tbuckley/cabot-search huggingface dataset:
Management of rheumatoid arthritis: summary of NICE guidance
Authors: C. Deighton, R. O'Mahony, J. Tosh, C. Turner, M. Rudolf
Journal: BMJ (2009)

Rheumatoid arthritis is a chronic, progressive autoimmune disease associated with inflammation principally in synovial joints and affecting over 400 000 people in the United Kingdom.1 In recent years it has become clear that pain and disability can be avoided if the disease is recognised early and treated promptly and appropriately. It is therefore crucial that all health professionals have knowledge of the recognition, management, and appropriate referral of patients with rheumatoid arthritis. This article summarises the recommendations in the guideline from the National Institute for Health and Clinical Excellence (NICE) on the management of rheumatoid arthritis, from early identification to managing chronic and severe disease.2 NICE recommendations are based on systematic reviews of best available evidence. When minimal evidence is available, recommendations are based on the opinion of the Guideline Development Group (GDG) of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Referral, diagnosis, and investigations [ Based on high and moderate quality observational studies of early prognosis and identification or diagnosis ] [ Based on data from case series ]
Prospective, Randomized, Controlled Pilot Study of Partial Liquid Ventilation in Adult Acute Respiratory Distress Syndrome
Authors: RONALD B. HIRSCHL, MARTIN CROCE, DENNIS GORE, HERBERT WIEDEMANN, KEN DAVIS, JOSEPH ZWISCHENBERGER, ROBERT H. BARTLETT
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Section:ChooseTop of pageAbstract <<METHODSRESULTSDISCUSSIONAPPENDIX: VENTILATOR MANA...ReferencesCITING ARTICLES
Circadian Variation in Vascular Tone and Its Relation to α-Sympathetic Vasoconstrictor Activity
Authors: Julio A. Panza, Stephen E. Epstein, Arshed A. Quyyumi
Journal: New England Journal of Medicine (1991)

The frequency of several cardiovascular events, such as myocardial infarction, sudden death, and stroke, is increased during the early morning hours. There is also a similar circadian pattern in several physiologic variables, including blood pressure, suggesting that certain dynamic processes may contribute to the circadian distribution and onset of acute events.To determine whether there are circadian variations in vascular tone and to investigate their underlying mechanisms, we measured blood flow and vascular resistance in the forearm and their responses to phentolamine (an alpha-adrenergic-antagonist drug) and sodium nitroprusside (a direct vasodilator) in 12 normal subjects (7 men and 5 women; mean age [+/- SD], 44 +/- 9 years) at three different times of day (7 a.m., 2. p.m., and 9 p.m.). The drugs were infused into the brachial artery, and the responses were measured by strain-gauge plethysmography.The basal forearm vascular resistance was significantly higher, and the blood flow significantly lower, in the morning than in the afternoon and evening (mean vascular resistance, 31 +/- 8, 25 +/- 6, and 22 +/- 7 mm Hg per milliliter per minute per 100 ml of forearm volume, respectively; P less than 0.01). The vasodilator effect of phentolamine was also significantly greater in the morning (mean decrease in vascular resistance, 38 +/- 6 percent) than in the afternoon (26 +/- 6 percent) and evening (21 +/- 7 percent) (P less than 0.05). Consequently, there was no circadian variation in vascular resistance or blood flow after the infusion of this drug. In contrast, the vasodilation in response to sodium nitroprusside was similar at all three times of day.There is a circadian rhythm in basal vascular tone, due either partly or entirely to increased alpha-sympathetic vasoconstrictor activity during the morning. This variation may contribute to higher blood pressure and the increased incidence of cardiovascular events at this time of day.
The Elbow-EpiTrainer: a method of delivering graded resistance to the extensor carpi radialis brevis. Effectiveness of a prototype device in a healthy population
Authors: Rishi Navsaria, Dionne M Ryder, Jeremy S Lewis, Caroline M Alexander
Journal: British Journal of Sports Medicine (2013)

