tbuckley/cabot-search huggingface dataset:
A National Outbreak of<i>Salmonella enteritidis</i>Infections from Ice Cream
Authors: Thomas W. Hennessy, Craig W. Hedberg, Laurence Slutsker, Karen E. White, John M. Besser-Wiek, Michael E. Moen, John Feldman, William W. Coleman, Larry M. Edmonson, Kristine L. MacDonald, Michael T. Osterholm
Journal: New England Journal of Medicine (1996)

In September 1994, the Minnesota Department of Health detected an increase in the number of reports of Salmonella enteritidis infections. After a case-control study implicated a nationally distributed brand of ice cream (Schwan's) in the outbreak, the product was recalled and further epidemiologic and microbiologic investigations were conducted.We defined an outbreak-associated case of S. enteritidis infection as one in which S. enteritidis was cultured from a person who became ill in September or October 1994. We established national surveillance and surveyed customers of the implicated manufacturer. The steps involved in the manufacture of ice cream associated with cases of S. enteritidis infection were compared with those of products not known to be associated with infection matched for the date of manufacture. Cultures for bacteria were obtained from ice cream samples, the ice cream plant, and tanker trailers that had transported the ice cream base (premix) to the plant.We estimate that S. enteritidis gastroenteritis developed in 224,000 persons in the United States after they ate Schwan's ice cream. The attack rate for consumers was 6.6 percent. Ice cream associated with infection contained a higher percentage of premix that had been transported by tanker that had carried nonpasteurized eggs immediately before (P = 0.02). S. enteritidis was isolated from 8 of 226 ice cream products (3 percent), but not from environmental samples obtained from the ice cream plant (n = 157) or tanker trailers (n = 204).This nationwide outbreak of salmonellosis was most likely the result of contamination of pasteurized ice cream premix during transport in tanker trailers that had previously carried nonpasteurized liquid eggs containing S. enteritidis. To prevent further outbreaks, food products not destined for repasteurization should be transported in dedicated containers.
[604] COMPARISON OF A SHORTENED RIBAVIRIN TREATMENT VS A 24 WEEK STANDARD COMBINATION THERAPY IN HCV INFECTED PATIENTS WITH GENOTYPE 2/3
Authors: B. Kallinowski, K. Stein, W. Boecher, T. Goeser, U. Spengler, R. Link, H. Klinker, T. Bruckner, P. Haiss, P. Buggisch
Journal: Journal of Hepatology (2007)
Sequelae of the initial attack of acute rheumatic fever in children from north India. A prospective 5-year follow-up study.
Authors: S K Sanyal, A M Berry, S Duggal, V Hooja, S Ghosh
Journal: Circulation (1982)

We determined the outcome of acute rheumatic fever in 85 children from North India who had received regular antistreptococcal prophylaxis after their first attack. By the end of the 5-year follow-up, 33 patients had rheumatic heart disease. Mitral insufficiency, the most common valvular lesion, appeared in 91% of the patients, whereas mitral stenosis developed in only 18%. Initial carditis, congestive heart failure, cardiomegaly or moderate-to-severe mitral insufficiency significantly increased the risk of rheumatic heart disease (p less than 0.001). The recurrence rate of acute rheumatic fever in children who received continuous prophylaxis was 0.006 per patient-year. Most recurrence (92%) mimicked the first attack and produced further cardiac damage in five patients with carditis and in one patient with chorea. Cardiac status during the first attack of rheumatic fever and the continuity of prophylaxis were the major determinants of outcome. Statistical comparisons disclosed that with continuous prophylaxis, the prevalence rate, evolution and clinical spectrum of the sequelae of acute rheumatic fever in children from India do not differ significantly from those in the West.
Polymorphic Plaques Involving the Face and Extremities
Authors: Daniel Zaghi, Allison Readinger, Alan Menter
Journal: JAMA Dermatology (2014)

