tbuckley/cabot-search huggingface dataset:
Large Trials vs Meta-analysis of Smaller Trials
Authors: Joseph C. Cappelleri
Journal: JAMA (1996)

To evaluate the results of large clinical trials vs the pooled results of smaller trials.Meta-analyses with at least 1 "large" study were identified from the Cochrane Pregnancy and Childbirth Database and from MEDLINE (1966-1995).We used a sample size approach to select 79 meta-analyses with at least 1 large study of 1000 or more patients. We used a statistical power approach to select 61 meta-analyses with at least 1 large study based on statistical power considerations.The outcome of interest for each meta-analysis was the primary one stated in the original publication or, when not clearly specified, was decided on clinically.By random effects calculations, we found agreement between large and smaller trials in 90% of the meta-analyses selected by the sample size approach and in 82% of the meta-analyses selected by the statistical power approach. Twice as many disagreements appeared when the variability among large studies and among smaller studies was not considered (ie, fixed effects calculations). Of the 15 disagreements between results of large and smaller trials using the random effects model, plausible explanations were identified in 10 meta-analyses: 5 with differences in the control rate of events between large and smaller trials, 4 with specific protocol or study differences, and 1 with potential publication bias. Two other disagreements were not clinically important, and tentative reasons could be identified for 2 of the remaining 3 disagreements.Results of smaller studies are usually compatible with the results of large studies, but discrepancies do occur even when the diversity among both large studies and smaller studies is considered. Clinically important differences without a potential explanation are extremely uncommon. Future research should further examine sources of heterogeneity between the results of large and smaller trials.
COOPERATIVE CLINICAL RESEARCH PROGRAMS BETWEEN MEDICAL INSTITUTIONS
Authors: John M. Howard
Journal: JAMA (1961)

During the past few years, institutions have begun to join in the pooling of their experiences in clinical research. The results have been encouraging, often producing answers in a surprisingly short time.  Historically, individual surgeons have evaluated the natural history of a given disease or the effect of operation in altering its natural course. After a lapse of years, one might have summarized and reported his observations. Other surgeons might have reported various modifications with divergent results. As a result, after a generation can anyone tell whether postoperative irradiation influences the course of breast cancer? Can anyone outline with factual assurance the course and treatment of gastric ulcer, of thyroid malignancy, of pancreatitis or of recurring tonsillitis, contaminated wounds, or ruptured disc? The answer is NO . Prejudiced, incomplete, or noncomparable reports often fail to answer any single question.  Currently, a revival and extension of inter-institutional clinical research has occurred which
PWE-191 Is Gastropexy an Alternative to Radiological Gastrostomy? a Single Centre Experience
Authors: S S Salunke, D Barber, R McKay, A W McKinlay, J S Leeds
Journal: Gut (2013)

