tbuckley/cabot-search huggingface dataset:
Acquired immunodeficiency without evidence of HIV infection: national retrospective survey
Authors: A McNulty, J M Kaldor, A M McDonald, K Baumgart, D A Cooper
Journal: BMJ (1994)

in Glasgow the average prevalence was 27-3%, but the prevalence ranged from 7'6% in the postcode district of Easterhouse (G34) to 65-9% in Hyndland and Hillhead (G12).Table II shows the prevalence of breast feeding, according to information obtained from Guthrie cards, and, when available, from SMR2 forms, for all maternity units in Scotland with more than 1500 deliveries a year.
Risk Estimation with Epidemiologic Data When Response Attenuates at High-Exposure Levels
Authors: Kyle Steenland, Ryan Seals, Mitch Klein, Jennifer Jinot, Henry D. Kahn
Journal: Environmental Health Perspectives (2011)

In occupational studies, which are commonly used for risk assessment for environmental settings, estimated exposure-response relationships often attenuate at high exposures. Relative risk (RR) models with transformed (e.g., log- or square root-transformed) exposures can provide a good fit to such data, but resulting exposure-response curves that are supralinear in the low-dose region may overestimate low-dose risks. Conversely, a model of untransformed (linear) exposure may underestimate risks attributable to exposures in the low-dose region.We examined several models, seeking simple parametric models that fit attenuating exposure-response data well. We have illustrated the use of both log-linear and linear RR models using cohort study data on breast cancer and exposure to ethylene oxide.Linear RR models fit the data better than do corresponding log-linear models. Among linear RR models, linear (untransformed), log-transformed, square root-transformed, linear-exponential, and two-piece linear exposure models all fit the data reasonably well. However, the slopes of the predicted exposure-response relations were very different in the low-exposure range, which resulted in different estimates of the exposure concentration associated with a 1% lifetime excess risk (0.0400, 0.00005, 0.0016, 0.0113, and 0.0100 ppm, respectively). The linear (in exposure) model underestimated the categorical exposure-response in the low-dose region, whereas log-transformed and square root-transformed exposure models overestimated it.Although a number of models may fit attenuating data well, models that assume linear or nearly linear exposure-response relations in the low-dose region of interest may be preferred by risk assessors, because they do not depend on the choice of a point of departure for linear low-dose extrapolation and are relatively easy to interpret.
The therapeutic potential of human multipotent mesenchymal stromal cells combined with pharmacologically active microcarriers transplanted in hemi-parkinsonian rats
Authors: Gaëtan J.-R. Delcroix, Elisa Garbayo, Laurence Sindji, Olivier Thomas, Claire Vanpouille-Box, Paul C. Schiller, Claudia N. Montero-Menei
Journal: Biomaterials (2010)
Abstract P4-16-07: Selective use of post-mastectomy radiation therapy in the neoadjuvant setting
Authors: Peled A Warren, F Wang, AC Stover, HS Rugo, ME Melisko, JW Park, M Alvarado, CA Ewing, LJ Esserman, B Fowble, ES Hwang
Journal: Cancer Research (2012)

Abstract Background: Neoadjuvant chemotherapy, once reserved for locally advanced breast cancer, has become more common in Stage II disease. While one of its proven benefits is an increase in the frequency of breast conserving surgery, many women will undergo mastectomy despite an excellent clinical response. Indications for post-mastectomy radiation (PMRT) following neoadjuvant therapy are not well defined. Some studies have suggested that certain subgroups of women (young age, triple negative disease) with negative nodes or 1–3 positive nodes after chemotherapy have a significant risk of local-regional failure without PMRT. We conducted a single-institution retrospective study of women undergoing neoadjuvant chemotherapy and mastectomy without PMRT to assess clinical outcomes among this cohort. Methods: 101 women with initial stage I-III disease (20% stage I, 72% stage II, 8% stage III) received neoadjuvant chemotherapy (doxorubicin-based +/− taxane) followed by mastectomy without PMRT between 2005 and 2011. Mean age was 49 years (range 22–81 years). 16% were BRCA+. 66 patients (65%) had clinically negative axillary nodes at presentation, 34% had N1 disease and 1% had N2 disease. Subtype by IHC was 61% luminal A, 11% luminal B (ER+, Her2+), 20% triple negative and 8% ER−, Her2+. At the time of surgery, 81% were node negative and 19% had 1–3 positive nodes. Pathologic complete response (pCR) (breast + axilla) occurred in 28%. Median follow-up was 34 months (range 5.5–84.5 months). Results: There were 2 (2%) local-regional failures (1 axillary recurrence at 52 months after mastectomy and 1 chest wall recurrence at 10 months). Both of these recurrences were in patients with negative nodes and luminal A tumors; patients had 2.2 and 2.5 cm of residual invasive cancer, respectively, and negative margins at mastectomy. There were no local-regional failures in women with triple negative cancers, those with 1–3 positive nodes, or patients younger than 40. Additionally, there were no failures in women with a pCR, including those with initial stage IIIA-B disease. Conclusions: Among carefully selected patients fulfilling low risk criteria for local-regional recurrence, PMRT following neoadjuvant chemotherapy may be omitted without compromising local-regional control. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-16-07.
Risk assessment adjusted for gestational age in maternal serum screening for Down's syndrome.
Authors: J Gardosi, M Mongelli
Journal: BMJ (1993)

