tbuckley/cabot-search huggingface dataset:
T-SPOT.<i>TB</i> Interferon-γ Release Assay Performance in Healthcare Worker Screening at Nineteen U.S. Hospitals
Authors: Thomas C. King, Mark Upfal, Andrew Gottlieb, Philip Adamo, Edward Bernacki, Chris P. Kadlecek, Jeffrey G. Jones, Frances Humphrey-Carothers, Albert F. Rielly, Pamela Drewry, Kathy Murray, Marcie DeWitt, Janet Matsubara, Louis O'Dea, John Balser, Peter Wrighton-Smith
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Interferon-γ release assays have significant advantages over tuberculin skin testing in many clinical situations. However, recent studies have called into question their reliability in serial testing of healthcare workers because of reportedly high rates of positivity and high conversion/reversion rates on retesting.To define the performance characteristics of the T-SPOT.TB test, an interferon-γ release assay, during serial screening programs of healthcare workers at 19 U.S. hospitals.A total of 42,155 T-SPOT.TB test results from healthcare workers at 19 geographically diverse hospitals obtained for routine tuberculosis screening programs were analyzed to determine the rates of positivity, reversion, and conversion in serial testing data.In 19,630 evaluable serial pairs from 16,076 healthcare workers, the mean test positivity rate was 2.3% (range, 0.0-27.4%). The mean conversion rate was 0.8% (range, 0.0-2.5%), and the mean reversion rate was 17.6%. Positivity and conversion rates correlated with known tuberculosis risk factors including age and sex. The observed specificity of the T-SPOT.TB test was at least 98.6%.The high concordance and test completion rates in this study suggest that the T-SPOT.TB test is a reliable tool for healthcare worker serial screening. As expected, the observed positivity rates were lower compared with the tuberculin skin test, likely reflecting the higher specificity of this test. Furthermore, the observed rates of conversion were low and significantly correlated with the geographic incidence of tuberculosis. Our findings suggest that the T-SPOT.TB test is an accurate and reliable way to screen healthcare workers.
The ancient rubredoxin system: An efficient defense mechanism of pseudomonas aeruginosa during infections
Authors: Lutz Wiehlmann, Claus Urbanke, Thorsten Adams, Antje Munder, Burkhard Tümmler
Journal: European Respiratory Journal (2014)

Anaerobic bacteria use the ancient Rubredoxin / Rubredoxin Reductase (Rdx/RdxR) system for the detoxification of oxygen and the inactivation of reactive oxygen species (ROS). In  Pseudomonas aeruginosa  this system is only known to be necessary for growth on alkanes.  We identified the Rdx/RdxR system in a highly virulent CF- isolate as being essential for survival and proliferation after phagocytosis by human polymorphonuclear leucocytes. Transcriptome analyses showed that the Rdx/RdxR system is upregulated in several highly virulent CF isolates under high oxidative stress and in the stationary growth phase.  An  rdxR  mutant was severely impaired in quorum sensing and exhibited lower virulence in animal infection models. The bacterial cells had  in vitro  a substantially reduced resistance to ROS and had to face a higher oxidative stress (e.g. higher levels of cis-methylene fatty acids and increased Fe(III)/Fe(II) ratio). By complementation  in trans  these changes could be reverted  in vivo  and also  in vitro  by adding the heterologously expressed Rdx system to a RdxR knock out mutant cell lysate.  We showed that the Rdx/RdxR system transfers electrons with very high efficiency and nearly diffusion controlled to oxidized iron centres, keeping them in the reduced, reactive state. This enables  P. aeruginosa  to keep these proteins in an active state during oxygen stress and moreover to gain energy from the degradation of ROS. These findings support the hypothesis that the ancient oxygen protecting Rdx/RdxR system can act in  P. aeruginosa  as a highly efficient mechanism to minimize oxidative stress and facilitates persistence and proliferation in infected hosts.
Arthur T Porter
Authors: Karol Sikora
Journal: BMJ (2015)

Arthur Porter was one of the most colourful doctors I have had the privilege to meet. Born in Sierra Leone, he was educated in Freetown and Nairobi. He entered Selwyn College, Cambridge, where he read medicine. I met him at Addenbrooke’s Hospital 35 years ago, when he became my first ever houseman. He was a tremendous organiser, had wonderful empathy with patients, and I was so delighted when he announced he wanted to do oncology.

