tbuckley/cabot-search huggingface dataset:
What Comparative Effectiveness Research Is Needed? A Framework for Using Guidelines and Systematic Reviews to Identify Evidence Gaps and Research Priorities
Authors: Tianjing Li, S. Swaroop Vedula, Roberta Scherer, Kay Dickersin
Journal: Annals of Internal Medicine (2012)

The authors developed and tested a framework for identifying evidence gaps and prioritizing comparative effectiveness research by using a combination of clinical practice guidelines and systematic reviews. In phase 1 of the project, reported elsewhere, 45 clinical questions on the management of primary open-angle glaucoma were derived from practice guidelines and prioritized by using a 2-round Delphi survey of clinicians. On the basis of the clinicians' responses, 9 questions were classified as high-priority. In phase 2, reported here, systematic reviews that addressed the 45 clinical questions were identified. The reviews were classified as at low, high, or unclear risk of bias, and evidence gaps (in which no systematic review was at low risk of bias) were identified. The following comparative effectiveness research agenda is proposed: Two of the 9 high-priority questions require new primary research (such as a randomized, controlled trial) and 4 require a new systematic review. The utility and limitations of the framework and future adaptations are discussed.
H-2 mutation affecting immune response to Thy-1.1 antigen
Authors: M Zaleski, J Klein
Journal: The Journal of Experimental Medicine (1977)

Mouse thymus, thymus-derived lymphocytes, and brain share an antigen determined by gene at the Thy-1 locus in chromosome 9 (1). Two alleles have been identified at this locus: Thy-1(a), coding for antigen Thy-1.1 (or θ-AKR) present in AKR and seven other strains; and Thy-1(b), coding for antigen Thy-1.2 (or{teta}-C3H) and present in C3H and all the remaining inbred strains. Injection of AKR thymocytes into inbred mice carrying the Thy-1(b) allele results in an immune response that can be measured either serologically by determining the level of antibodies in the recipients serum (1) or by counting plaque- forming cells (PFC) detectable in spleens of the recipients by means of an assay, with AKR thymocytes as target cells(2). The magnitude of PFC and serum antibody responses after a single thymocyte injection depends on the genetic make-up of the recipient. Three genes controlling the PFC response to the Thy- 1.1 antigen have been identified: Ir-Thy-1A and Ir-Thy-1B, which are closely linked to the major histocompatibility complex (H-2) of the mouse (3-6), and Ir-5, which is located at a distance of 17 cm to the right of the H-2 complex on chromosome 17 (6). Previous genetic mapping with H-2 recombinant strains has indicated that the two Ir-Thy-1 loci are located to the left of the IC subregion (7). Further experiments strongly suggested that either one or both Ir-Thy-1 loci map to the K rather than the I region of the H-2 complex (8). In this report, the study of an H- 2 mutant, CBA-H-2(ka) (M523) (9), and its parental strain, CBA/LacStoY (CBA) provided further evidence that one of these loci apparently resides in the K region and might even be identical with the H-2K locus in that region.
Effects of a maximal exercise test on neurocognitive function
Authors: Tracey Covassin, Leigh Weiss, John Powell, Christopher Womack
Journal: British Journal of Sports Medicine (2007)

Objective: To examine the effects of a maximal exercise test on cognitive function in recreational athletes. Design: A repeated-measures design was used to compare baseline with post-cognitive function and fatigue symptoms after a maximal exercise test. Setting: Division 1 American Midwestern University, (Michigan State University, Michigan, USA). Participants: 102 male and female recreational athletes. Intervention: Participants in the experimental group (n = 54) were asked to perform a maximal treadmill exercise test to maximal oxygen uptake (VO 2 max). Participants in the control group were asked to rest for 15 min. Main outcome measurements: All participants were administered a neuropsychological test battery called Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) before and after exercise to measure neurocognitive function and fatigue symptoms. Results: Results revealed a significant group (control, experimental)×time (baseline, post-test 1, post-test 2) interaction for verbal memory composite scores (p = 0.025). Specifically, verbal memory composite scores decreased in the experimental group from baseline to post-test 1 (p = 0.00). These values returned to baseline 3 days after the V o 2 max test (p = 0.00). Further analysis on verbal memory composite scores demonstrated significant differences on immediate recall memory (p = 0.00) and delayed recall memory (p = 0.00). No significant differences were observed for visual memory (p = 0.54), motor processing speed (p = 0.68) and reaction time (p = 0.44) composite scores between the experimental and control groups. Conclusion: The results of this study suggest that a maximal exercise test attenuated a limiting effect on cognitive function. When utilising a neuropsychological test battery to evaluate a patient who has sustained a head injury, the test should not be administered immediately after a practice or a game session.
Negative inotropic effects of recombinant interleukin 2 in patients without left ventricular dysfunction
Authors: René A. Tio, Judith Nieken, Elisabeth G.E. de Vries, Carolein Pfeiffer, Mike J.L. de Jongste, Els Pieper, Han Moshage, Piet C. Limburg, Nanno H. Mulder
Journal: European Journal of Heart Failure (2000)
IS IT ETHICAL FOR MEDICAL MEN TO PATENT MEDICAL INVENTIONS?
Authors: F. E. STEWART
Journal: JAMA (1897)

