tbuckley/cabot-search huggingface dataset:
The prognosis for research
Authors: H. T. Sorensen, K. J Rothman
Journal: BMJ (2010)

Improve research through training, and begin with editors

The costs of mistakes in biomedical research include the opportunity cost of misallocated resources and direct harm that leads to suboptimal prevention and treatment. Some scientists have recently questioned the quality of clinical and epidemiological research1 2 3; in the linked article (doi:10.1136/bmj.b4184), Hemingway and colleagues highlight “the tide of low quality, low impact, prognosis research.”4 They outline 10 steps to improving such research, and they include in their recommendations the advance registration of study protocols and new guidelines for reporting the results of prognosis research.

The main areas of clinical research encompass studies of diagnosis, prognosis, and treatment. Why should prognosis research be singled out? If the overall aim of clinical research is to improve prognosis, the path towards that end involves accurate diagnosis and effective treatment. With improving diagnostic techniques and evolving treatments, prognosis research may always be in flux and out of date. Indeed, if prognosis research for a disease is current and accurate, it might imply that prevention and treatment for that disease are stagnant.

No doubt the quality of much prognosis research could be improved, but we wonder why this area merits special mention. Problems affecting the quality of research are not restricted to studies of prognosis. Among the many factors that influence research quality throughout the spectrum of biomedical studies are the consistency and quality of training, …
Angiotensin-converting enzyme inhibition with fosinopril sodium in the prevention of restenosis after coronary angioplasty.
Authors: W Desmet, M Vrolix, I De Scheerder, J Van Lierde, J L Willems, J Piessens
Journal: Circulation (1994)

BACKGROUND Several angiotensin-converting enzyme inhibitors have antiproliferative effects in a rat model after carotid artery balloon injury. METHODS AND RESULTS We conducted a randomized, double-blind, placebo-controlled trial to assess the effect of fosinopril, a novel angiotensin-converting enzyme inhibitor, in restenosis prevention after percutaneous transluminal coronary angioplasty (PTCA). Patients received fosinopril or matched placebo 10 mg at least 18 hours before PTCA, 20 mg at least 4 hours before PTCA, and 40 mg daily for 6 months. In addition, all patients received aspirin. Coronary angiograms before PTCA and immediately after PTCA as well as at 6-month follow-up were quantitatively analyzed. A total of 509 patients were recruited. The final per-protocol population consisted of 153 fosinopril-treated and 151 placebo-treated patients. Restenosis rates according to the National Heart, Lung, and Blood Institute criterion 4 (loss of &gt; or = 50% of the initial gain [primary end point]) were 45.7% and 40.7% in the fosinopril and control groups, respectively (not significant). The respective mean differences in minimal coronary luminal diameter between post-PTCA and follow-up angiograms were -0.59 +/- 0.71 mm and -0.51 +/- 0.67 mm (not significant). Clinical events during the 6-month follow-up period, analyzed on an on-treatment basis, were ranked according to the most serious event. The respective numbers in the fosinopril and the control groups were for death, 0 and 0; myocardial infarction, 0 and 0; coronary artery bypass graft surgery, 1 and 3; repeat PTCA, 35 and 35; recurrent signs of ischemia necessitating early repeat coronary angiography and managed medically, 6 and 7; and none of the above, 111 and 106. All these differences were significant. CONCLUSIONS Administration of fosinopril in a dose of 40 mg daily during 6 months after PTCA does not prevent restenosis and has no effect on overall clinical outcome.
Early Diagnosis of Carcinoma of Breast
Authors: B. J. Tresman
Journal: BMJ (1966)

