tbuckley/cabot-search huggingface dataset:
Fungal Infections Associated with Contaminated Methylprednisolone in Tennessee
Authors: Marion A. Kainer, David R. Reagan, Duc B. Nguyen, Andrew D. Wiese, Matthew E. Wise, Jennifer Ward, Benjamin J. Park, Meredith L. Kanago, Jane Baumblatt, Melissa K. Schaefer, Brynn E. Berger, Ellyn P. Marder, Jea-Young Min, John R. Dunn, Rachel M. Smith, John Dreyzehner, Timothy F. Jones
Journal: New England Journal of Medicine (2012)

We investigated an outbreak of fungal infections of the central nervous system that occurred among patients who received epidural or paraspinal glucocorticoid injections of preservative-free methylprednisolone acetate prepared by a single compounding pharmacy.Case patients were defined as patients with fungal meningitis, posterior circulation stroke, spinal osteomyelitis, or epidural abscess that developed after epidural or paraspinal glucocorticoid injections. Clinical and procedure data were abstracted. A cohort analysis was performed.The median age of the 66 case patients was 69 years (range, 23 to 91). The median time from the last epidural glucocorticoid injection to symptom onset was 18 days (range, 0 to 56). Patients presented with meningitis alone (73%), the cauda equina syndrome or focal infection (15%), or posterior circulation stroke with or without meningitis (12%). Symptoms and signs included headache (in 73% of the patients), new or worsening back pain (in 50%), neurologic symptoms (in 48%), nausea (in 39%), and stiff neck (in 29%). The median cerebrospinal fluid white-cell count on the first lumbar puncture among patients who presented with meningitis, with or without stroke or focal infection, was 648 per cubic millimeter (range, 6 to 10,140), with 78% granulocytes (range, 0 to 97); the protein level was 114 mg per deciliter (range, 29 to 440); and the glucose concentration was 44 mg per deciliter (range, 12 to 121) (2.5 mmol per liter [range, 0.7 to 6.7]). A total of 22 patients had laboratory confirmation of Exserohilum rostratum infection (21 patients) or Aspergillus fumigatus infection (1 patient). The risk of infection increased with exposure to lot 06292012@26, older vials, higher doses, multiple procedures, and translaminar approach to epidural glucocorticoid injection. Voriconazole was used to treat 61 patients (92%); 35 patients (53%) were also treated with liposomal amphotericin B. Eight patients (12%) died, seven of whom had stroke.We describe an outbreak of fungal meningitis after epidural or paraspinal glucocorticoid injection with methylprednisolone from a single compounding pharmacy. Rapid recognition of illness and prompt initiation of therapy are important to prevent complications. (Funded by the Tennessee Department of Health and the Centers for Disease Control and Prevention.).
(Mis)interpreting studies on the adverse effects of statins
Authors: H. Zhang, J. Plutzky, A. Turchin
Journal: BMJ (2014)

Our study “Discontinuation of statins in routine care settings”1 has been cited in recent discussions in The BMJ on statin intolerance.2 3 4 Some of these reports misinterpreted our study.

Our study sought to investigate the “real world” experience of patients who developed symptoms that they, or their healthcare providers, thought might have been caused by statins. Using natural language …
Comparison of Outcomes of Phase II Studies and Subsequent Randomized Control Studies Using Identical Chemotherapeutic Regimens
Authors: Mohammad I. Zia, Lillian L. Siu, Greg R. Pond, Eric X. Chen
Journal: Journal of Clinical Oncology (2005)

Purpose To determine whether promising results from phase II studies could be reproduced in phase III studies, and to examine which characteristics of phase II studies might be of predictive value for subsequent phase III studies. Methods We searched for all phase III studies of chemotherapy in advanced solid malignancies, published in the English language literature from July 1998 to June 2003. Each phase III study was reviewed to identify preceding phase II studies. Phase II and phase III studies included in this analysis must have used identical regimens. Data were extracted from both phase II and phase III studies. Results Of 181 phase III studies identified, 43 used therapeutic regimens identical to those in 49 preceding phase II studies. Twelve phase III studies (28%) were “positive.” The vast majority (81%) of phase III studies have lower response rates than preceding phase II studies, with a mean difference of 12.9% among all studies analyzed. None of the phase II study characteristics evaluated significantly predicted for “positive” phase III studies, but the sample size of phase II studies demonstrated a trend toward being predictive (P = .083). Conclusion Promising results from phase II studies frequently do not translate into “positive” phase III studies. Response rates in most phase III studies are lower than those in preceding phase II studies.
Determination of 2-acetylaminofluorene adducts by immunoassay
Authors: Miriam C. Poirier, B'Ann True, Brian A. Laishes
Journal: Environmental Health Perspectives (1983)

