tbuckley/cabot-search huggingface dataset:
Emergence and spread of predominantly community-onset Clostridium difficile PCR ribotype 244 infection in Australia, 2010 to 2012
Authors: D W Eyre, L Tracey, B Elliott, C Slimings, P G Huntington, R L Stuart, T M Korman, G Kotsiou, R McCann, D Griffiths, W N Fawley, P Armstrong, K E Dingle, A S Walker, T E Peto, D W Crook, M H Wilcox, T V Riley
Journal: Eurosurveillance (2015)

We describe an Australia-wide Clostridium difficile outbreak in 2011 and 2012 involving the previously uncommon ribotype 244. In Western Australia, 14 of 25 cases were community-associated, 11 were detected in patients younger than?65 years, 14 presented to emergency/outpatient departments, and 14 to non-tertiary/community hospitals. Using whole genome sequencing, we confirm ribotype 244 is from the same C. difficile clade as the epidemic ribotype 027. Like ribotype 027, it produces toxins A, B, and binary toxin, however it is fluoroquinolone-susceptible and thousands of single nucleotide variants distinct from ribotype 027. Fifteen outbreak isolates from across Australia were sequenced. Despite their geographic separation, all were genetically highly related without evidence of geographic clustering, consistent with a point source, for example affecting the national food chain. Comparison with reference laboratory strains revealed the outbreak clone shared a common ancestor with isolates from the United States and United Kingdom (UK). A strain obtained in the UK was phylogenetically related to our outbreak. Follow-up of that case revealed the patient had recently returned from Australia. Our data demonstrate new C. difficile strains are an on-going threat, with potential for rapid spread. Active surveillance is needed to identify and control emerging lineages.
Care is needed before single test results are combined
Authors: G H Hall
Journal: BMJ (2006)

Editor—Tonelli et al have provided valuable data for those interested in the interpretation of multiple test results. I differ, however, on the question of the evaluations of interaction and risk “additivity.”1

It seems hard to believe that the interaction between the tests is of only “modest importance” when the odds of death are altered threefold for renal impairment and twofold for proteinuria (by the presence or absence of the other factor.) Admittedly, these are from unadjusted figures, but this is the situation the clinician will face as it is unlikely that all the values for the adjustment factors will be available. If only some are, the full regression equation would not be appropriate. Even with the adjusted figures, the difference in odds of death still amounts to some 16%. It would be helpful to know whether the interaction term for the two tests only is significant or not.​not.



Figure 1

Credit: IAN HOOTON/SPL



Secondly, it is claimed in “What this study adds” that the risk estimates from the two tests are additive. Certainly, the positive likelihood ratios for the separate tests (2.1 for proteinuria and 1.57 for renal impairment) sum to 3.67, almost the positive likelihood ratio for the combined result (3.73). This result is likely to be an accident of the figures as risk combination is usually achieved by multiplication of the positive likelihood ratio for Bayesian analysis or odds ratios for logistic regression (statistical independence assumed or imposed). The product of the positive likelihood ratio is 3.3, an underestimate. The reason for this discrepancy is that the association between renal failure and proteinuria is more marked in the affected (dead) group (odds ratio 2.6) than the living (odds ratio 1.6). Care is needed before single test results are combined.

I think that there can be no substitute for empirical checking of the results of test combinations, which are available here. Regression models inevitably refer to an imaginary population with a different composition from the actual population.
Methotrexate in Leukemia Intramuscularly
Authors: S. Zoger
Journal: JAMA (1966)

<h3>To the Editor:—</h3> We wish to report our experience with intramuscular use of methotrexate in the treatment of acute leukemia as originally reported by the Acute Leukemia Group B (<i>JAMA</i><b>194</b>:75, 1965). We have been struck by the high incidence of severe toxic symptoms in the patients we have treated with the recommended dosage of 30 mg/ sq m twice weekly. We have so treated seven cases, in all of which complete remission was obtained. In six of these, toxic manifestations serious enough to necessitate cessation of therapy or significant reduction of dosage have developed. The major symptom has been severe oral ulceration of a much more extensive and disabling variety than we have ever seen with conventional doses of methotrexate by mouth. These lesions are very large, with serpiginous borders and marked edema and erythema of adjacent tissues. We have also seen, in conjunction with oral ulcerations, distressing
Erratum: Corrigendum: Pim-1 regulates cardiomyocyte survival downstream of Akt
Authors: John A Muraski, Marcello Rota, Yu Misao, Jenna Fransioli, Christopher Cottage, Natalie Gude, Grazia Esposito, Francesca Delucchi, Michael Arcarese, Roberto Alvarez, Sailay Siddiqi, Gregory N Emmanuel, Weitao Wu, Kimberlee Fischer, Joshua J Martindale, Christopher C Glembotski, Annarosa Leri, Jan Kajstura, Nancy Magnuson, Anton Berns, Remus M Beretta, Steven R Houser, Erik M Schaefer, Piero Anversa, Mark A Sussman
Journal: Nature Medicine (2008)
"Phlebodynia"—A New Epidemic (?) Disease
Authors: JOHN S. PEARSON
Journal: Circulation (1953)

