tbuckley/cabot-search huggingface dataset:
Microbiology and outcomes in patients with pneumonia in an English Hospital
Authors: Tejmahal Rehman, Vikas Somani, Conor McGeary, Rabinder Randhawa, Ajikumar Kavidasan, Milan Bhattacharya, Mansoor Raza
Journal: European Respiratory Journal (2014)

Background   Current guidelines for pneumonia recommend antibiotics targeting common etiologic agents i.e  S.pneumoniae ,  M.pneumoniae, H.influenzae  for community acquired infections but suggest consideration of resistant organisms in those with co-morbidities. Lack of risk assessment can lead to choice of inappropriate antibiotics leading to poor response and outcomes. We undertook a retrospective review of sputum microbiology and other data for patients admitted with pneumonia.   Methods   A retrospective audit of sputum culture, LOS and mortality was carried out at Milton Keynes Hospital from 01.07.12 to 30.06.13, in patients with pneumonia.   Results   Of 49 patients admitted, 29 were male and 20 female. Median age was 73 years (18-86) and mean LOS of 19.7 days (0-129). 15 had COPD, 3 had bronchiectasis, 4 had lung fibrosis, and 8 other chest diseases. Sputum culture was sent in 46 cases. 6 were negative. 16 patients (35%) grew P.aeruginosa (PA) and 10(22%) grew enterobacteriaceae (EB). 5(11%) grew H. influenzae (HI), 3(7%) grew S.pneumoniae (SP), 1(2%) S.aureus (SA) and 1(2%) grew M.catarrhalis (MC). 4(9%) had Stenotrophomonas maltophila(SM).  Mean LOS was 39.5 days in those growing PA and 11.6 days in others. 17 out of 49(35%) patients died in hospital or within 28 days as against 7 out of 16(44%) with PA and 3 out of 4(75%) with SM   Conclusion   Aging and co-morbidity are likely causes of isolation of pseudomonas and other gram negative organisms not covered by standard first line antibiotics in our cohort, contributing to increased stay and mortality. Patients presenting with community acquired LRTI should have appropriate risk assessment for same, to guide antibiotic therapy, thus improving outcomes.
Thrombotic vascular risk factors in inflammatory bowel disease.
Authors: M Hudson, A Chitolie, R A Hutton, M S Smith, R E Pounder, A J Wakefield
Journal: Gut (1996)

Thrombosis may be an important effector mechanism in the pathogenesis of Crohn's disease.This study therefore investigated the prevalence of independent thrombotic risk factors (factor VII coagulant activity, lipoprotein (a), fibrinogen, plasma triglycerides, and smoking) in patients with Crohn's disease, ulcerative colitis, and normal controls.In Crohn's disease (n = 75), the mean plasma VII:C, lipoprotein (a) and fibrinogen concentrations were significantly greater than in the normal population (n = 85). In ulcerative colitis (n = 35), only the mean factor VII:C concentration was significantly higher than normal. Ninety three per cent of patients with Crohn's disease and 86% of those with ulcerative colitis had at least one risk factor for thrombotic vascular disease, compared with 61% of the normal population (p < 0.001).In many young patients with inflammatory bowel disease, plasma concentrations of these prothrombotic factors were in excess of the limits that are regarded as posing an increased risk for the development of occlusive vascular disease.
THE RELATIONSHIP OF THE STRUCTURE OF THE EPIDERMIS TO PERCUTANEOUS ABSORPTION
Authors: R. K. WINKELMANN
Journal: British Journal of Dermatology (1969)

Journal Article THE RELATIONSHIP OF THE STRUCTURE OF THE EPIDERMIS TO PERCUTANEOUS ABSORPTION Get access R. K. WINKELMANN R. K. WINKELMANN Section of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 81, Issue s4, 1 August 1969, Pages 11–22, https://doi.org/10.1111/j.1365-2133.1969.tb16057.x Published: 01 August 1969
Successful Pregnancy After Marrow Transplantation for Severe Aplastic Anemia and Immunosuppression With Cyclosporine
Authors: H. Joachim Deeg
Journal: JAMA (1983)

