tbuckley/cabot-search huggingface dataset:
Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: randomised trial
Authors: Hugh Reyburn, Hilda Mbakilwa, Rose Mwangi, Ombeni Mwerinde, Raimos Olomi, Chris Drakeley, Christopher J M Whitty
Journal: BMJ (2007)

<h3>Background</h3> Leukoaraiosis (LA) is a risk factor for stroke and dementia, but the mechanism is uncertain. Further studies are required, but there is no consensus about imaging requirements. MR imaging has greater sensitivity to LA than CT, but the greater specificity of CT may have some advantages. <h3>Methods</h3> We did a systematic review of studies of risk factors for LA using Medline and Embase via OVID interface and search of reference lists. We determined pooled estimates of associations between risk factors and the presence of LA, stratified by imaging modality. <h3>Results</h3> Of 74 papers reporting data on LA in relation to risk factor, 50 were MR-based and 24 CT-based. Pooled prevalence of LA was 26% (95% CI 19.8 to 32.2) in CT studies and 70.6% (60.7–80.5) in MRI studies, but with highly significant heterogeneity (both p&lt;0.00001), individual estimates ranging from &lt;10% to &gt;60% for CT and &lt;10% to &gt;90% for MRI. Risk factors for LA were, however, highly consistent, irrespective of imaging modality: hypertension (OR 1.9, 1.8–2.1), older age (2.7, 2.4–3.1), dementia (2.0, 1.5–2.5), and prior stroke (1.8, 1.5–2.1). No associations were found with sex, hyperlipidaemia, diabetes, smoking, IHD, PVD or atrial fibrillation. <h3>Conclusions</h3> We found highly consistent risk relations in MR and CT-based studies, despite large differences in absolute rates of LA between the imaging techniques. CT brain imaging remains a useful tool for studying LA.
Using Exome Sequencing to Reveal Mutations in TREM2 Presenting as a Frontotemporal Dementia–like Syndrome Without Bone Involvement
Authors: Rita João Guerreiro, Ebba Lohmann, José Miguel Brás, Jesse Raphael Gibbs, Jonathan D. Rohrer, Nicole Gurunlian, Burcu Dursun, Basar Bilgic, Hasmet Hanagasi, Hakan Gurvit, Murat Emre, Andrew Singleton, John Hardy
Journal: JAMA Neurology (2013)

To identify new genes and risk factors associated with frontotemporal dementia (FTD). Several genes and loci have been associated with different forms of FTD, but a large number of families with dementia do not harbor mutations in these genes.Whole-exome sequencing and whole-genome genotyping were performed in all patients. Genetic variants obtained from whole-exome sequencing were integrated with the data obtained from whole-genome genotyping.Database of the Behavioral Neurology Outpatient Clinic of the Department of Neurology, Istanbul Faculty of Medicine, Istanbul, Turkey. PATIENTS Forty-four Turkish patients with an FTD-like clinical diagnosis were included in the study. Relatives were screened when appropriate.Mutations in the triggering receptor expressed on myeloid cells 2 gene (TREM2).In 3 probands with FTD-like disease, we identified different homozygous mutations in TREM2 that had previously been associated with polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLOSL). None of these 3 patients had a typical clinical presentation of PLOSL: they presented with behavioral change and subsequent cognitive impairment and motor features but without any bone cysts or bone-associated phenotypes. Imaging showed white matter abnormalities as well as frontal atrophy in all 3 patients.Our results show that TREM2 is responsible for an unexpectedly high number of dementia cases in our cohort, suggesting that this gene should be taken into account when mutations in other dementia genes are excluded. Even for complex syndromes such as dementia, exome sequencing has proven to be a rapid and cost-effective tool to identify genetic mutations, allowing for the association of clinical phenotypes with unexpected molecular underpinnings.
Altered Expression of Retinoblastoma Protein and Known Prognostic Variables in Locally Advanced Bladder Cancer
Authors: C. J. Logothetis, H.-J. Xu, J. Y. Ro, S.-X. Hu, A. Sahin, N. Ordonez, W. F. Benedict
Journal: JNCI Journal of the National Cancer Institute (1992)

