tbuckley/cabot-search huggingface dataset:
An Algorithm for Tuberculosis Screening and Diagnosis in People with HIV
Authors: Kevin P. Cain, Kimberly D. McCarthy, Charles M. Heilig, Patama Monkongdee, Theerawit Tasaneeyapan, Nong Kanara, Michael E. Kimerling, Phalkun Chheng, Sopheak Thai, Borann Sar, Praphan Phanuphak, Nipat Teeratakulpisarn, Nittaya Phanuphak, Nguyen Huy Dung, Hoang Thi Quy, Le Hung Thai, Jay K. Varma
Journal: New England Journal of Medicine (2010)

Tuberculosis screening is recommended for people with human immunodeficiency virus (HIV) infection to facilitate early diagnosis and safe initiation of antiretroviral therapy and isoniazid preventive therapy. No internationally accepted, evidence-based guideline addresses the optimal means of conducting such screening, although screening for chronic cough is common.We consecutively enrolled people with HIV infection from eight outpatient clinics in Cambodia, Thailand, and Vietnam. For each patient, three samples of sputum and one each of urine, stool, blood, and lymph-node aspirate (for patients with lymphadenopathy) were obtained for mycobacterial culture. We compared the characteristics of patients who received a diagnosis of tuberculosis (on the basis of having one or more specimens that were culture-positive) with those of patients who did not have tuberculosis to derive an algorithm for screening and diagnosis.Tuberculosis was diagnosed in 267 (15%) of 1748 patients (median CD4+ T-lymphocyte count, 242 per cubic millimeter; interquartile range, 82 to 396). The presence of a cough for 2 or 3 weeks or more during the preceding 4 weeks had a sensitivity of 22 to 33% for detecting tuberculosis. The presence of cough of any duration, fever of any duration, or night sweats lasting 3 or more weeks in the preceding 4 weeks was 93% sensitive and 36% specific for tuberculosis. In the 1199 patients with any of these symptoms, a combination of two negative sputum smears, a normal chest radiograph, and a CD4+ cell count of 350 or more per cubic millimeter helped to rule out a diagnosis of tuberculosis, whereas a positive diagnosis could be made only for the 113 patients (9%) with one or more positive sputum smears; mycobacterial culture was required for most other patients.In persons with HIV infection, screening for tuberculosis should include asking questions about a combination of symptoms rather than only about chronic cough. It is likely that antiretroviral therapy and isoniazid preventive therapy can be started safely in people whose screening for all three symptoms is negative, whereas diagnosis in most others will require mycobacterial culture.
Transient parotitis after conscious sedation for endoscopy
Authors: S. Gültuna, O. Üsküdar, İ. Yüksel, Ö. Başar, S. Köklü
Journal: Endoscopy (2009)

Midazolam is one of the most widely used sedative agents in gastroenterology practice for conscious sedation before short endoscopic procedures [1]. We report a case of transient swelling of the parotid gland after midazolam administration.
The Histology of the Common Carotid Baroceptor Areas of the Cat
Authors: J. Boss, J. H. GREEN
Journal: Circulation Research (1956)

The areas of the cat's common carotid arteries, where baroceptor activity, similar to that in the carotid sinus, has recently been discovered, have been examined histologically; the nervous structures observed were similar to those in the carotid sinus and Nonidez' area. Additional information regarding the characteristic histology of these structures is presented.
Overview of the risk of respiratory cancer from airborne contaminants.
Authors: F E Speizer
Journal: Environmental Health Perspectives (1986)