ALLOGENEIC marrow transplantation has been used successfully for more than a decade to treat patients with severe aplastic anemia. At present, 70% to 80% of patients become long-term survivors,<sup>1,2</sup>and most of these patients are being followed up in general medical clinics rather than at specialized institutions. Since many patients afflicted by this disease are young, any treatment must take into consideration potential long-term side effects. Although there has been concern that high doses of cyclophosphamide, most widely used to condition patients for transplantation, might affect gonadal and reproductive function, there have been some reports of normal pregnancies and normal offspring in patients after marrow transplantation.<sup>3-5</sup>All these patients had received methotrexate after grafting as prophylaxis for graft-<i>v</i>-host disease. At present, however, many transplant centers are using the new immunosuppressant cyclosporine rather than methotrexate as prophylaxis of graft-<i>v</i>-host disease.<sup>6-8</sup>Experience with this drug
Gaucher Disease
Authors: Edward R. B. McCabe
Journal: JAMA (1996)

<h3>Objective.</h3> —To provide physicians with a responsible assessment of the diagnosis and treatment of Gaucher disease. <h3>Participants.</h3> —A nonfederal, nonadvocate, 14-member panel representing the fields of pediatrics, obstetrics and gynecology, genetics, endocrinology, molecular biology, internal medicine, and biostatistics. In addition, 30 experts in genetics, pediatrics, neurology, obstetrics and gynecology, orthopedics, hematology, genetic counseling, clinical pathology, and epidemiology presented data to the panel and a conference audience of 230 during a 1½-day public session. Questions and statements from conference attendees were considered during the open session. Closed deliberations by the panel occurred during the remainder of the second day and the morning of the third. <h3>Evidence.</h3> —The literature was searched through MEDLINE, and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. <h3>Consensus Process.</h3> —The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and on the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. <h3>Conclusions.</h3> —Despite the success of enzyme therapy, treatment is limited by the cost of the agent. This makes it imperative to determine the lowest effective initial and maintenance doses, to define the appropriate clinical indications for treatment, and to establish uniform methods to optimize outcome assessment. The value of treatment for asymptomatic individuals has not been determined. General population screening for affected individuals and for carriers is not appropriate at this time. As a prototype for all rare diseases, the plight of patients with Gaucher disease raises difficult financial and ethical issues, which we as a society must address. (<i>JAMA</i>. 1996;275:548-553)
Highly Active Antiretroviral Therapy and Cervical Squamous Intraepithelial Lesions in Human Immunodeficiency Virus-Positive Women
Authors: L. Ahdieh-Grant, R. Li, A. M. Levine, L. S. Massad, H. D. Strickler, H. Minkoff, M. Moxley, J. Palefsky, H. Sacks, R. D. Burk, S. J. Gange
Journal: JNCI Journal of the National Cancer Institute (2004)

Background: Women infected with human immunodeficiency virus (HIV) have an increased risk of persistent squamous intraepithelial lesions (SILs) of the cervix. We assessed the association between use of highly active antiretroviral therapy (HAART) and regression of SIL in HIV-infected women enrolled in the Women's Interagency HIV Study, a large, multicenter, prospective cohort study. Methods: Of 2059 HIV-infected participants, 312 HIV-infected women had normal cervical cytology at baseline and were subsequently diagnosed during 7 years of follow-up with incident SIL. Pap smears, CD4+ T-cell counts, and information regarding use of HAART were obtained every 6 months. The outcome of interest was lesion regression, defined as two consecutive normal Pap smears 6 months apart. Incidence rates of SIL regression were computed among person-years at risk, both before and after HAART initiation. All statistical tests were two-sided. Results: Of 312 women, 141 had lesions that regressed to normal cytology, with a median time to regression of 2.7 years. Overall, the incidence of regression increased ( Ptrend = .002) over time after HAART was introduced. At incident SIL, median CD4+ T-cell counts were lower in women whose lesions did not regress than in women whose lesions regressed (230 versus 336 cells/ μ L; P <.01). Before HAART was introduced, the rate of lesion regression was 0.0% (95% confidence interval [CI' = 0.0% to 2.4%). After HAART was introduced, the rate was 12.5% (95% CI = 9.9% to 15.1%) and was related to post-HAART CD4+ T-cell counts ( Ptrend = .002). Conclusions: HAART use was associated with increased regression of SIL among HIV-infected women, and among women who used HAART, increased CD4+ T-cell counts were associated with a greater likelihood of regression. However, the majority of cervical lesions among HIV-infected women, even among individuals who used HAART, did not regress to normal.
Death in the locker room
Authors: P. L. Thomas
Journal: British Journal of Sports Medicine (1986)

