tbuckley/cabot-search huggingface dataset:
Maternal Diabetes and Autism in Offspring
Authors: Barry Zitser
Journal: JAMA (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 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
Recent developments: Management of chronic heart failure
Authors: M. R Cowie
Journal: BMJ (2002)

Heart failure is a complex syndrome that results from any structural or functional cardiac disorder that impairs the ability of the heart to function as a pump. It has a major impact on longevity and quality of life. One to two per cent of the general population of developed countries have heart failure, and the average age at diagnosis is 76 years.1 Although the steady rise in hospital admissions for heart failure has slowed recently, the management of heart failure still accounts for 1-2% of healthcare expenditure in the United Kingdom and other countries in the developed world.2 Improvements in cardiac imaging and new biochemical assays have made diagnosis more straightforward. Major changes in treatment have resulted from a better understanding of the pathophysiology of heart failure and the results of large clinical trials. Improving outcomes now increasingly depends on improved communication between healthcare professionals, education of patients and carers, and better chronic disease management.

We searched the PubMed database for publications on the diagnosis and treatment of chronic heart failure in adult humans. We also consulted recent international guidelines to develop an overview of the evidence based management of heart failure.



Fig 1 
Algorithm for the diagnosis of heart failure (based on the most recent guidelines from the European Society of Cardiology)3



Heart failure is usually associated with dyspnoea, fatigue, and fluid retention. Symptoms alone cannot be relied on in making the diagnosis: a careful history and physical examination need to be supplemented by further tests. Diagnosis requires consideration of the underlying abnormality of the heart, the severity of the syndrome, the aetiology, the precipitating and exacerbating factors, the identification of concomitant disease relevant to management, and an estimation of prognosis. Figure 1 shows the algorithm for the diagnosis of heart failure currently recommended by the European Society …
Screening for Breast Cancer: Recommendations and Rationale
Journal: Annals of Internal Medicine (2002)

This statement summarizes the current U.S. Preventive Services Task Force (USPSTF) recommendations on screening for breast cancer and the supporting scientific evidence and updates the 1996 USPSTF recommendations on this topic. The complete USPSTF recommendation and rationale statement on this topic, which includes a brief review of the supporting evidence, is available through the USPSTF Web site (www.preventiveservices.ahrq.gov), the National Guideline Clearinghouse (www.guideline.gov), and in print through the Agency for Healthcare Research and Quality Publications Clearinghouse (telephone, 800-358-9295; e-mail, ahrqpubs@ahrq.gov). The complete information on which this statement is based, including evidence tables and references, is available in the accompanying article in this issue and in the summary of the evidence and systematic evidence review on the Web sites already mentioned. To update its recommendations on screening for breast cancer, the USPSTF reviewed the evidence regarding the effectiveness of mammography, clinical breast examination, and breast self-examination in reducing breast cancer mortality. The USPSTF did not review the evidence regarding genetic screening, surveillance of women with prior breast cancer, or formal evaluation of new screening modalities that have not been studied in the general population. A meta-analysis using a Bayesian random-effects model was conducted for the USPSTF to obtain a summary of relative risk estimates of the effectiveness of screening with mammography, either alone or in combination with clinical breast examination, in reducing breast cancer mortality. Clinical studies that evaluated breast self-examination were included in the review. Sources for estimates cited in this Recommendation and Rationale statement are described in the systematic evidence review on this topic, which is available on the USPSTF Web site (www.preventiveservices.ahrq.gov). * For a list of the members of the U.S. Preventive Services Task Force, see the Appendix.
Abstract 5992: Comparison of 4 Years Efficacy and Durability of Sirolimus-Eluting Stent and Paclitaxel- Eluting Stent Deployment in Patients with Very Long Coronary Lesions: Multicenter Registry in Asia
Authors: Sunao Nakamura, Hisao Ogawa, Jang-Ho Bae, Yeo Hans Cahyadi, Wasan Udayachalerm, Damras Tresukosol, Sudaratana Tansuphaswadikul
Journal: Circulation (2008)

