tbuckley/cabot-search huggingface dataset:
OC-143 Artificial neural network for the risk stratification of acute upper gastrointestinal bleeding: multicentre comparative analysis vs the Glasgow Blatchford and rockall scores
Authors: A Ali, J Swingland, C H Choi, J Chan, S Khan, S Bose, L Ayaru
Journal: Gut (2012)

<h3>Introduction</h3> Most patients presenting with acute upper GI bleeding (AUGIB) are at low risk of requiring clinical intervention or death. Nevertheless, risk assessment conventionally involves inpatient upper GI endoscopy which increases the cost of care. Non-endosopic risk scores, Glasgow Blatchford (GBS) and admission Rockall, are limited by poor specificity. The aim of this study was to develop an Artificial Neural Network (ANN) for the non-endoscopic triage of AUGIB. <h3>Methods</h3> An internal cohort of patients with AUGIB (n=400) admitted to the emergency departments of two teaching hospitals, January 2008 to December 2009, was retrospectively identified. A separate group with AUGIB (n=200) admitted to a third teaching hospital made up the external validation cohort. The composite endpoint was clinical intervention (blood transfusion, endoscopic therapy or surgery) and/or death. A multi-layered perceptron ANN model was generated using back propagation and logistic activation function with hidden nodes to make a prediction from 30 input variables. Training and validation of the internal cohort was performed through a “leave one out” analysis. Optimisation was carried out by excluding statistically insignificant variables and the ANN validated in the external cohort. ROC curve analysis was used to compare the ANN, GBS and Rockall scores. <h3>Results</h3> Demographics for patients in the internal cohort were: mean age 57 years, 70% male, 39.5% met the composite endpoint (22.3% endoscopic therapy, 25.3% transfusion, 1.5% surgery, 3.2% 30-day mortality). The external cohort was not significantly different apart from increased NSAID/anticoagulant use, smoking and prior history of AUGIB. In predicting the composite endpoint the ANN model performed well on external validation and had a significantly higher specificity (87.8%, 95% CI 81.4 to 92.7) than the other scores (GBS: 11.1% 95% CI 7.10 to 12.2, admission Rockall: 19.1% 95% CI 14.3 to 21.0, complete Rockall: 28.3% 95% CI 19.2 to 34.0). The ANN also had significantly higher PPV (77.1% 95% CI 65.1 to 86.4) (GBS: 42.9% 95% CI 40.3 to 43.5, admission Rockall: 45.0% 95% CI 41.8 to 46.3, complete Rockall: 60.2% 95% CI 55.2 to 63.4). In contrast the sensitivity (61.7%) and NPV (77.5% 95% CI 71.8 to 81.8) of the ANN model was inferior to the GBS score (100%) and (100% 95% CI 95.4 to 100). The ANN was significantly more accurate 0.83 (95% CI 0.77 to 0.90) than the GBS 0.56 (95% CI 0.46 to 0.65) or admission Rockall scores 0.60 (95% CI 0.51 to 0.69). <h3>Conclusion</h3> An ANN model can accurately predict need for intervention and outcome in patients with acute upper gastrointestinal bleeding and compares favourably with established risk scores. <h3>Competing interests</h3> None declared.
A major class of L-selectin ligands is eliminated in mice deficient in two sulfotransferases expressed in high endothelial venules
Authors: Kenji Uchimura, Jean-Marc Gauguet, Mark S Singer, Durwin Tsay, Reiji Kannagi, Takashi Muramatsu, Ulrich H von Andrian, Steven D Rosen
Journal: Nature Immunology (2005)
Cancer downwind from sour gas refineries: the perception and the reality of an epidemic.
Authors: M T Schechter, W O Spitzer, M E Hutcheon, R E Dales, L M Eastridge, N Steinmetz, P Tousignant, C Hobbs
Journal: Environmental Health Perspectives (1989)

