tbuckley/cabot-search huggingface dataset:
Virological response to entecavir is associated with a better clinical outcome in chronic hepatitis B patients with cirrhosis
Authors: Roeland Zoutendijk, Jurrien GP Reijnders, Fabien Zoulim, Ashley Brown, David J Mutimer, Katja Deterding, Wolf Peter Hofmann, Joerg Petersen, Massimo Fasano, Maria Buti, Thomas Berg, Bettina E Hansen, Milan J Sonneveld, Heiner Wedemeyer, Harry L A Janssen
Journal: Gut (2012)

<h3>Objective</h3> Entecavir (ETV) is a potent inhibitor of viral replication in chronic hepatitis B and prolonged treatment may result in regression of fibrosis. The aim of this study was to investigate the effect of ETV on disease progression. <h3>Design</h3> In a multicentre cohort study, 372 ETV-treated patients were investigated. Clinical events were defined as development of hepatocellular carcinoma (HCC), hepatic decompensation or death. Virological response (VR) was defined as HBV DNA &lt;80 IU/ml. <h3>Results</h3> Patients were classified as having chronic hepatitis B without cirrhosis (n=274), compensated cirrhosis (n=89) and decompensated cirrhosis (n=9). The probability of VR was not influenced by severity of liver disease (p=0.62). During a median follow-up of 20 months (IQR 11–32), the probability of developing clinical events was higher for patients with cirrhosis (HR 15.41 (95% CI 3.42 to 69.54), p&lt;0.001). VR was associated with a lower probability of disease progression (HR 0.29 (95% CI 0.08 to 1.00), p=0.05) which remained after correction for established risk factors such as age. The benefit of VR was only significant in patients with cirrhosis (HR 0.22 (95% CI 0.05 to 0.99), p=0.04) and remained after excluding decompensated patients (HR 0.15 (95% CI 0.03 to 0.81), p=0.03). A higher HBV DNA threshold of 2000 IU/ml was not associated with the probability of disease progression (HR 0.20 (95% CI 0.03 to 1.10), p=0.10). <h3>Conclusion</h3> VR to ETV is associated with a lower probability of disease progression in patients with cirrhosis, even after correction for possible baseline confounders. When using a threshold of 2000 IU/ml, the association between viral replication and disease progression was reduced, suggesting that complete viral suppression is essential for nucleoside/nucleotide analogue treatment, especially in patients with cirrhosis.
Efficacy and Safety of Tifacogin (Recombinant Tissue Factor Pathway Inhibitor) in Severe Sepsis
Authors: Edward Abraham, Konrad Reinhart, Steven Opal, Ignace Demeyer, Christopher Doig, Angel López Rodriguez, Richard Beale, Petr Svoboda, Pierre Francois Laterre, Stuart Simon, Bruce Light, Herbert Spapen, Judy Stone, Allan Seibert, Claus Peckelsen, Cathy De Deyne, Russell Postier, Ville Pettilä, Charles L. Sprung, Antonio Artigas, Sandra R. Percell, Vincent Shu, Christian Zwingelstein, Jeffrey Tobias, Lona Poole, James C. Stolzenbach, Abla A. Creasey
Journal: JAMA (2003)

