tbuckley/cabot-search huggingface dataset:
Towards fewer handicapped children
Authors: J. H Smith
Journal: BMJ (1980)

Ventilation and perfusion lung scans were performed in 58 patients before operation for bronchial carcinoma to determine in which patients the lung scan was most useful for assessing mediastinal spread and resectability of the tumour. Perfusion of the affected lung was less with larger and more centrally situated tumours. Perfusion was also less for left-sided than for right-sided tumours but this is explained by the normal differential perfusion of the right and left lungs. The lung scan was unhelpful in predicting resectability of peripheral tumours, but with central tumours if perfusion of the affected lung was less than 25% of the total perfusion the lesion was likely to be non-resectable because of spread to the mediastinum. Airways obstruction was present in 67% of the patients but did not interfere with the interpretation of the scans. In most cases ventilation scans provided no additional information, and the use of krypton-81 m as a sensitive indicator of regional ventilation did not improve on the predictive value of the perfusion scan.
Mandatory Testing for HIV
Authors: David M. Morens
Journal: JAMA (1993)

<h3>To the Editor.</h3> —Dr Francis'<sup>1</sup>no-nonsense proposal for a CDC-led national HIV prevention program is like a sniff of smelling salts after a deep swoon.<i>JAMA</i>readers of all political persuasions should examine it carefully. Reading it, I recalled an October 1981 conversation with Francis. As the "KS-OI" (Kaposi's sarcoma-opportunistic infection) (AIDS) Coordinator for the CDC's Center for Infectious Diseases, I had been developing a CDC plan to search for an infectious causative agent that I imagined might be epidemiologically similar to sexually transmitted cytomegalovirus. Francis suggested a better idea: perhaps the then poorly understood outbreak of Kaposi's sarcoma and opportunistic infections was due to a sexually transmitted retrovirus. This was the first time, to my knowledge, that anyone correctly theorized the cause of the AIDS epidemic. Later discoveries, of course, showed how prescient Francis had been. Are his ideas for a national HIV prevention strategy equally farsighted? He
Abstract S4-3: The EndoPredict score identifies late distant metastases in ER+/HER2− breast cancer patients
Authors: P Dubsky, JC Brase, K Fisch, R Jakesz, CF Singer, R Greil, O Dietze, KE Weber, C Petry, R Kronenwett, M Rudas, M Knauer, M Gnant, M Filipits
Journal: Cancer Research (2012)

Abstract Background: ER+/HER2− negative (ER+) breast cancers have a proclivity for late recurrence. A first step to an improved adjuvant treatment of late metastasis is to identify women at risk and understand the underlying biology. Several prognostic multigene tests have been developed for ER+ breast cancer patients. Some of these tests have been validated to predict early recurrence events. However, few gene expression assays have been shown to predict late metastases. Here, we assess whether the prognostic EndoPredict (EP) score, which incorporates both the expression levels of proliferative - and ESR1-related genes, can be used to identify late relapse events in ER+ breast cancer patients. Methods: Patients included in this study participated in the ABCSG-6 (tamoxifen-only arm) or ABCSG-8 phase III adjuvant trial and received either tamoxifen for 5 years or tamoxifen for 2 years followed by anastrozole for 3 years. All 1702 ER+/HER2− breast cancer patients were retrospectively assigned into risk categories based on the EP and on common clinical parameters. The primary endpoint was distant metastasis. Ongoing collection of follow-up events allowed estimation of metastasis rates using the Kaplan–Meier method in an early and late time cohort: 0–5 years/early recurrence and 5–10 years/late recurrence. Results: 49% of all patients were classified as low-risk according to the EP score. Kaplan Meier analysis demonstrated that the EP low-risk group had a significantly improved clinical outcome in the first (0–5 years; p &amp;lt; 0.0001) and second time interval (5–10 years; p = 0.002). Nodal metastasis was also significantly associated with the clinical outcome in both time intervals, with node-positive tumors showing a considerably higher rate of late recurrence events. In contrast, Ki67 levels and grading were not significantly associated with late metastasis. Multivariate analysis showed that EP was an independent prognostic parameter after adjustment for age, grade, lymph node status, tumor size and Ki67 in both the first and second time interval. The EPclin – a combination of the EP and the clinical risk factors nodal status and tumor size – showed the best performance in predicting late relapse events. Exploratory analyses of proliferative - versus ESR-1 related genes as contributors to early and late distant metastases show differential effects. Conclusions: The EndoPredict test identified a subgroup of patients that have a low likelihood of developing late metastases. The eight genes contained in the test provide complimentary prognostic information to clinico-pathologic parameters. Both the expression of proliferative - and ESR1-related genes contributes to the underlying biology of late distant metastases. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr S4-3.
An Unusual Case of Intraabdominal Nocardia Abscess Detected by Tc-99m HMPAO-Labeled WBC Study
Authors: Shabana Saeed, J Esteban Varela, Richard L. Nelson, Michael J. Blend
Journal: Clinical Nuclear Medicine (2004)

