tbuckley/cabot-search huggingface dataset:
Advising Patients Who Seek Alternative Medicine
Authors: Wayne B. Jonas
Journal: Annals of Internal Medicine (1998)

Letters15 February 1998Advising Patients Who Seek Alternative MedicineWayne B. Jonas, MD and Carol I. Hudgings, PhDWayne B. Jonas, MDOffice of Alternative Medicine; Bethesda, MD 20892Search for more papers by this author and Carol I. Hudgings, PhDOffice of Alternative Medicine; Bethesda, MD 20892Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-4-199802150-00048 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Eisenberg should be congratulated, not only for previously uncovering the great underground of alternative medicine use among our patients but also for now calling upon us in conventional medicine to take some responsibility in filling the communication gap that exists between patients and physicians in these areas [1].Although his suggestions on how to address alternative therapies with patients provide a reasonable strategy for opening dialogue about these practices, his approach lacks one key element that is needed before physicians can fulfill these responsibilities. Judgments about alternative medicine, like those in all areas of medicine, should ...References1. Eisenberg DM. Advising patients who seek alternative medical therapies. Ann Intern Med. 1997; 127:61-9. Google Scholar2. Dixon R, Munro J. Evidence Based Medicine: A Practical Workbook for Clinical Problem Solving. London: Butterworth-Heinemann; 1997. Google Scholar3. Jonas WB. Safety in complementary medicine. In: Ernst E, ed. Complementary Medicine: An Objective Appraisal. London: Butterworth-Heinemann; 1996:126-49. Google Scholar4. Vickers A, Cassileth B, Ernst E, Fisher P, Goldman P, Jonas W, et al. How should we research unconventional therapies? A panel report from the conference on complementary and alternative medicine research methodology, National Institutes of Health. Int J Technol Assess Health Care. 1997; 13:111-21. Google Scholar Author, Article, and Disclosure InformationAuthors: Wayne B. Jonas, MD; Carol I. Hudgings, PhDAffiliations: Office of Alternative Medicine; Bethesda, MD 20892 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 February 1998Volume 128, Issue 4Page: 329KeywordsCaregiversCase seriesDatabasesDecision makingEpidemiologyEvidence based medicine ePublished: 15 August 2000 Issue Published: 15 February 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Intractable Pain Therapy Using a New Epidural Catheter
Authors: Gabor B. Racz
Journal: JAMA (1982)

Conventional epidural catheters used in performing neurolytic blocks create frequent problems such as kinking, misplacement, and questionable localization of the catheter. We present a study of a new epidural catheter for injection of phenol in patients with severe pain problems. In four of five cases complete pain relief was obtained for several months. The design of this catheter provides improved localization of the injection site. (<i>JAMA</i>1982;248:579-581)
Congenital Heart Disease: Correlation of Pathologic Anatomy and Angiocardiography
Authors: Donald C. Fyler
Journal: JAMA (1965)

The authors have compiled their view of the morbid and roentgenographic anatomy of congenital heart disease, presenting their extensive experience in the form of x-rays, angiocardiograms, photographs of pathological specimens, and drawings. More than 1,000 photographic reproductions of excellent quality are provided. The quality and number of these illustrations undoubtedly account for the high price of these volumes. While the authors are extravagant with expensive paper and reproductions, only brief bits of concise text, rarely filling more than one-half page, are presented. The material is divided on the basis of degrees of pulmonary arterial vascularity, and subdivided according to the presence or absence of cyanosis. As a consequence, those common defects which may be associated with pulmonary vascular obstructive disease are discussed in two different places under acyanotic and cyanotic headings. This extensive repetition scarcely seems necessary in a book devoted to pathological and roentgenographic anatomy, since the secondary effects
Reduced Cerebellar Inhibition in Schizophrenia: A Preliminary Study
Authors: Zafiris J. Daskalakis, Bruce K. Christensen, Paul B. Fitzgerald, Sarah I. Fountain, Robert Chen
Journal: American Journal of Psychiatry (2005)

