tbuckley/cabot-search huggingface dataset:
A pilot validation in 10 European Union Member States of a point prevalence survey of healthcare-associated infections and antimicrobial use in acute hospitals in Europe, 2011
Authors: J S Reilly, L Price, J Godwin, S Cairns, S Hopkins, B Cookson, W Malcolm, G Hughes, O Lyytikaïnen, B Coignard, S Hansen, C Suetens, Collective National Participants in the ECDC pilot validation study
Journal: Eurosurveillance (2015)

We present a pilot validation study performed on 10 European Union (EU) Member States, of a point prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in Europe in 2011 involving 29 EU/European Economic Area (EEA) countries and Croatia. A total of 20 acute hospitals and 1,950 patient records were included in the pilot study, which consisted of validation and inter-rater reliability (IRR) testing using an in-hospital observation approach. In the validation, a sensitivity of 83% (95% confidence interval (CI): 79–87%) and a specificity of 98% (95% CI: 98–99%) were found for HAIs. The level of agreement between the primary PPS and validation results were very good for HAIs overall (Cohen’s κappa (κ):0.81) and across all the types of HAIs (range: 0.83 for bloodstream infections to 1.00 for lower respiratory tract infections). Antimicrobial use had a sensitivity of 94% (95% CI: 93–95%) and specificity of 97% (95% CI: 96–98%) with a very good level of agreement (κ:0.91). Agreement on other demographic items ranged from moderate to very good (κ: 0.57–0.95): age (κ:0.95), sex (κ: 0.93), specialty of physician (κ: 0.87) and McCabe score (κ: 0.57). IRR showed a very good level of agreement (κ: 0.92) for both the presence of HAIs and antimicrobial use. This pilot study suggested valid and reliable reporting of HAIs and antimicrobial use in the PPS dataset. The lower level of sensitivity with respect to reporting of HAIs reinforces the importance of training data collectors and including validation studies as part of a PPS in order for the burden of HAIs to be better estimated.
Incidental Detection of a Toxic Autonomous Thyroid Nodule During Breast Lymphoscintigraphy
Authors: Matthew Mattern, Perry Gerard
Journal: Clinical Nuclear Medicine (2006)

A 54-year-old woman with newly diagnosed infiltrating ductal carcinoma of the right breast underwent lymphoscintigraphy for preoperative sentinel lymph node detection. After intraparenchymal injection of technetium-99m sulfur colloid into the right breast, images revealed focal uptake in the lower pole of the left thyroid lobe. An iodine-123 thyroid scan demonstrated a large hyperfunctioning nodule at the lower pole of the left thyroid lobe with suppression of the remaining gland, consistent with a toxic autonomous thyroid nodule.
Use and Abuse of Antibiotics in a Small Community
Authors: William A. Nolen, Donald E. Dille
Journal: New England Journal of Medicine (1957)

THERE is general agreement in the medical profession that antibiotics are used much too freely. Articles dealing with this subject appear from time to time in most medical journals. A common problem in the compilation of these reports has been the difficulty of obtaining accurate patient data that would be typical for the average civilian community with its normal distribution of ages and sex. This situation does not prevail in the community where we have served our tours of military service. We believe, therefore, that the following discourse will be unique in its completeness and accuracy.It will be necessary, . . .
Abstract 5577: HER2 cytoplasmic staining and penile cancer
Authors: Alice M. Silva, Isabela W. Cunha, Gustavo C. Guimarães, Antonio Cubilla, Ademar Lopes, Fernando A. Soarea
Journal: Cancer Research (2012)

