tbuckley/cabot-search huggingface dataset:
Clinical Utility of Blood Cultures Drawn from Indwelling Central Venous Catheters in Hospitalized Patients with Cancer
Authors: Jeffrey A. DesJardin, Matthew E. Falagas, Robin Ruthazer, John Griffith, Dorothy Wawrose, David Schenkein, Kenneth Miller, David R. Snydman
Journal: Annals of Internal Medicine (1999)

Background: Because of concern about low specificity, the American College of Physicians guidelines and expert opinion discourage the use of a central venous catheter when obtaining blood for culture for bacteremia or fungemia. However, data on the reliability of cultures done with blood obtained from a central venous catheter are conflicting. Objective: To determine the sensitivity, specificity, and positive and negative predictive values of cultures done with blood obtained through a central venous catheter compared with peripheral venipuncture. Design: Retrospective cohort study of hospitalized patients with cancer in whom samples for paired cultures were drawn through a central venous catheter and peripheral venipuncture. Setting: Tertiary care, university-affiliated medical center. Patients: 185 patients hospitalized on a hematology-oncology ward between August 1994 and June 1996. Measurements: Blinded assessments of culture results done by infectious disease experts were used as the gold standard. Sensitivity, specificity, and positive and negative predictive values were compared for culture of blood from central catheters and culture of blood from peripheral venipuncture. Results: Of 551 paired cultures, 469 (85%) were catheter-negative/venipuncture-negative, 32 (6%) were catheter-positive/venipuncture-positive, 17 (3%) were catheter-negative/venipuncture-positive, and 33 (6%) were catheter-positive/venipuncture-negative pairs. For the 82 paired cultures with at least one positive result, blinded determination of true bacteremia or fungemia was made by two infectious disease specialists. For catheter draw compared with peripheral venipuncture, sensitivity was 89% (95% CI, 79% to 98%) and 78% (CI, 65% to 90%) (difference, 11 percentage points [CI, −6 to 28 percentage points]), specificity was 95% (CI, 93% to 97%) and 97% (CI, 96% to 99%) (difference, −2 percentage points [CI, −5 to 0.2 percentage points]), positive predictive value was 63% (CI, 50% to 75%) and 73% (CI, 60% to 86%) (difference, −10 percentage points [CI, −26 to 5 percentage points]), and negative predictive value was 99% [CI, 97% to 100%]) and 98% (CI, 96% to 100%) (difference, 1 percentage point [CI, −0.5 to 3 percentage points]). Conclusions: In hospitalized hematology-oncology patients, culture of blood drawn through either the central catheter or peripheral vein shows excellent negative predictive value. Culture of blood drawn through an indwelling central venous catheter has low positive predictive value, apparently less than from a peripheral venipuncture. Therefore, a positive result from a catheter needs clinical interpretation and may require confirmation. However, the use of a catheter to obtain blood for culture may be an acceptable method for ruling out bloodstream infections.
Randomised prospective parallel trial of therapeutic versus subtherapeutic nasal continuous positive airway pressure on simulated steering performance in patients with obstructive sleep apnoea
Authors: M. Hack
Journal: Thorax (2000)