Images of a 37-year-old woman with Crohn's disease and recent onset of left lower quadrant pain are presented. Physical and radiologic findings were inconclusive. A Tc-99m-HMPAO-WBC study was ordered and found helpful in differentiating active Crohn's disease of the bowel from a localized abscess. Surgical drainage revealed a well-encapsulated Nocardia abscess consistent with the WBC scan findings. The location of this type of infection is unusual for a patient with Crohn's disease not on immunosuppressive drugs.
Risk Index for Perioperative Renal Dysfunction/Failure
Authors: Solomon Aronson, Manuel L. Fontes, Yinghui Miao, Dennis T. Mangano
Journal: Circulation (2007)

An acute renal event after coronary bypass graft surgery is associated with high mortality and substantial additive cost.This prospective and descriptive study of 4801 patients having coronary bypass graft surgery with cardiopulmonary bypass from November 1996 to June 2000 at 70 centers in 16 countries established associations between predictor variables and postoperative renal composite (renal dysfunction and/or renal failure) from a cohort of 2381 patients and developed a risk index assessed in a validation cohort of 2420 patients. Postoperative renal composite occurred in 231 patients (4.8%). Independent and significant risk factors were age >75 years (odds ratio [OR], 2.04; 95% confidence interval [CI], 1.23 to 3.37; P=0.006), preoperative congestive heart failure (OR, 2.38; CI, 1.55 to 3.64; P<0.001), prior myocardial infarction (OR, 1.75; CI, 1.08 to 2.83; P=0.023), preexisting renal disease (OR, 3.71; CI, 2.41 to 5.70; P<0.001), intraoperative multiple inotrope use (OR, 2.75; CI, 1.75 to 4.31; P<0.001), intraoperative intra-aortic balloon pump insertion (OR, 4.41; CI, 2.21 to 8.80; P<0.001), cardiopulmonary bypass >2 hours (OR, 1.78; CI, 1.15 to 2.74; P=0.01), and preoperative pulse pressure such that for every additional 20-mm Hg increment in pulse pressure >40 mm Hg, there was an OR of 1.49 (CI, 1.17 to 1.89; P=0.001). Patients with pulse pressure hypertension >80 mm Hg were 3 times more likely to die a renal-related death compared with those without (3.7% versus 1.1%).Beside established risk factors, pulse pressure is independently and significantly associated with increased renal composite.
Digital Communication in Medical Practice
Authors: Stanley Borg
Journal: JAMA (2011)

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
Transjugular intrahepatic portal-systemic shunt in the treatment of refractory ascites: Effect on clinical, renal, humoral, and hemodynamic parameters
Authors: Jorge Quiroga, Bruno Sangro, Marina Núñez, Ignacio Bilbao, Jesús Longo, Luis García-Villarreal, José M. Zozaya, Maite Betés, José I. Herrero, Jesús Prieto
Journal: Hepatology (1995)

