tbuckley/cabot-search huggingface dataset:
Public Reporting of Mortality Rates for Hospitalized Medicare Patients and Trends in Mortality for Reported Conditions
Authors: Karen E. Joynt, E. John Orav, Jie Zheng, Ashish K. Jha
Journal: Annals of Internal Medicine (2016)

Background: Public reporting is seen as a powerful quality improvement tool, but data to support its efficacy are limited. The Centers for Medicare & Medicaid Services' Hospital Compare program initially reported process metrics only but started reporting mortality rates for acute myocardial infarction, heart failure, and pneumonia in 2008. Objective: To determine whether public reporting of mortality rates was associated with lower mortality rates for these conditions among Medicare beneficiaries. Design: For 2005 to 2007, process-only reporting was considered; for 2008 to 2012, process and mortality reporting was considered. Changes in mortality trends before and during reporting periods were estimated by using patient-level hierarchical modeling. Nonreported medical conditions were used as a secular control. Setting: U.S. acute care hospitals. Participants: 20 707 266 fee-for-service Medicare beneficiaries hospitalized from January 2005 through November 2012. Measurements: 30-day risk-adjusted mortality rates. Results: Mortality rates for the 3 publicly reported conditions were changing at an absolute rate of −0.23% per quarter during process-only reporting, but this change slowed to a rate of −0.09% per quarter during process and mortality reporting (change, 0.13% per quarter; 95% CI, 0.12% to 0.14%). Mortality for nonreported conditions was changing at −0.17% per quarter during process-only reporting and slowed slightly to −0.11% per quarter during process and mortality reporting (change, 0.06% per quarter; CI, 0.05% to 0.07%). Limitation: Administrative data may have limited ability to account for changes in patient complexity over time. Conclusion: Changes in mortality trends suggest that reporting in Hospital Compare was associated with a slowing, rather than an improvement, in the ongoing decline in mortality among Medicare patients. Primary Funding Source: National Heart, Lung, and Blood Institute.
Search for Epitopic Sites of Antibodies to Germ Cell Alkaline Phosphatase
Authors: U Harmenberg, E Ljungdahl-Ståhle, U Rudén, B Wahren
Journal: Cancer Communications (1991)

This study comprises a search for epitopic sites of the germ cell alkaline phosphatase by the use of polyclonal and monoclonal antibodies. The aim of this study was to define epitopes of the germ cell alkaline phosphatase molecule by synthetic peptides representing the known sequence of the molecule. The amino acid sequences of the epitopes to which antisera react were not known. We used overlapping peptides covering the whole 532 amino acid germ cell alkaline phosphatase molecule, including the signal 19 amino acid peptide. A polyclonal, and three monoclonal, antibodies known to react equally well with placental alkaline phosphatase isozyme (PLAP), but which differ in their reactivities with the germ cell alkaline phosphatase isozyme, were used. We have revealed potential epitopic sites of the germ cell alkaline phosphatase molecule using first polyclonal anti-PLAP, followed by monoclonal antibodies for the mapping. We could also show that the antibodies exhibited higher reactivities with such sites if they were combined in a linear synthesis. This indicates that the germ cell alkaline phosphatase molecule has discontinuous epitopes.