His career was meteoric. After senior house officer posts in London and Cambridge, …
Abstract 3255: Myoblast Sheet Implantation Can Prevent the Impairment of Diastolic Function and Late Remodeling After Left Ventricular Restoration in Severe Ischemic Cardiomyopathy
Authors: Shunsuke Saito, Goro Matsumiya, Sigeru Miyagawa, Atsuhiro Saito, Hisazumi Uenaka, Yasuhiro Shudo, Toru Kuratani, Yoshiki Sawa
Journal: Circulation (2009)
Super-paramagnetic iron oxide nanoparticles for use in extrapulmonary tuberculosis diagnosis
Authors: C.-N. Lee, Y.-M. Wang, W.-F. Lai, T.-J. Chen, M.-C. Yu, C.-L. Fang, F.-L. Yu, Y.-H. Tsai, W.H.-S. Chang, C.S. Zuo, P.F. Renshaw
Journal: Clinical Microbiology and Infection (2012)

The limited sensitivity of serological tests for mycobacterial antigens has encouraged the development of a nanoparticle probe specific for the extrapulmonary form of Mycobacterium tuberculosis (Mtb). We developed an innovative probe comprised of super-paramagnetic iron oxide (SPIO) nanoparticles conjugated with Mtb surface antibody (MtbsAb-nanoparticles) to provide ultrasensitive imaging of biomarkers involved in extrapulmonary Mtb infection. MtbsAb-nanoparticles were significantly conjugated with Mtb bacilli. The extent of contrast enhancement reduction on magnetic resonance imaging (MRI) for Mtb and human monocytic THP1 cells was proportional to the concentration of MtbsAb-nanoparticles. When MtbsAb-nanoparticles were intravenously injected into mice bearing Mtb granulomas, the granulomatous site showed a 14-fold greater reduction in signal intensity enhancement on T(2) -weighted MR images compared with an opposing site that received PBS injection. Mtb sAb-nanoparticles represent a new non-invasive technology for the diagnosis of extrapulmonary Mtb.
THE WASSERMANN TEST IN PRACTICAL PSYCHIATRY
Authors: LAWSON G. LOWREY
Journal: American Journal of Psychiatry (1916)

Statistics are presented dealing with the results of the Wassermann test on the blood serum of 1600 cases admitted to Danvers State Hospital. Only cases are reported in which the test has been used as a part of the routine examination. Of 864 male cases tested, 164, or 19 per cent, were positive. Of 736 female cases, 92, or 12.5 per cent, gave positive tests. Of the 1600 cases tested, 256, or 16 per cent, were positive. Doubtful tests occurred in 3.87 per cent of the cases. Including cases with positive spinal fluid test and negative or doubtful blood test, 273, or 17 per cent of 1600 admissions, give a positive test at some point. Of 164 positive blood tests among males, 113, or 68.8 per cent, occurred in cases of nervous syphilis. Of 92 females with positive blood test, 32, or 34.8 per cent, were paretics. Of 256 cases with positive blood test, 145, or 56.7 per cent, are cases of nervous syphilis. Excluding paretics from all figures, positive tests occurred in 7.6 per cent of 1455 admissions. Of the non-paretic cases with positive blood, 20 are "organic,"80 are"functional" and 10 are "unclassed." It appears that, if an insane man has a positive blood test, the chances are better than even that he will be a paretic; while if a positive test appears in an insane female, the chances are that she will not be a paretic. When paresis is excluded, the chances are about three in four that the person with positive blood will have a "functional" psychosis. An unexplained finding is the high percentage of positive blood tests among morphin habitues (small number of cases). No other non-paretic group contains any considerable group of cases with positive Wassermann. A person suffering from any psychosis may be syphilitic without belonging to the nerve syphilis group. Doubtful Wassermann tests later show positive reactions in blood or spinal fluid in about one-quarter of the cases. The test should always be repeated. Among the paretics of this series, the blood test was positive in 87.5 per cent and negative in 10.3 per cent. The spinal fluid test was positive in 87.2 per cent and negative in 8.5 per cent, while the test was positive in both fluids in 75 per cent of the cases. Of 276 cases with test on the spinal fluid, there are 126 positive results. Of these, 109 had blood and fluid test both positive; five had doubtful blood and positive fluid test; 12 had negative blood and positive fluid test. Of the 126 cases with positive fluid test, 121 were paretics; two imbeciles: one was organic dementia; one a heroin case; one psychoneurotic. The latter five may in the course of time develop paresis. The statistics here presented give evidence of the great practical importance of the Wassermann test in practical psychiatry.
Phase III trial of androgen suppression using goserelin in unfavorable-prognosis carcinoma of the prostate treated with definitive radiotherapy: report of Radiation Therapy Oncology Group Protocol 85-31.
Authors: M V Pilepich, R Caplan, R W Byhardt, C A Lawton, M J Gallagher, J B Mesic, G E Hanks, C T Coughlin, A Porter, W U Shipley, D Grignon
Journal: Journal of Clinical Oncology (1997)

