tbuckley/cabot-search huggingface dataset:
Philippines records highest number of new HIV cases since 1984
Authors: J. Parry
Journal: BMJ (2015)

The Philippines has reported its highest number of new cases of HIV in a single month since 1984, with 667 new cases reported in March. This represents a 34% increase over the same period last year. 

Sex without condoms among men who have sex with men was one of the key drivers of the epidemic, particularly in metropolitan Manila, where it accounted for 44% of the newly diagnosed cases.

Most of the cases (630) were attributed to sexual transmission, and 85% …
Insurers, doctors, and patients do not need to be apologetic about private treatment
Authors: P J Gravett
Journal: BMJ (1996)

EDITOR,—The private sector facilities that David Currie describes in his area bear no resemblance to those of the clinics in which I work.1 The days when private treatment was restricted to minor surgery in “dubious nursing homes” are long past, and the private sector, at least in the south east of Britain, has expanded to cover almost …
Anti-HLA antibody testing in hematology patients
Authors: Jeremy Ryan A. Peña, Susan L. Saidman
Journal: American Journal of Hematology (2015)

Anti-human leukocyte antigens (HLA) antibodies can adversely impact the care of hematology patients. In particular, HLA antibody testing provides important information for optimal stem cell and platelet donor selection in the management of stem cell recipients and platelet refractory patients. Current testing methods for HLA antibodies are briefly reviewed, with particular emphasis on laboratory and clinical issues associated with solid-phase multiplex assays.
Hair-analysis for acetyl-isoniazid/isoniazid ratio and N-acetyl-transferase-2-genotype in patients on treatment for mycobacterium tuberculosis infection
Authors: Michael Eisenhut, Detlef Thieme, Dagmar Schmid, Sybille Luederwald, Sachs Hans
Journal: European Respiratory Journal (2011)

Background:  In the presence of non-compliance, drug malabsorption or widely spaced intermittent therapy genetically determined faster acetylation of isoniazid has been shown to lead to treatment failure and relapse. Hepatotoxicity and peripheral neuritis are associated with slow acetylation of isoniazid. Objectives were to investigate what determines hair-levels of isoniazid and to assess whether acetylator phenotype in form of the isoniazid/acetyl-isoniazid ratio in hair reflects N-acetyltransferase –2 (NAT-2) genotype.   Patients and methods:  Hair was obtained from patients on isoniazid treatment. Isoniazid and acetyl isoniazid levels in hair were determined using HPLC/MS. Isoniazid/Acetyl isoniazid ratios were correlated with genotype of the NAT-2 determined by PCR. Hair levels of isoniazid were related to age, gender, weight, body mass index (BMI) and ethnic group.   Results:  Hair levels of isoniazid and acetyl-isoniazid were measured in 40 patients and genotype determined in 24. Hair levels of isoniazid correlated significantly with age and weight (p   Conclusions:  Results of hair-analysis for isoniazid showed age and weight dependency of isoniazid levels. Acetyl-isoniazid/isoniazid ratios were lower in patients with slow acetylator versus rapid acetylator genotypes.
Re. Calibration of peak expiratory flow (PEF) measuring devices
Authors: JS Milledge
Journal: European Respiratory Journal (1991)

Seventy-nine consecutive patients with symptomatic atherosclerotic stenosis ≥ 50% of intracranial vertebrobasilar artery (VBA) were treated by elective stenting. There were five strokes within 30 days, and three strokes in the VBA territory after 30 days (mean of 812 days). The annual stroke rate in the VBA territory (including any stroke and death within 30 days) was 4.6%. At the last follow-up time, 73 patients were independent (modified Rankin scale grade ≤ 2). The outcome compares favorably with medical therapy.
Usefulness of pneumococcal antigen detection in pleural fluid samples by immunochromatographic assay for diagnosis of pneumococcal pneumonia
Authors: F. Andreo, J. Domínguez, J. Ruiz-Manzano, C. Prat, S. Blanco, L. Lores, M.D. Sánchez, I. Latorre, M. Giménez, V. Ausina
Journal: Clinical Microbiology and Infection (2006)
Phase II trial of irinotecan in patients with progressive or rapidly recurrent colorectal cancer.
Authors: M L Rothenberg, J R Eckardt, J G Kuhn, H A Burris, J Nelson, S G Hilsenbeck, G I Rodriguez, A M Thurman, L S Smith, S G Eckhardt, G R Weiss, G L Elfring, D A Rinaldi, L J Schaaf, D D Von Hoff
Journal: Journal of Clinical Oncology (1996)

