tbuckley/cabot-search huggingface dataset:
Dried Blood Spot Real-time Polymerase Chain Reaction Assays to Screen Newborns for Congenital Cytomegalovirus Infection
Authors: Suresh B. Boppana
Journal: JAMA (2010)

Reliable methods to screen newborns for congenital cytomegalovirus (CMV) infection are needed for identification of infants at increased risk of hearing loss. Since dried blood spots (DBS) are routinely collected for metabolic screening from all newborns in the United States, there has been interest in using DBS polymerase chain reaction (PCR)-based methods for newborn CMV screening.To determine the diagnostic accuracy of DBS real-time PCR assays for newborn CMV screening.Between March 2007 and May 2008, infants born at 7 US medical centers had saliva specimens tested by rapid culture for early antigen fluorescent foci. Results of saliva rapid culture were compared with a single-primer (March 2007-December 2007) and a 2-primer DBS real-time PCR (January 2008-May 2008). Infants whose specimens screened positive on rapid culture or PCR had congenital infection confirmed by the reference standard method with rapid culture testing on saliva or urine.Sensitivity, specificity, and positive and negative likelihood ratios (LRs) of single-primer and 2-primer DBS real-time PCR assays for identifying infants with confirmed congenital CMV infection.Congenital CMV infection was confirmed in 92 of 20,448 (0.45%; 95% confidence interval [CI], 0.36%-0.55%) infants. Ninety-one of 92 infants had positive results on saliva rapid culture. Of the 11,422 infants screened using the single-primer DBS PCR, 17 of 60 (28%) infants had positive results with this assay, whereas, among the 9026 infants screened using the 2-primer DBS PCR, 11 of 32 (34%) screened positive. The single-primer DBS PCR identified congenital CMV infection with a sensitivity of 28.3% (95% CI, 17.4%-41.4%), specificity of 99.9% (95% CI, 99.9%-100%), positive LR of 803.7 (95% CI, 278.7-2317.9), and negative LR of 0.7 (95% CI, 0.6-0.8). The positive and negative predictive values of the single-primer DBS PCR were 80.9% (95% CI, 58.1%-94.5%) and 99.6% (95% CI, 99.5%-99.7%), respectively. The 2-primer DBS PCR assay identified infants with congenital CMV infection with a sensitivity of 34.4% (95% CI, 18.6%-53.2%), specificity of 99.9% (95% CI, 99.9%-100.0%), positive LR of 3088.9 (95% CI, 410.8-23 226.7), and negative LR of 0.7 (95% CI, 0.5-0.8). The positive and negative predictive values of the 2-primer DBS PCR were 91.7% (95% CI, 61.5%-99.8%) and 99.8% (95% CI, 99.6%-99.9%), respectively.Among newborns, CMV testing with DBS real-time PCR compared with saliva rapid culture had low sensitivity, limiting its value as a screening test.
The Search for Replacements for Unfractionated Heparin
Authors: Elliott M. Antman
Journal: Circulation (2001)

A ntithrombotic therapy is central to the management of patients presenting with an acute coronary syndrome (ACS).In addition to powerful new antiplatelet therapies, multiple agents capable of inhibiting thrombin are now available to clinicians (Figure).Although familiar to the vast majority of clinicians, unfractionated heparin (UFH) has the disadvantages of a variable anticoagulant effect (necessitating frequent monitoring of the activated partial thromboplastin time [aPTT]), sensitivity to platelet factor 4, a relative inability to inhibit clot-bound thrombin, and the potential to cause thrombocytopenia and the heparin-induced thrombocytopenia syndrome (HITS).Novel pharmacological regimens most extensively investigated in clinical trials as alternatives to UFH include the direct antithrombins and the low-molecular-weight heparins (LMWHs). 1 Direct AntithrombinsDirect antithrombins inhibit thrombin without requiring the cofactor antithrombin.All of the direct antithrombins exhibit a concentration-dependent anticoagulant effect.In vitro observations have identified some differences among the agents (eg, binding characteristics to thrombin, ability to inhibit generation of thrombin), but it is unclear whether such differences have any important impact on their clinical use.Because clot-bound thrombin is less effectively inhibited by UFH (because attachment of fibrin to the fibrin-binding domain makes the heparin-binding domain inaccessible), it was proposed that the direct antithrombins had an advantage over UFH because of their greater ability to block both fluid-phase and clot-bound thrombin.This "thrombin hypothesis" was the inspiration for several randomized trials.After the TIMI 9A, GUSTO IIa, and HIT 3 trials, which tested hirudin as an adjunct to fibrinolytic therapy, were terminated prematurely, the doses of both hirudin and UFH were reduced and the TIMI 9B 2 , GUSTO IIb, 3 and HIT 4 4 trials were undertaken.Pooled data from GUSTO IIb and TIMI 9B showed that hirudin was more effective at achieving and maintaining the target aPTT range.By careful adjustment of the doses of both hirudin and UFH, major bleeding could be reduced.There was no difference in mortality, however, in UFH-versus hirudin-treated patients; there was a 14% reduction in reinfarction by 30 days in patients treated with hirudin. 5A post hoc analysis of the GUSTO IIb data
INNOCENT TUMOURS OF THE BREAST
Authors: W. S. Handley
Journal: BMJ (1938)