During the fall and winter of 1950-1951 a group of student nurses was seen with a syndrome, which, to our knowledge, has not been reported previously. The common characteristic of all cases was incapacitating pain and exquisite tenderness along the course of the superficial venous tracts of one or more extremities. Numerous clinical, epidemiologic and laboratory investigations were made without establishing a specific etiologic diagnosis. Several cases are reported in detail to illustrate the condition.
Does delta infection play a part in the pathogenesis of hepatitis B virus related hepatocellular carcinoma?
Authors: A. Craxi, G. Raimondo, L. Pagliaro
Journal: BMJ (1984)

intervention trial study and combining the populations, we find that the frequency of lung cancer in the lighter smoking intervention groups was 56/7142 (0 78% ), and in the heavier smoking "normal care" groups was 53/7169 (0 74%/ ).The small advantage enjoyed by the heavier smokers is, of course, statistically non- significant.Nevertheless, these two randomised trials controlled for the bias of self selection.Although the numbers are too small to adjudicate between causal, constitutional, and combined hypotheses of the association between smoking and lung cancer, they are large enough to show how cautious we need to be when interpreting studies of self selected groups.
Diuretics and Sudden Cardiac Death
Authors: Ivar A. Aursnes
Journal: Annals of Internal Medicine (1996)

Letters15 August 1996Diuretics and Sudden Cardiac DeathIvar A. Aursnes, MD, PhDIvar A. Aursnes, MD, PhDUniversity of Oslo, Oslo N-0316, NorwaySearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-4-199608150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The article by Hoes and colleagues [1] calls for a general comment on the value of observational data in research related to the effects of antihypertensive drugs. Both our experiences in this field [2] and recently expressed views [3] suggest that caution should be used when such data are interpreted. Our results, which address the occurrence of acute myocardial infarction in hypertensive patients, conflict with those of another study that had a similar study design [4]. Taubes [3] expressed the view that relative risk should be large, various investigators should be unanimous, and the outcome should have ...References1. Hoes AW, Grobbee DE, Lubsen J, Veld AJ, van der Does E, Hofman A. Diuretics, β-blockers, and the risk for sudden cardiac death in hypertensive patients. Ann Intern Med. 1995; 123:481-7. Google Scholar2. Aursnes I, Litleskare I, Froyland H, Abdelnoor M. Association between various drugs used for hypertension and risk of acute myocardial infarction. Blood Pressure. 1995; 4:157-63. Google Scholar3. Taubes G. Epidemiology faces its limits. Science. 1995; 269:164-9. Google Scholar4. Psaty BM, Heckbert SR, Koepsell TD, Siscovick DS, Raghunathan TE, Weiss NS. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. 1995; 274:620-5. Google Scholar5. Kendall MJ, Lynch KP, Hjalmarson [42], Kjekshus J. β-blockers and sudden cardiac death. Ann Intern Med. 1995; 123:358-67. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Oslo, Oslo N-0316, Norway PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 August 1996Volume 125, Issue 4Page: 346KeywordsAcute myocardial infarctionCoronary heart diseaseDiureticsDrugsHeart failureOdds ratioRelative riskResearch designSudden cardiac death Issue Published: 15 August 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Major histocompatibility complex-restricted self recognition. A monoclonal anti-I-Ak reagent blocks helper T cell recognition of self major histocompatibility complex determinants.
Authors: R J Hodes, K S Hathcock, A Singer
Journal: The Journal of Experimental Medicine (1980)

