tbuckley/cabot-search huggingface dataset:
Clinical profile and surgical outcome for pulmonary aspergilloma: Nine year retrospective observational study in a tertiary care hospital
Authors: Mubashir Ali Khan, Abdul Majeed Dar, Nadeem Ulnazeer Kawoosa, Abdul Gani Ahangar, Ghulam Nabi Lone, Gulnaz Bashir, Mohammad Akbar Bhat, Shyam Singh
Journal: International Journal of Surgery (2011)
Prognostic Value of Lymphogenic Micrometastasis of Patients with Breast Carcinoma: A Multicenter Cohort Study.
Authors: P. Gobardhan, E. Madsen, S. Elias, B. van Wely, F. van den Wildenberg, E. Theunissen, M. Ernst, C. van der Pol, I. Borel Rinkes, J. Wijsman, W. Vles, P. de Hooge, H. Ruitenberg, C. Perre, T. van Dalen
Journal: Cancer Research (2009)

Abstract Introduction: Since the introduction of sentinel lymph node biopsy (SLNB) for staging breast cancer, lymphogenic micrometastases are commonly detected. The prognostic meaning of these small lymph node metastases and the consequences regarding the indication for adjuvant systemic treatment is under debate. Currently, robust data with a long time follow up are lacking.Method: Between January 2000 and December 2002 1411 patients with a cT1-2N0 breast carcinoma underwent surgery in seven hospitals in the Netherlands. Pathological examination of the sentinel node consisted of serial sectioning of SLN's and H&amp;E and IHC staining. Based on the presence of lymph node metastases patients where divided into four groups: pN0 (n = 922), pN1micro (n = 103), pN1a (n = 285) and pN≥1b (n = 101). Median follow up was 77 months.Results: At the end of follow-up 184 (13.0%) patients had died. Breast cancer recurred in 244 (17.3%) patients, 165 of them having distant metastases (11.7%) patients. The 5- years overall survival was 93% for patients with pN0 disease, 94% for pN1micro, 88% for pN1a and 78% for pN≥1b (p &amp;lt; 0.001). The 5-years disease free survival was 87%, 90%, 85% and 72% (p &amp;lt; 0.001) respectively.Following adjustment for possible confounding characteristics and for adjuvant systemic treatment, overall survival was similar for pN0 en pN1micro patients and significantly worse for pN1a and pN≥1b (HR 1.18; 95% CI 0.58-2.39, HR 2.47; 95% CI 1.69-3.63, HR 4.36; 95% CI 2.70-7.04 respectively). Disease free survival was similar too in the pN0 and pN1micro group, and worse for pN1a and pN≥1b (HR 0.96; 95% CI 0.56-1.67 vs. HR 1.64; 95% CI 1.19-2.27, HR 2.95; CI 1.98-4.42). Distant metastases were more commonly observed in the pN1micro group than in the pN0 group (HR 1.22; 95% CI 0.60-2.49), but not significantly and far less than in the pN1a and pN≥1b group (HR 2.26; 95% CI 1.49-3.40, HR 3.49; 95% CI 2.12-5.77).Conclusion: After a relative long time of follow up disease free and overall survival for patients with micrometastasis in SLNs is comparable to patients without lymphogenic metastasis and more favourable than patients with macrometastasis. The presence of micrometastatic disease in the SLN is in itself not an indication for adjuvant systemic therapy. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 307.
Surveillance trends of the 2009 influenza A(H1N1) pandemic in Europe
Authors: A Amato-Gauci, P Zucs, R Snacken, B Ciancio, V Lopez, E Broberg, P Penttinen, A Nicoll, collective on behalf of the European Influenza
Journal: Eurosurveillance (2011)

We describe the epidemiology and virology of the official length of the 2009 pandemic (68 weeks from April 2009 to August 2010) in the 27 European Union Member States plus Norway and Iceland. The main trends are derived from published literature as well as the analysis and interpretation of data provided to the European Centre for Disease Prevention and Control (ECDC) through the European Influenza Surveillance Network (EISN) and data collected by the ECDC itself. The 2009 influenza A(H1N1) pandemic started in Europe around week 16 of 2009 (although the World Health Organization (WHO) declared only in week 18). It progressed into an initial spring/summer wave of transmission that occurred in most countries, but was striking only in a few, notably the United Kingdom. During the summer, transmission briefly subsided but then escalated again in early autumn, just after the re-opening of the schools. This wave affected all countries, and was brief but intense in most, lasting about 14 weeks. It was accompanied by a similar but slightly delayed wave of hospitalisations and deaths. By the time the WHO declared the pandemic officially over in August 2010 (week 32), Europe had experienced transmission at low level for about 34 weeks.
MATERNALLY INDUCED TRANSPLANTATION IMMUNITY, TOLERANCE, AND RUNT DISEASE IN RATS
Authors: Alan E. Beer, R. E. Billingham, S. L. Yang
Journal: The Journal of Experimental Medicine (1972)

