tbuckley/cabot-search huggingface dataset:
Risk Calculations for HIV Transmission From Infected Health Care Workers
Authors: Mark A. Shelly
Journal: JAMA (1993)

<h3>To the Editor.</h3> —I applaud the efforts of the authors in the three articles showing no transmission of HIV infection from health care workers to their patients.<sup>1-3</sup>These add to the assurance that the risk is not large. I share the opinion that the actual risk of transmission is vanishingly low when universal precautions are observed. These articles point out the difficulty and high cost of determining the incidence of rare events. Unfortunately, in all three, the calculation of maximum probability based on their numerator of zero was incorrect. The question can be stated as follows: What is the minimum rate that would result in zero cases in<i>n</i>tries less than α (usually<i>P</i>=.05) percent of the time? The binomial distribution should be used, as suggested by von Reyn et al.<sup>3</sup>In the special case of zero of<i>n</i>, this simplifies to the following:
Bisphenol A Exposure during Adulthood Causes Augmentation of Follicular Atresia and Luteal Regression by Decreasing 17β-Estradiol Synthesis via Downregulation of Aromatase in Rat Ovary
Authors: Seung Gee Lee, Ji Young Kim, Jin-Yong Chung, Yoon-Jae Kim, Ji-Eun Park, Seunghoon Oh, Yong-Dal Yoon, Ki Soo Yoo, Young Hyun Yoo, Jong-Min Kim
Journal: Environmental Health Perspectives (2013)

Bisphenol A (BPA) has been detected in human body fluids, such as serum and ovarian follicular fluids. Several reports indicated that BPA exposure is associated with the occurrence of several female reproductive diseases resulting from the disruption of steroid hormone biosynthesis in the adult ovary.We hypothesized that long-term exposure to low concentrations of BPA disrupts 17β-estradiol (E2) production in granulosa cells via an alteration of steroidogenic proteins in ovarian cells.Adult female rats received BPA for 90 days by daily gavage at doses of 0, 0.001, or 0.1 mg/kg body weight. We determined serum levels of E2, testosterone (T), follicle-stimulating hormone (FSH), and luteinizing hormone (LH). We also analyzed the expressions of steroidogenic acute regulatory protein (StAR), P450 side-chain cleavage (P450scc), 3β-hydroxysteroid dehydrogenase isomerase (3β-HSD), and aromatase cytochrome P450 (P450arom) in the ovary.Exposure to BPA significantly decreased E2 serum concentration, which was accompanied by augmented follicular atresia and luteal regression via increase of caspase-3-associated apoptosis in ovarian cells. After BPA exposure, P450arom and StAR protein levels were significantly decreased in granulosa cells and theca-interstitial (T-I) cells, respectively. However, P450scc and 3β-HSD protein levels remained unchanged. The increase in LH levels appeared to be associated with the decreased synthesis of T in T-I cells after BPA exposure via homeostatic positive feedback regulation.BPA exposure during adulthood can disturb the maintenance of normal ovarian functions by reducing E2. The steroidogenic proteins StAR and P450arom appear to be targeted by BPA.
Case Studies in Schizophrenia
Authors: Marjorie C. Meehan
Journal: JAMA (1970)

Do not let the title scare you away from this valuable book. True, it is a report of seven severe cases of schizophrenia, but the cases are so varied, so carefully studied, and so well reported and discussed that it is much more worth reading than mere case reports. Dr. Schulz was a psychiatrist and Mrs. Kilgalen a nurse at the private hospital where Frieda Fromm-Reichmann worked, when they treated the patients described herein. Their work shows the influence of Fromm-Reichmann but is no mere imitation of hers. The patients were mostly young, intelligent, well-educated to the point where mental illness interfered with their education, and from families in comfortable economic circumstances. When the patients started treatment, all were very sick—mute, assaultive, self-destructive, or confused. Several had been in other hospitals. Their therepy, which usually lasted several years, was primarily intensive individual psychotherapy combined with good hospital care. As soon
Ileal Prolapse Through Ruptured Vagin: Complication of Manchester Operation
Authors: R. F. Heys
Journal: BMJ (1963)

