tbuckley/cabot-search huggingface dataset:
Megatrials for Clinical Decision Making
Authors: Heather L. Horton
Journal: Annals of Internal Medicine (1996)

Letters1 October 1996Megatrials for Clinical Decision MakingHeather L. Horton, MD, PhDHeather L. Horton, MD, PhDLankenau Hospital, Wynnewood, PA 19086Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-7-199610010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their article on meta-analyses, Borzak and Ridker [1] comment on a perplexing issue. Why did a reasonably large trial (LIMIT-2 [Second Leicester Intravenous Magnesium Intervention Trial]) [2] show a therapeutic benefit for magnesium in patients who had had acute myocardial infarction when a megatrial (ISIS-4 [Fourth International Study of Infarct Survival]) [3] did not? If the difference is the timing with which the drug was given, another trial can be done. If the results of LIMIT-2 were wrong, however, and magnesium has no benefit in the treatment of acute myocardial infarction under any circumstances, some serious ...References1. Borzak S, Ridker PM. Discordance between meta-analyses and large-scale randomized, controlled trials. Examples from the management of acute myocardial infarction. Ann Intern Med. 1995; 123:873-7. Google Scholar2. Woods KL, Fletcher S, Roffe C, Haider Y. Intravenous magnesium sulfate in suspected acute myocardial infarction: results of the second Leicester Intravenous Magnesium Intervention Trial (LIMIT-2). Lancet. 1992; 339:1553-8. Google Scholar3. ISIS-4: a randomized factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulfate in 58,050 patients with suspected acute myocardial infarction. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. Lancet. 1995; 345:669-85. Google Scholar Author, Article, and Disclosure InformationAuthors: Heather L. Horton, MD, PhDAffiliations: Lankenau Hospital, Wynnewood, PA 19086 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1996Volume 125, Issue 7 Page: 621 Keywords Acute myocardial infarction Decision making Drugs Evidence based medicine Magnesium ePublished: 15 August 2000 Issue Published: 1 October 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
A Prescription Corrected.
Authors: J. V. Shoemaker
Journal: JAMA (1898)

Philadelphia, Pa., March 3, 1898. <h3>To the Editor:</h3> —By an inadvertency an error has found its way into the report of my clinical lecture published in theJournal of the American Medical Associationfor Feb. 26, 1898. On page 464, in the second column, the second prescription should read as follows: In reading the proof furnished me that portion which contained the above prescription was missing. I have been informed by your printer that two galley slips had stuck together and that the prescription, together with the adjoining portion of text was concealed.
CURETTAGE AND THE TREATMENT OF UTERINE HAEMORRHAGE
Authors: B. Whitehouse
Journal: BMJ (1921)

