tbuckley/cabot-search huggingface dataset:
Progression of HIV disease in a haemophilic cohort followed for 11 years and the effect of treatment.
Authors: C A Lee, A N Phillips, J Elford, G Janossy, P Griffiths, P Kernoff
Journal: BMJ (1991)

OBJECTIVE--To describe the progression of HIV disease in a haemophilic cohort and to show the influence of treatment. DESIGN--11 year longitudinal clinical and laboratory study. SETTING--A haemophilia centre. PATIENTS--111 patients infected with HIV during October 1979 to July 1985. MAIN OUTCOME MEASURES--Symptoms of HIV infection, AIDs, and death. INTERVENTIONS--26 asymptomatic patients started taking zidovudine or placebo (1000 mg/day) during November 1988 to February 1990; 10 patients with CD4+ counts of 0.2 x 10(9)/l started zidovudine 500 mg/day during January to November 1990. 35 patients used pentamidine for primary or secondary prophylaxis. RESULTS--At 11 years from seroconversion the estimated rate of progression to AIDS was 42% (95% confidence interval 27% to 57%); to symptoms 85% (75% to 95%); and to death 41% (25% to 57%). Progression to AIDS was significantly faster in patients aged 25 and over than in those aged less than 25 (relative risk 5.0 (2.4 to 10.4); p less than 0.00001) and in those with previous cytomegalovirus infection than in those not infected (relative risk 3.0 (1.4 to 6.8); p = 0.006). 16 of 27 (59%) patients with p24 antigenaemia developed AIDS compared with 17 of 84 (20%) patients without p24 antigen (p less than 0.001). The risk of progression to AIDS before 30 November 1988 in patients with CD4+ counts less than or equal to 0.2 x 10(9)/l was higher than after November 1988 (relative risk 1.9 (0.85 to 4.43); p = 0.1). For 1989 and 1990 the observed cumulative numbers of AIDS cases (among 81 patients with sufficient CD4+ counts) were 22 and 25 compared with 29 and 37 predicted from the rate of fall of CD4+ counts up to the end of 1988 (p = 0.03). CONCLUSION--Treatment seems to be reducing the progression of HIV disease in this haemophilic cohort.
Practices and impact of primary outcome adjustment in randomized controlled trials: meta-epidemiologic study
Authors: N. Saquib, J. Saquib, J. P. A. Ioannidis
Journal: BMJ (2013)

<b>Objective</b> To assess adjustment practices for primary outcomes of randomized controlled trials and their impact on the results. <b>Design</b> Meta-epidemiologic study. <b>Data sources</b> 25 biomedical journals with the highest impact factor according to <i>Journal Citation Reports</i> 2009. <b>Study selection</b> Randomized controlled trials published in print in 2009 that reported primary outcomes. The search yielded 684 eligible papers of randomized controlled trials, of which 200 were randomly selected. <b>Data extraction</b> Two researchers independently extracted data on study population, intervention, primary outcome, and the adjustment plan for primary outcomes. They also recorded the magnitude and statistical significance of the intervention effect with and without adjustments, and estimated whether adjustment made a difference in the level of nominal significance. They also compared the analysis plan for model adjustment in the published trial versus the trial protocol with information on the protocol collected from registries, design papers, and communication with all corresponding authors. <b>Results</b> 54% of the trials used stratified randomization, 96% presented baseline characteristics in the compared arms, and 46% also evaluated differences in baseline factors with statistical testing. Half of the trials performed adjusted analyses for the main outcome, as the sole analysis (29%) or along with unadjusted analyses (21%). Adjustment for stratification variables and for baseline variables was performed in 39% (42/108) and 42% (84/199) of the trials, respectively. Among 40 comparisons with both adjusted and unadjusted analyses, 43% had statistically significant effects, 40% had non-significant effects, and 18% had significant effects with only one of the two analyses, but not with the other. Information on analysis plan regarding model adjustment was available in 6% (9/162) of trial registry entries, 78% (21/27) of design papers, and 74% (40/54) of protocols obtained from authors. The analysis plan disagreed between the published trial and the registry, protocol, or design paper in 47% (28/60) of the studies. <b>Conclusions</b> There is large diversity on whether and how analyses of primary outcomes are adjusted in randomized controlled trials and these choices can sometimes change the nominal significance of the results. Registered protocols should explicitly specify adjustments plans for main outcomes and analysis should follow these plans.
Right ventricular implantation of endometrial adenocarcinoma as a result of temporary pacing.
Authors: J S Chow, R Y Wang, L C Tang, C K Mok
Journal: BMJ (1985)

