tbuckley/cabot-search huggingface dataset:
Perforated and embedded intrauterine devices [reply to the letter of Wright] [letter]
Authors: Zakin D
Journal: JAMA (1983)

Dr. Wright used cervical hysterotomy in removing an IUD which from his description appears to have been a type 1-2 partial perforation.  He is to be congratulated on the fortunate outcome.  Although the method served him well we do not believe that it can be recommended as a routine or usual procedure in cases of partial perforation particularly with the inadequate information provided by ultrasonography.  In our series of 22 verified cases of perforated and embedded IUDs (unpublished data) there were 8 cases of complete perforation which need not concern us further as well as 7 cases of partial perforation and 7 cases of deep embedding.  Only 1 case was treated by cervical hysterotomy; a postoperative roentgenogram showed that a fragment of the IUD (metallic) had been left behind.  Cervical hysterotomy goes a step beyond dilatation and curettage by replacing the less accurate instrumental palpation by the more accurate digital palpation.  However this greater accuracy is of a limited nature and can only be applicable if the myometrial penetration is relatively superficial as in this case.  Both are blind procedures and can often be advantageously replaced by hysteroscopy when available.  The essence of the matter is accurate preoperative evalution.  When the string is not visible at the external os a gentle attempt at instrumental snaring of the string or palpation of the IUD is certainly in order.  If this maneuver is of a tentative nature and not forceful or unduly repetitve it is not usually followed by fever pain and as it turned out in this case myometrial abscess.  We believe that the operator was misled by the sonogram which informed him that the IUD was indeed within the uterus and presumably penetrating the posterior wall by virtue of its eccentric location but which did not indicate the exact place and degree of anatomic dislocation.  A far more useful procedure would have been hysterography (after a preliminary roentgenogram had shown the IUD was still in the patients pelvis) which accurately differentiates between the normally placed superficially embedded deeply embedded partially perforated and completely perforated IUDs.  In this instance it would clearly have shown the place and extent of myometrial penetration by the IUD and consequently would have pointed the way to the optimal method of removal.  In the present state of the art the role of ultrasonography in uterine perforation by IUD is limited as follows:  1) It can diagnose the properly placed IUD but cannot differentiate it from deep embedding.  2) It can diagnose complete perforation but only when the IUD is close to the uterus e.g. in the posterior cul-de-sac.  3) It can diagnose partial perforation but cannot pinpoint the exact area or indicate the exact degree of myometrial penetration.  (full text)
Genetic Diversity and Protective Efficacy of the RTS,S/AS01 Malaria Vaccine
Authors: Daniel E. Neafsey, Michal Juraska, Trevor Bedford, David Benkeser, Clarissa Valim, Allison Griggs, Marc Lievens, Salim Abdulla, Samuel Adjei, Tsiri Agbenyega, Selidji T. Agnandji, Pedro Aide, Scott Anderson, Daniel Ansong, John J. Aponte, Kwaku Poku Asante, Philip Bejon, Ashley J. Birkett, Myriam Bruls, Kristen M. Connolly, Umberto D’Alessandro, Carlota Dobaño, Samwel Gesase, Brian Greenwood, Jonna Grimsby, Halidou Tinto, Mary J. Hamel, Irving Hoffman, Portia Kamthunzi, Simon Kariuki, Peter G. Kremsner, Amanda Leach, Bertrand Lell, Niall J. Lennon, John Lusingu, Kevin Marsh, Francis Martinson, Jackson T. Molel, Eli L. Moss, Patricia Njuguna, Christian F. Ockenhouse, Bernhards Ragama Ogutu, Walter Otieno, Lucas Otieno, Kephas Otieno, Seth Owusu-Agyei, Daniel J. Park, Karell Pellé, Dana Robbins, Carsten Russ, Elizabeth M. Ryan, Jahit Sacarlal, Brian Sogoloff, Hermann Sorgho, Marcel Tanner, Thor Theander, Innocent Valea, Sarah K. Volkman, Qing Yu, Didier Lapierre, Bruce W. Birren, Peter B. Gilbert, Dyann F. Wirth
Journal: New England Journal of Medicine (2015)