Antisera elicited in rabbits were used in radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) to determine femtomole quantities of deoxyguanosin-(8-yl)-acetylaminofluorene (dg-8-AAF) and deoxyguanosin-(8-yl)-aminofluorene (dg-8-AF). These adducts have been monitored in liver and kidney DNA of male Wistar-Furth rats fed 0.02% or 0.04% 2-acetylaminofluorene (2-AAF) either continuously or for a limited time followed by an interval on control diet. After 24 hr of 0.02% 2-AAF feeding, substantial levels of binding (80 fmole/μg DNA) were observed in liver DNA and increased with time, reaching a plateau of approximately 230 fmole/μg DNA at 30 days and thereafter. During the first week of continuous feeding about 80% of the total C-8 adducts in the liver DNA were deacetylated (dG-8-AF). By 25-60 days, dG-8-AF represented 97-100% of all C-8 adducts as measured by RIA and confirmed by HPLC. Values for C-8 adduct formation in kidney DNA were severalfold lower than in liver and dG-8-AF represented &gt;90% of C-8 adducts at all times studied. In removal or repair experiments, rats were fed 2-AAF for 3, 7 or 28 days, the 2-AAF diet was discontinued and the liver adducts assayed after intervals on control diet. When dietary 2-AAF administration was for 3 or 7 days, removal of adducts was efficient and almost complete by 28 days on control diet, with preferential retention of dG-8-AF. However, when dietary 2-AAF administration was for 28 days, adduct levels were higher, the repair capacity was saturated and the removal of C-8 adducts was not complete after control diet for a 28-day interval. In a preliminary experiment when [3H]-2-AAF was fed for 3 days, after 25 days of 0.02% 2-AAF, the rates of newly formed adduct formation and removal were similar to those observed for the initial 3 days of 2-AAF feeding. These results demonstrate the predominance and persistence of dG-8-AF in liver and kidney DNA of 2-AAF-fed rats and suggest that the repair capacity of the whole rat liver was not diminished after 1 month of 2-AAF feeding.
Age at onset and different types of psoriasis
Authors: G. SWANBECK, A. INEROT, T. MARTINSSON, J. WAHLSTRÖM, C. ENERBÄCK, F. ENLUND, M. YHR
Journal: British Journal of Dermatology (2006)

The age at onset of psoriasis has been analysed for 11,366 psoriasis patients. The age at onset for siblings of probands has been analysed for 805 probands having one affected sibling and for 1 79 probands having two affected siblings. The age at onset curve for all probands shows a dominating maximum at about puberty but also indications for two more maxima at about 30 and 50 years of age, respectively. A more relevant picture of the risk of getting psoriasis at different ages is obtained if the onset for old people having psoriasis is investigated. The three maxima come out more clearly in this case, and the puberty maximum is not so dominating. For the families with one proband and two affected siblings there is a statistically significant correlation (Plt;0·001) between the age at onset of the proband and of the siblings, and also between the siblings. The correlation coefficient is between 0·30 and 0·45. For the probands with one affected sibling, the ages at onset of the siblings mainly fall in the same range as those of the probands. These data indicate three groups of patients with respeel to age at onset. However, the overlap between the different groups is considerable. The data presented are compatible with three, possibly genetically different, variants of psoriasis vulgaris. By studying the occurrence of psoriasis among parents of the probands, the gene frequency can be estimated assuming a recessive mode of inheritance. It then turns out that the gene frequency of the group with the earliest age at onset has a gene frequency of about 0·25, the next earliest, 0·18, and the latest, 0·14.
LIMITATIONS OF PATHOGNOMONIC SIGNS AND SYMPTOMS.
Authors: EDWARD G. JANEWAY
Journal: JAMA (1884)

