tbuckley/cabot-search huggingface dataset:
Abstract 17018: Amputation After Atherectomy: Studying Long-Term Outcomes Using an Instrumental Variable Method
Authors: Niveditta Ramkumar, Jesse A Columbo, Pablo M Camblor, A. James O’Malley, Philip P Goodney
Journal: Circulation (2018)

Introduction: Outcomes for atherectomy remain poorly characterized. Our objective was to use instrumental variable (IV) analysis to compare long-term amputation rates in patients receiving atherectomy versus other traditional peripheral vascular interventions (PVI) approaches. Methods: We queried the Medicare-linked Vascular Quality Initiative registry for patients undergoing PVI from 2010-2015. The exposure was treatment: atherectomy (+/- balloon angioplasty) versus other PVI types. The primary outcome was amputation. We used the proportion of atherectomy procedures of all PVIs performed at each hospital as an IV and compared the estimates from IV analysis to multivariable Cox regression and propensity-matched estimates. Results: In this cohort of 19693 patients, 2103 (10%) received atherectomy. Compared to patients receiving other PVI, patients receiving atherectomy were more likely to have a femoropopliteal artery (65% vs 48%, p&lt;0.001) treated with worse disease severity (TASC B and greater: 77% vs 69%, p&lt;0.001). The 5-year overall amputation rate was 31% (158 amputations per 1000 patients/year) in patients receiving atherectomy versus 24% (105 amputations per 1000 patients/year) for other PVIs (log-rank p&lt;0.001). Without adjustment, patients undergoing atherectomy were 40% more likely to have an amputation (Figure 1). After adjusting for patient demographics, comorbidities, and disease characteristics, this effect was mitigated to 15% and 16% for multivariable Cox and propensity-matched approaches, respectively. However, after the IV adjusted analysis accounted for unmeasured confounders, patients receiving atherectomy versus non-atherectomy PVI were 78% more likely to have an amputation. Conclusions: Patients receiving atherectomy were more likely to have an amputation. Unmeasured confounders such as selection bias may play an important role in the long-term risk of amputation for patients undergoing atherectomy.
Anaphylaxis in Hypersensitivity reactions to NSAIDs
Authors: Ana María Prieto-Moreno Pfeifer, Diana Pérez-Alzate, Isabel Torres Rojas, Maria Luisa Somoza Álvarez, Elisa Haroun-Díaz, Maria Vázquez de la Torre, Paula López-Gonzalez, Maria Desamparados Cervera Garcia, Carlos Blanco-Mota, Elena Diaz Vera, Francisco Ruano, Natalia Blanca-López
Journal: Journal of Allergy and Clinical Immunology (2022)
A group B Streptococcus alpha-like protein subunit vaccine induces functionally active antibodies in humans targeting homotypic and heterotypic strains
Authors: Andrzej Pawlowski, Jonas Lannergård, Majela Gonzalez-Miro, Duojia Cao, Sara Larsson, Jenny J. Persson, Geoff Kitson, Michael Darsley, Ane Lilleøre Rom, Morten Hedegaard, Per B. Fischer, Bengt Johansson-Lindbom
Journal: Cell Reports Medicine (2022)

