tbuckley/cabot-search huggingface dataset:
Sequential Stevens–Johnson syndrome and photo‐recall phenomenon
Authors: H.Y. Lee, M. Philippidou, R. Marcus, S. Walsh, D. Creamer
Journal: British Journal of Dermatology (2011)

Funding sources: none. Conflicts of interest: none declared. Madam, A 68‐year‐old woman with diffuse large B‐cell lymphoma of the brain was started on a chemotherapeutic regimen consisting of high‐dose intravenous methotrexate (MTX) at a dose of 2·5 g m−2 and procarbazine at a dose of 200 mg daily. Other medications started concurrently included dexamethasone, allopurinol and omeprazole. Fourteen days later, she developed an extensive rash with mouth ulcers and fever. Clinical examination showed atypical targets that were mainly truncal in distribution associated with buccal mucositis, anogenital erosions and fever. The skin biopsy showed full‐thickness apoptosis of keratinocytes, focal basal liquefactive degeneration and lymphocyte exocytosis with a chronic inflammatory infiltrate consisting of lymphocytes, histiocytes and eosinophils. A diagnosis of Stevens–Johnson syndrome (SJS) was made. An infection screen was negative. Allopurinol was deemed to be the culprit drug and was stopped. Superpotent topical corticosteroid ointment (clobetasol propionate) was prescribed with resolution of the rash 1 week later. She was readmitted electively 2 weeks later for further chemotherapy. Unfortunately, allopurinol was inadvertently reintroduced and there was a recrudescence of the rash with scattered atypical targets on the trunk. Allopurinol was immediately stopped and the target lesions settled rapidly. Two days later, she was commenced on her second cycle of chemotherapy consisting of MTX and procarbazine. Over the next 5 days, she developed a new dermatosis in a sun‐exposed distribution. There was a well‐defined erythema with oedema over the extensor aspects of both upper limbs and erythematous, scaly plaques over the V of the neck (Fig. 1). The autoimmune screen was unremarkable (negative antinuclear antibodies and extracted nuclear antigens, normal complement levels). A repeat biopsy of the lesional skin showed scattered apoptotic cells and focal squamatization of the basal layer overlying extensive solar elastosis and a scanty perivascular infiltrate of lymphocytes (Fig. 2). The clinical presentation and histology was suggestive of a photo‐recall phenomenon which was triggered by her chemotherapy, most likely MTX. She was started on prednisolone 0·5 mg kg−1 with improvement and was maintained on systemic corticosteroids during her subsequent cycle of chemotherapy with no further recurrences.
Cluster of ciguatera fish poisoning --- North Carolina, 2007
Authors: Ricky Langley, M Shehee, N MacCormack, James Reardon, L. Morrison, Hudson R. Granade, Edward L. E. Jester, Anisha A. Abraham, Usa Prevention
Journal: MMWR Morbidity and Mortality Weekly Report (2009)

Ciguatera fish poisoning (CFP) is a distinctive type of foodborne disease that results from eating predatory ocean fish contaminated with ciguatoxins. As many as 50,000 cases are reported worldwide annually, and the condition is endemic in tropical and subtropical regions of the Pacific basin, Indian Ocean, and Caribbean. In the United States, 5--70 cases per 10,000 persons are estimated to occur yearly in ciguatera-endemic states and territories. CFP can cause gastrointestinal symptoms (nausea, vomiting, abdominal cramps, or diarrhea) within a few hours of eating contaminated fish. Neurologic symptoms, with or without gastrointestinal disturbance, can include fatigue, muscle pain, itching, tingling, and (most characteristically) reversal of hot and cold sensation. This report describes a cluster of nine cases of CFP that occurred in North Carolina in June 2007. Among the nine patients, six experienced reversal of hot and cold sensations, five had neurologic symptoms only, and overall symptoms persisted for more than 6 months in three patients. Among seven patients who were sexually active, six patients also complained of painful intercourse. This report highlights the potential risks of eating contaminated ocean fish. Local and state health departments can train emergency and urgent care physicians in the recognition of CFP and make them aware that symptoms can persist for months to years. Language: en
Patient-Oriented SCORAD (PO-SCORAD): a new self-assessment scale in atopic dermatitis validated in Europe
Authors: J.-F. Stalder, S. Barbarot, A. Wollenberg, E. A. Holm, L. De Raeve, S. Seidenari, A. Oranje, M. Deleuran, F. Cambazard, A. Svensson, D. Simon, E. Benfeldt, T. Reunala, J. Mazereeuv, F. Boralevi, B. Kunz, L. Misery, C. G. Mortz, U. Darsow, C. Gelmetti, T. Diepgen, J. Ring, M. Moehrenschlager, U. Gieler, A. Taïeb
Journal: Allergy (2011)