Une observation rare chez une femme de 76 ans. Stimulation cardiaque par catheter implante pendant l'operation pour epithelioma du corps uterin. Un an apres l'hysterectomie, metastase localisee du ventricule droit
The role of lecithin: cholesterol acyltransferase for lipoprotein (a) assembly. Structural integrity of low density lipoproteins is a prerequisite for Lp(a) formation in human plasma.
Authors: E Steyrer, S Durovic, S Frank, W Giessauf, A Burger, H Dieplinger, R Zechner, G M Kostner
Journal: Journal of Clinical Investigation (1994)

The composition of lipoproteins in the plasma of patients with LCAT deficiency (LCAT-D) is grossly altered due to the lack of cholesteryl esters which form the core of normal lipoproteins. When plasma from LCAT-D patients and their relatives was examined we found that nine heterozygotes had plasma Lp(a) levels of 2-13 mg/dl whereas none of 11 affected homozygous individuals from different families contained detectable amounts of Lp(a) in their plasma. Therefore, the binding of apo(a) to LDL density particles was studied in vitro using LDL density fractions prepared from patients, and recombinant apo(a) [r-apo(a)], which was expressed and secreted by transfected COS-7 cells. The LDL from heterozygotes were chemically indistinguishable from normal LDL and homogeneous with regard to morphology, whereas the crude LDL floating fraction from homozygotes consisted of a heterogeneous mixture of large vesicles, and small spheres resembling normal LDL. The LDL density fraction from the LCAT-D patient lacked almost completely cholesteryl esters. Incubation of LCAT-D plasma with active LCAT caused a substantial augmentation of the original subfraction which morphologically resembled normal LDL. Using r-apo(a) and normal LDL or LDL of heterozygous individuals, apoB:r-apo(a) complexes were formed when incubated at 37 degrees C in vitro for 20 h. In contrast, the total LDL floating fraction from a homozygous LCAT-D patient failed to form apoB:r-apo(a) complexes. After treatment with active LCAT, a significant apoB:r-apo(a) association was observed with LCAT-D LDL-density particles. Our data emphasize the importance of the integrity of LDL structure and composition for the formation of Lp(a). In addition, we demonstrate that the absence of LCAT activity has a fundamental impact on the regulation of plasma Lp(a) levels.
The Maintenance of Life: Preventing Social Death Through Euthanasia Talk and End-of-Life Care—Lessons From The Netherlands
Authors: Pat Fosarelli
Journal: JAMA (2010)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The 1988 National Resident Matching Program
Authors: JOHN S. GRAETTINGER
Journal: Annals of Internal Medicine (1988)

Editorials1 May 1988The 1988 National Resident Matching ProgramJOHN S. GRAETTINGER, M.D.JOHN S. GRAETTINGER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-5-761 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe attractiveness of careers in internal medicine to senior medical students from schools in the United States has been diminishing (1). The results of the 1988 National Resident Matching Program show a further decrease in the filling of categorical career positions. Participating categorical programs increased to 417 from 404, but the number of positions offered decreased by 144 to 5197, compared with those offered in 1987. The number of US senior medical students matched decreased by 110 to 3316, the lowest number matched since 1978. Since 1985, US senior medical students matched in categorical programs in internal medicine have decreased...Reference1. GRAETTINGER J. Internal medicine in the National Resident Matching Program 1987: the Ides of March. Ann Intern Med. 1988;108:101-15. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: National Resident Matching Program Evanston, Illinois PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIntern candidates who withdraw from contractsTeaching Medicine as a Human Experience: A Patient-Doctor Relationship Course for Faculty and First-Year Medical StudentsWilliam T. Branch, MD, Ronald A. Arky, MD, Beverly Woo, MD, John D. Stoeckle, MD, Donald B. Levy, MD, William C. Taylor, MDMeaningful experiences in medicineThe content of internal medicine residency training and its relevance to the practice of medicineResidency training in the inpatient setting 1 May 1988Volume 108, Issue 5Page: 761-762 Issue Published: 1 May 1988 PDF downloadLoading ...
Irritation potential of bath and shower oils before and after use: a double-blind randomized study
Authors: M. Loden, I. Buraczewska, F. Edlund
Journal: British Journal of Dermatology (2004)

