tbuckley/cabot-search huggingface dataset:
Clinical Trials in Sub-Saharan Africa and Established Standards of Care
Authors: David M. Kent, D. Mkaya Mwamburi, Michael L. Bennish, Bruce Kupelnick, John P. A. Ioannidis
Journal: JAMA (2004)

ContextThe minimum standard of care required for participants in clinical trials conducted in resource-poor settings is a matter of controversy; international documents offer contradictory guidance.ObjectiveTo determine whether recently published trials conducted in sub-Saharan Africa met standards of care consistent with best current clinical standards for human immunodeficiency virus (HIV) treatment, tuberculosis treatment, and malaria prevention.Data SourcesTrials published during or after January 1998 that were indexed at the time of the MEDLINE and Cochrane Controlled Trials Register Search (November 20, 2003).Study SelectionAll randomized clinical trials that were conducted in sub-Saharan Africa in 3 clinical domains: HIV disease, tuberculosis treatment, and malaria prophylaxis.Data ExtractionTo establish criteria for best current standards of care, evidence from the literature and published guidelines accepted for well-resourced settings were analyzed; the actual care offered in the trial was then compared with these standards.Data SynthesisA total of 128 eligible articles described data from 73 different randomized clinical trials. Only 12 trials (16%) provided care that met guidelines to both intervention and control patients. Only 1 of the 34 trials that enrolled patients with HIV disease provided antiretroviral treatment that conformed to guidelines. Conversely, all tuberculosis treatment trials (n = 13, including 3 for HIV-infected patients) provided tuberculosis therapy that conformed to guidelines. Twenty-one (72%) of 29 malaria prophylaxis trials tested interventions that met guidelines, but only 3 (10%) used any active prophylactic intervention in the control group. Of the 59 trials (81%) that reported on the process of ethical review, all were reviewed by a host African institution and 64% were additionally reviewed by an institution in a developed country.ConclusionsRates of adherence to established clinical guidelines of care in randomized clinical trials of HIV treatment, tuberculosis treatment, and malaria prophylaxis varied considerably between disease categories. In determining clinical standards for trials in sub-Saharan Africa, researchers and ethics committees appear to take the local level of care into account.
ANOMALIES OF THE TEMPORAL BONE.
Authors: EMIL AMBERG
Journal: JAMA (1905)

<h3>DISPLACEMENT OF THE MASTOID PROCESS BY THE LATERAL SINUS.1</h3> One of the most common forms of asymmetry in the human skull consists in the right lateral sinus being situated more anteriorly than the left. Trautmann<sup>2</sup>has made extensive investigations into these conditions, and following his ideas I examined a series of 17 picked temporal bones and described them under the title, "Some Practical Remarks on the Anatomy of the Temporal Bone."<sup>3</sup>Basing my conclusions on the measurements of those 17 temporal bones, in which the distance of the most protruding part of the lateral sinus from the suprameatal spine varied from 21 mm. (in a right temporal bone) to 6 mm. (also in a right temporal bone), I concluded that a lateral sinus which comes nearer to the supra-meatal spine than 10.6 mm. can be regarded as displaced forward. The distance in the specimen shown in Figures 1
Potential Cost of Screening Surgeons for HIV-Reply
Authors: Kathryn A. Phillips
Journal: JAMA (1994)

In Reply.  —We thank Drs Roizen, Foss, and Mantha for reemphasizing the potential impact of false-positive test results that may occur when testing a low-prevalence population such as physicians and dentists. As they noted, with our baseline estimate as 0.4% prevalence, 20% of physicians testing positive would be false positives.  As Roizen et al discuss, the costs of false-positive test results will depend on the prevalence in the population, the sensitivity and specificity of the testing sequence, and the consequences of false results. We stated in our article that the true values for these factors are uncertain; therefore, we used a wide range of values in our sensitivity analyses. Our analysis could not quantify all the potential costs and benefits of testing programs, some of which are nicely described by Roizen et al. Our analysis does include the costs of physician visits and of monitoring CD4 + counts in individuals with
A major role for neutrophils in experimental bullous pemphigoid.
Authors: Z Liu, G J Giudice, X Zhou, S J Swartz, J L Troy, J A Fairley, G O Till, L A Diaz
Journal: Journal of Clinical Investigation (1997)