To cite this article: Stalder J-F, Barbarot S, Wollenberg A, Holm EA, De Raeve L, Seidenari S, Oranje A, Deleuran M, Cambazard F, Svensson A, Simon D, Benfeldt E, Reunala T, Mazereeuv J, Boralevi F, Kunz B, Misery L, Mortz CG, Darsow U, Gelmetti C, Diepgen T, Ring J, Moehrenschlager M, Gieler U, Taïeb A, for the PO-SCORAD Investigators Group. Patient-Oriented SCORAD (PO-SCORAD): a new self-assessment scale in atopic dermatitis validated in Europe. Allergy 2011; 66: 1114–1121. Abstract Background: Patient-oriented medicine is an emerging concept, encouraged by the World Health Organization, to greater involvement of the patient in the management of chronic diseases. The Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD) index is a self-assessment score allowing the patient to comprehensively evaluate the actual course of atopic dermatitis (AD), using subjective and objective criteria derived mainly from the SCORAD, a validated AD severity clinical assessment tool. Objectives: To validate the PO-SCORAD index in a large European population of patients exhibiting all forms of AD severity by assessing its correlation with the SCORAD index. Patients/methods: Four hundred and seventy-one patients (185 adults, 286 children) consulting for AD in hospitals from 9 European countries were recruited. The investigators and the patients used the SCORAD and PO-SCORAD scales, respectively, to assess AD severity at inclusion (D0) and 28 ± 7 days later (D28). Results: Patient-Oriented SCORing Atopic Dermatitis and SCORAD scores were significantly correlated at D0 [r = 0.67 (95% CI: 0.62; 0.72), P < 0.0001]. Consistency was confirmed at D28, with a stronger linear correlation between both scales [r = 0.79 (95% CI: 0.75; 0.83), P < 0.0001]. Absolute changes from baseline in SCORAD and PO-SCORAD scores were also significantly correlated [r= 0.71 (95% CI: 0.64; 0.76), P < 0.0001]. Although no specific intervention was investigated, AD improved over the study, with a decrease of PO-SCORAD and SCORAD scores from D0 to D28 by −19.19% and −24.39%, respectively. The consistency of the correlations was similar in the adult and children groups. Conclusions: This study validated the use of PO-SCORAD to self-assess AD severity and demonstrated its good correlation with SCORAD.
Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA<sup>2</sup>LEN
Authors: T. Werfel, B. Ballmer‐Weber, P. A. Eigenmann, B. Niggemann, F. Rancé, K. Turjanmaa, M. Worm
Journal: Allergy (2007)