Maternal vaccination is a promising strategy for preventing neonatal disease caused by group B Streptococcus. The safety and immunogenicity of the prototype vaccine GBS-NN, a fusion protein consisting of the N-terminal domains of the alpha-like proteins (Alp) αC and Rib, were recently evaluated favorably in healthy adult women in a phase 1 trial. Here we demonstrate robust immunoglobulin G (IgG) and immunoglobulin A (IgA) responses against αC and Rib, as well as against the heterotypic Alp family members Alp1–Alp3. IgA and heterotypic IgG responses are more variable between subjects and correlate with pre-existing immunity. Vaccine-induced IgG mediates opsonophagocytic killing and prevents bacterial invasion of epithelial cells. Like the vaccine-induced response, naturally acquired IgG against the vaccine domains is dominated by IgG1. Consistent with the high IgG1 cross-placental transfer rate, naturally acquired IgG against both domains reaches higher concentrations in neonatal than maternal blood, as assessed in a separate group of non-vaccinated pregnant women and their babies.
Feasibility of Specimen Self-collection in Young Children Undergoing SARS-CoV-2 Surveillance for In-Person Learning
Authors: Jonathan Altamirano, Marcela Lopez, India G. Robinson, Leanne X. Chun, Grace K.-Y. Tam, Nuzhat J. Shaikh, Elisabeth G. Hoyte, Yuan Jin Carrington, Shilpa G. Jani, Elizabeth Y. Toomarian, Julianna C. Hsing, Jasmin Ma, Uma Pulendran, Prasanthi Govindarajan, Andra L. Blomkalns, Benjamin A. Pinsky, C. Jason Wang, Yvonne Maldonado
Journal: JAMA Network Open (2022)

<h3>Importance</h3> There is an urgent need to assess the feasibility of COVID-19 surveillance measures in educational settings. <h3>Objective</h3> To assess whether young children can feasibly self-collect SARS-CoV-2 samples for surveillance testing over the course of an academic year. <h3>Design, Setting, and Participants</h3> This prospective pilot cohort study was conducted from September 10, 2020, to June 10, 2021, at a K-8 school in San Mateo County, California. The research consisted of quantitative data collection efforts: (1) demographic data collected, (2) student sample self-collection error rates, and (3) student sample self-collection time durations. Students were enrolled in a hybrid learning model, a teaching model in which students were taught in person and online, with students having the option to attend virtually as needed. Data were collected under waiver of consent from students participating in weekly SARS-CoV-2 testing. <h3>Main Outcomes and Measures</h3> Errors over time for self-collection of nasal swabs such as contaminated swabs and inadequate or shallow swabbing; time taken for sample collection. <h3>Results</h3> Of 296 participants, 148 (50.0%) were boys and 148 (50.0%) were girls. A total of 87 participants (29.2%) identified as Asian; 2 (0.6%), Black or African American; 13 (4.4%), Hispanic/Latinx; 103 (34.6%), non-Hispanic White; 87 (29.2%), multiracial; and 6 (2.0%), other. The median school grade was fourth grade. From September 2020 to March 2021, a total of 4203 samples were obtained from 221 students on a weekly basis, while data on error rates were collected. Errors occurred in 2.7% (n = 107; 95% CI, 2.2%-3.2%) of student encounters, with the highest rate occurring on the first day of testing (20 [10.2%]). There was an overall decrease in error rates over time. From April to June 2021, a total of 2021 samples were obtained from 296 students on a weekly basis while data on encounter lengths were collected. Between April and June 2021, 193 encounters were timed. The mean duration of each encounter was 70 seconds (95% CI, 66.4-73.7 seconds). <h3>Conclusions and Relevance</h3> Mastery of self-collected lower nasal swabs is possible for children 5 years and older. Testing duration can be condensed once students gain proficiency in testing procedures. Scalability for larger schools is possible if consideration is given to the resource-intensive nature of the testing and the setting's weather patterns.
Nicotine inhaler for smoking cessation
Authors: A. Goldstein
Journal: JAMA (1993)

broadcast antismoking commercials, smoking restrictions in restaurants and private workplaces, the radio and television ad ban, and the tar/nicotine listing requirement.3The 1971 radio and television ad ban resulted in about a 27.8% savings in real ad spending for cigarette companies with no detectable reduction in demand.3To be prudent, a total ad ban should be accompanied by controls on the introduction of new cigarette brands/varieties and by antismoking policies known to reduce consumption.Such effective measures include excise tax increases, res¬ taurant smoking restrictions, and broadcasting antismoking commercials.For each 10% increase in real cigarette price, a demand decrease of approximately 3.7% results.3For each 10% increase in the smoking-age population covered by gov¬ ernment smoking restrictions, a drop in demand of around 6.5% is seen.3An optimal antismoking agenda would give highest priority to these efficacious policies.
Coronary disease.
Authors: J Trowell
Journal: BMJ (1982)