The RTS,S/AS01 vaccine targets the circumsporozoite protein of Plasmodium falciparum and has partial protective efficacy against clinical and severe malaria disease in infants and children. We investigated whether the vaccine efficacy was specific to certain parasite genotypes at the circumsporozoite protein locus.We used polymerase chain reaction-based next-generation sequencing of DNA extracted from samples from 4985 participants to survey circumsporozoite protein polymorphisms. We evaluated the effect that polymorphic positions and haplotypic regions within the circumsporozoite protein had on vaccine efficacy against first episodes of clinical malaria within 1 year after vaccination.In the per-protocol group of 4577 RTS,S/AS01-vaccinated participants and 2335 control-vaccinated participants who were 5 to 17 months of age, the 1-year cumulative vaccine efficacy was 50.3% (95% confidence interval [CI], 34.6 to 62.3) against clinical malaria in which parasites matched the vaccine in the entire circumsporozoite protein C-terminal (139 infections), as compared with 33.4% (95% CI, 29.3 to 37.2) against mismatched malaria (1951 infections) (P=0.04 for differential vaccine efficacy). The vaccine efficacy based on the hazard ratio was 62.7% (95% CI, 51.6 to 71.3) against matched infections versus 54.2% (95% CI, 49.9 to 58.1) against mismatched infections (P=0.06). In the group of infants 6 to 12 weeks of age, there was no evidence of differential allele-specific vaccine efficacy.These results suggest that among children 5 to 17 months of age, the RTS,S vaccine has greater activity against malaria parasites with the matched circumsporozoite protein allele than against mismatched malaria. The overall vaccine efficacy in this age category will depend on the proportion of matched alleles in the local parasite population; in this trial, less than 10% of parasites had matched alleles. (Funded by the National Institutes of Health and others.).
Cardiac hypertrophy is exacerbated in aged mice lacking the osteoprotegerin gene
Authors: Yilin Hao, Toshihiro Tsuruda, Yoko Sekita-Hatakeyama, Syuji Kurogi, Keishi Kubo, Sumiharu Sakamoto, Midori Nakamura, Nobuyuki Udagawa, Tomohisa Sekimoto, Kinta Hatakeyama, Etsuo Chosa, Yujiro Asada, Kazuo Kitamura
Journal: Cardiovascular Research (2016)

Osteoprotegerin (OPG) may play a role in the progression of cardiac hypertrophy and heart failure. However, its pathophysiological role in changes in cardiac structure and function with ageing remains to be elucidated. We conducted experiments using 2.5- and 12-month-old OPG−/− mice and age-matched wild-type (WT) mice and compared the morphology and function of the left ventricle (LV). Both 2.5- and 12-month-old OPG−/− mice showed a higher systolic blood pressure and a greater heart weight/body weight ratio than age-matched WT mice. Twelve-month-old OPG−/− mice had a significantly larger LV chamber and reduced wall thickness compared with age-matched WT mice, and contractile function was decreased. The morphological differences were accompanied by an increase in the number of apoptotic cells and activation of tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) in the LV of 12-month-old OPG−/− mice. Correspondingly, OPG small interfering RNA induced the expressions of TRAIL and cleaved caspase-3 in cultured cardiac myocytes. In addition, these mice revealed a decrease in interstitial fibrosis, activation of matrix metalloproteinase (MMP)-2 and tissue inhibitors of MMP-1 and -2, and inactivation of procollagen α1 synthesis. Moreover, intraperitoneal administration of recombinant OPG to either 2.5- or 12-month-old OPG−/− mice for 28 days led to partial improvement of LV structure and function without affecting systolic blood pressure. These results suggest that OPG plays a role in preserving myocardial structure and function with ageing through a reduction in apoptosis and preservation of the matrix structure. In addition, this appears to be independent of effects on the vasculature.
Doxycycline for prevention of erlotinib-induced rash in patients with non-small-cell lung cancer (NSCLC) after failure of first-line chemotherapy: A randomized, open-label trial
Authors: Gaël Deplanque, Radj Gervais, Alain Vergnenegre, Lionel Falchero, Pierre-Jean Souquet, Jean-Michel Chavaillon, Bruno Taviot, Ghislaine Fraboulet, Hakim Saal, Caroline Robert, Olivier Chosidow
Journal: Journal of the American Academy of Dermatology (2016)
Prediction of Treatment Effects for Individual Cancer Patients Using Data from Randomized Clinical Trials
Authors: R.C.M. van Kruijsdijk, F.L.J. Visseren, A.C. Dingemans, H.J.M. Groen, J.G. Aerts, Y. van der Graaf, E.F. Smit
Journal: Annals of Oncology (2014)
Even a worm can turn
Authors: Andrés F Henao-Martínez, Nancy Madinger
Journal: BMJ (2015)

