tbuckley/cabot-search huggingface dataset:
P147 The Wells PE Score – an Effective Pre-Test Probability Tool?: Abstract P147 Table 1
Authors: J Karalis, J Curtin Norfolk
Journal: Thorax (2012)

<h3>Introduction and Objectives</h3> British Thoracic Society guidelines advise all patients with possible PE should have pre-test clinical probability assessed and documented. The Norfolk and Norwich University Hospital (NNUH) uses the Wells PE score. Validation studies have shown it to be a sensitive tool with a positive predictive value of: low risk (5%), medium risk (25%), and high risk (70%) respectively. We wanted to assess the correlation of the Wells PE score with PE positivity rates on CT Pulmonary Angiogram (CTPA) in our patient population. We anticipated similar positive predictive rates as those seen in the original validation studies. <h3>Methods</h3> We retrospectively collected data from CTPA requests submitted between October 2009 to September 2010. The Wells PE score was used to risk stratify patients into low (score &lt; 2), moderate (score 2–6), or high risk (score &gt; 6). These were correlated with the outcome of the CTPAs. We also used the alternate dichotomised Wells PE score of PE Unlikely (score ≤ 4) and PE likely group (score &gt; 4) and correlated with results. <h3>Results</h3> 1160 CTPA requests were identified, 66 were excluded, (they lacked a wells PE score). 1094 CTPA requests were analysed. <h3>Conclusion</h3> We found poor correlation between the pre-test probability score and confirmed PE; <h3>Results</h3> show a positive predictive value of low risk (21.4%), medium risk (22.1%) and high risk (35.3%). The dichotomised score showed PE Unlikely (19.1%) and PE Likely (27.4%). Analysis of the Wells PE variables revealed that they lacked a high specificity and high sensitivity, the subjective variable demonstrated the lowest specificity. The Wells PE score is not an effective pre-test probability tool for discriminating low, moderate and high risk groups in the patient population at NNUH <h3>Reference</h3> Wells PS, Anderson DR, Rodger M, et al. Derivation of a simple clinical model to categorise patients probability of pulmonary embolism: Increasing the models utility with the SimpliRED D-dimer. Thrombosis and Haemastasis. 2000; 83 (3): 416–420.
Myeloid dendritic cells type 2 in allergic asthma
Authors: B. Dua, S. Smith, T. Kinoshita, H. Imaoka, G. Gauvreau, P. O'Byrne
Journal: Allergy (2013)

Myeloid dendritic cells type 2 (mDC2s) are a new subtype of DCs identified in both the circulation and the lung and suggested to have a role in allergic asthma.Circulating mDC2s were enumerated in 19 healthy, 18 atopic nonasthmatic, 18 mild atopic asthmatic, and 16 moderate/severe atopic asthmatic subjects using flow cytometry.The number of circulating mDC2s was significantly lower in atopic subjects compared with healthy controls and in asthmatic subjects compared with nonasthmatic subjects. There was a trend toward lower levels of circulating mDC2s with increasing allergy and asthma severity. The largest differences were seen in moderate/severe atopic asthmatics being 430.78 ± 48.91/ml compared with healthy controls being 767.05 ± 101.64/ml (P < 0.05).Circulating mDC2s are lower in atopic and asthmatic subjects, which suggests that these cells efflux from the blood into the airways in patients with allergic disease.
Endoscopic Ultrasound in the Diagnosis and Staging of Gastrointestinal Kaposi's Sarcoma
Authors: W. G. Zoller, J. R. Bogner, F. Powitz, H. Liess, F.-D. Goebel
Journal: Endoscopy (1995)