The expression and release of tissue factor is a major trigger for the activation of coagulation in patients with sepsis. Tissue factor pathway inhibitor (TFPI) forms a complex with tissue factor and blood protease factors leading to inhibition of thrombin generation and fibrin formation.To determine if administration of tifacogin (recombinant TFPI) provides mortality benefit in patients with severe sepsis and elevated international normalized ratio (INR) and to assess tifacogin safety in severe sepsis, including patients with low INR.A randomized, double-blind, placebo-controlled, multicenter, phase 3 clinical trial conducted from March 21, 2000, through September 27, 2001, in 245 hospitals in 17 countries in North America, Europe, and Israel.The primary efficacy population consisted of 1754 patients (> or =18 years) with severe sepsis and a high INR (> or =1.2) randomly assigned to intravenous infusion of either tifacogin (0.025 mg/kg per hour for 96 hours, n = 880) or placebo (arginine citrate buffer, n = 874), and 201 patients with a low INR (<1.2) randomly assigned to receive the same dose of either tifacogin or placebo.All-cause 28-day mortality.Overall mortality at 28 days in the tifacogin-treated group (n = 880) vs the placebo group (n = 874) for high INR was 34.2% vs 33.9%, respectively (P =.88, Pearson chi2 test; P =.75, logistic regression model). None of the protocol-specified secondary end points differed between the tifacogin vs placebo groups. An analysis on the first 722 patients demonstrated a mortality rate of 38.9% for placebo vs 29.1% for tifacogin (P =.006, Pearson chi2 test). Tifacogin significantly attenuated prothrombin fragment 1.2 and thrombin:antithrombin complex levels (P<.001, 2-sample t test) in patients with high and low INR. Overall mortality was lower in the tifacogin response in patients with low INR (12%; n = 83) vs placebo (22.9%; n = 118) (P =.051, Pearson chi2 test; P =.03, logistic regression model). There was an increase in serious adverse events with bleeding in the tifacogin group in both cohorts (6.5% tifacogin and 4.8% placebo for high INR; 6.0% tifacogin and 3.3% placebo for low INR).Treatment with tifacogin had no effect on all-cause mortality in patients with severe sepsis and high INR. Tifacogin administration was associated with an increase in risk of bleeding, irrespective of baseline INR.
Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia: population based cohort study
Authors: M. Rebolj, T. Helmerhorst, D. Habbema, C. Looman, R. Boer, J. van Rosmalen, M. van Ballegooijen
Journal: BMJ (2012)

<b>Objective</b> To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result. <b>Design</b> Population based cohort study using data from a nationwide pathology register. <b>Setting</b> The Netherlands, 1994 to 2006. <b>Population</b> 38 956 women with histologically confirmed intraepithelial neoplasia grades 1 to 3 with completed follow-up after treatment. <b>Intervention</b> Routine post-treatment follow-up of cervical intraepithelial neoplasia, recommending smear tests at six, 12, and 24 months. <b>Main outcome measure</b> Incidence of cervical cancer in the period from completed follow-up with negative test results after cervical intraepithelial neoplasia to the next primary test. 10-year hazard ratios were compared with periods after normal results for the primary smear test, adjusted for year in follow-up. <b>Results</b> 20 cervical cancers were diagnosed during 56 956 woman years after completed follow-up of cervical intraepithelial neoplasia, whereas 1613 cervical cancers were diagnosed during 25 020 697 woman years after a normal primary smear test result. The incidence of 35.1 (95% confidence interval 21.4 to 54.2) per 100 000 woman years and 6.4 (6.1 to 6.8) per 100 000 woman years, respectively, led to an adjusted hazard ratio of 4.2 (95% confidence interval 2.7 to 6.5) for periods after completed follow-up compared with periods after normal primary smear test results. This hazard ratio was increased for all ages. No significant difference in risk of cervical cancer was observed by grade of cervical intraepithelial neoplasia. <b>Conclusions</b> An excess risk of cervical cancer previously observed for women treated for cervical intraepithelial neoplasia was also observed in the subgroup of women who completed their post-treatment follow-up with three consecutive normal smear test results. The overall corrected risk of cervical cancer in these women was increased fourfold 35 cases per 100 000 woman years) compared with women with normal primary smear test results (6 per 100 000 woman years).
Macrophage plasma membrane and secretory properties in murine malaria. Effects of Plasmodium yoelii blood-stage infection on macrophages in liver, spleen, and blood.
Authors: S H Lee, P Crocker, S Gordon
Journal: The Journal of Experimental Medicine (1986)