Cocaine- and amphetamine-regulated transcript (CART) is one of the most abundant neuropeptides in vagal afferents, including those involved in regulating feeding. Recent observations indicate that metabolic challenges dramatically alter the neuropeptidergic profile of CART-producing vagal afferents. Here, using confocal microscopy, we reassessed the distribution and regulation of CART(55–102) immunoreactivity in vagal afferents of the male mouse in response to metabolic challenges, including fasting and high-fat-diet feeding. Importantly, the perikarya and axons of vagal C-fibers were labeled using mice expressing channelrodhopsin-2 (ChR2-YFP) in Na<sub>v</sub>1.8-Cre–expressing neurons. In these mice, approximately 82% of the nodose ganglion neurons were labeled with ChR2-YFP. Furthermore, ChR2-YFP–labeled axons could easily be identified in the dorsovagal complex. CART(55–102) immunoreactivity was observed in 55% of the ChR2-YFP–labeled neurons in the nodose ganglion and 22% of the ChR2-YFP–labeled varicosities within the area postrema of fed, fasted, and obese mice. The distribution of positive profiles was also identical across the full range of CART staining in fed, fasted, and obese mice. In contrast to previous studies, fasting did not induce melanin-concentrating hormone (MCH) immunoreactivity in vagal afferents. Moreover, prepro-MCH mRNA was undetectable in the nodose ganglion of fasted mice. In summary, this study showed that the perikarya and central terminals of vagal afferents are invariably enriched in CART and devoid of MCH.
Validation of the RTOG recursive partitioning analysis (RPA) classification for small cell lung cancer-only brain metastases: A single institution experience
Authors: G. M. Videtic, D. J. Adelstein, T. Mekhail, T. W. Rice, G. H. J. Stevens, S.-Y. Lee, J. H. Suh
Journal: Journal of Clinical Oncology (2004)

1557 Background: Brain metastases clinical trials have generally excluded small cell lung cancer (SCLC) cases. The RTOG developed 3 prognostic classes for brain metastases using a recursive partitioning analysis (RPA), however only 4% of patients had an SCLC diagnosis. Validation of these RPA classes for SCLC-only is important for rational trial design. Methods: A 20-year retrospective review of 164 SCLC patients with brain metastases treated between 4/1983 and 5/2003 was performed. Patients who underwent surgery as part of their treatment were excluded from this study. This provided 154 patients for analysis. RPA criteria used for class assignment were Karnofsky performance status (KPS), primary tumor status (PD), presence of extracranial system metastases (SD) and age. Results: Median follow-up was 4.7 months (range 0.3–40.3). Median age was 65 (range 42–85). Median KPS was 70 (range 40–100). Median number of lesions was 3 (range1–30) [data on 139 patients]. Number of patients with controlled PD and no SD was: 20 (13%) and with SD: 27 (18%); without controlled PD and no SD: 34 (22%) and with SD: 73 (47%). RPA class distribution was: class I- 8 (5%); class II- 96 (62%); class III- 51 (33%). For the whole patient cohort, median survival was 4.9 months, with 4 (2.6%) alive at analysis. Median survival (in months) by RPA class for SCLC-only is: class I- 8.6; class II- 5.3; class III- 2.5. Original RTOG RPA survival (in months) by class is: class I- 7.1; class II- 4.2; class III- 2.3. Outcomes for SCLC-only brain metastases appear similar to the RTOG database. Conclusions: This analysis suggests that the RPA classes are valid for brain metastases from SCLC and supports the inclusion of SCLC patients in future brain metastases trials. This classification may also serve as a basis for historical comparisons. No significant financial relationships to disclose.
Toxic Substances Control in the 1990s: Are We Poisoning Ourselves with Low-level Exposures?
Authors: Lester B. Lave, Fanny K. Ennever
Journal: Annual Review of Public Health (1990)

In recent decades, public health policy and practice have been increasingly challenged by globalization, even as global financing for health has increased dramatically. This article discusses globalization and its health challenges from a vantage of ...Read More
Alterations in collagen cross-linking impair myocardial contractility in the mouse heart.
Authors: J M Capasso, T F Robinson, P Anversa
Journal: Circulation Research (1989)

