tbuckley/cabot-search huggingface dataset:
Combination therapy reduces symptoms and joint erosion in rheumatoid arthritis
Authors: Susan Mayor
Journal: BMJ (2004)

The combination of etanercept (a drug that blocks tumour necrosis factor) and methotrexate achieves significantly greater reduction in symptoms and joint erosion than either drug used alone, a trial published in the Lancet last week has found.

The study randomised 686 participants with active, adult onset, rheumatoid arthritis to etanercept (25 mg subcutaneously twice a week) or oral methotrexate (up to 20 mg every week), or a combination of both drugs.

The mean age of the participants was about 53 years, with mean disease duration of 6.3 to 6.8 years (range 6 months to 20 years). All participants …
A vector-based 5 electrode 12-lead ECG (EASI®) is equivalent to the conventional 12-lead ECG for diagnosis of myocardial ischemia
Authors: Gabriele Wehr, Ron Peters, Khalifé Khalife, Adrian Banning, Volker Kuehikamp, Anthony Rickards, Rob Adams, Udo Sechtern
Journal: Journal of the American College of Cardiology (2002)
Are All Significant P Values Created Equal?
Authors: Warren S. Browner
Journal: JAMA (1987)

Just as diagnostic tests are most helpful in light of the clinical presentation, statistical tests are most useful in the context of scientific knowledge. Knowing the specificity and sensitivity of a diagnostic test is necessary, but insufficient: the clinician must also estimate the prior probability of the disease. In the same way, knowing the<i>P</i>value and power, or the confidence interval, for the results of a research study is necessary but insufficient: the reader must estimate the prior probability that the research hypothesis is true. Just as a positive diagnostic test does not mean that a patient has the disease, especially if the clinical picture suggests otherwise, a significant<i>P</i>value does not mean that a research hypothesis is correct, especially if it is inconsistent with current knowledge. Powerful studies are like sensitive tests in that they can be especially useful when the results are negative. Very low<i>P</i>values are like very specific tests; both result in few false-positive results due to chance. This Bayesian approach can clarify much of the confusion surrounding the use and interpretation of statistical tests. (<i>JAMA</i>1987;257:2459-2463)
Misinterpretation of Electrocardiograms and Cardiac Catheterization Laboratory Activations
Authors: Andrew T. Yan
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
Human Reproduction: The Core Content of Obstetrics, Gynecology and Perinatal Medicine
Authors: Larry McGowan
Journal: JAMA (1972)

This textbook presents core material of obstetrics, gynecology, and perinatal medicine within a single volume of modest size. As the authors state, it is difficult, if not impossible, to define the core content of human reproduction in such a way as to please all anatomists, physiologists, geneticists, embryologists, biochemists, obstetrician-gynecologists, and pediatricians. Drs. Page and Villee have, in their opinion, included that body of knowledge which every student should learn irrespective of intended or actual area of specialization. The book includes only the principles of treatment, and leaves the details of medical and surgical therapy for the clinical clerkship, internship, or residency. Infrequent disease entities and variants of specific disorders have been intentionally omitted. Seventeen chapters cover a wide range of topics such as development and anatomy of the female reproductive tract; the female reproductive cycle; family planning; human genetics; fertilization; the placenta and gravid uterus; fetal nutrition and growth;
Abstract 145: 1-Shock Protocol Compared with 3-Stacked-Shock Protocol by Emergency Medical Services Responders in Patients with Bystander-Unwitnessed Out-of-Hospital Shockable Cardiac Arrest
Authors: Tsukasa Yagi, Ken Nagao, Eizo Tachibana, Kei Nishikawa, Naohiro Yonemoto, Morimasa Takayama, Hiroshi Nonogi, Shinichi Shirai, Takeshi Kimura
Journal: Circulation (2011)

BACKGROUND The AHA 2005 and 2010 guidelines for electrical therapy of cardiopulmonary resuscitation (CPR) led to the recommendation of a 1-shock plus immediate CPR instead of a 3-shock sequences in...
Nitrogen Sparing Induced by a Mixture of Essential Amino Acids Given Chiefly as Their Keto-Analogues during Prolonged Starvation in Obese Subjects
Authors: Daniel G. Sapir, Oliver E. Owen, Thomas Pozefsky, Mackenzie Walser
Journal: Journal of Clinical Investigation (1974)

