tbuckley/cabot-search huggingface dataset:
Minimum clinically important improvement for the incremental shuttle walking test
Authors: S J Singh, P W Jones, R Evans, M D L Morgan
Journal: Thorax (2008)

The incremental shuttle walking test (ISWT) is used to assess exercise capacity in patients with chronic obstructive pulmonary disease (COPD) and is employed as an outcome measure for pulmonary rehabilitation. This study was designed to establish the minimum clinically important difference for the ISWT.372 patients (205 men) performed an ISWT before and after a 7-week outpatient pulmonary rehabilitation programme. After completing the course, subjects were asked to identify, from a 5-point Likert scale, the perceived change in their exercise performance immediately upon completion of the ISWT. The scale ranged from "better" to "worse".The mean (SD) age was 69.4 (8.4) years, forced expiratory volume in 1 s (FEV(1)) 1.06 (0.53) l and FEV(1)/forced vital capacity (FVC) ratio 50.8 (18.1)%. The baseline shuttle walking test distance was 168.5 (114.6) m which increased to 234.7 (125.3) m after rehabilitation (mean difference 65.9 m (95% CI 58.9 to 72.9)). In subjects who felt their exercise tolerance was "slightly better" the mean improvement was 47.5 m (95% CI 38.6 to 56.5) compared with 78.7 m (95% CI 70.5 to 86.9) in those who reported that their exercise tolerance was "better" and 18.0 m (95% CI 4.5 to 31.5) in those who felt their exercise tolerance was "about the same".Two levels of improvement were identified. The minimum clinically important improvement for the ISWT is 47.5 m. In addition, patients were able to distinguish an additional benefit at 78.7 m.
Combination gemcitabine and oxaliplatin for advanced non small cell lung cancer (NSCLC): <i>An Australian multicenter randomized phase II sequencing trial</i>
Authors: A. Broad, M. Links, M. A. Rosenthal, P. Mitchell
Journal: Journal of Clinical Oncology (2005)

7244 Background: This multicentre trial examined a combination of Gemcitabine and Oxaliplatin, as developed in a prior phase I study, in patients with advanced NSCLC. In the phase I study the regimen was well tolerated with minimal neurotoxicity. Primary endpoint in this phase II study was efficacy. Limited data exists on the effect of sequencing of gemcitabine with platinum drugs; the sequence of administration was randomized in this study and pharmacokinetics assessed. Methods: Patients with IIIb/IV or recurrent NSCLC were eligible if they had not received prior chemotherapy other than as a neoadjuvant regimen or as part of a definitive chemoradiation schedule. Patients had to be WHO PS ≤ 2, have estimated minimum life expectancy of 12 weeks, and have measurable disease by RECIST criteria. Treatment was open label and comprised Gemcitabine (1250mg/m2) and Oxaliplatin (70mg/m2), each given day 1 and day 8 q 21 days. Patients were randomized 1:1 to the sequencing of the two drugs for the duration of the study: Gem → Oxali or Oxali → Gem. Bloods for PK analysis were taken during cycle 1. Patients were formally assessed every two cycles (maximum 6 cycles). Primary endpoint was response rate (RR). Secondary endpoints were progression-free survival, overall survival, toxicity profile and the effect of drug sequencing on toxicity, efficacy and pharmacokinetics. Results: 46 patients were enrolled in 12 months across 6 sites; 43 were evaluable for response. The RR was 26% incorporating 11/43 patients with PR as best response. PFS was 4.3 mths, and OS was 6.7 mths (95% CI 4.4 - 10.1). Toxicity was mild; notably there was little neurosensory toxicity despite a median oxaliplatin dose in excess of 500mg/m2 (1 case of grade 3 neurosensory toxicity). With regards to sequencing of agents no appreciable differences in clinical endpoints of efficacy or safety were observed. Conclusions: This Oxaliplatin/Gemcitabine regimen has shown activity in advanced NSCLC. The toxicities of established Cisplatin and Carboplatin-based ‘doublet’ regimens are well documented. The favorable toxicity profile of this doublet, in light of comparable tumour response rate, warrants its further investigation. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Lilly Oncology, Sanofi Lilly Oncology Lilly Oncology Lilly Oncology
Physical function in ankylosing spondylitis is independently determined by both disease activity and radiographic damage of the spine
Authors: R Landewe, M Dougados, H Mielants, H van der Tempel, D van der Heijde
Journal: Annals of the Rheumatic Diseases (2008)

