tbuckley/cabot-search huggingface dataset:
Epidemiology of Community-Associated<i>Clostridium difficile</i>Infection, 2009 Through 2011
Authors: Amit S. Chitnis, Stacy M. Holzbauer, Ruth M. Belflower, Lisa G. Winston, Wendy M. Bamberg, Carol Lyons, Monica M. Farley, Ghinwa K. Dumyati, Lucy E. Wilson, Zintars G. Beldavs, John R. Dunn, L. Hannah Gould, Duncan R. MacCannell, Dale N. Gerding, L. Clifford McDonald, Fernanda C. Lessa
Journal: JAMA Internal Medicine (2013)

Clostridium difficile infection (CDI) has been increasingly reported among healthy individuals in the community. Recent data suggest that community-associated CDI represents one-third of all C difficile cases. The epidemiology and potential sources of C difficile in the community are not fully understood.To determine epidemiological and clinical characteristics of community-associated CDI and to explore potential sources of C difficile acquisition in the community.Active population-based and laboratory-based CDI surveillance in 8 US states.Medical records were reviewed and interviews performed to assess outpatient, household, and food exposures among patients with community-associated CDI (ie, toxin or molecular assay positive for C difficile and no overnight stay in a health care facility within 12 weeks). Molecular characterization of C difficile isolates was performed. Outpatient health care exposure in the prior 12 weeks among patients with community-associated CDI was a priori categorized into the following 3 levels: no exposure, low-level exposure (ie, outpatient visit with physician or dentist), or high-level exposure (ie, surgery, dialysis, emergency or urgent care visit, inpatient care with no overnight stay, or health care personnel with direct patient care).Prevalence of outpatient health care exposure among patients with community-associated CDI and identification of potential sources of C difficile by level of outpatient health care exposure.Of 984 patients with community-associated CDI, 353 (35.9%) did not receive antibiotics, 177 (18.0%) had no outpatient health care exposure, and 400 (40.7%) had low-level outpatient health care exposure. Thirty-one percent of patients without antibiotic exposure received proton pump inhibitors. Patients having CDI with no or low-level outpatient health care exposure were more likely to be exposed to infants younger than 1 year (P = .04) and to household members with active CDI (P = .05) compared with those having high-level outpatient health care exposure. No association between food exposure or animal exposure and level of outpatient health care exposure was observed. North American pulsed-field gel electrophoresis (NAP) 1 was the most common (21.7%) strain isolated; NAP7 and NAP8 were uncommon (6.7%).Most patients with community-associated CDI had recent outpatient health care exposure, and up to 36% would not be prevented by reduction of antibiotic use only. Our data support evaluation of additional strategies, including further examination of C difficile transmission in outpatient and household settings and reduction of proton pump inhibitor use.
Combinatorial patterns of histone acetylations and methylations in the human genome
Authors: Zhibin Wang, Chongzhi Zang, Jeffrey A Rosenfeld, Dustin E Schones, Artem Barski, Suresh Cuddapah, Kairong Cui, Tae-Young Roh, Weiqun Peng, Michael Q Zhang, Keji Zhao
Journal: Nature Genetics (2008)
Fas Signaling Is Involved in the Control of Hair Follicle Response to Chemotherapy
Authors: Andrei A. Sharov, Frank Siebenhaar, Tatyana Y. Sharova, Natalia V. Botchkareva, Barbara A. Gilchrest, Vladimir A. Botchkarev
Journal: Cancer Research (2004)

Chemotherapeutic agents induce p53-dependent apoptosis in the hair follicle (HF) resulting in hair loss, a common side effect of cancer therapy. Here, we show that Fas as a p53 target plays important role in the HF response to cyclophosphamide. Specifically, we demonstrate that Fas is up-regulated in HF keratinocytes after cyclophosphamide treatment, Fas ligand-neutralizing antibody partially inhibits HF response to cyclophosphamide in wild-type mice, and Fas knockout mice show significant retardation of cyclophosphamide-induced HF involution associated with reduced Fas-associated death domain and caspase-8 expression. These data raise a possibility to explore blockade of Fas signaling as a part of complex local therapy for inhibiting keratinocyte apoptosis and hair loss induced by chemotherapy.
Wegener's Granulomatosis
Authors: Barkley Beidleman
Journal: JAMA (1963)