TJTERINE HAEMORRHAGE.r THu -umaiN 981DEc. To, 1t2111-MuDICAx JOURtNAL diaphragm.. Thie spleen (2 gra,ms), pale and soft, was similarly flattened aud pressed against the parietes on the left side of the .upperabdonieti.The lheart (5 granis) slhowed some congeation of the coronary veinis anid capillaries.The lutngs (left 3.8 grams, riglht 4.0 gramis) were wholly uniexpauded, andl showed earlymaceration.The thyroid (0.25 gram) Nvas small anid soft, andl tlhe thymuis (1 gramii) sh-owed early maceration.The brain (87 grams) was soft, anid showevd slight congestioni of the meningeal veinis and capillaries.The pituitary (O.C4 gram) showed nothing, of note.iliitology.-Examination was made of brain, lung, liver, spleen, kidney, suprarenal, thymts, thyroid, testis, nnmbilical c rd, anterior abdominal wall, and a portion of the sac wall.BeyonAI commencing macerationi in-most of the abdominal orga'nsinothing abinoimal was founid.Portions of luniig, liver, spleen, kidney, suprarenal, and the wall of the retroperitoneal sac were exaninie(d for spirochaetes by the method of Levaditi, buit with inegative result.COMMENT.The case above described, while one of "foetal ascites fromii thle clinical point of view, cannot be regarded as suci in the true sense of thle term.It is possible, certainly, that some degree of true ascites was present, but there can be no doubt that the greater part, if not the whiole, of the abdominal cinlargement was produLced by the enormously dlistended bladder-liko structure described.A brief con sideration of thle stages of development of tlhe hiind end of the body is sufficient to lead to the conclusion tlhat this muscular-walled sac, lying belhind the peritoneumn witlh the relations already detailed, mlust be a persistent cloaca.In the human embryo the gut, in its earliest stage, ends blindly in the c6ccygeal 1regioni.From, thie ventral part of the primitive gut in th-e cloacal region the allantois arises as a pocket or sacculation, which passes forwards as it (levelops.The term " cloaca, " is definiedI by Kiebel aud Mall 10 as that part of the inteetinial 6bay whicli lies caudal to the point where the allautois is given off.Iuto it there open from above tbe hiid gut and the allanitois.It is a blind sac, oval in transverse section, ancd its ventral surface, which is compressed to form ani angle, is in contact and fused with the ectoderm of the surface of the body.This area of fusion is known as the cloacal miiemiibranie.From the ri(dge of tissue betweeni the cloacal open- iga of thie injtestine and that of the allantois there grows down the septum uro-rectale, whiclh dlivides off a dorsal portionl of the cloaca-the recttum-from the remainder of the cloacal cavity.This -division remainis incomplete for-some timiie, so that there is a small passage-tle cloacal (luct-immediately above the cloacal miembratie by lvhich the rectum communicates witli the ventral remiiainis of the cloacs.The uro-rectal septtum ulti-
The Feedback Whirlpool of Early Childhood Sleep and Behavior Problems
Authors: Michelle M. Garrison
Journal: JAMA Pediatrics (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Abstract P1-01-07: Touch Imprint Cytology for Intraoperative Evaluation of Sentinel Lymph Node in Patients with Early-Stage Breast Cancer: A Five-Year Experience
Authors: J-j Chen, B Yang, J-y Chen, Z-b Liu, X-y Huang, W-t Yang, W-p Xu, Z-M Shao, Z-z Shen, J. Wu
Journal: Cancer Research (2010)

Abstract Background: Accurate intraoperative diagnosis of sentinel lymph node (SLN) metastases enables the selection of patients for axillary lymph node dissection during the same operation and reduces the need for re-operation. Touch imprint cytology (TIC) serves as a main intraoperative assessment of SLNs in our institute for over five years. The purpose of the present study is to evaluate the clinical value of TIC as an intraoperative assessment for the diagnosis of SLN. Methods: Patients treated for early-stage breast cancer between Feb-2005 and May-2010 enrolled in the study. TIC was routinely performed intraoperatively, the result of which was correlated with definitive histological assessments of serial section with Hematoxylin-Eosin staining. Subsequent immunohistochemistry staining with CK-19 and MUC-1 were performed for research purposes. The Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram was applied in this retrospective study to estimate probability of SLN involvement of each case. Results: A total of 1,077 patients with early-stage breast cancer enrolled in the study, and 3,048 SLNs were successfully harvested during the surgeries. Among those, 265 (24.6%) patients proved to have at least one SLN that was positive for carcinoma. Altogether, 397 (13.0%) involved nodes were removed from patients in the aforementioned patient pool. Based on the final pathology report, the sensitivity, specificity and overall accuracy of TIC was 83.4%, 99.0% and 95.2%, respectively on a per patient basis, and 78.3%, 99.4% and 96.7%, respectively on a per node basis. The sensitivity for macrometastasis and micrometastasis are 88.6% and 39.3%, respectively on a per patient basis, while 87.4% and 31. 3%, respectively on a per node basis. Of the patients included in this study, 98.7% had a positive SLN within their first three harvested SLNs. All the patients who were at a &amp;lt;10% chance of SLNs metastases according to the MSKCC nomogram were proved to be node negative by the final pathology. Conclusion: TIC is feasible and is able to detect macrometastasis in SLNs with an acceptable accuracy for clinical use in early-stage breast cancer patients while its ability to detect micrometastasis is limited. Limiting intraoperative TIC to the first three harvested SLNs in the diagnosis of SLN metastasis may make this diagnostic procedure significantly cheaper and easier for pathologists to perform. The MSKCC nomogram could be applied as a screening tool. Intraoperative assessment for SLNs, such as TIC, could be spared for patients with extremely low MSKCC scores (&amp;lt;10%). Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-01-07.
P20. Lack of T cell exhaustion in acute myeloid leukaemia
Authors: FM Schnorfeil, FS Lichtenegger, K Emmerig, M Schlüter, R Draenert, W Hiddemann, M Subklewe
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts The prognosis of acute myeloid leukemia (AML), particularly when associated with adverse chromosomal or molecular aberrations, is poor due to a high relapse rate after induction chemotherapy. Postremission therapy for elimination of minimal residual disease remains a major
Early Scintigraphic Findings of Occult Femoral and Tibial Fractures in Infants
Authors: HEE-MYUNG PARK, CLYDE B. KERNEK, JOHN A. ROBB
Journal: Clinical Nuclear Medicine (1988)

