tbuckley/cabot-search huggingface dataset:
Clinical Decision Rules for Excluding Pulmonary Embolism: A Meta-analysis
Authors: Wim Lucassen, Geert-Jan Geersing, Petra M.G. Erkens, Johannes B. Reitsma, Karel G.M. Moons, Harry Büller, Henk C. van Weert
Journal: Annals of Internal Medicine (2011)

Background: Clinical probability assessment is combined with d-dimer testing to exclude pulmonary embolism (PE). Purpose: To compare the test characteristics of gestalt (a physician's unstructured estimate) and clinical decision rules for evaluating adults with suspected PE and assess the failure rate of gestalt and rules when used in combination with d-dimer testing. Data Sources: Articles in MEDLINE and EMBASE in English, French, German, Italian, Spanish, or Dutch that were published between 1966 and June 2011. Study Selection: 3 reviewers, working in pairs, selected prospective studies in consecutive patients suspected of having PE. Studies had to estimate the probability of PE by using gestalt or a decision rule and verify the diagnosis by using an appropriate reference standard. Data Extraction: Data on study characteristics, test performance, and prevalence were extracted. Reviewers constructed 2 × 2 tables and assessed the methodological quality of the studies. Data Synthesis: 52 studies, comprising 55 268 patients, were selected. Meta-analysis was performed on studies that used gestalt (15 studies; sensitivity, 0.85; specificity, 0.51), the Wells rule with a cutoff value less than 2 (19 studies; sensitivity, 0.84; specificity, 0.58) or 4 or less (11 studies; sensitivity, 0.60; specificity, 0.80), the Geneva rule (5 studies; sensitivity, 0.84; specificity, 0.50), and the revised Geneva rule (4 studies; sensitivity, 0.91; specificity, 0.37). An increased prevalence of PE was associated with higher sensitivity and lower specificity. Combining a decision rule or gestalt with d-dimer testing seemed safe for all strategies, except when the less-sensitive Wells rule (cutoff value ≤4) was combined with less-sensitive qualitative d-dimer testing. Limitations: Studies had substantial heterogeneity due to prevalence of PE and differences in threshold. Many studies (63%) had potential bias due to differential disease verification. Conclusion: Clinical decision rules and gestalt can safely exclude PE when combined with sensitive d-dimer testing. The authors recommend standardized rules because gestalt has lower specificity, but the choice of a particular rule and d-dimer test depend on both prevalence and setting. Primary Funding Source: Dutch Heart Foundation.
Diagnosis of Diabetic Eye Disease
Authors: Robert H. Fier
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The recent article on the diagnosis of diabetic eye disease by Sussman et al showed an alarming percentage of incorrect diagnoses made by ophthalmologists and retina specialists. The reason for this poor showing may be found in the protocol used for this study. The methods disclosed that the ophthalmologists used only indirect ophthalmoscopy for their examination. In my training program, it was stressed that the best way to examine a patient for proliferative diabetic retinopathy was with the use of a Hruby lens, contact lens, and direct ophthalmoscopy as well as indirect ophthalmoscopy. I find that I cannot adequately examine a patient for this problem without the use of some, if not all of these modalities. I do, however, agree with the major thrust of the article, which concluded that the primary care physician should make more use of their ophthalmologic referrals to prevent missing diabetic eye
Hypertension prevalence in obstructive sleep apnoea and sex: a population-based case-control study
Authors: J. Hedner
Journal: European Respiratory Journal (2006)

Obstructive sleep apnoea (OSA) is a recognised risk factor for hypertension (HT). The current authors investigated confounders of this association in a sex-balanced community-based sample of patients with HT (n = 161) from the Skaraborg Hypertension and Diabetes Project (n = 1,149) and normotensive controls (n = 183) from an age and sex stratified community-based population sample (n = 1,109). All participants underwent ambulatory home polysomnography. Severe OSA (apnoea-plus-hypopnoea index (AHI) ≥30 events·h<sup>−1</sup>) was found in 47 and 25% of hypertensive and normotensive males, respectively. The corresponding numbers in females were 26 and 24%, respectively. The odds ratio (OR) for HT increased across AHI tertiles from 1.0 to 2.1 (95% confidence interval: 0.9–4.5) and 1.0 to 3.7 (95% CI: 1.7–8.2) in males, but not in females where the OR increased from 1.0 to 1.8 (95% CI: 0.8–3.9) and 1.0 to 1.6 (95% CI: 0.7–3.5). Regression analysis correcting for age, body mass index (or waist–hip ratio) and smoking did not eliminate the association between OSA and HT in males. The present data suggest that obstructive sleep apnoea is highly prevalent in both the general population and in patients with known hypertension. The contribution of obstructive sleep apnoea to hypertension risk may be sex dependent and higher in males than in females.
β-thalassemia and hemoglobin types in Argentina: Determination of most frequent mutations
Authors: Néstor W. Soria, Clara L. Tulián, François Plassa, German A. Roth
Journal: American Journal of Hematology (1997)

