tbuckley/cabot-search huggingface dataset:
Effect of Bronchoalveolar Lavage–Directed Therapy on Pseudomonas aeruginosa Infection and Structural Lung Injury in Children With Cystic Fibrosis
Authors: Claire E Wainwright, Suzanna Vidmar, David S Armstrong, Catherine A Byrnes, John B Carlin, Joyce Cheney, Peter J Cooper, Keith Grimwood, Marj Moodie, Colin F Robertson, Harm A Tiddens
Journal: JAMA (2011)

Early pulmonary infection in children with cystic fibrosis leads to increased morbidity and mortality. Despite wide use of oropharyngeal cultures to identify pulmonary infection, concerns remain over their diagnostic accuracy. While bronchoalveolar lavage (BAL) is an alternative diagnostic tool, evidence for its clinical benefit is lacking.To determine if BAL-directed therapy for pulmonary exacerbations during the first 5 years of life provides better outcomes than current standard practice relying on clinical features and oropharyngeal cultures.The Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) randomized controlled trial, recruiting infants diagnosed with cystic fibrosis through newborn screening programs in 8 Australasian cystic fibrosis centers. Recruitment occurred between June 1, 1999, and April 30, 2005, with the study ending on December 31, 2009.BAL-directed (n = 84) or standard (n = 86) therapy until age 5 years. The BAL-directed therapy group underwent BAL before age 6 months when well, when hospitalized for pulmonary exacerbations, if Pseudomonas aeruginosa was detected in oropharyngeal specimens, and after P. aeruginosa eradication therapy. Treatment was prescribed according to BAL or oropharyngeal culture results.Primary outcomes at age 5 years were prevalence of P. aeruginosa on BAL cultures and total cystic fibrosis computed tomography (CF-CT) score (as a percentage of the maximum score) on high-resolution chest CT scan.Of 267 infants diagnosed with cystic fibrosis following newborn screening, 170 were enrolled and randomized, and 157 completed the study. At age 5 years, 8 of 79 children (10%) in the BAL-directed therapy group and 9 of 76 (12%) in the standard therapy group had P. aeruginosa in final BAL cultures (risk difference, -1.7% [95% confidence interval, -11.6% to 8.1%]; P = .73). Mean total CF-CT scores for the BAL-directed therapy and standard therapy groups were 3.0% and 2.8%, respectively (mean difference, 0.19% [95% confidence interval, -0.94% to 1.33%]; P = .74).Among infants diagnosed with cystic fibrosis, BAL-directed therapy did not result in a lower prevalence of P. aeruginosa infection or lower total CF-CT score when compared with standard therapy at age 5 years.anzctr.org.au Identifier: ACTRN12605000665639.
Reduced Macrophages IL-12 Production After Stimulation By BCG/INF-Gamma Suggestive Of Impaired INF-Gamma Pathway Signalling In a Child With Disseminated Atypical Mycobacterial Infection and History Of Chemotherapy For Langerhans Cell Histiocytosis
Authors: Eliska Furlong, Richard K.S. Loh, Grace Wooi Kee Gong, Andrew McLean-Tooke
Journal: Journal of Allergy and Clinical Immunology (2014)
Selecting Patients for Insect Venom Immunotherapy
Authors: Peter-Willem G. van der Linden
Journal: Annals of Internal Medicine (1993)

