tbuckley/cabot-search huggingface dataset:
Prognostic Value of Coronary Computed Tomography Angiography in Patients With Diabetes: A Meta-analysis
Authors: Csilla Celeng, Pál Maurovich-Horvat, Brian B. Ghoshhajra, Béla Merkely, Tim Leiner, Richard A.P. Takx
Journal: Diabetes Care (2016)

OBJECTIVE The usefulness of coronary computed tomography angiography (CTA) for the evaluation of coronary artery disease (CAD) in patients with diabetes is ambiguous. We therefore performed a meta-analysis of studies reporting event rates and hazard ratios (HR) to determine the prognostic value of CTA in this patient population. RESEARCH DESIGN AND METHODS We searched PubMed and Embase up to November 2015. Study subjects’ characteristics, events (all-cause mortality or cardiac death, nonfatal myocardial infarction, unstable angina pectoris, stroke, revascularization), and events excluding revascularization were collected. We calculated the prevalence of obstructive and nonobstructive CAD on CTA, annualized event rates, and pooled unadjusted and adjusted HR using a generic inverse random model. RESULTS Eight studies were eligible for inclusion into this meta-analysis, with 6,225 participants (56% male; weighted age, 61 years) with a follow-up period ranging from 20 to 66 months. The prevalence of obstructive CAD, nonobstructive CAD, and no CAD was 38%, 36%, and 25%, respectively. The annualized event rate was 17.1% for obstructive CAD, 4.5% for nonobstructive CAD, and 0.1% for no CAD. Obstructive and nonobstructive CAD were associated with an increased HR of 5.4 and 4.2, respectively. A higher HR for obstructive CAD was observed in studies including revascularization compared with those that did not (7.3 vs. 3.7, P = 0.124). CONCLUSIONS CTA in patients with diabetes allows for safely ruling out future events, and the detection of CAD could allow for the identification of high-risk patients in whom aggressive risk factor modification, medical surveillance, or elective revascularization could potentially improve survival.
Urinary Tract Infection
Authors: D. J. O'Sullivan, M. G. FitzGerald, M. J. Meynell, J. M. Malins
Journal: BMJ (1961)

Physicians must interpret coronary angiography with caution and skepticism. Coronary angiography is considered the gold standard for defining coronary artery anatomy, diagnosing coronary artery disease, and guiding intervention. However, it does not provide functional information and may be misleading.
Defining Second-Hit Genetic Abnormalities Involved in the t(12; 21) TEL-AML1 Acute Lymphoblastic Leukemia by Array-Based Comparative Genomic Hybridization.
Authors: Shinobu Tsuzuki, Sivasundaram Karnan, Keizo Horibe, Kimikazu Matsumoto, Koji Kato, Kanji Sugita, Shinpei Nakazawa, Masao Seto
Journal: Blood (2005)
P-160 Impact of KRAS mutation on patterns of metastasis in a series of colorectal cancer patients
Authors: M. Domenech Viñolas, C. Santos, J. Pérez Martín Francisco, M. Varela, M. Merche, J. Grasselli, A. Teule, G. Soler, N. Mulet Margalef, M. Bergamino Sirven, A. Ortega Franco, X. Sanjuan, R. Salazar
Journal: Annals of Oncology (2016)
Hydraulic dilation with a shape-measuring balloon in idiopathic achalasia: a feasibility study
Authors: Wouter Kappelle, Auke Bogte, Peter Siersema
Journal: Endoscopy (2015)

<b>Background and aim:</b> Pneumatic dilation is a commonly used treatment in achalasia. Recent studies have shown that esophageal distensibility measurements can be used to assess the effect of dilation and possibly the risk of perforation. A new hydraulic dilation balloon allows visualization of the shape of the balloon in vivo and measurement of distensibility during dilation. We aimed to evaluate the technical feasibility of a 30-mm shape-measuring hydraulic dilation balloon for the treatment of achalasia. <b>Methods:</b> Consecutive patients with newly diagnosed achalasia were dilated using a 30-mm shape-measuring hydraulic dilation balloon. Patients were contacted 1 week, 1 month, and 3 months after dilation. Technical success, clinical success, and major complications were evaluated. <b>Results:</b> Technical success was achieved in all of the 10 patients included. Median esophagogastric junction distensibility (mm<sup>2</sup>/mmHg) increased from 1.1 (IQR 0.6 – 1.3) before dilation therapy to 7.0 (IQR 5.5 – 17.8) afterwards (<i>P</i> = 0.005). No major complications were seen. Three patients (30 %) reported recurrent dysphagia. <b>Conclusion:</b> Hydraulic dilation with a shape-measuring balloon in achalasia patients is feasible. In vivo esophageal distensibility measurements may allow for an individualized, patient-specific dilation regimen. The Netherlands National Trial Register: NTR4371
Case 36-1968
Authors: William F. McNeely, Benjamin Castleman
Journal: New England Journal of Medicine (1968)