I use the word patent in the sense commonly accepted by the medical profession, viz., "restrained from general use," and, by medical men I mean physicians, surgeons and apothecaries, for they are all practicing medical arts. In his primitive state man lived on the fruits of the field without being obliged to till the soil, but as people multiplied on the face of the earth, agriculture was one of the first arts which man practiced. The inventor of the plow may have named it, or the name may have been given it by some one else. At any rate, the name plough was given by somebody who coined the title for that purpose, and it was afterward modified to plow. Here we have an original invention of the purest kind, and a coined word given to it as a title. I can not conceive any reason why the inventor of
SP0039 Development of a Web-Based Patient Decision AID to Support Arthritis Patients with Making Decisions About Medication.
Authors: I. Nota
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Increasingly, patients are encouraged to participate in treatment decisions. Shared Decision Making (SDM) is assumed to have various potential advantages, including improved satisfaction, less decisional conflict and better treatment adherence. In our previous study we found that many patients with Rheumatoid Arthritis (RA) are less involved in decisions about medication than they prefer. Aim of this project is to develop and evaluate a Patient Decision Aid (PtDA), to improve patient involvement in decisions about disease modifying anti-rheumatic drugs (DMARDs). <h3>Methods</h3> A users' centered design-approach was used. First, patients (n=30) were interviewed regarding their opinions about a PtDA, and regarding their beliefs, concerns about and experiences with different DMARDs. Throughout the process, rheumatologists and nurse practitioners were asked about their opinions regarding the content and implementation of the PtDA. Based upon literature and the results of these studies, a concept version of the PtDA was developed, which was then adapted upon the results of a usability study among 10 patients. <h3>Findings</h3> The developmental process resulted in an online PtDA, consisting of various parts: 1) general information about shared decision making, RA, and types of medication, 2) an application to compare medication options suggested by the rheumatologist; 3) a value clarification exercise to get insight into personal concerns, doubts and preferences 4) a printed summary that patients can discuss with their rheumatologist. <h3>Discussion</h3> Currently, the PtDA is being evaluated in a quasi-experimental study. During the presentation we will elaborate on the developmental process, and the PtDA will be demonstrated. <h3>Disclosure of Interest</h3> I. Nota Grant/research support from: Dutch Arthritis Association
Loss of One Copy of Zfp148 Reduces Lesional Macrophage Proliferation and Atherosclerosis in Mice by Activating p53
Authors: Volkan I. Sayin, Omar M. Khan, Lara E. Pehlivanoglu, Anna Staffas, Mohamed X. Ibrahim, Annika Asplund, Pia Ågren, Anna Nilton, Göran Bergström, Martin O. Bergo, Jan Borén, Per Lindahl
Journal: Circulation Research (2014)

Rationale: Cell proliferation and cell cycle control mechanisms are thought to play central roles in the pathogenesis of atherosclerosis. The transcription factor Zinc finger protein 148 (Zfp148) was shown recently to maintain cell proliferation under oxidative conditions by suppressing p53, a checkpoint protein that arrests proliferation in response to various stressors. It is established that inactivation of p53 accelerates atherosclerosis, but whether increased p53 activation confers protection against the disease remains to be determined. Objective: We aimed to test the hypothesis that Zfp148 deficiency reduces atherosclerosis by unleashing p53 activity. Methods and Results: Mice harboring a gene-trap mutation in the Zfp148 locus ( Zfp148 gt/+ ) were bred onto the apolipoprotein E ( Apoe ) –/– genetic background and fed a high-fat or chow diet. Loss of 1 copy of Zfp148 markedly reduced atherosclerosis without affecting lipid metabolism. Bone marrow transplantation experiments revealed that the effector cell is of hematopoietic origin. Peritoneal macrophages and atherosclerotic lesions from Zfp148 gt/+ Apoe –/– mice showed increased levels of phosphorylated p53 compared with controls, and atherosclerotic lesions contained fewer proliferating macrophages. Zfp148 gt/+ Apoe –/– mice were further crossed with p53-null mice ( Trp53 –/– [the gene encoding p53]). There was no difference in atherosclerosis between Zfp148 gt/+ Apoe –/– mice and controls on a Trp53 +/– genetic background, and there was no difference in levels of phosphorylated p53 or cell proliferation. Conclusions: Zfp148 deficiency increases p53 activity and protects against atherosclerosis by causing proliferation arrest of lesional macrophages, suggesting that drugs targeting macrophage proliferation may be useful in the treatment of atherosclerosis.
Syncope in a patient with relapsing polychondritis
Authors: W R Saliba
Journal: Annals of the Rheumatic Diseases (2003)

