tbuckley/cabot-search huggingface dataset:
Vitamin D Supplements and the Risk of Falls—Reply
Authors: Erin S. LeBlanc, Roger Chou
Journal: JAMA Internal Medicine (2015)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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 Internal Medicine journal
LEGISLATION FOR THE PREVENTION OF BLINDNESS.
Authors: L Howe
Journal: JAMA (1893)

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
Attention deficit hyperactivity disorder in adolescent mania
Authors: S. A. West, S. L. McElroy, Stephen Strakowski, P. E. Keck, B. J. McConville
Journal: American Journal of Psychiatry (1995)

The purpose of this study was to examine the rate of attention deficit hyperactivity disorder in adolescents with bipolar disorder and to explore the potential effects of comorbid attention deficit hyperactivity disorder on the phenomenology of adolescent bipolar disorder.The authors assessed the rate of attention deficit hyperactivity disorder for adolescents with bipolar disorder who were hospitalized for treatment of acute mania or hypomania.Eight (57%) of 14 adolescent bipolar patients also met DSM-III-R criteria for attention deficit hyperactivity disorder. Patients with both disorders were more likely to be male and Caucasian and to have mixed rather than manic bipolar disorder. Patients with attention deficit hyperactivity disorder had a higher mean total score on the Young Mania Rating Scale than patients with bipolar disorder alone.Although preliminary, these findings may have important implications regarding the potential relationship between bipolar disorder and attention deficit hyperactivity disorder.
Parasternal intercostal electromyography in the assessment of preschool wheeze
Authors: Victoria MacBean, Anne Greenough, John Moxham, Gerrard Rafferty
Journal: European Respiratory Journal (2013)

Introduction: Assessment of respiratory disease in preschool children relies mainly on physician judgement due to the lack of objective measures in this age group. Assessment of neural respiratory drive (NRD) using respiratory muscle electromyography (EMG) provides a measure of respiratory load and reflects lung disease severity. EMG of the parasternal intercostal muscles (EMGpara), obligate inspiratory muscles, provides a non-invasive, effort-independent measure of NRD which may offer a method for objectively assessing pulmonary function in preschool children.  Aim: To measure EMGpara in both healthy and wheezy preschool children, and assess any change following bronchodilator (BD).  Methods: EMGpara was measured in 20 preschool children (median (range) age 3.7 (0.7–5.1) years) with physician diagnosed asthma or infant wheeze (AST), and 21 controls (CON) (median (range) age 3.2 (1.2–5.0) years). EMGpara was recorded during tidal breathing using surface electrodes over the 2nd intercostal space. EMGpara was converted to root-mean-square (RMS), and expressed as mean peak RMS EMGpara per breath over the final minute of a 10 minute recording. In AST, the measurement was repeated following 400μg of salbutamol.  Results: EMGpara was significantly higher (p=0.0017) in AST preBD than CON (median (range) EMGpara 8.20 (4.15–14.92)μV vs 6.39 (5.57–16.46)μV) and decreased significantly (p=0.0037) postBD (6.98 (4.99–17.06)μV); postBD EMGpara was not different to CON (p=0.18).  Conclusion: NRD as assessed by EMGpara is significantly higher in preschool children with asthma/wheeze compared to healthy children and falls following BD. EMGpara may provide a method for assessing respiratory disease in preschool populations.
Depletion of antigen-presenting cells by clodronate liposomes reverses the psoriatic skin phenotype in KC-Tie2 mice
Authors: N.L. Ward, C.M. Loyd, J.A. Wolfram, D. Diaconu, C.M. Michaels, T.S. McCormick
Journal: British Journal of Dermatology (2010)