A rural population in southwestern Alberta, Canada, living downwind from natural gas refineries, has expressed concerns about an excess of adverse health outcomes over the last 25 years. This has escalated to the point of causing a prominent sociopolitical controversy within the province. As part of a large field epidemiologic study undertaken during the summer of 1985 to investigate possible health effects, a residential cohort study was carried out to study cancer incidence. The cohort was defined as all those individuals who resided in the area in 1970. A total of 30,175 person-years of risk within Alberta were experienced by this cohort from 1970 to 1984. The incident cancers during this period were enumerated by computerized record linkage with the Alberta Cancer Registry. Age- and sex-standardized incidence ratios, based on expected rates from three prespecified demographically similar, nonmetropolitan Southern Alberta populations, were 1.05, 1.09, and 1.03, respectively, none of which was significantly different from unity. Although they do not address the issue of etiologic association, these data can provide considerable reassurance to a community that was convinced it had experienced an epidemic of cancer.
Recent Advances and Current Challenges in Tumor Immunology and Immunotherapy
Authors: Barbara-ann Guinn, Noriyuki Kasahara, Farzin Farzaneh, Nagy A Habib, James S Norris, Albert B Deisseroth
Journal: Molecular Therapy (2007)

Despite advances in animal studies, where the cure of the majority of mice with pre-established (albeit early-stage) tumors has become almost standard, human clinical trials have been much less successful. Here we describe some of the most recent advances in the specialist field of tumor immunology and immunotherapy, highlighting salient work to identify key problem areas and potential solutions. We make particular note of recent developments in adoptive therapy; whole-cell, DNA, and peptide vaccines; and antibody therapy. We also describe the revival of interest in regulatory T cells and conclude by detailing the need for clinical trial read-out autonomy and methods to predict which patients will respond to a particular treatment. Despite advances in animal studies, where the cure of the majority of mice with pre-established (albeit early-stage) tumors has become almost standard, human clinical trials have been much less successful. Here we describe some of the most recent advances in the specialist field of tumor immunology and immunotherapy, highlighting salient work to identify key problem areas and potential solutions. We make particular note of recent developments in adoptive therapy; whole-cell, DNA, and peptide vaccines; and antibody therapy. We also describe the revival of interest in regulatory T cells and conclude by detailing the need for clinical trial read-out autonomy and methods to predict which patients will respond to a particular treatment.
Selective release of excreted DNA sequences from phytohemagglutinin-stimulated human peripheral blood lymphocytes. Effects of trypsin and divalent cations.
Authors: C W Distelhorst, K Cramer, J C Rogers
Journal: Journal of Clinical Investigation (1978)

We studied the synthesis of excreted DNA sequences and their release from phytohemagglutinin-stimulated human peripheral blood lymphocytes under conditions permitting optimal cell growth. Cells were labeled by constant exposure to low specific activity [3H]thymidine. Excreted DNA sequences were synthesized during the period of logarithmic cell growth and moved slowly from the high molecular weight chromosomal DNA fraction into the low molecular weight cell DNA fraction (Hirt supernate) from which they could be specifically released by treating the cells briefly with small amounts of various proteases; 1 microgram/ml trypsin for 5 min was optimal. On day 5 of culture, 13.3 +/- 6.9% of the total cellular acid-precipitable [3H]thymidine was released by this treatment. Trypsin-induced release was partially and reversibly inhibited by incubating the cells for 16 h with 5 mM dibutyryl-cyclic AMP. Cells incubated in the absence of divalent cations spontaneously released this Hirt supernatant DNA; after maximal release had occurred under these circumstances, additional trypsin treatment caused no further release of DNA. Trypsin-induced DNA release could be completely and reversibly inhibited by incubating the cells in the presence of 10 mM calcium. Trypsin-released DNA was isolated and analyzed by reassociation kinetics. A major component, representing 54% of the DNA, reassociated with a C0t1/2 of 68 mol.s/liter (the value at which DNA association is 50% complete). The reassociation of this DNA was studied in the presence of an excess of DNA isolated from stimulated lymphocytes on day 3 in culture, and in the presence of an excess of resting lymphocyte DNA. The high molecular weight fraction of day-3 cell DNA contained three times more copies of the trypsin-released DNA major component as compared to resting lymphocyte DNA. Hirt supernatant DNA isolated from day-5 stimulated lymphocytes reassociated in an intermediate component representing 34% of the DNA with a Cot1/2 of mol.s/liter; after cells were treated with trypsin, this component could no longer be identified in the Hirt supernatant fraction, presumably because it had been released into the incubation medium. These data describe a quantitatively reproducible system with which synthesis and release of excreted DNA sequences can be studied.
Inferior Vena Cava Obstruction Due to Plasmacytoma Demonstrated on Phlebography Using 99m7c Macroaggregated Albumin
Authors: MICHAEL M. McDANIEL, D JAMES M. COLEMAN, M E MORTON
Journal: Clinical Nuclear Medicine (1977)

