tbuckley/cabot-search huggingface dataset:
The CURB65 pneumonia severity score outperforms generic sepsis and early warning scores in predicting mortality in community-acquired pneumonia
Authors: G. Barlow, D. Nathwani, P. Davey
Journal: Thorax (2006)

<b>Background:</b> The performance of CURB65 in predicting mortality in community-acquired pneumonia (CAP) has been tested in two large observational studies. However, it has not been tested against generic sepsis and early warning scores, which are increasingly being advocated for identification of high-risk patients in acute medical wards. <b>Method:</b> A retrospective analysis was performed of data prospectively collected for a CAP quality improvement study. The ability to stratify mortality and performance characteristics (sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating curve) were calculated for stratifications of CURB65, CRB65, the systemic inflammatory response syndrome (SIRS) criteria and the standardised early warning score (SEWS). <b>Results:</b> 419 patients were included in the main analysis with a median age of 74 years (men = 47%). CURB65 and CRB65 stratified mortality in a more clinically useful way and had more favourable operating characteristics than SIRS or SEWS; for example, mortality in low-risk patients was 2% when defined by CURB65, but 9% when defined by SEWS and 11–17% when defined by variations of the SIRS criteria. The sensitivity, specificity, positive predictive value and negative predictive value of CURB65 was 71%, 69%, 35% and 91%, respectively, compared with 62%, 73%, 35% and 89% for the best performing version of SIRS and 52%, 67%, 27% and 86% for SEWS. CURB65 had the greatest area under the receiver operating curve (0.78 <i>v</i> 0.73 for CRB65, 0.68 for SIRS and 0.64 for SEWS). <b>Conclusions:</b> CURB65 should not be supplanted by SIRS or SEWS for initial prognostic assessment in CAP. Further research to identify better generic prognostic tools is required.
Congress to Simplify Those Complex, Anxiety-Provoking Immunization Booklets
Authors: Charles Marwick
Journal: JAMA (1992)

THE NEW YEAR should see a simplification of information given to parents or guardians when their child is immunized ( JAMA . 1992;267:2005-2007).  All predictions indicate that the new Congress—which convenes about a month from now—is going to revise existing legislation about providing immunization information. Present law requires (as of April 15 of this year) a lengthy immunization-explaining document, much of which deals with risks rather than benefits.  The information is contained in 3 unillustrated 8.5 × 5.5-in brochures that cover the poliomyelitis (1817 words), diphtheria-tetanus-pertussis (2217 words), and measles-mumps-rubella (2550 words) vaccines, whether given in combination or separately. Each is subtitled What You Need to Know .  Many parents and physicians say that it's probably more than the reader needs to know. These brochures are too long, complex, and anxiety-provoking, they say.  Strong Dissatisfaction  Thus, critics add, the brochures—developed over a period of of more than two years in response to the
Relevance of basophil histamine release changes during venom immunotherapy
Authors: V. STEPHAN, J. KÜHR, R. URBANEK
Journal: Allergy (1989)