oestrogen has been available for many years.Using data generated in the Royal College of General Practitioners' oral contraception study, I was unable to show in 19741 any correlation between reports of hypertension in oral contraceptive users and the oestrogen dose.At the same time, there was a sug- gestion that the progestogen component might be implicated.Convincing evidence of this association was published in 19772 and additional data were made available in 1980.3I accept that some workers regard conclusions drawn from reports of the occurrence of hypertension as less reliable than analyses of blood pressure measurements, but in retro- spect the doubts may not have been entirely justified.We must also take account of the strong evidence that the excess of arterial disease in oral contraceptive users is associated with the progestogen activity3-6 and that this is closely correlated with undesirable changes in highdensity lipoprotein cholesterol concentra- tions6-9 and carbohydrate metabolism.10Clearly, Khaw and Peart's advice to use oral contraceptives with the lowest effective progestogen activity must be emphatically endorsed.
Clinical Lectures Delivered at Charing Cross Hospital
Authors: H. Salter
Journal: BMJ (1862)

Cardiac (Cough.Aortic Regu),qitant Pulse: its Jfechanism.Circumstances conspiring to Heart-Displacement.Caardiac Sputum.D iagnos- tic Value of Age.Treatment.GENTLEMEN -The case to which I wish to-day to call your attention is that of a man lying (or rather sitting, for he cannot lie) in bed No. 9 of Bow Ward.The case is one of regurgitant aortic disease, and its history is as follows.Robert Carey, aged 40, a widower, by occupation a bill.poster, and has been engaged in that occupation seven years.He has been what he calls a temperate man, taking, on the average, " two pints of porter and a drop of gini" a day, and rarely exceeding that quantity.Up to three years ago he was a healthy, strong man; at that time he had rheumatic fever, which affected his head, back, and every joint in his body, and for which he was under treatment seven weeks in the Kingsland Road Infirmary.When he came out, he was quite well in every respect except his heart, which had suffered greatly during the rheumatism, and which was still the seat of pain when he left the infirmary.He suffered a good deal too from palpitation, which to a certain ex- tent embarrassed his respiration and incapacitated him from violent exertion.These symptoms gradually
The survival outcomes of the metastatic renal cell carcinoma with rhabdoid differentiation in immunotherapy era: Princess Margaret Cancer Center experience.
Authors: Esmail Mutahar Al-Ezzi, Abhenil Mittal, Brooke Wilson, Marco Iafolla, Pavlina Spiliopoulou, Srikala S. Sridhar, Nazanin Fallah-Rad, Peter W. M. Chung, Nathan Perlis, Aaron Richard Hansen
Journal: Journal of Clinical Oncology (2022)