A previous report that the offspring of outbred Sprague-Dawley rats, born of mothers presensitized or tolerant with respect to tissue antigens of the Lewis strain, and reinoculated with Lewis cells during their pregnancy, reject test grafts of Lewis skin in an accelerated manner has been confirmed. This "maternally induced" alteration in reactivity of the progeny has been found to be long lasting, immunologically specific, and probably not due to transfer of humoral antibody. It has been established that the reexposure of the mothers to donor cellular antigen during pregnancy augmented the influence of the prior states of tolerance or sensitivity. To obviate the complications inherent in working with the outbred Sprague-Dawley rats, the key experiments summarized above were repeated with isogenic Fischer rats as parents and Lewis rats as the tissue donors as before. With this combination it was found that a state of prior sensitization or tolerance in the mothers resulted in the apparent induction of tolerance in some of their progeny. Reinoculation of either the tolerant or sensitized mothers during pregnancy slightly increased the incidence and degree of impairment of their offsprings' capacity to reject Lewis skin grafts. A single intraperitoneal injection of 100 x 106 million Lewis lymphoid cells into normal Fischer rats in the 14th–16th day of pregnancy also weakened the reactivity of their progeny to Lewis test grafts. Further to test the premise that this weakened reactivity might be due to maternal induction of tolerance, by antenatal transmission of alien cells, the lymphohematopoietic tissue system of adult Fischer females was replaced by that from Lewis donors with the aid of cyclophosphamide. It was anticipated that when these animals were mated with Fischer males, sufficient Lewis leukocytes might cross the placentas to induce high degrees of tolerance. Although normal sized healthy litters were born, about 50% of the infants succumbed to graft-versus-host (GVH) or runt disease within 40 days, many of them giving evidence of being tolerant of Lewis grafts. The mothers, too, developed chronic GVH disease. The offspring of Fischer females made chimeric with cells from (Fischer x Lewis)F1 hybrid donors, as well as their mothers, remained healthy. Intraperitoneal injection of normal Fischer females, in the 15th–17th day of pregnancy, with 100 million lymphoid cells from specifically sensitized Lewis rats, also caused fatal runt disease to develop in about 50% of their offspring, but left the mothers unscathed. Taken together, these various findings indicate that in some genetic contexts at least the extent of the natural surreptitious transplacental cellular traffic can be considerably augmented experimentally, though how this comes about and why lymphocytic cells that are foreign to the mother can apparently gain access to fetuses more readily than her own cells remain to be determined.
Emergency Preparedness and Public Health
Authors: Tia Powell, Dan Hanfling, Lawrence O. Gostin
Journal: JAMA (2012)

When Hurricane Sandy hit downtown Manhattan, three neighboring hospitals each made different decisions about when to evacuate. Across the metro region, more than five hospitals and over 20 nursing and assisted living facilities were evacuated, making this the central public health challenge of this calamitous event. It is a familiar story — a super storm comes ashore, infrastructure is overwhelmed, and healthcare facilities evacuate patients, with major delays in returning to normal functioning. Afterwards, policy makers evaluate lessons learned for the next disaster, but similar missteps are often repeated.Although not identical, it is instructive to compare Hurricane Katrina with the still unfolding events of Sandy. Unlike in Katrina, New York hospitals had more detailed emergency plans. What seemed to be missing, however, were clear and consistent criteria to guide evacuation decisions. Evacuation decisions are complex — a decision to evacuate prematurely places patients at risk, while waiting too long can have devastating consequences. Public officials, in collaboration with facilities, should decide whether to shelter in place or risk transfer of fragile patients. Governors should consider early emergency declarations, including request for a formal “public health emergency declaration”, to reduce legal concerns and regulatory constraints. Federal, state, and municipal authorities can better prepare for the next disaster and have a duty to do so.
Effectiveness of JUMP-in, a Dutch primary school-based community intervention aimed at the promotion of physical activity
Authors: Judith S B de Meij, Mai J M Chinapaw, Maartje M van Stralen, Marcel F van der Wal, Lotte van Dieren, Willem van Mechelen
Journal: British Journal of Sports Medicine (2010)

