tbuckley/cabot-search huggingface dataset:
Commercial Serological Antibody Detection Tests for the Diagnosis of Pulmonary Tuberculosis: A Systematic Review
Authors: Karen R Steingart, Megan Henry, Suman Laal, Philip C Hopewell, Andrew Ramsay, Dick Menzies, Jane Cunningham, Karin Weldingh, Madhukar Pai
Journal: PLoS Medicine (2007)

Background The global tuberculosis epidemic results in nearly 2 million deaths and 9 million new cases of the disease a year. The vast majority of tuberculosis patients live in developing countries, where the diagnosis of tuberculosis relies on the identification of acid-fast bacilli on unprocessed sputum smears using conventional light microscopy. Microscopy has high specificity in tuberculosis-endemic countries, but modest sensitivity which varies among laboratories (range 20% to 80%). Moreover, the sensitivity is poor for paucibacillary disease (e.g., pediatric and HIV-associated tuberculosis). Thus, the development of rapid and accurate new diagnostic tools is imperative. Immune-based tests are potentially suitable for use in low-income countries as some test formats can be performed at the point of care without laboratory equipment. Currently, dozens of distinct commercial antibody detection tests are sold in developing countries. The question is "do they work?" Methods and Findings We conducted a systematic review to assess the accuracy of commercial antibody detection tests for the diagnosis of pulmonary tuberculosis. Studies from all countries using culture and/or microscopy smear for confirmation of pulmonary tuberculosis were eligible. Studies with fewer than 50 participants (25 patients and 25 control participants) were excluded. In a comprehensive search, we identified 68 studies. The results demonstrate that (1) overall, commercial tests vary widely in performance; (2) sensitivity is higher in smear-positive than smear-negative samples; (3) in studies of smear-positive patients, Anda-TB IgG by enzyme-linked immunosorbent assay shows limited sensitivity (range 63% to 85%) and inconsistent specificity (range 73% to 100%); (4) specificity is higher in healthy volunteers than in patients in whom tuberculosis disease is initially suspected and subsequently ruled out; and (5) there are insufficient data to determine the accuracy of most commercial tests in smear microscopy–negative patients, as well as their performance in children or persons with HIV infection. Conclusions None of the commercial tests evaluated perform well enough to replace sputum smear microscopy. Thus, these tests have little or no role in the diagnosis of pulmonary tuberculosis. Lack of methodological rigor in these studies was identified as a concern. It will be important to review the basic science literature evaluating serological tests for the diagnosis of pulmonary tuberculosis to determine whether useful antigens have been described but their potential has not been fully exploited. Activities leading to the discovery of new antigens with immunodiagnostic potential need to be intensified.
Prolapsing Gastric Polyp, an Unusual Cause of Gastric Outlet Obstruction: A Review of the Pathology and Management of Gastric Polyps
Authors: A. Kumar, C. R. G. Quick, D. L. Carr-Locke
Journal: Endoscopy (1996)

Gastric polyps are rare and largely asymptomatic, but attract importance because of their strong potential to progress to carcinoma. Rarely, pedunculated polyps arising in the antrum may prolapse through the pylorus, causing intermittent gastric outlet obstruction. We describe here our experience of four cases collected over a ten-year period, each presenting dissimilarly with this phenomenon. We review the literature referring to the pathogenesis of gastric polyps and their association with malignancy and other disorders. We proceed to discuss the efficacy of barium studies versus gastroscopy in detecting these lesions, the relative roles and merits of endoscopic polypectomy and surgery, and the importance of prolonged follow-up of patients harbouring gastric polyps.
Managed Care Ethics
Authors: Daniel Temianka
Journal: Annals of Internal Medicine (1998)

