tbuckley/cabot-search huggingface dataset:
Annual Revaccination Against Influenza and Mortality Risk in Community-Dwelling Elderly Persons
Authors: A. C. G. Voordouw
Journal: JAMA (2004)

Although large-scale observational studies have demonstrated the effectiveness of influenza vaccination, no large studies have systematically addressed the clinical benefit of annual revaccinations.To investigate the effect of annual influenza revaccination on mortality in community-dwelling elderly persons.A population-based cohort study using the computerized Integrated Primary Care Information (IPCI) database in the Netherlands including community-dwelling individuals aged 65 years or older from 1996 through 2002. For each year, we computed the individual cumulative exposure to influenza vaccination since study start.Association between the number of consecutive influenza vaccinations and all-cause mortality vs no vaccination after adjusting for age, sex, chronic respiratory and cardiovascular disease, hypertension, diabetes mellitus, renal failure, and cancer.The study population included 26,071 individuals, of whom 3485 died during follow-up. Overall, a first vaccination was associated with a nonsignificant annual reduction of mortality risk of 10% (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.78-1.03) while revaccination was associated with a reduced mortality risk of 24% (HR, 0.76; 95% CI, 0.70-0.83). Compared with a first vaccination, revaccination was associated with a reduced annual mortality risk of 15% (HR, 0.85; 95% CI, 0.75-0.96). During the epidemic periods this reduction was 28% (HR, 0.72; 95% CI, 0.53-0.96). Similar estimates were obtained for persons with and without chronic comorbidity and those aged 70 years or older at baseline. Overall, influenza vaccination is estimated to prevent 1 death for every 302 vaccinees at a vaccination coverage that varied between 64% and 74%.Annual influenza vaccination is associated with a reduction in all-cause mortality risk in a population of community-dwelling elderly persons, particularly in older individuals.
A Trial of a 9-Valent Pneumococcal Conjugate Vaccine in Children with and Those without HIV Infection
Authors: Keith P. Klugman, Shabir A. Madhi, Robin E. Huebner, Robert Kohberger, Nontombi Mbelle, Nathaniel Pierce
Journal: New England Journal of Medicine (2003)

Acute respiratory tract infections caused by Streptococcus pneumoniae are a leading cause of morbidity and mortality in young children. We evaluated the efficacy of a 9-valent pneumococcal conjugate vaccine in a randomized, double-blind study in Soweto, South Africa.At 6, 10, and 14 weeks of age, 19,922 children received the 9-valent pneumococcal polysaccharide vaccine conjugated to a noncatalytic cross-reacting mutant of diphtheria toxin (CRM197), and 19,914 received placebo. All children received Haemophilus influenzae type b conjugate vaccine. Efficacy and safety were analyzed according to the intention-to-treat principle.Among children without human immunodeficiency virus (HIV) infection, the vaccine reduced the incidence of a first episode of invasive pneumococcal disease due to serotypes included in the vaccine by 83 percent (95 percent confidence interval, 39 to 97; 17 cases among controls and 3 among vaccine recipients). Among HIV-infected children, the efficacy was 65 percent (95 percent confidence interval, 24 to 86; 26 and 9 cases, respectively). Among children without HIV infection, the vaccine reduced the incidence of first episodes of radiologically confirmed alveolar consolidation by 20 percent (95 percent confidence interval, 2 to 35; 212 cases in the control group and 169 in the vaccinated group) in the intention-to-treat analysis and by 25 percent (95 percent confidence interval, 4 to 41; 158 and 119 cases, respectively) in the per-protocol analysis (i.e., among fully vaccinated children). The incidence of invasive pneumococcal disease caused by penicillin-resistant strains was reduced by 67 percent (95 percent confidence interval, 19 to 88; 21 cases in the control group and 7 in the vaccinated group), and that caused by strains resistant to trimethoprim-sulfamethoxazole was reduced by 56 percent (95 percent confidence interval, 16 to 78; 32 and 14 cases, respectively).Vaccination with a 9-valent pneumococcal conjugate vaccine reduced the incidence of radiologically confirmed pneumonia. The vaccine also reduced the incidence of vaccine-serotype and antibiotic-resistant invasive pneumococcal disease among children with and those without HIV infection.
Myeloid leukemia in children 4 years or older with Down syndrome often lacks GATA1 mutation and cytogenetics and risk of relapse are more akin to sporadic AML
Authors: H Hasle, J Abrahamsson, M Arola, A Karow, A O'Marcaigh, D Reinhardt, D K H Webb, E van Wering, B Zeller, C M Zwaan, P Vyas
Journal: Leukemia (2007)
Glucose ingestion in dogs alters the hepatic extraction of insulin. In vivo evidence for a relationship between biologic action and extraction of insulin.
Authors: J Jaspan, K Polonsky
Journal: Journal of Clinical Investigation (1982)

