tbuckley/cabot-search huggingface dataset:
Reviews and Notes: Guidelines for Clinical Practice: From Development to Use
Authors: Ronald Andersen
Journal: Annals of Internal Medicine (1994)

Literature of Medicine1 February 1994Reviews and Notes: Guidelines for Clinical Practice: From Development to UseRonald AndersenRonald AndersenUniversity of California, Los Angeles, School of Public Health, Los Angeles, CA 90024-1772Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-3-199402010-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Guidelines for Clinical Practice: From Development to UseMarilyn J. Field and Kathleen N. Lohr; eds. 426 pages. Washington, D.C.: National Academy Press; 1992. $34.95.Practice guidelines are a fact of life. They increasingly influence the work of practitioners and the thinking of patients, payers, researchers, and policymakers. Further, they are variably viewed with great expectations or frustrations by all of these groups. This book is intended to offer the first balanced view of guidelines—their strengths and limitations and how they can be used more effectively to benefit health care.The book is the product of an Expert Committee appointed ... Author, Article, and Disclosure InformationAffiliations: University of California, Los Angeles, School of Public Health, Los Angeles, CA 90024-1772 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1994Volume 120, Issue 3Page: 252-253KeywordsDecision makingForecastingHealth careHealth information technologyHearingMotivationQuality improvementTreatment guidelines ePublished: 15 August 2000 Issue Published: 1 February 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
P414Cardiac pacing modifies connexin43 localization within the intercalated disc during ischaemia, 24h later
Authors: M Kovacs, T Kun, M Gonczi, G Miskolczi, GY Seprenyi, A Vegh
Journal: Cardiovascular Research (2014)

Purpose: We have now examined whether the ischaemia-induced structural alterations of the main gap junction (GJ) protein connexin43 (Cx43) are modified by rapid cardiac pacing, 24h previously. Methods: Under light pentobarbital anesthesia, in 8 dogs a pacing electrode was introduced into the right ventricle through which, in half of these dogs, the heart was paced four times for 5 min at a rate of 240 beats/min. Twenty-four hours later, both the non-paced controls (SPO; n=4) and the paced (PO; n=4) animals were subjected to a 30 min occlusion of the left anterior descending (LAD) coronary artery. Another 3 dogs were also instrumented, but these animals were not subjected to either pacing or coronary artery occlusion (SP, n=3). In each experimental group left ventricular tissue samples from the LAD region were taken for immunohistochemical, western blot and co-immunoprecipitation analyses. Results: The immunohistochemical images showed that a 30 min of ischaemia resulted in increased intensity of Cx43 and obvious structural alterations of the intercalated discs (ID); the connections became disoriented and ‘blurred’ particularly at the longitudinal sections. In contrast, in the paced dogs the structural integrity of GJs was well-preserved and the intensity of Cx43was reduced to the same level as has been observed in the SP group. Under normal conditions, the GJs are mainly located at the periphery of the ID, the intensity and size of GJs is less pronounced at the center region of the disc. Ischaemia altered this distribution pattern resulting in enhanced intensity in both the peripheral and central regions of the ID. These ischaemia-induced changes were, however, almost completely abolished by pacing, commenced 24h previously. Compared with the SP dogs, ischaemia reduced the phosphorylation and increased the dephosphorylation of Cx43 (phospho/dephospho ratio was 40/60%). Pacing reversed this phospho/dephospho ratio of Cx43 (55/45%). Conclusions: These results suggest that rapid cardiac pacing favorably modifies the ischaemia-induced structural changes of GJs occurring within the ID. The preliminary results of the co-immunoprecipitation studies indicate that these changes may associate with alterations in the connection of Cx43 and ZO1 proteins.
Dreaming as an active construction of meaning
Authors: Rita B. Ardito
Journal: Behavioral and Brain Sciences (2000)

