tbuckley/cabot-search huggingface dataset:
Denial of effective treatment and poor quality of clinical information in placebo controlled trials of ondansetron for postoperative nausea and vomiting: a review of published trials
Authors: R. L Aspinall, N. W Goodman
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To determine how many patients were deprived of treatment by being given placebo as comparator in trials of ondansetron for postoperative nausea and vomiting. <b>Design</b>: Review of published trials of ondansetron during 1991 to July 1994. <b>Setting</b>: Medline search in a university department of anaesthesia. <b>Subjects</b>: 8806 patients who had been included in 18 indexed placebo controlled trials of ondansetron as prophylaxis against or treatment of postoperative nausea and vomiting. <b>Results</b>: Five studies (1236 patients) had been published by July 1992. All were placebo controlled trials. By July 1994, 8806 patients had been included in 18 indexed placebo controlled studies of prophylaxis or treatment. Only 462 patients had been in studies that compared ondansetron with other drugs, and there were no indexed comparative trials of treatment of nausea and vomiting. Roughly 2180 patients had been given placebo as prophylaxis and 440 had been given placebo when already experiencing postoperative nausea or vomiting. <b>Conclusions</b>: Around 2620 patients in the reviewed studies were denied existing drugs, which, though not completely effective or without side effects, do bring some relief from postoperative nausea and vomiting. Drug regulatory bodies should collaborate with drug companies to ensure better comparison of new with established drugs. This would avoid placebos being given to more than the fewest patients necessary to confirm effect and would allow doctors to be informed more quickly about relative efficacies.
Tolerance of elemental diet administered without starter regimen.
Authors: R G Rees, P P Keohane, G K Grimble, P G Frost, H Attrill, D B Silk
Journal: BMJ (1985)

had a blood pressure persistently greater than 140/90 mm Hg except the one patient being treated for hypertension.A family history of coronary heart disease was obtained in 22 cases. CommentHigh consumption of cigarettes, high serum cholesterol concentra- tion, and high relative body weight appear to be the main risk factors for coronary heart disease in young soldiers.The low prevalence of hypertension and glucose intolerance may reflect the fact that these two risk factors, and possibly gross obesity, preclude recruitment.Only insulin dependent diabetes results in premature discharge from the service; other risk factors are managed in the normal way.A positive family history is no more common in soldiers than civilians.The table shows the high cigarette consumption of young soldiers with coronary heart disease compared with healthy soldiers and healthy civilians.Smoking habit of young soldiers with coronary heart disease, healthy soldiers, and healthy civilians Average 01 Of No of Percent consuming: smokers cigarettes smoked/ 201/ .30140/ day day day day Soldiers with coronary heart disease 95 28 85 45 28 Healthy soldiers"* 60 21 52 12 Healthy civilians4 45 18 21
Bile canalicular morphometry in arteriohepatic dysplasia
Authors: C. L. Witzleben, Milton Finegold, David A. Piccoli, William R. Treem
Journal: Hepatology (1987)

The diagnosis of arteriohepatic dysplasia may be difficult, particularly in very young patients with no family history, and the pathogenesis of the disorder remains obscure. It has been reported that the typical ultrastructural changes of cholestasis are scant in this condition and proposed that there is a failure of the hepatocytes to secrete bile into the canaliculi. In an attempt to expand on these observations and to test the value of ultrastructure as a differential diagnostic test for this condition, we chose two parameters felt to be associated with cholestasis that could be reliably and relatively simply determined by ultrastructural morphometry: canalicular dilatation and loss of canalicular microvilli. The values for these parameters were compared in arteriohepatic dysplasia with those in other infantile cholestatic conditions and with those in noncholestatic controls. The results of these morphometric studies corroborated the previous observation that canalicular dilatation in arteriohepatic dysplasia is minimal. There was, however, only a marginal difference in canalicular area between patients with arteriohepatic dysplasia and those with extrahepatic biliary atresia. There was significant overlap of values for canalicular area among all groups. Surprisingly, the studies showed no real loss of canalicular microvilli in any of the cholestatic conditions. The findings suggest that, at least for these two parameters, caution should be exercised in using qualitative electron microscopic evaluation as a diagnostic test for arteriohepatic dysplasia.
MicroRNA and proliferation control in chronic lymphocytic leukemia: functional relationship between miR-221/222 cluster and p27
Authors: Michela Frenquelli, Marta Muzio, Cristina Scielzo, Claudia Fazi, Lydia Scarfò, Claudia Rossi, Giuliana Ferrari, Paolo Ghia, Federico Caligaris-Cappio
Journal: Blood (2010)
Total serum IgD is increased in atopic subjects
Authors: Z. PENG, R. FISHER, N. FRANKLIN ADKINSON
Journal: Allergy (1991)

