tbuckley/cabot-search huggingface dataset:
Hot Spots on Liver Scans Associated With Superior or Inferior Vena Caval Obstruction
Authors: TOSHIHIRO MURAMATSU, TATSUYA MIYAMAE, MASAMI MASHIMO, KENJI SUZUKI, SHINICHIRO KINOSHITA, YUTAKA DOHI
Journal: Clinical Nuclear Medicine (1994)

Although hot spots on hepatic scintigrams have been reported in association with superior and inferior vena caval obstruction, these studies were not clinically correlated, and are hampered by the poor resolution of earlier scintillation cameras. In this report, a modern scintillation camera was used to study the formation of hot spots associated with superior and inferior vena caval obstruction. Moreover, radionuclide cavography was performed in 70 patients with superior vena caval (SVC) obstruction and in 95 patients with inferior vena caval (IVC) obstruction. As a result, 13 cases of hot spots in the liver were observed. In cases of SVC obstruction, hot spots were seen in the quadrate lobe, the medial segment, and the bare area of the liver. In IVC obstruction, a hot spot was seen in the quadrate lobe in all cases. In rare instances, in cases of both SVC and IVC obstruction, a hot spot was seen in the wide area. For these hot spots to develop, it appears necessary to have systemic-portal venous blood flow through the internal thoracic vein and the paraumbilical vein.
Variations in Methadone Treatment Practices
Authors: Stephen Magura
Journal: JAMA (1992)

<h3>To the Editor.</h3> — Drs D'Aunno and Vaughn<sup>1</sup>report that methadone treatment "units that have higher average dose levels are more likely to have clients who remain in treatment," which they interpret as supporting higher dosage levels. Unfortunately, serious defects in the data analysis render this interpretation highly questionable. Their Table 5 presents a set of multiple regression analyses relating characteristics of clients, units, and their environments (as predictors) to treatment practices (as dependent variables). But average dose level (one of their eight treatment practice variables) is then introduced suddenly, as an additional predictor variable in the multiple regression on average time in treatment (also a treatment practice variable). This choice appears arbitrary, because the bivariate correlation between dose level and time in treatment (<i>r</i>=.12) is not statistically significant (Table 4) and because the analysis excludes two other treatment practice variables—take-home dosage and decreasing dosage, which do exhibit
A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men
Authors: Elise A. Olsen, David Whiting, Wilma Bergfeld, Jeffrey Miller, Maria Hordinsky, Rita Wanser, Paul Zhang, Bruce Kohut
Journal: Journal of the American Academy of Dermatology (2007)
Reply to the Letter to the Editor Entitled The IASLC Lung Cancer Staging Project: Revision Proposal of Pleural Effusion and Contralateral Nodule Staging, by V. Barbieri, P. Tassone, and P. Tagliaferri
Authors: Ramón Rami-Porta, Pieter E. Postmus, Peter Goldstraw
Journal: Journal of Thoracic Oncology (2008)
Quality-of-Life Outcomes With Coronary Artery Bypass Graft Surgery in Ischemic Left Ventricular Dysfunction
Authors: Daniel B. Mark, J. David Knight, Eric J. Velazquez, Jaroslaw Wasilewski, Jonathan G. Howlett, Peter K. Smith, John A. Spertus, Miroslaw Rajda, Rakesh Yadav, Baron L. Hamman, Marcin Malinowski, Ajay Naik, Gena Rankin, Tina M. Harding, Laura A. Drew, Patrice Desvigne-Nickens, Kevin J. Anstrom
Journal: Annals of Internal Medicine (2014)

