tbuckley/cabot-search huggingface dataset:
Antipsychotics for Preventing Delirium in Hospitalized Adults
Authors: Esther S. Oh, Dale M. Needham, Roozbeh Nikooie, Lisa M. Wilson, Allen Zhang, Karen A. Robinson, Karin J. Neufeld
Journal: Annals of Internal Medicine (2019)

Delirium is an acute disorder marked by impairments in attention and cognition, caused by an underlying medical problem. Antipsychotics are used to prevent delirium, but their benefits and harms are unclear.To conduct a systematic review evaluating the benefits and harms of antipsychotics for prevention of delirium in adults.PubMed, Embase, CENTRAL, CINAHL, and PsycINFO from inception through July 2019, without restrictions based on study setting, language of publication, or length of follow-up.Randomized, controlled trials (RCTs) that compared an antipsychotic with placebo or another antipsychotic, and prospective observational studies with a comparison group.One reviewer extracted data and graded the strength of the evidence, and a second reviewer confirmed the data. Two reviewers independently assessed the risk of bias.A total of 14 RCTs were included. There were no differences in delirium incidence or duration, hospital length of stay (high strength of evidence [SOE]), and mortality between haloperidol and placebo used for delirium prevention. Little to no evidence was found to determine the effect of haloperidol on cognitive function, delirium severity (insufficient SOE), inappropriate continuation, and sedation (insufficient SOE). There is limited evidence that second-generation antipsychotics may lower delirium incidence in the postoperative setting. There is little evidence that short-term use of antipsychotics was associated with neurologic harms. In some of the trials, potentially harmful cardiac effects occurred more frequently with antipsychotic use.There was significant heterogeneity in antipsychotic dosing, route of antipsychotic administration, assessment of outcomes, and adverse events. There were insufficient or no data available to draw conclusions for many of the outcomes.Current evidence does not support routine use of haloperidol or second-generation antipsychotics for prevention of delirium. There is limited evidence that second-generation antipsychotics may lower the incidence of delirium in postoperative patients, but more research is needed. Future trials should use standardized outcome measures.Agency for Healthcare Research and Quality. (PROSPERO: CRD42018109552).
Chemical modification of DNA with muta-carcinogens. II. Base sequence-specific binding to DNA of 2-amino-6-methyl-dipyrido[1,2-a:3',2'-d]imidazole (Glu-P-1).
Authors: Y Hashimoto, K Shudo
Journal: Environmental Health Perspectives (1985)

2-Amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole (Glu-P-1) binds covalently to DNA after metabolic activation to give 2-(C8-guanyl)amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole (Gua-Glu-P-1). The importance of the intercalative ability of the Glu-P-1 skeleton into DNA base pairs for this reaction is emphasized. The reactive form of Glu-P-1, N-acetoxy-Glu-P-1 (N-OAc-Glu-P-1), reacts preferentially at the C8 position of guanine residues in G-C-rich regions of DNA.
AN EVIDENCE-DRIVEN APPROACH TO SCRUM LAW MODIFICATIONS IN AMATEUR RUGBY PLAYED IN SOUTH AFRICA
Authors: S Hendricks, L Micheal, B James, R Clint, V Wayne
Journal: British Journal of Sports Medicine (2014)

