tbuckley/cabot-search huggingface dataset:
Clinical Depression Versus Distress Among Patients With Type 2 Diabetes
Authors: Lawrence Fisher, Marilyn M. Skaff, Joseph T. Mullan, Patricia Arean, David Mohr, Umesh Masharani, Russell Glasgow, Grace Laurencin
Journal: Diabetes Care (2007)

We sought to determine differences between structured interviews, symptom questionnaires, and distress measures for assessment of depression in patients with diabetes.We assessed 506 diabetic patients for major depressive disorder (MDD) by a structured interview (Composite International Diagnostic Interview [CIDI]), a questionnaire for depressive symptoms (Center for Epidemiological Studies Depression Scale [CESD]), and on the Diabetes Distress Scale. Demographic characteristics, two biological variables (A1C and non-HDL cholesterol), and four behavioral management measures (kilocalories, calories of saturated fat, number of fruit and vegetable servings, and minutes of physical activity) were assessed. Comparisons were made between those with and without depression on the CIDI and the CESD.Findings showed that 22% of patients reached CESD > or = 16, and 9.9% met a CIDI diagnosis of MDD. Of those above CESD cut points, 70% were not clinically depressed, and 34% of those who were clinically depressed did not reach CESD scores > or = 16. Those scoring > or = 16, compared with those < 16 on the CESD, had higher A1C, kilocalories, and calories of saturated fat and lower physical activity. No differences were found using the CIDI. Diabetes distress was minimally related to MDD but substantively linked to CESD scores and to outcomes.Most patients with diabetes and high levels of depressive symptoms are not clinically depressed. The CESD may be more reflective of general emotional and diabetes-specific distress than clinical depression. Most treatment of distress, however, is based on the depression literature, which suggests the need to consider different interventions for distressed but not clinically depressed diabetic patients.
Correlation between change in body weight rather than current body weight and change in serum adiponectin levels in a Japanese population—the Funagata study
Authors: Nobuko Arawaka, Makoto Daimon, Toshihide Oizumi, Yumi Jimbu, Wataru Kameda, Hiroshi Yamaguchi, Hiroshi Ohnuma, Makoto Tominaga, Takeo Kato
Journal: Metabolism (2006)
The Ongoing Debate of Who to Treat for Chronic Hepatitis C Virus
Authors: Marc G. Ghany
Journal: JAMA Internal Medicine (2014)

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
Group A Streptococcus Septicemia in Children
Authors: David A. Hexter
Journal: JAMA (1992)

To the Editor.  —Wheeler et al 1 reported a real increase in the incidence of  of severe group A streptococcus sepsis in children in Denver based on an increase in cases per 10 000 patient discharges. A case was defined as a patient with one or more positive blood cultures. It is important to determine whether the incidence of discovery of septicemia in this defined medical care environment has changed over the 10-year period of this study and is therefore responsible for the observed increase in incidence rather than an actual increase in  in Denver. Similar increases in the incidence of septicemia  have been observed in our institution, but these disappear when intensity of discovery is controlled for.  In order to control for changes in length of stay, it is necessary to calculate the incidence density for each period, which can be defined as follows: (number of
Implementing a Mobile Stroke Unit Program in the United States
Authors: Suja S. Rajan, Sarah Baraniuk, Stephanie Parker, Tzu-Ching Wu, Ritvij Bowry, James C. Grotta
Journal: JAMA Neurology (2014)