11 normal obese subjects were fasted for 33 days. In five, who served as controls, urine urea nitrogen excretion remained constant for 2 wk thereafter. The other six were given seven daily infusions containing 6-8 mmol each of the alpha-keto-analogues of valine, leucine, isoleucine, phenylalanine, and methionine (as sodium salts) plus 3-4 mmol each of the remaining essential amino acids (lysine, threonine, tryptophan, and histidine). Rapid amination of the infused ketoacids occurred, as indicated by significant increases in plasma concentrations of valine, leucine, isoleucine, alloisoleucine, phenylalanine, and methionine. Glutamine, glycine, serine, glutamate, and taurine fell significantly. Blood glucose, ketone bodies, plasma free fatty acids, and serum immunoreactive insulin concentrations were unaltered. Urine urea nitrogen fell from 1.46 to 0.89 g/day on the last day of infusions; 5 days later it was still lower (0.63 g/day) and in two subjects studied for 9 and 17 days postinfusion it remained below preinfusion control values. Urine ammonia, creatinine, and uric acid were unaltered. Nitrogen balance became less negative during and after infusions. The results indicate that this mixture of essential amino acids and their keto-analogues facilitates nitrogen sparing during prolonged starvation, in part by conversion of the ketoacids to amino acids and in part by altering mechanisms of nitrogen conservation. The latter effect persists after the ketoacids are metabolized.
Percutaneous Direct Cardiac Catheterization
Authors: Morris J. Levy, C. Walton Lillehei
Journal: New England Journal of Medicine (1964)

COMPREHENSIVE assessment of the aortic valve in severe valvular stenosis, in the presence of peripheral arteriosclerosis and in infants is difficult or impossible by the "retrograde" approach through the aortic valve. In these circumstances various technics for puncture of the left ventricle1 , 2 or the left atrium3 4 5 have been applied that have offered less opportunity for selective angiography and have resulted in a relatively higher morbidity and mortality. The transseptal technic6 , 7 offers an excellent and safe approach for assessment of the mitral valve but is less satisfactory for complete aortic-valve evaluation.Our approach consists of introducing a small and short catheter . . .
Increased EP4 Receptor Expression in Colorectal Cancer Progression Promotes Cell Growth and Anchorage Independence
Authors: Simon D. Chell, Ian R. Witherden, Richard R. Dobson, Morganaden Moorghen, Andrew A. Herman, David Qualtrough, Ann C. Williams, Christos Paraskeva
Journal: Cancer Research (2006)

Abstract Cyclooxygenase-2 and prostaglandin E2 (PGE2) levels are increased in colorectal cancers and a subset of adenomas. PGE2 signaling through the EP4 receptor has previously been associated with colorectal tumorigenesis. However, changes in EP4 expression during adenoma to carcinoma progression have not been investigated, neither has whether levels of EP4 influence important markers of malignant potential, such as anchorage-independent growth or the tumors growth response to PGE2. We report using immunohistochemistry that in vivo EP4 receptor protein expression was increased in colorectal cancers (100%) as well as adenomas (36%) when compared with normal colonic epithelium. EP4 expression was also higher in colorectal carcinoma compared with adenoma cell lines and increased with in vitro models of tumor progression. Adenoma (PC/AA/C1 and RG/C2) and carcinoma cell lines (HT29) were growth stimulated by PGE2 up to 0.5 μmol/L. However, although carcinoma and transformed adenoma (PC/AA/C1SB10C, a transformed derivative of PC/AA/C1) cells remain stimulated by higher doses of PGE2 (10 μmol/L), the adenoma cell lines were inhibited. Interestingly, enforced expression of EP4 in the adenoma cell line, RG/C2, resulted in stimulation of growth by 10 μmol/L PGE2 and promoted anchorage-independent growth. Both in vivo and in vitro data from this study suggest that increased EP4 receptor expression is important during colorectal carcinogenesis. We propose that high levels of PGE2 in a tumor microenvironment would select for cells with increased EP4 expression, and that the EP4 receptor may therefore represent an important target for colorectal cancer prevention and treatment. (Cancer Res 2006; 66(6): 3106-13)
Posthumous storage and use of sperm and embryos: survey of opinion of treatment centres
Authors: E. Corrigan, S E. Mumford, M G R Hull
Journal: BMJ (1996)