PURPOSE To evaluate irinotecan (CPT-11; Yakult Honsha, Tokyo, Japan) in patients with metastatic colorectal carcinoma that had recurred or progressed following fluorouracil (5-FU)-based therapy. PATIENTS AND METHODS Patients were treated with irinotecan 125 to 150 mg/m2 intravenously (IV) every week for 4 weeks, followed by a 2-week rest. Forty-eight patients were entered onto the study and all were assessable for toxicity. Forty-three patients completed one full course of therapy and were assessable for response. RESULTS One complete and nine partial responses were observed (response rate, 23%; 95% confidence interval [CI], 10% to 36%). The median response duration was 6 months (range, 2 to 13). The median survival time was 10.4 months and the 1-year survival rate was 46% (95% CI, 39% to 53%). Grade 4 diarrhea occurred in four of the first nine patients (44%) treated on this study at the 150-mg/m2 dose level. The study was amended to reduce the starting dose of irinotecan to 125 mg/m2. At this dose, nine of 39 patients (23%) developed grade 4 diarrhea. Aggressive administration of loperamide also reduced the incidence of grade 4 diarrhea. Grade 4 neutropenia occurred in eight of 48 patients (17%), but was associated with bacteremia and sepsis in only case. CONCLUSION Irinotecan has significant single-agent activity against colorectal cancer that has progressed during or shortly after treatment with 5-FU-based chemotherapy. The incidence of severe diarrhea is reduced by using a starting dose of irinotecan 125 mg/m2 and by initiating loperamide at the earliest signs of diarrhea. These results warrant further clinical evaluation to define the role of irinotecan in the treatment of individuals with colorectal cancer.
Neurosurgeons’ Critical Role in Managing Traumatic Brain Injury—Reply
Authors: Bellal Joseph, Viraj Pandit, Hassan Aziz
Journal: JAMA Surgery (2015)

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Dose-Escalated Irradiation and Overall Survival in Men With Nonmetastatic Prostate Cancer
Authors: Anusha Kalbasi, Jiaqi Li, Abigail T. Berman, Samuel Swisher-McClure, Marc Smaldone, Robert G. Uzzo, Dylan S. Small, Nandita Mitra, Justin E. Bekelman
Journal: JAMA Oncology (2015)

<h3>Importance</h3> In 5 published randomized clinical trials, dose-escalated external-beam radiation therapy (EBRT) for prostate cancer resulted in improved biochemical and local control. However, scarce evidence addresses whether dose escalation improves overall survival. <h3>Objective</h3> To examine the association between dose-escalated EBRT and overall survival among men with nonmetastatic prostate cancer. <h3>Design, Setting, and Participants</h3> We conducted a retrospective, nonrandomized comparative effectiveness study of dose-escalated vs standard-dose EBRT for prostate cancer diagnosed from 2004 to 2006 using the National Cancer Database (NCDB), which includes data from patients treated at Commission on Cancer–accredited community, academic, and comprehensive cancer facilities. Three cohorts were evaluated: men with low-risk (n = 12 229), intermediate-risk (n = 16 714), or high-risk (n = 13 538) prostate cancer. <h3>Exposures</h3> We categorized patients in each risk cohort into 2 treatment groups: standard-dose (from 68.4 Gy to &lt;75.6 Gy) or dose-escalated (≥75.6 Gy to 90 Gy) EBRT (1 Gy = 100 rad). <h3>Main Outcomes and Measures</h3> We compared overall survival between treatment groups in each analytic cohort using Cox proportional hazard models with an inverse probability weighted propensity score (IPW-PS) approach. In secondary analyses, we evaluated dose response for survival. <h3>Results</h3> Dose-escalated EBRT was associated with improved survival in the intermediate-risk (IPW-PS adjusted hazard ratio [HR], 0.84; 95% CI, 0.80-0.88;<i>P</i> &lt; .001) and high-risk groups (HR, 0.82; 95% CI, 0.78-0.85;<i>P</i> &lt; .001) but not the low-risk group (HR, 0.98; 95% CI, 0.92-1.05;<i>P</i> = .54). For every incremental increase of about 2 Gy in dose, there was a 7.8% (95% CI, 5.4%-10.2%;<i>P</i> &lt; .001) and 6.3% (95% CI, 3.3%-9.1%;<i>P</i> &lt; .001) reduction in the hazard of death for intermediate- and high-risk patients, respectively. <h3>Conclusions and Relevance</h3> Dose-escalated EBRT is associated with improved overall survival in men with intermediate- and high-risk prostate cancer but not low-risk prostate cancer. These results add to the evidence questioning aggressive local treatment strategies in men with low-risk prostate cancer but supporting such treatment in men with greater disease severity.
Hypersensitivity Reactions to Oxaliplatin: Cross-Reactivity to Carboplatin and the Introduction of a Desensitization Schedule
Authors: Lars Meyer, Torsten Zuberbier, Margitta Worm, Helmut Oettle, Hanno Riess
Journal: Journal of Clinical Oncology (2002)