Although the work of Revonsuo is commendable for its attempt to use an evolutionary approach to formulate a hypothesis about the adaptive function of dreaming, the conclusions arrived at by this author cannot be fully shared. Particularly questionable is the idea that the specific function of dreaming is to simulate threatening events. I propose here a hypothesis in which the dream can have a different function. [Revonsuo]
1294 Identification and upregulation of the intermediate-conductance CA-activated K (IK) channel in activated rat hepatic stellate cells: specific blockage by charybdotoxin and clotrimazol results in significant reduction of proliferation
Authors: R SOMASUNDARAM, M RUEHL, R KOEHLER, M LOESEKANN, D SCHUPPAN, M ZEITZ, J HOYER
Journal: Hepatology (2003)

Ginseng extracts are known to have angiogenic effects. However, to date, only limited information is available on the molecular mechanism underlying the angiogenic effects and the main components of ginseng that exert these effects. Human umbilical-vein endothelial cells (HUVECs) are used as an in vitro model for screening therapeutic agents that promote angiogenesis and wound healing. We recently isolated gintonin, a novel ginseng-derived lysophosphatidic acid (LPA) receptor ligand, from ginseng. LPA plays a key role in angiogenesis and wound healing.In the present study, we investigated the in vitro effects of gintonin on proliferation, migration, and tube formation of HUVECs, which express endogenous LPA1/3 receptors.Gintonin stimulated proliferation and migration of HUVECs. The LPA1/3 receptor antagonist, Ki16425, short interfering RNA against LPA1 or LPA3 receptor, and the Rho kinase inhibitor, Y-27632, significantly decreased the gintonin-induced proliferation, migration, and tube formation of HUVECs, which indicates the involvement of LPA receptors and Rho kinase activation. Further, gintonin increased the release of vascular endothelial growth factors from HUVECs. The cyclooxygenase-2 inhibitor NS-398, nuclear factor kappa B inhibitor BAY11-7085, and c-Jun N-terminal kinase inhibitor SP600125 blocked the gintonin-induced migration, which shows the involvement of cyclooxygenase-2, nuclear factor kappa B, and c-Jun N-terminal kinase signaling.The gintonin-mediated proliferation, migration, and vascular-endothelial-growth-factor release in HUVECs via LPA-receptor activation may be one of in vitro mechanisms underlying ginseng-induced angiogenic and wound-healing effects.
COMPARATIVE EFFECTS OF CORTICOSTEROIDS ON HOST RESISTANCE TO INFECTION IN RELATION TO CHEMICAL STRUCTURE
Authors: Robert M. Fauve, Cynthia H. Pierce-Chase
Journal: The Journal of Experimental Medicine (1967)

In a comparative study concerning the effect of corticosteroids on host resistance to infections, five compounds were found to decrease host resistance, while three did not have this property, although all eight compounds were highly antiinflammatory. The compounds capable of decreasing host resistance were (I) hydrocortisone acetate; (III) 9α-fluoro, 16α-methylprednisolone acetate; (IV) 9α-fluoro, 16α-hydroxyprednisolone; (V) 9α-fluoro, 16α-hydroxyprednisolone, 16α–17α-acetonide; and (VII) 9α-fluoro, 16α-hydroxypredmsolone, 16α-, 17α-acetonide, 21 disodium phosphate. Following a single injection of 10 mg of any of these compounds, latent corynebacterial infection was provoked into active pseudotuberculosis. Also, mice injected with these corticosteroids were more susceptible to infection with Corynebacterium kutscheri, Staphylococcus aureus, Klebsiella pneumoniae, or Listeria monocytogenes. These same corticosteroids inhibited the ability of mouse peritoneal macrophages to spread on glass surfaces. The three compounds incapable of decreasing host resistance, although highly antiinflammatory, were: (II) 6α-methylprednisolone, 21 sodium hemisuccinate: (VI) 9α-fluoro, 16α-hydroxyprednisolone, 16α-, 17α-acetonide, 21 hemisuccinate; and (VIII) 9α-fluoro, 16α-hydroxyprednisolone, 16, 21 dihemisuccinate. These three compounds were also unable to inhibit the spreading of macrophages on glass. The importance of succinate group bound to the corticosteroid molecule as hemisuccinate is emphasized since it is seen that the infection-provoking property can be dissociated from the antiinflammatory property. This finding may be of practical consequence in selecting a corticosteroid for treatment in disease, and also shows that one cannot use, indifferently, corticosteroids only on the basis of their common antiinflammatory property.
Dual Primary Subclavicular Angiosarcoma and Lung Cancer Imaging With C-11 Acetate PET and FDG PET
Authors: Tomohiro Abiko, Satoko Koizumi, Iwao Takanami
Journal: Clinical Nuclear Medicine (2009)

