tbuckley/cabot-search huggingface dataset:
Strategies to intervene on social determinants of infectious diseases
Authors: J C Semenza
Journal: Eurosurveillance (2010)

Systematic health inequalities exist in all European countries today. Individuals with lower socio-economic status suffer disproportionally from adverse health outcomes. While this is widely accepted for chronic diseases, a literature review covering the years 1999-2010 reveals that infectious diseases are also distributed unevenly throughout society, with vulnerable groups bearing a disproportionate burden. This burden is not restricted to a few 'signature infections of social determinants' such as tuberculosis or human immunodeficiency virus (HIV) infections, but also a wide array of other infectious diseases. Tremendous advances in public health over the last century have reduced the absolute magnitude of inequalities but relative differences remain. In order to explore the underlying reasons for such persistent inequalities in Europe, I examined interventions targeting social determinants of infectious diseases: interventions on social determinants tend to focus on chronic diseases rather than infectious diseases, and interventions for these mainly focus on HIV/AIDS or other sexually transmitted infections. Thus, there seems to be a need to intervene on inequalities in infectious diseases but ideally with a comprehensive public health approach. Three intervention strategies are discussed: population-at-risk, population, and vulnerable population approaches. Strengths and weaknesses of these options are illustrated.
Small Vessel Replacement by Human Umbilical Arteries With Polyelectrolyte Film-Treated Arteries
Authors: Halima Kerdjoudj, Nicolas Berthelemy, Simon Rinckenbach, Anna Kearney-Schwartz, Karine Montagne, Pierre Schaaf, Patrick Lacolley, Jean-François Stoltz, Jean-Claude Voegel, Patrick Menu
Journal: Journal of the American College of Cardiology (2008)
Abstract 1252: A Multimarker Strategy for Risk Prediction in Heart Failure: Application of Novel Methods in a Community Cohort
Authors: Shannon M Dunlay, Yariv Gerber, Susan A Weston, Jill M Killian, Margaret M Redfield
Journal: Circulation (2008)

Introduction: Mortality among patients with heart failure (HF) is high. Though individual biomarkers have been studied to determine their value in risk prediction, the role of a multimarker strategy in predicting mortality above established risk indicators requires evaluation in a relevant cohort using robust analytical methods. Objective: To determine whether adding C-reactive protein (CRP), B-type natriuretic peptide (BNP), and troponin T (TnT) to established risk indicators improved HF mortality risk prediction. Methods: Olmsted County residents presenting with HF from July 2004 to September 2007 were prospectively recruited to undergo biomarker measurement. We investigated whether addition of CRP, BNP, and TnT to a model including established risk indicators improved 6-month mortality risk prediction using multiple methods ( c statistic, net reclassification index, integrated discrimination improvement). Results: Of 566 participants (mean age 77±13 years, 48% male), 87(15%) patients died after 6 months follow-up. Patients with CRP (&lt;12.1mg/L), BNP (&lt;341pg/mL), and TnT (≥0.01ng/mL) below the median (n=112) had the lowest mortality (3%), those with one or two biomarkers above the median had intermediate mortality, and those with all biomarkers above the median (n=105) had markedly increased 6-month mortality (33%). After adjustment for other predictors, higher CRP, BNP, and TnT were each associated with increased mortality, with odds ratios (95% confidence intervals) of 1.66(1.24 –2.24), 2.06(1.42–3.07), and 1.45(1.12–1.87), respectively. While adding CRP, BNP, and TnT individually to the model improved mortality risk prediction, the combination of two or more biomarkers offered greater incremental benefit. Using all biomarkers resulted in an increase in the c statistic from 0.747 to 0.832 (p&lt;0.001), a net reclassification index of 0.33 (p&lt;0.001), and a 100% relative improvement in risk discrimination (integrated discrimination improvement 0.097, p&lt;0.001). Conclusions: The combined use of CRP, BNP, and TnT markedly improved the prediction of 6-month mortality in HF beyond established risk indicators. Implementation of a multimarker strategy including CRP, BNP, and TnT for risk prediction in HF should be considered. This research has received full or partial funding support from the American Heart Association, AHA Midwest Affiliate (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, South Dakota &amp; Wisconsin).
Results of Thalamotomy for Parkinson's Disease
Authors: T J SPEAKMAN
Journal: JAMA (1963)