In order to know the spectrum of β-thalassemia alleles and other mutations affecting the β-globin gene, we analyzed the hemoglobin abnormalities in 24 patients from the Province of Córdoba in Argentina. Molecular screening of samples was performed by the polymerase chain reaction (PCR), using six sets of oligonucleotides to amplify fragments encompassing the whole β-globin coding region and splice junctions, as well as the promoter and 3′ untranslated regions. The altered fragments were determined by denaturing gradient gel electrophoresis (DGGE), and the corresponding mutations were identified by restriction enzyme analysis or by direct sequencing of PCR products. Using this approach, three different β-thalassemia mutations were detected, codon 39 (C→T), IVS-1-110 (G→A), and IVS-1-1 (G→A), and also the hemoglobin S trait. This is the first report of β-thalassemia mutations described in Argentina. Our results show that these mutations are similar to those found in Spain and Italy, possibly due to the important Mediterranean migratory stream received in our country, and could be important for prenatal diagnosis of these diseases in Córdoba, Argentina. Am. J. Hematol. 54:160–163, 1997 © 1997 Wiley-Liss, Inc.
A No-Prophylaxis Platelet-Transfusion Strategy for Hematologic Cancers
Authors: Simon J. Stanworth, Lise J. Estcourt, Gillian Powter, Brennan C. Kahan, Claire Dyer, Louise Choo, Lekha Bakrania, Charlotte Llewelyn, Timothy Littlewood, Richard Soutar, Derek Norfolk, Adrian Copplestone, Neil Smith, Paul Kerr, Gail Jones, Kavita Raj, David A. Westerman, Jeffrey Szer, Nicholas Jackson, Peter G. Bardy, Dianne Plews, Simon Lyons, Linley Bielby, Erica M. Wood, Michael F. Murphy
Journal: New England Journal of Medicine (2013)

The effectiveness of platelet transfusions to prevent bleeding in patients with hematologic cancers remains unclear. This trial assessed whether a policy of not giving prophylactic platelet transfusions was as effective and safe as a policy of providing prophylaxis.
Inflammatory profiles in nasal mucosa of patients with persistent <i>vs</i> intermittent allergic rhinitis
Authors: F. Liu, J. Zhang, Y. Liu, N. Zhang, G. Holtappels, P. Lin, S. Liu, C. Bachert
Journal: Allergy (2010)

To date there is little information on the inflammatory profiles of patients suffering from persistent (PER) and intermittent allergic rhinitis (IAR). Also, it is not clear whether differences exist in eosinophilic inflammation and/or T-helper cell sub-populations and their markers. The aim of this study was to primarily evaluate the inflammatory profiles of patients with moderate/severe PER and IAR.Inferior nasal turbinate tissue was obtained from 12 PER, 12 IAR and 12 nonallergic nonrhinitic (control) patients, and symptoms (visual analogue scales, VAS) and impairment of life was monitored. All tissues were assessed for eosinophil and mast cell numbers by immunohistochemistry; IL-5, ECP and IgE concentrations by immunoassay; mRNA for transcription factors GATA-3, T-bet, FOXP3 and RORc by quantitative real-time polymerase chain reaction; and IgE-induced release of LTC(4)/D(4)/E(4) and PGD(2)in vitro.Eosinophils and mast cells were significantly increased in patients with PER and patients with IAR compared to control subjects; by patients with PER demonstrating even significantly greater increase of both cell types than patients with IAR. Similarly, ECP IL-5, GATA-3 mRNA expression and IgE-induced release of LTC4/D(4)/E(4) and PGD(2) from mast cells were significantly increased in patients with PER compared to patients with IAR. In contrast, the expression of T-bet, FOXP3 or RORc mRNA was not significantly different in the PER, IAR or control patients.The findings from the present study suggest that PER is characterized by a significantly greater eosinophilic and predominantly Th2 cell-mediated nasal inflammatory profile compared to IAR.
Analytic and Clinical Validation of a Prostate Cancer–Enhanced Messenger RNA Detection Assay in Whole Blood as a Prognostic Biomarker for Survival
Authors: Daniel C. Danila, Aseem Anand, Nikolaus Schultz, Glenn Heller, Mingliang Wan, Clifford C. Sung, Charles Dai, Raya Khanin, Martin Fleisher, Hans Lilja, Howard I. Scher
Journal: European Urology (2013)
Efficacy of RTS,S/AS02 malaria vaccine against Plasmodium falciparum infection in semi-immune adult men in The Gambia: a randomised trial
Authors: Kalifa A Bojang, Paul JM Milligan, Margaret Pinder, Laurence Vigneron, Ali Alloueche, Kent E Kester, W Ripley Ballou, David J Conway, William HH Reece, Philip Gothard, Lawrence Yamuah, Martine Delchambre, Gerald Voss, Brian M Greenwood, Adrian Hill, Keith PWJ McAdam, Nadia Tornieporth, Joe D Cohen, Tom Doherty
Journal: The Lancet (2001)
Special populations with hepatitis B virus infection
Authors: Marion G. Peters
Journal: Hepatology (2009)