Endoscopic ultrasonography (EUS) has been evaluated for diagnosing and staging of a variety of gastrointestinal tumors, but there are no data on EUS in Kaposi's sarcoma (KS). The aim of the present study was to evaluate the role of EUS in addition to endoscopy in the diagnosis and staging of patients with established or suspected upper gastrointestinal KS.22 male acquired immune deficiency syndrome (AIDS) patients were prospectively studied, three of them before and after chemotherapy with liposomal doxorubicin. The features of gastrointestinal KS were recorded, and EUS was assessed for diagnosis in endoscopically negative or inconclusive cases, and for staging in endoscopically visible KS lesions.The typical EUS feature of KS was a hypoechoic and nonhomogeneous lesion leading predominantly to mucosal and submucosal thickening, whereas a few lesions presented only with submucosal involvement. EUS detected suspicious lesions in two patients with negative endoscopy, which turned out to be KS on follow-up. Restaging after chemotherapy in three patients showed regression of lesions both on endoscopy and EUS.EUS may contribute to better detection of early KS lesions and a more reliable delineation of the extent of gastrointestinal KS, which is valuable for assessing the effect of various forms of therapy.
Abstract 1000: Oncogenic Kras inhibits mitochondrial metabolism by regulating the pyruvate dehydrogenase complex under conditions of nutrient stress
Authors: Diego Jaitin, Leanne Sayles, Tereza Goliazova, Nicholas Denko, Alejandro Sweet-Cordero
Journal: Cancer Research (2012)

Abstract Kras is one of the most frequently mutated oncogenes in human cancer. Previous studies have suggested a role for oncogenic Kras in regulating glucose metabolism, although the exact mechanism is unclear. By analyzing the transcriptional consequences of Kras mutation under conditions of nutrient stress, a direct role for oncogenic Kras in regulating oxidative phosphorylation was observed. Signaling downstream of Kras via the MEK/ERK pathway inhibits expression of PDP1, a mitochondrial phosphatase that regulates the pyruvate dehydrogenase complex (PDC). PDC is a key enzyme in the conversion of pyruvate into acetyl-CoA. Decreased expression of PDP1 induced by oncogenic Kras leads to increased phosphorylation and thereby inactivation of PDC. Therefore, oncogenic Kras represses mitochondrial function and oxygen consumption by maintaining PDC in an inactive state. This effect is not apparent under the high-glucose conditions in which cells are typically cultured. However, at glucose concentrations more closely reflective of what cells experience in vivo, the effect of oncogenic Kras signaling on PDP1 expression becomes readily apparent. This study demonstrates a novel role for oncogenic Kras in the regulation of mitochondrial metabolism. Further studies underway may clarify a role for this pathway as a target for therapeutic intervention in Kras-mutant tumors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1000. doi:1538-7445.AM2012-1000
Colonoscopic Diagnosis and Medical Treatment of Ten Patients with Colonic Tuberculosis
Authors: C. V. Ferentzi, J. O. Sieck, M. A. Ali
Journal: Endoscopy (1988)

Ten patients with tuberculous enterocolitis were diagnosed colonoscopically. In four, the diagnosis was confirmed by positive acid fast stain or the presence of caseating granuloma in colonic biopsy material or ileal washings. In one other patient a cervical lymph gland revealed acid-fast bacilli. He was the only patient with extraintestinal disease, indicating that primary tuberculous colitis is probably more common than secondary in Saudi Arabia. In the other five patients the colonoscopic diagnosis was confirmed by a complete response to antituberculous triple therapy. Six patients had hypertrophic, two ulcerohypertrophic and two widespread ulcerative lesions. Colonoscopy with biopsies has definite advantages over barium enema in diagnosis. After thus excluding malignancy, Crohn's disease remains the most important differential diagnosis. A ten-week therapeutic trial of antituberculous treatment is recommended in patients from high-risk populations with a typical history and colonoscopic picture to avoid the morbidity and mortality of diagnostic laparotomy.
Donations of orthopaedic equipment also cause problems
Authors: A. Gregori
Journal: BMJ (1997)