Letters1 September 1993Selecting Patients for Insect Venom ImmunotherapyPeter-Willem G. van der Linden, MD, C. Erik Hack, MD, and Albert Struyvenberg, MDPeter-Willem G. van der Linden, MDSearch for more papers by this author, C. Erik Hack, MDSearch for more papers by this author, and Albert Struyvenberg, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-5-199309010-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The natural history of allergy to fire ants is different from that to yellow jackets and honey bees. The epidemiologic questions in the second part of Dr. Jung's letter have been partly answered in retrospective studies involving field stings in large groups of patients [1-3]. We previously addressed some of those questions in a prospective study involving sting challenges [4]. Preliminary data of a new prospective study involving more than 300 sting-challenged patients indicate that none of the current epidemiologic indices unequivocally relates to the clinical reaction after a sting challenge. We agree that more research is necessary.... References1. Lockey RF, Turkeltaub PC, Baird-Warren IA, Olive CA, Olive ES, Peppe BC, et al. The Hymenoptera venom study I, 1979-1982: demographics and history-sting data. J Allergy Clin Immunol. 1988; 82: 370-81. Google Scholar2. Reisman RE. Natural history of insect-sting allergy: relationship of severity of symptoms of initial sting anaphylaxis to re-sting reactions. J Allergy Clin Immunol. 1992; 90:335-9. Google Scholar3. Golden DB, Marsh DG, Kagey-Sobotka A, Freidhoff L, Szklo M, Valentine MD, et al. Epidemiology of insect venom sensitivity. JAMA. 1989; 262:240-4. Google Scholar4. Kampelmacher MJ, van der Zwan JC. Provocation test with a living insect as a diagnostic tool for systemic reactions to bee or wasp venom: a prospective study with emphasis on clinical aspects. Clin Allergy. 1987; 17:317-27. Google Scholar5. Waldhausen E, Keser G, Marquardt B. Der anaphylaktische shock. Anaesthesist. 1987; 36:150-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1993Volume 119, Issue 5Page: 437-439KeywordsAllergy and immunologyAnaphylaxisEpinephrineForecastingProspective studiesQuestionnairesRetrospective studiesSkin testsSpecificityVenoms ePublished: 15 August 2000 Issue Published: 1 September 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Interaural Level Difference-Dependent Gain Control and Synaptic Scaling Underlying Binaural Computation
Authors: Xiaorui R. Xiong, Feixue Liang, Haifu Li, Lukas Mesik, Ke K. Zhang, Daniel B. Polley, Huizhong W. Tao, Zhongju Xiao, Li I. Zhang
Journal: Neuron (2013)
Methotrexate Therapy for Psoriasis
Authors: William A. Burke
Journal: JAMA (1988)

To the Editor.—  Drs Shupack and Webster 1 recently reported two patients with pancytopenia following low-dose methotrexate therapy for psoriasis. The authors state that because there is as yet no clear explanation for pancytopenia due to low-dose methotrexate, it is difficult to make authoritative recommendations for its prevention. However, the authors fail to mention whether a folate level was obtained on these patients to ensure that folic acid deficiency was not a cause of their pancytopenia. We recently saw a patient with refractory psoriasis who developed a similar case of pancytopenia several weeks after beginning oral methotrexate therapy at 15 mg/wk.  Report of Cases.—Case 1.—  A 53-year-old man had been treated in the past with up to 50 mg of intramuscular methotrexate per week without complications. Renal and liver parameters were normal, and a liver biopsy revealed only grade I (mild portal inflammation) changes. The red blood cell
Fluctuations of HIV load in semen of HIV positive patients with newly acquired sexually transmitted diseases
Authors: M C Atkins, E M Carlin, V C Emery, P D Griffiths, F Boag
Journal: BMJ (1996)

Most HIV infections worldwide are acquired sexually, yet most coital episodes involving an infected partner do not result in acquisition of HIV. Acquisition of HIV must depend on both the volume of secretions transferred from the infected partner (donor) and the concentration of HIV present in the secretions. However, exposure alone to such a virus inoculum is clearly insufficient to ensure transmission. The coexistence of other sexually transmitted diseases in either the recipient or donor could potentially increase the risk of transmission by causing genital ulcers or by releasing inflammatory cytokines which increase HIV replication.1

We measured the HIV load in the semen and blood of HIV infected patients presenting with acute sexually transmitted diseases to determine if viral load …
COLON AS SITE OF FOCAL INFECTION IN CHRONIC PYELITIS, CYSTITIS AND PROSTATITIS
Authors: F. H. REDEWILL
Journal: JAMA (1930)

On the subjects of intestinal flora, intestinal stasis, lazy colon and intestinal autointoxication with its ramifications, the literature is naturally enormous. Also the vast number of bacteria, not only species but genera that may be present in the so-called intestinal flora, are superseded in numbers only by the many scientific and pseudoscientific articles written about these enteric organisms. Commendable work is being done in isolating these bacteria, and as in astronomy experts with improved telescopes, specializing in one corner of a constellation, are ever discovering new stars, so bacteriologic specialists, confining their time to the study of one class of organisms, by special intricate methods of culture are continually isolating more species of the particular genus. For instance, Bauer,<sup>1</sup>working with Meyer in an adjacent laboratory to us at Hooper Foundation, isolated the seventh tetanus bacillus from human feces. With scores of bacteriologists specializing on the various genera, making
F-18 FDG PET/CT Imaging of Metastatic Extrarenal Wilms Tumor Arising in the Inguinal Canal
Authors: Young Jin Jeong, Myung-Hee Sohn, Seok Tae Lim, Dong Wook Kim, Hwan-Jeong Jeong, Chang-Yeol Yim
Journal: Clinical Nuclear Medicine (2011)