This overview on defining risk of respiratory cancer from airborne pollutants summarizes broad issues related to a number of the environmental agents that are discussed in the articles that follow. Lung cancer kills more than 100,000 people annually and is the major form of cancer in both sexes in middle age. Cigarette smoking is the major cause of respiratory cancer and must be taken into account in any study of the effect of an environmental agent on the risk of respiratory cancer, particularly at relatively low levels of excess risk (RR greater than 1.0 but less than 2.0). The agents considered in this series all have the potential for widespread community exposures, either because there is widespread long-term exposure (passive smoking), the agents are direct byproducts of energy consumption (organic particles), have ubiquitous production and use patterns (formaldehyde and fibers), or occur widely in natural settings (radon). Several issues--measurement of exposure, latency, confounding factors and bias, extrapolation from animals to humans, population at risk, and attributable risk--must be considered for each agent. A further issue related to exposure estimates is the relationship of exposure to actual dose. Understanding exposure some 25 to 40 years in the past is important because of the prolonged latency period in the development of respiratory cancers. To the degree that these agents act synergistically with smoking, the reduction of smoking or of exposure to these agents may have greater public health consequences than would be anticipated from the directly measured attributable risk of each of these agents separately.
WHAT WILL PROBABLY BE THE DENTAL EDUCATIONAL STANDARD FOR THE COMING DECADE?
Authors: CHARLES C. CHITTENDEN
Journal: JAMA (1905)

At the last meeting of this Section, at Atlantic City, in 1904, a symposium on dental educational standards was read, which was exhaustive and thorough in its character. In a paper presented at that symposium I had the honor to report chronologically the various facts as they had transpired, during the current year, concerning the attitude of the individual dental schools and the National Association of Dental Faculties toward the newly inaugurated four years' college course. It had become apparent that a large number of the smaller and financially hampered schools were determined on returning to the three years' course. This Section, at that time, in its discussions, expressed, in no uncertain terms, its entire disapproval of any such retrograde action. Immediately following the meeting of this Section came the annual meeting of the National Association of Dental Faculties at Washington, D. C., where the whole subject was gone over
Lubrication and Wear in Joints
Authors: M. A. R. Freeman
Journal: Annals of the Rheumatic Diseases (1970)

Book Reviews 449 stances, the incorporation of complement components in such interactions has been demonstrated.It is now reported that a correlation can be shown between the amount of such complexes and the diminution in titre of complement activity in joint fluids.Complement-containing immune complexes have long been known to show phlogistic porperties and their possible role in promoting phagocytosis (with the subsequent release of lysosomal enzymes), in the immune vasculitis which characterizes severe rheumatoid arthritis, and in the possible direct activation of kinins, are topics examined in the concluding sections of the conference.The papers are accompanied by references to earlier, and to other current, work in this field and also by verbatim accounts of the discussion generated by each paper.This volume therefore serves as an admirable reference source for those actively engaged in this field.
Kidney Physiology and Kidney Disease: An Introduction to Nephrology
Authors: Leonard B. Berman
Journal: JAMA (1977)

Authors probably ought not to write prefaces, for such pages serve only to illuminate the gap between intention and performance. In accepting the challenge of squeezing nephrology into a small book, Maude entered into a losing battle. The core of a good pocket book of nephrology is here; editorial judment could have saved the day, but plan and execution are badly marred. Specifically, a short introduction to nephrology should not give away precious space to routine anatomy, surface area nomograms, sketches of glomeruli surrounded by detailed lists of filtered solutes, and prolonged discussion of organic base excretion and hydrogen ion homeostasis. These insertions are coupled with some truly awesome omissions. A section on chronic renal failure that does not mention the word transplantation staggers me, a veteran reviewer. A description of dehydration that ignores skin turgor grieves me. Some of the discussion, for example, of potassium deficits, low protein diets,
The efficacy of topical growth factors in wound healing – Which one is better?
Authors: Charles Loh, Alex Loh, Philip Lim
Journal: International Journal of Surgery (2013)