McDANIEL, MICHAEL M. M.D.; COLEMAN, JAMES M. M.D.; MORTON, M E Ph.D., M.D. Author Information
Genetic polymorphism in C8 beta-chains. Evidence for two unlinked genetic loci for the eighth component of human complement (C8).
Authors: C A Alper, D Marcus, D Raum, B H Petersen, T J Spira
Journal: Journal of Clinical Investigation (1983)

Genetic polymorphism in the beta-subunit of the eighth component of human complement, C8, was defined by isoelectric focusing of serum in polyacrylamide gel in the presence of urea and development of specific patterns of hemolysis in an overlay gel containing antibody-sensitized erythrocytes and C8 beta-chain-deficient serum. Bands of hemolysis induced by serum from unrelated Caucasians suggested autosomal codominant inheritance of three structural alleles at a single locus, C82: C82 degrees A (acidic), C82 degrees B (basic), and C82 degrees A1 (very acidic) with frequencies of 0.952, 0.044, and 0.004, as well as the probable null allele C82 degrees Q0. The distribution of phenotypes agreed with the Hardy-Weinberg equilibrium. The previously described genetic polymorphism in human C8 defined with the use of "complete" C8 (C8 alpha-gamma-chain)-deficient serum was distinct from and independent of the inherited structural variation at C82. Therefore, the locus for C8 alpha-gamma-chains has been redesignated C81, and has the alleles C81 degrees A, C81 degrees A1, and C81 Q0. Linkage studies failed to show close linkage between the two loci for C8, C81, and C82, and between C82 and the major histocompatibility complex or C6.
Use of DDAVP in inherited and acquired platelet dysfunction
Authors: Donna M. Dimichele, Wm. E. Hathaway
Journal: American Journal of Hematology (1990)

Abstract Twenty‐one patients with prolonged bleeding times secondary to inherited disorders of platelet function and eight patients with prolonged bleeding times secondary to acquired platelet dysfunction were given 0.3 μg per kilogram of DDAVP, 1‐deamino‐8‐D‐arginine vasopressin, intravenously. Sixteen of twenty‐two DDAVP trials in patients with inherited platelet dysfunction (73%) and seven of the nine DDAVP trials in patients with acquired platelet dysfunction (78%) resulted in normalization or shortening of the prolonged bleeding times by at least 4 min. The bleeding time response did not correlate with changes in the levels of von Willebrand factor (vWf) antigen or ristocetin cofactor activity, nor was it associated with changes in vWf multimeric analysis or in vitro platelet aggregations following the administration of DDAVP. Shortening of the bleeding time with DDAVP was seen in patients with a failure to release/storage pool type defect, thromboxane synthesis type defect, Bernard‐Soulier syndrome, Glanzmann's thrombasthenia, the May‐Hegglin anomaly, liver disease, nonuremic renal disease, myelofibrosis, and Tangier's disease.
Abstract 365: Extracorporeal Cardiac Shock Wave Therapy Ameliorates Left Ventricular Remodeling after Myocardial Ischemia-Reperfusion Injury in Pigs
Authors: Yoshitaka Ito, Kenta Ito, Takashi Shiroto, Ryuji Tsuburaya, JunYi Gao, Yoku Kikuchi, Kentaro Aizawa, Morihiko Takeda, Satoshi Yasuda, Hiroaki Shimokawa
Journal: Circulation (2008)

We have previously demonstrated that low-energy extracorporeal cardiac shock wave (SW) therapy effectively induces angiogenesis and improves cardiac function in a porcine model of chronic myocardial ischemia and in patients with end-stage coronary artery disease. We also have recently demonstrated that SW therapy improves left ventricular (LV) remodeling after acute myocardial infarction (AMI) caused by a permanent coronary artery ligation in pigs  in vivo . However, in the clinical setting, most of the patients with AMI receive reperfusion therapy. In this study, we thus examined whether our SW therapy ameliorates LV remodeling after myocardial ischemia-reperfusion (I/R) injury in pigs. Sixteen pigs were subjected to ischemia (90 min occlusion of the left anterior descending coronary artery) and reperfusion using a balloon catheter. Three hours after the reperfusion, they were randomly assigned to the 2 groups with or without the SW therapy to the ischemic border zone (0.09 mJ/mm 2 , 200 pulses/spot, 9 spots/animal, n=8 each) on day 1, 3 and 5. Control group received the same procedures but without the SW therapy on the same schedule. After I/R, the maximum serum concentrations of cardiac troponin T were comparable between the 2 groups, indicating the comparable extent of myocardial I/R injury. Furthermore, on day 1 after I/R and before the SW treatment, LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), LV end-diastolic pressure (LVEDP) and wall thickening fraction (WTF) of ischemic border zone were all comparable between the 2 groups. Four weeks after I/R, LVEDV was markedly increased and LVEDP was elevated in the control group, and both indices of LV remodeling were significantly ameliorated in the SW group (LVEDV, 100±7 vs. 130±9 ml; LVEDP, 4±1 vs. 11±2 mmHg, both P 2 , P in vivo .
A Case–Crossover Study of Wintertime Ambient Air Pollution and Infant Bronchiolitis
Authors: Catherine Karr, Thomas Lumley, Kristen Shepherd, Robert Davis, Timothy Larson, Beate Ritz, Joel Kaufman
Journal: Environmental Health Perspectives (2005)