We have studied the effect of infection with the blood-stage of Plasmodium yoelii 17X, a nonlethal parasite, on plasma membrane antigens, receptors, and secretory properties of macrophages (M phi) in murine liver, spleen, and blood. mAb F4/80 (M phi specific), F7/4 (a marker for immature and immunologically activated M phi, as well as neutrophils), and Mac-1, which binds to the type 3 complement receptor, were used to measure the distribution and total content of antigens in situ and to assay surface expression of antigens on M phi isolated by collagenase perfusion-digestion and adherence. We also examined respiratory burst activity after stimulation with PMA, FcR activity, Ia antigen expression, and binding of 125I-mannose-BSA and unopsonized sheep erythrocytes by isolated M phi. In the normal animal, spleen M phi expressed Mac-1 and F7/4 antigens and relatively high levels of respiratory burst activity, in contrast to Kupffer cells in liver, where all three features were virtually absent. The introduction of parasitized erythrocytes into the circulation resulted in a large influx of F4/80+ M phi into the blood, liver, and spleen, where local M phi proliferation could also contribute. Liver M phi during malaria infection showed increased Mac-1 and 7/4 antigen and an increased respiratory burst potential compared with uninfected controls. Increases in total, but not specific activity of FcR, Ia antigen, and binding of unopsonized sheep erythrocytes were found in spleen and liver M phi populations after infection. In both populations, there was an early but persistent marked reduction in specific binding and uptake of 125I-mannose-BSA. These results confirm and extend observations that normal Kupffer cells are relatively homogeneous in morphology, surface markers, and anatomical location, in contrast to M phi in normal spleen, and that both of these populations differ from resident M phi elsewhere, including the peritoneal cavity. In the course of infection by P. yoelii, M phi with high levels of opsonic receptors (CR3, FcR) and respiratory burst potential are mobilized in large numbers at specific sites such as liver and spleen, in accordance with an important role for M phi in the clearance of parasitized erythrocytes from blood.
Low-Salt Diet and Diuretic Effect on Blood Pressure and Organ Damage
Authors: Paolo Manunta, Giuseppe Bianchi
Journal: Journal of the American Society of Nephrology (2004)

This review focuses on some aspects of the complex relationship among dietary salt intake, BP, organ complication, and genetic factors. First, the reason regarding the debate in the effect of a low-salt diet on BP and organ damage is discussed. Certainly, the lack of controlled long-term studies, taken together with the opposite effect of a low-salt diet on cardiovascular risk factors, justifies the contrasting opinions about the opportunity to reduce the sodium (Na) content in the diet of the general population. Second, the contribution that the genetic polymorphisms may furnish to explain the BP response in studies that apply either a moderate or a brisk reduction of salt intake is considered. Finally, the long-term effects of diuretics that produce a decrease in body Na similar to that achieved by moderate long-term dietary salt reduction are examined. Diuretics are able to reduce organ complications in the general population. However, these beneficial effects may be the net results of opposite effects in a subset of patients. Recently, the results of an observational study on hypertensive patients who were treated with a variety of antihypertensive drugs have been published. These results show that in carriers of the 460Trp ADD1 allele (38% of the population), the administration of diuretics halves the incidence of myocardial infarction and stroke when compared with other antihypertensive treatments that produce similar reduction of BP. These data support the notion that matching of the genetic mechanism with the drug mechanisms of action produces a clear therapeutic benefit.
MDM2 SNP309 and TP53 Arg72Pro interact to alter therapy-related acute myeloid leukemia susceptibility
Authors: Nathan A. Ellis, Dezheng Huo, Ozlem Yildiz, Lisa J. Worrillow, Mekhala Banerjee, Michelle M. Le Beau, Richard A. Larson, James M. Allan, Kenan Onel
Journal: Blood (2008)
Screening for Abdominal Aortic Aneurysm: U.S. Preventive Services Task Force Recommendation Statement
Authors: Michael L. LeFevre
Journal: Annals of Internal Medicine (2014)

Update of the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for abdominal aortic aneurysm (AAA).The USPSTF commissioned a systematic review that assessed the evidence on the benefits and harms of screening for AAA and strategies for managing small (3.0 to 5.4 cm) screen-detected AAAs.These recommendations apply to asymptomatic adults aged 50 years or older.The USPSTF recommends 1-time screening for AAA with ultrasonography in men aged 65 to 75 years who have ever smoked. (B recommendation). The USPSTF recommends that clinicians selectively offer screening for AAA in men aged 65 to 75 years who have never smoked. (C recommendation). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for AAA in women aged 65 to 75 years who have ever smoked. (I statement). The USPSTF recommends against routine screening for AAA in women who have never smoked. (D recommendation).
How Preventable Is Bacterial Meningitis?
Authors: John D. Nelson
Journal: New England Journal of Medicine (1982)

When someone falls ill with bacterial meningitis, there is understandable concern among those who live or work with the patient about the contagiousness of the disease. When two or more cases occur in a group of people, concern often increases toward panic. The situation is frequently compounded by conflicting and confusing advice from physicians and public-health officials.Such was the situation in Houston in February 1981 when an unprecedented six cases of meningococcal disease occurred in a single classroom during a six-day period. I remember vividly the nationwide publicity given to the event on television and radio and in the . . .
Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases
Authors: Saad B. Omer, Daniel A. Salmon, Walter A. Orenstein, M. Patricia deHart, Neal Halsey
Journal: New England Journal of Medicine (2009)