<h3>Introduction</h3> Standard inside-out PEG insertion is not always technically possible or safe especially when there is narrowing of the oesophagus or pharynx with head-and-neck or oesophageal cancers. There is also concern about tumour seeding with inside-out technique. Similarly, in some patients it is not possible to pass the standard gastroscope through to upper GI tract. Gastropexy is an alternative technique which allows insertion of a gastrostomy tube with outside-in technique and can be performed using slimmer scopes. Gastropexy has been routinely performed in our unit for some time and therefore we aimed to review the experience of Gastropexy insertion in our unit. <h3>Methods</h3> Gastropexy placement in our unit is based upon a previously described technique using Kimberly Clark MIC introducer kit. A standard endoscopy is performed by the oral or nasal route, a site identified and the stomach secured against the anterior abdominal wall with 3 pre-loaded T-toggles which can be fastened with a locking disc. A tract is formed using a single serial dilator passed over a guidewire and a 14F balloon gastrostomy inserted through the dilator and secured. The outer sheath of the dilator will then be peeled out. All patients receive pre-procedural prophylactic antibiotics. A retrospective review of all gastropexy procedures between June 2009 and November 2012 was carried out. Patient demographics, indication, sedation requirements and complication rates were recorded. <h3>Results</h3> 45 procedures were carried out on 42 patients (28 males, median age 63 years range 56 – 84) with a technical success rate of 95.7% for placement. Indication for placement was head-and-neck cancer (n = 34), oesophageal stricture/cancer (n = 9) and neurological (n = 2). 17% of procedures were performed under general anaesthesia as part of another surgical procedure with the remainder having conscious sedation (mean doses midazolam 3.8mg and pethidine 17.8mg). 58% of procedures were performed using a nasal/neonatal endoscope. Of these, 62% cases had head-and-neck cancer, 31% had oesophageal cancer/stricture. One patient had a minor gastric fluid leak and one patient developed a pneumoperitoneum both of which were managed conservatively. At 7 days, 1/45 (2.2%) had a site infection and 1/45 (2.2%) had died whereas at 28 days, 5/45 (11.1%) had a site infection and 4/45 (8.8%) had died. Mortality at 1 year was 48%, with median survival of 5 months. The primary pathology in all the patients who died was head and neck or oesophageal cancer. None of the deaths were procedure related. <h3>Conclusion</h3> Gastropexy is a suitable alternative in patients with difficult access and can be inserted with high success rate and low complication rates. Ideally, a randomised trial comparing gastropexy and radiological gastrostomy insertion should be undertaken. <h3>Disclosure of Interest</h3> None Declared.
Effect of Insulin and Glucagon on Fulminant Murine Hepatitis
Authors: M. Farivar, J.R. Wands, K.J. Isselbacher, N.L.R. Bucher
Journal: New England Journal of Medicine (1976)

Fulminant hepatic failure is the most serious complication of viral hepatitis, the mortality of patients with Stage 4 coma being approximately 80 to 90 per cent.1 2 3 4 Most of the survivors recover completely, at least in part because of the remarkable capacity of the liver to regenerate.5 Attempts to sustain life by supportive measures until spontaneous regeneration could occur have so far failed to reduce mortality.6 7 8 We have therefore adopted an approach based on recent studies by Bucher and Swaffield showing that in laboratory animals, hepatic regeneration can be enhanced by the synergistic action of two pancreatic hormones — insulin and . . .
Family Support in Advanced Cancer
Authors: B. A. Given, C. W. Given, S. Kozachik
Journal: CA A Cancer Journal for Clinicians (2001)

Changes in the health care system have resulted in a shift of cancer care from the in-patient arena to ambulatory and home settings. This shift has likewise translated into increased family involvement in the day-to-day care of the person with cancer. Cancer patients have multifaceted needs, including disease and treatment monitoring, symptom management, medication administration, emotional support, assistance with personal care, and assistance with instrument care. Family caregivers may be ill prepared to assume these tasks, requiring information on the disease and treatment, as well as instruction in technical and care skills. Moreover, caregiving must be balanced against already established roles and role responsibilities. In addition, family caregivers have their own emotional responses to the patients' diagnosis and prognosis, and may require coaching and emotional support themselves. The health care system can facilitate positive outcomes by embracing the family caregiver as a partner in the health care team, providing instruction and guidance to the caregiver as he/she assumes this role, and evaluating the home care situation. Research to date has only scratched the surface of testing interventions that meet the needs of the cancer caregiver. A research agenda is proposed to more fully elucidate the cancer caregiver's experience throughout the illness and treatment trajectory, and identify the means to effecting positive outcomes for the person with cancer, their family caregiver, and the health care system.
Removal of Filaria Worm from Eye
Authors: M. C. T. Reilly
Journal: BMJ (1943)

JURNAL103In two days she developed what appeared to be an acute follicular tonsillitis, with a few punctate septic spots on both tonsils.The tongue was dry and furred, she complained of thirst, and had vomited occasionally.The temperature was raised to 103.5', the pulse was rapid, the face flushed, and she presented the usual general febrile condition.In the course
CATAPHORESIS IN TRACHOMA.
Authors: GEORGE F. KEIPER
Journal: JAMA (1899)