Aim : The aim of this study is to compare the 4 years safety and durability of Sirolimus-eluting stent (SES) and Paclitaxel-eluting stent (PES) deployment on the outcome of patients with very long coronary lesions (VLL). Methods : A prospective analysis of 656 patients 730 lesions (male 70.4%, mean age 66.9 yrs) with very long coronary lesion (≥40mm) (368 SES and 288 PES) in five high volume Asian centers after successful stenting in VLL was performed. Lesion locations of VLL were LAD 48.2% (SES 50.2%, PES 45.7%), LCX 18.5%, RCA 33.3%. Complete clinical follow-up to 4 years is being analyzed for all patients. Results : The baseline clinical characteristics between 2 groups were similar. At 4 years overall cardiac events of SES (16.3%) were lower than PES (24.0%) (p=0.03). See table for clinical results. Conclusion : The use of SES and PES in patients with very long coronary lesion was safe and feasible with low acute complication and low incidence of restenosis. SES showed lesser incidence of cardiac events (death, myocardial infarction, CABG and PCI) at 4 years clinical follow-up. SAT (sub acute stent thrombosis), LAST (late stent thrombosis: ~1year), VLAST (very late stent thrombosis: 1year~ 4years) MACE (death, myocardial infarction, CABG and PCI).
Emergency Medicine: A Comprehensive Study Guide
Authors: Judith E. Tintinalli, Ronald L. Krome, Ernest Ruiz
Journal: Annals of Internal Medicine (1992)

A study guide for clinical emergency medicine management and for those preparing for board or recertification examinations. This edition contains 308 chapters. New two-colour figures have been added, along with additional tables and algorithms. A new compact atlas features emergency medicine pictures in colour, and many sections have been completely revised, including Toxicology and Pediatrics, and there are new sections on Nontraumatic Musculo-Skeletal Disorders and Special Patients.
Primary sclerosing cholangitis, autoimmune hepatitis, and overlap in utah children: Epidemiology and natural history
Authors: Mark Deneau, Kyle M. Jensen, John Holmen, Marc S. Williams, Linda S. Book, Stephen L. Guthery
Journal: Hepatology (2013)

The epidemiology and natural history of pediatric primary sclerosing cholangitis (PSC), autoimmune sclerosing cholangitis (ASC), and autoimmune hepatitis (AIH) are not well characterized. Using multiple, overlapping search strategies followed by a detailed records review, we identified all cases of pediatric PSC, ASC, AIH, and inflammatory bowel disease (IBD) in a geographically isolated region of the United States. We identified 607 cases of IBD, 29 cases of PSC, 12 cases of ASC, and 44 cases of AIH. The mean age at diagnosis was 13.0 years for PSC, 11.3 years for ASC, and 9.8 years for AIH. The incidence and prevalence of PSC, ASC, and AIH were 0.2 and 1.5 cases, 0.1 and 0.6 cases, and 0.4 and 3.0 cases per 100,000 children, respectively. The mean duration of follow-up was 5.9 years. The probability of developing complicated liver disease within 5 years of the diagnosis of liver disease was 37% [95% confidence interval (CI) = 21%-58%] for PSC, 25% (95% CI = 7%-70%) for ASC, and 15% (95% CI = 7%-33%) for AIH. The 5-year survival rates with the native liver were 78% (95% CI = 54%-91%) for PSC, 90% (95% CI = 47%-99%) for ASC, and 87% (95% CI = 71%-95%) for AIH. Cholangiocarcinoma developed in 2 of the 29 PSC patients (6.9%). PSC occurred in 9.9% of patients with ulcerative colitis (UC) and in 0.6% of patients with Crohn's disease (CD). ASC occurred in 2.3% of UC patients and 0.9% of CD patients. AIH occurred in 0.4% of UC patients and in 0.3% of CD patients. Liver disease occurred in 39 of 607 IBD patients (6.4%) overall.Immune-mediated liver diseases are important sources of morbidity in children. Using a population-based design, this study quantifies the burden and natural history of immune-mediated liver disease in children.
Protective effect of fenspiride on bronchi in rats with COPD
Authors: Nataliya Kuzubova, Elena Lebedeva, Anatoliy Fedin, Ivetta Dvorakovskaya
Journal: European Respiratory Journal (2012)