We examined the association of infant bronchiolitis with acute exposure to ambient air pollutants.We employed a time-stratified case-crossover method and based the exposure windows on a priori, biologically based hypotheses.We evaluated effects in 19,901 infants in the South Coast Air Basin of California in 1995-2000 with a hospital discharge record for bronchiolitis in the first year of life (International Classification of Diseases, 9th Revision, CM466.1).Study subjects' ZIP code was linked to ambient air pollution monitors to derive exposures. We estimated the risk of bronchiolitis hospitalization associated with increases in wintertime ambient air pollutants using conditional logistic regression.We observed no increased risk after acute exposure to particulate matter < or = 2.5 microm in aerodynamic diameter (PM2.5), carbon monoxide, or nitrogen dioxide. PM2.5 exposure models suggested a 26-41% increased risk in the most premature infants born at gestational ages between 25 and 29 weeks; however, these findings were based on very small numbers.We found little support for a link between acute increases in ambient air pollution and infant bronchiolitis except modestly increased risk for PM2.5 exposure among infants born very prematurely. In these infants, the periods of viral acquisition and incubation concurred with the time of increased risk. RELEVANCE TO PROFESSIONAL PRACTICE: We present novel data for the infant period and the key respiratory disease of infancy, bronchiolitis. Incompletely explained trends in rising bronchiolitis hospitalization rates and increasing number of infants born prematurely underscore the importance of evaluating the impact of ambient air pollution in this age group in other populations and studies.
Safety and efficacy of elective carotid artery stenting in high-risk patients
Authors: Fayaz Shawl, Waleed Kadro, Michael J Domanski, Fernando L Lapetina, Aleem A Iqbal, Kathy G Dougherty, David D Weisher, Jaime F Marquez, S.Tariq Shahab
Journal: Journal of the American College of Cardiology (2000)
Interruption of methadone treatment by imprisonment
Authors: L. Gruer, J. Macleod
Journal: BMJ (1997)

Editor—The number of opiate dependent drug injectors being prescribed methadone in Glasgow has risen 10-fold in the past five years and by the end of 1996 exceeded 2200. There is increasing evidence that this is helping many people achieve substantial improvements in health, social stability, and reduced criminality.1 After several reports that methadone prescribing was being …
Mesenteric Venous Infarction presenting as an Upper GI Bleeding and Diagnosed by Upper GI Endoscopy
Authors: A. Leiser, A. Wysjenbeek, U. Kadish
Journal: Endoscopy (1985)

A case of primary mesenteric vein thrombosis with extensive small bowel infarct beginning at the ligament of Treitz presented as upper gastrointestinal bleeding. Although endoscopy of the upper GI tract disclosed erosive gastritis this finding was considered insufficient to explain the hematemesis; therefore the endoscope was advanced further until a necrotic and aperistaltic-looking mucosa was found in the area of the ligament of Treitz. This paper describes the endoscopic picture of necrotic duodenal mucosa, and stresses the importance of a deeper examination into the duodenum when a clear-cut cause for the bleeding is not found in the stomach or duodenal bulb.
Playing the numbers
Authors: D. Spence
Journal: BMJ (2009)

“No more bets, please” said the croupier at the roulette table. I was at a university reunion at a casino. It was like the old days; indeed, my friends were still wearing the same clothes and hairstyles as at university. We had £25 split on 33/36, £200 on red, and £100 as an outside bet—all our chips staked on one roll of the ball. “Red 36.” We jumped and hugged, exchanging loud, poorly chosen expletives—heterosexual male love is strong. It wasn’t the …
Severe Gastrointestinal Haemorrhage: Haemangiomata Demonstrated by Selective Visceral Arteriography
Authors: E. C. Ashby, T. J. Mott, F. Starer
Journal: BMJ (1968)

