tbuckley/cabot-search huggingface dataset:
Staging of hepatocellular carcinoma: assessment of the CLIP, Okuda, and Child-Pugh staging systems in a cohort of 257 patients in Toronto
Authors: I Levy
Journal: Gut (2002)

<b>Background:</b> A new staging system for hepatocellular carcinoma (HCC) has recently been reported from Italy (CLIP classification). It combines Child-Pugh staging with tumour criteria: tumour morphology, portal invasion, and alpha fetoprotein levels. <b>Aims:</b> To validate the use of the CLIP staging in a cohort of HCC patients and compare it with Okuda staging. <b>Patients and methods:</b> A retrospective analysis of patients with HCC diagnosed in the Toronto General Hospital between October 1994 and December 1998. <b>Results:</b> A total of 313 patients were identified; 19 patient with insufficient data and 37 transplant patients were excluded. Hence 257 patients in whom complete data for clinical staging were available were included in the study. The median survival of the cohort was 22.8 months. The CLIP stage 0 group (23.1% of the cohort) and the Okuda stage 1 group (50.7% of the cohort) had a five year survival rate of 67% and 35%, respectively (p&lt;0.02). The CLIP stage 0 criteria more accurately defined patients with a good prognosis. The Okuda classification failed to identify two thirds of the 37 patients with a poor prognosis, who were identified by the CLIP criteria. Patients with a CLIP score ≥4 shared a very poor prognosis (median survival 1–3 months). Further classification above stage 4 was unnecessary. <b>Summary:</b> The CLIP classification for HCC is easy to implement and more accurate than the Okuda classification. Our cohort was different from the CLIP cohort (more hepatitis B) but the results were still consistent.
80. Pre-Existing Cytotoxic T-Lymphocyte (CTL) Responses to the AAV CAP Protein Do Not Interfere with AAV Transgene Expression in Mice
Authors: William M. Siders, Johanne Kaplan, Michael Lukason, Jacqueline Shields, Lisa Woodworth, Sam Wadsworth, Abraham Scaria
Journal: Molecular Therapy (2006)

The use of adeno-associated viral (AAV) vectors as a delivery method for gene replacement strategies is currently being explored in several clinical indications. AAV vectors do not express any viral proteins suggesting that they represent a less immunogenic delivery system. However, recent data have suggested that administration of AAV vectors may actually result in the stimulation of T-cell responses that result in a loss of transgene expression and may limit the utility of these vectors. By using computer prediction algorithms, we identified several AAV peptides as putative MHC I binders. Immunization of mice with peptides predicted to have the highest binding affinities did not result in a detectable cytotoxic T lymphocyte (CTL) response. In addition, intravenous administration of increasing doses of AAV serotype 2 vector also failed to induce a measurable CTL response. In contrast, immunization with either a plasmid or an adenoviral vector encoding the full length AAV2 CAP protein, to mimic exposure to wild type AAV, generated a potent CTL response. A pre-existing CTL response is likely to be present in the human population and C57Bl/6 IgH6 knock-out (KO) mice were used to determine whether such CTLs could affect AAV transduction and subsequent transgene expression. When immunized with two doses of CAP plasmid, the IgH6 KO mice mounted a robust CTL response without the generation of AAV neutralizing antibodies. The mice were then injected with an AAV2 vector encoding the alpha-galactosidase (a-gal) protein. AAV transduction was unimpeded and the serum levels of a-gal protein as well as the longevity of transgene expression were comparable to those observed in mice pre-immunized with empty plasmid as a control. In contrast, wild-type C57Bl/6 mice pre-immunized with CAP plasmid, which developed both CTLs and neutralizing antibodies against AAV, did not show any evidence of a-gal expression after the injection of vector. Taken together, results of these experiments suggest that pre-existing AAV-specific CTLs may have little or no effect on AAV transduction or transgene expression and confirm that neutralizing antibodies significantly interfere with transduction by AAV vector. I am an employee of Genzyme Corporation.
A personal-contact weight-loss maintenance intervention reduced weight regain in overweight and obese adults
Authors: Lawrence J. Cheskin
Journal: Annals of Internal Medicine (2008)

Source Citation Svetkey LP, Stevens VJ, Brantley PJ, et al. Comparison of strategies for sustaining weight loss: the Weight Loss Maintenance randomized controlled trial. JAMA. 2008;299:1139-48. 18334689
Thrombosis of Cerebral Veins in the Puerperium
Authors: D. R. Cairns, G. Melton
Journal: BMJ (1942)