<h3>Aim:</h3> To study the relationship between disease activity, radiographic damage and physical function in patients with ankylosing spondylitis (AS) <h3>Patients and methods:</h3> Baseline and 2-year data of the Outcome in Ankylosing Spondylitis International Study (OASIS)(217 patients) were used. Physical function was expressed by the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Dougados Functional Index (DFI); disease activity by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and by erythrocyte sedimentation rate and C-reactive protein; and structural damage by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Syndesmophyte- and non-syndesmophyte sum cores, and numbers of affected (bridged) vertebral units were derived from the mSASSS. Univariate correlations were calculated on baseline values using the Spearman rank correlation. Multivariate associations were investigated by generalised estimating equations (GEE) on baseline and 2-year data. <h3>Results:</h3> mSASSS correlated moderately well with BASFI (Spearman's r = 0.45) and DFI (r = 0.38). BASDAI correlated well with BASFI (r = 0.66) and DFI (r = 0.59). Correlation coefficients for mSASSS versus BASFI and DFI decreased by increasing levels of BASDAI, being zero at the highest quintile of BASDAI. GEE showed that both BASDAI and mSASSS independently and significantly helped to explain either BASFI or DFI. Results were similar for syndesmophyte sum score, non-syndesmophyte sum score, number of affected VUs or number of VUs with bridging. The lumbar part of the mSASSS contributed similarly to the cervical part in explaining BASFI/DFI. <h3>Conclusion:</h3> Physical function impairment in AS is independently caused by patient-reported disease activity and the level of structural damage of the lumbar and cervical spine. Syndesmophytes and other radiographic abnormalities contribute to physical function impairment.
Association of PAI-1 and Fibrinogen With Diabetic Retinopathy in the Veterans Affairs Diabetes Trial (VADT)
Authors: Nasrin Azad, Lily Agrawal, Nicholas V. Emanuele, Ronald Klein, Gideon D. Bahn, Madeline McCarren, Peter Reaven, Rodney Hayward, William Duckworth
Journal: Diabetes Care (2013)

OBJECTIVE To test the hypothesis that high levels of plasminogen-activating inhibitor (PAI)-1 and fibrinogen at baseline were associated with the onset or progression of diabetic retinopathy (DR) during the Veterans Affairs Diabetes Trial (VADT). RESEARCH DESIGN AND METHODS The VADT was an open-label, prospective, randomized controlled trial to test the effect of standard glycemic control (STD) compared with intensive control (INT) on cardiovascular events in patients with advanced type 2 diabetes mellitus (T2DM). Diabetic retinopathy (DR) outcomes were also collected. Incidence and progression of DR were assessed by grading seven-field stereoscopic fundus photographs at baseline and 5 years later taken in 858 of a total of 1,791 participants who completed both eye examinations. RESULTS Assignment to INT was not independently associated with decreased risk of onset of DR. However, after adjustment for multiple covariates, baseline level of PAI-1 was an independent risk factor for the onset of DR. The risk for incidence of DR increased by 12% for each 10 ng/dL increase in baseline PAI-1 concentration (odds ratio [OR] 1.012 [95% CI 1.00–1.024], P = 0.042). Assignment to INT was not independently associated with decreased risk of progression of DR. However, there was an interaction between glycemic treatment assignment and fibrinogen level at baseline. INT was associated with decreased progression of retinopathy in those with fibrinogen &amp;lt;296 mg/dL (OR 0.55 [95% CI 0.31–1.00], P = 0.03). CONCLUSIONS The results require confirmation but are consistent with greater hypercoagulabilty and inflammation, as measured by higher levels of PAI-1 and fibrinogen, being related to DR and responsiveness to INT.
Risk of monoclonal gammopathy of undetermined significance (MGUS) and subsequent multiple myeloma among African American and white veterans in the United States
Authors: Ola Landgren, Gloria Gridley, Ingemar Turesson, Neil E. Caporaso, Lynn R. Goldin, Dalsu Baris, Thomas R. Fears, Robert N. Hoover, Martha S. Linet
Journal: Blood (2005)
Accuracy and sensitivity of the interrupter technique for measuring the response to bronchial challenge in normal subjects
Authors: SB Phagoo, RA Watson, NB Pride, M Silverman
Journal: European Respiratory Journal (1993)