OBJECTIVE--To investigate the relation between errors in calculation of gestational age and assessment of risk of Down9s syndrome and to analyse the implications for screening programmes. DESIGN--Retrospective analysis of dating of gestational age by menstrual history v ultrasound scan. Computer program with maternal age and concentrations of alpha fetoprotein and free beta human chorionic gonadotrophin to calculate risk for a range of expected dates of delivery. Computer simulated prospective application of new screening programme. SETTING--Teaching hospitals in Nottingham. SUBJECTS--31,561 women with singleton pregnancies with gestational age based on routine ultrasound scan. Computer simulation of 20,000 women in three age ranges (up to 37; up to 40; all). MAIN OUTCOME MEASURES--Distribution of error between gestational age based on ultrasound scan v menstrual history. Proportion of women in the population who require precise dating of pregnancy; proportion of women who require amniocentesis. RESULTS--With gestational age derived from ultrasound scan as reference the 95% confidence interval for gestational age by menstrual history was -27 to +9 days. A screening programme for Down9s syndrome for women up to age 40 would yield a low risk (&lt; 1:250) for this range of days in 86.0% of cases. The 14.0% of women remaining would have one or more high risk values in their report and would thus require an ultrasound scan for precise dating of the pregnancy; 30% of these--that is, 3.7% of the screened population--would be identified as high risk and require consideration for amniocentesis. CONCLUSIONS--Screening programmes for Down9s syndrome require the facility for precise dating of pregnancy to improve the accuracy of risk assessment. This can be achieved without introducing additional scans for early dating in the whole population but by selecting only those cases (about 14%) when an error in dates is likely to affect the risk of Down9s syndrome.
Sub-specialization or Super-specialization in Surgery?
Authors: J. Charnley
Journal: BMJ (1970)

A special centre for prosthetic hip replacement set up 10 years ago has been successful in its primary objectives, producing high quality work at low cost and stimulating research. The project has not yet been successful in achieving a permanent staffing structure, but this is the effect of certain British ideologies in surgical training, with the result that craftsmanship and technology cannot be reconciled with pure intellectual attainment.The success of the project suggests the importance of isolating elective surgery from emergency surgery in the interests of cost-effectiveness. Problems of isolation from teaching hospitals are not insurmountable, but isolation to some degree is essential to achieve the minimum size necessary for efficiency and to ensure unbroken professional team-work among all levels of staff. While maximum efficiency in this field can be achieved only in special centres, too many primary operations will be required every year to insist that total hip replacement should be done only in special centres. A special feature of this field is the need for a permanent staffing structure to hand on technical expertise as an unbroken tradition.
Susceptibility to Measles, Mumps, and Rubella in Newly Arrived Adult Immigrants and Refugees
Authors: Christina Greenaway, Pierre Dongier, Jean-François Boivin, Bruce Tapiero, Mark Miller, Kevin Schwartzman
Journal: Annals of Internal Medicine (2007)

