tbuckley/cabot-search huggingface dataset:
Pathogenesis of <i>Staphylococcus aureus</i> Bloodstream Infections
Authors: Lena Thomer, Olaf Schneewind, Dominique Missiakas
Journal: Annual Review of Pathology Mechanisms of Disease (2016)

Staphylococcus aureus, a Gram-positive bacterium colonizing nares, skin, and the gastrointestinal tract, frequently invades the skin, soft tissues, and bloodstreams of humans. Even with surgical and antibiotic therapy, bloodstream infections are associated with significant mortality. The secretion of coagulases, proteins that associate with and activate the host hemostatic factor prothrombin, and the bacterial surface display of agglutinins, proteins that bind polymerized fibrin, are key virulence strategies for the pathogenesis of S. aureus bloodstream infections, which culminate in the establishment of abscess lesions. Pathogen-controlled processes, involving a wide spectrum of secreted factors, are responsible for the recruitment and destruction of immune cells, transforming abscess lesions into purulent exudate, with which staphylococci disseminate to produce new infectious lesions or to infect new hosts. Research on S. aureus bloodstream infections is a frontier for the characterization of protective vaccine antigens and the development of immune therapeutics aiming to prevent disease or improve outcomes.
Abstract 4509: Individual Patient Risks of Major Bleeding and Myocardial Infarction and Their Implications for Mortality and for Treatment Choice in Acute Coronary Syndromes: Findings From the ACUITY Trial
Authors: Roxana Mehran, Stuart Pocock, Tim Clayton, Alexandra J Lansky, Ajay Kirtane, George D Dangas, Steven V Manoukian, Frederick Feit, Harvey D White, E. Magnus Ohman, Gregg W Stone
Journal: Circulation (2009)

Objectives: To develop prognostic models for risk of major bleed and risk of MI in patients (pts) with ACS to assess their subsequent impact on mortality, and to assess how alternative treatment strategies affect these risks in individual pts. Methods: ACUITY trial randomized 13,819 ACS pts to heparin + GPIIb/IIIa (Hep+GPI), bivalirudin (Biv) + GPI, or Biv alone. Multivariate logistic regression models were developed relating independent baseline predictors to risk of non-CABG major bleed and of MI within 30 days. Time-updated covariate Cox models assessed how major bleeding and MIs impact on mortality risk up to 1 year. Results: There were 9 independent predictors of major bleed (N=645, 4.7%), the strongest being female gender, planned PCI, anemia, age, and raised creatinine. Pts in the top 5th of bleeding risk score had 10x the risk of those in the bottom 5th. In the top 5th, the absolute risk of bleed was 13.8% on Hep+GPI and 6.7% on Biv. There were 5 independent predictors of MI (N=705, 5.1%), the str...
Postgraduate Training in Child Psychiatry: The Content of the Curriculum
Authors: B. G. Boothroyd Brooks
Journal: American Journal of Psychiatry (2006)

In order to help others in the field arrive at a more precise knowledge of what constitutes a satisfactory curriculum of postgraduate training in child psychiatry, the author presents the content of a recently designed two-year program. It has been planned to achieve the maximum possible coordination of courses and to provide broad clinical experience.
MULTICENTRE TRIAL OF PEG-INTERFERON alpha 2A & RIBAVIRIN IN PEDIATRIC CHRONIC HEPATITIS C
Authors: Etienne Sokal, Xavier Stéphenne, Annick Bourgois, Gilda Porta, Themis R. Silveira, Dace Gordovska, Bjorn Fischler, Deirdre A. Kelly
Journal: Hepatology (2009)
Suicide and schizophrenia: data from a prospective community treatment study [published erratum appears in Am J Psychiatry 1990 Aug;147(8):1110]
Authors: L J Cohen, M A Test, R L Brown
Journal: American Journal of Psychiatry (1990)

This article reports the analysis of prospectively gathered data on eight young adults who committed suicide during an ongoing longitudinal study of long-term treatment of schizophrenia in the community. Young adult men with an early onset of psychiatric illness were identified as a high-risk subgroup. At the time of admission to the study, the subjects who eventually committed suicide reported significantly more distress and tended to be less satisfied with their lives than the other subjects. Specifically, baseline measures of self-reported subjective distress were consistently predictive of later suicide, whereas interviewer-rated measures and postbaseline assessments were not.
Single use disposable contact lenses should cut risk
Authors: M. Edwards, K. Davey
Journal: BMJ (1995)