than the others.The years from 1983 to 1993 were a time of profound change in the NHS, particularly in general practice.It is impossible to pinpoint precise times when changes occurred in the popularity of different careers or to know yet the extent to which cur- rent career choices in this cohort will be sustained.We thank all the doctors who have participated in the study.We thank Karen Hollick, Janet Justice, and Alison Stockford for their accuracy and diligence
The Angelchik Prosthesis and Gastroesophageal Reflux
Authors: JAMES A. SAPALA
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 August 1983The Angelchik Prosthesis and Gastroesophageal RefluxJAMES A. SAPALA, M.D., M. ANDREW SAPALA, M.D., MARIO HURTADO, M.D.JAMES A. SAPALA, M.D.Search for more papers by this author, M. ANDREW SAPALA, M.D.Search for more papers by this author, MARIO HURTADO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-2-280_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We read with interest the report by Kozarek and colleagues on the use of the Angelchik antireflux prosthesis in the treatment of gastroesophageal reflux (1). Their data in ten patients with a 3-month clinical follow-up were similar to our findings in 26 patients with a 6-month follow-up (SAPALA MA, HURTADO MH, JUNG JY, CASSIN BJ, SAPALA JA. Correction of gastroesophageal reflux with the Angelchik antireflux prosthesis—a preliminary report in twenty-six patients. Presented at the Sixth Triennial meeting of the Roy D. McClure Surgical Society, Henry Ford Hospital, Detroit, Michigan, October 1982). In our series, patient satisfaction was...References1. KOZAREKPHELPSSANOWSKIGROBEFREDELL RJRJC. An anti-reflux prosthesis in the treatment of gastroesophageal reflux. Ann Intern Med. 1983;98:310-5. LinkGoogle Scholar2. ISMAIL-BEIGIHORTONPOPE FPC. Histologic consequences of gastroesophageal reflux in man. Gastroenterology. 1970;58:163-74. CrossrefMedlineGoogle Scholar3. STARLINGREICHELDERFERPELLETBELZER JMJF. Treatment of symptomatic gastroesophageal reflux using the Angelchik™ prosthesis. Ann Surg. 1982;195:686-91. CrossrefMedlineGoogle Scholar4. PELOSO O. Intra-abdominal migration of an antireflux prosthesis: a cause of bizarre pain. JAMA. 1982;248:351-3. CrossrefMedlineGoogle Scholar5. SAPALASAPALAHURTADOJUNG MJMJ. A technique for anatomical placement of the Angelchik™ antireflux prosthesis. Surg Gynecol Obstet. In press. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAMES A. SAPALA, M.D.; M. ANDREW SAPALA, M.D.; MARIO HURTADO, M.D.Affiliations: 803 South Superior Street; Albion, MI 49224 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRandomized prospective trial of the Angelchik anti-reflux prosthesisProspective study of the Angelchik anti-reflux prosthesisAssessment of the Angelchik prosthesis for treatment of symptomatic esophageal refluxComplications of the Angelchik antireflux prosthesis 1 August 1983Volume 99, Issue 2Page: 280-280KeywordsGastroesophageal reflux disease ePublished: 1 December 2008 Issue Published: 1 August 1983 PDF downloadLoading ...
Lymphoid reconstitution of the human fetal thymus in SCID mice with CD34+ precursor cells.
Authors: B Péault, I L Weissman, C Baum, J M McCune, A Tsukamoto
Journal: The Journal of Experimental Medicine (1991)

