tbuckley/cabot-search huggingface dataset:
Serum Bilirubin and Risk of Respiratory Disease and Death
Authors: Laura J. Horsfall
Journal: JAMA (2011)

<h3>Context</h3>Serum total bilirubin levels in healthy patients reflect genetic and environmental factors that could influence the risk of developing respiratory disease.<h3>Objective</h3>To examine the relationship between bilirubin levels and respiratory disease.<h3>Design, Setting, and Participants</h3>Cohort study among 504 206 adults from a UK primary care research database (the Health Improvement Network) with serum bilirubin levels recorded but no evidence of hepatobiliary or hemolytic disease. Data were recorded between January 1988 and December 2008.<h3>Main Outcome Measures</h3>Incidence of chronic obstructive pulmonary disease (COPD), lung cancer, and all-cause mortality.<h3>Results</h3>Median bilirubin levels were 0.64 mg/dL (interquartile range, 0.47-0.88 mg/dL) in men and 0.53 mg/dL (interquartile range, 0.41-0.70 mg/dL) in women. There were 1341 cases of lung cancer, 5863 cases of COPD, and 23 103 deaths, with incidence rates of 2.5, 11.9, and 42.5 per 10 000 person-years, respectively. The incidence of lung cancer per 10 000 person-years in men was 5.0 (95% confidence interval [CI], 4.2-6.0) in the first decile category of bilirubin compared with 3.0 (95% CI, 2.3-3.8) in the fifth decile. The corresponding incidences for COPD in men were 19.5 (95% CI,17.7-21.4) and 14.4 (95% CI, 12.7-16.2). The mortality rates per 10 000 person-years in men were 51.3 (95% CI, 48.5-54.2) in the first decile category compared with 38.1 (95% CI, 35.5-40.8) in the fifth decile. The associations were similar for women. After adjusting for other important health indicators, regression estimates for incidence rate of lung cancer per 0.1-mg/dL increase in bilirubin level were an 8% decrease (95% CI, 5%-11%) for men and an 11% decrease (95% CI, 7%-14%) for women. The regression estimate for COPD in men per 0.1-mg/dL increase in bilirubin level was a 6% decrease (95% CI, 5%-7%) and for mortality in men was a 3% decrease (95% CI, 2%-3%) after accounting for other health indicators. The results for COPD and mortality in women were very similar.<h3>Conclusion</h3>Among patients with normal-range bilirubin levels in primary care practices, relatively higher levels of bilirubin were associated with a lower risk of respiratory disease and all-cause mortality.
Reporting of Power and Sample Size in Randomized Controlled Trials
Authors: Claude O. Burdick
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Mr Moher and colleagues<sup>1</sup>have done a great service to the medical community by reviewing a large sample of articles from important journals for sample size adequacy. They noted that most trials with negative results did not have sample sizes large enough to detect a 25% or a 50% relative difference and that few trials discussed whether the observed differences were clinically important. Pressure from managed care organizations to save money can take the form of providing fewer services, with the rationale that there appears to be no outcome difference between a more costly and a less costly path of diagnosis or treatment. For example, it has been suggested that biochemical profiles be reduced from 23 to three tests,<sup>2</sup>that three stool specimens be pooled for a single examination,<sup>3</sup>and that laboratories should not search for<i>Yersinia</i>organisms in patients with diarrhea.<sup>4</sup> These
IMPACT OF INCOMPLETE CORONARY REVASCULARIZATION ON ONE-YEAR OUTCOMES AFTER PERCUTANEOUS CORONARY INTERVENTION IN ACUTE CORONARY SYNDROMES: THE ACUITY TRIAL
Authors: Gregg Rosner, Ajay Kirtane, Philippe Genereux, Alexandra Lansky, Ecaterina Cristea, Bernard Gersh, Giora Weisz, Helen Parise, Roxana Mehran, Gregg Stone
Journal: Journal of the American College of Cardiology (2012)
Serum mitochondrial aspartate aminotransferase as a marker of chronic alcoholism: Diagnostic value and interpretation in a liver unit
Authors: Bertrand Nalpas, Anne Vassault, Serge Charpin, Bernard Lacour, Pierre Berthelot
Journal: Hepatology (1986)