<h3>BACKGROUND</h3> Obstructive sleep apnoea (OSA) impairs vigilance and may lead to an increased rate of driving accidents. In uncontrolled studies accident rates and simulated steering performance improve following treatment with nasal continuous positive airway pressure (NCPAP). This study seeks to confirm the improvement in steering performance in a randomised controlled trial using subtherapeutic NCPAP as a control treatment. <h3>METHODS</h3> Fifty nine men with OSA (Epworth Sleepiness Score (ESS) of ⩾10, and ⩾10/h dips in Sao<sub>2</sub> of &gt;4% due to OSA) received therapeutic or subtherapeutic NCPAP (≈1 cm H<sub>2</sub>O) for one month. Simulated steering performance over three 30-minute "drives" was quantified as: standard deviation (SD) of road position, deterioration in SD across the drive, length of drive before "crashing", and number of off-road events. The reaction times to peripheral target stimuli during the drive were also measured. <h3>RESULTS</h3> Subtherapeutic NCPAP did not improve overnight &gt;4% Sao<sub>2</sub>dips/h compared with baseline values, thus acting as a control. The SD of the steering position improved from 0.36 to 0.21 on therapeutic NCPAP, and from 0.35 to 0.30 on subtherapeutic NCPAP (p = 0.03). Deterioration in SD of the steering position improved from 0.18 to 0.06 SD/h with therapeutic NCPAP and worsened from 0.18 to 0.24 with subtherapeutic NCPAP (p = 0.04). The reaction time to target stimuli was quicker after therapeutic than after subtherapeutic NCPAP (2.3 versus 2.7 seconds, p = 0.04). <h3>CONCLUSIONS</h3> Therapeutic NCPAP improves steering performance and reaction time to target stimuli in patients with OSA, lending further support to the hypothesis that OSA impairs driving, increases driving accident rates, and that these improve following treatment with NCPAP.
Cell proliferation and forestomach carcinogenesis.
Authors: N Ito, M Hirose, S Takahashi
Journal: Environmental Health Perspectives (1993)

To analyze the role of cell proliferation in phenolic compound-induced rat forestomach carcinogenesis, early forestomach histopathological changes as well as oncogene expression and reversibility of early forestomach lesions were examined in F344 male rats. For the analysis of early lesions, five animals each were treated with butylated hydroxyanisole (BHA), caffeic acid, sesamol, or 4-methoxyphenol in the diet, each at a dose of 2%, and killed for histopathological examination after 12 hr, 1, 3, or 7 days. For oncogene analysis, three animals each were treated with BHA for 15, 30 min, 1, 3, 6, or 24 hr and then sacrificed. In the reversibility study, groups of animals were treated with BHA, caffeic acid, sesamol or 4-methoxyphenol for 24 weeks, and basal diet alone was supplied for a further 24-week period. Animals were killed at 24 and 48 weeks and forestomach epithelium was examined histopathologically. DNA synthesis increased within 12 hr to 3 days after commencement of chemical treatment in all cases. Toxicity and cell proliferation became evident subsequent to increase in DNA synthesis in each case. Elevated expression of c-fos and c-myc oncogenes was demonstrated 15 min after beginning treatment with BHA. In the reversibility study, although most of the proliferative lesions induced by these antioxidants regressed after cessation of chemical treatment, some dysplastic lesions were still observed at week 48. The results indicate that these phenolic compounds act primarily as mitogens in rat forestomach epithelium, with regeneration due to toxicity further enhancing cell proliferation.(ABSTRACT TRUNCATED AT 250 WORDS)
Salivary Secretion of Blood Factors in Cancer-Reply
Authors: Melvin J. Krant
Journal: JAMA (1968)

<h3>To the Editor:—</h3> Our interest in salivary secretion of mucopolysaccharides in cancer developed from Dr. McNeil's publication in<i>Nature</i>(<b>208</b>:299, 1965), in which he reported that the nonsecretor frequency in bronchogenic carcinoma was approximately 5.7%, a remarkable decrease in expected frequency in a normal population. Despite the skewing of the frequency of nonsecretors with blood type O in bronchogenic carcinoma in our studies, in an analysis which now exceeds 120 patients with that disease, we find the same frequency of nonsecretors as we reported in our paper. Even were we to postulate a 10% error in blood type O patients, which far surpasses the 1% to 3% of aberrant secretors to be expected in any population, this would not change the indication that the frequency of nonsecretors in bronchogenic carcinoma is nowhere near the level that Dr. McNeil reported in his paper, and approaches the frequency of a normal
Splenic Vein Thrombosis and Bleeding Esophageal Varices
Authors: Charles E. Yale
Journal: JAMA (1971)

Seven patients with bleeding esophageal varices secondary to splenic vein thrombosis were studied over the past five years. This infrequently reported condition was apparently caused by pancreatitis in five cases, retroperitoneal Hodgkin's disease in one, and shunt surgery in one. Four of the five patients treated by splenectomy are alive without recurrent hemorrhages from 8 to 60 months after operation. Angiography is the definitive preoperative examination. Splenectomy is the treatment of choice.
Sudden infant death syndrome: links with infant care practices.
Authors: M Gantley, D P Davies, A Murcott
Journal: BMJ (1993)