Vaccines are among the most effective prevention tools available to clinicians. However, the success of an immunization program depends on high rates of acceptance and coverage. There is evidence of an increase in vaccine refusal in the United States and of geographic clustering of refusals that results in outbreaks. Children with exemptions from school immunization requirements (a measure of vaccine refusal) are at increased risk for measles and pertussis and can infect others who are too young to be vaccinated, cannot be vaccinated for medical reasons, or were vaccinated but did not have a sufficient immunologic response. Clinicians can play a crucial role in parental decision making. Health care providers are cited as the most frequent source of immunization information by parents, including parents of unvaccinated children. Although some clinicians have discontinued or have considered discontinuing their provider relationship with patients who refuse vaccines, the American Academy of Pediatrics Committee on Bioethics advises against this and recommends that clinicians address vaccine refusal by respectfully listening to parental concerns and discussing the risks of nonvaccination.
Late-onset peripheral joint disease in ankylosing spondylitis
Authors: M. D. Cohen, W. W. Ginsburg
Journal: Annals of the Rheumatic Diseases (1982)

We reviewed the records of 150 patients with definite ankylosing spondylitis who had significant peripheral arthritis and were seronegative and found 7 patients who had the onset of peripheral arthritis after their spinal disease became inactive. This late-onset peripheral arthritis may lead to significant joint deformity, and aggressive therapy may be warranted.
Factors related to the diagnostic yield of ultrathin bronchoscope for peripheral pulmonary lesions
Authors: Noelia Cubero de Frutos, Rosa López Lisbona, Lizbeth Pari Espinosa, Daniel Huertas Lamela, Jordi Dorca Sargatal, Antoni Rosell Gratacós
Journal: European Respiratory Journal (2012)

INTRODUCTION:  The global diagnostic yield of peripheral pulmonary lesions (PPL) not candidates for CT-FNA, is 20-80%. Our aim is to evaluate the factors that affect the diagnostic yield of the fluoroscopy guided ultrathin bronchoscope.   MATERIALS:  We performed biopsy and brushing if a lesion was seen and only brushing when it was only detected by fluoroscopy. Bronchial washing (BW) was always sent.   RESULTS:  30 patients were included (77% men) with a mean age of 66 (SD 9). Median size of the PPL was 27 mm. Endobronchial lesion was viewed in 63%: mucosal change (6), tumor (5), compression (7) and secretions (1); in 79% of them a final diagnosis was obtained. The diagnostic yield for malignancy was 37%: adeno (3), squamous (3), NSCLC (2), mesenchymal tumor (1) and atypia (2). BW was diagnostic for malignancy in 23%, brushing in 27% and biopsy in 23%. After multivariate analysis the only significant variable was the presence of endoscopic vision.   CONCLUSIONS:  Fluoroscopy guided ultrathin bronchoscope obtains specific diagnosis in 43% of the patients, 85% of them with endobronchial abnormality. In 42% of patients with an endobronchial abnormality we were not able to reach a diagnosis. In 37% (11/30) of patients we could not see any endobronchial abnormality. Dedicated needles and more accurate methods to locate and reach the PPL are needed.  Funded by FIS  PI09/90917  and SOCAP 2011.
Myocardial kinetics of thallium-201 after dipyridamole infusion in normal canine myocardium and in myocardium distal to a stenosis.
Authors: R D Okada, J A Leppo, C A Boucher, G M Pohost
Journal: Journal of Clinical Investigation (1982)