The interrupter technique is a non-invasive method for measuring airway calibre. Since the calculation of interrupter resistance (Rint) is critically dependent upon the analysis of the mouth pressure/time (Pmo(t)) curve obtained after flow interruption, we wanted to assess the relative merits of four different analyses of Pmo(t) curves, obtained under basal conditions and following methacholine-induced airway narrowing, in 10 healthy adults. Four methods of analysing the Pmo(t) curves were used to calculate Rint values: RintC-a smooth curve fit with back-extrapolation; RintL-two-point linear fit with back-extrapolation; RintEO-calculated from the pressure change after the post-interruption oscillations had decayed (end-oscillation); and RintEI-calculated from the pressure change at the end of the period of interruption. The airway response measured with the four Rint methods was compared with plethysmographic airway resistance (Raw). The sensitivity of the methods was determined by calculating a sensitivity index (SI), the change in resistance after challenge expressed in multiples of baseline standard deviation. Values of RintC were similar to Raw values under all conditions. Resistance values from the remaining Rint methods significantly exceeded Raw (mean basal difference: 0.13-0.34 kPa.l-1 x s; mean difference after challenge: 0.12-0.42 kPa.l-1 x s. Raw was the most sensitive method for detecting bronchoconstriction (doubling of Raw was equivalent to SI of 10.5). Of the Rint methods, RintEI gave the highest sensitivity index (SI = 3.1), with a 42% mean change; RintC produced the greatest proportionate change after challenge (55%), but with a lower SI (2.2).(ABSTRACT TRUNCATED AT 250 WORDS)
The Clinical Research Forum and Association of American Physicians disagree with criticism of the NIH Roadmap
Authors: W. Crowley
Journal: Journal of Clinical Investigation (2006)

As representatives of 50 leading academic medical centers focusing on clinical research and many of academic medicine's scientific leaders, the Clinical Research Forum and Association of American Physicians disagree with the JCI's recent editorials on the NIH Roadmap, Elias Zerhouni's leadership, and the future directions of biomedical research.
ASBESTOS AND THE PUBLIC HEALTH
Authors: F D Liddell
Journal: JAMA (1967)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Characterization of a Factor H Mutation That Perturbs the Alternative Pathway of Complement in a Family with Membranoproliferative GN
Authors: Edwin K.S. Wong, Holly E. Anderson, Andrew P. Herbert, Rachel C. Challis, Paul Brown, Geisilaine S. Reis, James O. Tellez, Lisa Strain, Nicholas Fluck, Ann Humphrey, Alison Macleod, Anna Richards, Daniel Ahlert, Mauro Santibanez-Koref, Paul N. Barlow, Kevin J. Marchbank, Claire L. Harris, Timothy H.J. Goodship, David Kavanagh
Journal: Journal of the American Society of Nephrology (2014)

Complement C3 activation is a characteristic finding in membranoproliferative GN (MPGN). This activation can be caused by immune complex deposition or an acquired or inherited defect in complement regulation. Deficiency of complement factor H has long been associated with MPGN. More recently, heterozygous genetic variants have been reported in sporadic cases of MPGN, although their functional significance has not been assessed. We describe a family with MPGN and acquired partial lipodystrophy. Although C3 nephritic factor was shown in family members with acquired partial lipodystrophy, it did not segregate with the renal phenotype. Genetic analysis revealed a novel heterozygous mutation in complement factor H (R83S) in addition to known risk polymorphisms carried by individuals with MPGN. Patients with MPGN had normal levels of factor H, and structural analysis of the mutant revealed only subtle alterations. However, functional analysis revealed profoundly reduced C3b binding, cofactor activity, and decay accelerating activity leading to loss of regulation of the alternative pathway. In summary, this family showed a confluence of common and rare functionally significant genetic risk factors causing disease. Data from our analysis of these factors highlight the role of the alternative pathway of complement in MPGN.
Invasive amoebiasis: an unusual presentation.
Authors: B R Davidson, J P Neoptolemos, D Watkin, I C Talbot
Journal: Gut (1988)

