tbuckley/cabot-search huggingface dataset:
Validation of Clinical Classification Schemes for Predicting Stroke
Authors: Brian F. Gage, Amy D. Waterman, William Shannon, Michael Boechler, Michael W. Rich, Martha J. Radford
Journal: JAMA (2001)

ContextPatients who have atrial fibrillation (AF) have an increased risk of stroke, but their absolute rate of stroke depends on age and comorbid conditions.ObjectiveTo assess the predictive value of classification schemes that estimate stroke risk in patients with AF.Design, Setting, and PatientsTwo existing classification schemes were combined into a new stroke-risk scheme, the CHADS2 index, and all 3 classification schemes were validated. The CHADS2 was formed by assigning 1 point each for the presence of congestive heart failure, hypertension, age 75 years or older, and diabetes mellitus and by assigning 2 points for history of stroke or transient ischemic attack. Data from peer review organizations representing 7 states were used to assemble a National Registry of AF (NRAF) consisting of 1733 Medicare beneficiaries aged 65 to 95 years who had nonrheumatic AF and were not prescribed warfarin at hospital discharge.Main Outcome MeasureHospitalization for ischemic stroke, determined by Medicare claims data.ResultsDuring 2121 patient-years of follow-up, 94 patients were readmitted to the hospital for ischemic stroke (stroke rate, 4.4 per 100 patient-years). As indicated by a c statistic greater than 0.5, the 2 existing classification schemes predicted stroke better than chance: c of 0.68 (95% confidence interval [CI], 0.65-0.71) for the scheme developed by the Atrial Fibrillation Investigators (AFI) and c of 0.74 (95% CI, 0.71-0.76) for the Stroke Prevention in Atrial Fibrillation (SPAF) III scheme. However, with a c statistic of 0.82 (95% CI, 0.80-0.84), the CHADS2 index was the most accurate predictor of stroke. The stroke rate per 100 patient-years without antithrombotic therapy increased by a factor of 1.5 (95% CI, 1.3-1.7) for each 1-point increase in the CHADS2 score: 1.9 (95% CI, 1.2-3.0) for a score of 0; 2.8 (95% CI, 2.0-3.8) for 1; 4.0 (95% CI, 3.1-5.1) for 2; 5.9 (95% CI, 4.6-7.3) for 3; 8.5 (95% CI, 6.3-11.1) for 4; 12.5 (95% CI, 8.2-17.5) for 5; and 18.2 (95% CI, 10.5-27.4) for 6.ConclusionThe 2 existing classification schemes and especially a new stroke risk index, CHADS2, can quantify risk of stroke for patients who have AF and may aid in selection of antithrombotic therapy.
Pituitary Tumor-Transforming Gene: Physiology and Implications for Tumorigenesis
Authors: George Vlotides, Tamar Eigler, Shlomo Melmed
Journal: Endocrine Reviews (2007)

Pituitary tumor-transforming gene-1 (PTTG1) is overexpressed in a variety of endocrine-related tumors, especially pituitary, thyroid, breast, ovarian, and uterine tumors, as well as nonendocrine-related cancers involving the central nervous, pulmonary, and gastrointestinal systems. Forced PTTG1 expression induces cell transformation in vitro and tumor formation in nude mice. In some tumors, high PTTG1 levels correlate with invasiveness, and PTTG1 has been identified as a key signature gene associated with tumor metastasis. Increasing evidence supports a multifunctional role of PTTG1 in cell physiology and tumorigenesis. Physiological PTTG1 properties include securin activity, DNA damage/repair regulation and involvement in organ development and metabolism. Tumorigenic mechanisms for PTTG1 action involve cell transformation and aneuploidy, apoptosis, and tumorigenic microenvironment feedback. This paper reviews recent advances in our understanding of PTTG1 structure and regulation and addresses known mechanisms of PTTG1 action. Recent knowledge gained from PTTG1-null mouse models and transgenic animals and their potential application to subcellular therapeutic targeting PTTG1 are discussed.
SARS genome patent: to manage and to share
Authors: Lap-Chee Tsui
Journal: The Lancet (2003)

