tbuckley/cabot-search huggingface dataset:
Cases of influenza A(H1N1)v reported in Turkey, May-July 2009
Authors: M A Ciblak, N Albayrak, Y Odabas, A Basak Altas, M Kanturvardar, M Hasoksuz, B Sucaklı, G Korukluoglu, E Bal, M Ertek, S Badur
Journal: Eurosurveillance (2009)

Following the declaration by the World Health Organization (WHO) of human cases of infection with a new influenza A(H1N1)v virus of swine origin, the Turkish Ministry of Health launched a case-based reporting of influenza A(H1N1)v throughout the country on 27 April 2009. The index case was detected on 15 May 2009. As of 17 July 2009 the number of laboratory-confirmed cases of influenza A(H1N1)v totaled 128 of whom 38 were indigenous cases.
Abstract 681: Characteristics of Atherosclerotic Plaque Burden in Patients With and Without Acute Coronary Syndrome Presenting With Acute Chest Pain to the Emergency Department
Authors: Fabian Bamberg, Maros Ferecik, Quynh Truong, Ian Rogers, Michael Shapiro, Thomas J Brady, John T Nagurney, Udo Hoffmann
Journal: Circulation (2008)

Background: Coronary computed tomography (CT) may improve the early triage of patients with acute chest pain in the emergency department (ED). The aim of this study was to compare the presence and extent of coronary atherosclerotic plaque as detected by coronary CT in patients with and without acute coronary syndromes (ACS). Methods: The study was designed as a prospective, observational cohort study in patients with acute chest pain but negative cardiac biomarkers and no diagnostic ECG changes, admitted to rule out myocardial ischemia. All patients underwent coronary CT prior to hospital admission. The presence of coronary plaque was treated as a dichotomous outcome, and the extent of CAD was defined as number of (1) coronary segments with plaque, or (2) major coronary arteries with plaque detected by MDCT as assessed by two independent observers. The clinical outcome (ACS) was adjudicated by a review committee using established AHA criteria; subjects with history of CAD (stent placement, bypass) were excluded. Results : Among 368 patients with acute chest pain (mean age 53±12 years, 61% male) 31 patients were determined to have ACS (8%). None of the 183 subjects without plaque (50%) had an ACS. Among the remaining 185 subjects (mean age 58.0±11.5 years, 68% male) in whom coronary plaque was detected, patients with ACS had a significantly more plaque (7.2±3.7 vs. 4.2±3.4, p&lt;0.0001 segments) as compared to subjects without ACS. Similar results were seen for calcified plaque and non-calcified plaque (6.5±3.7 vs. 3.6±3.5 segments, p&lt;0.0001; and 3.6±3.2 vs. 1.8±2.2 segments, p&lt;0.0001, respectively). In addition, the rate of ACS increased with the number of major coronary arteries with plaque (1-vessel: 6.8%, 2-vessels: 10.6%, 3 vessels: 30.8%, and 4-vessels: 25%; p&lt;0.01). In contrast, the ratio of non-calcified to calcified plaque was not different between patients with and without ACS (0.68±0.6 vs. 0.54±0.72, p=0.31). Conclusions: The extent of coronary plaque differs between subjects with and without ACS among patients presenting with acute chest pain. Detailed assessment of the extent and composition of coronary plaque may be helpful to assess risk of ACS among patients with acute chest pain but inconclusive initial ED evaluation.
Abstract 913: Persistent High Risk of Death and Myocardial Infarction in Patients with Peripheral Arterial Disease Undergoing PCI: Results from the NHLBI Dynamic Registry
Authors: Shoaib Saya, Subhash Banerjee, Faith Selzer, J D Abbott, Srihari S Naidu, Robert L Wilensky, David P Faxon, Alice K Jacobs, Elizabeth M Holper
Journal: Circulation (2008)

