tbuckley/cabot-search huggingface dataset:
Health Care in Crisis
Authors: Lawrence C. Kleinman
Journal: JAMA (1991)

UNIVERSAL access to health care is a social goal, yet one in seven Americans is estimated to be without health insurance, and millions more have inadequate insurance. A deficit in health care provision exists, with deleterious consequences.<sup>1,2</sup>Most of the uninsured live in families in which at least one person is employed. Even the most well-to-do among the uninsured may be within one illness of destitution. Medically indigent and underserved populations defy stereotypes. They range from working men to pregnant women.<sup>3,4</sup>Minorities, the elderly, children, women, veterans of the armed forces, persons with handicaps or chronic illness, and members of other vulnerable populations have joined those disproportionately excluded from health care. Data suggest that the more unequal the distribution of wealth within a country, the more the excess burden of mortality falls on the poor.<sup>5</sup>Health outcomes in certain ethnic groups continue to be poor through the
Results of the OPAL Study: A Phase II Study to Evaluate the Efficacy, Safety and Tolerability of Tosedostat (CHR-2797) in Elderly Subjects with Treatment Refractory or Relapsed Acute Myeloid Leukemia
Authors: Jorge E. Cortes, Eric J Feldman, Karen Yee, David A. Rizzieri, Anjali S. Advani, Anthony Charman, Martin J. Toal, Hagop M. Kantarjian
Journal: Blood (2011)
Transverse movement of spin-labeled phospholipids in the plasma membrane of a hepatocytic cell line (HepG2): Implications for biliary lipid secretion
Authors: P Muller, T Pomorski, S Porwoli, R Tauber, A Herrmann
Journal: Hepatology (1996)

The redistribution of spin–labeled phospholipid analogs across the plasma membrane of HepG2 cells, either in suspension or grown as monolayers, was investigated. After incorporation into the outer membrane leaflet spin–labeled aminophospholipids phosphatidylserine (PS) and phosphatidylethanolamine (PE) moved rapidly to the inner monolayer, whereas the analog of phosphatidylcholine (PC) disappeared more slowly from the outer leaflet. The fast, inward movement of the aminophospholipids was abolished after adenosine triphosphate (ATP)– depletion of cells, suggesting the presence of an aminophospholipid translocase in the plasma membrane of these cells. Compared with human red blood cells, the activity of the aminophospholipid translocase is two orders of magnitude higher in HepG2 cells. From these data, a transverse phospholipid asymmetry can be inferred with the aminophospholipids mainly concentrated on the inner monolayer and the choline–containing phospholipids on the outer leaflet. The relevance of the enrichment of PC in the outer membrane leaflet for the formation and composition of the bile is discussed.
The impact of routine pathology review on treatment for node-negative breast cancer.
Authors: H. F. Kennecke, C. Speers, K. A. Gelmon, I. Olivotto, M. Hayes
Journal: Journal of Clinical Oncology (2010)

6046 Background: Central review of pathology slides is not universally done and its impact on treatment is poorly described. We determined the impact of routine pathology review by pathologists specializing in cancer care on treatment recommendations for patients with node negative (pN0) breast cancer. Methods: Routine, centralized pathology review of specimen slides was recommended to ascertain diagnosis for all British Columbia (BC) patients with newly diagnosed, pN0, in situ or invasive breast cancer but was not always performed. Cases reviewed in two randomly chosen time periods in 2004 (3 months) and 2007 (5 months) were included. Cases with node positive or node unknown (pNX) or metastatic disease were excluded. ER, PR and HER2 testing were not routinely repeated. Results: Of 906 eligible pN0 cases, 405 (45%) had a documented pathology review. Reviewed patients were younger (median age [MA] = 58) than nonreviewed cases (MA = 65) (p < 0.001) and were more likely to have close/positive margins (p < 0.001), while other prognostic variables were similar. A total of 104 changes were documented among 81 (20%) patients. Tumor grade was the most common change (44), followed by documentation of lymphovascular invasion (23), change in nodal status (17), margins (12), PR (3), ER (3) and in 2 cases disease changed from invasive to in situ disease. Among 405 cases, results on pathology review resulted in 27 treatment changes among 25 (6.2%) patients. Systemic therapy was added in 12 and modified in 3, while radiation was added in 4 and modified in 8 patients. Conclusions: Routine review of pathology slides for pN0 breast cancer resulted in changes in curative therapy in a significant proportion of patients and should be considered for this patient population. Findings remain relevant in the era of tumor gene signatures as changes in nodal and margin status contributed to a significant proportion of the treatment changes. No significant financial relationships to disclose.
Controlling the hemorrhage of routine coagulation tests
Authors: G. N. Fox
Journal: JAMA (1990)