Differentiation of occult skeletal injuries from early acute osteomyelitis in infants and young children is important clinically. The Tc-99m MDP scintigraphic findings in six patients who had occult femoral or tibia) fractures were reviewed. The images obtained early (at 1–4 days from the onset of symptoms) shared the common characteristic finding of a subtle but definite, generalized increased uptake of the tracer along the entire length of the injured bone. This pattern of uptake was similar regardless of the type of fracture. These were different from the focal abnormalities that have been observed in early acute osteomyelitis. In the absence of an extensive cellulitis or a vascular occlusive disease, a bone image showing a mild diffuse uniform increased uptake along the entire length of the tibia or femur in infants and young children with tower extremity pain of less than 1 week's duration should suggest the diagnosis of occult skeletal fractures.
Successful Treatment of Latrodectism with Antivenin after 90 Hours
Authors: Gerald F. O'Malley, Richard C. Dart, Edwin F. Kuffner
Journal: New England Journal of Medicine (1999)

To the Editor: A 13-year-old boy awoke from sleep with a sharp pain on the left side of his neck. He killed a large black spider in the bed. Because of local neck pain and muscle cramps migrating into his chest, abdomen, and legs, he sought care at a nearby hospital. Treatment with 6.5 ml of 10 percent calcium gluconate, 50 mg of meperidine, and a combination of hydrocodone and acetaminophen (Vicodin) resulted in only minor relief of his symptoms. Despite being unable to walk, he was discharged after 24 hours. The patient sought care at the emergency department of . . .
Haploinsufficiency, rather than the effect of an excessive production of soluble CD95 (CD95ΔTM), is the basis for ALPS Ia in a family with duplicated 3′ splice site AG in CD95 intron 5 on one allele
Authors: Joachim Roesler, Jose-Maria Izquierdo, Martin Ryser, Angela Rösen-Wolff, Manfred Gahr, Juan Valcarcel, Michael J. Lenardo, Lixin Zheng
Journal: Blood (2005)
Thyroid hormone preconditioning: Protection against ischemia-reperfusion liver injury in the rat
Authors: Virginia Fernández, Iván Castillo, Gladys Tapia, Pamela Romanque, Sebastián Uribe-Echevarría, Mario Uribe, Denise Cartier-Ugarte, Gonzalo Santander, María T. Vial, Luis A. Videla
Journal: Hepatology (2006)