Oral glucose (25 g) fed to seven healthy, conscious dogs resulted in an increase in peripheral plasma glucose from 109 +/- 3 to 178 +/- 10 mg/dl. Concurrently serum insulin increased in the portal vein to levels approximately threefold greater than those in the periphery. Hepatic insulin delivery rose from 10.8 +/- 0.7 to 59.0 +/- 19.9 m U/min at 60 min. coincident with an increased hepatic insulin extraction from 3.3 to 41.4 mU/min (corresponding to an increase in hepatic extraction from 31 +/- 4 to 59 +/- 7%), both returning to basal at 3 h. In each animal there was a positive correlation between hepatic insulin delivery and extraction (r = 0.80, P less than 0.001 for the seven experiments combined). These changes in heptic insulin delivery and extraction after glucose metabolism associated with insulin action. As hepatic insulin extraction increased, hepatic glucose output declined, both parameters returning to basal levels by 3 h, indicating a negative correlation between hepatic insulin extraction and hepatic glucose output (r = 0.63, P less than 0.001; n = 7). The factors that mediate this marked and rapidly occurring increase in hepatic insulin extraction after oral glucose are unknown, and may include hepatic insulin delivery, glucose levels in the blood flow, and gut factors released by oral glucose intake. The association of changes in hepatic insulin extraction in vivo with an insulin effect on the liver as measured hepatic glucose output is consistent with in vitro observations relating insulin degradation to receptor binding.
Benefit of a 600-mg Loading Dose of Clopidogrel on Platelet Reactivity and Clinical Outcomes in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome Undergoing Coronary Stenting
Authors: Thomas Cuisset, Corinne Frere, Jacques Quilici, Pierre-Emmanuel Morange, Lyassine Nait-Saidi, Joseph Carvajal, Agnès Lehmann, Marc Lambert, Jean-Louis Bonnet, Marie-Christine Alessi
Journal: Journal of the American College of Cardiology (2006)
Action is needed to prevent further increase in cancer cases
Authors: P. Dinsdale
Journal: BMJ (2011)

A leading cancer research charity says that the forthcoming UN summit on non-communicable diseases (NCDs) is a once in a generation opportunity to avoid a public health disaster, warning that a failure to develop robust global and national policies to reduce NCDs will lead to millions of preventable deaths.

New estimates from the World Cancer Research Fund show that around 2.8 million cancer cases a year are linked to diet, physical activity, and weight. The fund predicts that this figure will rise dramatically in the next 10 years. While recognising the importance of smoking in causing cancer, the charity concentrates its efforts on publicising those causes that are less …
Atopic Dermatitis
Authors: John S. Strauss, Albert M. Kligman
Journal: New England Journal of Medicine (1957)

ALLERGISTS tend to suspect that the dermatitic skin of patients with atopic dermatitis may be a specific allergic manifestation of the atopic state. Yet it must be admitted that specific therapy directed against an allergic cause (hyposensitization and avoidance of exposure) is usually unrewarding. In favor of an allergic etiology, however, is the definite flare-up that exposure to the specific allergen produces in a few persons.1 2 3 4 5 6 7 Although such flare-ups may be provoked by hyposensitizing injections, inhalation or ingestion, one point stands out in all such reports — namely, that the exacerbations are localized to pre-existing lesions or healed sites, not . . .
A dose-ranging study evaluating once-daily oral administration of the factor Xa inhibitor rivaroxaban in the treatment of patients with acute symptomatic deep vein thrombosis: the Einstein–DVT Dose-Ranging Study
Authors: Harry R. Buller, Anthonie W. A. Lensing, Martin H. Prins, Giancarlo Agnelli, Alexander Cohen, Alexander S. Gallus, Frank Misselwitz, Gary Raskob, Sebastian Schellong, Annelise Segers
Journal: Blood (2008)
Treatment of Infections Associated with Surgical Implants
Authors: Rabih O. Darouiche
Journal: New England Journal of Medicine (2004)

