tbuckley/cabot-search huggingface dataset:
Patterns of Tuberculosis Transmission in Central Los Angeles
Authors: Peter F. Barnes, Zhenhua Yang, Susan Preston-Martin, Janice M. Pogoda, Brenda E. Jones, Michiko Otaya, Kathleen D. Eisenach, Laura Knowles, Sydney Harvey, M. Donald Cave
Journal: JAMA (1997)

Recent studies suggest that many tuberculosis cases in urban areas result from recent transmission. Delineation of the epidemiologic links between patients is important to optimize strategies to reduce tuberculosis transmission.To identify epidemiologic links among recently infected urban patients with tuberculosis.Prospective evaluation of patients with tuberculosis.Central Los Angeles, Calif.A total of 162 patients who had culture-proven tuberculosis.Patients were prospectively interviewed to identify their contacts and whereabouts. The IS6110-based and pTBN12-based restriction fragment length polymorphism analyses were performed on Mycobacterium tuberculosis isolates. Patients whose isolates had identical or closely related restriction fragment length polymorphism patterns were considered a cluster. Unconditional logistic regression was used to identify independent predictors of clustering.Relationship of clinical and epidemiologic variables to clustering.A total of 96 (59%) of 162 patients were in 8 clusters. Only 2 of the 96 clustered patients named others in the cluster as contacts. The degree of homelessness was an independent predictor of clustering. Compared with nonclustered patients, patients in 6 clusters were significantly more likely to have spent time at 3 shelters and other locations when at least 1 patient in the cluster was contagious, and these locations were independent predictors of clustering. Among nonhomeless persons, clustered patients were significantly more likely than nonclustered patients to have used daytime services at 3 shelters.(1) Traditional contact investigation does not reliably identify patients infected with the same M tuberculosis strain, and (2) locations at which the homeless congregate are important sites of tuberculosis transmission for homeless and nonhomeless persons. Measures that reduce tuberculosis transmission should be based on locations rather than on personal contacts.
Impact du dépistage organisé du cancer colorectal par Hemoccult sur l'activité de coloscopie
Authors: B Denis, EA Sauleau, P Lalanne, D Camara, M Poupon, M Schmitt, I Gendre, P Perrin
Journal: Endoscopy (2007)

Le dépistage organisé (DO) du cancer du colon va être étendu à toute la France. But: évaluer l'impact du DO par Hemoccult® sur l'activité de coloscopie (C).
Antibiotic Batch Certification and Bioequivalence
Authors: Karl A. DeSante
Journal: JAMA (1975)

All antibiotics marketed in the United States must undergo batch certification by the Food and Drug Administration. It is often assumed that the different brands of a particular antibiotic that pass in vitro batch certification tests have equal in vivo bioavailability. The fallacy of this assumption is clearly supported for commercially available lots of tetracycline hydrochloride that had passed batch certification tests yet had different serial serum concentrations.
Effects of Halothane on Left Ventricular Function and Distribution of Regional Blood Flow in Dogs and Primates
Authors: STEPHEN F. VATNER, N. TY SMITH
Journal: Circulation Research (1974)

Left ventricular and regional vascular effects of halothane were assessed in dogs and primates in which coronary, mesenteric, renal, and iliac blood flows, arterial blood pressure, left ventricular diameter and pressure, dD/dt (i.e., the velocity of myocardial fiber shortening), and dP/dt were continuously measured in the control resting state, while the conscious animals were breathing O 2 , and during halothane-O 2 anesthesia maintained at 1% or at 2% for 90 minutes (separate experimental days). Halothane caused a concentration-dependent depression of myocardial contractility: (dP/dt)/P fell 68 ± 5% during 2% halothane anesthesia and left ventricular end-diastolic diameter rose. Halothane also caused a redistribution of regional blood flows. At a concentration of 1% halothane, the most intense vasodilatation occurred in the renal bed (renal resistance fell 46 ± 5%), but mesenteric resistance rose (42 ± 15%). With 1% halothane regional vascular resistances tended to rise with time, but with 2% halothane regional blood flows rose with time. A direct vasodilating action of halothane was observed following direct intra-arterial injection of the drug. Probably this action was responsible for the renal and iliac vasodilatations and for the opposition to the metabolically induced vasoconstriction in the coronary bed. Thus, the administration of the most commonly employed potent inhalation anesthetic, halothane, substantially alters myocardial contractility and regional blood flows and resistances. These effects are, in many instances, a function of the concentration of the anesthetic and the duration of its administration.
Hypopituitarism in a woman with a severe primary antiphospholipid syndrome
Authors: M ANDRE, O AUMAITRE, J C PIETTE, P THIEBLOT
Journal: Annals of the Rheumatic Diseases (1998)