Rationing health careAllocating resources only to treating present dangers would ruin preventive health care and jeopardise future livesEditor-In his article on the objectives of the NHS John Harris argues that "there is a good principle that real and present dangers should be met before future and speculative ones." 1 Has he really thought about the implications of this?Immunisation, health promotion, and preventive interventions would all be swept away in favour of curative treatments.As the lives lost by such a shift in resources would be future lives and the people not identifiable beforehand, they would count for nothing.The state's obligation to protect the "citizen against threats to her life and liberty" only applies to immediate threats.Harris argues that the health budget should be larger, as if a larger budget will somehow allocate itself and obviate the need for choosing between competing alternatives.He also claims that health care (and he means curative care) should be afforded a high priority in the state budget.This presents a simple dilemma: should the state spend more on raising the income of impoverished families or on resources to provide more intensive care beds?Since raising the income of poor families has no impact on immediate threats to health, according to Harris we must clearly prefer spending more on providing more intensive care beds.Harris fails to recognise the first problem in identifying healthcare needs.If resources are not the immediate constraint on a healthcare system then rationing takes place on the basis of whether a need (or a want) can be legitimised as a healthcare need.In times of plenty the remit of formal health care expands.Harris seems to desire this process to continue.In wishing for more of our labour to be devoted to financing this end, he can see no cost or opportunity cost to the process.Am I alone in finding this naive?
Changes in hepatic lobe volume in biliary tract cancer patients after right portal vein embolization
Authors: Masato Nagino, Yuji Nimura, Junichi Kamiya, Satoshi Kondo, Katsuhiko Uesaka, Yukoh Kin, Naokazu Hayakawa, Hideo Yamamoto
Journal: Hepatology (1995)

Changes in lobar volume of the liver and in total hepatic function were studied in 19 patients with biliary tract cancer who underwent right portal vein embolization as preoperative management for extensive liver resection. Computed tomography (CT) was performed to estimate liver volume before and approximately 11 days after embolization. An indocyanine green (ICG) test was performed before and 11 to 13 days after embolization. The calculated volume of the right lobe decreased from 761 +/- 181 cm3 to 625 +/- 110 cm3 11 days after embolization (P < .0001), whereas the volume of the left lobe increased from 420 +/- 94 cm3 to 555 +/- 110 cm3 (P < .0001). Thus, portal embolization produced a gain in left lobe volume of 136 +/- 62 cm3 and an almost equivalent loss in right lobe volume. The hypertrophy ratio of the left lobe, expressed as percentage of postembolization volume of the left lobe to preembolization size, of the 5 patients with diabetes mellitus (DM) was lower than that of the 14 patients without diabetes (116.7 +/- 6.3% vs. 140.4 +/- 18.4%; P < .005). The ICG disappearance rate in 16 patients improved from 0.163 +/- 0.034 to 0.177 +/- 0.027 (P < .05). The improvement was especially evident in 9 of 14 post-jaundice patients, although the rate decreased slightly in 2 patients without jaundice. We conclude that right portal vein embolization can produce a compensatory hypertrophy of the left lobe within 11 days without seriously affecting hepatic function. In diabetic patients, however, a longer interval between embolization and operation may be needed to achieve sufficient hypertrophy of the left lobe.
PSYCHODRAMA AS A TREATMENT FOR HOSPITALIZED PATIENTS: A CONTROLLED STUDY
Authors: PAUL FREDRIC SLAWSON
Journal: American Journal of Psychiatry (1965)

Twenty-seven hospitalized adult psychiatric patients participated in twice-weekly psychodrama sessions. They were matched on the basis of three variables (age, sex, MMPI profile) to controls drawn from the psychiatric hospital population. Both experimental and control patients were given a general personality inventory (MMPI) on admission and were retested at discharge. Such testing failed to distinguish between the psychodrama and control groups. These findings are discussed in the context of the available literature.
Repetitive Bilateral Arm Training and Motor Cortex Activation in Chronic Stroke
Authors: Andreas R. Luft, Sandy McCombe-Waller, Jill Whitall, Larry W. Forrester, Richard Macko, John D. Sorkin, Jörg B. Schulz, Andrew P. Goldberg, Daniel F. Hanley
Journal: JAMA (2004)

