tbuckley/cabot-search huggingface dataset:
Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: meta-analysis
Authors: Nina Buscemi, Ben Vandermeer, Nicola Hooton, Rena Pandya, Lisa Tjosvold, Lisa Hartling, Sunita Vohra, Terry P Klassen, Glen Baker
Journal: BMJ (2006)

<h3>Abstract</h3> <b>Objective</b> To conduct a systematic review of the efficacy and safety of exogenous melatonin in managing secondary sleep disorders and sleep disorders accompanying sleep restriction, such as jet lag and shiftwork disorder. <b>Data sources</b> 13 electronic databases and reference lists of relevant reviews and included studies; Associated Professional Sleep Society abstracts (1999 to 2003). <b>Study selection</b> The efficacy review included randomised controlled trials; the safety review included randomised and non-randomised controlled trials. <b>Quality assessment</b> Randomised controlled trials were assessed by using the Jadad Scale and criteria by Schulz et al, and non-randomised controlled trials by the Downs and Black checklist. <b>Data extraction and synthesis</b> One reviewer extracted data and another reviewer verified the data extracted. The inverse variance method was used to weight studies and the random effects model was used to analyse data. <b>Main results</b> Six randomised controlled trials with 97 participants showed no evidence that melatonin had an effect on sleep onset latency in people with secondary sleep disorders (weighted mean difference −13.2 (95% confidence interval −27.3 to 0.9) min). Nine randomised controlled trials with 427 participants showed no evidence that melatonin had an effect on sleep onset latency in people who had sleep disorders accompanying sleep restriction (−1.0 (−2.3 to 0.3) min). 17 randomised controlled trials with 651 participants showed no evidence of adverse effects of melatonin with short term use (three months or less). <b>Conclusions</b> There is no evidence that melatonin is effective in treating secondary sleep disorders or sleep disorders accompanying sleep restriction, such as jet lag and shiftwork disorder. There is evidence that melatonin is safe with short term use.
Valvular and Systemic Arterial Hemodynamics in Aortic Valve Stenosis
Authors: Warren K. Laskey, William G. Kussmaul, Abraham Noordergraaf
Journal: Circulation (1995)

Assessment of the severity of a stenotic aortic valve has been confounded by reports of flow dependence of stenosis severity. We hypothesized that the pressure gradient at the stenotic aortic valve would be dependent on the characteristics of the arterial circulation. Therefore, clinically useful measures of the severity of aortic valve stenosis may have to take this dependence into account.We developed an analog model of the systemic arterial circulation in the presence of a stenotic aortic valve. The model clearly describes the dependence of stenosis severity (described by coefficients A and B) on the resistive and capacitive properties of the arterial system. We used high-fidelity pressure recordings obtained at the time of diagnostic cardiac catheterizations and found that a highly significant relation between the measured mean transvalvular gradient and that predicted by the model was demonstrated both at rest (r2 = .90) and with exercise (r2 = .80). Furthermore, the relative constancy of stenosis coefficients A and B was validated.Transvalvular hemodynamics in patients with aortic valve stenosis are dependent on the properties of the arterial system. The current model describes such behavior, correctly predicts the transvalvular gradient from model parameters, and may be useful in the assessment of stenosis severity under various clinical and physiological conditions.
Endogenous Opioids Modulate Ventilation and Peak Oxygen Consumption in Obese Zucker Rats
Authors: S. D. LEE, H. NAKANO, L. E. GOSSELIN, J. A. KRASNEY, E. H. SCHLENKER, G. A. FARKAS
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Levels of endogenous opioids are increased in morbidly obese humans and obese rats. Endogenous opioids are important neuromodulators, and are involved in a wide range of functions including ventilatory control. We studied eight lean and eight obese Zucker (Z) rats at 6 and 16 wk of age. We assessed minute ventilation (V˙ e) at rest and during hypercapnic challenges, as well as peak oxygen consumption (V˙ o 2peak) after the administration of saline (control), naloxone hydrochloride (NHCl), and naloxone methiodide (NM). Administration of NHCl and NM to lean animals had no effect on V˙ e and V˙ o 2peak. Similarly, NM failed to alter V˙ e and V˙ o 2peak in obese rats studied at 6 or 16 wk of age. In young obese rats, NHCl significantly (p < 0.05) increased resting V˙ e (721 ± 154 [mean ± SD] ml/kg/min versus 937 ± 207 ml/kg/min, saline versus NHCl, respectively); Ve in response to 4% CO2 (924 ± 110 ml/kg/min versus 1,212 ± 172 ml/ kg/min); V˙ e in response to 8% CO2 (1,233 ± 172 ml/kg/min versus 1,565 ± 327 ml/kg/min); and V˙ o 2peak (90.8 ± 9.6 ml/kg0.75/min versus 98.3 ± 5.9 ml/kg0.75/min). However, NHCl administration had no effect on V˙ e or V˙ o 2peak in obese rats retested at 16 wk of age. Thus, endogenous opioids modulate resting ventilation, ventilatory responsiveness to CO2, and V˙ o 2peak in young obese rats by acting specifically on receptors located within the central nervous system. This modulation disappears once the animals reach 16 wk of age.
MOTION PICTURE STUDY OF THE TOXIC ACTION OF STREPTOLYSINS ON LEUCOCYTES
Authors: James G. Hirsch, Alan W. Bernheimer, Gerald Weissmann
Journal: The Journal of Experimental Medicine (1963)