EDITOR,--Cherry F Radford and colleagues show that the use of daily wear disposable contact lenses is a major risk factor for acanthamoeba keratitis, attributable largely to inadequate disinfection.1

Analysing type of disposable contact lenses, the authors claim a crude minimum relative risk for Acuvue of 2.63. Acuvue were the first disposable lenses introduced into Britain and have been marketed nationwide from 1988. …
Abstract 3230: Elevated Glucose and Mortality in Patients Hospitalized with Heart Failure
Authors: Mikhail Kosiborod, Silvio Inzucchi, John A Spertus, Yongfei Wang, Frederick A Masoudi, Edward P Havranek, Harlan M Krumholz
Journal: Circulation (2008)

Background: While some professional societies recommend target-driven blood glucose (BG) control for all hospitalized patients, the association between elevated BG and adverse outcomes has not been well established in patients hospitalized with heart failure (HF). Methods: We evaluated a nationally representative cohort of 50,532 patients hospitalized with HF between 04/1998 – 06/2001. Admission BG was analyzed as a categorical variable (≤110, &gt;110 –140, &gt;140 –170, &gt;170 –200, &gt;200 mg/dL), and in 10 mg/dL increments. The association between BG and all-cause mortality over 30 days and 1 year was analyzed using Cox regression, both in the entire cohort and in patients with and without diabetes (DM). Results: After multivariable adjustment, there was no significant relationship between BG and 30-day mortality (for BG &gt;110 to 140, &gt;140 to 170, &gt;170 to 200, and &gt;200, hazard ratios and 95% confidence intervals were: 1.09 (0.98 –1.22), 1.27 (1.11–1.45), 1.16 (0.98–1.37), 1.00 (0.87–1.15) respectively vs. BG ≤110, P for linear trend 0.53). Results were similar for 1-year mortality, and did not differ between patients with and without DM (P values for DM*BG interaction 0.11 and 0.55 for 30-day and 1-year mortality respectively). A lack of association between BG and mortality over 30-days and 1-year was also observed when BG was analyzed in 10mg/dL increments (Figure ). Conclusions: We found no significant association between BG and mortality in a large cohort of hospitalized HF patients. While the impact of BG lowering on outcomes cannot be determined based on this study, our findings do not support resource-intensive interventions for BG monitoring and management in this patient group.
Children of parents with major affective disorder: a review
Authors: William R. Beardslee, Jules Bemporad, Martin B. Keller, Gerald L. Klerman
Journal: American Journal of Psychiatry (1983)

The authors review published studies of the children of parents with major affective disorder and report the rates of diagnosable disorder in the children, their clinical symptoms and other behavioral disturbances, and the differing impact of parental illness at different ages and stages of development. There is significant risk to children in having parents with major affective disorder, and considerable impairment is evident in these children. The authors discuss the methodological issues in the studies and offer suggestions for future investigations.
Chronic fatigue syndrome Role of psychological factors overemphasised
Authors: C Blatch, T Blatt, A Wilson, I Hickie, A Lloyd, D Hadzi-Pavlovic, C Boughton, J Dwyer, D Wakefield, E M Goudsmit, N Anderson, C Tannock, D C Costa, J Brostoff, D O Ho-Yen, A Grant, D O Ho-Yen, M Shanks, N C Abbot, V A Spence, J G Lowe, R C Potts, A H A Hassan, J J F Belch, J S Beck, C Read, S Howes, K Prince, C Shepherd, C Fleming, V Airs, J Broderick, S Woodcock
Journal: BMJ (1994)

Chronic fatigue syndromeRole ofpsychological factors overemphasised
Was it a heart attack?
Authors: E. S Kilpatrick
Journal: BMJ (2002)

Editor—McKenna and Forfar describe how the proposed redefinition of myocardial infarction has made the measurement of cardiac specific troponin central to its diagnosis.1 In a patient presenting with chest pain a troponin concentration above the 99th centile of normal is now sufficient to diagnose myocardial infarction, irrespective of any electrocardiographic changes. Previously, as the authors state, a patient had to show the development of Q waves on electrocardiography or an increase in creatine kinase activity to more than twice the upper reference limit before this judgment was made. The widespread introduction of troponin T and troponin I measurements is an undoubted improvement, but limitations exist with the assays, which most clinicians are unaware of and may give rise to diagnostic difficulties.