<h3>To the Editor.—</h3> The article entitled "Routine Use of the Prothrombin and Partial Thromboplastin Times"1 indicates that "education and other types of feedback have been tried with minimal or no long-term reduction in (inappropriate) laboratory use" by physicians. We contend that the reason for this is simple: hospitals generate profit from this testing. In our institution, Medicare patients represent 34% of the volume on a case basis (50% of the volume on a charge basis because of increased length of stay and complexity of illness). The number of patients eligible for testing is calculated on a case basis. If 50% of patients who undergo prothrombin time and partial thromboplastin time studies were funded on a fee-for-service basis and the markup on these tests were 100%, the hospital would break even. The hospital would have no incentive to intervene at this break-even point because of the cost of instituting educational programs
Abstract 1284: Resistance to BRAF and MEK inhibitors in BRAFV600E mutant melanoma
Authors: Hima Patel, Rosalin Mishra, Garrett Joan
Journal: Cancer Research (2019)

Abstract Melanoma five year survival rates are only 15% for patients with advanced disease. About 50% of melanomas contain the BRAFT1799A transversion which encodes for the constitutively active BRAFV600E oncoprotein. This opened up avenues for development of BRAF inhibitors which resulted in a response rate of about 50% and median progression-free survival of about 5 months. Co-targeting the downstream MEK protein with a MEK inhibitor along with BRAF inhibitor resulted in response rates of about 70% and are now approved as standard of care for patients harboring the BRAF-mutant melanoma. In spite of these successes, their long-term efficacy has been limited due to acquired resistance to these inhibitors. In order to study mechanisms underlying resistance, we generated dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor) resistant WM115 (WM115 TDR) and WM983 (WM983 TDR) cell lines by adding increasing concentration of the drugs to WM115 and WM983 cells with BRAFV600E mutation (parental cells). We observed that the resistant cells undergo a change in their morphology and continue to remain viable over increasing doses of dabrafenib and trametinib as compared to parental cells demonstrated by MTT cell proliferation assay and Matrigel 3D assay. TDR cells demonstrated maintenance of p-ERK levels at 4 and 24 hours which under the same conditions p-ERK was inhibited in the parental cells. Current studies underway include RNA sequencing in order to decipher differentially expressed genes in the parental and TDR which could mediate resistance to BRAF and MEK inhibitors. Additionally we will examine phosphorylated receptor tyorsine kinases (RTKs) using an array to identify divergences among activation of RTKs in parental versus TDR cells. Deciphering causes of resistance to BRAF and MEK inhibitors will help in the development of novel mechanism-based interventions aiding long-term patient prospects in BRAF-mutant melanoma. Citation Format: Hima Patel, Rosalin Mishra, Garrett Joan. Resistance to BRAF and MEK inhibitors in BRAFV600E mutant melanoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1284.
Use of Ames Test in Evaluation of Shale Oil Fractions
Authors: R. A. Pelroy, M. R. Petersen
Journal: Environmental Health Perspectives (1979)

