tbuckley/cabot-search huggingface dataset:
Differential Effectiveness of Placebo Treatments
Authors: Karin Meissner, Margrit Fässler, Gerta Rücker, Jos Kleijnen, Asbjorn Hróbjartsson, Antonius Schneider, Gerd Antes, Klaus Linde
Journal: JAMA Internal Medicine (2013)

<h3>Importance</h3> When analyzing results of randomized clinical trials, the treatment with the greatest specific effect compared with its placebo control is considered to be the most effective one. Although systematic variations of improvements in placebo control groups would have important implications for the interpretation of placebo-controlled trials, the knowledge base on the subject is weak. <h3>Objective</h3> To investigate whether different types of placebo treatments are associated with different responses using the studies of migraine prophylaxis for this analysis. <h3>Design, Setting, and Participants</h3> We searched relevant sources through February 2012 and contacted the authors to identify randomized clinical trials on the prophylaxis of migraine with an observation period of at least 8 weeks after randomization that compared an experimental treatment with a placebo control group. We calculated pooled random-effects estimates according to the type of placebo for the proportions of treatment response. We performed meta-regression analyses to identify sources of heterogeneity. In a network meta-analysis, direct and indirect comparisons within and across trials were combined. Additional analyses were performed for continuous outcomes. <h3>Exposure</h3> Active migraine treatment and the placebo control conditions. <h3>Main Outcomes and Measures</h3> Proportion of treatment responders, defined as having an attack frequency reduction of at least 50%. Other available outcomes in order of preference included a reduction of 50% or greater in migraine days, the number of headache days, or headache score or a significant improvement as assessed by the patients or their physicians. <h3>Results</h3> Of the 102 eligible trials, 23 could not be included in the meta-analyses owing to insufficient data. Sham acupuncture (proportion of responders, 0.38 [95% CI, 0.30-0.47]) and sham surgery (0.58 [0.37-0.77]) were associated with a more pronounced reduction of migraine frequency than oral pharmacological placebos (0.22 [0.17-0.28]) and were the only significant predictors of response in placebo groups in multivariable analyses (<i>P</i> = .005 and<i>P</i> = .001, respectively). Network meta-analysis confirmed that more patients reported response in sham acupuncture groups than in oral pharmacological placebo groups (odds ratio, 1.88 [95% CI, 1.30-2.72]). Corresponding analyses for continuous outcomes showed similar findings. <h3>Conclusions and Relevance</h3> Sham acupuncture and sham surgery are associated with higher responder ratios than oral pharmacological placebos. Clinicians who treat patients with migraine should be aware that a relevant part of the overall effect they observe in practice might be due to nonspecific effects and that the size of such effects might differ between treatment modalities.
Photochemotherapy of Psoriasis
Authors: Leonard C. Harber
Journal: New England Journal of Medicine (1974)

Psoriasis remains a puzzling cutaneous disease of unknown origin that often becomes resistant to standard therapy. Though certainly not a fatal disorder, psoriasis subjects its victims to definite morbidity, and it has been estimated that in excess of 1.5 million days of disability result from this skin disease each year.1 The pathophysiology of psoriasis is not yet clear although fundamental derangements of epidermal proliferative activity have been demonstrated in recent years.2 The epidermis of man, which, as far as is known, is uniquely susceptible to psoriasis, is a rapidly replicating living tissue that, in normal skin, has a turnover time . . .
Uncommon abdominal muscle injury in a tennis player: internal oblique strain: Figure 1
Authors: J Maquirriain, J P Ghisi
Journal: British Journal of Sports Medicine (2006)

The case of a strain injury of the internal oblique abdominal muscle in a professional tennis player is presented. This uncommon lesion resulted from eccentric, unbalanced trunk rotation. Magnetic resonance imaging helped to confirm the diagnosis. Tennis specific core strengthening is crucial for rehabilitation and recurrence prevention.
Hypertensive Work-ups
Authors: Michael Anteski
Journal: JAMA (1975)