AB0510 Alphacalcidol Therapy Decreases GSH, SOD and Catalase Levels in Erythrocytes of Rheumatoid Arthritis Patients
Authors: T. Zivanovic Radnic, K. Simic-Pasalic, M. Sefik-Bukilica, S. Misirlic Dencic, T. Stojkovic, N. Damjanov, J. Vojinovic
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Low vitamin D serum levels have been associated with several autoimmune diseases including rheumatoid arthritis (RA). Vitamin D deficiency enhances oxidative stress that plays a substantial role in pathogenesis of autoimmune diseases. <h3>Objectives</h3> Because erythrocytes are extremly vulnerabile to oxidative stress, the aim of this research was to analyse the effect of twelve weeks long alphacalcidol therapy in patients with RA on erythrocytes9 glutathione (GSH), superoxide dismutase (SOD) and catalase levels, as an oxidative stress markers. <h3>Methods</h3> In ten patients with active RA (DAS28(SE) score &gt;3.2) of both sexes, age 53.78±12.01 alphacalcidol (2μg/day) was added to previously applied therapy (stable dose of methotrexate, without any steroid therapy) during three months. Blood samples were taken before and after 12 weeks of alphacalcidol therapy. GSH, SOD and catalase levels in isolated and lysed erythrocytes were determined mannualy, using spectrophotometry method. Hemoglobin (Hb) levels were measured in lysed erythrocytes using biochemical analyser (Beckman coulter AcT diff) and levels expressed as μmol/g Hb for GSH and U/g Hb for catalase and SOD. In addition, parameters of inflammation (serum C-reactive protein (CRP) and sedimentation rate (SE)) were determined and disease activity was assessed using DAS28 (SE) score. Laboratory safety assessment of the study drug was evaluated monthly. Student9s t-test was used for statistical analysis. <h3>Results</h3> Average erythrocytes GSH level before treatment was 6.0±2.3 μmol/g Hb and it decreased to 3.7±1.3 μmol/g Hb (p=0.02) after treatment. Futhermore, initial catalase levels of 1412.3±840.2 U/ g Hb dropped to 211.3±119.1 U/g Hb (p=0.01) after twelve weeks of alphacalcidol therapy. Although slight reduction in SOD levels was observed after therapy, it was statistically insignificant. Significant clinical impovement was observed, DAS28(SE) was before treatment 5.81±0.89 and decreased to 4.31±1.03 (p=0.001), and CRP level of 28.41±28.16 dropped to 10.03±11.68 (p=0.000). <h3>Conclusions</h3> Decreased levels of erythrocytes9 GSH and catalase in RA patients after 12 weeks of alphacalcidol therapy indicate that alphacalcidol induced antioxidative effect. We assume that alphacalcidol lead to reduction of H<sub>2</sub>O<sub>2</sub> production in erythrocytes and therefore decreased the need for antioxidative enzymes catalase and glutathione peroxidase activity. Antioxidative effect of alphacalcidol was in line with good clinical outcome in patients. <h3>Disclosure of Interest</h3> None declared
&lt;emph type="ital"&gt;Gloucester Harbor&lt;/emph&gt;
Authors: Janet M. Torpy
Journal: JAMA (2012)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
OP0147 Intrinsic Cartilage Repair by Joint Distraction is Triggered by a Regenerative Transcriptional Response
Authors: S.C. Mastbergen, A. Miranda, K. Coeleveld, B.P. Meij, P.M. van Roermund, M. Tryfonidou, F.P. Lafeber
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Joint distraction provides long-term improvement of pain and function, accompanied by intrinsic cartilage repair evaluated indirectly by imaging and biochemical markers in humans with knee osteoarthritis (OA) (Wiegant et al, 2013). Moreover, joint distraction results in cartilage repair activity in an experimental canine model of OA, which corroborates with the structural observations of cartilage repair by surrogate markers in humans (Wiegant et al, 2014). Despite these promising results little is known about the exact mechanisms that boost them. <h3>Objectives</h3> This study evaluates for the first time the regenerative transcriptional response during joint distraction in an experimental model of osteoarthritis. <h3>Methods</h3> Knee OA was induced in 8 dogs according to the groove model. Ten weeks after OA induction, 4 dogs received joint distraction (D) and 4 dogs served as disease controls (OA). After 4 weeks of distraction the animals were sacrificed and knee tissues including fat pad, synovium, meniscus, bone and cartilage were harvested. qPCR analysis of more than 35 state-of -the-art regenerative gene markers was performed. <h3>Results</h3> The OA group revealed an upregulation of typical OA markers, like matrix metalloproteinases, collagen, and apoptosis markers confirming the