Introduction      Topical Growth Factors are future pillars in wound healing but still have limited evidence based clinical literature. We performed a meta-analysis and systematic review on all growth factors.     Methods      All human randomised control trials (RCTs) involving “wound” and “growth factor” were searched on Pubmed, Ovid, and Cochrane register. Non-randomised comparative retrospective analyses with large patient numbers were included for their statistical weight.     Results      Four main groups were identified: Platelet derived Growth factor (PDGF), platelet releasate/gel (PR), Fibroblast Growth factor (FGF) and Epidermal Growth Factor (EGF).   The combined patient number in all RCTs in each group: PDGF (n=3520), PR (n=6441), FGF (n=1683) and EGF(n=517).   Various types of wounds and trial length for healing to occur were heterogenous.      The relative risk of complete healing compared to placebo is 2.26-4.7 (EGF), 1.41-7.68 (PDGF), 1.33-1.68 (FGF) and 1.32 (PR).      The ratio of mean/median percentage area of wound healed compared to placebo is 1.2-3.5 (PDGF), 3.4 (PR) and 1.04-1.20 (FGF).      All values were statistically significant.      No significant differences in adverse events were noted.     Conclusion      Local application of PDGF appeared to produce the faster time to healing compared to the rest of the other growth factors and is especially so in the first 2 weeks.
Regulation of human Gc (vitamin D — binding) protein levels: Hormonal and cytokine control of gene expressionin vitro
Authors: Chandan Guha, Motoki Osawa, Phillip A. Werner, Robert M. Galbraith, Gary V. Paddock
Journal: Hepatology (1995)

Studies were performed in Hep3B hepatocytes to better elucidate the mechanisms regulating circulating levels of human group-specific component (Gc). We measured changes in Gc messenger RNA (mRNA) synthesis and levels of secreted protein resulting from treatment of hepatocytes with cytokines and hormones known to influence synthesis of other proteins of hepatic origin. We particularly focused on compounds known to be prototypic stimulants during the acute phase response. Interleukin-6 (IL-6) and dexamethasone were shown to increase Gc mRNA approximately twofold while transforming growth factor beta (TGF beta) decreased Gc mRNA in a dose-dependent fashion by up to fivefold. The effects on secreted Gc protein levels were similar. These results indicate that Gc protein appears to be regulated differently than the other members of this gene family, albumin and alpha-fetoprotein (AFP), which are negative acute phase reactants. In addition, these contrasting effects on Gc synthesis of IL-6 and dexamethasone and of TGF beta suggest that high basal levels of Gc synthesis may be maintained during the acute phase response.
Immunosuppressive Serum Factors in Viral Hepatitis. I. Characterization of Serum Inhibition Factor(s) as Lymphocyte Antiactivator(s)
Authors: Norbert W. Brattig, Peter A. Berg
Journal: Hepatology (1983)

Sera from patients with acute viral hepatitis B were found to inhibit the in vitro proliferation of normal lymphocytes induced by different mitogens and antigens. In addition, an effect on concanavalin A-induced T suppressor cell activity and pokeweed mitogen-stimulated IgG and IgM synthesis was demonstrated. Studies concerning the kinetics of serum immunosuppressive effects indicated that serum immunosuppressive factor (SIF) interfered with the intermediate phase of mitogen-induced lymphocyte activation which was defined by protein and RNA synthesis. Thus, when SIF-positive sera were added to lymphocytes, which were already activated by phytohemagglutinin, for 8, 12, or 18 hr, the inhibitory effect decreased in relation to the duration of lymphocyte activation. No inhibition could be demonstrated when SIF-positive sera were added 24 hr after initiation of mitogen stimulation. Furthermore, similar inhibitory effects were found measuring either uptake of [ 3 H]uridine (RNA synthesis) or [ 3 H]leucine (protein synthesis) in a 24 hr culture of phytohe-magglutinin-stimulated lymphocytes or [ 3 H]thymidine uptake (DNA synthesis) after 48 hr. These results indicate that SIF act(s) like an antiactivator and may belong to immunoregulatory physiologic serum factors.
Bioethical aspects of the recent changes in the policy of refusal of blood by Jehovah's Witnesses
Authors: O. Muramoto
Journal: BMJ (2001)

