tbuckley/cabot-search huggingface dataset:
Ventilator-associated Pneumonia Caused by Potentially Drug-resistant Bacteria
Authors: JEAN-LOUIS TROUILLET, JEAN CHASTRE, ALBERT VUAGNAT, MARIE-LAURE JOLY-GUILLOU, DANIÈLE COMBAUX, MARIE-CHRISTINE DOMBRET, CLAUDE GIBERT
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

To determine risk factors for ventilator-associated pneumonia (VAP) caused by potentially drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and/or Stenotrophomonas maltophilia, 135 consecutive episodes of VAP observed in a single ICU over a 25-mo period were prospectively studied. For all patients, VAP was diagnosed based on results of bronchoscopic protected specimen brush (> or = 10(3) cfu/ml) and bronchoalveolar lavage (> or = 10(4) cfu/ml) specimens. Seventy-seven episodes were caused by "potentially resistant" bacteria and 58 episodes were caused by "other" organisms. According to logistic regression analysis, three variables among potential factors remained significant: duration of mechanical ventilation (MV) > or = 7 d (odds ratio [OR] = 6.0), prior antibiotic use (OR = 13.5), and prior use of broad-spectrum drugs (third-generation cephalosporin, fluoroquinolone, and/or imipenem) (OR = 4.1). Distribution of the 245 causative bacteria was analyzed according to four groups defined by prior duration of MV (< 7 or > or = 7 d) and prior use or lack of use (within 15 d) of antibiotics. Although 22 episodes of early-onset VAP in patients receiving no prior antibiotics were caused by antibiotic-susceptible bacteria, 84 episodes of late-onset VAP in patients receiving prior antibiotics were mainly caused by potentially resistant bacteria. Differences in the potential efficacies (ranging from 100% to 11%) against microorganisms of 15 antimicrobial regimens were studied according to classification into these four groups. These findings may provide a more rational basis for selecting the initial therapy of patients suspected of having VAP.
Management of Household Contacts of Leprosy Patients
Authors: GREGORY A. FILICE
Journal: Annals of Internal Medicine (1978)

We describe an approach to the management of household contacts of leprosy patients and the rationale on which it is based. Initially, all household contacts should be interviewed and examined for symptoms and signs consistent with leprosy and appropriate diagnostic measures taken. Contacts of untreated lepromatous and dimorphous (borderline) leprosy patients are at relatively high risk of disease and should be examined annually for at least 5 years. Dapsone prophylaxis has been shown to prevent secondary cases in contacts up to 25 years old and should be used in these and possibly in older persons. Insufficient data exist to support a recommendation for the use of BCG at present.
Patients' denial of disease may pose difficulty for achieving informed consent
Authors: A T Gavin
Journal: BMJ (2002)

EDITOR—The 1998 Data Protection Act and the General Medical Council's guidance on confidentiality have resulted in uncertainty about whether patient consent is necessary to fulfil statutory requirements for fair and lawful processing of personal data such as the identifiable health information collected by cancer registries. 1 2 A regulation is expected under the Health and Social Care Act 2001 for England and Wales, while a consultation process is ongoing in Scotland and Northern Ireland, where health is a devolved matter.

If we wish to retain population …
Evaluation of a Portable Insulin Infusion Pump for Outpatient Management of Brittle Diabetes
Authors: Abbas E Kitabchi, Joseph N Fisher, George A Burghen, Mark S Gaylord, Nancy M Blank
Journal: Diabetes Care (1979)

Three “brittle” diabetic patients were given constant subcutaneous insulin infusion with a portable battery-driven pump, and their plasma glucose and hemoglobin A1 were measured at frequent intervals during inpatient or outpatient periods. Mean plasma glucose decreased significantly in all inhospital patients and remained significantly less before pump therapy in two of three as outpatients during the 8–12 wk of follow-ups; however, complete normalization of glucose metabolism was not accomplished in any. All three demonstrated a progressive decline in hemoglobin A1 levels to normal or near-normal values. The need for long-term studies of open loop infusion systems in a research setting before their adaptation to routine care is emphasized.
DERMATOMYOSITIS AND CARCINOMA
Authors: SUZANNE ALEXANDER, LOUIS FORMAN
Journal: British Journal of Dermatology (1968)

