tbuckley/cabot-search huggingface dataset:
Prevalence of and risk factors for IgE sensitization to <i>Anisakis simplex</i> in a Spanish population
Authors: B. Valiñas, S. Lorenzo, A. Eiras, A. Figueiras, M. L. Sanmartin, F. M. Ubeira
Journal: Allergy (2001)

Background: The number of allergic reactions to A. simplex reported in Spain has increased dramatically in the last decade. Nevertheless, there have been no studies of the prevalence of and possible risk factors for IgE sensitization to this parasite, possibly because suitably specific diagnostic methods have only recently become available. The objective was to investigate the prevalence of and risk factors for IgE sensitization to A. simplex in Galicia, a region of northwestern Spain with a population of about 3 million and high average fish consumption (78.5 g/person per day). Methods: The study was performed with a random sample of 2801 healthy blood donors distributed in 53 geographic areas, proportional to the density of donors. IgE sensitization to A. simplex was tested by a capture ELISA method that has proved to be the most specific method currently available. Results: The results showed a total of only 12 positive subjects, of whom five also showed IgG1 sensitization. All positive subjects and 101 randomly selected seronegative subjects were then included in a case‐control study of risk factors for sensitization to A. simplex , based on a telephone interview about fish consumption (especially raw and undercooked fish). All seropositive subjects (but only 25% of seronegative subjects) reported consumption of undercooked fish or homemade raw‐fish products. Conclusions: Our results strongly suggest that sensitization to A. simplex is caused only by live larvae, and not by allergens contained in fish tissues, and that ingestion of homemade boquerones (anchovies [ Engraulis encrasicholus ] in vinegar), and to a much lesser extent of undercooked fish, are the main risk factors for IgE sensitization to Anisakis in this region.
Measurement error in the assessment of radiographic progression in rheumatoid arthritis (RA) clinical trials: the smallest detectable change (SDC) revisited
Authors: V Navarro-Compán, D van der Heijde, Harris A Ahmad, Colin G Miller, R Wolterbeek, R Landewé
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objectives</h3> To evaluate if the mean smallest detectable change (SDC) of multiple time intervals using the Bland &amp; Altman (B&amp;A) levels of agreement (LoA) method is an appropriate surrogate for the generalisability analysis method for estimating the overall SDC of radiological progression in rheumatoid arthritis (RA) trials. Secondly, to compare the SDC based on 95% LoA with the SDC based on 80% LoA, and to investigate the association between SDC and baseline damage and progression. <h3>Methods</h3> Fifteen datasets from randomised controlled trials in RA were scored by 13 experienced readers as pairs according to the modified Sharp/van der Heijde method. The SDC using the 95% and 80% LoA and the generalisability methods was calculated. <h3>Results</h3> 21 295 radiographic time points from 7643 patients were included. The mean (range) SDC for the LoA and the generalisability methods was 3.1 (2.3–4.3) and 3.2 (2.3–4.6) units, respectively. The mean±SD difference between the two methods was −0.13±0.28. The mean SDC including all intervals (n=31) was 3.0±0.7 for 95% LoA and 2.0±0.4 for 80% LoA. No relationship was observed between baseline damage and the SDC, whereas the SDC increased with increasing radiological progression. <h3>Conclusions</h3> The mean of the interval SDCs obtained by the simple LoA method is a valid surrogate for the SDC obtained by complex generalisability methods. The SDC depends on the level of radiographic progression rather than on the level of absolute damage. In addition, the use of an SDC based on 80% rather than on 95% LoA is proposed.
Pathogenesis of High-Altitude Pulmonary Edema
Authors: Erik R. Swenson, Marco Maggiorini, Stephen Mongovin, J. Simon R. Gibbs, Ilona Greve, Heimo Mairbäurl, Peter Bärtsch
Journal: JAMA (2002)

IGH-ALTITUDE PULMONARY edema (HAPE) is a lifethreatening illness in climbers and tourists ascending to altitudes higher than 2500 m.The pathogenesis of this unique form of pulmonary edema that occurs rapidly in otherwise healthy people has not been entirely illuminated owing to the difficulties of studying the disease early in its evolution and to conflicting data from animal and human investigations.The central issue is whether the alveolar-capillary leak in HAPE is caused by high microvascular pressures or inflammation.Besides revealing a more definitive answer about HAPE itself, resolution of this question may facilitate our understanding, diagnosis, and treatment of other common forms of pulmonary edema, such as congestive heart failure and adult respiratory distress syndrome.Since the earliest descriptions of HAPE in the 1960s, acute pulmonary artery hypertension has always been associated with it and considered an es-
Mae West and the Doctor Shortage
Authors: THOMAS FINDLEY
Journal: Annals of Internal Medicine (1970)

