tbuckley/cabot-search huggingface dataset:
The Relation between Systematic Reviews and Practice Guidelines
Authors: Deborah J. Cook
Journal: Annals of Internal Medicine (1997)

Clinical practice guidelines have been developed to improve the process and outcomes of health care and to optimize resource utilization.By addressing such issues as prevention, diagnosis, and treatment, they can aid in health care decision making at many levels. Several other decision aids are cast in the guideline lexicon, regardless of their focus, formulation, or format; this can foster misunderstanding of the term "guideline." Whether created or adapted locally or nationally, most guidelines are an amalgam of clinical experience, expert opinion, and research evidence.Approaches to practice guideline development vary widely. Given the resources required to identify all relevant primary studies, many guidelines rely on systematic reviews that were either previously published or created de novo by guideline developers. Systematic reviews can aid in guideline development because they involve searching for, selecting, critically appraising, and summarizing the results of primary research. The more rigorous the review methods used and the higher the quality of the primary research that is synthesized, the more evidence-based the practice guideline is likely to be. Summaries of relevant research incorporated into guideline documents can help to keep practitioners up to date with the literature. Systematic reviews have also been published on the dissemination and implementation strategies most likely to change clinician behavior and improve patient outcomes. These can be useful in more effectively translating research evidence into practice.
Clinical relevance of testing for antineutrophil cytoplasm antibodies (ANCA) with a standard indirect immunofluorescence ANCA test in patients with upper or lower respiratory tract symptoms.
Authors: A Davenport, R J Lock, T B Wallington
Journal: Thorax (1994)

Reports from specialist nephrological centres have suggested that the antineutrophil cytoplasm antibody (ANCA) test is highly specific and sensitive for patients with Wegener's granulomatosis. To determine the usefulness of the ANCA test in everyday respiratory practice the results of the test were audited in all patients in the south west of England with respiratory symptoms who underwent the test.The results of all 335 patients who had presented with upper or lower respiratory tracts symptoms, or both, and were tested for ANCA by the indirect ANCA test in 1990, as recommended in the broadsheet of the British Association of Clinical Pathologists, were audited. Case notes and necropsy reports were available for review in 231 cases (69%), and in the remainder information was obtained by a standard questionnaire.There were 106 positive results, 45 (44%) from patients with Wegener's granulomatosis. The sensitivity and specificity of a positive ANCA test result in this study were 65% and 77% respectively. For a diagnosis of Wegener's granulomatosis the sensitivity and positive predictive accuracy of a positive cytoplasmic ANCA (c-ANCA) test were greater than of a positive perinuclear ANCA (p-ANCA) test. There were 61 positive tests in 266 patients who did not have Wegener's granulomatosis (23%); of these 27 were from patients with infection, 10 with fibrotic lung disease, nine with underlying connective tissue disease, seven with malignancy, and five following pulmonary emboli. Most of these positive ANCA results were p-ANCA (69%) rather than c-ANCA (31%). Serial ANCA requests were made in 15 cases of patients without Wegener's granulomatosis who had an initial positive ANCA test result. In all cases the ANCA tests subsequently became negative.In this study the sensitivity and specificity of a positive ANCA test result were less than that reported from specialised centres. However, the test was found to be useful in clinical practice, especially c-ANCA, in conjunction with clinical symptoms of respiratory pathology and evidence of renal disease.
Permethrin and Ivermectin for Scabies
Authors: Bart J. Currie, James S. McCarthy
Journal: New England Journal of Medicine (2010)

A 4-year-old boy is brought to a health center with sores on his arms and legs. He and several siblings receive a diagnosis of scabies. Crusted scabies is diagnosed in an elderly aunt in the same household. The family members are treated with topical permethrin, which disrupts the function of voltage-gated sodium channels in arthropods. The aunt is treated with oral ivermectin, which disrupts the function of chloride ion channels.
Pneumocystis carinii: inhibition of lung cell growth mediated by parasite attachment.
Authors: A H Limper, W J Martin
Journal: Journal of Clinical Investigation (1990)