We report the case of a 75-year-old woman with dual primary subclavicular angiosarcoma and lung cancer. FDG PET showed enhanced uptake (SUVmax 12.2) in the subclavicular lesion and equivocal uptake (SUVmax 3.8) in the lung lesion. C-11 acetate (AC) PET showed equivocal uptakes in both with SUVmax values of 1.56 and 1.1, respectively. Incisional biopsy of the subclavicular mass and video-assisted thoracoscopic surgery were performed, as we considered the 2 lesions to be unrelated malignant tumors based on the findings of FDG-PET and AC-PET. Finally, the 2 lesions were diagnosed as subclavicular angiosarcoma and lung cancer.
Comparison of spirometric thresholds in diagnosing smoking-related airflow obstruction
Authors: Martin R Miller
Journal: Thorax (2014)

Comparison of spirometric thresholds in diagnosing smoking-related airflow obstructionThe recent paper in Thorax by Bhatt et al 1 asserted that using the lower limit of normal (LLN) for FEV 1 /FVC to define airflow obstruction in the diagnosis of COPD fails to identify a number of patients with significant pulmonary pathology that are identified by using a fixed ratio for FEV 1 /FVC.However, they have not adequately proven that significant pulmonary pathology was being detected by using the fixed ratio.The authors first suggest that the LLN standard for defining airflow limitation from FEV 1 /FVC has not been clinically validated for lack of a gold standard.They then use CT-detected emphysema as a gold standard reference to judge various spirometry criteria.This approach is specious since there is no validated gold standard for CT defined emphysema.The authors concede in their article that 'there is no consensus on the cut-off for defining emphysema by quantitative CT'.3][4] Therefore, CT density thresholds for defining emphysema will need to adjust for the changes that just occur with age that are not due to a disease process (in a way similar to how lung function assessment using z-scores takes these age related changes into account).The authors have not done this.The authors' abstract states that 'Subjects with airflow obstruction by fixed ratio only had a greater degree of emphysema than those by LLN only.'They use this to suggest LLN is missing patients with disease.Those few subjects (n=18) abnormal only by LLN are known to include a predominance of younger women that the fixed ratio discriminates against (fails to diagnose true airflow limitation) and so being younger (mean age 47.2 years vs 65.3 years in the fixed ratio only group) they will have a different CT-density score.In younger people, it is likely airflow obstruction will arise from airway effects without so much emphysema.The important thing the authors fail to point out is that the substantial number of subjects (n=548) who were abnormal by fixed ratio alone have much less 'emphysema' (LAA856exp 19.8 vs 38.8) than those positive by both LLN and fixed ratio (n=2686).As others have found the
Transient Demyelination Increases the Efficiency of Retrograde AAV Transduction
Authors: Edmund R Hollis, Pouya Jamshidi, Ariana O Lorenzana, Jae K Lee, Steven J Gray, Richard J Samulski, Binhai Zheng, Mark H Tuszynski
Journal: Molecular Therapy (2010)