Seventeen cirrhotics with refractory ascites were treated with transjugular intrahepatic portosystemic shunt (TIPS) and followed for 15.5 +/- 3.4 months. Five patients died, four within 3 months after TIPS (hepatocellular failure) and one after 22 months (cholangiocarcinoma). Six patients received transplants 1 to 10 months after the procedure. Actuarial survival at 6, 12, and 24 months was 75%, 75%, and 63%, respectively. Portosystemic venous pressure gradient decreased by 46% at 1 month and by 38% at 7 to 12 months. Eight patients presented 18 stenoses 1 to 18 months after TIPS. Twelve stenoses required balloon dilatation. Tense ascites was present before TIPS in 100% of the patients, whereas it was mild or absent in 56% at 1 month, in 66% at 3 to 6 months, in 57% at 7 to 12 months, and in 100% at 24 months after TIPS. Requirements for diuretics and paracentesis decreased after TIPS (P < .001, both). One month after TIPS, urinary and fractional sodium excretion increased (P < .001, both), plasma renin activity, plasma aldosterone (P < .005, both), and plasma norepinephrine (P < .05) decreased and cardiac output (P < .01) increased, systemic vascular resistances (P < .005) decreased, and arterial pressure did not change. Acute hepatic encephalopathy was frequent early after TIPS but was responsive to treatment and caused no long-term disability. In conclusion, TIPS is useful in the treatment of refractory ascites through lowering portal pressure and improving renal sodium excretion. This effect could be attributable to an increase in effective blood volume causing deactivation of vasopressor systems.
Mexico and the tobacco industry: Editorial lost sight of the real enemy
Authors: Mauricio Hernandez Avila
Journal: BMJ (2006)

EDITOR—In their editorial on the tobacco industry in developing countries Sebrie and Glantz did not take into account potential positive effects and disregarded important accomplishments of Mexico's health ministry in tobacco control.1

Over the past five years, the ministry, under the leadership of the current minister of public health, Julio Frenk, has implemented several tobacco control initiatives. A tax increase on tobacco products reversed an …
Vitamin D receptor Fok1 polymorphism and blood lead concentration in children.
Authors: Erin N Haynes, Heidi J Kalkwarf, Richard Hornung, Richard Wenstrup, Kim Dietrich, Bruce P Lanphear
Journal: Environmental Health Perspectives (2003)

Variation in blood lead concentration is caused by a complex interaction of environmental, social, nutritional, and genetic factors. We evaluated the association between blood lead concentration and a vitamin D receptor (VDR) gene polymorphism. Environmental samples and blood were analyzed for lead, nutritional and behavioral factors were assessed, and VDR -Fok1 genotype was determined in 245 children. We found a significant interaction between floor dust lead and genotype on blood lead concentration. For every 1 microg/ft(2) increase in floor dust, children with VDR -FF genotype had a 1.1% increase in blood lead [95% confidence interval (CI), 0.69-1.5], VDR -Ff, 0.53% increase (95% CI, 0.1-0.92), and VDR -ff, 3.8% increase (95% CI, 1.2-6.3); however, at floor dust levels < 10 microg/ft(2), children with VDR -ff had the lowest blood lead concentrations. These data suggest that VDR -Fok1 is an effect modifier of the relationship of floor dust lead exposure and blood lead concentration.
Control of Serum Phosphorus in Uremia
Authors: Jack W. Coburn, Isidro B. Salusky
Journal: New England Journal of Medicine (1989)

Phosphate retention and hyperphosphatemia play a pivotal part in producing and aggravating the secondary hyperparathyroidism that develops in nearly all patients with chronic renal failure and in creating extraskeletal calcifications in such patients. The principal pathway through which phosphate retention leads to secondary hyperparathyroidism remains elusive.1 Hyperphosphatemia, however, can indirectly stimulate the release of parathyroid hormone by lowering the serum calcium level. Phosphate loading also reduces the renal synthesis of calcitriol, which enhances the release of parathyroid hormone.2 With progressive renal insufficiency, phosphate is retained, although hyperphosphatemia rarely develops before renal function has declined to about 25 percent of normal. . . .
Carpal-Tunnel Syndrome
Authors: Edward Hamlin, Ralph A. W. Lehman
Journal: New England Journal of Medicine (1967)

