tbuckley/cabot-search huggingface dataset:
Hemorrhagic Fever Viruses as Biological Weapons
Authors: Luciana Borio, Thomas Inglesby, C. J. Peters, Alan L. Schmaljohn, James M. Hughes, Peter B. Jahrling, Thomas Ksiazek, Karl M. Johnson, Andrea Meyerhoff, Tara O'Toole, Michael S. Ascher, John Bartlett, Joel G. Breman, Edward M. Eitzen, Jr, Margaret Hamburg, Jerry Hauer, D. A. Henderson, Richard T. Johnson, Gigi Kwik, Marci Layton, Scott Lillibridge, Gary J. Nabel, Michael T. Osterholm, Trish M. Perl, Philip Russell, Kevin Tonat, None for the Working Group on Civilian Biodefense
Journal: JAMA (2002)

ObjectiveTo develop consensus-based recommendations for measures to be taken by medical and public health professionals if hemorrhagic fever viruses (HFVs) are used as biological weapons against a civilian population.ParticipantsThe Working Group on Civilian Biodefense included 26 representatives from academic medical centers, public health, military services, governmental agencies, and other emergency management institutions.EvidenceMEDLINE was searched from January 1966 to January 2002. Retrieved references, relevant material published prior to 1966, and additional sources identified by participants were reviewed.Consensus ProcessThree formal drafts of the statement that synthesized information obtained in the evidence-gathering process were reviewed by the working group. Each draft incorporated comments and judgments of the members. All members approved the final draft.ConclusionsWeapons disseminating a number of HFVs could cause an outbreak of an undifferentiated febrile illness 2 to 21 days later, associated with clinical manifestations that could include rash, hemorrhagic diathesis, and shock. The mode of transmission and clinical course would vary depending on the specific pathogen. Diagnosis may be delayed given clinicians' unfamiliarity with these diseases, heterogeneous clinical presentation within an infected cohort, and lack of widely available diagnostic tests. Initiation of ribavirin therapy in the early phases of illness may be useful in treatment of some of these viruses, although extensive experience is lacking. There are no licensed vaccines to treat the diseases caused by HFVs.
Independent Adjudication of Symptomatic Heart Failure With the Use of Doxorubicin and Cyclophosphamide Followed by Trastuzumab Adjuvant Therapy: A Combined Review of Cardiac Data From the National Surgical Adjuvant Breast and Bowel Project B-31 and the North Central Cancer Treatment Group N9831 Clinical Trials
Authors: Stuart D. Russell, Kimberly L. Blackwell, Julia Lawrence, John E. Pippen, Matthew T. Roe, Freda Wood, Virginia Paton, Eric Holmgren, Kenneth W. Mahaffey
Journal: Journal of Clinical Oncology (2010)

An independent Adjuvant Cardiac Review and Evaluation Committee (ACREC) systematically reviewed cases of symptomatic heart failure events to uniformly define the cardiac event rate across two large trials (National Surgical Adjuvant Breast and Bowel Project [NSABP] B-31 and North Central Cancer Treatment Group [NCCTG] N9831) that assessed the addition of trastuzumab to standard adjuvant chemotherapy.The committee was composed of six independent oncologists and cardiologists. A retrospective review of patients with a cardiac event was performed by the primary investigators of the trials. The ACREC prospectively established criteria for determining a symptomatic heart failure event. Recovery status was determined from documented resolution of signs and symptoms. Potential risk factors were also assessed.Medical records for a total of 173 patients were reviewed: 40 in the chemotherapy-alone arm and 133 in the trastuzumab arm. Trastuzumab-treated patients had a 2.0% incidence of symptomatic heart failure events compared with 0.45% in the chemotherapy-alone arm. Complete or partial recovery was observed in 86.1% of trastuzumab-treated patients with symptomatic heart failure events. Of five patients who died, only one patient had received trastuzumab. Independent predictors for cardiac events were age older than 50 years, a low ejection fraction at the start of paclitaxel treatment, and trastuzumab treatment.The incidence of symptomatic heart failure events is 2.0% in patients treated with adjuvant trastuzumab, and the majority of these patients recover with appropriate treatment.
Effect of fissure integrity on lung volume reduction using a polymer sealant* in advanced emphysema
Authors: Helgo Magnussen, Mordechai R Kramer, Anne-Marie Kirsten, Charles Marquette, Arschang Valipour, Franz Stanzel, Reiner Bonnet, Juergen Behr, Oren Fruchter, Yael Refaely, Ralf Eberhardt, Felix J F Herth
Journal: Thorax (2012)