secretory capacity of the stomach, but secreted significantly higher acids in the basal state as compared with their normals.These cases are thus not comparable with the two series1 2 described above.We found prominent mucosal folds in duo- denum in only 11 with spasticity and in four of the 29 adult males with severe hookworm anaemia (mean haemoglobin 4.46 g./100 ml., S.E. 0.24).Ten out of these 29 cases had complained of upper abdominal pain with some resemblance to ulcer pain.Out of these ten cases four had prominent duodenal folds, with spasticity in two.Among the cases without abdominal pain seven out of 19 showed similar changes, with duodenal bulb irritability in two of them.There was no correlation between abdominal pain and radiological appearances which could be con- sidered as suggestive of " duodenitis."In all these cases gastric acid secretion was reduced irrespective of the presence of prominent mucosal folds or the abdominal pain.We have not studied duodenal histology in these cases.However, it would be of interest to note that in a separate study we could not find any correlation between morphological changes and the radiological appearances of prominent mucosal folds with or without irritability of the jejunum, where hookworm infestation is most marked.We feel that there is no convincing proof of existence of " duodenitis " as a distinct clinical, radiological, and pathological entity, and therefore use of this term in scientific communications should be condemned and the more considered approach of Fraser and his colleagues' and your leader should be followed.-Weare, etc.,
Interleukin-1 receptor antagonist production in cultured synovial cells from patients with rheumatoid arthritis and osteoarthritis.
Authors: Y Fujikawa, M Shingu, T Torisu, S Masumi
Journal: Annals of the Rheumatic Diseases (1995)

To measure the amounts of interleukin-1 receptor antagonist (IL-1ra) protein produced by cultured synovial cells obtained from patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Synovial cells obtained from patients with either RA or OA were cultured and the supernatants were measured for IL-1ra by enzyme linked immunosorbent assay. The synovial cells obtained from patients with RA produced significantly smaller amounts of IL-1ra than did those obtained from patients with OA, in a late passage (third to fifth) without stimulation and a first passage both with and without stimulation (p < 0.025, respectively). In addition, when the patients with RA were divided into two groups according to the maximum number of lining cell layers, the amounts of IL-1ra produced by the proliferative type were smaller than those produced by the less proliferative type (p < 0.025). The above findings suggest that IL-1ra production in RA synovial cells is suppressed, and that reduced IL-1ra protein production is one of the causes which leads to the proliferation of lining cells and persistent joint inflammation.
Staphylococci Associated with Toxic Shock Syndrome in the United Kingdom
Authors: MAUREEN J. DE SAXE
Journal: Annals of Internal Medicine (1982)

Only 15 cases of menstrual toxic shock syndrome were reported in the United Kingdom by 31 October 1981. The women affected used tampons of various brands. Staphylococcus aureus was isolated from the vaginas of 12 women. Two distinct strains were isolated from three women. Most strains were phage group I or nontypable strains related to them and were resistant only to penicillin, cadmium, and arsenate. Enterotoxin F was produced by strains from 10 of 12 patients and by 20% to 30% of strains from other sources--including healthy people. Its production was particularly common among control phage group I vaginal isolates. The reason for the rarity of toxic shock syndrome in the United Kingdom as compared to the United States is still unknown. There does not seem to be a low prevalence of toxigenic strains, but factors such as immunity to toxin and a difference in tampon use may be important and need further study.
Suppressive effect of secretin upon pancreatic alpha cell function
Authors: Fausto Santeusanio, Gerald R. Faloona, Roger H. Unger
Journal: Journal of Clinical Investigation (1972)

Highly purified secretin, infused endoportally in five conscious mongrel dogs at a rate of 10 clinical units per min for 20 min, caused a prompt and statistically significant reduction in the pancreaticoduodenal vein level of pancreatic glucagon from a control average of 1130 pg/ml (SEM±312) to a nadir of 492 pg/ml (SEM±194) 15 min later (P < 0.01). During modest hyperglycemia of about 130 mg/100 ml, induced by glucose infusion, the infusion of secretin at the same rate elicited even more dramatic suppression of pancreaticoduodenal glucagon levels to virtually unmeasurable concentrations. At a lower rate of infusion (5 U priming injection followed by 1 U/min for 20 min) significant suppression of glucagon secretion during hyperglycemia was also observed. Stimulation of endogenous secretin release by the intraduodenal administration of 14 mEq of HCl in 10 dogs during intravenous glucose infusion was followed by a decline in pancreaticoduodenal vein glucagon from 130 pg/ml (SEM±34) to a nadir of 99 pg/ml (SEM±32) 5 min later (P < 0.05).
Regulation is appropriate for this diverse range of products
Authors: K. Woods
Journal: BMJ (2012)

The articles on metal-on-metal hip implants do not accurately describe the Medicines and Healthcare Products Regulatory Agency’s work, in collaboration with expert advisers and orthopaedic associations, in providing objective advice to clinicians on this topic.1

