tbuckley/cabot-search huggingface dataset:
When Medical Care Leads to Harm—Difficulty Finding Words
Authors: Erin Chamberlain, Matt DiVeronica, Renee Segura
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
Prescribed diseases yield substantial compensation
Authors: J. Wilkinson
Journal: BMJ (1995)

are of enormous potential consequence, given the prevalence of ischaemic heart disease and hypercholesterolaemia in Britain alone.Many hundreds of thousands of patients could require cholesterol lowering drugs once dietary advice has failed.Given the magnitude of the problem, do we need more evidence that such results can be generalised before we embark on this colossal task?J HIPPISLEY-COX Trainee general practitioner
Distribution and determinants of right ventricular area in healthy adults measured by two-dimensional echocardiography
Authors: Mona Lichtblau, Ekkehard Grünig, Johanna Biskupek, Antonello D'Andrea, Nicola Ehlken, Christian Nagel, Johannes Weidenhammer, Philipp Henn, Christine Fischer, Eduardo Bossone
Journal: European Respiratory Journal (2014)

Background:  The right ventricular (RV) area is important for screening, diagnosis and follow-up in patients with pulmonary hypertension. Aim of this study was to define the distribution of RV area in healthy adults and to assess determining factors.   Methods:  A prospective study (n=860) investigating healthy adults was combined with a meta-analysis including all studies between 1979 and 2012 describing RV area in healthy subjects and endurance athletes (n=3942). Statistical analysis included the calculation of the weighted means and weighted standard deviations and analysis of determining factors.   Results:  In the prospective study mean RV areas of endurance athletes (25.1±2.0 cm 2 ; n=395) were significantly larger than of non-athletes (16.7±2.0 cm 2 ; n=210; p 2 ; n=255) and endurance-athletes (p   Conclusion:  This is the largest data set to define RV size in healthy adult subjects ( 50 years as well as children and patients suffering from PAH are needed to define reference values for RV area.
Cyst decompression surgery for autosomal dominant polycystic kidney disease.
Authors: L W Elzinga, J M Barry, V E Torres, H Zincke, H W Wahner, S Swan, W M Bennett
Journal: Journal of the American Society of Nephrology (1992)

A prospective study was undertaken to evaluate the efficacy of surgical cyst decompression for retarding the progression of renal failure and for the management of chronic pain associated with autosomal dominant polycystic kidney disease (ADPKD). Thirty patients with ADPKD and pain (14 patients), renal insufficiency (4 patients), or both (12 patients) underwent unilateral (19 patients) or bilateral (11 patients) cyst reduction surgery. The patients were monitored for 21 +/- 2 months postoperatively. The probability of being painfree was 80% at 1 yr and 62% at 2 yr. Preoperative and 1-to 3-month postoperative serum creatinine levels and GFR (clearance of insulin or (125I) iothalamate) were not significantly different (2.2 +/- 0.3 versus 2.2 +/- 0.3 mg/dL and 49 +/- 8 versus 54 +/- 9 mL/min/1.73 m2, respectively). One-year serum creatinine levels remained unchanged in patients with normal preoperative renal function (1.0 +/- 0.07 versus 1.0 +/- 0.05 mg/dL), whereas those with preoperative progressive renal insufficiency had no difference in the mean slope of reciprocal serum creatinine plots preceding and after surgery (-0.008 +/- 0.001 versus -0.009 +/- 0.002 dL/mg/month). In patients who underwent unilateral surgery, split function isotope scans showed no change in function of the operated kidney when compared with the nonoperated kidney. Surgical cyst decompression provides effective relief of chronic pain without compromising renal function. However, the data in this article do not support the use of this procedure to slow progression of renal insufficiency in ADPKD.
Significance of contacts in the manifestation of tuberculosis as an infectious disease
Authors: Ljiljana Simonovska, Mirjana Trajcevska
Journal: European Respiratory Journal (2013)