Background : The clinical behavior of the tumor in patients with locally advanced bladder carcinoma is unpredictable. Current predictors of clinical behavior include depth of muscle invasion, presence of vascular invasion, proliferation rate, and loss of blood group antigens. Treatment selection would be facilitated by the development of a reliable marker of tumor progression. Functional retino-blastoma (RB) gene loss has been reported to occur in bladder carcinoma, but the significance of this loss is unknown. Purpose: We have evaluated the frequency of functional loss of the RB gene in locally advanced bladder carcinoma and have compared the results to known prognostic factors in the same cohort. Methods : Forty-three study patients with patho logically well-characterized, locally advanced bladder carcinoma, who were placed in a protocol incorporating surgery and chemotherapy, were studied for known clinical and pathological prognostic indicators as well as for their Rb status. Formalin-fixed and paraffin-embedded archival primary tumor tissues were used for his-tological and immunohistochemical analyses. Results: Altered Rb protein expression was documented in 37% of the tumor specimens. The high rate of altered Rb expression found in this cohort with advanced urothelial tumors strongly suggests that RB functional loss may be associated with tumor progression in this malignancy. Altered Rb protein expression was found to be independent of other known prognostic variables. A significantly poorer tumor-free survival rate also was noted for those patients who had a tumor with an altered Rb protein with or without vascular invasion. Conclusion: The high frequency of Rb alteration in locally advanced bladder carcinomas, plus the fact that a significant correlation could not be found between the Rb status and other known prognostic markers in this preliminary study, suggests that altered RB expression may be an independent prognostic marker of tumor progression in bladder cancer. [J Natl Cancer Inst 84: 1256–1261, 1992]
Vaginal Spermicides and Congenital Disorders: The Validity of a Study-Reply
Authors: Hershel Jick, Alexander M. Walker, Kenneth J. Rothman
Journal: JAMA (1986)

<h3>In Reply.—</h3> Dr Watkins has selectively reclassified the exposure status of exposed cases without engaging in a similar effort for exposed noncases. The technique is one used in advocacy, but it is not good science. The ease with which clinical notes can be misconstrued even by a disinterested observer led us originally to prefer records of acquisition of spermicides as an impartial, though admittedly imperfect, proxy for exposure. Our classification of women's exposure to spermicides was based on a consideration of the typical time between purchases of spermicides at Group Health, which we took to be a reasonable indicator of the duration of potential use. Since pharmacy records do not specify dates of use or nonuse, there will inevitably be nondifferential misclassification of exposure in a study based on pharmacy data. The same is true of studies based on clinic records. In either case, the effect of the error will
Health systems and increased longevity in people with HIV and AIDS
Authors: R A Atun, I Gurol-Urganci, M McKee
Journal: BMJ (2009)

Lessons can be learnt from the extensive experience in other chronic disordersThe introduction of antiretroviral therapy in the 1990s transformed the lives of people with HIV and AIDS.1 2 Whereas AIDS was once a rapidly progressive disease, with a life expectancy often measured in months, it has now become yet another chronic disease where effective, well tolerated, and widely available treatment allows those affected to lead relatively normal lives.Ninety years ago, a similar therapeutic breakthrough, the isolation of insulin, transformed the lives of those with type 1 diabetes.Now, models based on empirical data estimate that a 25 year old person with HIV, when appropriately treated with antiretroviral therapy, can expect to enjoy a median survival of 35 years, remarkably similar to that for someone of the same age with type 1 diabetes.3
Rocky mountain spotted fever caused by blood transfusion
Authors: G. M. Wells
Journal: JAMA (1978)

Transfusion of 500 ml of blood, contributed by a donor three days before the onset of Rocky Mountain spotted fever and refrigerated for nine days, caused this disease in the recipient. The blood donor died of Rocky Mountain spotted fever after six days; rickettsia were identified in various tissues by immunofluorescence techniques. The recipient of the blood became mildly ill and recovered fully; specific antibiotic treatment was initiated on the fourth day of illness. Diagnosis of Rocky Mountain spotted fever was confirmed in the recipient by positive serologic reactions and isolation of Rickettsia rickettsii from blood after inoculation in animals and tissue culture.
Molar Pregnancy
Authors: Ross S Berkowitz, Donald P Goldstein
Journal: New England Journal of Medicine (2009)

A healthy 37-year-old woman presents at 10 weeks of pregnancy with vaginal bleeding. The level of serum human chorionic gonadotropin is 22,000 mIU per milliliter. Ultrasonography does not show an identifiable fetal heartbeat. The patient undergoes evacuation of the uterus; pathological examination indicates a complete molar pregnancy. How should this case be managed?
Psychiatric Status After Hysterectomy
Authors: Pedro A. Poma
Journal: JAMA (1981)