Abstract Treatment of patients with chronic hepatitis B virus (HBV) infection who have advanced disease or comorbidities can be challenging, and recommendations may differ from standard guidelines. Among the special populations that merit specific consideration are patients with compensated or decompensated cirrhosis, organ transplantation, acute hepatitis B, pregnancy, coinfection with hepatitis C and/or D virus, chronic renal failure, and children. Major advances have been made in management of many of these special populations because of recent increasing availability of oral nucleosides, which are generally well tolerated and highly effective despite presence of other morbidities or viral infections. Also important have been changes in the management of hepatitis B during the peri-liver transplantation period that allows for prevention of reinfection in the majority of cases. However, much remains to be done to determine which patients should be treated and which should be monitored on no specific therapy. Outcomes of chronic HBV infection in persons with coinfection and in children have varied from different areas of the world, but it is not clear whether these differences are due to host and racial differences or to viral genotypic differences. Further studies are particularly needed in assessing the safety and efficacy of therapy in pregnant women, in children, and in patients with hepatitis D and C virus coinfection. (Hepatology 2009;49:S146–S155.)
Pulmonary herpes simplex in burns patients
Authors: RJ Byers, PS Hasleton, A Quigley, C Dennett, PE Klapper, GM Cleator, EB Faragher
Journal: European Respiratory Journal (1996)

In this study we aimed to determine the incidence of herpes simplex virus (HSV) in the lungs of burns patients, and its association with the presence of adult respiratory distress syndrome (ARDS) and pneumonia. Haematoxylin and eosin (H&E), and immunohistochemical (IHC) staining for HSV was performed on lung tissue from 54 patients who had died following burn injury and from nine control cases. Polymerase chain reaction (PCR) for HSV deoxyribonucleic acid (DNA) was performed on a subset both of burns cases and controls. No viral inclusions were detected in H&E sections, but 50% of the burns cases were positive for HSV by IHC staining; no control cases were positive. Nuclear and cytoplasmic immunopositivity for HSV was seen in macrophages and epithelial lining cells. HSV was strongly associated with ARDS (p=0.007), but not with pneumonia (p=0.577). The relative risk of HSV infection was higher for cases with ARDS (2.21) than for those with pneumonia (1.26). PCR for HSV DNA was positive in three out of five burns cases, and in one out of five control cases. Immunohistochemical staining is more sensitive for the detection of herpes simplex virus than haematoxylin and eosin staining for detection of viral inclusions. Burns cases have a high incidence of pulmonary herpes simplex virus infection. Polymerase chain reaction results may not be fully representative due to problems of tissue necrosis postmortem. Pulmonary herpes simplex virus is strongly associated with adult respiratory distress syndrome and the two may be causally linked. Early detection and treatment of pulmonary herpes simplex virus in burns patients may reduce pulmonary complications and mortality.
Mesenchymal stem cell therapy prevents deterioration of left ventricular function in a porcine myocardial infarction model
Authors: Mohammed S. Qayyum, Kaname Takizawa, Malka Frantzen, Robb MacLellan, Michael Lill, Michael C. Fishbein, Takashi Miyamoto, Raj Makkar
Journal: Journal of the American College of Cardiology (2002)
In vitro determination of small intestinal permeability.
Authors: I Hamilton, I Cobden, A T Axon
Journal: Gut (1984)