It is clear that he had nothing to gain, and perhaps much to lose, by our paying more than passing attention to this aspect of his case.So far as is known, he was fairly well adjusted to the male sex, but that is not to say that he may not have suffered acutely throughout his life by possessing such a deformity.A genital abnormality of this nature FIG.3.-Section of the ovarian part of the gland showing an old corpus albicans.( x 75.)should nowadays call for full investigation within the first year of life ; once such investigation is complete, a decision may be made concerning the sex in which it is better to bring the patient up and appropriate plastic surgical procedures can be planned (Wilkins, 1 960; Gordon and Dewhurst, 1962).Summary The case is described-of a 40-year-old hermaphrodite whose social sex was male.The external genitalia showed a moderate-sized penis, a perineal urethra, and a rudimen- tary vagina; within the sac of a right inguinal hernia were a single ovotestis, a uterus, and a Fallopian tube.Chromo- some analysis showed him to have 46 chromosomes with an XX arrangement of sex chromosomes.We wish to record our grateful thanks to Mr. Francis Masina, under whose care the patient was admitted and who performed the operation, for permission to study and to report this case.
Admission Source to the Medical Intensive Care Unit Predicts Hospital Death Independent of APACHE II Score
Authors: José J. Escarce
Journal: JAMA (1990)

This study was conducted to determine if the source of admission to the medical intensive care unit (MICU) is associated with hospital death independent of the Acute Physiology and Chronic Health Evaluation (APACHE) II score. We calculated APACHE II scores and predicted risks of hospital death for 235 patients who were admitted to the MICU. The predicted death rate was the same as the actual rate for patients who were admitted directly from the emergency department (25% vs 22%), but was less than the actual rate for patients who were transferred from hospital floors (38% vs 55%), the medical intermediate care unit (32% vs 59%), and other hospitals (21% vs 36%). Logistic regression analysis confirmed an independent association between the MICU admission source and risk of death. Our findings suggest that APACHE II does not measure illness severity accurately in all patients who are admitted to intensive care units. If our results are generalizable, using APACHE II to compare intensive care outcomes among hospitals could lead to wrong conclusions about quality of care. Improving predictions of hospital death rates among patients who are in MICUs may require the inclusion of new types of information in the classification system.
A study examining inter- and intrarater reliability of three scales for measuring severity of psoriasis: Psoriasis Area and Severity Index, Physician's Global Assessment and Lattice System Physician's Global Assessment
Authors: J. Berth-Jones, K. Grotzinger, C. Rainville, B. Pham, J. Huang, S. Daly, M. Herdman, P. Firth, K. Hotchkiss
Journal: British Journal of Dermatology (2006)

There is a lack of consensus as to the best way of monitoring psoriasis severity in clinical trials. The Psoriasis Area and Severity Index (PASI) is the most frequently used system and the Physician's Global Assessment (PGA) is also often used. However, both instruments have some drawbacks and neither has been fully evaluated in terms of 'validity' and 'reliability' as a psoriasis rating scale. The Lattice System Physician's Global Assessment (LS-PGA) scale has recently been developed to address some disadvantages of the PASI and PGA.To evaluate the inter-rater and intrarater reliability of the PASI, PGA and LS-PGA.On the day before the study, 14 dermatologists (raters), with varied experience of assessing psoriasis, received detailed training (2.5 h) on use of the scales. On the study day, each rater evaluated 16 adults with chronic plaque psoriasis in the morning and again in the afternoon. Raters were randomly assigned to assess subjects using the scales in a specific sequence, either PGA, LS-PGA, PASI or PGA, PASI, LS-PGA. Each rater used one sequence in the morning and the other in the afternoon. The primary endpoint was the inter-rater and intrarater reliability as determined by intraclass correlation coefficients (ICCs).All three scales demonstrated 'substantial' (a priori defined as ICC > 80%) intrarater reliability. The inter-rater reliability for each of the PASI and LS-PGA was also 'substantial' and for the PGA was 'moderate' (ICC 75%).Each one of the three scales provided reproducible psoriasis severity assessments. In terms of both intrarater and inter-rater reliability values, the three scales can be ranked from highest to lowest as follows: PASI, LS-PGA and PGA.
The Kidney in Systemic Disease
Authors: Leonard B. Berman
Journal: JAMA (1976)

Two outstanding nephrologists, both devoted to teaching, have produced a book that would best be forgotten, quickly. Why should this be? Part of the answer lies in the separateness of editorial skills from teaching, patient care, and research skills. It is the editors who must plan and oversee the execution of the plan, but there is no sign of that in the present case. Let us listen to an imaginary dialogue between the editors (E) and critic (C). E: We state in our preface that much important information is "buried" in standard texts and that our book will make it available. C: That puzzles me. It seems just as easy to open the pages of Strauss and Welt as it is to open your book. Why is one buried and not the other? E: Never mind. How about our wish to avoid the "rigid didactic" style of standard texts? C:
The Radionuclide Assessment of a System for Slow Intrathecal Infusion of Drugs
Authors: RODNEY J. HICKS, VICTOR KALFF, GRAEME BRAZENOR, HALILI RAHMAT, MICHAEL J. KELLY
Journal: Clinical Nuclear Medicine (1989)