There is ongoing debate regarding the initiation of psoriatic plaque as primarily arising from an anomaly in epidermal keratinocytes (KCs) or from abnormalities in immunocytes that secondarily activate otherwise normal KCs. In mice engineered to overexpress the angiopoietin receptor Tie2 in KCs, skin spontaneously develops the characteristic clinical, histological and immune cell phenotypes of psoriasis which can be reversed with either transgene repression or ciclosporin administration, suggesting key roles for both KCs and T cells in mediating the skin disease in this murine model.To determine if antigen-presenting cells (APCs) and macrophages alone are sufficient to sustain psoriasiform inflammation in the KC-Tie2 murine model of psoriasis.Clodronate liposomes were intradermally injected into involved dorsal skin of KC-Tie2 or control animals once a week for 6weeks and acanthosis, angiogenesis, immune cell infiltration and cytokine production were quantitated using immunohistochemistry and interactive image analyses, enzyme-linked immunosorbent assay (ELISAs) and quantitative real-time polymerase chain reaction (qRT-PCR).Clodronate liposome injection eliminated CD11c+, F4/80+ and CD11b+ cells in the skin and returned CD8+ T-cell numbers to control mouse levels. APC depletion in KC-Tie2 mouse skin resulted in resolution of the acanthotic skin phenotype, decreased dermal angiogenesis, and a return to control mouse levels for interleukin (IL)-1α, IL-6, IL-23 and tumour necrosis factor (TNF)-α expression and modest reductions in interferon-γ and IL-17.These findings suggest a critical role for APCs and myeloid cell-derived IL-23 and TNF-α and underscore the importance of Th1 and Th17 T cells in maintaining the psoriasiform skin phenotype in the KC-Tie2 mouse model.
Activation of Human Factor VII in Plasma and in Purified Systems
Authors: Uri Seligsohn, Bjarne Østerud, Stephen F. Brown, John H. Griffin, Samuel I. Rapaport
Journal: Journal of Clinical Investigation (1979)

Factor VII can be activated, to a molecule giving shorter clotting times with tissue factor, by incubating plasma with kaolin or by clotting plasma. The mechanisms of activation differ. With kaolin, activated Factor XII (XIIa) was the apparent principal activator. Thus, Factor VII was not activated in Factor XII-deficient plasma, was partially activated in prekallikrein and high-molecular weight kininogen (HMW kininogen)-deficient plasmas, but was activated in other deficient plasmas. After clotting, activated Factor IX (IXa) was the apparent principal activator. Thus, Factor VII was not activated in Factor XII-,HMW kininogen-, XI-, and IX-deficient plasmas, but was activated in Factor VIII-, X-, and V-deficient plasmas. In further studies, purified small-fragment Factor XIIa (β-XIIa), kallikrein, and Factor IXa were added to partially purified Factor VII and to plasma. High concentrations of β-XIIa activated Factor VII in a purified system; much lower concentrations of β-XIIa activated Factor VII in normal plasma but not in prekallikrein or HWM kininogen-deficient plasmas. Kallikrein alone failed to activate partially purified Factor VII but did so when purified Factor IX was added. Kallikrein also activated Factor VII in normal, Factor XII-, and Factor IX-deficient plasmas. Purified Factor IXa activated partially purified Factor VII and had no additional indirect activating effect in the presence of plasma. These results demonstrate that both Factor XIIa and Factor IXa directly activate human Factor VII, whereas kallikrein, through generation of Factor XIIa and Factor IXa, functions as an indirect activator of Factor VII.
Carnitine Acetyltransferase Mitigates Metabolic Inertia and Muscle Fatigue during Exercise
Authors: Sarah E. Seiler, Timothy R. Koves, Jessica R. Gooding, Kari E. Wong, Robert D. Stevens, Olga R. Ilkayeva, April H. Wittmann, Karen L. DeBalsi, Michael N. Davies, Lucas Lindeboom, Patrick Schrauwen, Vera B. Schrauwen-Hinderling, Deborah M. Muoio
Journal: Cell Metabolism (2015)
Selection and the unification of science
Authors: Jay N. Eacker
Journal: Behavioral and Brain Sciences (2001)

Selection in behavior analysis fits the criteria of replication, variation and interaction proposed by the authors except for information under replication. If information requires physical structure, behavior analysis does not fit that model because functional analysis may provide parallels between behavior, neurology, and biochemistry but not sequencing. The three sciences are not unified by the model but another is available.
Audit of intervention to improve educational experience in a respiratory medicine department
Authors: Zoe Pond
Journal: European Respiratory Journal (2011)