Pneumocystis carinii pneumonia is a significant cause of mortality in immunocompromised patients. Current concepts suggest that attachment of P. carinii to alveolar epithelium is required for development of pneumonia. We examined the mechanism of P. carinii adherence to cultured A549 cells, a permanent cell line derived from human alveolar epithelium. P. carinii adherence was quantified by measuring attachment of 51Cr-labeled P. carinii to cultured A549 cells. After 8 h of incubation, 37.4 +/- 4.2% of P. carinii were adherent to A549 cells. In the presence of agents known to impair cytoskeletal function, including 10(-5) M cytochalasin B, 10(-5) M colchicine, and 10(-5) M trimethylcolchicinic acid (TMCA), adherence was decreased from 57.4 +/- 4.2% to 9.3 +/- 3.4%, 12.5 +/- 3.6%, and 21.5 +/- 3.6%, respectively (P less than 0.01, all comparisons). Secondly, we examined the effect of P. carinii on the function of A549 cells. P. carinii resulted in significant impairment of A549 cell growth, indicating P. carinii adversely affected the function of target lung cells. A P. carinii:A549 cell ratio of 50:1 resulted in 43.5 +/- 2.9% inhibition of A549 cell growth (P less than 0.001). Additionally, TMCA, which significantly prevented attachment of P. carinii, reversed the impairment of A549 cell growth. These data demonstrate that P. carinii attachment to cultured lung cells can be quantified, is dependent on intact cytoskeletal function and is necessary for impairment of lung cell replication.
Female vulnerability to pain and the strength to deal with it
Authors: Karen J. Berkley
Journal: Behavioral and Brain Sciences (1997)

Sex is one of biology's, that is, life's most potent experimental variables. So, are there sex differences in pain? And are these sex differences applicable clinically? The answer to both questions is decidedly yes, of course. But we still have a long way to go. We have much to learn from the study of females, making use of the lifelong changes in their reproductive conditions as experimental variables. We also have much to learn from animals, especially if we apply what we know about their social lives. However, the challenge in all of these studies is not first to look for some mythical neurological entity called pain experience and then to learn how sex modulates it, but rather to seek to understand the rules by which sex influences all of biology's mutually modulatory factors – social, psychological, physiological, cellular, molecular, and genetic – that collectively create the motivating circumstances we designate as pain. It appears almost beyond doubt that on the one hand these factors interact to make women more vulnerable to these circumstances than men, but on the other hand that women have more varied mechanisms for balance. Happily, the details of these sex differences at all levels biological (social to genetic) are now emerging in a rapidly growing body of literature that promises new insights into and applications for the individual person, male or female, in persistent pain.
Thio-Tepa in Treatment of Metastatic Cerebral Malignancy
Authors: Perk L. Davis
Journal: JAMA (1961)

SINCEthe publication of a previous paper on this subject<sup>1</sup>we have treated 97 patients with metastatic cerebral malignancy and 2 postoperative primary ones in addition to those previously recorded. This group of cases consisted of 31 squamous cell cancers of the lung in males whose ages ranged from 43 to 68 years, the average age being 55 years. The interval between total pneumonectomy and cerebral metastases was between 4 and 15 months, averaging 8 months. All of these patients were unconscious when first seen. We established a uniform method of treatment which was used on all patients, namely injection of 100 mg. of triethylenethiophosphoramide (Thio-TEPA) directly into the carotid artery on that side which seemed to indicate the greatest amount of metastatic disease by neurological and physical examination. The patients became conscious and lucid between 6 hours and 4 days after the injection. The injection of triethylenethiophosphoramide in
IL-27 acts on DCs to suppress the T cell response and autoimmunity by inducing expression of the immunoregulatory molecule CD39
Authors: Ivan D Mascanfroni, Ada Yeste, Silvio M Vieira, Evan J Burns, Bonny Patel, Ido Sloma, Yan Wu, Lior Mayo, Rotem Ben-Hamo, Sol Efroni, Vijay K Kuchroo, Simon C Robson, Francisco J Quintana
Journal: Nature Immunology (2013)
Relationship between Pulmonary Artery End-Diastolic Pressure and Left Ventricular Filling Pressure in Patients in Shock
Authors: MELVIN SCHEINMAN, G. THOMAS EVANS, ALAN WEISS, ELLIOT RAPAPORT
Journal: Circulation (1973)