Serum mitochondrial aspartate aminotransferase activity was measured using an immunochemical method in 251 subjects, of whom 140 were chronic alcoholics. The alcoholic patients included 37 with normal liver routine tests (Group I), 61 with noncirrhotic alcoholic liver disease (Group II) and 42 with cirrhosis (Group III), of whom 21 had been abstainers for at least 2 months. All of the remaining 111 subjects were nonalcoholic: 61 had various types of liver disease (Group IV) and 50 were healthy controls. A second assay of serum mitochondrial aspartate aminotransferase activity was performed in 76 alcoholics after a period of abstinence of about 7 days. In addition, serial mitochondrial aspartate aminotransferase determinations were performed in four nonalcoholic volunteers prior to, during and following an alcohol bout. Mean mitochondrial aspartate aminotransferase and mitochondrial aspartate aminotransferase/total aspartate aminotransferase ratio were significantly increased in the alcoholics whatever their liver status, with a sensitivity of the ratio of 81, 85 and 66% for Group I, Group II and the 21 drinkers of Group III, respectively. Only 1 of the 21 cirrhotic abstainers had an increased ratio. Among the 61 nonalcoholic patients with liver disease, 11 had an increased mitochondrial aspartate aminotransferase/total aspartate aminotransferase ratio, specificity of which was 82%. After drinking had been stopped for about 1 week, mitochondrial aspartate aminotransferase decreased by more than 50% and therefore appears as a reliable tool to assess abstinence. In the four cases of alcohol bouts, no significant modifications in mitochondrial aspartate aminotransferase serum values were observed, thus suggesting that mitochondrial aspartate aminotransferase is indeed a marker of chronic, but not of acute, alcohol intake.
Position Paper: Ethics Manual
Authors: Vijay Rajput
Journal: Annals of Internal Medicine (2005)

Letters18 October 2005Position Paper: Ethics ManualVijay Rajput, MDVijay Rajput, MDFrom Robert Wood Johnson Medical School, Cooper University Hospital, Camden, NJ 08103.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-8-200510180-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The fifth edition of the American College of Physicians (ACP) Ethics Manual (1) is well-written by 2 distinguished and dedicated lawyers. I was disheartened, however, that although more than 100 000 internists are members of this organization and several serve on the College's Ethics and Human Rights Committee, not a single soul was strong enough to come out as a coauthor for this manual. If I may say, intervention by interpreters of the law is an overly blunt way of tackling the delicate ethical dilemmas that internists must face as individual human beings who are guided by personal ...Reference1. Snyder L, Leffler C. Ethics manual: fifth edition. Ann Intern Med. 2005;142:560-82. [PMID: 15809467] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Robert Wood Johnson Medical School, Cooper University Hospital, Camden, NJ 08103.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEthics Manual Lois Snyder , Cathy Leffler , and Position Paper: Ethics Manual William E. Golden and Robert B. Doherty Metrics 18 October 2005Volume 143, Issue 8Page: 618KeywordsConflicts of interest ePublished: 18 October 2005 Issue Published: 18 October 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Lymphovascular Invasion Predicts Clinical Outcomes in Patients With Node-Negative Upper Tract Urothelial Carcinoma
Authors: Eiji Kikuchi, Vitaly Margulis, Pierre I. Karakiewicz, Marco Roscigno, Shuji Mikami, Yair Lotan, Mesut Remzi, Christian Bolenz, Cord Langner, Alon Weizer, Francesco Montorsi, Karim Bensalah, Theresa M. Koppie, Mario I. Fernández, Jay D. Raman, Wassim Kassouf, Christopher G. Wood, Nazareno Suardi, Mototsugu Oya, Shahrokh F. Shariat
Journal: Journal of Clinical Oncology (2008)