333 Background: Patients (pts) diagnosed with metastatic renal cell carcinoma (mRCC) with rhabdoid differentiation (RD) have a poor prognosis due to aggressive tumor behavior and inherent treatment resistance to targeted therapies. However, recent data has demonstrated the survival benefit of immunotherapy (IO) in mRCC. Here, we report survival outcomes of pts with mRCC with RD treated with targeted therapy and or IO. Methods: This retrospective survival analysis was performed in pts with mRCC and RD treated with targeted treatment and IO at Princess Margaret Cancer Centre (PM), Toronto. Demographics, disease characteristics and survival outcomes were collected. Overall survival (OS) was calculated using the Kaplan-Meier method (log-rank). OS hazard ratio (HR) were calculated using cox proportional hazards model. IBM SPSS Statistics v26 was used to conduct statistical analyses. Results: We identified 474 pts diagnosed with mRCC at PM between 2002 and 2019. A total of 57 (12%) pts diagnosed with mRCC had RD and were treated with targeted and or IO agents. Of these, 42 (73.7%) pts had pure RD and 15 (26.3%) pts had mixed RD and sarcomatoid features. Median age was 62 yrs (35-86yrs) and 42 (73.7%) were male. Overall, as per the IMDC score, 5(8.8%), 27(47.4%) and 25(43.8%) pts were categorized as good, intermediate, and poor risk, respectively. In total, 34 (59.6%) pts were treated with targeted therapy only during their first and second line treatment course and 23 (40.4%) pts received IO alone or in combination with targeted treatment in the first or second line. With a median follow up of 53.4 months (range, 38.3-68.4 months), the median OS for the whole mRCC with RD cohort was 23.1 months (95% CI: 14.6-31.5). The median OS in all pts treated with targeted therapy only vs IO receipt was 13.1 months (95%CI: 5.4-20.8 months) vs not reached; p = 0.026, respectively. HR for OS was 0.44 (95%CI: 0.22-0.93; p = 0.03) favoring IO receipt. Conclusions: While the number of pts included in our retrospective review was small, our analysis has suggested that pts with mRCC and RD have poor survival outcomes that may be improved with IO treatment. RD is a histopathological feature that could identify pts who may benefit from IO therapy. Further analysis is needed to explore the impact of RD on IO treatment response.
Clinical Lectures
Authors: C. F. Favell
Journal: BMJ (1846)

The case which I sekct as the subject for considera- tion t evening, posseses several features of much interest, and deserves your very patient attention.Hannah Flinn, aged 36, of a pale yellowish complexion and leucophlegmatic habit, was admitted into the Infirmary on the 11th of October, 1845.She was the seventh of a family of ten children, of whom only three are now living.Four died during infancy, two when they were 17 years of age, of cholera, and one at
<i>Announcement</i>: National Epilepsy Awareness Month and Veterans Day, November 11, 2016
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

November is National Epilepsy Awareness Month, and November 11 is Veterans Day.Epilepsy is a brain disorder that causes recurrent seizures, which are characterized by sudden, abnormal electrical activity in the brain that briefly changes the way a person behaves, thinks, or feels.Epilepsy affects 7-10 per 1,000 persons, or approximately 2.9 million persons in the United States (1,2).Although the prevalence of epilepsy in veterans is unknown, the Veterans Health Administration (VHA) estimates that during 2012-2014, the prevalence of epilepsy among veterans under treatment at VHA facilities was 13.9 per 1,000 persons (3).Approximately 13% of veterans with seizures were aged <45 years, 39% were aged 45-65 years, and 7% were female (3).Veterans are at higher risk for developing epilepsy than nonveterans because of an increased likelihood of traumatic brain injuries and post-traumatic stress disorder (4); these conditions are also associated with psychogenic nonepileptic seizures (events caused by psychological distress that resemble seizures, but are not associated with abnormal electrical activity in the brain).In a study published in this issue, veterans with epilepsy who were deployed in the Iraq and Afghanistan conflicts were found to have a higher prevalence of mental and physical comorbidity and substantially higher mortality than were veterans without epilepsy.The VHA Epilepsy Centers of Excellence (ECoE), a network of 16 sites that was created in 2008, provides comprehensive treatment and support to veterans with epilepsy (i.e., seizure disorders, including psychogenic nonepileptic seizures) (3).The ECoE's video series, Veterans and Epilepsy: Basic Training, helps educate veterans, their caregivers, and the general public about living with epilepsy, and helps reduce epilepsy-associated stigma (5).CDC supports community-based resources and services for all adults with epilepsy and evaluates epilepsy self-management programs for veterans with epilepsy.Information about these services and programs is available at http://www.cdc.gov/epilepsy.
Psychosexual problems.
Authors: E Stanley
Journal: BMJ (1987)