<h3>Objectives</h3> While new treatments for rheumatoid arthritis (RA) have markedly improved disease control by targeting immune/inflammatory pathways, current treatments rarely induce remission, underscoring the need for therapies that target other aspects of the disease. Little is known about the regulation of disease severity and joint damage, which are major predictors of disease outcome, and might be better or complementary targets for therapy. In this study, we aimed to discover and characterise a new arthritis severity gene. <h3>Methods</h3> An unbiased and phenotype-driven strategy including studies of unique congenic rat strains was used to identify new arthritis severity and joint damage genes. Fibroblast-like synoviocytes (FLS) from rats and patients with RA expressing or not Huntingtin-interacting protein 1 (HIP1) were studied for invasiveness, morphology and cell signalling. HIP1 knockout mice were used in in vivo confirmatory studies. Paired t-test was used. <h3>Results</h3> DNA sequencing and subcongenic strains studied in pristane-induced arthritis identified a new amino acid changing functional variant in HIP1. HIP1 was required for the increased invasiveness of FLS from arthritic rats and from patients with RA. Knocking down HIP1 expression reduced receptor tyrosine kinase-mediated responses in RA FLS, including RAC1 activation, affecting actin cytoskeleton and cell morphology and interfering with the formation of lamellipodia, consistent with reduced invasiveness. HIP1 knockout mice were protected in KRN serum-induced arthritis and developed milder disease. <h3>Conclusion</h3> HIP1 is a new arthritis severity gene and a potential novel prognostic biomarker and target for therapy in RA.
Changes in distribution of gestational age and birth weight among firstborn infants of Cardiff residents.
Authors: R Newcombe, I Chalmers
Journal: BMJ (1977)

We studied data on firstborn singleton infants born to primiparous Cardiff residents during the decade 1965-1974. Both mean birth weight and gestational age at delivery fell appreciably during 1965-74. Changes in maternal age, height, smoking habits, or history of abortion did not explain these findings. The increased proportion of infants weighing less than 2500 g may be explained by the overall reduction in gestational age at delivery, which, in turn, may have resulted from increased use of elective delivery during the second quinquennium.
Cervical Cancer: Successes and Failures
Authors: S. C. Rubin
Journal: CA A Cancer Journal for Clinicians (2001)

The decline in deaths from cervical cancer in the US, as well as the improved survival of women with advanced disease have resulted, according to Dr. Rubin, from widespread application of routine screening with the Pap test, the emergence of gynecologic oncology as a distinct medical subspecialty, and the completion of important clinical trials.
Abnormal expression of hemidesmosome-like structures by junctional epidermolysis bullosa keratinocytes in vitro
Authors: S.J. CHAPMAN, IRENE M. LEIGH, M.J. TIDMAN, R.A.J. EADY
Journal: British Journal of Dermatology (1990)

Journal Article Abnormal expression of hemidesmosome‐like structures by junctional epidermolysis bullosa keratinocytes in vitro Get access S.J. CHAPMAN, S.J. CHAPMAN Department of Cell Pathology, Institute of Dermatology, St Thomas's Hospital, Lambeth Palace Road, London SE17EH, U.K. Dr S. Chapman, Department of Dermatology, Royal Liverpool Hospital, Prescot Street, Liverpool L69 3BX, U.K. Search for other works by this author on: Oxford Academic Google Scholar IRENE M. LEIGH, IRENE M. LEIGH Department of Dermatology, The London Hospital, London E1, U.K. Search for other works by this author on: Oxford Academic Google Scholar M.J. TIDMAN, M.J. TIDMAN Department of Cell Pathology, Institute of Dermatology, St Thomas's Hospital, Lambeth Palace Road, London SE17EH, U.K. Search for other works by this author on: Oxford Academic Google Scholar R.A.J. EADY R.A.J. EADY Department of Cell Pathology, Institute of Dermatology, St Thomas's Hospital, Lambeth Palace Road, London SE17EH, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 123, Issue 2, 1 August 1990, Pages 137–144, https://doi.org/10.1111/j.1365-2133.1990.tb01840.x Published: 01 August 1990
Gastroesophageal Reflux Disease and Barrett's Esophagus
Authors: T. Rösch
Journal: Endoscopy (2000)