Read in the Section on Practice of Medicine and Materia Medica of American Medical Association, May, 1884. It has been the writer's intention to bring into this short paper, the results of observations extending over some time concerning certain limitations which must be placed upon signs which are considered, when present in certain states, more or less pathognomonic of a definite morbid condition. The word pathognomonic is not used in a strict sense, but somewhat as the word diagnostic. The writer has so frequently witnessed erroneous opinions as to the nature of disease, arising from the reception of some one sign as absolutely determining, that he has been impelled to write this article to impress more forcibly the necessity of studying all the phenomena present in cases of disease. Those diagnoses which are rightly denominated snap, may at times be brilliant, but he who indulges in them frequently, no matter
90Y-Ibritumomab tiuxetan, fludarabine, and TBI-based nonmyeloablative allogeneic transplantation conditioning for patients with persistent high-risk B-cell lymphoma
Authors: Ajay K. Gopal, Katherine A. Guthrie, Joseph Rajendran, John M. Pagel, George Oliveira, David G. Maloney, Manuela C. Matesan, Rainer F. Storb, Oliver W. Press
Journal: Blood (2011)
Spectrum of liver disease and duck hepatitis B virus infection in a large series of chinese ducks with hepatocellular carcinoma
Authors: Agnes Duflot, Raj Mehrotra, Shun-Zhang Yu, Luc Barraud, Christian Trepo, Lucyna Cova
Journal: Hepatology (1995)

The striking difference in the geographical distribution of liver cancer in ducks raised the question of whether duck hepatitis B virus (DHBV), like mammalian hepadnaviruses, could be an oncogenic agent. Hepatocellular carcinomas (HCCs) have been found only in domestic ducks in Qidong, China, where hepatitis B virus infection and aflatoxin B1 (AFB1) are both risk factors and where a high frequency of human HCCs has been reported. To date, the study of liver pathology occurring in Chinese ducks has been hampered by the small number of samples available. We describe here a series of 59 Chinese brown duck livers that were collected in Qidong more than 20 years ago and formalin fixed. Thirty-six HCCs, which ranged from well-differentiated trabecular to highly anaplastic type, were identified in relatively young ducks (average age, 3.3 years). Several unique features not previously reported, such as tumor giant cells, tumor necrosis, tumor thrombi in blood vessels, and inactive cirrhosis, were observed. Bile ductule proliferation, known to be a prominent feature of AFB1 exposure in ducks, was present in 86% of livers. Using polymerase chain reaction (PCR) and two primer pairs, located within conserved portions of the DHBV S and C genes, we demonstrated the presence of DHBV DNA in 23 of 34 HCCs analyzed (68%). The spectrum of liver pathology that we report in brown ducks from Qidong was never observed in Pekin ducks of the same age chronically infected with DHBV and followed under controlled conditions outside China, suggesting that causative factors other than virus infection may be involved in duck liver carcinogenesis observed in this area.(ABSTRACT TRUNCATED AT 250 WORDS)
Expression of CD25 antigen on CD34+ cells is an independent predictor of outcome in late-stage MDS patients treated with azacitidine
Authors: P Miltiades, E Lamprianidou, T P Vassilakopoulos, S G Papageorgiou, A G Galanopoulos, S Vakalopoulou, V Garypidou, M Papaioannou, E Hadjiharissi, V Pappa, H A Papadaki, E Spanoudakis, K Tsatalas, I Kotsianidis
Journal: Blood Cancer Journal (2014)

Expression of CD25 antigen on CD34+ cells is an independent predictor of outcome in late-stage MDS patients treated with azacitidine
Polycaprolactone-based fused deposition modeled mesh for delivery of antibacterial agents to infected wounds
Authors: Erin Yiling Teo, Shin-Yeu Ong, Mark Seow Khoon Chong, Zhiyong Zhang, Jia Lu, Shabbir Moochhala, Bow Ho, Swee-Hin Teoh
Journal: Biomaterials (2010)
Sulphasalazine hepatotoxicity after 15 years' successful treatment for ulcerative colitis.
Authors: T W Lennard, J R Farndon
Journal: BMJ (1983)

CommentLimited x ray facilities, distance from the x ray department, and availability of a radiographer are common reasons why a radiological check of the position of a catheter might be delayed for an hour or more.Furthermore, the x ray film is taken after the catheter has been sutured to skin and the site dressed, so that if repositioning proves necessary this entire procedure must be repeated, with increased risk of local sepsis, further inconvenience to patients and staff, and still more delays before the catheter can be used.Yet this painstaking regimen is followed irrespective of the urgency with which the central line is required.We have described a rapid, simple, and accurate method of recognis- ing misplacement of the catheter into the neck that permits early repositioning.If misplacement is thought to have occurred by this test we do not now check by x ray examination but immediately resite the line using a fresh guidewire.Only when satisfied by the guidewire test that the line is correctly placed do we confirm the position of the catheter and the absence of pneumothorax radiologically, by which time the catheter is in use.
Resistance calculation and expression
Authors: Emanuel Sikuler, Are Moran, Michael J. Henderson, Hussein M. Atta, Thomas G. Gilmore
Journal: Hepatology (1991)

