tbuckley/cabot-search huggingface dataset:
Prognostic Indices in Clinical Practice
Authors: Donald A. Redelmeier
Journal: JAMA (2001)

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
Mechanisms Underlying Spontaneous and Induced Ventricular Arrhythmias in Patients With Idiopathic Dilated Cardiomyopathy
Authors: Steven M. Pogwizd, John P. McKenzie, Michael E. Cain
Journal: Circulation (1998)

Background —To define the electrophysiological mechanism(s) of inducible and spontaneously occurring ventricular arrhythmias associated with nonischemic cardiomyopathy, 3-dimensional intraoperative mapping from 156 intramural sites was performed in 6 patients with idiopathic dilated cardiomyopathy undergoing cardiac transplantation. Methods and Results —Electrode density was sufficient to determine the mechanism for 52 of 74 beats of nonsustained ventricular tachycardia (VT) induced by programmed stimulation and 9 of 11 beats of spontaneous ventricular arrhythmias. The first, second, and third extrastimuli (S 2 through S 4 ) conducted with progressively greater degrees of conduction delay (total activation times [TAs] of 144±5, 166±5, and 194±5 ms, respectively) owing to slow conduction and on occasion intramural block. The first beats of induced VT arose from subendocardial or subepicardial sites distant from areas of marked conduction delay by a focal mechanism on the basis of the absence of intervening electrical activity between the termination of the last extrastimulus and the initiation of VT (123±31 ms). Subsequent beats arose by a focal mechanism and conducted with a TA of 127±6 ms ( P =NS versus initiating beats of VT [118±9 ms]). Spontaneous ventricular arrhythmias initiated in the subendocardium by a focal mechanism and conducted with a TA of 138±5 ms. Tissue analysis demonstrated a variable degree of interstitial fibrosis at sites of focal activation. Sites of conduction delay or block typically exhibited marked interstitial and/or replacement fibrosis but were spatially distant from sites initiating VT. Conclusions —Spontaneous and induced ventricular arrhythmias in patients with end-stage idiopathic cardiomyopathy can arise in the subendocardium or subepicardium by a focal mechanism.
PD5-3-4: The impact of multiplicity of metastatic nodal stations on survival in surgically resected non-small cell lung cancer patients: Is N2 disease really different from N1 disease?
Authors: Chang Hyun Kang, Young Tae Kim, Snag-Hoon Jeon, Sook-Whan Sung, Joo Hyun Kim
Journal: Journal of Thoracic Oncology (2007)
Good quality evidence is lacking
Authors: H. Lang, M. Joffe
Journal: BMJ (1996)

EDITOR,—T Dowswell and colleagues report that in a feasibility study of a randomised controlled trial of home and hospital births 14.2% (71/500) of women were considered eligible for randomisation; 15% of them (11/71) consented to be randomised.1 Participation rates depend both on the expectations of the inviting physician and on women's willingness to participate, and neither of these is free from the influences of experience, context, and personality. …
Airway responsiveness to bradykinin is related to eosinophilic inflammation in asthma.
Authors: G L Roisman, J G Lacronique, N Desmazes-Dufeu, C Carré, A Le Cae, D J Dusser
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

We investigated the relationship between airway inflammation and airway responsiveness, as assessed by PD15, to methacholine and to bradykinin in asthmatic patients. Bronchoalveolar lavage (BAL), bronchial biopsies, and methacholine and bradykinin challenges were performed in 18 nonsmoking subjects with mild or moderate perennial asthma. Bradykinin PD15 correlated negatively with eosinophil count in BAL (p < 0.05), in the epithelium (p < 0.05), in the lamina propria (p = 0.02) and in the total submucosa (p < 0.01). Conversely, no significant correlation existed between airway responsiveness to methacholine and eosinophil count in BAL or in airway mucosa. Airway responsiveness to either agonist did not correlate with the thickness of the basement membrane, the shedding of the airway epithelium, the count of lymphocytes in the airway mucosa, or the percentage of neutrophils, lymphocytes, and macrophage in BAL. The presence of degranulated eosinophils was associated with an increased number of eosinophils in the airway epithelium (p = 0.04), in the lamina propria (p = 0.03), in the total submucosa (p = 0.02), and with increased airway responsiveness to bradykinin (p < 0.02). We conclude that in asthmatic patients, airway responsiveness to bradykinin but not to methacholine is related to the magnitude of eosinophilic inflammation in the airway mucosa.
OSTEOMA OF THE FRONTAL SINUS
Authors: W. W. BOARDMAN
Journal: JAMA (1918)