Conditions that affect the sensitivity of the Ames assay of complex hydrocarbon mixtures derived from shale oil were studied. Two fractions, one enriched in polynuclear aromatic compounds (PNA fraction), and a second fraction enriched in aromatic and heterocyclic amines (basic fraction), were selected for most of this work because of their comparatively high mutagenicity (i.e., compared with raw shale oil). The crude shale oil, as well as the basic, PNA, and tar fractions were mutagenic against the Salmonella typhimurium test strains, TA98 and TA100. Mutation was dependent on metabolic activation by microsomal (S9) enzymes. Both test strains responded equally well to the crude product and to the basic fraction; however, strain TA100 was more effective than TA198 in demonstrating the mutagenicity of the PNA fraction. The mutagenicity of the tar fraction could be most easily detected after metabolic activation in a liquid medium, as opposed to S9 activation in the top agar of the standard Ames assay. The mutagenicity of the basic fraction or 2-aminoanthracene was also demonstrated by metabolic activation in a liquid medium. In other set of experiments, the effect of chemical composition on the expression of mutagenicity in the standard Ames assay was estimated. Premutagens requiring metabolic activation were added to the basic and PNA fractions, and the numbers of revertants obtained in the presence of the fractions were compared with mutation induced by the compounds alone. The basic fraction did not interfere with the mutagenicity of 2-aminoanthracene and 7,9 dimethylbenz[c]acridine. Moreover, in certain experiments, the mutagenicity of the complex fraction plus the added compound was higher than expected on the basis of assays performed on these materials separately. Conversely, the PNA fraction prevented or strongly inhibited mutation by several polynuclear aroumatic compounds, and an acridine. However, the PNA fraction did not inhibit mutation induced by 2-aminoanthracene. The effect of the basic fraction on stability of the S9 enzymes in the standard Ames test was also determined.
Design of treatment trials for functional gastrointestinal disorders
Authors: S J O V. van Zanten, N J Talley, P Bytzer, K B Klein, P J Whorwell, A R Zinsmeister
Journal: Gut (1999)

Until recently many clinical trials of functional gastrointestinal disorders (FGIDs) suffered from important weaknesses in trial design, study execution, and data analysis. This makes it difficult to determine whether truly efficacious therapies exist for these disorders. One of the important methodologic problems is the absence of validated outcome measures and lack of consensus among stakeholders on how to measure outcome. Currently much of the effort is being put into the development of validated outcome measures for several of the FGIDs. The randomized, controlled trial with parallel groups is the design of choice. In this report, guidelines are given for the basic architecture of intervention studies of FGIDs. Further studies on design issues are required to ensure the recommendations will become evidence based in the future.
Restoration of Urban Waterways and Vacant Areas: The First Steps toward Sustainability
Authors: John Cairns, Sarah E. Palmer
Journal: Environmental Health Perspectives (1995)

Increased population pressure and human activities have significantly altered the effectiveness of functions of ecosystems ("ecosystem services") at the local and regional scale. Of primary importance is the decrease in water quality due to urban storm water runoff. A number of communities have initiated restoration strategies to improve water quality standards. One such strategy is the incorporation of riparian walkways with native flora. As a result of such restoration efforts, habitats for native fauna have improved, and the number and diversity of wildlife have increased in urban settings. Restoration of urban habitats also provides social and economic benefits to the surrounding community. Efforts to mitigate the loss of ecological resources by restoring native habitats on lots that cannot be developed or on abandoned lots hold a high, unrealized potential. Habitat restoration not only provides natural diversions to urban surroundings, but also enlightens and educates individual citizens about the importance of balanced ecosystems and the role of humans within ecosystems. Education is the primary step toward creating ecologically sustainable communities.
The 'other STDs': do they really matter?
Authors: W. Cates
Journal: JAMA (1988)

ACQUIRED immunodeficiency syndrome (AIDS)—it seems to dominate all else. Do the other sexually transmitted diseases (STDs) matter? Whatever happened to gonorrhea... or syphilis? How about infection with chlamydia, which has hardly had a well-earned day in court? Does anyone remember herpes? Even concerns about human papilloma-virus causing cervical cancer cannot rally much enthusiasm. The other STDs clearly<i>do</i>matter... in fact, they matter more today than ever before. In this commentary, I contend that we create a false dichotomy between AIDS and the other STDs by considering them separately—a dichotomy that does more harm than good by detracting from the commonality of primary/secondary STD prevention activities. These activities taken together should ultimately potentiate reduction of<i>all</i>STDs, not just human immunodeficiency virus (HIV) infection, gonorrhea, syphilis, chlamydial infection, or any of the others. Why should we use a common approach for all STDs, including HIV infection? For simplicity, I will
SARCOMATOSIS CUTIS.
Authors: DAVID LIEBERTHAL
Journal: JAMA (1902)