Background: Despite effective vaccination programs for measles, mumps, and rubella in the United States and Canada, outbreaks continue to occur in susceptible subgroups, such as foreign-born persons. Objective: To determine the susceptibility of newly arrived immigrants and refugees to measles, mumps, and rubella. Design: Seroprevalence study. Setting: Two hospitals and three community clinics in Montreal, Quebec, Canada. Patients: 1480 adult immigrants and refugees who were recruited from October 2002 to December 2004. Measurements: Sociodemographic and clinical data and serology for measles, mumps, and rubella. Results: Thirty-six percent (range, 22% to 54%) of the study population was nonimmune to at least 1 of the 3 diseases. This proportion varied by age, sex, and region of origin. In multivariate analysis and after adjustment for region of origin, age, and socioeconomic factors, immigrant women had higher odds (odds ratio, 2.1) of being immune to measles (95% CI, 1.2 to 3.8) and an odds ratio of 1.7 of being nonimmune to rubella (CI, 1.2 to 2.6) compared with immigrant men. Limitations: The results from the community-based convenience sample of immigrants may not be generalizable to all immigrant populations. Conclusions: Many new immigrants and refugees, particularly women, are susceptible to measles, mumps, or rubella and may benefit from targeted vaccination programs.
Estimating Infection Attack Rates and Severity in Real Time during an Influenza Pandemic: Analysis of Serial Cross-Sectional Serologic Surveillance Data
Authors: Joseph T. Wu, Andrew Ho, Edward S. K. Ma, Cheuk Kwong Lee, Daniel K. W. Chu, Po-Lai Ho, Ivan F. N. Hung, Lai Ming Ho, Che Kit Lin, Thomas Tsang, Su-Vui Lo, Yu-Lung Lau, Gabriel M. Leung, Benjamin J. Cowling, J. S. Malik Peiris
Journal: PLoS Medicine (2011)

Background In an emerging influenza pandemic, estimating severity (the probability of a severe outcome, such as hospitalization, if infected) is a public health priority. As many influenza infections are subclinical, sero-surveillance is needed to allow reliable real-time estimates of infection attack rate (IAR) and severity. Methods and Findings We tested 14,766 sera collected during the first wave of the 2009 pandemic in Hong Kong using viral microneutralization. We estimated IAR and infection-hospitalization probability (IHP) from the serial cross-sectional serologic data and hospitalization data. Had our serologic data been available weekly in real time, we would have obtained reliable IHP estimates 1 wk after, 1–2 wk before, and 3 wk after epidemic peak for individuals aged 5–14 y, 15–29 y, and 30–59 y. The ratio of IAR to pre-existing seroprevalence, which decreased with age, was a major determinant for the timeliness of reliable estimates. If we began sero-surveillance 3 wk after community transmission was confirmed, with 150, 350, and 500 specimens per week for individuals aged 5–14 y, 15–19 y, and 20–29 y, respectively, we would have obtained reliable IHP estimates for these age groups 4 wk before the peak. For 30–59 y olds, even 800 specimens per week would not have generated reliable estimates until the peak because the ratio of IAR to pre-existing seroprevalence for this age group was low. The performance of serial cross-sectional sero-surveillance substantially deteriorates if test specificity is not near 100% or pre-existing seroprevalence is not near zero. These potential limitations could be mitigated by choosing a higher titer cutoff for seropositivity. If the epidemic doubling time is longer than 6 d, then serial cross-sectional sero-surveillance with 300 specimens per week would yield reliable estimates when IAR reaches around 6%–10%. Conclusions Serial cross-sectional serologic data together with clinical surveillance data can allow reliable real-time estimates of IAR and severity in an emerging pandemic. Sero-surveillance for pandemics should be considered. Please see later in the article for the Editors' Summary
Letter: pH of swimming pools.
Authors: H Gordon
Journal: BMJ (1976)

hours after dosing, by 7-16",, 16 hours after dosing, and by 8-13",, 24 hours after dosing.Thus once-daily therapy with sotalol has a 24-hour effect in reducing blood pressure.(2) The dose of sotalol eventually required was related to the initial diastolic blood pressure.(3) In at least one patient there appeared to be a correlation between standing diastolic pressure, heart rate, and sotalol dosage.
HEAD TO HEAD COMPARISON BETWEEN ORIGINAL AND GENERIC CLOPIDOGREL USING MULTIPLE ELECTRODES PLATELET AGGREGOMETRY IN STABLE PATIENTS WITH INDICATION FOR THERAPY WITH P2Y12 INHIBITOR
Authors: Oteh Maskon, Nabilah Salman Parasi, Hamat Hamdi Che Hassan, Fadhilah Aadul Wahid, Mohd Rafizi Md Rus, Osama Ibrahim, Choor Chee Ken, Magdi Yahya, Shamsul Azhar Shah
Journal: Journal of the American College of Cardiology (2014)
Year in review in Intensive Care Medicine 2011. II. Cardiovascular, infections, pneumonia and sepsis, critical care organization and outcome, education, ultrasonography, metabolism and coagulation
Authors: Massimo Antonelli, Marc Bonten, Jean Chastre, Giuseppe Citerio, Giorgio Conti, J. Randall Curtis, Daniel De Backer, Goran Hedenstierna, Michael Joannidis, Duncan Macrae, Jordi Mancebo, Salvatore M. Maggiore, Alexandre Mebazaa, Jean-Charles Preiser, Patricia Rocco, Jean-François Timsit, Jan Wernerman, Haibo Zhang
Journal: Intensive Care Medicine (2012)