Unless the diagnosis is certain and the tumour of very moderate size, the removal of a benign swelling of the breast should not be undertaken as an exercise in minor surgery.While in some cases, as in the mobile fibro- adenoma of the young woman in her twenties, the lump may be unquestionably innocent, in a woman over 40 a clinically similar lump may prove to be a mobile carci- *~~~-.F5ag
On Losing Your Humanity
Authors: Katelyn Dow Stepanyan
Journal: Annals of Internal Medicine (2015)

On Being a Doctor15 September 2015On Losing Your HumanityKatelyn Dow Stepanyan, MS, MDKatelyn Dow Stepanyan, MS, MDFrom University of California, Los Angeles, Los Angeles, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0731 Audio Reading - “On Losing Your Humanity” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "On Losing Your Humanity," by K.D. Stepanyan. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail It was the beginning of my first year of medical school. The emergency physician whom I would be shadowing walked abruptly into his office, accompanied by the faint smell of coffee and antiseptic. He sat down across from me with his hands folded on his lap, somber and appearing somewhat tired. His thick, gray eyebrows were raised and furrowed, creating an expression of both interest and skepticism.He didn't introduce himself or ask me any questions. Instead, he said, “Let me give you one piece of advice as you start medical school.”My muscles tensed slightly as I straightened up ... Author, Article, and Disclosure InformationAffiliations: From University of California, Los Angeles, Los Angeles, California.Corresponding Author: Katelyn Dow Stepanyan, MS, MD, 3260 Sawtelle Boulevard, Apartment 205, Los Angeles, CA 90066; e-mail, [email protected]ucla.edu. PreviousarticleNextarticle Advertisement Audio Reading - “On Losing Your Humanity” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "On Losing Your Humanity," by K.D. Stepanyan. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 15 September 2015Volume 163, Issue 6Page: 479-480KeywordsEmergency departmentEmotionsMuscular dystrophiesPersonalityResidencyShouldersSmellSweatThoraxVital signs ePublished: 15 September 2015 Issue Published: 15 September 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Battle Against Tobacco
Authors: J. Stjernsward
Journal: JNCI Journal of the National Cancer Institute (1989)