Abstract BACKGROUND: Although rare in developed regions, penile carcinoma is a serious concern for undeveloped countries such as Brazil, where it can represent up to 10% of all malignancies. HER2 is a well-known growth factor membrane receptor that has its expression level usually associated with aggressive disease. Recently, some studies have shown that soluble fractions of HER2 intracellular domain are found in tumors cytoplasm and they still activate intracellular pathways related to cell proliferation and survival. MATERIAL AND METHODS: Immunohistochemistry against HER2 was carried out in 195 penile carcinoma samples selected from the files of AC Camargo Hospital, Brazil, using the monoclonal CB11 antibody (Novocastra™), which recognizes specifically HER2 intracellular domain. Cases were classified as positive or negative according to membrane and to cytoplasmic staining. All statistical analyses were performed by the SPSS for Windows 18.0, SPSS Inc. Comparison between category variables was performed by the Pearson chi-square test or the Fisher's exact test. Survival rates were calculated using the Kaplan-Meier method and the curves were compared by means of the log-rank test. In all statistical tests, the alpha error was set at 5%. RESULTS: None of the cases showed membrane staining for HER2. However, a clear and strong cytoplasm staining was observed in 28 cases (14,9%), as shown in figure 1. The staining was limited to the tumor cells and does not represent background or artifact. Univariate analyses showed that overexpression is associated with higher histologic grade (p &amp;lt;0,001) and lower overall survival (p=0,007). Multivariate analyses showed that HER2 in the cytoplasm is an independent risk factor for death (RR=2,966; IC 95% [1,6-5,2]; p &amp;lt;0,001). CONCLUSIONS: Corroborating with recent findings that cytoplasmic fragments of HER2 can be active kinases, the present study suggests that the presence of HER2 in tumor cytoplasm is a prognostic marker in penile carcinoma. We have also demonstrated that, although no membrane staining was seen, presence of HER2 in cytoplasm is an independent risk factor for death in this neoplasm. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5577. doi:1538-7445.AM2012-5577
Small-Molecule Intramimics of Formin Autoinhibition: A New Strategy to Target the Cytoskeletal Remodeling Machinery in Cancer Cells
Authors: L. Leanne Lash, Bradley J. Wallar, Julie D. Turner, Steven M. Vroegop, Robert E. Kilkuskie, Susan M. Kitchen-Goosen, H. Eric Xu, Arthur S. Alberts
Journal: Cancer Research (2013)

Abstract Although the cancer cell cytoskeleton is a clinically validated target, few new strategies have emerged for selectively targeting cell division by modulating the cytoskeletal structure, particularly ways that could avoid the cardiotoxic and neurotoxic effects of current agents such as taxanes. We address this gap by describing a novel class of small-molecule agonists of the mammalian Diaphanous (mDia)-related formins, which act downstream of Rho GTPases to assemble actin filaments, and their organization with microfilaments to establish and maintain cell polarity during migration and asymmetric division. GTP-bound Rho activates mDia family members by disrupting the interaction between the DID and DAD autoregulatory domains, which releases the FH2 domain to modulate actin and microtubule dynamics. In screening for DID–DAD disruptors that activate mDia, we identified two molecules called intramimics (IMM-01 and -02) that were sufficient to trigger actin assembly and microtubule stabilization, serum response factor-mediated gene expression, cell-cycle arrest, and apoptosis. In vivo analysis of IMM-01 and -02 established their ability to slow tumor growth in a mouse xenograft model of colon cancer. Taken together, our work establishes the use of intramimics and mDia-related formins as a new general strategy for therapeutic targeting of the cytoskeletal remodeling machinery of cancer cells. Cancer Res; 73(22); 6793–803. ©2013 AACR.
Cimetidine on apparent liver blood flow
Authors: S L Grainger, J H Marigold, R P H Thompson
Journal: Gut (1984)

agents.We are pleased to be able to give preliminary results of the effect of edrophonium administered during coronary angiography.The results of this study will be published,1 indicating that edrophonium was not associated with spasm or other abnormality of the coronary arteries.There- fore we stand by our suggestion that edrophonium is a safer provocative agent than ergometrine, which is itself used to provoke coronary artery spasm.
Designing Health Care for the Most Common Chronic Condition—Multimorbidity
Authors: Mary E. Tinetti, Terri R. Fried, Cynthia M. Boyd
Journal: JAMA (2012)

The most common chronic condition experienced by adults is multimorbidity, the coexistence of multiple chronic diseases or conditions. In patients with coronary disease, for example, it is the sole condition in only 17% of cases.1 Almost 3 in 4 individuals aged 65 years and older have multiple chronic conditions, as do 1 in 4 adults younger than 65 years who receive health care.2 Adults with multiple chronic conditions are the major users of health care services at all adult ages, and account for more than two-thirds of health care spending.2

Despite the predominance of multiple chronic conditions, however, reimbursement remains linked to discrete International Classification of Diseases diagnostic codes, none of which are for multimorbidity or multiple chronic conditions. Specialists are responsible for a single disease among the patient’s many. Quality measurement largely ignores the unintended consequences of applying the multiple interventions necessary to adhere to every applicable measure. Uncertain benefit and potential harm of numerous simultaneous treatments, worsening of a single disease by treatment of a coexisting one, and treatment burden arising from following several disease guidelines are the well-documented challenges of clinical decision making for patients with multiple chronic conditions.3,4