The aim of the present study was to investigate the effect of the JUMP-in programme on sports participation, overall physical activity (PA), shuttle run score and body composition in 6-12-year-old children.JUMP-in is a school-based strategy combining environmental policy, neighbourhood, parents- and personal components. A controlled trial was carried out in 19 primary schools including 2848 children (50% boys). Measures were performed at the beginning of the first school year (T0: 2006) and repeated at the end of the first (T1: 2007) and second school year (T2: 2008).A significant beneficial intervention effect was found on organised sports participation (OR 2.8 (2.2 to 3.6)). Effects were stronger for girls (OR 3.6 (2.3 to 5.6)), and for Moroccan (OR 4.2 (3.6 to 5.7)) and Turkish children (OR 3.2 (1.9 to 5.2)). Participation in organised sports was associated with increased shuttle run score. No significant intervention effects on overall daily PA rates and body composition were observed.The present study proves that a school-based strategy combining environmental and personal interventions was successful in improving structural sports participation among children.
Diabetes, Insulin Resistance, and the Metabolic Syndrome in Patients With Acute Myocardial Infarction Without Previously Known Diabetes
Authors: Åke Tenerz, Anna Norhammar, Angela Silveira, Anders Hamsten, Göran Nilsson, Lars Rydén, Klas Malmberg
Journal: Diabetes Care (2003)

OBJECTIVE—Individuals with diabetes have an increased morbidity from acute myocardial infarction (AMI). Based on an oral glucose tolerance test (OGTT), 40–45% of patients with AMI have diabetes. The objective of this study was to characterize the glucometabolic profile of patients with AMI without known diabetes and to see if sustained glucometabolic perturbations are predictable during the hospital phase of the disease. RESEARCH DESIGN AND METHODS—A total of 145 patients with AMI and no previous diagnosis of diabetes were subjected to an OGTT at hospital discharge and 3 months thereafter. Based on the OGTT after 3 months, they were defined as having normal glucose tolerance (NGT; n = 50), impaired glucose tolerance (IGT; n = 59), or diabetes (n = 36). Components of the metabolic syndrome, including insulin resistance assessed by homeostasis model assessment (HOMA-IR), were recorded. RESULTS—Patients with AMI had no changes in insulin resistance from hospital discharge to follow-up. An OGTT and/or a single blood glucose taken 60 min (BG-60) after ingestion of 75 g glucose at hospital discharge were predictors of the outcome of the OGTT at follow-up. With a cutoff value for BG-60 of 8.6 mmol/l, 70% of the patients were correctly predicted as either belonging to the NGT group or the IGT/diabetes group after 3 months. Age, BMI, antihypertensive treatment, HbA1c, fasting blood glucose, blood lipids, insulin, proinsulin, HOMA-IR, and plasminogen activator inhibitor 1 did not add predictive power. CONCLUSIONS—Patients with AMI and no previous diagnosis of diabetes have no changes in insulin resistance from hospital discharge to a 3-month follow-up. An OGTT or a single BG-60 performed at hospital discharge predicts the diagnosis of IGT or diabetes 3 months thereafter.
Where expert witnesses fear to tread
Authors: M E Jan Wise
Journal: BMJ (2006)

Since 1997 the environment for expert witnesses in the United Kingdom has been increasingly hostile. This is partly because the UK has taken longer to tackle the issue of experts tending to favour the party instructing them. Unfortunately the calm thinking required to examine the merits of differing systems of ensuring impartial advice, which started in the late 1990s, has more recently been clouded by the emotive issues of child protection. The case of Roy Meadow exemplifies the problem—and now may have prompted a series of solutions.
Minimally invasive surgery for lumbar spinal stenosis
Authors: W. A. Moojen, W. C. Peul
Journal: BMJ (2015)

As good as open laminectomy, but no better 

Recent trends in spine surgery, such as endoscopic and other “micro” techniques, promised less invasive procedures and better outcomes compared with conventional open techniques for decompressing nerves. Minimally invasive techniques are popular with patients, promoted by industry, and increasingly used by surgeons.1 However, recent studies have failed to report any clear benefits for patients.2 Is our hunger for new techniques based on little more than a gut feeling that new and smaller is always better and, if so, is it ethically justifiable to “test” these new techniques on patients? In a linked paper (doi:10.1136/bmj.h1603) Nerland and colleagues provide some hard evidence to help inform these important debates.3