The search for human hematopoietic stem cells has been hampered by the lack of appropriate assay systems. Demonstration of the ability of precursor cell candidates to give rise to T cells is of significant difficulty since dissociated in vitro cultured thymus stroma cells lose their ability to sustain thymocyte maturation. To define further the differentiative capacities of the rare human fetal liver and bone marrow cells that express the CD34 surface antigen and exhibit in vitro myeloid and pre-B cell activities, we have microinjected them into HLA-mismatched fetal thymus fragments, partially depleted of hematopoietic cells by low temperature culture. In vitro colonized thymuses have then been allowed to develop upon engraftment into immunodeficient SCID mice. Using this modification of the SCID-hu system, we show that low numbers of fetal CD34+ progenitor cells can repopulate the lymphoid compartment in the human thymus.
Advance directives are compatible with good medical practice
Authors: S. Finfer
Journal: BMJ (1996)

EDITOR,—Bromley division of the BMA believes that advance directives are incompatible with good medical practice and ethics.1 I disagree strongly with this view.

Good medical practice requires doctors to advise patients of treatment options (including no treatment at all) and the likely outcomes. Patients may then choose the treatment most acceptable to them. This may be not the treatment that produces the best medical outcome but the one that produces the outcome that the patient favours. When patients are mentally incompetent an …
A new method of auditing surgical mortality rates: application to a group of elderly general surgical patients
Authors: R E C Collins
Journal: BMJ (1982)

Sepsis has a well-studied inflammatory phase, with a less-understood secondary immunosuppressive phase. Elevated blood lactate and slow lactate clearance are associated with mortality; however, regulatory roles are unknown. We hypothesized that lactic acid (LA) contributes to the late phase and is not solely a consequence of bacterial infection. No studies have examined LA effects in sepsis models in vivo or a mechanism by which it suppresses LPS-induced activation in vitro. Because mast cells can be activated systemically and contribute to sepsis, we examined LA effects on the mast cell response to LPS. LA significantly suppressed LPS-induced cytokine production and NF-κB transcriptional activity in mouse bone marrow–derived mast cells and cytokine production in peritoneal mast cells. Suppression was MCT-1 dependent and reproducible with sodium lactate or formic acid. Further, LA significantly suppressed cytokine induction following LPS-induced endotoxemia in mice. Because glycolysis is linked to inflammation and LA is a byproduct of this process, we examined changes in glucose metabolism. LA treatment reduced glucose uptake and lactate export during LPS stimulation. LA effects were mimicked by glycolytic inhibitors and reversed by increasing ATP availability. These results indicate that glycolytic suppression and ATP production are necessary and sufficient for LA effects. Our work suggests that enhancing glycolysis and ATP production could improve immune function, counteracting LA suppressive effects in the immunosuppressive phase of sepsis.
To reg or not to reg: that is the question in COPD
Authors: S. Baraldo, M. Saetta
Journal: European Respiratory Journal (2008)

Low tracking error active strategies (often called <i>enhanced active</i> strategies) have fallen out of favor in recent years as investors—keen to avoid wasting money on so-called <i>closet index funds</i>—have gravitated toward higher-risk, more-concentrated strategies or very low-cost index investing. We believe that, compared with other active strategies, enhanced active strategies are considerably underrepresented today and that many investors would benefit from exploring their potential. Recent research has shown that large investors are unable to adequately diversify their active allocations because of policy requirements and—crucially—capacity constraints. Because they are applying an overly narrow, manager-by-manager analysis of active share or active risk, many investors believe that the total risk exposure and return potential of their active allocations justify the fees they are paying for active management. They are often wrong. Our research demonstrates that enhanced active funds, with their significant capacity advantages, can be a highly effective tool to combat the overdiversification of active allocations. As such, we believe that investors should take a broad view of their active portfolios and consider the role that enhanced active strategies can play as a more desirable alternative to highly concentrated active management. <b>TOPICS:</b>Portfolio construction, passive strategies, performance measurement
Serum Angiotensin-Converting Enzyme in Granuloma Annulare
Authors: MICHAEL S. ROHRBACH
Journal: Annals of Internal Medicine (1979)