The authors describe a new radionuclide method for assessing the functional integrity of slow intrathecal infusion devices. Approximately 11 mCi (400 MBq) of Tc-99m DTPA is injected into the pump chamber. Early and delayed imaging of the pump, tubing, and spinal cerebrospinal fluid space is performed on a digital large-field-of-view gamma camera. The digitally displayed images are then reviewed by adjustment of the grey scale window. Four patients have had eight studies and in each case the result has been confirmed by surgical exploration or by clinical response to change in therapy.
One single erythemagenic UV irradiation is more effective in increasing the proliferative activity of melanocytes in melanocytic naevi compared with fractionally applied high doses
Authors: M. TRONNIER, P. RUDOLPH, T. KÖSER, B. RAASCH, J. BRINCKMANN
Journal: British Journal of Dermatology (1997)

Journal Article One single erythemagenic UV irradiation is more effective in increasing the proliferative activity of melanocytes in melanocytic naevi compared with fractionally applied high doses Get access M. TRONNIER, M. TRONNIER Department of Dermatology, Medical University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany Search for other works by this author on: Oxford Academic Google Scholar P. RUDOLPH, P. RUDOLPH Department of General Pathology, University of Kiel, Michaelisstrasse 11, 24105 Kiel, Germany Search for other works by this author on: Oxford Academic Google Scholar T. KÖSER, T. KÖSER Department of Dermatology, Fachklinik Bad Bentheim, Postfach 1437, 48445 Bad Bentheim, Germany Search for other works by this author on: Oxford Academic Google Scholar B. RAASCH, B. RAASCH Department of Dermatology, Fachklinik Bad Bentheim, Postfach 1437, 48445 Bad Bentheim, Germany Search for other works by this author on: Oxford Academic Google Scholar J. BRINCKMANN J. BRINCKMANN Department of Dermatology, Medical University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 137, Issue 4, 1 October 1997, Pages 534–539, https://doi.org/10.1111/j.1365-2133.1997.tb03782.x Published: 01 October 1997 Article history Accepted: 18 April 1997 Published: 01 October 1997
REM syndrome: reticular erythematous mucinosis (round-cell erythematosis), a new entity?
Authors: GERD KLAUS STEIGLEDER, HEINZ GARTMANN, UTE LINKER
Journal: British Journal of Dermatology (1974)

Journal Article REM syndrome: reticular erythematous mucinosis (round‐cell erythematosis), a new entity? Get access GERD KLAUS STEIGLEDER, GERD KLAUS STEIGLEDER Department of Dermatology (Head of Department: Professor Dr G.K. Steigleder), University of Cologne, Josef‐Stelzmann‐Strasse 9, D 5000 Koln 41, Germany Search for other works by this author on: Oxford Academic Google Scholar HEINZ GARTMANN, HEINZ GARTMANN Department of Dermatology (Head of Department: Professor Dr G.K. Steigleder), University of Cologne, Josef‐Stelzmann‐Strasse 9, D 5000 Koln 41, Germany Search for other works by this author on: Oxford Academic Google Scholar UTE LINKER UTE LINKER Department of Dermatology (Head of Department: Professor Dr G.K. Steigleder), University of Cologne, Josef‐Stelzmann‐Strasse 9, D 5000 Koln 41, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 91, Issue 2, 1 August 1974, Pages 191–199, https://doi.org/10.1111/j.1365-2133.1974.tb15865.x Published: 01 August 1974 Article history Accepted: 16 November 1973 Published: 01 August 1974
Starch Blockers — Still No Calorie-Free Lunch
Authors: Irwin H. Rosenberg
Journal: New England Journal of Medicine (1982)

The report by Bo-Linn et al.1 in this issue of the Journal, showing that one of the leading preparations of "starch blockers" had no demonstrable effect on the absorption of starch calories, raises a number of challenging questions about marketing, consumer response, and the appropriate role of federal regulatory agencies in the volatile field of nutritional products. It is appropriate to note that the long-term effectiveness of all these purported starch blockers — mostly extracts of kidney beans — although doubtful, has not been disproved by this single, carefully designed clinical study. What is clear, however, is that there . . .
Genital Dermatitis Caused by Penicillin: Its Response to Nicotinic Acid
Authors: George E. Morris
Journal: New England Journal of Medicine (1951)