<i>Aims</i>—The human ccn1 (hccn; hcyr61) gene has been identified previously at the mRNA and protein level as a 1,25-dihydroxyvitamin D<sub>3</sub> and growth factor regulated gene in human osteoblasts. This study aimed to analyse genomic clones containing the human ccn1 (cyr61) gene and to provide the 5′ flanking region. <i>Methods</i>—Genomic clones were isolated by screening a λ library and by array filter hybridisations of a genomic library. Sequencing was performed using the dye terminator method. Promoter activity was measured after transient transfection using a β galactosidase assay. CA repeat motifs were studied by a combined PCR/fragment analysis protocol. <i>Results</i>—The human 5′ flanking region of 870 nucleotides contains several stretches with high homology to the mouse promoter as well as CA repeat motifs. This first report on the human 5′ flanking sequence of the hccn1 (hcyr61) gene provides important insights into regulation pathways for the expression of this 1,25-dihydroxyvitamin D<sub>3</sub> and growth factor responsive early gene. A genomic clone containing the hccn1 (hcyr61) gene region also yielded a CA sequence located 3′ of the ccn1 (cyr61) gene. This CA repeat and one of the CA repeat motifs in the promoter were studied in detail and found to be polymorphic. <i>Conclusions</i>—The 5′ flanking sequence of the hccn1 (hcyr61) gene provides insights into the mechanisms of regulation of this immediate early gene product. The CA repeat polymorphisms within the gene region will be useful in the genetic study of disorders affecting bone metabolism.
Multiple Halothane Anesthesia in the Burn Patient
Authors: Gerald A. Gronert
Journal: JAMA (1968)

Halothane is the anesthetic agent of choice for burn patients in the Burn Unit at Brooke General Hospital. It is used repeatedly—an average of four administrations per patient, with a range to 22. From 1964 through 1968, 408 patients received 1,770 halothane anesthetics. Two cases of liver necrosis occurred, one massive; neither is attributable to halothane. The evidence indicates that repeated administrations of halothane in a six-week period involve no additional risk to the patient.
Clinical Immunology Update: Reviews for Physicians
Authors: Samuel Vaisrub
Journal: JAMA (1980)

Strictly speaking, clinical immunology is not a medical specialty. Its compass is much too wide. One can hardly expect rheumatologists to relinquish their franchise on rheumatoid arthritis, endocrinologists to give up their hold on thyrotoxicosis, hematologists to part with hemolytic anemia, oncologists with multiple myeloma, allergists with allergic pneumonitis, or neurologists with myasthenia gravis just because immune mechanisms play an important role in these conditions. Hence the 22 contributors to the book's three chapters review these and other topics not in the framework of a specialty, but in that of a discipline that aids physicians and surgeons in understanding disorders of fundamental immunologic processes and their correction as they relate to a wide range of diseases. This updated review will be read with interest by physicians regardless of their specialties.
Role of LFA-1/ICAM-1-dependent cell adhesion in CD40-mediated inhibition of anti-IgM antibody-induced B-cell death
Authors: M MAYUMI, S SUMIMOTO, Y OHSHIMA, K KATAMURA, T HEIKE, D HATA, S KANAZASHI, K FURUSHO
Journal: Journal of Allergy and Clinical Immunology (1995)
Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA)
Authors: Neil R Poulter, Hans Wedel, Björn Dahlöf, Peter S Sever, D Gareth Beevers, Mark Caulfield, Sverre E Kjeldsen, Arni Kristinsson, Gordon T McInnes, Jesper Mehlsen, Markku Nieminen, Eoin O'Brien, Jan Östergren, Stuart Pocock
Journal: The Lancet (2005)
Cardiac Magnetic Resonance With T2-Weighted Imaging Improves Detection of Patients With Acute Coronary Syndrome in the Emergency Department
Authors: Ricardo C. Cury, Khalid Shash, John T. Nagurney, Guido Rosito, Michael D. Shapiro, Cesar H. Nomura, Suhny Abbara, Fabian Bamberg, Maros Ferencik, Ehud J. Schmidt, David F. Brown, Udo Hoffmann, Thomas J. Brady
Journal: Circulation (2008)

