tbuckley/cabot-search huggingface dataset:
Methodological Differences in Clinical Trials Evaluating Nonpharmacological and Pharmacological Treatments of Hip and Knee Osteoarthritis
Authors: Isabelle Boutron
Journal: JAMA (2003)

Randomized controlled trials have been developed essentially in the context of pharmacological treatments (ie, oral drugs; intra-articular injection; and topical, intramuscular, and intravenous treatments), but assessment of the effectiveness of nonpharmacological treatments (ie, surgery, arthroscopy, joint lavage, rehabilitation, acupuncture, and education) presents specific issues.To compare the quality of articles of nonpharmacological and pharmacological treatments of hip and knee osteoarthritis and to identify specific methodological issues related to assessment of nonpharmacological treatments.We searched MEDLINE and the Cochrane Central Register of Controlled Trials for articles of randomized controlled trials published between January 1, 1992, and February 28, 2002, in 28 general medical and specialty journals with high impact factors and assessing nonpharmacological and pharmacological treatments in patients with hip or knee osteoarthritis.The quality of the methods reported in the selected articles was assessed by 2 independent reviewers using the Jadad scale, the Delphi list, and guidelines found in the Users' Guides to the Medical Literature. Investigators also used a checklist of items developed by the authors to analyze study characteristics.A total of 110 articles were included in the analysis; 50 (45.5%) assessed nonpharmacological treatments and 60 (54.5%) assessed pharmacological treatments. Reports of nonpharmacological treatments had a lower global quality score than did reports of pharmacological treatments as measured by the Jadad scale (mean [SD] score, 1.4 [1.3] vs 3.0 [1.3]) and the Delphi list (mean [SD] score, 5.2 [1.5] vs 7.5 [1.1]). Lack of reporting adequate random sequence generation and intention-to-treat analyses were found in both nonpharmacological and pharmacological articles. Nonpharmacological treatments were less often compared with a placebo than were pharmacological treatments (28.0% of articles vs 71.7%). Compared with pharmacological articles, nonpharmacological articles less often described blinding of patients (26.0% vs 96.7%), care providers (6.0% vs 81.7%), and outcome assessors (68.0% vs 98.3%). Care providers' skill levels could influence treatment effect in 84.0% of nonpharmacological articles vs 23.3% of pharmacological articles.In this analysis of reports of hip and knee osteoarthritis therapy, nonpharmacological articles scored lower than pharmacological articles in terms of quality. Assessments of nonpharmacological treatments must take into consideration additional methodological issues.
Mumps Arthritis: Unusual Presentation as Adult Still's Disease
Authors: STUART C. GORDON
Journal: Annals of Internal Medicine (1982)

The clinical spectrum of Still's disease suggests disseminated infection. Although the cause of this syndrome remains unknown, recent case reports have noted its association with various viruses. Increased antiviral titers to rubella, coxsackieviruses, and adenovirus have been noted in patients with syndromes similar to juvenile rheumatoid arthritis. We describe a patient with apparent adult Still's disease in whom a significant rise in mumps antibody titers was observed. Arthritis in association with mumps infection is a relatively rare condition. To our knowledge, this is the first report of mumps virus infection related to a disorder similar to juvenile rheumatoid arthritis.
Gallium Detection of Inflammation
Authors: EDWARD B. SILBERSTEIN
Journal: Annals of Internal Medicine (1974)