Presentation of Case First admission. A forty-year-old man was admitted to the hospital because of the sudden onset of pain in the chest.During the previous four years the blood pressure had ranged between 140 and 170 systolic, 90 and 105 diastolic; no medication had been given. On the morning of admission he was awakened by a dull, aching pain in the interscapular region. On sitting up he experienced steady, constricting pain in the substernal region anteriorly, accompanied by slight shortness of breath and pain on deep inspiration, with radiation to the left shoulder. As he attempted to get out . . .
PD1-1-5: Five-years results of a non-randomised study evaluating spiral computed tomography (sCT) for early detection of lung cancer (LC)
Authors: Silvia Novello, Matteo Giaj Levra, Luciano Cardinale, Maria Pia Brizzi, Diego Sardo, Benedetta Crida, Paolo Lausi, Piero Borasio, Cesare Fava, Giorgio V. Scagliotti
Journal: Journal of Thoracic Oncology (2007)
Circulation of Cerebrospinal Fluid
Authors: G Roncari, U Meldolesi
Journal: BMJ (1964)

abnormality noted on examination.The haemo- globin value was 12.6 g./ 100 ml., with marked anisocytosis and many nucleated erythrocytes, spherocytes, and aberrant forms in a smear of peripheral blood.Of the erythrocytes approximately 40% were reticulocytes, and approxi- mately 80% contained Heinz bodies.The total serum bilirubin content was 5.3 mg./ 100 ml. and the conjugated serum bilirubin content 0.4 mg./100 ml.The mother's blood group was 0, Rh negative and the infant's blood group 0, Rh positive.The direct Coombs test was negative.The glucose-6-phosphate dehydrogen- ase (G6PD) activity by the method of Zinkham' was 260 units 100 ml. of erythrocytes.After transfusion of 100 ml. of blood the in- fant's condition improved rapidly.On 23 December the child was free of jaundice and purpura, the haemoglobin level was 23 g./100 ml., the erythrocytes were of normal appearance, and thrombocytes were present in normal numbers.The child has progressed well until the present time, with haemoglobin levels and thrombocyte counts within the normal range.Both parents are of Anglo-Saxon racial ex- traction.Over the last three weeks of pregnancy the mother had suffered from urinary symptoms and some oedema.For 15 days before delivery she had received sulphamethizole, 0.5 g. every four hours, and chlorothiazide, 0.5 g. daily.Case 2.-This female infant was first seen on 29 July 1963 at the age of 4 days, with a history of slowly increasing jaundice from the age of 24 hours.The infant was believed to be three weeks premature, but the birth weight was 3.6 kg.Gross jaundice was the only abnormality on physical examination.The total serum bilirubin content was 16.5 mg./100 ml., and the conju- gated serum bilirubin content less than 0.5 mg./ 100 ml.The haemoglobin level was 19.0 g./100 ml., reticulocytes comprised about 3 % of the erythrocytes, and Heinz bodies were present in approximately 20% of the erythrocytes.No
Physical exercise alleviates ER stress in obese humans through reduction in the expression and release of GRP78 chaperone
Authors: Abdelkrim Khadir, Sina Kavalakatt, Jehad Abubaker, Preethi Cherian, Dhanya Madhu, Irina Al-Khairi, Mohamed Abu-Farha, Samia Warsame, Naser Elkum, Mohammed Dehbi, Ali Tiss
Journal: Metabolism (2016)
205P Development of nomograms including HER2 status for predicting survival in metastatic gastric cancer
Authors: Y. Narita, S. Kadowaki, I. Oze, H. Taniguchi, T. Ura, M. Ando, S. Ito, Y. Yatabe, M. Tajika, K. Muro
Journal: Annals of Oncology (2015)
Fibroma-Myxoma Virus Transformations in Different Types of Tissue Culture
Authors: Lawrence Kilham, M.D.
Journal: JNCI Journal of the National Cancer Institute (1958)

Fibroma-Myxoma Virus Transformations in Different Types of Tissue Culture Get access Lawrence Kilham, M.D. Lawrence Kilham, M.D. Division of Biologics Standards,2Bethesda, Maryland Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 20, Issue 4, April 1958, Pages 729–739, https://doi.org/10.1093/jnci/20.4.729 Published: 01 April 1958 Article history Received: 20 September 1957 Published: 01 April 1958
HIV and Transplantation: New Reasons for HOPE
Authors: Preeti Malani
Journal: JAMA (2016)