Reorganization in central motor networks occurs during early recovery from hemiparetic stroke. In chronic stroke survivors, specific rehabilitation therapy can improve upper extremity function.To test the hypothesis that in patients who have chronic motor impairment following stroke, specific rehabilitation therapy that improves arm function is associated with reorganization of cortical networks.A randomized controlled clinical trial conducted in a US ambulatory rehabilitation program with 21 patients (median [IQR], 50.3 [34.8-77.3] months after unilateral stroke). Data were collected between 2001 and 2004.Patients were randomly assigned to bilateral arm training with rhythmic auditory cueing (BATRAC) (n = 9) or standardized dose-matched therapeutic exercises (DMTE) (n = 12). Both were conducted for 1 hour, 3 times a week, for 6 weeks.Within 2 weeks before and after the intervention, brain activation during elbow movement assessed by functional magnetic resonance imaging (fMRI) and functional outcome assessed using arm function scores.Patients in the BATRAC group but not in the DMTE group increased hemispheric activation during paretic arm movement (P = .03). Changes in activation were observed in the contralesional cerebrum and ipsilesional cerebellum (P = .009). BATRAC was associated with significant increases in activation in precentral (P<.001) and postcentral gyri (P = .03) and the cerebellum (P<.001), although 3 BATRAC patients showed no fMRI changes. Considering all patients, there were no differences in functional outcome between groups. When only BATRAC patients with fMRI response were included (n = 6), BATRAC improved arm function more than DMTE did (P = .02).These preliminary findings suggest that BATRAC induces reorganization in contralesional motor networks and provide biological plausibility for repetitive bilateral training as a potential therapy for upper extremity rehabilitation in hemiparetic stroke.
Parathyroid Hormone–Related Peptide in Sickness and in Health
Authors: John P. Bilezikian
Journal: New England Journal of Medicine (1990)

The proposal that hypercalcemia of cancer is caused by the ectopic secretion of a parathyroid hormone-like substance has been a riveting hypothesis for the past 50 years.1 We now know that certain solid tumors do synthesize and secrete a polypeptide that has striking biologic similarities to parathyroid hormone.2 This substance, however, is not authentic parathyroid hormone, because parathyroid hormone cannot be detected in the circulation or in tumor tissue. Instead, a substance known as parathyroid hormone-related peptide (PTHRP) is responsible for the biochemical features of hypercalcemia, hypophosphatemia, and elevations in urinary cyclic AMP excretion. The ability of inhibitors of parathyroid . . .
How free healthcare became mired in corruption and murder in a key Indian state
Authors: P. Chatterjee
Journal: BMJ (2012)

The deaths of three medical officials in India’s most populous state have taken the sheen off an ambitious attempt to bring free healthcare to the country’s poorest citizens. <b>Patralekha Chatterjee</b> reports from Uttar Pradesh on how the organised looting of government funds has crippled the National Rural Health Mission
Role of apoptosis in reperfusion injury
Authors: F Eefting
Journal: Cardiovascular Research (2004)

Many changes occur during reperfusion of the myocardium after ischemic damage. Necrosis and apoptosis appear to be ongoing during ischemia, while apoptosis is boosted by the reperfusion event. In the past 10 years, distinct intracellular pathways important for hypertrophy, apoptosis, cardiac failure, ischemic preconditioning and reperfusion damage have been recognized. The eventual response of the cardiomyocyte will depend on energy and time available as well as changes in pH and ion handling and the delicate balance of activation of signaling molecules and transcription factors. There is agreement on the central role of mitochondria and nitric oxide (NO) in programmed cell death. However, although many groups analyzed the contribution of NO to cell death, still the circumstances and levels required for cardioprotection or death are unclear. Growth factors, cytokines, and downstream signaling molecules have been shown to influence programmed cell death through mechanisms reminiscent of preconditioning. Here, the role of apoptosis in ischemia reperfusion-related cell death is reviewed. Important data have been obtained in isolated cells, intact hearts and intact animals. Both pharmacological as well as genetic interventions are discussed. Proof for apoptosis in man post-myocardial infarction (MI) treated through primary Percutaneous Trans-luminal Coronary Angioplasty or other reperfusion therapy is reviewed. Finally, the currently available quantification methods for apoptosis post-MI are mentioned.
Morphological evidence that high density lipoproteins are not internalized by steroid-producing cells during in situ organ perfusion.
Authors: E Reaven, Y D Chen, M Spicher, S Azhar
Journal: Journal of Clinical Investigation (1984)