Letters15 October 1998Managed Care EthicsDaniel Temianka, MDDaniel Temianka, MDHealthCare Partners Medical Group; Torrance, CA 90502Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-8-199810150-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I submit that Hall and Berenson's “red-faced test” [1] should be applied with at least equal vigor and consistency in the world of private practice. For example, what shade of pink will the face of the cardiologist be when informing his patient that he will earn several hundred dollars more today if he inserts a Swan-Ganz catheter? This is of particular importance in light of major recent studies [2, 3] showing that the outcome of such an intervention is likely to be worse than if care is conservative (that is, if the procedure is denied).Hall and ...References1. Hall MA, Berenson RA. Ethical practice in managed care: a dose of realism. Ann Intern Med. 1998; 128:395-402. Google Scholar2. Tu JV, Pashos CL, Naylor CD, Chen E, Normand SL, Newhouse JP, et al. Use of cardiac procedures and outcomes in elderly patients with myocardial infarction in the United States and Canada. N Engl J Med. 1997; 336:1500-5. Google Scholar3. Connors AF. The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA. 1996; 276:889-97. Google Scholar Author, Article, and Disclosure InformationAffiliations: HealthCare Partners Medical Group; Torrance, CA 90502 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 October 1998Volume 129, Issue 8Page: 673KeywordsCathetersDecision makingHealth maintenance organizationsLegislationPatients Issue Published: 15 October 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Acute Pancreatitis: Advances in Pathogenesis, Diagnosis and Treatment
Authors: Sumner C. Kraft
Journal: JAMA (1985)

The title of this monograph correctly describes its content, presented in 18 concise chapters by a multidisciplinary assembly of pancreatologists from seven countries. The intent of the meeting was to contribute to both a better understanding of and a more rewarding treatment for acute pancreatitis. Efforts to compensate for the somewhat delayed publication of these proceedings are evidenced by references in the majority of the chapters to articles and books published in 1982. The text encompasses etiopathogenesis, diagnosis, clinical features, and therapy—the last representing 40% of the text. Noteworthy areas of coverage include a comprehensive opening chapter on the neurohormonal control of pancreatic secretion, an especially well-referenced review of drug-induced pancreatitis, clearly illustrated overviews of the value of ultrasonography and computed tomography, and surgical aspects of management. Consideration is given to choosing among therapeutic options, with at least brief mention of the major points for or against the use of
Relation between frequency of asthma and IgE antibody levels against Dermatophagoides farinae and total serum IgE levels in schoolchildren
Authors: Masanao Shibasaki, Kimio Tajima, Akihiro Morikawa, Masato Mitsuhashi, Ryo Sumazaki, Kenichi Tokuyama
Journal: Journal of Allergy and Clinical Immunology (1988)
Left ventricular end-systolic elastance is incorrectly estimated by the use of stepwise afterload variations in conscious, unsedated, autonomically intact dogs.
Authors: A J Crottogini, P Willshaw, J G Barra, R H Pichel
Journal: Circulation (1994)

BACKGROUND End-systolic elastance (Ees), the slope parameter of the end-systolic pressure (ESP)-volume (ESV) relation (ESPVR), is usually estimated in patients by producing stepwise, steady-state pharmacological afterload variations and collecting one ESP-ESV point from each step. The ESPVR is then constructed by fitting a linear equation to these points. In sedated, autonomically blocked dogs, it has been shown that when one point from control, one point from a state of increased afterload, and one point from a state of decreased afterload are used, the resulting Ees incorrectly estimates true Ees, defined as the slope of the ESPVR obtained by transient vena caval occlusion. We investigated if this was also the case in unsedated, autonomically intact dogs when the points used belonged to steady states of progressively decreasing or progressively increasing afterload pressure. METHODS AND RESULTS In 10 conscious dogs instrumented with left ventricular (LV) endocardial sonomicrometers to measure LV volume, a LV pressure transducer, and an inferior vena caval (IVC) occluder, two protocols were carried out on separate days. In each protocol, an ESPVR was generated by IVC occlusion in the control state and in two steady-state levels of afterload change produced by stepwise infusion of nitroprusside (protocol 1, afterload decrease) and angiotensin II (protocol 2, afterload increase). In each protocol, steady-state ESP-ESV data points were averaged from the control state and from each level of afterload variation. Linear equations were fitted to the three steady-state points from each protocol, and the estimated Ees values obtained (EesEST) were compared with the Ees values of the control ESPVRs obtained by IVC occlusion (EesTRUE). In protocol 1, EesEST underestimated EesTRUE by about 16% (EesEST, 6.49 +/- 1.55 mm Hg/mL; EesTRUE, 7.48 +/- 1.29 mm Hg/mL; P &lt; .02). In protocol 2, EesEST overestimated EesTRUE by about 37% (EesEST, 9.99 +/- 3.97 mm Hg/mL; EesTRUE, 6.43 +/- 3.88 mm Hg/mL; P &lt; .007). CONCLUSIONS In conscious, autonomically intact dogs, the use of stepwise, steady-state afterload variations to obtain ESP-ESV data points to construct the ESPVR incorrectly estimates Ees. In the case of afterload reduction, EesTRUE is underestimated an average of 16.3%, and in the case of afterload increase, EesTRUE is overestimated an average of 37.1%. These errors should be taken into account when interpreting clinical studies using this methodology.
Cyclosporine: GVHD and beyond
Authors: Robertson Parkman
Journal: New England Journal of Medicine (1988)