Cardiac magnetic resonance (CMR) imaging permits early triage of patients presenting to the emergency department with acute chest pain but has been limited by the inability to differentiate new from old myocardial infarction. Our objective was to evaluate a CMR protocol that includes T2-weighted imaging and assessment of left ventricular wall thickness in detecting patients with acute coronary syndrome in the emergency department.In this prospective cohort observational study, we enrolled patients presenting to the emergency department with acute chest pain, negative cardiac biomarkers, and no ECG changes indicative of acute ischemia. The CMR protocol consisted of T2-weighted imaging, first-pass perfusion, cine function, delayed-enhancement magnetic resonance imaging, and assessment of left ventricular wall thickness. The clinical outcome (acute coronary syndrome) was defined by review of clinical charts by a consensus panel that used American Heart Association/American College of Cardiology guidelines. Among 62 patients, 13 developed acute coronary syndrome during the index hospitalization. The mean CMR time was 32+/-8 minutes. The new CMR protocol (with the addition of T2-weighted and left ventricular wall thickness) increased the specificity, positive predictive value, and overall accuracy from 84% to 96%, 55% to 85%, and 84% to 93%, respectively, compared with the conventional CMR protocol (cine, perfusion, and delayed-enhancement magnetic resonance imaging). Moreover, in a logistic regression analysis that contained information on clinical risk assessment (c-statistic=0.695) and traditional cardiac risk factors (c-statistic=0.771), the new CMR protocol significantly improved the c-statistic to 0.958 (P<0.0001).The present study indicates that a new CMR protocol improves the detection of patients with acute coronary syndrome in the emergency department and adds significant value over clinical assessment and traditional cardiac risk factors.
FIBROID TUMORS OF THE VAGINA, WITH REPORT OF A CASE.
Authors: J. M. EMMERT
Journal: JAMA (1897)

May 10, 1895, I was called in consultation with Dr. Weaver of Cumberland, Iowa, to see Mrs. A. G. M., who gave the following history: Born in Germany; aged 46; married three times; now living with last husband; had six children, of whom three are now living; last child delivered by forceps. About 1892, while working in a brewery, lifting and carrying heavy baskets of bottles, she felt a heavy, dragging sensation in her pelvis and upon examination a tumor was found in the vagina. She was taken to a hospital where she says she remained twenty weeks. She states that no operation was performed, but the tumor was allowed to slough away, or partly so. After leaving the hospital and coming to this country she for a time felt no inconvenience from the tumor; but the dragging sensation again returned and Dr. Weaver was sent for, who asked me
The Lysyl Oxidase LOX Is Absent in Basal and Squamous Cell Carcinomas and Its Knockdown Induces an Invading Phenotype in a Skin Equivalent Model
Authors: Charbel Bouez, Caroline Reynaud, Emmanuelle Noblesse, Amélie Thépot, Claudine Gleyzal, Jean Kanitakis, Eric Perrier, Odile Damour, Pascal Sommer
Journal: Clinical Cancer Research (2006)

