tbuckley/cabot-search huggingface dataset:
A secret and dirty war
Authors: C M Milroy
Journal: BMJ (1994)

I am always apprehensive before giving evidence in court, even when confident of my facts. This time I was more nervous than usual. Not only had the previous witness had a vigorous cross examination, but a request had come into the department for a forensic pathologist to go to Kurdistan at the end of the week. I was the only one who was able to go.

The request had come from the Kurdistan Human Rights Project, a non-political human rights organisation that monitors human rights abuses against the Kurdish people. The project had received information that Turkish security forces had used chemical weapons or napalm against Kurdish guerrillas, members of the Kurdish Workers Party (PKK). Would I be prepared to travel to Turkish Kurdistan to conduct postmortem examinations to determine the truth of the allegations?

“Kurdish villages are regularly razed to the ground, Kurdish politicians have been assassinated.”

I knew very little about Turkish Kurdistan. Turkey contains the largest number of Kurds, around 14 million, mainly in the south east, where they form the majority of the population. After the first world war Kemal Attaturk refused to recognise the Kurds as a separate minority. Forbidden to speak or write their own language, their culture was suppressed and a policy of assimilation was pursued by the Turkish authorities.

Since 1984 the PKK has been waging a …
Kidney transplantation and wait-listing rates from the international Dialysis Outcomes and Practice Patterns Study (DOPPS)
Authors: Suditida Satayathum, Ronald L. Pisoni, Keith P. McCullough, Robert M. Merion, Bjorn Wikstrom, Nathan Levin, Kenneth Chen, Robert A. Wolfe, David A. Goodkin, Luis Piera, Yasushi Asano, Kiyoshi Kurokawa, Shunichi Fukuhara, Philip J. Held, Friedrich K. Port
Journal: Kidney International (2005)
Continuous wave Doppler echocardiography for noninvasive assessment of left ventricular dP/dt and relaxation time constant from mitral regurgitant spectra in patients
Authors: Chunguang Chen, Leonardo Rodriguez, Jean-Paul Lethor, Robert A. Levine, Marc S. Semigran, Michael A. Fifer, Arthur E. Weyman, James D. Thomas
Journal: Journal of the American College of Cardiology (1994)
Surgery for neurogenic claudication and spinal stenosis
Authors: J. Fairbank
Journal: BMJ (2013)

Time to think again about controversial (and costly) interspinous devices

A linked paper (doi:10.1136/bmj.f6415) by Moojen and colleagues reports on a well executed randomised controlled trial in the Netherlands that compared two treatment options for adults with neurogenic claudication secondary to spinal stenosis.1 The researchers randomised 159 adults with lumbar stenoses at one or two vertebral levels into two groups. One group was treated with conventional decompressive surgery and the other with an interspinous spacer. Moojen and colleagues found little difference in a range of outcomes between the groups, although those treated with a spacer were significantly more likely to need revision surgery than those treated with conventional surgery (29% v 8%). A similarly high revision rate after treatment with interspinous spacer devices was recently reported in a trial from Sweden.2 

Spinal stenosis, or narrowing of the vertebral canal, was first described in English in 1954 by a Dutch neurosurgeon.3 He made the important distinction between “developmental” (seen in achondroplasia but also in normal people) and “degenerative” stenosis (secondary to distortion of the normal anatomy by disc degeneration). Two years later, Blau and Logue coined the term neurogenic claudication for the syndrome linked to spinal stenosis.4 The advent of whole body imaging (computed tomography and then magnetic resonance imaging) …
SEROLOGICAL RELATIONSHIPS OF TYPE-SPECIFIC AND DEGRADED PNEUMOCOCCI
Authors: Hobart A. Reimann
Journal: The Journal of Experimental Medicine (1926)

1. Immune sera prepared with the degraded or variant forms of pneumococci (R strains) are similar in their reactions to sera prepared with the protein or cell solutions of pneumococci. They contain antibodies reactive with the protein of all types of pneumococci, but no antibodies reactive with the type-specific substances. 2. Pneumococci of the variant or R form, regardless of type derivation, are serologically identical and have the antigenic characteristics of pneumococcus protein. They evoke the species-specific and not the type-specific antibodies. 3. Antipneumococcus sera obtained by immunization with S strains may contain species-specific antibodies in addition to those which are type-specific. Each kind of antibody can be removed separately from these sera by selective absorption with the R or S strains of pneumococci.
The hanta hunting study: underdiagnosis of Puumala hantavirus infections in symptomatic non-travelling leptospirosis-suspected patients in the Netherlands, in 2010 and April to November 2011
Authors: M Goeijenbier, R A Hartskeerl, J Reimerink, J Verner-Carlsson, J F Wagenaar, M G Goris, B E Martina, Å Lundkvist, M Koopmans, A D Osterhaus, E C van Gorp, C B Reusken
Journal: Eurosurveillance (2014)