Adeno-associated virus (AAV) is capable of mediating retrograde viral transduction of central and peripheral neurons. This occurs at a relatively low efficiency, which we previously found to be dependent upon capsid serotype. We sought to augment retrograde transduction by providing increased axonal access to peripherally delivered AAV. Others have described utilizing full transection of peripheral nerves to mediate retrograde viral transduction of motor neurons. Here, we examined the ability of a transient demyelinating event to modulate levels of retrograde AAV transduction. Transient demyelination does not cause lasting functional deficits. Ethidium bromide (EtBr)-induced transient demyelination of the sciatic nerve resulted in significant elevation of retrograde transduction of both motor and sensory neurons. Retrograde transduction levels of motor neurons and heavily myelinated, large-diameter sensory neurons increased at least sixfold following peripheral delivery of self-complementary AAV serotype 1 (scAAV1) and serotype 2 (scAAV2), when preceded by demyelination. These findings identify a means of significantly enhancing retrograde vector transport for use in experimental paradigms requiring either retrograde neuronal identification and gene expression, or translational treatment paradigms.
Scientists screen embryo for genetic predisposition to cancer
Authors: S. Gottlieb
Journal: BMJ (2001)

Scientists in Chicago, Illinois, have announced the birth of a baby who underwent genetic testing as an embryo to screen for a disease that might not show up until adulthood, if at all.

The work is the latest in a series of recent developments that have allowed couples to screen their test tube embryos for the presence or absence of disease genes, then transfer only the healthy embryos to the mother's womb. The technology has freed a growing number of families from inherited illness, but it has also raised fears …
The Patient–Doctor
Authors: Marya J. Cohen
Journal: Annals of Internal Medicine (2010)

On Being a Patient7 December 2010The Patient–DoctorMarya J. Cohen, MDMarya J. Cohen, MDFrom Massachusetts General Hospital, Boston, MA 02114.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-11-201012070-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I thought it would be easy to sleep in the hospital again. It had been a few years, but I soon remembered the feeling of the vinyl pillow slipping out from its thin cotton case, the weight of industrial-issue clothes laced with sweat, and the pink irritation on the backs of my hands from the sterilizing soap. One never quite feels clean in the hospital. Tired, cold, and hungry, I used to hunt for an abandoned perch with questionably new sheets, hoping to close my eyes before the familiar cadence “doo-da-doo-da-do” beeped from the clip on my waist. I could ... Author, Article, and Disclosure InformationAffiliations: From Massachusetts General Hospital, Boston, MA 02114.Corresponding Author: Marya J. Cohen, MD, Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, MA 02114; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 7 December 2010Volume 153, Issue 11Page: 763KeywordsAnxietyEmotionsHemorrhagePregnancySleepSoapsSteroidsSweatUltrasound imagingWheelchairs ePublished: 7 December 2010 Issue Published: 7 December 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
NHS requires radical rethinking to avoid "terminal collapse," warns report
Authors: B. Christie
Journal: BMJ (2010)

The NHS will struggle to control costs as budgets tighten in the years ahead, marking the beginnings of a terminal collapse, warns a report that calls for radical new thinking to create a sustainable future.

It says that the NHS has never experienced a protracted period of static funding in its 60 year history and that the current approach of marshalling limited resources in smarter ways to meet rising demand will not be enough to meet this challenge.

The report is by the Scottish based think tank International Futures Forum (www.internationalfuturesforum), which was set up in 2001 with a grant from BP and works with organisations such …
The Annual Physical
Authors: John Grey
Journal: JAMA (2007)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Glucometrics in Patients Hospitalized With Acute Myocardial Infarction
Authors: Mikhail Kosiborod, Silvio E. Inzucchi, Harlan M. Krumholz, Lan Xiao, Philip G. Jones, Suzanne Fiske, Frederick A. Masoudi, Steven P. Marso, John A. Spertus
Journal: Circulation (2008)

