tbuckley/cabot-search huggingface dataset:
Maternal mortality and distance to facility-based obstetric care in rural southern Tanzania: a secondary analysis of cross-sectional census data in 226 000 households
Authors: Claudia Hanson, Jonathan Cox, Godfrey Mbaruku, Fatuma Manzi, Sabine Gabrysch, David Schellenberg, Marcel Tanner, Carine Ronsmans, Joanna Schellenberg
Journal: The Lancet Global Health (2015)

BackgroundAccess to skilled obstetric delivery and emergency care is deemed crucial for reducing maternal mortality. We assessed pregnancy-related mortality by distance to health facilities and by cause of death in a disadvantaged rural area of southern Tanzania.MethodsWe did a secondary analysis of cross-sectional georeferenced census data collected from June to October, 2007, in five rural districts of southern Tanzania. Heads of georeferenced households were asked about household deaths in the period June 1, 2004, to May 31, 2007, and women aged 13–49 years were interviewed about birth history in the same time period. Causes of death in women of reproductive age were ascertained by verbal autopsy. We also asked for sociodemographic information. Multilevel logistic regression was used to analyse the effects of distance to health facilities providing delivery care on pregnancy-related mortality (direct and indirect maternal and coincidental deaths).FindingsThe study included 818 583 people living in 225 980 households. Pregnancy-related mortality was high at 712 deaths per 100 000 livebirths, with haemorrhage being the leading cause of death. Deaths due to direct causes of maternal mortality were strongly related to distance, with mortality increasing from 111 per 100 000 livebirths among women who lived within 5 km to 422 deaths per 100 000 livebirths among those who lived more than 35 km from a hospital (adjusted odds ratio 3·68; 95% CI 1·37–9·88). Neither pregnancy-related nor indirect maternal mortality was associated with distance to hospital. Among women who lived within 5 km of a hospital, pregnancy-related mortality was 664 deaths per 100 000 livebirths even though 72% gave birth in hospital and 8% had delivery by caesarean section.InterpretationLarge distances to hospital contribute to high levels of direct obstetric mortality. High pregnancy-related mortality in those living near to a hospital suggests deficiencies in quality of care.FundingBill & Melinda Gates Foundation.
Toll-like receptors 2/4 agonists: a potential strategy for preventing invasion and metastasis of hepatocellular carcinoma
Authors: P. Yu, X. Cheng, J. Guo, X. Wang
Journal: Gut (2010)

In their recent study, Mencin and colleagues1 summarised the role of toll-like receptors (TLRs) and TLR ligands in the pathophysiology of some chronic liver diseases, including hepatocellular carcinoma (HCC), and discussed the potential role of TLR agonists, antagonists and probiotics for the treatment of these diseases.

As we know, the long-term prognosis of HCC remains unsatisfactory even after surgical resection and chemotherapy because of a high recurrence rate. Invasion, together with metastasis formation, are commonly associated with the HCC recurrence and represent the most common reasons for the poor prognosis. However, fewer agents are currently available to block or postpone HCC progression.

Mencin and colleagues discussed the repressive effects of TLR agonists on the replication of hepatitis C virus (HCV) and HBV, which are two risk factors of developing HCC. Regarding our study, we would like to bring to your attention that the TLR 2/4 agonist …
Association between Cutaneous Nevi and Breast Cancer in the Nurses' Health Study: A Prospective Cohort Study
Authors: Mingfeng Zhang, Xuehong Zhang, Abrar A. Qureshi, A. Heather Eliassen, Susan E. Hankinson, Jiali Han
Journal: PLoS Medicine (2014)