Letters and Comments1 September 1970Mae West and the Doctor ShortageTHOMAS FINDLEY, M.D., M.A.C.P.THOMAS FINDLEY, M.D., M.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-73-3-490_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: One of the rewards of this office is the view it affords of life in Appalachia. It is not a pleasing picture, especially the health problem which reveals itself vividly in a little town just south of the intersection of 1-75 and the Kentucky-Tennessee line. There is a docter there, but he sees 150 patients daily in his hospital, and even this is not nearly enough. The point of this communication is to say that the village fathers there thought to fill the need several years ago by building a lovely little Hill-Burton affair on a hillside... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: 11-12 Henson Hall University of Tennessee Knoxville, Tenn. 37916 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1970Volume 73, Issue 3Page: 490-490 Issue Published: 1 September 1970 PDF DownloadLoading ...
MUC1 expression in early-stage triple-negative breast cancer.
Authors: J Miedler, F Abdul-Karim, N Wang, J Baar
Journal: Cancer Research (2009)

Abstract Abstract #3009 Background. Triple-negative breast cancer (TNBC) comprises ∼10-15% of newly-diagnosed early-stage breast cancer. Most TN tumors are high grade and have a high incidence of recurrence and distant metastases. Patients with early stage TNBC usually do not receive any maintenance systemic therapy beyond standard cytotoxic chemotherapy and may therefore benefit from novel experimental therapies, including immunotherapy. MUC1 is a tumor antigen expressed on differentiated tumor cells, including BC, and therefore represents an ideal target for MUC1-based vaccination. In this study, we evaluated TNBC for the expression of MUC1 by immunohistochemical (IHC) analysis.&amp;#x2028; Material and Methods. Fifty-three cases of ER(-) PR(-) HER-2/neu(-) early-stage BC were evaluated for expression of the MUC1 glycoprotein by IHC stain analysis. Immunoreactivity was graded based on the intensity and percent of tumor cells staining for MUC1. Intensity of staining was graded as negative (0), positive (1) or strongly-positive (2), and the percent of tumor cells staining positively was graded from 0 to 100%. A specimen was considered positive if immunoreactive cells were found in at least 5% of tumor cells. An overall score of 0 to 2.0 was then calculated for each case by multiplying the intensity of staining by the percent of tumor cells staining positively.&amp;#x2028; Results. Forty nine of the fifty three cases of TNBC (92%) were MUC1+ by IHC stain analysis. The mean score was 0.90, with a range of 0 to 1.9. Cases were evenly distributed over this range, and the majority of cases (66%) exhibited moderate to strong expression of MUC1 (score 0.5 to 1.90). A minority of cases (26%) demonstrated weak expression, and 8% of cases lacked expression of MUC1 by study criteria.&amp;#x2028; Discussion. MUC1 expression has been documented in the epithelium of secretory tubules, acini, and intralobular ducts of normal breast tissue and in breast carcinoma of undefined subtype. However, this is the first study to specifically evaluate TNBC for the expression of MUC1. The results of our study suggest that the vast majority of cases of early stage TNBC express MUC1. Since other MUC1+ tumors such as prostate, pancreatic and ER+ breast cancer have been successfully vaccinated with MUC1-based peptide vaccines, this study suggests that consideration may be given to patients with early stage TNBC as possible candidates for such novel MUC1-based vaccines after having completed standard therapies for TNBC. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3009.
Improving Cardiopulmonary Resuscitation With a CPR Feedback Device and Refresher Simulations (CPR CARES Study)
Authors: Adam Cheng, Linda L. Brown, Jonathan P. Duff, Jennifer Davidson, Frank Overly, Nancy M. Tofil, Dawn T. Peterson, Marjorie L. White, Farhan Bhanji, Ilana Bank, Ronald Gottesman, Mark Adler, John Zhong, Vincent Grant, David J. Grant, Stephanie N. Sudikoff, Kimberly Marohn, Alex Charnovich, Elizabeth A. Hunt, David O. Kessler, Hubert Wong, Nicola Robertson, Yiqun Lin, Quynh Doan, Jordan M. Duval-Arnould, Vinay M. Nadkarni
Journal: JAMA Pediatrics (2014)

