tbuckley/cabot-search huggingface dataset:
Epidemic intelligence: a new framework for strengthening disease surveillance in Europe
Authors: C Paquet, D Coulombier, R Kaiser, M Ciotti
Journal: Eurosurveillance (2006)

In a rapidly changing environment, national institutions in charge of health security can no longer rely only on traditional disease reporting mechanisms that are not designed to recognise emergence of new hazards. Epidemic intelligence provides a conceptual framework within which countries may adapt their public health surveillance system to meet new challenges. Epidemic intelligence (EI) encompasses all activities related to early identification of potential health hazards, their verification, assessment and investigation in order to recommend public health control measures. EI integrates both an indicator-based and an event-based component. ‘Indicator-based component’ refers to structured data collected through routine surveillance systems. ‘Event-based component’ refers to unstructured data gathered from sources of intelligence of any nature. All EU member states have long-established disease surveillance systems that provide proper indicator-based surveillance. For most countries, the challenge lies now in developing and structuring the event-based component of EI within national institution in charge of public health surveillance. In May 2006, the European Union member states committed to comply with provisions of the revised International Health Regulations (IHR(2005)) considered relevant to the risk posed by avian and potential human pandemic influenza. This provides for the European Centre for Disease Prevention and Control (ECDC) with an opportunity to guide member states in developing and/or strengthening their national EI , in addition to the ECDC’s task of developing an EI system for the EU.
Genomewide Association Studies — Illuminating Biologic Pathways
Authors: Joel N Hirschhorn
Journal: New England Journal of Medicine (2009)

Human geneticists seek to understand the inherited basis of human biology and disease, aiming either to gain insights that could eventually improve treatment or to produce useful diagnostic or predictive tests. As recently as 2004, few genetic variants were known to reproducibly influence common polygenic diseases (including cancer, coronary artery disease, and diabetes) or quantitative phenotypes (including lipid levels and blood pressure). This relative ignorance limited potential insights into the pathophysiology of common diseases.The completion of the human genome sequence in 2005 and the provision of an initial catalogue of human genetic variation and a haplotype map (known as . . .
Foodborne hepatitis A outbreak associated with bakery products in northern Germany, 2012
Authors: M Harries, M Monazahian, J Wenzel, W Jilg, M Weber, J Ehlers, J Dreesman, E Mertens
Journal: Eurosurveillance (2014)

In October 2012, a hepatitis A (HA) outbreak with 83 laboratory-confirmed cases occurred in Lower Saxony. We defined primary outbreak cases as people with laboratory-confirmed HA and symptom onset between 8 October and 12 November 2012, residing in or visiting the affected districts. Secondary outbreak cases were persons with symptom onset after 12 November 2012 and close contact with primary cases. We identified 77 primary and six secondary cases. We enrolled 50 primary cases and 52 controls matched for age and sex, and found that 82% of cases and 60% of controls had consumed products from a particular bakery (OR=3.09; 95% CI: 1.15–8.68). Cases were more likely to have eaten sweet pastries (OR=5.74; 95% CI: 1.46–22.42). Viral isolates from five selected cases and three positively tested surfaces in the bakery had identical nucleotide sequences. One additional identical isolate derived from a salesperson of the bakery suffering from a chronic disease that required immunosuppressive treatment. Epidemiological and laboratory findings suggested that the salesperson contaminated products while packing and selling. Future risk assessment should determine whether food handlers with chronic diseases under immunosuppressive treatment could be more at risk of contaminating food and might benefit from HAV immunisation.
The Heart in Heart Failure
Authors: ARNOLD M. WEISSLER
Journal: Annals of Internal Medicine (1968)

The inevitable occurrence of congestive heart failure in the course of chronic cardiac disease has led to much speculation concerning a possible defect in intrinsic contractile performance of the myocardium as a basis for this state. Recent evidence suggests that such a deficiency in contractile function of the myocardium is present in cardiac hypertrophy and failure. Investigative attention has been focused upon attempts to elucidate the cellular mechanismsresponsible for the alterations in myocardial performance. Present evidence indicates that the defect primarily involves the energy utilization phase of myocardial metabolism. No specific cellular locus for such a defect has been uncovered to date. It is postulated that with the development of cardiac hypertrophy ineffective coordination of the functions of the growing cellular components may account for the deficient biologic activity in the myocardium.
A multicenter trial to compare blood culture with polymerase chain reaction in severe human sepsis
Authors: Frank Bloos, Frank Hinder, Karsten Becker, Svea Sachse, Armand Mekontso Dessap, Eberhard Straube, Vincent Cattoir, Christian Brun-Buisson, Konrad Reinhart, Georg Peters, Michael Bauer
Journal: Intensive Care Medicine (2009)
Hyposensitization Therapy In Ragweed Hay Fever
Authors: Barry M. Josephson
Journal: JAMA (1966)