The medical community generally knows that Jehovah's Witnesses refuse blood transfusions. Jehovah's Witnesses reject red and white blood cells, platelets, and plasma, even at the cost of their lives, but they accept so called minor fractions such as albumin and globulin as a personal choice.1 The church organisation, the Watchtower Society, introduced the policy on refusal of blood in 1945. Since 1961 the church has enforced it by “disfellowshipping” or expelling un-repentant members who wilfully accept prohibited blood components. Other members are then instructed by the church to ostracise and shun the expelled individual. Internal dissidents have criticised this practice, which they feel coerces those who have divergent views on this issue and compromises autonomous decision making in medical care. 2 3 I analyse the recently publicised changes in this policy from a bioethical viewpoint to help understand the impact of this controversial policy on clinical practice.4

#### Summary points

Under recent changes in the policy of refusal of blood by Jehovah's Witnesses, members can remain silent about the medical treatment they receive and avoid religious punishment

Such freedom of conscience hinges on the integrity of medical confidentiality, which may not be adequate for Jehovah's Witnesses

A broadening of options for acceptable blood products could open the way for use of various secondary blood products

Such a change could also make the distinction between acceptable and unacceptable treatments further obscure and subject to personal interpretation

In light of these changes it has become essential to treat members independently of the church's official policy by exploring personal conviction and preference

### Judicial proceedings

In June 2000, the Watchtower Society issued a directive stating that the organisation would no longer disfellowship members who did not comply with the policy of refusal of blood. Its official statement to the media was that “if a baptized member of …
NON-CALCULOUS CHOLECYSTITIS.
Authors: DAVID S. FAIRCHILD
Journal: JAMA (1905)

The literature bearing on diseases of the liver and bile passages has become voluminous and of late years, since operations for the relief from gallstones has become the recognized treatment for this disease, many books and other valuable contributions have been added having special relation to the surgery of the liver, bile passages and pancreas. Notwithstanding the fact that calculous cholecystitis or cholecystitis associated with gallstones have been well worked out, it is only recently that a class of cases of long-standing gall-bladder disease without gallstones has received attention. Gall-bladder inflammations designated as acute or chronic catarrhal cholecystitis or the complicating condition known as empyema of the gall bladder or suppurative cholangitis involving the ducts of the liver are well described. The special form of gall-bladder inflammation referred to in this communication differs somewhat in both the clinical and pathologic relations from the conditions above referred to on the one
Lack of community care is responsible for crisis in hospitals, meeting hears
Authors: N. Hawkes
Journal: BMJ (2013)

Hospitals filled with patients who do not need to be there have brought the urgent care system to the verge of failure, a meeting was told on 19 March. “We need change immediately,” said Mark Newbold, chief executive of the Heart of England NHS Foundation Trust in Birmingham. “It’s imperative.”

The problem was not that patients had been admitted inappropriately but that they could not be discharged because they had nowhere to go. 

“Twenty years ago there used to be a lot of non-ill patients on the wards,” he said. “That’s no longer true. Our problem is the inability to discharge patients who no longer need acute care, because there is nowhere for them to go. There is not enough support in …
Use of geographic information system technology to aid Health Department decision making about childhood lead poisoning prevention activities.
Authors: D B Reissman, F Staley, G B Curtis, R B Kaufmann
Journal: Environmental Health Perspectives (2001)

The Centers for Disease Control and Prevention recommend that local public health agencies use local data to identify children at risk for lead exposure to ensure that they receive preventive services. The objective of this study was to demonstrate the usefulness of a geographic information system (GIS) in identifying children at risk for lead exposure. We conducted a descriptive study, using GIS technology, of the blood lead (BPb) levels and residential location of at-risk children screened for lead exposure.
The Greeks Had a Word for It
Authors: Ben Ames Williams
Journal: New England Journal of Medicine (1945)

AMONG the lesser deities worshiped by the ancient Greeks there was one who wore the beard, the ears and the horns of a goat. In fact, his imaginary aspect largely shaped our subsequent conception of the Devil. According to the Greeks, when this creature appeared suddenly to human beings, he awoke in them a storm of sudden fear. They called him Pan, and called the fear that he evoked "panic."In this respect, in this trait of provoking panic or fear, the great god Pan has his prototype today; but we no longer worship the lesser gods, so we do not . . .
Revisiting parallel and serial processing in the somatosensory system
Authors: Preston E. Garraghty
Journal: Behavioral and Brain Sciences (2007)