Relapsing polychondritis (RP) is a rare disease, characterised by recurrent episodes of inflammation of cartilaginous tissues and other proteoglycan rich structures.1,2 The cardiovascular system is affected in 24–52% according to different series,1,3,4 and typically is not the presenting feature but appears after a mean of six years after the onset of symptoms5; aortic regurgitation is the most common manifestation (4–10%), followed by mitral regurgitation (2–8%), aortic aneurysm (2–7%), pericarditis (0–8%), and conduction disturbances (4–6%).1,3,6,7 Cardiovascular disease mostly affects male patients and is the second most common cause of death in RP.5 All types of atrioventricular conduction defects have been reported in RP. …
Diagnosis of Acute Aortic Dissection by D-Dimer
Authors: Toru Suzuki, Alessandro Distante, Antonella Zizza, Santi Trimarchi, Massimo Villani, Jorge Antonio Salerno Uriarte, Luigi De Luca Tupputi Schinosa, Attilio Renzulli, Federico Sabino, Richard Nowak, Robert Birkhahn, Judd E. Hollander, Francis Counselman, Ravi Vijayendran, Eduardo Bossone, Kim Eagle
Journal: Circulation (2009)

D-dimer has been reported to be elevated in acute aortic dissection. Potential use as a "rule-out" marker has been suggested, but concerns remain given that it is elevated in other acute chest diseases, including pulmonary embolism and ischemic heart disease. We evaluated the diagnostic performance of D-dimer testing in a study population of patients with suspected aortic dissection.In this prospective multicenter study, 220 patients with initial suspicion of having acute aortic dissection were enrolled, of whom 87 were diagnosed with acute aortic dissection and 133 with other final diagnoses, including myocardial infarction, angina, pulmonary embolism, and other uncertain diagnoses. D-dimer was markedly elevated in patients with acute aortic dissection. Analysis according to control disease, type of dissection, and time course showed that the widely used cutoff level of 500 ng/mL for ruling out pulmonary embolism also can reliably rule out aortic dissection, with a negative likelihood ratio of 0.07 throughout the first 24 hours.D-dimer levels may be useful in risk stratifying patients with suspected aortic dissection to rule out aortic dissection if used within the first 24 hours after symptom onset.
THE ROYAL COLLEGE OF SURGEONS OF EDINBURGH: ITS EARLY CONNEXION WITH MEDICAL TEACHING
Authors: R. M. Johnston
Journal: BMJ (1905)

__L,i I,9 Sueeessive contrast is explained by assuming that when the colour-perceiving centre in the brain has ju,4 been perceiving rqys of a certain kind, it and the retina are directly afterwards less responsive to those rays than to rays of a different degree of refrangibility, and so surrounding objects will appear to be deficient in that colour.VJ.-Adaptation Corresponds to an Accumulation of Visual Purple in the Retina, thereby making it More Sensitive to Feeble Impressions of LigAt.
The family history method: whose psychiatric history is measured?
Authors: Kenneth S. Kendler, Judy L. Silberg, Michael C. Neale, Ronald C. Kessler, Andrew C. Heath, Lindon J. Eaves
Journal: American Journal of Psychiatry (1991)