The occurrence of osteoma of the frontal sinus is relatively infrequent, as may be judged from the fact that Sewall,<sup>1</sup>after carefully reviewing the literature, found only ninety-two cases. In these cases the diagnosis was based on the presence of anatomic deformities secondary to the osteoma; in only a few had the roentgen ray been used to confirm the clinical impression, and in none had the condition been primarily diagnosed roentgenographically. During the past six months the following two cases of clinically unsuspected osteoma of the frontal sinus have been discovered in the routine examination of skull plates. <h3>Case 1.</h3> —A man entered the Stanford University Medical School Hospital, complaining of very severe headaches of long duration. In the early stages these had been frontal, but of late they had been principally occipital. Diffuse brain tumor seemed to be the clinical diagnosis. However, lateral stereoscopic skull plates showed an
P57 Factors Influencing Length Of Hospital Stay In Asthma Exacerbations: Results Of A Service Improvement Project
Authors: A. Hanson, Y. Vali, J. Fisher-Black, G. Woltmann, M. Richardson, A. Wardlaw, S. Siddiqui
Journal: Thorax (2014)

<h3>Background</h3> Asthma exacerbations pose a significant burden to the NHS, however the factors that underpin inpatient length of stay remain poorly understood. We undertook a service improvement project using hospital episode statistics to evaluate the demographics of the asthma hospital exacerbation population in Leicester hospitals and risk factors that influence length of stay. <h3>Methods</h3> Hospital episode statistics were generated using an ACCESS database query set capturing a range of clinical meta data including length of stay, ICD-10 coding for two types of asthma admission (asthma and status asthmaticus), sex, age, ethnicity, financial year quarter of admission. In addition comorbidity was calculated by cross referencing spell diagnoses to the Charlson comorbidity index score. This database was subsequently linked to pathology data reporting blood eosinophils, neutrophils, CRP at admission and the highest ever historical blood eosinophil count. A backwards logistic regression model was used to identify factors that increased length of stay beyond the median for the overall population. <h3>Results</h3> We identified 719 exacerbations between 1/4/2013- 31/3/2014. The number of exacerbations ranged from 157–228/quarter with the winter quarters (Q3/4) being associated with the highest exacerbation frequency. Exacerbators had a median (IQR) age of 46 (31–64) years, length of stay of 2 (1–5) days, Charlson score 4[4–4]. The majority of patients were female (72%). The percentage of repeat attender was 12% of the total population with the highest percentage in the winter quarters. Logistic regression models identified that ethnicity (non-white/Caucasian), baseline admission CRP, neutrophil count, age, coding of status asthmaticus and Charlson co morbidity index significantly increased length of stay beyond the median of 2 days. In contrast neither admission or highest ever blood eosinophil count influenced the median length of stay. <h3>Conclusions</h3> We have identified a number of factors associated with an increased length of stay in asthma hospital exacerbations in Leicester. Our observations support the notion that age, comorbidity and biochemical features of infection rather than eosinophilic inflammation increase length of stay. Further research is required to examine the mechanisms that underpin asthma admissions in this population and to reduce length of stay.
Echocardiographic studies of abnormalities associated with coarctation of the aorta.
Authors: J A Scovil, N C Nanda, C M Gross, A C Lombardi, R Gramiak, E O Lipchick, J A Manning
Journal: Circulation (1976)