Graft-versus-host disease (GVHD) holds a dual place in contemporary medicine. Clinically, it presents a serious problem in histocompatible bone marrow transplantation, and it is the principal limitation to histoincompatible bone marrow transplantation. Biologically, GVHD is a model for diseases of autoimmunity and immune dysregulation. After bone marrow transplantation, GVHD can present as either of two clinical syndromes: the acute disease, which is characterized by the cytolytic destruction of the recipient's skin, gastrointestinal tract, and liver; or chronic GVHD, in which there are scleroderma-like changes in the skin, gastrointestinal tract, and liver and the development of autoantibodies in the presence of . . .
Thalidomide plus dexamethasone as a maintenance therapy after autologous hematopoietic stem cell transplantation improves progression‐free survival in multiple myeloma
Authors: Angelo Maiolino, Vania T.M. Hungria, Marcia Garnica, Gislaine Oliveira‐Duarte, Luciana C.O. Oliveira, Daniel R. Mercante, Eliana C. Miranda, Adriana A. Quero, Ana L.M. Peres, José C. Barros, Paola Tanaka, Roberto P. Magalhães, Eduardo M. Rego, Irene Lorand‐Metze, Carmen S.P. Lima, Ilana Z. Renault, Esteban Braggio, Carlos Chiattone, Marcio Nucci, Carmino A. de Souza
Journal: American Journal of Hematology (2012)

Despite the good response of stem cell transplant (SCT) in the treatment of multiple myeloma (MM), most patients relapse or do not achieve complete remission, suggesting that additional treatment is needed. We assessed the impact of thalidomide in maintenance after SCT in untreated patients with MM. A hundred and eight patients (<70 years old) were randomized to receive maintenance with dexamethasone (arm A; n = 52) or dexamethasone with thalidomide (arm B; n = 56; 200 mg daily) for 12 months or until disease progression. After a median follow-up of 27 months, an intention to treat analysis showed a 2-year progression-free survival (PFS) of 30% in arm A (95% CI 22-38) and 64% in arm B (95% CI 57-71; P = 0.002), with median PFS of 19 months and 36 months, respectively. In patients who did not achieve at least a very good partial response, the PFS at 2 years was significantly higher when in use of thalidomide (19 vs. 59%; P = 0.002). Overall survival at 2 years was not significantly improved (70 vs. 85% in arm A and arm B, respectively; P = 0.27). The addition of thalidomide to dexamethasone as maintenance improved the PFS mainly in patients who did not respond to treatment after SCT.
"Tridione" in Treatment of Epilepsy
Authors: C. W. M. Whitty
Journal: BMJ (1949)

