tbuckley/cabot-search huggingface dataset:
Death and laughter
Authors: H Snook
Journal: BMJ (1994)

Colin's kid brother has got cancer. There's a real danger of him dying. Their parents think it would be better for Colin to be away and so he is sent off from Australia to Pommyland to stay with his Auntie Iris, Uncle Bob, and cousin Alistair. The peace of the Mudford household in London is shattered because 12 year old Colin keeps getting into scrapes trying to meet the Queen. Elizabeth II, he thinks, could send someone to cure his brother. “I'll bet the Queen has the world's best doctor right there beside her in London,” he says optimistically. (“Aren't you thinking of Victoria?” I thought.)

Frankly, I don't believe someone the same age …
Truth Survival in Clinical Research: An Evidence-Based Requiem?
Authors: Thierry Poynard, Mona Munteanu, Vlad Ratziu, Yves Benhamou, Vincent Di Martino, Julien Taieb, Pierre Opolon
Journal: Annals of Internal Medicine (2002)

Purpose: Factors associated with the survival of truth of clinical conclusions in the medical literature are unknown. The authors hypothesized that conclusions derived from studies using better methodology should have a longer half-life. Data Sources: MEDLINE and hand searches of journals with studies on cirrhosis and hepatitis. Study Selection: Original articles and meta-analyses published from 1945 to 1999 about cirrhosis or hepatitis in adults. Data Synthesis: In 2000, 285 of 474 conclusions (60%) were still considered to be true, 91 (19%) were considered to be obsolete, and 98 (21%) were considered to be false. The half-life of truth was 45 years. The 20-year survival of conclusions derived from meta-analysis was lower (57% ± 10%) than that from nonrandomized studies (87% ± 2%) (P < 0.001) or randomized trials (85% ± 3%) (P < 0.001). The survival of conclusions was not different when studies of high methodologic quality were compared with those of low quality. In randomized trials, the 50-year survival rate was higher for 52 negative conclusions (68% ± 13%) than for 118 positive conclusions (14% ± 4%) (P < 0.001). Conclusions: Contrary to the authors' hypothesis, conclusions based on recognized, good methodology had no clear survival advantage. To better convince clinicians of the long-term utility of evidence-based medicine, better prognostic factors should be developed.
Time course and duration of bronchodilatation with formoterol dry powder in patients with stable asthma.
Authors: A Wallin, T Sandstrom, L Rosenhall, B Melander
Journal: Thorax (1993)

BACKGROUND--Formoterol, a new beta 2 agonist, is long and fast acting when given as an aerosol. The aim was to determine the onset and duration of bronchodilatation with formoterol as a dry powder compared with salbutamol dry powder and with placebo. METHODS--Fifteen patients with stable asthma with a reversibility of 15% or more participated in a double blind, within patient study. On five different days the patients received formoterol 6 micrograms, 12 micrograms, or 24 micrograms, salbutamol 400 micrograms, or placebo in random order. Forced expiratory volume in one second (FEV1) was measured 10 minutes before, 30 minutes after, and then every hour for up to 12 hours after treatment. Specific airway resistance (sRaw) and specific airway conductance (sGaw) were measured immediately before and one, three, five, 10, 15, and 30 minutes after treatment. RESULTS--Formoterol 12 micrograms and 24 micrograms caused bronchodilatation as rapidly as salbutamol 400 micrograms. Peak values were not significantly different in the active treatments. The duration of action, calculated as median time with 20% or more of the maximum achieved increase in FEV1, was sustained for 9 hours and 16 minutes with salbutamol 400 micrograms, for 9 hours and 45 minutes with formoterol 6 micrograms, for 11 hours and 22 minutes with formoterol 12 micrograms, and for 11 hours and 42 minutes with formoterol 24 micrograms. CONCLUSIONS--Formoterol as a dry powder at doses of 12 micrograms and 24 micrograms produces a rapid onset of action and has a bronchodilator effect comparable with salbutamol 400 micrograms as a dry powder. The bronchodilatation was sustained for 11-12 hours. Formoterol 6 micrograms caused similar bronchodilatation but more slowly and for a shorter time.
Survey of acute renal failure in patients with cystic fibrosis in the UK
Authors: C. Bertenshaw, A. R Watson, S. Lewis, A. Smyth
Journal: Thorax (2007)