A 63 year old Asian woman who presented with three week9s abdominal pain was found to have a hard right iliac fossa mass and rectal ulceration. Profuse rectal bleeding necessitated a laparotomy. An inflammatory paracaecal mass with fistulae involving appendix, small bowel, and bladder was excised with exteriorisation of the bowel ends. Microscopy showed invasive amoebae. Re-anastomosis was successfully done after treatment with metronidazole and diloxanide. There are no previous reports of a paracaecal amoeboma with fistulae to either the appendix, or urinary bladder.
Identification of distinct subpopulations of intercalated cells in the mouse collecting duct.
Authors: P Teng-umnuay, J W Verlander, W Yuan, C C Tisher, K M Madsen
Journal: Journal of the American Society of Nephrology (1996)

Structurally and functionally distinct populations of intercalated cells have been described in the collecting duct of both rat and rabbit. However, little is known about these cells in the mouse kidney. The study presented here examines ultrastructural and immunological characteristics of different types of intercalated cells in the mouse. Kidneys of two strains of normal female mice, C57BL/6 and IBR, were preserved by in vivo perfusion with 1% glutaraldehyde or paraformaldehyde-picric acid fixatives and processed for morphological evaluation or light and electron microscopic immunohistochemistry, respectively. The avidin-biotin-horseradish peroxidase procedure was performed on was sections using antibodies against carbonic anhydrase II, H+ -ATPase and Band 3 protein. Immunogold cytochemistry was performed on Lowicryl sections using antibodies to H+ -ATPase and Band 3 protein. Colocalization of H+ -ATPase and Band 3 protein was performed by double labeling using an immunogold technique with silver enhancement. Intercalated cells identified by positive staining for H+ -ATPase and carbonic anhydrase II constituted 35% to 40% of all cells in the connecting tubule (CNT), cortical collecting duct (CCD), and outer medullary collecting duct (OMCD). Type A intercalated cells identified by positive Band 3 staining constituted 16%, 24%, and 33% of the total cell population in the CNT, CCD, and OMCD, respectively. Electron microscopy and immunogold cytochemistry demonstrated three distinct populations of intercalated cells. Type A intercalated cells with apical H+ -ATPase and basolateral Band 3 immunoreactivity were present in all segments examined, and had prominent apical microprojections and characteristic tubulovesicular structures beneath the apical surface, both coated with studs on the cytoplasmic face. Type B intercalated cells with basolateral and cytoplasmic H+-ATPase and no Band 3 immunoreactivity were most frequently observed in the initial collecting tubule, but were present also in the CNT and early CCD. Type B intercalated cells had a fairly smooth apical surface, a gray zone free of organelles beneath the apical plasma membrane, and small cytoplasmic vesicles without studs throughout the cell. A third type of intercalated cell with apical and cytoplasmic H+-ATPase, but no basolateral Band 3 protein, was observed exclusively in the CNT and the initial collecting tubule. This type of cell was large, with numerous mitochondria, and vesicles coated with studs were present throughout the cell. It resembled a third type of intercalated cell described previously in the rat. It is concluded that three morphologically and immunologically distinct types of intercalated cells are present in the mouse kidney.
The changing etiology of liver abscess. Further observations
Authors: L. M. De la Maza
Journal: JAMA (1974)

The incidence of liver abscess discovered at autopsy at the Mallory Institute of Pathology has remained fairly constant over the past 70 years (0.57%). The causes, however, are changing. In a review of cases over the period 1959 through 1968, it was discovered that (1) the incidence of liver abscess secondary to acute appendicitis decreased, but liver abscess secondary to biliary obstruction from cholelithiasis or carcinoma increased, and (2) the percentage of abscesses associated with Gramnegative bacteria has increased steadily since the introduction of antibiotics.
Continuous positive airway pressure for sleep apnoea/hypopnoea syndrome: usefulness of a 2 week trial to identify factors associated with long term use
Authors: G Popescu
Journal: Thorax (2001)