One issue concerns the use of the 99th centile of normal as the cut off point for myocardial infarction. Most assays are not sensitive enough to measure values as low as this. For example, the 99th centile for troponin T (Roche Diagnostics, Lewes, UK) is about 0.01 μg/l, but the laboratory assay in routine use is unable to measure reliably below 0.03 μg/l. This means that patients with troponin T concentrations between 0.01 μg/l and 0.03 μg/l, who would be defined by the new criteria as having had a myocardial infarction, are currently being missed and included in the low risk category. McKenna and Forfar mention the use of bedside as opposed to laboratory troponin measurement, but near patient tests are less sensitive again, with the troponin T example being suitable for measurement only down to 0.1 μg/l.

A second issue is that troponin measurement involves immunoassay analytical techniques as opposed to the more robust enzymatic methods used with traditional cardiac markers such as creatine kinase. As Ismail and Barth pointed out, immunoassay methods can—unpredictably—lead to wrong results in some people and in the context of troponins these are likely to be difficult to identify.2

These and other limitations of troponin assays should not detract from the value they provide in most patients tested. They do raise concerns, however, if these tests are being used as the sole means of diagnosing myocardial infarction in a patient presenting with chest pain.
Rapid Self‐Integrating, Injectable Hydrogel for Tissue Complex Regeneration
Authors: Sen Hou, Xuefei Wang, Sean Park, Xiaobing Jin, Peter X. Ma
Journal: Advanced Healthcare Materials (2015)

A novel rapid self-integrating, injectable, and bioerodible hydrogel is developed for bone-cartilage tissue complex regeneration. The hydrogels are able to self-integrate to form various structures, as can be seen after dying some hydrogel disks pink with rodamine. This hydrogel is demonstrated to engineer cartilage-bone complex. As a service to our authors and readers, this journal provides supporting information supplied by the authors. Such materials are peer reviewed and may be re-organized for online delivery, but are not copy-edited or typeset. Technical support issues arising from supporting information (other than missing files) should be addressed to the authors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Mold‐sensitivity in children with moderate‐severe asthma is associated with HLA‐DR and HLA‐DQ
Authors: A. P. Knutsen, H. M. Vijay, V. Kumar, B. Kariuki, L. A. Santiago, R. Graff, J. D. Wofford, M. R. Shah
Journal: Allergy (2010)

Several epidemiologic studies in the United States and Europe have linked Alternaria sensitivity to both persistence and severity of asthma. In this study, we examined T cell responses and HLA class II alleles in children with moderate-severe asthma.Ninety-six children with moderate-severe asthma were compared to 90 children with mild asthma. HLA class II genotyping was performed to determine HLA allelic frequencies. Th1/Th2 Alternaria-specific T cell cytokine responses were determined by the use of Alternaria-stimulated cultures. HLA class II restriction was examined by inhibition of Alternaria-stimulated lymphoproliferative responses with blocking anti-HLA class II monoclonal antibodies.Children with moderate-severe asthma had significantly increased sensitivities to Aspergillus fumigatus; sensitivities to Alternaria were similar in both moderate-severe and mild asthmatics. The frequency of HLA-DRB1*13 alleles were increased in mold-sensitive moderate-severe asthmatic children. HLA-DRB1*03 tended to be increased in mold-sensitive moderate-severe asthmatics. The frequency of HLA-DQB1*03 alleles was significantly decreased in mold and Alternaria-sensitive moderate-severe asthma. HLA class II blocking monoclonal antibodies demonstrated HLA-DR restriction. Alternaria-stimulated IL-5 and IL-13 synthesis was significantly increased in moderate-severe asthmatics. IL-5 and IL-13 synthesis was significantly increased in Alternaria-stimulated lymphocyte cultures of HLA-DQB1*03- asthmatics compared to HLA-DQB1*03+ asthmatics.In children with Alternaria-sensitive moderate-severe asthma, there was increased Th2 sensitivity to Alternaria stimulation. This was associated with HLA-DR restriction and with increased frequency of HLA-DRB1*13 and HLA-DRB1*03. There was decreased frequency of HLA-DQB1*03 in Alternaria-sensitive moderate-severe asthma, suggesting HLA-DQB1*03 may be protective of the development of Alternaria-sensitive severe asthma.
Decreased Adrenal Responsiveness to Angiotensin II: A Defect Present in Spontaneously Hypertensive Rats
Authors: Gordon H. Williams, Lynne M. Braley, Alphonsa Menachery
Journal: Journal of Clinical Investigation (1982)