A previously fit and well 24 year old US born white man presented for evaluation of abdominal pain. He had felt tired for the past two days and had been experiencing headaches, subjective fevers, and diffuse abdominal pain. Despite this he had maintained a good appetite and his normal diet, which included eating sushi at least once a week. His symptoms improved greatly after he noted a tape-like object in his stool. He had travelled to California, …
Long term marijuana use is linked to impaired verbal memory
Authors: Jacqui Wise
Journal: BMJ (2016)

Long term marijuana use is associated with impaired verbal memory in middle age but does not affect other aspects of cognitive function, a 25 year follow-up study has shown.1

The Coronary Artery Risk Development in Young Adults (CARDIA) study included 3885 black and white participants aged 18-30 at the start of the study, who were asked periodically about their marijuana use over the next 25 years.

After 25 years some …
Rearrangement and overexpression of the BCL-1/PRAD-1 gene in intermediate lymphocytic lymphomas and in t(11q13)-bearing leukemias
Authors: R Rimokh, F Berger, G Delsol, C Charrin, MF Bertheas, M Ffrench, M Garoscio, P Felman, B Coiffier, PA Bryon
Journal: Blood (1993)
Abstract 222: Optimizing the Application of a Mechanical Chest Compression Device Within a High-Performance CPR Approach to Out-of-Hospital Cardiac Arrest Resuscitation
Authors: Michael Levy, Dana Yost, Robert G Walker, Erich A Scheunemann, Steve R Mendive
Journal: Circulation (2014)

Background: Minimizing the chest compression pause associated with application of a mechanical CPR (mCPR) device is a key component of optimal integration of mCPR into the overall resuscitation process. As part of a multi-agency implementation project, Anchorage Fire Department deployed LUCAS mCPR devices on BLS and ALS vehicles for initiation early in resuscitation efforts. A 2012 report from that project identified the pause interval for mCPR device application as a key opportunity for quality improvement (QI). In early 2013 we began a QI initiative to reduce device application time and optimize the overall CPR process, which included education on the importance of minimizing pauses, training on techniques for efficient device application, and a requirement for two manual CPR cycles prior to initiation of mCPR. To assess QI initiative effectiveness, we compared key CPR process metrics from before to during and after its implementation. Methods: We included all cases of EMS-treated out-of-hospital cardiac arrest during 2012 and 2013 in which mCPR was used and the defibrillator electronic record was available. Continuous ECG and impedance data were analyzed to measure chest compression fraction, duration of the pause from last manual to first mechanical compression, and duration of the longest overall pause in the resuscitation effort. Results: Compared to cases from 2012 (n=61), median (25th, 75th percentile) duration of the pause prior to first mCPR compression for cases from 2013 (n=71) decreased from 21 (15, 31) to 7 (4, 12) seconds (p&lt;0.001), while median chest compression fraction increased from 0.90 (0.88, 0.93) to 0.95 (0.93, 0.96) (p&lt;0.001). Median duration of the longest pause decreased from 25 (20, 35) to 13 (10, 20) seconds (p&lt;0.001), while the proportion of cases where the longest pause was for mCPR device application decreased from 74% to 32% (p&lt;0.001). Conclusions: Our QI initiative substantially reduced the duration of the pause prior to first mCPR compression. Combined with the simultaneous significant increase in compression fraction and significant decrease in duration of the longest pause, this finding strongly suggests a large improvement in mCPR device application efficiency within an overall high-performance CPR process.
PWE-029 Nationwide linkage analysis in Scotland implicates age as the critical overall determinant of mortality in ulcerative colitis
Authors: R J Nicholls, D N Clark, L Kelso, A M Crowe, A D Knight, P Hodgkins, J Satsangi
Journal: Gut (2010)