The initial morphologic alteration in rabbit polymorphonuclear leucocytes exposed to streptolysin is rapid and extensive lysis of cytoplasmic granules. The granules appear to rupture directly into the cell sap. Within a few minutes following degranulation, the leucocyte rounds up, filamentous processes appear on the cell membrane, the cytoplasm liquefies, and finally the nuclear lobes swell and fuse. Streptolysin O causes these changes in intact leucocytes when added in concentrations only slightly higher than those required for release of hydrolases from isolated liver lysosomes, and furthermore exerts its action on granulocytes promptly. On the other hand streptolysin S acts on white cells only after a 15 to 30 minute delay, and the levels necessary to disrupt granules in leucocytes are considerably higher than those which act on lysosome suspensions. Exposure of rabbit alveolar macrophages to streptolysin O also results in lysis of granules, soon followed by alterations in the cytoplasm and membrane. The observations are in accord with the hypothesis that streptolysins penetrate the leucocyte membrane and bring about lysis of granules. Autolytic enzymes released from the granules might then be responsible for the subsequent damage seen in various other cell structures.
Pathologic Fracture of Femoral Neck
Authors: Otto E. Aufranc
Journal: JAMA (1963)

Dr.W. H.Harris: A 27-year-old Japanese post-graduate student was well until 15 months prior to admission to Massachusetts General Hospital, when pain spontaneously developed in the left hip. Roentgenograms were said to reveal a lesion of the proximal femur with a "little" fracture. The bone lesion was biopsied in Japan and was called a "benign giant cell tumor." The lesion was curetted and packed with autogenous iliac bone grafts. Following this, the patient's condition improved and he was able to walk without pain or limp. While running upstairs, two months prior to admission to our hospital, he felt a sharp pain in the left hip. After that, he walked with a slight limp and had mild pain. Just prior to admission he fell and severe pain developed in the left hip. His past medical history was not contributory. On admission, the left leg was held in 20° of external
Regional collaboration in the Middle East to deal with H5N1 avian flu
Authors: Alex Leventhal, Assad Ramlawi, Adel Belbiesi, Ran D Balicer
Journal: BMJ (2006)

<i>In 2005-6 Arab and Israeli collaboration contained outbreaks of avian flu in the Middle East. This initiative shows how building relationships through joint efforts creates an infrastructure for cross border collaboration during emergencies</i>
Clinical Spectrum of Obesity and Mutations in the Melanocortin 4 Receptor Gene
Authors: I Sadaf Farooqi, Julia M Keogh, Giles S H Yeo, Emma J Lank, Tim Cheetham, Stephen O'Rahilly
Journal: New England Journal of Medicine (2003)