Purpose To assess the association of lymphovascular invasion (LVI) with cancer recurrence and survival in a large international series of patients treated with radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC). Patients and Methods Data were collected on 1,453 patients treated with RNU at 13 academic centers and combined into a relational database. Pathologic slides were rereviewed by genitourinary pathologists according to strict criteria. LVI was defined as presence of tumor cells within an endothelium-lined space. Results LVI was observed in 349 patients (24%). Proportion of LVI increased with advancing tumor stage, high tumor grade, presence of tumor necrosis, sessile tumor architecture, and presence of lymph node metastasis (all P &lt; .001). LVI was an independent predictor of disease recurrence and survival (P &lt; .001 for both). Addition of LVI to the base model (comprising pathologic stage, grade, and lymph node status) marginally improved its predictive accuracy for both disease recurrence and survival (1.1%, P = .03; and 1.7%, P &lt; .001, respectively). In patients with negative lymph nodes and those in whom a lymphadenectomy was not performed (n = 1,313), addition of LVI to the base model improved the predictive accuracy of the base model for both disease recurrence and survival by 3% (P &lt; .001 for both). In contrast, LVI was not associated with disease recurrence or survival in node-positive patients (n = 140). Conclusion LVI was an independent predictor of clinical outcomes in nonmetastatic patients who underwent RNU for UTUC. Assessment of LVI may help identify patients who could benefit from multimodal therapy after RNU. After confirmation, LVI should be included in staging of UTUC.
Indoor Tanning Among Young Non-Hispanic White Females
Authors: Gery P. Guy, Zahava Berkowitz, Meg Watson, Dawn M. Holman, Lisa C. Richardson
Journal: JAMA Internal Medicine (2013)

In the primary analyses, PPV23 vaccination did not substantially alter the risk of CAP (hazard ratio [HR], 0.94 [95% CI, 0.80-1.12];P = .51),AMI (HR, 1.01 [95% CI, 0.82-1.25];P = .92),or ischemic stroke (HR, 1.03 [95% CI, 0.83-1.28];P = .81).After propensity and multivariate adjustments, PPV23 vaccination remained unassociated with the outcomes studied (Table 2).Discussion | Our data do not support a cardiovascular protective role of PPV23 and refute prior data reporting a protective effect in our interim analysis. 4Our findings show an increased short-term risk of acute thrombotic events among patients with CAP (2.8% and 0.7% of them developed AMI or ischemic stroke within 30 days after a CAP diagnosis, respectively), but vaccination did not reduce these risks.The major strengths of this study were its populationbased design and the validation of outcome events by checking clinical records.The main limitation is that vaccination status was not randomized.We used rigorous methods to adjust for the propensity for vaccination and further adjusted for underlying conditions in multivariate analyses; however, as with all observational studies, a residual confounding cannot be completely excluded.Those individuals who had received PPV23 more than 5 years ago were considered to be unvaccinated.It is possible that some of these individuals could have a certain degree of antibody immunity that was not considered; however, a possible bias is unlikely considering that vaccination did not seem to be effective in more recent vaccinated subjects.In conclusion, we found that the PPV23 does not provide any clinically relevant benefit against overall CAP, AMI, or stroke among the general population old than 60 years.More effective antipneumococcal vaccination strategies (eg, using conjugated and/or protein-based pneumococcal vaccines) 5,6 for adults are needed.
Tc-99m ANTIGRANULOCYTE ANTIBODY IN THE EVALUATION OSTEOMYELITIS (OM) IN PATIENTS WITH FOOT ULCERS
Authors: G. Hung, C. A. Stewart, F. Sapico, R. Chambers, J. Montgomerie, A. Bessman
Journal: Clinical Nuclear Medicine (1995)

Hung, G.; Stewart, C. A.; Sapico, F.; Chambers, R.; Montgomerie, J.; Bessman, A. Author Information
Neuroscience Becomes Image Conscious as Brain Scans Raise Ethical Issues
Authors: M. J. Friedrich
Journal: JAMA (2005)

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
Flow cytometry and IG/TCR quantitative PCR for minimal residual disease quantitation in acute lymphoblastic leukemia: a French multicenter prospective study on behalf of the FRALLE, EORTC and GRAALL
Authors: R Garand, K Beldjord, H Cavé, C Fossat, I Arnoux, V Asnafi, Y Bertrand, M-L Boulland, C Brouzes, E Clappier, E Delabesse, T Fest, F Garnache-Ottou, F Huguet, M-C Jacob, E Kuhlein, S Marty-Grès, A Plesa, N Robillard, M Roussel, J Tkaczuk, H Dombret, E Macintyre, N Ifrah, M C Béné, A Baruchel
Journal: Leukemia (2012)
Syringotropic cutaneous T-cell lymphoma: a variant of mycosis fungoides?
Authors: B. ZELGER, N. SEPP, K. WEYRER, K. GRUNEWALD, B. ZELGER
Journal: British Journal of Dermatology (1994)