Although it is clear that high density lipoproteins (HDL) can support steroidogenesis in several rat cell systems, questions still arise as to how HDL are processed by cells. In particular, it is not yet clear whether HDL are internalized by a pathway similar to that used for low density lipoproteins. This issue was examined in the present study using the luteinized ovaries of hormone-primed immature rats in an in situ perfusion system. Ovaries were perfused for 2-120 min with 125I-labeled human or rat HDL and processed for autoradiographic studies at the light and electron microscopic level, or homogenized and used for isolation of subcellular membranes. The results show that the luteal cells of this tissue bind both human and rat HDL with great specificity. Moreover, the intact HDL particle does not appear to be internalized by the luteal cell during the period of perfusion: i.e., the protein moiety of the labeled HDL remains associated with the plasma membrane at all times. Evidence from the autoradiographs suggest, however, that with time, an increasing proportion of the plasma membrane-bound protein is associated with inverted microvilli, which are embedded within the cytoplasm and make close contact with structures of the interior of the cell. We speculate that HDL-cholesterol may be transferred at such sites.
872. Chimpanzee Derived Adenoviral Vectors Transduce and Activate Human Dendritic Cells
Authors: Sury Somanathan, Soumitra Roy, Guangping Gao, Arbans Sandhu, James M. Wilson
Journal: Molecular Therapy (2005)

Chimpanzee derived adenoviral vectors offer a promising tool for the development of readminstrable vaccines against several life threatening diseases such as HIV infections, rabies and SARS. Recently, several chimpanzee derived adenoviral vectors have been cloned and vectored. In the present study we studied the efficacy of Pan 5, Pan 6, Pan 7, Pan 9 and C1-based vectors to transduce and activate human dendritic cells. Our data demonstrate that chimpanzee derived adenoviral vectors transduce and activate monocyte derived dendritic cells. However, the level of activation and the efficiency to transduce dendritic cells varied among the different serotypes. Activation of the cells resulted in an increased expression of co-stimulatory molecules and the secretion of cytokines. In contrast to monocyte derived dendritic cells (mDCs), the different serotypes do not efficiently transduce plasmocytoid dendritic cells (pDCs). However, suprisingly, the chimpanzee derived vectors do activate pDCs resulting in a large secretion of IFN-alpha. The levels of IFN-alpha secreted was 5-10 fold higher than that found when using human adenovirus 5. Furthermore, we show that the activation of pDCs could occur in the absence of gene expression from the vector backbone and the transgene. The possible role of pattern recognition receptors in recognizing adenoviral vectors and activating dendritic cells is discussed.
Production of human monoclonal anti-basement membrane zone (BMZ) antibodies from a patient with bullous pemphigoid (BP) by Epstein-Barr virus transformation. Analyses of the heterogeneity of anti-BMZ antibodies in BP sera using them.
Authors: T Sugi, T Hashimoto, T Hibi, T Nishikawa
Journal: Journal of Clinical Investigation (1989)

We established three lymphoblastoid cell lines from a bullous pemphigoid (BP) patient's peripheral blood by means of EBV transformation, which produced human monoclonal anti-basement membrane zone (BMZ) IgG antibodies. A blocking immunofluorescence test using these MAbs, designated 5A, 5E, and 10D, revealed that 5A and 5E recognized the same or a closely associated epitope, but the epitope for 10D was completely different, 18 of 30 BP sera blocked the reactivity of 10D MAb and 17 sera blocked 5E, while 9 sera did not block the staining of either antibody. Immunoblot analysis demonstrated that both 5A and 5E MAbs reacted exclusively with a protein band of approximately 230 kD in normal human epidermal extracts. However, 10D did not show any protein band. 22 of 30 BP sera strongly reacted with the same 230-kD protein, while none of control sera showed such reactivity. These results clearly demonstrated the heterogeneity of anti-BMZ antibodies in terms of epitopes. These MAbs should be useful in future investigations concerning not only the immunopathology but also the biochemial and molecular analyses of the BP antigen.