Background— Hyperglycemia on admission is associated with an increased mortality rate in patients with acute myocardial infarction. Whether metrics that incorporate multiple glucose assessments during acute myocardial infarction hospitalization are better predictors of mortality than admission glucose alone is not well defined. Methods and Results— We evaluated 16 871 acute myocardial infarction patients hospitalized from January 2000 to December 2005. Using logistic regression models and C indexes, 3 metrics of glucose control (mean glucose, time-averaged glucose, hyperglycemic index), each evaluated over 3 time windows (first 24 hours, 48 hours, entire hospitalization), were compared with admission glucose for their ability to discriminate hospitalization survivors from nonsurvivors. Models were then used to evaluate the relationship between mean glucose and in-hospital mortality. All average glucose metrics performed better than admission glucose. The ability of models to predict mortality improved as the time window increased (C indexes for admission, mean 24 hours, 48 hours, and hospitalization glucose were 0.62, 0.64, 0.66, 0.70; P &lt;0.0001). Statistically significant but small differences in C indexes of mean glucose, time-averaged glucose, and hyperglycemic index were seen. Mortality rates increased with each 10-mg/dL rise in mean glucose ≥120 mg/dL (odds ratio, 1.8; P =0.003 for glucose 120 to &lt;130 mg/dL) and with incremental decline &lt;70 mg/dL (odds ratio, 6.4; P =0.01 versus glucose 100 to &lt;110 mg/dL). The slope of these relationships was steeper in patients without diabetes. Conclusions— Measures of persistent hyperglycemia during acute myocardial infarction are better predictors of mortality than admission glucose. Mean hospitalization glucose appears to be the most practical metric of hyperglycemia-associated risk. A J-shaped relationship exists between average glucose and mortality, with both persistent hyperglycemia and hypoglycemia associated with adverse prognosis.
Mass orphanhood in the era of HIV/AIDS
Authors: N. R. Matshalaga
Journal: BMJ (2002)

AIDS has devastated the social and economic fabric of African societies and made orphans of a whole generation of children. Although donor agencies initially viewed the plight of orphans as a short term humanitarian disaster, they now acknowledge the long term social consequences of African children growing up without parental love and guidance. The potential for these children to form a large group of dysfunctional adults, which could further destabilise societies already weakened by AIDS, has increased the urgency of finding an effective solution to the orphan crisis.

Africa is home to 95% of the world's 13 million children orphaned as a result of AIDS. The numbers will rise until at least 2010, by which time a third of African children will be orphaned. 1 2 These orphans' psychosocial needs are a growing concern. Orphans in Africa suffer recurrent psychological trauma, starting with the illness and deaths of their parents, followed by cycles of poverty, malnutrition, stigma, exploitation, and, often, sexual abuse. Experiencing this without family love and support, and without the education needed to understand and rise above their circumstances, these …
AGING IMPAIRS DOBUTAMINE AUGMENTATION OF EARLY DIASTOLIC INTRAVENTRICULAR PRESSURE GRADIENT
Authors: Takahiro Ohara, Cassie L. Niebel, Kelley C. Stewart, Rahul Kumar, John J. Charonko, Min Pu, Pavlos P. Vlachos, William C. Little
Journal: Journal of the American College of Cardiology (2011)
The PCORI Perspective on Patient-Centered Outcomes Research
Authors: Lori Frank, Ethan Basch, Joe V. Selby
Journal: JAMA (2014)

The Patient-Centered Outcomes Research Institute (PCORI) was established as part of the US Patient Protection and Affordable Care Act of 2010 to fund patient-centered comparative clinical effectiveness research, extending the concept of patient-centeredness from health care delivery to health care research. In the United States, patient-centered outcomes research is new and not defined in the legislation, and the rationale is unclear to many. In this Viewpoint, we address 2 related questions: What does patientcenteredness in research mean? Why conduct patientcentered outcomes research? The essence of the PCORI definition of patientcentered outcomes research is the evaluation of questions and outcomes meaningful and important to patients and caregivers. The definition rests on the axiom that patients have unique perspectives that can change and improve the pursuit of clinical questions. Relevant to both the definition and rationale is the hypothesis that including the perspectives of end users of the research, which include patients, physicians, and other health care stakeholders, will enhance the relevance of research to actual health decisions these end users face. In turn, increased relevance is hypothesized to improve uptake of the evidence and improve the likelihood that patients will achieve the health outcomes they desire. Although this proposed causal chain is readily understood in relation to questions of direct interest to pa