<h3>Rationale</h3> Interlobar fissure integrity has previously correlated with responsiveness to endobronchial lung volume reduction therapy in patients with advanced emphysema. <h3>Objective</h3> This report summarises the effect of interlobar fissure integrity on responses to treatment with a novel endoscopic tissue sealant (AeriSeal emphysematous lung sealant (ELS)) that collapses hyperinflated lung. <h3>Methods</h3> Fissure status, lung volumes, tissue density and disease heterogeneity were assessed radiographically in 28 patients (age 63.4±6.1 years, 20 men) with advanced upper lobe predominant emphysema (density=888.0±18.2 HU; upper lobe tissue density &lt;−950=2.62±1.74). Post-treatment changes in lobar volume, pulmonary function, exercise capacity, symptoms and quality of life were compared in patients with complete fissures (CFs) and incomplete fissures (ICFs). <h3>Results</h3> ELS therapy reduced lung volumes independent of interlobar fissure integrity. In patients with upper lobe emphysema and CFs, lobar volume reduction was 214±127 ml/treatment compared with 256±175 ml/treatment in those with ICFs (p=0.453). Reductions in gas trapping and improvements in spirometry, functional capacity and quality of life were similar in patients with CFs and ICFs. Stepwise multiple regression modelling confirmed that fissure integrity did not contribute to post-treatment changes in forced expiratory volume in 1 s, residual volume/total lung capacity ratio or lobar volume measured by CT analysis. <h3>Conclusions</h3> Interlobar fissure integrity, an important determinant of responsiveness to endobronchial lung volume reduction therapy in prior studies, had minimal impact on physiological and functional responses to ELS therapy in patients with severe upper lobe predominant emphysema. <h3>Clinical trial registration number</h3> Registration numbers for trials contributing to datasets in this report: NCT00884962, NCT01051258 and NCT01181466.
Hospitals pay value added tax on drugs
Authors: I A. Tait
Journal: BMJ (1995)

contact between those managing patients and those managing the institution.They would also interact with financial advisers and institutional service managers at board level.There are some difficulties in implementing a horizontally managed, team based approach.For example, governments, institutions, and professional organisations would need to modify existing regulations3 and redefine their relations.Individuals must learn to value each other's con- tributions and be prepared to work in small groups, with some of the conflict and intimacy that that implies.4This, however, allows more opportunities for consultants to implement their many skills.A consultant's professional responsi- bilities include the management of patients, education of trainees and colleagues, and research.Administration is also a major commitment and includes personal time management, continuing education, quality control (audit), the development of policies and guidelines, committee work, and participation in professional and political organisa- tions.Consultants are more able to fulfil these essential tasks by working in a team with a flexible skill mix.In summary, consultants' professional role is enhanced by the opportunity for initiative, task sharing, and delegation within a team with a mix of skills.This can reduce role conflict,' decrease stress, foster morale, and improve the quality of patients' care.
Long-term Use of CPAP Therapy for Sleep Apnea/Hypopnea Syndrome
Authors: NIGEL McARDLE, GRAHAM DEVEREUX, HASSAN HEIDARNEJAD, HEATHER M. ENGLEMAN, THOMAS W. MACKAY, NEIL J. DOUGLAS
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Patients with the sleep apnea/hypopnea syndrome (SAHS) treated by nasal continuous positive airway pressure (CPAP) need to use CPAP long-term to prevent recurrence of symptoms. It is thus important to clarify the level of long-term CPAP use and the factors influencing long-term use. We examined determinants of objective CPAP use in 1, 211 consecutive patients with SAHS who were prescribed a CPAP trial between 1986 and 1997. Prospective CPAP use data were available in 1, 155 (95.4%), with a median follow-up of 22 mo (interquartile range [IQR], 12 to 36 mo). Fifty-two (4.5%) patients refused CPAP treatment (these were more often female and current smokers); 1,103 patients took CPAP home, and during follow-up 20% stopped treatment, primarily because of a lack of benefit. Methods of survival analysis showed that 68% of patients continued treatment at 5 yr. Independent predictors of long-term CPAP use were snoring history, apnea/hypopnea index (AHI), and Epworth score; 86% of patients with Epworth > 10 and an AHI >/= 30 were still using CPAP at 3 yr. Average nightly CPAP use within the first 3 mo was strongly predictive of long-term use. We conclude that long-term CPAP use is related to disease severity and subjective sleepiness and can be predicted within 3 mo.
Positively Selected Disease Response Orthologous Gene Sets in the Cereals Identified Using Sorghum bicolor L. Moench Expression Profiles and Comparative Genomics
Authors: Alejandro Zamora, Qi Sun, Martha T. Hamblin, Charles F. Aquadro, Stephen Kresovich
Journal: Molecular Biology and Evolution (2009)

