tbuckley/cabot-search huggingface dataset:
Four-weekly infliximab in the treatment of severe hidradenitis suppurativa
Authors: B. Moriarty, Z. Jiyad, D. Creamer
Journal: British Journal of Dermatology (2013)

Journal Article Four‐weekly infliximab in the treatment of severe hidradenitis suppurativa Get access B. Moriarty, B. Moriarty Department of Dermatology King's College Hospital Denmark Hill London SE5 9RS U.K Search for other works by this author on: Oxford Academic Google Scholar Z. Jiyad, Z. Jiyad Department of Dermatology King's College Hospital Denmark Hill London SE5 9RS U.K Search for other works by this author on: Oxford Academic Google Scholar D. Creamer D. Creamer Department of Dermatology King's College Hospital Denmark Hill London SE5 9RS U.K Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 170, Issue 4, 1 April 2014, Pages 986–987, https://doi.org/10.1111/bjd.12713 Published: 01 April 2014
Ethical issues in the design and conduct of cluster randomised controlled trials
Authors: S. J L Edwards, D. A Braunholtz, R. J Lilford, A. J Stevens
Journal: BMJ (1999)

<b>1841</b> <h3><b>Objectives</b></h3> To evaluate and compare the performance of both visual and voxel-based analysis (SPM) of the 18F-FDG PET scan (lobar localization and lateralization value of epileptic zone) and to study their role in presurgical investigation of partial epilepsy. <h3><b>Methods</b></h3> 141 patients with intractable focal epilepsy (age range 10-59 years) underwent interictal 18F-FDG PET scan. PET images were analyzed by both visual assessment and SPM. On SPM analysis, a cut-off threshold p &lt;0.01 was considered statistically significant to find epileptogenic zone (EZ). Lateralization value and performance of lobar localization were compared with the EZ determined by scalp video electroencephalographic monitoring (video-EEG) and MRI results. <h3><b>Results</b></h3> MRI showed structural lesions in 98/141 (70%) patients and normal findings in 43/141 (30%). Visual analysis was positive in 89% of patients, while SPM in 87%. Although, the sensitivity was 88% for PET visual and 86% for SPM in patients without MRI structural lesions. The sensitivity of both PET visual and SPM was 85% in the correct localization of EZ, but SPM analysis performed higher specificity (99%vs96%) and accuracy (92%vs90%) than visual assessment. Moreover, SPM was better than visual assessment in the correct lateralization (98%vs96%). Also, in more than 50% of cases, visual and SPM analysis have been useful to guide or to avoid the placement of intracranial electrodes and to greatly improved the surgical resection. <h3><b>Conclusions</b></h3> In our institution 18F-FDG PET with SPM have been routinely performed in the presurgical evaluation of patients with drug-resistant partial epilepsy in combination with clinical, electrophysiological and neuroimaging, demonstrating high values of sensitivity, specificity and diagnostic accuracy in the correct localization of epileptogenic foci. PET-SPM findings were also useful to better guide the placement of intracranial electrodes and to decide the best surgical approach.
Trends in Hip Fracture Rates in Canada
Authors: William D. Leslie
Journal: JAMA (2009)