Introduction:  A continuing rise in service pressures and reduced working hours creates an ever increasing challenge in the provision of a good quality training experience for junior doctors.   Objectives:  The aims were to determine trainees9 perception of the education in their current post, provide opportunity for suggestions for improvement, make changes and then assess the effectiveness of changes made.   Methods:  All juniors within the department were asked to complete an anonymous questionnaire, covering educational aspects of their post, within the last few weeks of July 2010. This was repeated in November to assess the impact of changes made.   Results:  Response rates of 87.5% (14/16) and 85% (17/20) were obtained with all grades represented. Training was rated fair to excellent. The most useful educational experience for the more junior doctors, in both audits, were on call duties where they were managing conditions they had not previously encountered. The more senior trainees found ward rounds most helpful.  Areas for improvement identified in the first audit included enabling juniors to attend grade-specific teaching, increasing ward round teaching, and increasing opportunities for workplace based assessments.  Following implementation of changes, 62.5% reported workplace based assessments gave useful feedback compared to 36% previously. Attendance at grade-specific teaching increased from 57% to 89% in more junior trainees. All grades commented on the usefulness of this teaching as it was targetted at their level.   Conclusions:  Surverying trainees regarding their educational experience is useful and can allow focussed intervention to improve areas of respiratory education.
A memorable evening: A doctor's family
Authors: P. Edmondson
Journal: BMJ (1998)

Chronic refractory breathlessness is defined as breathlessness at rest or on minimal exertion that will persist chronically despite optimal treatment of the underlying cause(s). At any time, 1% of the population report a modified Medical Research Council dyspnoea score of ≥3 chronically. Despite the prevalence, severity and chronicity of this symptom and an evidence base of affordable and safe interventions, chronic refractory breathlessness remains grossly undertreated. Many patients and clinicians accept the presence of the chronic refractory breathlessness as an inevitable part of an illness, with no thought of treating the symptom despite an evidence base for its safe treatment. Consensus statements from major respiratory clinician organisations now endorse such a clinical course. Failure to enquire about, assess and properly treat chronic refractory breathlessness with opioids as outlined in specialist clinical guidelines is now an unacceptable level of care ethically and is, arguably, a breach of people9s human rights. Adequate pain control through access to pain relief is now accepted as a human right and, given its burden across the world, the symptomatic treatment of chronic refractory breathlessness should be seen in exactly the same way.
Effectiveness of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease
Authors: Samy Suissa
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Recent large-scale cohort studies that reported an important reduction in mortality and chronic obstructive pulmonary disease (COPD) morbidity with inhaled corticosteroids may be biased. We used a population-based cohort of Saskatchewan residents 55 years of age or over, first hospitalized for COPD during 1990 to 1997, to study this potential bias. These 979 subjects were followed for a year from discharge until their first readmission for COPD or death (389 subjects). Inhaled corticosteroid exposure was measured as any dispensing within 90 days after discharge. Cox's proportional hazards model was used to compare the time-fixed analysis employed in the recent studies with the alternative time-dependent analysis. The time-fixed adjusted rate ratio was 0.69 (95% CI: 0.55–0.86) for inhaled corticosteroid use within 90 days, whereas the time-dependent rate ratio was 1.00 (95% CI: 0.79–1.26). With the time-fixed analysis, the rate ratios were affected by the length of the exposure period, decreasing from 0.98 for a 15-day exposure period to 0.51 for 365 days, but remained stable between 1.06 and 0.94 with the time-dependent analysis. Inhaled corticosteroid use after hospitalization for COPD was not found to reduce mortality and morbidity. Although observational studies can be valuable, the recent reports of reductions in mortality and morbidity with inhaled corticosteroids are biased by their inappropriate allocation of exposure and analysis of immortal time.
High-dose cisplatin with sodium thiosulfate protection.
Authors: C E Pfeifle, S B Howell, R D Felthouse, T B Woliver, P A Andrews, M Markman, M P Murphy
Journal: Journal of Clinical Oncology (1985)