Corticosteroid resistance in COPD is urgent problem so the search for drugs that have bronchodilator and anti-inflammatory effect at all stages of COPD is needed.   Aim:  to study effect of non-corticosteroid drug fenspiride (F) on contractile activity of bronchial smooth muscle (SM) in rats with COPD.   Methods.  Model of COPD was induced in rats by nitrogen dioxide (NO 2 ) exposure (15 ppm, 1,5 h/day, 60 days). F (0,15 or15mg/kg) was administered  per os  daily before exposure to NO 2 . Control rats received 0,9% NaCl. Isometric contraction of bronchial segments caused by electrical stimulation (st) of preganglionic nerve or SM was recorded by displacement electromechanical transducer.   Results.  Treatment with F at the acute stage of COPD (15 days) prevented the bronchial constrictor effect of NO 2 . Contractile reactions of bronchi were lower than in control with st both nerve (89±4%; 107±2% for 0,15 and 15 mg/kg, control 118±5%, p   Conclusion.  Mechanism of F action on bronchial SM depends on its dose. Revealed bronchodilator and anti-inflammatory effect of extremely low dose F can be used for prevention of COPD development in persons exposed to aggressive environmental factors.
Abstract 33: Parity is Associated with Aortic Remodeling: The Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Shivani R Aggarwal, David A Bluemke, William G Hundley, João A Lima, Murray A Mittleman, Pamela Ouyang, Nisha I Parikh, Dhanajay Vaidya, Joseph Yeboah, David M Herrington
Journal: Circulation (2014)

Introduction: Several lines of evidence suggest that increased gravidity and/or parity is associated with increased risk for clinical cardiovascular events and left ventricular remodeling. However, the mechanism(s) that account for these associations remain unclear. Recent analyses from MESA indicate that parity is also associated with increased carotid stiffness; consistent with the hypothesis that extra-cellular matrix remodeling that occurs to facilitate child birth may also lead to adverse effects on arterial structure and function. To date there are few data on the effects of gravidity or parity on central aortic structure and function. To study this we examined the relationship between reproductive history and MRI-based measures of aortic dimensions in women enrolled MESA. Methods: Study subjects included 1908 women aged 45-84, from four race/ethnic groups who were free from cardiovascular disease. Women were classified as having 0 to ≥ 5 live births and 0 to ≥6 pregnancies. Minimum and maximum cross-sectional area and average diameter of the descending aorta at the level of the right pulmonary artery were measured using thoracic MRI. After exploratory data analysis and data cleaning, univariate and multivariable models were used to describe the relationship between number of pregnancies or live births and aortic dimensions, after adjustment for potential confounders including age, race-ethnicity, height, weight, smoking, diabetes, total and HDL cholesterol, SBP, use of anti-hypertensive medications and education as a proxy for socio-economic status. Results: Of 1908 participants, 41.1% were Caucasian, 31.1% African-American, 16.7% Hispanic and 11.1% Chinese-American. The mean (±SD) age was 61.1±10.0 years, 46% had HTN, and 19% had diabetes mellitus or impaired fasting glucose. In univariate analyses, minimum and maximum aortic area were 14 mm 2 larger and average diameter was 0.28 mm greater for each live birth (all p&lt;0.001). In fully adjusted models the number of live births remained significantly associated with min and max area and average diameter (all p&lt;0.005). Qualitatively similar results were seen using number of pregnancies. Conclusions: Increasing number of pregnancies and live births is associated with greater aortic remodeling. Further studies are needed to determine if specific physiologic effects of pregnancy are responsible for the apparent deleterious consequences on arterial remodeling and whether these changes translate into adverse cardiovascular outcomes.
Abstract MP51: Global, Regional, And National Intakes Of Sugar-sweetened Beverages, Milk, And Fruit Juice: A Systematic Analysis Including 193 Country-specific Nutrition Surveys Worldwide.
Authors: Gitanjali M Singh, Renata Micha, Shahab Khatibzadeh, Peilin Shi, Stephen Lim, Kathryn Andrews, Rebecca E Engell, Majid Ezzati, Dariush Mozaffarian
Journal: Circulation (2014)