The family history method, in which an informant is asked about the history of psychiatric illness in relatives, is widely used in psychiatric research. Previous research has examined the influence on family history information of characteristics of the relative. In this report, the authors seek to clarify the impact on family history reporting of the psychiatric history of the informant.Both members of female twin pairs from a population-based twin registry were asked about the history of major depression, generalized anxiety disorder, and alcoholism in their mother and father. The authors examined twin pairs discordant for each of the three diagnoses and predicted that the affected twin would report higher rates of the same disorder in her parent than would the unaffected twin.Twins with a history of major depression or generalized anxiety disorder but not twins with alcoholism were significantly more likely to report the same disorder in their parents than were their unaffected co-twins.For major depression and generalized anxiety disorder, a family history diagnosis appears to reflect the psychiatric history of both the relative and the informant. Caution may be needed in the interpretation of results based on the family history method, although the magnitude of this problem may be attenuated by the use of multiple informants.
A prospective study of downhill mountain biking injuries
Authors: Johannes Becker, Armin Runer, Daniel Neunhäuserer, Nora Frick, Herbert Resch, Philipp Moroder
Journal: British Journal of Sports Medicine (2013)

Downhill mountain biking (DMB) has become an increasingly popular extreme sport in the last few years with high velocities and bold manoeuvres. The goal of this study was to provide information on the pattern and causes of injuries in order to provide starting points for injury prevention measures.We performed a monthly e-mail-based prospective survey of 249 riders over one summer season ranging from April until September 2011.A total of 494 injuries occurred during the 29 401 h of downhill exposure recorded, of these 65% were mild, 22% moderate and 13% severe, of which 41% led to a total restriction greater than 28 days. The calculated overall injury rate was 16.8 injuries per 1000 h of exposure. For experts it was 17.9 injuries per 1000 h of exposure, which is significantly higher than the 13.4 for professional riders (OR 1.34; 95% CI, 1.02 to 1.75; p=0.03). A significantly higher rate of injury was reported during competition (20 per 1000 h) than during practice (13 per 1000 h) (OR 1.53; 95% CI, 1.16 to 2.01; p=0.0022). The most commonly injured body site was the lower leg (27%) followed by the forearm (25%). Most frequent injury types were abrasions (64%) and contusions (56%). Main causes of injury reported by the riders were riding errors (72%) and bad trail conditions (31%).According to our data DMB can be considered an extreme sport conveying a high risk of serious injury. Strategies of injury prevention should focus on improvements in riders' technique, checking of local trail conditions and protective equipment design.
Cardiopulmonary Physiology in Critical Care
Journal: Thorax (1993)

cases diagnosed as a result of the contact tracing described in this paper is small, however, and it would be a pity if the possibility of late tuberculosis were discounted on the grounds that no such cases were found in South Glamorgan.We recently reported on a child who was found to have a tuberculous pleural effusion six months after being a close contact of a patient with smear positive tuberculosis.'This child had been thought to be negative on being screened six weeks after the last contact.In children at least, longer follow up may be appropriate.
The Safety of Our Drinking Water
Authors: Betty H. Olson
Journal: New England Journal of Medicine (1989)

The question of the safety of drinking water has concerned the American public for more than 150 years. The issues have changed from the dramatic cholera and typhoid epidemics of the 1800s and early 1900s to other microbial pathogens and myriad chemical contaminants.1 The study by Hayes et al. of a waterborne outbreak of cryptosporidiosis in Georgia reported in this issue of the Journal 2 is a dramatic and important reminder of the country's need to keep a vigilant eye on its water supplies.Historically, concern has focused on microbial pathogens in the water supply, but over time the effects of . . .
Crosstalk between Extrinsic and Intrinsic Cell Death Pathways in Pancreatic Cancer: Synergistic Action of Estrogen Metabolite and Ligands of Death Receptor Family
Authors: Aruna Basu, Valerie P. Castle, Mohammed Bouziane, Kapil Bhalla, Subrata Haldar
Journal: Cancer Research (2006)

