tbuckley/cabot-search huggingface dataset:
Update: Outbreak of Acute Febrile Illness Among Athletes Participating in Eco-Challenge-Sabah 2000—Borneo, Malaysia, 2000
Authors: C. Hahn, L. Mascola, R. Cader, D. Haake, D. Vugia, C. Easman, J. Keystone, B. Connor, J. Purdue, K. Hendricks, J. Pape, L. McFarland, M. Eyeson-Annan, P. Buck, H. Artsob, M. Evans, R. Salmon, B. Smyth, T. Coleman, V. Cardenas
Journal: JAMA (2001)

1 Influenza activity was low to moderate but increasing in the United States.Since October 1, the most frequently isolated viruses were influenza A (H1N1) and were well matched antigenically with the 2000-01 influenza A (H1N1) vaccine strain.During October 1, 2000-January 13, 2001, World Health Organization collaborating laboratories and National Respiratory and Enteric Virus Surveillance System laboratories in the United States tested 26,789 specimens for influenza: 1545 (6%) were positive.Of these, 1132 (73%) were influenza A and 413 (27%) were influenza B. Of the 1132 influenza A isolates collected, 457 (40%) have been subtyped: 441 (96%) were A (H1N1) and 16 (4%) were A (H3N2).Of the 56 influenza A (H1N1) isolates characterized antigenically at CDC, 53 (95%) were A/New Caledonia/ 20/99-like (H1N1) viruses, the H1N1 component of the 2000-01 vaccine strain, and three (5%) were A/Bayern/ 07/95-like (H1N1) viruses.The A/New Caledonia/20/99 vaccine strain produces high titers of antibody that are cross-reactive to A/Bayern/07/95-like (H1N1) viruses. 2 Ten influenza A (H3N2) viruses and 20 influenza B viruses were characterized; all were similar antigenically to vaccine strains A/Panama/2007/99 (H3N2) and B/Beijing/184/93, respectively.The percentage of positive influenza infections, an important indicator of influenza activity, increased from 4% during the week ending November 25 to 15% during the week ending January 13.During November 6, 2000-January 13, 2001, 2%-3% of patient visits to U.S. sentinel physicians were for influenzalike illness (ILI).* During the week ending January 13 (week 2), patient visits for ILI were at baseline levels (0-3%) in seven of nine surveillance regions.Levels were above baseline in the Pacific (6%) and West South Central (4%) regions.During the same week, widespread † influenza activity was reported in Rhode Island and Virginia, and regional activity was reported in 21 states (Alabama, Arizona, Colorado, Connecticut, Idaho, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Minnesota, Mississippi, Nevada, North Carolina, Oregon, Tennessee, Texas, Utah, Washington, and Wyoming); 26 states reported sporadic activity, and one state did not report.The 122 Cities Mortality Reporting System attributed 7.7% of recorded deaths to pneumonia and influenza (P&I).This percentage was below the epidemic threshold ‡ of 8.5% for week 2. The percentage of P&I deaths has remained below the epidemic threshold for each week since October 1.
Temporal Trends in Percutaneous Coronary Intervention Appropriateness
Authors: Steven M. Bradley, Chad M. Bohn, David J. Malenka, Michelle M. Graham, Chris L. Bryson, James M. McCabe, Jeptha P. Curtis, Anne Lambert-Kerzner, Charles Maynard
Journal: Circulation (2015)