It would far exceed the time allotted should we attempt to consider the class of true sarcomata occurring within the skin, or all those forms belonging to the class of sarcoid tumors, as mycosis fungoids, lymphodermia perniciosa and leucemia cutis. We will limit ourselves to the discussion of the idiopathic multiple pigmentary or hemorrhagic sarcoma (Kaposi) and the so-called sarcomatosis cutis (Kaposi) and their relation to each other, after citing cases of the first type from our own observation, which, differing somewhat from the usual type, offers some interesting points which tend to show that in the two affections we probably have to deal with an identical process. <h3>A. IDIOPATHIC MULTIPLE HEMORRHAGIC SARCOMA.</h3><h3>Case 1.</h3> —C. L., German, 40 years old, married, has three healthy children. His parents died well advanced in years from causes unknown to him. He never suffered from any illness nor had venereal disease. His present
Gab2 is Essential for Transformation by FLT3-ITD in Acute Myeloid Leukemia
Authors: Katharina Sies, Corinna Spohr, Albert Gründer, Rumyana Todorova, Franziska Maria Uhl, Julia Huber, Robert Zeiser, Heike Luise Pahl, Heiko Becker, Konrad Aumann, Tilman Brummer, Sebastian Halbach
Journal: HemaSphere (2019)
REMOVAL OF CONTRAST MEDIA FROM THE CORONARY SINUS ATTENUATES RENAL INJURY AFTER CORONARY ANGIOGRAPHY AND INTERVENTION
Authors: David M. Kaye, Peter Ruygrok, Craig Juergens, Horst Sievert, Mark Richards, James Blake, Robert Whitbourn, Omar Farouque, Terry Pertile, Stephen Duffy
Journal: Journal of the American College of Cardiology (2010)
Nephrolithiasis connected with hydronephrosis of a crossed renal ectopia
Authors: M. Eichwald
Journal: JAMA (1970)

A case of nephrolithiasis occurred together with marked hydronephrosis of a crossed renal ectopia. The bizarre and confusing appearance of the scout film was the most interesting feature of this case. Very surprising is the fact that this patient lived to middle age with scarcely any subjective symptoms despite the proved and extensive damage to the urinary tract.
The value of corticosteroids in the treatment of infectious mononucleosis
Authors: C. E. Bender
Journal: JAMA (1967)

Corticotropin or prednisolone was used to treat 66 students who had severe but uncomplicated mononucleosis, after it was clinically apparent that the illness was worsening under conservative management. Treated patients included those with anginose, typhoidal, and hepatic syndromes. Duration of fever after starting treatment was used to assess the drug effect. Each treated patient was matched with an untreated patient which resulted in 66 pairs of patients having minimal biologic variations as well as very similar clinical syndromes and fever ranges. A comparison of the febrile periods in the matched pairs showed an average period of 5.6 days for the untreated group and 1.4 days for the treated group. The difference, 4.2 days, was highly significant.
Adverse effects of contact lens wear during decompression
Authors: D. R. Simon
Journal: JAMA (1980)

The effects of corneal contact lens wear during and after exposures for 30 minutes to a depth of 45.5 m (150 ft of sea water) or an altitude of 11,277 m (37,000 ft) were studied. Subjects wore either membrane (soft) lenses or one of two types of polymethylmethacrylate (hard) lenses: fenestrated (0.4-mm hole in the center) or nonfenestrated. During and after decompression from the dive, subjects wearing nonfenestrated polymethylmethacrylate lenses experienced ocular symptoms, the result of corneal epithelial edema caused by formation and trapping of nitrogen bubbles in the precorneal tear film. No bubbles, or only a few miniscule ones, and no symptoms were present when lenses were not worn during the dive or at a high altitude. The reasons why gas trapping and corneal edema do or do not occur are discussed and recommendations for contact lens wear are proposed. (<i>JAMA</i>244:1213-1214, 1980)
Ultrasonic fetal cephalometry.
Authors: W Littler, P Sleight
Journal: BMJ (1972)