MEIALJURAabove case, since there was evidence of some pelvic sepsis.It would be of interest to know if cases had been reported of this condition associated with pelvic thrombosis arising out of other conditions-for example, post-operative pelvic thrombosis.My thanks are due to Dr. W. I.
Reporting Cost-effectiveness Analyses With Confidence-Reply
Authors: Joanna E. Siegel
Journal: JAMA (1997)

<h3>In Reply.</h3> —The Panel on Cost-Effectiveness in Health and Medicine has recommended that summary tables reporting incremental cost-effectiveness exclude ratios for dominated alternatives.<sup>1,2</sup>Drs Sacristán and Obenchain correctly point out that, even if a medical intervention is judged on the basis of baseline estimates to be dominated by another intervention (eg, to have higher cost but produce less health benefit than the other), the conclusion of dominance may be premature owing to uncertainties in baseline parameters. Sacristán and Obenchain would recommend use of CIs for reported cost-effectiveness ratios on all alternatives. Our specific recommendation that cost-effectiveness ratios should not appear for dominated alternatives is intended to reduce confusion concerning the interpretation of cost-effectiveness results tables. The calculation of base-case results for the efficient options (those not dominated under the main assumptions in the analysis) is less transparent if ratios for dominated programs are included in cost-effectiveness tables. Sacristán and Obenchain's main
Communication between general practitioners and consultants: what should their letters contain?
Authors: J. Newton, M. Eccles, A. Hutchinson
Journal: BMJ (1992)

To canvass the views of all general practitioners and consultants working in Newcastle upon Tyne on the content of referral letters and replies, the feasibility of standardising certain aspects of referral letters, and the use of communications data for audit purposes.A postal questionnaire was sent to all general practitioners and consultants in Newcastle upon Tyne in May 1991. Questions were asked about the clinical and administrative content of letters, the utility of standard categories to state the reason for referral, the idea of using letters for feedback purposes, and communications as a potential topic for professionally led audit.Area served by Newcastle upon Tyne Family Health Services Authority and District Health Authority.Replies were received from 274 (77%) doctors (115 general practitioners and 159 consultants). A majority (225; 82%) were in favour of items defined as "always important" forming a minimum requirement for referral letters and for consultants' replies. Using standardised categories to state the reason for referral was not endorsed: 102 (89%) general practitioners and 132 (83%) consultants preferred referrers to use their own words. Using referral communications to provide feedback was less popular with consultants (54; 34%) than general practitioners (72; 63%). Finally, a majority of doctors (179; 65%) were in favour of using written communications as a topic for professionally led audit.A high degree of consensus exists among clinicians about the content of referral communications. Although doctors may still reject the concept of standardised communications, they have unambiguously endorsed a standard for communication that they can aspire to, and they are prepared to use it as a yardstick for their actual performance.
Lung-Residing Myeloid-derived Suppressors Display Dual Functionality in Murine Pulmonary Tuberculosis
Authors: Julia K. Knaul, Sabine Jörg, Dagmar Oberbeck-Mueller, Ellen Heinemann, Lisa Scheuermann, Volker Brinkmann, Hans-Joachim Mollenkopf, Vladimir Yeremeev, Stefan H. E. Kaufmann, Anca Dorhoi
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Myeloid cells encompass distinct populations with unique functions during homeostasis and disease. Recently, a novel subset of innate cells, myeloid-derived suppressor cells (MDSCs), has been described in cancer, which suppresses T-cell responses and fosters disease progression. The role of MDSCs in infection is insufficiently addressed.To examine the presence and function of MDSCs during experimental pulmonary tuberculosis (TB) and further understand the immunologic consequences of direct interactions between MDSCs and lung bacterial pathogens.Using cell-based approaches and experimental mouse models for pulmonary TB we characterized MDSCs as novel myeloid populations directly interacting with Mycobacterium tuberculosis (Mtb).MDSCs readily phagocytosed Mtb, and released proinflammatory (IL-6, IL-1α) and immunomodulatory (IL-10) cytokines while retaining their suppressive capacity. MDSCs were identified at the site of infection in the lung in disease-resistant and -susceptible mice during pulmonary TB. Excessive MDSC accumulation in lungs correlated with elevated surface expression of IL-4Rα and heightened TB lethality, whereas targeted depletion of MDSCs ameliorated disease.Our data reveal that MDSCs provide a niche for pathogen survival and tailor immunity in TB. These findings suggest MDSCs as amenable targets for host-directed therapies and emphasize them as cellular-immune regulators during chronic inflammatory conditions, including chronic infections and microbial complications of neoplastic disorders.
Gastric Carcinoma and Serum Pepsinogen I
Authors: G. DAVIS GAMMON
Journal: Annals of Internal Medicine (1981)

