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Medicine

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Oral Anticoagulants: Mechanism of Action, Clinical Effectiveness, and Optimal Therapeutic Range

Jack Hirsh, James E. Dalen, D. Anderson, Leon Poller, Henry Bussey, Jack Ansell

Organizing Care for Patients with Chronic Illness

Edward H. Wagner, Brian T. Austin, Michael Von Korff

Peripherally administered antibodies against amyloid |[beta]|-peptide enter the central nervous system and reduce pathology in a mouse model of Alzheimer disease

One hallmark of Alzheimer disease is the accumulation of amyloid β-peptide in the brain and its deposition as plaques. Mice transgenic for an amyloid β precursor protein (APP) mini-gene driven by a platelet-derived (PD) growth factor promoter (PDAPP...

Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer

purpose: To determine the long-term impact of medical and surgical treatment of well differentiated papillary and follicular thyroid cancer.methods: Patients with papillary and follicular cancer (n = 1,355) treated either in U.S. Air Force or Ohio State...

Nanoparticle therapeutics: an emerging treatment modality for cancer.

Nanoparticles — particles in the size range 1–100 nm — are emerging as a class of therapeutics for cancer. Early clinical results suggest that nanoparticle therapeutics canshow enhanced efficacy, while simultaneously reducing side effects, owing...

Measuring Social Class in US Public Health Research: Concepts, Methodologies, and Guidelines

Increasing social inequalities in health in the United States and elsewhere, coupled with growing inequalities in income and wealth, have refocused attention on social class as a key determinant of population health. Routine analysis using conceptually...

Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma

Although lymphoid tissue is absent in normal gastric mucosa, primary lymphomas arise in the stomach and most of these recapitulate the features of mucosa-associated lymphoid tissue (MALT). Gastric lymphoid tissue is known to be acquired in response to...

Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial.

BACKGROUND: Among patients with substantial carotid artery narrowing but no recent neurological symptom (stroke or transient ischaemia), the balance of surgical risks and long-term benefits from carotid endarterectomy (CEA) was unclear. METHODS: During...

Subclinical Thyroid Disease: Scientific Review and Guidelines for Diagnosis and Management

Martin I. Surks, Eduardo Ortiz, Gilbert H. Daniels, Clark T. Sawin, Nananda F. Col, Rhoda H. Cobin, Jayne A. Franklyn, Jerome M. Hershman, Kenneth D. Burman, Margo A. Denke, Colum A. Gorman, Richard S. Cooper, Neil J. Weissman

Classification of Inflammatory Bowel Disease

Infection, ischaemia, physical damage, or specific immunologic sensitivity should be excluded as far as possible before a diagnosis of non-specific inflammatory bowel disease is made. Non-specific inflammations can be subdivided on the basis of macroscopic...

Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate.

To compare the clinical usefulness of the serum markers prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP), we measured them by radioim-munoassay in 2200 serum samples from 699 patients, 378 of whom had prostatic cancer. PSA was elevated...

Surveillance for Asthma -- United States, 1960-1995

Problem/Condition: Asthma is one of the most common chronic diseases in the United States, and it has increa preceding 20 years. Despite its importance, no comprehensive surveillance system has been established that measures as level. Reporting Period:...

A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer.

background The effect of adjuvant treatment on survival in pancreatic cancer is unclear. We report the final results of the European Study Group for Pancreatic Cancer 1 Trial and update the interim results. methods In a multicenter trial using a two-by-two...

Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome.

John C. Marshall, Deborah J. Cook, Nicolas V. Christou, Bernard Gr, William J. Sibbald

The Oswestry Disability index

Jeremy Fairbank, P. B. Pynsent

Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery

The scarcity of early biomarkers for acute renal failure has hindered our ability to launch preventive and therapeutic measures for this disorder in a timely manner. We tested the hypothesis that neutrophil gelatinase-associated lipocalin (NGAL) is an...

