tbuckley/cabot-search huggingface dataset:
Issues in reporting epidemiological studies: Study raises several concerns
Authors: Karl-Heinz Jöckel, Andreas Stang
Journal: BMJ (2005)

Users' guide to detecting misleading claims in researchMisleading claims may be symptom of even more serious flaws Editor-Montori et al justifiably draw attention to misleading claims in published clinical trials. 1 This is a serious and common problem. 2 3 However, I object to their radical proposal that only the methods and results sections should be read, while the remainder of the paper should be ignored.The proposal is inconsistent with the title of their paper, "Users' guide to detecting misleading claims in clinical research reports." 1 How are these misleading claims to be identified if the sections containing them are omitted?Furthermore, anyone capable of critically appraising a trial solely on the basis of the methods and results is unlikely to be fooled by misleading claims in the discussion.But, more importantly, the proposal would deprive the discerning reader of witnessing the conflict between the results and the unwarranted conclusions.If researchers are willing to disseminate misleading claims then their integrity is brought into question.But if so, then all aspects of the trial-including the methods and results sections-are also brought into question.Misleading claims should be identified and broadcast loudly for they signal doubts about the entire study.Large scale randomised trials create the ideal conditions for data manipulation.Yet this is merely one of a multitude of problems stemming from a flawed method. 3 The remedy?When reading a study, ignore everything except the number of patients recruited.If this is large proceed no further as there is little prospect of encountering any data of genuine benefit to patients.
How to find a practice.
Authors: H R Guly
Journal: BMJ (1979)

1 Hull, M G R, et al, The Endocrine Function of the Human Ovary, ed V H T James, M Serio, and G Giusti, p 245. London, Academic Press, 1976. 2 Jacobs, H S, et al, Hormone Research, 1975, 6, 268. 3 Franks, S, et al, British Journal of Obstetrics and Gynaecology, 1977, 84, 241. 4 Hull, MGR,?? al, British Journal of Obstetrics and Gynaecology. In press. 5 Knuth, U A, Hull, MGR, and Jacobs, H S, British Journal of Obstetrics and Gynaecology, 1977, 84, 801. 6 Jacobs, H S, and Murray, M A F, The Management of the Menopause and Postmenopausal Years, ed S Campbell, p 359. Lancaster, MTP Press, 1976. 7 Franks, S, et al, Clinical Endocrinology, 1975, 4, 597. 8 Tietze, C, International Journal of Fertility, 1968, 13, 385. 9 Lamb, E J, Colliflower, W W, and Williams, J W, Obstetrics and Gyneco logy, 1972, 39, 389. 10 Lenton, E A, Weston, G A, and Cooke, I D, Fertility and Sterility, 1977, 28, 913. 11 Merrell, Clomid. Slough, Richardson-Merrell Ltd, 1976. 12 Hancock, K W, and Oakey, R E, International Journal of Fertility, 1973, 18, 49. 13 Lunenfeld, B, and Insler, V, Diagnosis and Treatment of Functional In fertility. Berlin, Grosse Verlag, 1978. 14 Brown, J B, et al. Journal of Obstetrics and Gynaecology of the British Commonwealth, 1969, 76, 289. 15 Pepperell, R J, McBain, J C3 and Healy, D L, Australian and New Zealand Journal of Obstetrics and Gynaecology, 1977, 17, 181. 16 Evans, J, and Townsend, L, American Journal of Obstetrics and Gynecology, 1976, 125, 321. 17 Crisp, A H, Hospital Medicine, 1967, 1, 713. 18 Nabarro, J D N, in Advances in Gynaecological Endocrinology, ed H S Jacobs, p 141. London, Royal College of Obstetricians and Gynaeco logists, 1979. 19 Jacobs, H S, et al, Clinical Endocrinology, 1976, 5, 439. 20 Rolland, R, in Advances in Gynaecological Endocrinology, ed H S Jacobs, p 263. London, Royal College of Obstetricians and Gynaecologists, 1979. 21 Smith, K D, Rodriguez, L, and Steinberger, E, Male Infertility, Work-up, Treatment and Research, ed A T K Cockett and R L Urry, p 211. London, Grune and Stratton, 1977. 22 Tietze, C, Fertility and Sterility, 1956, 7, 88. 23 Vessey, M P, et al, British Medical Journal, 1978, 1, 265.
The McMaster curriculum: a critique.
Authors: J D Hamilton
Journal: BMJ (1976)