SUMMARY. A man aged 56 complained of itching, and subsequently erythema of the face, orbits and other areas exposed to light. Six weeks later, he developed haematuria, and in the following week, a rapidly progressive weakness of the shoulder girdle muscles. He was found to have a rising titre of complement fixing antibody in his serum to an extract of his own bladder tumour. Immunofluorescent tests showed deposits of γ‐globulin around muscle bundles and in the upper cutis.
Use of efavirenz or atazanavir/ritonavir is associated with better clinical outcomes of HAART compared to other protease inhibitors: routine evidence from the Italian MASTER Cohort
Authors: M.C. Postorino, M. Prosperi, E. Quiros-Roldan, F. Maggiolo, S. Di Giambenedetto, A. Saracino, S. Costarelli, S. Lorenzotti, L. Sighinolfi, M. Di Pietro, C. Torti
Journal: Clinical Microbiology and Infection (2014)
ESSEX AND COLCHESTER HOSPITAL: CLINICAL OBSERVATIONS ON A CASE OF SUBACUTE PNEUMONIA OF THE UPPER LOBE OF THE RIGHT LUNG
Authors: P. M. Duncan
Journal: BMJ (1856)

Symptoms of Hepatisation oj the Tper L1 of the Right Lung; great Constituional Depression; atsbaequent Afection of the Upper Part of tlhe Left Lung; Recover?y.Histort.Mary Underwood, aged 23 years, a domestic servant, had, up to a fortnight ago, enjoyed good health.Her work had not been severe, she had been well fed and lodged, and had lived in a very healthy locality.The menstrual function was regular; she had had good spirits and strength, and there was no evidence of previous disease, hereditary taint, or of severe exposure to cold.Late in March 1855 she took cold, and had slight shiverings and the usual accompaniments of catarrh.A few days elapsed and the cold increased and became complicated by cough; she began to be languid and low spirited, and felt worse than her symptoms appeared to admit of.Her mistress gave her some simples; but day after day the cough in- creased, and although the expectoration was always clear and scanty, her physical power became singularly depressed.
AT-43 * MULTI-CENTRE, RANDOMIZED, DOUBLE-BLIND PHASE II STUDY COMPARING CEDIRANIB (AZD2171) PLUS GEFITINIB (IRESSA, ZD1839) WITH CEDIRANIB PLUS PLACEBO IN SUBJECTS WITH RECURRENT/PROGRESSIVE GLIOBLASTOMA
Authors: P. Mulholland, D. Krell, I. Khan, C. McBain, C. Patel, K. Wanek, K. Hopkins, S. Jeffries, R. Jager, P. Smith, Q. Liu, R. Stupp, I. Tomlinson
Journal: Neuro-Oncology (2014)

BACKGROUND: The vascular endothelial growth factor receptor (VEGFR) 2 tyrosine kinase inhibitor cediranib failed to improve outcome in recurrent glioblastoma in a randomized phase III trial (Batchelor et al.). One resistance mechanism for cediranib is through up-regulation of epidermal growth factor receptor (EGFR). This study was designed to test if the efficacy of cediranib is improved with the addition of gefitinib (an EGFR inhibitor). METHODS: We planned to 1:1 randomize 112 subjects with recurrent/progressive glioblastoma to cediranib + gefitinib (C + G) or cediranib + placebo (C + P) (NCT01310855), with PFS as the primary endpoint. Secondary end-points: OS, radiographic response rate, PFS rate at 6 months, 12 months survival rate, steroid use, time to deterioration of neurological status, safety and tolerability. Recruitment was discontinued early following AstraZeneca's suspension of the cediranib programme. RESULTS: 38 subjects were randomized, the interim results on 34 subjects (17 in each arm) are currently available. 24 male and 10 female. Mean age 54 (range 30-71). KPS ≤80 (35%), >80 (65%). The base-line characteristics for subjects in the 2 arms of the study were well balanced. Median PFS (95% CI) C + G 4.0 mo (2.7, *n/c), C + P 4.1 mo (2.0, 7.3); 6 month PFS C + G 40%, C + P 26%; 12 month PFS n/c; C + G vs C + P HR = 0.49, 95% CI (0.22, 1.11, p = 0.15). OS (mo): Median C + G 7.7 (95% CI 3.8, n/c), C + P 5.5 (95% CI 2.5, 7.3); 12 month n/c; C + G vs C + P HR = 0.359, 95% CI (0.12, 1.1; p = 0.076). No safety concerns. CONCLUSIONS: These interim results demonstrate no difference in PFS, however there was a trend (p = 0.08) for improved OS with the combination. The final results of the study for all 38 subjects will be available. *n/c not calculable due to limited data at time of analysis
Pathophysiologic and The Considarations of Curling's Ulcer In the Rat
Authors: Donald L. Foss, L. Stanton Stavney, Todao Haraguchi, Henry N. Harkins, Lloyd M. Nyhus
Journal: JAMA (1964)