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Effect of Enalapril on Mortality and the Development of Heart Failure in Asymptomatic Patients with Reduced Left Ventricular Ejection Fractions
Authors: S Yusuf, B Pitt, C E Davis, W B Hood, J N Cohn
Journal: New England Journal of Medicine (1992)

It is not known whether the treatment of patients with asymptomatic left ventricular dysfunction reduces mortality and morbidity. We studied the effect of an angiotensin-converting—enzyme inhibitor, enalapril, on total mortality and mortality from cardiovascular causes, the development of heart failure, and hospitalization for heart failure among patients with ejection fractions of 0.35 or less who were not receiving drug treatment for heart failure.
Authors' reply
Authors: Andrew Farmer, Patricia Yudkin, Elizabeth Goyder, Andrew Neil
Journal: BMJ (2007)

We agree with Moore et al that the results of a clinical trial should be interpreted in the context of an individual patient. Our trial of self monitoring of blood glucose does not exclude the possibility of a clinically important benefit for specific patient subgroups. While we welcome the improvements in care offered by Lister to his patients, personalising care on the basis of clinical judgment remains of critical importance. We agree with Evans that clinical judgment should be guided, rather than prescribed, by evidence from randomised trials. However, she has misunderstood the design of the more intensive self monitoring intervention where patients were provided with training and support to interpret readings and revise behavioural goals to reach treatment targets.1

We take issue with Moore et al on several points.

Firstly, it is not self evident that self monitoring will help where control is poor. We agree that the benefits of monitoring are self evident, but the relative benefits of self monitoring compared with repeated HbA1c measurements are unclear. We plan to explore this in exploratory subgroup analyses.

Secondly, we disagree with their comments about use of health economic models. The cost implications of routinely recommending self monitoring for all non-insulin treated patients with type 2 diabetes need to be carefully considered, and it would be unethical not to do so.

Finally, it is disappointing that they turn to a cohort study, which is likely to be confounded by unmeasured, and unmeasurable, individual characteristics, to claim “terrific” results for self monitoring.2 Randomised trials remain the gold standard for assessing an intervention.
P205 Admission trends and outcomes of individuals with bronchiectasis admitted to adult general critical care units in England, Wales and Northern Ireland: Abstract P205 Table 1
Authors: V Navaratnam, C Muirhead, RB Hubbard, A De Soyza
Journal: Thorax (2015)

<h3>Introduction</h3> Whilst studies suggest increasing incidence and mortality from bronchiectasis in UK, there are sparse data on outcomes of individuals with bronchiectasis admitted to intensive care (ICU). We investigated trends in bronchiectasis admissions to ICU and estimated outcomes in patients with bronchiectasis admitted to ICU compared to a better studied group, i.e. Chronic Obstructive Pulmonary Disease (COPD). <h3>Methods</h3> We used data from the Intensive Care National Audit and Research Centre (ICNARC), a database of patient outcomes from adult critical care units across England, Wales and Northern Ireland. 95% of adult critical care units contribute data to ICNARC which includes information from 1.5 million individuals. Admissions from bronchiectasis and COPD from 1/1/2009 to 31/12/2013 were extracted. Bronchiectasis admissions included patients whose primary or secondary reason for admission was exacerbation of bronchiectasis, excluding people with cystic fibrosis. COPD admissions were those whose primary or secondary reason for admission was either COPD with acute lower respiratory infection; or COPD with acute exacerbation. Patients with COPD-bronchiectasis overlap were excluded. ICU mortality was defined as status on leaving ICU. <h3>Results</h3> There were 614,352 admissions across 219 critical care units during the study period, 536 (0.1%) of which were from bronchiectasis and 19,754 (3.2%) from COPD. Bronchiectasis admissions increased from 74 in 2009 to 121 in 2013, equating to a crude annual increase of 8% (95% Confidence Interval [CI] 2 to 15%; p = 0.01) (see Table 1). The mean age increased from 56.6 (standard deviation [SD] 18) to 65.8 years (SD 15.2; p = 0.042) whilst ICU mortality did not change (27.0% vs 28.9%; p = 0.83). The unadjusted yearly increase in COPD admissions was 1% (95% CI: 0.3% to 2%; p = 0.012). The mean age in COPD patients remained static (67.5 years [SD 10.6] vs. 67.9 years [SD 10.6]; p = 0.16), but ICU mortality decreased (20.5% vs. 18.0%; p = 0.005). ICU mortality in people with bronchiectasis over 70 (n = 219) was higher compared to those under 70 (31.1% vs. 18.3%; p &lt; 0.001) despite having similar mean APACHE II acute physiology scores. <h3>Conclusion</h3> Bronchiectasis admissions to ICU are increasing, and ICU mortality for is higher bronchiectasis compared to COPD, particularly in individuals above 70 years of age.
Relationship between pulmonary rehabilitation and care dependency in COPD
Authors: D J A Janssen, S Wilke, D E Smid, F M E Franssen, I M Augustin, E F M Wouters, M A Spruit
Journal: Thorax (2016)