It may seem odd to start presenting a new medical curriculum with quotations well over half a century old. But a close reading of the report of Abraham Flexner,2 on which most subsequent medical education was founded, does show that many of the principles that the new wave of medical education has developed were already clearly understood in 1910. It was the methods and administrative arrangements that developed in the decades after his report that seemed to confound the principles. It is a sobering thought for those of us who have been concerned with a new medical school. We have tried a fresh approach, an alternative to conventional methods, and in presenting the McMaster curriculum, I shall do my best to balance our achievements and our problems.
Impact of the Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis In Myocardial Infarction 22/Reversal of Atherosclerosis With Aggressive Lipid Lowering Trials on Trends in Intensive Versus Moderate Statin Therapy in Ontario, Canada
Authors: Peter C. Austin, Muhammad M. Mamdani
Journal: Circulation (2005)

In March 2004, the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial demonstrated that intensive lipid-lowering therapy (atorvastatin 80 mg/d) reduced progression of coronary atherosclerosis compared with moderate lipid-lowering therapy (pravastatin 40 mg/d). The following month, the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction 22 (PROVE IT-TIMI 22) study demonstrated the superiority of intensive (atorvastatin 80 mg/d) versus moderate (pravastatin 40 mg/d) lipid-lowering therapy for reducing death or cardiovascular events in patients suffering from an acute coronary syndrome. We sought to determine the impact of these 2 trials on trends in intensive versus moderate statin therapy in Ontario, Canada.This is a retrospective time-series analysis of statin prescribing between June 1997 and September 2004 in Ontario, Canada, for all residents age 65 years and older. The publication of the PROVE IT-TIMI 22 and REVERSAL trials was associated with a sustained and statistically significant increase in the number of prescriptions dispensed for atorvastatin 80 mg (range, 272 to 635 additional prescriptions per month), whereas the number of prescriptions filled for pravastatin 40 mg did not change. Similarly, it resulted in a temporal increase in the relative market share of atorvastatin at a dose of 80 mg versus that of atorvastatin at a dose of 40 mg. However, the proportion of simvastatin prescriptions for 80 mg relative to 40 mg did not change over time, implying a drug-specific effect rather than a class effect in prescribing practice.The publication of the PROVE IT-TIMI 22 and REVERSAL trials resulted in a significant sustained increase in the use of intensive compared with moderate statin therapy. This shift was evident primarily in an increased use of high-dose atorvastatin and did not appear to be generalizable to other statins.
Surgery for Coronary Artery Disease
Authors: Arthur Baue
Journal: JAMA (1969)

Dr. Julius Elson, Attending Physician, Jewish Hospital of St. Louis, and Instructor in Clinical Medicine, Washington University School of Medicine: This 67-year-old man was admitted for evaluation for coronary artery surgery because of disabling angina pectoris. The patient was in good health until May 23, 1955, when he suffered an episode of prolonged chest pain and was hospitalized at another institution for three weeks because of an acute myocardial infarction. The clinical course was uneventful and he was discharged without congestive failure or angina pectoris. The patient returned to work and remained active and well until 1961, when he noticed the onset of typical angina when on effort; it was well-controlled by one or two nitroglycerin tablets per day. In 1963 chest pain occurred 5 to 12 times daily when less effort than before was exerted and this was still relieved by nitroglycerin. In an attempt to diminish the frequency
14C triolein breath test: a routine test in the gastroenterology clinic?
Authors: K Mylvaganam, P R Hudson, A Ross, C P Williams
Journal: Gut (1986)

The absorption of 14C triolein in a standard fat meal was measured in 60 controls and 66 patients with gastrointestinal disorders by 14CO2 breath sampling. A reference range based upon cumulative eight hour values of the controls was independent of height, weight, and sex. The range was of log normal distribution and declined with age (p less than 0.05). Acceptable 'within-day' and 'between-day' reproducibility was found. All patients tested with untreated coeliac disease, pancreatic insufficiency and most with symptomatic small intestinal Crohn's disease had subnormal values. Twenty per cent of those with irritable bowel syndrome had subnormal values. Patients with ulcerative colitis were all normal. The reagents used and the breath samples after collection were stable. In our experience the 14C triolein test is simple, inexpensive, and helpful in the detection of diseases associated with fat malabsorption. It is of value in monitoring the response to treatment of individual patients with coeliac disease.
Calcitriol vs. dithranol in combination with narrow-band ultraviolet B (311 nm) in psoriasis
Authors: U.B. Hofmann, A.A.O. Eggert, E-B. Brocker, M. Goebeler
Journal: British Journal of Dermatology (2003)