Surgical destruction of a portion of the ventrolateral nucleus of the thalamus is currently the procedure of choice for the treatment of incapacitating tremor and rigidity of parkinsonism. Seventy-three patients were treated by 105 thalamotomies at the University of Alberta Hospital and assessed one to four years later for improvement of function in everyday activities. Fifty-six patients were improved, 12 were unchanged, and five had died. Only two of the deaths were related to the operation. Paresis was permanent in only one patient. Twenty-five patients had bilateral operations and 22 of these showed improvement of function. Contraindications to operation include serious cardiovascular disease, mental deterioration, and those parkinsonian patients whose disability is chiefly due to akinesia, oculogyric crisis, dysphasia or dysarthria.
Abstract 2171: The Rechargeable ICD: A new Application for a Well-Known Technology: Results of a Long-term Animal Study.
Authors: Michael Niehaus, Heidi Goerler, Daniel Detsch, Gunnar Klein
Journal: Circulation (2008)

Current ICD-systems use a non rechargeable dry battery as energy source. Thus, the life span of these systems is limited by the capacity of their battery. Therefore, this project deals with the development of a device (rechargeable ICD - rICD) being recharged transcutaneously by a magnetic field. Method: A prototype of this rICD consisting of an 4 th generation ICD housing containing a lithium polymer rechargeable battery, a charging coil for receiving the transmitted energy, integrated circuits for charging controls and a new telemetry system. These devices were tested in a long-term animal study in 10 Merino sheep (age 2±0.5 years, weight 54±9 kg) over a period of 1 year. By means of the telemetry system, the rICD was controlled. State of charge, LiIon voltage, charging current and temperature of LiIon battery, electronics and rICD housing were monitored continuously. Under general anaesthesia (ITN), the prototypes were implanted on the lateral neck of the sheep. The implantation of the devices, positions of charging coils and telemetry antennas as well as the implantation depths were documented by means of x-ray. All animals underwent monthly follow-ups with full charge-discharge cycles. At last, the animals were euthanatized and the ICD pockets were excised and analyzed microscopically. Results: Implantations were successful in all animals. Mean implantation depth was 2.2±0.6 cm. Monthly follow-up measurements showed that neither the tissue exposed to the electromagnetic field nor the device itself nor the LiIon battery presented with significant heating. Mean charging current was 34±11 mA. Thus, efficient charging of the LiIon battery was possible. One animal presented with a pocket infection. Other tissue alterations of the ICD-pockets have not been observed. Conclusion: The transcutaneous wireless energy transfer for rechargeable ICDs has been shown to be reliable, stable and effective in a long-term animal study.
Secondary morbidity among the recently bereaved
Authors: V Mor, C McHorney, S Sherwood
Journal: American Journal of Psychiatry (1986)

Discussions of the health consequences of bereavement have appeared with increasing frequency in the literature in recent years. Capitalizing on one of the largest samples of bereaved subjects to date, the authors analyzed National Hospice Study bereavement interview data regarding the rate of medical care use and short-term secondary morbidity. Results suggest that physician visit rates were somewhat higher but hospitalization rates lower among the recently bereaved than age- and sex-adjusted national norms. Multivariate analyses revealed that previous health problems and having been married to the deceased were consistently the strongest predictors of morbidity and health care use.
Abstract 13804: Extremes of Aromatase Activity Predict Increased 25 Year Risk of Cardiovascular Mortality in Postmenopausal Women: The Rancho Bernardo Study
Authors: Gail A Laughlin, Elizabeth Barrett-Connor, Kevin Cummins, Lori B Daniels
Journal: Circulation (2010)

Objective: Peripheral conversion of androgens to estrogens via aromatase is the primary source of estrogen in postmenopausal women and may play a role in cardiovascular health. This study examines ...
Improved treatment results in childhood B-cell neoplasms with tailored intensification of therapy: A report of the Berlin-Frankfurt-Münster Group Trial NHL-BFM 90.
Authors: Alfred Reiter, Martin Schrappe, Markus Tiemann, Wolf-Dieter Ludwig, Elif Yakisan, Martin Zimmermann, Georg Mann, Andreas Chott, Wolfram Ebell, Thomas Klingebiel, Norbert Graf, Bernhard Kremens, Stefan Müller-Weihrich, Hans-Jürgen Plüss, Felix Zintl, Günter Henze, Hansjörg Riehm
Journal: Blood (1999)
Abstract P024: Skin Intrinsic Fluorescence is Independently Associated with Coronary Artery Disease in Individuals with Long Duration Type 1 Diabetes
Authors: Baqiyyah N Conway, Vanita R Aroda, John D Maynard, Robert E Ratner, Trevor J Orchard
Journal: Circulation (2012)