Comments1 June 1974Gallium Detection of InflammationEDWARD B. SILBERSTEIN, M.D.EDWARD B. SILBERSTEIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-80-6-774 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the article, "Gallium-67 for Localization of Septic Lesions" (Ann Intern Med79:403-406, 1973), it was reported that gallium scanning detected intra-abdominal abscess in four cases (Patients 1-4). The abscesses were confirmed by surgery or drain placement. It is stated that "scans obtained as early as 2 hours after the intravenous injection show surprisingly high concentrations of radioactivity in inflammatory tissue. . . ." The authors indicate that in patients "whose clinical condition would not permit bowel cleansing, the ratio of activity between abscess and background has always been sufficient to obtain interpretable scans." In a recent...References1. EDWARDSHAYES CR: Scanning malignant neoplasms with gallium-67. JAMA 212:1182-1191, 1970 CrossrefMedlineGoogle Scholar2. LITTENBERGALAZRAKITAKETA RNR: A clinical evaluation of gallium-67 citrate scanning. Surg Gynecol Obstet 137:424-430, 1973 MedlineGoogle Scholar1. MILDERGLICKHENDERSON MJE: 67Ga scintigraphy in acute leukemia. Cancer 32:803-808, 1973 CrossrefMedlineGoogle Scholar2. GELRUDARSENEAUJOHNSTON LJG: Gallium-67 localization in experimental and clinical abscesses (abstract). Clin Res 21:600, 1973 Google Scholar3. GELRUDARSENEAUMILDER LJM: The kinetics of Ga-67 localization into inflammatory lesions: clinical and experimental studies. J Lab Clin Med. In press Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Radioisotope Laboratory Cincinnati General Hospital Cincinnati, Ohio 45229 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPulmonary Sarcoidosis: A Disease Characterized and Perpetuated by Activated Lung T-LymphocytesRONALD G. CRYSTAL, M.D., WILLIAM C. ROBERTS, M.D., GARY W. HUNNINGHAKE, M.D., JAMES E. GADEK, M.D., JACK D. FULMER, M.D., BRUCE R. LINE, M.D.Role of gallium 67 in inflammatory disease 1 June 1974Volume 80, Issue 6Page: 774-776KeywordsAbscessesAttentionInflammationIntravenous injectionsLesionsSurgery Issue Published: 1 June 1974 PDF DownloadLoading ...
Bleeding peptic ulcers.
Authors: S Bown
Journal: BMJ (1991)

Sir, ?Professor Stephen Bown is correct to remark on the recent advances in endoscopie treatment of bleeding peptic ulcers.1 With the emerging evidence of the efficacy of endoscopie techniques, and with an aging population, who tolerate laparotomy badly, these techniques should be more widely available. Professor Bown discusses the evidence of their efficacy in a traditional narrative manner, and I am confident that his con? clusions are correct. He has not, however, explored the results of three relevant meta-analyses.24 Two of these studies were reviewed at a workshop on meta-analysis in gastrointestinal haemorrhage held in Newcastle, New South Wales, in September last year.' This was a satellite meeting of the World Congress of Gastroenterology. The table summarises the results presented at the workshop. Several conclusions can be drawn. Firstly, evidence of benefit seems to be greatest in the case of laser treatments, with both meta analyses showing significant (p<005) reductions in rates of rebleeding and mortality. In the case of thermal contact devices (heater probes with monopolar and multipolar electrodes) the evidence is convincing for rebleeding, but for mortality the confidence intervals for the pooled odds ratio include one. We came to similar conclusions in a meta-analysis published in 1987.J Injection treat? ment seems to be associated with low rebleeding rates, but the meta-analyses disagreed somewhat on the extent and significance of the reduction in mortality. It should be noted that the numbers of subjects included in these studies are small. The data presented in the table are probably out of date now, which underscores the need for continual revision of meta-analyses of important topics such as this. The pooled odds ratio is only an approximate guide to the true magnitude of the benefits from endoscopie treatment. Sacks et al reported pooled rate differences for all endoscopie interventions combined, which indicate that in the relatively high risk patients who entered the trials the reduction in rebleeding was around 0 27 and in mortality around 0T0.' This means that it may be necessary to treat only four patients to prevent a case of further haemorrhage or 10 patients to prevent a death. Sacks et al also concluded that the data are insufficient to make direct comparisons between treatment modalities, and presently this is the crucial point. The pressing need now is for randomised trials to compare the efficacy of different endoscopie treatments for haemostasis. Because of their convenience and feasibility thermal contact devices and injection treatment should probably be the modalities that are com? pared in future trials. These trials will have to be large. To date, the controlled trials of endoscopie haemostasis have been too small, with total numbers of subjects ranging from 16 to 174.' Numbers in the thousands will be needed,6 and gastroenterologists need to look to the example of their colleagues in cardiovascular medicine, who have set new stan? dards in international multicentre trials when
The Medical Management of Primary Hyperparathyroidism
Authors: JOHN P. BILEZIKIAN
Journal: Annals of Internal Medicine (1982)