Recently, we reported that oxidative stress due to 3,3′,5-triiodothyronine (T3)-induced calorigenesis up-regulates the hepatic expression of mediators promoting cell protection. In this study, T3 administration in rats (single dose of 0.1 mg/kg intraperitoneally) induced significant depletion of reduced liver glutathione (GSH), with higher protein oxidation, O2 consumption, and Kupffer cell function (carbon phagocytosis and carbon-induced O2 uptake). These changes occurred within a period of 36 hours of T3 treatment in animals showing normal liver histology and lack of alteration in serum AST and ALT levels. Partial hepatic ischemia-reperfusion (IR) (1 h of ischemia via vascular clamping and 20 h reperfusion) led to 11-fold and 42-fold increases in serum AST and ALT levels, respectively, and significant changes in liver histology, with a 36% decrease in liver GSH content and a 133% increase in that of protein carbonyls. T3 administration in a time window of 48 hours was substantially protective against hepatic IR injury, with a net 60% and 90% reduction in liver GSH depletion and protein oxidation induced by IR, respectively. Liver IR led to decreased DNA binding of nuclear factor-κB (NF-κB) (54%) and signal transducer and activator of transcription 3 (STAT3) (53%) (electromobility shift assay), with 50% diminution in the protein expression of haptoglobin (Western blot), changes that were normalized by T3 preconditioning. Conclusion: T3 administration involving transient oxidative stress in the liver exerts significant protection against IR injury, a novel preconditioning maneuver that is associated with NF-κB and STAT3 activation and acute-phase response. (Hepatology 2007;45:170–177.)
Membrane protein CNNM4–dependent Mg2+ efflux suppresses tumor progression
Authors: Yosuke Funato, Daisuke Yamazaki, Shin Mizukami, Lisa Du, Kazuya Kikuchi, Hiroaki Miki
Journal: Journal of Clinical Investigation (2014)

Intracellular Mg(2+) levels are strictly regulated; however, the biological importance of intracellular Mg(2+) levels and the pathways that regulate them remain poorly understood. Here, we determined that intracellular Mg(2+) is important in regulating both energy metabolism and tumor progression. We determined that CNNM4, a membrane protein that stimulates Mg(2+) efflux, binds phosphatase of regenerating liver (PRL), which is frequently overexpressed in malignant human cancers. Biochemical analyses of cultured cells revealed that PRL prevents CNNM4-dependent Mg(2+) efflux and that regulation of intracellular Mg(2+) levels by PRL and CNNM4 is linked to energy metabolism and AMPK/mTOR signaling. Indeed, treatment with the clinically available mTOR inhibitor rapamycin suppressed the growth of cancer cells in which PRL was overexpressed. In ApcΔ(14/+) mice, which spontaneously form benign polyps in the intestine, deletion of Cnnm4 promoted malignant progression of intestinal polyps to adenocarcinomas. IHC analyses of tissues from patients with colon cancer demonstrated an inverse relationship between CNNM4 expression and colon cancer malignancy. Together, these results indicate that CNNM4-dependent Mg(2+) efflux suppresses tumor progression by regulating energy metabolism.
Comparing epidemiologic studies of ingested asbestos for use in risk assessment.
Authors: L S Erdreich
Journal: Environmental Health Perspectives (1983)

Epidemiologic data can be used in risk assessment in various ways: to calculate the dose-response relationship between exposure levels and adverse effects; to establish ranges of exposure known to be safe or unsafe; to verify an endpoint in humans derived from a route or species extrapolation; to support assumptions necessary for performing extrapolation procedures. These points are illustrated in the risk assessment for exposure to asbestos in drinking water. A previous risk assessment for asbestos, the EPA's Ambient Water Quality Criteria (AWQC) for Asbestos, was derived from cohort studies of inhalation exposure. Epidemiologic studies of ingested asbestos, all of geographical correlation design, were compared on the basis of their ability to add information in support of both the route extrapolation and low-dose extrapolation used in this risk assessment. Results of these ingestion studies were inconsistent due to variable ability to detect a risk from chronic low-level exposure. After preliminary comparisons of factors that determine scientific validity and statistical power, two ingestion studies were selected to determine if they had the potential to detect the risk predicted by the AWQC. This evaluation has shown that these studies do not offer quantitative data for estimating levels associated with a defined risk. Due to short exposure duration and limited power, clearly safe and clearly unsafe ranges could not be definitely identified. The most appropriate ingestion studies suggest, but do not prove, the endpoint derived from the route extrapolation in the AWQC.
Logical approach to lignocaine therapy.
Authors: C Aps, J A Bell, B S Jenkins, P A Poole-Wilson, F Reynolds
Journal: BMJ (1976)