OBJECTIVE: Postmortem and structural imaging studies suggest that patients with schizophrenia have disrupted cerebellar activity. It has been speculated that these abnormalities mediate disorganized thought processes and psychosis. The authors' goal was to use transcranial magnetic stimulation to measure cerebellar inhibition, a proxy of cerebellar activity, as the principal output of the cerebellum is inhibitory. METHOD: Cerebellar inhibition was accomplished by delivering a magnetic cerebellar conditioning stimulus 5–15 msec before a magnetic test stimulus to the motor cortex. The cerebellar conditioning stimulus inhibits the size of the motor evoked potential produced by the test stimulus by approximately 50%. Ten patients with schizophrenia and 10 healthy comparison subjects completed the cerebellar inhibition protocol. RESULTS: Patients with schizophrenia demonstrated significant deficits in cerebellar inhibition compared with healthy subjects. CONCLUSIONS: The authors conclude that deficits in cerebellar inhibitory activity in schizophrenia may be the result of an abnormality in the cerebellum or disrupted cerebellar-thalamic-cortical connectivity.
951-70 Absence of Bleeding and Subacute Occlusion After Palmaz-Schatz Coronary Stenting Using a New Antithrombotic Regimen
Authors: Francisco Fernández-Avilés, Joaquín Alonso, Juan M. Durán, Federico Gimeno, Juan C. Muñoz, Luis Fuente, Alberto San Román, Enrique Guillem
Journal: Journal of the American College of Cardiology (1995)
OC-120 The “nutrition support pyramid”—composition and trends in a regional paediatric cohort from South East Scotland
Authors: C E Paxton, P Henderson, D C Wilson
Journal: Gut (2012)

<h3>Introduction</h3> Within nutrition support (NS) there is a spectrum of complexity ranging from oral supplements via enteral tube feeding (ETF) to parenteral nutrition (PN) for intestinal failure (IF). Nutrition support teams (NST) are involved with those children with chronic or complex nutrition needs on home ETF (HETF) and home PN (HPN). There is no current robust data available on the prevalence of children on each level of what we newly describe as the nutrition support pyramid (NSP). <h3>Aims</h3> To introduce the concept of the NSP and to describe the composition and temporal trends in the NSP in a UK regional paediatric cohort. <h3>Methods</h3> We performed a retrospective cohort study (database/clinical note review) of all children (&lt;16 yrs) in SE Scotland requiring NS over a 7-year period (2004–2010). We divided all children having NS into levels of the NSP, which comprises four levels of nutrition support; a 5th level is children with IF who have required transplantation (Tx) to achieve intestinal adaptation. The NSP base comprises children receiving HETF, the second level is children with severe upper GI dysmotility requiring jejunal HETF, the penultimate level is children with type II IF (prolonged hospital PN), and the top level is type III IF (children who receive HPN). Poisson regression models and Fisher9s exact testing were then used to compare the period prevalence (per calendar year) of children &lt;16 yrs requiring NS and the proportions of each level of the NSP between the two epochs of 2004–2006 and 2008–2010. <h3>Results</h3> There were a total of 780 NS episodes in 702 children (51% male); 69 (10%) had multiple episodes of NS. Median (IQR) age at commencing NS was 1.0 (0.2–4.7) yrs. There was a significant increase in the period prevalence of children requiring NS between the two epochs (p=0.004). However, although the number of children requiring HETF (level 1) rose from 372 to 422 between the two epochs, there was a non-significant change in the shape of the NSP (determined by the relative size of each level) between the two epochs (p=0.736). During the entire study period a total of 715 NS episodes were located on the base level (HETF); 31 on the second level (jejunal HETF); 21 on the penultimate level (type II IF); and 14 on the top level (type III IF), with four children requiring Tx to achieve enteral autonomy. <h3>Conclusion</h3> We have introduced the concept of a NSP, not previously described, and shown that the NSP has significantly increased in size (number of children requiring NS) without a significant change in the shape (relative distribution of complexity). The NSP is a simple tool which allows us to show a significant increase in NST workload without any decrease in complexity over just 7 years. <h3>Competing interests</h3> None declared.
A FACCT-filled agenda for public information. Foundation for Accountability
Authors: A. A. Skolnick
Journal: JAMA (1997)