A previously healthy man in his 30s requested a second opinion after a recentdiagnosisof cutaneoussarcoidosis.Hepresentedwith a 14-month history of several pink plaques, initially on his facewith subsequent involvement of the proximal arms and legs. He denied anyconstitutionalsymptoms,arthralgias,nightsweats,dyspnea,motor weakness, or sick contacts. He had immigrated to the United States in 2002 from Chennai, India, with return visits approximately every2years.Onphysical examination, hehad5discoid, annular, and geographic erythematous plaques with minimal overlying scaleoverhis face, upper arms, and right thigh.A representative plaque over the left upper arm is depicted in the Figure, A. Pinprick testingsuggested lesional anesthesia.Nohandor foot jointdeformities, palpable peripheral nerves,motor neuropathy, ormucosal involvementwerenoted.Findings fromlaboratorytests, including a complete blood cell count, compressive metabolic panel, antinuclear antibody, angiotensin-converting enzyme and calcium levels, and C-reactive protein were unremarkable. Results from a purifiedproteinderivative (PPD) skin testwerenegative. Results from a chest radiographwas normal. Punch biopsies for histopathologic examination (Figure, B and C) and polymerase chain reaction testing for the suspected causative organismwere performed. What is your diagnosis?
Puberty, IDDM, and Death in Japan
Authors: Rimei Nishimura, Naoko Tajima, Masato Matsushima, Ronald E LaPorte
Journal: Diabetes Care (1998)

OBJECTIVE To investigate the impact of age at onset on the prognosis of childhood IDDM in Japan. RESEARCH DESIGN AND METHODS The study population consisted of 987 prepubertal-onset and 345 pubertal-onset IDDM cases who were registered by two nationwide surveys and who were diagnosed between 1965 and 1979. The living status was identified as of 1 January 1990 with the ascertainment rate of 96.5%. Prognosis was evaluated by cause- and agespecific mortality rates and life-table analyses; in addition, an attained-age-matched case-control study was analyzed by conditional logistic regression. RESULTS The adjusted mortality rates per 100,000 person-years for the pubertal-onset cases were significantly higher than those of the prepubertal-onset cases (835 [95% CI 573–1,168] vs. 391 [283–526]). Life-table analyses revealed that the survival rate of the pubertal-onset cases was lower than that of the prepubertal-onset cases for each observation period. Life-table analyses after the age of 15 years indicated that the prognosis of pubertal cases was almost the same as that of the prepubertal cases despite having a shorter duration of diabetes. The attained-age–matched case-control study indicated that the pubertal onset was a potent determinant of death. CONCLUSIONS The prognosis of pubertal-onset IDDM was considerably poorer than that of prepubertal-onset IDDM.
Influence of continuous interleukin-2 administration via the portal vein on liver regeneration following partial hepatectomy in rats
Authors: K Wadamori
Journal: Hepatology (1996)

We have reported the efficacy of intraarterial-combined immunochemotherapy including interleukin-2 (IL-2) for unresectable hepatocellular carcinoma (HCC). To further test this therapy for prevention of intrahepatic recurrence after hepatectomy, the influence of IL-2 on liver regeneration was examined using mitotic index (MI) and the bromodeoxyuridine (BrdU) labeling index (LI) in 70% hepatectomized Donryu rats. In addition, gap junction appearance, which may change during liver regeneration, was analyzed using a monoclonal antibody (HAM8). Serum albumin, alanine transaminase, and total bilirubin (TB) levels were also evaluated. IL-2 (45,000 Japanese reference units [JRU]/d) or saline was administered continuously via the portal vein immediately after hepatectomy using an infusion pump. We also examined the influence of IL-2 on liver regeneration after hepatectomy with splenectomy. No difference in the weight of the liver, serum albumin, alanine transaminase, or TB was observed in any groups at 1, 2, or 4 days after hepatectomy. Neither IL-2 nor splenectomy influenced MI and BrdU LI at all three points. Gap junctions began to disappear after hepatectomy and reached a minimum on day 2 in all groups. Four days after hepatectomy, the density of the reappearing gap junctions was markedly lower in groups treated with IL-2 than in those receiving saline with or without splenectomy. However, the density returned to close to preoperative levels 6 days after hepatectomy in all groups. Continuous portal infusion of IL-2 transiently disturbed gap junction reappearance during liver regeneration. However, no other parameters of liver regeneration or liver functions differed. These results suggest that the liver regeneration after partial hepatectomy may be suppressed by the administration of IL-2, even though the suppression may not be harmful for overall recovery of the resected liver. However, it seems that hepatic IL-2 administration can be performed without serious complications after hepatectomy.
Doctors lose power to regulate their profession
Authors: Clare Dyer
Journal: BMJ (2007)