There was enormous interest in the diagnosis and treatment of gastroesophageal reflux disease (GERD) and Barrett's esophagus (BE) at this year's Digestive Diseases Week (DDW). Since this topic predominated over other areas of clinical research in gastrointestinal endoscopy, it will be given broader scope in this series of DDW reports. As usual in recent years, data have been taken from the published abstracts, to avoid confusion; exceptions are only made for some of the new endoscopic antireflux treatments.
Nouns and Adjectives
Authors: Charles G. Roland
Journal: JAMA (1967)

Nouns designate "things" or abstractions. And adjectives limit nouns. This arrangement seems simple enough at the "see the red ball" level. However, when we consider the more complex subject of medical writing, we see that authors frequently misuse these parts of speech. The benign connective tissue new growth known as granuloma pyogenicum is usually a single rapidly-growing red-to-purplish small pedunculated raspberry-like lesion often varying in size from that of a pea to that of a cherry. This example contains several instances of overuse of modifiers, especially adjectives. The noun "growth" is modified by a long string of adjectives plus "tissue," a noun-used-as-an-adjective. And worse is the<i>single rapidly-growing red-to-purplish small pedunculated raspberry-like lesion</i>; in this breath-taking conglomeration we find that adjectives ("single," "red-to-purplish," "small," etc), a noun ("raspberry"), and an adverb-verbal combination ("rapidly-growing") all modify the noun "lesion." To correct this type of long-chain run is relatively easy. For example,
Authorship for Software
Authors: JAMES A. COWAN
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 June 1984Authorship for SoftwareJAMES A. COWAN, M.D.JAMES A. COWAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-100-6-914_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The decision to review microcomputer software related to internal medicine is timely (1). As the initial reviews show (2, 3), the quality of available software is variable, and there is presently no good way to catalog [for potential users] the content and quality of such software. Another problem relates to the authorship of programs with intellectual applications in internal medicine. Although not specifically addressing the issue of software, the questions raised in the same issue by Fotion and Conrad (4) are as applicable to software as to the traditional forms of medical literature.Should authors of software...References1. HUTH E. Microcomputer software for medical applications [Editorial]. Ann Intern Med. 1984;100:607. LinkGoogle Scholar2. WIGTON R. Review of Sci-Mate Universal Online Searcher and Sci-Mate Personal Data Manager. Ann Intern Med. 1984;100:621-2. LinkGoogle Scholar3. MILLER R. Review of Internist. Ann Intern Med. 1984;100:622-3. LinkGoogle Scholar4. FOTIONCONRAD NC. Authorship and other credits. Ann Intern Med. 1984;100:592-4. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1984Volume 100, Issue 6Page: 914-914 Issue Published: 1 June 1984 PDF DownloadLoading ...
Survival Comparison of the Ross Procedure and Mechanical Valve Replacement With Optimal Self-Management Anticoagulation Therapy
Authors: M. Mostafa Mokhles, Heinrich Körtke, Ulrich Stierle, Otto Wagner, Efstratios I. Charitos, Ad J.J.C. Bogers, Jan Gummert, Hans-Hinrich Sievers, Johanna J.M. Takkenberg
Journal: Circulation (2010)