The purpose of this study was to evaluate the importance of contact in the manifestation of tuberculosis, ie what age, which forms manifest tuberculosis and what is the time period from contact to manifestation of tuberculosis.  For this purpose, the histories of 88 cases of tuberculosis in persons who have been in contact with tuberculosis, for the period 2010-2012.  The contact was comfirmed at 7.5% of analyzed TB patients.  47.7% were male and 52.3% were female. 28.4% belonged to the age group of 0-14 years, 54.5% of the age group 16-44 years and 17% were older than 44 years.  92% were with pulmonary, and 8% with extrapulmonary tuberculosis.  M. tuberculosis from sputum was isolated at 44.9%.  The source of infection in a close family member was in 76% .  In 12% source was another member of the family (grandmother, grandfather, aunt). In 12% source was a roommate from the prisoner’s room, or classmate or neighbor.  In 75%, the source of infection in the family was one of the parents, in 15.6% was brother or siste, and at 9.4 % was one of the spouses.  Analyzing the time period for manifestation of tuberculosis after the contact, in 56.7% tuberculosis is diagnosed to 3 months after the contact, in 23.3% in a period of 3 to 6 months, and after 6 months tuberculosis manifested in 20% of the respondents.  Conclusion: Contact was confirmed at 7.5% of analysed TB patients. In 76% of the cases source was in the family, and the most common source was one of the parents (75.6%). After the contact tuberculosis usually manifests in the first three months (56.7%). Because the tuberculosis can manifest even after 6 months of contact, there is a need for contact tracing in an extended period of time.
Irinotecan in the Treatment of Colorectal Cancer: Clinical Overview
Authors: Udo Vanhoefer, Andreas Harstrick, Wolf Achterrath, Shousong Cao, Siegfried Seeber, Youcef M. Rustum
Journal: Journal of Clinical Oncology (2001)

PURPOSE AND METHODS: For more than three decades, the therapeutic options for patients with advanced colorectal cancer have almost exclusively been based on fluoropyrimidines. With the recognition that topoisomerase-I (TOP-I) is an important therapeutic target in cancer therapy, irinotecan, a semisynthetic TOP-I–interactive camptothecin derivative, has been clinically established in the treatment of colorectal cancer. RESULTS: Irinotecan was investigated as second-line chemotherapy after prior treatment with fluorouracil (FU)-based regimens in two large randomized phase III trials comparing irinotecan with either best supportive care or an infusional FU/leucovorin (LV) regimen. The outcomes of these trials established irinotecan as the standard therapy in the second-line treatment of colorectal cancer. The therapeutic value of irinotecan in the first-line treatment of metastatic colorectal cancer was investigated in two large randomized phase III trials comparing the combination of irinotecan and FU/LV with FU/LV alone. Both trials demonstrated significant superior efficacy for the combination of irinotecan and FU/LV in terms of response rate, median time to disease progression, and median survival time. Consequently, the combination of irinotecan and FU/LV has been approved as first-line chemotherapy for patients with metastatic colorectal cancer and constitutes the reference therapy against which other treatment options must be tested in the future. CONCLUSION: In this review, the clinical rationale and update of the present clinical status of irinotecan in the treatment of colorectal cancer and future prospects of irinotecan-based combinations are discussed.
Chronic pulmonary aspergillosis: Characteristics of 30 nonimmunocompromised patients
Authors: Boubou Camara, Bernadette Lebeau, Christel Saint-Raymond, Gilbert Ferretti, Jaques Cadranel, Herve Pelloux, Christophe Pison
Journal: European Respiratory Journal (2011)