LIKE IT or not, the health care system in the United States is being driven by marketplace economics. For the marketplace to work in controlling prices and improving quality, consumers must be able to make informed choices. However, the information they need often is unavailable, hard to find, difficult to understand, or lost in the noise of confusing messages. "We cannot have an effective privatesector health care market,with little government regulation, unless most consumers become active and informed managers of their health care," said David J.Lansky, PhD, president of the Foundation for Accountability (FACCT), a not-for-profit coalition of corporate, consumer, and government purchasers of health care based in Portland, Ore. The foundation was established in 1995 to develop quality measures that meet the needs ofbuyers and users of health care. Its board members include representatives from the Health Care Financing Administration (HCFA), Federal Employee Health Benefit Plan, US Department of
MicroRNA-Related Genetic Variants Associated with Clinical Outcomes in Early-Stage Non–Small Cell Lung Cancer Patients
Authors: Xia Pu, Jack A. Roth, Michelle A.T. Hildebrandt, Yuanqing Ye, Hua Wei, John D. Minna, Scott M. Lippman, Xifeng Wu
Journal: Cancer Research (2013)

Abstract Given the density of single-nucleotide polymorphisms (SNP) in the human genome and the sensitivity of single-nucleotide changes in microRNA (miRNA) functionality and processing, we asked whether polymorphisms within miRNA processing pathways and binding sites may influence non–small cell lung cancer (NSCLC) patients' prognosis. We genotyped 240 miRNA-related SNPs in 535 patients with stage I and II NSCLCs to determine associations with overall recurrence and survival as well as effect in specific treatment subgroups. After correcting for multiple comparisons, the G allele of FZD4:rs713065 displayed a significant association with decreased risk of death in surgery-only patients [HR, 0.46; 95% confidence interval (CI), 0.32–0.65]. DROSHA:rs6886834 variant A allele (HR, 6.38; 95% CI, 2.49–16.31) remained significant for increased risk of recurrence in the overall and surgery-only populations, respectively. FAS:rs2234978 G allele remained significantly associated with survival in all patients (HR, 0.59; 95% CI, 0.44–0.77), whereas borderline significant in subgroups (surgery-only: HR, 0.59; 95% CI, 0.42–0.84; surgery plus chemo: HR, 0.19; 95% CI, 0.07–0.46). Luciferase assays showed that the FAS SNP created a miR-651 functional binding site. Survival tree analysis was conducted to classify patients into distinct risk subgroups based on their risk genotype combinations. These results indicate that miRNA-related polymorphisms may be associated with NSCLC patients' clinical outcomes through altered miRNA regulation of target genes. Cancer Res; 73(6); 1867–75. ©2013 AACR.
Antibiotic-Induced D-Lactic Acidosis
Authors: Boris E. Coronado
Journal: Annals of Internal Medicine (1995)

Objective: To describe a case of oral antibiotic-induced d-lactic acidosis in a patient with enteric overgrowth of Lactobacillus acidophilus. Design: Single case study. Setting: University-affiliated community hospital. Intervention: Oral carbohydrate challenge test with 4000 kcal/d. Main Results: A patient had several episodes of d-lactic acidosis after receiving oral antibiotics. Stool cultures yielded Lactobacillus acidophilus resistant to the implicated agents. Provocative challenge with dietary carbohydrate alone, in the absence of antibiotics, failed to reproduce the syndrome. Conclusions: Oral antibiotics may induce d-lactic acidosis in patients with the short-bowel syndrome by promoting the overgrowth of resistant d-lactate-producing organisms. Interactions between carbohydrate intake and antibiotic use are likely determinants in the development of this syndrome. Periodic use of stool cultures with antimicrobial susceptibility testing may assist in the management of these patients by optimizing the selection of antimicrobial agents.
Therapeutic consultation centres are helpful in developing countries
Authors: A. Figueras
Journal: BMJ (2002)

EDITOR—The increasing global gap between rich and poor countries leads to inequalities in access to drugs and to the knowledge and skills needed for their rational use. It also leads to qualitatively different information needs.