Extrarenal Wilms tumor (ERWT) is rare, and has been reported sporadically in the literatures. ERWT can arise anywhere from the renal bed to the testes; reported locations of ERWTs include the retroperitoneum, inguinal canal, endocervix, uterus, epididymis, and sigmoid mesocolon. We report the F-18 FDG PET/CT imaging findings of an ERWT arising from the inguinal canal in a 9-year-old boy. F-18 FDG accumulated in the metastatic lesions of the lung and mediastinal lymph nodes, as well as the primary ERWT. After chemotherapy, a follow-up PET/CT showed complete metabolic remission. F-18 FDG PET/CT is useful in detecting primary and metastatic ERWTs and in evaluating treatment response.
Relation between infection with Helicobacter pylori and living conditions in childhood: evidence for person to person transmission in early life
Authors: P M Webb, T Knight, S Greaves, A Wilson, D G Newell, J Elder, D Forman
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Abstract Objectives</b> : To relate the prevalence of infection with Helicobacter pylori in adults to their living conditions in childhood to indentify risk factors for infection. <b>Design</b> : Prevalence study of IgG antibodies to H pylori (&gt;10 μg IgG/ml, determined by enzyme linked immunosorbent assay (ELISA)) and reported living conditions and other socioeconomic factors in childhood. <b>Setting</b> : Three factories in Stoke on Trent. <b>Subjects</b> : 471 male volunteers aged 18 to 65 years. <b>Main outcome measures</b> : Seroprevalence and variables in childhood. <b>Results</b> : Seroprevalence of H pylori increased with age (22/74 (29.7%) at &lt;30 years v 29/46 (63%) at 55-65 years; P&lt;0.001 for trend) and was related to manual occupation (14/65 (21.5%) for non-manual v 162/406 (39.9%) for manual; P=0.003). After data were adjusted for age and occupation subjects from large families, whose childhood homes were crowded or who regularly shared a bed in childhood, were significantly more likely to be seropositive (adjusted odds ratio (95% confidence interval) 2.15 (1.41 to 3.30) for crowding and 2.13 (1.38 to 3.30) for sharing a bed), but there was no relation with possession of a bathroom, inside toilet, refrigerator, or household pets in childhood. <b>Conclusions</b> : Close person to person contact in childhood is an important determinant of seroprevalence of H pylori in adulthood, suggesting that the infection is transmitted directly from one person to another and may be commonly acquired in early life.
Intra-arterial calcium stimulation test for detection of insulinomas: detection rate, responses of pancreatic peptides, and its relationship to differentiation of tumor cells
Authors: Justin G.S Won, Hsiao-Shan Tseng, An-Hang Yang, Kam-Tsun Tang, Tjin-Shing Jap, Ching-Fai Kwok, Chen Hsen Lee, Hong-Da Lin
Journal: Metabolism (2003)
Transposon mutagenesis identifies genetic drivers of BrafV600E melanoma
Authors: Michael B Mann, Michael A Black, Devin J Jones, Jerrold M Ward, Christopher Chin Kuan Yew, Justin Y Newberg, Adam J Dupuy, Alistair G Rust, Marcus W Bosenberg, Martin McMahon, Cristin G Print, Neal G Copeland, Nancy A Jenkins
Journal: Nature Genetics (2015)
Postgraduate Medical Education
Authors: Thomas H. Sternberg
Journal: JAMA (1963)

To the Editor:  —Many medical educators have viewed the encroachment on postgraduate medical education of the pharmaceutical houses and, more lately, the proposal of a so-called  without  contained in the Dryer Report, with a great deal of concern. It does not seem proper that the pharmaceutical houses should be active in the promotion and offering of postgraduate medical courses, since the absolute prerequisite of any kind of education is complete objectivity. Insofar as the university without walls is concerned, most of the recommendations for development and implementation of a national program are excellent. However, the control of a national postgraduate medical organization must rest with the physician through his official organizations, and the financing of such a program by commercial houses which are medically oriented, or by a grant-in-aid from the Department of Health, Education and Welfare, could very well lead to the loss of such control. I
ERGOTAMINE TARTRATE IN PRURITUS
Authors: S. S. Lichtman
Journal: JAMA (1933)