Background— It is unknown whether the appropriate use of percutaneous coronary intervention (PCI) has improved over time and whether trends in PCI appropriateness have been accompanied by changes in the use of PCI. Methods and Results— We applied appropriate use criteria to determine the appropriateness of all 51 872 PCI performed in Washington State from 2010 through 2013. We evaluated the number of PCIs performed from 2006 through 2013 to provide a comparator period that preceded statewide appropriateness assessment beginning in 2010. Between 2010 and 2013, the overall number of PCI decreased by 6.8% (13 267 PCIs in 2010 to 12 193 in 2013) with a 43% decline in the number of PCIs for elective indications (3818 PCIs in 2010 to 2193 PCIs in 2013). The decline in the use of elective PCI was significantly larger after the onset of statewide PCI appropriateness assessment in 2010 ( P =0.03). The proportion of elective PCIs classified as appropriate increased from 26% in 2010 to 38% in 2013, whereas the proportion of inappropriate PCIs decreased from 16% to 13% ( P &lt;0.001 for trends). Significant improvements in the proportion of inappropriate PCI were limited to the tertile of hospitals with the largest decline in PCIs classified as inappropriate (25% in 2010 to 12% in 2013; P =0.03). Conclusions— In Washington State, the use of PCI for elective indications has decreased over time with concurrent improvements in PCI appropriateness. However, improvements in PCI appropriateness were limited to a minority of hospitals. Understanding processes at these high-performing hospitals may inform efforts to improve PCI appropriateness.
Abstract P256: Associations Between Periaortic Vascular Adipose Tissue, Cardiometabolic Risk Factors and Aortic Calcification in a Multiethnic Cohort of Men From the ERA JUMP Study
Authors: Mindy L Columbus, Emma Barinas-Mitchell, Belinda McQuaide, Lina Bai, Marnie Bertolet, Marina Bodomova, Daniel Edmundowicz, Beatriz Rodriguez, Bradley Wilcox, Chol Shin, Kamal Masaki, Akira Sekikawa
Journal: Circulation (2015)

Background: Aortic calcification (AC) is a direct measure of subclinical cardiovascular disease (CVD) linked with CVD events and mortality. Periaortic vascular adipose tissue (PVAT) may exert local pro-atherogenic effects on the arteries, through secretion of pro-inflammatory adipocytokines, in addition to systemic effects. Racial differences exist between various adipose depots including visceral and epicardial fats, however little is known for PVAT. Our objectives were to evaluate 1) the associations between PVAT volume and cardiometabolic risk factors and 2) the relationship between PVAT volume and AC among middle-aged White, Japanese American, and Korean men. Methods: We measured thoracic PVAT volume (cm 3 ) in 54 (17 US White, 19 Japanese American and 18 Korean) men with high AC (AC Agatston Score ≥400) and in 59 (20 US White, 19 Japanese American and 20 Korean) age- and BMI- frequency matched controls with low AC (0-100) from the ERA-JUMP study. PVAT volume was quantified in aortic scans by electron-beam computed tomography using Slice-O-Matic reading software and a Hounsfield Units range of -190 to -30 for adipose tissue. Overall and race-specific univariate correlations were calculated to assess associations of PVAT with cardiometabolic risk factors and logistic regression was used to assess PVAT associations with AC≥400. Results: Overall mean (SD) age and BMI were 45.6 (3.0) years and 27.1 (2.8) kg/m 2 , respectively. Median PVAT was 44.4 (IQR: 35.7-56.0) and differed by race; 50.3 (IQR: 39.5-60.0) in Whites, 47.9 (IQR: 37.5-55.8) in Japanese Americans and 37.4 (IQR: 32.5-49.2) in Koreans, p=0.002. Waist circumference, BMI, visceral and subcutaneous fat, total cholesterol, HDL-C, triglycerides, and insulin were significantly associated with PVAT volume in the overall group. In race-specific analyses, all measures of adiposity were significantly associated with PVAT. Furthermore, PVAT volume was significantly associated with HDL-C (inversely) in Whites, with triglycerides in Whites and Japanese Americans and with BP in Japanese Americans. Median PVAT volume was higher in cases than controls [47.9 cm 3 (IQR: 34.5-61.1) vs 44.0 cm 3 (IQR: 36.7-51.0)] though not significantly different. PVAT was not significantly associated with high AC. Conclusions: In this multiethnic group of men aged 40-49 years, PVAT was higher in US Whites and Japanese Americans and lower in Koreans. PVAT was associated with overall and central adiposity and with markers of cardiometabolic risk across racial/ethnic groups. However, additional research needs to be done to substantiate these findings.
Abstract 13781: Assessment of Microvascular Dysfunction by Transthoracic Echocardiography Compared to Positron Emission Tomography
Authors: Marie M Michelsen, Naja D Mygind, Adam A Pena, Rasmus H Olsen, Nis Høst, Thomas E Christensen, Philip Hasbak, Andreas Kjaer, Jens Kastrup, Eva Prescott
Journal: Circulation (2014)