Melanocortin 4 receptor (MC4R) deficiency is the commonest monogenic form of obesity. However, the clinical spectrum and mode of inheritance have not been defined, pathophysiological mechanisms leading to obesity are poorly understood, and there is little information regarding genotype-phenotype correlations.We determined the nucleotide sequence of the MC4R gene in 500 probands with severe childhood obesity. Family studies were undertaken to examine cosegregation of identified mutations with obesity. Subjects with MC4R deficiency underwent metabolic and endocrine evaluation; the results were correlated with the signaling properties of mutant receptors.Twenty-nine probands (5.8 percent) had mutations in MC4R; 23 were heterozygous, and 6 were homozygous. Mutation carriers had severe obesity, increased lean mass, increased linear growth, hyperphagia, and severe hyperinsulinemia; homozygotes were more severely affected than heterozygotes. Subjects with mutations retaining residual signaling capacity had a less severe phenotype.Mutations in MC4R result in a distinct obesity syndrome that is inherited in a codominant manner. Mutations leading to complete loss of function are associated with a more severe phenotype. The correlation between the signaling properties of these mutant receptors and energy intake emphasizes the key role of this receptor in the control of eating behavior in humans.
Stimulation with a monoclonal antibody (mAb4E4) of scavenger receptor-mediated uptake of chemically modified low density lipoproteins by THP-1-derived macrophages enhances foam cell generation.
Authors: P Holvoet, G Perez, H Bernar, E Brouwers, B Vanloo, M Rosseneu, D Collen
Journal: Journal of Clinical Investigation (1994)

mAb4E4, a murine monoclonal antibody that is specific for acetylated LDL and malondialdehyde-treated LDL, binds specifically to modified LDL present in human atherosclerotic lesions. It is directed against an epitope that is poorly exposed in delipidated and solubilized apolipoprotein B-100 from modified LDL. mAb4E4, as well as its F(ab')2 and Fab fragments, enhanced the uptake of both acetylated LDL and malondialdehyde-treated LDL by THP-1-derived macrophages resulting in a sixfold increase of cytoplasmic cholesteryl ester levels. The increased uptake of modified LDL/mAb4E4 complexes did not occur via the Fc receptor and did not depend on aggregation of modified LDL particles. However, their uptake was inhibited by blocking the scavenger receptors with fucoidin or by downregulation of receptor expression with endotoxins or interferon-gamma, indicating that their uptake is mediated via these receptors. Thus, generation of autoimmune antibodies against modified LDL and subsequent endocytosis of soluble modified LDL/antibody complexes via scavenger receptors may enhance foam cell generation. This mechanism may contribute to the progression of atherosclerotic lesions.
Inflammatory Bowel Diseases
Authors: ROSE MECHAN
Journal: Gut (1997)

Inflammatory Bowel Diseases. Third edition. Editors RN Allen, JM Rhodes, SB Hanauer, MRB Keighley, J Alexander-Williams, VW Fazio. (Pp 989; illustrated; £125.00.) Edinburgh: Churchill Livingstone, 1996. ISBN 0-443-05067-8.

The time will come, one supposes, when all the brain’s mysteries will be disclosed. Then, the combined forces of information technology and neurosciences will come up with methods to introduce and store knowledge—conveniently when we are asleep—so that existing methods of learning will be so inefficient that the lecture, seminar and written word will become redundant.