The aims of this study were to explore care dependency before and after pulmonary rehabilitation (PR) in patients with COPD (n=331) and to compare the response to PR between care dependent and independent patients. At baseline, 85 (25.7%) patients had a Care Dependency Scale (CDS) score ≤68 points and were considered as care dependent. CDS scores of these patients improved after PR (p&lt;0.001). After PR, CDS score of 38 (44.7%) patients with a baseline CDS score ≤68 points increased to &gt;68 points. Patients with a baseline CDS score ≤68 points or &gt;68 points showed after PR a comparable improvement in COPD Assessment Test, Hospital Anxiety and Depression Scale and 6-min walk distance (all p&lt;0.05). <h3>Trial registration number</h3> NTR3416 (The Netherlands).
Prognosis of Variant Angina Manifesting as Aborted Sudden Cardiac Death
Authors: Jung-Min Ahn, Ki Hong Lee, Sang-Yong Yoo, Young-Rak Cho, Jon Suh, Eun-Seok Shin, Jae-Hwan Lee, Dong Il Shin, Sung-Hwan Kim, Sang Hong Baek, Ki Bae Seung, Chang-Wook Nam, Eun-Sun Jin, Se-Whan Lee, Jun-Hyok Oh, Jae Hyun Jang, Hyung Wook Park, Nam Sik Yoon, Jeong Gwan Cho, Cheol Hyun Lee, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Jun Kim, Young-Hak Kim, Ki-Byung Nam, Cheol Whan Lee, Kee-Joon Choi, Jae-Kwan Song, You-Ho Kim, Seong-Wook Park, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2016)
Inpatient signs and symptoms and factors associated with death in children aged 5 years and younger admitted to two Ebola management centres in Sierra Leone, 2014: a retrospective cohort study
Authors: Tejshri Shah, Jane Greig, Linda Margaretha van der Plas, Jay Achar, Grazia Caleo, James Sylvester Squire, Alhaji Sayui Turay, Grace Joshy, Catherine D'Este, Emily Banks, Florian Vogt, Kamalini Lokuge
Journal: The Lancet Global Health (2016)

Médecins Sans Frontières (MSF) opened Ebola management centres (EMCs) in Sierra Leone in Kailahun in June, 2014, and Bo in September, 2014. Case fatality in the west African Ebola virus disease epidemic has been highest in children younger than 5 years. Clinical data on outcomes can provide important evidence to guide future management. However, such data on children are scarce and disaggregated clinical data across all ages in this epidemic have focussed on symptoms reported on arrival at treatment facilities, rather than symptoms and signs observed during admission. We aimed to describe the clinical characteristics of children aged 5 years and younger admitted to the MSF EMCs in Bo and Kailahun, and any associations between these characteristics and mortality.In a retrospective cohort study, we included data from children aged 5 years and younger with laboratory-confirmed Ebola virus disease admitted to EMCs between June and December, 2014. We described epidemiological, demographic, and clinical characteristics and viral load (measured using Ebola virus cycle thresholds [Ct]), and assessed their association with death using Cox regression modelling.We included 91 children in analysis; 52 died (57·1%). Case fatality was higher in children aged less than 2 years (76·5% [26/34]) than those aged 2-5 years (45·6% [26/57]; adjusted HR 3·5 [95% CI 1·5-8·5]) and in those with high (Ct<25) versus low (Ct≥25) viral load (81·8% [18/22] vs 45·9% [28/61], respectively; adjusted HR 9·2 [95% CI 3·8-22·5]). Symptoms observed during admission included: weakness 74·7% (68); fever 70·8% (63/89); distress 63·7% (58); loss of appetite 60·4% (55); diarrhoea 59·3% (54); and cough 52·7% (48). At admission, 25% (19/76) of children were afebrile. Signs significantly associated with death were fever, vomiting, and diarrhoea. Hiccups, bleeding, and confusion were observed only in children who died.This description of the clinical features of Ebola virus disease over the duration of illness in children aged 5 years and younger shows symptoms associated with death and a high prevalence of distress, with implications for clinical management. Collection and analysis of age-specific data on Ebola is very important to ensure that the specific vulnerabilities of children are addressed.No specific funding was received for this study. EB is supported by the National Health and Medical Research Council of Australia.
Detection of the E1 protein of HCV in peripheral blood mononuclear cells and in lymphocyte infiltrates in the liver.
Authors: T Suzuki, T Roskams, A Ducatteeuw, C Desmaretz, C Fretz, D Jeannel, V Beral, P van de Perre, F Fumoux, G Maertens, E Depla
Journal: Hepatology (1998)
Plasma Coenzyme Q10 Levels in Patients With Multiple System Atrophy
Authors: Jun Mitsui, Takashi Matsukawa, Tsutomu Yasuda, Hiroyuki Ishiura, Shoji Tsuji
Journal: JAMA Neurology (2016)