IN 1880, in the Archives of Medicine, a paper appeared under the title, "Acroparesthesia," by Dr. J. J. Putnam, at that time "electrician" to the Outpatient Department of the Massachusetts General Hospital. Later, his title was altered to "neurologist." This paper was subtitled "A Series of Cases of Paresthesia – Mainly of the Hands – Recurrence and Possibly of Vasomotor Origin"; a history of 8 patients was detailed, and there were notes on 31 others.The principal symptoms were numbness in part of the median-nerve sensory distribution – worse between the hours of 3 and 4 a.m., and relieved . . .
Effect of sodium taurolithocholate on bile flow and bile acid excretion
Authors: Norman B. Javitt, Sidney Emerman
Journal: Journal of Clinical Investigation (1968)

Sodium taurolithocholate and sodium taurocholenate were infused intravenously into rats and hamsters. Each bile acid salt was given alone or in combination with varying amounts of a primary bile salt, either sodium taurocholate or sodium taurochenodeoxycholate. Bile flow, total bile acid salt excretion, and the excretion of sodium taurolithocholate were quantitatively determined. In addition, mannitol excretion in bile was determined at various flow rates. Sodium taurolithocholate was found to be rapidly excreted in bile in concentrations greater than its aqueous solubility. When the endogenous excretion rate of bile salt or the infusion of primary bile salt was less than the molar amount of administered sodium taurolithocholate, cholestasis always occurred. Increasing molar amounts of primary bile salt prevented cholestasis and enhanced the excretion rate of sodium taurolithocholate. Infusion of sodium taurocholenate, a nonhemolytic bile salt, caused an effect on bile flow and bile acid salt excretion qualitatively similar to sodium taurolithocholate. The induction of cholestasis can be attributed to the physical properties of these poorly water soluble bile salts. The reduction in bile flow could not be shown to be related to water reabsorption from the biliary tree since there was no increase in mannitol concentration in bile during cholestasis. Reduction in bile flow may be related to obstruction of segments of the biliary tree by precipitates of sodium taurolithocholate and possibly to a decrease in water entry into the biliary tree during infusion of this bile acid salt.
Depot Neuroleptics: Cost-effective and Underutilized
Authors: William Glazer
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Direct treatment costs of schizophrenia in the United States total more than $10 billion per year.<sup>1</sup>Approximately 50% of patients with chronic schizophrenia receiving outpatient treatment relapse within 1 year after discharge as a result of medication noncompliance.<sup>2</sup>As a result, medication noncompliance accounts for approximately 33% of the cost of relapse and rehospitalization of patients with chronic schizophrenia.<sup>2</sup>Long-acting depot neuroleptics have been shown to enhance medication compliance and thereby reduce the risk of relapse and, consequently, hospital days.<sup>3</sup>In the United Kingdom, 50% of patients with schizophrenia receive treatment with long-acting, injectable depot neuroleptic therapy, while in this country only 10% to 20% receive depot therapy.<sup>4</sup>If US psychiatrists began to use depot neuroleptics as widely as their European colleagues, millions of dollars in relapse- and rehospitalization-related costs could be saved each year.<sup>2</sup> Another reason that depot neuroleptics are
Sudden Death in Arthritic Children Receiving Large Doses of Indomethacin
Authors: Jerry C. Jacobs
Journal: JAMA (1967)

DEATH in children with rheumatoid arthritis is rare. A review of 110 cases seen at the Columbia-Presbyterian Medical Center from 1928 through 1956 reported eight deaths.<sup>1</sup>From 1952 to 1963, 79 new juvenile patients with rheumatoid arthritis were seen. Although corticosteroids were used in many children during these years, none died. Of the eight deaths occurring in the preceding 36 years, one was from hepatitis following therapeutic blood transfusions commonly administered in earlier years, two were from secondary amyloidosis, one from diabetic acidosis, one from acute appendicitis, one from colitis, and one occurred during induction of anesthesia one day after therapy with prednisone was discontinued. At the time of death, five of these eight patients were adults with long-standing rheumatism (11 to 22 years); only three died during childhood. None had overwhelming infection. In the past three years, however, two arthritic children seen in our hospital have suddenly become
Evaluation of Suspected Pulmonary Embolism During Pregnancy
Authors: Mark D. Siegel
Journal: JAMA (2008)

