tbuckley/cabot-search huggingface dataset:
Stopping clinical trials early
Authors: Adrian Grant
Journal: BMJ (2004)

Data monitoring committees may have important role 

H alting high profile trials early has been in the news again this year.1 Legitimate questions have been raised about who decides that a trial should stop early, how they do it, and on what basis they reach such a decision.

Nearly all ongoing randomised clinical trials need some form of data monitoring.2–4 Differences between treatments may be larger than expected or unanticipated adverse effects may occur, and either of these may justify early termination of a trial. Although this has obvious bearing on current and potential participants in the trial, it also has potentially profound wider implications. In particular, the data from the trial may later constitute the evidence base for management of future patients. Hence the data should be sufficiently convincing to the wider clinical and patient community to determine future practice. Those taking a decision to stop a trial early therefore carry a heavy responsibility for ensuring that this would be in the best interests both of the individuals involved in the trial and of society.

Currently only a minority of trials have a formal group, often called a data monitoring committee, whose remit is to monitor a trial's data as they accumulate, …
Diabetes, Parental Diabetes, and Obesity in Oklahoma Indians
Authors: Elisa Lee, Paul S Anderson, John Bryan, Carman Bahr, Thomas Coniglione, Mario Cleves
Journal: Diabetes Care (1985)

The relationship between diabetes and parental diabetes status and obesity in Oklahoma Indians was studied. Data from 2095 adult Oklahoma Indians (1085 type II diabetic subjects and 1010 nondiabetic subjects) through a complete physical examination and personal interview showed a strong association between diabetes and parental diabetes status. Frequency of diabetes among siblings was significantly higher in families with affected parents than those without diabetic parents. No significant difference was found between families with one diabetic parent and those with two diabetic parents. The diabetic individuals were more obese than the nondiabetic individuals at age 18 and at interview. Obesity was defined as percent body mass index &amp;gt;120. After adjusting for possible age and sex effects, the risk of diabetes for the obese was estimated as almost twice that for the nonobese.
Governments pledge to clamp down on counterfeit drugs
Authors: R. Watson
Journal: BMJ (2011)

<h3>Abstract</h3> Mosquitoes are major infectious disease-carrying vectors. Assessment of current and future risks associated with the mosquito population requires knowledge of the full repertoire of pathogens they carry, including novel viruses, as well as their blood meal sources. Unbiased metatranscriptomic sequencing of individual mosquitoes offers a straightforward, rapid and quantitative means to acquire this information. Here, we profile 148 diverse wild-caught mosquitoes collected in California and detect sequences from eukaryotes, prokaryotes, 24 known and 46 novel viral species. Importantly, sequencing individuals greatly enhanced the value of the biological information obtained. It allowed us to a) speciate host mosquito, b) compute the prevalence of each microbe and recognize a high frequency of viral co-infections, c) associate animal pathogens with specific blood meal sources, and d) apply simple co-occurrence methods to recover previously undetected components of highly prevalent segmented viruses. In the context of emerging diseases, where knowledge about vectors, pathogens, and reservoirs is lacking, the approaches described here can provide actionable information for public health surveillance and intervention decisions.
THE FIRST CONGEESS OF THE INTERNATIONAL SOCIETY OF TROPICAL DERMATOLOGY.
Authors: W. H. Jopltng
Journal: British Journal of Dermatology (1964)

Journal Article THE FIRST CONGEESS OF THE INTERNATIONAL SOCIETY OF TROPICAL DERMATOLOGY. Get access W. H. Jopltng W. H. Jopltng Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 76, Issue 8-9, 1 August 1964, Pages 390–391, https://doi.org/10.1111/j.1365-2133.1964.tb14550.x Published: 01 August 1964
Role of intra‐arterial steroid administration in the management of steroid‐refractory acute gastrointestinal graft‐versus‐host disease
Authors: Arafat Tfayli, George Selby, Feroz Maqbool, Walter Bierbaum, Mehdi Hamadani
Journal: American Journal of Hematology (2006)