We investigated the effect of rush and long-term venom immunotherapy on histamine release parameters in bee venom allergic patients. Ten patients received rush venom immunotherapy, and histamine release data were obtained immediately before and after treatment. 17 patients were assessed by histamine release 24 to 63 months after termination of long-term venom immunotherapy. A control group of 10 non-allergic subjects was included in this study. Histamine released from whole blood was determined in a sensitive radio-enzymatic assay using a single isotope technique. Bee venom phospholipase A-induced histamine release from whole blood proved to be a test procedure of high specificity and sensitivity. Eight of 10 untreated patients and no control subject showed significant antigen-induced histamine release. Results obtained from patients immediately after successful rush venom immunotherapy showed an important decrease (mean 45.9%) of total histamine content of basophil leukocytes in all patients. Antigen-induced maximum histamine release was found to be increased in one, decreased in two and unchanged in seven patients. In patients who received long-term immunotherapy cell sensitivity to phospholipase A was significantly lower than in a group of untreated patients (P less than or equal to 0.002). These results suggest that even years after discontinuation of immunotherapy, histamine release parameters reflect patients' protection from systemic sting reactions as assessed by sting challenges. Histamine depletion of basophils induced by rush immunotherapy may play an important role in patients' protection immediately after termination of the rush regimen.
Genetic and Proteomic Features Associated with Survival after Treatment with Erlotinib in First-Line Therapy of Non-small Cell Lung Cancer in Eastern Cooperative Oncology Group 3503
Authors: Joseph M. Amann, Ju-Whei Lee, Heinrich Roder, Julie Brahmer, Adriana Gonzalez, Joan H. Schiller, David P. Carbone
Journal: Journal of Thoracic Oncology (2010)
Induction of Innate Lymphoid Cell-Derived Interleukin-22 by the Transcription Factor STAT3 Mediates Protection against Intestinal Infection
Authors: Xiaohuan Guo, Ju Qiu, Tony Tu, Xuanming Yang, Liufu Deng, Robert A. Anders, Liang Zhou, Yang-Xin Fu
Journal: Immunity (2014)
Interactions between the frequency of viral infections and IFN-γ production in the first year of life
Authors: D.F. DaSilva, K.A. Roberg, K.T. Carlson-Dakes, C.J. Tisler, K. Shen, P.A. Shult, C.J. Kirk, R.E. Gangnon, J.E. Gern, R.F. Lemanske
Journal: Journal of Allergy and Clinical Immunology (2003)
Health Disparities and Toxicant Exposure of Akwesasne Mohawk Young Adults: A Partnership Approach to Research
Authors: Lawrence M. Schell, Julia Ravenscroft, Maxine Cole, Agnes Jacobs, Joan Newman
Journal: Environmental Health Perspectives (2005)

In this article we describe a research partnership between the Akwesasne Mohawk Nation and scientists at the University at Albany, State University of New York, initiated to address community and scientific concerns regarding environmental contamination and its health consequences (thyroid hormone function, social adjustment, and school functioning). The investigation focuses on cultural inputs into health disparities. It employs a risk-focusing model of biocultural interaction: behaviors expressing cultural identity and values allocate or focus risk, in this instance the risk of toxicant exposure, which alters health status through the effects of toxicants. As culturally based behaviors and activities fulfill a key role in the model, accurate assessment of subtle cultural and behavioral variables is required and best accomplished through integration of local expert knowledge from the community. As a partnership project, the investigation recognizes the cultural and socioeconomic impacts of research in small communities beyond the production of scientific knowledge. The components of sustainable partnerships are discussed, including strategies that helped promote equity between the partners such as hiring community members as key personnel, integrating local expertise into research design, and developing a local Community Outreach and Education Program. Although challenges arose during the design and implementation of the research project, a collaborative approach has benefited the community and facilitated research.
Quality of Life Assessment in Patients with Hormone&amp;ndash;Resistant Prostate Cancer Treated with Epirubicin or with Epirubicin plus Medroxy Progesterone Acetate &amp;ndash; Is It Feasible?
Authors: G. van Andel, K.H. Kurth, R.L. Rietbroek, J.A. van de Velde-Muusers
Journal: European Urology (2000)
H3 or H4 histamine receptors: That which contributes to suppressing human cholangiocarcinoma progression still remains to be clarified
Authors: Gong-Hao He, Gui-Li Xu, Wen-Ke Cai, Wei Xia
Journal: Hepatology (2012)