PURPOSE Although androgen suppression results in a tumor response/remission in the majority of patients with carcinoma of the prostate, its potential value as an adjuvant has not been substantiated. MATERIALS AND METHODS In 1987, the Radiation Therapy Oncology Group (RTOG) initiated a randomized phase III trial of adjuvant goserelin in definitively irradiated patients with carcinoma of the prostate. A total of 977 patients had been accessioned to the study. Of these, 945 remained analyzable: 477 on the adjuvant arm and 468 on the observation arm. RESULTS Actuarial projections show that at 5 years, 84% of patients on the adjuvant goserelin arm and 71% on the observation arm remain without evidence of local recurrence (P &lt; .0001). The corresponding figures for freedom from distant metastases and disease-free survival are 83% versus 70% (P &lt; .001) and 60% and 44% (P &lt; .0001). If prostate-specific antigen (PSA) level greater than 1.5 ng is included as a failure (after &gt; or = 1 year), the 5-year disease-free survival rate on the adjuvant goserelin arm is 53% versus 20% on the observation arm (P &lt; .0001). The 5-year survival rate (for the entire population) is 75% on the adjuvant arm versus 71% on the observation arm (P = .52). However, in patients with centrally reviewed tumors with a Gleason score of 8 to 10, the difference in actuarial 5-year survival (66% on the adjuvant goserelin arm v 55% on the observation arm) reaches statistical significance (P = .03). CONCLUSION Application of androgen suppression as an adjuvant to definitive radiotherapy has been associated with a highly significant improvement in local control and freedom from disease progression. At this point, with a median follow-up time of 4.5 years, a significant improvement in survival has been observed only in patients with centrally reviewed tumors with a Gleason score of 8 to 10.
Pulmonary involvement in extrapulmonary tuberculosis patients
Authors: K.B. Gupta, Manju Jose, Uma Chaudhary, Sarita Magu
Journal: European Respiratory Journal (2011)

Background:  Molecular epidemiological studies using genotyping proved that disease transmission is higher in EPTB which also proves the infectiousness of EPTB.   Aims and objectives:  To detect the pulmonary involvement in new EPTB patients with the help of sputum examination, X-ray chest, High Resolution Computed Tomography scan of Thorax (HRCT) and Fiberoptic Bronchoscopy (FOB).   Methods:  A total of 140 patients of EPTB referred to our DOTs center were investigated for pulmonary involvement from July 2009 through November 2010.   Results:  The most common EPTB site was the Lymph nodes 46.43%, followed by pleural effusion 40.71%. Sputum could be collected from 87.14% patients, and showed 9.83% positivity for AFB on Direct smear and 11.47% positivity on culture. X-Ray chest was done in all 140 patients and parenchymal lesions detected in 82.85%. CT-Thorax could be done in 60.71% patients, and 88.23% showed parenchymal lesions. In FOB performed on 33 patients, 84.84% were found bacteriologically positive. Sputum culture had an additional yield of 2 over sputum smear. CT scan had an additional yield of 13 over x -ray. FOB had an additional yield of 26 over sputum examinations and 5 over x ray. Total patients with pulmonary involvement of 130 (92.85%) was found; of this bacteriologycally proven was 40 (28.57%) patients.   Conclusion:  We observed that majority of extra pulmonary tuberculosis patients showed parenchymal involvement, significant bacillary positivity sometimes even with a normal chest x-ray. It suggests the potential infectiousness of extra pulmonary tuberculosis patients which is always under estimated, so contact investigations and the disease prevention precaution measures should also be advised in these patients.
Neoadjuvant Chemotherapy for Peripheral Malignant Neuroectodermal Tumor of Bone: Recent Experience at the Istituto Rizzoli
Authors: Gaetano Bacci, Stefano Ferrari, Franco Bertoni, Davide Donati, Patrizia Bacchini, Alessandra Longhi, Adalberto Brach del Prever, Cristiana Forni, Simonetta Rimondini
Journal: Journal of Clinical Oncology (2000)