UPPER GASTROINTESTINAL ULCERATION and bleeding are frequent complications of massive thermal burns.<sup>1</sup>Many theories of the pathogensis of this disease have been proposed since it was first described by Thomas Curling,<sup>2</sup>an English physician, in 1842. While the original explanation which implicated hypertrophy of Brunner's glands has been largely forgotten, several new explanations have been suggested involving sepsis,<sup>1,3,4</sup>toxins,<sup>5</sup>hemoconcentration,<sup>6</sup>gastric hypersecretion,<sup>7</sup>and, most recently, adrenocortical hyperactivity. This latter explanation is most widely accepted today. Gray and associates,<sup>8</sup>in 1951, were the first to postulate that in stress the anterior hypothalamus secreted a substance which stimulated the pituitary gland to release corticotropin which in turn caused the adrenals to release cortisone. In 1953, Bothe and Magee<sup>9</sup>reported a case wherein multiple gastrointestinal ulcers followed a thermal burn and suggested again that intense adrenal stimulation may be a factor in the etiology of
Lifestyle assessment: just asking makes a difference.
Authors: H A Skinner, B A Allen, M C McIntosh, W H Palmer
Journal: BMJ (1985)

A 10 minute assessment of 180 family practice patients showed that 11% indicated a problem with drinking alcohol, 20% with cigarette smoking, 36% with consumption of coffee or tea, and 3% with non-medical drug use, while 11% wanted to discuss their use of medications. Moreover, being asked questions resulted in a twofold or threefold increase in the patients' intentions of discussing such a problem with their doctor. Although there was good overall agreement in recognising a problem between the patient and doctor, in roughly 40% of instances where the patient indicated a problem the doctor was unaware of it. These patients tended to be young, well educated, and employed in professional occupations, and were on their first visit to the doctor. Such brief assessments of lifestyle should be routinely conducted in family practice for both case finding and prevention.
Pemetrexed Maintenance Therapy in Patients with Malignant Pleural Mesothelioma
Authors: Debby P.M. van den Bogaert, Ellen M. Pouw, Gerda van Wijhe, René M. Vernhout, Veerle F.M. Surmont, Henk C. Hoogsteden, Rob J. van Klaveren
Journal: Journal of Thoracic Oncology (2006)
Compliance becomes concordance
Authors: P. D. Mullen
Journal: BMJ (1997)

At long last the “compliance problem” may be getting a new name and, with it, a new view of the patient's role in the doctor-patient relationship. A report published this week by the Royal Pharmaceutical Society of Great Britain's working party on medicine taking recommends that “concordance” should replace the term “compliance.”1 Although substitute terms have been suggested and used previously without much impact, this eloquent analysis of the importance of a new concept by a highly visible and distinguished panel may hold the promise of change. Moreover, the panel recommends a £1.8m ($2.7m) research budget to support analysis of the problem and training of health professionals.