Clinical observations indicate that dexamisole and levamisole, the isomers of tetramisole, cause mood elevation. Their effects on smooth muscle cells and adrenergic nerves were investigated in strips of dogs9 saphenous veins. Dexamisole (2.5 X 10(-6) to 4 X 10(-5) M) augmented the contractile response to norepinephrine but depressed that to tyramine; cocaine inhibited the augmentation of the norepinephrine response. Levamisole (10(-5) M) did not alter the response to norepinephrine, but augmented that to tyramine. At 1.6 X 10(-4) M dexamisole, more than levamisole, depressed the responses to norepinephrine, tyramine and acetylcholine. Activation by K+ ions was not affected by the isomers. Preparations, incubated with 3H-norepinephrine, were mounted for superfusion, tension recording and determination of 3H-norepinephrine and metabolites in the superfusate. Dexamisole and levamisole augmented the 3H-norepinephrine overflow during nerve stimulation; levamisole decreased the efflux of deaminated metabolites. During tyramine-induced contractions, dexamisole depressed and levamisole augmented the efflux of 3H-norepinephrine; they reduced the appearance of metabolites. The increases in 3H-norepinephrine caused by the isomers during nerve stimulation were not seen after phenoxybenzamine. Dexamisole, more than levamisole, inhibited tissular uptake of 3H-norepinephrine. Levamisole, more than dexamisole, inhibited monoamine oxidase activity in vein homogenates. These interferences with release and disposition of norepinephrine may be related to the antidepressant properties of the tetramisole isomers.
EDITORIAL NOTES.
Journal: JAMA (1890)

<h3>HOME.</h3> Prof. George H. Rohéhas been appointed to the honorable and responsible position of Commissioner of Health for the City of Baltimore. He will bring to the accomplishment of his work experience, culture, and rare executive power. The city is to be congratulated for this selection. <h3>Precautions against Fire in Hospitals.</h3> — The disastrous conflagration which befell the Presbyterian Hospital in New York, has had this compensation that it has stimulated the authorities of some of the older hospitals to an inspection of their fire-escape provisions. A systematic fire-drill has been put in practice in the case of some of them, and other precautions have been devised to prevent a loss of life in the emergency of a fire. The construction of not a few of these institutions has been faulty from their inception, from an apparent ignoring of the possibility of such an accident. <h3>Addresses of the Secretaries</h3>
Detecting visually significant cataract using retinal photograph-based deep learning
Authors: Yih-Chung Tham, Jocelyn Hui Lin Goh, Ayesha Anees, Xiaofeng Lei, Tyler Hyungtaek Rim, Miao-Li Chee, Ya Xing Wang, Jost B. Jonas, Sahil Thakur, Zhen Ling Teo, Ning Cheung, Haslina Hamzah, Gavin S. W. Tan, Rahat Husain, Charumathi Sabanayagam, Jie Jin Wang, Qingyu Chen, Zhiyong Lu, Tiarnan D. Keenan, Emily Y. Chew, Ava Grace Tan, Paul Mitchell, Rick S. M. Goh, Xinxing Xu, Yong Liu, Tien Yin Wong, Ching-Yu Cheng
Journal: Nature Aging (2022)

Age-related cataracts are the leading cause of visual impairment among older adults. Many significant cases remain undiagnosed or neglected in communities, due to limited availability or accessibility to cataract screening. In the present study, we report the development and validation of a retinal photograph-based, deep-learning algorithm for automated detection of visually significant cataracts, using more than 25,000 images from population-based studies. In the internal test set, the area under the receiver operating characteristic curve (AUROC) was 96.6%. External testing performed across three studies showed AUROCs of 91.6-96.5%. In a separate test set of 186 eyes, we further compared the algorithm's performance with 4 ophthalmologists' evaluations. The algorithm performed comparably, if not being slightly more superior (sensitivity of 93.3% versus 51.7-96.6% by ophthalmologists and specificity of 99.0% versus 90.7-97.9% by ophthalmologists). Our findings show the potential of a retinal photograph-based screening tool for visually significant cataracts among older adults, providing more appropriate referrals to tertiary eye centers.
A course of Lectures on Clinical Medicine
Authors: W. R. Basham
Journal: BMJ (1846)