Disease response genes (DRGs) diverge under recurrent positive selection as a result of a molecular arms race between hosts and pathogens. Most of these studies were conducted in animals, and few defense genes have been shown to evolve adaptively in plants. To test for adaptation in the molecules mediating disease resistance in the cereals, we first combined information from the expression pattern of Sorghum bicolor genes and from divergence to the full genome of rice to identify candidate DRGs. We then used evolutionary analyses of orthologous gene sets from several grass species, to determine whether the DRGs show signals of positive selection and the residues targeted. We found 140 divergent genes upregulated under biotic stress in S. bicolor by evaluating the relative abundance of expressed sequence tags in different libraries and comparing them with rice genes. For 10 of these genes, we found sets of orthologs including sequences from rice and three other cereals; six genes showed a pattern of substitution that was consistent with positive selection. Three of these genes, a thaumatin, a peroxidase, and a barley mlo homolog, are known antifungal proteins. The other three genes with evidence of positive selection were a MCM-1 agamous deficiens SRF- (MADS) box transcription factor, an eIF5 translation initiation factor, and a gene of unknown function but with evidence of expression during stress. Permutation analyses, using different ortholog and paralog sequences, consistently identified five positively selected codons in the peroxidase, a member of a cluster of genes and a large gene family. We mapped the positively selected residues onto the structure of the peroxidase and thaumatin and found that all sites are on the surface of these proteins and several are close to biochemically determined active sites. Identifying new positively selected plant disease resistance genes and the critical amino acid sites provides a basis for functional studies that may increase our understanding of their underlying molecular mechanisms of action. Additionally, it may lead to the identification of individuals having variation at functionally important sites, as well as eventually using this information in the rational design and engineering of proteins involved in plant disease resistance.
Who will win the Premiership, Mr Obama?
Authors: Kamran Abbasi
Journal: Journal of the Royal Society of Medicine (2009)

Is it possible to read any publication without it mentioning Barack Obama, the man with all the answers? Can he tell us, for example, which of Liverpool and Manchester United will win the Premiership? Or how long the Jade Goody effect on uptake of cervical screening will last?

Only God and perhaps Obama know. The JRSM has been as guilty as any with references to the new American President but the genius of Obama's success is that he is at the heart of the global debate on almost any topic.

Farooq and colleagues begin this issue by using Obama as a journalistic hook for a bold plea for the feminization of orthopaedic surgery (JRSM 2009;102:124–5). Last year, Clare Marx was elected the first female president of the British Orthopaedic Association, a revolutionary gesture for a specialty caricatured by beer-swilling rugby-playing bruisers.

Hence inevitably female medical students view a career in orthopaedic surgery as too physical, a hindrance to family, biased towards men and a submission to antisocial hours. But the authors argue that female role models, and the change in work pattern forced by the European Working Time Directive, might help women to ‘smash through the reinforced concrete ceiling of orthopaedic surgery’. A more balanced workforce will also help better serve patients, they conclude.

Meanwhile, Minhas and Wendt focus more keenly on Obama and his health policy (JRSM 2009;102:129–33). Obama's attention has naturally been on the US economy but should that excuse the fact his victory speech failed to mention healthcare, and only a passing reference was made in his inauguration speech? Nonetheless, healthcare will come under increasing focus, argues Noam Chomsky, because of the unsustainable financial impact on corporate America.

Obama's strategy on healthcare is not only dictated by the state of the economy but also by the legacy of his current Secretary of State, Hillary Clinton. Her brand of ‘Hillarycare’ was criticized by experts, employers and republicans. Obama's reforms are unlikely to stretch to ‘socialized medicine’, in other words an NHS-type system, argue the authors, but the US system holds a perpetual fascination for UK policy-makers who look to it for useful lessons and welcome US companies and ideas to the NHS.