Compliance has long been criticised as denoting obedience-“following doctors' orders.” Although many researchers and practitioners have carefully avoided the term,2 the common alternatives-“adherence” or “cooperation”-do not take the user very far from compliance. One member of the working party, David Sackett, in his 1976 …
STUDIES ON THE NUTRITION OF HEMOPHILUS INFLUENZAE
Authors: Charles L. Hoagland, S. M. Ward, Helena Gilder, Robert E. Shank
Journal: The Journal of Experimental Medicine (1942)

The metabolic activity of H. influenzae can be followed quantitatively by measurement of the nitrite produced in a medium containing 0.2 per cent potassium or sodium nitrate. When X-factor, or hemin, and other specific substances required for the optimum growth of H. influenzae, are present in excess, the nitrite produced by this organism is quantitatively related to the concentration of V-factor, or total coenzyme. This quantitative relationship has been demonstrated for five strains of H. influenzae. It has been shown that various media, which in the past have been used for the determination of coenzyme by growth of H. influenzae, have in many instances been deficient in X-factor and that this substance rather than coenzyme has been the specific factor limiting growth. When 0.5 per cent blood is added to a basal proteose-peptone medium the specific requirements for optimum growth and metabolic activity of H. influenzae, other than coenzyme, are met, and a large number of specific biocatalysts and nutritive substances added to this medium are without effect in stimulating further growth. The foregoing studies have formed the basis for a quantitative method for the determination of total coenzyme in blood and tissue. This method is being described elsewhere.
Procedures in practice. Liver biopsy.
Authors: J R Walters, A Paton
Journal: BMJ (1980)

LIVER BIOPSYPercutaneous needle biopsy of the liver is a simple bedside procedure that provides a core of tissue for laboratory investigation and so is valuable in many types of liver disease and systemic illness.Several different instru- ments are available, each with its own technique.The general principles apply to all, but our discussion of procedure is confined to the disposable Tru-cut needle.Liver biopsy may also be carried out at laparotomy and laparoscopy and transvenously, but we do not propose to discuss these methods.
PTH-123 The Effectiveness of an Alcohol Liaison Nurse Service at Reducing Future Alcohol Related Attendances to a County’S Accident &amp; Emergency Departments
Authors: E Davies, M Vardy, S Prabhakaran, I Ahmad, K Cobain, D Aldulaimi
Journal: Gut (2013)

<h3>Introduction</h3> Worcestershire Acute NHS Trust has an Alcohol Liaison Nurse Service (ALN) based in two Emergency Departments; this provides assessments including screening, brief interventions and referrals into treatment. They function during office hours only. We wanted to evaluate how effective these roles are in reducing the trend in future alcohol related attendances. <h3>Methods</h3> Patients were identified by either non-specialist clinicians or the ALN, where alcohol had been a factor in their attendance at A&amp;E, Emergency Decisions Unit (EDU) or Medical Assessment Unit (MAU). They were seen by the ALN who delivered a Brief Intervention (BI). Their attendances to A+E were compared for the period 12 months before and after the brief intervention to identify whether their attendance patterns varied. The comparison was carried out by visual audit of patient records on Patient First A+E records system. <h3>Results</h3> Since the inception of the ALN service, year on year the figures show a reduced number of re-attendance. Since the inception of the ALN service 1688 patients received a brief intervention, the number of attendances 12 months pre BI were 3814, with 2155 in the 12 months following BI. This shows a reduction of 43%. Based on National Indicators on average, each alcohol related A&amp;E attendance costs £80 (NHS evidence ID:10/0021 2012), this suggests a Trust saving of £132,720.00 over a four year period. <h3>Conclusion</h3> These results confirm the efficacy of BI delivered by an ALN service in district general hospital based emergency departments. As a result of these findings other departments within our Trust are developing identification of Alcohol use disorders and Brief Interventions. <h3>Disclosure of Interest</h3> None Declared.
Effect of glyceryl trinitrate on the sphincter of Oddi motility and baseline pressure.
Authors: M Staritz, T Poralla, K Ewe, K H Meyer zum Buschenfelde
Journal: Gut (1985)