Background Cutaneous nevi are suggested to be hormone-related. We hypothesized that the number of cutaneous nevi might be a phenotypic marker of plasma hormone levels and predict subsequent breast cancer risk. Methods and Findings We followed 74,523 female nurses for 24 y (1986–2010) in the Nurses' Health Study and estimate the relative risk of breast cancer according to the number of cutaneous nevi. We adjusted for the known breast cancer risk factors in the models. During follow-up, a total of 5,483 invasive breast cancer cases were diagnosed. Compared to women with no nevi, women with more cutaneous nevi had higher risks of breast cancer (multivariable-adjusted hazard ratio, 1.04, 95% confidence interval [CI], 0.98–1.10 for 1–5 nevi; 1.15, 95% CI, 1.00–1.31 for 6–14 nevi, and 1.35, 95% CI, 1.04–1.74 for 15 or more nevi; p for continuous trend = 0.003). Over 24 y of follow-up, the absolute risk of developing breast cancer increased from 8.48% for women without cutaneous nevi to 8.82% (95% CI, 8.31%–9.33%) for women with 1–5 nevi, 9.75% (95% CI, 8.48%–11.11%) for women with 6–14 nevi, and 11.4% (95% CI, 8.82%–14.76%) for women with 15 or more nevi. The number of cutaneous nevi was associated with increased risk of breast cancer only among estrogen receptor (ER)–positive tumors (multivariable-adjusted hazard ratio per five nevi, 1.09, 95% CI, 1.02–1.16 for ER+/progesterone receptor [PR]–positive tumors; 1.08, 95% CI, 0.94–1.24 for ER+/PR− tumors; and 0.99, 95% CI, 0.86–1.15 for ER−/PR− tumors). Additionally, we tested plasma hormone levels according to the number of cutaneous nevi among a subgroup of postmenopausal women without postmenopausal hormone use (n = 611). Postmenopausal women with six or more nevi had a 45.5% higher level of free estradiol and a 47.4% higher level of free testosterone compared to those with no nevi (p for trend = 0.001 for both). Among a subgroup of 362 breast cancer cases and 611 matched controls with plasma hormone measurements, the multivariable-adjusted odds ratio for every five nevi attenuated from 1.25 (95% CI, 0.89–1.74) to 1.16 (95% CI, 0.83–1.64) after adjusting for plasma hormone levels. Key limitations in this study are that cutaneous nevi were self-counted in our cohort and that the study was conducted in white individuals, and thus the findings do not necessarily apply to other populations. Conclusions Our results suggest that the number of cutaneous nevi may reflect plasma hormone levels and predict breast cancer risk independently of previously known factors. Please see later in the article for the Editors' Summary
Aetiology of traveller’s diarrhoea: evaluation of a multiplex PCR tool to detect different enteropathogens
Authors: Y. Zboromyrska, J.C. Hurtado, P. Salvador, M.J. Alvarez-Martínez, M.E. Valls, J. Mas, M.A. Marcos, J. GascÓn, J. Vila
Journal: Clinical Microbiology and Infection (2014)
Allergen-specific Immunotherapy Using A Highly Modified Allergen And The Immunomodulator Polyoxidonium In A Murine Model Of Allergic Asthma
Authors: A.A. Babakhin, L.S. Litvin, S.M. Andreev, O.N. Stetzenko, L.N. Voronkova, M.R. Khaitov, G.G. Barsegyan, I.V. DuBuske, L.M. DuBuske
Journal: Journal of Allergy and Clinical Immunology (2007)
Current management of patients hospitalized with complicated skin and soft tissue infections across Europe (2010–2011): assessment of clinical practice patterns and real-life effectiveness of antibiotics from the REACH study
Authors: J. Garau, H. Ostermann, J. Medina, M. Ávila, K. McBride, F. Blasi
Journal: Clinical Microbiology and Infection (2013)

Complicated skin and soft tissue infections (cSSTI) are common and frequently require treatment in hospital. Comprehensive current data on management practices in patients hospitalized with cSSTI are limited. REACH was a retrospective, observational cohort study designed to provide data on current clinical management of moderate to severe cSSTI in European hospitals. Data were collected via an electronic case report form from 129 sites in ten European countries. The study population comprised patients ≥18 years, hospitalized between March 2010 and February 2011 with cSSTI who received intravenous antibiotic treatment. Presented here is an analysis of the disease characteristics, treatment patterns during hospitalization and clinical outcomes identified by the study. The total population included 1995 patients (mean age 60.6 years; 57.7% male). Initial antibiotic treatment modification was reported in 39.6% (n = 791) of patients; it was more common in patients with co-morbidities (42.6%), those requiring surgical intervention (43.4%), those with more severe infections such as bacteraemia (51.6%) or with fascia affected (49.0%), those admitted to the intensive care unit (56.2%) and those with lesions > 50 cm2 (44.3%). A switch to narrower-spectrum antibiotic treatment (streamlining) occurred in 5.6% of patients. Mean length of hospital stay was 18.5 days (±19.9; median 12.0) and the total mortality rate was 3.4%. The data collected in REACH give a comprehensive and current view of real-life clinical management of cSSTI in European hospitals and provide evidence of a high rate of initial antibiotic treatment modification.
Quantitative immunohistochemical assessment of bovine myocardial innervation before and after cryosurgical cardiac denervation
Authors: L. Gordon, J. Wharton, J. A R Gaer, G. C Inglis, K. M Taylor, J. M Polak
Journal: Cardiovascular Research (1993)