<h3>Abstract</h3> To describe characteristics of COVID-19 outbreaks in Australia to guide policy development for mitigation of future outbreaks, we conducted a retrospective analysis of COVID-19 outbreaks affecting two or more people reported to COVID-Net—an Australian national surveillance network—from 28 January until 27 December 2020. The COVID-Net surveillance network covered all Australian states and territories, with an estimated population of 25,649,985 persons as at 31 June 2020. We reported the epidemiology of COVID-19 outbreaks in Australia, including the setting in which they occurred, size, and duration. 853 outbreaks of COVID-19 were reported; associated with 13,957 confirmed cases, of whom 2,047 were hospitalised, and 800 died. The pattern of outbreaks followed a similar trend to the epidemic in Australia, defined by two distinct peaks in mid-March and July. Victoria reported the greatest number of outbreaks across all settings aligned with the second wave of infections. Outbreaks most commonly occurred in the workplace/industry setting (22%, 190/853), followed by education (14%, 122/853), residential aged care (13%, 114/853) and hospitals (10%, 83/853). The majority (40%, 340/853) of outbreaks had 6 to 24 cases, and the median outbreak duration increased in proportion with the number of associated cases. This report summarising COVID-19 outbreaks in Australia identifies settings of highest risk. Surveillance of outbreaks informs our understanding of transmission dynamics in Australia relative to national and jurisdictional interventions. For settings that are high risk for COVID-19, it is important to prioritise planning, surveillance, and implementation of control measures.
VOLUNTEER MEDICAL SERVICE CORPS
Authors: Hugh Neil MacKechnie
Journal: JAMA (1918)

<h3>FROM CHICAGO</h3><h3>To the Editor:</h3> —There has been brought to your attention, as evidenced in Queries and Minor Notes of last week's issue, a letter and questionnaire that have been sent out over the signature of the chairman of the Medical Section of the Advisory Commission of the Council of National Defense. I believe these demand consideration and discussion inThe Journal. While one is reading these documents many questions spring to mind, chief of which concern the inferred inefficiency or insufficiency of the Surgeon-Generals' Offices and the Provost Marshal-General's Office; the purpose and necessity of this new organization; its relation to the above mentioned offices, and its relation to the profession and of the profession to it and to the government. For an answer to these we read with interest, if not with enlightenment, the "pledge," the "scope and purpose," the "object of the corps," the "working plans" and
History of American Pediatrics
Authors: Jean D. Lockhart
Journal: JAMA (1980)

History is said to be written by the victors. In this history of pediatric care in America, Dr Cone has written a celebration of the victory over childhood diseases in the New World. What a marvelous historian he is! He traces childhood illness in America beginning at the colonial period and gives a lively account of the diseases that crossed the Atlantic with the colonists, the pitiful medical tools of the trade during the early periods, and the great men and women who brought new understanding to ageold diseases. Although a colonial child had a better chance of surviving infancy than his English counterpart, fewer than two of three infants lived to see their tenth birthdays. Over the years, as problems of infection and malnutrition succumbed to research, pediatricians began to take interest in political and legislative solutions to childhood ills. This, too, is faithfully recorded by Dr Cone. In
Characterization of a Novel Anti-DR5 Monoclonal Antibody WD1 with the Potential to Induce Tumor Cell Apoptosis
Authors: Jing Wang, Zhou Lin, Chunxia Qiao, Ming Lv, Ming Yu, He Xiao, Qingyang Wang, Liyan Wang, Jiannan Feng, Beifen Shen, Yangfang Ma, Yan Li
Journal: Cellular and Molecular Immunology (2008)
A phase III randomized controlled trial of adjuvant chemoradiotherapy (CRT) and postoperative radiotherapy (PORT) versus PORT alone in high risk bladder cancer patients
Authors: M. S. Zaghloul, H. M. Khaled, M. Loutayef, M. S. Nazmy, H. William
Journal: Journal of Clinical Oncology (2005)