Letters and Corrections1 April 1981Gastric Carcinoma and Serum Pepsinogen IG. DAVIS GAMMON, M.D.G. DAVIS GAMMON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-4-541 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Nomura and colleagues (1) recently reported the results of a case control study of the association between gastric carcinoma and serum pepsinogen I levels in Oriental men in Hawaii. Their case and control groups were derived from a population participating in a prospective cohort study, the Honolulu Heart Program. This population, consisting of approximately 7500 largely first- and second-generation Japanese men, was at considerably higher risk of acquiring gastric carcinoma than the U.S. population as a whole. The authors reported annual age-specific incidence rates of gastric carcinoma ranging from 23.1 cases per 100 000 population for ages...References1. NOMURASTEMMERMANSAMLOFF AGI. Serum pepsinogen I as a predictor of stomach cancer. Ann Intern Med. 1980;93:537-40. LinkGoogle Scholar2. MAUSNERBAHN JA. Epidemiology: An Introductory Text. Philadelphia: W.B. Saunders Co.; 1974:250. Google Scholar3. COLTON T. Statistics in Medicine. Boston: Little, Brown and Co.; 1974:71. Google Scholar4. MACMAHONPUGH BT. Epidemiology: Principles and Methods. Boston: Little, Brown and Co.; 1970:65 Google Scholar1. STEMMERMANNISHIDATESAMLOFF GTI: Intestinal metaplasia of the stomach in Hawaii and Japan: a study of its relation to serum pepsinogen I, gastrin, and parietal cell antibodies. Am J Dig Dis. 1978;23:815-20. CrossrefMedlineGoogle Scholar2. VARISSAMLOFFIHAMAKISIURALA KITM. An appraisal of tests for severe atrophic gastritis in relatives of patients with pernicious anemia. Am J Dig Dis. 1979;24:187-91. Google Scholar3. CORREAHAENSZELCUELLOTANNENBAUMARCHER PWCSM. A model for gastric cancer epidemiology. Lancet. 1975;2:58-60. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Yale University School of Medicine New Haven, CT 06519 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHuman pepsinogens: A review of clinical and genetic aspects 1 April 1981Volume 94, Issue 4_Part_1Page: 541-542KeywordsCohort studiesHeart Issue Published: 1 April 1981 PDF DownloadLoading ...
Basis for defective proliferation of peripheral blood T cells to anti-CD2 antibodies in primary Sjögren's syndrome.
Authors: R Gerli, A Bertotto, E Agea, L Lanfrancone, C Cernetti, F Spinozzi, P Rambotti
Journal: Journal of Clinical Investigation (1990)

Anti-CD2-induced T cell proliferation was analyzed in the peripheral blood samples of 31 primary and 8 secondary untreated Sjögren's syndrome patients. Anti-CD2-stimulated PBMC proliferation was very low in about one-third of primary Sjögren's syndrome samples, despite the number of CD2+ cells being similar in primary and secondary Sjögren's syndrome and normal PBMC samples. The depressed response to anti-CD2 was mainly found in anti-Ro+/La+ patients. Experiments on purified T cells demonstrated that a defect at the T cell level was responsible for the anti-CD2 unresponsiveness. Cell proliferation failure was associated with poor IL-2 and IL-2 receptor mRNA expression and, consequently, IL-2 and IL-2 receptor synthesis. Since defective anti-CD2-induced mitogenesis could be reversed by phorbol myristate acetate, but not calcium ionophore A23187, it is probably correlated with impaired protein kinase C activation. Comparison of anti-CD2-triggered PBMC proliferation in treated and untreated patients and a long-term study of nine patients showed that the defect is a stable characteristic in primary Sjögren's syndrome patients, but that it can be reversed by pharmacological immunosuppression.
REVISION OF THE INSANITY LAWS OF VIRGINIA
Authors: William Francis Drewry, W. F. D.
Journal: American Journal of Psychiatry (1900)