<h3>To the Editor:—</h3> Dr. Fontana states that no children were included in the study who were sensitive to inhalants other than ragweed. He further adds that<i>most</i>of his patients were not entirely void of symptoms preceding the ragweed season. It is very rare to find a patient with symptoms during the fall hay-fever season who is not reactive to dust, epidermoids, and other minor weeds. In over 500 patients in my private practice and clinic experience, I have yet to find one in whom ragweed is the only reactant. Dr. Fontana has apparently found 70. If one is interested in a double-blind evaluation of hyposensitization therapy with ragweed alone, the treatment mixture should contain all pertinent weeds, dust, molds, and epidermoids, and the placebo mixture should contain these ingredients, omitting the ragweed.
PA SYSTOLIC PRESSURE BY RIGHT HEART CATHETERIZATION OFFERS ADDITIVE VALUE TO THE MELD SCORING SYSTEM TO PREDICT OUTCOMES IN PATIENTS WITH END-STAGE LIVER FAILURE
Authors: Arvind Bhimaraj, Andrea Cordero-Reyes, Hye Yeon Jhun, Kassi Mahwash, Alejandro Trevino, Howard Monsour, Catherine Frenette, Barry Trachtenberg, Guillermo Torre-Amione, Jerry Estep
Journal: Journal of the American College of Cardiology (2013)
Investigation of Value of Carcinoembryonic Antigen (Cea) and Carbohydrate Antigen (Ca) 19.9 in the Diagnosis of Gastric Cancer
Authors: Fatima Zahra Hijri, Adil Najdi, Samia Arifi, Nawfel Mellas, Mohamed Amine Berraho, Chakib Nejjari, Omar El Mesbahi
Journal: Annals of Oncology (2013)
Antibiotics for acute purulent rhinitis
Authors: B. Arroll
Journal: BMJ (2002)

Despite efforts to lower the prescribing of antibiotics for upper respiratory infections the prescription rates are still over 60%.1 Mucopurulent rhinitis is a component of the common cold, for which antibiotics are generally not effective.2 Guidelines specifically recommend against using antibiotics to treat rhinitis. 3 4 Nevertheless, the colour of the nasal discharge doubles the odds of being prescribed antibiotics.5 In one study no general practitioners said that they would give antibiotics for clear rhinitis but 72% would for purulent rhinitis.6 Moreover, a recent study of acute purulent rhinitis showed a significant reduction in the duration of purulent symptoms from 14 days for placebo to nine days for amoxicillin.7 These findings warrant a reconsideration of the evidence and guidelines for antibiotics in acute purulent rhinitis.

One evidence based guideline in paediatrics (reviewed by the American Academy of Pediatrics) stated that mucopurulent rhinitis is not an indication for antimicrobial treatment unless it persists for more than 10 to 14 days.3 Although this may be sensible advice, it is referenced to only one study, by Todd et al, who found no benefit from cephalexin for mucopurulent nasopharyngitis at five to six days.8 In contrast to the text, the table in that guideline includes two other papers that actually found a benefit for antibiotics on …
Coronary artery surgery: are women discriminated against?
Authors: M Petticrew, M McKee, J Jones
Journal: BMJ (1993)

OBJECTIVE--To determine whether the sex differences in access to cardiac surgery observed in the United States exist in the United Kingdom. DESIGN--Retrospective analysis of routinely collected data. SETTING--South West Thames and North West Thames regional health authorities. SUBJECTS--8564 patients discharged from hospital with a principal diagnosis of coronary heart disease in 1987-8 in South West Thames region and 15243 discharges in North West Thames region in 1990-1. MAIN OUTCOME MEASURES--Performance of angiography or coronary artery bypass surgery. RESULTS--In all age groups and among patients with a principal diagnosis of either angina or chronic ischaemia men were significantly more likely than women to undergo revascularisation in both regions. Using multiple logistic regression to control for potential clinical and demographic confounders, the male to female odds ratio for revascularisation among all cases was 1.59 (95% confidence interval 1.25 to 2.03) in South West Thames region and 1.47 (1.32 to 1.63) in North West Thames region. CONCLUSION--There appears to be a systematic difference in the treatment received by men and women in the United Kingdom. The reasons for this are uncertain.
The ??Fading?? Meckel??s Diverticulum: An Unusual Scintigraphic Presentation
Authors: DOMINIQUE DELBERK, MARIA FREXES-STEED
Journal: Clinical Nuclear Medicine (1992)