Primary hyperparathyroidism has become a relatively common endocrine disorder. Greater recognition of this disease has led to earlier detection. Consequently, primary hyperparathyroidism is now characterized frequently by asymptomatic mild hypercalcemia rather than by the more classical presentation with bone or renal involvement. Patients who have hypercalcemia and signs or symptoms should undergo neck surgery and removal of the abnormal parathyroid tissue. For the growing population of asymptomatic patients, however, indications for surgery are not as clear. The natural history of primary hyperparathyroidism is variable, and predicting who will develop complications of this disorder is not possible. Alternatives to surgery are careful and regular observation combined with various general and specific approaches currently receiving attention. Available information on the medical management of asymptomatic, mild primary hyperparathyroidism is summarized.
Digital 3-D velocity reconstructions allow extraction of the vena contracta (VC) area for flow rate computation: an in vitro study using raw scanline transfer and reconstruction of 3-D data
Authors: Yoshiki Mori, Paul R. Detmer, Xiang-Ning Li, Roy W. Martin, Antoinette Kenny, Susan L. Martin, David J. Sahn
Journal: Journal of the American College of Cardiology (2002)
The Suicidal Patient: Recognition, Intervention, Management
Authors: T. L. Brink
Journal: JAMA (1983)

This book is geared to the practicing physician and is based on the author's lectures and workshops on the topic. For its intended audience, it is probably the most useful book in its subject area. The book contains 18 short chapters, divided into five sections, three appendices (one is a bibliography of more than 200 items), and a ten-page, two-column index.  The first section is a brief, qualitative introduction to the phenomena of suicide—important terms and distinctions are clarified, and the research on suicide is summarized into who, how, and why. The second section concerns identifying the potential suicide and includes a general discussion of clues along with a worksheet for predicting a given patient's suicidal risk. The third section's six chapters discuss the management of the suicidal patient. Here the suggestions are extremely practical, ranging from recommendations for specific medication dosages to a series of anecdotes, such as one
THE PHYSICIAN AND THE PUBLIC HEALTH
Authors: HARLOW BROOKS
Journal: JAMA (1927)

I speak today from the point of view of a medical man engaged in active practice in one of the great urban centers. I shall consider particularly those various points on which the medical practitioner in these centers is likely to be, or may be, out of complete sympathy with the activities of lay organizations that have largely interested themselves in questions pertaining to public health matters. At the outset I wish to state that I, and I believe all my fellow practitioners, honor, respect and crave the assistance of every lay person and organization that is devoted to altruistic service to the public, to the alleviation of suffering, and to the betterment of mankind. Whatever I may say in the way of criticism is meant to be in the nature of a constructive one. Our purpose is, and should be, identical. As to the methods by which this may
Liver-Directed Adenoviral Gene Transfer in Murine Succinate Semialdehyde Dehydrogenase Deficiency
Authors: Maneesh Gupta, Erwin E.W Jansen, Henry Senephansiri, Cornelis Jakobs, O.Carter Snead, Markus Grompe, K.Michael Gibson
Journal: Molecular Therapy (2004)

Murine succinate semialdehyde dehydrogenase (SSADH) deficiency (OMIM 271980; EC 1.2.1.24), a model of the corresponding human disorder, displays 100% mortality at weeks 3-4 of life, associated with lethal tonic-clonic seizures. The biochemical hallmark, gamma-hydroxybutyrate (GHB), accumulates in both human and murine disorders. In the current study we evaluated rescue of the murine model with liver-directed gene therapy using the E1-deleted adenoviral vector AD:pAD-RSV-humanSSADH. Our working hypotheses were: (1) liver expresses considerable SSADH activity and therefore represents a major source of GHB output, (2) correction of liver enzyme deficiency will reduce GHB load both peripherally and in the central nervous system, and (3) SSADH expression will improve survival. SSADH(-/-) and SSADH(+/+) mice were treated under two protocols: (A) intraperitoneal injection of 10(8)-10(11) viral particles by day 10 of life or (B) retro-orbital injection of 10(11) viral particles at day 13 of life. Intravenous administration was prohibited by the small size and fragility of the mice. Maximal survival (39%; P<0.001) was achieved with intraperitoneal administration (10(8) particles) at day 10; intraperitoneal (10(10) and 10(11) particles) and retro-orbital administration (10(11) particles) yielded lower survival of 11-25% (P<0.02). Under both protocols, the maximal hepatic SSADH enzyme activity was approximately 20% of SSADH(+/+) liver activity (retro-orbital > ip). At various time points postinjection, ip-treated animals (10(8) viral particles) demonstrated upward of 80% reduction in liver GHB concentrations, with little impact on brain or serum GHB levels except at 48-72 h posttreatment (approximately 50% reduction for both tissues). Accordingly, we harvested retro-orbitally treated animals at 72 h and observed significant reductions of 60-70% for GHB in liver, kidney, serum, and brain extracts. Histochemical analysis of liver from retro-orbitally treated mutants demonstrated substantial SSADH staining, but with variability both within tissues and between animals. Our studies provide proof-of-principle that liver-mediated gene therapy has efficacy in treating SSADH deficiency and that hepatic tissue contributes significantly to the pool of GHB within the CNS.
Obligatory Running and Anorexia Nervosa-Reply
Authors: James A. Blumenthal
Journal: JAMA (1985)