The increase in the number of tobacco-caused deaths over the last 50 years is one of the most tragic developments in the modern history of medicine. The most common cancers globally are stomach cancer, with 669,400 cases diagnosed each year, and lung cancer with 660,500 new cases yearly (/). Those rates are not stable, however; lung cancer is actually overtaking gastric cancer. This is the situation for a mainly self-induced, avoidable—in other words, preventable—disease. To win the war against cancer, we must first win the battle against tobacco. A study of cancer mortality trends between 1960 and 1980 in 28 industrialized countries, conducted by the United Nations' World Health Organization (WHO), showed that the age-adjusted mortality rate for men increased by 19% in that period. Lung cancer mortality increased by 76% for men and 135% for women (2). Over the last 20 years, mortality rates from lung cancer in women increased more than 100% in Japan, Norway, Poland, Sweden, and the United Kingdom; more than 200% in Australia, Denmark, and New Zealand; and more than 300% in Canada and the United States (3). A WHO survey of smoking prevalence between 1975 and 1986 in 65 countries showed that, of the 30 countries with the highest rates, 21 were  and nine were  nations. It is estimated that one of three males above the age of 15 smokes cigarettes in developed countries, and one of two in developing countries. The rates for females are lower, but they are rising rapidly in developing countries. For years to come, cancer mortality is expected to increase in nearly all regions of the world, owing to a general increase in the age of the populations and an increasing use of tobacco. Cancer incidence is increasing globally, in spite of the enormous body of knowledge accumulated in cancer control over the last 40 years. The earlier-mentioned WHO analyses revealed the limited impact of treatment on overall mortality from common cancers and, consequently, the urgent need for strengthening preventive measures, especially tobacco control. Nothing would have greater impact today on cancer worldwide than the effective application of current knowledge about cancer control. Existing knowledge is best implemented through national programs that set the right priorities and strategies for use of available resources (4). Methods have already been
Postmortem assessment of chronic airways obstruction by tantalum bronchography.
Authors: K W Scott, G M Steiner
Journal: Thorax (1975)

Tantalum bronchography was performed on 22 left lungs obtained at necropsy. Seven were from patients dying in cor pulmonale as a result of chronic airways obstruction and 15 were from unselected necropsies. Of the latter group, nine had no evidence of respiratory disease and six had pathological changes of emphysema and bronchial mucous gland enlargement when the lungs were examined following formalin fixation. A range of changes in the bronchographic appearances from the normal to the groosly abnormal is illustrated. The main changes in severely diseases lungs were: irregularity of the bronchial walls, failure of the walls to taper towards the periphery, areas of narrowing and dilatation, and 'pooling' of tantalum at the ends of airways. A count was made of the numbers of small airway branches in the most distal 4 cm of the lung and also of the number of airways of less than 1 mm in diameter. Patients dying in cor pulmonale had a significantly reduced total number of patent small airways in the area measured and also fewer patent airways of less than 1 mm diameter compared to both the other groups. Histological study of four of the lungs in greater detail revealed that the reduction in small airways filling was the result of a combination of obliteration and obstruction of the lumen by pus. Tantalum bronchography provides a good indication of the state of the bronchial tree at the time of death, and the changes seen are the result of both acute and chronic disease processes.
Afatinib versus placebo for patients with advanced, metastatic non-small-cell lung cancer after failure of erlotinib, gefitinib, or both, and one or two lines of chemotherapy (LUX-Lung 1): a phase 2b/3 randomised trial
Authors: Vincent A Miller, Vera Hirsh, Jacques Cadranel, Yuh-Min Chen, Keunchil Park, Sang-We Kim, Caicun Zhou, Wu-Chou Su, Mengzhao Wang, Yan Sun, Dae Seog Heo, Lucio Crino, Eng-Huat Tan, Tsu-Yi Chao, Mehdi Shahidi, Xiuyu Julie Cong, Robert M Lorence, James Chih-Hsin Yang
Journal: The Lancet Oncology (2012)
Optimized basal-bolus therapy using a fixed mixture of 75% lispro and 25% NPL insulin in type 1 diabetes patients: no favorable effects on glycemic control, physiological responses to hypoglycemia, well-being, or treatment satisfaction
Authors: M M Janssen, F J Snoek, N Masurel, R P Hoogma, W L Devillé, C Popp-Snijders, R J Heine
Journal: Diabetes Care (2000)

To investigate the effects of a multiple injection regimen with a mixture of 75% lispro and 25% intermediate-acting insulin (lispro high mixture [HM]) before meals on glycemic control, physiological responses to hypoglycemia, well-being, and treatment satisfaction.We studied 35 type 1 diabetes patients. After an 8- to 10-week lead-in period, patients were randomized to HM or human regular insulin therapy for 12-14 weeks. During the lead-in and treatment periods, HbA1c levels and hypoglycemic frequencies were measured, and patients completed the Well-Being Questionnaire and the Diabetes Treatment Satisfaction Questionnaire. In 19 patients, responses to hypoglycemia were tested during stepped euglycemic-hypoglycemic clamps.HM treatment improved postprandial glycemia but had no effect on HbA1c, frequency of hypoglycemia, well-being, or treatment satisfaction. During experimental hypoglycemia, HM therapy was associated with a slightly lower total adrenaline response and a higher autonomic symptom threshold (i.e., the autonomic symptom response occurred at a lower blood glucose level) than human regular insulin therapy. We speculate that this effect resulted from an accumulation of insulin during the night.Multiple injection therapy with HM rather than human regular insulin before meals does not offer advantages regarding glycemic control, frequency of hypoglycemia, well-being, or treatment satisfaction. In addition, this regimen causes an attenuation of the adrenaline and autonomic symptom responses to hypoglycemia.
Crowdfunding genomics and bioinformatics
Authors: Pamela Cameron, David W Corne, Christopher E Mason, Jeffrey Rosenfeld
Journal: Genome biology (2013)