<h3>To the Editor.—</h3> I have some criticisms of Dr. Melby's defense of the rationale in favor of doing extensive hypertensive work-ups (231:399, 1975) that were not mentioned in the rebuttal by Dr. Finnerty (231-402, 1975). First, Dr. Melby implies in context that all secondary hypertension is "curable" hypertension. This is a greatly overoptimistic stand, especially in the group of renovascular anomalies and abnormalities, the most common subgroup of conditions causing secondary hypertension. Second, in presenting data on Dr. Laragh's work in high-, normal-, and low-renin hypertension as an additional support in favor of the extensive work-up, he did not mention the considerable body of authoritative opinion, based on good studies, that in the last year have tended to refute Laragh's results or at least render them tentative. The general impression of most clinicians, that Laragh's data are not generally reproducible and not yet applicable to the current clinical therapeutic setting,
Cyclic β-1,2-glucan is a brucella virulence factor required for intracellular survival
Authors: Beatriz Arellano-Reynoso, Nicolas Lapaque, Susana Salcedo, Gabriel Briones, Andrés Eduardo Ciocchini, Rodolfo Ugalde, Edgardo Moreno, Ignacio Moriyón, Jean-Pierre Gorvel
Journal: Nature Immunology (2005)
The Doctor's Role in a Permissive Society — In Conflict with the G.M.C. — The Tattoo Sign
Authors: John Lister
Journal: New England Journal of Medicine (1972)

THE medical profession cannot escape the side effects of modern permissive society. Although there has been a great decline in the influence of the church and to a less extent of family life, the doctor is still frequently called upon to act as counselor and friend, and if he has the courage to take advantage of his opportunities, he may be able to influence the attitude of his patients, who after all are the public and the society of which we are all a part. There may be a lack of agreement on the extent to which he should attempt . . .
Gastrocolic fistula complicating benign peptic ulceration.
Authors: D. N. Glass
Journal: BMJ (1967)

evidence not fit the conclusions ?Presumably the latter, since Tow's other current report' on the same series concludes "in a half the cases a primary uterine growth was absent " and " hysterectomy did not improve the survival in pulmonary choriocarcinoma.This is in agree- ment with . . ." The virtually simultaneous presentation of totally opposite conclusions, drawn from the same data, must cast doubt on their value.In this unit we see patients who have undergone elective hysterectomy in the hope of promoting spontaneous regression, or to confirm a diagnosis already apparent, and they sometimes die before effective chemo- therapy can be given.Metastases from choriocarcinoma may have a volume-doubling time of 2 to 4 days, so that a 15-to 30-fold increase in the early postoperative phase can occur.This is not prevented by operative " cytotoxic cover," which in any case may prejudice the effectiveness of these drugs when used later.A suspicion of chorio- carcinoma presents an emergency ; but, unless the uterus has perforated, hysterectomy is better deferred.Tow and Cheng's paper would seem to be the strongest possible argument for the investigation and treatment of uncommon diseases such as choriocarcinoma in specialized centres.-I am, etc.,
Coronary Artery Anomalies
Authors: HU A. BLAKE, WILLIAM C. MANION, THOMAS W. MATTINGLY, GIORGIO BAROLDI
Journal: Circulation (1964)

Twenty-two selected anomalies of the coronary arteries are related to cases previously reported in the literature. These are presented with simplified drawings and photographs in an attempt to provide a workable understanding of the practical problems such create for both the internist and surgeon.
Combination of Myostatin Pathway Interference and Dystrophin Rescue Enhances Tetanic and Specific Force in Dystrophic mdx Mice
Authors: Julie Dumonceaux, Solenne Marie, Cyriaque Beley, Capucine Trollet, Alban Vignaud, Arnaud Ferry, Gillian Butler-Browne, Luis Garcia
Journal: Molecular Therapy (2010)

Duchenne muscular dystrophy is characterized by muscular atrophy, fibrosis, and fat accumulation. Several groups have demonstrated that in the mdx mouse, the exon-skipping strategy can restore a quasi-dystrophin in almost 100% of the muscle fibers. On the other hand, inhibition of the myostatin pathway in adult mice has been described to enhance muscle growth and improve muscle force. Our aim was to combine these two strategies to evaluate a possible additive effect. We have chosen to inhibit the myostatin pathway using the technique of RNA interference directed against the myostatin receptor AcvRIIb mRNA (sh-AcvRIIb). The restoration of a quasi-dystrophin was mediated by the vectorized U7 exon-skipping technique (U7-DYS). Adeno-associated vectors carrying either the sh-AcvrIIb construct alone, the U7-DYS construct alone, or a combination of both constructs were injected in the tibialis anterior (TA) muscle of dystrophic mdx mice. We show that even if each separate approach has some effects on muscle physiology, the combination of the dystrophin rescue and the downregulation of the myostatin receptor is required to massively improve both the tetanic force and the specific force. This study provides a novel pharmacogenetic strategy for treatment of certain neuromuscular diseases associated with muscle wasting.
Immunohistochemistry in diagnostic dermatopathology
Authors: Michael L. Wallace, Bruce R. Smoller
Journal: Journal of the American Academy of Dermatology (1996)