It is widely accepted that glyceryl trinitrate (GTN) effectively dilates the smooth muscles of blood vessels. A similar effect has been postulated on the smooth muscles in the gastrointestinal tract. In this study the motility of the sphincter of Oddi and the common bile duct pressure as determined by endoscopic manometry was investigated in nine patients before and after sublingual application of 1.2 mg GTN (nitro group). Eight untreated patients served as controls. Three minutes after application of GTN the papillary contraction amplitude decreased from 69.3 +/- 4.3 mmHg to 36.8 +/- 5.1 mmHg (p less than 0.005) and the papillary baseline pressure fell from 8.9 +/- 0.6 mmHg to 2.9 +/- 0.2 mmHg (p less than 0.005) respectively. The contraction frequency in the nitro group and all motility parameters in the control group remained unchanged. These results indicate that GTN does not influence the sphincter of Oddi motility, but it relaxes very effectively the sphincter of Oddi muscle. Thus, GTN should be taken into account for the treatment of biliary colic. In our endoscopic unit GTN proved to be useful as premedication for endoscopic examinations, particularly for the removal of small and medium size common bile duct stones through the intact papilla.
Abstract 4318: A constitutively active NF-κB2 mutant drives plasma cell tumor development in mice
Authors: Liqun Yang, Brian McCarthy, Jane Ding, Han-Fei Ding
Journal: Cancer Research (2011)

Abstract NF-κB2 is a member of the NF-κB family of transcription factors. Genetic mutations that lead to the constitutive action of NF-κB2 signaling occur in approximately 20% human multiple myeloma, a common malignant tumor of plasma cells. Some of the mutations occur in the NF-κB2 gene, leading to the generation of C-terminally truncated NF-κB2 mutants that are constitutively active transcription factors. We investigated the pathogenic role of NF-κB2 mutation in the development of plasma cell tumors using a transgenic mouse line with targeted expression of a tumor-derived NF-κB2 mutant, p80HT, in lymphocytes. The mutant mice developed predominantly B cell-lineage lymphomas, with half of them being plasma cell tumors and producing monoclonal Ig. Some of the plasma cell tumors display key features of human multiple myeloma, including a marked increase in bone marrow plasma cell content, osteolytic bone lesions and/or diffuse osteoporosis. Gene expression profiling of splenic B cells from monoclonal Ig-producing p80HT transgenic mice and their wild-type littermates revealed 740 genes that were differentially expressed (575 upregulated and 165 downregulated) in p80HT B cells versus wild-type B cells. Among the genes selectively upregulated in p80HT B cells are those known to be relevant to human multiple myeloma pathogenesis, including cyclin D1, cyclin D2, CD27, CD80, IL10, and survivin. The upregulation of cyclin D1, IL10 and survivin was confirmed by immunoblotting and/or real-time PCR. Chromatin immunoprecipitation and quantitative PCR assays demonstrated direct interaction of p80HT with the surviving gene promoter in vivo. These findings provide direct evidence for a causal role of NF-κB2 mutation in the pathogenesis of plasma cell tumors in mice and suggest a molecular mechanism underlying the tumorigenic activity of NF-κB2 mutation. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4318. doi:10.1158/1538-7445.AM2011-4318
Aziz Mahmood Shukri
Authors: M I Aldoori, Salwa Shukri
Journal: BMJ (2005)

Pioneer of cervical screeningBetty Macgregor was the cytologist who made northeast Scotland the United Kingdom's first centre for systematic cervical screening.It was because of her published results that screening was taken up throughout the UK.She published important papers on many aspects of screening, including cervical cytology, the epidemiology of cervical cancer, improving the prognosis, cost effectiveness, cervical abnormalities in various subgroups of women, and the problems of false negative results.Her booklet Taking Uterine Cervical Smears (1982), published by the British Society of Clinical Cytology, sold 25 000 copies.Betty McPherson was born in Glasgow in 1920.When she was 7 her mother died from tuberculosis.Betty studied medicine at Glasgow University during the second world war, qualifying in 1943.She met Alastair Macgregor there, and they married a year later.She did her house jobs at Glasgow Royal Infirmary and Western General Hospital.During the next few years she raised their four children and worked part time in child welfare clinics.In 1958