Online crowdfunding websites such as RocketHub, Indiegogo and Kickstarter have financed an increasingly eclectic variety of initiatives: multimillion dollar movie projects attached to big Hollywood names, music and book publishing, gadget development, a hoodie that lasts ten years.Controversially, one crowdfunding campaign aimed to raise funds for a drug dealer, who it was thought might be persuaded to hand over compromising video footage of a prominent politician in exchange for the cash.Recently, a number of scientists have sought to use crowdfunding as a means to bypass traditional funding routes when budgeting for new projects.In doing so, they are expanding on the concept of citizen science from crowd participation to crowdfunding.As is the traditional crowdfunding method, these scientists hope to attract funding using two main incentives: (1) the desire by the
Interferon-γ and Interleukin-10 Gene Polymorphisms in Pulmonary Tuberculosis
Authors: Dolores López-Maderuelo, Francisco Arnalich, Rocio Serantes, Alicia González, Rosa Codoceo, Rosario Madero, Juan J. Vázquez, Carmen Montiel
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Several genes coding for different cytokines may affect host susceptibility to tuberculosis. This study investigates the relationship of the single base change polymorphic variants identified in the first intron of interferon-γ (+874 T/A) and in the promoter region of interleukin-10 gene (−1,082 G/A), with cytokine production by peripheral blood mononuclear cells and tuberculosis susceptibility. We studied a Spanish population of 113 patients with culture-proven pulmonary tuberculosis, 207 healthy close contacts (125 tuberculin reactive and 82 tuberculin negative), and 100 healthy tuberculin-negative control subjects. Multiple logistic regression analysis showed that individuals homozygous for the interferon-γ (+874) A allele had a 3.75-fold increased risk of developing tuberculosis (95% confidence interval, 2.26–6.23, p = 0.0017). Stimulated production of interferon-γ by peripheral mononuclear cells from patients with genotype AA was depressed compared with that of non-AA homozygotes at the time of diagnosis and after completion of therapy. Multivariate analysis showed that the presence of an AA genotype and the absolute number of lymphocytes were the only independent predictors of interferon-γ production. In contrast, the different rates of interleukin-10 production associated with the interleukin-10 polymorphism did not affect susceptibility to tuberculosis. Thus, a genetic defect in the production of interferon-γ in individuals homozygous for the (+874) A allele could contribute to their increased risk of developing tuberculosis.
Breathing pattern and gas exchange at peak exercise in COPD patients with and without tidal flow limitation at rest
Authors: O. Díaz, C. Villafranca, H. Ghezzo, G. Borzone, A. Leiva, J. Milic-Emili, C. Lisboa
Journal: European Respiratory Journal (2001)