A glass of dry white wine, supper en famille and 15 minutes on a back massage machine might be taken from Barack Obama's book of top 10 relaxation tips from the master of the world. Instead, this is the preferred method of winding down at the end of the working day for Trisha Greenhalgh, the mistress of ‘doing the juggle’ – holding down an academic job while also being a wife and mother and managing major life events in the extended family (JRSM 2009;102:165–6). Greenhalgh kicks off our new series on the working days of 21st-century medics. A must read for everybody seeking to smash a reinforced concrete ceiling or just escape Barack Obama for a few minutes.
Calcium-sensitive modulation of Ig capping: evidence supporting a cytoplasmic control of ligand-receptor complexes.
Authors: G F Schreiner, E R Unanue
Journal: The Journal of Experimental Medicine (1976)

Capping of anti-Ig-Ig complexes was studied in murine B lymphocytes. Morphological studies indicated that caps formed rapidly on cells before any changes in shape. The first changes in cell shape were evident as a contraction right under the cap area. The removal of extracellular calcium had no effect on cap formation. Furthermore, the introduction of calcium by the ionophore A-23187 stopped capping. The ionophere by itself in the absence of extracellular calcium had no effect. Caps were found to be disrupted, the complexes scattering over the entire cell surface if the cells were treated by A-23187 after the caps had formed. The disruptive effect of A-23187 as dependent on extracellular calcium and could be stopped by drugs that affected energy metabolism. The cytochalasins also disrupted the formed caps. Drugs that affect energy metabolism by themselves did not disrupt the caps. We interpret the effects of the ionophore as resulting from a systemic hypercontractility of microfilaments. A theory for explaining the formation and disruption of capping is discussed.
Crush Fracture of Sesamoid Bone of Thumb
Authors: W. H. Scobie
Journal: BMJ (1941)

Why did the outbreak end ?The killing off of old pigs is clearly a self-limited process.The consumption of raw or lightly cooked pork may have been discouraged by propaganda, though I find it hard to believe that its effect would be felt for long.The former is more likely to have been the determining factor.To sum up, I suggest that the killing off of old stock threw a few trichinosed swine on to the market.These produced overt disease in a few localities, which were determined by the pork-eating habits of the people: there were probably a number of such localities, but in only a few did the disease become prevalent enough to attract attention and thus be diagnosed.The need to slaughter these swine was determined by economic conditions, and was of limited duration.The outbreaks draw attention to one fact of importance -trichiniasis exists among English swine.It is probably widespread, since the Harpenden cases were believed to be associated with pigs from East Anglia, the Penrith cases with local stock, and the Wolverhampton cases with West Midland stock, while those in Birmingham may have come from any one or more of a number of districts throughout England.The infestation is probably most of the time slight, as regards both the number of pigs affected and the severity of the disease.I am indebted to Dr. H. P. Newsholme, medical officer of health for Birmingham, for permission to publish this account.It is also a pleasure to record the willingness with which medical practitioners furnished me with particulars of their patients, both in and out of hospital.
Mast Cell Sarcoma: A Rare and Aggressive Entity—Report of Two Cases and Review of the Literature
Authors: Sophie Georgin-Lavialle, Claire Aguilar, Romain Guieze, Ludovic Lhermitte, Julie Bruneau, Sylvie Fraitag, Danielle Canioni, Marie-Olivia Chandesris, Felipe Suarez, Catherine Grandpeix-Guyodo, Gandhi Damaj, Stéphane Barete, Achille Aouba, Caroline Fite, Charlotte Robert, Philippe Gaulard, Olivier Lortholary, Olivier Tournilhac, Patrice Dubreuil, Olivier Hermine
Journal: Journal of Clinical Oncology (2012)
MECHANISM OF ACTION OF MIGRATION INHIBITORY FACTOR (MIF)
Authors: Richard W. Leu, A. L. W. F. Eddleston, John W. Hadden, Robert A. Good
Journal: The Journal of Experimental Medicine (1972)