<h3>Importance</h3> Multiple system atrophy (MSA) is an intractable neurodegenerative disease characterized by autonomic failure in addition to various combinations of parkinsonism, cerebellar ataxia, and pyramidal dysfunction. It has recently been reported that functionally impaired variants of<i>COQ2</i>, which encodes an essential enzyme in the biosynthetic pathway of coenzyme Q10 (CoQ10), are associated with MSA. However, little is known about the role of CoQ10 in the pathogenesis of MSA. <h3>Objective</h3> To compare the levels of plasma CoQ10 in patients with MSA with those in age-, sex-, and<i>COQ2</i>genotype–matched controls. <h3>Design, Setting, and Participants</h3> We enrolled 44 Japanese patients with MSA and 39 Japanese controls from September 1, 2012, to December 31, 2015. Patients with MSA were diagnosed on the basis of the second consensus criteria by at least 2 neurologists. Plasma CoQ10 levels were measured by high-performance liquid chromatography with electrochemical detection. Sanger sequencing of<i>COQ2</i>was performed to determine the<i>COQ2</i>genotypes. Multiple logistic regression analysis was performed to determine the association between MSA and the plasma CoQ10 level. <h3>Main Outcomes and Measures</h3> Plasma CoQ10 levels in patients with MSA were compared with those in controls after adjusting for age, sex, and<i>COQ2</i>genotype. <h3>Results</h3> Among 44 patients with MSA (mean [SD] age, 63.7 [8.3] years) and 39 controls (mean [SD] age, 60.3 [13.0] years), the mean (SD) plasma level of CoQ10 in patients with MSA was lower than that in controls (0.51 [0.22] vs 0.72 [0.42] µg/mL;<i>P</i> = .01) (difference between medians: −0.14; 95% CI, –0.25 to –0.03). The mean (SD) plasma levels of CoQ10 in patients with the cerebellar variant of MSA and those with the parkinsonian variant of MSA were 0.58 (0.19) and 0.49 (0.26) µg/mL, respectively. After adjusting for age, sex, and<i>COQ2</i>genotype, the levels of plasma CoQ10 were significantly associated with MSA (95% CI, 0.10; range, 0.02 to 0.66) (<i>P</i> = .02). <h3>Conclusions and Relevance</h3> Our data showed decreased levels of plasma CoQ10 in patients with MSA regardless of the<i>COQ2</i>genotype, supporting a hypothesis that supplementation with CoQ10 is beneficial for patients with MSA.
Smallpox
Authors: Carolyn J. Hildreth
Journal: JAMA (2009)

mallpox is a viral infection caused by the Variola virus (an Orthopoxvirus) that can affect people of all ages.Smallpox is contagious and has a 30% fatality rate.The infection manifests with a fever, which precedes the development of a progressive rash that occurs all over the body starting in the mouth and on the face.The rash appears as firm, fluid-filled, and singularly dimpled bumps that eventually become crusty and then form scabs.The rash can persist for several weeks and leaves pitted scars when the scabs fall off.There is no known treatment for smallpox.Millions of people died during widespread smallpox epidemics in the past.Fortunately, smallpox was eradicated as a naturally occurring disease in 1980 after a successful worldwide vaccination program.There have been no cases in the United States since 1972.Most persons born before 1971 were vaccinated once against smallpox.Currently there are no recommendations for vaccination of the general public against smallpox, although there is concern that this virus could be used for bioterrorism.The United States has an adequate supply of smallpox vaccine for those who would need it in the event of such an outbreak.This includes all those known to be directly exposed, health care workers, public health workers, and volunteer responders to the crisis situation.The March 11, 2009, issue of JAMA includes an article about smallpox vaccination.