The usual scintigraphic presentation of a Meckel's diverticulum is progressive accumulation of Tc-99m pertechnetate within the ectopic gastric mucosa that parallels uptake in the stomach. The authors present a case of an adult with acute gastrointestinal bleeding, negative endoscopic and radiologic evaluation, and atypical scintigraphy. An abnormal focus of uptake appeared at the same time as the stomach but faded away in the 15-minute image before reappearing while the stomach was still progressively accumulating the radioisotope. Meckel's diverticulum was confirmed by surgery. This case emphasizes the importance of scintigraphy in the evaluation of gastrointestinal bleeding, and it further emphasizes that any uptake that cannot be physiologically related is suspicious, even in a young adult.
The Drug Laws
Authors: George R. Edison
Journal: JAMA (1978)

The laws controlling narcotic and other psychoactive drugs are viewed as one of three major forms of treatment designed to deal with the drug problem: laws, prevention, and rehabilitation. All three modalities should be evaluated for effectiveness and safety in the same way we would evaluate surgical or pharmacologic treatment. As a treatment, the drug laws appear to be only marginally effective. Their side effects are so dangerous that the treatment is often more devastating than the disease. A judgment based strictly on the effectiveness and safety of the drug laws would require their immediate repeal or overhaul. The government should be pressed to undertake further evaluation and action. If society decides on retention of these laws, it should do so only if it believes other benefits override the laws' failure as treatment. (<i>JAMA</i>239:2578-2583, 1978)
Infectious Mononucleosis and Other Mono-like Syndromes
Authors: Alfred S. Evans
Journal: New England Journal of Medicine (1972)

The etiologic role of EB virus in the pathogenesis of infectious mononucleosis has been strengthened by two recent large-scale prospective studies, one in the United States and the other in England.1 , 2 The results fully confirm previous observations made in Yale University students.3 4 5 6 7 In one study, as yet published only in abstract form, 800 Cornell students were investigated by Hirshaut et al.1 over a two-year period; 15 cases of clinical infectious mononucleosis occurred in the 200 students lacking EBV antibody, and none in those already possessing EBV antibody. In the other study, 1457 entering freshmen from six English universities and colleges . . .
Decrease in Nosocomial Clostridium difficile–Associated Diarrhea by Restricting Clindamycin Use
Authors: Suzanne M. Pear, Theresa H. Williamson, Kristine M. Bettin, Dale N. Gerding, John N. Galgiani
Journal: Annals of Internal Medicine (1994)

Objective: To report the investigation and effective control of a nosocomial epidemic of Clostridium difficile–associated Diarrhea. Design: Concurrent surveillance for identification of new nosocomial cases, retrospective case–control analysis, and hospital formulary control of antibiotic use. Setting: University-affiliated Veterans Affairs Medical Center located in southwestern United States. Patients: Hospitalized patients who developed diarrhea submitted stool specimens for cytotoxin assay. Patients who were positive for cytotoxin were compared with control patients without infection. Measurements: Isolates of C. difficile were typed by restriction endonuclease analysis. Antimicrobial agent use from hospital pharmacy records and selected patient data from chart review were correlated with frequency of specific laboratory abnormalities. Results: For 13 months, the monthly incidence of C. difficile infection averaged more than five times that for the previous 21 months. Stool specimens from 34 patients (59%) contained a single strain (restriction enzyme analysis type J7). Clindamycin was statistically associated with the epidemic as shown by the following: clindamycin use at our center compared with national normal values, clindamycin use for years before compared with during the epidemic, monthly use of clindamycin compared with monthly frequency of infection, frequency of infection in patients receiving clindamycin compared with that in patients receiving other antimicrobial agents, and amount of clindamycin used by infected patients compared with that used by control patients. Restricting clindamycin use led to a prompt decrease in infection rate and the type J7 organisms. Conclusion: A nosocomial epidemic of C. difficile diarrhea was controlled by analysis of antibiotic use patterns and by subsequent restriction of clindamycin.
Electrophysiological testing and nonsustained ventricular tachycardia. Use and limitations in patients with coronary artery disease and impaired ventricular function.
Authors: D J Wilber, B Olshansky, J F Moran, P J Scanlon
Journal: Circulation (1990)