4585 Background: Locally advanced bladder cancer patients have low survival rates after radical cystectomy. PORT though improved this survival, yet this improvement was not satisfactory. Methods: A prospective randomized trial started on August 2002, aimed at accrual of 180 patients in 2 arms, included 113 locally advanced bladder cancer patients so far. Patients who underwent radical cystectomy and had P3b, P4a, GIII and/or pelvic nodal involvement were randomized into 2 groups: Group I (59 patients) received PORT 45 Gy/30 fractions /3 weeks. Group II (54 patients) received adjuvant CRT in the form of 2 courses of Gemcitabine 1 g/m2 D1 and D8 and cisplatin 70 mg/m2 D2, same regimen of PORT as in group I followed by another 2 courses of Gemcitabine- cisplatin. The primary end point is disease-free survival (DFS). Results: Group II patients received 208 cycles of chemotherapy, only 3 patients (6%) could not complete their prescribed regimen. Chemotherapy was tolerated in most of the patients with grade 1/2 toxicities. Grade3/4 anemia was observed in 8% of the cycles. Grade 3/4 vomiting was observed in 37% of the cycles, while grade 3/4 renal complications were observed in one patient only. Early radiation reactions were also tolerable in both groups. Only 11% of the patients experienced grade 3 diarrhea with no differences between the 2 treatment groups. Severe Tensmus (grade 3) were experienced by 2 patients (3%). Patients were followed up for3–28(median 17) months. The 18-months DFS rate for group I patients was35±10% while that of group II patients was 48±10%, with no statistical difference of significance (p=0.4).The difference between DFS of Transitional Cell (TCC) and Squamous Cell Carcinoma (SCC) were not statistically significant in both groups. Though the cumulative distant metastasis rate was higher in group I (35±10%) than group II (21±9%) (p=0.08). Conclusions: Adjuvant CRT using Gemcitabine- cisplatin and PORT were tolerable with minimal severe toxicities. The 18-months disease free survival was encouraging for such high risk patients. Distant metastasis decreased, though not statistically significant yet, in adjuvant CRT group. No significant financial relationships to disclose.
UNIVERSITY COLLEGE HOSPITAL: LARGE CYSTIC TUMOUR OF THIGH: OPERATION: WITH REMARKS
Authors: J. Erichsen
Journal: BMJ (1856)

on the 24th of February, 1856.He is a native of Boston, in Lincolnshire, where he now resides, and whence he was sent by Mr. Tuxford.He appears strong and healthy, has plenty of flesh, good muscular development, and a rather ruddy complexion.About eighteen months ago he first noticed a swelling on the inner aspect of the upper third of left thigh.The tumour gradually continued to increase for thirteen months, when it was tapped by Mr. Tuxford, and some pints of turbid serous fluid were evacuated.This operation was followed by the general collapse of the tumour, which ap- peared to consist of a single large cyst.The sac rapidly filled again, and the fluid was evacuated a second time,
SPIROCHÆTA HEBDOMADIS, THE CAUSATIVE AGENT OF SEVEN DAY FEVER (NANUKAYAMI)
Authors: Yutaka Ido, Hiroshi Ito, Hidetsune Wani
Journal: The Journal of Experimental Medicine (1918)

A new species of spirochete which we have called Spirochaeta hebdomadis has been described as the specific etiological agent of seven day fever, a disease prevailing in the autumn in Fukuoka and other parts of Japan. This spirochete is distinguishable from Spirochaeta icterohaemorrhagiae to which it presents certain similarities. Young guinea pigs are susceptible to inoculation with the blood of patients and to pure cultures of the spirochete, and those developing infection exhibit definite symptoms suggestive of those of seven day fever in man. The blood serum of convalescents from seven day fever contains specific immune bodies acting spirochetolytically and spirocheticidally against the specific spirochetes, but not against Spirochaeta icterohaemorrhagiae. The field mouse (Microtus montebelli) is the normal host of the spirochetes, which have been detected in the kidneys and urine of 3.3 per cent of the animals examined. The endemic area of prevalence of seven day fever corresponds with the region in which field mice abound.
Development of a Laser Balloon for the Treatment of Gastrointestinal Obstruction
Authors: D. Fleischer, E. Cattau Jr., E. Sinofky, J. Newsome, E. Lack, A. Andriuk, S. Benjamin
Journal: Endoscopy (1989)

This work describes the initial results using a laser balloon in a canine model in an attempt to deliver the energy in a circumferential pattern. A balloon catheter, 2 cm long and 3 mm in diameter, was developed. Using a standard cw 100 watt Nd:YAG laser, a 600 micron fiber was tapered to 200 microns and passed through the proximal end of the balloon. Laparotomies were performed on mongrel dogs 14-18 kg in weight. After a gastrotomy, the gastric mucosa was exposed and rugal folds were pulled over the balloon to create a cylinder. Using power settings between 10 and 60 watts, and pulse durations between 10 and 40 seconds, radial energy was delivered and the tissue was examined for both gross and histologic effects. Circumferential zones of coagulation and necrosis were demonstrated.