The word "cataphoresis" is derived from two Greek words.** The word "catalysis,"*** is often used synonymously with "cataphoresis," and incorrectly. Cataphoresis is a subdivision of the electrical process called catalysis. Cataphoresis, as now understood, is a process whereby medicinal substances are introduced into the body, through skin or mucous membrane or both, by the help of the galvanic current. <h3>Synonyms.</h3> —Anodal diffusion, electric osmosis, voltaic narcotism, electric transportation, anaphoresis, electric medicamental diffusion, and electric transfer of particles and liquids, are the synonyms in use. <h3>History.</h3> —The process is not a new one, though it is attracting more attention to-day and has been for the last ten years, than ever before. Dr. B. W. Richardson, in 1859, wrote two articles on "Voltaic Narcotism." In October, 1858, after vainly trying to produce anesthesia in a rabbit's ear, by the electric current alone, he used a solution of morphin
Columbia/HCA Promotes Pepsi
Authors: Ronald Hirsch
Journal: New England Journal of Medicine (1996)

has written an illuminating two-part report on the for-profit hospital business, highlighting the dominant player in the game, Columbia/HCA (Aug. 1 and Aug. 8 issues). 1 He correctly points out that not-for-profit hospitals, including university medical centers, are also changing the ways in which they operate.Chief executive officers and boards of directors of university medical centers are ever more mindful of their own bottom lines, mainly because they now have to compete with nonacademic players for the "covered lives" out there.It is understandable when Columbia/HCA puts medical education and research low on its list of priorities, but when academic medical centers make decisions that have adverse effects on their academic missions in order to maximize income over expenses, things may be going too far.I am not urging fiscal irresponsibility.Trimming costs is important and possible.It is a matter of priorities.Medical education and research are important, as are the possible consequences of curtailing them.Just where do the Columbia/HCA administrators think all those doctors they are co-opting come from?And how do they think basic medical knowledge and its application to the care of people were developed?The answers are obvious: education and research.Neither is free, or even inexpensive, but both must be supported.If the administrators of Columbia/HCA and other for-profit hospitals do not believe these efforts are in their job descriptions, we must figure out a way to pay for them, probably by some sort of public support.Higher "sin taxes" are but one way.Higher taxes on the profits of for-profit hospitals are another.Only if the public becomes disenchanted with man-aged care and the priority on profit will there be a change in the system.Meanwhile, as physicians, let us hold the high ground and take the best care of patients that we possibly can.
Re: Axillary Lymph Node Staging in Breast Cancer by 2-Fluoro-2-deoxy-D-glucose-Positron Emission Tomography: Clinical Evaluation and Alternative Management
Authors: H. Torrenga, J. Licht, J. J. M. van der Hoeven, O. S. Hoekstra, S. Meijer, P. J. van Diest
Journal: JNCI Journal of the National Cancer Institute (2001)

Greco et al.(1) reported that 2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) is a reliable and accurate method to predict the axillary status in breast cancers of 1-2 cm in diameter: Histopathology detected axillary lymph node (ALN) metastases in 72 (43%) of 167 patients, and 68 ALN metastases were detected by PET (sensitivity ‫ס‬ 94.4%).To determine the sensitivity of FDG-PET to detect ALN metastases, the histopathologic methodology is crucial.Compared with other PET studies on this subject, a relatively detailed description was provided by Greco et al.(1), who stated, "each lymph node was sectioned into two or three parts, and one or more sections were prepared from each part," and who used only hematoxylin-eosin (H&E) staining.It remains unclear, however, how many sections were taken on average per ALN, which is important information.With step sectioning at regular intervals (e.g., five sections at 250 m) and immunohistochemistry (e.g., against keratins by using CAM5.2 anti-keratin antibodies), the detection of ALN metastases is markedly increased (2,3).We reported previously (4) a detection difference (i.e., upstaging) of 20% (95% confidence interval [CI] ‫ס‬ 11% to 28%) between one section stained with only
Complement factor C5a as mast cell activator mediates vascular remodelling in vein graft disease
Authors: Margreet R. de Vries, Anouk Wezel, Abbey Schepers, Peter J. van Santbrink, Trent M. Woodruff, Hans W. M. Niessen, Jaap F. Hamming, Johan Kuiper, Ilze Bot, Paul H. A. Quax
Journal: Cardiovascular Research (2012)