Since writing this paper, the attorney-general of Virginia advises me that the commission to ascertain insanity is composed of the county or the corporation judge or ONE justice of the peace (instead of two), and two (2) physicians. A typographical error in the draft of the original bill caused it to read two justices instead of one justice, as the author of the bill intended.
Flucytosine Treatment of Candida Arthritis
Authors: Stephen A. Imbeau
Journal: JAMA (1977)

THE INCIDENCE of systemic candidiasis in hospitalized patients has risen markedly in the past decade,<sup>1</sup>but its occurrence is almost solely confined to persons with serious underlying disease or therapy that compromises host defense mechanisms. Septic arthritis is occasionally seen with systemic candidiasis, but isolated arthritis (without evidence of other<i>Candida</i>infection) is rare. We herein report the third documented case of isolated<i>Candida</i>arthritis; treatment with a short course of amphotericin B and then prolonged oral flucytosine was successful. <h3>Report of a Case</h3> A 75-year-old woman was referred to University Hospitals for treatment of suppurative arthritis. She had been receiving intra-articular steroid injections (beta-methasone, 0.25 ml, and triamcinolone hexacetonine, 1.25 ml) for degenerative arthritis of the knees since 1965. In 1973, a painful effusion developed in the left knee and<i>Candida parapsilosis</i>was isolated.
Co-education at Royal Free Hospital
Authors: K. V. Macquire
Journal: BMJ (1966)

short, a person specially trained in accident and emergency management.A person who can, one moment, expeditiously remove a fish bone from a child's vallecula fossa ; the next, a foreign body embedded in the cornea; then, with no delay, extract a halfpenny stuck midway down a juvenile gullet.He may be called upon to correct a short circuit in a cardiac pace-regulator which has failed.Aside from such confrontations he may have to rescue from imminent asphyxiation some- one with extreme angioneurotic oedema of face, fauces, and larynx.Your trained expert does not side-step these crises by calling for outside aid; he knows what to do instantly, and another life is saved by his promptitude.Any other specialist, highly capable within
Perianal streptococcal cellulitis with penile involvement
Authors: P. DUHRA, A. ILCHYSHYN
Journal: British Journal of Dermatology (1990)

Perianal streptococcal cellulitis is described occurring in a 5‐year‐old boy. The condition also involved the penis and presented as a possible case of sexual abuse. The correct diagnosis was established by culturing β‐haemolytic streptococci group A from the penile and perianal skin.
Cerebral Palsy in Childhood and Adolescence
Authors: Eric Denhoff
Journal: JAMA (1962)

<i>Cerebral Palsy in Childhood and Adolescence</i>will serve well as a supplementary monograph to the few textbooks already published. The data presented concern the eastern region of Scotland. After reviewing 301 suspected cases in patients under 21 years of age that were registered, the authors confirmed, through retrospective history data and actual examination, the diagnosis of cerebral palsy in 240 cases. A detailed analysis of each type of cerebral palsy was done, and comparison was made with other studies elsewhere in the world. Orthopedic, ophthalmological, dental, psychological, educational, and social aspects were studied in orderly fashion. They found a close relationship between prematurity and the "cerebral diplegia" syndrome. Increased maternal age, delivery by forceps, and primiparity are not important except, possibly, in athetoid cerebral palsy. Hemorrhage occuring in the first 3 months of pregnancy may be of importance in some cases. The authors consider that physiotherapy and bracing is the
THE GIRDLESTONE SPLINT FOR BILATERAL DELTOID PARALYSIS
Authors: Philip Lewin
Journal: JAMA (1926)

While I was visiting Mr. Girdlestone at Oxford, England, in June, 1925, he demonstrated a splint for use in bilateral deltoid paralysis, both as prophylactic and curative measures. He has not published the description and assents to the suggestion of the desirability of makit known so that it might have a suitable trial. The splint (fig. 1) is made of one-eighth inch duralumin<sup>1</sup>with sponge-rubber pads. It consists of six curved bands, and two straight bands each with a short right angled bend, one cross piece behind and four padded metal plates. It is self retaining and very light. The patient (fig. 2) was a man, aged 25, born in the United States, a Rhodes scholar studying at Oxford. He was stricken with infantile paralysis in September, 1923, resulting in complete paralysis below the ninth dorsal segment, almost complete loss of the intercostals and neck muscles, except the platysma, and complete loss of both shoulders and upper arm.
Blood Pressure and Obesity
Authors: H. M. WHYTE
Journal: Circulation (1959)

