tbuckley/cabot-search huggingface dataset:
Reduced in-hospital mortality after improved management of children under 5 years admitted to hospital with malaria: randomised trial
Authors: Sidu Biai, Amabelia Rodrigues, Melba Gomes, Isabela Ribeiro, Morten Sodemann, Fernanda Alves, Peter Aaby
Journal: BMJ (2007)

To test whether strict implementation of a standardised protocol for the management of malaria and provision of a financial incentive for health workers reduced mortality.Randomised controlled intervention trial.Paediatric ward at the national hospital in Guinea-Bissau. All children admitted to hospital with severe malaria received free drug kits.951 children aged 3 months to 5 years admitted to hospital with a diagnosis of malaria randomised to normal or intervention wards.Before the start of the study, all personnel were trained in the use of the standardised guidelines for the management of malaria, including strict follow-up procedures. Nurses and doctors were randomised to work on intervention or control wards. Personnel in the intervention ward received a small financial incentive ($50 (25 pounds sterling; 35 euros)/month for nurses and $160 for doctors) and their compliance with standard case management was closely monitored.In-hospital mortality and cumulative mortality within 4 weeks of hospital admission.In-hospital mortality was 5% for the intervention group and 10% in the control group (risk ratio 0.48, 95% confidence interval 0.29 to 0.79). The effect may have been stronger in patients with positive malaria slides (0.36, 0.16 to 0.80). Cumulative mortality 4 weeks after discharge was also lower in the intervention group (0.61, 0.40 to 0.95).Supervising healthcare workers to adhere to a standardised treatment protocol was associated with greatly reduced in-hospital mortality. Financial incentives may be important for the dedication and compliance of staff members.Clinical Trials NCT00465777 [ClinicalTrials.gov].
Dietary Patterns and Glycemic Control and Compliance to Dietary Advice Among Fasting Patients With Diabetes During Ramadan
Authors: Rubina Hakeem, Muhammad Yakoob Ahmedani, Syed Faraz Danish Alvi, Muhammad Saif Ulhaque, Abdul Basit, Asher Fawwad
Journal: Diabetes Care (2014)

Modified eating habits during the month of Ramadan and the significant increase in food intake after breaking the fast can unbalance the metabolism of patients with diabetes (1–3). Evidence-based guidelines for food intake during Ramadan do not exist. A study was planned to observe the association between different dietary patterns and glycemic control and compliance to dietary advice among fasting patients with diabetes.

Observational data were obtained as part of a study conducted at the outpatient department of Baqai Institute of Diabetology and Endocrinology during Ramadan of 2009 (4). An educational session was given to each patient by a dietitian on a one-to-one basis. All patients were advised to keep a record of food intake and blood glucose readings. Individual counseling was provided to encourage 1 ) adequate intake of energy, 2 ) consumption of balanced meals, and 3 ) distribution of carbohydrate intake over various meals …
Real-Time Testing for <i>Helicobacter Pylori</i> and Atrophy of the Gastric Body: Reply to the Editorial of D. Graham
Authors: A. Tucci
Journal: Endoscopy (2006)

In an editorial in the October issue of Endoscopy [1] accompanying our study on a novel device for testing for Helicobacter pylori and gastric atrophy, namely the Mt 21 - 42 [2], Graham suggested that it was a tool that endoscopists would only have needed several decades ago and whose clinical usefulness had probably passed. We think that the arguments he uses to support that conclusion are highly debatable and want to clarify the issue from our standpoint. In answer to his editorial, we have to consider three points:
Access to antiretroviral treatment in Africa
Authors: R. Loewenson
Journal: BMJ (2004)

New resources and sustainable health systems are needed 

The demand for people living with HIV and AIDS in Africa to access treatment cannot be ignored. At the same time the challenges to meeting this demand are many. They include the shortfalls in health services and lack of knowledge about treatment, making decisions about newer regimens, and the risk of resistance to antiretrovirals highlighted in the paper by Stevens et al (p 280). 1 2

The challenges also include ensuring uninterrupted drug supplies, laboratory capacities for CD4 monitoring, accessible voluntary counselling and testing, trained healthcare workers, and effective monitoring of resistance to antiretroviral drugs.3 A series of papers produced in 2003 through the southern African regional network on equity in health raised further concerns about measures to ensure fairness in the rationing of scarce treatment resources and the diversion of scarce resources from strained public health services into vertical treatment programmes.4–8