30% of patients with essential hypertension have a decreased adrenal response to angiotensin II (A II) on a low but not a high sodium intake. They also have a compensatory increase in the activity of the renin-angiotensin system best documented in a sodium-restricted state.
Abstract 14970: Incidence, Predictors, and Long-Term Mortality of Recurrent Myocardial Infarction in Patients following Discharge for Acute Myocardial Infarction
Authors: Daisaku Nakatani, Yasuhiko Sakata, Shinichiro Suna, Masaya Usami, Sen Matsumoto, Masahiko Hara, Toshimitsu Hamasaki, Hiroshi Sato, Shinsuke Nanto, Issei Komuro
Journal: Circulation (2011)

Background:  Procedural related factors including final coronary stenosis less than 30 %, residual coronary dissection and residual intracoronary thrombus have been reported to predict early occurrence of recurrent myocardial infarction (Re-MI) (within 30 days) in patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI). However, there are few reports regarding incidence, predictors and long-term mortality of Re-MI after discharge for AMI in the PCI era.   Methods and Results:  A total of 7,869 survived AMI patients who were registered in the Osaka Acute Coronary Insufficiency Study between 1998 and 2008 were studied. In the acute stage of AMI, 6,716 (85.3%) patients had received emergent PCI. During a median follow-up period of 3.9 years, 353 (4.5%) patients experienced Re-MI, with 7 (2.0%) of those dying within 30 days, which was classified as fatal Re-MI. Multivariate Cox regression analyses revealed that predictors of Re-MI were diabetes mellitus (HR, 1.817; 95% CI, 1.425-2.315; P   Conclusions:  In post-AMI patients treated in the PCI era, the incidence of Re-MI was relatively low compared to that reported previously. Patients’ clinical, rather than procedural, factors appear to affect the occurrence of Re-MI. Although nearly all Re-MI are non-fatal, Re-MI may place patients at a higher risk for subsequent mortality.
Individual Versus Group Aftercare Treatment
Authors: MARVIN I. HERZ, ROBERT L. SPITZER, MIRIAM GIBBON, KENNETH GREENSPAN, STEPHEN REIBEL
Journal: American Journal of Psychiatry (1974)

The authors designed a study to test the relative efficacy of minimal individual contact versus group therapy, given an equal amount of therapist time allocated to each treatment. One hundred forty-four aftercare patients were randomly assigned to either group or individual therapy conducted by 12 incoming first-year residents. Results at the end of one year showed no significant differences in outcome measures for either group. However, the therapists greatly preferred the group method, and the group patients seemed more enthusiastic. Greater utilization of group treatment in aftercare clinics is recommended.
Abstract 3718: Preliminary Findings ff ECG Screening in 9,125 Young Adults
Authors: Matthew Nora, Frank Zimmerman, Philip Ow, Patrick Fenner, Joseph Marek
Journal: Circulation (2007)

Introduction: The occurrence of SCD in young adults is devastating to a community. It is estimated that over 1,000 of these deaths occur annually in the USA. Experience in Italy utilizing ECG screening has demonstrated an 89% reduction in SCD in young athletes. Reports in the literature suggest a high % of abnormal findings in athletes. Concern is therefore raised that ECG screening will lead to a large number of abnormal ECGs which may lead to widespread testing and anxiety for the students. Methods: We have developed an efficient screening process to perform ECG testing on high school students utilizing community volunteers. Six high schools in the Chicago suburban region cooperated in an ECG screening program. Screening was performed during regular school hours. A total of 9,125 students were tested. A total of 138 of ECGs were abnormal (2%). The ECG abnormalities detected are outlined in Fig. 1. Many of the ECG abnormalities are likely to represent clinically important findings for these young adults. Conclusion: ECG screening of high school student results in an acceptable % of abnormal findings. The types of abnormalities detected are often of clinical significance. Number of Abnormal ECGs
Abstract 9485: Fragmented QRS Complexes, Conduction Disorder, and ST Segment Abnormality on Twelve-Lead Electrocardiography Predict Severe Cardiac Manifestation in Sarcoidosis
Authors: Satomi Nagao, Hiroshi Watanabe, Makoto Kodama, Junichi Tanaka, Eiichi Suzuki, Ichiei Narita, Yoshifusa Aizawa
Journal: Circulation (2011)

