F. Passos
Journal: American Journal of Respiratory and Critical Care Medicine (2016)