To ensure safe and effective care for adults with multiple chronic conditions, particularly the millions of baby boomers entering their years of declining health and increasing health service use, health care must shift its current focus on managing innumerable individual diseases. To align with the clinical reality of multimorbidity, care should evolve from a disease orientation to a patient goal orientation, focused on maximizing the health goals of individual patients with unique sets of risks, conditions, and priorities. Patient goal–oriented health care involves ascertaining a patient’s health outcome priorities and goals, identifying the diseases and other modifiable factors impeding these goals, calculating and communicating the likely effect of alternative treatments on these goals, and guiding shared decision making informed by this information.4
Open source clinical science for emerging infections
Authors: Jake W Dunning, Laura Merson, Gernot G U Rohde, Zhancheng Gao, Malcolm G Semple, Dat Tran, Anthony Gordon, Piero L Olliaro, Saye H Khoo, Roberto Bruzzone, Peter Horby, J Perren Cobb, Kajsa-Stina Longuere, Paul Kellam, Alistair Nichol, Stephen Brett, Dean Everett, Timothy S Walsh, Tran-Tinh Hien, Hongjie Yu, Maria Zambon, Guillermo Ruiz-Palacios, Trudie Lang, Tamuna Akhvlediani, Frederick G Hayden, John Marshall, Steve Webb, Derek C Angus, Nahoko Shindo, Sylvie van der Werf, Peter J M Openshaw, Jeremy Farrar, Gail Carson, J Kenneth Baillie
Journal: The Lancet Infectious Diseases (2013)

Emerging infections cause justifiable global concern. Current outbreaks of avian influenza A H7N91 and the Middle East respiratory syndrome (MERS)2 raise troubling memories of pandemic influenza and severe acute respiratory syndrome (SARS). With few mutations,3–5 these or other pathogens could evolve to cause widespread outbreaks.
The Association between Coronary Atherosclerotic Burden and Asymmetric Dimethylarginine, Carotis Intima Media Thickness and Endothelial Function
Authors: Murat Ziyrek, Fatma Can, Murat Civan, Şükran Erdem, Zeydin Acar, Sinan Şahin, Çavlan Çiftçi
Journal: Journal of the American College of Cardiology (2013)
“Nonalcoholic fatty liver disease” in a developing country: A different perspective
Authors: Sujoy Maitra
Journal: Hepatology (2010)

I read with great interest the article by Das et al.1 Although presence of nonalcoholic fatty liver (NAFL) in nonobese individuals is a fairly common observation in India, this is the first such scientific documentation for the same. However, I would like to make a few points in this regard. First, NAFL constitutes a wide spectrum of liver disease with varied natural history extending from simple steatosis to more sinister variants, i.e., nonalcoholic steatohepatitis (NASH) and fibrosis/cirrhosis. Only a proportion of NAFL actually progresses to the more sinister end of this spectrum. Therefore, instead of a blanket focus on NAFL, it would be more appropriate to identify the subset of patients with NAFL who are more likely to progress to NASH. In this regard, the authors have defined "potentially significant NAFL" as "subjects with definite NAFL who had persistently elevated ALT (>40 IU/L)". However, even in this study only one-third of these subjects with "potentially significant NAFL" were found to have NASH on liver biopsy, which means elevated ALT alone is not a good enough marker of "potentially significant" NAFL. A full panel of noninvasive markers of liver fibrosis would be more appropriate to define this subset and save costly and/or potentially harmful procedures like liver biopsy or computed tomography scans for them. Second, although the authors have claimed to have excluded people with alcohol consumption from this study, this population in context comes largely from a tribal background who indulges in many nonconventional forms of ethanol consumption, e.g., mahua flower (Madhuca longifolia). It would be interesting to know if the authors have ruled out those possibilities as well. Third, risk of NAFL is undoubtedly associated with obesity and metabolic syndrome and has been traditionally associated with more affluent living standards. In the current study too, even nonobese subjects with NAFL had worse metabolic parameters and higher income than their age-matched and sex-matched counterparts who did not have NAFL. Nevertheless, coexistence of intrauterine and neonatal malnutrition and the development of obesity, type 2 diabetes, and related comorbidities have been confirmed in a number of studies in humans and animal models.2 Moreover, it has been shown that, in humans, the intrahepatic lipid content increase following starvation also may be due to reduced apolipoprotein B-100 production and hepatic lipid export, and/or impaired mitochondrial function; this could have implications for exacerbations of steatohepatitis that is sometimes seen with rapid weight loss, anorexia nervosa, and parenteral nutrition.3 Therefore, in contrast to the popular view, malnutrition rather than obesity at different stages of life may well be an explanation for pathogenesis of NAFL in this predominantly poor population. Sujoy Maitra M.D., MRCP Dr.*, * Consultant Hepatologist, Columbia Asia Hospital Calcutta, India.
GENDER AND BLEEDING RISK FOLLOWING PERCUTANEOUS CORONARY INTERVENTIONS: A CONTEMPORARY REPORT FROM THE NCDR&amp;reg;
Authors: Stacie L. Daugherty, Sunghee Kim, Lauren Thompson, Sunil Rao, Sumeet Subherwal, Thomas Tsai, John Messenger, Frederick Masoudi
Journal: Journal of the American College of Cardiology (2012)
Validating Satellite-Derived Land Surface Temperature with <i>in Situ</i> Measurements: A Public Health Perspective
Authors: Jalonne L. White-Newsome, Shannon J. Brines, Daniel G. Brown, J. Timothy Dvonch, Carina J. Gronlund, Kai Zhang, Evan M. Oswald, Marie S. O’Neill
Journal: Environmental Health Perspectives (2013)