OA disease cascade in specifically cartilage, bone and synovial tissue. Joint distraction caused downregulation of the typical OA markers and the maintenance of some important matrix remodeling genes for regeneration, e.g. aggrecanase. Moreover, genes from several pathways were differentially expressed between the D and OA group, including TGF-β, Wnt, and Notch signaling pathways. Interestingly, a high number of events occurred in bone, highlighting the importance of this tissue in the regenerative outcome of joint distraction on OA cartilage. <h3>Conclusions</h3> Distraction is a good candidate for knee OA treatment resulting in prolonged clinical and structural changes. This study demonstrates distinctively that joint distraction initiates a transcriptional regulation of several important regenerative genes indicating that a reset of joint homeostasis can lead to cartilage repair in OA. <h3>References</h3> Sustained clinical and structural benefit after joint distraction in the treatment of severe knee osteoarthritis. Wiegant K, van Roermund PM, Intema F, Cotofana S, Eckstein F, Mastbergen SC, Lafeber FP. Osteoarthritis Cartilage. 2013 Nov;21(11):1660-7. Evidence for cartilage repair by joint distraction in a canine model of osteoarthritis. Wiegant K, Intema F, van Roermund PM, Barten-van Rijbroek AD, Doornebal A, Hazewinkel HA, Lafeber FP, Mastbergen SC. Arthritis Rheumatol. 2014 Oct 9. [Epub ahead of print] <h3>Acknowledgements</h3> Supported by a grant from the Dutch Arthritis Foundation <h3>Disclosure of Interest</h3> None declared
SAT0504 How Experts on Autoinflammatory Diseases Classify Inherited Periodic Fevers and Pfapa: Preliminary Results of the Eurofever Delphi Survey
Authors: S. Federici, F. Vanoni, S. Ozen, J. Frenkel, H. Lachmann, A. Martini, N. Ruperto, M. Hofer, M. Gattorno
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Provisional evidence-based classification criteria for inherited periodic fever (TRAPS, FMF, MKD and CAPS) have been recently developed based on the Eurofever registry. However, no consensus on how to combine clinical criteria with results of molecular analysis has been reached so far. Moreover evidence-based classification criteria on PFAPA are still lacking. <h3>Objectives</h3> To understand how physicians involved in the clinical care of patients with Autoinflammatory diseases (AIDs) classify patients with inherited periodic fever and PFAPA in daily practice. <h3>Methods</h3> By using the Delphi and Nominal Group Technique, we started an initial phase of three following e-mail surveys. In the first survey, clinicians/biologists or other health professionals working in the field of autoinflammation were asked to identify the variables that they consider as important, in the current clinical practice, for the diagnosis of patients with inherited periodic fever and PFAPA. This survey was open to not influence the experts. <h3>Results</h3> We sent the first survey to 129 experts. The overall rate of response was 102 (79%): 96 experts responded to be interested in the survey and 72 completed and confirmed it; 6 experts responded not to be interested. Up to date, we have analysed 44 experts9 survey. Not all the participants completed the survey for each disease. The table shows the preliminary results of the analysis. There was any clinical variable chosen by all the participants for the five diseases. For a high rate of experts, a positive genetic test is a relevant element for the diagnosis of FMF, TRAPS and MKD. Conversely, for the PFAPA the exclusion of the inherited genetic periodic fever by genetic test is important for a little part of experts. The response to treatment was proposed as interesting variable for FMF, CAPS and PFAPA. <h3>Conclusions</h3> The preliminary results of the first Eurofever Delphi Survey show a high rate of response, underlying the interest of the scientific community in this topic. There is a wide heterogeneity in the experts9 response for each disease. At the end of the Delphi Survey rounds, we will obtain different set of clinical criteria and we will verify their performance in comparison to already existing criteria in a cohort of patients with inherited periodic fever and PFAPA enrolled in the Eurofever Registry. The final step will be a Consensus among experts (geneticists and clinicians) in order to define the best combination of clinical and genetic data for the definitive classification of patients with inherited periodic fevers and PFAPA. <h3>Disclosure of Interest</h3> None declared
PTU-321 Completing in-hospital alcohol detox in the community: is this safe practice?