There are many ways a mobile stroke unit (MSU) might prove valuable for patients with ischemic and hemorrhagic stroke, such as earlier recognition, more accurate triage, improved management of blood pressure and other critical physiological variables, and eventually earlier implementation of effective therapies. The MSU may be particularly valuable for treatment of patients with acute ischemic stroke with tissue plasminogen activator (tPA) within 4.5 hours of symptom onset, the most evidence-based effective emergency treatment for the most prevalent stroke diagnosis.To review existing data on prehospital stroke treatment, especially relevant to MSU technology, to identify gaps in our understanding of MSU feasibility, especially relevant to applying the MSU strategy in the United States, and to describe the Houston MSU program and clinical trial.Published data from English-language journals in PubMed from 1995 to present reviewing early treatment with tPA and prehospital stroke evaluation and treatment.The MSU may result in an overall shift toward earlier evaluation and treatment with tPA, particularly into the first hour after symptom onset, leading to substantially better outcomes. As a result of improved clinical outcomes owing to earlier treatment, the costs of an MSU program may be offset by a reduction in the costs of long-term stroke care and an increase in quality-adjusted life-years, thereby supporting more widespread use of this technology. To make MSU deployment more practical, the vascular neurologist aboard the MSU must be replaced by a remote vascular neurologist connected to the MSU by telemedicine, reducing manpower requirements and costs.The MSU strategy could dramatically transform the way acute stroke is managed in the United States. A prospective study evaluating the logistics, outcomes, and cost-effectiveness of this approach is needed and under way.
TYPHOID FEVER IN CHILDREN.
Authors: WILLIAM J. BUTLER
Journal: JAMA (1905)

the superficial portions of the denuded surface, it will result in a small area of included tissue which pulls the skin in- ward, and there will be a small perineum.Dr. G. B. Somers declared it seems that we are still at sea as to what is really necessary to be done in repairing a lacer- ated perineum.The anatomy and function of the perineum are not understood.He does not maintain that one operation is better than another, but he does maintain that before re- pairing a perineum we must establish certain definite princi- ples as a working basis; we must have an anatomic rather than a pathologic basis.One can build up a perineum by any one of about forty methods so as to get a good looking peri- neum, but the point is: Will that perineum last?With the Emmet or Hegar or Tait operation he has found that after six or eight months the tissues have stretched, because pathologic and not normal structures have been used.The first point he tried to demonstrate was the importance of the levator ani muscle.It is the most important muscle of the perineum, and unless the surgeon is convinced of that the operation is a useless one.The sphincter action of this muscle must be re- stored so as to maintain the closure of the vaginal walls, keeping the anterior wall in contact with the posterior.Dr.Somers expected to be misunderstood in many of the points he tried to make, and he expected that some one would bring up the old point of the difference between the muscle and the fascia.This shows that there is a lingering idea that the function of the perineum depends on the strength of the tis- sue of which it is composed, rather than on its sphincter-like action.No muscle is of value apart from its fascia, so that when in speaking of a muscle, one must also consider its fascia.The levator ani has rectal as well as vesical fascia, and both are important.It is true that tears rarely occur in the median line, and Dr. Somers' demonstration was as to the ultimate re- sults of a tear in one of the sulci.The majority of lacerations occur in the sulci.He maintains, however, that the fibers gradually retract and atrophy, so that ultimately the condi- tions are the same as if the tear had been in the median line.With reference to the importance of the superficial mus- cles, he said that in the majority of women who have borne children, these are torn and the vulva gapes open, exposing more or less the entrance to the vagina, but a little farther within it is perfectly plain that the vaginal walls are held to- gether by a strong band of levator fibers, and as long as these are intact there is neither rectocele nor eystocele.If one be- lieves tfiat the levator ani muscle is the principal portion of .theperineum, and that the function of this muscle should be restored, then he must have some way of uniting it.Simply to use the Hegar or Emmett operation does not provide for a direct union of the two edges of the muscle.Dr. Somers' chief object in presenting the paper was to show an easy method of restoring the function of this muscle.TYPHOID FEVER IN CHILDREN.
DIAGNOSIS IN TRAUMATIC NEUROSIS
Authors: WALTER F. SCHALLER
Journal: JAMA (1918)

Opinions regarding the outlook for recovery in accident neuroses, commonly known as "traumatic neuroses," vary widely by the writers on this subject. Formerly this question of prognosis was studied in the subsequent medical history of persons injured in railway accidents, and afterward developing a neurosis. In this connection, the often quoted and striking statistics of Braun are interesting. This investigator studied the relative frequency of the neuroses following railway accidents in the ten years preceding and the ten years following the Austrian accident insurance law of 1895. Whereas in the period preceding the enactment of the law no case of disability was noted attributable to a purely nervous state, in the ten years following forty-six such cases were observed. From this investigation, traumatic neurosis and accident compensation appeared to be very intimately related. Pearce Bailey<sup>1</sup>cites Page, who studied the proportion of recoveries in 234 persons injured on the
New Paradigm for Management of Hepatocellular Carcinoma by Imaging
Authors: Ijin Joo, Byung Ihn Choi
Journal: Liver Cancer (2012)