Dauphinee and Sinclair review a classification of biliary cirrhosis existing at that time and, after presenting and reviewing 10 cases, suggest the term primary biliary cirrhosis as a substitute for what had previously often been referred to as "hypertrophic biliary cirrhosis'' or "Hanot's cirrhosis.
Patterns of viral decline during PEG-interferon alpha-2b therapy in HBeAg-positive chronic hepatitis B: Relation to treatment response
Authors: Martijn J. ter Borg, Monika van Zonneveld, Stefan Zeuzem, Hakan Senturk, Ulus S. Akarca, Christopher Simon, Bettina E. Hansen, Bart L. Haagmans, Robert A. de Man, Solko W. Schalm, Harry L.A. Janssen
Journal: Hepatology (2006)

In chronic hepatitis B, it is difficult to predict an early therapeutic response. We investigated the viral decline during therapy with pegylated interferon alpha-2b (PEG-IFN) with or without lamivudine in 266 HBeAg-positive chronic hepatitis B patients. In patients treated with PEG-IFN and lamivudine, a uniform biphasic viral decline pattern was found during therapy and there were no marked differences in viral load between those who lost HBeAg at the end of follow-up (response) or not. In contrast, those treated with PEG-IFN monotherapy exhibited different viral decline patterns. A delayed decline of at least two log from baseline HBV DNA after week 4 but before week 32 was associated with the highest response rate (63%). In comparison, response was 52% for patients with an early decline (week 0-4), 38% for a late decline (week 32-52), 27% for a posttreatment decline (week 52-78) and 11% for patients with no substantial decline. The HBsAg loss was 22% in the delayed decline pattern compared to 4% for those with early decline and none for other decline patterns. In conclusion , different patterns of decline in viral load during treatment with PEG-IFN monotherapy were associated with different rates of HBeAg and HBsAg loss at the end of follow-up. Since there was a considerable response, even in patients with a late or posttreatment decline pattern, prediction of response based on viral decline during the first months of therapy was difficult.
Transforming Growth Factor- β<sub>2</sub>Induces Pleurodesis Significantly Faster than Talc
Authors: Y. C. GARY LEE, LISETE R. TEIXEIRA, CLINTON J. DEVIN, MARCELO A. C. VAZ, FRANCISCO S. VARGAS, PHILIP J. THOMPSON, KIRK B. LANE, RICHARD W. LIGHT
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Transforming growth factor- β2 (TGF- β2) has recently been shown to produce effective pleurodesis in rabbits. Conventional pleurodesing agents such as talc act by inducing pleural injury, which results in acute inflammation and fibrosis. TGF- β2 is a profibrotic cytokine capable of producing fibrosis without inducing significant pleural inflammation. We hypothesize that intrapleural administration of TGF- β2 would (1) produce an effective pleurodesis faster; (2) stimulate more collagen deposition, and (3) induce less inflammation when compared with intrapleural injection of talc. Thirty rabbits were divided into two groups and given either TGF- β2 (1.7 μ g) or talc slurry (400 mg/kg) via a chest tube. Five rabbits from each group were killed at Days 1, 4, and 7. Gross pleurodesis was graded from 1 (none) to 8 (complete symphysis). The microscopic pleural inflammation and fibrosis were graded from 0 to 4. Pleural thickening and the total area of collagen deposition were compared. Intrapleural injection of TGF- β2 produced effective pleurodesis within 7 d (median pleurodesis score = 7 at Day 7). At Day 7, TGF- β2 induced significantly more collagen deposition (19.4 ± 19.6% versus 4.6 ± 2.9% of total area of pleura at Day 7), higher pleural fibrosis score (3.0 ± 1.0 versus 1.8 ± 0.5), and pleural thickness (286 ± 191 versus 85 ± 37 μ m) than did talc. There was no difference in the degree of pleural inflammation between the two groups at Day 7 (2.6 ± 0.9 for TGF- β2 versus 2.4 ± 0.6 for talc) or at any other time points. In conclusion, the intrapleural administration of TGF- β2 produced excellent pleurodesis in rabbits at a rate faster than talc slurry and all other pleurodesing agents investigated before. TGF- β2 stimulated more collagen deposition without inducing excess inflammation when compared with talc slurry. TGF- β2 may have advantages over talc slurry in the management of recurrent pleural effusion and pneumothorax.
Consensus statement * on the treatment of allergic rhinitis
Authors: P. Van Cauwenberge, C. Bachert, G. Passalacqua, J. Bousquet, G. W. Canonica, S. R. Durham, W. J. Fokkens, P. H. Howarth, V. Lund, H.‐J. Malling, N. Mygind, D. Passali, G. K. Scadding, D.‐Y. Wang
Journal: Allergy (2000)
Early prediction of IgA nephropathy progression: Proteinuria and AOPP are strong prognostic markers
Authors: Béatrice Descamps-Latscha, Véronique Witko-Sarsat, Thao Nguyen-Khoa, Anh Thu Nguyen, Valérie Gausson, Nadya Mothu, Camila Cardoso, Laure-Hélène Noël, Alain P. Guérin, Gérard M. London, Paul Jungers
Journal: Kidney International (2004)
Oral carnitine therapy in children with cystinosis and renal Fanconi syndrome.
Authors: W A Gahl, I Bernardini, M Dalakas, W B Rizzo, G S Harper, J M Hoeg, O Hurko, J Bernar
Journal: Journal of Clinical Investigation (1988)