Letters and Corrections1 March 1979Serum Angiotensin-Converting Enzyme in Granuloma AnnulareMICHAEL S. ROHRBACH, PH.D., STEVEN KOSSARD, M.B., PH.D., R. K. WINKELMANN, M.D.MICHAEL S. ROHRBACH, PH.D.Search for more papers by this author, STEVEN KOSSARD, M.B., PH.D.Search for more papers by this author, R. K. WINKELMANN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-90-3-441_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Lieberman and Rea (1) have recently shown that elevated levels of serum angiotensin-converting enzyme are not confined to patients with sarcoidosis but can also be found in patients with leprosy and Gaucher's disease. In contrast, patients with deep fungal granulomas and tuberculosis usually have normal levels of this enzyme.Granuloma annulare is a cutaneous disorder that shares some of the characteristics of sarcoidosis. Both are granulomas of unknown cause, and elevated levels of serum macrophage migration inhibiting factors have been seen in both (2). Although cutaneous sarcoidosis and generalized granuloma can usually be differentiated clinically, the two...References1. LIEBERMAN J and REA T: Serum angiotensin-converting enzyme in leprosy and coccidioidomycosis. Ann Intern Med 87:422-425, 1977 LinkGoogle Scholar2. UMBERT P, BELCHER R, and WINKELMANN R: Lymphokines (MIF) in serum of patients with sarcoidosis and cutaneous granuloma annulare. Br J Dermatol 95:481-485, 1976 CrossrefMedlineGoogle Scholar3. UMBERT P and WINKELMANN R: Granuloma annulare and sarcoidosis. Br J Dermatol 97:481-486, 1977 CrossrefMedlineGoogle Scholar4. ROHRBACH M: (Glycine-1-14 C) Hippuryl-L-histidyl-L-levucine: a substrate for the radiochemical assay of angiotensin converting enzyme. Anal Biochem 84:272-276, 1978 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MICHAEL S. ROHRBACH, PH.D.; STEVEN KOSSARD, M.B., PH.D.; R. K. WINKELMANN, M.D.Affiliations: Mayo Clinic Rochester, MN 55901 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEffects of canary seed on two patients with disseminated granuloma annulareSPECULATIONS ON THE PATHOGENESIS OF GRANULOMA ANNULARESerum angiotensin converting enzyme in pulmonary diseaseGranuloma annulare 1 March 1979Volume 90, Issue 3Page: 441-441KeywordsAngiotensin converting enzymeEnzymesGranulomasLeprosyMacrophagesSarcoidosis ePublished: 1 December 2008 Issue Published: 1 March 1979 PDF downloadLoading ...
Evidence for the participation of the Ssp-3 antigen in the invasion of nonphagocytic mammalian cells by Trypanosoma cruzi.
Authors: S Schenkman, T Kurosaki, J V Ravetch, V Nussenzweig
Journal: The Journal of Experimental Medicine (1992)

Trypomastigotes of Trypanosoma cruzi have to invade mammalian cells in order to multiply. They bear on their plasma membrane a sialic acid-containing epitope (Ssp-3) defined by a series of monoclonal antibodies (mAbs). Previous investigations have shown that Fab fragments of these mAbs inhibit the attachment of trypomastigotes to 3T3 fibroblasts. To further define the role of Ssp-3 in invasion, here we use, as targets for infection, L cells and CHO cells stably transfected with cDNA coding for the mouse Fc receptors genes. When the trypomastigotes are incubated with small, nonagglutinating amounts of antibodies to Ssp-3, their attachment to the transfected cells is greatly enhanced, without a parallel increase in invasion. The enhancement in attachment is Fc mediated, since it is abolished by treatment of the transfected cells with mAbs to Fc receptors. In contrast, both attachment to, and invasion of, the transfected cells are increased if the parasites are incubated with polyclonal or monoclonal antibodies against T. cruzi surface membrane antigens other than Ssp-3. If, however, antibodies to Ssp-3 are added to the incubation mixtures containing any of the other anti-T. cruzi antibodies, the enhancement of invasion (but not of attachment) is reversed. These results suggest that Ssp-3-bearing molecules participate in the process of parasite internalization.