Abstract Lysyl oxidase initiates the enzymatic stage of collagen and elastin cross-linking. Among five isoforms comprising the lysyl oxidase family, LOX is the better studied. LOX is associated to an antitumor activity in ras-transformed fibroblasts, and its expression is down-regulated in many carcinomas. The aim of this work was to shed light on LOX functions within the epidermis by studying its expression in human basal and squamous cell carcinomas and analyzing the effect of its enzymatic activity inhibition and protein absence on human keratinocytes behavior in a skin equivalent. In both carcinomas, LOX expression by epidermal tumor cells was lacking, while it was up-regulated around invading tumor cells in association with the stromal reaction. Lysyl oxidase activity inhibition using β-aminoproprionitrile in a skin equivalent model prepared with both primary human keratinocytes and HaCaT cell line affected keratin 10 and filaggrin expression and disorganized the collagen network and the basement membrane. In spite of all these changes, no invasion phenotype was observed. Modelization of the invasive phenotype was only noticed in the skin equivalent developed with LOX antisense HaCaT cell line, where the protein LOX is specifically absent. Our results clearly indicate that lysyl oxidase enzymatic activity is essential not only for the integrity maintenance of the dermis but also for the homeostasis of the epidermis. Moreover, LOX protein plays a role in the skin carcinomas and invasion but not through its enzymatic activity.
Treatment of mastalgia with bromocriptine: a double-blind cross-over study.
Authors: M Blichert-Toft, A N Anderson, O B Henriksen, T Mygind
Journal: BMJ (1979)

Treatment of mastalgia with bromocriptine: a double-blind cross-over study Mastalgia is often associated with fibrocystic disease of the breast.Treatments, however, often fail, probably owing to an unsatisfactory understanding of the nature of the condition.In this study we assess the therapeutic efficacy of bromocriptine. Patients, methods, and resultsSevere mastalgia was the dominant feature in 10 women with diffuse fibrocystic disease of the breast as judged by palpation and mammography and verified histologically.One patient (case 1) had galactorrhoea.None had prominent characteristics of the premenstrual syndrome.Mastalgia had been present for from six months to several years.In a double-blind cross- over trial patients were allocated at random to receive either bromocriptine or identical placebo capsules, each for a period of two months, in a dose of one capsule (bromocriptine 2-5 mg or placebo) daily during the first week of each period and thereafter two capsules daily.For one month before the trial and throughout the period of medication the presence and intensity of pain were recorded daily by each patient.They were seen in the outpatient clinic every four weeks.The code was broken at the end of each trial.Serum prolactin concentration was measured before the trial, on the day of cross- over, and on the final day of the trial (normal range 3-0-13-5 jug/l).During treatment with bromocriptine pain was totally or almost totally relieved in eight patients and in two the pain was much reduced (table).Placebo treatment failed to relieve mastalgia in any patient except one (case 9), in whom the relief during bromocriptine continued while taking placebo.Statistical analysis by Koch's method' showed that the relief obtained during bromocriptine therapy was significantly greater (P<002) than that during placebo medication, while period effects as well as carry-over effects were absent (P > 0-05).Mastalgia reappeared as soon as active medication was stopped, with the exception of the patient in case 9.The breasts became smaller, softer, and less tender during bromocriptine treatment.The pretrial serum prolactin concentration was slightly raised in three patients and normal in seven.During treatment with bromocriptine these concentrations were significantly lowered (P<0-01, sign test).There were no side effects from placebo.While taking bromocriptine five patients had slight, transitory nausea and dizziness, which is a recognised side effect.Three others had persistent and more pronounced nausea, dizziness, and general malaise.
Role of positron emission tomography in determining the extent of CNS ischemia in patients with sickle cell disease
Authors: W. Reed, W. Jagust, M. Al-Mateen, E. Vichinsky
Journal: American Journal of Hematology (1999)