PURPOSE: The results achieved in 44 patients with nonmetastatic peripheral neuroectodermal tumor (PNET) of bone treated with neoadjuvant chemotherapy are reported. PATIENTS AND METHODS: A six-drug regimen of chemotherapy (vincristine, doxorubicin, dactinomycin, cyclophosphamide, ifosfamide, and etoposide) was administered to all patients. Local treatment consisted of surgery in 20 patients, surgery followed by radiotherapy in 13, and radiotherapy only in 11. RESULTS: At a mean follow-up of 4.5 years (range, 2 to 7 years), 23 patients (52%) remain event-free, 20 have relapsed (45%), and one has died of chemotherapy-related toxicity. The 5-year event-free survival and overall survival were 54.2% and 62.7%, respectively. To assess the prognostic significance of neural differentiation in the family of Ewing’s sarcoma, these results have been compared with the outcomes of 138 concomitant patients with typical Ewing’s sarcoma (TES) who were treated according to the same protocol. Of these, 103 (75%) remained continuously event-free, 34 (24%) relapsed, and one died of chemotherapy-related toxicity. It follows that PNET patients treated with this chemotherapy regimen have a significantly worse prognosis than typical ES patients (5-year event-free survival, 54.2% v 70.6%, P &lt; .012; 5-year overall survival, 62.7% v 78.3%, P &lt; .002). CONCLUSION: The authors conclude that studies into new adjuvant therapy for Ewing’s sarcoma modulated according to risk of relapse should also consider neural differentiation as a risk factor.
Comparison of laparoscopic sleeve gastrectomy pulmonary complications comparing to laparoscopic adjustable gastric banding
Authors: Olga Talkar, David Shitrit
Journal: European Respiratory Journal (2012)

Introduction/rationale

Major changes in gastric anatomy and physiology following Laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) may increase the risk of esophageal regurgitation, increasing possibility of long-term pulmonary complications.

Methods

A retrospective case-control study was performed including all patients undergoing bariatric surgery, LAGB or LSG, over a 10-year period (2000-2010) at Meir Medical Center, Israel. Two groups were defined: patients who underwent LAGB or LSG. Data included all perioperative management and were recorded in hospital computer database. All patients were thoroughly examined and questioned about pulmonary complaints, such as: shortness of breath, persistent cough, pneumonias, infected bronchiectasis.The data were analyzed using Mann Whitney test for independent samples and Chi square test, with p< 0.05 considered significant.

Results

The patients underwent either LAGB (n=193, mean age 43.1 yrs., + -12.3 yrs., 144 (76.6%) females, 21(10.9%) with previous lung disease) or LSG (n=114, mean age 45.5, +-11.3 yrs., 83 (73%) females, 12(10.5%) with previous lung disease). The LSG patients had significantly lower rates of morning cough and postprandial cough than did the LAGB patients: 14(12.3%) vs. 115(59.6%), p< 0.001, 12(10.5%) vs. 112(58.0%), p< 0.001, respectively, similar rate of pneumonia(2 cases in each group) was noted follow the surgery. Mortality was zero.

Conclusions

Follow-up data demonstrated relatively less postoperative pulmonary complications after LSG comparing to LAGB. Additional follow-up is required to define long-term safety.
Effect of chemotherapy on survival of craniofacial osteosarcoma: a systematic review of 201 patients.
Authors: L E Smeele, P J Kostense, I van der Waal, G B Snow
Journal: Journal of Clinical Oncology (1997)

PURPOSE To evaluate the possible value of chemotherapy in the treatment of craniofacial osteosarcoma (CFOS). DESIGN In a systematic review, data of 201 patients (age, 36.6 +/- 19.0 years [mean +/- SD]) from 20 uncontrolled series on CFOS indexed in Medline and Excerpta Medica between 1974 and 1994 were pooled; 180 patients had undergone surgery. Various chemotherapy regimens had been given to 71 patients. Radiotherapy was used in 69 patients. All patients had data for overall survival, and 182 had data for disease-free survival analysis. Cumulative survival distributions were estimated by the product-limit method, and a multiple regression analysis was performed. RESULTS Patients' overall and disease-free survival rates were significantly improved by treatment with chemotherapy. This was confirmed for patients with complete surgical removal, as well as for those with incomplete removal of tumor. In a proportional hazards model, complete surgical removal and chemotherapy were independent significant factors for overall and disease-free survival. The effect of radiotherapy was insignificant. No prognostic factors could be identified among age groups, sex, and subsites. CONCLUSION Evidence exists that chemotherapy improves survival in CFOS. We advocate the adoption of the chemotherapy protocols used for OS of the long bones for CFOS.
Hyaluronan: A novel sputum marker for the screening and diagnosis of lung cancer patients
Authors: Maristela Peres Rangel, Vanessa Karen de Sá, João Roberto Maciel Martins, Edwin Roger Parra Cuentas, Rui Vieira Reis, Adhemar Longatto Filho, Tereza Takagaki, Helena Nader, Vera Luiza Capelozzi
Journal: European Respiratory Journal (2012)