We have developed a sandwich-type ELISA system for measuring total IgD levels in the serum of atopics and non-atopic controls. In this ELISA system, affinity purified goat anti-human IgD was used for capture. Results were superior to those obtained with monoclonal anti-human IgD antibody. No cross-reactivity could be demonstrated to IgG, IgM, IgA or IgE. The assay showed minimal non-specific binding even with initial serum dilutions of 1:2. The results obtained were reproducible among replicates (Mean CV +/- SEM = 0.03 +/- 0.002; n = 251), between dilutions (CV = 0.08 +/- 0.006; n = 108), and between assays (CV = 0.05 +/- 0.12; n = 5). We used routine radioimmunoassay for measuring total serum IgE. Using these assays total serum IgD and IgE levels were measured in 75 atopic patients and 33 normal subjects. None of the atopics had recent immunotherapy. As expected, the geometric mean serum IgE in atopics (373 ng/ml) was significantly higher than that in normal subjects (49 ng/ml) (P less than 0.01). However, geometric mean serum IgD was also significantly higher in atopics (20.3 micrograms/ml) than that in normal subjects (8.4 micrograms/ml) (P less than 0.02). In both atopic and normal groups, mean serum IgD level did not differ significantly on the bases of age, sex or asthmatic status. Furthermore, total serum IgD was not significantly correlated with total serum IgE (r = 0.14; P = 0.14; n = 108), indicating that immunoregulatory control of the basal levels of the two isotypes is not linked.(ABSTRACT TRUNCATED AT 250 WORDS)
A Clinical Estimation of the Blood Pressure in the Minute Vessels of the Human Skin by the Method of Elevation and Reactive Hyperemia
Authors: RUTHERFORD S. GILFILLAN, NORMAN E. FREEMAN, FRANK H. LEEDS
Journal: Circulation (1954)

The filling pressure in the minute vessels of the skin of the foot has been estimated by a method of elevation and reactive hyperemia. A series of 90 observations was made on 78 patients. This test has been found helpful in evaluating the degree of arterial insufficiency, permitting a more accurate selection of patients to be treated by conservative methods, local amputation or more radical procedures.
THE ALLEGED PURIFICATION OF AIR BY THE OZONE MACHINE
Authors: HELEN L. BECKWITH
Journal: JAMA (1913)

The experiments of a number of careful investigators have discredited the claims made for ozone as a purifier of air. Largely on the basis of claims already disproved, several manufacturers are so successful in introducing ozone machines into public buildings that this purposeful adulteration of the air with ozone and its accompanying impurities threatens to become a public health problem. Ohlmüller<sup>1</sup>demonstrated that ozone in considerable strength was incapable of killing dry bacteria within the time-limits of his tests. Erlandsen and Schwarz<sup>2</sup>showed the falsity of the claim that the presence of free ozone means the absence of organic impurity in the air. They demonstrated, through careful analyses, that ammonia and hydrogen sulphid were not diminished in amount by the presence of ozone. They showed also that the deodorizing property of ozone consisted of the masking of one odor with another. In their experiments with a number of
Adult respiratory distress syndrome in Leptospira canicola infection.
Authors: M Zaltzman, J M Kallenbach, G D Goss, M Lewis, S Zwi, J H Gear
Journal: BMJ (1981)