Food allergy and atopic eczema (AE) may occur in the same patient. Besides typical immediate types of allergic reactions (i.e. noneczematous reactions) which are observed in patients suffering from AE, it is clear that foods, such as cow’s milk and hen’s eggs, can directly provoke flares of AE, particularly in sensitized infants. In general, inhaled allergens and pollen‐related foods are of greater importance in older children, adolescents and adults. Clinical studies have revealed that more than 50% of affected children with AE that can be exacerbated by certain foods will react with a worsening of skin eczema either alone or in addition to immediate symptoms. Adolescents and adults may also react to foods, but reactions to ‘classical’ food allergens, such as hen’s eggs and cow’s milk, are not as common as in childhood. Some patients with AE do react to pollen‐associated foods. Food‐induced eczema should not be neglected by the allergologist: On the one hand, food can be a relevant trigger factor of persistent moderate‐to‐severe AE; on the other hand, unnecessary diets which are not based on a proper diagnosis may lead to malnutrition and additional psychological stress on patients suffering from AE. Eczematous reactions to food can only be diagnosed by a thorough diagnostic procedure, taking into account the patient’s history, the degree of sensitization and the clinical relevance of the sensitization. The latter has often to be proven by oral food challenges. Upon oral food challenge it is most important to evaluate the status of the skin with an established score (e.g. SCORAD, EASI) after 24 h and later because otherwise worsening of eczema will be missed.
Abstract MP26: Adherence to Low Carbohydrate and Low Fat Diets in Relation to Weight Loss and Cardiovascular Risk Factor Reduction
Authors: Tian Hu, Patrick Stuchlik, Lu Yao, Kristi Reynolds, Paul Whelton, Jiang He, Lydia Bazzano
Journal: Circulation (2015)

A low carbohydrate (carb) diet can reduce body weight and some cardiovascular disease (CVD) risk factors as compared to a low fat diet, but differential adherence may play a role. We compared indicators of dietary adherence between two dietary interventions and examined their relationship with dietary efficacy using data from 148 obese adults (Mean age, 47 y; Mean body mass index, 35.4 kg/m2; 11.5% men; 51% Black) who participated in a randomized controlled trial comparing the effect of a low carb diet (net carb<40 g/day) with a low fat diet (<30% energy from fat, <10% from saturated fat) on changes in weight and CVD risk factors. Indicators of dietary adherence included attendance at dietary counseling sessions which provided the same behavioral curriculum for weight loss to each group, deviation from the macronutrient goal of the diet, and the cumulative percentage of urinary ketones detected at each of the 26 behavioral sessions. A composite adherence score was created based on these three indicators. ...
Abstract 2223: Shear Induced Platelet Function Is Highly Increased In Patients With Cardiac Arrest Undergoing Cardio-pulmonary Resuscitation (CPR)
Authors: Alexander O Spiel, Florian B Mayr, Martin Frossard, Andreas Kliegel, Heidrun Losert, Fritz Sterz, Anton N Laggner, Bernd Jilma
Journal: Circulation (2007)

Background: The prognosis of patients with cardiac arrest is still poor, and hardly any specific therapeutic options exist to improve outcome. Platelet activation has been observed in patients undergoing cardiopulmonary resuscitation (CPR). This may contribute to impairment of microcirculatory function and overall poor outcome despite return of spontaneous circulation. Data on direct platelet function in cardiac arrest are scarce. Platelets of patients with myocardial infarction are hyperfunctional, which predicts the degree of myocardial necrosis. Thus, we hypothesized that platelets may be even more hyper-functional in patients whose myocardial infarction causes cardiac arrest. We determined platelet function under high shear rates of patients with cardiac arrest and were further interested whether this may be related to the cause of cardiac arrest. Methods: We conducted a prospective study in 77 cardiac arrest patients at the Emergency Department of a tertiary care hospital. Collagen adenosine diphosphate closure time (CADP-CT) was assessed by the FDA-approved platelet function analyzer (PFA-100). In addition, plasma levels of von Willebrand factor (vWf:RiCo) were measured by turbidometry. Independent staff members of the emergency department not otherwise involved in this trial diagnosed the origin of cardiac arrest. Results: More than half of cardiac arrests were caused by myocardial ischemia. CADP-CT values (54s; 95%CI: 48–60s in 3.8% citrate) were much shorter in these patients as compared to patients with other causes of cardiac arrest (110s; 95%CI: 84–135s, p&lt;0.001). This is substantially less than the 87s (95%CI: 80–94s) in patients with ST-elevation myocardial infarction as previously published. vWf:RiCo levels were substantially increased above the upper normal limit (180 U/dL) in all patient groups. Conclusion: Patients with myocardial ischemia triggered cardiac arrest displayed the highest degree of platelet hyper-function under high shear rates, which was not solely due to increased vWF. Those patients may benefit from a rapid, more aggressive anti-platelet therapy than currently performed or an anti-vWF targeted therapy.
Tracheocele: a rare cause of difficult endotracheal intubation and subsequent pneumomediastinum
Authors: G M Möller, E J ten Berge, C M Stassen
Journal: European Respiratory Journal (1994)