Immunopathology continues to be important in diagnostic dermatopathology. Immunopathologyis an invaluable tool for assessing the tissue of origin or direction of differentiation of cells. In some cases this can result in a more precise diagnosis. This article reviews the role of immunopathology in determining the biologic behavior of hematolymphoid infiltrates. It explores the methodology of immunoperoxidase, discusses the most commonly used antibody reagents, and presents a series of diagnostic dilemmas in which immunopathology can be useful. In each case a strategy is established that maximizes the likelihood of making a definitive diagnosis. Immunopathology continues to be important in diagnostic dermatopathology. Immunopathologyis an invaluable tool for assessing the tissue of origin or direction of differentiation of cells. In some cases this can result in a more precise diagnosis. This article reviews the role of immunopathology in determining the biologic behavior of hematolymphoid infiltrates. It explores the methodology of immunoperoxidase, discusses the most commonly used antibody reagents, and presents a series of diagnostic dilemmas in which immunopathology can be useful. In each case a strategy is established that maximizes the likelihood of making a definitive diagnosis.
SCA1-like Disease in Mice Expressing Wild-Type Ataxin-1 with a Serine to Aspartic Acid Replacement at Residue 776
Authors: Lisa Duvick, Justin Barnes, Blake Ebner, Smita Agrawal, Michael Andresen, Janghoo Lim, Glenn J. Giesler, Huda Y. Zoghbi, Harry T. Orr
Journal: Neuron (2010)
STUDIES ON THE MECHANISM OF RECOVERY IN PNEUMONIA DUE TO FRIEDLÄNDER'S BACILLUS
Authors: Llewellyn Sale, W. Barry Wood
Journal: The Journal of Experimental Medicine (1947)

Experimental pneumonia due to Friedländer's bacillus was produced in white rats by the intrabronchial inoculation of the bacilli suspended in mucin. The pneumonia was lobar in type, was almost uniformly fatal, and simulated the acute form of the natural disease in human beings. The pathogenesis of the pneumonic lesion was studied by examination of microscopic sections of the lungs of animals killed at frequent intervals during the course of the infection. The histologic characteristics of the various stages of the pneumonia were essentially the same as those previously described in experimental pneumococcal (Type I) pneumonia except for the following differences: (1) In isolated areas of the lung in Friedländer's pneumonia many more bacteria were encountered in the alveoli than were ever noted in experimental pneumococcal pneumonia. (2) Abscess formation was common in the late stages of Friedländer's infection, whereas it was not noted in the pneumococcal lesion. (3) Organization of the alveolar exudate, rarely observed in experimental pneumococcal pneumonia, was a prominent feature of the pneumonia due to Friedländer's bacillus. The mechanism of spread of Friedländer's lesion appeared to be the same as that of pneumococcal pneumonia. Likewise there was noted the same phagocytosis of organisms in the lungs of even bacteremic animals dying of the infection.
DrKoop.com criticised for mixing information with advertising
Authors: F. Charatan
Journal: BMJ (1999)

One year ago, the former US Surgeon General, C Everett Koop, opened his own health website (www.drkoop.com), which became a public company last June (19 June, p 1644).

With its 80 000 electronic pages, it quickly became the most popular of the estimated 15 000 health related websites in the United States.

Dr Koop is now facing a mounting barrage of criticism from medical ethicists (including two representatives of the American Medical Association), consumer advocates, and others. The major complaint is that the website frequently blurs the line between its objective information and its advertising and promotional content.