I do not understand why Richard Gold (June 14, p 2002)1Gold ER SARS genome patent: symptom or disease.Lancet. 2003; 361 (2002-03)Summary Full Text Full Text PDF PubMed Scopus (18) Google Scholar singled out the University of Hong Kong (HKU) in his defence of the US Center for Disease Control and Prevention (CDC) and the British Columbia Cancer Agency (BCCA), who have reportedly proceeded to patent the genome of the coronavirus associated with severe acute respiratory syndrome (SARS). Specifically, the Commentary argued that the patent option would provide the two institutions "with more leverage in dealing with [HKU's] Versitech". Gold further argued that CDC and BCCA would "use the patent system to serve the public good". I wish to make clear that HKU is a research-led institution, committed to the public cause of higher education and benefiting society. Versitech is a technology transfer company, established in accordance with good practices of international universities to handle HKU's intellectual properties. Neither HKU nor Versitech are profit-seeking organisations, and they both hold the same view as CDC and BCCA—namely, to serve the public. HKU is committed to sharing its research results with society; locally, regionally, and internationally. We will continue to build up our research strength, but we cannot hope to share the benefits of our newly found knowledge if we do not properly manage our intellectual property rights.
Subcutaneous Veltuzumab, a Humanized Anti-CD20 Antibody, in the Treatment of Refractory Pemphigus Vulgaris
Authors: Christoph T. Ellebrecht, Eun J. Choi, David M. Allman, Donald E. Tsai, William A. Wegener, David M. Goldenberg, Aimee S. Payne
Journal: JAMA Dermatology (2014)

IMPORTANCE B-cell depletion with the anti-CD20 antibody rituximab is highly effective for pemphigus vulgaris (PV) treatment. However,most patients experience relapse, and intravenous rituximab infusions are expensive. Therefore, cost-effective anti-CD20 therapies are desirable.OBSERVATIONS A compassionate-use investigational new drug protocol was approved to administer veltuzumab, a second-generation humanized anti-CD20 antibody, to a patient with refractory PV. Veltuzumab was administered as two 320-mg (188mg/m2) subcutaneous doses 2 weeks apart, resulting in complete remission of disease off therapy. The disease relapsed 2 years after treatment. A second cycle of subcutaneous veltuzumab, using the same dosage regimen, again induced complete remission off therapy, which remained at9 months. No serious adverse events occurred during 35 months of follow-up. Serum veltuzumab levels were 22 and 29 μg/mL 2 weeks after the first dose of each cycle, and the drug remained detectable in the serum for longer than 3 months. Relapse and response to veltuzumab generally correlated with desmoglein 3 enzyme-linked immunosorbent assay index values. Shortly after a relapse that occurred after a long-term remission, the patient demonstrated an elevated naive (CD19+CD27−) to memory (CD19+CD27+) B-cell ratio of 19.5 and transitional (CD19+CD24+CD38+) B-cell frequency of 12.5%.CONCLUSIONS AND RELEVANCE Subcutaneous veltuzumab may be a safe, effective, and more economical alternative to intravenous rituximab for PV therapy. Clinical trials of subcutaneous veltuzumab for PV are warranted.
Improved Method of Recombinant AAV2 Delivery for Systemic Targeted Gene Therapy
Authors: Cathryn Mah, Thomas J. Fraites, Irene Zolotukhin, Sihong Song, Terence R. Flotte, Jon Dobson, Christopher Batich, Barry J. Byrne
Journal: Molecular Therapy (2002)

A major hurdle in most current gene therapy modalities is the ability to transduce target tissues at very high efficiencies that ultimately lead to therapeutic levels of transgene expression. We have developed a novel method of recombinant adeno-associated virus 2 (rAAV) delivery that results in increased vector transduction efficiencies using microspheres reversibly conjugated to rAAV vectors. We hypothesize that conjugation to microspheres should result in a higher effective concentration of vector as well as longer relative exposure time of vector to target cells as it moves through the tissue vasculature. In vitro experiments demonstrate that the same level of transduction seen with free vector can be achieved using 1% of vector when conjugated to microspheres. In addition, using magnetic microspheres, the region of infection can be targeted. In vivo, we demonstrate that microsphere-mediated delivery of rAAV vector results in higher transduction efficiencies than delivery with free vector alone when administered either intramuscularly or intravenously. Furthermore, we demonstrate targeting of transgene expression to specific tissues by retention of microsphere-bound vector in the capillary bed. These studies demonstrate a novel method to deliver rAAV vectors more effectively that could prove to be a successful alternative mode of virus-mediated human gene therapy.
Paying More Fairly for Medicare Capitated Care
Authors: Lisa I. Iezzoni, John Z. Ayanian, David W. Bates, Helen R. Burstin
Journal: New England Journal of Medicine (1998)