Interventions for preventing falls in older people living in the community

As people get older, they may fall more often for a variety of reasons including problems with balance, poor vision, and dementia. Up to 30% may fall in a year. Although one in five falls may require medical attention, less than one in 10 results in...

Controlled Sedation with Alphaxalone-Alphadolone

Alphaxalone-alphadolone (Althesin), diluted and administered as a controlled infusion, was used as a sedative for 30 patients in an intensive therapy unit. This technique allowed rapid and accurate control of the level of sedation. It had three particularly...

A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis.

Background Etanercept, which blocks the action of tumor necrosis factor, reduces disease activity in patients with long-standing rheumatoid arthritis. Its efficacy in reducing disease activity and preventing joint damage in patients with active early...

Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview

Summary Background High blood glucose concentration may increase risk of death and poor outcome after acute myocardial infarction. We did a systematic review and metaanalysis to assess the risk of in-hospital mortality or congestive heart failure after...

Hip fractures in the elderly: A world-wide projection

Hip fractures are recognized to be a major public health problem in many Western nations, most notably those in North America, Europe and Oceania. Incidence rates for hip fracture in other parts of the world are generally lower than those reported for...

Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality

Background: Experimental models and observational studies suggest that vitamin E supplementation may prevent cardiovascular disease and cancer. However, several trials of high-dosage vitamin E supplementation showed non–statistically significant increases...

A Comparison of Immediate Angioplasty with Thrombolytic Therapy for Acute Myocardial Infarction

Background The success of thrombolytic therapy for acute myocardial infarction is limited by bleeding complications, the impossibility of reperfusing all occluded coronary arteries, recurrent myocardial ischemia, and the relatively small number of patients...

Prevalence and Clinical Spectrum of Gastroesophageal Reflux: A Population-Based Study in Olmsted County, Minnesota

1.9‐5.0), and globus sensation (OR, 1.9; 95% CI, 1.0‐ 3.6) but not with asthma, hoarseness, bronchitis, or reflux symptoms. 20,21 a history of pneumonia. Among subjects with reflux Population-based research in Olmsted...

High-Intensity Strength Training in Nonagenarians: Effects on Skeletal Muscle

Muscle dysfunction and associated mobility impairment, common among the frail elderly, increase the risk of falls, fractures, and functional dependency. We sought to characterize the muscle weakness of the very old and its reversibility through strength...

The Prevalence of Hepatitis C Virus Infection in the United States, 1999 through 2002

Results: The prevalence of anti-HCV in the United States was 1.6% (95% CI, 1.3% to 1.9%), equating to an estimated 4.1 million (CI, 3.4 million to 4.9 million) anti-HCV–positive persons nationwide; 1.3% or 3.2 million (CI, 2.7 million to 3.9 million)...

Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women: the Women's Health Initiative Memory Study: a randomized controlled trial

Sally A. Shumaker, Claudine Legault, Stephen R. Rapp, Robert B. Wallace, Judith K. Ockene, Susan L. Hendrix, Annlouise R. Assaf, Rebecca D. Jackson, Jane Morley Kotchen, Sylvia Wassertheil-Smoller, Jean Wactawski-Wende

Medical image registration

Radiological images are increasingly being used in healthcare and medical research. There is, consequently, widespread interest in accurately relating information in the different images for diagnosis, treatment and basic science. This article reviews...

Graft-versus-leukemia Effect of Donor Lymphocyte Transfusions in Marrow Grafted Patients

The immune reactivity of allogeneic lymphocytes plays a major role in the control of leukemia after bone marrow transplantation. In patients with recurrent leukemia after marrow transplantation, chimerism and tolerance provide ideal conditions for adoptive...