It is suggested that in young adults the Ross procedure results in better late patient survival compared with mechanical prosthesis implantation. We performed a propensity score-matched study that assessed late survival in young adult patients after a Ross procedure versus that after mechanical aortic valve replacement with optimal self-management anticoagulation therapy.We selected 918 Ross patients and 406 mechanical valve patients 18 to 60 years of age without dissection, aneurysm, or mitral valve replacement who survived an elective procedure (1994 to 2008). With the use of propensity score matching, late survival was compared between the 2 groups. Two hundred fifty-three patients with a mechanical valve (mean follow-up, 6.3 years) could be propensity matched to a Ross patient (mean follow-up, 5.1 years). Mean age of the matched cohort was 47.3 years in the Ross procedure group and 48.0 years in the mechanical valve group (P=0.17); the ratio of male to female patients was 3.2 in the Ross procedure group and 2.7 in the mechanical valve group (P=0.46). Linearized all-cause mortality rate was 0.53% per patient-year in the Ross procedure group compared with 0.30% per patient-year in the mechanical valve group (matched hazard ratio, 1.86; 95% confidence interval, 0.58 to 5.91; P=0.32). Late survival was comparable to that of the general German population.In comparable patients, there is no late survival difference in the first postoperative decade between the Ross procedure and mechanical aortic valve implantation with optimal anticoagulation self-management. Survival in these selected young adult patients closely resembles that of the general population, possibly as a result of highly specialized anticoagulation self-management, better timing of surgery, and improved patient selection in recent years.
In Vivo Proliferation of Hepadnavirus-Infected Hepatocytes Induces Loss of Covalently Closed Circular DNA in Mice
Authors: Marc Lutgehetmann, Tassilo Volz, Anne Köpke, Tim Broja, Eike Tigges, Ansgar W. Lohse, Eberhard Fuchs, John M. Murray, Joerg Petersen, Maura Dandri
Journal: Hepatology (2010)

Chronic hepatitis B virus (HBV) infection is maintained by the presence of covalently closed circular DNA (cccDNA), the template of viral transcription and replication. In quiescent hepatocytes, cccDNA is a stable molecule that can persist throughout the hepatocyte lifespan. However, in chronic HBV infection, immunomediated cell injury and compensatory hepatocyte proliferation may favor cccDNA decline and selection of cccDNA-free cells. To investigate the impact of liver regeneration on cccDNA stability and activity in vivo, we used the urokinase-type plasminogen activator (uPA)/severe combined immunodeficiency (SCID) mouse model. Primary tupaia hepatocytes (PTHs) chronically infected with woolly monkey HBV (WM-HBV) were isolated from one highly viremic uPA/SCID chimeric mouse and transplanted into 20 uPA recipients. Expansion of transplanted PTHs and viral load changes were determined by real-time polymerase chain reaction and immunohistochemistry. Transplantation of WM-HBV infected hepatocytes led to an average of 3.8 PTH doublings within 80 days, 75% reduction of virion productivity (relaxed circular DNA/cccDNA), and lower expression levels of pregenomic RNA and hepatitis B core antigen. Remarkably, a median 2-log decline of cccDNA per cell determined during PTH proliferation was due to both dilution of the cccDNA pool among daughter cells and a 0.5-log loss of intrahepatic cccDNA loads ( P = 0.02). Intrahepatic viral DNA sequences persisting at the end of the study were mostly present as replicative intermediates and not as integrated virus. Conclusion: Cell division in the setting of liver regeneration and without administration of antiviral drugs induced strong destabilization of the cccDNA reservoir, resulting in cccDNA clearance in the great majority of chronically infected hepatocytes. (Hepatology 2010)
Perforation of the Aorta by Benign Esophageal Ulcer
Authors: George L. Nardi
Journal: New England Journal of Medicine (1953)

SPONTANEOUS perforation of the aorta by a benign esophageal ulcer has not been reported. As a surgical complication such a perforation has been described in 3 cases. Merindino and Emerson1 presented 2 cases in which aortoesophagogastric fistula followed resection for esophageal carcinoma. In 1, a misplaced suture passed through the aortic media. In the other, separation of the suture line resulted in an abscess followed by an aortoesophagogastric fistula with fatal hemorrhage ten months after operation.Malignant ulcers commonly invade the aorta, with fatal consequences. Knaut2 found a total of 34 cases in 1896. Carr and Hanford3 added 18 cases . . .
Local anaesthesia for fibreoptic bronchoscopy.
Authors: C Teale, M F Muers, S B Pearson
Journal: Thorax (1990)

Letters to the Editor 24 changes from another beta agonist to fenoterol as a result of the admission, and 46 changes in the other direction (most of the latter patients were switched to salbutamol).On the other hand, there were substantial changes for other classes of asthma drugs.In particular, as a result of the admission, the proportion of patients prescribed oral corticosteroids increased from 28% to 62%.