Based on recent clinical practice guidelines, imaging is largely replacing pathology as the preferred diagnostic method for determination of hepatocellular carcinoma (HCC). A variety of imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, and angiography, are currently used to examine patients with chronic liver disease and suspected HCC. Advancements in imaging techniques such as perfusion imaging, diffusion imaging, and elastography along with the development of new contrast media will further improve the ability to detect and characterize HCC. Early diagnosis of HCC is essential for prompt treatment, which may in turn improve prognosis. Considering the process of hepatocarcinogenesis, it is important to evaluate sequential changes via imaging which would help to differentiate HCC from premalignant or benign lesions. Recent innovations including multiphasic examinations, high-resolution imaging, and the increased functional capabilities available with contrast-enhanced US, multidetector row CT, and MRI have raised the standards for HCC diagnosis. Although hemodynamic features of nodules in the cirrhotic liver remain the main diagnostic criterion, newly developed cell-specific contrast agents have shown great possibilities for improved HCC diagnosis and may overcome the diagnostic dilemma associated with small or borderline hepatocellular lesions. In the 20th century paradigm of medical imaging, radiological diagnosis was based on morphological characteristics, but in the 21st century, a paradigm shift to include biomedical, physiological, functional, and genetic imaging is needed. A multidisciplinary team approach is necessary to foster an integrated approach to HCC imaging. By developing and combining new imaging modalities, all phases of HCC patient care, including screening, diagnosis, treatment, and therapy, can be dramatically improved.
Lentivectors for Regulated and Reversible Cutaneous Gene Delivery
Authors: Zurab Siprashvili, Paul A Khavari
Journal: Molecular Therapy (2003)

Systemic administration of therapeutic proteins has value in treating a wide variety of disorders, including erythropoietin (Epo)-responsive anemias. Recombinant proteins, however, are costly and require repeated injections, while gene delivery approaches have suffered from inefficiency and difficulties with regulation. The skin effectively delivers polypeptides to the circulation, and improved approaches would support sustainable, topically regulated protein expression after a single vector injection. Toward this goal, we generated lentivectors in which both gene delivery and persistence in skin are regulated by administration of distinct steroid ligands. Following a single injection of regulated lentivector into human skin regenerated on immunodeficient mice, topical glucocorticoid ligands regulated Epo levels and hematocrit over time. Abrogation of gene delivery was achieved by both glucocorticoid cessation and proviral excision via a 4-hydroxytamoxifen-inducible Cre recombinase. These findings establish an approach to durable, topically controlled systemic delivery of therapeutic proteins from human skin tissue.
Mildly raised intraocular pressure is a risk factor, not glaucoma itself
Authors: D. Morsman
Journal: BMJ (1995)

Regular funduscopy should therefore be under- taken by expedition doctors to detect the presence of baemorrhages in otherwise symptomless people.Direct ophthalmoscopy in a darkened tent should be sufficient.While the presence of a small (diameter less than one half disc) uncomplicated haemorrhage may not necessarily be an indication for descent, certain factors may lead to long term damage to the eye-for instance, rebleeding, involvement of the vitreous, the presence of a detectable scotoma, or symptoms of early retinal detachment-and descent should be advocated when these are present.The desire to climb has to be balanced against the possibility of long term visual impairment.
GASTRO-HYSTERORRHAPHY WITHOUT OPENING THE ABDOMINAL CAVITY.Read in the. Section on Obstetrics and Diseases of Women, at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: FRITZ BAUM
Journal: JAMA (1894)