<b>Background:</b> There has been a recent increase in the number of reported cases of acute renal failure (ARF) in cystic fibrosis (CF). A study was undertaken to determine the incidence risk of ARF in patients with CF in the UK and to identify possible aetiological factors. <b>Methods:</b> All doctors working at UK CF centres were asked if they had been involved with the management of a patient with CF who had developed ARF. Those responding positively were asked to request informed consent for entry into the study and the patient's case notes were then reviewed. The analysis was restricted to patients developing ARF between 1997 and 2004. A second questionnaire sought information on aminoglycoside prescribing practice. <b>Results:</b> Responses were received from 55 of 56 centres with 64 reports, 9 of which were duplicates, leaving 55 cases. Consent was obtained for data extraction in 26 cases, of which 24 fitted the criteria for ARF (verified data). Median age at presentation with ARF was 9.7 years (range 0.4–31.8) and 12 cases were male. The incidence risk of ARF was 4.6 (verified data) to 10.5 cases (all data)/10 000 CF patients/year. In 21 cases (88%) an aminoglycoside was prescribed at onset of ARF or in the preceding week; 16 (76%) of those receiving an aminoglycoside had gentamicin. A renal biopsy was performed in 7 cases and histological examination revealed acute tubular necrosis in 6, all of whom had received gentamicin. Renal dialysis was required in 13 cases (54%). Complete recovery was seen in 22/24 patients (92%). <b>Conclusions:</b> ARF is increasingly being recognised in patients with CF. There is significant morbidity with most patients requiring dialysis. This study implicates intravenous aminoglycosides, particularly gentamicin, in the aetiology of ARF in CF.
Reversible oesophageal dysphagia and long-term ingestion of chlormethiazole.
Authors: P Dewis, F Local, D C Anderson, J Bancewicz
Journal: BMJ (1982)

erythrocyte sedimentation rate of 58 mm in first hour with acute-phase proteins.A computed tomogram and a myelogram were normal.Cerebrospinal fluid protein concentration was raised and showed a polyclonal globulin band with no cells.An increased dose of prednisolone and azathioprine improved both her ocular and neurological disease, the neurological signs and Lhermitte's sign disappearing after about three months.
In-vivo Cytogenetic Effects of Perphenazine and Chlorpromazine: A Negative Study
Authors: M. M. Cohen, E. Lieber, H. N. Schwartz
Journal: BMJ (1972)

No evidence was found that either perphenazine or chlorpromazine induced chromosomal damage in patients given the drugs. These results were reached independently at two separate laboratories; earlier reports of possible adverse cytogenetic effects of these drugs can probably be discounted.
Expression of Bone‐related Genes in Bone Marrow MSCs after Cyclic Mechanical Strain: Implications for Distraction Osteogenesis
Authors: Meng‐chun Qi, Shu‐juan Zou, Li‐chi Han, Hai‐xiao Zhou, Jing Hu
Journal: International Journal of Oral Science (2009)

Understanding the response of mesenchymal stem cells (MSCs) to mechanical strain and their consequent gene expression patterns will broaden our knowledge of the mechanobiology of distraction osteogenesis. In this study, a single period of cyclic mechanical stretch (0.5 Hz, 2,000 μɛ) was performed on rat bone marrow MSCs. Cellular proliferation and alkaline phosphatase (ALP) activity was examined. The mRNA expression of six bone‐related genes (Ets‐1, bFGF, IGF‐II, TGF‐β, Cbfa1 and ALP) was detected using real‐time quantitative RT‐PCR. The results showed that mechanical strain can promote MSCs proliferation, increase ALP activity, and up‐regulate the expression of these genes. A significant increase in Ets‐1 expression was detected immediately after mechanical stimulation, but Cbfa1 expression becameelevated later. The temporal expression pattern of ALP coincided perfectly with Cbfa1. The results of this study suggest that mechanical strain may act as a stimulator to induce differentiation of MSCs into osteoblasts, and that these bone‐related genes may play different roles in the response of MSCs to mechanical stimulation.
Academics complain that NHS R&amp;D departments are damaging UK clinical trials
Authors: J. Carlowe
Journal: BMJ (2010)

Several professors in pharmacology and drug development have attacked NHS Research and Development departments calling them wasteful.