We read with great interest the article by Meng et al.1 regarding the anti-epithelial-mesenchymal transition (EMT) and antitumor metastasis effects of a histamine receptor ligand, clobenpropit, on human cholangiocarcinoma (CCA) both in vitro and in vivo. In this well-performed study the authors provided evidence that clobenpropit significantly decreased CCA proliferation by way of a Ca2+-dependent pathway and altered morphological development and invasion in vitro, which effects became greater after H3 histamine receptors (H3HRs) knockdown or overexpression of H4 histamine receptors (H4HRs). The authors hence attributed these effects of clobenpropit to primary H4HR-mediated effects. We agree with the authors that clobenpropit is a specific H3 antagonist / H4 agonist and appreciate the efforts that the authors made to exclude the involvement of H3HRs in vitro. However, some statements mentioned by the authors may be inaccurate and the in vivo evidence may be insufficient to some extent, which made their conclusion less persuasive. The authors demonstrated in the Discussion that clobenpropit stimulated H4HRs at a much higher affinity compared with H3HRs according to one reference (see reference 28 in the article). On the contrary, according to the comprehensive information from the International Union of Pharmacology (IUPHAR) receptor database,2 the affinity of clobenpropit for human H3HRs (pKi value: 8.4-9.4) is much higher than that for human H4HRs (pKi value: 7.4-8.3). Furthermore, the authors showed that, after H3HR knockdown, clobenpropit decreased CCA proliferation to a greater extent than in cells with H3HR expression, which we believe should not be interpreted as that H3HRs were not involved but logically indicates that H3HRs did play certain roles in CCA proliferation in this in vitro system. Decreased expression of H3HRs will obviously result in loss of a blocking effect of their antagonism. Therefore, the blocking effect of clobenpropit on H3HRs should not be neglected, especially in vivo, when the endogenous natural agonist, histamine, widely exists. However, the in vivo experiments of this study did not exclude the possible involvement of H3HRs. Therefore, we feel that more evidence (obtained based on either pharmacological methods or transgenic animal models) should be provided before any conclusion can be drawn about which receptors (H3HRs or H4HRs) are really involved in suppressing human CCA progression. Gong-Hao He M.D., Ph.D.*, Gui-Li Xu Ph.D.*, Wen-Ke Cai M.D., Ph.D.*, Wei Xia M.Sc.*, * Kunming General Hospital of Chengdu Military Region, Kunming, Yunnan, China.
High-resolution mapping of epitopes on the C2 domain of factor VIII by analysis of point mutants using surface plasmon resonance
Authors: Phuong-Cac T. Nguyen, Kenneth B. Lewis, Ruth A. Ettinger, Jason T. Schuman, Jasper C. Lin, John F. Healey, Shannon L. Meeks, Pete Lollar, Kathleen P. Pratt
Journal: Blood (2014)
Molecular Epidemiology of the 1984–1986 Outbreak of Diphtheria in Sweden
Authors: R Rappuoli, M Perugini, E Falsen
Journal: New England Journal of Medicine (1988)

Despite mass vaccination against diphtheria, many people have antibody titers below the protective level of 0.01 IU per milliliter. A recent outbreak of diphtheria in Sweden caused 17 clinical cases of diphtheria in the city of Göteborg; three of the patients died. A satellite outbreak occurred in Stockholm after a few months' delay. Using a new genetic probe, we analyzed 36 strains of Corynebacterium diphtheriae isolated in Sweden and Denmark during the period 1976 to 1986. Although the 36 strains can be classified in 17 different groups of C. diphtheriae (several of them containing toxigenic strains), all the clinical and fatal cases of diphtheria were caused by isolates from the same group, strongly suggesting that the outbreak in Sweden was caused by a single strain that possibly had a virulence factor separate from toxigenicity. This strain may have been imported into Sweden from Denmark, since it was isolated for the first time in Copenhagen in 1983, before the outbreak in Sweden.
The Road to an Effective HIV Vaccine
Authors: Lindsey R. Baden, Raphael Dolin
Journal: New England Journal of Medicine (2012)

During the 30 years since the discovery of HIV as the cause of AIDS, efforts to develop a vaccine have faced immense challenges. First, naturally acquired immunity to protect against infection that results in disease, found with virtually all other known infectious agents, may not exist for HIV. Second, the best available experimental animal model for AIDS, the nonhuman primate, provides potentially important information but also has substantial limitations. Therefore, advancement in the field has put an extraordinarily high premium on data from human studies. Yet only three candidate HIV vaccines have completed clinical efficacy trials. The first of these . . .
The Record on Rosiglitazone and the Risk of Myocardial Infarction
Authors: Bruce M. Psaty, Curt D. Furberg
Journal: New England Journal of Medicine (2007)