Background: Advanced glycation end products (AGEs), thought to be a measure of cumulative glycemic exposure and glycemia-induced vascular damage, are increased both in renal disease and diabetes. As AGE formation increases the stiffness of the arterial wall and vascular matrix AGEs interfere with nitric oxide action, AGEs may be an important link between renal and coronary artery disease (CAD). Skin intrinsic fluorescence (SIF) is a noninvasive marker of AGEs. We sought to determine if SIF was associated with CAD in type 1 diabetes and whether this relationship was independent of renal function and renal disease. Methods: SIF was measured on the volar area of the forearm of 112 subjects from the Pittsburgh Epidemiology of Diabetes Complications study and 60 subjects from MedStar Health Research Institute when mean age and diabetes duration were 48 and 36years, respectively. CAD was defined as a history of myocardial infarction, bypass surgery/revascularization, percutaneous coronary intervention or stenosis &gt;50%. Overt nephropathy (ON) was defined as albumin excretion rate &gt; 200 µg/min, spot urine albumin/creatinine &gt; 300 ug/mg, or history of dialysis/ renal transplant. Cumulative glycemic exposure (updated mean A1c) was determined by averaging HbA1c values collected over follow-up (mean of 18 years in EDC and 10.3 years in MedStar). SIF and serum creatinine were natural log transformed before analyses. Odds ratios (OR) are expressed as per standard deviation change in a given variable. Results: Of the 172 participants, 30 had CAD, with an equal number in each sex. SIF levels were higher in those with CAD (p&lt;0.0001). Sex-specific analyses revealed a strong association between SIF and CAD in men in analyses controlled for age and updated mean HbA1c (HR=5.6, 95% CI=2.1-14.6), but a much weaker non-significant association in women (OR=1.4, 95% CI=0.61-3.3); however, formal analyses revealed no significant effect modification by sex (p=0.11) and thus the sexes were combined for the remainder of the analyses. In the combined analyses, controlling for age, sex, and updated mean A1c, each standard deviation change in SIF was associated with a 2.8 greater likelihood of CAD (95 % CI=1.6-5.1). Controlling for serum creatinine (OR=3.1, CI=1.7-5.6) or ON (OR=2.6, CI=1.4-4.8) rather than updated mean A1c did not change this relationship. Accounting for both updated mean A1c and serum creatinine in analyses that also included age and sex, each standard deviation change in SIF was associated with a 2.7-fold greater likelihood for CAD (CI=1.5-5.1) and remained significant when further controlled for ON (OR=2.0, CI=1.0-3.9, p=0.04) Conclusion: Skin intrinsic fluorescence is cross-sectionally associated with CAD, independent of renal function and updated mean A1c in subjects with type 1 diabetes.
Clinical and molecular characterization of a rare syndrome of acute promyelocytic leukemia associated with translocation (11;17)
Authors: Jonathan D. Licht, Christine Chomienne, Andre Goy, Alex Chen, Amy A. Scott, David R. Head, Jean Louis Michaux, Yu Wu, Anthony DeBlasio, Wilson H. Miller, Andrew D. Zelenetz, Cheryl L. Willman, Zhu Chen, Sai Juan Chen, A. Zelent, Elizabeth Macintyre, Agnes Veil, Jorge Cortes, Hagop Kantarjian, Samuel Waxman
Journal: Blood (1995)
Abstract 20862: Bayesian Number-Needed-to-Treat Analysis of Rosuvastatin for Prevention of Venous Thromboembolism in Patients with Elevated High Sensitivity C-Reactive Protein
Authors: Christopher Lang, Rohit Arora
Journal: Circulation (2010)

Background: Recent clinical trials have investigated the role of statin therapy on the prevention of thromboembolic events. The JUPITER trial specifically evaluated a subset of patients particularl...
Ethical market in organs
Authors: I. R Marino
Journal: BMJ (2002)

Editor—Although we admire Harris and Erin's commitment to solve the dilemmas posed by a shortage of organs, we strongly disagree not only with their conclusions but also with their assumption—namely, that the selling and buying of human organs can be made ethical. 1

Harris and Erin harness their theory to the laudable commitment to raise donation rates but arrive at the definition of an ethical market by promoting a system that seems to depend only on a restricted group of citizens—those who find the monetary incentives proposed appealing.