Dr Joshua Hauser, a medical ethicist at the University of Chicago, said that when he visited the website he …
Polysomy of Chromosome 17 in Breast Cancer.
Authors: K. Nielsen, B. Ejlertsen, S. Møller, E. Balslev, S. Müller, A. Knoop, H. Mouridsen
Journal: Cancer Research (2009)

Abstract Purpose: Polysomy of chromosome 17 is frequently described in breast cancer, but firm definition of polysomy is lacking. We have used normal breast tissue to define the ploidy levels in the truncated nuclei of cut sections based on standard cytogenetic definition of ploidy in whole nuclei. Data from patients with invasive breast cancer enrolled in a randomized clinical trial was used to investigate the effect of polysomy of centromere 17 on patient survival. (Ejlertsen B et al., Eur J Cancer 2007:43:877-84).Material and methods: Fluorescence in situ hybridization (FISH) with TOP2A/CEN-17 was performed on 120 normal breast specimens. Centromere 17 (CEN-17) measurements from matching HER2/CEN-17 and TOP2A/CEN-17 FISH data was available from 649 patients from a previously published biomarker study (Knoop A et. al., J Clin Oncol 2005;23:7483-90).Results: Two thirds of the tumors had an average number of CEN-17 signals below two and 10% had more than three average CEN-17 signals. Monosomy (&amp;lt;1.25 CEN-17/nucleus) of centromere 17 was observed in 8% of the tumors, 60% of the samples were diploid (1.26-2.09 CEN-17/nucleus), 22% triploid (2.10-2.93 CEN-17/nucleus), 5% tetraploid (2.94-3.77 CEN-17/nucleus) and 5% of the tumors had higher ploidy level (&amp;gt;3.78 CEN-17/nucleus). In the aneuploid tumors and especially in the highly polyploidy tumors, amplification is the most frequent event in the HER2 assay whereas deletions increased with the ploidy level in TOP2A assay. Increasing ploidy was associated with decreased overall survival (P=0.0001), but multivariate analysis showed that polyploidy was not an independent prognostic factor neither predictive for treatment outcome.Conclusion: Polysomy 17 is a rare event in tumor samples from patients, but correlate to HER2 amplification and TOP2A deletion. However, inclusion of a reference probe is necessary if deletions are to be revealed and to avoid false positive amplified cases with a high proportion of dividing cells or a doubling of the DNA content. Very high polyploidy is associated with poor survival but is not an independent prognostic factor when other prognostic factor are included in a multivariate analysis. In this large clinical study, polysomy 17 was neither an independent prognostic nor predictive marker. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4035.
Tuberculous pericarditis with rapid progression to constriction. Prompt diagnosis and treatment are needed.
Authors: C P Clifford, G J Davies, J Scott, S Shaunak, J Sarvill, J B Schofield
Journal: BMJ (1993)

Box 8-Costs ofan MRSA outbreak * Cost to patients: pain and discomfort, loss oftime and earnings, inconvenience, excess morbidity, and mortality * Cost to the hospital: delayed discharge and attendant costs, drugs and antiseptics, containment measures, infection control procedures, litigation, contracts imperilled, exclusion of affected staff resistant S aureus is about seven times that of treating a bacteraemia with methicillin sensitive S aureus.30Containment measures use increasingly scarce resources.A 1987 study in the North East Thames region put the recurrent annual financial cost then of containing outbreaks at around £250 000 in the worst affected hospitals.In addition, there were capital costs associated with the establishment of an isolation ward.Another cost that must not be neglected is that of litigation by infected patients, a growing hazard of outbreaks in hospitals.Hospitals then need to show that well documented and effective control measures are in place.Furthermore, infection control now features as one of the main quality indicators in contracts between purchaser and provider agencies.
Modification of ventricular fibrillation latency following coronary artery occlusion in the conscious pig.
Authors: J E Skinner, J T Lie, M L Entman
Journal: Circulation (1975)

Abrupt occlusion of the left anterior descending coronary artery was performed on 45 unanesthetized farm pigs in order to evaluate the relative effects on the latency to ventricular fibrillation (VFL) of 1) adaptation of the animals to the laboratory, and 2) beta-receptor blockade by propranolol. Compared to control values, VFL was greatly lengthened (i.e., VF delayed or prevented) by adaptation (P smaller than 0.01), was shortened by large (2 MG/KG) doses of racemic propranolol in unadapted animals (P smaller than 0.02), and was again increased while under the influence of the drug, by adaptation (P smaller than 0.051). Neither a lower (0.02 mg/kg) dose of racemic propranolol, 2 mg/kg of dextropropranolol, nor ventricular pacing to a higher heart rate had an effect on VFL. The results suggest that reduced psychological stress was very effective in retarding or preventing the onset of VF, that low doses of propranolol were ineffective, and that higher doses were deleterious in unadapted animals.
THERAPEUTICS OF TESTICULAR DYSFUNCTION
Authors: JAMES B. HAMILTON
Journal: JAMA (1941)