The quality of cardiopulmonary resuscitation (CPR) affects hemodynamics, survival, and neurological outcomes following pediatric cardiopulmonary arrest (CPA). Most health care professionals fail to perform CPR within established American Heart Association guidelines.To determine whether "just-in-time" (JIT) CPR training with visual feedback (VisF) before CPA or real-time VisF during CPA improves the quality of chest compressions (CCs) during simulated CPA.Prospective, randomized, 2 × 2 factorial-design trial with explicit methods (July 1, 2012, to April 15, 2014) at 10 International Network for Simulation-Based Pediatric Innovation, Research, & Education (INSPIRE) institutions running a standardized simulated CPA scenario, including 324 CPR-certified health care professionals assigned to 3-person resuscitation teams (108 teams).Each team was randomized to 1 of 4 permutations, including JIT training vs no JIT training before CPA and real-time VisF vs no real-time VisF during simulated CPA.The proportion of CCs with depth exceeding 50 mm, the proportion of CPR time with a CC rate of 100 to 120 per minute, and CC fraction (percentage CPR time) during simulated CPA.The quality of CPR was poor in the control group, with 12.7% (95% CI, 5.2%-20.1%) mean depth compliance and 27.1% (95% CI, 14.2%-40.1%) mean rate compliance. JIT training compared with no JIT training improved depth compliance by 19.9% (95% CI, 11.1%-28.7%; P < .001) and rate compliance by 12.0% (95% CI, 0.8%-23.2%; P = .037). Visual feedback compared with no VisF improved depth compliance by 15.4% (95% CI, 6.6%-24.2%; P = .001) and rate compliance by 40.1% (95% CI, 28.8%-51.3%; P < .001). Neither intervention had a statistically significant effect on CC fraction, which was excellent (>89.0%) in all groups. Combining both interventions showed the highest compliance with American Heart Association guidelines but was not significantly better than either intervention in isolation.The quality of CPR provided by health care professionals is poor. Using novel and practical technology, JIT training before CPA or real-time VisF during CPA, alone or in combination, improves compliance with American Heart Association guidelines for CPR that are associated with better outcomes.clinicaltrials.gov Identifier: NCT02075450.
Use of Cholestyramine Resin in Digitoxin Toxicity
Authors: Robert E. Pieroni
Journal: JAMA (1981)

DIGITOXIN has a long half-life and is associated with a substantial incidence of toxicity.<sup>1,2</sup>It is partially excreted in the bile and later reabsorbed, contributing to its long half-life.<sup>1,2</sup>A nonabsorbable agent that binds digitoxin in the gut should help speed its disappearance from the serum. Cholestyramine resin, an ion exchange resin used for some hyperlipoproteinemias, appears to be such an agent. Several reports have described such a digitoxin-binding effect in animals.<sup>3,4</sup>This property, however, has received scant study in the digitoxin-intoxicated patient.<sup>4-7</sup>Recently, we encountered a patient with clinical, laboratory, and ECG evidence of digitoxin toxicity. Digitoxin elimination was studied before, during, and after administration of cholestyramine resin. The resin resulted in an accelerated elimination of digitoxin and would appear to be a valuable adjunct in therapy of patients with digitoxin toxicity. <h3>Report of a Case</h3> A 72-year-old woman was admitted to the emergency room
Fluid Shear Stress Stimulates Mitogen-Activated Protein Kinase in Endothelial Cells
Authors: Hennessey Tseng, Timothy E. Peterson, Bradford C. Berk
Journal: Circulation Research (1995)