Hip fractures are a public health concern because they are associated with significant morbidity, excess mortality, and the majority of the costs directly attributable to osteoporosis.To examine trends in hip fracture rates in Canada.Ecologic trend study using nationwide hospitalization data for 1985 to 2005 from a database at the Canadian Institute for Health Information. Data for all patients with a hospitalization for which the primary reason was a hip fracture (570,872 hospitalizations) were analyzed.Age-specific and age-standardized hip fracture rates.There was a decrease in age-specific hip fracture rates (all P for trend <.001). Over the 21-year period of the study, age-adjusted hip fracture rates decreased by 31.8% in females (from 118.6 to 80.9 fractures per 100,000 person-years) and by 25.0% in males (from 68.2 to 51.1 fractures per 100,000 person-years). Joinpoint regression analysis identified a change in the linear slope around 1996. For the overall population, the average age-adjusted annual percentage decrease in hip fracture rates was 1.2% (95% confidence interval, 1.0%-1.3%) per year from 1985 to 1996 and 2.4% (95% confidence interval, 2.1%-2.6%) per year from 1996 to 2005 (P < .001 for difference in slopes). Similar changes were seen in both females and males with greater slope reductions after 1996 (P < .001 for difference in slopes for each sex).Age-standardized rates of hip fracture have steadily declined in Canada since 1985 and more rapidly during the later study period. The factors primarily responsible for the earlier reduction in hip fractures are unknown.
COMPARISON OF VASCULAR RESPONSE AFTER EVEROLIMUS-ELUTING STENTS AND BARE METAL STENTS IMPLANTATION IN ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION ASSESSED BY OPTICAL COHERENCE TOMOGRAPHY
Authors: Yasushi Ino, Takashi Kubo, Takashi Tanimoto, Hironori Kitabata, Kunihiro Shimamura, Yasutsugu Shiono, Makoto Orii, Keisuke Satogami, Tsuyoshi Nishiguchi, Yoshiki Matsuo, Takashi Yamano, Tomoyuki Yamaguchi, Kumiko Hirata, Atsushi Tanaka, Toshio Imanishi, Takashi Akasaka
Journal: Journal of the American College of Cardiology (2014)
Metabolic acidosis in acute myocardial infarction.
Authors: M. A. Neaverson
Journal: BMJ (1966)

All cases seen and included were those that had suffered an inf arct during the four days before admission, having E.C.G. changes of acute infarction, a raised S.G.O.T. of greater than 60 units, or serial E.C.G. changes. On history and clinical examination and E.C.G. findings they were graded according to the prognostic index of Peel et al. (1962). In that index all cases are given scores for age and sex, history, and physical and E.C.G. findings. Any patient with a prognostic index greater than 13?that is, a 25% chance of dying?and who was under the age of 70, was admitted to the intensive therapy unit when the Sanborn monitor was available. While still in the casualty department, before admission to either a ward or the intensive therapy unit, an arterialized venous sample of blood was removed. Such samples have been shown by Harrison and Galloon (1965) to approximate arterial blood closely. The method used was to immerse the hand in a hot-water bath of approximately 45? C. for a period of 15 minutes and then remove a sample of blood from a suitable vein at the back of the hand, without compression, into an already heparinized syringe. This sample was then analysed for Po2, Pco2, pH, and base deficit by the Astrup microelectrode technique (Astrup et al., 1960). Those patients who were admitted to the intensive therapy unit were monitored by the Sanborn monitor for 72 hours and had continual oxygen by Polymask at 8 litres/minute for a period of 36 hours. In cases of shock the base deficit was corrected by titrated doses of intravenous sodium bicarbonate ; at the end of three days the cases were then transferred to a general ward. The other cases were admitted direct into a general ward and had continual oxygen for 36 hours. The patients under 60 in both groups were anticoagulated with heparin and phenindione, and other supportive treatment was given as required.
Adiponectin deficiency increases leukocyte-endothelium interactions via upregulation of endothelial cell adhesion molecules in vivo
Authors: Raogo Ouedraogo, Yulan Gong, Brett Berzins, Xiandong Wu, Kalyankar Mahadev, Kelly Hough, Lawrence Chan, Barry J. Goldstein, Rosario Scalia
Journal: Journal of Clinical Investigation (2007)

This study reports on what we believe are novel mechanism(s) of the vascular protective action of adiponectin. We used intravital microscopy to measure leukocyte-endothelium interactions in adiponectin-deficient (Ad–/–) mice and found that adiponectin deficiency was associated with a 2-fold increase in leukocyte rolling and a 5-fold increase in leukocyte adhesion in the microcirculation. Measurement of endothelial NO (eNO) revealed that adiponectin deficiency drastically reduced levels of eNO in the vascular wall. Immunohistochemistry demonstrated increased expression of E-selectin and VCAM-1 in the vascular endothelium of Ad–/– mice. Systemic administration of the recombinant globular adiponectin domain (gAd) to Ad–/– mice significantly attenuated leukocyte-endothelium interactions and adhesion molecule expression in addition to restoring physiologic levels of eNO. Importantly, prior administration of gAd also protected WT mice against TNF-α–induced leukocyte-endothelium interactions, indicating a pharmacologic action of gAd. Mechanistically, blockade of eNOS with Nω-nitro-l-arginine methyl ester (l-NAME) abolished the inhibitory effect of gAd on leukocyte adhesion, demonstrating the obligatory role of eNOS signaling in the antiinflammatory action of gAd. We believe this is the first demonstration that gAd protects the vasculature in vivo via increased NO bioavailability with suppression of leukocyte-endothelium interactions. Overall, we provide evidence that loss of adiponectin induces a primary state of endothelial dysfunction with increased leukocyte-endothelium adhesiveness.
Guar crispbread in the diabetic diet.
Authors: D J Jenkins, R H Taylor, T M Wolever, S Bacon, T D Hockaday, D J Reynolds
Journal: BMJ (1980)