Our understanding of the neural basis of perceptual decision making has been built in part on relating co-fluctuations of single neuron responses to perceptual decisions on a trial-by-trial basis. The strength of this relationship is often compared across neurons or brain areas, recorded in different sessions, animals, or variants of a task. We sought to extend our understanding of perceptual decision making in three ways. First, we measured neuronal activity simultaneously in early [primary visual cortex (V1)] and midlevel (V4) visual cortex while macaque monkeys performed a fine orientation discrimination perceptual task. This allowed a direct comparison of choice signals in these two areas, including their dynamics. Second, we asked how our ability to predict animals9 decisions would be improved by considering small simultaneously-recorded neuronal populations rather than individual units. Finally, we asked whether predictions would be improved by taking into account the animals9 choice and reward histories, which can strongly influence decision making. We found that responses of individual V4 neurons were weakly predictive of decisions, but only in a brief epoch between stimulus offset and the indication of choice. In V1, few neurons showed significant decision-related activity. Analysis of neuronal population responses revealed robust choice-related information in V4 and substantially weaker signals in V1. Including choice- and reward-history information improved performance further, particularly when the recorded populations contained little decision-related information. Our work shows the power of using neuronal populations and decision history when relating neuronal responses to the perceptual decisions they are thought to underlie. <b>SIGNIFICANCE STATEMENT</b> Decades of research has provided a rich description of how visual information is represented in the visual cortex. Yet how cortical responses relate to visual perception remains poorly understood. Here we relate fluctuations in small neuronal population responses, recorded simultaneously in primary visual cortex (V1) and area V4 of monkeys, to perceptual reports in an orientation discrimination task. Choice-related signals were robust in V4, particularly late in the behavioral trial, but not in V1. Models that include both neuronal responses and choice-history information were able to predict a substantial portion of decisions. Our work shows the power of integrating information across neurons and including decision history in relating neuronal responses to perceptual decisions.
A Syndrome Resembling Pheochromocytoma Following a Stroke
Authors: Richard M. Mazey
Journal: JAMA (1974)

A 38-year-old hypertensive patient suffered a stroke. Pheochromocytoma was suspected because of the clinical history, an extremely labile blood pressure that responded to therapy with a-adrenergic blocking agents, and elevated vanillylmandelic acid (VMA) and catecholamine excretion rates. However, on the basis of a surgical exploration that showed no evidence of a tumor and subsequently normal VMA excretion rates, pheochromocytoma proved to be unlikely. We recommend caution in making the diagnosis of pheochromocytoma within several months of cerebrovascular accident. (<i>JAMA</i>230:575-577, 1974)
The Poor Quality of Early Evaluations of Magnetic Resonance Imaging
Authors: Lawton S. Cooper
Journal: JAMA (1988)

To study the quality of early research on the clinical efficacy of diagnostic imaging with magnetic resonance, we assessed 54 evaluations published in the first four years after introduction of this modality using ten commonly accepted criteria of research methodology. The terms sensitivity, specificity, false-positive or false-negative, accuracy, and predictive values were used infrequently. Nineteen percent of the evaluations used three terms appropriately, 48% used one or two terms, and 33% used none. Data were presented appropriately for one or more of the five terms in 59% of evaluations. A "gold standard" comparison with the results of an independent procedure, such as surgical or autopsy findings, was presented in 22% of evaluations. Results of another imaging procedure were described in 63% of evaluations. Only one evaluation clearly described a prospective study design, although 11 evaluations apparently were planned in advance. Not one evaluation contained an appropriate statistical analysis of the distributions of quantitative readings, "blinded" image readers to diagnosis or other test results, measured observer error, or randomized the order of magnetic resonance imaging and other imaging procedures. We conclude that health care professionals paying for expensive innovative diagnostic technology should demand better research on diagnostic efficacy.
Native Medicine in Viet Nam
Authors: Carl E. Bertecchi
Journal: JAMA (1966)