The reasons for these challenges are not a mystery. They …
Regulation of the absorption of dietary carbohydrate in man by two new glycosidase inhibitors.
Authors: R H Taylor, H M Barker, E A Bowey, J E Canfield
Journal: Gut (1986)

Two new reversible inhibitors of intestinal alpha-glycosidases (BAY m1099 & o1248) have been derived from deoxynojirimycin. Their inhibitory substrate specificity has been investigated in man using test meals of the dietary carbohydrates, sucrose, maltose, and starch. Both inhibitors abolished the postprandial glycaemic rise after sucrose and m1099 50 mg did after maltose and starch, whereas o1248 20 mg had no effect after maltose and only a small effect after starch. Breath hydrogen evolution, as an indirect measure of malabsorption, showed that the reduced glycaemic responses, particularly after sucrose, were associated with considerable substrate malabsorption. Dose response studies showed that lower doses of both inhibitors could reduce postprandial glycaemia significantly without causing malabsorption. Both inhibitors were tolerated well. These two new enzyme inhibitors have different substrate specificity in man and can, in appropriate dose, regulate postprandial glycaemia by selective inhibition of brush border enzymes without causing malabsorption. In addition to their therapeutic importance, they provide a valuable experimental model of specific intestinal enzyme deficiency states.
Safety of Patients Isolated for Infection Control
Authors: Henry Thomas Stelfox
Journal: JAMA (2003)

Hospital infection control policies that use patient isolation prevent nosocomial transmission of infectious diseases, but may inadvertently lead to patient neglect and errors.To examine the quality of medical care received by patients isolated for infection control.We identified consecutive adults who were isolated for methicillin-resistant Staphylococcus aureus colonization or infection at 2 large North American teaching hospitals: a general cohort (patients admitted with all diagnoses between January 1, 1999, and January 1, 2000; n = 78); and a disease-specific cohort (patients admitted with a diagnosis of congestive heart failure between January 1, 1999, and July 1, 2002; n = 72). Two matched controls were selected for each isolated patient (n = 156 general cohort controls and n = 144 disease-specific cohort controls).Quality-of-care measures encompassing processes, outcomes, and satisfaction. Adjustments for study cohort and patient demographic, hospital, and clinical characteristics were conducted using multivariable regression.Isolated and control patients generally had similar baseline characteristics; however, isolated patients were twice as likely as control patients to experience adverse events during their hospitalization (31 vs 15 adverse events per 1000 days; P<.001). This difference in adverse events reflected preventable events (20 vs 3 adverse events per 1000 days; P<.001) as opposed to nonpreventable events (11 vs 12 adverse events per 1000 days; P =.98). Isolated patients were also more likely to formally complain to the hospital about their care than control patients (8% vs 1%; P<.001), to have their vital signs not recorded as ordered (51% vs 31%; P<.001), and more likely to have days with no physician progress note (26% vs 13%; P<.001). No differences in hospital mortality were observed for the 2 groups (17% vs 10%; P =.16).Compared with controls, patients isolated for infection control precautions experience more preventable adverse events, express greater dissatisfaction with their treatment, and have less documented care.
MYCOPLASMAS AND THEIR ASSOCIATION WITH SKIN DISEASE
Authors: A. M. Gordon, Alan Lyell
Journal: British Journal of Dermatology (1970)

Journal Article MYCOPLASMAS AND THEIR ASSOCIATION WITH SKIN DISEASE Get access A. M. Gordon, A. M. Gordon Departments of Biochemistry and Dermatology, Royal Infirmary, Glasgow Search for other works by this author on: Oxford Academic Google Scholar Alan Lyell Alan Lyell Departments of Biochemistry and Dermatology, Royal Infirmary, Glasgow Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 82, Issue 4, 1 April 1970, Pages 414–417, https://doi.org/10.1111/j.1365-2133.1970.tb06843.x Published: 01 April 1970
Divergent patterns of total and cancer mortality in ulcerative colitis and Crohn's disease patients: the Florence IBD study 1978-2001
Authors: G Masala
Journal: Gut (2004)