Therapeutic information on the management of HIV infection and AIDS flows at two separate levels: although some doctors debate about the potential benefits of new viral transmembrane protein blockers, others are wondering how to manage a patient with pneumocystis pneumonia because of insufficient financial resources to purchase co-trimoxazole. These people …
US television drug advertisements paint a “black and white scenario”
Authors: Janice Hopkins Tanne
Journal: BMJ (2007)

An analysis of drug advertising on US television for four consecutive weeks in 2004 showed that one of the most powerful messages used by advertisers to sell their products was the idea that taking a prescription drug gives you back control over your life. 

US television viewers see as many as 16 hours of advertising for prescription drugs a year, much more time than spent seeing public health messages or with their primary care doctors, said lead author Dominick Frosch, assistant professor of medicine at the …
The functional utility of consciousness depends on content as well as on state
Authors: Anil K. Seth
Journal: Behavioral and Brain Sciences (2007)

This commentary considers Merker's mesodiencephalic proposal in relation to quantitative measures of neural dynamics suggested to be relevant to consciousness. I suggest that even if critical neural mechanisms turn out to be subcortical, the functional utility of consciousness will depend on the rich conscious contents generated by continuous interaction of such mechanisms with a thalamocortical envelope.
Lessons and myths in the HIV/AIDS response
Authors: Jon E Rohde
Journal: The Lancet (2009)

Peter Piot and colleagues1Piot P Kazatchkine M Dybul M Lob-Levyt J AIDS: lessons learnt and myths dispelled.Lancet. 2009; 374: 260-263Summary Full Text Full Text PDF PubMed Scopus (64) Google Scholar neglect to mention the most egregious oversight made by the public health community in dealing with the HIV epidemic: the avoidance of surveillance and contact tracing and the secrecy involved in dealing with potentially infectious cases. Infectious disease control through public health measures has repeatedly shown the efficacy of making new cases reportable, of identifying and tracing contacts, and of including them in further surveillance and containment efforts. These basic public health principles have been avoided in HIV over concerns about confidentiality, which itself has exacerbated the stigma and discrimination that Piot and colleagues admit have been a significant impediment to HIV control. Appropriate measures can protect against these unfortunate outcomes without total secrecy. Had full implementation of normal public health procedures for control of an emerging infectious disease been followed, such as we saw for severe acute respiratory syndrome (SARS), it is likely that the extent of the AIDS epidemic would have been substantially curtailed. Even at this late date, making the disease reportable and tracing all possible contacts with intensive education of all exposed, along with HIV testing and continued surveillance and needed clinical care, would do much to stem the spread of this epidemic. I declare that I have no conflicts of interest. Lessons and myths in the HIV/AIDS response – Authors' replyWe agree with Ann Starrs that many important causes of ill health in low-income and middle-income countries are seriously underfunded, and that "general funding for health as well as specifically for AIDS must increase significantly". The momentum created by the global AIDS response has already led to increased funding for health, but clearly not enough. Additionally, efficiency gains can be made in HIV interventions, and we should do as much as we can to ensure that the synergies between the AIDS response and other health programmes are optimised. Full-Text PDF
Angiotensin converting enzyme activity and evolution of pulmonary vascular disease in rats with monocrotaline pulmonary hypertension.
Authors: J M Kay, P M Keane, K L Suyama, D Gauthier
Journal: Thorax (1982)

We have investigated the role of angiotensin converting enzyme (ACE) in the development of pulmonary hypertension, right ventricular hypertrophy, and pulmonary vascular disease in rats given a single subcutaneous injection of the pyrrolizidine alkaloid monocrotaline. Thirty-six young female Wistar rats were divided into a test group of 27 animals and a control group of nine animals. Each test rat was given a single subcutaneous injection of monocrotaline (60 mg/kg body weight). On the first, third, fifth, seventh, tenth, twelfth, fourteenth, seventeenth, and twenty-second days after the injection of monocrotaline the mean right ventricular systolic blood pressure was measured in one control and three test rats. The animals were then killed and we measured the specific activity of ACE in serum and lung homogenate. We also evaluated muscularisation of pulmonary arterioles, medial hypertrophy of muscular pulmonary arteries, and right ventricular hypertrophy. The sequence of changes was as follows: muscularisation of pulmonary arterioles and medial hypertrophy of muscular pulmonary arteries were apparent seven days after administration of monocrotaline; pulmonary hypertension and reduced lung ACE activity occurred after 10 days; right ventricular hypertrophy was detected after 12 days. Serum ACE activity was unchanged. It is concluded that the reduction in lung ACE activity is a result rather than a cause of the pulmonary hypertension. This reduction in lung ACE activity may be a protective mechanism designed to limit the elevation of the pulmonary arterial pressure.
BMA annual representative meeting: Debate needed on balance between patient confidentiality and needs of research
Authors: Linda Beecham
Journal: BMJ (2004)