About half of all nosocomial infections are associated with indwelling devices. Infections associated with implanted surgical devices are particularly difficult to deal with because they can require prolonged antibiotic treatment and repeated surgical procedures. This review summarizes the diagnostic challenges and explains the approaches to managing infections that are associated with various devices, including prosthetic heart valves, vascular grafts, pacemakers and defibrillators, and joint prostheses.
Radionuclide Blood Flow Studies Before and After Gelfoam Embolization of Intracranial Meningiomas
Authors: SHELDON BAUM, LINDA L. COLEMAN, ROBERT F LATSHAW, ROBERT B. PAGE, WILLIAM A. WEIDNER
Journal: Clinical Nuclear Medicine (1979)

Radionuclide blood flow studies were employed to evaluate the success or failure of preoperative Gelfoam embolization in two patients with intracranial meningiomas. In both cases, the initial radionuclide blood flow study showed tumor visualization during the arterial phase. Immediately following the embolization procedure, the radionuclide blood flow study showed no visualization of the meningioma during the arterial phase, indicating a successful embolization procedure in preparation for removal of the tumor in a relatively bloodless field.
Anaphylaxis After Administration of Ibritumomab Tiuxetan for Follicular Non-Hodgkin Lymphoma
Authors: Rachel Jankowitz, Judith Joyce, Samuel A. Jacobs
Journal: Clinical Nuclear Medicine (2008)

We report an anaphylactic reaction in a 45-year-old gentleman with an 8-year history of extensively treated, relapsing follicular lymphoma who was receiving a second treatment with ibritumomab tiuxetan. Within seconds of receiving Y-90 ibritumomab, he developed chest tightness, shallow respirations, hypotension, and incontinence. After successful resuscitation, a human antimouse antibody (HAMA) level was found to be elevated, 618 ng/mL (reference 0–188 ng/mL).
Simple Techniques Aid Eye Drop Penetration
Authors: Timothy F. Kirn
Journal: JAMA (1987)

OPHTHALMOLOGISTS ARE eye-balling a couple of techniques that may help drugs penetrate behind the cornea and sclera. Two techniques described at a Research to Prevent Blindness (RPB) Science Writers Seminar (in Bethesda, Md) may prove to be better ways to get more medication into the poorly-vascularized eye. What's more, the researchers say, their methods will reduce the side effects that patients often experience when treated with ophthalmic drugs. Patients using topical ophthalmic drugs frequently don't get the therapeutic benefit they should and they often experience uncomfortable and/or dangerous side effects, says Thom J. Zimmerman, MD. According to the University of Louisville School of Medicine's professor of pharmacology and toxicology, the solution to both problems is more careful application of the medications. Originally, says Zimmerman, who is also chair of the Department of Ophthalmology at Louisville, the idea was to have people press their index finger on the junction of the
An Address on the Surgical Treatment of Empyema
Authors: H. Marsh
Journal: BMJ (1888)

would have no hesitation in opening it through the pleura, and treating it on the same antiseptic principles.--Dr.WA3RDLOP GRIFFITH deprecated the habit of excision of a portion of a rib as part of a primary operation, and maintained that satisfactory draminage was obtained in the great majority of cases by sinlple incision and insertion of a drainage-tube.lie discussed the manner of reexpansion of the lung after operation, and held with Dr. Robertson, of Oldham, that Mr. Rickuman Godlee's explanation was inadequate for the majority of cases, but that it was brought about by the valvular action of the dresing.lie held that, whlen an empyema was incised, the functionally active portion of the lung did not collapse, and quoted some observations and experi- ments brought forward by Dr. Samuel West in the Bradshlawe Lecture as lending support to this view.-Mr.WINKFTEll)
Inhaled corticosteroids modulate the (+)insert smooth muscle myosin heavy chain in the equine asthmatic airways
Authors: Roxane Boivin, Amandine Vargas, Josiane Lefebvre-Lavoie, Anne-Marie Lauzon, Jean-Pierre Lavoie
Journal: Thorax (2014)