Authors: PS Sidhu, S Lin, A Tipton, S Peagram, R Karwa, A Agrawal
Journal: Gut (2015)

<h3>Introduction</h3> The National Health Service expenditure on alcohol services is estimated to be £2.7 billion with over 78% of costs incurred from hospital-based care. Patients with alcohol problems are major contributors to hospital readmission.<sup>1</sup>Part contributor to this burden is the full in-hospital alcohol detox (AD) offered to such patients. We investigate the feasibility and safety of completing AD in the community. <h3>Method</h3> Discharge summaries, case-notes and blood results were reviewed for patients initiating in-hospital AD between 1/10/2013 and 1/3/2014 and were followed up to 1/8/2014. Satisfying our in-hospital risk assessment criteria, specific patients were selected for community AD (CAD) completion. The criteria which would exclude a patient from CAD completion included complex withdrawals, symptomatic in the past 24 h, unsupported living, mental health instability, chaotic drug use, mixing alcohol and medications and neurological symptoms. Data was collected on demographics, Emergency Department (ED) re-attendance, re-admission to hospital, CAD days, community alcohol services (CAS) engagement and Maddrey’s Discriminant Function (MDF). <h3>Results</h3> 189 patients were identified requiring input from the in-hospital alcohol liaison team. Of these, 70% were male (n = 132) with mean age of 50 years old (range: 23 to 88 years). In-hospital AD was initiated in 76% (n = 144) of the patients and of these, 26% (n = 37) completed AD in the community satisfying the above criteria. Mean CAD completion days per patient was 3.3 days. There was no significant difference (SD) between full in-hospital AD and CAD completion in relation to subsequent ED re-attendance (p = 0.37), hospital re-admission and further AD (p = 0.97) and re-admissions secondary to alcohol (p = 0.98). Furthermore, there was no SD in readmissions of those referred to CAS (p = 0.24) or who had engaged with CAS (p = 0.87) between the groups. The severity of liver disease was similar as evidenced by a MDF score &gt;32 in 8% in CAD completion and 11% of those whom completed AD in-hospital (p = 0.72). <h3>Conclusion</h3> This study demonstrates that completing AD in the community using pre-selected criteria is feasible, safe and will reduce the NHS expenditure in this area. Additionally this data validates our criteria for early discharge although we recommend further confirmation of these findings in a larger cohort of patients across multiple sites. In addition, we also validate our current in-hospital risk assessment tool. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Alcohol related disease: meeting the challenge of improved quality of care and better use of resources (2010). A joint position paper by BSG/BASL/AHA. www.bsg.co.uk
Lesions of Chronic Thiamine Deficiency in Mice
Authors: Thelma B. Dunn, Harold P. Morris, Celia S. Dubnik
Journal: JNCI Journal of the National Cancer Institute (1947)

Journal Article Lesions of Chronic Thiamine Deficiency in Mice Get access Thelma B. Dunn, Thelma B. Dunn pathologist National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar Harold P. Morris, Harold P. Morris nutrition chemist National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar Celia S. Dubnik Celia S. Dubnik chemist National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 8, Issue 3, December 1947, Pages 139–155, https://doi.org/10.1093/jnci/8.3.139 Published: 01 December 1947 Article history Received: 05 August 1947 Published: 01 December 1947
Teaching value clarification: the example of gender and psychotherapy
Authors: P P Rieker, E Carmen
Journal: American Journal of Psychiatry (1983)

The authors describe an effective model for teaching and evaluating a one-semester course on gender and psychotherapy for psychiatry residents. Clarification of values and attitudes about gender involves learning at both intellectual and affective levels. The authors conceptualize this cognitive-affective interplay as a series of stages or turning points in the process of value change and professional resocialization. The process may also be viewed as a microcosm of the inevitable gender-based conflicts that occur in the daily lives of the participants and in the wider social context. The course evaluation demonstrates that residents are able to translate the new knowledge into clinical practices.
Revolutions and the rights of man
Authors: G M Carstairs
Journal: American Journal of Psychiatry (1977)

The author describes the dialectical struggle in psychiatric treatment between those who advocate maximum liberty in the management of the mentally disordered and those who believe such patients will benefit more from firm guidance and discipline. He uses illustrations from British psychiatric history to illustrate this struggle. He also points out and discusses two current challenges to psychiatry worldwide: the unconstructive hostility of the various schools of antipsychiatry and the political abuse of psychiatric diagnosis and treatment, particularly in the USSR.