The STICH (Surgical Treatment for Ischemic Heart Failure) trial compared a strategy of routine coronary artery bypass grafting (CABG) with guideline-based medical therapy for patients with ischemic left ventricular dysfunction.To describe treatment-related quality-of-life (QOL) outcomes, a major prespecified secondary end point in the STICH trial.Randomized trial. (ClinicalTrials.gov: NCT00023595).99 clinical sites in 22 countries.1212 patients with a left ventricular ejection fraction of 0.35 or less and coronary artery disease.Random assignment to medical therapy alone (602 patients) or medical therapy plus CABG (610 patients).A battery of QOL instruments at baseline (98.9% complete) and 4, 12, 24, and 36 months after randomization (collection rates were 80% to 89% of those eligible). The principal prespecified QOL measure was the Kansas City Cardiomyopathy Questionnaire, which assesses the effect of heart failure on patients' symptoms, physical function, social limitations, and QOL.The Kansas City Cardiomyopathy Questionnaire overall summary score was consistently higher (more favorable) in the CABG group than in the medical therapy group by 4.4 points (95% CI, 1.8 to 7.0 points) at 4 months, 5.8 points (CI, 3.1 to 8.6 points) at 12 months, 4.1 points (CI, 1.2 to 7.1 points) at 24 months, and 3.2 points (CI, 0.2 to 6.3 points) at 36 months. Sensitivity analyses to account for the effect of mortality on follow-up QOL measurement were consistent with the primary findings.Therapy was not masked.In this cohort of symptomatic high-risk patients with ischemic left ventricular dysfunction and multivessel coronary artery disease, CABG plus medical therapy produced clinically important improvements in quality of life compared with medical therapy alone over 36 months.National Heart, Lung, and Blood Institute.
Dietary fish oil reduces leukocyte/endothelium interaction following systemic administration of oxidatively modified low density lipoprotein.
Authors: H A Lehr, C Hübner, B Finckh, D Nolte, U Beisiegel, A Kohlschütter, K Messmer
Journal: Circulation (1991)

BACKGROUND In vitro and in vivo experiments have demonstrated the role of oxidatively modified low density lipoprotein (oxLDL) in eliciting leukocyte/endothelium interaction during early atherogenesis. METHODS AND RESULTS In the present study we investigated the effect of dietary fish oil on oxLDL-induced leukocyte/endothelium interaction using intravital fluorescence microscopy in the dorsal skinfold chamber model in awake Syrian golden hamsters. Hamsters were fed for 4 weeks prior to the experiments with either standard laboratory chow or a diet supplemented with 5% of a fish oil concentrate (18% eicosapentaenoate, 12% docosahexaenoate). The efficacy of the fish oil diet was demonstrated by the incorporation of fish oil-derived omega-3 fatty acids into plasma, leukocyte, and erythrocyte lipids. In control hamsters (n = 7) and fish oil-fed hamsters (n = 7), leukocyte/endothelium interaction was assessed in the time course after intravenous injection of human LDL (4 mg/kg), oxidized by 7.5 microM Cu2+ (6 hours, 37 degrees C). In control hamsters, injection of oxLDL elicited the rolling and sticking of leukocytes to the endothelium of arterioles and postcapillary venules with a maximum 15 minutes after injection (arterioles: from 3 +/- 1 to 91 +/- 25 cells/mm2 at 15 minutes; venules: from 13 +/- 6 to 150 +/- 46 cells/mm2 at 15 minutes; mean +/- SD). This phenomenon was significantly reduced in fish oil-fed hamsters, where 15 minutes after injection of oxLDL leukocyte sticking reached a maximum of only 15 +/- 7 and 20 +/- 5 cells/mm2 in arterioles and postcapillary venules, respectively (p less than 0.01 versus control animals). CONCLUSIONS The results of the present study suggest that inhibition of leukocyte/endothelium interaction may be one of the mechanisms by which dietary fish oil exerts its protective effects on experimental and clinical atherogenesis.
Home at Montclair
Authors: M. Therese Southgate
Journal: JAMA (2007)

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
Consultant participation in hospital management
Authors: T Manners
Journal: BMJ (1976)