Journal Article Calcitriol vs. dithranol in combination with narrow‐band ultraviolet B (311 nm) in psoriasis Get access U.B. Hofmann, U.B. Hofmann Department of Dermatology, University of Würzburg, Josef‐Schneider‐Str. 2, D‐97080 Würzburg, Germany Uta B.Hofmann. E‐mail: uta.hofmann@mail.uni‐wuerzburg.de Search for other works by this author on: Oxford Academic Google Scholar A.A.O. Eggert, A.A.O. Eggert Department of Dermatology, University of Würzburg, Josef‐Schneider‐Str. 2, D‐97080 Würzburg, Germany Search for other works by this author on: Oxford Academic Google Scholar E‐B. Bröcker, E‐B. Bröcker Department of Dermatology, University of Würzburg, Josef‐Schneider‐Str. 2, D‐97080 Würzburg, Germany Search for other works by this author on: Oxford Academic Google Scholar M. Goebeler M. Goebeler Department of Dermatology, University of Würzburg, Josef‐Schneider‐Str. 2, D‐97080 Würzburg, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 148, Issue 4, 1 April 2003, Pages 779–783, https://doi.org/10.1046/j.1365-2133.2003.05175.x Published: 01 April 2003 Article history Accepted: 26 July 2002 Published: 01 April 2003
Remarks ON A CASE OF RECURRING JAUNDICE IN FOUR SUCCESSIVE PREGNANCIES, WITH FATAL JAUNDICE IN THREE SUCCESSIVE INFANTS
Authors: H. D. Rolleston
Journal: BMJ (1910)

SThis lady, aged 31t, was sent to me by a well-known surgeon who had operated for carcinoma of the left breast about two years previously.Closely following upon the shock of the death oft near relative from cancer, recurrence made its appearance o. the side of the chest and in the supraclavicular region, *hile avague induration appeared in the axilla.Radium treat- ment was applied in Paris, without much benefit.About the end of April, 1909, swelling of the arm became very marked, anid pain and discomfort from this cause began.Radium treatment was recommended by Dr. Louis Wiokham for this condition, but the patient herself felt that the applications aggravated the swelling.Radium treatment was continued in England after the patient's return.She continued, in spite of her sufferings, to lead an active life, and although her condition would have confined most women to bed, she frequently spent a whole day in the hunting field, carrying the swollen arm on the saddle in front of her.Her determination to fight and conquer the disease was truly heroic.She had noticed that
The ???Warm??? Sacroiliac Joint
Authors: JAMES D. SLAVIN, NEIL EPSTEIN, JORDAN A. NEGRIN, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1990)

Two patients with pain referable to the low back and sacroiliac regions had bone scans with similar findings. In each, one sacroiliac joint was “warm” (uptake on that side was slightly greater than that in the contralateral area). Ga-67 imaging also demonstrated increased uptake in the same locale. Subsequent CT scanning revealed pelvic abscesses adjacent to the affected joints. Asymmetric uptake of bone imaging agent may have been related to hyperemia and “heating” of the sacroiliac joint. Rapid defervescence with antibiotics and drainage (and no CT evidence of bone involvement) suggested that osteomyelitis was not involved in these cases.
The Present Status of Parathyroid Thermography
Authors: Barry I. Samuels
Journal: JAMA (1975)

THE PURPOSES of this communication are to (1) demonstrate the usefulness of parathyroid thermography in the localization of parathyroid adenomas, (2) stress that this technique is only partly efficacious in patients with parathyroid hyperplasia, and (3) underline the advantages of this noninvasive technique and suggest that it may be acceptable as a screening procedure in patients with hypercalcemia. Because of the increased use of multiphasic screening, the need exists for a simple screening procedure in individuals with asymptomatic hypercalcemia. Although parathyroid thermography is an incompletely tested procedure, preliminary studies suggest that it may prove efficacious in the presurgical localization of parathyroid adenomas.<sup>1-4</sup> Approximately 80% to 90% of parathyroid adenomas lie in the neck, with the inferior parathyroid glands affected in more than 75%. In spite of the established efficacy of selective catheterization of the thyroid venous plexus with radioimmunoassay of the samples for parathyroid hormone concentration, the catheterization may
Near-Fatal Heat Stroke during the 1995 Heat Wave in Chicago
Authors: Jane E. Dematte
Journal: Annals of Internal Medicine (1998)