<h3>In Reply.—</h3> Ms Dresser's comments raise three issues: the scope of our study, the possibility of selection bias, and the similarities in the phenomena of obligatory running and anorexia nervosa. I agree with Dresser's first point, that our study did not investigate all of the many potential relationships between obligatory running and anorexia nervosa. However, we never claimed to have performed the definitive study on obligatory running and anorexia nervosa. Our study was simply a test of the assertion by Yates et al<sup>1</sup>that the two groups "seemed to share certain measurable personality characteristics" including denial, introversion, depression, and discomfort with the expression of anger. Our selection of the Minnesota Multiphasic Personality Inventory was based on its widespread use in clinical and research settings and its proven reliability and validity in assessing these very traits. While the observations and speculations by Yates et al were interesting, it is essential
Abstract P6-11-05: Novel sorafenib-derivatives induce apoptosis in breast cancer cells through STAT3 inhibition
Authors: C-Y Liu, L-M Tseng, K-C Chang, P-Y Chu, J-C Su, C-W Shiau, K-F Chen
Journal: Cancer Research (2012)

Abstract Background: STAT3 has emerged as a novel potential anti-cancer target and its signaling is constitutively activated in various cancers including breast cancer. Our previous study has shown that STAT3 is a major kinase-independent target of sorafenib in HCC. (J Hepatol. 2011). Moreover, recent evidence has shown that p-STAT3 can be down-regulated by phosphatases, such as SHP-1 tyrosine phosphatase. We have designed and synthesized a series of sorafenib analogues devoid of sorafenib's kinase inhibition activity, some of which showed stronger p-STAT3 inhibition and apoptosis-inducing effects than sorafenib in HCC cells (Eur J Med Chem. 2011). Here, we tested the efficacy of novel sorafenib derivatives, SC-1 and SC-43, in breast cancer cells and examined the drug mechanism. Methods: Six Breast cancer cell lines were used for in vitro studies. Cell viability was examined by MTT-assay. Apoptosis was examined by both flow cytometry and Western blot. Signal transduction pathways in cells were assessed by Western Blot. SHP-1 activity was measured by a phosphatase activity assay kit. In vivo efficacy of Sorafenib, and sorafenib derivatives were tested in xenografted nude mice. Results: Sorafenib, SC-1 and SC-43 induced apoptosis in association with down-regulation of P-STAT3 and its downstream proteins Cyclin D1 and survivin in a dose-dependent manner in breast cancer cell lines (HCC-1937, MDA MB-468, MDA MB-231, MDA MB-453, SKBR-3, MCF-7) and the apoptotic effects induced by SC-1 and SC-43 were more potent than Sorafenib. Over-expression of STAT3 in MDA MB-468 cells protected cells from apoptosis induced by sorafenib, SC-1 and SC-43. Moreover, SC-1 and SC-43 up-regulated higher SHP-1 activity than sorafenib by in vitro phosphatase assays. Knockdown of SHP-1 by siRNA reduced apoptosis induced by SC-1 and SC-43. Importantly, SC-1 and SC-43 showed in vivo efficacy in MDA-468 xenografted tumor. Conclusions: Our data indicated that inhibiton of p-STAT3 by up-regulating SHP-1 activity mediated apoptotic effects of sorafenib, SC-1 and SC-43 in breast cancer cells. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-11-05.
Diffuse MRI marrow pattern correlates with increased angiogenesis, advanced disease features and poor prognosis in newly diagnosed myeloma treated with novel agents
Authors: L A Moulopoulos, M A Dimopoulos, D Christoulas, E Kastritis, D Anagnostou, A Koureas, M Roussou, M Gavriatopoulou, M Migkou, M Iakovaki, M Gkotzamanidou, A Tasidou, E Terpos
Journal: Leukemia (2010)
Static mechanical properties of the developing and mature rat aorta
Authors: C. L. BERRY, S. E. GREENWALD, J. F. RIVETT
Journal: Cardiovascular Research (1975)