Background Tennis elbow or lateral epicondylopathy (LE) is experienced as the lateral elbow has a reported prevalence of 1.3%, with symptoms lasting up to 18 months. LE is most commonly attributed to tendinopathy involving the extensor carpi radialis brevis (ECRB) tendon. The aim of tendinopathy management is to alleviate symptoms and restore function that initially involves relative rest followed by progressive therapeutic exercise. Objective To assess the effectiveness of two prototype exercises using commonly available clinical equipment to progressively increase resistance and activity of the ECRB. Method Eighteen healthy participants undertook two exercise progressions. Surface electromyography was used to record ECRB activity during the two progressions, involving eccentric exercises of the wrist extensors and elbow pronation exercises using a prototype device. The two progressions were assessed for their linearity of progression using repeated ANOVA and linear regression analysis. Five participants repeated the study to assess reliability. Results The exercise progressions led to an increase in ECRB electromyographic (EMG) activity (p&lt;0.001). A select progression of exercises combining the two protocols increased EMG activity in a linear fashion (p&lt;0.001). The ICC values indicated good reliability (ICC&gt;0.7) between the first and second tests for five participants. Conclusions Manipulation of resistance and leverage with the prototype exercises was effective in creating significant increases of ECRB normalised EMG activity in a linear manner that may, with future research, become useful to clinicians treating LE. In addition, between trial reliability for the device to generate a consistent load was acceptable.
Disseminated superficial porokeratosis and immunosuppression
Authors: R. A. NEUMANN, R. M. KNOBLER, D. METZE, W. JURECKA
Journal: British Journal of Dermatology (1988)

Journal Article Disseminated superficial porokeratosis and immunosuppression Get access R. A. NEUMANN, R. A. NEUMANN Department of Dermatology II, University of Vienna, Austria Reinhard A.Neumann, Department of Dermatology II, University of Vienna, Alserstrasse 4, A‐1090 Vienna, Austria Search for other works by this author on: Oxford Academic Google Scholar R. M. KNOBLER, R. M. KNOBLER Department of Dermatology II, University of Vienna, Austria Search for other works by this author on: Oxford Academic Google Scholar D. METZE, D. METZE Department of Dermatology II, University of Vienna, Austria Search for other works by this author on: Oxford Academic Google Scholar W. JURECKA W. JURECKA Department of Dermatology II, University of Vienna, Austria Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 119, Issue 3, 1 September 1988, Pages 375–380, https://doi.org/10.1111/j.1365-2133.1988.tb03231.x Published: 01 September 1988
Actions of Alcohol, vol 1: Biochemical, Physiological, and Psychological Aspects; vol 2: Chronic and Clinical Aspects
Authors: Donald W. Goodwin
Journal: JAMA (1971)

If you have a $64 question about alcohol or alcoholism, this is the book to buy. Provided you have $64 —the price of the book. Why so steep? True, the book is a "set," consisting of two volumes. Together, however, they run to less than 900 pages and one book would have sufficed. Is the set particularly handsome? Not particularly. Does it unlock the mystery of alcoholism and hand us the keys? Hardly. Then why the exorbitant price? One explanation may be the exorbitant effort that went into producing it. Drs. Wallgren and Barry spent seven years at the job. Their transatlantic collaboration — Wallgren is a Finnish chemist, Barry an American psychologist—involved reviewing the alcohol literature of the 1960s plus much of what came before, sifting and evaluating this massive morass (much of it equivocal and contradictory), and assembling a coherent series of statements touching on every aspect of
Remission of severe epidermolysis bullosa acquisita induced by extracorporeal photochemotherapy
Authors: J.L. MILLER, G.P. STRICKLIN, J.D. FINE, L.E. KING, M. DEL CARMEN ARZUBIAGA, D.L. ELLIS
Journal: British Journal of Dermatology (1995)

