tbuckley/cabot-search huggingface dataset:
Interventions to Improve Research Participants' Understanding in Informed Consent for Research
Authors: James Flory, Ezekiel Emanuel
Journal: JAMA (2004)

Available data suggest that prospective research participants may frequently not understand information disclosed to them in the informed consent process. Little is known about how understanding can be improved.To review research on interventions to improve research participants' understanding of information disclosed in the informed consent process.A search of MEDLINE was performed using the terms informed consent and clinical research and informed consent and (comprehension or understanding) from 1966 to March 2004 , which included randomized controlled trials, longitudinal trials, and controlled trials with nonrandom allocation that compared the understanding of research participants who had undergone only a standard informed consent process to that of participants who had received an intervention to improve their understanding. A comprehensive bibliography of empirical research on informed consent published in January 1999 was also reviewed, as were personal files and all issues of the journals IRB and Controlled Clinical Trials.Study design, quality criteria, population characteristics, interventions, and outcomes for each trial were extracted. The statistical significance of the interventions' effects on understanding were noted, as were mean scores for understanding for each group of each trial. For those trials that measured the secondary outcomes of satisfaction and willingness to enroll, results were also summarized.Thirty studies described 42 trials that met inclusion criteria. Of 12 trials of multimedia interventions, 3 showed significant improvement in understanding. Of 15 trials of enhanced consent forms, 6 showed significant improvement in understanding (all P<.05), but 5 of 6 trials were of limited quality, casting doubt on their practical relevance. Of 5 trials of extended discussion, 3 showed significant improvement in understanding (all P<.001) and 2 showed trends toward improvement (P=.054 and P=.08). Of 5 trials of test/feedback, all showed significant improvement in understanding (all P<.05) but were flawed in that they may have mistaken rote memorization for improvement in understanding. Another 5 trials were put into a miscellaneous category and had varying impact on understanding. Some demographic factors, particularly lower education, were associated with less understanding. Satisfaction and willingness to enroll were never significantly diminished by an intervention .Efforts to improve understanding through the use of multimedia and enhanced consent forms have had only limited success. Having a study team member or a neutral educator spend more time talking one-on-one to study participants appears to be the most effective available way of improving research participants' understanding; however, further research is needed.
Trinitrine par voie per-cutanée en prévention de la pancréatite aiguë après cathétérisme bilio-pancréatique: étude randomisée contre placebo
Authors: L Heyries, M Barthet, N Lesavre Rosenzweig, JP Bernard, C Nojgaard, K Bakkevold, T Hauge, M Elkjaer, M Hornum, P Matzen, J Sahel
Journal: Endoscopy (2008)

But: L'hyperpression canalaire pancréatique secondaire à un spasme réactionnel du sphincter d'Oddi semble un facteur déterminant de la pancréatite aiguë (PA) post-cholangiopancréatographie rétrograde endoscopique (CPRE). La Trinitrine (TNT) ayant un effet relaxant sur le sphincter d'Oddi, nous avons mené un essai comparant la TNT au placebo.
HIGH INTENSITY, INTERVAL EXERCISE IMPROVES QUALITY OF LIFE, VENTRICULAR DIASTOLIC FUNCTION, ERGOMETRIC CAPACITY AND PSYCHOLOGICAL STATUS OF PATIENTS WITH CHRONIC HEART FAILURE: A PHASE III RANDOMIZED CLINICAL TRIAL
Authors: Christine Chrysohoou, Christos Pitsavos, George Tsitsinakis, Ioannis Vogiatzis, Dimitris Tsiachris, Athanasios Aggelis, Demosthenes Panagiotakos, Nikolaos Koulouris, Christodoulos I Stefanadis
Journal: Journal of the American College of Cardiology (2014)
Be young with Yoga
Authors: Allan J. Ryan
Journal: JAMA (1962)