The 1997 Balanced Budget Act (Public Law 105-33) not only balanced the federal budget for the first time in decades but also mandated major changes in Medicare. One important goal of these changes was to expand the choice of health plans for Medicare beneficiaries, both to encourage the provision of high-quality care and to control aggregate program costs through competition and risk sharing. Under the new provisions, health-plan options include traditional fee-for-service care, high-deductible medical savings accounts, provider-sponsored organizations, and capitated plans, such as health maintenance organizations. However, questions arose about whether all beneficiaries would have these choices. In particular, . . .
Leukopheresis Therapy of a Hypereosinophilic Disorder
Authors: Leonard Ellman
Journal: JAMA (1974)

A young woman developed myositis, myocarditis, and vasculitis associated with severe eosinophilia following the use of sulfisoxazole (Gantrisin). Her illness was not altered by corticosteroid therapy and appeared to be progressive. Following leukopheresis and removal of large numbers of eosinophils on a continuous flow cell separator, there was a prompt decrease in the eosinophilia and rapid clinical improvement. Although the mechanism of this effect is unknown, leukopheresis may be a worthwhile modality of therapy in other patients with progressive hypereosinophilic disorders. (<i>JAMA</i>230:1004-1005, 1974)
The Fever of Leicester
Authors: J. Sloane
Journal: BMJ (1857)

saline antimonial mixture to keep the circulation quiet.Everything seemed to go on favourably till the evening of May 18th, when he complained of heat of the scalp; the pulse rose to 94. Ice was applied to the head, after twelve leeches had been used.May 19th.Pulse 110.The scalp was hot; the pupils were rather dilated and sluggish.The patient did not appear conscious unless spoken to loudly, when he answered ration.ally.The treatment was continued, with the addition of a few doses of calomel.May 20th.The coma had increased during the night, and once or twice he had attempted to get out of bed; the pulse varied at short intervals from 90 to 130.It was now evident that, although the depressed bone had not of itself produced arny serious symptoms calling for its removal at an earlier period, yet the results of the depression, the inflammation set up in the encephalon by it, rendered an operation necessary to give exit to the inflammatory products.The wound was accordingly enlarged; and a portion of bone being removed by a Hey's saw, gave exit to a small quantity of pus, and allowed the extraction of two pieces of the inner table of the skull Which had perforated the dura mater, and were sticking in the substance of the brain; the dura mater was dark and sloughy.Water dressing was applied to the parts.The man never recovered consciousness, though he lingered till the 23rd, when he died.His friends refused to allow a post mortem examination.
Units of analysis
Authors: P. Sedgwick
Journal: BMJ (2013)

Researchers assessed the effectiveness of a physical activity programme during one school year on the physical and psychological health of young schoolchildren. A cluster randomised controlled trial design was used. The physical activity programme consisted of three existing physical education lessons each week supplemented by a further two lessons, daily short activity breaks, and physical activity homework. Children in the control group received only the three existing physical education lessons each week.1

In total, 28 classes at 15 elementary schools in Switzerland were recruited. Classes were randomly assigned to treatment in a 4:3 ratio; 16 classes at nine schools were assigned to the intervention and 12 classes at six schools were assigned to the control. There were 297 children allocated to intervention and 205 to control.

Primary outcome measures included for each child the change between baseline and follow-up in body fat, aerobic fitness, physical activity, and quality of life measures. The researchers reported that the school based multicomponent physical activity intervention improved physical activity …
Jakob-Creutzfeldt Disease
Authors: Orville T. Bailey
Journal: JAMA (1968)