<h3>To the Editor:—</h3> In the short period of time prior to my departure for Viet Nam, I searched for information that would help acquaint me with some of the medical practices of the Vietnamese people. I was able to find two articles that dealt with practices generally found in that part of the world. I was to be stationed at one of the more rural areas of the country, where knowledge of practices would have been extremely helpful. My location in Viet Nam is near Soc Trang, a town of about 40,000 people in the Mekong Delta region of the country, about 130 miles southwest of Saigon. My particular function at the Soc Trang Military Compound is as a US Army flight surgeon. Because of the nature of my mission in Army Aviation, I have had countless opportunities to travel throughout the delta in medical ambulances and combat helicopters. These
Observations ON THE PNEUMONOCONIOSES
Authors: E. H. Kettle
Journal: BMJ (1932)

Although dust diseases of the lung have been recognized in this country for many years, for most of our exact knowledge of the pathology of the condition we have to consult South African experience, because, for reasons into which I need not enter here, an intensive study of pneumonoconiosis has been carried out in Johannesburg for the last twenty years in a way which has not been ap proached in any other part of the world. But South African workers have had to consider only one form of pneumonoconiosis?that due to the presence in the atmo sphere of the Rand mines of crystalline silica in a high degree of concentration. In this country we have to deal with various trades and industries in which a comparable atmospheric pollution occurs. But this is only part of our problem. In many industries the workers are exposed to dusty atmospheres into the composition of which silica does not enter at all, or only in a minor degree, and such questions are constantly arising as : Is silica the only form of dust capable of producing pneumono coniosis? Must the silicon be present as silica, the dioxide of silicon, or is it. dangerous when in the form of a silicate? Is the action of silica modified by the presence of other dusts, and, if so, is this modification merely a matter of dilution, or do the adulterant dusts specifically inhibit or alter the action of the silica? What action on the lung, if any, have non-siliceous dusts if inhaled over a considerable period of time? It might be supposed that these and similar questions are capable of being answered by ordinary human and medical experience, but, if only for the sake of argument, I am prepared to adopt a rafher extreme attitude/ and to assert that our human and medical experience in these matters is so conflicting and so poorly substantiated by definite facts as to be worth very little. I am not very impressed by the accuracy of the mortality statistics which represent the scientific data on which many generalizations about pneumonoconiosis have been based, and until we have at our disposal a mass of statistics composed of the correlated observations of the clinician, the radiologist, and the pathologist, we shall be wise in approaching the problems with unprejudiced minds. I do not wish to labour the point, but to take only one instance, the work of Cummins and Sladden1?of which no doubt we shall hear more later?dangerously disturbs the doctrine of the immunity of the coal miner to sili cosis, and all that that implies. If we are to answer the questions formulated above we must build up our own statistics, and must supplement our observations on the human being by recourse to experimental animals.
IMPACT OF FEE-FOR-SERVICE VERSUS MANAGED CARE HEALTH PLANS ON OUTCOMES OF PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION
Authors: Puja Parikh, Luis Gruberg, Allen Jeremias, Srihari S. Naidu, Richard A. Shlofmitz, Sorin J. Brener, Thomas Pappas, Kevin P. Marzo, David L. Brown
Journal: Journal of the American College of Cardiology (2011)
Sample size determinations in original research protocols for randomised clinical trials submitted to UK research ethics committees: review
Authors: T. Clark, U. Berger, U. Mansmann
Journal: BMJ (2013)