Objective: The aim was to determine the relative distribution and possible origins of peptide containing nerves in the bovine heart before and after functional extrinsic denervation established by cryosurgery. Methods: A quantitative immunohistochemical technique was used. Results: In the intact heart, myocardial nerve fibres and fascicles displaying immunoreactivity for the general neural marker protein gene product 9.5 had an atrial to ventricular gradient in density. The right atrium was the most densely innervated region and a major proportion of the total myocardial innervation, visualised by protein gene product 9.5 immunoreactive nerves, showed neuropeptide tyrosine (45%) and tyrosine hydroxylase (20%) immunofluorescence staining, while nerves immunoreactive for vasoactive intestinal polypeptide and calcitonin gene related peptide formed relatively minor subpopulations (representing less than 2% and 0.5%, respectively, of the total fluorescent myocardial innervation). Following cryoablation there was a significant reduction in the percentage fluorescent area of protein gene product 9.5 immunoreactive nerves throughout the heart, of greater than 90% of the control values. There were highly significant reductions in the percentage fluorescent area of nerves showing immunoreactivity to neuropeptide tyrosine, tyrosine hydroxylase, and calcitonin gene related peptide, to 1.01, 0.92, and 0.05%, respectively, of the intact myocardial innervation. The distribution of vasoactive intestinal polypeptide immunoreactive nerves was more variable and displayed an equivocal response to cardiac cryoablation. Conclusions: The majority of nerves showing immunoreactivity to neuropeptide tyrosine, tyrosine hydroxylase, and calcitonin gene related peptide are of extrinsic origin, while vasoactive intestinal polypeptide immunoreactive nerves may have intrinsic as well as extrinsic origins. The distribution and apparent origins of immunohistochemically defined nerves in the bovine heart are similar to those observed in the human heart which suggests that the calf may be an appropriate model for comparative studies. Cardiovascular Research 1993;27:318-326
Elaboration and validation of a questionnaire assessing patient expectations about management of knee osteoarthritis by their physicians: the Knee Osteoarthritis Expectations Questionnaire
Authors: Mathilde Benhamou, Isabelle Boutron, Marie Dalichampt, Gabriel Baron, Sophie Alami, François Rannou, Philippe Ravaud, Serge Poiraudeau
Journal: Annals of the Rheumatic Diseases (2012)

<h3>Objectives</h3> To develop a questionnaire assessing the expectations of patients regarding management of osteoarthritis (OA of the knee. <h3>Methods</h3> A detailed document reporting on a qualitative analysis of interviews of patients with knee OA was sent to experts and a Delphi procedure was adopted for item generation. Eighty physicians (64 general practitioners, 16 rheumatologists) recruited 566 patients with knee OA to test the provisional questionnaire. Items were reduced according to their metric properties and exploratory factor analysis. The reliability of the questionnaire was tested by the Cronbach α coefficient. Construct validity was tested by divergent validity and confirmatory factor analysis. Test–retest reliability was assessed by the intraclass correlation coefficient (ICC) and the Bland–Altman technique. <h3>Results</h3> Sixty items were extracted from analysis of the interview data. The experts needed three Delphi rounds to obtain consensus on a 33-item provisional questionnaire. The item reduction process resulted in an 18-item questionnaire. Exploratory factor analysis extracted three main factors: factor 1 represented expectations for education, factor 2 expectations for information on technical and human support, and factor 3 expectations for physician empathy. The Cronbach α coefficient was 0.91 (95% CI 0.89 to 0.92). Expected divergent validity was observed. Confirmation factor analyses confirmed higher intra-factor than inter-factor correlations. Test–retest reliability was good with an ICC of 0.79, and Bland–Altman analysis did not reveal a systematic trend. <h3>Conclusions</h3> A new 18-item questionnaire assessing patient expectations of management of knee OA by their physicians is proposed. The questionnaire has good content and construct validity.
Ultrasound definition of tendon damage in patients with rheumatoid arthritis. Results of a OMERACT consensus-based ultrasound score focussing on the diagnostic reliability
Authors: George A W Bruyn, Petra Hanova, Annamaria Iagnocco, Maria-Antonietta d'Agostino, Ingrid Möller, Lene Terslev, Marina Backhaus, Peter V Balint, Emilio Filippucci, Paul Baudoin, Richard van Vugt, Carlos Pineda, Richard Wakefield, Jesus Garrido, Ondrej Pecha, Esperanza Naredo
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objective</h3> To develop the first ultrasound scoring system of tendon damage in rheumatoid arthritis (RA) and assess its intraobserver and interobserver reliability. <h3>Methods</h3> We conducted a Delphi study on ultrasound-defined tendon damage and ultrasound scoring system of tendon damage in RA among 35 international rheumatologists with experience in musculoskeletal ultrasound. Twelve patients with RA were included and assessed twice by 12 rheumatologists-sonographers. Ultrasound examination for tendon damage in B mode of five wrist extensor compartments (extensor carpi radialis brevis and longus; extensor pollicis longus; extensor digitorum communis; extensor digiti minimi; extensor carpi ulnaris) and one ankle tendon (tibialis posterior) was performed blindly, independently and bilaterally in each patient. Intraobserver and interobserver reliability were calculated by κ coefficients. <h3>Results</h3> A three-grade semiquantitative scoring system was agreed for scoring tendon damage in B mode. The mean intraobserver reliability for tendon damage scoring was excellent (κ value 0.91). The mean interobserver reliability assessment showed good κ values (κ value 0.75). The most reliable were the extensor digiti minimi, the extensor carpi ulnaris, and the tibialis posterior tendons. An ultrasound reference image atlas of tenosynovitis and tendon damage was also developed. <h3>Conclusions</h3> Ultrasound is a reproducible tool for evaluating tendon damage in RA. This study strongly supports a new reliable ultrasound scoring system for tendon damage.
Multiple minute palmar-plantar digitate hyperkeratoses
Authors: ELIZABETH H. KNOBLER, M.E. GROSSMAN, A.D. RABINOWITZ
Journal: British Journal of Dermatology (1989)