<h3>Introduction</h3> Mortality rates of patients hospitalised with ulcerative colitis (UC) were defined to identify important risk factors. <h3>Methods</h3> A cohort study was undertaken using the Scottish national record linkage database. Three-year mortality rates of patients with a primary diagnosis of UC between 1998 and 2000 were determined according to the type of admission: colectomy elective, colectomy emergency, no colectomy elective and no colectomy emergency. Univariate and multivariate analyses were used to determine the influence of age, gender, comorbidity, interval from admission to surgery, social deprivation, length of stay and type of hospital. <h3>Result</h3> Of 1078 patients identified (90.9% audit completeness), 177 were coded as colectomy elective, 100 as colectomy emergency, 244 as no colectomy elective and 557 as no colectomy emergency. Crude three-year mortality rates were 5.6%, 9.0%, 9.8% and 16.0%. Male gender, comorbidity and length of stay were each independently related to mortality on multivariate analysis. Age was the critical determinant of mortality; no patient aged &lt;30 years died; mortality in the under 50s (10/587 (1.7%)) was significantly lower than for those aged 50–64 years (26/246 (10.6%)) (χ<sup>2</sup>=32.91, p&lt;0.0000001) and 65 years and above (96/245 (39.2%)) (χ<sup>2</sup>=218.2, p&lt;0.0000001). There was no significant difference in mortality by admission type under 65 years. At 65 years and beyond the three year mortality in the four admission groups was 29.4%, 33.3%, 28.1% and 44.7%. <h3>Conclusion</h3> Three-year mortality after an incident admission for UC is high over 65 years and is highest for emergency admissions not undergoing surgery. Management protocols in the elderly should be reconsidered in the light of these data.
Small Particulate Debris Adhering to Cell Surfaces in Human Leukocyte Cultures: Relationship With Presence of Herpes-Type Virus Particles<xref ref-type="fn" rid="FN2">2</xref>
Authors: S. Chandra, T. Liszczak, J. H. Monroe
Journal: JNCI Journal of the National Cancer Institute (1970)