Nephrotoxicity frequently limits the dose of cisplatin to less than 120 mg/m2 per injection. Sodium thiosulfate is a neutralizing agent for cisplatin that protects against renal damage. To determine whether injection of thiosulfate would permit larger doses of cisplatin to be administered, a fixed 9.9-g/m2 dose of thiosulfate was given intravenously over three hours concurrently with escalating doses of cisplatin. Cisplatin was administered over the last two hours of the thiosulfate infusion. Using this technique, it was possible to escalate the cisplatin dose to 225 mg/m2 before dose-limiting toxicities were encountered. Comparison of cisplatin pharmacokinetics in patients treated with 202.5 mg/m2 plus thiosulfate to those in patients treated with 100 mg/m2 without thiosulfate indicated that there were no changes in the elimination rate constant, volume of distribution, or total body clearance of cisplatin. The total drug exposure for the plasma was approximately twofold at the higher cisplatin dose. This study demonstrates that concurrent administration of thiosulfate permits at least a twofold increase in dose and total exposure to cisplatin.
The Third Intergroup Rhabdomyosarcoma Study.
Authors: W Crist, E A Gehan, A H Ragab, P S Dickman, S S Donaldson, C Fryer, D Hammond, D M Hays, J Herrmann, R Heyn
Journal: Journal of Clinical Oncology (1995)

PURPOSE The ultimate goal of the Third Intergroup Rhabdomyosarcoma Study (IRS-III, 1984 to 1991) was to improve treatment outcome in children with rhabdomyosarcoma through clinical trials comparing risk-based protocols of surgery and multiagent chemotherapy, with or without irradiation. PATIENTS AND METHODS One thousand sixty-two previously untreated, eligible patients who were entered onto the study after surgery were randomized or assigned to treatment by clinical group (I through IV), histology (unfavorable or favorable), and site of the primary tumor. Initial responses, progression-free survival (PFS), and survival (S) were the end points used in comparisons between randomized groups and between patients treated in IRS-III and IRS-II (1978 to 1984). RESULTS The overall outcome of therapy in IRS-III was significantly better than in IRS-II (5-year PFS, 65% +/- 2% v 55% +/- 2%; P &lt; .001 by stratified testing). Patients with group I favorable-histology tumors fared as well on a 1-year regimen of vincristine and dactinomycin (VA), as did a comparable group treated with VA plus cyclophosphamide (C) (5-year PFS, 83% +/- 3% v 76% +/- 4%; P = .18). Results for patients with group II favorable-histology tumors, excluding orbit, head, and paratesticular sites, were inconclusive regarding the benefit from addition of doxorubicin (ADR) to VA. Patients with group III tumors, excluding those in special pelvic, orbit, and other selected nonparameningeal head sites, fared much better on the more intensive regimens of IRS-III than on pulsed VAC or VAC-VADRC in IRS-II (5-year PFS estimates, 62% +/- 3% v 52% +/- 3%; P &lt; .01); however, there were no significant differences in outcome among the groups treated in IRS-III. Patients with metastatic disease at diagnosis (clinical group IV) did not benefit significantly from the more complex therapies evaluated in IRS-III. CONCLUSION Intensification of therapy for most patients in IRS-III, using a risk-based study design, significantly improved treatment outcome overall. The largest gain from this strategy was realized in patients with gross residual tumor after biopsy (clinical group III). It was also possible to decrease therapy for selected patient subsets without compromising survival.
Adherence to continuous positive airway pressure therapy (CPAP) in patients with obstructive sleep apnea (OSA) in an Asian privately funded healthcare system
Authors: Cheah Hooi Ken Lee, Leong Chai Leow, Pei Rong Song, Huihua Li, Thun How Ong
Journal: European Respiratory Journal (2014)