To the Editor.—  In the recent article by Martin et al, the authors noted that the symptoms observed in their patients a year later were already present before surgery. However, in the Results section, one notes the appearance of three new cases of psychiatric treatment, three new cases of psychiatric diagnosis, and the worsening of symptoms in a few. Obviously, these new cases do not add statistical significance.  Psychological sequelae of gynecologic surgery are not usually seen until at least two years after the operation. The initial concern is survival. Other considerations, such as the desire for more children, sexuality, and self-esteem may be deferred, but they later reappear. Menstruation has a self-reassuring effect on some women and, when it is missing, may alter self-image. Furthermore, some persons have unrealistic expectations about procedures or treatments; they assign them magic qualities. 1 Luckily, more women are participating in the decision-making process
112 INCIDENCE AND PREDICTIVE FACTORS OF HEPATOCELLULAR CARCINOMA AND COMPLICATIONS IN HBV- OR HCV-RELATED COMPENSATED CIRRHOSIS. A MULTICENTER PROSPECTIVE COHORT IN 1653 PATIENTS (ANRS CO12 CirVir)
Authors: J.C. Trinchet, V. Bourcier, C. Chaffaut, M. Ait Ahmed, P. Marcellin, D. Guyader, S. Pol, D. Larrey, F. Zoulim, D. Roulot, V. De Ledinghen, D. Ouzan, J.P. Zarski, P. Nahon, S. Chevret
Journal: Journal of Hepatology (2013)
Good-Parent Beliefs of Parents of Seriously Ill Children
Authors: Chris Feudtner, Jennifer K. Walter, Jennifer A. Faerber, Douglas L. Hill, Karen W. Carroll, Cynthia J. Mollen, Victoria A. Miller, Wynne E. Morrison, David Munson, Tammy I. Kang, Pamela S. Hinds
Journal: JAMA Pediatrics (2014)

Parents' beliefs about what they need to do to be a good parent when their children are seriously ill influence their medical decisions, and better understanding of these beliefs may improve decision support.To assess parents' perceptions regarding the relative importance of 12 good-parent attributes.A cross-sectional, discrete-choice experiment was conducted at a children's hospital. Participants included 200 parents of children with serious illness.Ratings of 12 good-parent attributes, with subsequent use of latent class analysis to identify groups of parents with similar ratings of attributes, and ascertainment of whether membership in a particular group was associated with demographic or clinical characteristics.The highest-ranked good-parent attribute was making sure that my child feels loved, followed by focusing on my child's health, making informed medical care decisions, and advocating for my child with medical staff. We identified 4 groups of parents with similar patterns of good-parent-attribute ratings, which we labeled as: child feels loved (n=68), child's health (n=56), advocacy and informed (n=55), and spiritual well-being (n=21). Compared with the other groups, the child's health group reported more financial difficulties, was less educated, and had a higher proportion of children with new complex, chronic conditions.Parents endorse a broad range of beliefs that represent what they perceive they should do to be a good parent for their seriously ill child. Common patterns of how parents prioritize these attributes exist, suggesting future research to better understand the origins and development of good-parent beliefs among these parents. More important, engaging parents individually regarding what they perceive to be the core duties they must fulfill to be a good parent may enable more customized and effective decision support.
Further Observations on Age of the Menarche
Authors: D. C. Wilson, I. Sutherland
Journal: BMJ (1950)

of cortisone therapy.No remarkable effects were noted by these workers on heart size or blood pressure, but in three cases tachycardia was replaced by bradycardia.The dosages of cortisone used were considerably greater than in the present series; on reducing the daily dosage from 200 mg. to 100 mg. the heart rate increased to normal levels.Hench and his associates offered no explanation of the cardiovascular action of cortisone. SummaryCortisone was administered to 11 patients (3 males and 8 females) with chronic adrenal insufficiency.The drug was given by intramuscular injection or pellet implantation in doses of 163 to 850 mg.over 5 to 18 days.All patients had been treated previously by various forms of replacement therapy.The cardiograms in six of the patients showed the abnor- malities often encountered in chronic adrenal insufficiency- namely, abnormal T waves or prolonged PR or QT intervals.In the remaining five patients the cardiograms were normal.After cortisone therapy four of the six abnormal cardio- grams improved, and two were unchanged.No effect was noted in the five normal cardiograms.The improvement was still present in one patient five months after the treatment was stopped.In two others in whom cortisone pellets had been implanted cardiographic improvement was maintained over a two-months observation period.The cardiogram in one, patient had partly regressed two months after cortisone was suspended.The way in which cortisone influences the cardiogram in chronic adrenal insufficiency is unknown.
The Body Has a Head
Authors: Lester S. King
Journal: JAMA (1970)