We present a case of primary pericardial mesothelioma occurring in an asbestos-exposed 67-year-old man who underwent four aortocoronary bypass grafting seven years prior to the onset of the mesothelioma. Primary pericardial mesothelioma is a rare tumor whose association with asbestos is more infrequent than that of the much more common pleural form. Factors other than asbestos that may play a role include genetic predisposition, immune impairment, infections, radiation, dietary factors, and recurrent serosal inflammation. We consider that, in the presented case, inflammation and healing resulting from pericardiotomy might have had a synergistic effect with asbestos in the pathogenesis of the tumor. To our knowledge, this is the first reported case of primary pericardial mesothelioma arising in a patient exposed to asbestos who previously underwent cardiac surgery.
Hybrid superparamagnetic iron oxide nanoparticle-branched polyethylenimine magnetoplexes for gene transfection of vascular endothelial cells
Authors: Ran Namgung, Kaushik Singha, Mi Kyung Yu, Sangyong Jon, Yong Sook Kim, Youngkeun Ahn, In-Kyu Park, Won Jong Kim
Journal: Biomaterials (2010)
Familial Cases of Endomyocardial Fibrosis in Uganda
Authors: A. K. Patel, J. L. Ziegler, P. G. D'Arbela, K. Somers
Journal: BMJ (1971)

This report describes nine cases of endomyocardial fibrosis occurring in four families. All patients came from Rwanda or South-western Uganda, and five had tropical splenomegaly syndrome as well. It seems likely that genetic as well as environmental factors are operative in the aetiology of endomyocardial fibrosis.
Anticoagulant therapy--1974
Authors: S. Wessler
Journal: JAMA (1974)

THE national impact of thrombosis should not be underestimated. Arterial thromboembolism is a major, if not the primary, contributor to the number 1 (acute myocardial infarction), number 3 (stroke), and the number 4 (renal) causes of death in the United States. In addition, thromboembolic episodes are frequently associated (either causally or as a complication) with rheumatic or atherosclerotic valvular diseases, arrythmias, congestive heart failure, and intimal damage in the carotid artery, the aorta-iliac region, and the arteries of the lower extremities. Some infections and severe blood dyscrasias also may be associated with arterial thrombosis.  Venous thromboembolism causes approximately 300,000 patients annually to be hospitalized in the United States, of which more than 50,000 die. The cost of the hospitalization of the 250,000 survivors has been calculated to be approximately $750 million per year. These figures do not include the morbidity and cost for patients with venous thrombosis alone, nor the
Conversion of human erythrocyte-adenosine deaminase activity to different tissue-specific isozymes. Evidence for a common catalytic unit.
Authors: R Hirschhorn
Journal: Journal of Clinical Investigation (1975)

Adenosine deaminase activity resides in various characteristic isozymes in red blood cells (RBC-ADA) and other tissues. Absence of RBC-ADA has been reported in a proportion of patients with autosomally inherited severe combined immunodeficiency (SCID). We have previously reported that the tissue isozymes of ADA are also deficient in children with SCID and RBC-ADA deficiency, although these isozymes differ from RBC-ADA in molecular weight, accessible SH groups, and electrophoretic mobility. The deficiency of all types of ADA in SCID implies that a catalytic unit of ADA in each isozyme is coded by the same structural gene. The relationship of RBC-ADA and the different tissue ADA isozymes is the subject of this paper. Incubation of RBC-ADA with ADA-deficient liver, kidney, and fibroblast extracts resulted in the appearance of new isozymes of ADA. These newly generated isozymes had the physicochemical and electrophoretic characteristics of the tissue-specific isozymes obtained from normal tissues. The electrophoretic mobility of the isozyme generated appeared to depend upon the tissue utilized and corresponded to the electrophoretic mobilities of the ADA isozymes found naturally in each of the different tissues. Additionally, the genetically determined polymorphism exhibited by RBC-ADA could be detected in the isozyme generated. Incubation with normal kidney also caused conversion of the RBC isozyme to the kidney form. These findings further support the concept that the catalytic activity of each of the several forms of the ADA enzyme resides in a single molecule coded at the same genetic locus as is defective in one form of SCID. The tissue-specific isozymes, which differ in electrophoretic mobility and molecular weight, are generated by interaction of the RBC catalytic unit with tissue-specific factors present in the different tissues of normal humans and patients.
Narcotics and Pulmonary Edema
Authors: KENNETH MASTER
Journal: Annals of Internal Medicine (1972)