Digitate hyperkeratoses are rare lesions of unknown cause. We wish to add a new variant of this entity to the few reports in the literature. Our patient is a 79-year-old woman with palmar pits and digitate hyperkeratoses limited to her palms and soles.
Thyrotropin Releasing Hormone: Secretion and Actions
Authors: J F Wilber
Journal: Annual Review of Medicine (1973)

Extensive physiologic and anatomic studies have demonstrated the central role of the anterior hypothalamus in the neurohumoral control of pituitary thyrotropin (TSH) secretion and biosynthesis (1, 2). The structural elucidation in 1969 of thyro­ tropin releasing hormone (TRH), isolated from more than 100,000 hypothalamic fragments derived from pigs (3) and sheep (4), constituted a momentous achieve­ ment in endocrine research. The subsequent large scale synthesis and availability of TRH has catalyzed vigorous activity in multiple areas of basic and clinical investiga­ tion. The progress made in understanding the structure, synthesis, secretion, de­ gradation, and actions ofTRH forms the substance of the present chapter. Excellent reviews on various aspects ofTRH physiology have been published recently (5-9).
Selected Medical Errors in the Intensive Care Unit
Authors: Maité Garrouste-Orgeas, Jean François Timsit, Aurelien Vesin, Carole Schwebel, Patrick Arnodo, Jean Yves Lefrant, Bertrand Souweine, Alexis Tabah, Julien Charpentier, Olivier Gontier, Fabienne Fieux, Bruno Mourvillier, Gilles Troché, Jean Reignier, Marie Françoise Dumay, Elie Azoulay, Bernard Reignier, Jean Carlet, Lilia Soufir
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Rationale: Although intensive care units (ICUs) were created for patients with life-threatening illnesses, the ICU environment generates a high risk of iatrogenic events. Identifying medical errors (MEs) that serve as indicators for iatrogenic risk is crucial for purposes of reporting and prevention.Objectives: We describe the selection of indicator MEs, the incidence of such MEs, and their relationship with mortality.Methods: We selected indicator MEs using Delphi techniques. An observational prospective multicenter cohort study of these MEs was conducted from March 27 to April 3, 2006, in 70 ICUs; 16 (23%) centers were audited. Harm from MEs was collected using specific scales.Measurements and Main Results: Fourteen types of MEs were selected as indicators; 1,192 MEs were reported for 1,369 patients, and 367 (26.8%) patients experienced at least 1 ME (2.1/1,000 patient-days). The most common MEs were insulin administration errors (185.9/1,000 d of insulin treatment). Of the 1,192 medical errors, 183 (15.4%) in 128 (9.3%) patients were adverse events that were followed by one or more clinical consequences (n = 163) or that required one or more procedures or treatments (n = 58). By multivariable analysis, having two or more adverse events was an independent risk factor for ICU mortality (odds ratio, 3.09; 95% confidence interval, 1.30–7.36; P = 0.039).Conclusions: The impact of medical errors on mortality indicates an urgent need to develop prevention programs. We have planned a study to assess a program based on our results.
Doping control in Japan. An automated extraction procedure for the doping test.
Authors: T. Nakajima, T. Matsumoto
Journal: British Journal of Sports Medicine (1976)