The first major advancements in endocrinologic knowledge came from studies pertaining to the testis. Aristotle<sup>1</sup>recognized that the absence of the testis is responsible for the changes observed in castrate animals and man. In 1849 Berthold<sup>2</sup>concluded that the testis produces an internal secretion, since capons with an implanted testis have comb growth and other characteristics of the cock. Thereafter, the study of testicular function lagged behind that of other ductless glands until, as a result of intensive study<sup>3</sup>during the last decade, the status of androgenic substances shifted abruptly from that of relatively unknown materials to that of highly active crystalline compounds that can be prepared synthetically and are available for therapeutic use. The androgens of chief interest in therapeusis are testosterone, a substance isolated from testis tissue (of the bull<sup>4</sup>), and androsterone and dehydroisoandrosterone, which are excreted in human urine.<sup>5</sup>Clinically, testosterone is
UK government gives consultants pay award in stages
Authors: Michael Day
Journal: BMJ (2006)

The UK government has incurred the wrath of senior doctors by deciding to increase their pay in two stages, starting with a rise of only 1% from this month. Nurses and junior doctors will receive immediate rises of 2.5% and 2.2%.

Consultants' salaries will not rise by the full 2.2% recommended by the Doctors' and Dentists' Pay Review Body until November this year. The overall rise for the year will work out at 1.5%.

Doctors' leaders reacted furiously to news of the staged rise. Paul …
Medicine Discovers Child Abuse
Authors: Carole Jenny
Journal: JAMA (2008)

The battered-child syndrome is a term the authors used to describe young children who received serious physical abuse, generally from a parent or foster parent. In response to a survey, 71 hospitals reported that 302 battered children were seen in the past year. Characteristics of the battered-child syndrome were described and 2 cases were reported in detail.See PDF for full text of the original JAMA article.
Adjusting Glucose-Stimulated Insulin Secretion for Adipose Insulin Resistance: An Index of β-Cell Function in Obese Adults
Authors: Steven K. Malin, Sangeeta R. Kashyap, Jeff Hammel, Yoshi Miyazaki, Ralph A. DeFronzo, John P. Kirwan
Journal: Diabetes Care (2014)

OBJECTIVE The hyperbolic relationship between insulin secretion and sensitivity has been used to assess in vivo β-cell function (i.e., the disposition index). The disposition index emphasizes the importance of taking into account both skeletal muscle and hepatic insulin resistance to depict insulin secretion. However, we propose that adipose tissue insulin resistance also needs to be accounted for when characterizing glucose-stimulated insulin secretion (GSIS) because elevated plasma free fatty acids (FFAs) impair β-cell function. RESEARCH DESIGN AND METHODS To characterize the adipose disposition index, we used [1-14C] palmitate infusion to determine basal FFA turnover rate/adipose insulin resistance and an oral glucose tolerance test to characterize the first (i.e., 0–30 min) and second phase (i.e., 60–120 min) of GSIS. We validated a simplified version of the tracer infusion calculation as the product of (1/plasma FFA concentration × plasma insulin concentration) × GSIS in 44 obese insulin-resistant subjects. RESULTS The plasma FFA and palmitate tracer infusion calculations of the first- and second-phase disposition index were strongly correlated (r = 0.86, P &amp;lt; 0.000001 and r = 0.89, P &amp;lt; 0.000001, respectively). The first- and second-phase adipose disposition index derived from plasma FFA also was tightly associated with fasting hyperglycemia (r = −0.87, P &amp;lt; 0.00001 and r = −0.89, P &amp;lt; 0.00001, respectively) and 2-h glucose concentrations (r = −0.86, P &amp;lt; 0.00001 and r = −0.90, P &amp;lt; 0.00001). CONCLUSIONS Adjusting GSIS for adipose insulin resistance provides an index of β-cell function in obese subjects across the glucose spectrum. Plasma FFA–derived calculations of β-cell function may provide additional insight into the role of adipose tissue in glucose regulation.