Journal Article Syringotropic cutaneous T‐cell lymphoma: a variant of mycosis fungoides? Get access B. ZELGER, B. ZELGER Department of Dermatology. University of Innsbruck, Innsbruck, Austria Search for other works by this author on: Oxford Academic Google Scholar N. SEPP, N. SEPP Department of Dermatology. University of Innsbruck, Innsbruck, Austria Search for other works by this author on: Oxford Academic Google Scholar K. WEYRER, K. WEYRER Laboratory of Molecular Genetics and Diagnostics. University of Innsbruck, Innsbruck, Austria Search for other works by this author on: Oxford Academic Google Scholar K. GRÜNEWALD, K. GRÜNEWALD Laboratory of Molecular Genetics and Diagnostics. University of Innsbruck, Innsbruck, Austria Search for other works by this author on: Oxford Academic Google Scholar B. ZELGER B. ZELGER Department of Pathology. University of Innsbruck, Innsbruck, Austria Dr Bernbard Zelger. Department of Dermatology, University of Innsbruck, Anichstrasse 35, A‐6020 Innsbruck, Austria. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 130, Issue 6, 1 June 1994, Pages 765–769, https://doi.org/10.1111/j.1365-2133.1994.tb03415.x Published: 01 June 1994 Article history Accepted: 01 November 1993 Published: 01 June 1994
Biplane transesophageal echocardiographv: Echo-anatomic correlations, description of new views comparison with single plane, and the clinical utility
Authors: Andrew Weintraub, Natesa Pandian, S.Geoffrey Richardson, Rohit Kumar, Steven Schwartz, Linda Gillam, John Pastore, Janet Simonetti, Sarah Katz, Marjory Caldeira
Journal: Journal of the American College of Cardiology (1991)
New postgraduate education body welcomed
Authors: L. Beecham
Journal: BMJ (2002)

The BMA's annual representative meeting last week welcomed the proposal to establish the Medical Education Standards Board.

In December 2001 the Department of Health made fundamental changes to the way that postgraduate medical education was organised. It established the board as the “competent authority” to agree and monitor standards of education across the United Kingdom.

Dr Paul Miller, a consultant psychiatrist in Sunderland, called for support for a motion welcoming the board, because the board would end the monopolistic conflicts of interest …
Expression of <i>HER2</i> and the Coamplified Genes <i>GRB7</i> and <i>MLN64</i> in Human Breast Cancer: Quantitative Real-time Reverse Transcription-PCR as a Diagnostic Alternative to Immunohistochemistry and Fluorescence <i>In situ</i> Hybridization
Authors: Ursula Vinatzer, Brigitta Dampier, Berthold Streubel, Margit Pacher, Michael J. Seewald, Christian Stratowa, Klaus Kaserer, Martin Schreiber
Journal: Clinical Cancer Research (2005)

Accurate testing of HER2 is centrally important for breast cancer therapy and prognosis. Immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) are current standard testing methods. As a potential alternative for assessment of HER2, we explored quantitative real-time reverse transcription-PCR (RT-PCR), a fast and inexpensive method yielding quantitative results insensitive to interobserver variability and amenable to standardized scoring.We assessed HER2 status at the DNA, mRNA, and protein levels with FISH, quantitative RT-PCR, and IHC in 136 tumor samples from 85 breast cancer patients. Expression of GRB7, MLN64, and p21, genes coregulated with HER2, was also quantified with quantitative RT-PCR and correlated with the overall survival (OS) and disease-free survival (DFS) individually and in combination with HER2.Twenty-nine percent and 19% of the patients scored HER2 positive with IHC and quantitative RT-PCR, respectively. In 18 of 19 cases, HER2 statuses in tumors and lymph node metastases were identical. HER2 status significantly correlated with DFS when determined by IHC (P < 0.01), quantitative RT-PCR (P < 0.003), but not with FISH (P = 0.09). The combination of HER2 with MLN64, but not with GRB7 or p21, enhanced the prognostic power for the DFS (P < 0.00005) and OS (P < 0.0008).Quantitative RT-PCR seems to be clinically as useful in the assessment of HER2 status as IHC and FISH, yielding comparable correlations of HER2 status with the OS and DFS. Thus, quantitative RT-PCR analysis of HER2 or HER2 plus MLN64 is a promising complement or alternative to current methods for HER2 testing, particularly in laboratories lacking FISH or IHC technology.
Sequential mitoxantrone, daunorubicin, and cytosine arabinoside for patients with newly diagnosed acute myelocytic leukemia
Authors: Paolo Alberto Paciucci, Janet Cuttner, Arlan Gottlieb, Roger B. Davis, Orlando Martelo, James F. Holland
Journal: American Journal of Hematology (1997)