Echocardiograms were performed in thirty-six patients (aged 4 to 36 years) with proven coarctation of the aorta. Nineteen patients (53%) were found to have marked diastolic eccentricities of their aortic valves (Eccentricity Index greater 1.5), indicating the presence of bicuspid aortic valves. One of these patients also had multilayered aortic root echoes in diastole. Five patients had angiographic proof of their aortic valve morphologies which corroborated the echo findings. Five patients with bicuspid aortic valves showed mitral valve diastolic flutter indicative of aortic regurgitation. Idiopathic hypertrophic subaortic stenosis (IHSS) was suspected in four patients (11%) with abnormal systolic anterior motion of the mitral valve; three of these patients also had asymmetric septal hypertrophy. There was catheterization proof of IHSS in one patient. Two patients (5.6%) demonstrated mitral valve proplapse.
Pollen sensitization and allergy in children depend on the pollen load
Authors: H. Zwick, W. Popp, S. Jager, C. Wagner, K. Reiser, F. Horak
Journal: Allergy (1991)

We investigated the influence of grass and birch pollen load on specific IgE response, skin prick test reactivity, and manifest allergic disorders of the eyes and respiratory tract. The study population was two groups of 200 children each, matched in sex and age, who were domiciled in areas with high and low pollen load, respectively. In the children from the area with high pollen load, the grass pollen load was 1.7 times higher than in the other and only specific IgE to grass pollen was found to be present more frequently (23.5 % as against 12.5%; P &lt; 0.01), In the same area, the birch pollen load was 2.8 times higher, which caused specific IgE in 10.5% as against 3.5% of the other group ( P &lt; 0.01) as well as positive skin prick test in 9.0% as against 3.5% ( P &lt; 0.05), Reports of subjective complaints were rare among the group with high pollen load but the total number did not amount to a statistically significant increase. There was no difference between the two groups concerning sensitization and allergy to house dust mite. This suggests that the influence of the pollen load is strongest on the development of specific IgE, and less on skin test reactivity and manifest allergies.
Rash in systemic lupus erythematosus: prevalence and relation to cutaneous and non-cutaneous disease manifestations.
Authors: A J Wysenbeek, D Guedj, M Amit, A Weinberger
Journal: Annals of the Rheumatic Diseases (1992)

Rash is a common cutaneous sign in patients with systemic lupus erythematosus (SLE) but no data regarding its prevalence or relation to disease manifestations are known, possibly due to the fact that it is a common but non-specific sign. Rash was present in 48/81 (59%) patients with SLE. Patients with rash had more cutaneous symptoms and signs, lymphadenopathy, increased levels of antibodies to double stranded DNA and decreased complement levels. They were also receiving a higher dose of prednisone. There was no difference between patients with and without rash with respect to renal or central nervous system disease. Rash did not correlate with the disease activity index and clinical parameters of disease exacerbation.
Arthroprosthetic cobaltism associated with metal on metal hip implants
Authors: S. S. Tower
Journal: BMJ (2012)

Our initial experience with metal on metal hip implants1 was favourable. But several years later an uncharacteristically high proportion of patients developed progressive, unresolved, or new hip pain, some showing metal debris around the hip with tissue damage. Two patients had remarkably high cobalt concentrations, cognitive decline, cranial neuropathy, and early cardiomyopathy.2

We have just identified a fifth case of probable arthroprosthetic cobaltism …
HIV Sexual Risk—Reduction Interventions for African-American Women
Authors: Bernard M. Branson
Journal: JAMA (1996)

<h3>To the Editor.</h3> —We commend Drs DiClemente and Wingood<sup>1</sup>for their randomized controlled trial of an HIV prevention intervention. Although their intervention and evaluation incorporated many of the recommendations developed by Oakley et al<sup>2</sup>in their critical review of HIV prevention research, we have concerns about several methodological issues that bring the study's conclusions into question. It appears that the randomization procedure was unsuccessful in providing similar experimental and control groups. The authors identified disparities in income and duration of long-term relationships between participants in the two groups. In addition, control participants were less likely to return for follow-up examinations and, at baseline, demonstrated considerably less HIV knowledge, sexual self-control, assertiveness skill, and consistent condom use. Although these baseline differences between groups were not statistically significant, perhaps because of small numbers, the desired study outcomes were consistently reported more frequently by the intervention group at baseline. These baseline
Two Superb Vaccines Against Hepatitis B in Mexican Standoff
Authors: Francis E. André
Journal: JAMA (1988)