In an open letter published in the Times (2 August), four academics accused the departments of using inexperienced staff and working outside 2004 clinical trials legislation.

“If the NHS wishes to cut wasteful expenditure it needs look no further than its misnamed ‘research and development’ departments,” the letter began.

It went on to explain how a single proposal for a blood pressure drugs trial, had proliferated into “almost 100 R&D [research and development] submissions”—a process that took two years.

“Since trial participants achieve better blood pressure control, are better protected from strokes and …
Classification of Human Papillomavirus Infection
Authors: Robert D. Burk
Journal: JAMA (1993)

<h3>To the Editor.</h3> —Infection with oncogenic strains of human papillomavirus (HPV) constitutes a major risk factor for development of precancerous neoplastic lesions and/or cancer of the cervix.<sup>1</sup>The inability to culture HPV and the lack of reliable serologic tests have hindered characterization of the life cycle and the natural course of HPV infection.<sup>2</sup> The use of imprecise terminology that implies a knowledge of the stage of HPV infection is common in the medical literature. For instance, the term<i>latent</i>has been used to refer to individuals who have only molecular biological evidence of infection. However, epidemiologists refer to the<i>latent period</i>of a disease as the interval between disease onset and detection.<sup>3</sup>Indeed, individuals who have HPV DNA but no other evidence of infection may be in this early stage of disease. On the other hand, virologists refer to latent viral infections as a state of persistent
Improving the Quality of Reporting Studies of Quality Improvement: The SQUIRE Guidelines
Authors: Harold C. Sox
Journal: Annals of Internal Medicine (2008)

Editorials4 November 2008Improving the Quality of Reporting Studies of Quality Improvement: The SQUIRE GuidelinesHarold C. Sox, MD, EditorHarold C. Sox, MD, EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-9-200811040-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In June 2003, Annals of Internal Medicine began a section called Improving Patient Care. In the subsequent 126 issues to date, we'e published 77 Improving Patient Care articles: 9 randomized trials, 35 observational studies, 19 essays, 5 systematic reviews, and 9 articles from the Quality Grand Rounds series. Some of these articles were about the effect of interventions to improve quality of care (for example, reminders about an appointment for colonoscopy). Some of these studies used preexisting data, and some were planned, controlled experiments. In the review and editing process, we treated these interventional studies much as we treat a ...Reference1. Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney S; SQUIRE Development Group. Publication guidelines for improvement studies in health care: evolution of the SQUIRE project. Ann Intern Med. 2008;149:670-76. LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Harold C. Sox, MD, EditorCorresponding Author: Harold C. Sox, MD, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, [email protected]acponline.org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 4 November 2008Volume 149, Issue 9Page: 683KeywordsDrugsHealth careHealth care qualityInsulinObservational studiesPatientsQuality improvementRandomized trialsResearch reporting guidelinesSystematic reviews ePublished: 4 November 2008 Issue Published: 4 November 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
External validity of randomised controlled trials in asthma: to whom do the results of the trials apply?
Authors: J. Travers, S. Marsh, M. Williams, M. Weatherall, B. Caldwell, P. Shirtcliffe, S. Aldington, R. Beasley
Journal: Thorax (2006)

Asthma is a heterogeneous disease with a wide range of clinical phenotypes, not all of which may be encompassed in the subjects included in randomised controlled trials (RCTs). This makes it difficult for clinicians to know to what extent the evidence derived from RCTs applies to a given patient.To calculate the proportion of individuals with asthma who would have been eligible for the major asthma RCTs from the data of a random community survey of respiratory health.A postal survey was sent to 3500 randomly selected individuals aged 25-75 years. Respondents were invited to complete a detailed respiratory questionnaire and pulmonary function testing. Participants with current asthma were assessed against the eligibility criteria of the 17 major asthma RCTs cited in the Global Initiative for Asthma (GINA) guidelines.A total of 749 participants completed the full survey, of whom 179 had current asthma. A median 4% of participants with current asthma (range 0-36%) met the eligibility criteria for the included RCTs. A median 6% (range 0-43%) of participants with current asthma on treatment met the eligibility criteria.This study shows that the major asthma RCTs on which the GINA guidelines are based may have limited external validity as they have been performed on highly selected patient populations. Most of the participants with current asthma on treatment in the community would not have been eligible for these RCTs.
Gut hormones in tropical malabsorption.
Authors: H S Besterman, G C Cook, D L Sarson, N D Christofides, M G Bryant, M Gregor, S R Bloom
Journal: BMJ (1979)