Abstract We report here a case of severe steroid‐refractory gastrointestinal graft‐versus‐host disease treated with intra‐arterial administration of corticosteroids. A 53‐year‐old female with non‐Hodgkin's lymphoma received peripheral blood hematopoietic stem cell transplant from her HLA‐matched sibling. She developed grade II skin and grade IV gastrointestinal graft‐versus‐host disease with no hepatic involvement. Therapy with oral prednisone easily controlled her skin rash but she had profuse diarrhea that did not respond to high dose intravenous corticosteroids and denileukin diftitox. Infusion of methyl‐prednisolone into superior and inferior mesenteric arteries produced dramatic improvement of diarrhea, with complete resolution of gastrointestinal graft‐versus‐host disease. Am. J. Hematol., 2006, © 2006 Wiley‐Liss, Inc.
Review: Low-quality evidence fails to show that antihypertensive drugs affect outcomes in mild hypertension
Authors: James Brophy
Journal: Annals of Internal Medicine (2012)

ACP Journal Club18 December 2012Review: Low-quality evidence fails to show that antihypertensive drugs affect outcomes in mild hypertensionJames Brophy, MD, FRCP, PhDJames Brophy, MD, FRCP, PhDMcGill University Health Center, Montreal, Quebec, Canada (J.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-12-201212180-02006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationDiao D, Wright JM, Cundiff DK, Gueyffier F. Pharmacotherapy for mild hypertension. Cochrane Database Syst Rev. 2012;(8):CD006742. https://pubmed.ncbi.nlm.nih.gov/22895954Clinical Impact RatingsGIM/FP/GP: Cardiology: Author, Article, and Disclosure InformationAffiliations: McGill University Health Center, Montreal, Quebec, Canada (J.B.)This article was published at Annals.org on 4 December 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAre we using blood pressure-lowering drugs appropriately? Perhaps now is the time for a change 18 December 2012Volume 157, Issue 12Page: JC6-6KeywordsAntihypertensive drug therapyCoronary heart diseaseDatabasesDrugsHypertensionStrokeSystematic reviewsTreatment guidelines ePublished: 18 December 2012 Issue Published: 18 December 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Immunogenetic study of the response to streptococcal carbohydrate antigen of the cell wall in rheumatic fever.
Authors: M Hafez, A Abdalla, F el-Shennawy, Y al-Tonbary, A Sheaishaa, Z el-Morsi, S Tawfik, A Settien, M Abou el-Khair
Journal: Annals of the Rheumatic Diseases (1990)

An immunogenetic study of the response to streptococcal carbohydrate antigen of the cell wall was carried out on members of 15 multiplex families each having more than one sib affected with rheumatic heart disease. They comprised 30 parents and 61 sibs (32 with rheumatic disease and 29 without). Fifty healthy unrelated subjects served as controls. A history was taken and clinical examination carried out. Rheumatic activity was determined and HLA typing was carried out for nine A antigens, 15 B antigens, and six DR antigens. The immune response of lymphocytes to streptococcal polysaccharide antigen of the cell wall of group A beta haemolytic streptococci in vitro was studied by tritiated thymidine uptake. The results were statistically and genetically analysed. It was found that (a) all subjects with rheumatic disease were highly responsive to the streptococcal polysaccharide antigen of the cell wall, the sib pairs being mostly HLA identical; (b) all low responders had no rheumatic disease and their phenotypes were mostly different from those of the rheumatic member of their sib pair; (c) correlation of immune responsiveness (high or low) between HLA-identical sibs was significant, but insignificant between haplotype identical and non-identical sibs; (d) the gene responsible for high responsiveness to the streptococcal polysaccharide antigen of the cell wall is recessive and closely linked to HLA. In conclusion, it was found that exposure to pharyngeal infection with group A beta haemolytic streptococci may lead to acute rheumatic fever in those with an inherited recessive gene responsible for high responsiveness to the streptococcal polysaccharide antigen of the cell wall.
Detection with the polymerase chain reaction of human papillomavirus DNA in condylomata acuminata treated in vitro with liquid nitrogen, trichloroacetic acid, and podophyllin
Authors: Wen-Yuan Zhu, Andrew Blauvelt, Barbara A. Goldstein, Craig Leonardi, Neal S. Penneys
Journal: Journal of the American Academy of Dermatology (1992)