Leptospirosis and haemorrhagic fever with renal syndrome (HFRS) are hard to distinguish clinically since these two important rodent-borne zoonoses share hallmark symptoms such as renal failure and haemorrhage. Leptospirosis is caused by infection with a spirochete while HFRS is the result of an infection with certain hantaviruses. Both diseases are relatively rare in the Netherlands. Increased incidence of HFRS has been observed since 2007 in countries that border the Netherlands. Since a similar rise in incidence has not been registered in the Netherlands, we hypothesise that due to overlapping clinical manifestations, hantavirus infections may be confused with leptospirosis, leading to underdiagnosis. Therefore, we tested a cohort of non-travelling Dutch patients with symptoms compatible with leptospirosis, but with a negative diagnosis, during 2010 and from April to November 2011. Sera were screened with pan-hantavirus IgG and IgM enzyme-linked immunosorbent assays (ELISAs). Sera with IgM reactivity were tested by immunofluorescence assay (IFA). ELISA (IgM positive) and IFA results were confirmed using focus reduction neutralisation tests (FRNTs). We found hantavirus-specific IgG and/or IgM antibodies in 4.3% (11/255) of samples taken in 2010 and in 4.1% (6/146) of the samples during the 2011 period. After FRNT confirmation, seven patients were classed as having acute Puumala virus infections. A review of hantavirus diagnostic requests revealed that at least three of the seven confirmed acute cases as well as seven probable acute cases of hantavirus infection were missed in the Netherlands during the study period.
Randomized, placebo-controlled, double blind study on the clinical efficacy of a cream containing 5%alpha-lipoic acid related to photoageing of facial skin
Authors: H. Beitner
Journal: British Journal of Dermatology (2003)

alpha-lipoic acid (LA) or the reduced form dihydrolipoate (DHLA) is a potent scavenger with anti-inflammatory properties. Previous uncontrolled studies with topical treatment with 5% LA-containing creams indicate a beneficial effect on photoageing skin.The purpose of this study was to investigate whether a cream containing 5% LA showed any advantages concerning a number of the criteria associated with ageing of the facial skin, compared with an identical cream lacking LA.Thirty-three women, mean age 54.4 years, were included in this controlled study. After randomization half the face was treated twice daily for 12 weeks with the LA cream and the other half with the control cream. The following methods of assessment were used: self-evaluation by the test subjects, clinical evaluation, photographic evaluation and laser profilometry. Profilometry was performed before the start of treatment and at the end.All four methods of assessment showed a statistically significant improvement on the LA-treated half of the face. Laser profilometry, the most objective method used, showed an average decrease in skin roughness of 50.8% (44.9-54.0) on the LA-treated side, compared with 40.7% (32.4-48.7) on the placebo-treated half of the face P < 0.001 (Wilcoxon matched pairs test).It is indicated that 12 weeks of treatment with a cream containing 5% LA improves clinical characteristics related to photoageing of facial skin.
T cell repertoire following autologous stem cell transplantation for multiple sclerosis
Authors: Paolo A. Muraro, Harlan Robins, Sachin Malhotra, Michael Howell, Deborah Phippard, Cindy Desmarais, Alessandra de Paula Alves Sousa, Linda M. Griffith, Noha Lim, Richard A. Nash, Laurence A. Turka
Journal: Journal of Clinical Investigation (2014)