Patients with peripheral arterial disease (PAD) undergoing PCI are at high risk for adverse cardiovascular events in follow up. Trends over time in outcomes with advances in PCI and medical therapy are unknown. We evaluated 866 patients with PAD in the NHLBI Dynamic Registry undergoing PCI according to treatment eras: the early bare metal stent (BMS) era (Wave 1: ‘97–’98, n=180), the BMS era (Waves 2 and 3; ’99 and ’01–’02; n=339), and the drug-eluting stent (DES) era (Waves 4 and 5:’04 and ‘06; n=347). We compared in-hospital and 1-year outcomes by recruitment era. In-hospital CABG rates were significantly lower in the later eras (3.9%, 0.9%, 0.6%, early BMS, BMS, and DES eras respectively, p=0.005), and an increasing percentage of patients were discharged on asprin, beta blockers, statins, and ticlopidine or clopidogrel (all p&lt;0.001). The cumulative 1-year adverse event rates are seen in the table . Comparison cumulative 1-year event rates in patients without PAD in the early BMS era (n=2323), BMS era (n=3803) and DES era (n=3915) of death were 4.2%, 4.4%, and 4.0% (p=0.76); of MI were 5.3%, 5.0%, and 4.4% (p=0.19), and repeat revasculatization were 21.5%, 15.9%, and 11.4% (p&lt;0.001). The 1-year adjusted hazard ratios (HR) of adverse events in patients with PAD using the early BMS era as the reference are as follows: Death: BMS era HR=0.84 (95% CI 0.46–1.55, p=0.58) and DES era HR=1.35 (95% CI 0.71–2.56, p=0.36); MI: BMS era HR=0.89 (95% CI 0.48–1.66, p=0.72) and DES era HR=1.02 (95% CI 0.55–1.87, p=0.95); and Repeat Revascularization: BMS era HR=0.63 (95% CI 0.41– 0.97, p=0.04) and DES era HR=0.46 (95% CI 0.29–0.73, p=001).
Abstract 1975: Detection Of Left Ventricular Thrombus With Cardiac Magnetic Resonance Imaging In Patients With Acute St-segment Elevation Myocardial Infarction (stemi)
Authors: Ingo Eitel, Kathrin Schindler, Josef Friedenberger, Georg Fuernau, Gerhard Schuler, Dietmar Kivelitz, Holger Thiele
Journal: Circulation (2007)

Introduction Previously published studies showed differences regarding the prevalence of intraventricular thrombi in patients with acute myocardial infarction (MI) (4–56%). Until now there are no exact results about the occurrence of left ventricular thrombi in acute STEMI. Recognition of LV thrombus is important because the related risk of systemic embolization is high. Methods To investigate the extent of myocardial infarction we examined 225 consecutive patients undergoing primary percutaneous coronar intervention (PCI) in acute STEMI within 12 h after symptom onset by cardiac magnetic resonance imaging within 2– 4 days. Routinely all patients were examined with transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). All images were analyzed for the presence of intraventricular thrombi. Results In 18 patients (8.0%) we detected left ventricular thrombi, but none of these were seen in TTE or TEE. In two cases an intraventricular thrombus was detected by TEE and TTE, but in the subsequently performed MRI no thrombus was found. In all cases the left ventricular thrombi could be detected in the late enhancement sequence, 8 (44.4%) of them were missed in the cine SSFP sequences. Left ventricular thrombi were more frequently diagnosed in patients with moderate to severe impairment of the left ventricular systolic function (13/18 [72,2%]). Remarkable was also that 14 (77.8%) of the 18 patients with left ventricular thrombus in MRI had an anterior MI, whereas only 2 (11.1%) had an inferior MI, 1 (5,6%) a septal MI and 1 patient (5,6%) a lateral MI. Conclusion In our study TEE and TTE missed left ventricular thrombi in all 18 patients as compared to MRI. There were two false-positive results in TEE and TTE as compared to MRI. Patients with impaired left ventricular function and acute anterior MI have a higher risk of developing left ventricular thrombi than in other infarct-locations. Therefore it could be potentially important to screen in particular high-risk patients (with anterior MI and impaired left ventricular function) with cardiac magnetic resonance imaging to exclude left ventricular thrombi and to lower the risk of embolic events. In particular late enhancement sequences are suitable to detect intraventricular thrombi.
The establishment of a palliative care consult team in a comprehensive cancer center
Authors: N. Dhillon, S. Kopetz, E. Del Fabbro, S. Reddy, E. Bruera
Journal: Journal of Clinical Oncology (2005)