Horse racing in Japan consists of two systems, the National (10 racecourses) and the Regional public racing (32 racecourses) having about 2,500 racing meetings in total per year. Urine or saliva samples for dope testing are collected by the officials from thw winner, second and third, and transported to the laboratory in a frozen state. In 1975, 76, 117 samples were analyzed by this laboratory. The laboratory provides the following four methods of analysis, which are variously combined by request. (1) Method for detection of drugs extracted by chloroform from alkalinized sample. (2) Methods for detection of camphor and its derivatives. (3) Method for detection of barbiturates. (4) Method for detection of ethanol. These methods consist of screening, mainly by thin layer chromatography and confirmatory tests using ultra violet spectrophotometry, gas chromatography and mass spectrometry combined with gas chromatography. In the screening test of doping drugs, alkalinized samples are extracted with chloroform. In order to automate the extraction procedure, the authors contrived a new automatic extractor. They also devised a means of pH adjustment of horse urine by using buffer solution and an efficient mechanism of evaporation of organic solvent. Analytical data obtained by the automatic extractor are presented in this paper. In 1972, we started research work to automate the extraction procedure in method (1) above, and the Automatic Extractor has been in use in routine work since last July. One hundred and twnety samples per hour are extracted automatically by three automatic extractors. The analytical data using this apparatus is presented below.
Efficacy of Pacing Therapies for Treating Atrial Tachyarrhythmias in Patients With Ventricular Arrhythmias Receiving a Dual-Chamber Implantable Cardioverter Defibrillator
Authors: Stuart W. Adler, Christian Wolpert, Eduardo N. Warman, Shailesh K. Musley, Jodi L. Koehler, David E. Euler
Journal: Circulation (2001)

Background — Although overdrive pacing for treating atrial flutter is well established, the efficacy of device-based atrial pacing for treating spontaneous atrial tachyarrhythmias in patients with implantable cardioverter defibrillators (ICD) is unknown. This study evaluated the efficacy of novel pacing therapies for treating atrial tachyarrhythmias in patients receiving a dual-chamber ICD to treat ventricular tachyarrhythmias. Methods and Results — A Jewel AF ICD was implanted in 537 patients with ventricular arrhythmia who were followed for 11.4±8.2 months (74% had a documented history of atrial tachyarrhythmias). The device discriminated atrial tachycardia (AT) from atrial fibrillation (AF) on the basis of cycle length and regularity, and it used 3 different methods of overdrive atrial pacing (Ramp, Burst+, and 50-Hz burst) to treat AT episodes and one method (50-Hz burst) to treat AF episodes. Pacing successfully terminated 59% of 1500 spontaneous AT episodes in 127 patients and 30% of 880 AF episodes in 101 patients ( P &lt;0.001). With AT and AF episodes combined, pacing efficacy was 48%. Pacing efficacy was significantly reduced at AT cycle lengths ≤220 ms and AF cycle lengths ≤160 ms ( P &lt;0.01) The median time from pacing to AT/AF termination was 1.1 minute for the pacing successes and 96 minutes for the failures ( P &lt;0.001). Conclusions — Atrial pacing terminated 48% of AT/AF episodes in patients with a history of ventricular arrhythmias. Pacing efficacy was greater for device-classified AT than AF. Pacing efficacy was significantly influenced by tachycardia cycle length. Successful pacing significantly reduces the time required for AT/AF termination.
MASTOIDITIS HYPERPLASTICA SEROSA
Authors: W. JERVEY
Journal: JAMA (1922)

There exists a certain pathologic condition of the mastoid which, up to this time, has not been recognized. The mastoiditis of the textbooks and of current medical literature of the world, for thirty years past at least, is an infective process, always accompanied by pus formation and, inferentially, of some specific bacillary origin. I believe that there is another and quite distinct type of mastoid disease. It is well known that there exists a "serous labyrinthitis"; why not a "ser ous mastoiditis?" The existence, not rare, of a "hyperplastic sinusitis" is an accepted fact; why not a "hyperplastic mastoiditis?" Not to go into a prolonged discussion of the latter type, for instance, hyperplastic ethmoiditis, it is enough to say that more might be known of its etiology and pathology. It may exist in association with an interstitial and intracellular serous exudate, or it may not. In the mastoid structure, the