Yoga, one of the six systems of Hindu philosophy, is characterized by its emphasis on body control in the achievement of union with the object of knowledge. For those who practice Yoga as a religious way of life, this object is Brahma, the universal spirit. For atheists, it is deeper knowledge of self. The eight stages of Yoga supposedly lead to perfect knowledge. This book deals principally with the third and fourth stages, the practice of postures (<i>asana</i>) and the regulation of breath (<i>pranayama</i>), which together constitute physical Yoga (<i>Hatha</i>). Physical Yoga is equated with what are supposed to be the characteristics of youth: flexibility, grace, serenity, ability to relax and to sleep restfully, vitality, endurance, clarity of mind, and the ability to maintain proper circulation and normal weight. Followers believe that in those who do not practice Yoga there is rapid development of the characteristics of age: stiffness, awkwardness,
Skeletal Muscle Ventricles, Left Ventricular Apex-to-Aorta Configuration
Authors: Kevin A. Greer, Huiping Lu, Ali D. Spanta, Robert L. Hammond, Larry W. Stephenson
Journal: Circulation (1997)

Skeletal muscle ventricles (SMVs) have been used in animals in a variety of configurations to provide circulatory assistance. Long-term survival and function have been demonstrated. Our laboratory recently obtained promising short-term hemodynamic data in a left ventricular apex-to-aorta model.SMVs were constructed from the left latissimus dorsi muscle in five adult mongrel dogs. After a 3-week period of vascular delay and 5 to 7 weeks of electrical conditioning, valved conduits were used to connect the left ventricular apex to the SMV and the SMV to the descending aorta. The SMV was then stimulated to contract during cardiac diastole. Initial measurements showed a significant increase in the mean femoral diastolic pressure (62 +/- 6 versus 51 +/- 5 mm Hg, P < .05). There was also a decrease in the left ventricular tension-time index (11.5 +/- 2.5 versus 14.6 +/- 2.1 mm Hg.s, P < .05), indicating a decrease in the work requirement of the left ventricle. During SMV stimulation, the majority of flow (65%) was through the SMV circuit and was associated with reversal of flow in the proximal descending thoracic aorta. The longest-surviving animal survived 76 days, at which time pressure augmentation was still seen (mean femoral diastolic pressure, 63 +/- 0.9 versus 50 +/- 1.2 mm Hg, P < .05).Survival beyond the acute setting is possible with this model. Diastolic pressure augmentation can be effectively maintained over time.
Extending CONSORT to include cluster trials
Authors: Michael J Campbell
Journal: BMJ (2004)

Welcome extension will help to understand trials better and reduce bias 

Anyone who has tried to appraise a randomised controlled trial critically will be aware of the frustration that arises when a key piece of information is missing. To understand the results of a randomised controlled trial a reader must understand its design, conduct, analysis, and interpretation. That goal can be achieved only through complete transparency from authors. The original and revised CONSORT (consolidated standards of reporting trials) statements were designed to help authors improve reporting by using a checklist and flow diagram and have been well cited.1 These have now been extended to include cluster trials (p 702).2 Cluster trials randomise interventions to groups of patients rather than to individual patients and have their own problems. Using the extended CONSORT statement should help reduce bias and help readers to understand a cluster trial's conduct and to assess thevalidity of its …
Small beer or G and T?
Authors: Des Spence
Journal: BMJ (2007)

I was “remedial,” an old fashioned term for dim. I got “special” lessons. These were a rough and exclusively male affair involving joke telling, arm wrestling, conkers, crayons, and learning to spell swear words—invaluable life skills that I have used throughout my career. Unfortunately at 10 years old, my word blindness began to lift. I had to leave my poor simpleton friends for nerd section of the class, but I never forgot them. Apparently we morons are no longer herded together and separated, because it erodes “self esteem” to be told that you are stupid at the …
Trends in Incidence, Severity, and Outcome of Hospitalized Myocardial Infarction
Authors: Véronique L. Roger, Susan A. Weston, Yariv Gerber, Jill M. Killian, Shannon M. Dunlay, Allan S. Jaffe, Malcolm R. Bell, Jan Kors, Barbara P. Yawn, Steven J. Jacobsen
Journal: Circulation (2010)