Background: Land surface temperature (LST) and percent surface imperviousness (SI), both derived from satellite imagery, have been used to characterize the urban heat island effect, a phenomenon in which urban areas are warmer than non-urban areas.Objectives: We aimed to assess the correlations between LSTs and SI images with actual temperature readings from a ground-based network of outdoor monitors.Methods: We evaluated the relationships among a) LST calculated from a 2009 summertime satellite image of the Detroit metropolitan region, Michigan; b) SI from the 2006 National Land Cover Data Set; and c) ground-based temperature measurements monitored during the same time period at 19 residences throughout the Detroit metropolitan region. Associations between these ground-based temperatures and the average LSTs and SI at different radii around the point of the ground-based temperature measurement were evaluated at different time intervals. Spearman correlation coefficients and corresponding p-values were calculated.Results: Satellite-derived LST and SI values were significantly correlated with 24-hr average and August monthly average ground temperatures at all but two of the radii examined (100 m for LST and 0 m for SI). Correlations were also significant for temperatures measured between 0400 and 0500 hours for SI, except at 0 m, but not LST. Statistically significant correlations ranging from 0.49 to 0.91 were observed between LST and SI.Conclusions: Both SI and LST could be used to better understand spatial variation in heat exposures over longer time frames but are less useful for estimating shorter-term, actual temperature exposures, which can be useful for public health preparedness during extreme heat events.
Biting Off the Bracelet: A Study of Children in Hospitals
Authors: Ruth P. Zager
Journal: JAMA (1989)

In this book, Beuf examines the "social situation of the hospitalized child" in the United States today, based on her fieldwork during the early 1970s at two hospitals in the Northeast, a tertiary children's hospital and a medium-sized general community one. She describes how hospital routines, medical procedures, personnel attitudes, and technological advances traumatize and render helpless child patients already separated from their parents and severely stressed. Beuf faults nursing, and particularly medical personnel, for generally failing to consider the children's emotional needs or the way they are additionally traumatized by hospital procedures and personnel behavior. Beuf ascribes this situation to a combination of (1) the manner in which children are usually treated in the United States—as generally helpless, incompetent, and powerless; (2) the adoption of a modified Parsons "sick role model"; and (3) the children's hospital's role as "a form of [a] total institution" (p 58), wreaking on its
Two-dimensional echocardiographic assessment of papillary muscle contractility in patients with prior myocardial infarction
Authors: Akira Kisanuki, Yutaka Otsuji, Ryuichi Kuroiwa, Takashi Murayama, Ryoji Matsushita, Kunihiko Shibata, Toshiro Yutsudo, Shoichiro Nakao, Kunihiro Nomoto, Tsutomu Tomari, Hiromitsu Tanaka
Journal: Journal of the American College of Cardiology (1993)
Cases of Lyme Disease in the United States: Locations Correlated with Distribution of Ixodes dammini
Authors: ALLEN C. STEERE
Journal: Annals of Internal Medicine (1979)