To the Editor:  —InThe Journal, February 4, page 328, Drs. Ernstene and Banks record their experience with ergotamine tartrate as an antipruritic agent and refer to my clinical note (The Journal, Nov. 14, 1931, p. 1563) on the subject. The lack of uniform results with this drug in the treatment of pruritus in urticaria and other dermatoses has already been recognized.  It has been pointed out that ergotamine tartrate exerts its depressant action on the sympathetic nervous system, the tonus of which is heightened. The prompt relief from pruritus obtained in patients with jaundice and azotemia suggested the existence of a sympathicotonia in these individuals. The metabolic changes in the skin in these conditions provokes the increased nervous irritability.  In my experience to date, and in that of physicians and clinics which has been brought to my attention, the claim for the drug has been confirmed. In about 75
SCHOOL MEDICAL INSPECTION IN CHICAGO.
Authors: WILLIAM D. BYRNE
Journal: JAMA (1901)

That school medical inspection is at last receiving the merited attention of enlightened school boards and health officers in our larger cities argues well for its future, and adds additional luster to the fame of these medical pioneers who first introduced and championed its cause in humanity's interests. This great aid to prophylaxis was foreshadowed in those admirable German laws which went into effect July 14, 1884, by the adoption of the Prussian Circular to the Royal Governors of Provinces, which concerns the closing of schools in the event of the occurrence of infectious diseases. The diseases and the laws pertaining to them are classified as follows: —a. Cholera, dysentery, measles, rubella, scarlet fever, diphtheria, smallpox, typus, relapsing fever, cerebrospinal meningitis; b, typhoid fever, contagious inflammation of the eyes, itch and pertussis (while spasmodic). Children suffering from these diseases are to be excluded from school. Healthy children living in same
Prevalence of antiphospholipid antibodies in patients with fetal loss.
Authors: H J Out, H W Bruinse, G C Christiaens, M van Vliet, J F Meilof, P G de Groot, R J Smeenk, R H Derksen
Journal: Annals of the Rheumatic Diseases (1991)

The prevalence of antiphospholipid and antinuclear antibodies in 102 patients with at least three unexplained miscarriages before a gestational age of 12 weeks, or at least one intrauterine fetal death after 12 weeks, was investigated and compared with the prevalence in 102 normal pregnant controls. Six patients had a history of thrombosis and six had 9lupus-like9 disease. Twenty one patients had anticardiolipin antibodies compared with 10 controls. Serum samples of nine patients and one control contained antinuclear antibodies. The lupus anticoagulant was present in the plasma of five patients with anticardiolipin antibodies. The influence of patient selection on the results was illustrated by the finding that antiphospholipid antibodies and antinuclear antibodies were mainly detected in patients with lupus-like disease or a history of thrombosis. When these patients were excluded there was no significant difference in the prevalence of anticardiolipin and antinuclear antibodies between patients and controls. Therefore, in the absence of lupus-like disease or a history of thrombosis, screening for antiphospholipid antibodies in patients with adverse pregnancy outcomes seems not to be indicated.
REPORT ON THREE CASES OF PARALYSIS OF THE SUPERIOR RECTUS, AND SOME REMARKS.
Authors: E. J. BERNSTEIN
Journal: JAMA (1895)

One requires considerable temerity to ask the time and attention of a body of specialists for any remarks on this subject without giving anything new, but I seek my excuse in this, that I wish to record two simple and uncomplicated cases of paralysis of the superior rectus, and possibly a third. I say, possibly a third, because from the remedy employed to correct it, I have some doubts whether this was really the case. We know from Mauthner, Graefe-Saemisch and such authors that isolated paralysis of this muscle is one of the rarest affections which disturb ocular equilibrium. It was with a great deal of ignorance but much assurance that I saw the first case, which is the one I call the doubtful one, and following the rule that rare cases occur in groups, saw the two soon after, which were undeniably affections of this sort. Is, then, this
Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Injections
Authors: Ravi Retnakaran, J. Hans DeVries, Helene Hanaire-Broutin, Robert J. Heine, Vincent Melki, Bernard Zinman
Journal: Diabetes Care (2005)

With either continuous subcutaneous insulin infusion (CSII) or multiple daily insulin injection (MDII) therapy, the optimal meal insulin is a rapid-acting analog (lispro or aspart). To date, the efficacy of CSII versus MDII therapy has been evaluated in a limited number of randomized controlled trials in which rapid-acting analogs were used for both regimens. In this context, we recently conducted a pooled analysis (1) using raw trial data from three such studies undertaken in adults with type 1 diabetes (2–4). This analysis suggested that CSII is associated with better glycemic control, particularly in those patients with poor initial control. Indeed, the relative benefit of CSII over …
Chronic ulcer of the leg: clinical history.
Authors: M J Callam, D R Harper, J J Dale, C V Ruckley
Journal: BMJ (1987)