Introduction:  Chronic pulmonary aspergillosis (CPA) is a severe respiratory infection characterized by pulmonary cavities and increased levels of antibodies to  Aspergillus  specie. We describe 30 nonimmunocompromised patients with CPA.   Materials and methods:  Multidisciplinary working group devoted to epidemiological surveillance of invasive aspergillosis was created in our hospital in January 2000. Among 1545 alerts, 30 cases of CPA in nonimmunocompromised patients were identified. In a retrospective study, we investigated characteristics of patients with CPA.   Results:  30 patients were identified. Their mean age was 69.2 years (interquartile range (IQR) 43.8 – 83.9 years) and 19 (63%) of the patients were men. 19 (63%) of patients had a smoking > 10 pack-years, 23 patients (77%) had COPD, 6 patients in GOLD stage IV and 8 patients in GOLD stage III. All had detectable  Aspergillus  spp precipitins and inflammatory markers.  Aspergillus  spp was isolated in respiratory specimens of 16 (53%) patients. The radiological improvement was essentially: excavations (n=19, 64%); consolidation (n=14, 47%); bronchiectasis (n=12, 40%), nodules (n=9, 30%) and sequelae of tuberculosis (n=5, 17). The average duration of follow up was 31.5 months (IQR 0.2 – 131 months). The average duration of treatment was 7, 6 months (IQR 0.2 – 23 months). The outcome was favorable in 18 (60%) patients and negative in 14 (40%) patients significantly correlated with the degree of bronchial obstruction.   Conclusion:  CPA typically occurs in patients with preexisting structural lung disease, and it causes significant respiratory and constitutional symptoms. Prospective studies are required to better characterize the profile of patients.
Escalating incidence of eosinophilic esophagitis in <scp>C</scp>anton of <scp>V</scp>aud, <scp>S</scp>witzerland, 1993–2013: a population‐based study
Authors: B. Giriens, P. Yan, E. Safroneeva, M. Zwahlen, A. Reinhard, A. Nydegger, S. Vavricka, C. Sempoux, A. Straumann, A. M. Schoepfer
Journal: Allergy (2015)

Abstract Background Eosinophilic esophagitis (EoE) is a chronic, inflammatory disease of the esophagus with a rapidly increasing incidence. However, population‐based epidemiologic data on EoE are rare and limited to regions with less than 200 000 inhabitants. We evaluated the incidence and prevalence of EoE over time in Canton of Vaud, Switzerland. Materials and methods Canton of Vaud lies in the French‐speaking, Western part of Switzerland. As of December 2013, it had a population of 743 317 inhabitants. We contacted all pathology institutes ( n = 6) in this canton to identify patients that have been diagnosed with esophageal eosinophilia between 1993 and 2013. We then performed a chart review in all adult and pediatric gastroenterology practices to identify patients with EoE. Results Of 263 patients with esophageal eosinophilia, a total of 179 fulfilled the diagnostic criteria for EoE. Median diagnostic delay was 4 ( IQR 1–9) years. No patient was diagnosed with EoE prior to 2003. Incidence of EoE increased from 0.16/100 000 inhabitants in 2004 to 6.3/100 000 inhabitants in 2013 ( P &lt; 0.001). The cumulative EoE prevalence in 2013 was 24.1/100 000. The incidence in males was 2.8 times higher (95% CI 2.01–3.88, P &lt; 0.001) when compared to that in females. The annual EoE incidence was 10.6 times higher (95%‐ CI 7.61–14.87, P &lt; 0.001) in the period from 2010 to 2013 when compared to that in the period from 1993 to 2009. Conclusions The incidence and cumulative prevalence of EoE in Canton of Vaud, Switzerland, has rapidly increased in the past 10 years.
Parental lung function is associate with asthma and allergies in the offspring
Authors: Marta Rava, Cecilie Svanes, Anne-Elie Carsin, Julia Dratva, Bertil Forsberg, Karl Franklin, Matthias Holm, Christer Janson, Deborah Jarvis, Ane Johannessen, Eve Lindberg, Dan Norback, Ernst Omenaas, Antonio Pereira, Jose Louis Sanchez, Vivi Schlunsen, Torben Sigsgaard, Jordi Sunyer, Shyamali C. Dharmage
Journal: European Respiratory Journal (2013)

Familial aggregation of asthma is well known, but little is known about the association between parental lung function and respiratory symptoms in offspring beyond early life.

We studied asthma and allergic diseases in offspring, using data from the third follow-up of the Respiratory Health In Northern Europe (RHINE) study, as related to parental lung function, using data from ECRHS II. Lung function measurements were available for 1551 RHINE III participants (mean age 42 yrs, 44% men), with respiratory health data for 3590 offspring (mean age=23). Association between offspring asthmatic and allergic status and parental lung function was estimated with GEE logistic regression models adjusting for offspring age, and parental sex, age and sex interaction, squared height, smoking status and pack-years. Lower parental FEV1 and FEV1/FVC were associated with increased risk of asthma and hay fever in offspring; lower FEV1 and FVC were associated with a higher prevalence of offspring atopic eczema.