Article Tools SPECIAL DEPARTMENTS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2002.20.4.1146 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11844841 Hypersensitivity Reactions to Oxaliplatin: Cross-Reactivity to Carboplatin and the Introduction of a Desensitization Schedule Lars MeyerxLars MeyerSearch for articles by this author , Torsten ZuberbierxTorsten ZuberbierSearch for articles by this author , Margitta WormxMargitta WormSearch for articles by this author , Helmut OettlexHelmut OettleSearch for articles by this author , Hanno RiessxHanno RiessSearch for articles by this author Show More University Hospital Charité, Humboldt University Berlin, Berlin, Germany https://doi.org/10.1200/JCO.2002.20.4.1146 First Page Full Text PDF Figures and Tables © 2002 by American Society of Clinical Oncology
Abstract 313: Interleukin-6 Mediates Concentric Hypertrophy, Diastolic Dysfunction and Myocardial Fibrosis in Rats
Authors: Giselle C Melendez, Yan Du, Joseph S Janicki, Gregory L Brower
Journal: Circulation (2008)

Induction of inflammatory cytokines has been implicated in the progression of myocardial remodeling and heart failure (HF). Increased levels of circulating TNF-α and interleukin-6 (IL-6) in patients with HF, suggest that these cytokines may be involved in the pathogenesis of heart disease. In previous studies we have shown that TNF-α is an important contributor to the adverse myocardial remodeling. TNF-α is known to mediate collagen degradation as well as in-series sarcomeric addition contributing to ventricular dilatation. However, the effects of IL-6 on cardiac remodeling in vivo have not been investigated. Accordingly, in this study we explore the hypothesis that up-regulation of IL-6 mediates adverse myocardial remodeling. To this end, a group of adult male Sprague Dawley rats was infused with IL-6 (2.5 μg/kg/hr, IP) for 7 days via osmotic minipump and compared to aged-matched shams. LV pressure, size, and function were measured using a blood-perfused isolated heart preparation. At the end of the experiment, hearts were weighed and analyzed for collagen volume fraction (CVF) and isolated cardiomyocyte size. The EDP-EDV (End Diastolic Pressure and Volume) relationship provided that IL-6 infusion produced LV stiffness and a clear tendency for a shift of the EDP-EDV curve to the left due to ventricular hypertrophy and diastolic dysfunction. LV weight differences demonstrate concentric hypertrophy (749 mg versus 660 mg in control hearts; p&lt; 0.05) and a marked increase in interstitial collagen in the IL-6 infused hearts relative to that in control hearts (CVF of 6.2% vs. 1.7%, respectively; p&lt; 0.001). The cardiomyocyte hypertrophy at the cellular level also reflected a concentric phenotype, with cells being significantly longer and thicker (18% and 32%, respectively; p&lt; 0.01). These novel observations demonstrate a direct effect of IL-6 on cardiac remodeling in vivo, which in contrast to TNF-α, induces a dramatic myocardial fibrosis together with concentric cardiac hypertrophy. This suggests that IL-6 may contribute to the development of diastolic dysfunction, and as such could drive the transition to heart failure.
Improving hand hygiene in hospitals—more is better
Authors: Matthew P Muller
Journal: BMJ (2015)