In this issue of the Journal, 1 Home and colleagues report interim results from the Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycaemia in Diabetes, or RECORD, study (NCT00379769). The RECORD study is a 6-year, open-label, noninferiority trial in which patients with type 2 diabetes who had inadequate glucose control with metformin or sulfonylurea alone were randomly assigned to receive rosiglitazone (Avandia) or the combination of metformin and sulfonylurea. The primary outcome was a composite of hospitalization and death from cardiovascular causes. As of March 2007, data were available on the 4447 patients randomly assigned to receive one of these . . .
Toward Full Disclosure of Referral Restrictions and Financial Incentives by Prepaid Health Plans
Authors: D F Levinson
Journal: New England Journal of Medicine (1987)

Prepaid plans provide an increasingly large share of today's health care in the United States. At present, 27.7 million people are enrolled in health maintenance organizations (HMOs), as compared with 10.5 million five years ago.* Of these, 44.2 percent are now enrolled in for-profit plans. Certain of these plans include controversial features to limit the use of services: a primary physician who serves as a gatekeeper to control specialty referrals, and financial incentives and disincentives held out to individual physicians and based on the case-by-case or annual cost of services.I believe that such referral restrictions and financial incentives should . . .
Abstract 5036: Blockade of the CD39 immunoregulatory pathway by monoclonal antibodies
Authors: Jeremy Bastid, Cécile Dejou, Jérôme Giustiniani, Stéphanie Cochaud, Gilles Alberici, Armand Bensussan, Jean-François Eliaou, Nathalie Bonnefoy
Journal: Cancer Research (2014)

Abstract The CD39/ CD73/ adenosine pathway is an important regulator of effector immune cell response. We previously demonstrated that, in human cancer specimen, CD39 is expressed by infiltrating regulatory T cells, tumor cells and the tumor associated stroma. CD39 enzymatic activity decreases peritumoral ATP, a potent tumor cell toxicity and immunogenic inducer, and generates immunosuppressive adenosine that binds adenosine receptors and inhibits CD4, CD8 T cell and NK cell responses. We and other demonstrated that CD39-mediated decrease of extracellular ATP and increase of adenosine promote tumor progression and immune escape as well as resistance to chemotherapy-induced immune response. We therefore generated several CD39 blocking monoclonal antibodies and present here the latest developments of these antibodies. We provide evidence that CD39 blocking antibodies restore the proliferation of CD4 and CD8 T cells inhibited by melanoma cells expressing CD39 and increase the generation of CD8 cytotoxic T cells against CD39+ melanoma cells. We also demonstrated that CD39+ lymphoma cells are less sensitive to NK cell cytotoxic activity than CD39- lymphoma cells, and that CD39-blocking monoclonal antibodies increase NK-mediated lysis of CD39+ lymphoma cells but not CD39- lymphoma cells. In conclusion, CD39 blocking antibodies may represent a novel immunotherapy strategy for inhibiting regulatory T cells and tumor cell-mediated immunosuppression. The results presented here support the ongoing development of CD39 blocking monoclonal antibodies as potential anticancer drugs to restore antitumor immune response. Citation Format: Jeremy Bastid, Cécile Dejou, Jérôme Giustiniani, Stéphanie Cochaud, Gilles Alberici, Armand Bensussan, Jean-François Eliaou, Nathalie Bonnefoy. Blockade of the CD39 immunoregulatory pathway by monoclonal antibodies. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5036. doi:10.1158/1538-7445.AM2014-5036
Principles of Economic Analysis of Health Care Technology
Authors: Alan L. Hillman
Journal: Annals of Internal Medicine (1996)