The last few years have seen a renewed interest in the clinical features of Jakob-Creutzfeldt disease, its identity among the presenile dementias, its pathology, and very recently its apparent transmission to chimpanzees. Dr. Kirschbaum writes with great authority, for his personal contributions date from the very earliest recognition of the condition and remain fundamental to its understanding. They may well outweigh those of Creutzfeldt, in spite of the eponym. The monograph begins with an excellent brief historical account, followed by a thorough discussion of the clinical manifestations and a clear description of the neuropathology, including electronmicroscopic studies and the suggestion that virological investigations may prove valuable (as, indeed, they have since the book was finished). Over half the volume is devoted to the tabular presentation of 150 cases and detailed descriptions of 17. There is a comprehensive bibliography. The illustrations are carefully chosen and technically good, though reproduced on semimatte
French government wastes 15bn a year on useless drugs, book claims
Authors: S. Arie
Journal: BMJ (2012)

Half of all drugs on the French market are useless, some can be harmful, and the state is wasting up to €15bn (£12bn; $20bn) a year paying for them, a book published by two leading French doctors claims.

Guide des 4000 Medicaments Utiles, Inutiles ou Dangereux ( A Guide to 4000 Useful, Useless and Dangerous Medicines ), published in France on 13 September, says that 50% of the drugs on the French market are useless and 5% are potentially dangerous and that, despite those facts, 75% are paid for by the social security system.1

Patients are being prescribed drugs that make no difference at all for conditions …
The Effect of Desiccated Thyroid on Plasma and Tissue Lipids and Atherogenesis in the Stilbestrol-Treated Chick
Authors: J. STAMLER, A. J. MILLER, L. AKMAN, E. N. SILBER, C. BOLENE, L. N. KATZ
Journal: Circulation (1950)

Repeated implantations of diethylstilbestrol pellets cause a sustained hyperlipemia in the chick, and atherosclerosis eventually supervenes. Desiccated thyroid significantly reduces the incidence and degree of the stilbestrol-induced atherosclerosis in the chick, although it is without sustained effect upon the plasma and tissue lipids.
An age-specific kinetic model of lead metabolism in humans.
Authors: R W Leggett
Journal: Environmental Health Perspectives (1993)

Although considerable progress has been made in recent years in reducing human exposures to lead, the potential for high intake of this contaminant still exists in millions of homes and in many occupational settings. Moreover, there is growing evidence that levels of lead intake considered inconsequential just a few years ago can result in subtle, adverse health effects, particularly in children. Consequently, there have been increased efforts by health protection agencies to develop credible, versatile methods for relating levels of lead in environmental media to levels in blood and tissues of exposed humans of all ages. In a parallel effort motivated largely by the Chernobyl nuclear accident, the International Commission on Radiological Protection (ICRP) is assembling a set of age-specific biokinetic models for calculating radiation doses from environmentally important radionuclides, including radioisotopes of lead. This paper describes a new age-specific biokinetic model for lead originally developed for the ICRP but expanded to include additional features that are useful for consideration of lead as a chemical toxin. The model is developed within a generic, physiologically motivated framework designed to address a class of calciumlike elements. This framework provides a useful setting in which to synthesize experimental, occupational, and environmental data on lead and exploit common physiological properties of lead and the alkaline earth elements. The modular design is intended to allow researchers to modify specific parameter values or model components to address special problems in lead toxicology or to incorporate new information. Transport of lead between compartments is assumed to follow linear, first-order kinetics provided the concentration in red blood cells remains below a nonlinear threshold level, but a nonlinear relation between plasma lead and red blood cell lead is modeled for concentrations above that level. The model is shown to be consistent with data on human subjects exposed to lead under a variety of experimental and natural conditions.
The relationship of daily mortality to suspended particulates in Santa Clara County, 1980-1986.
Authors: D Fairley
Journal: Environmental Health Perspectives (1990)