Lyme disease, defined by erythema chronicum migrans and sometimes followed by neurologic, cardiac, or joint involvement, is known to have affected 512 patients in the United States. The disease seems to occur in three distinct foci: along the northeastern coast, in Wisconsin, and in California and Oregon, a distribution that correlates closely with that of Ixodes dammini in the first two areas and with Ixodes pacificus in the last. The implicated tick, saved by six patients in the Northeast, was identified as nymphal I. dammini. Residence in or travel to endemic areas and history of tick bite may be important clues to diagnosis.
Examination of Visual Fields
Authors: SUNDARAM V. RAMANAN
Journal: JAMA (1976)

<h3>To the Editor.—</h3> The technique of visual field testing described by Dr King has been advocated for many years by neurologists at the National Hospital for Nervous Diseases in London. To the advantages of the method already described must be added one other: the detection of visual inattention. The phenomenon of "inattention" or "extinction" is one in which the patient is able to appreciate on only one side bilateral stimuli that are presented simultaneously. Depending on the nature of the stimulus used, the condition may be described as tactile or visual inattention. This form of cortical sensory deficit is characteristic of a parietal lobe lesion. Testing for visual fields in the manner recommended by Dr King ensures that visual inattention, when present, will be detected; this important finding cannot be appreciated with unilateral visual field testing.
Cardiac Output Response to Exercise in Patients with Inferior Vena Caval Ligation
Authors: MURRAY A. VARAT, NOBLE O. FOWLER, ROBERT J. ADOLPH
Journal: Circulation (1970)

Studies were carried out to determine whether hemodynamic alterations may follow inferior vena caval (IVC) ligation. Five patients, aged 29 to 49 years, who had been operated upon 2 to 5 years previously, and five normal controls, aged 39 to 44 years, were studied at rest and during graded submaximal treadmill exercise. There were no significant differences in heart rate, right atrial pressure, brachial arterial pressure, oxygen consumption, or cardiac output between the patients and normals in the supine rest and head-up tilt positions. During treadmill exercise the heart rate and oxygen consumption were comparable in the two groups, but the cardiac output response was definitely diminished in the patient group. This was reflected in the exercise factor, that is, the increase in cardiac output per 100 ml increase in oxygen consumption. The mean exercise factor was 406 ml for the patient group and 726 ml for the controls, a significant difference ( P &lt; 0.001). It is concluded that the cardiac output response to upright exercise may be impaired in patients with IVC ligation. Inadequate venous return following IVC ligation may explain the persistent postoperative exertional dyspnea that has been noted in our patients.
Evaluation of Standardized Uptake Value to Assess Cerebral Glucose Metabolism
Authors: SHIGERU YAMAJI, KAZUNARI ISHII, MASAHIRO SASAKI, TETSUYA MORI, HAJIME KITAGAKI, SETSU SAKAMOTO, ETSURO MORI
Journal: Clinical Nuclear Medicine (2000)

Purpose When the cerebral metabolic rate of glucose (CMRglc) is to be measured, arterial blood sampling is usually required for fluorine-18 fluorodeoxyglucose (FDG) and positron emission tomography (PET) studies. However, blood sampling is inconvenient because it requires several staff members and is invasive for patients. Methods To assess cerebral glucose metabolism by a noninvasive and simplified method, the authors used the standardized uptake value (SUV), which requires no input function or blood sampling. The study participants included 18 healthy volunteers (4 men and 14 women; mean ± SD age, 68.2 ± 6.3 years), 18 patients with mild Alzheimer's disease (AD) (4 men and 14 women; mean ± SD age, 68.8 ± 7.3 years), and 18 patients with moderate AD (5 men and 13 women, mean ± SD age, 69.5 ± 8.5 years). Regional CMRglc and regional cerebral SUV were measured in the three groups using FDG PET, and the correlation between global CMRglc and global SUV was estimated. Results The correlation coefficients of global CMRglc and global SUV in the healthy volunteers, mild AD patients, and moderate AD patients were 0.82, 0.67, and 0.62, respectively. Compared with the healthy persons, the patients with mild AD showed significantly decreased CMRglc in the temporal, frontal, and parietal cortices, but they did not show significantly decreased SUV in any region. Patients with moderate AD had significantly decreased CMRglc in the temporal, frontal, occipital, parietal, and sensorimotor cortices and significantly decreased SUV in the temporal, frontal, occipital, and parietal cortices. Conclusion The SUV would be useful as a semiquantitative index of cerebral glucose metabolism only in healthy persons or those with mild AD.