tbuckley/cabot-search huggingface dataset:
Use of Cell Culture and a Rapid Diagnostic Assay for Chlamydia trachomatis Screening
Authors: Edward W. Hook
Journal: JAMA (1994)

To compare a rapid, office-based test with standard cell culture for screening of women for Chlamydia trachomatis infections.An 8-month prospective crossover trial used alternating screening protocols in two Baltimore (Md) sexually transmitted disease clinics from January 2 through August 14, 1991.Consecutive women attending the two clinics who had no indication for administration of antichlamydial antibiotic therapy (eg, history of recent sexual contact with a partner with a sexually transmitted disease, mucopurulent cervicitis, pelvic inflammatory disease, known gonorrhea, or previously diagnosed Chlamydia infections).Chlamydia screening was offered according to one of two protocols. Use of the two screening protocols was alternated between clinics each month. In the "rapid test clinic," eligible women were screened with both a 30-minute enzyme immunoassay test and tissue culture. Patients screened with the rapid test were asked to remain in the clinic until their rapid assay results were available so that, if positive, the patients could be treated. In the "routine screening clinic," eligible women were screened for Chlamydia by cell culture. Women identified as being infected with Chlamydia by screening culture were later confidentially notified of their test results by health department disease intervention specialists and referred for therapy.Performance of screening tests for bringing infected patients to therapy; time intervals between initial clinic visits and therapy; and pelvic inflammatory disease occurring between initial visits and therapy.Chlamydia cultures were positive in 100 (6.6%) of 1526 women screened with the solid-phase immunoassay, 47 of which were detected and treated on the basis of rapid test results. In contrast, 93 (74%) of 126 women with positive screening cultures returned to the clinic and received therapy. The median interval between testing and therapy for women with positive screening cultures was 14 days, and three (3.2%) developed pelvic inflammatory disease in the interval between testing and return for therapy.Neither cell culture nor a rapid diagnostic test performed well for ensuring therapy of women with Chlamydia infections. The sensitivity of the rapid diagnostic test was low, and nearly one fourth of the women with positive screening cultures did not return for therapy. Evaluation of screening for Chlamydia should consider the utility of strategies for bringing patients to treatment, as well as the more usual measures of test performance, such as sensitivity, specificity, and predictive values.
Silica-Based Nanoparticle Uptake and Cellular Response by Primary Microglia
Authors: Judy Choi, Qingdong Zheng, Howard E. Katz, Tomás R. Guilarte
Journal: Environmental Health Perspectives (2009)

Silica nanoparticles (SiNPs) are being formulated for cellular imaging and for nonviral gene delivery in the central nervous system (CNS), but it is unclear what potential effects SiNPs can elicit once they enter the CNS. As the resident macrophages of the CNS, microglia are the cells most likely to respond to SiNP entry into the brain. Upon activation, they are capable of undergoing morphological and functional changes.We examined the effects of SiNP exposure using primary rat microglia.We observed microglial uptake of SiNPs using transmission electron and fluorescence confocal microscopy. Microglial functions, including phagocytosis, generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS), expression of proinflammatory genes, and cytokine release, were measured after SiNP exposure at different concentrations.Microglia are capable of avidly taking up SiNPs at all concentrations tested. These same concentrations did not elicit cytotoxicity or a change in phagocytic activity. SiNPs did increase the productions of both intracellular ROS and RNS. We also observed a significant decrease in tumor necrosis factor-alpha gene expression at all concentrations tested and a significant increase in COX-2 (cyclooxygenase-2) gene expression at the highest concentration of SiNPs. Analysis of cytokine release showed a detectable level of interleukin-1beta.This is the first study demonstrating the in vitro effects of SiNPs in primary microglia. Our findings suggest that very low levels of SiNPs are capable of altering microglial function. Increased ROS and RNS production, changes in proinflammatory genes, and cytokine release may not only adversely affect microglial function but also affect surrounding neurons.
Clinical Essays on the Heart
Authors: Milton Mendlowitz
Journal: JAMA (1983)