Journal Article Remission of severe epidermolysis bullosa acquisita induced by extracorporeal photochemotherapy Get access J.L. MILLER, J.L. MILLER Department of Internal Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, TN, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar G.P. STRICKLIN, G.P. STRICKLIN Department of Internal Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, TN, U.S.A.Nashville Department of Veterans Affairs Medical Center, Nashville, TN, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar J.D. FINE, J.D. FINE Department of Dermatology, University of North Carolina Medical Center, Chapel Hill, NC, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar L.E. KING, L.E. KING Department of Internal Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, TN, U.S.A.Nashville Department of Veterans Affairs Medical Center, Nashville, TN, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar M. DEL CARMEN ARZUBIAGA, M. DEL CARMEN ARZUBIAGA Nashville Department of Veterans Affairs Medical Center, Nashville, TN, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar D.L. ELLIS D.L. ELLIS Department of Internal Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, TN, U.S.A.Nashville Department of Veterans Affairs Medical Center, Nashville, TN, U.S.A. Dr Darrel L. Ellis, Division of Dermatology, Vanderbilt University Medical Center, 3903 The Vanderbilt Clinic, Nashville, TN 37232‐5227, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 133, Issue 3, 1 September 1995, Pages 467–471, https://doi.org/10.1111/j.1365-2133.1995.tb02680.x Published: 01 September 1995 Article history Accepted: 08 November 1994 Published: 01 September 1995
AUTOMATED QUANTIFICATION OF AORTIC ROOT REMODELING IN AORTIC STENOSIS USING VOLUMETRIC 3-D TRANSESOPHAGEAL ECHOCARDIOGRAPHY: IMPLICATIONS FOR TRANS-CATHETER AORTIC VALVE REPLACEMENT (TAVR)
Authors: Anna Calleja, Razvan Ionasec, Paaladinesh Thavendiranathan, Shizhen Liu, Helene Houle, Chittoor Sai-Sudhakar, Juan Crestanello, William Perez, Michael Andritsos, Thomas Ryan, Mani Vannan
Journal: Journal of the American College of Cardiology (2011)
Do We Really Want Broad Access to Health Care?
Authors: James J. Mongan, Thomas H. Lee
Journal: New England Journal of Medicine (2005)

In the United States, about 45 million people do not have health insurance. Mongan and Lee argue that even though most Americans say they believe in access to health care for all, the public is not willing to pay for it. They urge health care providers to assume a leadership role and advocate for the tax increases necessary to provide health insurance to everyone.
Healthcare reform forms a big part of Obama's budget
Authors: J. H. Tanne
Journal: BMJ (2009)

Barack Obama’s proposed $3.1 trillion budget includes $634bn (£450bn; €500bn) for healthcare reform, including universal health insurance coverage, electronic medical records, and preventive health care.

He has nominated Kathleen Sebelius of Kansas, the Democratic governor in a Republican state, as head of the Department of Health and Human Services, and will convene a White House healthcare summit meeting this week.

The president presented the budget on 26 February, two days after the Institute of Medicine released a report, called America’s Uninsured Crisis: Consequences for Health and Health Care (available at www.iom.edu). The report says that nearly 46 million Americans lack health insurance, including one in five adults aged under 65 years and one in 10 children, and that numbers would increase as the economy worsened. It says, “For decades the health insurance crisis has grown without any decisive action by policy makers to stop it. Now is the time for action.”

More than half of Americans said that their households have cut back on health care in the past year because of costs, a …
Tipifarnib Plus Tamoxifen in Tamoxifen-Resistant Metastatic Breast Cancer: A Negative Phase II and Screening of Potential Therapeutic Markers by Proteomic Analysis
Authors: Florence Dalenc, Sophie F. Doisneau-Sixou, Ben C. Allal, Sabrina Marsili, Valérie Lauwers-Cances, Karima Chaoui, Odile Schiltz, Bernard Monsarrat, Thomas Filleron, Nicole Renée, Emilie Malissein, Elise Meunier, Gilles Favre, Henri Roché
Journal: Clinical Cancer Research (2010)