Bullous pemphigoid (BP) is an inflammatory subepidermal blistering disease associated with an IgG autoimmune response to the hemidesmosomal protein, BP180. Using a passive transfer mouse model, our group has shown previously that antibodies to the murine BP180 (mBP180) ectodomain are capable of triggering a blistering skin disease that closely mimics human BP. In this study, we investigated the role of neutrophils in the immunopathogenesis of this disease model. BALB/c mice depleted of circulating neutrophils by treatment with neutrophil-specific antibodies were no longer susceptible to the pathogenic effects of anti-mBP180 IgG. IgG and complement were deposited at the dermal-epidermal junction of these animals, but there was no evidence of inflammatory infiltration or blistering. C5-deficient mice, which are resistant to the pathogenic activity of anti-mBP180 IgG, could be made susceptible to this IgG-mediated blistering disease by intradermal administration of a neutrophil chemoattractant, IL-8 or C5a. Intraperitoneal injection of IL-8, which sequesters neutrophils in the peritoneal cavity, interferes with anti-mBP180-induced neutrophilic infiltration of the skin and prevented the development of BP disease in BALB/c mice. These findings provide the first direct evidence that neutrophils recruited to the skin via a C5-dependent pathway play an essential role in subepidermal blister formation in experimental BP, and suggest new directions for disease intervention.
Endothelial Cell–Specific FGD5 Involvement in Vascular Pruning Defines Neovessel Fate in Mice
Authors: Caroline Cheng, Remco Haasdijk, Dennie Tempel, Esther H. M. van de Kamp, Robert Herpers, Frank Bos, Wijnand K. Den Dekker, Lau A.J. Blonden, Renate de Jong, Petra E. Bürgisser, Ihsan Chrifi, Erik A.L. Biessen, Stefanie Dimmeler, Stefan Schulte-Merker, Henricus J. Duckers
Journal: Circulation (2012)

Background— New vessel formation contributes to organ development during embryogenesis and tissue repair in response to mechanical damage, inflammation, and ischemia in adult organisms. Early angiogenesis includes formation of an excessive primitive network that needs to be reorganized into a secondary vascular network with higher hierarchical structure. Vascular pruning, the removal of aberrant neovessels by apoptosis, is a vital step in this process. Although multiple molecular pathways for early angiogenesis have been identified, little is known about the genetic regulators of secondary network development. Methods and Results— Using a transcriptomics approach, we identified a new endothelial specific gene named FYVE, RhoGEF, and PH domain–containing 5 (FGD5) that plays a crucial role in vascular pruning. Loss- and gain-of-function studies demonstrate that FGD5 inhibits neovascularization, indicated by in vitro tube-formation, aortic-ring, and coated-bead assays and by in vivo coated-bead plug assays and studies in the murine retina model. FGD5 promotes apoptosis-induced vaso-obliteration via induction of the hey1-p53 pathway by direct binding and activation of cdc42. Indeed, FGD5 correlates with apoptosis in endothelial cells during vascular remodeling and was linked to rising p21 CIP1 levels in aging mice. Conclusion— We have identified FGD5 as a novel genetic regulator of vascular pruning by activation of endothelial cell–targeted apoptosis.
CONGENITAL DISLOCATION OF THE SHOULDER-JOINT
Authors: VICTOR F. HUNTLEY
Journal: JAMA (1910)

The skiagram shown here was taken during some experimental work on the chest, in an effort to demonstrate early tuberculosis. The case appeared to me to be so unusual at least, that I thought it might prove of interest to the many readers ofThe Journal; hence this report: The case is that of a young man aged about 30, who has always been able by raising the arms above the head to produce a complete dislocation of the head of the humerus; the dislocation being downward and outward as is well portrayed by the skiagram. This anomalous condition causes no discomfort, as his occupation does not require any considerable employment of his arms in an overhead position, and the head of the humerus immediately resumes its proper place when the arms are in their resting position, the excursion of the head apparently
PHYSIOLOGIC ASSESSMENT OF ANOMALOUS ORIGIN OF RIGHT CORONARY ARTERY FROM LEFT CORONARY CUSP USING DOBUTAMINE STRESS FRACTIONAL FLOW RESERVE
Authors: Sang Eun Lee, Bon Kwon Koo, Cheol Woong Yu, Ji-Hyun Kim, Kyung Woo Park, Hyun-Jae Kang, Han-Mo Yang, Chang-Hwan Yoon, Jung-Won Suh, Young-Seok Cho, Tae-Jin Youn, Chae In-Ho, Dong-Ju Choi, Hyo-Soo Kim, Byung-Hee Oh, Young-Bae Park
Journal: Journal of the American College of Cardiology (2012)
Lupus erythematosus cell phenomenon in patients with chronic ulcerative colitis
Authors: D. Alarcon-Segovia, T. Herskovic, W. H. Dearing, L. G. Bartholomew, J. C. Cain, R. G. Shorter
Journal: Gut (1965)