<h3>Rationale</h3> Overexpression of the (+)insert smooth muscle myosin heavy chain (SMMHC) isoform could contribute to airway bronchospasm by increasing the velocity of contraction. Whether the (+)insert isoform is present in the small airways and its expression is reversible in asthma are unknown. <h3>Objectives</h3> To determine the anatomical location and the expression kinetics of the (+)insert SMMHC isoform in airways of horses with heaves and to evaluate its modulation in response to disease status. <h3>Methods</h3> We evaluated the (+)insert SMMHC isoform in the airways of horses with heaves during disease exacerbation and remission, and in controls. The expression kinetics of the SMMHC (+)insert was then assessed at multiple time points in two studies: first, in horses with heaves treated for a 1-year period with antigen avoidance alone, inhaled corticosteroids alone or both; second, in horses with heaves before and after a 30-day natural antigen exposure. Gene expression analysis was assessed by quantitative PCR and protein expression was confirmed by targeted mass spectrometry. <h3>Measurements and main results</h3> The (+)insert SMMHC isoform was significantly increased in central and peripheral airways, but not in the trachea of heaves-affected horses in clinical exacerbation when compared horses with heaves in remission and controls. Both corticosteroid administration and antigen avoidance led to a significant reduction of the (+)insert expression in the airways. The (+)insert SMMHC isoform was not significantly increased in airways after 1 month of antigenic re-exposure. <h3>Conclusions</h3> The (+)insert SMMHC expression is increased throughout the bronchial tree in horses with heaves and reversible by corticosteroids administration and antigen avoidance.
Frequency of Severe Hypoglycemia in Patients With Type I Diabetes With Impaired Awareness of Hypoglycemia
Authors: Ann E Gold, Kenneth M Macleod, Brian M Frier
Journal: Diabetes Care (1994)

OBJECTIVE To determine the frequency of hypoglycemia in patients with type I diabetes and impaired awareness of hypoglycemia by prospective assessment. RESEARCH DESIGN AND METHODS A prospective study was undertaken for 12 months in 60 patients with type I diabetes: 29 had impaired awareness of hypoglycemia and 31 retained normal awareness of hypoglycemia. The two groups of patients were matched for age, age at onset of diabetes, duration of diabetes, and glycemic control. Episodes of severe hypoglycemia were recorded within 24 h of the event and verified where possible by witnesses. RESULTS During the 12 months, 19 (66%) of the patients with impaired awareness had one or more episodes of severe hypoglycemia with an overall incidence of 2.8 episodes · patient–1 ·year–1. By comparison, 8 (26%) of the patients with normal awareness experienced severe hypoglycemia (P &amp;lt; 0.01) with an annual incidence of 0.5 episode · patient–1 · year–1 (P &amp;lt; 0.001). Severe hypoglycemia occurred at different times of the day in the two groups: patients with impaired awareness experienced a greater proportion of episodes during the evening (P = 0.03), and patients with normal awareness experienced a greater proportion in the early morning (P = 0.05). An assessment of fear of hypoglycemia revealed that patients with impaired awareness of hypoglycemia worried more about hypoglycemia than did patients with normal awareness (P = 0.008), but did not modify their behavior accordingly. CONCLUSIONS This prospective evaluation demonstrated that impaired awareness of hypoglycemia predisposes to a sixfold increase in the frequency of severe hypoglycemia, much of which occurred at home during waking hours.
Extranodal Extension Is a Powerful Prognostic Factor in Bladder Cancer Patients with Lymph Node Metastasis
Authors: Harun Fajkovic, Eugene K. Cha, Claudio Jeldres, Brian D. Robinson, Michael Rink, Evanguelos Xylinas, Thomas F. Chromecki, Eckart Breinl, Robert S. Svatek, Gerhard Donner, Scott T. Tagawa, Derya Tilki, Patrick J. Bastian, Pierre I. Karakiewicz, Bjoern G. Volkmer, Giacomo Novara, Abdennabi Joual, Talia Faison, Guru Sonpavde, Siamak Daneshmand, Yair Lotan, Douglas S. Scherr, Shahrokh F. Shariat
Journal: European Urology (2012)
Comparison of the Male Toad and Hogben Pregnancy Tests
Authors: G. M. G. Barton
Journal: BMJ (1953)

Members of the IFN-inducible PYHIN protein family, such as absent in melanoma-2 and IFN-γ–inducible protein (IFI)16, bind dsDNA and form caspase-1–activating inflammasomes that are important in immunity to cytosolic bacteria, DNA viruses, or HIV. IFI16 has also been shown to regulate transcription of type I IFNs during HSV infection. The role of other members of the PYHIN protein family in the regulation of immune responses is much less clear. In this study, we identified an immune-regulatory function for a member of the murine PYHIN protein family, p205 (also called Ifi205). Examination of immune responses induced by dsDNA and other microbial ligands in bone marrow–derived macrophages lacking p205 revealed that inflammasome activation by dsDNA, as well as ligands that engage the NLRP3 inflammasome, was severely compromised in these cells. Further analysis revealed that p205-knockdown cells showed reduced expression of apoptosis-associated speck-like molecule containing CARD domain (Asc) at the protein and RNA levels. p205 knockdown resulted in reduced binding of actively transcribing RNA polymerase II to the endogenous <i>Asc</i> gene, resulting in decreased transcription and processing of Asc pre-mRNA. Deletion of p205 in B16 melanoma cells using CRISPR/Cas9 showed a similar loss of Asc expression. Ectopic expression of p205 induced expression of an <i>Asc</i> promoter–luciferase reporter gene. Together, these findings suggest that p205 controls expression of Asc mRNA to regulate inflammasome responses. These findings expand on our understanding of immune-regulatory roles for the PYHIN protein family.
A Biomarker of Myocardial Fibrosis Predicts Long-Term Response to Cardiac Resynchronization Therapy
Authors: Ignacio García-Bolao, Alfonso Macías, Begoña López, Arantxa González, Juan J. Gavira, Pedro Azcárate, Eduardo Alegría, Javier Díez
Journal: Journal of the American College of Cardiology (2006)
Exercise training in patients with chronic heart failure: Fig 1
Authors: Massimo F Piepoli, Darrel P Francis
Journal: BMJ (2004)