In human leukocyte cultures containing herpes-type virus (HTV) particles, some non-virus-containing cells had small particulate debris on their cell surfaces. Essentially consisting of membranous bodies of various sizes and shapes, the debris sometimes contained a few HTV particles. The percentage of cells with such a debris “coat” was much higher than that of cells infected with HTV in a given culture. The presence of particulate debris in a leukocyte culture was shown to indicate the presence of HTV. Such debris may be responsible for membrane immunofluorescence in human leukocyte cultures.
Phase 3, Double-Blind, Placebo-Controlled Study of Vemurafenib Versus Vemurafenib + Cobimetinib in Previously Untreated Brafv600 Mutation–Positive Patients with Unresectable Locally Advanced or Metastatic Melanoma (Nct01689519)
Authors: G.A. McArthur, P.A. Ascierto, J. Larkin, A. Ribas, G. Liszkay, M. Maio, M. Mandalà, L.V. Demidov, D. Stroyakovsky, L. Thomas, L. De La Cruz Merino, V. Atkinson, C. Dutriaux, C. Garbe, I. Chang, S.P. Hack, B. Dréno
Journal: Annals of Oncology (2014)
Nonclassical activation of gli1 as a therapeutic target for squamous cell lung cancer
Authors: Chunli Shao, Sahba Kasiri, Alexandra Wilson, Baozhi Chen, Paul Yenerall, Patrick Dospoy, Suzie Hight, Luc Girard, Hui Tian, Carmen Behrens, Ignacio Wistuba, Adi Gazdar, James Kim
Journal: Journal of Thoracic Oncology (2016)
Acceptable Results Of Allo-HSCT From Unrelated Donors In AML Patients Who Failed To Achieve The Complete Remission
Authors: Miroslaw Markiewicz, Monika Dzierzak-Mietla, Malwina Rybicka, Magdalena Gaj, Anna Koclega, Patrycja Zielinska, Krzysztof Bialas, Slawomira Kyrcz-Krzemien
Journal: Blood (2013)
Dengue epidemic - Puerto Rico, January-July 2010.
Authors: L. G. Feliciano, C. Deseda, A. Rivera, K. M. Tomashek, J. Munoz-Jordan, E. Hunsperger, O. Padro, L. M. Santiago, E. Soto, J. Perez, R. Rodriguez, H. Seda, R. Barrera, D. F. Arguello, H. Margolis
Journal: MMWR Morbidity and Mortality Weekly Report (2010)
Is intercompartmental urea clearance during hemodialysis a perfusion term? A comparison of two pool urea kinetic models.
Authors: D Schneditz, B Fariyike, R Osheroff, N W Levin
Journal: Journal of the American Society of Nephrology (1995)

Analyses of intradialytic and postdialytic urea profiles call for models that consider delayed urea transfer from different parts of the body to the blood. There are two different approaches to the problem. In the classical cell membrane model it is assumed that the two compartments refer to the serial (s) arrangement of extracellular and intracellular volumes, whereas in the regional blood flow model the two compartments are identified as parallel (p) organ systems with high or low perfusion. In the cell membrane model, delayed urea removal from peripheral body compartments is governed by intercompartmental clearance (Kc) which is a function of cell membrane permeability, whereas in the regional blood flow model delayed urea removal is related to low perfusion (QL) of the large muscle/skin/bone compartment. Both models were compared in a set of 16 high-efficiency hemodialysis treatments. Modeled volumes (Vm,s = 31.2 +/- 9.5 L; Vm,p = 30.0 +/- 8.3 L) and modeled dose of hemodialysis (Kt/Vm,s = Kt/Vm,p = 1.12 +/- 0.33) were the same for both models. However, volumes modeled by either technique were significantly lower than anthropometric volumes (V alpha = 35.0 +/- 6.4 L). These data suggest that at this point the two models are experimentally indistinguishable. Moreover, the main system parameters of both models, Kc (0.54 +/- 0.16 L/min) and QL (0.63 +/- 0.15 L/min) showed a strong linear dependence (QL = 0.921 Kc + 0.139, r2 = 0.884), whereas no relation could be found between Kc and Vm. Therefore, delayed transport that has up to now been characterized by membrane permeability may also be explained by peripheral perfusion.
Rate of positive blood cultures after 3 days of empiric antibiotics in pediatric cancer
Authors: B. Kanathezhath, J. Feusner
Journal: Journal of Clinical Oncology (2007)