Expiratory flow limitation (FL) at rest is frequently present in chronic obstructive pulmonary disease (COPD) patients. It promotes dynamic hyperinflation with a consequent decrease in inspiratory capacity (IC). Since in COPD resting IC is strongly correlated with exercise tolerance, this study hypothesized that this is due to limitation of the maximal tidal volume ( V T,max ) during exercise by the reduced IC. The present study investigated the role of tidal FL at rest on: 1) the relationship of resting IC to V T,max ; and 2) on gas exchange during peak exercise in COPD patients. Fifty-two stable COPD patients were studied at rest, using the negative expiratory pressure technique to assess the presence of FL, and during incremental symptom-limited cycling exercise to evaluate exercise performance. At rest, FL was present in 29 patients. In the 52 patients, a close relationship of V T,max to IC was found using non-normalized values (r=0.77; p&lt;0.0001), and stepwise regression analysis selected IC as the only significant predictor of V T,max . Subgroup analysis showed that this was also the case for patients both with and without FL (r=0.70 and 0.76, respectively). In addition, in FL patients there was an increase (p&lt;0.002) in arterial carbon dioxide partial pressure at peak exercise, mainly due to a relatively low V T,max and consequent increase in the physiological dead space ( V D )/ V T ratio. The arterial oxygen partial pressure also decreased at peak exercise in the FL patients (p&lt;0.05). In conclusion, in chronic obstructive pulmonary disease patients the maximal tidal volume, and hence maximal oxygen consumption, are closely related to the reduced inspiratory capacity. The flow limited patients also exhibit a significant increase in arterial carbon dioxide partial pressure and a decrease in arterial oxygen partial pressure during peak exercise.
THE CYTOLOGY OF RICKETTSIAE
Authors: Hans Ris, John P. Fox
Journal: The Journal of Experimental Medicine (1949)

Internal structures of rickettsiae seen with phase contrast microscopy and in the electron microscope contain desoxyribonucleic acid and are therefore nuclear structures similar to those found in bacteria. They are minute spherical bodies, either single as in spherical rickettsiae or varying in number from 2 to 4 in rod-shaped forms. Occasional dumbbell-shaped chromatinic bodies are thought to represent these structures in the process of division. The presence of ribonucleic acid in the cytoplasm of rickettsiae was demonstrated with the use of ribonuclease and basic dyes. Rickettsiae therefore have a cellular organization similar to that of certain bacteria, with a clear differentiation into nuclear structure and cytoplasm.
Dissection of the Peripheral Motion Channel in the Visual System of Drosophila melanogaster
Authors: Jens Rister, Dennis Pauls, Bettina Schnell, Chun-Yuan Ting, Chi-Hon Lee, Irina Sinakevitch, Javier Morante, Nicholas J. Strausfeld, Kei Ito, Martin Heisenberg
Journal: Neuron (2007)
Serotonin transporter overexpression is responsible for pulmonary artery smooth muscle hyperplasia in primary pulmonary hypertension
Authors: Saadia Eddahibi, Marc Humbert, Elie Fadel, Bernadette Raffestin, Michèle Darmon, Frédérique Capron, Gerald Simonneau, Philippe Dartevelle, Michel Hamon, Serge Adnot
Journal: Journal of Clinical Investigation (2001)

Hyperplasia of pulmonary artery smooth muscle cells (PA-SMCs) is a hallmark pathological feature of primary pulmonary hypertension (PPH). Here we found that PA-SMCs from patients with PPH grow faster than PA-SMCs from controls when stimulated by serotonin or serum and that these effects are due to increased expression of the serotonin transporter (5-HTT), which mediates internalization of indoleamine. In the presence of 5-HTT inhibitors, the growth stimulatory effects of serum and serotonin were markedly reduced and the difference between growth of PA-SMCs from patients and controls was no longer observed. As compared with controls, the expression of 5-HTT was increased in cultured PA-SMCs as well as in platelets and lungs from patients with PPH where it predominated in the media of thickened pulmonary arteries and in onion-bulb lesions. The L-allelic variant of the 5HTT gene promoter, which is associated with 5-HTT overexpression and increased PA-SMC growth, was present in homozygous form in 65% of patients but in only 27% of controls. We conclude that 5-HTT activity plays a key role in the pathogenesis of PA-SMC proliferation in PPH and that a 5HTT polymorphism confers susceptibility to PPH.
Forecasting the presence of atmospheric pollens
Authors: YRJÖ MÄKINEN
Journal: Allergy (1985)

The forecasting process includes several aspects. The scientific aspects include (i) a priori observations, like statistics of weather attributes during recent years, variation of earlier atmospheric pollen amounts, and general correlations between weather factors and pollen frequencies. (ii) The present-day observations are made closer to the flowering season, and they include e.g. the development of the present and forecasted weather, the development of the flower buds, and information obtained from other countries. The practical aspects include effective television, radio and newspaper service, necessary education and information, rapid data analysis and transfer systems, and good national and international cooperation.