A number of genetic disorders in humans are associated with defects in the synthesis and metabolism of collagen, which are accompanied by multiple cardiovascular disease processes. To determine whether genetically determined cross-linking abnormalities of collagen may alter cardiac function, left ventricular papillary muscles of mice with a genetic defect in the cross-linking of collagen (Movbr) were studied in vitro. With respect to controls, increases in time to peak tension, from 102 +/- 1.4 to 125 +/- 5.4 msec (p less than 0.001), and time to one-half relaxation, from 76 +/- 3.0 to 98 +/- 6.1 msec (p less than 0.05), were measured. Moreover, resting tension at the length associated with maximum developed isometric force (L) was elevated, from 11.1 +/- 1.7 to 19.3 +/- 1.1 mN/mm2 (p less than 0.001), and a similar difference was also seen throughout the physiological range of muscle lengths. In contrast, developed tension was depressed at 93-97% of L. Peak rate of tension rise and decay were diminished whereas time to peak rate of tension rise was prolonged. Isotonically, a decrease in the magnitude of peak shortening at L, from 4.0 +/- 0.5 to 2.0 +/- 0.2% (p less than 0.04), and an increase in time to peak shortening, from 100 +/- 2.3 to 129 +/- 2.8 msec (p less than 0.001), were seen. In addition, peak velocities of shortening and relengthening were diminished in the Movbr mouse heart. In conclusion, the impairment in collagen cross-linking alters cardiac mechanics by a reduction in force-generating ability and a prolongation of the timing parameters of the systolic and diastolic phases of contraction in vitro.
Determination of asymmetric dimethylarginine, an endogenous nitric oxide synthase inhibitor, in umbilical blood
Authors: Hirokazu Tsukahara, Naoko Ohta, Shuko Tokuriki, Koji Nishijima, Fumikazu Kotsuji, Hisako Kawakami, Norihito Ohta, Kyouichi Sekine, Hironori Nagasaka, Mitsufumi Mayumi
Journal: Metabolism (2008)
Effect of body position on tongue posture in awake patients with obstructive sleep apnoea
Authors: K. Miyamoto, M. M. Ozbek, A. A. Lowe, J. A. Fleetham
Journal: Thorax (1997)

Snoring and obstructive sleep apnoea (OSA) are worse or may only occur in the supine position. The effect of body position on upper airway size has been reported, but the effect on tongue posture has not previously been examined.Detailed measurements were made of tongue posture from upright and supine lateral cephalograms on 24 men with OSA and 13 men with non-apnoeic snoring matched for age, body mass index, and craniofacial skeletal pattern. Patients with OSA had apnoea/hypopnoea indices (AHI) of > 50/hour and/or apnoea indices (AI) of > 25/hour while non-apnoeic snorers had AHI of < 10/hour and AI of < 5/hour.In non-apnoeic snorers the tongue depth measurements for the superior-posterior portion of the tongue were larger in the supine than in the upright position (p < 0.05). There was no significant difference in tongue depth measurements between the upright and the supine position in the patients with OSA.When awake patients with OSA move from the upright to the supine position they maintain their upright tongue posture which may tend to protect against upper airway collapse secondary to the increased gravitational load on the tongue. In contrast, when awake non-apnoeic snorers move from the upright to the supine position a significant dorsal movement in the superior-posterior portion of the tongue is observed.
Molecular Grading of Ductal Carcinoma <i>In situ</i> of the Breast
Authors: Rosemary L. Balleine, Lucy R. Webster, Sean Davis, Elizabeth L. Salisbury, Juan P. Palazzo, Gordon F. Schwartz, Dennis B. Cornfield, Robert L. Walker, Karen Byth, Christine L. Clarke, Paul S. Meltzer
Journal: Clinical Cancer Research (2008)

Increased incidence of ductal carcinoma in situ (DCIS) associated with mammographic screening for breast cancer has emphasized the challenges of managing this condition. The aim of this study was to identify informative clinical indicators of DCIS biology by molecular profiling.Areas of in situ carcinoma, atypical ductal hyperplasia, and benign epithelium were microdissected from 46 invasive breast cancers. Oligonucleotide probes showing differential expression between DCIS associated with grade 1 and 3 invasive cancer were identified by microarray-based gene expression profiling. Expression at these probes was used to define a "molecular grade" subcategorization of all samples. The genomic basis of molecular grade was examined by array-based comparative genomic hybridization. Clinical course was examined in a cohort of 134 patients with DCIS treated by surgery alone.DCIS samples were designated as low or high molecular grade based on expression at 173 probes. The low molecular grade subgroup included low (n = 10) and intermediate (n = 11) nuclear grade DCIS as well as all samples of atypical ductal hyperplasia (n = 4) and benign epithelium (n = 7). The high molecular grade subgroup included DCIS of intermediate (n = 7) and high (n = 19) nuclear grade. The character and degree of genomic aberration were distinct between molecular grade subgroups. A classification tree model including nuclear grade and Ki67 score accurately predicted molecular grade for 95.7% of samples. In an independent cohort, this showed a pattern of rapid disease recurrence for high molecular grade DCIS.Molecular profiling indicates a binary grading scheme for DCIS. This practical approach has potential to improve clinical evaluation of DCIS.
Diabetes in the Department of Veterans Affairs
Authors: Gayle E. Reiber, Edward J. Boyko, Charles Maynard, Thomas D. Koepsell, Leonard M. Pogach
Journal: Diabetes Care (2004)