Background: Sugar-sweetened beverages (SSBs), fruit juice, and milk each significantly contribute to health and disease. To-date, assessment of their global distributions and health impacts have been limited by insufficient comparable and reliable data by country, age, and sex. Objective: To quantify global, regional, and national levels of SSB, fruit juice, and milk intake by age and sex in adults over age 20 in 2010. Methods: We identified, obtained, and assessed data on intakes of these beverages in adults, by age and sex, from 193 nationally representative diet surveys worldwide, representing 62% of the world’s population. We developed a multi-level hierarchical Bayesian model to account for differences in national and regional missingness, measurement incomparability, study representativeness, and sampling and modeling uncertainty. Results: In 2010, global average intakes were 0.58 (95%UI: 0.37, 0.89) 8 oz servings/day for SSBs, 0.16 (0.10, 0.26) for fruit juice, and 0.57 (0.39, 0.83) for milk. There was significant heterogeneity in consumption of each beverage by region and age (Figure). SSB intakes were highest in the Caribbean (1.9 servings/day; 1.2, 3.0) fruit juice intakes were highest in Australia and New Zealand (0.66; 0.35, 1.13), and milk intakes were highest in Central Latin America and parts of Europe (1.06; 0.68, 1.59). Consumption levels of all three beverages were lowest in East Asia and Oceania. Globally and within regions, SSB consumption was highest in younger adults; fruit juice consumption showed little relation with age; and milk intakes were highest in older adults. Conclusions: This quantitative assessment of current beverage intakes at global, regional, and national levels, as well as by age and sex, is imperative for informing public health and policy priorities for intervention strategies, as well as for quantifying the impacts of these beverages on health worldwide.
Personal therapy for therapists
Authors: Roger P. Greenberg, Jud Staller
Journal: American Journal of Psychiatry (1981)

Clinicians have often advocated personal therapy as a useful method in the training of psychotherapists. Yet, for decades arguments have existed about the value of a personal therapy experience. In an attempt to clarify the situation, the authors discuss the debate within a historical context and present a critical review of the empirical evidence gathered to date on personal therapy. They found a paucity of reported research on the subject and conclude that additional evidence is required before firm conclusions can be drawn about the merits of psychoanalysis as a training method.
Use of mutation profiling of breast cancer using sequenom technology to detect distinct mutation patterns in triple-negative compared to receptor-positive cancers.
Authors: L. Santarpia, A. M. Gonzalez-Angulo, Y. Qi, K. Stemke-Hale, B. Wang, D. J. Booser, G. N. Hortobagyi, W. F. Symmans, A. Di Leo, L. Pusztai
Journal: Journal of Clinical Oncology (2010)

1039 Background: Mutations and polymorphisms in various genesrepresent potential therapeutic targets. The objective of this study was to assess the mutation landscape of breast cancer and correlate these findings with clinicopathological characteristics. Methods: We examined fine needle aspiration specimens from 262 stage I-III breast cancers for activating mutation or SNPs hot spots in 35 genes. A total of 166 sequence sites were studied using mass spectroscopy-based sequencing (Sequenom). Genetic alterations were compared between 3 distinct groups of cancers including HER2+ (n=61), ER+/HER2- (n=86), and triple negative (TN, n=115). Results: Mutations were detected in 17 genes and in 79% of cancers. Twenty percent of cases had only 1 mutation (median number of mutations > 2, range 0-13), 32% (116/366) of mutations were confined to receptor tyrosine kinases (RTKs) including FGFR-2, -3, PDGFR, and EGFR and KIT. Frequent mutations were also found in the PIK/m-TOR pathway including the PIK3CA, AKT, PHLLP2, PIK3R1, and FBXW7 genes (96/366, 26%). Sporadic mutations were detected in CDK4, PRKAG2 and BRAF genes (69/366, 19%). Two percent of tumors harbored other rare mutations. The number of mutations was not significant different in the three cancer subtypes. Mutations in RTK genes were evenly distributed in all tumors, whereas mutations in the PIK/mTOR genes were more common in receptor-positive tumors than TN (42% vs. 12%, p=0.0001). SNPs were detected in 88% of cancers (median=2, range 0-5 SNP/tumor). Half of all SNPs were confined to the VEGF gene. The distribution of SNPs did not differ among the 3 groups, but SNPs in VEGF were associated with increased tumor size (p=0.009). Conclusions: Breast cancers harbor a variety of activating mutations in important regulatory genes that correspond to existing and novel therapeutic targets. Multiple mutations are common and mutation-directed combination therapies represent a potential new therapeutic approach. No significant financial relationships to disclose.
A CASE OF INFECTIOUS MONONUCLEOSIS WITH ATYPICAL PNEUMONIA
Authors: M RODSTEIN
Journal: Annals of Internal Medicine (1948)