The interesting suggestion is put forward that sulphonamides may unmask a latent lupus diathesis in some patients with ulcerative colitis.
Effect of Treatment with Radioactive Iodine and Iodine-Deficient Diet on Development and Maintenance of Renal Hypertension in Rats
Authors: M. J. FREGLY, J. F. GENNARO, A. B. OTIS, M. I. Baker, Jacobson, S., Glichman M.
Journal: Circulation Research (1960)

Treatment of kidney encapsulated rats with 850 µC. of radioactive iodine effectively prevented both the characteristic rise of blood pressure to hypertensive levels and cardiac hypertrophy. Iodine-deficient diet was ineffective under these conditions. Once hypertension was established, treatment with 850 µC. radioactive iodine lowered blood pressure toward normal levels although a significant decrease in heart weight was not observed. The iodine-deficient diet was also ineffective under these conditions. It is felt that hypothyroidism produced by administration of high doses of radioactive iodine is as effective in preventing blood pressure rise as that observed with propylthiouracil treatment. The antihypertensive effect of these antithyroid treatments appears to be the direct result of inhibition of secretion of thyroid hormone.
Efficacy of a low-dose oral contraceptive containing 20 μg of ethinyl estradiol and 100 μg of levonorgestrel for the treatment of moderate acne: A randomized, placebo-controlled trial
Authors: James Leyden, Alan Shalita, Maria Hordinsky, Leonard Swinyer, Frank Z. Stanczyk, Margaret E. Weber
Journal: Journal of the American Academy of Dermatology (2002)
Recurrent chest infections, ciliary abnormalities and partial complement deficiency in a Jordanian family.
Authors: I D Starke, B Corrin, P J Selby, A D Webster, M Turner-Warwick
Journal: Thorax (1981)

Four girls born to second cousin parents developed chronic chest infection and bronchiectasis in infancy. Three were studied in detail: they all had the same HLA haplotype, all showed random orientation of cilia or compound cilia in the respiratory tract, and all had low levels of the C1 and C2 components of the complement system. Although the cause of the respiratory disease in this family remains unclear, it is suggested that the low C1 levels may have contributed to the disease in two of the children while the low C2 levels were artefacts and the ciliary abnormalities were secondary to chronic chest infection.
Health secretary urges better management of chronic disease
Authors: Lynn Eaton
Journal: BMJ (2006)

Better management of patients with long term conditions in a community setting could improve their lives, reduce emergency admissions, and reduce NHS costs, said England's health secretary, Patricia Hewitt, in a press statement.

The health service could save more than £400m (€580m; $700m) a year if it reduced the number of unnecessary admissions of people with illnesses such as asthma, angina, and chronic obstructive pulmonary disease (conditions defined as “ambulatory care sensitive”). …
Meta-Analysis: The Value of Clinical Assessment in the Diagnosis of Deep Venous Thrombosis
Authors: Steve Goodacre, Alex J. Sutton, Fiona C. Sampson
Journal: Annals of Internal Medicine (2005)