Background— In 2000, the definition of myocardial infarction (MI) changed to rely on troponin rather than creatine kinase (CK) and its MB fraction (CK-MB). The implications of this change on trends in MI incidence and outcome are not defined. Methods and Results— This was a community study of 2816 patients hospitalized with incident MI from 1987 to 2006 in Olmsted County, Minnesota, with prospective measurements of troponin and CK-MB from August 2000 forward. Outcomes were MI incidence, severity, and survival. After troponin was introduced, 278 (25%) of 1127 incident MIs met only troponin-based criteria. When cases meeting only troponin criteria were included, incidence did not change between 1987 and 2006. When restricted to cases defined by CK/CK-MB, the incidence of MI declined by 20%. The incidence of non–ST-segment elevation MI increased markedly by relying on troponin, whereas that of ST-segment elevation MI declined regardless of troponin. The age- and sex-adjusted hazard ratio of death within 30 days for an infarction occurring in 2006 (compared with 1987) was 0.44 (95% confidence interval, 0.30 to 0.64). Among 30-day survivors, survival did not improve, but causes of death shifted from cardiovascular to noncardiovascular ( P =0.001). Trends in long-term survival among 30-day survivors were similar regardless of troponin. Conclusions— Over the last 2 decades, a substantial change in the epidemiology of MI occurred that was only partially mediated by the introduction of troponin. Non–ST-segment elevation MIs now constitute the majority of MIs. Although the 30-day case fatality improved markedly, long-term survival did not change, and the cause of death shifted from cardiovascular to noncardiovascular.
Efficacy Endpoints Of A 5 Grass Pollen Sublingual Tablets In Adults And Children
Authors: P. Devillier, E. Vicaut, O. de Beaumont, A. Montagut, M. Le Gall, S. Jean-Alphonse, A. Didier, U. Wahn, J.M. Grouin
Journal: Journal of Allergy and Clinical Immunology (2010)
Papaverine Revisited as a Hepatotoxin
Authors: Hyman J. Zimmerman
Journal: New England Journal of Medicine (1969)

The proliferation of therapeutic agents during the past quarter-century has been accompanied by an increased frequency of drug-induced hepatic disease.1 , 2 Usually, the ability of an agent to produce hepatic injury is recognized within a few years of its introduction into clinical use. Accordingly, the convincing report of hepatic disease induced by papaverine in this issue of the Journal comes as a surprise after more than a half-century of its uneventful clinical use. Reasons for the long oversight are suggested by the authors.The authors' deduction that hypersensitivity to the drug was responsible is consistent with the period of three to . . .
ECTOPIC PREGNANCY, WITH REPORT OF TWO CASES.Read before the Gynecological Society of Chicago, September 26, 1890.
Authors: HENRY BANGA
Journal: JAMA (1891)

On June 23, 1890, a lady called at my office complaining of bloatedness, backache, and constipation. She gave her age as 27, was of American birth, had enjoyed perfect health up to her marriage four years ago; pregnant once three years ago, labor at full term, normal. Right after she got up from confinement she had ulceration of the womb, for which she was treated over a year in Milwaukee. It is an exacerbation of this womb trouble (she thinks) that now compels her to consult a physician. Upon examination I found the cervix neither lacerated nor ulcerated. In the region of the right ovary there was a painful swelling; a thorough examination, however, was impossible, on account of the tenseness of the abdominal walls. I told the patient that part of her complaint was no doubt due to constipation, and that I would first try to relieve this and
'Turning the right screw': targeting the interleukin-6 receptor to reduce unfavourable tissue remodelling after myocardial infarction
Authors: H. Mollmann, H. M. Nef, C. Troidl
Journal: Cardiovascular Research (2010)

This editorial refers to ‘Antibody against interleukin-6 receptor attenuates left ventricular remodelling after myocardial infarction in mice’, by M. Kobara et al ., pp. 424–430, this issue. 

To be upfront about it: left ventricular remodelling (LVR) and scar formation, including compensatory effects on the remote tissue, is urgently warranted and life-saving for the patient suffering from myocardial infarction (MI) because they avert life-threatening ventricular ruptures. However, in addition to these beneficial effects, LVR often initiates secondary complications due to unfavourable changes in LV geometry that subsequently lead to heart failure—a process that considerably impacts patients' morbidity and mortality.1

Experimental investigations of the molecular and cellular mechanisms underlying LVR after MI raise the hope of developing new therapeutic strategies. In particular, inflammation-targeting strategies have rushed into the spotlight. These strategies influence myocardial remodelling, resulting in the reduction of necrosis and the advancement of discrete but resilient scar formation.