Electrophysiological testing was performed in 100 consecutive patients with spontaneous asymptomatic nonsustained ventricular tachycardia, chronic coronary artery disease, and ejection fraction of less than 40%. Fifty-seven patients without inducible sustained ventricular arrhythmias were discharged on no antiarrhythmic therapy. Sustained monomorphic ventricular tachycardia was induced in 37 patients, and polymorphic ventricular tachycardia or ventricular fibrillation was induced in six patients. Of the 43 patients with inducible sustained ventricular arrhythmias, three had spontaneous cardiac arrest during serial drug testing and were excluded from further analysis. Twenty patients were discharged on drug therapy, resulting in suppression of inducible sustained ventricular arrhythmias. The remaining 20 patients with persistently inducible sustained arrhythmias were discharged on drug therapy, resulting in maximal rate slowing of the induced tachycardia. During a mean follow-up of 16.7 months, there were 10 recurrent cardiac arrests or sudden deaths. The 1- and 2-year actuarial incidence of these events was 2% and 6%, respectively, in patients without inducible sustained ventricular arrhythmias; 0% and 11%, respectively, in patients in whom inducible arrhythmias were suppressed; and 34% and 50%, respectively, in patients with persistently inducible sustained ventricular arrhythmias. Multivariate Cox analysis identified only the persistence of inducible sustained ventricular arrhythmias as a significant independent predictor of sudden death or recurrent sustained arrhythmias (p less than 0.001; relative risk, 3.5; 95% confidence intervals, 2.1-4.9). In this population, therapeutic intervention to prevent sudden death is unnecessary in patients without inducible sustained ventricular arrhythmias.(ABSTRACT TRUNCATED AT 250 WORDS)
Inhibition of TGF? signaling potentiates the FGF-2-induced stimulation of cardiomyocyte DNA synthesis
Authors: F SHEIKH, C HIRST, Y JIN, M BOCK, R FANDRICH, B NICKEL, B DOBLE, E KARDAMI, P CATTINI
Journal: Cardiovascular Research (2004)

Added transforming growth factor beta (TGFbeta) inhibits the proliferation of immature cardiomyocytes. We have now examined the hypothesis that suppression of endogenous TGFbeta signaling will boost the proliferative response (DNA synthesis) of cardiac myocytes to serum and/or to the mitogenic factor fibroblast growth factor-2 (FGF-2).Overexpression of a kinase-deficient TGFbeta type II receptor (TGFbetaRIIDeltaKD) resulted in a 2.8-fold increase in cardiomyocyte DNA synthesis in serum-rich cultures, an effect requiring active FGFR-1 since it was not observed in the presence of excess kinase-deficient FGFR-1. This finding suggested that endogenous TGFbeta-TGFbetaRII suppressed endogenous FGFR-1-mediated signals that stimulate or are permissive for DNA synthesis. TGFbeta had no effect, however, on the FGF-2-induced acute stimulation of extracellular signal regulated kinase1/2. FGF-2, added in the absence or presence of TGFbeta inhibition, elicited a 3- or a 13-fold stimulation of DNA synthesis, respectively, pointing to a synergistic effect.Inhibition of TGFbetaRII-transduced signaling upregulates the proliferative response of cardiomyocytes to serum, and greatly potentiates the stimulatory effect of FGF-2. A combinatorial strategy including activation of FGF-2 and inhibition of TGFbeta-triggered signal transduction may be required for maximal stimulation of immature cardiomyocyte DNA synthesis.
Hepatitis B virus transmission and hepatocarcinogenesis: a 9 year retrospective cohort of 13676 relatives with hepatocellular carcinoma
Authors: Chien-Hung Chen, Yang Yuan Chen, Gran-Hum Chen, Sien-Sing Yang, Huang-Shang Tang, Hsien Hong Lin, Deng-Yn Lin, Sing Kai Lo, Jeng-Ming Du, Ting-Tsung Chang, Shinn-Cherng Chen, Li-Ying Liao, Chung-Huang Kuo, Kwo-Chuan Lin, Dar-In Tai, Chi-Sin Changchien, Wen-Yu Chang, Jin-Chuan Sheu, Ding-Shinn Chen, Yun-Fan Liaw, Juei-Low Sung
Journal: Journal of Hepatology (2003)
My mum wanted assisted dying but we watched her die slowly and in pain
Authors: T. McPherson
Journal: BMJ (2012)

