tbuckley/cabot-search huggingface dataset:
Therapeutic modulation of cytokines.
Authors: B Henderson
Journal: Annals of the Rheumatic Diseases (1995)

Cytokine Physiology and Pathophysiology Cytokine Physiology, A. Meager Immunoregulatory Cytokines, F.S. diGiovine, J.B. Mee, and G.W. Duff Cytokines in Inflammation: An Overview, E.R. Pettipher Overview of Cytokine Modulation, B. Henderson Low Molecular Mass Cytokine Inhibitors Low Molecular Weight Inhibitors of Cytokine Synthesis, A.R. McKenzie Immunosuppressants as Cytokine Inhibitors, J.A. Schmidt and R.V. Bundick Cytokine Convertase Inhibitors, D.K. Miller Oligonucleotide-Based Inhibitors of Cytokine Expression and Function, C.F. Bennett and S.T. Crooke Naturally Occurring Inhibitors and Neutralizing Antibodies Interleukin-1 Receptor Antagonist, S.M. Opal TNFa Neutralization by Biological Antagonists, M.W. Bodmer and R. Foulkes Anti-Interleukin-5 Antibodies as Therapeutic Agents in Asthma and Other Eosinophilic Diseases, R.W. Egan, F.M. Cuss, S.P. Umland, and R.W. Chapman Modulation of Cytokine Signal Transduction Signal Transduction Mechanisms of Interleukin-1 and Tumor Necrosis Factor, J. Saklatvala Modulatory Cytokines Transforming Growth Factor-Betas: Endogenous Immunosuppressive and Anti-Inflammatory Molecules, G.M. Hochwald, M.A. Palladino, and G.J. Thorbecke Interleukin-10, J. Banchereau, F. Briere, C. Caux, A.-C. Fluckiger, P. Merville, and F. Rousset
Rules on extracontractual referrals relaxed NHS white paper proposes three projects Ombudsman now has a role in clinical complaints Trusts should have flexibility over manpower
Authors: L. Beecham
Journal: BMJ (1996)

# Rules on extracontractual referrals relaxed {#article-title-2}

From April 1998 NHS trusts will no longer be required to seek authorisation for elective extra-contractual referrals (ECRs). An executive letter (EL(96)94) explains that local protocols agreed between health authorities, general practitioners, and dentists will ensure that trusts can accept ECRs without having to seek authority from the responsible health authority. This was one of the recommendations of the NHS Efficiency Scrutiny in its report Seeing the wood, sparing the trees.

The original timetable envisaged completion by April 1997 but it was decided that more time was needed to allow smooth transition to the new system so that protocols can be completed by the end of September 1997 in time to influence the 1998–9 contracting round.

The efficiency scrutiny estimated that this change together with the abolition of notification requirements for tertiary and emergency ECRs, which have already been implemented, would save about £12m a year in NHS trust administrative costs.

# NHS white paper proposes three projects {#article-title-3}

The government's white paper on the NHS, A Service with Ambitions, which was published last week (16 November, p 1226), proposed three programmes of work which will be carried out over the next six to nine months. The projects will be on information, professional development, and managing for quality.

Information is not only about giving patients more informed choices, but also about access to databases by clinicians and what information technology is needed to support research and clinical development. The team …
Comparison of statins and apples was unfair
Authors: T. E. Strandberg
Journal: BMJ (2014)

Briggs and colleagues’ study suggested comparable mortality benefits from statins and apples.1 However, their study may not give due credit to statins for several reasons.