Cyclo-oxygenase-2 (COX 2) inhibitors should be used only as the last choice after other types of non-steroidal anti-inflammatory drugs (NSAIDs) to relieve chronic pain in people with heart disease or at high risk of it, the American Heart Association has recommended.Its statement, published online in Circulation on 26 February (http://circ.ahajournals.orgdoi:10.1161/circulationaha.106.181424), was designed to end any remaining confusion about the cardiovascular risk of these agents.The association has recommended a stepped approach to treatment.The first step should be non-pharmacological approaches, such as physical therapy and weight loss, for patients with known cardiovascular disease or with risk factors for ischaemic heart disease.Drug treatment should start with agents with the lowest reported risk of cardiovascular events, before other agents are prescribed, and at each step account should be taken of the risk-benefit balance.First line drug choices include paracetamol (acetaminophen), aspirin, tramadol, and short term use of other narcotic analgesics.If these fail to achieve adequate pain control, the next option is non-acetylated salicylates, such as naproxen.The association recommended NSAIDs that aren't COX 2 inhibitors if pain is still inadequately controlled, then NSAIDs with some COX 2 activity as the next step, and lastly COX 2 selective NSAIDs.The committee considered the risk of all three of these classes to be sufficiently high to require that patients taking them should be monitored regularly for sustained hypertension (or worsening of prior blood pressure control), oedema, worsening renal function, or gastrointestinal bleeding.See pp 436, 450. Save COX 2 inhibitors till last for cardiac patientsUK NEWS HFEA allows women to donate eggs for research, p445 World NEWS repeal law that puts "FdA on the payroll of the industry", p447 bmj.comUK government defeated on community treatment forms
315 CIPROFLOXACIN VS. CEFTRIAXONE IN THE PREVENTION OF BACTERIAL INFECTION IN PATIENTS WITH ADVANCED CIRRHOSIS AND GASTROINTESTINAL HEMORRHAGE
Authors: J.W. Yun, B.I. Kim, J.H. Park, H.J. Kim, D.I. Park, Y.K. Cho, C.I. Shon, W.K. Jeon
Journal: Journal of Hepatology (2008)
Hypoxia and Thoracic Scoliosis
Authors: D. B. Shaw, J. Read
Journal: BMJ (1960)

The incidence of lobar pneumonia rose with age, segmental pneumonia was most frequent in young children, and acute bronchitis was most often found in the young and the elderly.Similar facts were observed in the report of the College of General Practitioners (1956).These three clinical conditions also had quite dilTerent disability rates at follow-up.The highest disability rate was found in those who had suffered from acute bronchitis (71 %), and the lowest in those with segmental pneumonias (16%); that for lobar pneumonia was in between (42%).It was also found that the lower social classes were more likely to suffer from these acute chest infections, whereas only II% of the practice population belonged to classes IV and V; 44% of the patients with these chest infections were in
Early Echocardiographic Deformation Analysis for the Prediction of Sudden Cardiac Death and Life-Threatening Arrhythmias After Myocardial Infarction
Authors: Mads Ersbøll, Nana Valeur, Mads Jønsson Andersen, Ulrik M. Mogensen, Michael Vinther, Jesper Hastrup Svendsen, Jacob Eifer Møller, Joseph Kisslo, Eric J. Velazquez, Christian Hassager, Peter Søgaard, Lars Køber
Journal: JACC. Cardiovascular imaging (2013)
Baby to be tested for HIV against parents' wishes
Authors: C. Dyer
Journal: BMJ (1999)

A High Court judge in London gave the go ahead last week for a 4 month old baby to be tested for HIV against her parents' wishes. Camden Council's social services department in north London sought the court's permission to test the baby, whose mother is infected with HIV and who is breast feeding her.

The council, which was backed in its action by the Official Solicitor who represented the interests of the child, hopes to dissuade the mother from continuing to breast feed if the baby …
Hepatitis C Virus Genotypes in the United States: Epidemiology, Pathogenicity, and Response to Interferon Therapy
Authors: Nizar N. Zein
Journal: Annals of Internal Medicine (1996)