Their study compares the “old” standard surgical treatment for spinal stenosis (open laminectomy) with a newer and less invasive alternative (microdecompression). Microdecompression is a procedure to decompress the lumbar nerves by removing a minimal amount of bone and the ligamentum flavum but leaving the spinous process and the supraspinous and interspinous ligaments intact. The authors analyse data from a large, well organised and comprehensive national registry in Norway (the Norwegian Registry for Spine Surgery, NORspine). Thirty …
Subtypes of pancreatic ductal adenocarcinoma and their differing responses to therapy
Authors: Eric A Collisson, Anguraj Sadanandam, Peter Olson, William J Gibb, Morgan Truitt, Shenda Gu, Janine Cooc, Jennifer Weinkle, Grace E Kim, Lakshmi Jakkula, Heidi S Feiler, Andrew H Ko, Adam B Olshen, Kathleen L Danenberg, Margaret A Tempero, Paul T Spellman, Douglas Hanahan, Joe W Gray
Journal: Nature Medicine (2011)
Length of Stay and Costs for Hospitalized Hemodialysis Patients
Authors: ABHIJIT V. KSHIRSAGAR, SUSAN L. HOGAN, LARRY MANDELKEHR, RONALD J. FALK
Journal: Journal of the American Society of Nephrology (2000)

The high cost of hospitalization for hemodialysis patients has become a major health care issue. To address this issue, length of hospital stay and costs for these patients were compared with services covered by nephrologists and services covered by internists. Hemodialysis patients (n = 161) were prospectively admitted 219 times on alternate days to services covered by nephrologists or by internists from July 1995 to March 1996. Admissions to nonmedical services and admissions for overnight observation were excluded. Length of stay, costs, and risk-adjusted predicted length of stay and costs, as well as the number of consultations were compared between services, using Wilcoxon rank sum tests. Readmissions and deaths were compared using chi(2) tests. Mean length of stay for admissions to the nephrology service (n = 114) was 6.3 days compared with 8.1 days for admissions to internal medicine services (n = 105) (P = 0.017). The predicted length of stay was similar. Mean overall cost for admissions under the care of nephrologists was $7,925 versus $10,773 under the care of internists (P = 0.101). The internal medicine service averaged 1.5 consultations versus 0.5 consultations for the nephrology service (P = 0.001). The risk of readmission was 24% for nephrologists and 30% for internists (P = 0.328). Death within 90 days of discharge was 12% for the nephrology group and 22% for the internal medicine group (P = 0.07). The length of stay was significantly shorter for hemodialysis patients under the care of nephrologists compared with internists. The average total costs and risk of readmissions tended to be lower for nephrologists. If these results are corroborated, the care of hemodialysis patients by the nephrologist could diminish the overall expense of the ESRD program.
Expression of CYP1A1 and CYP1B1 in human endothelial cells: regulation by fluid shear stress
Authors: Daniel E. Conway, Yumiko Sakurai, Daiana Weiss, J. David Vega, W. Robert Taylor, Hanjoong Jo, Suzanne G. Eskin, Craig B. Marcus, Larry V. McIntire
Journal: Cardiovascular Research (2009)

CYP1A1 and CYP1B1, members of the cytochrome P450 protein family, are regulated by fluid shear stress. This study describes the effects of duration, magnitude and pattern of shear stress on CYP1A1 and CYP1B1 expressions in human endothelial cells, towards the goal of understanding the role(s) of these genes in pro-atherogenic or anti-atherogenic endothelial cell functions.We investigated CYP1A1 and CYP1B1 expressions under different durations, levels, and patterns of shear stress. CYP1A1 and CYP1B1 mRNA, protein, and enzymatic activity were maximally up-regulated at > or =24 h of arterial levels of shear stress (15-25 dynes/cm2). Expression of both genes was significantly attenuated by reversing shear stress when compared with 15 dynes/cm2 steady shear stress. Small interfering RNA knockdown of CYP1A1 resulted in significantly reduced CYP1B1 and thrombospondin-1 expression, genes regulated by the aryl hydrocarbon receptor (AhR). Immunostaining of human coronary arteries showed constitutive CYP1A1 and CYP1B1 protein expressions in endothelial cells. Immunostaining of mouse aorta showed nuclear localization of AhR and increased expression of CYP1A1 in the descending thoracic aorta, whereas reduced nuclear localization of AhR and attenuated CYP1A1 expression were observed in the lesser curvature of the aortic arch.CYP1A1 and CYP1B1 gene and protein expressions vary with time, magnitude, and pattern of shear stress. Increased CYP1A1 gene expression modulates AhR-regulated genes. Based on our in vitro reversing flow data and in vivo immunostained mouse aorta, we suggest that increased expression of both genes reflects an anti-atherogenic endothelial cell phenotype.
The mechanism by which adenosine and cholinergic agents reduce contractility in rat myocardium. Correlation with cyclic adenosine monophosphate and receptor densities.
Authors: J Linden, C E Hollen, A Patel
Journal: Circulation Research (1985)