Background In 2012, the South African Rugby Union approved a new set of scrum Laws for amateur rugby, to be implemented at the start of the 2013 rugby season. These Law changes were based on the relatively high proportion of scrum-related catastrophic injury data collected as part of the BokSmart National Rugby Safety Programme over the preceding 4 years. Objective Describe the scrum-related catastrophic injury data in South Africa between 2008–2012, and discuss how this evidence justified the change in the Amateur Scrum Laws. Design Prospective. Setting The South African amateur and professional rugby-playing population. Participants Junior and Senior rugby-playing population within South Africa. Risk factor assessment Independent variables included playing position, scrum injury mechanism, subjective comments relating to the cause of the injury, possession at the time of the scrum, coaching received on safe scrum techniques, surface footing at the time of the scrum. Main outcome measurements Catastrophic head, neck and spinal injuries. These were classified into Acute Spinal Cord Injury (ASCI) or Traumatic Brain Injury (TBI). Results The scrum accounted for 33% (n=20 of 60) of all catastrophic injuries between 2008 and 2012. Eighteen of the 20 scrum injuries (90%) were confirmed ASCIs, with 13 of these being permanent injuries. For the scrum injury mechanisms (n=19), ‘impact on the engagement’ was the most frequently reported (n=11 of 19, 58%), followed by “collapsed scrum” (n=7 of 19, 37%) and “popping out” (n=1 of 19, 5%). Conclusions Based on these scrum-related catastrophic injury data, a change in the Amateur Scrum Laws of South African Rugby was justified. The purpose of these Scrum Law changes is to reduce the number of scrum-related catastrophic injuries by minimising impact injury and subsequent scrum collapse in amateur rugby in South Africa.
Immunologic aspects of cardiovascular disease
Authors: D. K. Ledford
Journal: JAMA (1992)

THE PRIMARY immunologic diseases of the blood vessels are termed<i>vasculitis</i>and of the heart,<i>carditis</i>. Histological characteristics of these disorders are deposition in the affected tissue of immunoglobulin and complement and/ or an inflammatory cellular infiltration without local infection, trauma, bland thrombosis, or foreign body. Proposed mechanisms of immune injury include tissue modification or immunologic exposure by previous infection or trauma resulting in an autoimmune process; immunologic response to unrelated antigens cross-reacting with vascular or cardiac antigens; and passive deposition of blood-borne immune reactants.<sup>1</sup>The classification scheme is primarily descriptive because the etiology and principal pathophysiological mechanism of most of the immunologic cardiovascular diseases are unknown. <h3>CARDITIS</h3> Carditis is a descriptive term for inflammation of any one of the three tissues of the heart (pericarditis, myocarditis, endocarditis) or of all three (pancarditis). Symptoms and signs suggest the portion of the heart involved—chest pain and accumulation of pericardial fluid
Polyunsaturated fatty acids ameliorate hepatic steatosis in obese mice by SREBP-1 suppression
Authors: M Sekiya
Journal: Hepatology (2003)

Leptin-deficient ob/ob mice show many characteristics of obesity, including excess peripheral adiposity as well as severe hepatic steatosis, at least in part, due to increased hepatic lipogenesis. Polyunsaturated fatty acids (PUFAs) are not only ligands for peroxisome proliferator-activated receptor (PPAR) α but are also negative regulators of hepatic lipogenesis, which is thought to be mediated by the repression of sterol regulatory element-binding protein (SREBP)-1. We have previously shown that the disruption of SREBP-1 in ob/ob mice decreased their liver triglyceride storage. To examine whether PUFAs could reduce hepatic triglyceride deposition, we challenged ob/ob mice with dietary PUFA. It is demonstrated that PUFA markedly decreased the mature form of SREBP-1 protein and thereby reduced the expression of lipogenic genes such as fatty acid synthase (FAS) and stearoyl-CoA desaturase 1 (SCD1) in the livers of ob/ob mice. Consequently, the liver triglyceride content and plasma alanine aminotransferase (ALT) levels were decreased. Furthermore, both hyperglycemia and hyperinsulinemia in ob/ob mice were improved by PUFA administration, similar to the effect of PPARα activators. In conclusion, PUFAs ameliorate obesity-associated symptoms, such as hepatic steatosis and insulin resistance, presumably through both down-regulation of SREBP-1 and activation of PPARα. (Hepatology 2003;38:1529-1539.)
Computerised cognitive behaviour therapy (cCBT) as treatment for depression in primary care (REEACT trial): large scale pragmatic randomised controlled trial
Journal: BMJ (2016)