Apparently many people greatly admire the writing of Gustav Eckstein. The publishers, Harper &amp; Row, certainly do and they have sent out quite ecstatic publicity releases. They quote comments from enthusiastic prepublication readers. The editorial board of the Book-of-the-Month Club must have similar opinions, for they have chosen this as a March selection. I wish to take a firm stand in opposition, even though I may be a minority of one. The book, I believe, is badly written, shows a low ratio of substantive content to verbiage, and is enormously boring. Dr. Eckstein has written a book on elementary physiology intended for the layman, covering almost every phase of bodily activity. It is narrated in what I call a floating hyperbolic style, undisciplined and interminable, a sort of flamboyant free association. Here is a random example. The subject is "Deglutition" and the subtitle is "A Swallow in Three Acts." A
Determination of Cardiac Output and Pressure Gradients at Operation
Authors: Herbert L. Tanenbaum, Eugene Braunwald, Andrew G. Morrow
Journal: New England Journal of Medicine (1958)

PRECISE evaluation of the results of mitral or aortic commissurotomy has been dependent upon the measurement of pressure gradients by means of left-sided heart catheterization and of cardiac output before operation and in the postoperative period.1 2 3 4 The immediate effectiveness of the commissurotomy can be determined to some extent by measurements of the gradient in the course of the operation.5 , 6 In the presence of valvular stenosis, however, blood flow is turbulent, and pressure gradients are proportional to the square of the flow rate.7 Thus, relatively small alterations in flow through the valve may result in large changes in the pressure gradient. . . .
Oratio Harveiana: In Aedibus Collegii Regalis Medicorum Habita, die Junii xxix, mdcccl
Authors: A J. A. Wilson
Journal: BMJ (1850)

aidexhibitid tat diased structure termed mammary sacoma.inner edge of the ilium, where the pain had existed so many months, was carefully exned, but there was no morbid appearance discoveraw ble. in the part-, or in the nerves leading to it.The thorax was not opened.REARis.This case is, I think, interesting, and worthy to be re- corded.It shows that the symptoms did not point to the true seat of disease, till a short time before the patient's death; and that exten- sive disorganization may be going on in the brain, without impairing its functions, or manifesting those signs by which it may be detected.The fretful and altered manner of the patient led to the apprehension that softening of the brain might be going on; but the total absence of pain in the head, and of rigors, or any indication of inflammatory action, rendered the diagnosis very difficult.It is highly probable, that the pain in the right side of the pelvis was occasioned by disease of the left side of the brain, and furnishes an additional instance to those recorded by Sir Henr Halford, where neuralgia was the effect of cerebral disorganiza- tion.When the latter disease had so far advanced as to disqualify tbe nerves from suffering so exquisitely, then the pain ceased.This case shows the importance of attending to the brain, in all long-continued 4tnd obscure neuralgic pains, although the functions of that organ may not be impaired.
NECROTIZING ULCERS COMPLICATING ERYSIPELAS
Authors: PAUL F. STOOKEY
Journal: JAMA (1934)

During the past two years we have observed five instances of necrotizing ulcers complicating severe erysipelas. These ulcers were confined to the edematous, loose areolar tissue about the eyes. The distinguishing characteristics of the ulcers were their rapid development, phagedenic properties, punched out appearance, edematous base and profuse, creamy, yellow discharge. Two of the five cases resulted fatally. Three cases were observed in the Isolation Hospital, one in consultation with Dr. A. E. Eubank and one in consultation with Drs. H. B. Davis and Donald R. Black. The three cases observed in the Isolation Hospital were available for a bacteriologic study, which is the basis of this paper. <h3>REPORT OF CASES</h3><h3>Case 1.—</h3> A white woman, aged 28, entered the hospital, Feb. 22, 1933, with typical severe erysipelas of the face. The loose areolar tissue about the eyes was markedly edematous. Three days later a necrotizing process developed in the
Molecular Ontogeny of Donor-Derived Follicular Lymphomas Occurring after Hematopoietic Cell Transplantation
Authors: Oliver Weigert, Nadja Kopp, Andrew A. Lane, Akinori Yoda, Suzanne E. Dahlberg, Donna Neuberg, Anita Y. Bahar, Bjoern Chapuy, Jeffery L. Kutok, Janina A. Longtine, Frank C. Kuo, Terry Haley, Maura Salois, Timothy J. Sullivan, David C. Fisher, Edward A. Fox, Scott J. Rodig, Joseph H. Antin, David M. Weinstock
Journal: Cancer Discovery (2011)