8093 Background: Palliative care Consult teams (PCT) are being established in cancer centers for the management of physical and psychosocial distress. Patterns of referrals and clinical findings have not been previously reported. PCT was established for specialist consultation and follow up at M.D. Anderson Cancer Center. Methods: We retrospectively reviewed 1067 consults that took place in 922 unique patients in 1 year from our referral database. Results: Mean age was 58 (range 3–98), with 51% female. Median follow up was 6 days (range 1–54). The most frequent cancer diagnoses were lung (21%), lymphoma (7%), renal (6%), ovarian, head and neck and leukemia (5% each). Consults occurred in the inpatient, outpatient, ICU and ER areas in 92%, 3%, 3% and 2%, respectively. Thirty four percent were transferred to the inpatient palliative care unit (PCU) and 66% remained on the mobile team until discharge. Of the 507 admissions to the PCU, 67% were seen by the PCT, while 33% patients were direct admissions from the clinics or ER. Problems identified in 829 patients were pain (56%), delirium (31%), dyspnea (24%), fatigue (14%), and end of life care issues (EOL) (9%). Pain was a major problem in only 19%. Death during admission was more likely in patients with delirium (p=0.01), dyspnea (p< 0.001), and EOL issues (p <0.001) and less likely if patients were seen for pain (p=0.03) and depression (p=0.02). Dyspnea and pain were more common in patients with solid tumors (p<0.001 for both) while EOL issues were more common in hematological malignancies (p=0.004). Discharge data was available for 925 consults with 26% dying during admission (56% in the PCU and 44% elsewhere in the hospital). Of the 74% patients who survived to discharge, disposition was to hospice (38%), home with clinic follow up (54%), and home with home health (3%). Conclusions: PCTs see a wide variety of patients with different primary tumors for a median follow up of six days. The majority of these patients do not die during admission. The primary management problems include delirium, dyspnea, and pain. Delirium, dyspnea and EOL issues are associated with inpatient death. PCTs are the largest source of PCU admissions and they increase the number of hospice discharges from a tertiary care cancer center. No significant financial relationships to disclose.
The rise of clinical teaching fellowships
Authors: Daniel Furmedge, Anju Verma, Kazuya Iwata, Rosie Belcher, Eleana Ntatsaki, Laura-Jane Smith, Gil Myers, Sarah Bennett, Alison Sturrock
Journal: BMJ (2013)

The number of clinical teaching fellowships in the UK has increased considerably in recent years. <b>Daniel Furmedge and colleagues </b>look at this expanding role in medical education and offer advice for those who are considering applying for a post
Seroprevalence of herpes simplex virus type 1 and type 2 in Thuringia, Germany, 1999 to 2006
Authors: A Sauerbrei, S Schmitt, T Scheper, A Brandstädt, S Saschenbrecker, M Motz, E Soutschek, P Wutzler
Journal: Eurosurveillance (2011)

Binary file ES_Abstracts_Final_ECDC.txt matches
Factors affecting event free survival (EFS) after high dose chemotherapy with stem cell rescue (HDC/SCR) in children with brain tumors
Authors: J. Aguayo, A. Teplick, A. Butturini, A. Erdreich-Epstein, R. Jubran, J. Villablanca, D. Hyder, B. Britt, J. Finlay
Journal: Journal of Clinical Oncology (2006)

9057 Background: HDC/SCR is a novel approach for treatment of children with brain tumors. Despite several studies suggesting results are better in children with primitive neural ectodermal tumors (PNET) or medulloblastoma (MB), it is controversial whether other factors can predict outcome. Methods: We retrospectively analyzed data from 53 patients who underwent HDC/SCR for brain tumors at Children Hospital Los Angeles between June 1992 and June 2005. Patients were aged 4 months to 15.8 years at diagnosis and 9 months to 18.1 years at transplant. In all cases the conditioning regimen included thiotepa and/or etoposide and/or carboplatin. The variables considered were age at diagnosis, histology, extent of disease, conditioning regimen, radiation therapy, stem cell type and timing of transplant. Results: Diagnoses included 33 PNET/MB, 8 high-grade gliomas, 5 ependymomas, 3 germinomas, 2 choroid plexus carcinomas and 2 rhabdoid tumors. Overall event free survival at 36 months was 53±9.1% in PNET/MB and 40±15.5% in tumors with other histology. Variables associated with better EFS in PNET/MB were no prior progression (p=0.00094), no spread into bone marrow (p=1.2 E-10) and age less than 3 years at diagnosis (p=0.046). There was a trend toward improved outcome if there was gross total resection of the tumor (p=0.11). Patients with PNET transplanted before progression had better EFS if they had localized disease at diagnosis (p=0.00024), and if gross total surgical resection was accomplished (p=0.11). Patients with PNET/MB transplanted after progression had better EFS if there was no spread of disease into blood or bone marrow (p=0.00023), if they were male (p=0.053), had localized disease at relapse (p=0.12) and if radiotherapy was given after transplant (p=0.053). In patients with tumors of other histology, the only variable associated with prolonged EFS was gross total resection (p=0.026). Conclusions: Children most likely to benefit from HDC/SCR for brain tumors are those less than 3 years old who are newly diagnosed with PNET that is locally confined, and those with a non-PNET diagnosis who have gross total resection of tumor. No significant financial relationships to disclose.
Abstract 22: Acute Coronary Syndrome--Related Symptoms on the Scene and Actual Diagnoses
Authors: Chika Nishiyama, Taku Iwami, Tetsuhisa Kitamura, Sumito Hayashida, Tatsuya Matsuzono, Takashi Kawamura
Journal: Circulation (2011)