Background: Clinical assessment of suspected deep venous thrombosis (DVT) should be based on systematically evaluated evidence. Purpose: To determine whether clinical findings, risk scores, and physicians' empirical judgments affect the likelihood of detecting DVT on definitive testing. Data Sources: MEDLINE, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, ACP Journal Club, and citation lists (1966 to January 2005). Study Selection: Cohort studies published in English, French, Spanish, or Italian that compared clinical assessment with a reference standard. Data Extraction: The authors extracted standardized data, including setting, exclusions, population characteristics, reference standard, and results, and assessed quality against validated criteria. Data Synthesis: The authors combined data by using random-effects meta-analysis and, if appropriate, used meta-regression to identify covariates that predicted diagnostic accuracy. Only malignancy (likelihood ratio [LR], 2.71), previous DVT (LR, 2.25), recent immobilization (LR, 1.98), difference in calf diameter (LR, 1.80), and recent surgery (LR, 1.76) were useful for ruling in DVT, while only absence of calf swelling (LR, 0.67) or difference in calf diameter (LR, 0.57) was useful for ruling out DVT. The Wells clinical score was more valuable than the individual characteristics; it stratified patients into groups with high (LR, 5.2), intermediate, and low (LR, 0.25) probability of DVT. The Wells score seemed able to stratify patients by risk only for proximal DVT, and it performed better in cohorts that were younger or excluded patients with previous thromboembolism. Limitations: Pooled estimates were subject to substantial heterogeneity. This may limit extrapolation between observers and settings. Only published studies were included, so findings may be subject to publication bias. Conclusion: Individual clinical features are of limited value in diagnosing DVT. Overall assessment of clinical probability by using the Wells score is more useful.
A Clonogenic Progenitor with Prominent Plasmacytoid Dendritic Cell Developmental Potential
Authors: Nobuyuki Onai, Kazutaka Kurabayashi, Mayuka Hosoi-Amaike, Noriko Toyama-Sorimachi, Kouji Matsushima, Kayo Inaba, Toshiaki Ohteki
Journal: Immunity (2013)
Persistent Ear Discomfort and Neck Pain
Authors: David E. Conwill
Journal: JAMA (1993)

<h3>To the Editor.</h3> —We read with interest the excellent synopsis of otorhinolaryngologic causes of persistent ear discomfort and neck pain by Leliever.<sup>1</sup>In our experience, in addition to eustachian tube dysfunction, an often overlooked cause of the symptoms described is activation of myofascial trigger points in the clavicular division of the sternocleidomastoid muscle (although some have questioned the basic concept<sup>2,3</sup>). As characterized by Travell and Simons,<sup>4</sup>when activated sternocleidomastoid trigger points are present and produce characteristic referred ear and neck pain on one side in the pattern described in the question posed to LeLiever,<sup>1</sup>such points are usually found on the opposite side as well. This would account for the bilateral distribution of the patient's pain, as well as her increased pain on flexion of her neck. Travell and Simons note that persons with such trigger points also often experience referred frontal headaches and referred autonomic
Pneumonectomy in a Case of Fistula Between the Middle Lobe Bronchus and Middle Lobe Artery
Authors: F. Soave
Journal: Thorax (1950)

This case, of a patient treated by pneumonectomy for a fistula between the right middle lobe bronchus and the artery to the right middle lobe, is of interest as no other appears to have been described in the literature. CASE REPORTThe patient, a 48-year-old man, was admitted to Professor Crafoord's clinic on December 27, 1947.His mother had died of a cerebral haemorrhage, and one of his brothers had died at 20 years of age of pulmonary tuberculosis.Two of his sisters suffered from cancer and had been treated elsewhere.The patient was healthy as a child.At the age of 20 he began work as a turner.He was married and had two children who were physically and mentally sound.When he was 24 years old the patient recalled that he had had small haemoptyses.In 1930, when 31 years old, without pulmonary symptoms in the meantime, he had a violent haemoptysis of about 1,500 ml.The patient subsequently continued his work in good physical condition for about 12 years and underwent regular medical examinations.These revealed no pulmonary disease, and failed to show anv reason for the haemoptyses.During 1942 the patient had no less than 12 slight haemoptyses.In 1943 bronchoscopy was carried out, and the findings were normal for the larynx, the trachea, the carina, and the left bronchial tree.On the right side there were signs of increasing subacute inflammation of the mucous membrane down to the middle lobe bronchus, whose lumen showed marked oedema and a certain degree of stenosis.A large clot of blood had formed in its lumen.Biopsy of the mucous membrane at the point of the greatest constriction caused a fairly profuse haemorrhage.The microscopic report indicated the presence of chronic tuberculosis.There were no signs of a neoplastic process.During the following month repeated examinations, both clinical and radiological, gave negative results.A month later renewed control bronchoscopy was performed with exactly the same findings as before.The inflamed mucous membrane was treated with lactic acid.The clots in the middle lobe bronchus were removed by suction.A probe passed easily, and no definite stenosis of the middle lobe bronchus could be established.This examination also failed to confirm the histological diagnosis, although chronic tuberculosis was considered to be the most probable cause.For nearly two years the patient was well and under strict medical control, and in 1945 radiographic examination showed a normal left side, but signs of partial
Inhaled Corticosteroids and Adrenal Function
Authors: Jacques Romney
Journal: Annals of Internal Medicine (2004)