Firstly, the clinical effect of statins was based on rigorous mostly placebo controlled trials, whereas the effect of apples was based on data from observational studies. This is inevitable because no placebo …
Why Partial Liquid Ventilation Did Not Fulfill Its Promise
Authors: Robert M. Kacmarek, Arthur S. Slutsky
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

With regard to the recent article byKacmarek and colleagues, we are in complete agreement on the absolute necessity of making public the results of negative trials (1). Discovering the reason(s) why randomized controlled trials did not confirm the information on which they were based can be highly instructive. Partial liquid ventilation (PLV), once introduced in the clinical arena, failed to live up to expectations. These disappointing results of a highly promising technique occurred in the context of major improvements in the outcome of control patients treated with conventional mechanical ventilation (CMV) utilizing a lung-protective strategy. Others have speculated that high-dose perfluorocarbon administration in the LiquiVent trial may have resulted in the socalled baby lung effect (2). We believe that the initial enthusiasm about PLV was based on a too hasty extrapolation from total liquid ventilation (TLV) data and on a poorly adapted study design used to investigate the effectiveness of PLV. In 1991, the scientific community welcomed PLV as a major technical simplification of TLV, and it was assumed that the new hybrid method would preserve all the obvious benefits of TLV. Gradually, however, we learned that the physiology of PLV is fairly complicated and definitely different from that of TLV. The lung-protective effect of PLV turned out to be less important than that associated with TLV. It took several years before the effect of perfluorocarbon liquid volume and the gas ventilation strategy to be used during PLV were investigated in depth. Strange to say, initially, most investigators used a study design adopted from surfactant research to assess PLV efficacy. In animals with respiratory failure, no attempt was made to adjust or optimize the ventilation settings. In a Medline (1966–December 2001) and personal file search, we identified 50 animal studies likely overestimating the benefits of PLV because the control groups were ventilated inadequately in terms of modern standards (3). As a consequence of inappropriate study design, much effort, time, and money have been wasted. When PLV was compared with other recruitment strategies, perfluorocarbons did not prove to be the golden bullet (4, 5), even after optimizing the gas ventilation strategy (6). We hope that PLV researchwill not be perceived as a frustrating misadventure to be forgotten as soon as possible, but rather as an instructive experience not bearing repetition.
Exposure misclassification bias in studies of environmental tobacco smoke and lung cancer.
Authors: A H Wu
Journal: Environmental Health Perspectives (1999)

It is now recognized that exposure to environmental tobacco smoke (ETS) in the workplace and other settings outside the home may be equally as important as residential ETS exposure. This review examines the sources of misclassification in the assessment of workplace ETS exposure in questionnaire-based epidemiologic studies. Cogent to this discussion is the role of misclassification of ever smokers as never smokers, which is important in studies of both workplace and residential ETS exposure and lung cancer and is discussed first. The collective evidence from studies that have used direct or indirect approaches to estimate smoker misclassification shows that although some misclassification of ever smokers as never smokers exists in studies of ETS and lung cancer, the potential bias from the misclassification of smokers is unlikely to explain the observed increased risk of lung cancer associated with ETS exposure.
Exploring the Behavior of Hospital Composite Performance Measures
Authors: Sean M. O’Brien, Elizabeth R. DeLong, Rachel S. Dokholyan, Fred H. Edwards, Eric D. Peterson
Journal: Circulation (2007)

Composite scores that combine several performance measures into a single ranking are becoming the accepted metric for assessing hospital performance. In particular, the Centers for Medicare & Medicaid Services Hospital Quality Incentive Demonstration (HQID) project bases financial rewards and penalties on these scores. Although the HQID composite calculation is straightforward and easily understood, its method of combining process and outcome measures has not been validated.Using data on 530 hospitals from the Society of Thoracic Surgeons National Cardiac Database, we replicated the HQID methodology with 6 nationally endorsed performance measures (5 process measures plus survival) for coronary artery bypass surgery. Composite scores were essentially determined by process measure performance alone; the survival component explained only 4% of the composite score's total variance. This result persisted even when the survival component was allowed a 5-fold greater weighting in the composite summary. The popular "all-or-none" measurement approach was also dominated by the process component. Substantial disagreement was found among hospital rankings when several alternative methods were used; up to 60% of hospitals eligible for the top financial reward under HQID would change designation depending on the composite methodology used. The application of a simple statistical adjustment (standardization) to each method would provide more consistent results and a more balanced assessment of performance based on both process and outcomes.Existing methods used to create composite performance measures have remarkably different weighting of process versus outcomes metrics and lead to highly divergent provider rankings. Simple alternative methods can create more balanced process-outcome performance assessments.
IgG4-Related Skin Disease—Reply
Authors: Saskia Ingen-Housz-Oro, Nicolas Ortonne, Olivier Chosidow
Journal: JAMA Dermatology (2013)