Letters, Comments, and Corrections1 November 1972Narcotics and Pulmonary EdemaKENNETH MASTER, M.D.KENNETH MASTER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-77-5-817_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Drs. Frand, Shim, and Williams at Einstein Medical Center have presented us with two excellent discussions on the pathogenesis, clinical course, and pulmonary function results in methadone-induced and heroin-induced pulmonary edema (76:975-979 and 77: 29-35, 1972).We have had similar findings at Metropolitan Hospital: of 31 patients admitted to the pulmonary intensive care unit in the past 12 months for heroin or methadone overdosage, 23 developed overt pulmonary edema, and 8 did not. Two of the 31 patients had methadone overdosage and developed pulmonary edema. One of the two was a nonaddict who had ingested an unknown... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: KENNETH MASTER, M.D.Affiliations: Pulmonary Division Metropolitan Hospital New York, N.Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrug-induced pulmonary edema and acute respiratory distress syndromeOut-of-hospital Treatment of Opioid Overdoses in an Urban Setting 1 November 1972Volume 77, Issue 5Page: 817-817KeywordsEdemaHeroinPathogenesisPulmonary functionPulmonary intensive care units ePublished: 1 December 2008 Issue Published: 1 November 1972 PDF downloadLoading ...
Thyroid eye disease. Patients need joint care.
Authors: J L Noble, B Leatherbarrow
Journal: BMJ (1993)

Thyroid eye diseaseMore treatment options EDrTOR,-Donald Munro clearly reviews the pathogenesis and treatment of dysthyroid eye disease.'There are, however, alternative treat- ments which merit consideration.Lid retraction may be asymptomatic but a considerable proportion of patients benefit from upper or lower eyelid lengthening procedures.2These can be very effective in improving the cosmetic appearance and protecting the cornea.These procedures are preferable to lateral tarsor- rhaphy because the cosmetic results are better and anterior displacement of the globe is not restricted (thus lessening the risk of optic nerve compression).High dose steroid treatment is effective in relieving compressive optic neuropathy, but the disease often progresses when the dose is gradually reduced to a more modest level.So, in many cases, long term maintenance treatment is required.Local treatment is therefore preferable and avoids the well known side effects of steroids.Surgical decompression of the orbit into the maxillary and ethmoid sinuses is a successful procedure for many patients, including those for whom the "eye signs are disfiguring or disabling."Complications include double vision due to stra- bismus and infraorbital hypoaesthesia.Radiotherapy is dismissed by Munro: "Britain has few enthusiasts for local irradiation of the orbit."Carefully planned low dose external beam radiotherapy is very effective in patients with progressive disease,34 particularly disease of less than two years' duration.The long term risk of neoplasia is low.It is negligible in elderly patients, for whom this treatment is particularly indicated because of the problems associated with taking steroids long term.
ENCEPHALITIS ASSOCIATED WITH MEASLES
Authors: JOSEPHINE B. NEAL
Journal: JAMA (1927)

The literature on encephalitis associated with measles is meager and rather indefinite. The ideas with regard to encephalitis have undergone considerable change in the past few years as a result of the intensive study of epidemic encephalitis. There are numerous references to involvement of the central nervous system during or shortly after an attack of measles. In most instances the authors apparently regarded these symptoms as incidental. Only rarely were the symptoms referable to the central nervous system grouped and designated as a definite clinical entity. It has been recognized for a long time that the various acute infections, as measles, scarlet fever, pneumonia and pertussis, may be followed by encephalitis, most of which have manifested themselves in the form of a cerebral hemiplegia. Particular attention was called to these points by Abt<sup>1</sup>in 1906. While we have seen a few instances of encephalitis following various of the acute