ExcerptINTRODUCTIONAccording to Smadel,16"Primary atypical pneumonia is a clinical-pathological entity which has a diverse etiology. One of the first approaches to the problem of this disease should be the establishment of an etiological diagnosis wherever possible. In this way certain cases can be removed from the general group and studied in a more intelligent manner." Recent investigation of this disease includes the virus and bacteriological study of humans and animals, and the development of a number of serological tests for the detection of a widely different group of antibodies which develop chiefly during the convalescent phase of the disease....
HEART DISEASE: ITS MEDICAL ASPECTS
Authors: S A LEVINE
Journal: Annals of Internal Medicine (1950)

Article1 September 1950HEART DISEASE: ITS MEDICAL ASPECTSSAMUEL A. LEVINE, M.D., F.A.C.P.SAMUEL A. LEVINE, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-33-3-572 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt is not surprising that the medical profession and the entire country are intensely concerned with the problem of heart disease. From a public health point of view it outranks all others in importance. As far as the medical profession is concerned, heart disease is no longer confined to the field of internal medicine. The surgeon has now taken on a major responsibility in the treatment of an increasing number of types of heart disease. Specialists in many other fields often find that the heart plays an important rôle in the diseases under their care. The dermatologist may be treating...Bibliography1. Levine SA: A clinical conception of rheumatic heart disease, Am. Heart J. 9: 26, 1933. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Presented at the Thirty-first Annual Session of the American College of Physicians, Boston, Mass., April 21, 1950. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byChest Pain 1 September 1950Volume 33, Issue 3Page: 572-581KeywordsCardiovascular therapyHeart diseasesPrevention, policy, and public healthSurgeons Issue Published: 1 September 1950 PDF downloadLoading ...
Abstract 15995: Role of Kir Channels in Flow-Induced Vasodilatation
Authors: Sang Joon Ahn, Jing-Tan Bian, Sarah Schwab, Mary Szczurek, Shane A Phillips, Irena Levitan
Journal: Circulation (2014)

Introduction: Flow-induced vasodilation (FIV) is an important physiological stimulus for regulating vascular tone. A loss of endothelial-dependent FIV is an early indication of endothelial dysfunction. Earlier studies proposed that endothelial inwardly-rectifying K + channels (Kir) are putative flow sensors, but the role of Kir in the regulation of vascular tone is not known. Hypothesis: Kir channels play a key role in FIV. Methods: FIV was assessed in mouse mesenteric arteries isolated from wild type (WT) and Kir2.1 +/- heterozygous mice. Briefly, resistance arteries were isolated, cannulated and pressurized in an organ chamber with glass micropipettes. Preparations were visualized in real time and the inner diameter of the vessels was measured using acquired images. Kir channels in arteries isolated from WT mice were downregulated by a dominant-negative subunit of Kir2.1 or blocked by Ba 2+ . The role of Kir channels in flow-induced release of NO was tested by Diaminorhodamine-4M, NO specific fluorescence dye. Results: Our results show that FIV is significantly inhibited in mesenteric arteries isolated from Kir2.1 +/- mice that have reduced Kir2.1 expression as compared with WT mice (42%±3% relaxation in Kir2.1 +/- vs 94.06%±2.2% in WT mice, n=11, p&lt;0.05). Moreover, blocking Kir channels with Ba 2+ or downregulating its activity with a dominant-negative subunit of Kir2.1 also resulted in significant inhibition of FIV in arteries isolated from WT mice (47%±3% relaxation in the presence of Ba 2+ , 43%±5% in arteries infected with dnKir2.1 vs 94.06%±2.2% in WT n=3, p&lt;0.05). As expected, inhibiting NO release by LNAME, a nitric oxide synthase inhibitor, reduced FIV in WT arteries (39%±5%, n=4, p&lt;0.05), but no effect was observed in arteries isolated from Kir2.1 +/- mice. Furthermore, flow-induced release of NO was significantly reduced (1.5-fold decreased, p&lt;0.05). In contrast, inhibiting Ca 2+ -dependent K + channels (SK/IK) had an additive effect to Kir suppression suggesting that SK/IK and Kir channels regulate FIV by parallel pathways. In conclusion, our results indicate that Kir channels contribute significantly to FIV by regulating NO release.