Autologous hematopoietic stem cell transplantation (HSCT) is commonly employed for hematologic and non-hematologic malignancies. In clinical trials, HSCT has been evaluated for severe autoimmunity as a method to "reset" the immune system and produce a new, non-autoimmune repertoire. While the feasibility of eliminating the vast majority of mature T cells is well established, accurate and quantitative determination of the relationship of regenerated T cells to the baseline repertoire has been difficult to assess. Here, in a phase II study of HSCT for poor-prognosis multiple sclerosis, we used high-throughput deep TCRβ chain sequencing to assess millions of individual TCRs per patient sample. We found that HSCT has distinctive effects on CD4+ and CD8+ T cell repertoires. In CD4+ T cells, dominant TCR clones present before treatment were undetectable following reconstitution, and patients largely developed a new repertoire. In contrast, dominant CD8+ clones were not effectively removed, and the reconstituted CD8+ T cell repertoire was created by clonal expansion of cells present before treatment. Importantly, patients who failed to respond to treatment had less diversity in their T cell repertoire early during the reconstitution process. These results demonstrate that TCR characterization during immunomodulatory treatment is both feasible and informative, and may enable monitoring of pathogenic or protective T cell clones following HSCT and cellular therapies.
A Masked Marauder
Authors: Stephen G. Pauker, Richard I. Kopelman
Journal: New England Journal of Medicine (1994)

A 61-year-old man with seropositive rheumatoid arthritis consulted his rheumatologist because of a three-week history of pain in the right hip.My first concern would be to find out whether the hip pain is related to the rheumatoid arthritis. I would want to know whether the man's right hip was involved in the past and whether there was a history of recent trauma. If the patient had been treated with corticosteroids, I would wonder about aseptic necrosis of the hip or infection.The pain was severe and localized to the right lateral iliac crest, with occasional radiation . . .
Procedures for treating precancerous cervical cancer do not reduce fertility, study shows
Authors: S. Mayor
Journal: BMJ (2015)

Procedures that are commonly used to diagnose and treat precancerous cervical cancer do not reduce women’s subsequent chances of getting pregnant, shows a large US study that unexpectedly found higher rates of pregnancy in women who had these procedures than in control groups.1

Women with an unclear or abnormal cervical screening test generally have a diagnostic colposcopy and biopsy to see whether any lesions are precancerous. Those women found to have …
The Rise and Fall (and Rise?) of Rheumatic Fever
Authors: Alan L. Bisno
Journal: JAMA (1988)

The dramatic decline in incidence of acute rheumatic fever in the United States during the past half century has been a truly remarkable phenomenon. During the years 1943 to 1945, for example, the incidence of the disease among army personnel stationed in the northeastern United States was 388 per 100 000. As recently as the mid-1960s, rates of approximately 25 to 35 per 100 000 population were recorded among school children in midsized American cities such as Baltimore and Nashville, Tenn. Yet surveys conducted within the past decade in several geographic locales from coast to coast have recorded rheumatic fever incidence rates in the range of 0.5 to 1.88. The experience has been similar in the other highly developed countries of Europe and North America. These facts were commented on in a recent<i>JAMA</i>Landmark Perspective, "The Rise and Fall of Rheumatic Fever,"<sup>1</sup>and were the subject of a
Quality Management Practices in Medicaid Managed Care
Authors: Bruce E. Landon, Arnold M. Epstein
Journal: JAMA (1999)

ContextRapid expansion of Medicaid managed care has raised concerns about the capacity and willingness of health plans enrolling Medicaid beneficiaries to provide high-quality care. Recently, legislation has facilitated market entry of Medicaid plans, health plans that draw most of their enrollment from the Medicaid population.ObjectiveTo characterize and compare the organizational characteristics and programs related to quality of care of commercial and Medicaid health plans that participate in the Medicaid program.DesignCross-sectional survey conducted September 1997 to April 1998.SettingThe Medicaid program in 11 states and the District of Columbia.ParticipantsAll 154 health plans in these localities that provided prepaid general medical care to Medicaid beneficiaries during June 1997, of which 130 (84%) responded to the survey.Main Outcome MeasuresHealth plan reports of structural characteristics, services offered, performance measurement and feedback, disease management programs, information systems capabilities, and provider network composition and relationships.ResultsHalf of the respondents were Medicaid plans, with 75% or more of enrollees drawn from the Medicaid population. Medicaid plans tended to be smaller and newer than commercial plans that also served the Medicaid population and had more enabling programs targeting the special needs of the Medicaid population, such as inadequate transportation (85% of Medicaid plans vs 62% of commercial plans; P = .003) and illiteracy (66% vs 38%, respectively; P = .002). Overall, 71% of Medicaid plans vs 43% of commercial plans had enabling programs targeted at 6 or more of the 8 special needs we specified (P = .001). While commercial plans had a higher proportion of board-certified primary care physicians (81% vs 73%; P = .01), we found no major differences between Medicaid plans and commercial plans in collection and dissemination of performance measures, designation of specific areas for quality improvement, or use of disease management programs targeted at conditions prevalent in the Medicaid population. Neither commercial nor Medicaid plans reported high success in improving quality of care.ConclusionsBased on our survey, while Medicaid plans resemble commercial plans serving the Medicaid population in many aspects of quality management, they are more likely to target programs directed to the specific needs of the Medicaid population. Neither commercial nor Medicaid plans have notably strong records in actual quality improvement.
Are Age-Based Criteria the Best Way to Determine Eligibility for Prostate Cancer Screening?
Authors: Manfred Gogol
Journal: Annals of Internal Medicine (2009)