In this context the experimental data presented by Kobara et al .2 from a mouse MI model represent a promising therapeutic approach. Targeting inflammation by interfering with interleukin-6 (IL-6) signalling using an antibody directed against the IL-6 … 

*Corresponding author. Tel: +49 6032 996 2819; fax: +49 6032 996 2827, Email: h.moellmann{at}kerckhoff-fgi.de
Outcomes Assessment and Quality of Life in Patients with Human Immunodeficiency Virus Infection
Authors: Alvin R. Tarlov
Journal: Annals of Internal Medicine (1992)

Editorials15 January 1992Outcomes Assessment and Quality of Life in Patients with Human Immunodeficiency Virus InfectionAlvin R. Tarlov, MDAlvin R. Tarlov, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-2-166 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe article by Wachtel and colleagues concerning quality of life in persons with human immunodeficiency virus (HIV) infection, published in this issue (1), is noteworthy in at least two ways. It quantifies the devastating effects on functioning and well-being by each of the major sequelae of the acquired immunodeficiency syndrome (AIDS), and, more generally, it provides additional empiric justification for the introduction of measures of functional status and well-being into everyday practice to improve the effectiveness of medical care.The authors showed that constitutional symptoms, neurologic symptoms, dyspnea, or diarrhea had steep gradient effects (in proportion to their frequency) on...Reference1. WachtelPietteMorSteinFleishmanCarpenter TJVMJC. Quality of life in persons with HIV infection: measurement by the Medical Outcomes Study instrument. Ann Intern Med. 1992;116:129-37. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Alvin R. Tarlov, MDAffiliations: New England Medical Center and Harvard School of Public Health Boston, MA 02111 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBethesda conference: conference for the design of clinical trials to study circulatory support devices for chronic heart failurePre-AIDS physical disability: Data from the AIDS time-oriented health outcome studyImpact of epilepsy on QOL in a Portuguese population: exploratory studyDisease-Related Factors Associated With Health-Related Quality of Life in People With Nonadvanced HIV Disease Assessed Using an Italian Version of the MOS-HIV Health SurveyDOES TRANSPLANTATION PRODUCE QUALITY OF LIFE BENEFITS?Self-Appraised Health, HIV Infection, and Depression in Female Clients of AIDS Counseling CentersPerceived health, HIV illness, and mental distress in African-American clients of AIDS counseling centersQuality of Life in Octogenarians After Open Heart SurgeryThe integration of alternative treatment modalities in HIV infection—the patient's perspectiveMethods for measuring outcomes to evaluate interventions to improve health-related quality of life in HIV infectionFunctional Health and Well-Being in Patients With Severe Atherosclerotic Peripheral Vascular Occlusive DiseaseQuality of Life and Antihypertensive Therapy in Men -- A Comparison of Captopril with Enalapril 15 January 1992Volume 116, Issue 2Page: 166-167KeywordsAIDSDiarrheaDyspneaHIVHIV infectionsQuality of life ePublished: 1 December 2008 Issue Published: 15 January 1992 PDF downloadLoading ...
Urinary Incontinence in the Elderly
Authors: MARK E. WILLIAMS
Journal: Annals of Internal Medicine (1982)

Urinary incontinence is a problem affecting 5% to 10% of the elderly in the community and up to 50% of the elderly in institutions. Despite complex factors governing normal micturition, the causes of urinary incontinence can be classified into detrusor instability, overflow incontinence, sphincter insufficiency, functional illness, and iatrogenic causes. An accurate pathophysiologic diagnosis is a prerequisite to successful treatment. A decision sequence is presented to help design a reasonable diagnostic approach. With appropriate therapy, most incontinent elderly patients can expect significant improvement or cure.
Blood Resource Management
Authors: John Bernard Henry
Journal: JAMA (1979)