Bedside catheterization permitted 56 simultaneous measurements of left ventricular end-diastolic pressure (LVEDP) and pulmonary artery end-diastolic pressure (PAEDP) in 25 patients in shock. Measurements were made over a wide range of heart rates (60-160 beats/min), arterial oxygen tension (P o o2 ; 33-562 mm Hg), stroke volumes (9-105 ml), and systolic arterial pressures (65-250 mm Hg), and before and during various therapeutic interventions. There was good correlation between PAEDP and LVEDP (r = +0.85) and PAEDP and left ventricular pre-a pressure (r = +0.82). In 16 patients breathing room air, mean arterial P o o2 was 58 ± 15 mm Hg and rose significantly to 282 ± 16 mm Hg after breathing oxygen (P&lt;0.01), but there was no significant change in the correlation between PAEDP and LVEDP before (r = +0.80) or during oxygen breathing (r = +0.80). Similarly, in seven patients treated with inotropic agents there was excellent correlation between PAEDP and LVEDP before (r = +0.96) and during inotropic therapy (r = +0.86). A PAEDP in excess of 15 mm Hg nearly always reflected increased LVEDP while a PAEDP less than 10 mm Hg was always associated with normal LVEDP. Thus in our patients with shock PAEDP represented a good estimate of LVEDP during a variety of therapeutic interventions and therefore represents a useful tool in guiding the therapy of patients in shock.
Differential Effects of VEGFR-1 and VEGFR-2 Inhibition on Tumor Metastases Based on Host Organ Environment
Authors: Yoon-Jin Lee, Daniel L. Karl, Ugwuji N. Maduekwe, Courtney Rothrock, Sandra Ryeom, Patricia A. D'Amore, Sam S. Yoon
Journal: Cancer Research (2010)

Abstract Tumors induce new blood vessel growth primarily from host organ microvascular endothelial cells (EC), and microvasculature differs significantly between the lung and liver. Vascular endothelial growth factor (VEGF or VEGF-A) promotion of tumor angiogenesis is thought to be mediated primarily by VEGF receptor-2 (VEGFR-2). In this study, VEGFR-2 antibody (DC101) inhibited growth of RenCa renal cell carcinoma lung metastases by 26%, whereas VEGFR-1 antibody (MF-1) had no effect. However, VEGFR-2 neutralization had no effect on RenCa liver metastases, whereas VEGFR-1 neutralization decreased RenCa liver metastases by 31%. For CT26 colon carcinoma liver metastases, inhibition of both VEGFR-1 and VEGFR-2 was required to induce growth delay. VEGFR-1 or VEGFR-2 inhibition decreased tumor burden not by preventing the establishment of micrometastases but rather by preventing vascularization and growth of micrometastases by 55% and 43%, respectively. VEGF induced greater phosphorylation of VEGFR-2 in lung ECs and of VEGFR-1 in liver ECs. EC proliferation, migration, and capillary tube formation in vitro were suppressed more by VEGFR-2 inhibition for lung EC and more by VEGFR-1 inhibition for liver EC. Collectively, our results indicate that liver metastases are more reliant on VEGFR-1 than lung metastases to mediate angiogenesis due to differential activity of VEGFRs on liver EC versus lung EC. Thus, therapies inhibiting specific VEGFRs should consider the targeted sites of metastatic disease. Cancer Res; 70(21); 8357–67. ©2010 AACR.
Abstract 2549: Histone deacetylase regulation of hypoxia-inducible factor 1α may play a key role in cancer drug resistance
Authors: Timothy B. Lautz, Janette L. Holub, Sandra H. Clark, Yi-Yong Qiu, Mary Beth Madonna, Fei Chu
Journal: Cancer Research (2010)

Abstract Hypoxia-inducible factor 1α (HIF-1α) is a transcription factor that mediates the downstream expression of genes controlling the cellular response to hypoxic conditions. Overexpression of HIF-1α has been implicated in promoting angiogenesis and a more invasive phenotype in a variety of cancer cells. HIF-1α expression may also promote chemoresistance and increased expression of the MDR gene. Previous work from our laboratory has implicated class II histone deacetylases (HDACs) as key mediators of chemoresistance, however the mechanism for this observation remains unclear. It is known that HDACs decrease HIF-1α acetylation, preventing proteosomal degradation and increasing HIF-1α activity. We hypothesized that class II HDAC modulation of HIF-1α activity may contribute to the development of resistance to anti-cancer therapy. In the present study, HDAC4 and HDAC6 expression were upregulated in doxorubicin-resistant human breast (MCF-7-DoxR), human osteosarcoma (SaOS2-DoxR) and human neuroblastoma (SK-N-SH-DoxR) cells compared to their parental cells by western blot and RT-PCR. Likewise, after treatment with deferoxamine mesylate (DFO) to prevent HIF-1α degradation under normoxic conditions, HIF-1α expression was found to be upregulated in MCF-7-DoxR and SaOS2-DoxR cells. Inhibition of HDACs with suberoylanilide hydroxamic acid (SAHA), sodium butyrate (NaB), or siRNA against HDAC4 or HDAC6 resulted in decreased HIF-1α expression and restoration of sensitivity to anti-cancer agents in both drug resistant cell lines. The percentage of viable drug-resistant cells was lower after treatment with doxorubicin plus SAHA or NaB, compared to doxorubicin, SAHA or NaB alone. In summary, HDAC regulation of HIF-1α expression may be an important mediator of tumor resistance to anti-cancer agents. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2549.
Proceedings: Heterogeneity of human synovial tissue cultures.
Authors: J M Marsh, S Spencer, O Wiebkin, R N Maini, D C Dumonde, H Muir
Journal: Annals of the Rheumatic Diseases (1974)