nervosa.She was subject to recurrent hypoglycaemia and on one occasion had a grand mal fit.After a joint medicopsychiatric admission she was followed up in both clinics in conjunction.She remained at about 42 kg (standard 50 kg) until just after taking 0 levels at 16; she lost 4 kg in a few weeks, and was subsequently found dead in bed.A few missed periods and fluctuations in weight are commonplace in adolescence.Primary anorexia nervosa is liable to arise when lack of menses and weight loss come specifically to assuage high levels of adolescent anxiety.The combination of the illusion of self control, the safety of emotional regression, -and reaffirmation of parental concern may be rewarding enough to maintain and intensify weight-reducing behaviour.In our second patient the strains of puberty and adolescence were added to the psychological disturbance common in unstable diabetes3-leading to overdose, wristcutting, and finally anorexia nervosa.The reason for her death was un- certain but she did not have autonomic neuropathy, which can predispose to cardio- respiratory arrest in diabetes.4It seems that the association between anorexia nervosa and diabetes mellitus is neither excessively rare nor particularly common, but what would be expected by chance.However, since the secondary forms of anorexia nervosa merge into various neurotic reactions it is probable that a search among diabetics would produce an appreciable number with neurotic be- haviour which included an obsession with weight.
Where next for evidence based healthcare?
Authors: C. Heneghan, F. Godlee
Journal: BMJ (2013)

A BMJ conference aims to inspire a new generation of evidence creators and consumers

Evidence based healthcare has taken root as one of the central pillars of modern medicine. Arguably, the delivery of healthcare based on evidence has never been more important as we grapple with unexplained variations in practice and spiralling healthcare costs. But despite its widespread acceptance as a mechanism for rational decision making, evidence based healthcare remains in many ways an ideal rather than a fully fledged reality. On top of its well rehearsed limitations,1 new challenges are undermining its potential to improve healthcare outcomes.

First though, let us acknowledge the progress that has been made since evidence based medicine was first articulated in the early 1990s.2 Systematic review was then in its infancy, and methods for searching, selecting, and meta-analysing data have advanced almost beyond recognition. Our expectations of the quality of reporting for clinical trials and other study designs have risen sharply thanks to the widespread adoption of checklists, such as those created …
Open Radical Retropubic Prostatectomy Using High Anterior Release of the Levator Fascia and Constant Haptic Feedback in Bilateral Neurovascular Bundle Preservation Plus Early Postoperative Phosphodiesterase Type 5 Inhibition: A Contemporary Series
Authors: J. Mikel Hubanks, Eric C. Umbreit, R. Jeffrey Karnes, Robert P. Myers
Journal: European Urology (2011)
GAD65 Antigen Therapy in Recently Diagnosed Type 1 Diabetes Mellitus
Authors: Johnny Ludvigsson, David Krisky, Rosaura Casas, Tadej Battelino, Luis Castaño, James Greening, Olga Kordonouri, Timo Otonkoski, Paolo Pozzilli, Jean-Jacques Robert, Henk J. Veeze, Jerry Palmer, Diamyd Medical
Journal: New England Journal of Medicine (2012)