Background Difficulties in avoiding weak irritants may contribute to chronic contact dermatitis. A large variety of shower and bath oils are claimed to be suitable for use on dry skin because of their mildness and because they deposit a protective oil film on the skin. Objectives The aim of the present study was to investigate possible differences in the irritation potential of eight shower or bath oils and to investigate whether surfactant residues may form a reservoir of irritant substance on the skin. Patients and methods The study was double-blind and randomized using healthy human volunteers. The inherent capacity of the products to induce irritation was determined using conventional patch test techniques. Detection of potentially irritant residues was done by occlusion of the treated and rinsed skin area, followed by evaluation of the biological response. Instrumental measurements of transepidermal water loss and superficial skin blood flow served as indicators of the injurious effects of the products. Results and conclusions The results showed large differences between the products in irritant potential. Some did not irritate skin more than water, whereas others demonstrated considerably damaging effects. Moreover, the study proved the presence of barrier-impairing residues on the skin after rinsing with water. Thus, instead of protecting the skin, some formulations may induce subclinical injuries and delay skin barrier function recovery with prolonged risk for patients with eczema.
Complementary medicine should be integrated into the NHS
Authors: Z. Kmietowicz
Journal: BMJ (1997)

A report on the future role of complementary and alternative medicines and how therapies such as homoeopathy, acupuncture, and osteopathy can be more fully integrated into the NHS has been widely welcomed.

The report is the culmination of 18 month's work by four working groups set up in February last year at the request of the Prince of Wales. The document, which is part of the Prince's Initiative on Integrated Medicine, is designed to stimulate debate on the possible role of complementary medicines …
1166-209 Long-term sensitivity and positive predictive value of symptoms as an index of atrial tachyarrhythmia recurrence in paced patients: A report of device-based monitoring in the natural history of atrial fibrillation trial
Authors: Adam Strickberger, John Ip, Sanjeev Saksena, Kenneth Curry, Tristram Bahnson, Douglas Hettrick, Paul Ziegler
Journal: Journal of the American College of Cardiology (2004)
Is human language just another neurobiological specialization?
Authors: Stephen F. Walker
Journal: Behavioral and Brain Sciences (1996)

Abstract One can disagree with Müller that it is neurobiologically questionable to suppose that human language is innate, specialized, and species-specific, yet agree that the precise brain mechanisms controlling language in any individual will be influenced by epigenesis and genetic variability, and that the interplay between inherited and acquired aspects of linguistic capacity deserves to be investigated.
Blocking Smad7 restores TGF-β1 signaling in chronic inflammatory bowel disease
Authors: Giovanni Monteleone, Andrea Kumberova, Nicholas M. Croft, Catriona McKenzie, Howard W. Steer, Thomas T. MacDonald
Journal: Journal of Clinical Investigation (2001)

TGF-β1 functions as a negative regulator of T cell immune responses, signaling to target cells using the Smad family of proteins. We show here that Smad7, an inhibitor of TGF-β1 signaling, is overexpressed in inflammatory bowel disease (IBD) mucosa and purified mucosal T cells. Both whole tissue and isolated cells exhibit defective signaling through this pathway, as measured by phospho-Smad3 immunoreactivity. Specific antisense oligonucleotides for Smad7 reduce Smad7 protein expression in cells isolated from patients with IBD, permitting the cells to respond to exogenous TGF-β1. TGF-β1 cannot inhibit proinflammatory cytokine production in isolated lamina propria mononuclear cells from patients with Crohn disease (CD), but inhibition of Smad7 restores TGF-β1 signaling and enables TGF-β1 to inhibit cytokine production. In inflamed mucosal tissue explants from patients with CD, inhibition of Smad7 also restores p-Smad3 and decreases proinflammatory cytokine production, an effect that is partially blocked by anti–TGF-β1. These results show that Smad7 blockade of TGF-β1 signaling helps maintain the chronic production of proinflammatory cytokines that drives the inflammatory process in IBD and that inhibition of Smad7 enables endogenous TGF-β to downregulate this response.
Diagnosing breast carcinoma in young women: Authors' reply
Authors: R C Coombes, H T Ford, J-C Gazet
Journal: BMJ (1991)