Plasma lignocaine concentrations were measured during and after lignocaine infusions administered for suppressing ventricular dysrhythmias. Twenty-four patients with a primary diagnosis of acute myocardial infarction without gross circulatory disturbance received, after a bolus of lignocaine, either 4 mg/min for 30 minutes, 2 mg/min for two hours, then 1 mg/min thereafter or 1 mg/min throughout. The higher dose regimen produced continous therapeutic levels of lignocaine, which were achieved only after four hours by the lower dose. On the other hand, in patients who had undergone cardiac surgery and who had circulatory and heptic dysfunction the lower dose regimen achieved therapeutic levels early. The plasma half life was longer in the surgical group (P less than 0.02). The higher initial infusion rate is recommended for patients with acute myocardial infarction without gross circulatory impairment.
What Should the Profession Do About the Incompetent Physician?
Authors: Robert C. Derbyshire
Journal: JAMA (1965)

Ideally answer to the question, "What should the profession do about the incompetent physician?" is too simple to warrant discussion. It should be answered with one word, prevention. There should not be any incompetent physicians, for their very existence could be prevented by several methods. First, selection of medical students should be on such a scientific basis that the potentially incompetent physician could be eliminated by denying him admission. If, despite the refinements of the inexact science of modern psychology an incompetent student is admitted he can be promptly eliminated at the end of the first year and certainly before graduation. What? Have we detected an incompetent house officer? Improbable, but it may not be too late to persuade him to adopt another profession because he surely will be denied a license by a state board of medical examiners. And here my story should end. But wait! Let's be practical.
The 'Batwing' Thyroid Gland
Authors: DWIGHT M. ACHONG
Journal: Clinical Nuclear Medicine (1993)

Tc-99m thyroid scintigraphy in a 12-year-old girl with a left neck mass demonstrated a large "cold" intrathyroidal nodule that appeared to bisect an enlarged left lobe,giving the gland an unusual and distinctive morphology Surgical exploration revealed moderately well-differentiated adenocarcinoma of the thyroid with regional lymph node metastases.
MicroRNAs in Common Human Diseases
Authors: Yu Li, Kris V. Kowdley
Journal: Genomics Proteomics & Bioinformatics (2012)

Abstract MicroRNAs (miRNAs) are a class of short non-coding RNA molecules that have attracted tremendous attention from the biological and biomedical research communities over the past decade. With over 1900 miRNAs discovered in humans to date, many of them have already been implicated in common human disorders. Facilitated by high-throughput genomics and bioinformatics in conjunction with traditional molecular biology techniques and animal models, miRNA research is now positioned to make the transition from laboratories to clinics to deliver profound benefits to public health. Herein, we overview the progress of miRNA research related to human diseases, as well as the potential for miRNA to becoming the next generation of diagnostics and therapeutics.
MPs criticise UK government's science adviser for stance on homoeopathy
Authors: J. Wise
Journal: BMJ (2009)

<h3>Abstract</h3> In this paper, we revisit the problem of computational modeling of simple and complex cells for an over-parameterized and direct-fit model of visual perception. Unlike conventional wisdom, we highlight the difference in parallel and sequential binding mechanisms between simple and complex cells. A new proposal for abstracting them into space partitioning and composition is developed as the foundation of our new hierarchical construction. Our construction can be interpreted as a product topology-based generalization of the existing k-d tree, making it suitable for brute-force direct-fit in a high-dimensional space. The constructed model has been applied to several classical experiments in neuroscience and psychology. We provide an anti-sparse coding interpretation of the constructed vision model and show how it leads to a dynamic programming (DP)-like approximate nearest-neighbor search based on <i>C</i><sub>∞</sub>-optimization. We also briefly discuss two possible implementations based on asymmetrical (decoder matters more) auto-encoder and spiking neural networks (SNN), respectively.