Introduction: Microvessel dysfunction can be assessed by measurement of Coronary Flow Reserve (CFR) by Transthoracic Doppler Echocardiography (TTDE). Positron Emission Tomography (PET) is regarded as the gold standard for CFR measurements. Only one previous study based on 10 healthy males has validated TTDE against PET measured CFR. The aim of the study was to compare CFR measurements by TTDE to those obtained by PET in women with angina pectoris but no obstructive coronary artery disease (CAD). Methods: Patients (n=93) were randomly selected from a cohort of women with angina pectoris but no obstructive CAD and a successful CFR measurement by TTDE of the left anterior descending artery (LAD) during dipyridamole infusion (0.84 mg/kg). CFR was measured by rubidium-82 PET during adenosine infusion (0.84 mg/kg). A Quality Index (QI) of CFR measured by TTDE was assessed on a scale from 1-9 on the basis of visibility of vessel and characteristics of flow curves. Concordance between the methods was assessed by the Bland Altman method. Results: CFR was successfully measured in 88 women by rubidium PET (exclusion due to inability to complete examination (n=4) and one outlier with un-physiological high CFR value of 5.9). Median CFR (iq range) was 2.69 (2.24; 3.05) for PET and 2.36 (1.92; 2.75) for TTDE. CFR was systematically assessed higher by PET (mean difference 0.39, p&lt;0.01. Reproducibility was compared to a large study (n=125) regarding PET-PET agreement (table 1). Conclusions: Results are similar to previous assessments of reproducibility of CFR assessed by PET. For patients with TTDE CFR QI &gt; 6 there is a higher concordance between TTDE and PET CFR, indicating that the validity of CFR is dependent on quality. However, part of the divergence between PET and TTDE could be due to difference in method; TTDE estimates LAD flow velocities whereas PET estimates global flow per myocardial tissue mass. CFR measured with TTDE is a valid method to investigate cardiac microvascular dysfunction.
Author's Reply: Flexible Office Hours
Authors: S. J. Mellette
Journal: CA A Cancer Journal for Clinicians (1986)

The Cancer Patient atWorkâ€ • (Ca35:360â€"3 73.1985).discusses the many problems cancer patients may have once they get to the work place, it neglects a very significant problem for patients who workâ€"the conflict be tween their need to be working and the propensity for oncologists to schedule treatment during â€oe¿ usual working hours.â€•Even when cancer patients are feeling well and tolerating their therapy (whether it is radiation therapy or chemotherapy),
The British Medical Journal and prescribing of minocycline for acne
Authors: C. Moss, R.E. Ferner
Journal: British Journal of Dermatology (2012)

Funding sources: none. Conflicts of interest: none declared. Madam, Walsh and Creamer,1 in their commentary on a French report of the adverse effects of minocycline used for acne,2 note the apparent influence of the British Medical Journal (BMJ) on prescribing. They state that BMJ guidance in 2002 recommended minocycline as a first‐line treatment for acne; despite a Cochrane review the next year that failed to find any reliable evidence favouring minocycline, it ‘was not until 2006 and again in 2007 and 2009 that the [British Medical] journal published guidance concurring with the recommendations of the Cochrane Review of 2003; it was around this time that prescribing rates of minocycline began to fall’. In fact a much more significant fall in minocycline prescribing had already occurred in the U.K., between 1995 and 2002, and is also apparent in the French data. Following a BMJ report in January 1996 of rare but serious adverse effects,3 and our accompanying editorial,4 U.K. prescription numbers had fallen to 70% by the end of the first quarter of 1996, and in the following quarter to 62% of the prior values, and remained at that level for at least the 15 months of observation5 (Fig. 1).
Personal views: Accountability
Authors: Edmund Hey
Journal: BMJ (2002)

First, what to wear? Perhaps blazer, club tie, and stout brown walking shoes. Definitely not a suit. The week-long update course is, shall we say, not aimed primarily at hospital doctors.

When I get there, there are no suits and precious few blazers, but lots of pullovers and a truly impressive range of sensible, comfortable footwear. And everyone seems very relaxed, even at the ritual initiation of coffee and registration.

Familiar faces? A fair few, mainly local doctors whose patients I see from time to time. Among them is an equable survivor of a house job more than 30 years ago: a co-resident for six months on a rota with no weekends and weekly hours running well into three figures. By Tuesday we are even chatting about the residency cockroaches, as though they were old friends too. A less familiar face turns out to be a former student from a little under 20 years ago. A quick, astonishing intercontinental update follows: general practice in East Africa sounds, um, challenging.