<h3>Objectives</h3> A problem with the approach of Evidence-based Medicine (EBM) is the current ability to only reduce but not prevent overdiagnosis. Overdiagnosis is broadly defined as ‘making people patients unnecessarily, by identifying problems that were never going to cause harm or by medicalising ordinary life experiences through expanded definitions of diseases’. One aspect of overdiagnosis is <i>overdefinition</i>, such as lowering the threshold for treatment for a risk factor. A current example is the UK’s National Institute for Health and Care Excellence (NICE) updated draft guidance for the diagnosis and management of hypertension in adults. The recommendations in the guidance are not evidence based and will increase overdiagnosis. However, EBM would be insufficient to avoid overdiagnosis even if this NICE guidance followed the principles. The objective of this study is to show why EBM is insufficient to avoid over diagnosis. <h3>Method</h3> This study analyse the NICE draft guidance by the principles of following EBM guidance: Users’ Guides to the Medical Literature by (Guyatt et al), Guidance for modifying the definition of diseases: A checklist (Doust et al), and EBM manifesto for better healthcare (Heneghan et al). The principles of these analyses are what the consequences would have been <i>if</i> the NICE guidance had followed these principles. The principles and consequences are then analysed for their epistemological and ontological properties to determine what kind of scientific theory that leads the current EBM. <h3>Results</h3> EBM do not sufficiently assess the ontological aspect of a diagnosis. In the case of the NICE guidance, the ontological status of hypertension is primarily as a risk factor. A risk factor of such is a continuum with no clear boundary between normal (health risk small enough to be accepted) and pathological (health risk unacceptably high). Therefore, the diagnosis of hypertension is subject to the problematic <i>sorites paradox.</i> The original puzzle, from 400 BCE, is: how many times can we remove grains from a heap before we no longer have a heap? In this case, when a risk factor is accepted as a disease, how low a risk is low enough <i>not</i> to be a disease? EBM does not assess this problem. Instead, the present EBM is dominated by an epistemological approach, which legitimise any risk to become a disease, followed by the consequence of overdiagnosis. <h3>Conclusions</h3> Due to lack of ontological awareness and epistemological dominance, the current EBM approach does not sufficiently address overdiagnosis. Increase awareness of ontological aspects is necessary. The NICE guidance for hypertension provides a good basis for a much-needed discussion about what possible ontological solutions could bring us closer to limiting overdiagnosis via EBM.
THE KEEPING QUALITY OF TUBERCULIN DILUTIONS
Authors: J. D. Pilcher
Journal: JAMA (1931)

As there was a possibility that the potency of tuberculin dilutions deteriorated fairly rapidly even when kept at icebox temperature, fresh dilutions had been made bimonthly in this hospital. The preparation of the dilutions involved expenditure of considerable time and often waste of material as the older solutions were discarded. The keeping quality of tuberculin dilutions is of importance to the practitioner also who needs to use tuberculin but occasionally. As no reference was found in the<i>Quarterly Cumulative Index Medicus</i>to this subject, the activity of tuberculin dilutions has been determined during a period of some three to four years. The weaker dilutions, 1:10,000 and 1:1,000, were examined from time to time but the 1:100 and 1:10 dilutions only at the end of the experiment as they were considered to be more stable than the weaker ones. The dilutions were made in distilled water with 0.2 per cent tricresol
New Method to Delineate Myocardial Damage at Surgery
Authors: GERARD A. KAISER, ALBERT L. WALDO, PAUL D. HARRIS, FREDERICK O. BOWMAN, BRIAN F. HOFFMAN, JAMES R. MALM
Journal: Circulation (1969)

A technique is described for obtaining unipolar and bipolar ventricular electrograms at surgery. The alterations in the form of the electrogram in various pathologic states are consistent, reliable, and reproducible. The method has advantages over dye technique for delineating areas of damaged myocardium and has been used in a clinical series of 12 patients undergoing cardiac surgery.
Low-Density Lipoprotein Size, Pravastatin Treatment, and Coronary Events
Authors: Hannia Campos, Lemuel A. Moye, Stephen P. Glasser, Meir J. Stampfer, Frank M. Sacks
Journal: JAMA (2001)

Small low-density lipoprotein (LDL) particle size has been hypothesized to be a risk factor for coronary heart disease (CHD). Animal models link large LDL to atherosclerosis. However, the strong association between small LDL and other risk factors, particularly triglyceride levels, impedes determining whether LDL size independently predicts CHD in humans.To examine whether LDL size is an independent predictor of recurrent coronary events in patients with known CHD, as opposed to a marker for other lipid abnormalities.Prospective, nested case-control study in the Cholesterol and Recurrent Events (CARE) trial, a randomized placebo-controlled trial of pravastatin conducted in 1989-1996.Survivors of myocardial infarction with typical LDL concentrations (416 cases and 421 controls).Subsequent myocardial infarction or coronary death during the 5-year follow-up, analyzed by quintile of LDL particle size and by treatment group.Overall, the mean LDL size was identical in cases and controls (25.6 nm). In patients in the placebo group, large LDL predicted coronary events in models adjusted only for age (relative risk [RR], 1.79; 95% confidence interval [CI], 1.01-3.17) and for age and lipid and nonlipid risk factors (RR, 4.00; 95% CI, 1.81-8.82), comparing those in the highest (mean, 26.6 nm) and lowest (mean, 24.5 nm) quintiles of LDL size. This increased risk was not present in those taking pravastatin (age-adjusted analysis: RR, 0.98; 95% CI, 0.47-2.04; P =.046 for interaction for a difference in the effect of LDL size on coronary events between the placebo and treatment groups; multivariable analysis: RR, 1.33; 95% CI, 0.52-3.38; P =.11 for interaction).Large LDL size was an independent predictor of coronary events in a typical population with myocardial infarction, but the adverse effect was not present among patients who were treated with pravastatin. Identifying patients on the basis of LDL size may not be useful clinically, since effective treatment for elevated LDL cholesterol concentrations also effectively treats risk associated with large LDL.
Studies reshape some views of the aging heart
Authors: Donald E. Riesenberg
Journal: JAMA (1986)