What will then become a blockbuster textbook such as the present offering? Is it to be replaced by a chip downloaded directly into our brains? Maybe so, but until that time we shall just have to make do with the good, old-fashioned read—and try and retain what …
Cervical Discography: Is Surgery Necessary?
Authors: David J. Silver
Journal: JAMA (1976)

<h3>To the Editor.—</h3> Some skepticism should be directed towards Dr Roth's article, "Cervical Analgesic Discography: A New Test for the Definitive Diagnosis of the Painful-Disk Syndrome" (235:1713, 1976), on both anatomical and clinical grounds. First, Dr Roth has not proved that "a cervical disk can be a source of chronic pain without protrusion, nerve root compression, or neurologic deficit." When a lumbar disk is removed under local anesthesia, pain may result from manipulation of the nerve root or incision of the posterior longitudinal ligament, but not from removal of the disk material itself.<sup>1</sup>I am unaware of any study that demonstrates pain fibers within lumbar or cervical disks, and particularly in the nuclear center where the spinal needle is placed for analgesic discography. The injection of 1 ml of a 2% solution of lidocaine (Xylocaine) into a cervical disk is a relatively large volume compared with the total volume
Early Detection of High Cholesterol Levels in Young Adults
Authors: Scott M. Grundy
Journal: JAMA (2000)

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
Health agencies must better communicate bird flu risk, UN coordinator says
Authors: Nellie Bristol
Journal: BMJ (2006)

Global and local health agencies need to do a better job of communicating the risk of bird flu transmission and preventive methods, said David Nabarro this week. The senior United Nations' system coordinator for avian and human influenza was at a summit about bird flu in Washington, DC.

“Are we communicating what we know about risks or what we know about the propensity of individual groups to reduce that risk—are we communicating that effectively?” Dr Nabarro asked. “Answer: absolutely not.” Changes in behaviour that alleviate risk are being practised by few of the people considered …
An Account of Two Hundred and Eight Consecutive Cases of Abdominal Section Performed between Nov. 1st, 1881, and December 31st, 1882
Authors: L. Tait
Journal: BMJ (1883)

BAT4RL [Feb.17, 18&% patient had sustained.afracture near the middle of the leg.She was a woman aged 72 years, who appeared well in health, and there was no evidence of the existence of secondary deposits.Lstly, some.tumours of epithelial origin are met with which are so, slightly differentiated, so elemental, that they cannot be distin- guished,.except in rare instances, from round-cell sarcomata.I referespecially to themelanotic tumours which originate in connection withthepigmentedepithelial cells of the rete Malpighii.M-anyother fpcts might be quoted to show that there are tumovro oc- cupying positions intermediate between the innocent and malignant types.But these will suffice to prove that a sharp distinction, as re- gards theiranatomical structure, cannot be made between the innocent aid malignant tumours.In proportion as a tumour is more highly organised will it be more innocent, more stable, and more circumscribed; while in the measure in which its tissue is elemental or "embryonic," will it be more malignant, more diffused, and more rapidly growing.We may, perhaps, infer, from these facts, as-Sir James Paget* has already suggested, that the different varieties of tumours may be produced by evolution and involution through hereditary transmission; the evolution taking place from the higher to the lower forms, as from adenoma to cancer.Considerations have also been brought forward which indicate a probability that the formation of tumours is the result of the same tendencies to variation as those giving rise to the malformations by excess, such as accessory glands or glandules, multiple exostoses, or, perhaps, even the supernumerary digits.The existence
A Cooperative Model for Provision of Regional Health Services in a Developing Nation
Authors: C. D. Bessinger
Journal: JAMA (1984)

The development of health care in the Leogane region of Haiti has been a ten-year story of international cooperation among health professionals, of closely targeted assistance, and of policy coordination between assisting private agencies and the Haitian government. The broadly based health care program of l'Hopital Sainte Croix of Leogane is presented as a model of a cooperative effort that has resulted in rapid regional health care development and as an encouragement to the many differing types of groups responding to a world in medical need.
Treatment IND for Advanced Non-small-cell Lung Cancer
Authors: Stuart L. Nightingale
Journal: JAMA (1994)

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
Verbal Eccentricities in Scientific Writing
Authors: Lois DeBakey
Journal: New England Journal of Medicine (1966)