Cardiac failure: epidemiology and treatment Mebazaa and colleagues in two interesting papers [1,2] described the clinical presentation, management, and outcomes of acute heart failure (AHF) through the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF) on AHF conducted in nine countries in four continents.In the first paper [1] data from 4,953 patients with AHF were collected via questionnaire from 666 hospitals.
Acute neurology services must be provided by neurologists, report says
Authors: M. Limb
Journal: BMJ (2011)

Health services for patients with neurological conditions are “poorly organised” and local hospital care is substandard for those admitted with acute illness, says a report.

The Royal College of Physicians and the Association of British Neurologists say patients with neurological emergencies other than stroke need better access to specialists.

There should also be an integrated “neurology network” that caters effectively for patients, including those with chronic disease, at all stages of their condition.

David Bateman, a consultant neurologist who chaired the report working party, said improvements could be achieved mainly through reorganisation rather than extra spending.

“The Department of Health and commissioners cannot afford to ignore this report,” he said.

Neurological disorders account for about one in 10 GP consultations, 10% of emergency medical admissions (excluding …
Development of a mechanical 'pivot shift' knee stability test
Authors: M P Sena, D Coughlin, R Dellamaggiora, J C Lotz, B T Feeley
Journal: British Journal of Sports Medicine (2011)

Anterior cruciate ligament (ACL) injuries are common in sports, with 135 000 ACL tears leading to over 95 000 annual reconstructions in the US. The manual ‘pivot shift' test is the most specific clinical examination for diagnosis of ACL injuries. The presence of a ‘pivot' (anterior/internal tibial subluxation followed by a rapid reduction or ‘clunk') postoperatively correlates with poor patient outcome. Unfortunately, the pivot shift is semi-quantitative and difficult to perform reproducibly. We developed a mechanical pivot shift device (MPSD) that mimics this test through the application of standardised dynamic loads. Manual and mechanised pivot shift tests were performed on right and left cadaveric knees (n=4) in intact and ACL-deficient states. The resultant tibiofemoral motion was recorded using the Optotrak® navigation system (Manual and MPSD tests produced similar kinematic trajectories, with subluxation/reduction occurring at ∼20° /35° for ACL-deficient knees. Following ACL transection, both tests produced increased instability metrics: maximum tibial internal rotation (IRmax), anterior displacement, and posterior translational velocity (PTV). The coefficient of variation (cv=σ/μ) for these metrics was significantly lower using the MPSD (cv=0.03) in comparison to the manual test (cv=0.16). Between right and left knees, MPSD metrics differed by less than 1.5° and 2 mm. These results demonstrate that our device can produce a realistic ‘pivot shift' with a high degree of reproducibility. Logistic regression revealed IRmax as the best single predictor of intact versus deficient ACL state (R2=0.41, p=0.0001), while IRmax and PTV combined predicted knee state with complete accuracy (R2=1, p=0.0001). These data suggest that measurements made using the MPSD are sensitive to clinically relevant ACL condition and may provide kinematic signatures specific to graded soft tissue defects of the knee joint, or to different ACL reconstruction techniques.
Pharmacokinetics and pharmacodynamics of torasemide and furosemide in patients with diuretic resistant ascites
Authors: Paolo Gentilini, Giorgio La Villa, Fabio Marra, Vinicio Carloni, Lorenzo Melani, Marco Foschi, Giorgio Cotrozzi, Mariano Quartini, Guido Chibbaro, Alberto Candidi Tommasi, Alberto Bernareggi, Antonella Simoni, Giampiero Buzzeli, Giacomo Laffi
Journal: Journal of Hepatology (1996)
INDIUM-111-LABELLED GRANULOCYTE ACCUMULATION IN RESPIRATORY TRACT OF PATIENTS WITH BRONCHIECTASIS
Authors: D.C. Currie, A.M. Peters, P. George, J.P. Lavender, S.H. Saverymuttu, S.G. Needham, D.P. Dhillon, P.J. Cole
Journal: The Lancet (1987)
False-Positive Intradermal Skin Tests and Thimerosal
Authors: Howard I. Maibach
Journal: JAMA (1972)