Introduction Little is known about the association between acute coronary syndrome (ACS)-related symptoms and actual diagnoses. Objective To compare the occurrence of ACS between those with ACS-related symptoms and those without. Method Design: Population-based cohort study. Participants: All persons aged 20 years or more who called an ambulance because of internal diseases and who were taken to a hospital by emergency medical service (EMS) personnel in Osaka, Japan in January, 2011. Data collection and analyses: Data on patients' symptoms including chest pain and other ACS-related symptoms; shortness of breath, syncope, cold sweat, vomiting, and palpitation were prospectively collected on the scene by an EMS interview. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of either chest pain or chest pain plus other ACS-related symptoms for the occurrence of ACS were calculated. Results Among 8876 cases, 207 (2.3%) was diagnosed as ACS. 424 (4.8%) had chest pain and 205 (2.3%) had both chest pain and other ACS-related symptoms. The sensitivity, specificity, PPV, and NPV of chest pain for ACS were 32.9% (68/207), 95.8% (8092/8448), 16.0% (68/424), and 98.3% (8092/8231), respectively (Table A). The sensitivity, specificity, PPV, and NPV of chest pain plus other ACS-related symptoms for ACS were 17.9% (37/207), 98.0% (8280/8448), 18.0% (37/205), and 98.0% (8280/8450), respectively (Table B). Conclusion The specificity and NPV of chest pain for ACS were very high. However, the PPV of ACS-related symptoms was poor even if the patient had both chest pain and other ACS-related symptoms. Further research is needed to detect additional factors to increase the diagnostic accuracy of ACS.
Abstract 5856: Long-term Outcomes and Costs of Ventricular Assist Devices among United States Medicare Beneficiaries
Authors: Adrian F Hernandez, Alisa Shea, Carmelo A Milano, Joseph G Rogers, Bradley G Hammill, Kevin A Schulman, Eric D Peterson, Lesley H Curtis
Journal: Circulation (2008)

BACKGROUND: Little is known about long-term outcomes and costs associated with VAD therapy among Medicare beneficiaries. METHODS: Using the 100% inpatient and denominator files from 2000–2006, we identified Medicare fee-for-service beneficiaries as VAD only or VAD post-cardiotomy (at time of or within 30 days of cardiac surgery) and followed outcomes. Cumulative incidence of VAD reimplantation, explantation, cardiac transplantation, readmission and death were estimated accounting for censoring and competing risks. Cox proportional hazards model was used to determine factors associated with time-to-death. Inpatient costs–total and per survived day outside of the hospital were calculated from Medicare payments. RESULTS: From 2000 through 2005, 2701 patients received a VAD from 549 hospitals; 1379 (51%) VADs post-cardiotomy and 1322 (49%) VAD only. Overall index hospital survival rate was 67% for VAD only and 39% for VAD post-cardiotomy. By one year these survival rates declined to 52% and 31% respectively (Figure ). Mean inpatient cost to Medicare in the first year was $178,626 (± $143,120) for VAD only and $112,013 (± $95,473) for VAD post-cardiotomy. For all VAD recipients, Medicare inpatient expenditures per day survived and out of the hospital were $1,021 for year 1 and $466 over 3 years. CONCLUSIONS: VAD therapy is being used more commonly for end stage heart failure among Medicare beneficiaries; however, mortality and costs remains high. Advances in technology, and improved patient selection are needed before the use of VADs can expand more widely.
Depression Treated with Imipramine and ECT: The DeCarolis Study Reconsidered
Authors: David Avery, Aldo Lubrano
Journal: American Journal of Psychiatry (1979)