The mechanisms of action for local treatments used against condylomata acuminata are unknown, but most are believed to cause physical destruction of infected tissue.Our purpose was to determine whether liquid nitrogen, trichloroacetic acid (TCA), and podophyllin damage HPV DNA found in condylomata acuminata.Fourteen genital warts were excised from 14 patients and divided. One part was treated with liquid nitrogen, the second and third parts were treated with TCA and podophyllin, respectively, and the remainder served as a control. DNA was then extracted from tissue by proteolytic digestion and amplified by the polymerase chain reaction. Dot blots were performed with the use of radiolabeled consensus and HPV type-specific probes.HPV DNA was amplified and detected in 100% of untreated specimens, in 92% of specimens treated with liquid nitrogen, and in 15% and 7% of specimens treated with podophyllin and TCA, respectively.TCA and podophyllin damage HPV DNA more effectively than does liquid nitrogen.
Differences in Bile Acid Excretion
Authors: BRUCE A. KOTTKE
Journal: Circulation (1969)

Total daily bile acid excretion was measured in 10 patients with primary hypercholesteremia and in nine patients with combined hypercholesteremia and hypertriglyceridemia by using 14 C-labeled cholic acid and 3 H-labeled chenodeoxycholic acid. The average bile acid excretion by the patients with primary hypercholesteremia was 282 mg/day; that by the patients with combined hypercholesteremia and hypertriglyceridemia, 1,094 mg/day. These findings suggest a fundamental difference in cholesterol metabolism in these two types of hyperlipidemia.
Abstract 800: Novel GMDS mutation and clinical estimation of fucosylation in several kinds of human cancer
Authors: Kenta Moriwaki, Saori Tsuda, Shinichiro Shinzaki, Yoichi Furukawa, Eiji Miyoshi
Journal: Cancer Research (2010)

Abstract Oligosaccharides are some of the most important factors in the posttranslational modification of proteins and lipids. It is well known that oligosaccharide structures change during malignant transformation. Fucose is a type of constituent of oligosaccharides, and is notably associated with cancer and inflammation. Fucosylation is catalyzed by several kinds of fucosyltransferases, the GDP-fucose synthetic enzymes, and GDP-fucose transporter. Recently, we found a mutation of the GMDS gene, which involved in the synthesis of GDP-fucose, in a colon cancer cell line, HCT116, leading to a virtually complete deficiency of fucosylation. Down-regulation of cellular fucosylation rendered the cells resistant to tumor necrosis factor-related apotosis-inducing ligand (TRAIL) -induced apoptosis, resulting in the escape from natural killer (NK) cell-mediated tumor immune surveillance. Thus, GMDS and fucosylation are thought to be regulatory factors for TRAIL-induced apoptosis and tumor immune surveillance. In the present study, we searched mutation of the GMDS gene in human cancer cell lines and various kinds of cancer tissues. The aberrant transcripts with deletions of exons 2-4 and 5-7 were detected in the cDNA of LS174T and NCI-H716 cells, respectively. Since these mutations were heterozygous, the deficiency of fucosylation was not observed. In a gastric choriocarcinoma cell line, SCH, only short transcript with deletion of exons 2-4 was detected. This cell line showed a marked decrease in the fucosylation level. PCR and subsequent direct sequencing analyses using 100 human colon cancer tissues identified mutations in two cases. One of the two was c.739 C&amp;gt;T (p.R247X) in exon7, and the other was c.345+5 G&amp;gt;A (IVS4+5) in intron 4. Furthermore, RT-PCR analysis identified aberrant transcripts in 5 of 10 ovarian cancer tissues. All mutant GMDS genes found in this study had no enzymatic activity. Subsequently, the level of fucosylation in many colon cancer tissues was investigated by immunohistochemical analysis using two types of fucosylated oligosaccharide-specific lectin. The decrease of fucosylation was observed in certain cases. Especially, core-fucosylation was decreased in colon cancer with lymph node metastasis. These results suggest that cancer progression in certain patients with colon cancer is dependent on de-fucosylation. Thus, fucosylation is an attractive target for cancer diagnosis and therapy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 800.
The Sloane Hospital Chronicle
Authors: John H. Raach
Journal: JAMA (1964)