A case is described in which accidental perforation of a tracheocele caused by endotracheal intubation resulted in a postoperative pneumomediastinum. The tracheocele, an extremely rare finding in clinical anaesthesia, was confirmed radiologically and for the first time demonstrated by computed tomography.
Abstract 13152: A Net Clinical Outcome Analysis Comparing Fatal or Irreversible Ischemic and Bleeding Events in ATLAS ACS 2 - TIMI 51
Authors: C. Michael Gibson, Bennett Levitan, Sabina A Murphy, Zhong Yuan, Anjan Chakrabarti, Michael Lee, Jessica Mega, Eugene Braunwald
Journal: Circulation (2012)

Background: Net clinical outcome analyses in ACS have mingled fatal/irreversible events with survivable/reversible events that vary greatly in their clinical impact. An efficacy & safety comparison...
Inhaled Triamcinolone and Chronic Obstructive Pulmonary Disease
Authors: Brian J. Lipworth, Catherine M. Jackson, Andrea De Maria, G. Walter Canonica, Simon O'Connor, David William Reid, Amir Soltani, Haydn Walters, Robert Wise, John Connett, Paul Scanlon, Cristina Elisabetta Mapp
Journal: New England Journal of Medicine (2001)
Progress with Childhood Leukaemia
Authors: C R PENGELLY
Journal: BMJ (1965)

is similar in all racial groups.In England and Wales, according to data based on the 1951 census and collected during the years 1950-3, the risk of dying from cancer of the cervix rose steeply from social class I to social class V.4 For married women aged 20-64 the standardized mortality ratio in social class V was double that for social class I.A similar difference was seen in single women in the same age category, but in this case the ratios were based on small numbers.Above the age of 65 the social-class gradient was less.Many factors appear to influence the risk of cervical cancer.These are held to include age at marriage, number of times married, promiscuity, circumcision of the husband, use of contraceptives, and the Jewish Niddah ritual.'But many investigators now believe that the most important is personal hygiene in the broadest sense.General practitioners are particularly well placed to identify women in the higher-risk groups.In addition smears might be taken routinely at antenatal, family-planning, and venereal-disease clinics.More controversial is the place of the Davis cytopipette,' whereby women can take samples of vaginal fluid from themselves and send them to the labora- tory for examination.It would seem that women who are unwilling to attend clinics can sometimes be persuaded to
Comparison of four systems for assessing severity of community acquired pneumonia
Authors: Tiago Abreu, Telma Lopes, Marisa Anciães, Dalila Ferreira, Sara Salgado, Gil Duarte
Journal: European Respiratory Journal (2011)