In July 1995, Chicago sustained a heat wave that resulted in more than 600 excess deaths, 3300 excess emergency department visits, and a substantial number of intensive care unit admissions for near-fatal heat stroke.To describe the clinical features of patients admitted to an intensive care unit with near-fatal classic heat stroke. Patients were followed for 1 year to assess delayed functional outcome and mortality.Observational study.Intensive care units in the Chicago area.58 patients admitted to the hospital from 12 July to 20 July 1995 who met the case definition of classic heat stroke.The data collection tool was designed to compile demographic and survival data and to permit analysis of organ system function by abstracting data on physical examination findings, electrocardiography and echocardiography results, fluid resuscitation, radiography results, and laboratory findings. Data on functional status at discharge and at 1 year were collected by using a modified Stanford Health Assessment Questionnaire.Patients experienced multiorgan dysfunction with neurologic impairment (100%), moderate to severe renal insufficiency (53%), disseminated intravascular coagulation (45%), and the acute respiratory distress syndrome (10%). Fifty-seven percent of patients had evidence of infection on admission. In-hospital mortality was 21%. Most survivors recovered near-normal renal, hematologic, and respiratory status, but disability persisted, resulting in moderate to severe functional impairment in 33% of patients at hospital discharge. At 1 year, no patient had improved functional status, and an additional 28% of patients had died.Near-fatal classic heat stroke is associated with multiorgan dysfunction. A high percentage of patients had infection at presentation. A high mortality rate was observed during acute hospitalization and at 1 year. In addition, substantial functional impairment at discharge persisted 1 year. The degree of functional disability correlated highly with survival at 1 year.
<i>In vivo</i>Inhibition of Human CD19-Targeted Effector T Cells by Natural T Regulatory Cells in a Xenotransplant Murine Model of B Cell Malignancy
Authors: James C. Lee, Erik Hayman, Hollie J. Pegram, Elmer Santos, Glenn Heller, Michel Sadelain, Renier Brentjens
Journal: Cancer Research (2011)

Abstract Human T cells genetically modified to express chimeric antigen receptors (CAR) specific to the B cell tumor antigen CD19 can successfully eradicate systemic human CD19+ tumors in immunocompromised SCID (severe combined immunodeficient)-Beige mice. However, in the clinical setting, CD4+ CD25hi T regulatory cells (Treg) present within the tumor microenvironment may be potent suppressors of tumor-targeted effector T cells. In order to assess the impact of Tregs on CAR-modified T cells in the SCID-Beige xenotransplant model, we isolated, genetically targeted and expanded natural T regulatory cells (nTreg). In vitro nTregs modified to express CD19-targeted CARs efficiently inhibited the proliferation of activated human T cells, as well as the capacity of CD19-targeted 19-28z+ effector T cells to lyse CD19+ Raji tumor cells. Intravenous infusion of CD19-targeted nTregs into SCID-Beige mice with systemic Raji tumors traffic to sites of tumor and recapitulate a clinically relevant hostile tumor microenvironment. Antitumor efficacy of subsequently infused 19-28z+ effector T cells was fully abrogated as assessed by long-term survival of treated mice. Optimal suppression by genetically targeted nTregs was dependent on nTreg to effector T-cell ratios and in vivo nTreg activation. Prior infusion of cyclophosphamide in the setting of this nTreg-mediated hostile microenvironment was able to restore the antitumor activity of subsequently infused 19-28z+ effector T cells through the eradication of tumor-targeted nTregs. These findings have significant implications for the design of future clinical trials utilizing CAR-based adoptive T-cell therapies of cancer. Cancer Res; 71(8); 2871–81. ©2011 AACR.
Cost-Consequence Analysis Evaluating the Use of Botulinum Neurotoxin-A in Patients with Detrusor Overactivity Based on Clinical Outcomes Observed at a Single UK Centre
Authors: Vinay Kalsi, Roshni B. Popat, Apostolos Apostolidis, Rajesh Kavia, Isaac A.O. Odeyemi, Helen A. Dakin, Juliet Warner, Soheir Elneil, Clare J. Fowler, Prokar Dasgupta
Journal: European Urology (2005)
Autophagy-Dependent Production of Secreted Factors Facilitates Oncogenic RAS-Driven Invasion
Authors: Rebecca Lock, Candia M. Kenific, Andrew M. Leidal, Eduardo Salas, Jayanta Debnath
Journal: Cancer Discovery (2014)