The adenosine analogue phenylisopropyladenosine decreased the basal and isoproterenol-stimulated contractile state of isolated rat left atria. The ED50 levels for both responses were similar, suggesting that direct and antiadrenergic effects may be mediated by the same receptor. Phenylisopropyladenosine decreased the cyclic adenosine monophosphate content of isolated atria and inhibited isoproterenol-stimulated adenylate cyclase activity in membranes prepared from atria and ventricles, but not as much as did methacholine. A maximally effective concentration of phenylisopropyladenosine or methacholine greatly reduced atrial contractility measured in the presence of either isoproterenol (1 microM) or Ro7-2956 (a phosphodiesterase inhibitor, 1 mM); however, in the presence of isoproterenol plus Ro7-2956, the contractile effects of phenylisopropyladenosine and methacholine were greatly attenuated. From the contractile data and cyclic adenosine monophosphate analyses, we conclude that direct and antiadrenergic contractile effects of both phenylisopropyladenosine and methacholine result primarily from their effects on cyclic adenosine monophosphate metabolism. The densities of adenosine, muscarinic, and beta-adrenergic receptors in rat atrial membranes were found to be 30, 551, and 24 fmol/mg protein, respectively, based on equilibrium-binding assays conducted with 125I-aminobenzyl-adenosine, [3H]quinuclidinyl benzilate, and 125I-labeled pindolol. The greater effectiveness of methacholine than phenylisopropyladenosine as a negative inotropic agent and an inhibitor of adenylate cyclase in atria may be related to the relative densities of muscarinic and adenosine receptors.
A CD8+ T cell immune evasion protein specific to Epstein-Barr virus and its close relatives in Old World primates
Authors: Andrew D. Hislop, Maaike E. Ressing, Daphne van Leeuwen, Victoria A. Pudney, Daniëlle Horst, Danijela Koppers-Lalic, Nathan P. Croft, Jacques J. Neefjes, Alan B. Rickinson, Emmanuel J.H.J. Wiertz
Journal: The Journal of Experimental Medicine (2007)

γ1-Herpesviruses such as Epstein-Barr virus (EBV) have a unique ability to amplify virus loads in vivo through latent growth-transforming infection. Whether they, like α- and β-herpesviruses, have been driven to actively evade immune detection of replicative (lytic) infection remains a moot point. We were prompted to readdress this question by recent work (Pudney, V.A., A.M. Leese, A.B. Rickinson, and A.D. Hislop. 2005. J. Exp. Med. 201:349–360; Ressing, M.E., S.E. Keating, D. van Leeuwen, D. Koppers-Lalic, I.Y. Pappworth, E.J.H.J. Wiertz, and M. Rowe. 2005. J. Immunol. 174:6829–6838) showing that, as EBV-infected cells move through the lytic cycle, their susceptibility to EBV-specific CD8+ T cell recognition falls dramatically, concomitant with a reductions in transporter associated with antigen processing (TAP) function and surface human histocompatibility leukocyte antigen (HLA) class I expression. Screening of genes that are unique to EBV and closely related γ1-herpesviruses of Old World primates identified an early EBV lytic cycle gene, BNLF2a, which efficiently blocks antigen-specific CD8+ T cell recognition through HLA-A–, HLA-B–, and HLA-C–restricting alleles when expressed in target cells in vitro. The small (60–amino acid) BNLF2a protein mediated its effects through interacting with the TAP complex and inhibiting both its peptide- and ATP-binding functions. Furthermore, this targeting of the major histocompatibility complex class I pathway appears to be conserved among the BNLF2a homologues of Old World primate γ1-herpesviruses. Thus, even the acquisition of latent cycle genes endowing unique growth-transforming ability has not liberated these agents from evolutionary pressure to evade CD8+ T cell control over virus replicative foci.