<h3>To the Editor.</h3> —In response to an editorial<sup>1</sup>that criticized the choice of 10 μg of yeast-derived hepatitis B surface antigen (HBsAg) as the dose for Recombivax-HB, Drs Gerety and Ellis<sup>2</sup>seek to justify the decision to use a lower dose of HBsAg than the 20 μg present in the plasma-derived Heptavax-B vaccine. They minimize the quantitative difference that has been clearly demonstrated<sup>3</sup>in the immune response to yeast-derived and plasma-derived hepatitis B vaccines manufactured by Merck Sharp &amp; Dohme. In support of their argument, Drs Gerety and Ellis make reference to the published abstract<sup>4</sup>of a presentation that I made at the recent International Symposium on Viral Hepatitis and Liver Disease and state that the "article indicates that therapy with either 10 μg of Recombivax-HB or 20 μg of another yeast-derived vaccine produces comparable antibody response." The fact is, the abstract and my presentation gave
A Novel Dithiol Amide CB3 Attenuates Allergic Airway Disease through Negative Regulation of p38 Mitogen-activated Protein Kinase
Authors: So Ri Kim, Kyung Sun Lee, Seoung Ju Park, Kyung Hoon Min, Min Hee Lee, Kyung Ae Lee, Orit Bartov, Daphne Atlas, Yong Chul Lee
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

Rationale: Cellular redox homeostasis altered by excessive production of reactive oxygen species (ROS) and weakening of the antioxidant defense leads to oxidative stress. Oxidative stress is characterized as a decrease in glutathione/glutathione disulfide (GSH/GSSG) and the triggering of a number of the redox-sensitive signaling cascades. Recent studies have demonstrated that ROS play an important role in the pathogenesis of airway inflammation and hyperresponsiveness.Objectives: Here we characterized for the first time the protective properties of a new hydrophobic thiol compound, N-acetyl cysteine proline cysteine amide (CB3), in allergic airway diseases.Methods: We used ovalbumin (OVA)-inhaled mice to evaluate the role of CB3 as an antiinflammatory reagent and to determine its molecular signaling activity in allergic airways.Measurements and Main Results: The administration of CB3 (1–50 mg/kg) to OVA-inhaled mice restored the decreased GSH levels, enhanced IL-10 expression, and significantly reduced the increase of Th2 cytokines and OVA-specific IgE. CB3 decreased the number of inflammatory cells and airway hyperresponsiveness in the lungs. We also found that the administration of CB3 dramatically decreased the nuclear translocation of the nuclear factor-κB (NF-κB) and the phosphorylation of p38 mitogen-activated protein kinases (MAPKs) in lungs after OVA inhalation. In addition, allergen-induced airway inflammation and hyperresponsiveness were substantially reduced by the administration of inhibitors of NF-κB and p38 MAPK, BAY 11-7085, and SB 239063, respectively.Conclusions: These results suggest that CB3 attenuates allergic airway disease by up-regulation of GSH levels as well as inhibition of NF-κB and p38 MAPK activity.
Neurological Consequences of Diabetic Ketoacidosis at Initial Presentation of Type 1 Diabetes in a Prospective Cohort Study of Children
Authors: Fergus J. Cameron, Shannon E. Scratch, Caroline Nadebaum, Elisabeth A. Northam, Ildiko Koves, Juliet Jennings, Kristina Finney, Jeffrey J. Neil, R. Mark Wellard, Mark Mackay, Terrie E. Inder
Journal: Diabetes Care (2014)