The functional role of cell surface Ia antigens has been studied for in vitro antibody responses, using as a probe the ability of anti-Ia reagents to inhibit these responses. A hybridoma monoclonal anti-Ia reagent specific for a product of I-Ak (Ia.17) profoundly inhibited in vitro antibody responses to TNP-KLH by spleen cells of the I-Ak but not I-Ab haplotype. This inhibition by anti-I-Ak product, but not by interaction with T or B cell product, in spite of the fact that functional B cells as well as accessory cells could be shown to express the determinant detected by this hybridoma reagent. These results suggest that the Ia expressed by accessory cells in of unique functional importance in these responses. To further characterize the function of Ia antigens in this response system, the mechanism of anti-I-Ak inhibition was determined. The inhibition resulting from interaction of anti-I-Ak with accessory cell Ia was not mediated by nonspecific suppressor cells, nor was there nonspecific interference with accessory cell function as a result of the binding of anti-Ia antibody. The relationship between anti-Ia inhibition and T helper cell recognition of self determinations on accessory cells was analyzed using T cells from radiation bone marrow chimeras. It was demonstrated that (B10 X B10.A)F1 leads to B10 (F1 leads to B10) chimera T cells were able to cooperate with B10 (H-2b and I-Ab) but not B10.A (H-2a and I-Ak) accessory cells for responses to TNP-KLH; F1 leads to B10.A T cells were able to cooperate with B10.A but not B10 accessory cells; and both chimera populations were able to cooperate with (B10 X B10.A)F1 (F1) accessory cells. Monoclonal anti-I-Ak inhibited the cooperation of F1 leads to B10.A T cells with the same F1 accessory cells. Thus, inhibition by anti-I-Ak is dependent upon active helper T cell recognition of I-Ak-encoded determinants expressed on accessory cells. These findings demonstrate that T cells recognize self Ia determinants expressed on accessory cells, and that such recognition is required for the generation of T cell-dependent antibody responses.
LOCAL SPECIFIC TREATMENT OF EXPERIMENTAL PNEUMOCOCCUS MENINGITIS
Authors: FRED W. STEWART
Journal: JAMA (1927)

Pneumococcus meningitis is recognized as a highly fatal disease. In spite of rare reports of recovery, the mortality closely approaches 100 per cent. It is still uncertain whether the very occasional reported instances of recovery are not cases of incomplete or incorrect diagnosis. With a relative mortality from this form of meningeal infection so great, every effort should be made to achieve a treatment, although drastic, which may in some degree mitigate its fatality. During the past year our attention has been directed toward the study of the means of production, nature of the pathologic changes, and modes of treatment of type I pneucoccal meningitis in animals. After a number of trials, dogs were selected as most suitable for the experiments. Cognizance has, of course, been taken of the fact that in man pneumococcus meningitis usually is a concomitant of secondary infection in association with pneumonia or another distant focal
The Appreciation of Medical Politicians
Authors: Basil E. Barton
Journal: New England Journal of Medicine (1954)

THE seed of this discourse was planted several years ago when the Council of the Massachusetts Medical Society raised the dues to $35. It is well known that stimulation of the pocketbook will make the subject cry out. Members of the Society were at once heard crying out to each other: "What is this Council anyway? Who elects it? What do we get for our $35?" Those questions were actually put in so many words by men who are successful practitioners but who had never paid attention to anything outside their own practices. They had been too busy. One would . . .
Osteopontin binding to lipopolysaccharide lowers tumor necrosis factor-α and prevents early alcohol-induced liver injury in mice
Authors: Xiaodong Ge, Tung-Ming Leung, Elena Arriazu, Yongke Lu, Raquel Urtasun, Brian Christensen, Maria Isabel Fiel, Satoshi Mochida, Esben S. Sørensen, Natalia Nieto
Journal: Hepatology (2013)