Introduction:  The use of severity scores for community acquired pneumonia (CAP) is recommended by many clinical guidelines. However, debate about the preferred system is ongoing.   Objective:  To compare the performance of 4 systems to identify severe CAP.   Material and methods:  We reviewed 176 patients diagnosed with CAP, admitted in a Pneumology ward, from January 2007 to July 2009. We compared 4 systems: Pneumonia Severity Index (PSI), CURB65, modified American Thoracic Society criteria for severe pneumonia (ATSm) and SCAP score.  We divided the patients in 2 groups: low/intermediate risk and high risk, the later defined as CURB65 ≥3, PSI classes IV/V, ATSm – ≥1 major criteria or ≥ 3 minor criteria and SCAP score – ≥1 major criteria or ≥ 2 minor criteria.  We evaluated the performance of these systems in predicting patient adverse outcomes, defined as mortality and need for ICU admission, based on sensitivity, specificity and area under the ROC curve (AUC).   Results:  Sensitivity and specificity (95% confidence interval in brackets) were, respectively: CURB65 – 27.3% [9.7 - 56.6] and 91.5% [86.3 - 94.9]. PSI – 81.8% [52.3 - 94.9] and 55.8% [48.1 - 63.1]. ATSm – 54.6% [28.0 – 78.7] and 95.8% [91.5 - 97.9]. SCAP – 81.8% [52.3 - 94.9] and 70.9% [63.6 - 71.3].  AUC was: CURB65 – 0.594, PSI – 0.688, ATSm – 0.752 and SCAP – 0.764.   Conclusions:  PSI and SCAP were the most sensitive systems, while CURB65 and ATSm were the most specific. Although the best discriminative capacity was found in SCAP, it presented many false positives. Probably, a good approach would be to rely on clinical judgment, triage of high risk patients with PSI or SCAP and use of ATSm to determine need for ICU admission.
Outcome of Patients with T-Cell Lymphoblastic Leukemia or Lymphoma: The GRAALL Experience.
Authors: Stéphane Leprètre, Martine Escoffre-Barbe, Patrice Chevallier, Thibaut Leguay, Laurence Legros, Emmanuel Raffoux, Philippe Rousselot, Pascal Turlure, Norbert Vey, Denis Guyotat, Yves Chalandon, André Delannoy, Marie-Christine Béné, Elizabeth Macintyre, Norbert Ifrah, Françoise Huguet, Hervé Dombret, Agnès Buzyn
Journal: Blood (2007)
Migration of Calcium and Atheromatous Plaque in Computed Tomography
Authors: Sung-Jin Hong, Myeong-Ki Hong, Young-Guk Ko, Geu-Ru Hong, Jae-Kwang Shim, Young-Lan Kwak, Sak Lee, Byung-Chul Chang, Yangsoo Jang
Journal: Journal of the American College of Cardiology (2014)
Effects of national antibiotic stewardship and infection control strategies on hospital-associated and community-associated meticillin-resistant Staphylococcus aureus infections across a region of Scotland: a non-linear time-series study
Authors: Timothy Lawes, José-María Lopez-Lozano, Cesar A Nebot, Gillian Macartney, Rashmi Subbarao-Sharma, Ceri RJ Dare, Karen D Wares, Ian M Gould
Journal: The Lancet Infectious Diseases (2015)
Reduced Dose-Intensity Subcutaneous Bortezomib Plus Prednisone (VP) Or Plus Cyclophosfamide (VCP) Or Plus Melphalan (VMP) For Newly Diagnosed Multiple Myeloma Patients Older Than 75 Years Of Age
Authors: Alessandra Larocca, Federica Cavallo, Valeria Magarotto, Massimo Offidani, Vincenzo Federico, Vanessa Innao, Antonietta Pia Falcone, Alessandra Romano, Tommaso Caravita, Davide Rossi, Giovanna Mansueto, Roberto Mina, Chiara Nozzoli, Giulia Benevolo, Tommasina Guglielmelli, Anna Marina Liberati, Daniele Derudas, Stefania Oliva, Fortunato Morabito, Angelo Michele Carella, Silvia Gentili, Elona Saraci, Maria Teresa Petrucci, Pieter Sonneveld, Mario Boccadoro, Antonio Palumbo
Journal: Blood (2013)
Vitamin D levels in patients with a clinical diagnosis of tuberculosis
Authors: Dominic Reynish, Nuala Whitehead, Cheryl Kay, Anna Newman, Suresh Babu
Journal: European Respiratory Journal (2013)