Abstract Local alterations in the hemodynamic environment regulate endothelial cell function, but the signal-transduction mechanisms involved in this process remain unclear. Because mitogen-activated protein (MAP) kinases have been shown to be activated by physical forces, we measured the phosphorylation and enzyme activity of MAP kinase to identify the signal events involved in the endothelial cell response to fluid shear stress. Flow at physiological shear stress (3.5 to 117 dynes/cm 2 ) activated 42-kD and 44-kD MAP kinases present in cultured bovine aortic endothelial cells, with maximal effect at 12 dynes/cm 2 . Activation of a G protein was necessary, as demonstrated by complete inhibition by the nonhydrolyzable GDP analog GDP-βS. Activation of protein kinase C (PKC) was required, as shown by inhibiting PKC with staurosporine or downregulating PKC with phorbol 12,13-dibutyrate. Both Ca 2+ -dependent and -independent PKC activity, measured by translocation and substrate phosphorylation, increased in response to flow. However, MAP kinase activation was not dependent on Ca 2+ mobilization, since Ca 2+ chelation had no inhibitory effect. On the basis of these findings, it is proposed that flow activates two signal-transduction pathways in endothelial cells. One pathway is Ca 2+ dependent and involves activation of phospholipase C and increases in intracellular Ca 2+ . A new pathway, described in the present study, is Ca 2+ independent and involves a G protein and increases in PKC and MAP kinase activity.
Life in the Lutyens household.
Authors: M Lutyens
Journal: BMJ (1986)

Although I realise that there are different types of diabetes and that each case must be treated separately and according to expert advice, my experience leads me to wonder whether this kind of treatment, which I have used successfully for so long, is being used today as often as it should be, because it seems to me to be so reasonable. Its main advantage is that by spreading the intake of insulin more evenly over each 24 hour period and therefore injecting it in smaller doses the patient can more easily maintain a stable blood sugar level and enjoy a flexible lifestyle free from any complications associated with poor control. In this respect it seems indeed to have something in common with many of the most recent developments in treatment, such as infusion pumps, button infusers, Penjects, and the like. It is also my opinion that, given a sound understanding of the nature of diabetes and a clear recognition of the powerful effect of insulin, the following are the only other essential requirements for its successful use:
Mortality of Physicians.
Authors: J. M. Farrington
Journal: JAMA (1895)

microscopic examination of the stools of cholera cases, he found different forms and kinds of germs, and among these was one of comma-shape, which he fancied was the cause of this disease.Through the process of "culture," and "experiment" upon the lower animals he asserts he has demonstrated that this germ is the actual cause of this disease.
THE MORPHOLOGY OF THE PARASITE (HISTOPLASMA CAPSULATUM) AND THE LESIONS OF HISTOPLASMOSIS, A FATAL DISEASE OF TROPICAL AMERICA
Authors: Samuel T. Darling
Journal: The Journal of Experimental Medicine (1909)

Histoplasmosis is a fatal infectious disease of tropical America resembling kala-azar of India. It is characterized clinically by splenomegaly, emaciation, irregular pyrexia, leucopenia and anemia. The pathological features are the invasion of endothelial cells in the smaller lymph and blood vessels and capillaries by enormous numbers of a small encapsulated microorganism (Histoplasma capsulatum) causing necroses of the liver with cirrhosis, splenomegaly, psudo-granulomata of the lungs, small and large intestines, with ulceration of the latter, and necrosis of lymph nodes draining the injected viscera. The disease is caused by a small round or oval microörganism 1 to 4 micro in diameter possessing a polymorphous, chromatin nucleus, basophilic cytoplasm and achromatic spaces all enclosed within an achromatic refractile capsule. The microorganism differs from the Leishman-Donovan body of kala-azar in the form and arrangement of its chromatin nucleus, and in not possessing a chromatin rod.
Abstract P6-04-26: Tamoxifen may block estrogen induced secretion of certain cytokines to interrupt tumor associated macrophage infiltration in breast cancer
Authors: J Ding, CM Chen, W Jin, Z Shao, J Wu
Journal: Cancer Research (2012)