The 65-kD isoform of glutamic acid decarboxylase (GAD65) is a major autoantigen in type 1 diabetes. We hypothesized that alum-formulated GAD65 (GAD-alum) can preserve beta-cell function in patients with recent-onset type 1 diabetes.We studied 334 patients, 10 to 20 years of age, with type 1 diabetes, fasting C-peptide levels of more than 0.3 ng per milliliter (0.1 nmol per liter), and detectable serum GAD65 autoantibodies. Within 3 months after diagnosis, patients were randomly assigned to receive one of three study treatments: four doses of GAD-alum, two doses of GAD-alum followed by two doses of placebo, or four doses of placebo. The primary outcome was the change in the stimulated serum C-peptide level (after a mixed-meal tolerance test) between the baseline visit and the 15-month visit. Secondary outcomes included the glycated hemoglobin level, mean daily insulin dose, rate of hypoglycemia, and fasting and maximum stimulated C-peptide levels.The stimulated C-peptide level declined to a similar degree in all study groups, and the primary outcome at 15 months did not differ significantly between the combined active-drug groups and the placebo group (P=0.10). The use of GAD-alum as compared with placebo did not affect the insulin dose, glycated hemoglobin level, or hypoglycemia rate. Adverse events were infrequent and mild in the three groups, with no significant differences.Treatment with GAD-alum did not significantly reduce the loss of stimulated C peptide or improve clinical outcomes over a 15-month period. (Funded by Diamyd Medical and the Swedish Child Diabetes Foundation; ClinicalTrials.gov number, NCT00723411.).
PROGRESS IN THE UNDERSTANDING OF LUPUS ERYTHEMATOSUS. *
Authors: STEPHEN GOLD
Journal: British Journal of Dermatology (1960)

Journal Article PROGRESS IN THE UNDERSTANDING OF LUPUS ERYTHEMATOSUS. Get access STEPHEN GOLD, M.D., F.R.C.P. STEPHEN GOLD, M.D., F.R.C.P. St. John's Hospital for Diseases of the Skin and the Institute of Dermatology, Lisle Street, London, W.C. 2 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 72, Issue 6, 1 June 1960, Pages 231–239, https://doi.org/10.1111/j.1365-2133.1960.tb13883.x Published: 01 June 1960
Rates of Complications and Mortality in Older Patients With Diabetes Mellitus
Authors: Elbert S. Huang, Neda Laiteerapong, Jennifer Y. Liu, Priya M. John, Howard H. Moffet, Andrew J. Karter
Journal: JAMA Internal Medicine (2013)

In the coming decades, the population of older adults with type 2 diabetes mellitus is expected to grow substantially. Understanding the clinical course of diabetes in this population is critical for establishing evidence-based clinical practice recommendations, identifying research priorities, allocating resources, and setting health care policies. OBJECTIVE To contrast the rates of diabetes complications and mortality across age and diabetes duration categories.
Coagulation Abnormalities in Women Taking Oral Contraceptives
Authors: Angelina C. A. Carvalho
Journal: JAMA (1977)

Thirteen asymptomatic women taking oral contraceptives (OCs) were compared with normal subjects. Platelet aggregation and serotonin (tagged with carbon 14) release with adenosine diphosphate, epinephrine, and collagen did not differ from controls. Activation of the intrinsic coagulation pathway was evaluated by measurements of factor XII, prekallikrein, and kallikrein inhibitors. Women taking OCs had normal factor XII levels, moderately elevated prekallikrein levels, and decreased kallikrein inhibitor levels, a pattern not consistent with activation of the intrinsic pathway. The concentration of heavy molecular weight fibrinogen derivatives (HMWFD) was significantly elevated (P less than .001). In contrast, fibrin and fibrinogen degradation products in serum were lower than normal (P less than .05). The increased HMWFD concentration may reflect activation of the coagulation system not mediated by factor XII activation nor potentiated by decreased antithrombin III. Thus, plasma coagulation abnormalities rather than platelet changes may be the factor that predisposes women taking OCs to thromboembolic disorders.
Advances in Chemotherapy
Authors: Emil Frei
Journal: JAMA (1973)

Chemotherapy is employed as primary treatment for patients with disseminated (stages IIIB and IV) Hodgkin's disease. A number of agents or classes of agents are capable of producing an objective response in patients with Hodgkin's disease. These include the alkylating agents, the periwinkle alkaloids, ie, vincristine sulfate (Oncovin), and vinblastine sulfate (Velban), procarbazine hydrochloride (Natulan [Great Britain]; Matulane, comparable US product), carmustine (BCNU) [1,3, bis (2-chloroethyl)-1-nitrosourea], adriamycin, and the corticosteroids. The time-honored approach has been to employ single agents in sequence starting usually with an alkylating agent and progressing to vinblastine sulfate. An agent was employed until it was clear that response was not going to occur, or until relapse occurred following response, at which point the next agent in sequence was introduced. Basic therapeutic and clinical studies in the leukemias indicate that the therapeutic index can be improved by manipulation of such variables as dose schedules, duration of treatment,
A full complement of receptors in immune complex diseases
Authors: Jeffrey V Ravetch
Journal: Journal of Clinical Investigation (2002)