The referral for treatment of a patient with nasal and pulmonary lesions typical of Wegener's granulomatosis occasioned investigation of the role of adrenal corticosteroids in its treatment. Reports of eight cases including sufficient detail to be helpful were found. Of these, remissions of 3 to 26 months coincided with treatment in four. Therefore, a determined trial of continuous treatment with relatively large daily doses of steroids was begun. On two occasions, cessation of therapy and reduction of dosage allowed definite clinical relapses eventuating in the patient's death 8 months after onset. Numerous complications of therapy occurred but were controlled. Autopsy findings confirmed the clinical diagnosis. It is felt that this experience should favor rather than discourage further prolonged trials of large doses of adrenal steroids in similar patients with Wegener's granulomatosis.
A weak leg
Authors: J. Colledge, S. Quigley, S. Liyanage
Journal: BMJ (2012)

A 50 year old right handed man presented with weakness of his right leg and arm of two months’ duration. The symptoms had come on over several days, during which he described a “dead leg” and he noticed his foot dragging while walking. On examination he had right lower limb pyramidal type distal weakness with a foot drop, power was graded at 4/5, and he had an upgoing plantar reflex. A computed tomogram of the brain showed a left parietal lesion with surrounding oedema but no midline shift, so contrast enhanced magnetic resonance imaging was undertaken (figs 1⇓ and 2⇓). Analysis of the cerebrospinal fluid showed raised protein with normal cell counts, normal angiotensin converting enzyme values, oligoclonal bands, IgG of 185 mg/L (normal value <40), and a negative viral polymerase chain reaction. Serum immunoglobulins and vitamin B12 values were normal; viral antibodies and antibodies for spirochetes were negative. He had no history of a neurological deficit. 



Fig 1 Axial fluid attenuation inversion recovery (FLAIR) magnetic resonance image at the level of the superior aspect of the lateral ventricles





Fig 2 Contrast enhanced T1 weighted magnetic resonance image at the same level as fig 1





### 1 What does magnetic resonance imaging show?

#### Short answer

The fluid attenuation inversion recovery (FLAIR) sequence shows multiple foci of periventricular high signal and a larger area of high signal in the left centrum semiovale (fig 1), which …
Dietary intake of sodium chloride in the rat influences [3H]nitrendipine binding to adrenal glomerulosa cell membranes but does not alter binding to vascular smooth muscle membranes.
Authors: R J Schiebinger
Journal: Journal of Clinical Investigation (1985)

Angiotensin II-stimulated secretion by adrenal glomerulosa cells and contraction by vascular smooth muscle (VSM) are dependent on calcium influx through membrane calcium channels. We have examined the hypothesis that the altered responsiveness of adrenal glomerulosa cells and VSM to angiotensin II during NaCl restriction may be associated with a change in membrane calcium channel number. To test this hypothesis, female rats were placed on a high or low NaCl diet. On the 14th day, membranes were prepared from the zona glomerulosa, aorta, mesenteric artery, and uterus. [3H]Nitrendipine binding was used to monitor calcium channel number. The [3H]nitrendipine binding capacity was observed to be higher in the zona glomerulosa during NaCl restriction than during high NaCl intake (83 +/- 18 vs. 49 +/- 9 fmol/mg protein, P less than 0.025, n = 6 paired experiments). The binding capacities of [3H]nitrendipine on the low and high NaCl diet were similar in the mesenteric artery (10 +/- 1 vs. 9 +/- 1 fmol/mg protein, n = 8), aorta (33 +/- 5 vs. 35 +/- 8 fmol/mg protein, n = 5), or uterus (87 +/- 15 vs. 85 +/- 16 fmol/mg protein, n = 4), respectively. The dissociation constants of [3H]nitrendipine binding did not differ on a low or high NaCl intake in the zona glomerulosa (0.84 +/- .12 vs. 0.79 +/- .10 nM), mesenteric artery (0.82 +/- .06 vs. 83 +/- .05 nM), aorta (0.90 +/- .11 vs. 0.92 +/- .12 nM), or uterus (0.55 +/- .12 vs. 0.56 +/- .10 nM), respectively. We conclude that the blunted response of VSM to angiotensin II during NaCl restriction is best explained by the previously reported lower number of angiotensin II receptors since calcium channel number does not change. In the adrenal glomerulosa cell, NaCl restriction is associated with a higher number of membrane calcium channels and angiotensin II receptors. The increase in calcium channel number may reflect the influence of an unknown factor(s) believed to be necessary for the full expression of the adrenal glomerulosa cell response to NaCl restriction.
Effects of Haemodialysis on Bone in Chronic Renal Failure
Authors: M. C. Bishop, C. G. Woods, D. O. Oliver, J. G. G. Ledingham, R. Smith, D. A. Tibbutt
Journal: BMJ (1972)