results comparable to and in some ways superior to more traditional forms of care (W D Savage and R M Cochrane, Nivel international conference on primary care obstetrics and perinatal health, s'Hertogenbosch, 1991).We accept that such a scheme, in which hospital specialists visit local surgeries during their antenatal clinics and in which women therefore need not attend hospital at all, would be inappropriate in some areas.Nevertheless, some may wish to emulate the idea for the benefits outlined above and for the fruitful interprofessional respect that such care engenders.
OCCUPATION AND NEUROSIS
Authors: R. D. Gillespie
Journal: BMJ (1932)

rMEDICAL, J0OURNAL may wholly or in part be attributable to muscular exhaus- tion, and this may be suspected if it is found that thoracic respiration preponderates over abdominal in the supinie position, and if excessive tone or tenderniess is found in the muscles in the neighbourhood of the sternum.At the same time, all such patie-nts should receive ftll investigation, since it is less dangerous to mistake muscular exhaustion for anigina pectoris than to make the converse error in diagnosis.
SYNERGISTIC EFFECT OF IMPAIRED KIDNEY FUNCTION AND MICROALBUMINURIA ON ARTERIAL STIFFNESS IN HYPERTENSIVE PATIENTS
Authors: Panagiota Pietri, Charalambos Vlachopoulos, Nikolaos Ioakeimidis, Mahmoud Abdelrasoul, Ioanna Gourgouli, Christodoulos I Stefanadis
Journal: Journal of the American College of Cardiology (2014)
PROGNOSTIC VALUE AT 6 MONTHS OF DISCHARGE RESIDUAL PULMONARY VASCULAR OBSTRUCTION IN INTERMEDIATE- TO HIGH-RISK PULMONARY EMBOLISM
Authors: Nicolas F. Meneveau, Omar Ider, Vincent Descotes-Genon, Marie-France Seronde, Romain Chopard, Sebastien Janin, Yvette Bernard, Francois Schiele
Journal: Journal of the American College of Cardiology (2011)
Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care
Authors: Harvey Max Chochinov
Journal: BMJ (2007)

Kindness, humanity, and respect—the core values of medical professionalism—are too often being overlooked in the time pressured culture of modern health care, says <b>Harvey</b><b>Chochinov</b>, and the A, B, C, and D of dignity conserving care can reinstate them
Prednisone for chronic active liver disease: dose titration, standard dose, and combination with azathioprine compared.
Authors: W H Summerskill, M G Korman, H V Ammon, A H Baggenstoss
Journal: Gut (1975)

Among 120 consecutive patients with chronic active liver disease (CALD) randomized to different treatments, those receiving maintenance doses of prednisone 20 mg daily (Pred), prednisone in doses given on alternate days and titrated to secure resolution of clinical and biochemical abnormalities (Pred-Titrad), or a combination of prednisone 10 mg and azathioprine 50 mg daily (Comb) survived and underwent resolution of clinical and biochemical features of disease more often than a control group receiving placebo or azathioprine 100 mg daily. Histological remission occurred significantly more often with Pred and Comb than with other regimens. Major side-effects of therapy were commoner with Pred than with Comb or Pred-Titrad, which did not differ. We conclude that Comb is the initial treatment of choice for CALD, since clinical, biochemical, and histological resolution of disease activity occurs as often as with Pred, whereas early side-effects are significantly less frequent.
Monitoring clinical trials interim data should be publicly available
Authors: R. J Lilford, D. Braunholtz, S. Edwards, A. Stevens
Journal: BMJ (2001)