View this table:

Parental lung function parameters and asthma/allergy in the offspring (N=3537)





Associations between FEV1/FVC and asthma after 10 years and hay fever were confirmed in non-asthmatics.

Conclusion: Lower parental lung function was associated with a higher prevalence of asthma and allergies in the offspring.
Perceptions about exercise and pulmonary rehabilitation in two Arabic Gulf countries (Iraq and State of Qatar); a qualitative study in patients with chronic obstructive pulmonary disease (COPD) and their health care providers
Authors: Mouath Al Tamimi, Aisha Hussain, Ahmed Younis, Nameer Abdulahad, Dimitra Nikoletou
Journal: European Respiratory Journal (2014)

Background:  Pulmonary rehabilitation (PR) programmes are effective for COPD patients but are not yet established in the Gulf countries. Little is known about patient9s and their health care providers9 (HCP) perceptions about exercise and attitudes to participation to PR in Iraq and Qatar.   Aims:  This study explored the similarities and differences between COPD patients9 and their HCPs perceptions toward exercise, COPD management and participation to PR programmes in two Gulf countries with different socio-economic status.   Methods:  We conducted semi-structured interviews in thirteen COPD patients (M:F=10: 3; Mean (SD) FEV 1 % predicted:57.7 (14.1) ) and sixteen HCP recruited from chest clinics in Baghdad Hospital (Iraq) and Hamad Medical Corperation (Qatar).   Results:  Four main themes emerged: 1) COPD patients9 limited understanding of their disease and its management, 2) Lack of effective communication between HCPs and patients due to different factors, 3) HCPs suggestions about patients9 lack of access to rehabilitation programmes and involvement in physical activity and 4) Patients9 education level as a factor affecting management of the disease. Iraqi patients were more active due to participation to religious rituals and lack of private transportation compared to Qatari patients.   Conclusion:  COPD patients and HCPs recognised the benefit of PR and willingness to establish it but there were differences in their perception about quality of information provided. The need for further education was identified in both countries.
β-Blocker–Associated Risks in Patients With Uncomplicated Hypertension Undergoing Noncardiac Surgery
Authors: Mads E. Jørgensen, Mark A. Hlatky, Lars Køber, Robert D. Sanders, Christian Torp-Pedersen, Gunnar H. Gislason, Per Føge Jensen, Charlotte Andersson
Journal: JAMA Internal Medicine (2015)

Perioperative β-blocker strategies are important to reduce risks of adverse events. Effectiveness and safety may differ according to patients' baseline risk.To determine the risk of major adverse cardiovascular events (MACEs) associated with long-term β-blocker therapy in patients with uncomplicated hypertension undergoing noncardiac surgery.Association study based on in-hospital records and out-of-hospital pharmacotherapy use using a Danish nationwide cohort of patients with uncomplicated hypertension treated with at least 2 antihypertensive drugs (β-blockers, thiazides, calcium antagonists, or renin-angiotensin system [RAS] inhibitors) undergoing noncardiac surgery between 2005 and 2011.Various antihypertensive treatment regimens, chosen as part of usual care.Thirty-day risk of MACEs (cardiovascular death, nonfatal ischemic stroke, nonfatal myocardial infarction) and all-cause mortality, assessed using multivariable logistic regression models and adjusted numbers needed to harm (NNH).The baseline characteristics of the 14,644 patients who received β-blockers (65% female, mean [SD] age, 66.1 [12.0] years) were similar to those of the 40,676 patients who received other antihypertensive drugs (57% female, mean [SD] age, 65.9 [11.8] years). Thirty-day MACEs occurred in 1.3% of patients treated with β-blockers compared with 0.8% of patients not treated with β-blockers (P < .001). β-Blocker use was associated with increased risks of MACEs in 2-drug combinations with RAS inhibitors (odds ratio [OR], 2.16 [95% CI, 1.54-3.04]), calcium antagonists (OR, 2.17 [95% CI, 1.48-3.17]), and thiazides (OR, 1.56 [95% CI, 1.10-2.22]), compared with the reference combination of RAS inhibitors and thiazides. Results were similar for all-cause mortality. Risk of MACEs associated with β-blocker use seemed especially pronounced for patients at least 70 years old (number needed to harm [NNH], 140 [95% CI, 86-364]), for men (NNH, 142 [95% CI, 93-195]), and for patients undergoing acute surgery (NNH, 97 [95% CI, 57-331]), compared with patients younger than 70 years, women, and patients undergoing elective surgery, respectively.Antihypertensive treatment with a β-blocker may be associated with increased risks of perioperative MACEs and all-cause mortality in patients with uncomplicated hypertension.
Carcinosarcomas (Malignant Mixed Müllerian Tumor) of the Uterus: Advances in Elucidation of Biologic and Clinical Characteristics
Authors: Lauren E. Kernochan, Rochelle L. Garcia
Journal: Journal of the National Comprehensive Cancer Network (2009)