This is another worthwhile book in the ever-growing number of historical sketches of notable hospitals in this country and abroad. The author has availed himself of source material such as lecture notes, which are usually neglected in the writing of historical background. His use of personal letters, bylaws, rules and regulations of the Sloane Hospital, minutes of the College of Physicians and Surgeons, as well as of Columbia College, have enabled him to give a first-rate account of the development of this important institution. Dr. Speert has included an excellent introduction in which he traces the development of medical practice and its teaching in the city of New York from colonial days to the 1880's. He continues his discussion of the developments in local medicine whenever circumstances warrant, to explain events at the Sloane. One of the outstanding features is the inclusion of numerous illustrations of people—lay and professional—who were
Legal and Ethical Considerations: Group 4 Report
Authors: A. T. Axon, U. Beilenhoff, T. James, S. D. Ladas, E. Larsen, C. S. Neumann, A. Nowak, R. Schöfl, K. M. Tveit
Journal: Endoscopy (2004)

In the clinical situation patients approach their doctor with a medical problem. The duties of the doctor are clear: he or she has to address the patient’s concerns. The responsibility for establishing the relationship lies with the patient who has approached the doctor. Where screening is concerned, the situation is different. In this case it is a health provider or doctor who approaches normal, fit members of the public, warning them that although they believe themselves to be healthy they may, nevertheless be harboring serious disease but if they are prepared to undergo certain clinical procedures they can abolish or reduce their likelihood of developing it. In this case it is the medical system that has created the interface and it must bear the responsibility for the outcome. Fit, normal people may be seriously disadvantaged or even die as a result of the intervention their medical advisers propose to undertake. The principle ”first do no harm” is in this case subordinated to the concept of providing the greatest benefit for the largest number.
Challenging time ahead for NHS as recession bites and health problems increase
Authors: A. McGauran
Journal: BMJ (2008)

<h3>Objective</h3> To describe the characteristics of sustained improved nutritional outcomes through the use of quality improvement (QI) methodology. <h3>Design</h3> Retrospective analysis of a QI intervention in two institutions, implemented as part of larger national collaboratives. <h3>Setting</h3> Paediatric cystic fibrosis (CF) programmes in academic centres in Alabama and Illinois. <h3>Participants</h3> All paediatric patients enrolled in the CF Foundation (CFF) Patient Data Registry were included. <h3>Interventions</h3> Improved and sustained nutrition outcomes occurred through implementation of the CFF practice guidelines for CF nutrition management via care delivery processes, nutritional interventions, team engagement and data display. <h3>Measurement</h3> Mean body mass index (BMI) percentile, percentage of patients less than 50th percentile and percentage less than 10th percentile for all patients aged 2–20 years were tracked through run charts and statistical process control charts. Mann–Whitney U and χ<sup>2</sup> tests were used to determine significance between each centre and national outcomes. <h3>Results</h3> Each centre achieved rapid improvement in mean BMI percentile in patients, one centre rising from the 40th percentile in 2001 to the 49th percentile in 2003, the other rising from the 37th percentile in 2003 to the 45th percentile in 2004. These centres have also maintained improved nutritional outcomes, so that they were at the 60th and 55th percentiles, respectively, in 2011. Sustained improvement was accomplished through QI methodology, use of data as a driver for improvement and a change in culture. <h3>Conclusions</h3> Participation in collaboratives led to improved nutrition outcomes while a strong culture of QI facilitated sustained improvement.
Against Minimalism in Breast Cancer Follow-up
Authors: Michael D. Wertheimer
Journal: JAMA (1991)