AimsFailure of vein graft conduits due to vein graft thickening, accelerated atherosclerosis, and subsequent plaque rupture is applicable to 50% of all vein grafts within 10 years. New potential therapeutic targets to treat vein graft disease may be found in components of the innate immune system, such as mast cells and complement factors, which are known to be involved in atherosclerosis and plaque destabilization. Interestingly, mast cells can be activated by complement factor C5a and, therefore, a direct role for C5a-mediated mast cell activation in vein graft disease is anticipated. We hypothesize that C5a-mediated mast cell activation is involved in the development and destabilization of vein graft lesions.
Tackling Childhood Overweight and Obesity
Authors: Joyce M. Lee, Eduardo Villamor
Journal: JAMA Pediatrics (2012)

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
THE QUESTION OF EPINEPHRIN IN THE CIRCULATION AND ITS RELATION TO BLOOD PRESSURE
Authors: Theodore C. Janeway, Edwards A. Park
Journal: The Journal of Experimental Medicine (1912)

1. The modified Meyer method here proposed, of parallel tests upon segments of surviving carotid and coronary arteries from the ox, is a satisfactory means for detecting epinephrin in complex body fluids like blood. 2. At the present time there is no evidence that epinephrin, in amounts sufficient to produce its physiological effects upon any hitherto used test objects, exists in the circulating blood, with the exception of blood from the suprarenal vein. 3. The examination of uncoagulated blood from six persons with high blood pressure has failed to show the presence of epinephrin or other constricting substances. 4. The constrictor substance in defibrinated blood and serum is not an epinephrin-like substance. In its point of action and its effects it is similar to barium chlorid. It is a direct stimulant to smooth muscle and seems to have no relation to the sympathetic innervation of muscle.
Ulcerative colitis with autoimmune haemolytic anaemia.
Authors: A. J. Black, A. J. Eisinger, C. A. Loehry, G. D. Johnson
Journal: BMJ (1969)

Lymphosarcoma with a PositivePaul-Bunneli Test British MedicalJournal, 1969, 2, 31 This case is reported because the findings of a positive Paul-Bunnell test delayed the relevant treatment for the patients real illness.It also illustrates the point that a negative biopsy specimen from one area of the pathological tissue does not always exclude malignancy in other areas.On reviewing the literature we were unable to find previous reports of lympho- sarcoma presenting with a positive Paul-Bunnell test. CASE REPORTA 71-year-old woman originally presented at the outpatient department on 25 October 1967 with a six-weeks history of sore throat, general malaise, and cervical adenopathy.Examination showed enlarged, ulcerated tonsils and pharyngitis.Tonsillar biopsy showed no evidence of malignancy and a Paul-Bunnell test was positive (titres: unabsorbed serum 1/224, absorbed with guinea-pig kidney 1/224, absorbed with ox red cells 1/14), When seen again on 9 November she was subjectively much improved, but bilateral axillary nodes were noted.By 30 November she was much worse and gave a four-days history of pale stools, dark urine, and coffee- ground vomit.She was admitted for further investigation.On
A SHORT STUDY IN THE THERAPEUTICS OF CHRONIC DISEASE.
Authors: W. W. VAN VALZAH
Journal: JAMA (1892)

The results of the surgical treatment of disease are palpable and often brilliant. The wonderful achievements and rapid advances of modern surgery are manifest, and its results can be built up into statistics that will not yield to skepticism's destroying touch. It is not so in medicine, more particularly in the therapeutics of chronic disease. The surgeon believes in the knife because he knows its power, recognizes its limitations, brings other powerful means to its aid, and proceeds in a way often clearly marked out in every detail, to the accomplishment of a definite purpose. The physician's skepticism is born of the obscurity of therapeutic results, faulty and narrow methods, a failure to recognize the limitations imposed by the nature and stage of the morbid process, and a too ready belief in the unaided power of drugs. Medical statistics are deceptive, and ultimate results come slowly and are conjectural. Our
The effect of interferon alpha and prednisolone on the serum concentrations of the aminoterminal domain of procollagen type III(PIIIP) and type IV (7-S collagen) in patients with chronic hepatitis B
Authors: Akira Hayasaka, Hirofumi Kohen, Noritaka Yoshikawa, Shinji Iida, Masao Ohto
Journal: Journal of Hepatology (1993)
Charity pays drug addicts to use long term contraception
Authors: M. Limb
Journal: BMJ (2011)

A charity is paying female drug addicts in the UK to use birth control, saying it has stopped its controversial offer to fund sterilisations.