PELLAGROUS dermatitis of the genitals has been recognized for years. Redness, swelling, vesiculation, fissures, scaling and even bullae may occur. Vaginitis, vulvovaginitis, proctitis and scrotal and inguinal inflammations have been described. This type of pellagra can (and commonly does) occur without concomitant dermatitis of the areas usually involved in this disease — the parts exposed to the sun, the mouth and so forth.In the past five years, 20 cases of genital and rectal dermatitis have been observed to result from the administration of penicillin. All 20 cases have responded dramatically to the administration of nicotinic acid by mouth and . . .
Identification of an immunogenic CD8+ T-cell epitope derived from γ-globin, a putative tumor-associated antigen for juvenile myelomonocytic leukemia
Authors: Naoto Hirano, Marcus O. Butler, Zhinan Xia, Alla Berezovskaya, Andrew P. Murray, Sascha Ansén, Seiji Kojima, Lee M. Nadler
Journal: Blood (2006)
Changes in Lung Function and Chylous Effusions in Patients With Lymphangioleiomyomatosis Treated With Sirolimus
Authors: Angelo M. Taveira-DaSilva, Olanda Hathaway, Mario Stylianou, Joel Moss
Journal: Annals of Internal Medicine (2011)

Background: Lymphangioleiomyomatosis (LAM) is a disorder that affects women and is characterized by cystic lung destruction, chylous effusions, lymphangioleiomyomas, and angiomyolipomas. It is caused by proliferation of abnormal smooth muscle–like cells. Sirolimus is a mammalian target of rapamycin inhibitor that has been reported to decrease the size of neoplastic growths in animal models of tuberous sclerosis complex and to reduce the size of angiomyolipomas and stabilize lung function in humans. Objective: To assess whether sirolimus therapy is associated with improvement in lung function and a decrease in the size of chylous effusions and lymphangioleiomyomas in patients with LAM. Design: Observational study. Setting: The National Institutes of Health Clinical Center. Patients: 19 patients with rapidly progressing LAM or chylous effusions. Intervention: Treatment with sirolimus. Measurements: Lung function and the size of chylous effusions and lymphangioleiomyomas before and during sirolimus therapy. Results: Over a mean of 2.5 years before beginning sirolimus therapy, the mean (±SE) FEV1 decreased by 2.8% ± 0.8% predicted and diffusing capacity of the lung for carbon monoxide (Dlco) decreased by 4.8% ± 0.9% predicted per year. In contrast, over a mean of 2.6 years of sirolimus therapy, the mean (±SE) FEV1 increased by 1.8% ± 0.5% predicted and Dlco increased by 0.8% ± 0.5% predicted per year (P < 0.001). After beginning sirolimus therapy, 12 patients with chylous effusions and 11 patients with lymphangioleiomyomas experienced almost complete resolution of these conditions. In 2 of the 12 patients, sirolimus therapy enabled discontinuation of pleural fluid drainage. Limitations: This was an observational study. The resolution of effusions may have affected improvements in lung function. Conclusion: Sirolimus therapy is associated with improvement or stabilization of lung function and reduction in the size of chylous effusions and lymphangioleiomyomas in patients with LAM. Primary Funding Source: Intramural Research Program, National Heart, Lung, and Blood Institute, National Institutes of Health.
Results of a phase II, multiple-dose, randomized trial of an anti-CD23 monoclonal antibody (IDEC-152) in patients with seasonal allergic rhinitis
Authors: T.B. Casale, W.W. Busse, R.G. Lizambri, P.E. Korenblat, W.F. Schoenwetter, J.M. Weiler, L.J. Rosenwasser, A.S. Nayak, R.M. Perea, M.C. Totoritis
Journal: Journal of Allergy and Clinical Immunology (2003)
Cellular immune reactivity to recombinant OspA and flagellin from Borrelia burgdorferi in patients with Lyme borreliosis. Complexity of humoral and cellular immune responses.
Authors: A Krause, G R Burmester, A Rensing, C Schoerner, U E Schaible, M M Simon, P Herzer, M D Kramer, R Wallich
Journal: Journal of Clinical Investigation (1992)