Abstract The issue of whether information is processed in parallel or in series in the somatosensory system is complicated by a number of factors. Included among these is the failure on the part of the scientific community to reach a consensus as to what actually constitutes the primary somatosensory cortex (SI) in higher primates. A second, related issue is the marked difference in the organization of the cortical areas subserving somatosensation across species.
Low-dose methotrexate may cause air trapping in patients with rheumatoid arthritis.
Authors: C S Dayton, D A Schwartz, N L Sprince, S J Yagla, C S Davis, R K Koehnke, D E Furst, G W Hunninghake
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Both rheumatoid arthritis (RA) and methotrexate (MTX) are reported to be associated with the development of pulmonary disease. To determine whether MTX enhanced the risk of developing abnormalities in pulmonary function in patients with RA, we prospectively studied 31 subjects (12 male, 19 female) with the diagnosis of classic RA for an average period of 4.4 yr (range, 1 to 5 yr). Each subject was placed on low-dose weekly MTX (mean 17 mg, range 2.5 to 40) for control of RA symptoms. Other medications included non-steroidal anti-inflammatory agents and prednisone if required for control of arthritis symptoms. No other immunosuppressive therapy was used. Each subject was evaluated by pulmonary function tests (PFT) and chest X-ray initially, and at 1, 2, 3.5, and 5 yr. Chest X-rays obtained initially and at the end of the study period were found to be normal. The percent predicted values for initial PFTs in the study group were within the normal range. From the beginning to the end of the observation period, the following mean changes in lung function were observed: 1.9% increase in TLC, 5.1% increase in residual volume (RV), 1.8% increase in FVC, 0.71% decrease in FEV1, 14.7% improvement in alveolar-arterial oxygen (A-aO2) difference, and a 12.7% increase in single-breath diffusing capacity (DLCO). To determine whether MTX (average dose, weekly dose, or cumulative dose) was significantly related to changes in pulmonary function, we used multivariate techniques to control for the initial measure of lung function while assessing the relationship between MTX and the subsequent measures of lung function.(ABSTRACT TRUNCATED AT 250 WORDS)
Regulation of low density lipoprotein receptor activity in freshly isolated human lymphocytes.
Authors: Y K Ho, S Brown, D W Bilheimer, J L Goldstein
Journal: Journal of Clinical Investigation (1976)

Circulating human lymphocytes freshly isolated from venous blood of 15 normal subjects exhibited a low capacity to bind, take up, and degrade 125I-labeled low density lipoprotein (LDL). However, when these cells were incubated for 72 h in the absence of lipoproteins, they gradually acquired in increased number of high affinity cell surface receptors for LDL. The increase in the number of LDL receptors was associated with a 16-fold increase in the rate at which the cells were able to take up and degrade the lipoprotein. The LDL binding and degradation processes that developed in normal lymphocytes exhibited the following characteristics; (a) high affinity (saturation was achieved at LDL concentrations below 50 mug protein/ml); (b) specificity (unlabeled LDL was much more effective than human high density lipoprotein or other plasma proteins in competing with 125I-LDL for binding to the LDL receptor); and(c) feedback regulation (the increase in the number of LDL receptors that appeared after incubation of freshly isolated lymphocytes in lipoprotein-deficient medium was prevented by exposure of the cells to either LDL or a mixture of 25-hydroxycholesterol plus cholesterol but not to HDL). Freshly isolated lymphocytes obtaine from three subjects with the homozygous form of familial hypercholesterolemia failed to develop normal amounts of LDL receptor activity when incubated in medium devoid of lipoproteins. The current data indicate: (a) that the LDL receptors that appear on the surface of cholesterol-deprived, normal human lymphocytes are genetically identical to the previously characterized LDL receptors of cultured human fibroblasts and long-term lymphoid cells and (b) that at least one cell type in the human body, the circulating human lymphocyte, has the capacity to produce a high affinity LDL receptor that mediates the cellular uptake and degradation of plasma LDL.