To investigate the impact of new-onset diabetic ketoacidosis (DKA) during childhood on brain morphology and function.Patients aged 6-18 years with and without DKA at diagnosis were studied at four time points: <48 h, 5 days, 28 days, and 6 months postdiagnosis. Patients underwent magnetic resonance imaging (MRI) and spectroscopy with cognitive assessment at each time point. Relationships between clinical characteristics at presentation and MRI and neurologic outcomes were examined using multiple linear regression, repeated-measures, and ANCOVA analyses.Thirty-six DKA and 59 non-DKA patients were recruited between 2004 and 2009. With DKA, cerebral white matter showed the greatest alterations with increased total white matter volume and higher mean diffusivity in the frontal, temporal, and parietal white matter. Total white matter volume decreased over the first 6 months. For gray matter in DKA patients, total volume was lower at baseline and increased over 6 months. Lower levels of N-acetylaspartate were noted at baseline in the frontal gray matter and basal ganglia. Mental state scores were lower at baseline and at 5 days. Of note, although changes in total and regional brain volumes over the first 5 days resolved, they were associated with poorer delayed memory recall and poorer sustained and divided attention at 6 months. Age at time of presentation and pH level were predictors of neuroimaging and functional outcomes.DKA at type 1 diabetes diagnosis results in morphologic and functional brain changes. These changes are associated with adverse neurocognitive outcomes in the medium term.
Compendium of Treatment
Authors: C. W. H. Havard
Journal: BMJ (1973)

<b>Objectives:</b> To test the hypothesis of a positive association, independent of social position, between participation in leisure activities and cognitive function in middle age. The nature of this relation is explored by first classifying leisure activities as entailing high or low cognitive effort, and then classifying them as entailing individual or social activities. <b>Setting:</b> London based office staff (Whitehall II study) in 20 civil service departments at baseline. <b>Methods:</b> Data are from the fifth wave of data collection (phase 5) of a prospective cohort study, collected through clinical examination and a self administered questionnaire. Firstly, hierarchical multiple regression was used to examine age and socioeconomic status (SES) adjusted effect of each leisure activity on cognition. Then structural equation models were used to examine the effects of two categories of leisure activities—activities entailing high or low cognitive effort and social or individual activities. All analyses are cross sectional. <b>Results:</b> There was an age and SES adjusted association between participation in leisure activities and cognitive function. More specifically, leisure activity entailing high cognitive effort or social interaction was associated with better cognitive ability. <b>Conclusions:</b> Participation in cognitively complex or social leisure activities has an independent association with adult cognition, suggesting that seeking mental stimulation may have a beneficial effect on cognition in middle age.
Increased Hepatic Transduction with Reduced Systemic Dissemination and Proinflammatory Cytokines Following Hydrodynamic Injection of Helper-Dependent Adenoviral Vectors
Authors: Nicola Brunetti-Pierri, Donna J. Palmer, Viraj Mane, Milton Finegold, Arthur L. Beaudet, Philip Ng
Journal: Molecular Therapy (2005)

Hydrodynamic injection of helper-dependent adenoviral vectors (HDAd) in mice results in increased hepatic transduction, reduced splenic and pulmonary transduction, and reduced levels of the proinflammatory cytokines IL-6 and IL-12 compared to conventional injection. These results indicate that hepatic transduction by HDAd, at least alone, does not necessarily provoke a severe innate inflammatory response. Instead, they suggest that systemic vector dissemination may play a major role in the severity of the innate inflammatory response. These results further suggest that the safety and efficacy of HDAd-mediated, liver-directed gene therapy may be improved if the vector could be preferentially, if not exclusively, targeted to liver.
Responsibilities of Authorship: Where Does the Buck Stop?
Authors: Arnold S. Relman
Journal: New England Journal of Medicine (1984)

IN 1972, the Journal published a Current Concepts article, "Management of the Thoracic-Outlet Syndrome," which recommended measurement of the ulnar-nerve conduction velocity across the thoracic outlet as a reliable indicator of the presence and severity of nerve compression.1 The authors of that article, Harold C. Urschel, Jr., and Maruf A. Razzuk, included a figure with a legend that identified it as a tracing from a patient with the thoracic-outlet syndrome, illustrating the slowing of nerve conduction across the obstruction.In the Correspondence section of this week's issue, Wilbourn and Lederman now challenge the validity of that figure, suggesting that it . . .