Quantitative histological studies have been done on 80 sequential bone biopsies taken at yearly intervals from 37 patients with chronic renal failure on long-term haemodialysis treatment. Twenty-three patients were studied at the start of dialysis, and in about half the bone was abnormal. During dialysis mean osteoid area and the maximum number of unmineralized osteoid lamellae increased, and mineralized bone area decreased. The loss of bone during dialysis was also reflected in reduction of the width of individual trabeculae. These trends were less obvious in patients already established on dialysis at the time of the initial biopsy. The course of osteitis fibrosa appeared to be unaffected by dialysis.
Improving the specificity of the PF4 ELISA in diagnosing heparin‐induced thrombocytopenia
Authors: Janice McFarland, Andrew Lochowicz, Richard Aster, Bryan Chappell, Brian Curtis
Journal: American Journal of Hematology (2012)

Heparin induced thrombocytopenia (HIT) is a serious complication of heparin therapy. The PF4 ELISA is a serologic assay that provides laboratory support for the clinical diagnosis of HIT, but it is often positive in patients who do not have the syndrome. We examined whether the specificity of the PF4 ELISA can be improved by 1) taking antibody potency into consideration, 2) by measuring only IgG antibodies, and 3) by utilizing a high concentration heparin inhibition step. We reviewed clinical information on 116 patients whose samples were referred for HIT antibody testing and assigned each a clinical score related to the likelihood of the patient having HIT. The scores were then correlated with serologic findings. Patients with strongly positive PF4ELISA results (OD ≥ 1.0) using both versions of the assay (IgG/A/M and IgG only) had clinical scores and SRA activity that were significantly higher than those having reactive or negative results. When the IgG-only PF4 ELISA was used, only the strongly positive result group had significantly higher clinical scores and SRA release, and fewer samples were classified as weakly positive or reactive, suggesting that detection of IgG only in the PF4 ELISA improves the assay's specificity. The heparin inhibition step identified "reactive" samples that were associated with clinical scores and SRA release indistinguishable from the "negative" result groups, confirming that this step further improves specificity of the test. This study supports utilizing these 3 modifications of the PF4 ELISA to improve specificity in supporting the clinical diagnosis of HIT.
Hepatodiaphragmatic Interposition of the Colon
Authors: J Nakagawa
Journal: New England Journal of Medicine (2000)

Figure 1. A 30-year-old man with a mild respiratory tract infection reported having had intermittent abdominal bloating for more than 15 years. He had no other symptoms, he took no medications, and his family history was unremarkable. On examination, his abdomen was slightly distended but not tender, and there was no dullness to percussion over the right upper quadrant. Laboratory studies were unremarkable, except for the finding of a benign monoclonal gammopathy. A posteroanterior chest film (Panel A) and a lateral chest film (Panel B) showed that the right hemidiaphragm was elevated and that the transverse colon was interposed between . . .
Species of coagulase-negative staphylococci isolated from catheter tips from open-heart surgery patients.
Authors: R Freeman, N Hjersing
Journal: Thorax (1980)