EXPERIMENTS in language are taking place every day, in advertising, in the sciences, in business and law, and among special groups of people — teen-agers, sociologists, politicians. Listen to the innovations, the coinages, the neologisms; study them, and you will understand better how the language works. But in your scientific writing stay close to the linguistic standards of the educated people; infractions of established literary principles are usually risky. Leave to advertisers such solecisms as "Us Tareyton smokers would rather fight than switch" and "Winston tastes good like a cigarette should." Leave to them too the coinage of the . . .
Attempted Suicide by Black Widow Spider Bite
Authors: Donald P. Fischer
Journal: JAMA (1976)

<h3>To the Editor.—</h3> Suicide by envenomation has been portrayed in classical literature in such dramatic events as Cleopatra's clasping the asp to her bosom. A 36-year-old man seen in this hospital's emergency room in June 1971 stated that he had been bitten by a black widow spider. He had captured the arachnid; it was indeed identified by the county health department as<i>Lactrodectus mactans</i>. No puncture site was found. He complained of soreness in the leg and back; a short while later he had perioral numbness, contractions of the abdominal wall, and malaise, followed by muscular cramps, particularly severe in the back and legs. Treatment during the first day of hospitalization included<i>Lactrodectus</i>antiserum (2.5 ml intramuscularly), dexamethasone, corticotropin, methocarbamol, calcium gluconate, and diazepam. Mild abdominal cramping over the ensuing 24 hours was relieved by methocarbamol. Twentyfour hours after admission, an ecchymotic lesion developed on the right leg. On the
Association of Self-reported Hospital Discharge Handoffs With 30-Day Readmissions
Authors: Ibironke Oduyebo, Christoph U. Lehmann, Craig Evan Pollack, Nowella Durkin, Jason D. Miller, Steven Mandell, Margaret Ardolino, Amy Deutschendorf, Daniel J. Brotman
Journal: JAMA Internal Medicine (2013)

Poor health care provider communication across health care settings may lead to adverse outcomes.To determine the frequency with which inpatient providers report communicating directly with outpatient providers and whether direct communication was associated with 30-day readmissions.We conducted a single-center prospective study of self-reported communication patterns by discharging health care providers on inpatient medical services from September 2010 to December 2011 at The Johns Hopkins Hospital.A 1000-bed urban, academic center.There were 13 954 hospitalizations in this time period. Of those, 9719 were for initial visits. After additional exclusions, including patients whose outpatient health care provider was the inpatient attending physician, those who had planned or routine admissions, those without outpatient health care providers, those who died in the hospital, and those discharged to other healthcare facilities, we were left with 6635 hospitalizations for analysis.Self-reported communication was captured from a mandatory electronic discharge worksheet field. Thirty-day readmissions, length of stay (LOS), and demographics were obtained from administrative databases.We used multivariable logistic regression models to examine, first, the association between direct communication and patient age, sex, LOS, race, payer, expected 30-day readmission rate based on diagnosis and illness severity, and physician type and, second, the association between 30-day readmission and direct communication, adjusting for patient and physician-level factors.Of 6635 included hospitalizations, successful direct communication occurred in 2438 (36.7%). The most frequently reported reason for lack of direct communication was the health care provider's perception that the discharge summary was adequate. Predictors of direct communication, adjusting for all other variables, included patients cared for by hospitalists without house staff (odds ratio [OR], 1.81 [95% CI, 1.59-2.08]), high expected 30-day readmission rate (OR, 1.18 [95% CI, 1.10-1.28] per 10%), and insurance by Medicare (OR, 1.35 [95% CI, 1.16-1.56]) and private insurance companies (OR, 1.35 [95% CI, 1.18-1.56]) compared with Medicaid. Direct communication with the outpatient health care provider was not associated with readmissions (OR, 1.08 [95% CI, 0.92-1.26]) in adjusted analysis.Self-reported direct communication between inpatient and outpatient providers occurred at a low rate but was not associated with readmissions. This suggests that enhancing interprovider communication at hospital discharge may not, in isolation, prevent readmissions.