<b>Objectives</b> To assess the completeness of reporting of sample size determinations in unpublished research protocols and to develop guidance for research ethics committees and for statisticians advising these committees. <b>Design</b> Review of original research protocols. <b>Study selection</b> Unpublished research protocols for phase IIb, III, and IV randomised clinical trials of investigational medicinal products submitted to research ethics committees in the United Kingdom during 1 January to 31 December 2009. <b>Main outcome measures</b> Completeness of reporting of the sample size determination, including the justification of design assumptions, and disagreement between reported and recalculated sample size. <b>Results</b> 446 study protocols were reviewed. Of these, 190 (43%) justified the treatment effect and 213 (48%) justified the population variability or survival experience. Only 55 (12%) discussed the clinical importance of the treatment effect sought. Few protocols provided a reasoned explanation as to why the design assumptions were plausible for the planned study. Sensitivity analyses investigating how the sample size changed under different design assumptions were lacking; six (1%) protocols included a re-estimation of the sample size in the study design. Overall, 188 (42%) protocols reported all of the information to accurately recalculate the sample size; the assumed withdrawal or dropout rate was not given in 177 (40%) studies. Only 134 of the 446 (30%) sample size calculations could be accurately reproduced. Study size tended to be over-estimated rather than under-estimated. Studies with non-commercial sponsors justified the design assumptions used in the calculation more often than studies with commercial sponsors but less often reported all the components needed to reproduce the sample size calculation. Sample sizes for studies with non-commercial sponsors were less often reproduced. <b>Conclusions</b> Most research protocols did not contain sufficient information to allow the sample size to be reproduced or the plausibility of the design assumptions to be assessed. Greater transparency in the reporting of the determination of the sample size and more focus on study design during the ethical review process would allow deficiencies to be resolved early, before the trial begins. Guidance for research ethics committees and statisticians advising these committees is needed.
Teaching the Perception of Expressive Aspects of Vocal Communication
Authors: MURRAY ALPERT, WILLIAM A. FROSCH, SAUL H. FISHER
Journal: American Journal of Psychiatry (1967)

In an effort to direct the attention of residents to important aspects of the patient's expressive communication, the authors present methods which are designed to help the novice focus on the infracontent aspects of the patient's vocal productions by removing confusing, conflicting, or more insistent cues or content. These methods include manipulation of temporal, intensity, frequency, and intelligibility aspects of the voice signal.
Dysregulation of glutathione synthesis during cholestasis in mice: Molecular mechanisms and therapeutic implications
Authors: Heping Yang, Komal Ramani, Meng Xia, Kwang Suk Ko, Tony W.H. Li, Pilsoo Oh, Jiaping Li, Shelly C. Lu
Journal: Hepatology (2009)

Glutathione (GSH) provides important antioxidant defense and regulates multiple critical processes including fibrogenesis. There are conflicting literature studies regarding changes in GSH during cholestasis. Here we examined changes in the GSH synthetic enzymes during bile duct ligation (BDL) in mice and how treatment with ursodeoxycholic acid (UDCA) and/or S-adenosylmethionine (SAMe) affects the expression of these enzymes and liver injury. The hepatic expression of glutamate-cysteine ligase (GCL) subunits and GSH synthase (GS) increased transiently after BDL but fell to 50% of baseline by 2 weeks. Nuclear factor-erythroid 2-related factor 2 (Nrf2) trans-activates gene expression by way of the antioxidant response element (ARE), which controls the expression of all three genes. Despite increased Nrf2 nuclear levels, Nrf2 nuclear binding to ARE fell 2 weeks after BDL. Nuclear levels of c-Maf and MafG, which can negatively regulate ARE, were persistently induced during BDL and the dominant proteins bound to ARE on day 14. UDCA and SAMe induced the expression of GCL subunits and raised GSH levels. They increased nuclear Nrf2 levels, prevented c-Maf and MafG induction, and prevented the fall in Nrf2 nuclear binding to ARE. Combined treatment had additive effects, reduced liver cell death, and prevented fibrosis. Conclusion: GSH synthesis falls during later stages of BDL due to lower expression of GSH synthetic enzymes. UDCA and SAMe treatment prevented this fall and combined therapy was more effective on preserving GSH levels and preventing liver injury. (HEPATOLOGY 2009.)
Resistance to Antiviral Drugs: The End of Innocence
Authors: Martin S. Hirsch, Robert T. Schooley
Journal: New England Journal of Medicine (1989)

Until recently, the problem of resistance to antiviral drugs has been more potential than real. Although individual reports of resistant viruses have appeared, such isolates have been rare and usually of low virulence. The articles by Erlich et al.1 and Erice et al.2 in this issue of the Journal, as well as reports published elsewhere,3 , 4 indicate that the situation has changed dramatically. Progressive disease due to acyclovir-resistant herpes simplex virus and to ganciclovir-resistant cytomegalovirus in patients with the acquired immunodeficiency syndrome (AIDS) or who are otherwise immunocompromised is now a reality with important ramifications.Resistance of herpes simplex virus . . .