Resistant Hypertension: Diagnosis, Evaluation, and Treatment. A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research

David A. Calhoun, Daniel W. Jones, Stephen C. Textor, David C. Goff, Timothy P. Murphy, Robert D. Toto, Anthony White, William C. Cushman, William B. White, Domenic A. Sica, Keith C. Ferdinand, Thomas D. Giles, Bonita Falkner, Robert M. Carey

Effect of Oral Alendronate on Bone Mineral Density and the Incidence of Fractures in Postmenopausal Osteoporosis

Background Postmenopausal osteoporosis is a serious health problem, and additional treatments are needed. Methods We studied the effects of oral alendronate, an aminobisphosphonate, on bone mineral density and the incidence of fractures and height loss...

Sarcopenia : European consensus on definition and diagnosis

The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools...

The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia

H. Frankel, D. O. Hancock, G Hyslop, J Melzak, L.S. Michaelis, G. Ungar, Vernon J, J. J. Walsh

Can lifestyle changes reverse coronary heart disease?: The Lifestyle Heart Trial

In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management...

DEFINITION AND CLASSIFICATION OF CHRONIC KIDNEY DISEASE: A POSITION STATEMENT FROM KIDNEY DISEASE: IMPROVING GLOBAL OUTCOMES (KDIGO)

Definition and classification of chronic kidney disease: A po- sition statement from Kidney Disease: Improving Global Out- comes (KDIGO). Chronic kidney disease (CKD) is a world- wide public health problem, with adverse outcomes of kidney failure, cardiovascular...

Mediators and moderators of treatment effects in randomized clinical trials.

Randomized clinical trials (RCTs) not only are the gold standard for evaluating the efficacy and effectiveness of psychiatric treatments but also can be valuable in revealing moderators and mediators of therapeutic change. Conceptually, moderators identify...

Estrogen plus progestin and the risk of coronary heart disease

Background Recent randomized clinical trials have suggested that estrogen plus progestin does not confer cardiac protection and may increase the risk of coronary heart disease (CHD). In this report, we provide the final results with regard to estrogen...

Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document

Giuseppe Mancia, Stéphane Laurent, Enrico Agabiti-Rosei, Ettore Ambrosioni, Michel Burnier, Mark Caulfield, Renata Cifkova, Denis Clement, Antonio Coca, Anna F. Dominiczak, Serap Erdine, Robert Fagard, Csaba Farsang, Guido Grassi, Hermann Haller, Antony Heagerty, Sverre E. Kjeldsen, Wolfgang Kiowski, Mallion Jm, Athanasios J. Manolis, Krzysztof Narkiewicz, Peter Nilsson, Michael H. Olsen, Rahn Kh, Josep Redon, Rodicio Jl, Luis M. Ruilope, Roland E. Schmieder, Harry Struijker-Boudier, Pieter van Zwieten, Margus Viigimaa, Alberto Zanchetti

Effects of Computerized Clinical Decision Support Systems on Practitioner Performance and Patient Outcomes: A Systematic Review

Context.— Many computer software developers and vendors claim that their systems can directly improve clinical decisions. As for other health care interventions, such claims should be based on careful trials that assess their effects on clinical performance...

Gefitinib in Combination With Gemcitabine and Cisplatin in Advanced Non–Small-Cell Lung Cancer: A Phase III Trial—INTACT 1

Purpose The purpose of this study was to determine whether the addition of the epidermal growth factor receptor tyrosine kinase inhibitor gefitinib (Iressa, ZD1839; AstraZeneca, Wilmington, DE) to standard first-line gemcitabine and cisplatin provides...

Inhibition of Poly(ADP-Ribose) Polymerase in Tumors from BRCA Mutation Carriers

Background: The inhibition of poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP) is a potential synthetic lethal therapeutic strategy for the treatment of cancers with specific DNA-repair defects, including those arising in carriers of a BRCA1...

Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys

Koen Demyttenaere, R. Bruffaerts, Jose Posada-Villa, I. Gasquet, Kovess, J.P. Lépine, Angermeyer Mc, S. Bernert, de Girolamo G, Pierfrancesco Morosini, G. Polidori, Takehiko Kikkawa, Norito Kawakami, Yutaka Ono, Tadashi Takeshima, Hidenori Uda, Elie G. Karam, John Fayyad, Aimee N. Karam, Zeina Mneimneh, María Elena Medina-Mora, Guilherme Borges, Carmen Lara, de Graaf R, J. Ormel, Oye Gureje, Yang Shen, Y. Q. Huang, Man Zhang, J. Alonso, Gemma Vilagut, Evelyn J. Bromet, Semyon F. Gluzman, Webb C, R. Kessler, Kathleen R. Merikangas, James C. Anthony, Von Korff Mr, Philip S. Wang, Traolach S. Brugha, Sergio Aguilar-Gaxiola, S. Lee, S. G. Heeringa, B. E. Pennell, Zaslavsky Am, T. B. Üstün, Somnath Chatterji

Human papillomavirus and cervical cancer.

SummaryCervical cancer is the second most common cancer in women worldwide, and knowledge regarding its cause and pathogenesis is expanding rapidly. Persistent infection with one of about 15 genotypes of carcinogenic human papillomavirus (HPV) causes...

The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance.

I Anna S Olsson, Jääskö L, Leyman Ia, S Steglind, A Fügl

Model for end-stage liver disease (MELD) and allocation of donor livers

Background & Aims: A consensus has been reached that liver donor allocation should be based primarily on liver disease severity and that waiting time should not be a major determining factor. Our aim was to assess the capability of the Model for End-Stage...

Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: results from a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer)

This placebo-controlled phase III study investigated the effect on survival of gefitinib as second-line or third-line treatment for patients with locally advanced or metastatic non-small-cell lung cancer.

Systemic lupus erythematosus.

Anisur Rahman, D. A. Isenberg

Improving Primary Care for Patients With Chronic Illness: The Chronic Care Model, Part 2

This article reviews research evidence showing to what extent the chronic care model can improve the management of chronic conditions (using diabetes as an example) and reduce health care costs. Thirty-two of 39 studies found that interventions based...

Diffusion tensor MR imaging of the human brain.

PURPOSE: To assess intrinsic properties of water diffusion in normal human brain by using quantitative parameters derived from the diffusion tensor, D, which are insensitive to patient orientation. MATERIALS AND METHODS: Maps of the principal diffusivities...

Gefitinib in Combination With Paclitaxel and Carboplatin in Advanced Non–Small-Cell Lung Cancer: A Phase III Trial—INTACT 2

Purpose Preclinical studies indicate that gefitinib (Iressa, ZD1839; AstraZeneca, Wilmington, DE), an orally active epidermal growth factor receptor tyrosine kinase inhibitor, may enhance antitumor efficacy of cytotoxics, and combination with paclitaxel...

Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial

Summary Background Male circumcision could provide substantial protection against acquisition of HIV-1 infection. Our aim was to determine whether male circumcision had a protective effect against HIV infection, and to assess safety and changes in sexual...

Inadequate Antimicrobial Treatment of Infections: A Risk Factor for Hospital Mortality Among Critically Ill Patients

Study objective: To evaluate the relationship between inadequate antimicrobial treatment of infections (both community-acquired and nosocomial infections) and hospital mortality for patients requiring ICU admission. Design: Prospective cohort study. Setting:...

Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify...

Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study.

Stent thrombosis is a safety concern associated with use of drug-eluting stents. Little is known about occurrence of stent thrombosis more than 1 year after implantation of such stents.

International uniform response criteria for multiple myeloma

International uniform response criteria for multiple myeloma New uniform response criteria are required to adequately assess clinical outcomes in myeloma. The European Group for Blood and Bone Marrow Transplant/International Bone Marrow Transplant Registry...

Bias in analytic research

This chapter focuses on the bias in analytic research. Case-control studies are attractive. They can be executed quickly and at low cost, even when the disorders of interest are rare. The execution of pilot case-control studies is becoming automated;...