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 Dermatology 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 Dermatology journal
A genetic model for absent chylomicron formation: mice producing apolipoprotein B in the liver, but not in the intestine.
Authors: S G Young, C M Cham, R E Pitas, B J Burri, A Connolly, L Flynn, A S Pappu, J S Wong, R L Hamilton, R V Farese
Journal: Journal of Clinical Investigation (1995)

The formation of chylomicrons by the intestine is important for the absorption of dietary fats and fat-soluble vitamins (e.g., retinol, alpha-tocopherol). Apo B plays an essential structural role in the formation of chylomicrons in the intestine as well as the VLDL in the liver. We have developed genetically modified mice that express apo B in the liver but not in the intestine. By electron microscopy, the enterocytes of these mice lacked nascent chylomicrons in the endoplasmic reticulum and Golgi apparatus. Because these mice could not form chylomicrons, the intestinal villus enterocytes were massively engorged with fat, which was contained in cytosolic lipid droplets. These mice absorbed D-xylose normally, but there was virtually no absorption of retinol palmitate or cholesterol. The levels of alpha-tocopherol in the plasma were extremely low. Of note, the absence of chylomicron synthesis in the intestine did not appear to have a significant effect on the plasma levels of the apo B-containing lipoproteins produced by the liver. The mice lacking intestinal apo B expression represent the first genetic model of defective absorption of fats and fat-soluble vitamins and provide a useful animal model for studying nutrition and lipoprotein metabolism.
Premarital Screening for HIV
Authors: James L. Nadler
Journal: JAMA (1988)

<h3>To the Editor.</h3> —On Jan 1, 1988, Illinois and Louisiana became the first states to begin compulsory premarital screening for human immunodeficiency virus (HIV) antibodies. The following case report of an indeterminate test result demonstrates one of several serious difficulties encountered with premarital HIV testing. Equivocal results place undue emotional stress on the engaged couple and are confounded by the time constraints of the marriage license application process. <h3>Report of a Case.</h3> —A woman in her early 20s came to the clinic for a mandatory premarital blood test. Our clinical staff had prepared extensively to provide couples with educational material and consent forms, as well as to ensure timely, accurate, and strictly confidential test results.<sup>1</sup> A week later the results showed a repeatedly reactive enzyme-linked immunosorbent assay result (her fiancé had a negative result). Western blot assay showed an indeterminate result reactive to the p24 antigen only. She had
Aspergillosis in Four Renal Transplant Recipients
Authors: JOHN R. BURTON
Journal: Annals of Internal Medicine (1972)

Four patients who had recently received kidney transplants became infected with Aspergillus fumigatus while receiving immunosuppressive therapy. Three were shown to have invasive pulmonary mycotic disease, and one of these had documented dissemination. A fourth patient had respiratory symptoms and fever and was found to have mycelial forms consistent with A. fumigatus in his sputum, verified by cultures. All four were effectively treated with amphotericin B in low, widely spaced doses. Early diagnosis was apparently the key to successful management of the invasive Aspergillus fumigatus infection in these patients. Discovery of mycelial forms in fresh preparations of sputa or bronchial washings is a valuable clue to active infections. Securing tissue by biopsy is warranted in those patients who develop a pulmonary infiltrate or cavity that is not otherwise causally explained.
Endoscopic variceal ligation in prophylaxis of first variceal bleeding in cirrhotic patients with high-risk esophageal varices
Authors: C Lay, Y Tsai, C Y Teg, W S Shyu, W S Guo, K L Wu, K J Lo
Journal: Hepatology (1997)