This book, according to the editor, is meant to substitute for the previous update volumes. Its purpose, along with the succeeding volumes, is to span the gap between the editions of the editor's outstanding and authoritative book, The Heart .  The present volume is now called Clinical Essays , because each essay is less than a complete review of the subject but more elaborate than a paper suitable for publication in a journal. The selection of authors seems haphazard and the quality of some of the essays does not live up to the prestige of the editor.  Some of the essays, however, are excellent, such as the one on echocardiography with its beautiful illustrations. However, the review of the interactions between psychotropic drugs and the heart is so prolix as to be of limited interest. The style of many of the essays is jerky, with multiple subtitles making for difficult reading. One
The fallacy of competing interest statements: no shortcut to rigour in research
Authors: Kara G Hanson, Lucy Gilson, Catherine Goodman, Anne Mills
Journal: Journal of the Royal Society of Medicine (2009)

We are concerned that it could be taken to imply that we failed to declare appropriately 'competing interests' that might have influenced our views in a recent PLOS Medicine debate on the role of the private sector. 2 We refute this suggestion and believe that it is essential to distinguish competing interests from the broad range of factors that influence and shape judgements about evidence -such as personal values and beliefs, professional and disciplinary training, et cetera.We do not claim to be lacking in self-interestthat would run counter to most bodies of economic thought -but it is incorrect to suggest that our views were influenced by competing interests as usually defined: '. anything that interferes with, or could reasonably be perceived as interfering with, the full and objective presentation, review, or publication of research findings .'. 3 The authors of the editorial do not argue that we received any direct financial benefits from our contribution.However, they imply that a range of potential institutional linkages may have affected our position on the appropriate role for the private sector -our employer (the London School of Hygiene and Tropical Medicine), the World Health Organization and the other 'governments, foundations, NGOs and UN agencies' with which we have all collaborated or received funding from in the past.There are two issues here.The first is that none of these organizations could be said to have a single and unitary view on the private sector -they are all institutions within which a range of positions and perspectives thrive.Second, it is difficult to see how we would stand to benefit, jointly or individually, from presenting any particular perspective.Neither our reputation, nor our incomes, nor those of our employer, depend on taking a particular side in this debate.Indeed, given the current wave of interest in the private sector we might argue the opposite -that taking a more positive line on the private sector might attract greater income for our activities!The suggestion
Invasion of the Spleen By Basal Cell Carcinoma
Authors: William H. Strimel
Journal: JAMA (1968)

<h3>To the Editor:—</h3> This communication reports a case of basal cell carcinoma (originating in the skin of the left flank) which penetrated the abdominal cavity, invaded the spleen, and caused death by sepsis and gastrointestinal hemorrhage. <h3>Report of a Case:—</h3> A 71-year-old white male was first seen by a physician in 1959 and a large eroding "rodent type" lesion was discovered on the skin of the lateral thoracoabdominal wall on the left side (Fig 1). The patient apparently had kept this a guarded secret from his family for at least ten years prior to seeking medical help. He was admitted to Germantown Hospital and the lesion was identified as an invasive basal cell carcinoma. The patient rejected surgical treatment other than biopsy but accepted a course of x-ray therapy. Because of its large size, the lesion was irradiated through two portals enclosing an area 11×30 cm to include adjacent normal
A CASE OF CHRONIC APPENDICITIS SIMULATING ANGINA PECTORIS
Authors: Anthony Bassler
Journal: JAMA (1923)

Instances of chronic appendicitis being confused with disturbance in the gallbladder, gastroduodenal ulcer and various functional gastric disturbances are well known, operation usually disclosing the misdiagnosis, generally with benefit to the patient from the indicated surgery. There being no surgery or curative treatment for angina pectoris, this case is of interest: A. M., a stock broker, aged 50, came under observation, Jan. 17, 1922. His father died of "heart disease," his mother of apoplexy. His past history was negative. He had been constipated most of his adult life, excepting on vacations, so he thought it was due to nervousness from active business strain. One night in early November, 1921, he suddenly awakened with an intense pain in the lower abdomen, followed by a temperature of 104, nausea and vomiting. The illness lasted four days, and was treated by rest in bed and colon irrigations, the latter being continued for two
Newly identified gene linked to dementia
Authors: S. Gottlieb
Journal: BMJ (1999)

A single alteration in the DNA sequence of a newly discovered gene may be the cause of familial British dementia, a rare form of hereditary dementia that is characterised by amyloid deposition in the brain and is considered to be closely related to Alzheimer's disease.