Concentrations of various gut hormones were measured after a test breakfast in eight patients with severe tropical malabsorption and 12 controls. The patients with tropical malabsorption had greatly raised basal plasma motilin and enteroglucagon concentrations, but their postprandial release of both gastric inhibitory polypeptide and insulin was significantly reduced. The pattern of gut hormone release differed from that found in coeliac disease. The measurement of gut hormones, each of which has a specific site and function, thus throws new light on the pathophysiology of tropical malabsorption and may suggest approaches of treatment.
Differentiating Reversible Cerebral Vasoconstriction Syndrome With Subarachnoid Hemorrhage From Other Causes of Subarachnoid Hemorrhage
Authors: Susanne Muehlschlegel, Oguzhan Kursun, Mehmet A. Topcuoglu, Joshua Fok, Aneesh B. Singhal
Journal: JAMA Neurology (2013)

IMPORTANCEReversible cerebral vasoconstriction syndrome (RCVS) is a clinical-angiographic syndrome characterized by recurrent thunderclap headaches and reversible segmental multifocal cerebral artery narrowing.More than 30% of patients with RCVS develop subarachnoid hemorrhage (SAH).Patients with RCVS with SAH (RCVS-SAH) are often misdiagnosed as having potentially ominous conditions such as aneurysmal SAH (aSAH) or cryptogenic "angiogram-negative" SAH (cSAH) owing to overlapping clinical and imaging features.OBJECTIVE To identify predictors that can distinguish RCVS-SAH from aSAH and cSAH at the time of clinical presentation.DESIGN Retrospective analysis of 3 patient cohorts: patients with RCVS (1998-2009), patients with aSAH (1995-2003), and patients with cSAH (1995-2003).SETTING Academic hospital and tertiary referral center.PARTICIPANTS Consecutive patients with RCVS-SAH (n = 38), aSAH (n = 515), or cSAH (n = 93) whose conditions were diagnosed using standard criteria. MAIN OUTCOMES AND MEASURESMultivariate logistic regression analysis was used to identify predictors that differentiate RCVS-SAH from aSAH and cSAH.RESULTS Predictors differentiating RCVS-SAH from aSAH were younger age, chronic headache disorder, prior depression, prior chronic obstructive pulmonary disease, lower Hunt-Hess grade, lower Fisher SAH group, higher number of affected arteries, and the presence of bilateral arterial narrowing.Predictors differentiating RCVS-SAH from cSAH were younger age, female sex, prior hypertension, chronic headache disorder, lower Hunt-Hess grade, lower Fisher SAH group, and the presence of bilateral arterial narrowing. CONCLUSIONS AND RELEVANCEWe identified important clinical and imaging differences between RCVS-SAH, aSAH, and cSAH that may be useful for improving diagnostic accuracy, clinical management, and resource utilization.
Consensus Developed For Colon/Rectal Cancer
Authors: A. Jacobs-Perkins
Journal: JNCI Journal of the National Cancer Institute (1990)

Journal Article Consensus Developed For Colon/Rectal Cancer Get access Andree Jacobs-Perkins Andree Jacobs-Perkins Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 82, Issue 10, 16 May 1990, Page 820, https://doi.org/10.1093/jnci/82.10.820 Published: 16 May 1990
Surviving Cardiac Arrest
Authors: Arthur B. Sanders, Karl B. Kern
Journal: JAMA (2008)

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
A METHOD FOR DETERMINING CHANGES IN V-Q RATIOS DUE TO INTERVENTION
Authors: A Waxman, Z Mohsenifar, M Ross, P Goldbach, D Brown, L Ramanna, D Berman, D Tanasescu, M Brachman, S Koerner
Journal: Clinical Nuclear Medicine (1984)