Abstract 2-Methoxyestradiol is a physiologic metabolite of 17β-estradiol. This orally active compound can inhibit tumor growth or metastasis in tumor models without inducing any clinical sign of toxicity. Our previous studies indicated that 2-methoxyestradiol-mediated apoptosis involves the disappearance of intact 21-kDa Bid protein, cytochrome c release, and predominant procaspase-3 cleavage. Here, using MIA PaCa-2 cells as a model, we investigated whether this estrogen metabolite induces apoptosis by converging two major pathways: the death receptor–mediated extrinsic and the mitochondrial intrinsic pathway. Exogenous expression of dominant-negative caspase-8 or dominant-negative FADD reverts the effect of 2-methoxyestradiol-mediated cell death. In parallel with this observation, Z-IETD-FMK, a cell permeable irreversible inhibitor of caspase-8, can render significant protection against 2-methoxyestradiol-induced apoptosis. RNase protection assay and cell surface receptor analysis by flow cytometry show the up-regulation of members of death receptor family in 2-methoxyestradiol-exposed pancreatic cancer cells. Our mechanistic studies also implicate that oxidative stress precedes 2-methoxyestradiol-mediated c-Jun NH2-terminal kinase activation, leading to elevated Fas level. Because 2-methoxyestradiol is able to trigger death receptor signaling, we were interested in examining the effects of 2-methoxyestradiol and Fas ligand (FasL)/tumor necrosis factor–related apoptosis-inducing ligand (TRAIL) together on pancreatic cancer cell death. Interestingly, the endogenous angiogenesis inhibitor 2-methoxyestradiol augments FasL/TRAIL–induced apoptosis in these cells. Moreover, the combination of 2-methoxyestradiol and TRAIL reduces the tumor burden in vivo in MIA PaCa-2 tumor xenograft model by caspase-3 activation. (Cancer Res 2006; 66(8): 4309-18)
Recurrence Pattern After Temozolomide Concomitant With and Adjuvant to Radiotherapy in Newly Diagnosed Patients With Glioblastoma: Correlation With <i>MGMT</i> Promoter Methylation Status
Authors: Alba A. Brandes, Alicia Tosoni, Enrico Franceschi, Guido Sotti, Giampiero Frezza, Pietro Amistà, Luca Morandi, Federica Spagnolli, Mario Ermani
Journal: Journal of Clinical Oncology (2009)

Purpose The aim of the present study was to evaluate factors predicting the recurrence pattern after the administration of temozolomide (TMZ), initially concurrent with radiotherapy (RT) and subsequently as maintenance therapy, which has become standard treatment for patients with newly diagnosed glioblastoma (GBM). Patients and Methods Ninety-five patients with newly diagnosed GBM were treated with RT plus TMZ (75 mg/m 2 /d) followed by maintenance TMZ cycles (150 to 200 mg/m 2 for 5 days every 28 days). Assessable MGMT methylation status and magnetic resonance imaging follow-up were mandatory in all cases. Results After a median follow-up of 18.9 months (range, 6.6 to 44.8 months), 79 patients (83%) had recurrence: inside the RT field in 57 patients (72.2%), outside in 17 patients (21.5%), and at RT margin in five patients (6.3%). MGMT status was correlated with the site of recurrence, which occurred inside, or at the margin of, the RT field in 51 patients (85%) with MGMT unmethylated status and in 11 patients (57.9%) with MGMT methylated status (P = .01). Recurrences outside the RT field occurred after a longer time interval than those inside the RT field (14.9 v 9.2 months, P = .02). Conclusion After the administration of TMZ concomitant with and adjuvant to RT in patients with GBM, the pattern of, and time to, recurrence are strictly correlated with MGMT methylation status.
Studies to determine the basis for hyperkalemia in recipients of a renal transplant who are treated with cyclosporine.
Authors: K S Kamel, J H Ethier, S Quaggin, A Levin, S Albert, E J Carlisle, M L Halperin
Journal: Journal of the American Society of Nephrology (1992)

Hyperkalemia is commonly encountered in patients who receive a renal transplant and the immunosuppressive drug, cyclosporine. There is also a high incidence of hypertension (which is thought to be due to expansion of the extracellular fluid volume) and hyperchloremic metabolic acidosis in this group of patients. This constellation of findings led to the suspicion of the possibility that their basis might be type II hypoaldosteronism. To test this hypothesis, 12 patients with hyperkalemia (plasma K+, 5.1 +/- 0.2 mmol/L at the time of study) while receiving cyclosporine were studied. Patients who had diabetes mellitus, those receiving drugs known to cause hyperkalemia (e.g., beta blockers, angiotensin-converting enzyme inhibitors, K(+)-sparing diuretics), or those with a serum creatinine greater than 200 mumol/L were excluded. The renal response to hyperkalemia was inappropriate because the transtubular K+ concentration gradient (TTKG) was only 4.3 +/- 0.4 compared with a TTKG of 13 +/- 1, 2 h after 50 mmol of KCl was given to normal subjects. The TTKG, after administration of 200 micrograms of fludrocortisone, was still very low (5.6 +/- 0.6) in the patients compared with that of controls (12 +/- 1). After administration of 250 to 500 mg of acetazolamide to increase the delivery of bicarbonate to the distal nephron, the TTKG rose significantly to 11 +/- 1 in patients on cyclosporine, compared with 17 +/- 1 in the controls.(ABSTRACT TRUNCATED AT 250 WORDS)