Background and objective:  We explored CPAP adherence patterns among OSA patients in a privately funded healthcare system.   Methods:  Patients who were newly diagnosed with symptomatic (Epworth sleepiness score (ESS) ≥10) moderate-severe OSA (apnea hypopnea index (AHI)>15) participated in a telephone interview 1 year after initiation of CPAP treatment to assess their level of adherence (using CPAP>4 hours/day). Logistic regression analysis was performed to evaluate for factors associated with CPAP adherence.   Results:  135 out of 529 patients who underwent diagnostic polysomnography from January 2012 to June 2012 met inclusion criteria. 78 (57.8%) patients were initiated on CPAP treatment, but 57 (42.2%) patients rejected CPAP upfront. 41 (52.6%) patients who initiated CPAP were adherent at one year. Patients who were CPAP adherent had higher AHI (63.7 vs. 49.1, p=0.0011) and reported more symptomatic improvement after CPAP. Mask and machine related side effects were associated with lower adherence (p=0.015). Those who rejected CPAP therapy upfront cited inconvenience, cost and poor disease perception as reasons.   Conclusions:  In this Asian privately funded healthcare system, almost half of the patients with significant OSA rejected CPAP treatment upfront but adherence among those who started CPAP is comparable to other reports. A change in funding model and improved patient education may help improve CPAP uptake.
Impacts of long-term CPAP therapy on fatty liver in male OSA patients with abdominal obesity
Authors: Yoshiro Toyama, Kimihiko Murase, Masanori Azuma, Satoshi Hamada, Ryo Tachikawa, Takeshi Kubo, Kiminobu Tanizawa, Morito Inouch, Tomohiro Handa, Takefumi Hitomi, Toru Oga, Michiaki Mishima, Kazuo Chin
Journal: European Respiratory Journal (2014)

Background:  The evidences for significant relationships between obstructive sleep apnoea (OSA) and fatty liver is gradually accumulating. However, placebo-controlled studies in OSA patients with mild fatty liver reported that several months of continuous positive airway pressure (CPAP) therapy did not improve fatty liver. On the other hand, the strong causal factor of fatty liver is abdominal obesity, the central factor of metabolic syndrome. The aim of this study is to evaluate the changes in liver fat accumulation (LFA) of OSA patients with abdominal obesity and developed fatty liver after longer-term CPAP therapy.   Methods:  The participants were 61 male OSA patients who had started CPAP between 2008 and 2010 and had abdominal obesity (waist circumference ≥ 85 cm; Japanese criterion) at the time. At the follow-up examination, the data from abdominal computed tomography (CT), fasting blood tests and CPAP memory cards were collected. LFA was determined as an average CT value of liver. Visceral fat accumulation and subcutaneous fat accumulation were also measured.   Results:  The average age, BMI and LFA at the baseline, and the average period and daily usage time of CPAP were 57.2 y, 28.6 kg/m 2 , 49.7 HU, 31.3 M, and 4.8 h/d, respectively. In the entire group, LFA did not change during the CPAP therapy. On the other hand, in those who had developed fatty liver (CT value of liver l 50 HU) at the baseline, LFA decreased after the CPAP in spite of stable BMI, visceral and subcutaneous fat accumulation, and other metabolic conditions.   Conclusion:  Long-term CPAP may contribute to improvement of fatty liver in OSA patients with abdominal obesity and developed fatty liver.
Equity in the NHS Allocating resources for health and social care in England
Authors: K Judge, N Mays
Journal: BMJ (1994)

The fair allocation of resources for health and social care in relation to the needs of the population in different parts of the United Kingdom has become particularly important since the implementation of the new arrangements for community care in April 1993. These depend on close collaboration between health authorities and local authority social services departments. Yet funding reaches these authorities by different means and according to different criteria. Most health authority funds come through a weighted capitation formula that overemphasises the effects of age, while family health services funding is largely not cash limited and hence demand led. Funds to local authorities for community care are being transferred from the social security budget but on a basis that partly reflects past provision of residential and nursing home care. None of these mechanisms responds to underlying needs that give rise to demands on the health and social care system as a whole, and none makes any attempt to compensate for defects in the others. The solution includes better research and a unified weighted capitation system for all sources of funding.