To determine the efficacy of endoscopic variceal ligation (EVL) in prophylaxis on the rate of first esophageal variceal bleeding, we conducted a prospective, randomized trial in 126 cirrhotic patients with no history of previous upper gastrointestinal bleeding and with esophageal varices endoscopically judged to be at high risk of hemorrhage. The end-points of the study were bleeding and death. Life-table curves showed that prophylactic EVL significantly diminished the rate of variceal hemorrhage (12/62 [19%] vs. 38/64 [60%]; P = .0001) and overall mortality (17/62 [28%] vs. 37/64 [58%]; P = .0011). The 2-year cumulative bleeding rate was 19% (12/ 62) in the EVL group and 60% (38/64) in the control group. The 2-year cumulative mortality rate was 28% (17/62) in the EVL group and 58% (37/64) in the control group. Comparison of Kaplan-Meier estimates of the time to death of both groups showed significantly lower mortality in the ligation group (P = .001). Patients undergoing EVL had few treatment failures and died mainly of hepatic failure. The lower risk in the EVL group was attributed to a rapid reduction of variceal size. Prophylactic EVL was more efficient in preventing first bleeding in patients with good condition (Child A) than in those with decompensated disease (Child B and C). We conclude that prophylactic EVL can decrease the incidence of first variceal bleeding and death over a period of 2 years in cirrhotic patients with high-risk esophageal varices.
Macrocytic Anaemia following Gastro-enterostomy
Authors: N. S. Gordon, J. Japa
Journal: BMJ (1941)

BRITISH 769 2. As regards psychological treatment, this will follow the usual lines of child guidance.Direct treatment aimed at removal of the symptom, by suggestion or other means, is, in my opinion, desirable in many cases, as it eases the situation considerably for both parent and child, and further treatment can be carried on for the neurosis as a whole.This will generally be in the nature of play therapy, de- pending on the technique employed.In adolescents, voca- tional guidance is usually necessary, as well as readjustment of their attitude to their problems.It must be pointed out, however, that prolonged treatment is not required in all cases.For many of them the symptom can be cured in two or three interviews or by simple environmental readjust- ment.3. Very good results can be obtained in an institution provided it is of the right type.A residential open-air school has cured some of the cases first seen at the child guidance clinic.Others are cured at hostels for evacuated children.Everything, however, depends on the good re- lation between staff and children.At the school mentioned above remedial exercises to strengthen the abdominal and pelvic muscles were considered useful.4. If simple measures fail a period -of observation in hospital may be advisable, both to eliminate organic dis- order and because it may effect a salutary break, and show the child and the parent that the habit can stop (just as asthmatic, epileptic, and other attacks often disappear while the child is in hospital. SummaryAn inquiry is made into the investigation and treat- ment of encopresis in children based on cases treated at the Birmingham Child Guidance Clinic over the past seven years.No definite organic condition is found, and the cause is held to be psychogenic, the symptom being a regressive one.Examples of cases and a summary of various lines of treatment are given.My thanks are due to Miss A.
Eczema: quality of life by body site and the effect of patch testing
Authors: K.F. Thomson, S.M. Wilkinson, S. Sommer, B. Pollock
Journal: British Journal of Dermatology (2002)