A core mission of the Department of Veterans Affairs (VA) Epidemiologic Research and Information Centers (ERICs) is to contribute to knowledge on the frequency and causes of health conditions and their outcomes in U.S. veterans. The Seattle ERIC selected the growing burden of diabetes in veterans as a priority area and with our colleagues prepared this supplement. Our goals are 1 ) to provide an overview of VA services, benefits, and diabetes advances to the diabetes community and 2 ) to describe research findings based on our veterans with diabetes.

The VA is the second largest of the 15 U.S. cabinet departments and operates nationwide programs for health care, financial assistance, and burial benefits. VA 2003 budget projections included $32.8 billion for benefits, $25.9 billion for health care, and $909 million for all VA construction, administration, and cemetery operations (1).

Veterans have a distinct sociodemographic profile that reflects their entry into military service in times of peace and conflict. Among those discharged from military service (veterans), the priority for VA health care goes first to those with service-connected disabilities and then to others based on income and medical need. VA financial benefits are provided to 3.3 million people. About 2.7 …
Racial/Ethnic Differences in Leisure-Time Physical Activity Levels Among Individuals With Diabetes
Authors: Leonard E. Egede, Mary E. Poston
Journal: Diabetes Care (2004)

Diabetes affects ∼18.2 million people or 6.3% of the U.S. population and is associated with significant morbidity, mortality, and health care costs (1). Regular physical activity is beneficial for the prevention and management of diabetes and established benefits include improvement in blood glucose control, reduction of cardiovascular risk factors, weight loss, and improvement in well-being (2,3).

The purpose of this study was to use nationally representative data with detailed information on frequency, duration, and intensity of 23 leisure-time physical activities (LTPAs) to 1 ) determine racial/ethnic variations in LTPA levels among adults with diabetes and 2 ) assess the independent effects of activity limitations and comorbidity on racial/ethnic differences in LTPA levels in adults with diabetes. We hypothesized that blacks and Hispanics would have lower levels of moderate to vigorous LTPA compared with their white counterparts. We further hypothesized that racial/ethnic differences in activity limitations and comorbidity would explain racial/ethnic variations in LTPA among adults with diabetes.

Combined data from the sample adult core and the adult prevention module of 1998 National Health Interview Survey (NHIS) (4) were analyzed. The NHIS is a nationally representative household survey of U.S. adults aged ≥18 years. The sample is selected by a complex sampling design involving stratification, clustering, and multistage sampling with a nonzero probability of selection for each person. Final weights allow estimates from the …
Anti-TNF-α-induced psoriasiform lesions in IBD: an abnormal immune activation or a ‘patchy cutaneous’ immune suppression?
Authors: Franco Scaldaferri, Valentina Petito, Alfredo Papa, Monica Cesarini, Vincenzo Arena, Loris Riccardo Lopetuso, Maddalena Corbi, Francesca Perino, Giacomo Caldarola, Angelo Carbone, Enrico Corazziari, Alessandro Sgambato, Antonio Gasbarrini, Clara De Simone
Journal: Gut (2013)

We read with interest the original article by Tillack et al who reported the characteristics of psoriasiform skin lesions induced by antitumour necrosis factor (anti-TNF)-α in patients with IBD.1 The authors show by immunohistochemical analysis that cutaneous lesions are characterised by interferon (IFN)α expression, infiltrates of interleukin (IL)-17A/IL-22-secreting T helper (Th)17 cells and IFNγ-secreting Th1 cells. They also demonstrate that therapy with ustekinumab, an anti-IL-12/IL-23 antibody, is highly effective in treating anti-TNF-α antibody-induced psoriasis and psoriasiform lesions.

Our group is interested in the pathogenesis of psoriasiform lesions induced by anti-TNF-α antibodies in IBD patients. We found an interesting case of an 18-year-old man diagnosed with ileo-colonic Crohn's disease in 2003. In June 2009, the patient presented with back pain and impaired spinal mobility and was diagnosed with ankylosing spondylitis by lumbar MRI. Since symptoms did not improve with steroids and physiotherapy, he switched to adalimumab (40 mg every other week following 160/80 mg induction …