<b>Background and aims:</b> Two divergent patterns of mortality for smoking related diseases in ulcerative colitis and Crohn's disease patients were suggested in a previous population based study in Florence, Italy. Long term follow up (median 15 years) was completed to re-evaluate mortality in this Mediterranean cohort. <b>Patients and methods:</b> Overall, 920 patients with inflammatory bowel disease were followed until December 2001 or death, with seven patients (0.8%) lost to follow up. A total of 14 040 person years were available for analysis; 118 deaths were observed (81/689 in ulcerative colitis and 37/231 in Crohn's disease). Expected deaths were estimated using age, sex, and calendar specific national and local mortality rates; standardised mortality ratios (SMR) and 95% confidence interval (CI) were calculated. <b>Results:</b> Among Crohn's disease patients, mortality was strongly increased for gastrointestinal diseases (SMR 4.49 (95% CI 1.80–9.25)), all cancers (SMR 2.10 (95% CI 1.22–3.36)), and lung cancer (SMR 4.00 (95% CI 1.60–8.24)), leading to a significant 50% excess total mortality. Ulcerative colitis patients showed a significantly reduced total mortality because of lower cardiovascular (SMR 0.67 (95% CI 0.45–0.95)) and lung cancer (SMR 0.32 (95% CI 0.07–0.95)) mortality. No significant excess for colorectal cancer mortality was evident in this extended follow up. <b>Conclusions:</b> These clearly divergent patterns of mortality correlate with documented differences in smoking habits between Crohn's disease and ulcerative colitis patients. Family doctors and gastroenterologists should consider stopping cigarette smoking a specific priority for Crohn's disease patients; the latter should be offered free participation in structured programmes for smoking cessation, with the aim of reducing smoking related excess mortality. Overall, no evidence of an increased mortality for large bowel cancer emerged in this series.
THE RÔLE OF MICROBIC VIRULENCE, DOSAGE, AND HOST RESISTANCE IN DETERMINING THE SPREAD OF BACTERIAL INFECTIONS AMONG MICE
Authors: Leslie T. Webster
Journal: The Journal of Experimental Medicine (1930)

1. In September, 1925, explosive and highly fatal epidemics of a Friedländer-like bacillus infection arose in three of four experimentally controlled mouse populations. In the populations to which daily additions were made, characteristic secondary waves ensued. These waves appeared at definite population levels, lasted a definite number of days, and reduced the population to a definite low census. Subsequently, endemic periods intervened, followed by the disappearance of the disease during March, 1926. 2. In August, 1926, renewed epidemics of the infection arose in all four populations. These outbreaks resembled one another but were more enduring than the preceding ones. Moreover, fewer secondary waves followed, and the disease disappeared in February, 1927. 3. The virulence or disease-producing power of the Friedländer-like organisms, as determined by the ability to spread and induce typical epidemics among populations of previously unexposed mice, and by direct inoculation titrations remained constant during pre-epidemic, epidemic, post-, and inter-epidemic phases of the infection. 4. The Friedländer-like organisms were not recovered in cultures from bedding, food, or feces, but they were obtained from the nasal passages. Mice harboring the organisms usually died within a few days of the test; a few, however, survived and ceased to be carriers. The carrier rate in a given community was found to increase prior to epidemic outbreaks and to decrease shortly before the time of peak mortality. 5. The substitution of relatively susceptible for "standard" immigrants in a population was followed by an increase in severity and spread of the disease, whereas a substitution of "standard" for resistant immigrants was followed by a fall in severity and extent of disease.
Treatment of Acute Cold Agglutinin Hemolytic Anemia With Transfusion of Adult i RBCs
Authors: Judith E. Woll
Journal: JAMA (1974)

ACUTE cold agglutinin disease with severe hemolysis following primary atypical pneumonia was first described in 1943 by Horstmann and Tatlock.<sup>1</sup>In a 1945 review of 200 cases of primary atypical pneumonia, 11 had hemolytic anemia of varying severity, which resulted in two deaths.<sup>2</sup>Despite subsequent identification of the specificity of the cold autoantibody (anti-I), transfusion of such patients has been limited by the difficulty in obtaining compatible blood. We report a patient with severe hemolysis associated with acute postinfectious cold agglutinin disease who was treated with transfusions of the rare, type i red blood cells (RBCs). <h3>Report of a Case</h3> A 51-year-old nulliparous white woman was admitted in October 1972 with a twoweek history of fever and cough, productive of yellow sputum, for which she took prescribed tetracycline for ten days. The fever remitted, but the cough persisted. Two days before admission, nausea and vomiting developed, and the
A complete theory of tests for a theory of mind must consider hierarchical complexity and stage
Authors: Michael Lamport Commons, Myra Sturgeon White
Journal: Behavioral and Brain Sciences (2003)