Summary Background Patients with dermatitis are known to have impaired quality of life. Whether this varies according to body site has not been evaluated. Patch tests have previously been shown to influence quality of life, although no previous studies have shown if this is dependent on the results of the patch tests. Objectives To evaluate the impact of patch testing on quality of life according to the outcome of the investigations and to determine how quality of life varies according to eczema body site. Methods One hundred and sixty consecutive adult patients with active eczema were selected from a patch test clinic for inclusion into the study. Quality of life was determined using the Dermatology Life Quality Index (DLQI) and the SF‐36, prior to patch testing and 2 months later. Perceived eczema severity at each time point was also noted, along with the outcome of patch testing. Baseline comparison of quality of life was performed between four body site groups (face, hand, generalized, other). Results Patients confirmed as having relevant positive contact allergens were shown to have a significant improvement in both perceived eczema severity (P = 0·0004) and DLQI score (P = 0·0015) at 2 months after patch testing. No significant changes were noted in the SF‐36 score, other than a borderline improvement in the pain score (P = 0·048). The improvement in quality of life and eczema severity was not noted in patients with negative patch tests. Eighty‐nine per cent of patients diagnosed as having contact allergy were able to comply with avoidance advice. No significant variation was noted in quality of life according to body site affected by eczema. There was a positive correlation between DLQI score and perceived eczema severity (P < 0·0001). Conclusions Patients confirmed as having contact allergy show a subsequent improvement in eczema severity and an improvement in quality of life.
Is the allergen‐inhalation challenge predictive of the severity of seasonal asthmatic exacerbations?
Authors: E. Crimi, A. Balbo, S. Voltolini, C. Troise, V. Brusasco, A. C. Negrini
Journal: Allergy (1993)

Fifteen asthmatic patients sensitized to Parietaria pollen were studied. Before the pollen season they underwent an allergen‐inhalation challenge which was preceded and followed by a methacholine‐inhalation challenge. Pollen count, symptom score, and drug consumption were monitored daily throughout the study. A severity score was obtained by adding symptom score and drug consumption. Patients underwent a third methacholine challenge during the pollen season, after they had been exposed to a high atmospheric concentration of pollen. The severity score during the first period of the pollen season was significantly correlated with both the early and the late asthmatic responses to the allergen observed before the season (r 2 =0.50; P &lt;0.005). Bronchial sensitivity to methacholine was significantly increased both after allergen challenge and after seasonal exposure, but these increases correlated neither with each other nor with the severity score. We conclude that bronchial responses to experimental exposure to allergens, but not the changes in nonspecific airway responsiveness, can, in part, predict the severity of asthma exacerbation during the pollen season.
Intravenous Insulin Infusion to Simulate Subcutaneous Absorption: Bioavailability and Metabolic Sequelae
Authors: Richard M Watanabe, Aage Vølund, Richard N Bergman
Journal: Diabetes Care (1991)

Objective To determine the bioavailability and bioactivity of subcutaneously injected insulin. Research Design and Methods A randomized block design with six male mongrel dogs as subjects. In protocol 1, purified pork insulin was infused intravenously to simulate the pattern of appearance in the blood that would have been expected from subcutaneous injection. Three intravenous doses (0.05, 0.10, and 0.15 U/kg) were infused on separate days in a pattern (0-300 min) designed to ~ simulate the absorption rate of subcutaneously injected insulin. In protocol 2, interscapular subcutaneous injections of pork insulin at 0.10 U/kg were made. Results Integrated insulin, decrement in plasma glucose, and maximal glucose clearance for subcutaneous injection experiments were similar to intravenous infusion of equal dose (P &amp;gt; 0.10) but significantly different from low-dose infusions (P &amp;lt; 0.025). Similar results were observed for hepatic glucose output and glucose uptake. Hypoglycemia elicited counterregulatory responses that appeared to be under a threshold differentiated at a plasma glucose of ~ 3 mM. Integrated insulin was plotted against insulin dose to create dose-response curves for intravenous data. The curve was then used to predict the actual appearance rate of insulin in plasma for subcutaneous injection. The estimated bioavailability of subcutaneous insulin was 103.0 ± 10.5% of the injected dose. Conclusions We concluded that, in dogs, insulin delivered subcutaneously in the interscapular area is not significantly degraded before absorption, resulting in metabolic effects equal to intravenous insulin infusion of equivalent dose.