Selective visceral arteriography was found to be invaluable in the management of two cases of severe gastrointestinal haemorrhage associated with cavernous haemangiomata (a large gastric haemangioma and a small jejunal haemangioma). It is suggested that arteriography may be indicated in cases where a previous laparotomy has not shown the cause of bleeding, when the patient's general condition precludes a prolonged operation, and when superficial haemangiomata are found.
Predominant activation and expansion of V gamma 9-bearing gamma delta T cells in vivo as well as in vitro in Salmonella infection.
Authors: T Hara, Y Mizuno, K Takaki, H Takada, H Akeda, T Aoki, M Nagata, K Ueda, G Matsuzaki, Y Yoshikai
Journal: Journal of Clinical Investigation (1992)

Gamma delta T cell receptor-positive cells (gamma delta T cells) have recently been implicated to play a role in the protection against infectious pathogens. Serial studies on gamma delta T cells in 14 patients with salmonella infection have revealed that the proportions of gamma delta T cells (mean +/- SD: 17.9 +/- 13.2%) in salmonella infection were significantly increased (P less than 0.01) compared with 35 normal controls (5.0 +/- 2.6%) and 13 patients with other bacterial infections (4.0 +/- 1.4%). Expansion of gamma delta T cells was more prominent in the systemic form (28.9 +/- 10.8%) than in the gastroenteritis form (10.5 +/- 7.9%) of salmonella infection (P less than 0.01). Most in vivo-expanded gamma delta T cells expressed V gamma 9 gene product. Increased activated (HLA-DR+) T cells were observed in all the six patients with the systemic form and four of the seven with gastroenteritis form. Especially in the six with systemic form, gamma delta T cell activation was significantly higher than alpha beta T cell activation at the early stage of illness (P less than 0.01). When peripheral blood lymphocytes from normal individuals were cultured with live salmonella, gamma delta T cells were preferentially activated and expanded and most of them expressed V gamma 9. Purified gamma delta T cells also responded to live salmonella in vitro. The present study suggests that human gamma delta T cells play a role in the protection against salmonella infection in vivo.
Cost and Price of Comparable Branded and Generic Pharmaceuticals
Authors: Bernard S. Bloom
Journal: JAMA (1986)

Substituting generic for brand drugs has been increasing for two decades with the expectation that it leads to important savings. We studied 891 862 prescriptions, written for 21 pairs of branded and generic drugs, dispensed between April 1, 1984, and June 30, 1984, by 1363 selected pharmacies in 39 states. The cost per pill paid by the pharmacy was always less for the generic than the branded drug. The price per pill paid by the consumer was usually less for the generic than the brand. The wide and skewed distribution of consumer prices within and among pharmacies means that consumers cannot be guaranteed the lowest cost simply by buying generic drugs. The probability that generic would be less expensive than brand varied widely across drug pairs from .33 to .99. Continued search is no guarantee that the full distribution of prices or the lowest or nearly-lowest price will be found.
1017-74 Length of Hospital Stay After Percutaneous Transluminal Coronary Angioplasty: Clinical and Angiographic Predictors
Authors: John A. Bittl, Mark W Wolfe, Gary S. Roubin, Marc Schweiger, Jeffrey M. Isner, James J. Ferguson, Adam D. Cannon, Michael Cleman, Henry Cabin, Ferdinand Leya, Raoul Bonan, John Strony, Burt Adelman
Journal: Journal of the American College of Cardiology (1995)
Lenalidomide induces complete and partial remissions in patients with relapsed and refractory chronic lymphocytic leukemia
Authors: Alessandra Ferrajoli, Bang-Ning Lee, Ellen J. Schlette, Susan M. O'Brien, Hui Gao, Sijin Wen, William G. Wierda, Zeev Estrov, Stefan Faderl, Evan N. Cohen, Changping Li, James M. Reuben, Michael J. Keating
Journal: Blood (2008)
Asymptomatic retinal haemorrhage is common at altitude
Authors: R. E MacLaren
Journal: BMJ (1995)

EDITOR,--In their article on mountaineering medicine Christine H D A'Court and colleagues neglect to discuss one of the commonest medical disorders at altitude; retinal haemorrhage.1 This is surprising since macular haemorrhage is listed as having affected one member of their team and was probably detected only after the subject complained of central …