EDITOR—The figure shows the forest plots of the hazard ratios and 95% confidence intervals. The forest plots were removed during revision for reasons of space.



Fig 1 
Hazard ratios and 95% confidence intervals for individual studies for effect of exercise training on risk of death and on risk of death and admission to hospital (full data available on bmj.com>)



As Metcalfe observes, in one fairly …
Anterior Cervical Osteophytes Causing Airway Compromise
Authors: Paul Aronowitz, Fabiola Cobarrubias
Journal: New England Journal of Medicine (2003)

An 81-year-old man had had mild dysphagia for several years. During the six months before admission, the dysphagia worsened, and he had occasional hemoptysis. For several days before admission he had increasing shortness of breath and throat tightness, both of which worsened in the supine position. Laryngoscopic examination revealed marked narrowing of the airway due to a visible retropharyngeal bulge. The patient was admitted to the intensive care unit, where stridor was noted on physical examination. Radiographs of the cervical spine and magnetic resonance images (MRI) of the neck were obtained immediately. The lateral radiograph of the cervical spine revealed . . .
STUDIES OF THE PULMONARY CIRCULATION IN MAN AT REST. NORMAL VARIATIONS AND THE INTERRELATIONS BETWEEN INCREASED PULMONARY BLOOD FLOW, ELEVATED PULMONARY ARTERIAL PRESSURE, AND HIGH PULMONARY “CAPILLARY” PRESSURES 1
Authors: L. Dexter, J. W. Dow, F. W. Haynes, J. L. Whittenberger, B. G. Ferris, W. T. Goodale, H. K. Hellems
Journal: Journal of Clinical Investigation (1950)

While many studies have been carried out on the dynamics of the pulmonary circulation in ex- perimental animals, few studies of this subject have been made in man until recently.With the advent of the cardiac catheter ( 1) it has become possible to make critical observations on the lesser circulation in health and disease.The volume of blood flowing through the pul- monary artery per unit of time is dependent upon the pressure in the pulmonary artery, the resist- ance to blood flow offered by the pulmonary vas- culature, and the ability of the left side of the heart to handle the volume of blood which it re- ceives.In this paper, the resting values for pul- monary blood flow, pulmonary arterial pressure, pulmonary "capillary" pressure, the pulmonary artery-pulmonary "capillary" pressure gradient, and the pulmonary arteriolar resistance are pre- sented.In addition, the interrelationships of these various components of the pulmonary circu- lation as affected by increased blood flow through the lung, by elevated pressures in the pulmonary artery, and by high pressures in the pulmonary capillaries have been analyzed.
Aortic root replacement in pregnancy
Authors: N. Khan, C. Pumphrey, J. Clarke, M. Jahangiri
Journal: Journal of the Royal Society of Medicine (2003)

Could the middle cerebral artery aneurysm have been missed at the original magnetic resonance angiography?Digital subtraction arteriography is certainly more sensitive; however, a basilar bifurcation aneurysm and the first and second portion of the left middle cerebral artery are clearly seen in the first magnetic resonance angiogram.Moreover, on examination of the published work 4-6 I could find no report of false-negative magnetic resonance angiography for an aneurysm greater than 10 mm in diameter.On this evidence I conclude that this aneurysm did not exist at the time of initial study 9 days earlier.
Erythematous Papules on the Forearms
Authors: Shilpi Khetarpal, Ivanka Kovalyshyn, Anthony P. Fernandez
Journal: JAMA Dermatology (2015)

This case report describes a 72-year-old man with heart disease and a 2-month history of scaly erythematous papules on both forearms that did not improve with chlorhexidine or hydrocortisone. He had elevated creatinine and serum iodine but was otherwise asymptomatic. What is your diagnosis?