Computerised cognitive behaviour therapy (cCBT) as treatment for depression in primary care (REEACT trial): large scale pragmatic randomised controlled trialThe original trial registration for this Research paper (BMJ 2015;351:h5627, doi:10.1136/bmj.h5627),the REEACT trial (http://www.controlled-trials.com/ISRCTN91947481),included depression as a primary outcome, measured in two ways: "Depression severity and symptomatology as measured by a validated self-report measure (the Patient Health Questionnaire [PHQ-9]) and the International Classification of Diseases (ICD-10) depression score at four months."The original protocol defined the primary outcome measure as "depression severity and symptomatology as measured by the PHQ-9 and a self-report computer-administered diagnostic interview (CIS-R) at four months."Before the start of the trial, the primary outcome measure was modified to consist of only the PHQ-9 at four months.We did not collect ICD diagnosed depression using a standardised interview schedule.
Minerva
Journal: BMJ (2003)

participation rates (table).Last systolic blood pressure was higher in participants-mean difference 9.0 mm Hg (95% confidence interval 5.1 to 13.0).We used logistic regression to examine the association between psychosis (dependent variable) and participation-crude odds ratio 0.76 (0.53 to 1.10).Adjustment for age, sex, practice, and systolic blood pressure made negligible difference to the association between psychosis and participation-adjusted odds ratio 0.74 (0.49 to 1.08).The psychosis group consulted their general practitioner more often-mean difference 1.8 (0.8 to 2.9) per year.Increased consultation rate also predicted screening uptake in the total sample (table ).Adding consultation rate to the model changed the odds ratio for participation in screening in the psychosis group to 0.65 (0.43 to 0.98).No interaction terms (involving psychosis and age, sex, consultation rate, or smoking) significantly enhanced the logistic model.Data were available on drug treatment in people with psychosis.Participation was not significantly associated with being on depot drugs, atypical antipsychotic agents, or higher doses (examined as percentage of maximum daily dose and chlorpromazine equivalents).
08.09 Effects of anti-tnf therapy on solubile urokinase plasminogen activator receptor (supar) levels in arthritis
Authors: Anita Pusztai, Edit Végh, Ágnes Horváth, Sándor Szántó, Attila Hamar, Zoltán Szekanecz
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The urokinase plasminogen activator receptor (uPAR) is expressed mainly on immune cells, smooth muscle cells and endothelial cells, favouring extracellular matrix degradation, cell adhesion, cell proliferation and regulates cell migration. The suPAR is the soluble form of the cell membrane-bound protein uPAR, elevated levels may reflect increased activation of immune system which observed in the autoimmun diseases. The aim of this study was to assess the effects of anti-TNF therapy on these levels in RA and AS patients. The suPAR levels also correlated with various autoimmun inflammatory markers. <h3>Patients and methods</h3> Altogether 33 arthritis patients including 22 RA patients treated with either etanercept (ETN) or certolizumab pegol (CZP) and 11 AS patients treated with ETN were included in a 12- month follow-up study. Circulating suPAR levels were assessed by suPARnostic Quick Test Reader. In addition,disease activity (DAS28 or BASDAI), CRP, IgM rheumatoid factor, anti-CCP were also assessed. Assessment were performed at baseline, as well as 6 and 12 months after treatment initation. <h3>Results</h3> Anti-TNF treatment was highly effective in both disease, as the mean DAS28 decreased in RA, mean BASDAI decresead in AS. There were no significant change in the suPAR levels after 12 months of anti-TNF therapy, although resulted non-significant decrease (p&lt;0,18) in RA patients with critical suPAR levels (&gt;9 ng/ml). Baseline suPAR levels positively correlated with anti-CCP (p&lt;0,001) and rheumatoid factor (p=0,024) in RA patients. Circulating suPAR levels did not correlate with DAS28, BASDAI or CRP. <h3>Conclusion</h3> In a mixed cohort of RA and AS patients, anti-TNF therapy did not affect the suPAR levels after 12 months. No correlations were observed between suPAR levels and CRP, DAS28, BASDAI. suPAR levels correlated with rheumatoid factor and anti-CCP. Based on these results suPAR may be a marker of autoimmunity rather than that of disease activity.
ODENZA: A study of patient preference between ODM-201 (darolutamide) and enzalutamide in men with metastatic castrate-resistant prostate cancer (mCRPC).
Authors: Geraldine Martineau, Stéphanie Foulon, Giulia Baciarello, Florence Joly, Remy Delva, Philippe Barthelemy, Yann Neuzillet, Franck Priou, Anne Sophie Hue, Karim Fizazi
Journal: Journal of Clinical Oncology (2019)