Coagulase-negative staphylococci isolated from the tips of catheters used in open-heart surgical patients were classified into species and the results compared with those obtained by speciation of coagulase-negative staphylococci isolated as blood culture contaminants. Staphylococcus epidermidis was the most common species in both populations, but other species occurred more often in the catheter tip group. Staphylococcus saprophyticus was found in 17% of the catheter tip series and was not found at all in the blood cultured contaminants. Species other than S epidermidis, and particularly S saprophyticus, were isolated more often from catheters which had been in situ some days. These findings suggest that speciation of coagulase-negative staphylococci from catheter tips may point to some species being better adapted to colonise and survive on prosthetic materials. In this study such evidence suggested that S saprophyticus might be such a species. It is concluded that if the initial results presented here are confirmed, a more logical approach to the chemoprophylaxis of prosthetic implant surgery would be possible.
BIOLIMUS–ELUTING STENTS WITH BIODEGRADABLE POLYMER COATING IN WOMEN
Authors: Giulio G. Stefanini, Lorenz Raber, Masanori Taniwaki, Pawel Buszman, Axel Linke, Thomas Ischinger, Bernhard Meier, Peter Juni, Patrick Serruys, Stephan Windecker
Journal: Journal of the American College of Cardiology (2013)
Kaposi's Sarcoma in an Elderly Patient
Authors: MARILYN A. TOMASKO
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 February 1987Kaposi's Sarcoma in an Elderly PatientMARILYN A. TOMASKO, M.D., DAVID S. CHUDWIN, M.D.MARILYN A. TOMASKO, M.D.Search for more papers by this author, DAVID S. CHUDWIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-2-334_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Before the acquired immunodeficiency syndrome (AIDS) developed, Kaposi's sarcoma mainly affected elderly men and was relatively rare in the United States (1). We report the case of a patient who fit the epidemiologic pattern for, and had a clinical course consistent with, classical Kaposi's sarcoma but who, in fact, had AIDS. This case supports the decision of the Centers for Disease Control to change the definition of AIDS to include persons over 60 years old who have Kaposi's sarcoma and evidence of human immunodeficiency virus (HIV) infection (2).A 75-year-old white man of European Jewish descent presented...References1. SAFAI B and GOOD K. Kaposi's sarcoma: a review and recent developments. CA. 1981;31:2-22. Google Scholar2. . Revision of the case definition of acquired immunodeficiency syndrome in national reporting—United States. MMWR. 1985;34:373-5. (Reprinted in Ann Intern Med. 1985;103:402-3.) MedlineGoogle Scholar3. SAFAI B, JOHNSON K, and MYEKOWSKI P. The natural history of Kaposi's sarcoma in the acquired immunodeficiency syndrome. Ann Intern Med. 1985;103:744-50. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MARILYN A. TOMASKO, M.D.; DAVID S. CHUDWIN, M.D.Affiliations: Rush-Presbyterian-St. Luke's Medical Center Chicago, IL 60612 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA Literature Review: HIV SEROPOSITIVITY IN THE ELDERLY 1 February 1987Volume 106, Issue 2Page: 334-335KeywordsAIDSClinical epidemiologyElderlyHIVHIV infectionsKaposi sarcoma ePublished: 1 December 2008 Issue Published: 1 February 1987 PDF downloadLoading ...
NINE-MONTH ANGIOGRAPHIC RESULTS FROM THE RANDOMIZED TRYTON BIFURCATION TRIAL IN DE NOVO TRUE BIFURCATION CORONARY LESIONS
Authors: Philippe Genereux, Indulis Kumsars, Maciej Lesiak, Annapoorna Kini, Gezá Fontos, Ton Slagboom, Ungi Imre, Christopher Metzger, Peter Kayaert, Pieter Stella, Glenn Van Langenhove, Laura Lasalle, Hector Garcia Garcia, Aaron Kaplan, Patrick Serruys, Martin Leon
Journal: Journal of the American College of Cardiology (2014)
Suicide in Physicians
Authors: Earl Cohen
Journal: JAMA (1972)

<h3>To the Editor.—</h3> Regarding suicide among physicians, Dr. Seymour Diamond suggests that medical schools take a more active interest in the problem (221:410,1972). I agree. Paradoxically, the subject of self-assault has been largely neglected in undergraduate medical school curricula, where it has been primarily relegated to the Department of Psychiatry. Even there, suicide is treated, for the most part, as a sequella of depression. It is the only sequella I know of that is among the ten leading causes of death in this country. The magnitude of the problem renders it worthy of more attention in the training of physicians. The University of California School of Medicine in San Francisco has been offering a one-unit elective course focusing on clinical self-assault relative to the general practice of medicine. If medical schools could make more time available for this problem in their curricula, perhaps the suicide rate among physicians, as well
FIRST-TRIMESTER PRENATAL DIAGNOSIS OF CYSTIC FIBROSIS WITH LINKED DNA PROBES
Authors: Martin Farrall, CharlesH. Rodeck, Philip Stanier, Willi Lissens, Eila Watson, Hai-Yang Law, Richard Warren, Maurice Super, Peter Scambler, Brandon Wainwright, Robert Williamson
Journal: The Lancet (1986)
Appendicitis with a palpable mass
Authors: S. Yan, Y. Liu, D. Chou
Journal: Endoscopy (2007)