The MHRA was the first regulatory agency in the world to issue advice to clinicians about such implants. The MHRA did not issue “emergency guidance . . . …
Genome-wide scan reveals association of psoriasis with IL-23 and NF-κB pathways
Authors: Rajan P Nair, Kristina Callis Duffin, Cynthia Helms, Jun Ding, Philip E Stuart, David Goldgar, Johann E Gudjonsson, Yun Li, Trilokraj Tejasvi, Bing-Jian Feng, Andreas Ruether, Stefan Schreiber, Michael Weichenthal, Dafna Gladman, Proton Rahman, Steven J Schrodi, Sampath Prahalad, Stephen L Guthery, Judith Fischer, Wilson Liao, Pui-Yan Kwok, Alan Menter, G Mark Lathrop, Carol A Wise, Ann B Begovich, John J Voorhees, James T Elder, Gerald G Krueger, Anne M Bowcock, Gonçalo R Abecasis
Journal: Nature Genetics (2009)
INTERFERENCE WITH IMMUNE HEMOLYSIS BY GLYCOPROTEIN ANTIGENS
Authors: E. R. Arquilla, J. Hamlin, S. Hamashige, A. Miller
Journal: The Journal of Experimental Medicine (1964)

1. The titer of an individual insulin antiserum measured by hemagglutination agrees favorably with the titer of the same antiserum as measured by immune hemolysis. 2. In contrast, a marked decrease is noted in the immune hemolysis titers relative to hemagglutination titers of antisera prepared against three different sialic acid-containing proteins (human chorionic gonadotropin, rabbit transferrin, and human transferrin). 3. The lower immune hemolytic titers of glycoprotein antisera are apparently not due to a lack of complement-fixing gamma(2)-antibodies. 4. The glycoprotein antigens in solution do not interfere with hemolysis in the insulin immune system. 5. By contrast, marked inhibition of insulin immune hemolysis occurs when cells are sensitized with both glycoprotein and insulin. 6. Cells treated with neuraminidase (to remove cell surface sialic acid) lyse in the presence of C'(a) alone. 7. If neuraminidase-treated cells are sensitized with sialic acid-containing protein, the lysis of these cells by complement is inhibited. 8. It is, therefore, postulated that during some initial phase of immune hemolysis, a sialic acid-containing substrate is cleaved from the cell surface, rendering the cell susceptible to lysis. If this removal is interfered with, i.e., by sensitization of the cell with competitive sialic acid-containing antigen, then the lytic portion of immune hemolysis cannot proceed.
THE VALUE OF THE CONVERSATIONAL METHOD OF MEDICAL INSTRUCTION.THE "STUDENTS' CONFERENCE"
Authors: JOSEPH McFARLAND
Journal: JAMA (1904)

The methods of medical pedagogy have undergone many changes during the last twenty-five years, the most important being that the antiquated didactic method of teaching has in a large measure given place to practical, clinical and laboratory teaching. Some excellent authorities now advocate the complete abandonment of the didactic method, recommending that in its place certain text-book readings shall be assigned to the student, and that demonstrations and conferences between the teachers and pupils covering this subject-matter shall constitute the essential part of the instruction. It has always seemed to me illogical to entirely do away with the didactic method, which I believe occupies an important and indispensable place in medical pedagogy; first, because there are many subjects that can be far better treated didactically than practically; second, because new and controversial matters can be far better summarized and treated by the professor whose business it is to familiarize himself
Smoke free areas do not harm profits, survey shows
Authors: R. Watson
Journal: BMJ (2003)

Creating no smoking areas in bars and restaurants does not lead to loss of income and can bring many advantages, according to a new survey conducted in five European countries.

The survey of 1754 owners, leaseholders, and employees of bars and restaurants showed that 73% of respondents believed that a smoke free area protects the health of customers, owners, and employees, while responding to public demand. A similar number (78%) agreed that environmental tobacco smoke increases the risk of lung cancer.