Six hundred patients with chronic leg ulcers were studied by detailed history and examination as part of a population survey. In 22% ulceration began before the age of 40, and in this group the sex incidence was equal. Over age 40 there was an increasing preponderance of women. Ulcers were significantly more common in the left leg in women but not in men. The site of 26% of ulcers did not include the classical medial goiter area. The median duration of the ulceration at the time of the survey was nine months and 20% had not healed in over two years. The great majority of patients had had recurrence, 66% having had episodes of ulceration for more than five years. Healing of ulcers is a serious problem, but preventing recurrence is the greater challenge.
Better access to general practice is linked to improved quality of care, finds analysis
Authors: Z. Kmietowicz
Journal: BMJ (2012)

General practices could improve the quality of their care by taking heed of patient satisfaction surveys and clinical effectiveness outcomes together and comparing themselves with the best performers, a health services think tank has said.

An analysis by the King’s Fund looked at the association between the clinical quality of services provided in general practice and the experience of patients using those services by analysing data from the Quality and Outcomes Framework (QOF) and surveys of patients for 2010-11 in all 8042 …
What's the evidence that NICE guidance has been implemented?: Analysis is subject to confounding
Authors: Colin Tilley, Fay Crawford, Jan Clarkson, Nigel Pitts, Mary McCann
Journal: BMJ (2005)

EDITOR—Sheldon et al show a gradual reduction in the number of wisdom teeth extractions, which they propose indicates a diffusion of guidance from the National Institute for Clinical Excellence (NICE) into clinical dental practice.1 The first figure in our response on bmj.com shows the annual number of courses of treatment that included at least one extraction of the third molar in the General Dental Service in Scotland.2 This figure corresponds to the presentation of data in figure 1 of Sheldon et al's paper.1

The raw number of claims per …
Pinpointing the cause of mucus production
Authors: Terra Ziporyn
Journal: JAMA (1981)

Bronchorrhea has tormented millions of patients with allergies, asthma, and associated diseases. Now, a team of researchers at the National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, Md, thinks it may at last have found the culprit. According to Michael Kaliner, MD, director of the Allergic Diseases Center at the NIAID, recent experiments on tissue cultures of human lung indicate that the agents of mucus release in these tissues may be the hydroxyeicosatetraenoic acids (HETEs), which are metabolic by-products of arachidonic acid, a major precursor of prostaglandins. Kaliner and colleagues Zvi Marom, MD, James H. Shelhamer, MD, and Frank Sun, PhD, studied the relationship between prostaglandins, arachidonic acid, and mucus secretion by measuring the quantity of<sup>3</sup>H-glucosamine-labeled mucus glycoproteins released when human bronchial tissue cultures were subjected to various stimuli. They did these studies because earlier findings had indicated that levels of all prostaglandins increased in human lung
NOVEL METHOD FOR REAL-TIME CARDIAC CT AND CORONARY ANGIOGRAPHY IMAGE REGISTRATION AS A TOOL FOR PERCUTANEOUS CORONARY INTERVENTION OF CHRONIC TOTAL OCCLUSIONS
Authors: Yu Nomura, Kazuma Oyama, Koki Shishido, Yoichi Imori, Yumiko Osaka, Futoshi Yamanaka, Nobuhiro Okamura, Shingo Mizuno, Hidetaka Suenaga, Masato Murakami, Junya Matsumi, Satoshi Takeshita, Shigeru Saito
Journal: Journal of the American College of Cardiology (2012)
Legislation for Sudden Infant Death Syndrome
Authors: Clara Raven
Journal: JAMA (1975)

To the Editor.—  To comment on Dr. Lewak's letter (230:671, 1974), I find that California is not the first state to introduce legislation for the management of the sudden infant death syndrome (SIDS). Washington has provided for autopsies on children under 3 years of age since 1963 (RCW 68.08.100). Massachusetts was the first to budget state funding for autopsies on children under 2 years of age (Chapter 1072 of the Acts of 1973). In Michigan, Rep James Damman introduced HB 5505 in 1973 to provide for payment for autopsies on SIDS infants and counseling of parents.  The National Foundation for Sudden Infant Deaths, Inc., which Dr. Lewak represents in Northern California, has publicized several instances of police mismanagement of SIDS, such as that noted in Elsinore. Such occurrences are rare and hopefully not frequent in the context of about 15,000 SIDS cases annually. Realistically, however, if Dr. Lewak should happen