Survival after the onset of congestive heart failure in Framingham Heart Study subjects.

BACKGROUND Relatively limited epidemiological data are available regarding the prognosis of congestive heart failure (CHF) and temporal changes in survival after its onset in a population-based setting.METHODS AND RESULTS Proportional hazards models were...

Serum TSH, T4, and Thyroid Antibodies in the United States Population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III)

NHANES III measured serum TSH, total serum T4, antithyroperoxidase (TPOAb), and antithyroglobulin (TgAb) antibodies from a sample of 17,353 people aged ≥12 yr representing the geographic and ethnic distribution of the U.S. population. These data provide...

Prevalence of Diabetes among Men and Women in China

Background Because of the rapid change in lifestyle in China, there is concern that diabetes may become epidemic. We conducted a national study from June 2007 through May 2008 to estimate the prevalence of diabetes among Chinese adults. Methods A nationally...

Gestational diabetes mellitus

Gestational diabetes mellitus is defined as glucose intolerance that is first detected during pregnancy.1 This simple definition belies the complexity of a condition that spans a spectrum of glycemia, pathophysiology, and clinical effects and for which...

Oxford textbook of palliative medicine

Full textFull text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (542K), or click on a page image below to browse page by page. 793794

Effect of Treatment With Low Doses of Hydrocortisone and Fludrocortisone on Mortality in Patients With Septic Shock

Context Septic shock may be associated with relative adrenal insufficiency. Thus, a replacement therapy of low doses of corticosteroids has been proposed to treat septic shock.Objective To assess whether low doses of corticosteroids improve 28-day survival...

Trends in the Incidence of Deep Vein Thrombosis and Pulmonary Embolism: A 25-Year Population-Based Study

Marc D. Silverstein, John A. Heit, David N. Mohr, Tanya M. Petterson, W. Michael O'Fallon, L. Joseph Melton

Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention Systematic Review and Meta-analysis

Context Antioxidant supplements are used for prevention of several diseases.Objective To assess the effect of antioxidant supplements on mortality in randomized primary and secondary prevention trials.Data Sources and Trial Selection We searched electronic...

Prevalence and burden of overactive bladder in the United States

Context: The National Overactive BLadder Evaluation (NOBLE) Program was initiated to better understand the prevalence and burden of overactive bladder in a broad spectrum of the United States pop- ulation. Objective: To estimate the prevalence of over-...

Blood flow in arteries

Donald M. McDonald

Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update.

Objective. —To combine the clinical data from 3 academic institutions that serve as centers of excellence for the surgical treatment of clinically localized prostate cancer and develop a multi-institutional model combining serum prostate-specific antigen...

Classification of Inflammatory Bowel Disease

Infection, ischaemia, physical damage, or specific immunologic sensitivity should be excluded as far as possible before a diagnosis of non-specific inflammatory bowel disease is made. Non-specific inflammations can be subdivided on the basis of macroscopic...

A Multicomponent Intervention to Prevent Delirium in Hospitalized Older Patients

Background Since in hospitalized older patients delirium is associated with poor outcomes, we evaluated the effectiveness of a multicomponent strategy for the prevention of delirium. Methods We studied 852 patients 70 years of age or older who had been...

A retrospective study

SummaryTwo hundred and twelve total hip replacements performed in one clinic over 1 year were reviewed. The mean operative time was 89 min and mean total blood loss 1090 ml. Homologous blood was administered to 74% of the patients. Blood loss was dependent...

PLASMA-HIGH-DENSITY-LIPOPROTEIN CONCENTRATION AND DEVELOPMENT OF ISCHÆMIC HEART-DISEASE

The body cholesterol pool increases with decreasing plasma-high-density- lipoprotein (H.D.L.), but is unrelated to the plasma concentrations of total cholesterol and other lipoproteins. This finding supports existing evidence that H.D.L. facilitates the...