9535 Background: Infections continue to be a major cause of morbidity and mortality in pediatric oncology patients (pts) with febrile neutropenia (FN). The proportion of such pts who have bacteremia documented after 72 hours (hrs) of broad-spectrum antibiotics, in the absence of local or systemic signs of infection, has not been previously reported. Methods: We conducted a retrospective analysis of all FN oncology pts admitted to our hospital during the period of August 1999 to October 2006. Blood cultures (BCs) from pts who were persistently febrile more than 3 days after initiation of empiric broad-spectrum antibiotics (ceftazidime and tobramycin) were analyzed. Medical records of pts with positive late blood cultures (LBCs) after 72 hrs were reviewed for onset of new signs and symptoms of infection. Hematopoietic stem cell transplant and HIV pts were excluded. Results: Ninety-seven episodes of persistent fever occurred in 71 FN pts. The total number of positive BCs in the first 72 hours was 24 (33.8%). Three (4.2%) of the persistently febrile pts had positive LBC. Of these 3 pts, one had preceding new signs and symptoms. Another had a probable contaminant (only 1 positive BC for coagulase-negative staphylococcus). Only one pt (1.4%) had positive LBC without any new local or systemic signs of infection. The observed frequency of positive LBC was 4.2% for pts and 0.8% (3/391) for total cultures obtained after 72 hours. There were no changes made in the antibiotic regimen of pts with positive LBC and none of them suffered from sepsis related mortality. Conclusions: This is the first report of late blood culture results in FN pediatric oncology pts. The practice of obtaining daily blood culture in such pts who are stable after 72 hrs of broad- spectrum antibiotics has a low yield (&lt;5%), and even lower (&lt;2%) if pts with new signs or symptoms at the LBC are excluded. This observation, if confirmed by larger studies from other centers, could lead to a more efficient, risk based strategy for following these pts. No significant financial relationships to disclose.
Prenatal Triclosan Exposure and Anthropometric Measures Including Anogenital Distance in Danish Infants
Authors: Tina Harmer Lassen, Hanne Frederiksen, Henriette Boye Kyhl, Shanna H. Swan, Katharina M. Main, Anna-Maria Andersson, Dorte Vesterholm Lind, Steffen Husby, Christine Wohlfahrt-Veje, Niels E. Skakkebæk, Tina Kold Jensen
Journal: Environmental Health Perspectives (2016)

Triclosan (TCS) is widely used as an antibacterial agent in consumer products such as hand soap and toothpaste, and human exposure is widespread. TCS is suspected of having endocrine-disrupting properties, but few human studies have examined the developmental effects of prenatal TCS exposure.We prospectively examined associations between prenatal TCS exposure and anthropometric measures at birth and anogenital distance (AGD) at 3 months of age.Pregnant women from the Odense Child Cohort (n = 514) provided urine samples at approximately gestational week 28 (median 28.7 weeks, range 26.4-34.0), and urinary TCS concentration was measured by isotope dilution TurboFlow-liquid chromatography-tandem mass spectrometry. Multiple linear regression analysis was used to examine associations between prenatal TCS exposure and measures of size at birth (birth weight, length, head and abdominal circumference) and AGD at 3 months of age (median 3.3 months, range 2.3-6.7 months), controlling for potential confounders.Newborn boys in the highest quartile of prenatal TCS exposure had a 0.7-cm [95% confidence interval (CI): -1.2, -0.1, p = 0.01] smaller head circumference than boys in the lowest quartile. Additionally in boys, inverse associations of borderline statistical significance were observed between prenatal TCS exposure and abdominal circumference at birth and AGD at 3 months of age (p-values < 0.10). Prenatal TCS exposure was not significantly associated with any of the outcomes in girls. However, AGD was measured in fewer girls, and we observed no significant interactions between a child's sex and prenatal TCS exposure in anthropometric measures at birth.Prenatal TCS exposure was associated with reduced head and abdominal circumference at birth and with reduced AGD at 3 months of age in boys, although the last two findings were statistically nonsignificant. These findings require replication but are compatible with an anti-androgenic effect of prenatal TCS exposure on fetal growth in boys.Lassen TH, Frederiksen H, Kyhl HB, Swan SH, Main KM, Andersson AM, Lind DV, Husby S, Wohlfahrt-Veje C, Skakkebæk NE, Jensen TK. 2016. Prenatal triclosan exposure and anthropometric measures including anogenital distance in Danish infants. Environ Health Perspect 124:1261-1268; http://dx.doi.org/10.1289/ehp.1409637.