Previous surveys have shown that height of observed blood pressure and degree of overweight are related. However, excess weight does not necessarily mean excess fat and the possibility of error in the measurement of blood pressure due to variations in the size of the arm has not been excluded. The present survey, taking these factors into account, shows that blood pressure is influenced by the total bulk of the body but not especially by fat except insofar as it contributes to total bulk. A possible explanation of the findings is offered.
Budd-chiari syndrome in patients with hematological disease: A therapeutic challenge
Authors: Subhas C. Ganguli, Nizar N. Ramzan, Michael A. McKusick, James C. Andrews, Robert L. Phyliky, Patrick S. Kamath
Journal: Hepatology (1998)

Advances in radiological imaging studies have simplified the diagnosis of Budd-Chiari syndrome (BCS), but many challenges still remain with respect to therapy.Patients with BCS who have a hematological disorder are an especially difficult group to treat.Major issues related to the treatment of BCS in these patients include the role of thrombolytic therapy, anticoagulation, and shunt surgery or transjugular intrahepatic portosystemic shunts (TIPS); the indications for and risks of liver transplantation; as well as control of the underlying hematological disease.
Does FEV1/FVC Correlate with Asthma Severity Score in Monitoring Asthma Control?
Authors: C.N. Foster, N.M. Rafaels, Y.J. Tsai, T. Murray, M. Stockton-Porter, E. Horowitz, H. Watson, K.C. Barnes
Journal: Journal of Allergy and Clinical Immunology (2009)

RATIONALE: Allergy to airborne fungus can cause rhinitis, hence the exposure to spores inside home is an imprtant factor of sensitizaiton.The role of allergy in chronic rhinosinusitis (CRS) is a pertinent yet unresolved issue.The aim of this study was to evaluate the fungus culture of nasal secretions in allergic rhinitis, allergic rhinitis with CRS, and healthy children. METHODS:The study was performed in 100 children (4-15 year-olds) during December 2007 through August 2008.We categorized the children into three groups: children having allergic rhinitis without CRS (Group I, n 5 40), allergic rhinitis with CRS (Group 2, n 5 40), and healthy children (Group 3, n 5 20).Nasal secretion was collected from all children, and the sample was cultured on the agar plates (Bukard Co.), which were incubated at 28 8 C for 4;6 days.The fungi were identified by morphological method.RESULTS: Positive cultures for fungi were obtained in 26 of 40 (65.0%)CRS patients, and 9 of 20 (45.0%) healthy children.The 6 different organisms were cultured from the nasal secretion and those were Yeast, Alternaria, Cladosporium, Penicillium, Aspergillus, Fusarium.Cladosporium, Aspergillus, Alternaria, and Penicilium were frequently isolated from CRS patients and healthy children.Positive skin test rates and serum eosinophil count were not different between the patients with positive fungus culture and those with negative culture.CONCLUSIONS: The six fungus organisms were cultured from the nasal secretions.The CRS was frequently related with positive fungus culture.Further studies are necessary to evaluate longer follow up of fungus cultures.
Patient Care and Professional Staffing Patterns in McKinney Act Clinics Providing Primary Care to the Homeless
Authors: Bruce H. Doblin
Journal: JAMA (1992)

To describe the patient care and staffing patterns of the 157 clinics that receive federal funding to provide health care to the homeless.Telephone interviews with clinic medical directors.Clinics treated a mean of 96 homeless patients per week, approximately 50% of the estimated homeless population. Three quarters treated homeless patients only, the others integrated homeless patients into an existing setting. One third of the clinics had no physician more than 5 hours per week, 10% had no physician staff at all, and 80% employed a nurse practitioner. The proportion of patients initially examined by a nurse practitioner and the proportion subsequently referred to a physician ranged between 10% and 100%. Clinic directors reported that in over 50% of clinics, physician recruitment was hampered by poor working conditions, inadequate salaries, physician biases against working with the homeless, and the lack of respect this work receives from the medical profession.Current financial constraints may be impeding the ability of clinics serving the homeless to ensure adequate access to high quality care. Additional research should evaluate the impact various staffing patterns have on access and quality of care and develop methods to improve physician recruitment.