Background: Cardiac Sarcoidosis is a potentially lethal disease, but many patients with cardiac sarcoidosis are asymptomatic and the diagnosis is difficult before severe cardiac manifestation. Therefore, we aimed to identify electrocardiographic predictors of cardiac sarcoidosis. Methods and Results: This prospective, observational cohort study included consecutive 227 patients with non-cardiac sarcoidosis who did not have cardiac manifestations including advanced atrioventricular block, ventricular tachycardia, and systolic dysfunction at baseline. We studied the association of baseline electrocardiographic findings with risk of developing cardiac manifestation. In patients with non-cardiac sarcoidosis, the abnormities were frequently found in the baseline electrocardiogram; conduction disorder in 26 patients (11%), ST segment abnormality in 23 patients (10%), and fragmented QRS complex defined as various RSR’ patterns without typical bundle branch block in 19 patients (8%). During a follow-up of 6.3±3.7 years, 11 patients developed severe cardiac involvement including advanced atrioventricular block (4 patients), ventricular tachycardia (4 patients), and systolic dysfunction (3 patients). In multivariate analyses, baseline heart rate and PR interval were associated with the increased risk of developing cardiac manifestation (Table). QRS duration or corrected QT interval were not associated with cardiac manifestation. Multivariate analyses revealed that conduction disorder, ST segment abnormality, and fragmented QRS complex were associated increased the risk of developing cardiac involvement. Conclusions: We identified the electrocardiographic predictors of severe cardiac manifestation in patients with non-cardiac sarcoidosis, suggesting that these electrocardiographic abnormalities may reflect the early stage of cardiac involvement.
Abstract 17909: Ventricular Fibrillation During First 48 Hours of ST-Elevation Myocardial Infarction Treated with Primary Angioplasty Increases In-Hospital Mortality but Does Not Affect One-Year Survival in Patients Discharged Alive
Authors: Marina M Demidova, Carl-Johan Höijer, David Erlinge, Pyotr G Platonov
Journal: Circulation (2011)

Background: ICD implantation is not advocated for survivors of ventricular fibrillation (VF) during first 48h of ST-elevation myocardial infarction (STEMI). However the guidelines are based mostly on the data obtained before primary percutaneous coronary interventions (PCI) had become a standard of care. Long-term follow-up studies in contemporary real-life STEMI population are lacking. Our aim was to assess the prognostic value of early VF in non-selected population of PCI-treated STEMI patients. Methods: Consecutive patients admitted to a tertiary care hospital for primary PCI during 2007-2009 were identified using hospital registry (n=1740, age 66±12 years, 71% male). The registry data were used to find those who had VF documented during index admission and their medical records were scrutinized for VF timing in regard to the symptom onset. Information regarding ICD implants during follow-up was retrieved from the ICD registry and delivery of adequate ICD therapy was checked in medical records. Kaplan-Mayer analysis was performed on patients alive at 48 hours after symptom onset using death at 1 year as a primary endpoint. Death, resuscitated VF or adequate ICD therapy was used as a combined endpoint. Results: Early VF occurred in 7% of STEMI patients (n=124, age 67±12, 73% male, VF group). In patients alive at 48h (n=1684), VF patients (n=103) had higher in-hospital mortality (12% vs 2%, p&lt;0,001, Figure). During follow-up, 22 patients received ICD for primary and 4 for secondary prevention (two of the later had adequate ICD-therapy). In those discharged alive (n=1646), VF patients (n=91) had low mortality (1%) and combined endpoint rate (3%) that did not differ compared to NoVF patients (4% and 4% respectively). Conclusion: In a large non-selected population of STEMI patients treated by primary PCI, VF during the first 48h of STEMI is associated with increased in-hospital mortality but does not influence the long-term prognosis for those discharged alive
Single-Payer Health Systems and Statistics—Reply
Authors: Jane M. Orient
Journal: JAMA (2005)

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