The WHO-5 bundle is a good place to start, but might work better with optional extras

Hand hygiene, performed appropriately by healthcare workers, protects patients and providers from infections acquired in hospital; ultimately, good hand hygiene saves lives. Despite this, adherence to hand hygiene guidelines is unacceptably poor.1 Hospitals worldwide need to tackle this critical patient safety issue. Many hospitals have tried to improve hand hygiene. Few have been unable to achieve sustained improvements.

In a linked paper, Luangasanatip and colleagues (doi:10.1136/bmj.h3728) sought to identify interventions that improve compliance with good hand hygiene in hospital and to establish their relative efficacy through a systematic review and network meta-analysis.2 They excluded study designs at high risk of bias (such as uncontrolled before-after studies). The authors conducted a thorough literature review that identified studies published in 1980-2014.

Their review included 41 studies that met eligibility criteria, 31 of which were published after 2009, including five of the six included randomised controlled trials. Most of the evaluated interventions were “multi-modal” or “bundled” interventions that included several different components; only six studies …
Surface of Localized Pleural Plaques Quantitated by Computed Tomography Scanning
Authors: JORIS VAN CLEEMPUT, HILDE DE RAEVE, JOHNY A. VERSCHAKELEN, JOZEF ROMBOUTS, LUDOVIC M. LACQUET, BENOIT NEMERY
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

To evaluate if there is a relation between the size of asbestos plaques and the level of past exposure and pulmonary function, we measured the surface of localized pleural plaques found on high-resolution (HR) CT scan, using a computerized video display unit-imaging system, in 73 workers (mean age, 43.5 yr) who had worked from 23 to 27 yr in an asbestos-cement factory. Their estimated cumulative exposure to asbestos ranged from 16.4 to 98.7 fiber-years/ ml (mean, 26.3 fiber-years/ml). Lung function measurements included lung volumes, maximal expiratory flows, and diffusing capacity. A control group of 21 workers was examined by the same procedures. Plaques were detected by CT in 51 (70%) asbestos-exposed subjects and in none of the control subjects. The average calculated plaque surface was 47.9 ± 61.7 cm2 (median, 22.1 cm2; range, 0 to 278.4 cm2). There was no relation between plaque surface and cumulative asbestos exposure (p = 0.24). In the 51 subjects with pleural plaques, the surface of the pleural lesions was not related to cumulative asbestos exposure, or to smoking history or time since first exposure. Neither the presence nor the extent of the plaques was correlated with lung function parameters.
Engagement of patients with psychosis in the consultation: conversation analytic study * Commentary: Understanding conversation
Authors: Rosemarie McCabe, Christian Heath, Tom Burns, Stefan Priebe
Journal: BMJ (2002)

<b>Objective:</b> To investigate how doctors engage with patients with psychotic illness in routine consultations. <b>Design:</b> Conversation analysis of 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder. <b>Setting:</b> Two psychiatric outpatient clinics in east London and south west London. <b>Participants:</b> 7 psychiatrists and 32 patients with schizophrenia or schizoaffective disorder. <b>Main outcome measure:</b> Mutual engagement in communication during the consultation. <b>Results:</b> Patients actively attempted to talk about the content of their psychotic symptoms in consultations by asking direct questions, repeating their questions and utterances, and producing these utterances in the concluding part of the consultation. In response, doctors hesitated, responded with a question rather than with an answer, and smiled or laughed (when informal carers were present), indicating that they were reluctant to engage with patients9 concerns about their psychotic symptoms. <b>Conclusions:</b> Patients repeatedly attempted to talk about the content of their psychotic symptoms, which was a source of noticeable interactional tension and difficulty. Addressing patients9 concerns about their illness may lead to a more satisfactory outcome of the consultation and improve engagement of such patients in the health services.
Effects of endurance training on pulmonary and systemic levels of interleukin-8 in patients with stable COPD
Authors: Ernest Sala, Catalina Balaguer, Feliu Renom, Ángel Ríos, Raquel Extremera, Alicia Binimelis, Bernat Togores, Amanda Iglesias, Josep Lluis Valera, Àlvar Agustí
Journal: European Respiratory Journal (2012)