Although osteopontin (OPN) is induced in alcoholic patients, its role in the pathophysiology of alcoholic liver disease (ALD) remains unclear. Increased translocation of lipopolysaccharide (LPS) from the gut is key for the onset of ALD because it promotes macrophage infiltration and activation, tumor necrosis factor-α (TNFα) production, and liver injury. Since OPN is protective for the intestinal mucosa, we postulated that enhancing OPN expression in the liver and consequently in the blood and/or in the gut could protect from early alcohol-induced liver injury. Wild-type (WT), OPN knockout (Opn−/−), and transgenic mice overexpressing OPN in hepatocytes (OpnHEPTg) were fed either the control or the ethanol Lieber-DeCarli diet. Ethanol increased hepatic, plasma, biliary, and fecal OPN more in OpnHEPTg than in WT mice. Steatosis was less in ethanol-treated OpnHEPTg mice as shown by decreased liver-to-body weight ratio, hepatic triglycerides, the steatosis score, oil red-O staining, and lipid peroxidation. There was also less inflammation and liver injury as demonstrated by lower alanine aminotransferase (ALT) activity, hepatocyte ballooning degeneration, LPS levels, the inflammation score, and the number of macrophages and TNFα+ cells. To establish if OPN could limit LPS availability and its noxious effects in the liver, binding studies were performed. OPN showed binding affinity for LPS which prevented macrophage activation, reactive oxygen, and nitrogen species generation and TNFα production. Treatment with milk OPN (m-OPN) blocked LPS translocation in vivo and protected from early alcohol-induced liver injury. Conclusion: Natural induction plus forced overexpression of OPN in the liver or treatment with m-OPN protect from early alcohol-induced liver injury by blocking the gut-derived LPS and TNFα effects in the liver. (Hepatology 2014;59:1600-1616)
Effect of danazol on the biochemical abnormality of inherited antithrombin III deficiency.
Authors: A J Fairfax, R M Ibbotson
Journal: Thorax (1985)

Seven members of a family affected by hereditary antithrombin III deficiency were identified. The disorder was associated with recurrent spontaneous episodes of phlebitis, deep venous thrombosis, and pulmonary embolism in middle age. Danazol, a 17-alkyl derivative of ethinyl testosterone, which has been used to treat other antiprotease deficiency states, was assessed in the management of two men with antithrombin deficiency. In a dose of 600 mg a day danazol appeared to correct the antithrombin deficiency. This drug may provide a useful adjunct to anticoagulant treatment, particularly before surgery.
SOME OBSERVATIONS ON TREATING CASES OF DIPHTHERIA.Read in the Section on Diseases of Children, at the Forty-fourth Annual Meeting of the American Medical Association.
Authors: G. BENSON DUNMIRE
Journal: JAMA (1893)

There is, perhaps, no subject at this time exciting more and deeper interest in the profession, certainly there is none more important than the management of cases of diphtheria. In this connection some general remarks seem necessary with reference to the ravages of the disease. The excess of deaths over births, which is depopulating the French nation to-day, is largely due to diphtheria. In England it is not confined to the large cities alone, but the rural districts are feeling its scourge.The same may be said of the United States, where there is a growing dread of the disease andjustly so, because of the gradual increase of cases, and deaths as well, which quite an extended correspondence with the different State Boards of Health, also the mortuary registers show, conclusively proving two things: 1, its infectiousness; 2, that the general efforts now put forth to stay its progress are inadequate.
Complications of the Angelchik Antireflux Prosthesis
Authors: Michael W.L. Gear, E. Walford Gillison, Brian L. Dowling
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 December 1985Complications of the Angelchik Antireflux ProsthesisMICHAEL W.L. GEAR, D.M., M.Ch., F.R.C.S., E. WALFORD GILLISON, F.R.C.S., BRIAN L. DOWLING, M.S., F.R.C.S.MICHAEL W.L. GEAR, D.M., M.Ch., F.R.C.S.Search for more papers by this author, E. WALFORD GILLISON, F.R.C.S.Search for more papers by this author, BRIAN L. DOWLING, M.S., F.R.C.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-6-959_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Last year, Benjamin and colleagues (1) presented a careful and thoughtful summary of the problems experienced in a few cases with the Angelchik prosthesis. Obviously, with a relatively new technique, it is important to establish the nature and incidence of the complications. However, we believe that the authors have not made clear that other techniques such as fundoplication, much more widely used worldwide, have their own morbidity and mortality. These rates are well documented (2) for fundoplication but not yet for the Angelchik device. The crucial factor missing from the article by Benjamin and colleagues is the...References1. BENJAMINKERRCOHENMOTAPARTHYCASTELL SRDVD. Complications of the Angelchik antireflux prosthesis. Ann Intern Med. 1984;100:570-5. LinkGoogle Scholar2. POLK H. Fundoplication for reflux esophagitis: misadventures with the operation of choice. Ann Surg. 1976;183:645-52. CrossrefMedlineGoogle Scholar3. GEARGILLISONDOWLING MEB. Randomized prospective trial of the Angelchik anti-reflux prosthesis. Br J Surg. 1984;71:681-3. CrossrefMedlineGoogle Scholar4. GOURLEYPELLETTLITHORESONADKINSODELL GJBCWG. A prospective, randomized, double-blind study of gastroesophageal reflux (GER) surgery: Nissen fundoplication vs. Angelchik prosthesis [Abstract]. Gastroenterology. 1984;86(5 pt 2):1095. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1985Volume 103, Issue 6_Part_1Page: 959-959KeywordsMorbidityMortality Issue Published: 1 December 1985 PDF DownloadLoading ...
Myocardial contrast washout reflects coronary blood flow in the absence of coronary autoregulation
Authors: Daniele Rovai, Massimo Lombardi, Gianna Ghelardini, Maria Giovanna Trivella, Edoardo Nevola, Maria Aurora Morales, Luigi Taddei, Birgitta Bjurk, Antonio L'Abbate
Journal: Journal of the American College of Cardiology (1991)
Storage and disposal of embryos and gametes
Authors: A. Trounson, K. Dawson
Journal: BMJ (1996)