The static mechanical properties of the aorta have been examined in rats, aged between 4 weeks and 2 years. Internal radius, relative wall thickness, circumferential incremental strain, and circumferential incremental elastic modulus have been measured at pressures between 1.33 and 33.3 kPa (10 and 250 mm Hg). The results show that the value of the incremental elastic modulus does not change after 12 weeks. Changes observed in younger animals are related to alterations in relative wall thickness. The findings correlate with previously observed chemical and morphological changes. Studies of muscle function indicate that the smooth muscle of the media does not contribute significantly to the static elastic properties of the vessel wall.
Effects of a 3-day fast and of ethanol on splanchnic metabolism of FFA, amino acids, and carbohydrates in healthy young men.
Authors: B M Wolfe, J R Havel, E B Marliss, J P Kane, J Seymour, S P Ahuja
Journal: Journal of Clinical Investigation (1976)

Splanchnic metabolism was studied to quantify changes underlying the fatty liver, hyperlipemia, and hypoglycemia produced by ethanol. Four subjects fasted for 15 h were compared with five subjects fasted for 69 h under basal conditions and during continuous intravenous infusion of sufficient ethanol to give a concentration of 3-5 mM in arterial blood plasma. Splanchnic storage of fatty acids was estimated from the difference between uptake of FFA and secretion of derived products. Basal values for splanchnic uptake of FFA were twofold higher after the 69-h fast while splanchnic storage of fatty acids and production of ketone bodies increased threefold. Values for basal secreation into the blood of triglycerides derived from FFA were similar in the two groups. In both nutritional states, the fraction of FFA taken up in the splanchnic region oxidized to ketone bodies and to CO2 fell when ethanol was given because of preferential oxidation of ethanol to acetate, and the fraction esterified rose. However, systemic transport and splanchnic uptake of FFA fell with ethanol in subjects fasted 15 h, so that neither storage of triglycerides in splanchnic tissues nor secretion into the blood increased. In subjects fasted 69 h, ethanol increased transport of FFA and splanchnic storage of fat. In all but one subject it also increased secretion of triglycerides into the blood. The concentration of glucose in blood fell during ethanol infusion in all five subjects undergoing the 69-h fast. Mean splanchnic glucose production was maintained at about one-half of the pre-ethanol value, despite virtual cessation of splanchnic uptake of lactate and of those amino acids that are metabolized via malate. Quantitative estimates of extrasplanchnic metabolism suggest that enhanced formation of alpha-glycerophosphate from glucose, in addition to impaired hepatic gluconeogenesis, may contribute to ethanol-induced hypoglycemia in man.
Radionuclide Imaging in Pyogenic Vertebral Osteomyelitis
Authors: DAVID HAASE, ROBERT MARTIN, THOMAS MARRIE
Journal: Clinical Nuclear Medicine (1980)

Five cases of pyogenic vertebral osteomyelitis diagnosed clinically and with radioisotope studies are reported. All patients presented with symptoms of back pain, an elevated erythrocyte sedimentation rate, and a normal leukocyte count. Three had positive blood cultures and four had changes on plain radiographs. All five had positive phosphate bone and Ga-67 imaging, and two showed paravertebral uptake of gallium giving a “butterfly”-like appearance.
<i>JAK2</i>Exon 12 Mutations in Polycythemia Vera and Idiopathic Erythrocytosis
Authors: Linda M. Scott, Wei Tong, Ross L. Levine, Mike A. Scott, Philip A. Beer, Michael R. Stratton, P. Andrew Futreal, Wendy N. Erber, Mary Frances McMullin, Claire N. Harrison, Alan J. Warren, D. Gary Gilliland, Harvey F. Lodish, Anthony R. Green
Journal: New England Journal of Medicine (2007)

The V617F mutation, which causes the substitution of phenylalanine for valine at position 617 of the Janus kinase (JAK) 2 gene (JAK2), is often present in patients with polycythemia vera, essential thrombocythemia, and idiopathic myelofibrosis. However, the molecular basis of these myeloproliferative disorders in patients without the V617F mutation is unclear.