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
800 FATTY ACIDS INDUCE INFLAMMASOME ACTIVATION AND SENSITIZE TO LPS-INDUCED INTERLEUKIN-1β (IL-1β) SECRETION IN HEPATOCYTES IN NASH
Authors: G. Szabo, T. Csak, M. Ganz, A. Dolganiuc, B. Nath, J. Petrasek, K. Kodys
Journal: Journal of Hepatology (2010)
Malpractice, Patient Satisfaction, and Physician-Patient Communication
Authors: Karl F. Weyrauch
Journal: JAMA (1995)

<h3>To the Editor.</h3> —I applaud the recent article by Dr Hickson and colleagues,<sup>1</sup>which draws attention to an important topic in primary care: physician-patient communication. Their data demonstrate that for 21 obstetricians in Florida who were sued frequently, patients offered more than twice as many complaints in response to open-ended questions as did patients of 133 obstetricians who were not sued at all. Frequently, the object of these complaints was the impersonal, rushed, and unsatisfactory interpersonal interaction between patient and physician. The article and Dr Levinson's accompanying Editorial<sup>2</sup>imply that the cause of poor communication is physicians' deficient interpersonal skills. Although I agree with the authors that interpersonal skills were targets of patient complaints, I do not agree that blaming deficient interpersonal skills is sufficient interpretation of the root cause for patient dissatisfaction. Instead, I suggest that three possible factors in addition to, or perhaps in place of,
Phase I Trial of Escalating-Dose Irinotecan Given Weekly With Cisplatin and Concurrent Radiotherapy in Locally Advanced Esophageal Cancer
Authors: David H. Ilson, Manjit Bains, David P. Kelsen, Eileen O’Reilly, Martin Karpeh, Daniel Coit, Valerie Rusch, Mithat Gonen, Katie Wilson, Bruce D. Minsky
Journal: Journal of Clinical Oncology (2003)

Purpose: To identify the maximum-tolerated dose and dose-limiting toxicity (DLT) of weekly irinotecan combined with cisplatin and radiation in esophageal cancer. Patients and Methods: Nineteen patients with clinical stage II to III esophageal squamous cell or adenocarcinoma were treated on this phase I trial. Induction chemotherapy with weekly cisplatin 30 mg/m 2 and irinotecan 65 mg/m 2 was administered for four treatments during weeks 1 to 5. Radiotherapy was delivered weeks 8 to 13 in 1.8-Gy daily fractions to a dose of 50.4 Gy. Cisplatin 30 mg/m 2 and escalating-dose irinotecan (40, 50, 65, and 80 mg/m 2 ) were administered on days 1, 8, 22, and 29 of radiotherapy. DLT was defined as a 2-week delay in radiotherapy for grade 3 to 4 toxicity. Results: Minimal toxicity was observed during chemoradiotherapy, with no grade 3 or 4 esophagitis, diarrhea, or stomatitis. DLT caused by myelosuppression was seen in two of six patients treated at the 80-mg/m 2 dose level, thus irinotecan 65 mg/m 2 was defined as the recommended phase II dose. Dysphagia improved or resolved after induction chemotherapy in 13 (81%) of 16 patients who reported dysphagia before therapy. Only one patient (5%) required a feeding tube. Six complete responses (32%) were observed, including four pathologic complete responses in 15 patients selected to undergo surgery (27%). Conclusion: Cisplatin, irinotecan, and concurrent radiotherapy can be administered on a convenient schedule with relatively minimal toxicity and an acceptable rate of complete response in esophageal cancer. Further phase II evaluation of this regimen is ongoing. A phase III comparison to fluorouracil or taxane-containing chemoradiotherapy should be considered.