Storage and disposal ofembryos and gametesPatients must be aware oftheir rights and responsibilitiesFreezing of sperm and preimplantation embryos is a technique used routinely in livestock industries, laboratory animal breed- ing, and genetic conservation, and more recently it has been used to aid the conservation of endangered species.In human infertility, freezing sperm ensures the safe, effective use of sperm for insemination.It also enables men who are about to undergo treatment which affects sperm production-involving drugs, chemotherapy, or radiotherapy-to store sperm for later use.Embryos are frozen for patients undergoing in vitro ferti- lisation, either to improve the chance of conception or to allow for planned use in the future.Freezing spare embryos allows replacement of an optimum number to avoid the risk of multi- ple birth and avoids the waste of discarding potentially viable
Psyllium Hypersensitivity, Nurses, and Geriatric Units
Authors: WILLIAM F. SCHOENWETTER
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 October 1985Psyllium Hypersensitivity, Nurses, and Geriatric UnitsWILLIAM F. SCHOENWETTER, M.D., PAUL STEINBERG, M.D.WILLIAM F. SCHOENWETTER, M.D.Search for more papers by this author, PAUL STEINBERG, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-4-642 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The excellent review of occupational hazards to hospital personnel by Patterson and associates (1) overlooks the problem of psyllium hypersensitivity.Many hospitalized patients, particularly those in geriatric units, receive daily treatment with bulk laxatives, many containing the ground husks or seeds of the psyllium plant. The dried, hydrophilic outer layer of the psyllium seed is used because it retains intestinal fluids. Psyllium has been shown to be allergenic and can stimulate the production of specific IgE antibodies (2). Sensitization and subsequent symptoms, usually rhinoconjunctivitis and asthma (2-4), are caused by inhalation of psyllium dust particles as small...References1. PATTERSONCRAVENSCHWARTZNARDALLKASMERNOBEL WDDEJJ. Occupational hazards to hospital personnel. Ann Intern Med. 1985;102:658-80. LinkGoogle Scholar2. BUSSESCHOENWETTER WW. Asthma from psyllium in laxative manufacture. Ann Intern Med. 1975;83:361-2. LinkGoogle Scholar3. GROSS R. Acute bronchospasm associated with inhalation of psyllium hydrophilic mucilloid [Letter]. JAMA. 1979;241:1573-4. CrossrefMedlineGoogle Scholar4. MACHADOZETTERSTROMFAGERBERG LOE. Occupational allergy in nurses to a bulk laxative. Allergy. 1979;34:51-5. CrossrefMedlineGoogle Scholar5. SCHOENWETTER W. Anaphylaxis in nurses caused by inhaled psyllium seed [Abstract]. J Allergy Clin Immunol. 1985;75:209. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: WILLIAM F. SCHOENWETTER, M.D.; PAUL STEINBERG, M.D.Affiliations: Park Nicollet Medical Center Minneapolis, MN 55416 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byOccupational IgE‐mediated psyllium allergy in contemporary gluten‐free and vegan baking: A case of allergic rhinitisAsma relacionada con la inhalación de Plantago ovataPsyllium-induced asthma 1 October 1985Volume 103, Issue 4Page: 642-642KeywordsAllergensAntibodiesAsthmaDustGeriatricsHypersensitivityInhalation ePublished: 1 December 2008 Issue Published: 1 October 1985 PDF downloadLoading ...