THE RISK of posttransfusion hepatitis associated with blood from compensated donors is estimated to be from three to ten times greater than that from blood given by volunteer donors. Anywhere from 10,000 to 30,000 cases of overt hepatitis occur each year as a result of blood transfusion. Further, there may be as many as 100,000 subclinical cases that go unreported. Citing the lifethreatening hazard that accompanies the use of blood from paid donors, the Food and Drug Administration in 1978 published a regulation requiring that blood be distinguished by source. Prominently marked labels bearing the statement "volunteer donor" or "paid donor" now must appear on each container of whole blood or components intended for transfusion. At the same time, limits on the capability of detecting viral hepatitis in donor blood suggest that the disease will continue to be transmitted through transfusion. Thus, while hepatitis remains a problem of no small
Prevention of In vitro neutrophil adhesion to endothelial cells through shedding of L-selectin by C-reactive protein and peptides derived from C-reactive protein.
Authors: C Zouki, M Beauchamp, C Baron, J G Filep
Journal: Journal of Clinical Investigation (1997)

C-Reactive protein (CRP), the classic acute-phase reactant in humans, diminishes accumulation of neutrophils at inflammatory sites. To evaluate the underlying mechanisms, we have studied whether CRP and peptides derived from CRP could affect the first step of neutrophil extravasation, the L-selectin-mediated interaction of neutrophils with endothelial cells. CRP markedly attenuated attachment of human neutrophils to cultured LPS-activated human coronary artery and pulmonary microvascular endothelial cells with apparent IC50 values of 20 and 22 microg/ml, respectively. At similar concentrations, CRP rapidly downregulated the expression of L-selectin on the neutrophil surface, whereas it failed to affect expression of CD11b and CD45 or to induce granule enzyme release. The loss of L-selectin was due to cleavage and shedding of the molecule from the cell surface, as quantitated by the soluble form of L-selectin in cell-free supernatants. The effects of CRP could be prevented by an anti-CRP antiserum and by KD-IX-73-4, which inhibits shedding of L-selectin. Inhibition of adhesion with CRP was additive with function-blocking anti-E-selectin and anti-CD18 antibodies, but was not additive with anti-L-selectin antibody. Neutrophil attachment and L-selectin expression were also diminished by CRP peptides 174-185 and 201-206, but not peptide 77-82, albeit these peptides showed a weaker inhibitory effect than the parent protein. These studies indicate a specific activation-independent action of CRP and CRP peptides 174-185 and 201-206 on expression of L-selectin, and suggest that by attenuating neutrophil adhesion to the endothelium and consequently neutrophil traffic into tissues, native CRP and peptides 174-185 and 201-206 may be major mechanisms to attenuate or limit the inflammatory response.
Effects of chronic hypertension and sympathetic nerves on the cerebral microvasculature of stroke-prone spontaneously hypertensive rats.
Authors: A H Werber, D D Heistad
Journal: Circulation Research (1984)

The purpose of this study was to examine hemodynamic mechanisms which protect cerebral vessels against chronic hypertension, and contribute to protective effects of sympathetic nerves in the cerebral circulation. We studied stroke-prone spontaneously hypertensive rats and normotensive Wistar-Kyoto rats. At 3-4 weeks of age, all rats underwent removal of one superior cervical sympathetic ganglion. Approximately 1 year later, we cut the superior cervical sympathetic nerve contralateral to the chronic ganglionectomy and exposed pial arterioles on the cerebral cortex ipsilateral or contralateral to the chronic ganglionectomy. We measured aortic, pial arteriolar, and venous pressures with a servo-null technique, and cerebral blood flow with microspheres. Large artery resistance and small vessel resistance were calculated. During control conditions, pressure in pial arterioles was higher in stroke-prone spontaneously hypertensive rats (83 +/- 6 mm Hg) (mean +/- SE) than in Wistar-Kyoto rats (60 +/- 3 mm Hg, P less than 0.05), even though large artery resistance was almost two-fold greater in stroke-prone spontaneously hypertensive rats than in Wistar-Kyoto rats (P less than 0.05). During maximal dilation produced by seizures, large artery resistance was almost three-fold higher in stroke-prone spontaneously hypertensive rats than in Wistar-Kyoto rats (P less than 0.05). Small vessel resistance also was increased in stroke-prone spontaneously hypertensive rats. During seizures in stroke-prone spontaneously hypertensive rats, large artery resistance was 29% lower in chronically denervated vessels than in acutely denervated vessels (P less than 0.05). Three stroke-prone spontaneously hypertensive rats had pial vessels with a "sausage string" appearance.(ABSTRACT TRUNCATED AT 250 WORDS)