Letters19 October 2004Inhaled Corticosteroids and Adrenal FunctionJacques Romney, MDJacques Romney, MDFrom University of Alberta, Edmonton, Alberta T6G 2S2, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-8-200410190-00024-w1 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The letter from White and Woodmansee (1) describing a patient with adrenal dysfunction who used inhaled fluticasone highlights an important potential side effect of high-dose corticosteroids. However, the patient had signs and symptoms more in keeping with an iatrogenic case of the Cushing syndrome (that is, cortisol excess) than with adrenal insufficiency. The low morning cortisol level, measured at 28 nmol/L, does indeed represent little endogenous cortisol production, as suppressed by the ongoing fluticasone treatment. The fluticasone itself was the source of excess corticosteroid for the patient, and it is likely that the fluticasone metabolites were not ...Reference1. White A, Woodmansee DP. Adrenal insufficiency from inhaled corticosteroids [Letter]. Ann Intern Med. 2004;140:W27. [PMID: 15023738] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Alberta, Edmonton, Alberta T6G 2S2, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAdrenal Insufficiency from Inhaled Corticosteroids Andrew White and Donald P. Woodmansee Inhaled Corticosteroids and Adrenal Function Andrew White and Donald P. Woodmansee Metrics 19 October 2004Volume 141, Issue 8Page: W-123KeywordsAdrenocorticotropic hormoneCortisolMetabolitesSigns and symptoms ePublished: 19 October 2004 Issue Published: 19 October 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
1255 High sensitivity and specificity of combinational usage of DES-gamma-carboxy prothrombin and alpha-fetoprotein for detecting hepatocellular carcinomas
Authors: S NAKAMURA, K SAKAGUCHI, H SHIMOMURA, Y IWASAKI, Y KOBAYASHI, N TOSHIKUNI, H TANAKA, E MATSUMOTO, Y SHIRATORI, Y ARAKI
Journal: Hepatology (2003)
THE APOSTOLI TREATMENT.THE FINAL RESULTS OF ITS USE IN SOME CASES OF FIBROID TUMOR OF THE UTERUS.
Authors: G. BETTON MASSEY
Journal: JAMA (1904)

It is now somewhat more than sixteen years since I began the electric treatment of fibroid tumors of the uterus after the method of the late Georges Apostoli of Paris, and having occasion recently to revise the subject for a work now in preparation, I have been strongly impressed with the desirability of giving to the profession a brief review of the practical results that have attended this work in this long series of years. The value of the Apostoli method was hotly contested in medical literature some years ago. The time has now come when a dispassionate conclusion as to its real value is in order. It may be recalled also by some of you that this society appointed a commission to investigate this question during this controversy. I think the date of this commission's appointment was in 1889 or 1890. I am not aware that a report was
564 HCV genotyping using real-time PCR assay
Authors: J SEBASTIAN, C TURNMIRE, H FARUKI, D BURRIS, N HTUN, M SHORT, E SWARTMAN, F WANG, M ZOCCOLI, J CAO
Journal: Hepatology (2003)

The bile canaliculus is the smallest and first biliary channel and is formed by two or three adjacent hepatocytes. Previous studies of chronic cholangiopathies such as primary sclerosing cholangitis have focused on the bile ductules. However, little is known about the pathological alterations in bile canaliculi in the early phase of cholangiopathies.To characterize the bile canalicular morphology in the early phase of sclerosing cholangitis we used 3,5-diethoxycarbonyl-1,4-dihydrocollidine-induced mouse model of sclerosing cholangitis.Mice were fed a diet with 3,5-diethoxycarbonyl-1,4-dihydrocollidine (0.1%). Serum biochemical, histological, immunohistochemical, and electron microscopic analyses were performed 1, 2, 4, and 7 days after feeding.All experimental groups showed significantly increased serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase levels. From day 1, bile canalicular abnormalities such as dilatation and meandering and loss of microvilli were observed. After bile canalicular abnormalities had appeared, substantial infiltration of inflammatory cells was observed amongst the necrotic cells and periductal region. After these inflammatory changes, cholangiocytes proliferated in the portal area and formed ductular reactions. Finally, periductal fibrosis appeared.This study provides novel evidence of the occurrence of bile canalicular abnormalities during the early phase of sclerosing cholangitis.