The purpose of the present study was to define myocardial and blood thallium-201 (Tl-201) kinetics after infusion of dipyridamole in normal canine myocardium and in myocardium distal to a coronary artery stenosis. Miniature radiation detector probes were implanted in the left ventricle in 39 open-chest dogs. A balloon constrictor was placed around the proximal left circumflex coronary artery. Electromagnetic flow probes were positioned proximally around both the left circumflex and left anterior descending coronary arteries. In five control dogs (group 1) the balloon occluder was not inflated; in 12 dogs (group 2) a mild stenosis was created such that resting flow was not reduced, yet the hyperemic response after 10 s of total occlusion was partially attenuated; in nine dogs (group 3) a moderate stenosis was created such that resting flow was not reduced, yet the hyperemic response was completely eliminated; and in 13 dogs (group 4) a severe stenosis was created such that resting flow was reduced. After intravenous dipyridamole (0.08 mg/kg . min-1 x 4 min), 1.5 mCi Tl-201 was injected intravenously and probe counts were collected continuously for 4 h. The mean 4-h fractional myocardial Tl-201 clearance for nonstenotic zones was 0.35, 0.27 for group 2 stenotic zones, 0.19 for group 3 stenotic zones, and 0.05 for group 4 stenotic zones (P less than 0.0001). After reaching peak activity, myocardial Tl-201 activity cleared biexponentially with a final decay constant lambda 2 = 0.0017 +/- 0.0001 min-1 (SE) for nonstenotic zones, 0.0011 +/- 0.0001 min-1 for group 2 stenotic zones, and 0.0006 +/- 0.0001 min-1 for group 3 stenotic zones (P less than 0.01). Group 4 stenotic zone Tl-201 clearances were negligible (decay constant essentially zero). Blood Tl-201 activity decayed triexponentially with a final blood lambda 3 = 0.0018 +/- 0.0001 min-1, which was almost identical to the final myocardial lambda 2 decay constant. Thus, the rate of myocardial Tl-201 clearance can distinguish between coronary stenoses of graded hemodynamic severity. These results may be applicable to quantitative techniques for determining myocardial Tl-201 clearance rates on serial clinical images after dipyridamole administration.
Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy for pancreatic or periampullary tumours: a multicentre randomised trial
Authors: Baki Topal, Steffen Fieuws, Raymond Aerts, Joseph Weerts, Tom Feryn, Geert Roeyen, Claude Bertrand, Catherine Hubert, Marc Janssens, Jean Closset
Journal: The Lancet Oncology (2013)
Non-fatal case of Crimean-Congo haemorrhagic fever imported into the United Kingdom (ex Bulgaria), June 2014
Authors: S Lumley, B Atkinson, S D Dowall, J K Pitman, S Staplehurst, J Busuttil, A J Simpson, E J Aarons, C Petridou, M Nijjar, S Glover, T J Brooks, R Hewson
Journal: Eurosurveillance (2014)

Crimean-Congo haemorrhagic fever (CCHF) was diagnosed in a United Kingdom traveller who returned from Bulgaria in June 2014. The patient developed a moderately severe disease including fever, headaches and petechial rash. CCHF was diagnosed following identification of CCHF virus (CCHFV) RNA in a serum sample taken five days after symptom onset. Sequence analysis of the CCHFV genome showed that the virus clusters within the Europe 1 clade, which includes viruses from eastern Europe.
Azoospermia in familial Mediterranean fever patients:the role of colchicine and amyloidosis
Authors: E. BEN-CHETRIT, R. BACKENROTH, R. HAIMOV-KOCHMAN, G. PIZOV
Journal: Annals of the Rheumatic Diseases (1998)

Familial Mediterranean fever (FMF) is a hereditary disease characterised by recurrent episodes of fever, peritonitis, pleuritis, arthritis or erysipelas-like skin lesions. The disease affects mainly Jews, Armenians, Arabs, and Turks. Typically, the episodes last two to three days and resolve spontaneously.1 One of the main complications of FMF is the development of secondary amyloidosis (AA type). The kidneys are the main target organ involved, leading to chronic renal failure.

Colchicine has been the preferred treatment for FMF since 1972.2 It is effective in suppressing the episodes in more than 90% of the patients and prevents both the development of amyloidosis and the additional deterioration of renal functions in those with early amyloidosis.3 Colchicine exerts its main effect at the cellular level by its interaction with tubulin at the microtubules, inhibiting motility and exostosis of intracellular granules.4 Furthermore, it has also a powerful antimitotic effect by causing metaphase arrest and is capable of arresting meiosis.5 Therefore, in cases of infertility in patients treated with colchicine, it has been …
Effects of school closure on incidence of pandemic influenza in Alberta, Canada
Authors: Beatrice Downie
Journal: Thorax (2012)

This study uses data from the influenza pandemic in Alberta, Canada in 2009 to investigate whether incidence and transmission are affected by weather changes and school closure.

During a 9-month period 35, 510 influenza tests were performed in Alberta, of which 19% tested positive for pandemic H1N1 (pH1N1). Using mathematical transmission modelling, …