Changes in regional V–Q ratios in response to various interventions have been evaluated using complex techniques. The purpose of this study was to develop a new and practical technique for accurately assessing changes in relative perfusion and ventilation in response to an intervention. For this purpose we have chosen to evaluate this method to access changes in V–Q values at rest and exercise. 18 male subjects underwent resting ventilation images using krypton-81 followed by perfusion images using 300 uCi of Tc-99m-MAA. All images contained 500,000 counts and were obtained in the posterior position. Using a cycle argometer, 80% of the maximal predicted heart rate was obtained and maintained for a 5− minute period. The subjects again breathed krypton, and an exercise ventilation image was obtained. This was immediately followed by a 3 mCi Tc-99m-MAA perfusion study. All information was acquired on computer using a 64x64 matrix. Positioning was kept constant by alignment of cobalt sources attached to the subject's back. The lung was trisected, allowing for regional analysis of V–Q ratios. This method was capable of demonstrating a significant increase in perfusion of upper lung zones in response to exercise. The resting perfusion to the right lung was significantly greater than the left, and during exercise there was a major trend to equalize perfusion between the two lungs. Ventilation increased over the right lung, resulting in a relatively higher V–Q ratio on the right than on the left. This method is simple to perform and analyze, and may have a role in determining the effects of therapeutic regimens in cardiovascular or pulmonary disease.
Origin of Nodular Lymphocyte-Predominant Hodgkin's Disease from a Clonal Expansion of Highly Mutated Germinal-Center B Cells
Authors: Theresa Marafioti, Michael Hummel, Ioannis Anagnostopoulos, Hans-Dieter Foss, Brunangelo Falini, Georges Delsol, Peter G. Isaacson, Stefano Pileri, Harald Stein
Journal: New England Journal of Medicine (1997)

The atypical cells of nodular lymphocyte-predominant Hodgkin's disease, designated lymphocytic and histiocytic (L&H) cells, have a B-cell phenotype. To clarify the clonality of these cells, we studied rearranged immunoglobulin genes for the variable region of the heavy chain (V H genes) in individual L&H cells from 11 patients with nodular lymphocyte-predominant Hodgkin's disease. We also studied the expression of immunoglobulin light chains by those cells in six of the same patients.
THE QUININ TREATMENT OF CHOLERA.
Authors: ERSKINE B. FULLERTON
Journal: JAMA (1906)

In this article, using the inductive method of reasoning that H. C. Buckle long ago characterized as peculiarly the American method, I shall endeavor to show that: Rightly administered, quinin has always proved the best remedy in Asiatic cholera. It has only failed to bring the best results when improperly used as to dosage or method of administration. It is just the remedy, of all others, from which we should expect these results. My own experience with the disease was in Columbus, Ohio, during the epidemic of 1873 in the Mississippi Valley. There were here 138 cases of the disease, with 90 deaths; a mortality of 65 per cent. Of cholera of statistic grade, I had 5 cases, all terminating in recovery. Of choleraic diarrhea, mostly of the intermittent (early morning) type mentioned below, I had some 30 cases during the time of the prevalance of the disease. It had
Alcohol Consumption Before Myocardial Infarction
Authors: Arthur L. Klatsky, Gary D. Friedman, Abraham B. Siegelaub
Journal: Annals of Internal Medicine (1974)

A statistically significant negative association between alcohol consumption and a subsequent first myocardial infarction in 464 patients was found in a study that was well controlled for cigarette smoking and five other established risk factors. There was a larger proportion of teetotalers among those who had a myocardial infarction (P < 0.01) as well as a smaller proportion of moderate (two or less drinks per day) and heavy (three or more drinks per day) consumers of alcoholic beverages. Alcohol consumption and cigarette smoking were strongly correlated habits. The lower consumption of alcohol by persons who subsequently had a myocardial infarction apparently was not the result of intake reduction because of known heart disease or risk-factor-related diseases such as hypertension and diabetes mellitus. Possible explanations include indirect association of drinking habits with ethnic origin, psychological traits or other unknown risk factors for myocardial infarction, or a protective effect of alcohol.