Background:  Patients with Chronic Obstructive Pulmonary Disease (COPD) may show increased levels of interleukin (IL)-8 (CXCL8). Respiratory physiotherapy may reduce IL-8 in induced sputum, but no information is available about the potential effects of endurance training on systemic or pulmonary levels of IL-8.   Objective:  To investigate the effects of endurance training on pulmonary and systemic levels of IL-8 in patients with stable COPD.   Methods:  Levels of IL-8 were quantified in plasma and induced sputum (ELISA) in a group of patients with moderate to severe stable COPD (study group [S]: n=6, 64±4 [mean±SD] years, FEV1: 49.5±14.2% pred. post-bd.) before and after an 8 weeks controlled endurance training program, and in a control group ([C]: n=5, 61±5 years, FEV1: 45.4±9.6% pred. post-bd.), who did not perform such a program.   Results:  After 8 weeks, levels of IL-8 in plasma (S: from 4.2±4.3 to 3.9±4.0 pg/mL; C: from 4.4±1.2 to 6.5±6.2 pg/mL) and sputum (S: from 2217.1±1555.8 to 4153.2±3024.5 pg/mL; C: from 3012.88±1593.03 to 2599.92±1200.12 to pg/mL), remained unchanged in either group, despite that S showed, respectively, an increase of peak oxygen consumption (from 1.1±0.3 to 1.2±0.3 L/min, p=0.04), and a decrease of lactic acid levels at peak exercise (from 5.5±1.0 to 4.2±0.7 mmol/L, p   Conclusions:  In patients with stable COPD, a controlled endurance training program does not modify the pulmonary and/or systemic levels of IL-8. Hence, the beneficial effects of physical training cannot be attributed to the reduction of systemic pro-inflammatory cytokines.
Fc alpha-receptor expression on the myelomonocytic cell line THP-1: comparison with human alveolar macrophages
Authors: Y Sibille, S Depelchin, P Staquet, B Chatelain, P Coulie, L Shen, C Vander Maelen, JP Vaerman
Journal: European Respiratory Journal (1994)

Immunoglobulin A (IgA) and alveolar macrophages are two important components of the immune system in the respiratory tract. Fc alpha-receptors (Fc alpha R) are present on neutrophils, eosinophils and a series of human mononuclear phagocytes, including monocytes, alveolar macrophages and leukaemia cell lines (U-937). In the present study, using idiotypes and anti-idiotypic antibodies, we report that THP-1 cells, a myelomonocytic cell line, constitutively express Fc alpha R and that all IgA preparations used bind the receptor. Of the stimuli used (phorbol myristate acetate, retinoic acid, calcitriol), only calcitriol can induce differentiation of THP-1 cells, as assessed by CD14 expression. The expression of Fc alpha R appears to be independent of cell differentiation, since calcitriol pretreatment has no effect on IgA-binding. Finally, My43, a monoclonal antibody recognizing the Fc alpha R on U-937 cells, does not bind to THP-1 cells or to human alveolar macrophages. In addition, preincubation of THP-1 cells or human alveolar macrophages with My43 does not diminish IgA-binding to these cells. Ribonucleic acid (RNA) encoding the Fc alpha R isolated from U-937 is expressed, although possibly at a lower level, in alveolar macrophages and THP-1 cells. In conclusion, Fc alpha R are constitutively expressed on THP-1 cells and share some characteristics with the Fc alpha R described in human alveolar macrophages. THP-1 cells, therefore, may represent a reasonable model for further investigation of the interaction of immunoglobulin A and tissue macrophages.