This paper explores the relationship between daily mortality and suspended particulates in Santa Clara County, CA, for years 1980 to 1986. An association was found between high particulate concentrations and increased mortality. This association persists after adjustment for temperature, relative humidity, year, and seasonality. Contrary to expectation, the magnitude of the particulate effect appears the same or larger than that estimated for London, despite Santa Clara County's cleaner air. The persistence of an effect at these lower particulate concentrations suggests that the particulate variable may be acting as a surrogate for some constituent particles, such as acid aerosols.
The Erythrocyte Sedimentation Rate
Authors: THOMAS MCC. CHESNEY
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 September 1986The Erythrocyte Sedimentation RateTHOMAS MCC. CHESNEY, M.D.THOMAS MCC. CHESNEY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-3-469 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: As a diagnostician, I was pleased to see the critical review of the current value, or lack thereof, of the erythrocyte sedimentation rate by Drs. Sox and Liang (1). I was surprised, however, when the authors did not even mention the use for this test that we find of greatest value in our large diagnostic hematology laboratory.Our laboratory annually processes about 3000 interpreted studies-1000 bone marrow aspirates and biopsy samples and 2000 anemia diagnostic studies. The anemia studies consist of an expanded complete blood count with erythrocyte indices, reticulocyte count (relative and absolute), erythrocyte sedimentation rate,...Reference1. SOXLIANG HM. The erythrocyte sedimentation rate: guidelines for rational use. Ann Intern Med. 1986;104:515-23. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAnticruelty CareThe Erythrocyte Sedimentation RateSEAD BEGANOVIC, M.D. 1 September 1986Volume 105, Issue 3Page: 469-470KeywordsAnemiaBiopsyBone marrowComplete blood countErythrocyte sedimentation rateHematologic testsResearch laboratoriesReticulocytes ePublished: 1 December 2008 Issue Published: 1 September 1986 PDF downloadLoading ...
ABSCESS OF THE LUNG
Authors: B. S. Kline
Journal: JAMA (1927)

<h3>To the Editor:</h3> —Referring to the editorial inThe Journal, October 8, page 1253, concerning abscess of the lung, it would have been productive of greater good if it had contained mention of the fact that many cases diagnosed abscess of the lung are in reality cases of pulmonary gangrene due to anaerobic organisms, notably spirochetes and fusiform bacilli. These cases may be frequently successfully treated by arsphenamines.
Increased calcium intake may reduce risk of primary hyperparathyroidism
Authors: J. Norman
Journal: BMJ (2012)

Moderate calcium supplementation in women should be encouraged



As little as 500 mg/ day of calcium may help

STEVE HORRELL/ SPL

In recent years, many basic science and clinical studies have provided evidence that untreated primary hyperparathyroidism is associated with an increased incidence of hypertension, cardiomyopathy, myocardial infarction, atrial fibrillation, stroke, and even breast and prostate cancer.1 2 3 4 5 6 Primary hyperparathyroidism is now known to exacerbate or underpin many more diseases and conditions than the classic osteoporosis and kidney stones. Physicians no longer wait until one of the classic complications arises but take a more proactive approach and recommend parathyroidectomy once the diagnosis has been secured. Such an approach is now easier because parathyroidectomy has become available as an outpatient procedure over the past decade.7

A linked cohort study …
Novel Drug-Delivery Stent
Authors: Yasuhiro Honda, Eberhard Grube, Luis M. de la Fuente, Paul G. Yock, Simon H. Stertzer, Peter J. Fitzgerald
Journal: Circulation (2001)

Background The aim of this study was to use serial intravascular ultrasound (IVUS) to evaluate the long-term effect of stent-based 7-hexanoyltaxol (QP2, a taxane analogue) delivery on neointimal tissue growth within the stent and on vessel dimensions at the adjacent reference segments. Methods and Results Serial IVUS analyses (immediately after intervention and at follow-up at 8.3 months) were performed in 15 native coronary lesions treated with the QuaDS-QP2 stent. IVUS measurements were performed at 8 cross-sections in each target segment (4 cross-sections within the stent and 2 cross-sections in each reference segment). At baseline, no significant plaque protrusion or thrombus was detected in the target segment. Mild incomplete stent apposition and edge dissection were observed in one and two cases, respectively. Percent expansion of the stent (minimum stent area/average reference lumen area) was 96.0±21.7%. At follow-up, mean neointimal area within the stent was 1.2±1.3 mm 2 , and mean cross-sectional narrowing (neointimal area/stent area) was 13.6±14.9%. At the vessel segments immediately adjacent to the stent, a significant increase in plaque area (1.9±2.6 mm 2 , P =0.001) was observed, but vessel area remained unchanged. However, no patients showed clinically significant in-stent or edge restenosis (diameter stenosis ≥50%) during the follow-up period. Conclusions The first human experience with the new drug-delivery stent showed a minimal amount of neointimal proliferation in the stented segment. Late lumen loss at the reference sites adjacent to the stent was acceptable and predominantly due to plaque proliferation.