TPS334 Background: In recent years, the treatment of mCRPC has evolved and next-generation androgen receptor (AR)-axis targeting drugs (enzalutamide (ENZ), and abiraterone) have been approved and are routinely used. Darolutamide (DARO) is a new next-generation AR inhibitor which has shown strong activity and minimal toxicity in two phase I-II trials ARADES (Fizazi, Lancet Oncol 2014) and ARAFOR (Massard, Eur Urol 2016) and is currently evaluated in a study in men with non-metastatic CRPC (ARAMIS trial). In contrast to ENZ, DARO does not significantly penetrate the blood-brain barrier in vivo, and this may reduce the risk of fatigue, cognitive impairment, and seizure. Assessing patient preference between DARO and ENZ may contribute further differentiating between these two agents. Methods: ODENZA is a prospective, randomized, open-label, multicenter, cross-over phase II trial assessing patient preference between DARO and ENZ. It was initiated in November 2017. Eligibility criteria include: men with asymptomatic or mildly symptomatic mCRPC, performance status 0-1, no prior next generation AR axis-targeted agent. The randomization is stratified on performance status and prior treatment with a taxane for CSPC. 250 patients will be randomized 1:1 to: 12-week ENZ followed by 12-week DARO or 12-week DARO followed by 12-week ENZ. The primary endpoint is patient preference between DARO and ENZ, assessed after the second treatment period. A two-sided binomial test with a power of 80% and a bilateral α of 0.05 will be used. Secondary endpoints include: reasons for patient preference, dose modifications and time to dose modification, safety, fatigue (BFI), cognitive function as assessed by Cogstate computerized cognitive tests, depression screening (CES-D) test, frequency of falls, PSA declines using Waterfall plots after each treatment period, Progression-Free Survival (PFS), association between 4-weeks PSA value and PFS, incidence of cancer progression or death, and tumor response. The study is recruiting. By October 23, 2018, 75 patients have been screened and 66 have been randomized. Clinical trial information: NCT03314324.
Anatomy Lesson
Journal: JAMA (2004)

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 Publications 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 2023 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
Improving Improvement
Authors: Bruce E. Landon, Paul D. Cleary, Ira B. Wilson
Journal: Annals of Internal Medicine (2004)

Letters16 November 2004Improving ImprovementBruce E. Landon, MD, MBA, MSc, Paul D. Cleary, PhD, and Ira B. Wilson, MD, MScBruce E. Landon, MD, MBA, MScFrom Harvard Medical School, Boston, MA 02115, and Tufts-New England Medical Center, Boston, MA 02111.Search for more papers by this author, Paul D. Cleary, PhDFrom Harvard Medical School, Boston, MA 02115, and Tufts-New England Medical Center, Boston, MA 02111.Search for more papers by this author, and Ira B. Wilson, MD, MScFrom Harvard Medical School, Boston, MA 02115, and Tufts-New England Medical Center, Boston, MA 02111.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-10-200411160-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Batalden suggests that more information than was provided in our article is needed to understand how to improve QI interventions. We agree completely. A good evaluation study should first assess whether an intervention was successful (1). When there is no effect, a good study should provide information about how well the program was implemented, as well as information on potential moderating effects. Annals articles must be concise, and we could not include all of these details in our article. However, we did assess virtually all of the factors mentioned by Dr. Batalden. We conducted detailed assessments of ...Reference1. Rossi PH, Freeman HE, Lipsey MW. Evaluation. A Systematic Approach. 6th ed. Thousand Oaks, CA: SAGE Publications; 1999. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Harvard Medical School, Boston, MA 02115, and Tufts-New England Medical Center, Boston, MA 02111. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of a Quality Improvement Collaborative on the Outcome of Care of Patients with HIV Infection: The EQHIV Study Bruce E. Landon , Ira B. Wilson , Keith McInnes , Mary Beth Landrum , Lisa Hirschhorn , Peter V. Marsden , David Gustafson , and Paul D. Cleary Improving Improvement Paul Batalden Improving Improvement Bruce D. Agins and Clemens Steinbock Metrics 16 November 2004Volume 141, Issue 10Page: 821-822KeywordsForecasting ePublished: 16 November 2004 Issue Published: 16 November 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
CHRONIC BRONCHITIS
Journal: JAMA (1962)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications 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) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 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
Hysteria today.
Authors: G G Wallis
Journal: BMJ (1976)