Carcinosarcoma of the uterus (malignant mixed Müllerian tumor [MMMT]) is an uncommon, typically extremely aggressive neoplasm histologically composed of malignant epithelial and mesenchymal (stromal) elements. Although the literature contains some debate, most authors now agree that most MMMTs derive from sarcomatous differentiation in a high-grade carcinoma. This article reviews the clinical and histopathologic features of this interesting neoplasm, with particular emphasis on recent data supporting MMMTs as primarily epithelial malignant neoplasms with areas of mesenchymal/spindle cell differentiation.
Dependence of Concomitant Tumor Immunity on Continued Antigenic Stimulation&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Richard K. Gershon, Kazunari Kondo
Journal: JNCI Journal of the National Cancer Institute (1971)

Previous studies of an allotransplanted hamster lymphoma showed that excision of the immunizing tumor may lead to a fall in existing concomitant tumor immunity, increased production of enhancing antibodies, and metastatic tumor dissemination. We studied some variables that may influence this sequence of events. After tumor inoculation, a limited period exists when the immune response may be affected by tumor removal. The length of the susceptible period depends on the size of the initial tumor dose—the larger the dose, the shorter the period. Reinoculation of 1 × 107 tumor cells at the site of tumor removal, immediately after excision, can prevent the loss of concomitant immunity. Thus there is a period in the immune response to some tumor allografts which depends on continued antigenic stimulation for its development. Once this response is established it is no longer, or at least less, antigen dependent.
Prevention of extubation failure in high-risk neuromuscular disease patients
Authors: Luciana Paladini, Giovanna Arcaro, Federico Gallan, Maria Rita Marchi, Fausto Braccioni, Maddalena Chizzolini, Alessia Donà, Andrea Vianello
Journal: European Respiratory Journal (2011)

Background:  A substantial proportion of Neuromuscular Disease (NMD) pts who undergo invasive MV for ARF should be considered at high risk for extubation failure. We prospectively investigated the efficacy of early application of Non-Invasive Ventilation (NIV) combined with Assisted Coughing (AC) as an intervention aimed at preventing extubation failure in NMD pts.   Methods:  Prospective analysis of the short-term outcomes of 10 NMD pts who were treated by NIV and AC immediately after extubation (Group A) and comparison with the outcomes of 10 historical control pts who received Standard Medical Treatment (SMT) alone (Group B).   Results:  Significantly fewer pts who received the treatment protocol required reintubation and tracheostomy compared with those who received SMT (reintubation: 3 vs 10; tracheostomy: 3 vs 9; p=0.002 and 0.01, respectively). Pts in Group A remained for a shorter time in the RICU compared to Group B (7.8±3.9 vs 23.8±15.8 days; p=0.006).   Conclusions:  Preventive application of NIV plus AC after extubation provides an important advantage to NMD pts by averting the need for reintubation or tracheostomy, and shortening their stay in the RICU.
Estimation of the number of nucleotide substitutions when there are strong transition-transversion and G+C-content biases.
Authors: K Tamura
Journal: Molecular Biology and Evolution (1992)

A simple mathematical method is developed to estimate the number of nucleotide substitutions per site between two DNA sequences, by extending Kimura's (1980) two-parameter method to the case where a G+C-content bias exists. This method will be useful when there are strong transition-transversion and G+C-content biases, as in the case of Drosophila mitochondrial DNA.