The authors reevaluate a large prospective Italian study (437 patients) that compared high-dose imipramine with ECT treatment in the treatment of depression. The superiority of ECT was evident among patients with endogenous depression, and especially evident among those with delusional depression (83% improved with ECT versus 40% with imipramine) and depressions defined as severe (83% versus 35%).
10-minute consultation: Rhinitis
Authors: N. Brookes
Journal: BMJ (2002)

Editor—Although the 10-minute consultation on rhinitis serves as a useful guide for treatment of this common condition, certain points merit clarification.1

We agree that unilateral nasal blockage and bleeding warrant prompt referral since these symptoms may indicate an underlying malignancy. Contrary to the authors' suggestion, however, this is an uncommon presentation of nasopharyngeal carcinoma, which is more frequently associated with unilateral glue ear or cervical lymphadenopathy. Examination of the nose by an experienced doctor using adequate illumination is essential to exclude other diagnoses, such as septal deflection, turbinate enlargement, and nasal polyposis. We are also surprised that no mention is made of the diagnostic value of allergy testing, which has been shown to be feasible in primary care.2

With regard to treatment, the authors do not emphasise that topical nasal decongestants such as oxymetazoline should be avoided in prolonged courses owing to the incidence of rebound oedema and rhinitis medicamentosa.3 We disagree with the assertion that steroid drops should not be used in chronic allergic rhinitis since they increase systemic absorption.

Betamethasone nasal drops do cause appreciable systemic bioavailability and in protracted regimens have been associated with undesirable side effects. This is not the case, however, with fluticasone nasal drops, which have negligible absorption (0.06%), less even than fluticasone spray (0.51%).4 Along with budesonide, they do not contain benzalkonium chloride preservative, which is found in most other topical preparations and to which some patients are sensitive.5 These preparations are therefore of particular use in patients developing nasal discomfort with more commonly prescribed sprays.

Either betamethasone or fluticasone nasal drops are preferable to the course of 20 mg oral prednisolone suggested by the authors—a treatment rarely given for allergic rhinitis even by specialists. Equally, the authors are unwise to suggest referral for immunotherapy as a realistic option in primary care, since this controversial technique is used in only a few centres.

We agree that many patients with allergic rhinitis can be treated successfully in primary care but believe that more emphasis should be placed on adequate initial examination of the patient and particularly on referral to a specialist otolaryngologist or allergist should initial treatment fail.
Abstract 14785: Impact of Impaired LDL Catabolism and Increased VLDL and VLDL Remnant Production on Hypercholesterolemia in Homozygous PCSK9 Gene Mutation: Evidence from Kinetic Study with Stable Isotope
Authors: Masa-aki Kawashiri, Katsunori Ikewaki, Hayato Tada, Tohru Noguchi, Atsushi Nohara, Akihiro Inazu, Junji Kobayashi, Hiroshi Mabuchi, Masakazu Yamagishi
Journal: Circulation (2011)

Background: Statin activates sterol regulatory element binding protein 2 (SREBP2) due to depletion of cholesterol in hepatocyte and results both in induction of low-density lipoprotein (LDL) recept...
General Medical Council unveils its reform package
Authors: Zosia Kmietowicz
Journal: BMJ (2000)

The General Medical Council has unveiled a package of reforms which, together with its revalidation scheme, it hopes will appease its critics and signal a new phase of public openness and confidence in the council.

A top priority is to speed up the process of hearing complaints and clear the backlog of cases that are currently waiting to be brought before the Professional Conduct Committee. There are also plans to review the structure of the chamber and the policy of appointing of non-elected members.

The GMC has been heavily criticised in recent weeks, being described as “dysfunctional, arrogant, and inefficient” by …
Abstract 15884: Arrhythmogenic Effect of Store-Operated Calcium Entry in Mouse Ventricular Myocytes
Authors: Hairuo Wen, Zhenghang Zhao, Nadezhda Fefelova, Charelle Allen, Lai-Hua Xie
Journal: Circulation (2011)

Background: Store operated Ca2+ entry (SOCE) has recently been found in myocytes isolated from fetal, neonatal, and diseased hearts. However, its existence, molecular nature and (patho)physiologica...