Interim results from clinical trials are, by growing convention, scrutinised by committees, commonly called data monitoring committees or institutional review boards. This allows clear evidence of benefit or harm to be identified expeditiously. The UK Medical Research Council sponsored trial of folic acid prophylaxis against recurrence of neural tube defects1 and a trial of antiarrhythmic medication for prophylaxis against ventricular fibrillation2 were terminated early because of favourable and adverse interim results respectively. Current practice is to keep interim data secret, on the presumption that their release would undermine recruitment and provoke “premature” adoption of treatment. Data monitoring committees offer timely expert advice on such matters as data collection 3 4 and can stop patients being offered randomisation to treatments that would be regarded as inferior by almost any person who had understood the interim data. Knowledge accrues incrementally,5 however, and we argue that interim results should be made publicly available, thereby enabling patients to make individual decisions on the basis of data that might rationally provoke different choices from different people. Firstly, we explain why the practice of withholding data is ethically dubious, and, secondly, we argue that making data publicly available has potential practical advantages.

#### Summary points

Interim analysis in clinical trials is done in secret because authorities fear premature adoption of promising but “unproved” treatments

Withholding, without debate and endorsement of the policy, information that patients might find useful is at best paternalistic, at worst …
2-Chlorodeoxyadenosine Treatment in Hairy Cell Leukemia
Authors: Alan Saven
Journal: Annals of Internal Medicine (1994)

Letters15 January 19942-Chlorodeoxyadenosine Treatment in Hairy Cell LeukemiaAlan Saven, MD and Lawrence Piro, MDAlan Saven, MDScripps Clinic and Research Foundation; La Jolla, CA 92037Search for more papers by this author and Lawrence Piro, MDScripps Clinic and Research Foundation; La Jolla, CA 92037Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-2-199401150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The favorable outcome of two patients with hairy cell leukemia in the Northwestern University study [1] of 2-CdA who had received previous DCF treatment supports our conclusion that cross-resistance may not exist between 2-CdA and DCF [2]. However, the number of treated patients is small, and, because of the subtle distinction between DCF intolerance and resistance, many more patients should be studied to draw firm conclusions.Although DCF is a tight-binding inhibitor of adenosine deaminase, 2-CdA does not inhibit the enzyme directly, but rather resists deamination because of its chlorine atom at the two position of the purine ...References1. Tallman M, Hakimian D, Variakojis D, Koslow, Sisney GA, Rademaker AW, et al. A single cycle of 2-chlorodeoxyadenosine results in complete remission in the majority of patients with hairy cell leukemia. Blood. 1992; 80:2203-9. Google Scholar2. Saven A, Piro LD. Complete remissions in hairy cell leukemia with 2-chlorodeoxyadenosine after failure with 2′-deoxycoformycin. Ann Intern Med. 1993; 119:278-83. Google Scholar3. Kawasaki H, Carrera CJ, Piro LD, Saven A, Kipps TJ, Carson DA. Relationship of deoxycytidine kinase and cytoplasmic 5′-nucleotidase to the chemotherapeutic efficacy of 2-chlorodeoxyadenosine. Blood. 1993; 81:597-601. Google Scholar4. Saven A, Carrera CJ, Carson DA, Beutler E, Piro LD. 2-Chlorodeoxyadenosine treatment of refractory chronic lymphocytic leukemia. Leukemia Lymphoma. 1991; 5(Suppl):133-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: Scripps Clinic and Research Foundation; La Jolla, CA 92037 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAnalysis of 2-Chloro-2′-deoxyadenosine Incorporation into Cellular DNA by Quantitative Polymerase Chain Reaction 15 January 1994Volume 120, Issue 2Page: 169KeywordsAdenosineChronic lymphocytic leukemiaDeoxycytidineEnzymesForecastingLymphocytesLymphocytic leukemiaPurinesToxicity Issue Published: 15 January 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
SAFETY AND EFFICACY OF A NOVEL METAL CATHETER IN CHRONIC TOTAL OCCLUSION LESIONS. -CORSAIR FIRST-IN-MAN (FIM) REGISTRY-
Authors: Masashi Kimura, Etsuo Tsuchikae, Osamu Katoh, Nobuyoshi Tanaka, Kenya Nasu, Tatsuya Ito, Yoshihisa Kinoshita, Mariko Ehara, Mitsuyasu Terashima, Yasushi Asaskura, Takahiko Suzuki
Journal: Journal of the American College of Cardiology (2010)