While a muscular 52-year-old man walks briskly on the treadmill, Jerome L. Fleg, MD, staff cardiologist at the Gerontology Research Center, checks the oxygen consumption tank. Then, after taking the patient's blood pressure, he says: "We'll be doing five treadmill tests this morning, using a modified Balke protocol." The cardiovascular response to treadmill exercise is one of scores of tests that subjects in the Baltimore Study of Aging undergo every two years. From such studies has come a better understanding of what changes occur—and what things remain unchanged— as the heart grows older. This work has helped reshape the understanding of the cardiovascular system in healthy elderly persons. One question that the center's cardiovascular section asked several years ago is whether elderly patients taking digitalis long term really needed the drug. Upon reviewing the literature, Fleg found that "the efficacy of digitalis in compensated congestive heart failure for persons who
US consumer group names “dirty dozen” dietary supplements
Authors: Janice Hopkins Tanne
Journal: BMJ (2004)

Americans can easily buy 12 dangerous dietary supplements over the counter or from theinternet, the latest (May) issue of Consumer Reports magazine says. At least five of these supplements are banned in Asia, Europe, or Canada.

Consumer Reports (accessible at http://www.consumerreports.org/) is published by the non-profit Consumers Union, which tests products and services and aims to protect the public through information and advocacy.

The revelation came in the same week that a federal judge finally upheld the US Food and Drug Administration's ban on ephedra, the stimulant …
25-Hydroxyvitamin D Concentrations and In Vivo Insulin Sensitivity and β-Cell Function Relative to Insulin Sensitivity in Black and White Youth
Authors: Kumaravel Rajakumar, Javier de las Heras, SoJung Lee, Michael F. Holick, Silva A. Arslanian
Journal: Diabetes Care (2012)

To examine the relationships between plasma 25-hydroxyvitamin D [25(OH)D] and in vivo insulin sensitivity and β-cell function relative to insulin sensitivity, disposition index (DI), in black and white youth.Plasma 25(OH)D concentrations were analyzed in banked specimens in healthy youth aged 8 to 18 years who had existing data on hyperinsulinemic-euglycemic and hyperglycemic clamp to assess insulin sensitivity and secretion, and measurements of body composition, and abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT).A total of 183 research volunteers (mean ± SD; age, 12.6 ± 2.2 years; 98 white, 98 male, 92 obese) were studied. Analysis of HbA(1c), fasting glucose and insulin, insulin sensitivity, and DI across quartiles of plasma 25(OH)D revealed no differences among whites. In blacks, the observed significance of higher insulin sensitivity and DI in the highest quartile of 25(OH)D disappeared after adjusting for any of the adiposity measures (BMI or fat mass or VAT or SAT). The difference in insulin sensitivity (9.4 ± 1.2 vs. 5.6 ± 0.5 mg/kg/min per μU/mL; P = 0.006) between 25(OH)D nondeficient (≥20 ng/mL) versus deficient (<20 ng/mL) black youth also was negated when adjusted for adiposity.In healthy youth, plasma 25(OH)D concentrations bear no independent relationship to parameters of glucose homeostasis and in vivo insulin sensitivity and β-cell function relative to insulin sensitivity. It remains to be determined whether in youth with dysglycemia the relationships are different and whether vitamin D optimization enhances insulin sensitivity and β-cell function.
Functional role of thromboxane production by acutely rejecting renal allografts in rats.
Authors: T M Coffman, W E Yarger, P E Klotman
Journal: Journal of Clinical Investigation (1985)