Cases of idiopathic erysipelas of the head; history of the cases; varieties of erysipelas; principles of treatment, the same in all; characters of the erysipelatous inflammation; concurring conditions; symptomatic fever, for the most part asthenic.-Treatment, local and genetral; varieties of local treatment; advantages of nitrate of silvcr; general principles of the general or constitutional treatment; effects qf mercuriah, cathartics, colchicum, ammonia, -opiitm, and stimulants.Gentlemen,-The last fortnight bas brought into my hands three cases of idiopathic erysipelas of the face, head, and scalp, all admitted within a few hours of each other; two of them occurring in the same family, a father and daughter; the third, -however, firom a different and distant locality, so that the idea that would present itself immediately to the nmind of a con- tagionist, that of a comumon or contagious origin, by which is meant an emanationi of imaginary germs, or germinal entities, given off from-the body of one and inoculating anotlher, cannot be maintained.Particular periods of the year are more favourable to the developnient of erysipelas than others, and to this fact we inust refer the appearance of these cases simultaneously.Let us first turn to the record of these cases in the ward books.CASE I.WV. M-, aged 43, a tailor by trade, was admuitted illto the lhospital on October 17th.He had felt unwell for the last two weeks; anorexia and debility; within the last four days had some sharp rigors, accomnpanied by severe headache.Tliree days since first felt uneasy sensations about the face and scalp, the cheeks, fore- head, and eyes, becoming swollen, sensitive, with burning heat and pricking sensations in the cuticle.Co-existent with this condition of the face were erratic pains in all his limbs, and more particularly in his loins.On admission the features were obliterated and obscured by an extensive erysipelatous inflammiiation, whichi had involved them all in a general tuinefaction; this extended upwards to the scalp as far as the sin- ciput, and below to a few lines beneath the chin; laterally the ears were involved, the cartilages of which were iimuch sxvollen, and had already begunl tovesicate.'The entire sutrface occupied by tLhis erysipelatous con- m3ition was of a dusky-red colour, extrenmely sensitive N^. 47, Noyemb)4cr 25, 1816 to the touch, and of glistening aspect, and conveying a constant burning sensation to the patient, the colour erapidly disappearing under the pressure of the finger, and as rapidly returning, ,nd the inflammatory redness
Calcium carbonate carriers for combined chemo- and radionuclide therapy of metastatic lung cancer
Authors: Alexander S Timin, Alisa S Postovalova, Timofey E Karpov, Dmitrii Antuganov, Anastasia S Bukreeva, Darya R Akhmetova, Anna S Rogova, Albert R Muslimov, Svetlana A Rodimova, Daria S Kuznetsova, Mikhail V Zyuzin
Journal: Journal of Controlled Release (2022)
Ingrowing toenails.
Authors: K. F. Sweetman
Journal: BMJ (1967)

It is therefore conceivable, even when full ;allowance is made for the length of time the processes of the law can take, that a marriage could be annulled on this particular ground -in the year 1967.-Iam, etc., Birmingham 30.A. I. ROITH.*** The Queen's Counsel who prepared the article comments that Dr. Roith is of course perfectly right in the point that he makes in his second paragraph, but he has perhaps
Geographic Differences in Prepregnancy Cardiometabolic Health in the United States, 2016 Through 2019
Authors: Natalie A. Cameron, Priya M. Freaney, Michael C. Wang, Amanda M. Perak, Brigid M. Dolan, Matthew J. O’Brien, S. Darius Tandon, Matthew M. Davis, William A. Grobman, Norrina B. Allen, Philip Greenland, Donald M. Lloyd-Jones, Sadiya S. Khan
Journal: Circulation (2022)