Abstract The role of tumor microenvironment during the initiation and progression of breast cancer is now realized to be of critical importance, both for understanding of the fundamental cancer biology and exploiting relatively new mechanism for breast cancer metastasis. Macrophage is a one of the most common components in the breast cancer microenvironment. Normally, the macrophage in tumor microenvironment is referred to tumor associated macrophage (TAM), which shares some attributes of alternatively activated macrophage. Many pre-clinical and clinical studies demonstrate an inverse correlation between TAM infiltration and patients' prognosis indicating a macrophage supporting role for tumor progression. It is well documented that selective patients with breast cancer can benefit from anti-estrogen therapy. However, the mechanisms involved are still not fully elucidated. Our previous study indicates that highly tumorigenic breast cancer cell line MDA-MB-231 can educate monocyte differentiation into alternatively activated macrophage, while weakly tumorigenic cell line MCF-7 (without estrogen supplementation) can not. In the present study, we explored the effects of estrogen and tamoxifen on the secreting of certain cytokines, which are required for monocyte chemotaxis and differentiation. Breast cancer cell lines with different estrogen receptor status were applied to estimate the level of cytokines (IL4, IL6, M-CSF, GM-CSF, and MCP-1) before and after cultured with 17β-estradiol, tamoxifen or both. We found that weakly invasive breast cancer cell lines (MCF-7, T47D, MDA-MB-468, and SKBR3) generally expressed lower levels of such cytokines compared with highly invasive breast cancer cell lines (MDA-MB-231, MDA-MB-231-BO, MDA-MB-231 HM, Bcap 37, BT549, and Hs578T) at baseline. However, the discrepancies could be compensated partially by exposure to 10nM 17β-estradiol in estrogen receptor (ER) positive cell lines (MCF-7 and T47D). Moreover, the compensation was substantially blocked by 2μM tamoxifen. On the contrary, tamoxifen, alone, didn't affect the secretion of such cytokines mentioned above in vitro. Based on these findings, we tentatively concluded that some patients with ER positive breast cancers benefiting from anti-estrogen therapy may partially attributes to blocking monocyte differentiation into TAM, which destroyed the tumor microenvironment. These findings suggest the future possibility of using TAM as a novel therapeutic target in patients with anti-estrogen resistance and primary triple-negative breast cancers (TNBC) with no effectively therapeutic measures nowadays, which are defined by lack of estrogen receptor, progesterone receptor and ERBB2 gene amplification, representing approximately 16% of all breast cancers. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-04-26.
Effect of a flow chart on use of blood transfusions in primary total hip and knee replacement: prospective before and after study
Authors: Urs Müller, Aristomenis Exadaktylos, Christoph Roeder, Markus Pisan, Stefan Eggli, Peter Jüni
Journal: BMJ (2004)

<b>Problem</b> A suspected high proportion of unnecessary blood transfusions occur in patients undergoing total joint replacement. <b>Design</b> Prospective before and after study evaluating the impact of a one page flow chart aimed at reducing the use of blood transfusions. <b>Setting</b> Orthopaedic tertiary care centre in Winterthur, Switzerland. 208 patients underwent primary total joint replacement of hips or knees during the control period (October 1998 to September 1999) and 217 during the intervention period (October 1999 to September 2000). <b>Key measures for improvement</b> Proportion of patients receiving allogeneic blood transfusions. <b>Strategies for change</b> A simple one page flow chart, which summarised graphically the perioperative decision pathways for anaemic patients, was placed in all charts of patients undergoing total joint replacement and handed out to medical staff from 4 October 1999 onwards. The implementation of the flow chart focused on its endorsement by chief physicians and the development of a sense of "ownership" among physicians and nurses. <b>Effects of change</b> The proportion of patients receiving allogeneic blood decreased from 35.0% to 19.8% (absolute difference -15.2%, 95% confidence interval -23.3 to -7.0%). The percentage of patients donating and receiving autologous blood also decreased. This led to overall savings of about £23 000 ($42 470; €34 441) (£103.50 per patient undergoing total joint replacement). Differences became more pronounced after adjustment for confounding factors. <b>Lessons learnt</b> Allogeneic blood transfusions in primary hip and knee replacement surgery may be reduced cost effectively by implementing a one page flow chart. Five key elements may have contributed: simplicity; wide distribution; no requirement for major changes; endorsement by local opinion leaders; and development of a sense of ownership. These elements may be used in other contexts to achieve sustained change of clinical practice.
England publishes first tables of hospital performance
Authors: P. Anderson
Journal: BMJ (1999)

The Department of Health has published "league tables" for England allowing health professionals and their patients to scrutinise hospitals' performance for the first time since the NHS was established.Two reports published last week compared the performance of hospitals against a set of six clinical indicators (see below) and how each health authority was performing in areas such as health improvement, and care outcomes (see below).The reports were compiled over two years by using the 11 million patient episode records collected annually in England.The report on clinical indicators showed wide variations in