Chronic Health Conditions in Adult Survivors of Childhood Cancer

Background Only a few small studies have assessed the long-term morbidity that follows the treatment of childhood cancer. We determined the incidence and severity of chronic health conditions in adult survivors. Methods The Childhood Cancer Survivor Study...

LEISHMANIASIS: CURRENT SITUATION AND NEW PERSPECTIVES

Leishmaniasis represents a complex of diseases with an important clinical and epidemiological diversity. Visceral leishmaniasis (VL) is of higher priority than cutaneous leishmaniasis (CL) as it is a fatal disease in the absence of treatment. Anthroponotic...

Prevalence of age-related macular degeneration in the United States.

David Friedman, Benita O'Colmain, Ivan Muñoz, Sandra C. Tomany, Catherine A. McCarty, Paulus T. V. M. deJong, Barbara Nemesure, Paul Mitchell, John H. Kempen, Peter Congdon

A Randomized, Placebo-Controlled Trial of Natalizumab for Relapsing Multiple Sclerosis

Background Natalizumab is the first α4 integrin antagonist in a new class of selective adhesion-molecule inhibitors. We report the results of a two-year phase 3 trial of natalizumab in patients with relapsing multiple sclerosis. Methods Of a total of...

Depression and Pain Comorbidity A Literature Review

Because depression and painful symptoms commonly occur together, we conducted a literature review to determine the prevalence of both conditions and the effects of comorbidity on diagnosis, clinical outcomes, and treatment. The prevalences of pain in...

A systematic review of the associations between dose regimens and medication compliance

Background: Previous reviews of the literature on medication compliance have confirmed the inverse relationship between number of daily doses and rate of compliance. However, compliance in most of these studies was based on patient self-report, blood-level...

Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases

Bisphosphonates are widely used in the management of metastatic disease to the bone and in the treatment of osteoporosis. We were struck in the past 3 years with a cluster of patients with necrotic lesions in the jaw who shared 1 common clinical feature,...

Maternal Thyroid Deficiency during Pregnancy and Subsequent Neuropsychological Development of the Child

Background When thyroid deficiency occurs simultaneously in a pregnant woman and her fetus, the child's neuropsychological development is adversely affected. Whether developmental problems occur when only the mother has hypothyroidism during pregnancy...

The Many Roles of Chemokines and Chemokine Receptors in Inflammation

In this review, the authors discuss the properties of chemokines and their receptors and highlight the roles of these chemoattractants in selected clinical disorders.

AHA Dietary Guidelines Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association

Ronald M. Krauss, Robert H. Eckel, Barbara V. Howard, Lawrence J. Appel, Stephen R. Daniels, Richard J. Deckelbaum, John W. Erdman, Penny M. Kris-Etherton, Ira J. Goldberg, Theodore A. Kotchen, Alice H. Lichtenstein, William E. Mitch, Rebecca Mullis, Killian Robinson, Judith Wylie-Rosett, Sachiko T. St. Jeor, J. W. Suttie, Diane L. Tribble, Terry Bazzarre

Memory : a contribution to experimental psychology

The language of life as well as of science in attributing a memory to the mind attempts to point out the facts and their interpretation somewhat as follows: Mental states of every kind, -- sensations, feelings, ideas, -- which were at one time present...

Poverty and obesity: the role of energy density and energy costs

Many health disparities in the United States are linked to inequalities in education and income. This review focuses on the relation between obesity and diet quality, dietary energy density, and energy costs. Evidence is provided to support the following...

Global illness and deaths caused by rotavirus disease in children.

To estimate the global illness and deaths caused by rotavirus disease, we reviewed studies published from 1986 to 2000 on deaths caused by diarrhea and on rotavirus infections in children. We assessed rotavirusassociated illness in three clinical settings...