A team of researchers from New York University School of Medicine, New York, and the National Hospital for Neurology and Neurosurgery and the Institute of Neurology, both in London, analysed tissue …
Interaction of Ketoconazole with Rifampin and Isoniazid
Authors: Dan Engelhard, Harris R. Stutman, Melvin I. Marks
Journal: New England Journal of Medicine (1984)

RIFAMPIN stimulates proliferation of the smooth endoplasmic reticulum of hepatocytes and induces microsomal enzymes involved in drug metabolism.1 It was recently reported that concurrent administration of rifampin and ketoconazole resulted in decreases in the expected serum concentrations of ketoconazole.2 , 2a We report here on a patient in whom both antifungal and antituberculous therapy failed to exert their expected effects when the drugs were administered concurrently. Pharmacokinetic studies demonstrated that this therapeutic failure was related to drug interactions resulting in markedly diminished serum concentrations of rifampin and ketoconazole.MethodsOur patient was first evaluated at Oklahoma Children's Memorial Hospital at 17 . . .
Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Celiac Lymph Nodes
Authors: M. Eloubeidi, P. Vilmann, M. Wiersema
Journal: Endoscopy (2004)

Endoscopic ultrasonography (EUS) is a well-established method of evaluating patients with gastrointestinal and pulmonary malignancies. EUS allows accurate tumor staging through the detection of local and distant lymph-node metastases, particularly in the area of the celiac axis [1] [2] [3]. Since the original reports of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) by Vilmann et al. [4] and Wiersema et al. [5], EUS-FNA of peri-intestinal lesions has become adopted as a routine method allowing cytological documentation of malignant involvement. This article outlines the principles used in evaluating the celiac axis with EUS and the methods of carrying out EUS-FNA of celiac lymph nodes, and it suggests absolute indications, relative indications, and contraindications to EUS-FNA of the celiac lymph nodes.
Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders
Authors: M. Linden, D. Zubraegel, T. Baer, U. Franke, P. Schlattmann
Journal: Psychotherapy and Psychosomatics (2004)

&lt;i&gt;Background:&lt;/i&gt; Generalized anxiety disorders (GAD) are amongst the most prevalent mental disorders. Recent studies have suggested that cognitive behaviour therapy (CBT) is an effective treatment for GAD. A controlled clinical trial was done to evaluate the efficacy of CBT treatment in outpatients with pure GAD who were treated by a therapist working in routine care. &lt;i&gt;Methods:&lt;/i&gt; Seventy-two outpatients, fulfilling GAD criteria according to DSM-IV, were included in the study. From this group, 36 patients (CBT-A) were randomly assigned to 25 sessions of CBT and the other 36 formed a contact control group (CCG). After the contact control period (CC period), these patients were also treated with CBT (CBT-B), allowing not only a parallel group comparison but also an A-B comparison. Therapists were licensed full-time psychologists who worked routinely in outpatient care and had a professional training in CBT. Treatment was done in accordance with a manual, and treatment conformity was controlled by several methods. &lt;i&gt;Results:&lt;/i&gt; The reduction in the score on the Hamilton Anxiety Observer Rating Scale was 6.4% (1.5 points) in the CCG, 35.4% (9.5 points) in the CBT-A and 47.3% (10.3 points) in the CBT-B. In the self-rating Spielberger State-Trait Anxiety Inventory, a reduction of 2.7% was seen in CCG, 14.6% in CBT-A, and 11.6% in CBT-B. According to the Clinical Global Impression Rating, 65.6% of patients were still at least moderately ill at the end of the CC period, while this rate was 33.4% at the end of CBT-A, or 15.7% at the end of CBT-B. All these differences between treatment and control group are statistically highly significant. The clinical improvement remained stable over a follow-up period of 8 months. &lt;i&gt;Conclusions:&lt;/i&gt; CBT is an effective method of treatment for GAD. Differences between control and treatment group are comparable to or larger than those reported in studies on antidepressant drugs.
Error in medicine
Authors: J. P. Cunnington
Journal: JAMA (1995)