Tipifarnib, a farnesyltransferase inhibitor, has antitumor activity in heavily pretreated metastatic breast cancer patients. Preclinical data suggest that FTIs could restore tamoxifen responsiveness in tamoxifen-resistant disease. Thus, combining FTIs and tamoxifen may be a promising clinical approach after relapse or progression on tamoxifen.Postmenopausal patients with measurable estrogen receptor- and/or progesterone receptor-expressing metastatic breast cancers were enrolled. Only patients with disease progression on tamoxifen were eligible, but there was no limitation regarding prior chemotherapy or hormone therapy regimens. Patients were immediately treated with 300 mg (n = 12) or 200 mg (n = 10) tipifarnib twice daily for 21 of 28-day cycles plus tamoxifen once daily. Serum was collected at baseline and after 8 weeks of treatment to enable proteomic comparison and identify possible predictive response markers.Twenty patients were enrolled and evaluated for efficacy: one patient had an objective response (liver metastasis) and nine had stable disease after 6 months for a clinical benefit rate of 50%; median duration of benefit was 10.3 (range, 7.4-20.2) months. The proteomic analysis by SELDI-TOF and LTQ-FT-Orbitrap identified a known peptide of fibrinogen alpha, the intensity of which was significantly increased in patients with progression compared with patients who benefited from the combined treatment after 8 weeks.Because the primary end point of efficacy (three objective responses) was not achieved, the study is negative. Nevertheless, the identified peptide could be of interest in discriminating, at 8 weeks of treatment, responders from nonresponders.
Unique checkpoints during the first cell cycle of fertilization after intracytoplasmic sperm injection in rhesus monkeys
Authors: Laura Hewitson, Tanja Dominko, Diana Takahashi, Crista Martinovich, João Ramalho-Santos, Peter Sutovsky, John Fanton, Darla Jacob, Daymond Monteith, Martha Neuringer, David Battaglia, Cal Simerly, Gerald Schatten
Journal: Nature Medicine (1999)
Circulating Levels of Factor VII, Fibrinogen, and von Willebrand Factor and Features of Insulin Resistance in First-Degree Relatives of Patients With NIDDM
Authors: Michael W. Mansfield, Daniella M. Heywood, Peter J. Grant
Journal: Circulation (1996)

Background First-degree relatives of patients with non–insulin-dependent diabetes mellitus (NIDDM) have an increased risk of coronary artery disease partly attributable to clustering of risk factors in association with insulin resistance. Circulating levels of some hemostatic factors predict coronary events, and there is growing evidence that insulin resistance is also associated with abnormalities of coagulation and fibrinolysis. This study examined the hypotheses that elevated levels of factor VII coagulant activity (FVII:C), fibrinogen, and von Willebrand factor (vWF) occur (1) in first-degree relatives of NIDDM patients and (2) in association with recognized features of insulin resistance. Methods and Results Fasting blood samples were taken from 132 first-degree relatives of NIDDM patients and 151 age-matched control subjects for measurement of FVII:C, fibrinogen, vWF, insulin, total and HDL cholesterol, triglyceride, glucose, and HbA 1C . Levels of FVII:C (130% versus 122%, P &lt;.02) and fibrinogen (3.0 versus 2.7 g/L, P =.002) were higher in relatives than in control subjects, and there was no significant difference in levels of vWF (0.98 versus 0.95 IU/mL). There was a graded association with features of insulin resistance, which was strongest for FVII:C, weaker for fibrinogen, and weakest for vWF. Conclusions FVII:C and fibrinogen levels are increased in relatives of patients with NIDDM. Levels of FVII:C and, to a lesser extent, fibrinogen and vWF cluster with other risk factors associated with insulin resistance. Abnormalities of circulating hemostatic factors, possibly in relation to insulin resistance, may contribute to cardiovascular risk in relatives of patients with NIDDM.
Hepatic regeneration and TGF-beta : growing to a prosperous perfection
Authors: E WILLIAMS
Journal: Gut (2000)

See article on page 719 

It is widely accepted that TGF-β1 is a potent growth inhibitory and profibrotic cytokine which plays a pivotal role in the physiological process of wound healing as well as in the pathogenesis of organ fibrosis.1 TGF-β expression has been shown to be increased in a wide range of fibrotic diseases. In the liver, TGF-β1 mRNA expression has been demonstrated to correlate with ongoing fibrotic injury in both experimental animal models and in human liver diseases. TGF-β1 mediates its profibrotic actions by stimulating fibroblasts and related cell types, including in the liver the hepatic stellate cell (HSC), to secrete a wide range of extracellular matrix proteins. In pathological conditions this leads to accumulation of fibrotic matrix or in a more physiological context to the efficient healing of wounds.2-4 Furthermore, blocking TGF-β activity by a variety of strategies has been shown to inhibit fibrosis in a series of experimental models. However, TGF-β has other important actions, namely its immunomodulatory properties and its antiproliferative effects …
RARE ACCIDENTS PRESUMED DUE TO NEGLIGENCE
Authors: H. Woods
Journal: BMJ (1920)