Letters3 February 2009Are Age-Based Criteria the Best Way to Determine Eligibility for Prostate Cancer Screening?Manfred Gogol, MDManfred Gogol, MDFrom Krankenhaus Lindenbrunn, Klinik fuer Geriatrie, Coppenbruegge 31863, Germany.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-3-200902030-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The USPSTF (1) defines an age cut-off for prostate cancer screening, recommending against screening for men older than 75 years or those with a life expectancy less than 10 years. It may be uncertain whether screening for prostate cancer by using prostate-specific antigen is a useful tool at any age. But an age cut-off of 75 years may be wrong for some men age 75 years or older. As Walter and Covinsky (2) reported, in 1997 the life expectancy was 14.2 years for U.S. men age 75 years in the top 25th percentile of the survival tables, ...References1. U.S. Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:185-91. [PMID: 18678845] LinkGoogle Scholar2. Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285:2750-6. [PMID: 11386931] CrossrefMedlineGoogle Scholar3. Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature. 2008;451:716-9. [PMID: 18204438] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Krankenhaus Lindenbrunn, Klinik fuer Geriatrie, Coppenbruegge 31863, Germany.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation StatementAre Age-Based Criteria the Best Way to Determine Eligibility for Prostate Cancer Screening? Ned Calonge , Diana B. Petitti , and Kenneth W. Lin Are Age-Based Criteria the Best Way to Determine Eligibility for Prostate Cancer Screening? Badrinath R. Konety , Matthew R. Cooperberg , and Peter R. Carroll Metrics Cited byThe decision-making process in prostate cancer screening in primary care with a prostate-specific antigen: A systematic reviewVariation in Prostate-Specific Antigen Screening in Men Aged 80 and Older in Fee-for-Service Medicare 3 February 2009Volume 150, Issue 3Page: 221KeywordsAge groupsAgingAntigensCancer screeningConflicts of interestDecision makingHealth care providersLife expectancyProstate cancer ePublished: 3 February 2009 Issue Published: 3 February 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
23 MYCOPHENOLATE MOFETIL WITH CORTICOSTEROIDS INDUCES REMISSION IN AUTOIMMUNE HEPATITIS WITH AZATHIOPRINE-INTOLERANCE AND IN OVERLAP SYNDROMES, BUT NOT IN AUTOIMMUNE HEPATITIS RESISTANT TO AZATHIOPRINE WITH CORTICOSTEROIDS
Authors: M.A. Pronk, I. Molendijk, M.J. Coenraad, H.R. van Buuren, R.A. de Man, K.J. van Erpecum, M.H. Lamers, J.P. Drenth, A.P. van den Berg, U.H. Beuers, J. den Ouden, G. Koek, C.M. van Nieuwkerk, G. Bouma, N. van Gerven, H.J. Brouwer, M. Guichelaar, B. van Hoek
Journal: Journal of Hepatology (2011)
Inquiry calls for greater transparency and quality of care in general practice
Authors: N. Hawkes
Journal: BMJ (2011)

General practice needs radical change to improve the quality of care it delivers, the healthcare think tank the King’s Fund has concluded after a comprehensive examination of primary care in England.

The inquiry, chaired by Ian Kennedy, an expert in health law and former chairman of the Healthcare Commission, found evidence of variation in diagnosis, referral, and prescribing; weakening of continuity of care; and deficiencies in treatment of long term conditions. Its conclusion is that general practice remains a “cottage industry” when what is needed is an enterprise of industrial scale created by better cooperation through federated networks of practices.