In this issue of the JCI, Shushakova et al.(1) describe experimental results that provide a direct link between the C5a anaphylotoxin and the IgG Fc receptors (FcγRs) in mediating immune complex-triggered (IC-triggered) inflammatory disease.Using a murine lung model of IC-induced inflammation, the authors demonstrate that C5a, acting through the C5a receptor (C5aR), exacerbates inflammation in part by altering the ratio of activation to inhibitory FcγR expression on alveolar macrophages, enhancing the former and suppressing the latter, thereby optimizing the ability of alveolar macrophages to respond to ICs and trigger cytokine release and neutrophil chemotaxis.C5a now joins the ranks of other regulators of FcγR expression, such as IFN-γ and intravenous immunoglobulin (IVIG), in modulating IC-induced inflammation by acting on the primary IC targets, the FcγRs.What makes this observation worthy of comment is the historical context of IC-mediated inflammation and the confusion that has surrounded the basic mechanism of this fundamental immunological reaction, the Arthus reaction.
Quinine for night cramps.
Authors: J Henry
Journal: BMJ (1985)

counselling.Fellow workers as well as employers should be well informed and concerned.A protective code of practice was thought desirable; but the Manpower Services Commis- sion produced a good one on disability in general last year, and that is not well enough known.7It is highly relevant to epilepsy both on recruitment and on promoting the interests of existing employees.
Controlling Costs: The Case of Kaiser
Authors: Les Zendle
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The article by Drs Grumbach and Bodenheimer on mechanisms for controlling costs<sup>1</sup>raises some interesting theoretical ideas about how organizational factors can be used to influence price, cost, and use. Unfortunately, the use of the Kaiser Permanente Medical Care Program as an example of supply limits to control physician use of magnetic resonance imaging (MRI) examinations is incorrect. It also maligns our program, our physicians, and the processes we use to provide high quality care to our members. Our physicians have worked hard to develop clinical practice guidelines for the use of MRI scans and many other tests and treatments. These guidelines are based on scientific evidence when empirical data are available, and on a formal consensus among our physician experts when empirical data are not sufficient to create evidence-based guidelines. We make MRI machine purchasing decisions based on careful forecasts of need. These forecasts are
Evaluation of the Research Norms of Scientists and Administrators Responsible for Academic Research Integrity
Authors: Stanley G. Korenman
Journal: JAMA (1998)

Context.—The professional integrity of scientists is important to society as a whole and particularly to disciplines such as medicine that depend heavily on scientific advances for their progress.Objective.—To characterize the professional norms of active scientists and compare them with those of individuals with institutional responsibility for the conduct of research.Design.—A mailed survey consisting of 12 scenarios in 4 domains of research ethics. Respondents were asked whether an act was unethical and, if so, the degree to which they considered it unethical and to select responses and punishments for the act.Participants.—A total of 924 National Science Foundation research grantees in 1993 or 1994 in molecular or cellular biology and 140 representatives from the researchers' institutions to the US Department of Health and Human Services Office of Research Integrity.Main Outcome Measures.—Percentage of respondents considering an act unethical and the mean malfeasance rating on a scale of 1 to 10.Results.—A total of 606 research grantees and 91 institutional representatives responded to the survey (response rate of 69% of those who could be contacted). Respondents reported a hierarchy of unethical research behaviors. The mean malfeasance rating was unrelated to the characteristics of the investigator performing the hypothetical act or to its consequences. Fabrication, falsification, and plagiarism received malfeasance ratings higher than 8.6, and virtually all thought they were unethical. Deliberately misleading statements about a paper or failure to give proper attribution received ratings between 7 and 8. Sloppiness, oversights, conflicts of interest, and failure to share were less serious still, receiving malfeasance ratings between 5 and 6. Institutional representatives proposed more and different interventions and punishments than the scientists.Conclusions.—Surveyed scientists and institutional representatives had strong and similar norms of professional behavior, but differed in their approaches to an unethical act.