Firstly, the integrity of the human body should never be subject to trade. Can we truly define this system as ethical because the selling and buying of organs is administered by the state?

Secondly, how can a system be called ethical when it implicitly penalises the weakest people and exacerbates discrimination based on census? Will a healthy well-off citizen ever decide to give away part of his or her body for monetary gain? Donation rates might be boosted, but, although both the rich and the poor will continue benefiting from transplantation indiscriminately, organ procurement will be increased only by contributions from poor people.

Any commitment towards raising donation rates can be better channelled by using targeted investments, as shown by our experience at the Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), a transplant programme recently established in an area with a large shortage in cadaveric organs. Living donation was vigorously pursued from the start of the programme in July 1999. Of 120 transplants performed to date (livers and kidneys), 33% have been from living donors, all family related. At the same time, however, considerable energy has been invested in promoting cadaveric donation. Those efforts have been rewarded by a 314% increase in the donation rate (from 2.8 donors per million in 1999 to 8.9 in 2001).

Any financial incentive to organ procurement, even if government regulated, must be avoided as it dangerously undermines human dignity by obscuring the difference between being human and marketing. We recently expressed our concern about the American Medical Association's suggestion of exploring monetary incentives for organ donation,2 and we are frightened by the enthusiastic support for it by such notable experts as Harris and Erin.
Abstract 17551: The Impact of Ordering Provider Specialty on Appropriateness Classification
Authors: Damita J Carryer, John W Askew, David O Hodge, Todd D Miller, Raymond J Gibbons
Journal: Circulation (2011)

The Impact of Ordering Provider Specialty on Appropriateness Classification In prior studies, our laboratory applied the ACCF/ASNC AUC for SPECT MPI to several cohorts of patients in Mayo Clinic Rochester. The purpose of this study was to re-examine our data to test the hypothesis that the specialty of the ordering provider affected the appropriateness. We compared the ordering providers specialty with appropriateness determined in prior studies. The study group consisted of 281 patients who underwent stress SPECT MPI studies in May 2005 and 282 patients in October 2006 (before any quality improvement initiatives were begun at Mayo). Appropriateness categories were assigned by 2 experienced nurses from the CV Research Studies Unit not affiliated with the nuclear laboratory. Patients who were studied for pre-operative evaluation (n = 20) or post myocardial infarction (n = 7) were excluded because they comprised less than 5 percent of the patients. Pre-operative testing in our institution is done primarily by stress echocardiography. The final study group consisted of 526 patients. Excluding the 64 unclassified patients, AUE categories were appropriate (75 %), uncertain (13 %), inappropriate (12%). Results by ordering provider are shown in the figure, where CV = Cardiovascular MDs, ED = Emergency Department MDs, IM = General and Internal Medicine MDs, RN = Registered Nurses, and SP = other Specialty MDs. There was no significant association (p = 0.19); Chi-square analysis between appropriateness and specialty groups. In a clinical practice where pre-operative testing using SPECT is infrequent, the rate of inappropriate studies was similar for all ordering providers. Quality improvement efforts in similar practices will likely require a broad focus on all ordering physicians/nurses.
Direct Access to Emergency Contraception—Reply
Authors: Tina R. Raine, Cynthia C. Harper
Journal: JAMA (2005)

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
As others see us: views from abroad: The importance of social context
Authors: J M Lim
Journal: BMJ (1998)

The NHS is in a reflective mood today and rightly so. The comprehensive “cradle to grave” care envisioned by the architects of the NHS in 1948 has been called the most socialist achievement of the Labour government of that era. Indeed, being 85% funded from taxes, free at point of use, and accessible to all, it may be seen as the part of Britain's welfare system that goes the furthest in the direction of welfarism.