A 65-year-old woman presented with intermittent right lower quadrant pain that had persisted for more than 2 weeks. The pain was described as cramping, and was unrelated to food intake or defecation. Five days before admission, a tender mass had become palpable over the right lower quadrant. There had been no fever episodes before she came to the hospital. The physical examination was unremarkable except for a palpable, tender mass over the ileocecal area. The laboratory data were within reference ranges, except for a white blood cell count of 11 700/mm3 (normal: 4500 - 10 000/mm3). Tumor markers, including carcinoembryonic antigen, CA199, and CA125, were normal. Abdominal ultrasonography revealed a heterogeneous mass lesion over the right lower quadrant. Contrast-enhanced computed tomography (CT) showed cecal wall thickening and an ill-defined pericecal mass lesion with marginal enhancement (Figure [1]). Because a cecal tumor could not be excluded, colonoscopy was performed, demonstrating mucosal bulging, edema, and hyperemia, with a spontaneous discharge of pus at the appendiceal orifice (Figure [2]). A diagnosis of appendicitis with abscess formation was made. Conservative treatment with intravenous antibiotics was administered, and the abdominal mass was not palpable 2 weeks later. The clinical course was uneventful, and the patient remained asymptomatic during the ensuing 3-month follow-up period.
Population strategies to prevent obesity
Authors: David Crawford
Journal: BMJ (2002)

Clinical review p 757

It has been accepted for some time that obesity is associated with an increased risk of disease and disability, and that this condition needs to be managed more effectively in obese individuals. Only recently, however, has obesity been recognised as a population wide problem that requires preventive action. Obesity has reached epidemic proportions in most developed countries. In England, the United States, and Australia more than a half of all adults are overweight or obese, and trend data show a dramatic increase in prevalence over the past two decades.1–3 What then are the causes of the obesity epidemic, and what can be done to prevent it?

Genes determine individual susceptibility to weight gain, but the obesity epidemic is not attributable to genetic factors, since the increase in the prevalence of obesity has occurred over too short a period for the genetic make up of the population to have changed substantially.4 According to a recent review …
Contribution of Beta-HPV Infection and UV Damage to Rapid-Onset Cutaneous Squamous Cell Carcinoma during BRAF-Inhibition Therapy
Authors: Daniel N. Cohen, Steven K. Lawson, Aaron C. Shaver, Liping Du, Harrison P. Nguyen, Qin He, Douglas B. Johnson, Wilfred A. Lumbang, Brent R. Moody, James L. Prescott, Pranil K. Chandra, Alan S. Boyd, Jeffrey P. Zwerner, Jason B. Robbins, Stephen K. Tyring, Peter L. Rady, James D. Chappell, Yu Shyr, Jeffrey R. Infante, Jeffrey A. Sosman
Journal: Clinical Cancer Research (2015)

Abstract Purpose: BRAF-inhibition (BRAFi) therapy for advanced melanoma carries a high rate of secondary cutaneous squamous cell carcinoma (cSCC) and risk of other cancers. UV radiation and α-genus human papillomavirus (HPV) are highly associated with SCC, but a novel role for β-genus HPV is suspected in BRAFi-cSCC. Cutaneous β-HPV may act in concert with host and environmental factors in BRAFi-cSCC. Experimental Design: Primary BRAFi-cSCC tissue DNA isolated from patients receiving vemurafenib or dabrafenib from two cancer centers was analyzed for the presence of cutaneous oncogenic viruses and host genetic mutations. Diagnostic specimens underwent consensus dermatopathology review. Clinical parameters for UV exposure and disease course were statistically analyzed in conjunction with histopathology. Results: Twenty-nine patients contributed 69 BRAFi-cSCC lesions. BRAFi-cSCC had wart-like features (BRAFi-cSCC-WF) in 22% of specimens. During vemurafenib therapy, BRAFi-cSCC-WF arose 11.6 weeks more rapidly than conventional cSCC when controlled for gender and UV exposure (P value = 0.03). Among all BRAFi-cSCC, β-genus HPV-17, HPV-38, HPV-111 were most frequently isolated, and novel β-HPV genotypes were discovered (CTR, CRT-11, CRT-22). Sequencing revealed 63% of evaluated BRAFi-cSCCs harbored RAS mutations with PIK3CA, CKIT, ALK, and EGFR mutations also detected. Conclusions: We examined clinical, histopathologic, viral, and genetic parameters in BRAFi-cSCC demonstrating rapid onset; wart-like histomorphology; β-HPV-17, HPV-38, and HPV-111 infection; UV damage; and novel ALK and CKIT mutations. Discovered β-HPV genotypes expand the spectrum of tumor-associated viruses. These findings enhance our understanding of factors cooperating with BRAF inhibition that accelerate keratinocyte oncogenesis as well as broaden the knowledge base of multifactorial mediators of cancer in general. Clin Cancer Res; 21(11); 2624–34. ©2015 AACR.