DR. D. C. DUMONDE (Kennedy Institute) Working with foreign species, globulin as antigen is something of a hazard for the experimental immunologist, because it may contain natural antibodies to certain mammalian tissue antigens.The question arises whether the results obtained with one such globulin antigen in various strains of mice are of general applicability.
Lecture on Recollections of Eminent Surgeons, and of Past Ophthalmic Practice
Authors: W. W. Cooper
Journal: BMJ (1873)

Here, again, you see the excluded peninsula within the county bounded by the included peninsula outside the county ; Brixworth and Kettering rejoicing in being able to defy the Local Government Board, and poor Mr. Haviland having to travel over a most extensive and impracticable circuit imperfectly supplied with railways.He is to receive for superintending this monster district only /50.ter anznm more than Dr. Saunders for a comparatively small district cut out of two counties, Middlesex and Hertford.Yet Dr. Saunders is by no means overpaid by a salary of /750, for his duties take himn from the immediate suburbs of London to a distance of nearly forty miles from it.Look again at these health-officers' circuits (Map I and II) extending into two of the great registration divisions of England.Counties we know; boroughs we know ; unions and registration districts, and even registration counties, we begin to understand; but what are these?Are we have a new order of divisions in England for medico-sanitary purposes ?The Registrar-General says that we have by far too many conflicting divisions already.These new districts, you will agree with me, could hardly be more confusedly arranged or absurdly shaped had one of the despised medical inspectors under Mr. Simon contrived them.Yet these are the only gentlemen connected with the Local Government Board who can bring any special experience to bear on the question.They "know practically what is the work of a health-officer, how often he should visit localities, what investigations he should make, by whom he should be supplied with facts and materials, what should be the purview and particulars of his reports, what time he should devote to a given population," etc.
Attempted suicide: Are effective disorders missed?: Authors' reply
Authors: M. Nordentoft, L. Breum, L. K Munck, A. G Nordestgaard, P. A L. Bjaeldager, A. Hunding
Journal: BMJ (1993)

trend.The number of elderly people and Asians has increased considerably in the past decade, and therefore great care needs to be exercised before an increased incidence of tuberculosis in England is predicted.Evidence in Birmingham points to a steadily decreasing rate, and we doctors need to ensure that it stays that way.
Transmission of Hepatitis A to Patients with Hemophilia by Factor VIII Concentrates Treated with Organic Solvent and Detergent To Inactivate Viruses
Authors: Pier Mannuccio Mannucci, Susan Gdovin, Alessandro Gringeri, Massimo Colombo, Alfonso Mele, Nicola Schinaia, Nicola Ciavarella, Suzanne U. Emerson, Robert H. Purcell
Journal: Annals of Internal Medicine (1994)

Objective: To determine whether an outbreak of hepatitis A virus (HAV) infection that occurred in 52 patients with hemophilia in Italy was acquired through infusion of contaminated factor VIII or through environmental enteric transmission. Design: A case–control study and a molecular analysis of HAV sequences from implicated lots of factor VIII and from infected patients. Patients: The first 29 patients with hemophilia and jaundice in whom hepatitis A developed were compared with one to three matched controls with hemophilia but no jaundice. Measurements: Type of concentrate and batches infused, number of doses, contacts with persons who had jaundice or hepatitis A, travel abroad to countries reported to have a high attack rate for hepatitis A, and consumption of raw shellfish. Hepatitis A viral sequences sought by polymerase chain reaction in lots of factor VIII and in serial serum samples from two patients with hemophilia in whom hepatitis A developed. Amplification by polymerase chain reaction of cDNA transcribed with reverse transcriptase from matched sets of factor VIII and recipient serum samples. Determination of nucleotide sequence of amplified hepatitis A virus genome. Main Results: Case patients were neither more nor less likely than controls to have traveled to high-risk countries, consumed raw shellfish, or had contact with persons with jaundice. Case patients were more likely than controls to have received a factor VIII concentrate treated with a solvent-detergent mixture to inactivate viruses (odds ratio, ∞; 95% CI, 4.5 to ∞) and to have had larger infusions of the concentrate during the presumed HAV incubation period (odds ratio, 8.54; CI, 2.78 to 27.5). Hepatitis A viral sequences were found in 5 of 12 tested lots of factor VIII. Genomic sequences of HAV obtained for two matched sets of factor VIII and recipient serum samples were identical within each set but different for the two sets. Conclusion: Hepatitis A was transmitted by a factor VIII concentrate treated by a virucidal method (solvent-detergent) that ineffectively inactivates nonenveloped viruses.
FATALITY OF SURGICAL OPERATIONS IN ALCOHOLISM.
Authors: I. N. QUIMBY
Journal: JAMA (1895)