of ours who is in long-term remission after chemotherapy of acute myeloblastic leukaemia in childhood.He is now married and has two normal children.In September 1963, when aged 9 years, he was found to have acute myeloblastic leukaemia, was treated with prednisone and 6-mercaptopurine, and went into remission.He relapsed in January 1965 and was then treated with prednisone and methotrexate, achieving a further but short remission and relapsing in July 1965.This second relapse was treated with prednisolone and cyclo- phosphamide and was followed by complete clinical and haematological remission which has been maintained ever since.Treatment was stopped at the end of 1967.The patient married in 1972 and has a daughter aged 4 and a son aged 2 years, both clinically well.He was last seen (with his family) in June 1976 and found to be in continued haematological remission.Between her two normal pregnancies his wife had a miscarriage, but nothing is known about the condition of the fetus.
Cancer therapy with unloaded monocyte-derived dendritic cells in patients with inoperable pancreatic and gall bladder cancer
Authors: T. Nesselhut, R. Y. Chang, C. Matthes, D. Marx, D. R. Lorenzen, N. Cillien, M. Martin, R. Gorter, J. H. Peters
Journal: Journal of Clinical Oncology (2004)

2569 Background: Several studies could show that immunotherapy with monocyte-derived dendritic cells (MoDC) loaded with tumor-cell-lysate or known peptides induce clinical antitumor response in certain patients with various types of solid tumors. Given that tumor proteins in the serum of cancer patients may be sufficient to internalize and presented by immature dendritic cells, we investigated whether immature dendritic cells incubated with the serum of cancer patients could induce an antitumor response in vivo. Methods: After isolating monocytes from peripheral blood of patients with pancreatic (n=17) and gall bladder cancer (n=6), dendritic cells were generated ex vivo in the presence of recombinant cytokines (IL-4;GMC-SF) and autologous serum. After 7 days of culture, the autologous MoDC were administered to the cancer patients (intradermal or intratumoral). Results: Flow cytometric analysis of the surface markers revealed that the generated MoDC were of immature type with expression of CD1a and MHC-II but not monocyte specific marker CD14. The generated MoDC could induce an antigen specific lymphocyte proliferation in vitro. Using a phagocytosis assay it could be demonstrated by flow cytometry and electron microscopy that immature dendritic cells are in general able to phagocytose different sized particles. The vaccination induced a clinical response in n=5 patients with pancreatic cancer including 2 stable diseases, 2 minor remissions and 1 mixed response (overall survival 4–32 months; 2 patients died of their disease after 10 and 21 months, respectively) as well as in n=1 patient with gall bladder cancer (stable disease after 18 months using intratumoral administration). A biopsy taken from the patient with the gall bladder cancer within the treatment period demonstrated unusually low proliferative activity. Conclusions: The results suggest that immature dendritic cells could be loaded by soluble tumor antigens in the serum of cancer patients as well as able to uptake tumor antigens in vivo. No significant financial relationships to disclose.