Project Prevention, which began in the US and launched in the UK last year, says women with drug or alcohol problems will receive £200 (€233; $324) if they agree to have contraceptive implants or coils fitted.

It said the money would be paid in three instalments—£50 when the device is fitted, a further £50 after six months, and £100 if the device is still in place after a year.

According to a BBC report, 26 female addicts in Britain have already been paid.

The US charity was founded by Barbara Harris from North Carolina who adopted four children …
Ectopic retroviral expression of LMO2, but not IL2Rγ, blocks human T-cell development from CD34+ cells: implications for leukemogenesis in gene therapy
Authors: K Pike-Overzet, D de Ridder, F Weerkamp, M R M Baert, M M A Verstegen, M H Brugman, S J Howe, M J T Reinders, A J Thrasher, G Wagemaker, J J M van Dongen, F J T Staal
Journal: Leukemia (2007)
Integrate, yes, but <i>what</i> and <i>how</i>? A computational approach of sensorimotor fusion in speech
Authors: Raphaël Laurent, Clément Moulin-Frier, Pierre Bessière, Jean-Luc Schwartz, Julien Diard
Journal: Behavioral and Brain Sciences (2013)

Abstract We consider a computational model comparing the possible roles of “association” and “simulation” in phonetic decoding, demonstrating that these two routes can contain similar information in some “perfect” communication situations and highlighting situations where their decoding performance differs. We conclude that optimal decoding should involve some sort of fusion of association and simulation in the human brain.
Tension–Time Index as a Predictor of Extubation Outcome in Ventilated Children
Authors: Gopinathannair Harikumar, Yaya Egberongbe, Simon Nadel, Elizabeth Wheatley, John Moxham, Anne Greenough, Gerrard F. Rafferty
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Indices that assess the load on the respiratory muscles, such as the tension-time index (TTI), may predict extubation outcome.
US doctors want to use private providers as levers for change
Authors: R. Jenkins
Journal: BMJ (2012)

I was dismayed by Spence’s recent column “Lessons from America.”1

Personal Medical Services (PMS)/General Medical Services (GMS) GPs should be classed as private providers of healthcare contracting with the NHS (arguably as a monopoly) and not differentiated from other “private” providers. It seems a convenient mistruth to use.

As a private provider …
Functionalization of 3D scaffolds with protein-releasing biomaterials for intracellular delivery
Authors: Joaquin Seras-Franzoso, Christoph Steurer, Mònica Roldán, Meritxell Vendrell, Carla Vidaurre-Agut, Anna Tarruella, Laura Saldaña, Nuria Vilaboa, Marc Parera, Elisa Elizondo, Imma Ratera, Nora Ventosa, Jaume Veciana, Alberto J. Campillo-Fernández, Elena García-Fruitós, Esther Vázquez, Antonio Villaverde
Journal: Journal of Controlled Release (2013)
A SIMPLE AND RELIABLE ASTIGMOMETER.Read in the Section of Ophthalmology at the Forty-first Annual Meeting of the American Medical Association, held at Nashville, Tenn., May, 1890.
Authors: F. C. HOTZ
Journal: JAMA (1890)

in our office by simply titillating the adenoid mass by a probe.They culminated with extreme sud¬ denness and endured for a couple of minutes, the second paroxysm being so severe as to suggest hasty preparations for tracheotomy and to cause us to desist from further experimentation in this di¬ rection.Surgical removal of the adenoid growth, somewhat incomplete for want of time, resulted in a disappearance of the bronchitic symptoms, and in such amelioration of the glottic spasms that they ceased to be a serious inconvenience.