I thought it might be of some interest to call the attention of this Section of ourAssociationto a form of rheumatism which has frequently come under my observation during the last twenty years, and which has not been fully, I think, recognized as a distinctive form of that disease by the profession. I have had some twenty cases of this form of rheumatism during the above mentioned period. Not to take up the time of the Section, I will only describe two or three typical cases to illustrate the few remarks I have to make. This form of rheumatism apparently arises wholly from the moderate but continuous use of fermented and distilled liquors and has been aptly termed alcoholic rheumatism. I think too many of us in our daily rounds in the treatment of the more common forms of diseases, are too apt, for want of time or
What is the optimal anticoagulation intensity to prevent stroke in patients with atrial fibrillation &gt;=75 versus &lt;75 years old? The anticoagulation and risk factors in atrial fibrillation (ATRIA) study
Authors: Alan S. Go, Elaine M. Hylek, Yuchiao Chang, Lori E. Henault, Kathleen A. Phillips, Daniel E. Singer
Journal: Journal of the American College of Cardiology (2002)
Intrahepatic peripheral cholangiocarcinoma in cirrhosis patients may display a vascular pattern similar to hepatocellular carcinoma on contrast-enhanced ultrasound
Authors: Ramón Vilana, Alejandro Forner, Luis Bianchi, Ángeles García-Criado, Jordi Rimola, Carlos Rodríguez de Lope, María Reig, Carmen Ayuso, Concepció Brú, Jordi Bruix
Journal: Hepatology (2010)

The aim of this study was to describe the imaging features by contrast-enhanced ultrasound (CEUS) of intrahepatic cholangiocarcinoma (ICC) in cirrhosis patients. We registered the CEUS images of cirrhosis patients with histologically confirmed ICC. In all cases magnetic resonance imaging (MRI) was done to confirm the diagnosis and/or staging purposes. A total of 21 patients met all the criteria to be included in the study. The median nodule size was 32 mm. All nodules showed contrast enhancement at arterial phase; in 10 cases it was homogeneous and in 11 cases peripheral (rim-like). All nodules displayed washout during the venous phases; it appeared during the first 60 seconds in 10 nodules, between 60-120 seconds in five cases, and in six cases after 2 minutes. Ten nodules (five larger than 2 cm) displayed homogeneous contrast uptake followed by washout and they correspond to the specific pattern of hepatocellular carcinoma according to the American Association for the Study of Liver Diseases criteria. However, none of these lesions displayed washout on MRI. Conclusion : CEUS should not be used as the sole imaging technique for conclusive hepatocellular carcinoma diagnosis and if the MRI does not display the diagnostic vascular pattern, a confirmatory biopsy is mandatory. Hepatology 2010;51:2020–2029
Pain Following Laceration-Reply
Authors: Ray J. Defalque
Journal: JAMA (1980)

<h3>In Reply.—</h3> The QUESTIONS AND ANSWERS item "Reflex Sympathetic Dystrophy [RSD] and Causalgia" prompts me to offer the following comments. First, a stellate ganglion block with a good Horner's syndrome occasionally produces an incomplete sympathectomy of the upper extremity, and thus the limb should always be checked as recommended by Dr Ecker, but such discrepancy between eye and arm denervation is rare. The persistence of the pain after the block was performed in Dr Martin's patient, the narrow distribution of pain along a definite neuroanatomic pathway, and the absence of cutaneous and vascular changes, all argue against the presence of a causalgia. Burning pain does not necessary imply RSD, and lesions of mixed nerves often produce such a symptom. This patient may well have protracted nerve damage, or, more plausibly, had scar entrapment of the lateral terminal branch of the median nerve. Meticulous palpation of the scar might uncover a