My mother, the general practitioner Ann McPherson, was passionate about a change in the UK law on assisted dying.[1] This was a lifelong mission, and as a child I was aware of her honest approach to death. Few of us, even doctors, are familiar with the reality of a drawn out undignified death, but my mum had seen many patients and their families suffer this reality and had felt impotent within the law to help. This makes the manner of her death almost a year ago even more poignant.[2]

Mum was diagnosed as having pancreatic cancer in 2007. She recognised the symptoms early, and because of this—and perhaps more importantly because of her tenacity—she survived until May 2011. We felt that she would go on forever. I had mixed feelings about her becoming so prominent in the assisted dying debate. I would avoid reading her articles or watching her appearances on television. Initially I wasn’t sure why she would want to invest so much of her limited time and energy in this. I also felt ambivalent about the issue and uncomfortable talking about the subject, which felt complex and ugly. Mum changed this for me—and for others too. This is my personal account of watching her die. But I am sure anyone who has been through these days, hours, and minutes will understand the frustration of watching an extremely dignified …
Update: A 47-Year-Old Woman With an Indwelling Intravenous Catheter and Sepsis
Authors: Eileen E. Reynolds, Neha S. Trivedi
Journal: JAMA (2012)

Context-Some veterans are eligible to enroll simultaneously in a Medicare Advantage (MA) plan and the Veterans Affairs health care system (VA).This scenario produces the potential for redundant federal spending because MA plans would receive payments to insure veterans who receive care from the VA, another taxpayer-funded health plan.Objective-To quantify the prevalence of dual enrollment in VA and MA, the concurrent use of health services in each setting, and the estimated costs of VA care provided to MA enrollees.
Infrared Thermography to Assess Proliferation and Involution of Infantile Hemangiomas
Authors: Javed Ayoub Mohammed, Alexandra Balma-Mena, Ajith Chakkittakandiyil, Florentina Matea, Elena Pope
Journal: JAMA Dermatology (2014)

Infantile hemangiomas (IHs) are common benign tumors of infancy that have the potential to interfere with vital organ function and cause permanent disfigurement. Currently, few objective and validated measures exist to assess IHs.To determine the utility of infrared thermography in assessing and monitoring the growth of IHs.In a prospective cohort study conducted at an outpatient dermatology clinic of a tertiary care hospital between February 2011 and December 2012, a convenience sample of 42 infants aged 0 to 6 months with an IH were enrolled. The mean age of the study group was 3.7 months, with the majority of IHs being mixed type (57%) affecting the head and neck (81%). Of the infants, 36 (86%) were receiving active treatment during the study period, and patients were followed for a minimum of 3 clinical visits, at least 1 month apart.Ability of infrared thermography to assess the proliferation and involution of IHs compared with a visual analog scale. Secondary outcomes were reliability, ease of use, and parental acceptance of the instrument.The mean temperature difference at baseline was 1.9°F (95% CI, 1.2°F to 2.7°F), which peaked at 3 months to 2.5°F (95% CI, 0.8°F to 4.2°F), and decreased progressively to 0.2°F (95% CI, -1.1°F to 1.4°F) at 18.5 months (P < .001). This change in temperature was inversely correlated with mean visual analog scale (r = -0.25). Mean temperature differences recorded at baseline and 30 minutes later were not significant (least squares mean baseline temperature, 87.9°F [95% CI, 87.4°F to 88.3°F], vs least squares mean temperature after 30 minutes, 88.1°F [95% CI, 87.7°F to 88.6°F] [P = .14]). Multivariate analysis demonstrated facial location (F(1,365) = 47.63, P < .001), IH type (F(2,365) = 3.26, P = .04), age (F(2,365) = 7.03, P = .001), and surface area at baseline (F(2,365) = 8.18, P < .001) as factors significantly affecting temperature difference over time. Only IH type (Wald χ(22) = 6.79, P = .03) and treatment (Wald χ(21) = 4.29, P = .04) significantly affected time to reach a zero-temperature difference. All caregivers (100%) reported IRT to be easy to implement, quick to perform, and comfortable for their child.Infrared thermography is a reliable and valid measure of IH growth that is noninvasive, convenient, and well tolerated by infants, making it well suited to daily clinical practice. It has the potential to provide real-time objective results that can be used for routine monitoring and evaluating treatment efficacy.