Introduction   Vitamin D influences the immune response in TB and low Vit D levels are associated with increased TB risk.   Aims and objectives   This prospective study looked at Vit D levels in patients with a confirmed diagnosis of TB and aimed to correlate the levels with various parameters including the site of disease.   Methods   All confirmed patients with TB (Jan-Dec 2012) had Vit D level (IDS 1,25-di(OH)vitamin D 3  ELISA) assayed. Levels ≤ 25 nmol/L considered deficient and 25-50 nmol/L considered insufficient. Data were expressed as median ± SEM. Correlations were drawn with sex, site of disease, ethinicity and AAFB isolation.   Results   40 patients had confirmed TB over the period analysed, 26 had Vit D levels assayed. The mean age was 38.2 ± 16.7 with 14 males, 12 females. The median Vit D level was 33 ± 4.8 nmol/L. 17/26 (65.4%) had AAFB isolated by smear and/or culture. 5/26 (19%) were born in the UK. 20/26 (76.9%) had pulmonary disease and the rest extra-pulmonary. There was no difference in levels among different ethnic groups. The Vit D levels are shown in the table below.   Conclusions   The Vit D levels in most patients with confirmed TB were insufficient. While Vit D levels in the males were significantly lower, there was no significant difference with site of disease, ethnicity, being born in the UK or if the patients isolated AAFB. Further studies with larger sample size with normal controls and patients with latent TB would provide useful data to evaluate the significance.
Abstract 17066: A Metabolic Basis for Histone Acetylation and a Potential Mechanism of Epigenetic Regulation in Right Ventricular Failure
Authors: Gopinath Sutendra, Peter Dromparis, Alois Haromy, Trevor H Stenson, Evangelos Michelakis
Journal: Circulation (2011)

Right ventricular (RV) failure is the most critical determinant of morbidity and mortality in patients with pulmonary arterial hypertension (PAH). There is an increasing awareness of important differences between the left ventricle (LV) and RV. Recently, histone deacetylase (HDAC) inhibitors, which increase histone acetylation, have had promising results on maladaptive LV hypertrophy. However, in RV hypertrophy (RVH), HDAC inhibition resulted in RV failure. Recently, nuclear acetylation processes have been shown to be dependent, in part, on the mitochondria. Since there is evidence of mitochondrial diversity between the RV and LV, we hypothesized that histone acetylation may have a metabolic basis and explain the transition to RV failure. In order to study histone acetylation and its relation to metabolism and disease progression in the failing RV, we used a rat model of monocrotaline (MCT)-induced PAH, in which we studied animals with normal RV function (n=6, RVSP=38±2 mmHg, CO=102±2 ml/min and RV/LV+Septum=22±1), compensated RVH (CRV; n=10, RVSP=66±8 mmHg, CO=80±13 ml/min and RV/LV+Septum=48±3, 2-3 weeks post-MCT) and decompensated RVH (DRV; n=9, RVSP=52±2 mmHg, CO=67±10 ml/min and RV/LV+Septum =58±2, 4-6 weeks post MCT). Compared to control, the myocardium (RV free wall) from CRV animals exhibited decreased mitochondrial activity shown by increased mitochondrial membrane potential and decreased mitochondrial-derived reactive oxygen species (mROS). This was associated with increased RV glucose uptake measured by PET in vivo, suggesting a shift of metabolism away from mitochondria towards glycolysis. CRV animals also showed decreased histone-3 (H3) acetylation (IHC/immunoblot). In contrast, DRV animals showed decreased RV glucose uptake, increased mROS as well as induction of the mitochondrial uncoupling-protein 2 in DRV myocardium. These metabolic/mitochondrial changes were associated with an increase in H3 acetylation in the DRV compared to the CRV animals. We show that metabolism and H3 acetylation closely follow mitochondrial remodeling and that these changes separate CRV from DRV potentially opening a new window in our understanding of RV failure.
Looking for Trouble and Finding It
Authors: Susan B. Trinidad, Stephanie M. Fullerton, Wylie Burke
Journal: The American Journal of Bioethics (2015)

We agree with Lazaro-Munoz and colleagues that patient preferences matter. Clinicians should strive to elicit and respect those preferences. We take issue, however, with how the authors apply this precept to “preventive genomic screening” (PGS). We believe their argument is flawed by the failure to distinguish screening from other medical care, or to acknowledge clinicians' responsibility to weigh the potential for benefit and harm in determining what healthcare choices to offer.