Mitoxantrone (M) is a synthetic aminoanthraquinone with anti-leukemic activity in patients with daunorubicin (D) resistant acute leukemia. The Cancer and Leukemia Group B (CALGB) has undertaken a limited access pilot study in which M, 12 mg/m 2 , over 30 min, daily for 3 days, and cytosine arabinoside (Ara-C), 100 mg/m 2 /day by constant infusion for 7 days were used for the induction of newly diagnosed patients with AML. Responding patients were consolidated with daunorubicin, 45 mg/m 2 /day for 3 days, and 7 days of Ara-C. After a second consolidation identical to induction, no further therapy was given. Twenty-nine patients with a median age of 50 years (range 18-72) were entered in the study; 18 were males and 11 females. Twenty-four (83%) patients achieved CR, 1 patient achieved a PR, and 4 died In induction from leukemia-related causes. Two patients died in CR from consolidation-related neutropenic sepsis and two additional patients died in CR. Of 24 patients, 7 remain disease-free at a median follow-up interval of 8 years. The regimen is active and well tolerated. The duration of disease-free survival in responding patients is consistent with that seen in similar regimens using intensification chemotherapy without prolonged maintenance.
What happens when children with attention deficit/hyperactivity disorder grow up?
Authors: G. Newton-Howes
Journal: Journal of the Royal Society of Medicine (2004)

Attention deficit/hyperactivity disorder1 and the associated hyperkinetic disorder,2 hereafter both referred to as ADHD, are the most prevalent and best researched of all the childhood mental illnesses. Although not diagnostically identical, the combined type ADHD and ICD-10 hyperkinetic disorder have sufficient in common for research into the two to be considered in parallel. They are, as we shall see, common, disabling and probably neurobiologically based. The received wisdom over the years has been that ADHD is a disorder of childhood whose symptoms lessen over time;3,4 consequently little attention was paid to the possibility that it might continue into adulthood. But is this old consensus correct? What does happen to the children who have ADHD?

The diagnosis and treatment of ADHD is a perplexing area for the child and adolescent psychiatrist, and in the opinion of some clinicians and researchers the check-lists of the DSM-IV and ICD-10 do little justice to the psychosocial and behavioural aspects of hyperkinetic activities.5 Moreover, review of the published work is hampered by the numerous changes in diagnostic criteria over the years.6 The notion that ADHD phenomena reflect other disorders, rather than being core components of a nosologically separate identity, persisted (particularly in the UK) long after the discovery by Bradley in 1937 that stimulant medication has a calming effect on hyperactive children.7 However, as the diagnostic tools have become more robust and the evidence to support pharmacological treatment has become stronger, the doubters are now in a minority. The attention dyscontrol–impulsivity–hyperactivity triad is widely accepted not only as a formal mental disorder but also as one whose diagnosis and management, both pharmacological and psychosocial, can offer profound benefit for the child and family.

Because ADHD was diagnosed and managed principally by child and adolescent psychiatrists, the long-term fate of the patients suffered relative neglect. The likelihood of remission seemed to be supported by a steady reduction in symptoms over time.8 However, the dearth of information has been substantially remedied over the past two decades and the possibility of ADHD as an adult diagnosis is gaining ground—opening treatment options for those affected. This paper explores existing knowledge and potential areas for further research.