Our negative results in treatment of prolapsus uteri by pessaries and supporters have proven conclusively that we can never gain our point in supporting the prolapsed uterus from below, and that we must find some means to uplift same from above, and in this way substitute the office of the relaxed round and broad ligaments. For this purpose we have constructed the following instrument, consisting of a hollow tube, like a big uterine sound; within this there is a piston-like rod with a handle at the outside and two needles threaded to one thread at the end inside. Now our idea is the following one: Place the patient in Trendelenburg's position, insert this instrument, called uterine ventro-fixator, into the uterus, and after correcting misplacement of same bring the fundus as high up as possible in direct contact with abdominal wall; then push the rod up until the needles protrude through
Teaching the Neophyte
Authors: Arthur Bobroff
Journal: JAMA (1964)

Dr. Brown, in his masterly Chairman's Address, "Who Teaches the Neophyte?" replies, "Practicing physicians." I admire Dr. Brown's presentation, but I think it should be preceded by the heading, "Part One." A later issue ofThe Journalwould bring "Part Two," the sequel: "Who Teaches the Practicing Physician?" The second answer would of course be "The patients," for, as is well known, medical schools have repudiated clinical instruction. Thus it is easy to demonstrate that the practice of healing remains, after thousands of years, an intuitive art developed and taught by its practitioners and gradually extended and enriched by their pupils. The role of science, never more than fragmentary in importance, has been greatly overemphasized for pecuniary reasons. Competent healing is economical, whereas scientific medicine entails heavy spending. It is axiomatic that when money is available some reason is soon found for spending it. Our era differs from earlier ones
INTRAPERITONEAL ESCAPE OF BARIUM ENEMA FLIUD PERFORATION OF SIGMOID COLON
Authors: Ivan Isaacs
Journal: JAMA (1952)

When acute perforation of the colon is suspected in a patient, a barium enema examination is obviously contraindicated. However, an unsuspected colon perforation or its occurrence during the administration of a barium enema may permit the free escape of barium fluid into the peritoneal cavity. This is probably not as rare an incident as would be indicated by the paucity of reported cases. The radiologist should be aware of this possibility and alert to recognize its roentgenoscopic appearance should it occur in spite of precautions.  The cases of two patients with perforation of the sigmoid colon are reported in this paper. In both instances the roentgenoscopic and radiographic findings were strikingly similar and presented a particular sign that may be of value for the prompt recognition of such a perforation during the roentgenoscopy. The barium escaping through a perforation in the sigmoid may immediately collect in the space between the
THE RATE OF ABSORPTION AND DURATION OF ACTION OF FOUR DIFFERENT SOLUTIONS OF METHYL NICOTINATE*
Authors: R. B. FOUNTAIN, B. S. BAKER, J. W. HADGRAFT, I. SARKANY
Journal: British Journal of Dermatology (1969)

SUMMARY.— The rate of absorption of methyl nicotinate dissolved in water, polyethylene glycol 300, propylene glycol and tetrahydrofurfuryl alcohol was studied by measuring, in vivo, the area and duration of the erythema which it produced. With all the solutions it was found that the slower the absorption the longer was the duration of action. This relationship did not alter, either with different sites on the back, or at different ambient temperatures. Methyl nicotinate was absorbed more quickly from the upper than the lower back. It was also absorbed more rapidly at higher ambient temperatures. Altering the concentration of methyl nicotinate between 0·25% and 1% did not change its rate of absorption although it increased the intensity of the reaction.
Survival in Untreated and Treated Cancer
Authors: M. B. Shimkin, M. H. Griswold, S. J. Cutler
Journal: CA A Cancer Journal for Clinicians (1984)

During 1935 to 1951, a total of 75,494 cancer cases occurred among the inhabitants of Connecticut, of whom there were 2,000,000 in 1950. The five-year survival rate has improved gradually from 12 and 19 percent of all males and females, respectively, in 1935 to 1940, to 20 and 32 percent, respectively, during 1947 to 1951. This improvement is not due to earlier diagnosis of the cases, as can be seen from the similar distribution of localized and disseminated cases during the whole period of study. The improvement has occurred in cancer that is diagnosed when it is clinically localized and when it involves regional areas, but not when it is disseminated. The most marked improvement is recorded for cancers of the colon and rectum in both sexes, and of the uterine cervix in women. The data are compared with survival rates anticipated in untreated neoplastic disease. A new era of detection and treatment of cancer is being entered through the studies on in situ and occult cancers among the population.
Keratinocyte Growth Factor: Not Yet Ready for Prime Time
Authors: Charles L. Loprinzi, James A. Martenson
Journal: Journal of Clinical Oncology (2003)