haematoma formation and no long-term sequelae.We wish to make two points.Firstly, the technique of insertion of the cannula is very important in avoiding trauma to the artery.We feel the Grandjean cannula (which uses a semirigid steel stilette) is a very significant advance.On the great majority of occasions the puncture is "first time" and through the anterior wall of the artery only.Secondly, the continuous flush technique removes problems of thrombosis at the catheter tip.Since using the Grandjean catheter we failed only once to insert the cannula at the first attempt.We have had no significant haema- toma formation at insertion or following re- moval.We do make a special point of form- ally examining the artery after insertion, at 12 hours, on removal at 24 hours, and at outpatient follow-up one month later.We have had no instances of arterial thrombosis, or pulse diminution, or splinter haemorrhages and, despite careful observation, no patients have developed forearm claudication after microcannulation, though, like others, we have certainly seen this after routine cardiac catheterization.We have our- selves had repeated arterial cannulation by this method.Obviously no invasive pro- cedure is entirely foolproof but we feel arterial microcannulation by this method is a safe procedure.-Weare, etc.,
Rh Antibodies and Domiciliary Midwifery
Authors: C. B. V. Walker
Journal: BMJ (1954)

Background: Previous studies have suggested that transcutaneous bilirubinometry (TcB) may provide a useful method for screening for significant jaundice, thereby reducing unnecessary blood tests. These studies have not allowed an estimation of the magnitude of such a benefit. Objectives: To evaluate the accuracy of TcB as a method of determining the need for serum bilirubin (SBR) measurements in full term babies and to quantify the magnitude of any benefit. Subjects: Babies born at more than 34 weeks gestation who had not previously been exposed to phototherapy and were requiring blood sampling in the first week of life. Method: TcB measurements were made at the same time as blood sampling. SBR was measured in all blood samples. For jaundiced babies, the ability of TcB to detect significant jaundice (SBR &gt; 249 μmol/l) was evaluated. Results: There was a correlation between SBR and TcB measurements (n = 303, r = 0.76, p &lt; 0.0001), but the 95% prediction interval for SBR from TcB was wide (± 88.3 μmol/l). For the 285 jaundiced babies, the area under the receiver operator characteristic curve was 0.89. A TcB value of 18 detected significant jaundice with a sensitivity of 100% and a specificity (95% confidence interval) of 45% (39% to 51%). If blood samples had only been taken from babies with a TcB value greater than 18, the number of samples taken would have been reduced by 34%. Conclusions: SBR cannot be measured accurately by TcB. However, TcB measurements can be used to determine the need for blood sampling in jaundiced babies and will reduce the number of blood samples taken. Recent improvements in TcB may improve the performance of this method.
Changing physician prescribing practices. Regulation vs education
Authors: R. L. Kane
Journal: JAMA (1994)

Changing physicians' behavior is not easy.<sup>1</sup>Although we would like to believe in a world where health professionals incorporate well-analyzed valid information into their daily practices, in fact, putting scientifically vetted information to use is slow and arduous. Translating consensus conference results into practice has proven a greater challenge than reaching consensus.<sup>2,3</sup>The guidelines now being promulgated by the Agency for Health Care Policy and Research face the same difficulties.
Screening for hemochromatosis in children of homozygotes: Prevalence and cost-effectiveness*1
Authors: P ADAMS
Journal: Hepatology (1995)

Although hereditary hemochromatosis is an autosomal recessive disease, most homozygotes are concerned with the genetic implications for their children. The optimal age for testing children and the cost implications of screening their children have not been clearly established. A clinical database consisting of 255 children from families with at least one homozygote is used to assess the prevalence of homozygotes among children of homozygous parents and to review the biochemical abnormalities and life-threatening symptoms in these young adults. Decision analysis is used to estimate the cost and utility of screening children of a homozygous parent. Eleven homozygotes were discovered among children of homozygotes. Only one male had a life-threatening event, cirrhosis. Decision analysis estimated cost saving of $12 per child screened ($ net present value) and a saving of 10 quality-adjusted days per child screened at age 10 years compared with not screening. If screening began at age 20 years, there is a cost saving of $65 per child screened. Sensitivity analysis showed that the major factors influencing cost savings were the cost of venesections, sensitivity and specificity of the screening tests, and prevalence of disease. Because the prevalence of hemochromatosis is higher in children of homozygotes than in the general population, screening with transferrin saturation and ferritin as early as age 10 years is recommended. Savings are augmented if the cost per venesection is eliminated by allowing hemochromatosis patients to become voluntary blood donors.