To the Editor.  —The article by Dr Leape 1 is provocative and offers a humane approach to a problem that creates suffering for patients and for physicians. However, Leape does us a disservice by not clearly distinguishing between true errors and other adverse outcomes. He defines error as an unintended act (either of omission or commission) or one that does not achieve its intended  This definition is too broad to be useful and obscures the difference between error and adverse outcome. For example, he implies that because 35% to 40% of autopsies reveal diagnoses not found in vivo, these are manifestations of error. The truth is that patients present with illnesses of varying degrees of complexity—some obvious, some covert. Diagnoses missed until autopsy may simply reflect the uncertainty inherent in medicine itself.  Similarly, he suggests that iatrogenic illness is a consequence of error, yet it is one of the
Immunohistochemical distribution of renal prostaglandin endoperoxide synthase and prostacyclin synthase: Diminished endoperoxide synthase in the hepatorenal syndrome
Authors: Sugantha Govindarajan, Cynthia C. Nast, William L. Smith, Martin A. Koyle, George Daskalopoulos, Robert D. Zipser
Journal: Hepatology (1987)

To evaluate possible causes of the diminished prostaglandin production in advanced hepatorenal syndrome, prostaglandin endoperoxide synthase and prostacyclin synthase were localized and semiquantitated by immunofluorescence in postmortem, biopsy and nephrectomy renal tissues. In normal kidneys, antiprostacyclin synthase serum caused intense staining in peritubular capillaries, in the adjacent renal interstitial cells and in glomerular mesangial regions. Antiprostaglandin endoperoxide synthase serum caused staining of collecting duct epithelial cells, cells of the thin ascending limb and possibly glomerular mesangial cells. Prostacyclin synthase-positive staining was graded 5+ (scale of 0+ to 5+) in all kidney samples. Medullary collecting tubule prostaglandin endoperoxide synthase-positive staining was graded 4+ or 5+ in kidney samples from patients with acute tubular necrosis or acute tubulointerstitial nephritis and from patients with liver failure without the hepatorenal syndrome. However, prostaglandin endoperoxide synthase-positive staining was markedly diminished or absent (average 1+) in patients with the hepatorenal syndrome. These data suggest that loss of the medullary prostaglandin endoperoxide synthase is the cause of diminished urinary prostaglandin E 2 excretion in the hepatorenal syndrome.
The American Public and the Critical Choices for Health System Reform
Authors: Robert J. Blendon
Journal: JAMA (1994)

AN ARTICLE published 2 years ago inThe JOURNALidentified the seven critical choices that are necessary to craft any national health plan.<sup>1</sup>Every proposal for reforming the health care system must, at a minimum, address these critical issues: (1) Should everyone be guaranteed health insurance? (2) How should universal coverage be provided? (3) How should universal coverage be paid for? (4) Should Medicaid be retained? (5) What health benefits should be included in a national plan? (6) How should health care costs be controlled? and (7) Who should administer a national health plan? During the subsequent period, public opinion has been an important participant in the debate over health system reform. Almost every week newspapers report the latest poll results on health system reform. These survey findings are continuously cited by proponents of various reform proposals to buttress their particular positions. In this article we undertake a comprehensive
The last armed service hospital
Authors: P. Fulford
Journal: BMJ (1999)

EDITOR—The decision to close the Royal Hospital Haslar at Gosport was announced by the Ministry of Defence amid some woolly proposals for a new centre for defence medicine and promises of money for recruitment. The headline in medicopolitical digest called this a boost for service medicine1; it seems more like the kiss of death.

With no established centre of clinical expertise and training it will be impossible to maintain some important functions. Military wings in civilian hospitals have failed to provide rapid clinical services for …
PROTECTION AGAINST LICE
Authors: George Homan
Journal: JAMA (1918)