INTRODUCTION: Hyaluronic Acid (HA) is elevated in several cancers, but there is no data regarding its concentration in the sputum of lung cancer patients.In this study, we examined the HA concentrations in the sputum and its impact on the screening and diagnosis of lung cancer patients. METHODS: HA was examined in sputum samples of 90 lung cancer patients, 25 COPD patients and 15 healthy controls.All the patients and healthy controls selected underwent a sputum induction.Sputum samples were incubated with urea 7M at 60oC and afterwards incubated with a proteolytic enzyme.The levels of HA were measured by a noncompetitive ELISA-like fluorometric assay. RESULTS: A significant different concentration pattern of HA in the sputum was found among lung cancer, COPD and healthy individuals (p<0.001; Fig1A).ROC curve between lung cancer and healthy volunteers furnished an area of 0.821 (0.727–0.915). Assuming a cut off value of 31.44ng/mg, the specificity was 100% and the sensitivity was 51% (Fig1B). ROC curve to distinguish COPD patients from lung cancer patients showed an area of 0.698 (0.600-0.797) and the cut off value of 48.3ng/mg presented 100% of specificity and 33% of sensitivity (Fig1C).

![Figure][1] 



CONCLUSIONS: The results presented suggest a promising role of HA quantification in the sputum as a novel screening and diagnostic marker for differentiating normal and other type of fibrotic pulmonary problems from lung cancer patients.

 [1]: pending:yes
Mutation and Cancer: A Model for Wilms' Tumor of the Kidney&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Alfred G. Knudson, Louise C. Strong
Journal: JNCI Journal of the National Cancer Institute (1972)

Statistical analysis of cases of Wilms' tumor supports a 2-mutation model previously reported for retinoblastoma. Comparison of data for familial, bilateral, unilateral, and unselected cases reveals that familial and bilateral cases have an early average age of diagnosis, with a distribution suggestive of a single-event process, while unilateral and unselected cases do not. Familial cases have an incidence of bilaterality higher than that of unselected cases and a pattern consistent with autosomal dominant inheritance. These findings suggest that Wilms' tumor may be attributed to a 2-mutational model; i.e., 2 mutations are required in all cases, but, in approximately 38%, one mutation has occurred in the germinal line of a parent and is inherited. Persons acquiring this germinal mutant develop an average of one second mutation each, which gives rise to tumor. Approximately 37% of gene carriers do not develop tumor, and 15% develop bilateral tumors. About 62% of cases of Wilms' tumor are non-hereditary, both of the mutations occurring in somatic cells. The association of Wilms' tumor with aniridia, hemihypertrophy, and genitourinary anomalies is fitted to the model. The familial pattern is noted to be similar to that of a delayed mutation; new germinal mutations may be attributable to a vertically transmitted tumor virus resembling the virus causing embryonal renal sarcoma in chickens.
Cerebellar Ataxia in the Elderly
Authors: A F Safe, S Cooper, A C M Windsor
Journal: Journal of the Royal Society of Medicine (1992)

In a retrospective study of 624 elderly patients referred with falls and gait disorders, 45 patients were found to have ataxia. Cerebrovascular diseases were the most common underlying cause of ataxia (15 patients, 37%). Nine patients had hereditary/degenerative cerebellar ataxia. History suggesting alcohol as an underlying cause was established in two patients with cerebellar ataxia. Three patients had normal pressure hydrocephalus and their condition improved remarkably after surgery. No definite cause was found in five patients. Cranial computed tomography (CT) showed cerebral atrophy in 16 patients and in three patients there was evidence of atrophy of the cerebellar vermis. Four patients had femoral neck fractures and three patients had other fractures. In a 5-year follow-up five patients died with bronchopneumonia (11% mortality) and patients with dementia showed rapid deterioration. All patients were referred to the day hospital for rehabilitation. The best treatment outcome was achieved in patients who had a single cerebrovascular accident with no cognitive impairment and in those whose ataxia was secondary to medication. Fourteen patients (44%) moved to residential care while 27 (66%) continued to live in their homes with community support. We concluded that there is no evidence of increased mortality in the elderly patients with cerebellar ataxia. CT scan is mainly helpful in diagnosing specific diseases such as tumours or hydrocephalus. A significant proportion of elderly patients with ataxia may have reversible or treatable conditions and can pursue an independent life.