The sleep apnoea/hypopnoea syndrome (SAHS) is common and treatment with continuous positive airway pressure (CPAP) is effective. However, not all patients can cope with the demands of using mask positive pressure. Compliance can be improved with an intensive educational programme and patient support, but this is not practical in most centres given the large numbers of patients coming forward for treatment. Several studies have evaluated correlations between various parameters at diagnosis in order to anticipate patients' behaviour and to avoid the social and health implications of undertreated SAHS. We have evaluated the use of additional data derived during a 2 week home CPAP trial to identify factors associated with longer term use of CPAP and compliance.Following a diagnostic study, 209 patients were offered a CPAP machine for a 2 week home trial. After completing the trial, patients were reassessed and scored their overall satisfaction with CPAP treatment on a five point scale ranging from "much worse" to "much better" and an Epworth score relating to the loan period. Machine run time was recorded from the integral clock. These data were added to those available at diagnosis to construct models indicative of continuing CPAP and average nightly use at 1 year.209 patients were offered the 2 week loan at least a year before June 1999 (90.9% men, mean (SD) age 51.0 (10.6) years, body mass index (BMI) 34.6 (7.7) kg/m(2), Epworth score 15 (IQR 11-18), apnoea/hypopnoea index (AHI) 38.1 (22.9) events/h). 153 patients (73.2%) opted to continue CPAP and 56 declined. One year later data were available for 187 patients; 128 (68.5% on an intention to treat analysis) continued to use the machine with a mean use of 5.0 (2.4) hours/night. A logistic regression model indicated that mean CPAP use during the loan period and the overall satisfaction score accurately defined continuing CPAP and "satisfactory" CPAP use at 1 year. For patients with low machine use and no symptomatic improvement during the loan period, the addition of baseline AHI, baseline Epworth score, and the Epworth score at the end of the loan to the equation identifying factors associated with "satisfactory" CPAP use (mean >2 hours/night) improved the value of the model.Data derived from a 2 week CPAP trial are useful in identifying patients who will comply with CPAP treatment to 1 year. It can be used to identify patients with significant symptomatic disease who will struggle with CPAP and may benefit from additional education and support. High mean hourly use and a high degree of overall satisfaction during the loan period identified patients likely to use CPAP and be compliant with it at 1 year.
Mother, Madonna, Whore: The Idealisation and Denigration of Motherhood
Authors: P. Ashurst
Journal: BMJ (2011)

It is a truth universally acknowledged that women, being in want of a penis, lack the necessary means for perversion. Or so it was until the publication in 1988 of Mother, Madonna, Whore . This seminal work by Estela Welldon was based on her experience of working as a consultant forensic psychotherapist at the Portman Clinic in London.

She challenged the accepted wisdom that women did not suffer from perversions. Her original ideas sent shockwaves through the psychoanalytic community and the feminist theorist circles of the time, …
SUPRALETHAL WHOLE BODY IRRADIATION AND ISOLOGOUS MARROW TRANSPLANTATION IN MAN*†
Authors: E. Donnall Thomas, Harry L. Lochte, Joe H. Cannon, Otto D. Sahler, Joseph W. Ferrebee
Journal: Journal of Clinical Investigation (1959)

Leukemia has been studied in two sets of identical two. One leukemic twin was irradiated with 850 r and the other with 1,140 r from Co/sup 60/ sources. Each was then given bone marrow from the respective normal twin. Successful transplantation of this isologous marrow was determined by the return of morrow function, evident after less than two weeks, and by a benign clinical course following radiation. Leukemia recurred after remissions of seven weeks in one case and 12 weeks in the other. From these two patients it was concluded that transplants of isopogous marrow are readily achieved in man; one thousand r of whole-body radiation does not produce troublesome acute radiation sickness in man when given at a rate of 20 to 40 r per hour; whole-body irradiation at the 1,000 r level produces a remission but not a cure of leukemia when followed by isologous marrow. (auth)
Unrecognised Mycobacterium tuberculosis bacteraemia among hospital inpatients in less developed countries
Authors: L Clifford McDonald, Lennox K Archibald, Sunthorn Rheanpumikankit, Somsit Tansuphaswadikul, Boonchuay Eampokalap, Okey Nwanyanwu, Peter Kazembe, Hamish Dobbie, L Barth Reller, William R Jarvis
Journal: The Lancet (1999)