<h3>To the Editor:</h3> —InThe Journal, April 27, 1918, p. 1247, your London correspondent mentions some important facts respecting the rôle of the louse as the cause of trench fever; and, from what is there said, it would appear that, while the typhus disease is conveyed by the bite of the louse, trench fever is the result of an infection from the other end of that insect. Indeed, it would seem that man, proud man, has been reduced to the last stage of physical degradation by being trodden on, preyed on, and his comfort, health and life placed in jeopardy by the excrement of this abhorred parasite—the indignity being literally rubbed into him in a double sense; and, in this connection, the means of prevention are of first importance—and as they appear to be simple and available, I now take the liberty of speaking on this subject. In the accounts
Stronger sanctions needed against companies that suppress data
Authors: Bob Roehr
Journal: BMJ (2004)

“Suppression of science is not an anomaly but is typical of, and produced by, the current economic, political, and social situation, and that is—money talks. It is the system; it is not just a few bad apples,” Dr David Egilman, a professor of medicine at Brown University, Providence, Rhode Island, told a conference this week.

Although money was important, there were also other forces at work, he said. “It is broader than money, it's ideology and power. Ideology is a much larger bias than money—much harder to ferret out and think through,” he added.

His words found a ready audience among those attending the one day conference Conflicted $cience: Corporate and …
Psychosocial stress in pregnancy and its relation to the onset of premature labour.
Authors: R W Newton, P A Webster, P S Binu, N Maskrey, A B Phillips
Journal: BMJ (1979)

A modified life events inventory was presented over a four-month period to 132 consecutive women going into spontaneous labour in Hull and Manchester. Three study groups were identified according to the duration of pregnancy. The levels of psychosocial stress in pregnancy were found to be particularly high in the mothers whose babies were born preterm. Stressful events may precipitate preterm labour in some women. The concept of antenatal care may have to be broadened if the incidence of premature labour and resulting perinatal mortality are to be reduced.
Drug Therapy for Criminals — Training of Doctors — The Doctor and His Wife
Authors: John Lister
Journal: New England Journal of Medicine (1973)

THE recent licensing of benperidol under the Medicines Act and the report of its use as a means of controlling the abnormal libido of sexual offenders in British prisons provoked a lively controversy in the Times on the ethics of this approach to the problem. Inevitably, the charge was made that prisoners had been used as guinea pigs, and prison reform groups were urged to campaign for the protection of mind, body and sexual desire from new forms of control in the guise of benevolent treatment. The prison psychiatrist who had been involved in the clinical trial pointed out that . . .
The Epidemiology, Diagnosis, and Management of Aristolochic Acid Nephropathy
Authors: M. Refik Gökmen, Jean-Pierre Cosyns, Volker M. Arlt, Marie Stiborová, David H. Phillips, Heinz H. Schmeiser, Monique S.J. Simmonds, H. Terence Cook, Jean-Louis Vanherweghem, Joëlle L. Nortier, Graham M. Lord
Journal: Annals of Internal Medicine (2013)

It has been 20 years since the first description of a rapidly progressive renal disease that is associated with the consumption of Chinese herbs containing aristolochic acid (AA) and is now termed aristolochic acid nephropathy (AAN). Recent data have shown that AA is also the primary causative agent in Balkan endemic nephropathy and associated urothelial cancer. Aristolochic acid nephropathy is associated with a high long-term risk for renal failure and urothelial cancer, and the potential worldwide population exposure is enormous. This evidence-based review of the diagnostic approach to and management of AAN draws on the authors' experience with the largest and longest-studied combined cohort of patients with this condition. It is hoped that a better understanding of the importance of this underrecognized and severe condition will improve epidemiologic, preventive, and therapeutic strategies to reduce the global burden of this disease.
Electrochemotherapy and inducible T cell co-stimulator (iCOS) antibody therapy: a novel combinational therapy for the enhanced treatment in cancers of poor prognosis
Authors: Morgan O'Brien, Patrick Forde, Derek Power, Declan Soden
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts The correlation between the level of immune involvement and immune cell infiltration within a treated tumour and the clinical outcome for patients has been well established in many solid tumour types. High numbers of tumour infiltrating lymphocytes has been associated with a
Addiction to Diazepam (Valium)
Authors: E. B. Gordon
Journal: BMJ (1967)

MMBICLJOURNALAddiction to Diazepam (Valium) SIR,-Prominence has recently been given to the phenomenon of addiction to so-called innocuous drugs.'The following is a case report of addiction to such a drug-namely, diazepam, a preparation which is being used widely in general practice and in psychiatry.