The relative timing of genetic alterations that contribute to follicular lymphoma remains unknown. We analyzed a donor-recipient pair who both developed grade 2/3A follicular lymphoma 7 years after allogeneic transplantation and donor lymphocyte infusions. Both patients harbored identical BCL2/IGH rearrangements also present in 1 in 2,000 cells in the donor lymphocyte infusion, and the same V(D)J rearrangement, which underwent somatic hypermutation both before and after clonal divergence. Exome sequencing of both follicular lymphomas identified 15 shared mutations, of which 14 (including alterations in EP300 and KLHL6) were recovered from the donor lymphocyte infusion by ultra-deep sequencing (average read coverage, 361,723), indicating acquisition at least 7 years before clinical presentation. Six additional mutations were present in only one follicular lymphoma and not the donor lymphocyte infusion, including an ARID1A premature stop, indicating later acquisition during clonal divergence. Thus, ultrasensitive sequencing can map clonal evolution within rare subpopulations during human lymphomagenesis in vivo.For the first time, we define the molecular ontogeny of follicular lymphoma during clonal evolution in vivo. By using ultrasensitive mutation detection, we mapped the time-course of somatic alterations after passage of a malignant ancestor by hematopoietic cell transplantation.
Evidence for a role of collagen synthesis in arterial smooth muscle cell migration.
Authors: E F Rocnik, B M Chan, J G Pickering
Journal: Journal of Clinical Investigation (1998)

Migration of smooth muscle cells (SMCs) and collagen synthesis by SMCs are central to the pathophysiology of vascular disease. Both processes can be induced shortly after vascular injury; however, a functional relationship between them has not been established. In this study, we determined if collagen synthesis was required for SMC migration, using ethyl-3,4-dihydroxybenzoate (EDHB), an inhibitor of prolyl-4-hydroxylase, and 3,4-DL-dehydroproline (DHP), a proline analogue, which we demonstrate inhibit collagen elaboration by porcine arterial SMCs. SMCs exposed to EDHB or DHP attached normally to collagen- and vitronectin-coated substrates; however, spreading on collagen but not vitronectin was inhibited. SMC migration speed, quantified by digital time-lapse video microscopy, was significantly and reversibly reduced by EDHB and DHP. Flow cytometry revealed that expression of beta1 integrins, through which SMCs interact with collagen, was unaffected by EDHB or DHP. However, both inhibitors prevented normal clustering of beta1 integrins on the surface of SMCs, consistent with a lack of appropriate matrix ligands for integrin engagement. Moreover, there was impaired recruitment of vinculin into focal adhesion complexes of spreading SMCs and disassembly of the smooth muscle alpha-actin-containing cytoskeleton. These findings suggest that de novo collagen synthesis plays a role in SMC migration and implicates a mechanism whereby newly synthesized collagen may be necessary to maintain the transcellular traction system required for effective locomotion.
Regions of focal DNA hypermethylation and long-range hypomethylation in colorectal cancer coincide with nuclear lamina–associated domains
Authors: Benjamin P Berman, Daniel J Weisenberger, Joseph F Aman, Toshinori Hinoue, Zachary Ramjan, Yaping Liu, Houtan Noushmehr, Christopher P E Lange, Cornelis M van Dijk, Rob A E M Tollenaar, David Van Den Berg, Peter W Laird
Journal: Nature Genetics (2011)
Awarding of Legal Fees as Penalty for Unwanted Treatment
Authors: Giles R. Scofield
Journal: JAMA (1991)

<h3>To the Editor. —</h3> Weir and Gostin's<sup>1</sup>comprehensive view of the post-<i>Cruzan</i>world omitted a factor that ought to weigh in the minds of physicians, administrators, and institutional lawyers who prefer seeking a court's judgment to exercising their own. In California,<sup>2</sup>Florida,<sup>3</sup>and Rhode Island,<sup>4</sup>state and federal courts have awarded counsel fees to patients who prevail in securing protection of the civil right to be free of unwanted or unwarranted treatment. One wonders how those involved in providing health care will feel about being ordered to pay a patient's legal bill and whether that prospect can have a prophylactic effect on the problems Weir and Gostin so ably identified.