<h3>To the Editor.—</h3> In 1963, Epstein (<i>J Allerg</i><b>34</b>:225) showed delayed hypersensitivity to thimerosal (Merthiolate) as a cause of false-positive delayed skin tests. Recently Hansson and Möller demonstrated peculiar patch test reactions to thimerosal in healthy young adults (<i>Brit J Derm</i><b>83</b>:349, 1970). This led them to intradermal skin test 412 young healthy Swedish recruits with old tuberculin (OT) which in Sweden contains thimerosal as a preservative purified protein derivative (PPD) (not containing thimerosal) and thimerosal in saline (<i>Scand J Infect Dis</i><b>3</b>:169, 1971). A positive reaction to thimerosal was recorded in 15% of the men. They found that thimerosal influenced the reactions in 63 of the 163 positive OT tests. On this basis they recommend that thimerosal not be added to intracutaneous test solutions (for delayed hypersensitivity) since the thimerosal may interfere with the evaluation of positive reactions. In the United States most commercial sources of
Advances in the Biology of Lung Cancer Chemoprevention
Authors: Fred R. Hirsch, Scott M. Lippman
Journal: Journal of Clinical Oncology (2005)

The heavy burden of lung cancer, which includes the highest worldwide mortality of any cancer, and its resistance to standard approaches (smoking cessation, screening, and therapy), have motivated an intense interest in chemoprevention of this disease. Randomized controlled trials of agents (including retinoids, beta-carotene, and vitamin E) to prevent lung cancer have produced only disappointing clinical results to date. New, molecular-targeted approaches are advancing rapidly, however, with many promising targets and interactive signaling pathways for developing novel agents and combinatorial approaches in this setting. This promise is illustrated by recent studies of 15-hydroxyprostaglandin dehydrogenase, which plays a critical role in polyunsaturated fatty acid metabolism and (like another important target, prostacyclin) is downstream of cyclooxygenase-2. 15-hydroxyprostaglandin dehydrogenase degrades prostaglandin E 2 , appears to have tumor suppressor activity, and can be induced both by peroxisome proliferator-activated receptor-gamma ligands and an epidermal growth factor receptor inhibitor. Other important targets/pathways include the insulin-like growth factor axis, phosphoinositide 3-kinase pathway, cyclin D and E family members, and epigenetic events. Defining highest lung cancer risk (eg, establishing molecular risk models through long-term analyses of high-risk cohorts) will facilitate the clinical development of molecular-targeted prevention that will potentially reduce the enormous burden of lung cancer.
THE MEDICINAL TREATMENT OF CHOREA: (CALCIUM ASPIRIN)
Authors: N. Mutch
Journal: BMJ (1934)

MDTHA BRITISHvirus is different from the others; at any rate there is no case on record of direct communIcaCon of tick or mite typhus from one person to another, and, after all, th!manner of conveyance of the diseases is by far the most important practical matter from the physician's point of * A communication read before the Dutch
The Poor Quality of Early Evaluations of MRI
Authors: Stanley Baum
Journal: JAMA (1988)

To the Editor.—  The article by Cooper et al 1 as well as the accompanying editorial by Dr Sheps 2 in the June 10 issue of JAMA are, in my view, very misleading. The implication of both the article and the editorial is that since scientifically valid techniques for evaluating technology are known, and since these techniques were not employed in the early phases of magnetic resonance imaging (MRI) evaluation, there must be a problem with the method chosen by the authors of the 54 articles reviewed.  The time frame that was used, namely, January 1980 through December 1984, was a period that was very early in the applications of MRI. If one considers the lag time for publication, Cooper et al were, for the most part, looking at studies that were performed between 1979 and 1983. (I also note that the article by Cooper et al was first submitted