Objective: To study 1) the geographic distribution and clinical significance of hepatitis C virus [HCV] genotypes in the United States and 2) the influence of HCV genotypes on response to interferon therapy. Design: Hepatitis C virus genotype was determined in 179 stored serum samples obtained from patients who were positive for antibody to HCV and for HCV RNA by using polymerase chain reaction. Setting: Tertiary referral centers in four geographic regions of the United States. Patients: Patients who visited medical centers in the Midwest (50 patients), Northeast (42 patients), Southeast (35 patients), and West (52 patients). Measurements: Chaotropic lysis and isopropanol precipitation were used to extract RNA from serum. Polymerase chain reaction was done on the NS5 region and was followed by automated direct sequencing and genotyping of desalted amplification products. Results: 104 patients (58%) had subtype 1a; 38 (21%) had subtype 1b; 4 (2%) had subtype 2a; 23 (13%) had subtype 2b; 8 (5%) had subtype 3a; and 2 (1%) had subtype 4a. Examination of the known risk factors for acquiring HCV showed no association between genotype and mode of acquisition (blood transfusion, injection drug use, employment at a health care facility) or histologic findings at presentation (mild active hepatitis, moderately active hepatitis, or cirrhosis). Sixty-eight percent of patients with genotype 1a, 80% of patients with genotype 1b, and 37% of patients with genotype 2a or 2b had severe hepatitis. Thirteen of 46 (28%) patients with genotype 1a and 4 of 15 (26%) patients with genotype 1b had a complete biochemical response after 6 months of interferon therapy. In contrast, 10 of 14 (71%) patients with genotype 2a or 2b had a complete response to interferon therapy. Five of 39 (13%) patients with genotype 1a, 1 of 14 (7%) patients with genotype 1b, and 2 of 11 (18%) patients with genotype 2a or 2b had a sustained biochemical response. Conclusions: In the United States, HCV genotypes 1a and 1b are the predominant genotypes in patients with chronic hepatitis C. Genotype is not correlated with mode of virus acquisition or with histologic findings at presentation. Patients with HCV genotype 1a or 1b had more severe liver disease and lower rates of response to interferon therapy than did patients with HCV genotype 2a or 2b. These findings may have implications for predicting outcome and selecting patients for interferon treatment. *For members of the Collaborative Study Group, see the Appendix.
Scabies presenting as bullous pemphigoid-like eruption
Authors: J. Bhawan, E. Milstone, R. Malhotra, T. Rosenfeld, M. Appel
Journal: Journal of the American Academy of Dermatology (1991)

Several diseases, at times, may be confused with scabies. We report the diagnosis and treatment of scabies in two patients. Their eruptions recurred and persisted and eventually developed blisters. The skin biopsy specimens submitted for light microscopy and immunofluorescence were considered to be consistent with bullous pemphigoid. Both patients were treated successfully with lindane and remained disease free for up to 6 months of follow-up.
Computerized Tomographic Scans for Headache
Authors: George L. Bohmfalk
Journal: JAMA (1980)

<h3>To the Editor.—</h3> The article by Larson et al discourages the use of CT head scanning in examination of patients with headache and normal neurological examinations. Their article implies that their patients were screened by neurological specialists and that normal findings from neurological examination in their hands are almost always associated with a normal CT scan. As a neurosurgeon to whom patients are referred largely by primary care physicians, I deal with the converse problem. Almost every week I see patients whose headaches have been attributed to sinus, hypertension, and various other causes, because the findings from the neurological examination were said to be normal. Ultimate diagnoses in the last few patients have included frontal meningioma, temporal lobe glioblastoma, intraventricular hemorrhage from aneurysm, cerebellar astrocytoma with hydrocephalus, adult aqueductal stenosis with hydrocephalus, and, of course, subdural hematoma. Most of these patients are referred to me not for headache, but only
Infarction and Coronary Insufficiency During Electroconvulsive Therapy
Authors: Paul H. Blachly
Journal: JAMA (1968)

To the Editor:—  The interesting article by Drs. Hussar and Pachter draws our attention to the following newer findings and techniques not mentioned:   Complete paralysis of the patient with succinylcholine and continuous ventilation with oxygen during the seizure as monitored by a cathode ray oscilloscope in the operating room decreases the likelihood of triggering a cardiac arrhythmia by hypoxia and alerts one for active intervention should a cardiac irregularity of serious import develop during the treatment.1-4  The continuous ventilation during the seizure prevents the build-up of carbon dioxide which may raise blood pressure unduly.  The presence of a cardiac defibrillator in the room or quickly available permits the active correction of certain cardiac arrhythmias if the electrocardiogram is monitored during the procedure.  The use of atropine administered intravenously shortly before the treatment rather than administering it subcutaneously prevents errors in administration by nonphysicians. The monitoring of
Validation and comparison of nomograms and scores to predict non-sentinel lymph node status in breast cancer patients with metastatic sentinel lymph node: a prospective multicentric study.
Authors: C Coutant, G Houvenaeghel, C Olivier, E Fondrinier, F Marchal, F Guillemin, N Seince, E Barranger, V Thomas, E Lambaudie, E Daraï, S Uzan, J Levêque, R Rouzier
Journal: Cancer Research (2009)