Platelet/Endothelial Cell Adhesion Molecule-1 Serves as a Costimulatory Agonist Receptor That Modulates Integrin-Dependent Adhesion and Aggregation of Human Platelets
Authors: David Varon, Denise E. Jackson, Boris Shenkman, Rima Dardik, Ilya Tamarin, Naphtali Savion, Peter J. Newman
Journal: Blood (1998)
Abnormalities Of 12p Are Associated With High-Risk Acute Myeloid Leukemia: A Children’s Oncology Group Report
Authors: Todd A. Alonzo, Robert B. Gerbing, Samir Kahwash, Amy Heerema-McKenney, Richard Aplenc, Lillian Sung, Laura Winter, Kathleen Glick, Ccrp, Stella M. Davies, Patti Byron, Robert S. Lavey, Franklin O. Smith, Phoenix A. Ho, Alan S. Gamis, Soheil Meshinchi, Susana C. Raimondi
Journal: Blood (2013)
PTH-315 Colorectal cancer outcomes in patients over 85 years old: is surgery the answer?
Authors: O Ng, E Watts, C Bull, AG Acheson, A Banerjea
Journal: Gut (2015)

<h3>Introduction</h3> In the UK population those aged over 85 will almost double by 2037. An ageing population, rising bowel cancer and recognition that chronological age is no longer a barrier to individualised treatment, renders colorectal cancer (CRC) in this age-group increasingly important. We report the outcomes for patients over 85 diagnosed with CRC in our institution. The aim was to appraise treatment choices and outcomes in order to inform decision making for patients in this age group. <h3>Method</h3> We reviewed all patients from 2008–10 discussed in colorectal MDT &gt;85 years old with proven colorectal adenocarcinoma. Data was collected from electronic notes, GP and public records. Patients were assigned to 3 treatment arms; curative surgery (CS), other treatments (OT) and best supportive care (BSC). OT group included chemotherapy, radiotherapy, local or endoscopic excision and stents. <h3>Results</h3> 105 patients (64 female) were included in this study. 42 had CS (7 laparoscopic), 36 OT and 27 BSC. Treated groups (CS and OT) were similar in age (p = 0.35) and staging (p = 0.16) while the BSC group were significantly older with higher stage disease (p &lt; 0.01). 13 (31%) had emergency surgery in the CS group. Survival was significantly poorer in BSC than those who are treated, mean 9.7 months (95% CI 4.7–14.7) vs. 41.6 months (95% CI 32.5–50.7) for CS and 27.3 months (95% CI 20.4–34.1) for OT (p &lt; 0.001). Interesting, within years 1–2, whether treated with CS or OT both groups had similar survival (p = 0.12), 53% for both. CS had higher 90 day mortality 12% (n = 6) vs. 3% OT (n = 1). However, after 2 years the group who had OT move toward a very similar 5 year survival to the BSC group (p &lt; 0.001), survival declining to 13% vs. 43% in CS by 5 years. Right sided tumours dominated CS (p &lt; 0.01) and in survival analysis by site, right sided tumours appeared to have a better survival, although not significant (p = 0.227). Rectal tumours formed the majority that were treated with OT (p &lt; 0.01) and had significantly better survival than those treated with CS (p &lt; 0.01). <h3>Conclusion</h3> Our study highlights that despite what is regarded curative treatment for CRC there appears to be no difference in survival over the first 2 years compared to other treatments. However, beyond 2 years a clear survival benefit is apparent. This is important when treating patients at the extremes of age who are the most likely to ask ‘what happens if I don’t have a big operation?’ and indeed, it is a duty of informed consent to talk about alternatives. Our results also suggest that the site of the cancer may matter. Right-sided cancers were more likely to be treated with CS. Rectal tumours were more likely to receive other treatment. Does this reflect our intuitive understanding of outcomes and risks in over 85 years old or are we prejudice? <h3>Disclosure of interest</h3> None Declared.