Patients with Lyme borreliosis (LB) usually develop a vigorous T cell response against the causative pathogen Borrelia burgdorferi, but little is known about the antigens recognized in the cellular response. Therefore, T cell reactivities against whole bacteria, recombinant 31-kD (outer surface protein A, [OspA]), and 41-kD proteins (flagellin) from B. burgdorferi were studied in patients with LB, non-LB patients, and healthy donors. In parallel, specific antibodies were determined by Western blot analysis. Virtually all patients with LB exhibited marked cellular responses to whole B. burgdorferi, which were significantly elevated compared with the control groups in both early and late disease stages. However, analyses using the purified antigens OspA and flagellin revealed considerable heterogeneity in the cellular reactivities among individuals as well as variations during the course of infection. T cell responses to OspA were significantly increased in patients with early LB compared with both control groups whereas in late-stage disease responses only exceeded those of non-LB patients and were not different from normal donors. Cellular immune reactivities to flagellin were significantly higher only in early LB compared with both control groups. Reciprocally, several control subjects demonstrated marked cellular responses to OspA and flagellin, suggesting that reactions to these proteins may not always be related to LB. T cell reactivity did not correlate well with the presence of specific antibodies. Almost all seropositive patients in both early and late stage LB had serum antibodies against flagellin, but antibodies to OspA were detectable only in a subset of late LB sera. These data demonstrate the complexity of the humoral and the cellular immune responses to components of B. burgdorferi.
Transient Photoreceptor Deconstruction by CNTF Enhances rAAV-Mediated Cone Functional Rescue in Late Stage CNGB3-Achromatopsia
Authors: András M Komáromy, Jessica S Rowlan, Amanda T Parton Corr, Shelby L Reinstein, Sanford L Boye, Ann E Cooper, Amaliris Gonzalez, Britt Levy, Rong Wen, William W Hauswirth, William A Beltran, Gustavo D Aguirre
Journal: Molecular Therapy (2013)

Achromatopsia is a genetic disorder of cones, and one of the most common forms is a channelopathy caused by mutations in the β-subunit, CNGB3, of the cone cyclic nucleotide-gated (CNG) channel. Recombinant adeno-associated virus of serotype 5 (rAAV5)-mediated gene transfer of human CNGB3 cDNA to mutant dog cones results in functional and structural rescue in dogs <0.5 years of age, but treatment is minimally effective in dogs >1 year. We now test a new therapeutic concept by combining gene therapy with the administration of ciliary neurotrophic factor (CNTF). Intravitreal CNTF causes transient dedifferentiation of photoreceptors, a process called deconstruction, whereby visual cells become immature with short outer segments, and decreased retinal function and gene expression that subsequently return to normal. Cone function was successfully rescued in all mutant dogs treated between 14 and 42 months of age with this strategy. CNTF-mediated deconstruction and regeneration of the photoreceptor outer segments prepares the mutant cones optimally for gene augmentation therapy. Achromatopsia is a genetic disorder of cones, and one of the most common forms is a channelopathy caused by mutations in the β-subunit, CNGB3, of the cone cyclic nucleotide-gated (CNG) channel. Recombinant adeno-associated virus of serotype 5 (rAAV5)-mediated gene transfer of human CNGB3 cDNA to mutant dog cones results in functional and structural rescue in dogs <0.5 years of age, but treatment is minimally effective in dogs >1 year. We now test a new therapeutic concept by combining gene therapy with the administration of ciliary neurotrophic factor (CNTF). Intravitreal CNTF causes transient dedifferentiation of photoreceptors, a process called deconstruction, whereby visual cells become immature with short outer segments, and decreased retinal function and gene expression that subsequently return to normal. Cone function was successfully rescued in all mutant dogs treated between 14 and 42 months of age with this strategy. CNTF-mediated deconstruction and regeneration of the photoreceptor outer segments prepares the mutant cones optimally for gene augmentation therapy.
NHS data are not accurate enough for monitoring doctors' performance
Authors: Susan Mayor
Journal: BMJ (2006)

Data routinely collected about patients attending NHS hospitals in England and Wales are not suitable for monitoring the performance of individual doctors, says a report by the Royal College of Physicians for the Department of Health in England and the Welsh Assembly Government.

The research explored the potential use of hospital episode statistics (HES) in England and the patient episode database Wales (PEDW) to support the appraisal and revalidation of consultants.

These databases include information such as when a patient is admitted to hospital, their medical condition, which consultant they are allocated to, and when they are discharged. In his latest report on revalidation, the chief medical officer …
Comparison of dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional insulin pump therapy for glycaemic control in patients with type 1 diabetes: an open-label randomised controlled crossover trial
Authors: Ahmad Haidar, Laurent Legault, Virginie Messier, Tina Maria Mitre, Catherine Leroux, Rémi Rabasa-Lhoret
Journal: The Lancet Diabetes & Endocrinology (2014)