We investigated the role of thromboxane in mediating the reduction in renal function and renal blood flow characteristic of acute renal allograft rejection. We transplanted kidneys from Lewis rats to Brown-Norway recipients. By the third day after transplantation, histologic changes that were consistent with cellular rejection occurred in the kidney. These changes were associated with a moderate reduction in renal function. By day 6, histologic changes of rejection were advanced and included interstitial and perivascular infiltration by mononuclear cells. The clearances of inulin and para-aminohippuric acid were also markedly reduced. As renal function deteriorated, thromboxane B2 (TXB2) production by ex vivo perfused renal allografts increased progressively from 2 to 6 d after transplantation. However, prostaglandin (PG) E2 and 6-keto PGF1 alpha production remained essentially unchanged. There was a significant inverse correlation between the in vivo clearance of inulin and the log of ex vivo TXB2 production. Infusion of the thromboxane synthetase inhibitor UK-37248-01 into the renal artery of 3-d allografts significantly decreased urinary TXB2 excretion and significantly increased renal blood flow (RBF) and glomerular filtration rate (GFR). Although renal function improved significantly after the acute administration of UK-37248-01, GFR and RBF did not exceed 33 and 58% of native control values, respectively. In other animals, daily treatment with cyclophosphamide improved the clearances of inulin and para-aminohippuric acid and reduced thromboxane production by 6-d renal allografts. These studies demonstrate that histologic evidence of rejection is associated with increased renal thromboxane production. Inhibition of thromboxane synthetase improves renal function in 3-d allografts. Cytotoxic therapy improves renal function, reduces mononuclear cell infiltration, and decreases allograft thromboxane production. Thus, the potent vasoconstrictor thromboxane A2 may play a role in the impairment of renal function and renal blood flow during acute allograft rejection.
A CONTRIBUTION TO THE TREATMENT OF PNEUMONIA WITH ANTIPNEUMOCOCCIC SERUM.
Authors: BRICE W. GOLDSBOROUGH
Journal: JAMA (1902)

One can but feel a very natural hesitation in presenting to this society any views on the treatment of pneumonia, because I very fully realize that the experience of all of us must have been, in the treatment of this grave disease, one of disappointment and, at times, of despair. As for myself, during the past twenty odd years, I have, in my vain endeavor to save the lives of those intrusted to my care and who were the victims of this disease, used nearly all of the many treatments which have been suggested. Each fall I have read the views of my brethren in the great medical centers, have earnestly studied their methods, and with renewed hope and fresh courage I have again entered into the battle with this disease. Each spring, looking back over the results of these various treatments and endeavoring to be honest with myself, I
Aortic and mitral valve incompetence: Long-term follow-up (10 to 19 Years) of patients treated with the Starr-Edwards prosthesis
Authors: Michael D. McGoon, Valentin Fuster, Dwight C. McGoon, Charles W. Pumphrey, James R. Pluth, Lila R. Elveback
Journal: Journal of the American College of Cardiology (1984)
Resection of esophageal leiomyoma using an endoscopic submucosal dissection technique
Authors: P. Chiu, Y. Lee, E. Ng
Journal: Endoscopy (2006)

A 55-year-old woman with a positive fecal occult blood test was investigated by upper endoscopy. This revealed an esophageal submucosal tumor, 18 cm from the incisors (Figure [1 a]). Endoscopic ultrasound confirmed that this lesion, which measured 10 mm × 10 mm, arose from the muscularis mucosae and involved only the submucosa. The tumor was removed by endoscopic resection, with initial marking by electrocautery and submucosal injection of 15 ml of normal saline mixed with indigo carmine and epinephrine. An endoscopic submucosal dissection was performed using a triangular-tip knife, an insulated-tip knife, and a Hook knife (Olympus, Tokyo, Japan) (Figure [1 b], Video 1). Histological examination of the tumor confirmed that it was a leiomyoma. The patient was discharged from hospital 3 days after the endoscopic submucosal dissection procedure and she had an uneventful recovery.
PRE-TRANSPLANT CHEMOTHERAPY DOES NOT AFFECT POST TRANSPLANT OUTCOME IN PATIENTS UNDERGOING OHT FOR AL CARDIOMYOPATHY
Authors: Nitasha Sarswat, Emily Niehaus, Sara Tabtabai, James Stone, Lauren Gilstrap, Matthew Maurer, Ronald Witteles, Jerry Estep, David Baran, Mark Zucker, David Seldin, Marc Semigran
Journal: Journal of the American College of Cardiology (2014)