We distinguish traditional cognition theories from hierarchically complex stacked neural networks that meet many of Newell's criteria. The latter are flexible and can learn anything that a person can learn, by using their mistakes and successes the same way humans do. Shortcomings are due largely to limitations of current technology.
Myocardial Infarction Caused by Cardiac Microvasculopathy in a Patient with the Primary Antiphospholipid Syndrome
Authors: Norman Kattwinkel, Andrew G. Villanueva, Sherif B. Labib, H. Thomas Aretz, Joseph W. Walek, David L. Burns, Jeffrey T. Klenz
Journal: Annals of Internal Medicine (1992)

Antiphospholipid antibodies occur in various clinical states, including the primary antiphospholipid syndrome. Clinical features in these conditions appear to be caused by vasculopathy associated with the presence of these antibodies. We report the case of a patient with primary antiphospholipid syndrome who experienced cardiac necrosis secondary to myocardial microvasculopathy in the absence of vasculitis. This case demonstrates unequivocally that noninflammatory myocardial microvasculopathy occurs in the primary antiphospholipid syndrome per se without any clinical or immunologic signs of systemic lupus erythematosus or other disease process. The histopathologic findings in the skin and myocardial biopsies showed a noninflammatory vasculopathy characterized by bland thrombi and lack of infiltration of the vessel wall by inflammatory cells. Ultrastructural examination of the myocardial biopsy confirmed the vascular thrombosis and endothelial activation and showed no deposits in basement membranes. The patient survived after appropriate treatment. Evidence presented here supports the concept that the vasculopathy in the antiphospholipid syndrome is distinct from other types of vascular occlusions seen in systemic lupus erythematosus. We suggest that myocardial biopsy can be crucial in showing an underlying myocardial ischemic process despite "normal" findings on coronary angiography. Results of the biopsy hastened the decision to use potentially lifesaving plasmapheresis and anticoagulation therapy in this patient.
Abstract 5391: MT-MMP cleavage profiling using rapid endopeptidase profiling library (REPLi)
Authors: Andrew Mitchell, Javier Giménez-Warren, Steven D. Shnyder, Jason H. Gill, Robert A. Falconer, Paul M. Loadman
Journal: Cancer Research (2014)

Abstract Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases that are associated with the metastatic process. Relative to non-diseased tissue, the increased expression and activity of Membrane-type matrix metalloproteinases (MT-MMPs) such as MMP-15 within the prostate tumour microenvironment can be exploited in order to selectively activate highly toxic chemotherapeutics. The main advantage to such a targeted drug delivery system is a significant reduction of systemic toxicity, resulting in a highly efficacious and successful treatment for prostate cancer. We have screened 3375 peptides with a variety of residue combinations using Rapid Endopeptidase Profiling Library (REPLi). A ‘small but smart’ design, the REPLi library template: MCA-Gly-Gly-Gly-Xaa-Xaa-Xaa-Gly-Gly-DPA-Lys-Lys contains a donor (MCA) and quenching acceptor (DPA) FRET pair. No fluorescence indicates the molecules within the pools are intact, however, upon cleavage, the tri-variable cores can be assessed via auto fluorescence of the MCA molecule. By analysing the 512 distinct substrate pools we have identified combinations of Phe/Tyr and Asn/Gln residues as having a greater MMP-15 cleavage bias over MMP-14, with the opposite being true for variable cores with Ile/Leu and Lys/Arg combinations. Since most known substrates show little (if any) MMP selectivity this is a novel finding, and as such, provides us with insights that are essential for designing prodrugs targeted to specific MMPs. Through detailed metabolic studies, this information is being utilised in a bid to maximise the successful development of novel MMP-15 targeted paclitaxel conjugated prostate cancer prodrugs. Citation Format: Andrew Mitchell, Javier Giménez-Warren, Steven D. Shnyder, Jason H. Gill, Robert A. Falconer, Paul M. Loadman. MT-MMP cleavage profiling using rapid endopeptidase profiling library (REPLi). [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5391. doi:10.1158/1538-7445.AM2014-5391
Mucocutaneous manifestations in 22 consecutive cases of primary HIV-1 infection
Authors: J. LAPINS, S. LINDBÄCK, P. LIDBRINK, P. BIBERFELD, L. EMTESTAM, H. GAINES
Journal: British Journal of Dermatology (1996)