Discusses a court finding of negligence. In the Court of King's Bench on March 24th, 1920, in the course of hiis judgement in an action for damages brought against a dental surgeon, Mr. Justice Bailhache laid down a principle of great importance and wide application. As it seems to be unsound, both in law and logic, it ought not to pass unchallenged, especially as the fallacy of it is not readily apparent to most people. Where an extremely rare accident occurs in a very common operation, the onus falls on the defendant of proving that he was not guLilty of negligence -- which will otherwise be assumed. There was not a particle of evidence of any negligence of which anyone present at the operation was aware. The defendant was found to have been negligent because he could not bring any evidence beyond his own statement on oath that lhe had not been negligent. The fact that the accident had occurred was regarded as in itself establishing negligence unless some cause for the accident was established inconsistent with the presumption of negligence. Language: en
A Cumulated Index to THE JOURNAL
Authors: Susan Crawford
Journal: JAMA (1975)

It is a little-known fact thatThe Journal of the American Medical Associationdates back to 1848. It was not calledThe Journalthen, but was issued under the titleTransactions of the AMA,and included news about the profession, association activities, as well as original scientific contributions reflecting medicine and its contemporary environmental context. There is an account of the member who pleaded reform, as a European visitor had just won a bet that he could earn a US medical diploma without attending a class (Trans AMA30:36, 1879). A scientific article was presented on the negative effects of tea and coffee on the laboring classes, ie, schoolteachers and social workers (Trans AMA2:635, 1849). And in those days, attending meetings was difficult, not because of holding patterns around airports, but rather because of uncertainties related to horse, carriage, and spring floods.  By 1882, the Transactions had grown to
The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma
Authors: Howard L. Kaufman, John M. Kirkwood, F. Stephen Hodi, Sanjiv Agarwala, Thomas Amatruda, Steven D. Bines, Joseph I. Clark, Brendan Curti, Marc S. Ernstoff, Thomas Gajewski, Rene Gonzalez, Laura Jane Hyde, David Lawson, Michael Lotze, Jose Lutzky, Kim Margolin, David F. McDermott, Donald Morton, Anna Pavlick, Jon M. Richards, William Sharfman, Vernon K. Sondak, Jeffrey Sosman, Susan Steel, Ahmad Tarhini, John A. Thompson, Jill Titze, Walter Urba, Richard White, Michael B. Atkins
Journal: Nature Reviews Clinical Oncology (2013)

Immunotherapy is associated with durable clinical benefit in patients with melanoma, and this consensus statement outlines recommendations for its use. The panel has based their guidance on the available evidence and outlines a treatment paradigm using drugs that are FDA approved. Immunotherapy is associated with durable clinical benefit in patients with melanoma. The goal of this article is to provide evidence-based consensus recommendations for the use of immunotherapy in the clinical management of patients with high-risk and advanced-stage melanoma in the USA. To achieve this goal, the Society for Immunotherapy of Cancer sponsored a panel of melanoma experts—including physicians, nurses, and patient advocates—to develop a consensus for the clinical application of tumour immunotherapy for patients with melanoma. The Institute of Medicine clinical practice guidelines were used as a basis for this consensus development. A systematic literature search was performed for high-impact studies in English between 1992 and 2012 and was supplemented as appropriate by the panel. This consensus report focuses on issues related to patient selection, toxicity management, clinical end points and sequencing or combination of therapy. The literature review and consensus panel voting and discussion were used to generate recommendations for the use of immunotherapy in patients with melanoma, and to assess and rate the strength of the supporting evidence. From the peer-reviewed literature the consensus panel identified a role for interferon-α2b, pegylated-interferon-α2b, interleukin-2 (IL-2) and ipilimumab in the clinical management of melanoma. Expert recommendations for how to incorporate these agents into the therapeutic approach to melanoma are provided in this consensus statement. Tumour immunotherapy is a useful therapeutic strategy in the management of patients with melanoma and evidence-based consensus recommendations for clinical integration are provided and will be updated as warranted.