Abstract The tumor-promoting functions of autophagy are primarily attributed to its ability to promote cancer cell survival. However, emerging evidence suggests that autophagy plays other roles during tumorigenesis. Here, we uncover that autophagy promotes oncogenic RAS-driven invasion. In epithelial cells transformed with oncogenic RAS, depletion of autophagy-related genes suppresses invasion in three-dimensional culture, decreases cell motility, and reduces pulmonary metastases in vivo. Treatment with conditioned media from autophagy-competent cells rescues the invasive capacity of autophagy-deficient cells, indicating that these cells fail to secrete factors required for RAS-driven invasion. Reduced autophagy diminishes the secretion of the promigratory cytokine interleukin-6 (IL-6), which is necessary to restore invasion of autophagy-deficient cells. Moreover, autophagy-deficient cells exhibit reduced levels of matrix metalloproteinase 2 and WNT5A. These results support a previously unrecognized function for autophagy in promoting cancer cell invasion via the coordinate production of multiple secreted factors. Significance: Our results delineate a previously unrecognized function for autophagy in facilitating oncogenic RAS-driven invasion. We demonstrate that an intact autophagy pathway is required for the elaboration of multiple secreted factors favoring invasion, including IL-6. Cancer Discov; 4(4); 466–79. ©2014 AACR. This article is highlighted in the In This Issue feature, p. 377
Peripheral blood lymphocyte phenotypes in patients with spondyloarthropathy
Authors: Plonquet A, Gleizes A, Briot K, Maison P, Chevalier X, Farcet Jp, Claudepierre P
Journal: Annals of the Rheumatic Diseases (2004)

A prevalent hypothesis in the pathogenesis of the spondyloarthropathies (SpA) is that gut lymphocytes primed by antigens in the gut lumen may enter the bloodstream and home in on target tissues—for example, the entheses and synovial membranes, where they may initiate a local immune process responsible for further local inflammation.1 Selective homing of lymphocytes is a well known process that is made possible, in part, by the lymphocyte phenotype acquired as a response to antigenic stimulation and characterised by a subset of receptors (such as integrins) associated with targeted trafficking.2 Among integrins, αEβ7, is expressed by T lymphocytes in or adjacent to mucosal epithelia, and exhibits features that indicate a possible role in this pathogenic process.3,4 To our knowledge, there are no data on the markers for activation and adhesion of circulating lymphocytes in the SpA. The main objective of this study was to …
Corruption: medicine's dirty open secret
Authors: A. Jain, S. Nundy, K. Abbasi
Journal: BMJ (2014)

<h3>Objective</h3> Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging is the reference standard for non-invasive assessment of fibrosis. In hypertrophic cardiomyopathy (HCM) patients the histological substrate for LGE is still unknown. The aim of this study was to assess the ability of LGE and strain echocardiography to detect type and extent of myocardial fibrosis in obstructive HCM patients undergoing septal myectomy. <h3>Methods</h3> Thirty-two HCM patients (age 60±10) were included in this cross-sectional study and preoperatively examined by speckle-tracking strain echocardiography and LGE-CMR (n=21). Histological fibrosis was classified as interstitial, replacement and total. <h3>Results</h3> Histological fibrosis was present in 31 patients. The percentage of total, interstitial and replacement fibrosis was 15(7, 31)%, 11(5, 24)% and 3(1, 6)%, respectively. Reduced longitudinal septal strain correlated with total (r=0.50, p=0.01) and interstitial (r=0.40, p=0.03), but not with replacement fibrosis (r=0.28, p=0.14). Septal LGE was detected in 13/21 (62%), but percentage LGE did not correlate with total fibrosis (r=0.25, p=0.28). Extent of fibrosis did not differ between patients with and without septal LGE (20(9, 58)% versus 14(5, 19)% p=0.41). Patients with ventricular arrhythmias (n=8) had lower septal longitudinal strain and increased extent total and interstitial fibrosis in myectomy specimens, but no differences were demonstrated in LGE. Reduced longitudinal septal strain and increased extent of interstitial fibrosis predicted ventricular arrhythmias independently of age and gender. <h3>Conclusions</h3> In myectomised HCM patients, reduced longitudinal septal strain correlated better with interstitial and total fibrosis in myectomy specimens, and was a more powerful tool to predict arrhythmias than LGE.