Twenty‐two consecutive patients presenting with symptomatic human immunodeficiency virus 1 (HTV‐1) seroconversion were studied. Most of the patients had a glandular fever‐like illness. All patients had fever and pharyngitis, and eight of them also suffered from ulcers of the oral, genital or anal mucosa. Uniform skin eruptions were observed in 17 of the 22 patients. The exanthem consisted of varying numbers of macular or maculopapular lesions that were oval or rounded in shape, ranging from a few millimetres to 1 cm in diameter. The lesions were distributed on the upper thorax in all cases, and were particularly profuse in the collar region. The face forehead and scalp were involved in most cases, but the eruption was sparse or absent at the periphery of the extremities. In the majority of patients, the exanthem appeared after 2 or 3 days of fever. The exanthem developed during the first day, persisted for 5‐8 days, and then cleared concurrently with the general recovery of the patients. Histopathological studies of skin punch biopsy specimens from four patients showed a sparse lymphocytic cell infiltrate distributed around vessels of the dermal superficial plexus. The infiltrates predominantly consisted of equally represented T‐helper/inducer and T‐suppressor/cytotoxic cells. A vacuolar aberration of basal layer cells was found in two of the four eases studied histologically. The microscopic findings correspond to the histopathological patterns seen in toxieodermia and in the interface dermatitis of morbilliform viral exanthems. The exanthem is a frequent and characteristic sign of primary HTV infection, which is further indicated if mucosal ulcers are present.
A NEW CHLOROFORM AND ETHER (OPEN METHOD) INHALER.
Authors: A. CECIL HERBERT
Journal: JAMA (1907)

The inhaler shown in the accompanying illustration has several advantages over any now in use. (1) It does away with the dangers consequent on the use of the cloth-covered inhaler, (2) it can be handled with ease, (3) it is self-retaining, and (4) it can be sterilized. The mask is made of fine wire mesh, shaped to conform to the face, and having opposite the nose and mouth a wire basket to contain cotton or gauze on which the anesthetic is dropped (Fig. 1). Small wire handles bent to accommodate the thumb and first finger project from each side, so that it can be used by either a right-handed or left-handed anesthetist. Over these handles may be slipped spectacle wires (Fig. 2), which, passing behind the ears, retain the mask firmly in position, leaving both hands of the anesthetist free. This will be found especially convenient when the mask is
Comparison of serum specific IgE antibodies to staphylococcal enterotoxins between atopic children with and without atopic dermatitis
Authors: Y. T. Lin, Y. H. Yang, Y. W. Hwang, M. J. Tsai, P. N. Tsao, B. L. Chiang, W. Y. Shau, L. F. Wang
Journal: Allergy (2000)

Background: The skin of patients with atopic dermatitis (AD) exhibits a striking susceptibility to colonization and infection by Staphylococcus aureus . The exotoxins secreted by S. aureus can act as superantigens and classic allergens, inducing the production of functionally relevant specific IgE antibodies. The aim of this study was to compare the levels and positive rates of serum staphylococcal enterotoxin A (SEA)‐ and staphylococcal enterotoxin B (SEB)‐specific IgE between atopic children with and without AD. Methods: Sixty children with AD, 55 children with respiratory allergy without AD, and 24 nonatopic healthy children were studied. The levels and positive rates of serum SEA‐ and SEB‐specific IgE were compared among three groups. The correlation between the levels or positive rates of serum SEA/SEB‐specific IgE and the severity of AD or the presence of previous skin infections was studied. Results: The children with AD had significantly higher levels and positive rates of serum SEA‐ and SEB‐specific IgE than the atopic children without AD ( P &lt;0.001) and the nonatopic children ( P &lt;0.001). There was no significant difference in the levels and positive rates of serum SEA‐ and SEB‐specific IgE between the atopic children without AD and the nonatopic children. With or without adjustment for the potential confounding effect of total serum IgE levels, the levels and positive rates of serum SEA‐ and SEB‐specific IgE were significantly correlated with severity of AD ( P &lt;0.005), but they were not significantly different between AD children with and without previous skin infections. Conclusions: SEA and SEB may contribute to chronic inflammation and exacerbation of AD through the IgE‐mediated immune response.