Our lecturers are mainly hospital colleagues. Lectures, it dawns upon me as they come and go, are self portraits too, verging occasionally upon self caricature. There is the rumpled, anxious Hampstead boy of 45, worrying still about what his mum thinks of his diet, his lifestyle, his suits—and all this he tells us, oy vay. Then the Edinburgh lady of a certain age: crisp, practical, and authoritative in her emerging subspecialty. Miss Jean Brodie, one feels, would be proud of someone so obviously one of her girls.

And it is all so relaxing: the schoolroom routine of talks and questions, breaks morning and afternoon, and time off for lunch. Lunch? Like many others in the trade, I had long abandoned the idea that lunch might mean sitting down, eating and talking with colleagues, and relaxing a little—more coffee? time with a newspaper? a walk as far as a bookshop?—before returning to work.

All this, and education too? Surely too much to ask, but by the end of a week spent variously taking notes, dozing off, and challenging or flattering our teachers, we have indeed been updated. In the collegial calm of the course, some pleasant and articulate doctors have shared their knowledge and their uncertainties too. Over a final coffee I discover that quite a few people come year after year. Yes. And perhaps—next year—a pullover.
Abstract 11902: Exercise in Heart Failure and Patterns of Inflammation and Myocardial Stress Over Time
Authors: Ruth M Masterson Creber, Christopher S Lee, Kenneth Margulies, Stephen Ellis, Barbara Riegel
Journal: Circulation (2014)

Background: Regular exercise is recommended to improve physical function in patients with heart failure (HF). Exercise is known to decrease inflammation and thought to decrease myocardial stress. Studies of N-terminal pro b-type natriuretic (NT-proBNP) and high-sensitivity C-reactive protein (hsCRP) have been mixed in patients with HF and physiologic heterogeneity in response to exercise training is common. A multi-marker analysis may help identify distinct subgroups of HF patients who respond to exercise. Objectives: Identify common and distinct patterns of change in serum biomarkers of hsCRP and NT-proBNP and quantify the influence of exercise therapy on the patterns of change. Methods: NT-proBNP and hsCRP were assessed in a random sample of 320 participants from the biomarker sub-study of the HF-ACTION study, a randomized clinical trial of exercise training versus usual care in patients with stable and chronic HF. Growth mixture modeling was used to identify unique biomarker patterns measured over 12-m...
Non-invasive approaches to monitor EGFR-TKI treatment in non-small-cell lung cancer
Authors: Wei Sun, Xun Yuan, Yijun Tian, Hua Wu, Hanxiao Xu, Guoqing Hu, Kongming Wu
Journal: Journal of Hematology & Oncology (2015)

Tyrosine kinase inhibitors of epidermal growth factor receptor (EGFR-TKIs) are standard treatments for advanced non-small-cell lung cancer (NSCLC) patients harboring activating epidermal growth factor receptor (EGFR) mutations. Nowadays, tumor tissues acquired by surgery or biopsy are the routine materials for EGFR mutation analysis. However, the accessibility of tumor tissues is not always satisfactory in advanced NSCLC. Moreover, a high proportion of NSCLC patients will eventually develop resistance to EGFR-TKIs. Invasive procedures, such as surgery or biopsy, are impractical to be performed repeatedly to assess the evolution of EGFR-TKI resistance. Thus, exploring some convenient and less invasive techniques to monitor EGFR-TKI treatment is urgently needed. Circulating cell-free tumor DNA (ctDNA) has a high degree of specificity to detect EGFR mutations in NSCLC. Besides, ctDNA is capable of monitoring the disease progression during EGFR-TKI treatment. Certain serum microRNAs that correlate with EGFR signaling pathway, such as miR-21 and miR-10b, have been demonstrated to be helpful in evaluating the efficiency of EGFR-TKI therapeutics. A commercialized serum-based proteomic test, named VeriStrat test, has shown an outstanding ability to predict the clinical outcome of NSCLC patients receiving EGFR-TKIs. Analysis of EGFR mutations in circulating tumor cells (CTCs) is feasible, and CTCs represent a promising material to predict EGFR-TKI-treatment efficacy and resistance. These evidences suggested that non-invasive techniques based on serum or plasma samples had a great potential for monitoring EGFR-TKI treatment in NSCLC. In this review, we summarized these non-invasive approaches and considered their possible applications in EGFR-TKI-treatment monitoring.
Clinical Diagnostic Reasoning
Authors: Geoffrey J McColl, Michele A Groves
Journal: New England Journal of Medicine (2007)