11 children with either cystinosis or Lowe's syndrome had a reduced content of plasma and muscle carnitine due to renal Fanconi syndrome. After treatment with oral L-carnitine, 100 mg/kg per d divided every 6 h, plasma carnitine concentrations became normal in all subjects within 2 d. Initial plasma free fatty acid concentrations, inversely related to free carnitine concentrations, were reduced after 7-20 mo of carnitine therapy. Muscle lipid accumulation, which varied directly with duration of carnitine deficiency (r = 0.73), improved significantly in three of seven rebiopsied patients after carnitine therapy. One Lowe's syndrome patient achieved a normal muscle carnitine level after therapy. Muscle carnitine levels remained low in all cystinosis patients, even though cystinotic muscle cells in culture took up L-[3H]carnitine normally. The half-life of plasma carnitine for cystinotic children given a single oral dose approximated 6.3 h; 14% of ingested L-carnitine was excreted within 24 h. Studies in a uremic patient with cystinosis showed that her plasma carnitine was in equilibrium with some larger compartment and may have been maintained by release of carnitine from the muscle during dialysis. Because oral L-carnitine corrects plasma carnitine deficiency, lowers plasma free fatty acid concentrations, and reverses muscle lipid accumulation in some patients, its use as therapy in renal Fanconi syndrome should be considered. However, its efficacy in restoring muscle carnitine to normal, and the optimal dosage regimen, have yet to be determined.
Microinjection of antibodies and expression vectors into living myocardial cells. Development of a novel approach to identify candidate genes that regulate cardiac growth and hypertrophy.
Authors: H E Shubeita, J Thorburn, K R Chien
Journal: Circulation (1992)

BACKGROUND Microinjection approaches in the cardiac cell context have allowed delivery of various calcium dyes and monitoring of short-term physiological responses. However, unlike other cell types, it has proved difficult to microinject myocardial cells without the concomitant loss of long-term cell viability. METHODS AND RESULTS An analysis of experimental variables was conducted to adapt microinjection techniques to the neonatal rat ventricular cell context. Among the variables optimized were the selection of culture dishes, plating substrate, microinjection parameters, and a variety of maneuvers to inhibit myocyte hypercontracture, injury, and consequent death after micropuncture. With the modified technique, the percentage of injected cells that maintained long-term viability (48 hours) increased from less than 1% to 30%. Similarly, an increased efficiency of gene transfer and expression (measured as the percentage of injected cells that express the delivered gene) was obtained after either cytoplasmic or nuclear injection of a beta-galactosidase expression vector into cardiac myocytes. Microinjection of marker immunoglobulin G does not interfere with the induction of the hypertrophic response or the expression of a coinjected atrial natriuretic factor promoter-luciferase reporter fusion gene construct. CONCLUSIONS To the best of our knowledge, this study provides the first description of the efficient microinjection of neonatal cardiac muscle cells with maintenance of long-term cell viability. The microinjection technique is now a viable approach to examine cause-and-effect relations between specific gene products and any defined feature or response of cardiac myocytes that can be assayed at a single-cell level.
Government proposes removing caps on trusts' private income
Authors: N. Timmins
Journal: BMJ (2009)

A 51 year old man with a 20 year history of ankylosing spondylitis and pronounced thoracic gibbus presented with two simultaneous complications of longstanding ankylosing spondylitis, upper lobe fibrobullous disease, and spinal pseudarthrosis. No neurological sequelae developed and treatment was conservative. Both these lesions mimic tuberculosis, and so it is important to determine them accurately to avoid unnecessary antituberculosis treatment. Both of these complications are reported to occur in longstanding ankylosing spondylitis and their simultaneous presentation may be more common than is realised. This case is believed to be the first such report of their association.