Despite the ambitions of its project, however, the panel responsible had to admit that it has …
Ten-year follow-up of adults with repaired tetralogy of fallot using serial radionuclide angiography
Authors: J.T. Elliott, V. Guru, M.A. Gatzoulis, D. Harrison, E. Oechslin, S. Siu, G. Webb, W.G. Williams, P. Liu, P. McLaughlin
Journal: Journal of the American College of Cardiology (1998)
Abstract 1246: Development of an agonistic antibody against the human T-cell costimulatory receptor CD27 as a potential immunotherapeutic tool.
Authors: Hans van Eenennaam, Elise Veraar, Winfried Mulder, Ellen Bastiaanssen, Lilian Driessen, David Lutje Hulsik, Paul Vink, Gerda van der Horst, Yanling Xiao, Jannie Borst, Andrea van Elsas
Journal: Cancer Research (2013)

Abstract Immunotherapy of cancer has reached a mature and exciting stage. Clinical activity of monoclonal antibodies (mAb) against the T-cell inhibitory receptors CTLA-4 and PD-1 indicate that cancer patients often have latent tumour-specific T cells that can be mobilized by blocking these receptors. Activation of the T-cell costimulatory receptor CD27, a member of the TNF receptor family, provides another opportunity to promote cytotoxic T cell (CTL)-based anti-tumor immunity. To generate agonistic mAb against human (h)CD27, we used our unique B-cell selection and immortalization technology. Various novel anti-hCD27 mAb were generated and tested for their agonistic properties. We used in vitro read-out systems detecting CD27 (co-)stimulatory function on the basis of NF-κB activity, T cell division and survival. One mAb hCD27.15 (KD ∼1 nM), induced CD27 receptor activation (EC50 ∼1 nM) without the need of cross-linking. Similar to its natural ligand CD70, our hCD27.15 mAb showed bona fide costimulatory properties. hCD27.15 strongly promoted CD8+ T cell expansion under conditions of suboptimal T-cell receptor (TCR) stimulation. hCD27.15 did not stimulate T cell function in absence of TCR engagement. hCD27.15 mAb demonstrated different binding kinetics and a unique epitope, compared to other antibodies that depend on cross-linking to activate CD27. Importantly, hCD27.15 retained its agonistic properties when expressed as a human IgG1 or IgG4 chimera. hCD27.15 was shown to bind and activate primate CD27 with similar potency, providing a rationale for pre-clinical safety testing. In conclusion, to our knowledge we have developed the first mAb to hCD27 that mimics ligand function without the need for cross-linking. Data from mouse models strongly support the application of CD27 agonism to enhance CTL-based anti-tumor immunity, by promoting the generation and survival of CTL, as well as their memory function. We propose therefore that hCD27.15 mAb is a promising tool for cancer immunotherapy. Citation Format: Hans van Eenennaam, Elise Veraar, Winfried Mulder, Ellen Bastiaanssen, Lilian Driessen, David Lutje Hulsik, Paul Vink, Gerda van der Horst, Yanling Xiao, Jannie Borst, Andrea van Elsas. Development of an agonistic antibody against the human T-cell costimulatory receptor CD27 as a potential immunotherapeutic tool. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1246. doi:10.1158/1538-7445.AM2013-1246
Another Option for Kidney Stone Removal
Authors: Marsha F. Goldsmith
Journal: JAMA (1987)

AN ALTERNATIVE to the knife and the stone crusher was offered kidney stone sufferers by Alan F. Hofmann, MD, professor of medicine and gastroenterology at the University of California, San Diego, speaking during Digestive Disease Week in Chicago. Hofmann's suggestion is stone dissolution on contact by means of a "smart pump"—a microprocessor-controlled device, incorporating a catheter, that pumps a stone-dissolving fluid in and out of the gallbladder extremely rapidly and monitors the pressure, aspirating it in case of gallbladder contraction, for example, so that no fluid is lost during the procedure. The fluid Hofmann and his colleague and coinventor, Salam F. Zacco, MD, use is a gasoline additive called methyl tert-butyl ether, which was found by Hofmann's former colleagues working at the Mayo Medical Center in Rochester, Minn, to induce very rapid dissolution of cholesterol gallstones (<i>N Engl J Med</i>1985;312:217-220). "The problem with dissolution by chenodeoxycholic acid or ursodeoxycholic
Focal adhesion kinase links mechanical force to skin fibrosis via inflammatory signaling
Authors: Victor W Wong, Kristine C Rustad, Satoshi Akaishi, Michael Sorkin, Jason P Glotzbach, Michael Januszyk, Emily R Nelson, Kemal Levi, Josemaria Paterno, Ivan N Vial, Anna A Kuang, Michael T Longaker, Geoffrey C Gurtner
Journal: Nature Medicine (2011)