A proposal for a wider debate on the balance between the need for personal health information to be confidential and the need to do research was carried as a “reference” to the council (for the council to consider and develop at a later date).

Professor Peter Dangerfield, representing the Liverpool division, emphasised the importance of confidentiality but also pointed out that researchers often need to collect data. He said that a person's health information was private to the patient and should not be …
Genetically engineered dopamine β-hydroxylase gene promoters with better PHOX2-binding sites drive significantly enhanced transgene expression in a noradrenergic cell-specific manner
Authors: Dong-Youn Hwang, Michelle M. Hwang, Han-Soo Kim, Kwang-Soo Kim
Journal: Molecular Therapy (2004)

A continuously growing body of evidence suggests that dysregulation of noradrenergic (NA) neurons is implicated in the etiology and pathophysiology of various human diseases such as depression, drug addiction, and autonomic dysfunction. An efficient NA neuron-specific promoter is potentially valuable to investigate the precise role of NA neurons in normal as well as in diseased brain and to treat the associated disorders by gene therapy. In this study, we tested a novel strategy to modify genetically the promoter of the human dopamine beta-hydroxylase (hDBH) gene to overcome its inherent weakness while maintaining its cell-type specificity. We optimized the nucleotide sequence motifs of PHOX2-binding sites (PRS2 and PRS3) residing within the hDBH promoter. Optimization of both PRS2 and PRS3 motifs significantly increased their binding affinities to PHOX2A, leading to a dramatic increase in the promoter strength (>20-fold). More importantly, these modifications do not alter the level of transgene expression in non-NA cells either in vitro or in vivo, demonstrating tight cell-type specificity. This work shows that a cellular gene promoter can be genetically modified to strengthen its promoter activity without losing cell-type specificity by optimizing critical cis-regulatory elements. Our genetically engineered promoter may be useful for cell-type-specific gene targeting as well as for generating in vivo animal models with altered gene expression in a specific cell type.
Effectiveness of University of California Postbaccalaureate Premedical Programs in Increasing Medical School Matriculation for Minority and Disadvantaged Students
Authors: Kevin Grumbach, Eric Chen
Journal: JAMA (2006)

Many medical schools administer postbaccalaureate premedical programs targeting underrepresented minority and disadvantaged students, with the goal of increasing the number of these students matriculating into medical school.To determine whether University of California (UC) postbaccalaureate programs are effective in increasing medical school matriculation rates for program participants.Retrospective cohort study assessing 5 UC medical school postbaccalaureate programs. The cohort comprised 265 participants in the postbaccalaureate programs in the 1999 through 2002 academic years and a control group of 396 college graduates who applied to the programs but did not participate. Of the participants, 66% were underrepresented minorities, and for 50% neither parent had attended college.Matriculation by 2005 into a US medical school accredited by the Liaison Committee on Medical Education.By 2005, 67.6% of participants and 22.5% of controls had matriculated into medical school (P<.001). After adjusting for baseline student characteristics, students who participated in postbaccalaureate programs had a higher probability of matriculating into medical school in a regression model controlling for grade point average and demographic characteristics (odds ratio, 6.30; 95% confidence interval, 4.08-9.72) and in a model further controlling for preparticipation Medical College Admissions Test score (odds ratio, 8.06; 95% confidence interval, 4.65-13.97).Postbaccalaureate premedical programs appear to be an effective intervention to increase the number of medical school matriculants from disadvantaged and underrepresented groups.