Vitamin D Deficiency and Risk of Cardiovascular Disease

Background— Vitamin D receptors have a broad tissue distribution that includes vascular smooth muscle, endothelium, and cardiomyocytes. A growing body of evidence suggests that vitamin D deficiency may adversely affect the cardiovascular system, but...

Dysmyelination revealed through MRI as increased radial (but unchanged axial) diffusion of water.

Myelin loss and axonal damage are both observed in white matter injuries. Each may have significant impact on the long-term disability of patients. Currently, there does not exist a noninvasive biological marker that enables differentiation between myelin...

An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence.

An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence.

Prevalence of Alzheimer's disease in a community population of older persons. Higher than previously reported.

Clinically diagnosed Alzheimer's disease and other dementing illnesses were assessed in a geographically defined US community. Of 3623 persons (80.8% of all community residents over 65 years of age) who had brief memory testing in their homes, a stratified...

Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients

\s=b\A randomized clinical trial was conducted to evaluate the effectiveness of a cognitive-behavioral therapy, ie, dialectical behavior therapy, for the treatment of chronically parasuicidal women who met criteria for borderline personality disorder....

Whole-Body Hypothermia for Neonates with Hypoxic-Ischemic Encephalopathy

background Hypothermia is protective against brain injury after asphyxiation in animal models. However, the safety and effectiveness of hypothermia in term infants with encephalopathy is uncertain. methods We conducted a randomized trial of hypothermia...

Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial

We did a randomised phase III trial comparing external irradiation alone and external irradiation combined with an analogue of luteinising-hormone releasing hormone (LHRH) to investigate the added value of long-term androgen suppression in locally advanced...

PPAR-gamma: adipogenic regulator and thiazolidinedione receptor.

The past several years have seen an explosive increase in our understanding of the transcriptional basis of adipose cell differentiation. In particular, a key role has been illustrated for PPAR-gamma, a member of the nuclear hormone receptor superfamily....

A Randomized, Controlled Trial of Surgery for Temporal-Lobe Epilepsy

Background Randomized trials of surgery for epilepsy have not been conducted, because of the difficulties involved in designing and implementing feasible studies. The lack of data supporting the therapeutic usefulness of surgery precludes making strong...

Relation between Renal Dysfunction and Cardiovascular Outcomes after Myocardial Infarction

Background The presence of coexisting conditions has a substantial effect on the outcome of acute myocardial infarction. Renal failure is associated with one of the highest risks, but the influence of milder degrees of renal impairment is less well defined....

Changes in physical fitness and all-cause mortality: a prospective study of healthy and unhealthy men.

This study examines the relationship between changes in physical fitness and risk of mortality using data on 9777 U.S. men who were given two clinical examinations about five years apart. The results show that "men who maintained or improved adequate...

The spectrum of thyroid disease in a community: the Whickham survey.

W.M.G. Tunbridge, D. C. Evered, Appleton Dr, M. Brewis, F. Clark, J. Grimley Evans, T. Bird, P. A. Smith

Recursive partitioning analysis (RPA) of prognostic factors in three radiation therapy oncology group (RTOG) brain metastases trials

Purpose: Promising results from new approaches such as radiosurgery or stereotactic surgery of brain metastases have recently been reported. Are these results due to the therapy alone or can the results he attributed in part to patient selection? An analysis...

Validation of the Framingham Coronary Heart Disease Prediction Scores Results of a Multiple Ethnic Groups Investigation

Context The Framingham Heart Study produced sex-specific coronary heart disease (CHD) prediction functions for assessing risk of developing incident CHD in a white middle-class population. Concern exists regarding whether these functions can be generalized...

The theory and practice of industrial pharmacy

Leon Lachman, Herbert A. Lieberman, Joseph L. Kanig

Addition of clopidogrel to aspirin in 45 852 patients with acute myocardial infarction: randomised placebo-controlled trial

COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group* Summary Background Despite improvements in the emergency treatment of myocardial infarction (MI), early mortality and morbidity remain high. The antiplatelet agent...

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