In May 1981, the then Minister for Health in Singapore declared that a cradle to grave health system was not for Singapore; K H Phua surmised that the “objectives of the restructuring programme were to avoid the problems of a welfare state system such as the British NHS.”1 In his 1996 National Day speech, Prime Minister Goh reiterated this point: “People often want the government to assume the full burden of the cost of medical care and provide treatment free to Singaporeans. Because of the painful lessons learned in other countries we have not done this. All the countries which have done this—Britain, France, Germany, Canada, and Communist China—have failed. Their systems break down as people overuse so-called ‘free’ health care, which they actually pay for indirectly through higher taxes. Their health services deteriorate. Waste and inefficiency become endemic. Now these countries are forced to cut back on services, introduce cost controls, and reform the system.”

#### Summary points

If the NHS depends on the collective role of society, the emphasis in Singapore is on individual responsibility

Singapore's politicians worry that an ostensibly free service promotes overuse and rising costs

Singapore therefore relies on compulsory savings to fund health care, together with copayments, in a system that rewards patients for staying well

The NHS depends on the collective role of society, whereas …
Prognostic Value of Self-Reported Versus Objectively Measured Functional Capacity in Patients With Heart Failure
Authors: Martijn A. Spruit, Micha T. Maeder, Christian Knackstedt, Peter Ammann, Urs Jeker, Nicole H.M.K. Uszko-Lencer, Stephanie Kiencke, Matthias E. Pfisterer, Hans Rickli, Hans-Peter Brunner-La Rocca
Journal: Journal of the American College of Cardiology (2012)
Abstract 5329: ROS-dependent Cysteine Sulfenic Acid Formation of IQGAP1 and ERK1/2 in VEGF-induced Endothelial Cell Proliferation and Migration
Authors: Nihal Kaplan, Norifumi Urao, Masooma Razvi, Yoshimasa Nakamura, Leslie B Poole, Tohru Fukai, Masuko Ushio-Fukai
Journal: Circulation (2009)

VEGF receptor type 2 (VEGFR2) activation induces endothelial cell (EC) proliferation and migration. ROS-mediated protein modification involves oxidation of reactive cysteine residues to form a cysteine sulfenic acid (Cys-SOH) and subsequent oxidation products. However, role of Cys-SOH formation in VEGF signaling linked to angiogenesis is unknown. We previously identified IQGAP1, as a novel VEGFR2 binding protein, involved in regulating ROS-dependent EC migration and proliferation by recruiting Nox2 NADPH oxidase to activated VEGFR2 signaling complex. By using a newly-developed Cys-SOH trapping reagent we show that VEGF stimulation significantly increases protein-Cys-SOH formation in HUVECs. Immunofluorescence reveals that Cys-SOH modified proteins accumulate at the leading edge where they colocalize with NADPH oxidase, F-actin and IQGAP1 in actively migrating ECs. VEGF stimulation increases IQGAP1-Cys-SOH formation within 5min (60%) with a maximum increase at 15min (90%). VEGF-induced Cys-SOH formation of IQGAP1 is prevented by pretreatment with a GSH donor antioxidant, N-acetylcysteine. Knockdown of IQGAP1 by siRNA or trapping of Cys-SOH with dimedone, blocks wound-induced Cys-SOH formation at the leading edge and EC migration toward the injured site (80%), EC chemotaxis (90%) and matrigel angiogenesis (80%). These suggest linkage between IQGAP1-Cys-SOH formation and IQGAP1-mediated EC migration. In addition, dimedone pretreatment inhibits VEGF-stimulated EC proliferation. VEGF stimulation also induces oxidation of ERK1/2 upon 5 min (50%) and 15min (80%) stimulation. Trapping Cys-SOH by dimedone inhibits ERK phosphorylation (95%), which is associated with increasing IQGAP1/ERK complex (50%) after VEGF stimulation. Hind limb ischemia increases oxidation of tissue proteins including IQGAP1 (80%) and ERK1/2 (60%) at day 1 after injury, which is prevented in mice lacking Nox2. Thus, oxidation of IQGAP1 and ERK contributes to directional migration and proliferation of ECs and to neo-vascularization in ischemic tissue. The present study should provide insights into identifying and visualizing Cys-SOH formed proteins as important strategy for understanding mechanisms by which ROS regulate EC function such as angiogenesis.