Nearly 25% of patients with sickle cell disease (SCD) experience central nervous system morbidity involving both large and small vessel disease. Optimal imaging methods for determining the extent of ischemia are not known. Positron emission tomography (PET) has the unique ability to show tissue function as well as structure. Reports concerning patients with non-SCD neurodegenerative disorders suggest PET may be useful in determining prognosis. We compared magnetic resonance imaging, magnetic resonance angiography, and neuropsychological testing with PET prospectively. Six patients with SCD and a history of stroke, aged 10 to 28, were enrolled. PET studies were performed on an ECAT HR 47 scanner (Siemens/CTI, Knoxville, TN) using 18-F-fluorodeoxyglucose as a tracer. PET interpretations were conducted in blinded fashion. MRI studies found two patients with only small vessel disease and four with both large and small vessel disease. In two of four subjects with large vessel disease, PET showed a corresponding metabolic abnormality and also identified an area of hypometabolism extending beyond the anatomical lesion as shown by MRI. PET did not demonstrate an abnormality corresponding with small vessel disease. Detailed neuropsychological testing demonstrated cognitive dysfunction in all cases. For some patients, PET may add sensitivity in detecting impaired metabolism in the area surrounding a major vessel infarct. However, the technique does not appear to be generally useful in characterizing small watershed or deep white matter infarcts. Larger studies, to include control subjects and carefully selected untransfused SCD patients, are needed. A combination of conventional imaging and neuropsychological testing remains the preferred evaluation for most SCD patients with neurologic symptoms. Am. J. Hematol. 60:268–272, 1999. © 1999 Wiley-Liss, Inc.
Government cuts targets to focus instead on "quality patient care"
Authors: Z. Kmietowicz
Journal: BMJ (2010)

The government has scrapped the target that guaranteed patients in England access to their GP within 48 hours.

Instead doctors are being given the authority to decide which patients need to be prioritised, although they will still be judged on patients’ overall experience of the NHS, the health secretary, Andrew Lansley, has announced.

In its revision to the 2010-11 NHS operating framework the government also announced that it was to discontinue supervising the 18 week target on time from referral to treatment and reducing the four hour target threshold in hospital accident and emergency departments from 98% of patients to 95%.

Mr Lansley said, “I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes. Doctors will be free to focus on the outcomes that matter: providing quality patient care.

“But I want to be clear: while the NHS will no longer be accountable to ministers or the department for its performance …
Double-Lumen Flotation Catheter for Use in Complex Congenital Cardiac Anomalies
Authors: DAVID T. KELLY, L. JEROME KROVETZ, RICHARD D. ROWE
Journal: Circulation (1971)

The use of the Swan-Ganz flow-directed right heart catheter should be a considerable aid in obtaining diagnostic information in complex congenital heart disease. It is safe and requires little technical expertise. Its use should decrease considerably the amount of radiation exposure to both patient and operator.
Disposition and Metabolism of Metronidazole in Patients with Liver Failure
Authors: Geoffrey Farrell, Judith Baird-Lambert, Mara Cvejic, Neil Buchanan
Journal: Hepatology (1984)

A pharmacokinetic study of metronidazole disposition was performed in 10 patients with severe liver disease, the majority of whom also had impaired renal function. Following a single intravenous dose, systemic clearance of metronidazole was decreased by 66% in patients compared with healthy controls (p &lt; 0.001). The apparent volume of distribution for metronidazole was also decreased in patients (by 21%), but the greater effect on clearance resulted in the elimination half-life being prolonged 152%. Total urinary excretion of unaltered metronidazole was not reduced in patients compared with controls, and systemic clearance of metronidazole did not correlate with creatinine clearance. Hepatic production of hydroxymetronidazole [l-(2-hydroxyethyl)-2-hydroxymethyl-5-nitroim-idazole], the major oxidative metabolite of metronidazole, was significantly lowered in patients with liver failure. Peak plasma levels of this metabolite were lower, the time taken to achieve peak levels was longer and the area under the plasma concentration ± time curve (AUC 0 - 25h ) was reduced in patients compared to controls (p &lt; 0.05). Similarly, urinary recovery of hydroxymetronidazole was lower in patients with liver disease while excretion of the other major oxy-metabolite, 1-acetic acid-2-methyl-5-nitroimidazole, appeared reduced to an even greater extent. Thus, while the presence of renal function impairment in a patient with cirrhosis indicates that metronidazole elimination is likely to be abnormal, the principal mechanism for delayed elimination is impaired hepatic drug metabolism rather than reduced renal clearance of metronidazole and its major metabolites.