Letters15 July 1996Principles of Economic Analysis of Health Care TechnologyAlan L. Hillman, MD, MBA, Mark V. Pauly, PhD, and J. Sanford Schwartz, MDAlan L. Hillman, MD, MBAUniversity of Pennsylvania, Philadelphia, PA 19104Search for more papers by this author, Mark V. Pauly, PhDUniversity of Pennsylvania, Philadelphia, PA 19104Search for more papers by this author, and J. Sanford Schwartz, MDUniversity of Pennsylvania, Philadelphia, PA 19104Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-2-199607150-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail [This letter was inadvertently omitted from the series of letters on this topic published in the 1 March 1996 issue of Annals. The authors are responding to the letters by Betty Jung and Sacristan and colleagues.]TO THE EDITOR:We agree with Ms. Jung that an interdisciplinary “consumer research approach” is an excellent idea but that it is unlikely to be implemented in the near future. As such, we believe that the Task Force's recommendations [1], which bring together more than 2 years of effort by 30 knowledgeable stakeholders, lay the groundwork for a “good housekeeping seal of approval” that ...References1. Task Force on Principles for Economic Analysis of Health Care Technology. Economic analysis of health care technology. A report on principles. Ann Intern Med. 1995; 122:61-70. Google Scholar2. Evans RG. Manufacturing consensus, marketing truth: guidelines for economic evaluation [Editorial]. Ann Intern Med. 1995; 122:59-60. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania, Philadelphia, PA 19104 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 July 1996Volume 125, Issue 2Page: 157KeywordsForecastingHealth careHealth economicsMedicare Issue Published: 15 July 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Aerospace medicine; the first 200 years
Authors: T. Ziporyn
Journal: JAMA (1986)

AMERICAN AEROSPACE MEDICINE went on record exactly 200 years ago, when a Massachusetts physician's account of his scientific observations during pioneering balloon flights was read before members of  Royal Society in Britain. Shortly thereafter, what has been called the first book in  English language on aeronautics by an  appeared under  title A Narrative of  Two Aerial Voyages of Doctor Jeffries with Mons [sic] Blanchard; with Meteorological Observations and Remarks, by Doctor Jeffries, London, 1786.  The author in both instances was John Jeffries, MD, who was born Feb 5, 1744, in Boston. He generally is credited with being the first American to make a free flight in a balloon and  first balloonist to conduct scientific studies of  atmosphere ( Aviat Space Environ Med 1984;55:993-999 and 1985;56:99-104). He did so during a Nov 30, 1784, flight from London to Kent and a Jan 7, 1785, crossing
Nine Canadian medical bodies launch campaign to reduce unnecessary medical tests and treatments
Authors: B. Kermode-Scott
Journal: BMJ (2014)

The Canadian Medical Association and eight of Canada’s medical specialty societies have launched a new campaign, Choosing Wisely Canada,1 to help the nation’s doctors and patients engage in conversations about unnecessary tests, treatments, and procedures. On 2 April the nine national medical organisations released lists describing 40 tests, treatments, and procedures2 that they said patients did not need in all circumstances. They noted definitive evidence that these 40 specific interventions provided no benefit to patients. Choosing Wisely Canada’s recommendations included the following:
Monthly intravenous methylprednisolone as an alternative treatment for patients with severe asthma on long-term daily oral prednisone
Authors: F.R. Oliveira, L.M. Silva, E.O.S. Vianna, S.H.P. Oliveira, F.Q. Cunha, L.K.P. Arruda, W. Sarti
Journal: Journal of Allergy and Clinical Immunology (2005)
Multiple Myeloma Cancer Stem Cells
Authors: Carol Ann Huff, William Matsui
Journal: Journal of Clinical Oncology (2008)

Multiple myeloma is characterized by the clonal expansion of neoplastic plasma cells within the bone marrow, elevated serum immunoglobulin, and osteolytic bone disease. The disease is highly responsive to a wide variety of anticancer treatments including conventional cytotoxic chemotherapy, corticosteroids, radiation therapy, and a growing number of agents with novel mechanisms of action. However, few if any patients are cured with these modalities and relapse remains a critical issue. A better understanding of clonogenic multiple myleoma cells is essential to ultimately improving long-term outcomes, but the nature of the cells responsible for myeloma regrowth and disease relapse is unclear. We review evidence that functional heterogeneity exists in multiple myeloma and discuss potential strategies and clinical implications of the stem-cell model of cancer in this disease.