The findings of the survey, which was conducted by separate organisations in Belgium, Finland, France, Germany, and …
Effects of the Amount and Intensity of Exercise on Plasma Lipoproteins
Authors: William E. Kraus, Joseph A. Houmard, Brian D. Duscha, Kenneth J. Knetzger, Michelle B. Wharton, Jennifer S. McCartney, Connie W. Bales, Sarah Henes, Gregory P. Samsa, James D. Otvos, Krishnaji R. Kulkarni, Cris A. Slentz
Journal: New England Journal of Medicine (2002)

Increased physical activity is related to reduced risk of cardiovascular disease, possibly because it leads to improvement in the lipoprotein profile. However, the amount of exercise training required for optimal benefit is unknown. In a prospective, randomized study, we investigated the effects of the amount and intensity of exercise on lipoproteins.
Development of connective tissue disease in patients presenting with Raynaud's phenomenon: a six year follow up with emphasis on the predictive value of antinuclear antibodies as detected by immunoblotting.
Authors: C G Kallenberg, A A Wouda, M H Hoet, W J van Venrooij
Journal: Annals of the Rheumatic Diseases (1988)

Eighty five patients referred because of Raynaud9s phenomenon (RP) were followed up for six years. Every two years they were screened for signs and symptoms of connective tissue disease (CTD) according to a protocol, and serum was stored. Initially, 30 patients had primary RP, 16 had one symptom of CTD (9possible CTD9), 18 had two or more symptoms (9probable CTD9), and 21 had definite CTD (14 of whom had scleroderma). Most of the symptoms were related to scleroderma. There was an insidious progression to scleroderma or CRST syndrome (calcinosis, Raynaud9s phenomenon, sclerodactyly, telangiectasia): 11 of 46 patients with primary RP or possible CTD developed probable scleroderma (two or more symptoms but not fulfilling all criteria), and seven of 13 patients with probable scleroderma developed definite scleroderma or CRST. The presence of distinct antinuclear antibodies (ANAs) as detected by immunoblotting in patients with primary RP and possible CTD at the start of the study was associated with the evolution of symptoms of CTD (chi 2 = 5.7, p less than 0.01). In patients initially with primary RP or possible CTD the antibody specificities of ANAs as determined by immunoblotting had prognostic value for the development of certain disease entities: anticentromere (CR-19) for CRST (sensitivity 60%, specificity 98%) and antitopoisomerase I (Scl-70 or Scl-86) for scleroderma or probable scleroderma (sensitivity 38%, specificity 100%).
Current Status of Off-Pump Coronary-Artery Bypass
Authors: Frederick L. Grover
Journal: New England Journal of Medicine (2012)

Until the mid-1990s, coronary-artery bypass grafting (CABG) was performed with the use of cardiopulmonary bypass with the induction of ischemic cardiac arrest (on-pump). This surgical approach provided excellent exposure in a bloodless field with an arrested heart, allowing for precise performance of coronary anastomoses.1 However, there was concern about potentially deleterious effects of cardiopulmonary bypass. Such effects include the induction of the systemic inflammatory response syndrome by the bypass circuit with consequent multiorgan injury and the risk of stroke or other systemic embolic events caused by the cross-clamping of the aorta. For these reasons, some surgeons began performing CABG procedures . . .
Preclinical Protocol for in Vivo Selection of Hematopoietic Stem Cells Corrected by Gene Therapy in Fanconi Anemia Group C
Authors: Meenakshi Noll, Raynard L. Bateman, Alan D. D'Andrea, Markus Grompe
Journal: Molecular Therapy (2001)

<h2>Abstract</h2> Fanconi anemia (FA) is an autosomal recessive disorder characterized by birth defects, increased incidence of malignancy, progressive bone marrow failure, and cellular hypersensitivity to DNA cross-linking agents. Bone marrow transplantation is therapeutic and therefore FA is a candidate disease for hematopoietic gene therapy. We have previously used mitomycin C (MMC) to achieve <i>in vivo</i> selection of wild-type hematopoietic stem cells (HSC) transplanted into FANCC knockout mice. However, clinical application of MMC in human FA gene therapy is unlikely because of its unknown toxicity profile in human FA patients. In contrast, cyclophosphamide (CPA) and γ-irradiation (IR) are already in use with human FA patients and we therefore tested these regimens for their ability to achieve selection of genetically corrected HSCs <i>in vivo.</i> We found that nonmyeloablative doses of CPA or IR or combinations of CPA + IR were highly efficient at achieving <i>in vivo</i> selection of transplanted wild-type HSC. Furthermore, this nontoxic regimen also selected FANCC-mutant HSC corrected by <i>ex vivo</i> retroviral gene therapy. We suggest those nontoxic doses of CPA and/or IR could also be used to enhance gene therapy in human FA patients.
Mucosubstances in neoplasms of the human colon and rectum
Authors: S. G. Subbuswamy
Journal: Gut (1971)