To the Editor: Bowen's review of educational strategies that can be used to promote clinical diagnostic reasoning (Nov.23 issue) 1 does not sufficiently emphasize the concept of premature closure.Acceptance of a diagnosis before sufficient verification has occurred and failure to consider plausible alternatives once a diagnosis has been reached 2,3 are common causes of diagnostic error and can occur at any level of training. 3,4One possible effect of anchoring -the inability to assimilate subsequent or evolving data -is a particularly important contributing factor in premature closure and may lead to faulty synthesis of information. 5The risk of premature closure may be greatest when learners are pressed for time or expected to have a level of expertise they have not yet attained.Premature closure may be just as likely to result from an "unlucky" adherence to an illness script as from gaps in knowledge.Clinical educators should encourage learners to continuously integrate new information into the decisionmaking process.
Abstract 13343: Up-regulated Expression of Neurotrophin 3 in the Interstitial Cells of Stenotic Aortic Valves May Promote Valvular Fibrosis
Authors: Qingzhou Yao, Xiyong yu, Xianzhong Meng, David A. Fullerton
Journal: Circulation (2014)

Introduction: Aortic valve stenosis is characterized by valvular fibrosis, calci[[Unable to Display Character: ﬁ]]cation and extracellular matrix (ECM) remodeling. Aortic valve interstitial cell (AVIC) proliferation and over-production of ECM proteins result in valve thickening and fibrosis. However, the factors that mediate AVIC proliferation and ECM protein expression need to be identified. Our previous work demonstrated that human AVICs express Toll-like receptor (TLR4), and TLR4 signaling can be activated by several endogenous proteins associated with aortic valve stenosis, including soluble biglycan and oxidized low density lipoprotein. Recently, we observed that AVICs of stenotic aortic valve express higher levels of NT3. It remains unknown whether NT3 induces the fibrogenic responses in AVICs and whether stimulation of TLR4 up-regulates NT3 expression in human AVICs. Hypothesis: Neurotrophin 3 induces AVIC proliferation and ECM protein production, and contributes to the mechanism of AVIC fib...
A seroepidemiological study of pandemic A/H1N1(2009) influenza in a rural population of Mali
Authors: O.A. Koita, L. Sangare, B. Poudiougou, B. Aboubacar, Y. Samake, T. Coulibaly, P. Pronyk, N. Salez, A. Kieffer, L. Ninove, A. Flahault, X. de Lamballerie
Journal: Clinical Microbiology and Infection (2011)
Abstract P243: Long-Term Exposure to Air Pollution and Markers of Inflammation, Coagulation and Endothelial Activation: A Repeat Measures Analysis in the Multi-Ethnic Study of Atherosclerosis
Authors: Anjum Hajat, Ana V Diez-Roux, Nancy Jenny, Adam Szpiro, Joel Kaufman
Journal: Circulation (2014)

Air pollution is associated with CVD and systemic inflammation is posited to mediate this effect. Animal, experimental and epidemiologic studies suggest that increases in short-term air pollution cause an inflammatory response. Few studies, however, have assessed the contribution of long-term exposure to pollutants even though chronic inflammation may be more relevant to the observed risk of atherosclerotic disease. We assessed the hypothesis that long-term exposure to pollutants is associated with markers of inflammation, coagulation and endothelial activation. We studied participants from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort with repeat measures of serum C-reactive protein (CRP), fibrinogen, D-dimer, soluble E-selectin and soluble Intercellular Adhesion Molecule-1 (sICAM-1). We estimated associations of these markers with outdoor PM2.5, individual-level ambient PM2.5 (integrating indoor concentrations and time-location data) and oxides of nitrogen (NOX). Pollutant concentrations were predicted from likelihood based models from cohort-specific monitoring and were averaged over the year prior to blood draw. CRP and D-Dimer were log-transformed for analysis. A random effects model controlling for relevant covariates was used to account for within person clustering. Participants with a recent history of acute infection were excluded from analysis. A total of 713 participants contributed 1736 observations (mean 1.8 observations per person over 3 visits). After excluding those with a recent infection we were left with 1233 observations among 491 participants. In multivariable models, both D-dimer and E-selectin were associated with pollutants, specifically PM2.5 and NOx (see table). There was no association between pollutants and CRP, fibrinogen or sICAM-1. In conclusion, these data are consistent with the hypothesis that associations between long-term exposure to particulate and traffic-related air pollution and CVD may be related to endothelial activation and fibrinolysis.