Abstract Abstract #203 Background&amp;#x2028; Five tools have been developed to predict non-SN status in breast cancer patients with SN metastasis: two nomograms (the Memorial Sloan-Kettering Cancer Center nomogram (MSKCC nomogram) and the nomogram developed by Degnim) and three scoring systems (the Tenon score, the score from the M.D. Anderson Cancer Center (MDA score), and the score developed by Saidi). Our purpose was to assess the validity of these tools in a prospective multicentric study of 561 SN-positive patients.&amp;#x2028; Methods&amp;#x2028; For 561 SN-positive patients who underwent ALND, we tested the accuracy of the five mathematical models. We calculated the false-negative (FN) rates and the areas under the receiver operating characteristics curves (AUC) as a measure of discriminatory capacity. We also tested the accuracy of each model in the subgroup of 246 patients with micrometastasis or isolated tumor cells in the SN; and in the subgroup of 165 patients with histological tumor size measuring more than 2 cm. Results were compared to the optimal logistic regression model that could be developed on the 561 patient cohort.&amp;#x2028; Results&amp;#x2028; At least one non-SN was positive in 147 patients (26.2%). The Tenon score, MSKCC nomogram, MDA score, nomogram of Degnim and score of Saidi applied to all 561 patients achieved AUCs of 0.81, 0.78, 0.73, 0.73, and 0.65 respectively. The FN rate were 4.4% (12/273), 6.5% (13/201), 5.7% (8/140), 12.5% (2/16) and 15% (21/140) respectively. In the subgroup of patients with only SN micrometastases, the FN rates were 2.9% (6/209) and 3.5% (5/143) for the Tenon score and the MSKCC nomogram respectively. The AUCs were 0.81 and 0.72 respectively&amp;#x2028; In the subgroup of patients with histological tumor size measuring more than 2 cm, the FN rates were 0% (0/10) and 28.6% (4/14) for the Tenon score and the MSKCC nomogram respectively. The AUCs were 0.69 and 0.66 respectively. For comparison, a logistic regression model developed on this multicentric cohort yielded AUCs of 0.83, 0.82, and 0.75 for the whole cohort, patients with micrometastasis or isolated tumor cells in the SN and in patients with tumor &amp;gt; 2 cm, respectively.&amp;#x2028; Conclusion&amp;#x2028; In this multicenter study, the Tenon score outperformed other scoring system. It was also more discriminant than other scores in patients with micrometastasis or isolated tumor cells in the SN and in patients with tumor &amp;gt; 2 cm. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 203.
Agranulocytosis Associated With Thioridazine Administration
Authors: Robert K. Shaw, James W. Raitt, Frederic S. Glazener
Journal: JAMA (1964)

FOLLOWING the introduction of chlorpromazine, there has been a continued search for other phenothiazines that may have a more favorable therapeutic index. Thioridazine hydrochloride (Mellaril) has been considered by many to be such an agent because of the low incidence of reported side effects.<sub>1-3</sub>Although leukopenia has been described in a patient receiving thioridazine,<sub>4,5</sub>to our knowledge agranulocytosis has not been previously reported with this drug. We have observed three patients with agranulocytosis during thioridazine administration. Two were receiving only thioridazine, and the third was receiving several drugs. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 45-year-old man had been hospitalized since 1949 for paranoid schizophrenia. Yearly hematocrit values, white blood cell counts (WBC), and differential counts had always been normal. A WBC on July 9, 1962, had been 8,200 per cubic millimeter, with 64% granulocytes. On Oct 17, 1962, the patient had been placed on a regimen of thioridazine
Book Review The Handbook of International Adoption Medicine: A Guide for Physicians, Parents, and Providers By Laurie C. Miller. 448 pp., illustrated. New York, Oxford University Press, 2005. $85 (cloth); $45 (paper). 0-19-517681-2 (cloth); 0-19-514530-5 (paper).
Authors: Mary Allen Staat
Journal: New England Journal of Medicine (2005)