Article Tools EDITORIALS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2003.02.041 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 12697863 Keratinocyte Growth Factor: Not Yet Ready for Prime Time Charles L. LoprinzixCharles L. LoprinziSearch for articles by this author , James A. MartensonxJames A. MartensonSearch for articles by this author Show More Mayo Clinic, Rochester, MN https://doi.org/10.1200/JCO.2003.02.041 Full Text PDF Figures and Tables "Keratinocyte Growth Factor: Not Yet Ready for Prime Time." Journal of Clinical Oncology, 21(8), pp. 1429–1430© 2003 by American Society of Clinical Oncology
Use of plasma exchange in methotrexate removal in a patient with osteosarcoma and acute renal insufficiency
Authors: Karin Zattar Cecyn, Juno Lee, Tsutomo Oguro, Antônio Sérgio Petrilli, José Orlando Bordin
Journal: American Journal of Hematology (2003)

Acute renal failure induced by methotrexate (MTX) can be lethal because renal excretion of the drug can be delayed. Pre-existing renal impairment, abstention, or underdosage of folinic acid and inadequate hydration facilitate toxicity. The prolonged high serum levels of MTX result in severe mucositis and pancytopenia, but strategies useful to accelerate MTX removal have not been universally accepted. We report a case of a 13-year-old girl with osteosarcoma who was treated with high-dose MTX because of thoracic tumor recurrence. No side effects were observed after 2 cycles of high-dose MTX; however, after the third cycle there was a delayed MTX elimination followed by clinical toxicity. Forty hours post-MTX infusion the serum level of MTX was 5.39 x 10(-4) mol/L. Treatment was based on symptomatic measures, such as maintenance of an abundant and alkaline diuresis and parenteral administration of folinic acid. Concomitantly, plasma exchange was employed to accelerate MTX removal and reduce its toxicity. After 24 days, she was discharged from the hospital, and her renal function recovered gradually.
Back pain and risk of fatal ischaemic heart disease: 13 year follow up of Finnish farmers
Authors: J Penttinen
Journal: BMJ (1994)

In the early 1980s some authors found an association between cardiovascular risk factors, especially smoking, and back pain.1 Quite recently Kauppila and Tollroth reported an association between history of back pain and atherosclerotic lesions of lumbar arteries in cadavers. They suggested that back pain could be an early symptom of atherosclerosis.2 Prospective studies concerning mortality related to back pain have not been published previously. My purpose was to find out whether patients reporting back pain have an increased risk of dying of ischaemic heart disease when compared with those who have no back symptoms.

The basic population consisted of 8816 Finnish farmers who participated in a postal survey in November 1979 to January 1980. Those 3842 women and 3648 men who did not report any cardiovascular disease in the questionnaire (except haemorrhoids or varices) and who were 30-66 years old in 1980 were selected for the follow up study.

I included back pain and sciatica in the year before follow up as dichotomous variables. Sciatic pain …
FINAL IVUS RESULTS FROM THE DESSOLVE–I FIRST–IN–HUMAN TRIAL: LONG–TERM ARTERIAL RESPONSE TO A NOVEL SIROLIMUS–ELUTING STENT WITH FULLY ABSORBABLE POLYMER AND CRYSTALLINE DRUG
Authors: Kyuhachi Otagiri, Kenji Sakamoto, Katsuhisa Waseda, Paul Yock, Robert Whitbourn, Matthias Vrolix, James Stewart, Mark Webster, Yasuhiro Honda, Willem Wijns, John Ormiston, Peter Fitzgerald
Journal: Journal of the American College of Cardiology (2013)