BREAST CANCER in 1990 continues to be a problem of major public health proportions. Approximately 10% of women in the United States (150 000) will be newly diagnosed in 1990 as having breast cancer. Breast cancer is the most common cancer in women and still one of the leading causes of death for adult American women. Approximately 44 000 women will die of breast cancer this year alone.<sup>1</sup>This number approaches the total number of American deaths in the Vietnam Conflict. These stark numbers mask a great deal of suffering and misery that statistics do not adequately portray and that neither clinical oncology nor public policy has been able to influence greatly. Effective prevention strategies are lacking, and research in this area is limited. The approach that has been taken to improve these grim statistics includes mammographic screening for early detection of disease, aggressive primary and adjuvant therapy, and
Continued medical education must not be an optional extra.
Authors: T P Schofield
Journal: BMJ (1987)

Continuing infection is suggested as the cause by the isolation of spirochetes from cerebrospinal and synovial fluid,'5 the identification of spirochetes in synovium" and myocardial tissues,2' and successful treatment of neuro- logical29 and arthritic disease with high dose intravenous penicillin.30Generally the yield of positive cultures has been very low: Steere et al investigated 118 patients, and only four specimens yielded spirochetes-23 specimens of joint fluid synovium and cartilage all gave negative results.3'Early treatment with antibiotics (tetracycline or penicillin) stops the disease's course.3233For adults the treatnent is tetracycline (250 mg four times daily for 10 days) and for children phenoxymethylpenicillin (50 mg/kg daily in divided doses).None of 39 patients treated with tetracycline developed late complications of the disease compared with 8% of those given penicillin and 14% given erythromycin."Here in Connecticut the spirochete is progressing relent- lessly up the Connecticut River valley into the heart of the state.In 1985 the state health laboratory recorded 863 new cases, and those of us in practice here see more cases each year.The rapid reporting of four cases in Britain shows that Lyme disease has now arrived in old England, too, and the disease may spread just as relentlessly.
Responding to Requests for Physician-Assisted Suicide
Authors: Michael W. Rabow, Amy J. Markowitz
Journal: JAMA (2002)

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
Fatal and Nonfatal Cardiovascular Disease and the Use of Therapies for Secondary Prevention in a Rural Region of India
Authors: Rohina Joshi, Clara K. Chow, P. Krishnam Raju, Rama Raju, K. Srinath Reddy, Stephen MacMahon, Alan D. Lopez, Bruce Neal
Journal: Circulation (2009)

Background— The rate of cardiovascular disease is widely considered to be increasing throughout India. Precise and reliable data on fatal and nonfatal cardiovascular disease, however, are few, and little is known about the use of preventive therapies. This is particularly true for rural regions. Methods and Results— Data were collected from 53 villages in the Godavari region of Andhra Pradesh. Mortality data were obtained from a verbal autopsy-based mortality surveillance system during a 12-month period in 2003 to 2004. The prevalence of nonfatal cardiovascular disease and the use of preventive therapies were estimated from a stratified random sample of 4535 adults (≥30 years of age) in 2005. Cardiovascular disease was the leading cause of mortality, accounting for at least 32% of all deaths. The average age at cardiovascular death was 65 years, and 51% of all cardiovascular deaths occurred in patients &lt;70 years of age. Among adults, the prevalence of coronary heart disease was estimated to be 4.8% (95% CI, 4.1 to 5.5), and the prevalence of cerebrovascular disease was estimated at 2.0% (95% CI, 1.5 to 2.4). Among individuals with either diagnosis, 14% (95% CI, 10 to 18) reported taking aspirin, 41% (95% CI, 36 to 47) took a blood pressure-lowering medication, and 5% (95% CI, 3 to 7) reported using a cholesterol-lowering medication. Conclusion— This region has a large disease burden attributable to cardiovascular disease with significant underuse of proven, low-cost preventive medications.