The patterns of mucosubstances secreted in the normal human colon and rectum, in benign tumours, and in and around malignant tumours of the colon and rectum have been studied. Very little neutral mucosubstance was seen in normal specimens; the secretion in these was made up of sulphated and nonsulphated acid mucosubstances, with the former predominating in the deeper half and the latter in the superficial half of the mucosa.Benign tumours contained moderate amounts of mucosubstance, predominantly acid nonsulphated mucosubstances. Differences in the pattern of secretion were observed between the adenomatous polyp on the one hand and the villous papilloma and the papillary parts of the papillary adenoma on the other. Carcinomas of colon and rectum contained very little secretion, with very scanty or no evidence of sulphation. The mucosa around carcinomas and in areas of non-polyploid hyperplasia in carcinoma-bearing colons showed two constant patterns, one consisting of very small amounts of secretion, with sulphated mucosubstance predominating, and the other showing normal or increased amounts of secretion almost entirely of the acid nonsulphated variety. The latter pattern extended for several centimetres from the tumour. The possibility that sulphated mucosubstance might have a role in controlling cell division and that a decrease in its secretion might initiate a sequence of changes leading to malignancy is discussed.
Deception by immunisation, revisited.
Authors: J D Bennett, L Tyszczuk
Journal: BMJ (1990)

unpolished rice rather than the polished rice we had had so far.We also requested that letters be allowed through (not one had arrived at the hospital, although we had heard that about 20 000 were held up in Batavia) and that books, dentures, glasses, and exercise facilities be provided.The Japanese announced that they intended to return the POWs fit and well and that, subject to general shortages in Java, they would do what they could to supply better food.But no promises were made and it remains to be seen if anything will happen. AfterwardsI stayed at Mater Dolorosa for just over one year.Between May 1944 and April 1945 I was moved twice more, ending up at the old jail where I had first been imprisoned.It was now grossly overcrowded, 3000 men (British, Australian, and Dutch) having a space of some 80 by 200 cm for each man.But there was some comfort-Red Cross parcels (the first we had seen) arrived with bully beef.And it was here that we finally heard that the war had ended on 24 August.I waited a month, assisting in the evacuation of British and Dutch patients, before flying to Singapore to sail home.Even then, I had an uncomfortable half an hour while the Dakota aeroplane almost had to turn back because of bad weather.
SUBPHRENIC ABSCESS AND ITS RELATION TO PYOTHORAX.
Authors: CARL BECK
Journal: JAMA (1896)

Among five cases of subphrenic abscess which I observed during the last six years, I could but twice make a correct diagnosis before operation. In two cases I diagnosed pyothorax, the symptoms being those made known by the more or less exhaustive descriptions of modern writers. From the study of the current literature on this subject, as well as from the reports of friends I know, however, that I do not assume an isolated position in this connection, and that pyothorax is very often confounded with subphrenic abscess—not unfrequently even after operation. Such errors impressed me gravely with the important necessity of widening our limited diagnostic knowledge upon this neglected subject. Practically this error, especially if made by a surgeon, is no great misfortune for the patient. It differs but little whether the abscess is located above or below the diaphragm, as the essential part of the treatment in either
Heparin-like Anticoagulant Occuring in Association with Chronic Nephritis
Authors: A. I. Cetingil, O. N. Ulutin, M. Karaca
Journal: BMJ (1959)

In the case here reported a heparin-like circulating anticoagulant developed during the course of chronic nephritis and caused a haemorrhagic diathesis.Circulating anticoagulants occur either spontaneously or as a result of transfusions.The presence of antihaemophilic globulin (A.H.G.) was noted in approximately 10 cases of haemophilia A reported in the literature.A case has been described in Turkey