The initial interaction between migration inhibitory factor (MIF) and the guinea pig alveolar and peritoneal macrophage was studied. MIF-containing supernatants were generated from sensitized lymph node lymphocytes obtained from guinea pigs immunized with bovine gamma globulin in complete Freund's adjuvant. MIF-containing supernatants were markedly inhibitory for the migration of the peritoneal macrophage but had no effect on the alveolar macrophage. A linear relationship was observed between per cent inhibition of migration and serial twofold dilution of supernatant. Reexpressed in arbitrary MIF units, this relationship reflects a dose-response relationship with saturation characteristics. Pulse exposure of peritoneal macrophages to MIF resulted in adsorption of MIF onto both viable and nonviable cells with corresponding depletion of supernatant MIF. The alveolar macrophage did not adsorb MIF. Pulse adsorption of MIF onto the peritoneal macrophage is dependent on time, temperature, and cell number. Pretreatment of the cells with proteolytic enzyme prevents the adsorption of MIF while leaving migration unaffected. These observations support the existence of a specific cell surface receptor for MIF. The existence of such a receptor provides selectivity of immune modulation of macrophage populations by lymphocytes in delayed hypersensitivity reactions.
Pustular psoriasis of the nails: treatment and long-term follow-up of 46 patients
Authors: B.M. Piraccini, A. Tosti, M. Iorizzo, C. Misciali
Journal: British Journal of Dermatology (2001)

Pustular psoriasis of the nail apparatus is a common disease that greatly influences the quality of life because of its chronic course and poor response to treatment.To review the clinical and histopathological features, the response to treatment and the long-term follow-up of 46 patients with pustular psoriasis of the nail unit.Treatments utilized included oral retinoids (n = 12), oral nimesulide (n = 13), topical calcipotriol (n = 15) and topical steroids (n = 18). Retinoids were utilized as first choice in seven patients with involvement of several digits and in five patients with severe relapses, whereas topical calcipotriol, oral nimesulide or topical steroids were utilized in patients with involvement of a single nail. Topical calcipotriol was also prescribed as maintenance therapy in patients who responded to oral treatment. Twenty-five patients were followed for more than 5 years.Improvement or regression of the lesions was obtained in 23 of 46 patients. Retinoids were effective in six of 12 patients, nimesulide in four of 13, topical calcipotriol in nine of 15 and topical steroids in four of 18. The long-term follow-up showed a complete remission of the disease in only two patients, both affected by pustular psoriasis involving multiple nails. All other patients experienced periodic relapses which were in most cases controlled by regular use of topical calcipotriol.Severe cases of pustular psoriasis of the nail are best treated with systemic retinoids. Topical calcipotriol is effective in about 50% of patients with localized disorder and is also useful as maintenance therapy after retinoid treatment.
The management of adult psychiatric emergencies in low-income and middle-income countries: a systematic review
Authors: Abhijit Nadkarni, Charlotte Hanlon, Urvita Bhatia, Daniela Fuhr, Celina Ragoni, Sérgio Luiz de Azevedo Perocco, Sandra Fortes, Rahul Shidhaye, Eugene Kinyanda, Thara Rangaswamy, Vikram Patel
Journal: The Lancet Psychiatry (2015)
Abnormalities in myocardial contractility, metabolism and perfusion reserve in non-stenotic coronary segments in heart failure patients
Authors: Ad F.M van den Heuvel, Jeroen J Bax, Paul K Blanksma, Willem Vaalburg, Harry J.G.M Crijns, Dirk J van Veldhuisen
Journal: Cardiovascular Research (2002)

Objective: Myocardial blood flow (MBF) reserve is impaired in congestive heart failure (CHF), while fluorine-18-deoxyglucose (18FDG) uptake is relatively preserved. To determine whether this mismatch could be interpreted as ischemia, we performed dobutamine stress echocardiography (DSE). Methods: 12 males with coronary artery disease (CAD) and CHF were compared with 12 controls with similar CAD but normal left ventricular (LV) function. MBF in non-infarct-related artery areas was assessed using [13N]ammonia positron emission tomography (PET), at rest and after dipyridamole infusion and 18FDG uptake was determined. DSE was performed with doses up to 40 μg/kg per min. Results: In areas with non-stenotic arteries MBF reserve was more impaired in CHF patients (1.6±0.6 vs. 2.2±0.5; CHF versus normal LV, respectively, P<0.05). MBF reserve was related to LV ejection fraction (r = 0.6, P<0.05) and wall stress (r = −0.72, P<0.05). PET showed mismatch in 4±1% of the myocardium in normal LV, compared to 26±26% in CHF (P<0.05), coinciding with more ischemic wall motion abnormalities on DSE (21 vs. 4%; CHF versus normal LV, respectively, P<0.05). Conclusions: In CHF, mismatch was found in areas supplied by non-stenotic coronary arteries. Corresponding areas showed ischemic wall motions on DSE. These findings suggest that the condition of CHF may play a role in perpetuating myocardial failure by inducing myocardial ischemia. Follow-up studies to investigate the ischemia–CHF relationship in time would be needed.