tbuckley/cabot-search huggingface dataset:
Multivariable Analysis: A Practical Guide for Clinicians
Authors: Leonard E. Braitman
Journal: Annals of Internal Medicine (2000)

Medical Writings: Book Notes6 June 2000Multivariable Analysis: A Practical Guide for CliniciansLeonard E. Braitman, PhDLeonard E. Braitman, PhDAlbert Einstein Medical Center, Philadelphia, Pennsylvania. (Braitman)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-11-200006060-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Katz M. 208 pages. New York: Cambridge Univ Pr; 1999. $24.95. ISBN 0521596939. Order phone 800-872-7423.Field of medicine: Multivariable statistics in clinical medicine.Format: Softcover book.Audience: Physicians and trainees.Purpose: To enable clinicians to understand, set up, perform, and interpret multivariable analyses.Content: The concepts of multiple linear and logistic regression and proportional hazards survival regression are presented with only minimal mathematical notation. In the context of clinical examples, graphs and nontechnical language are used to introduce more advanced topics, such as regression trees, bootstrap and jackknife validation, and variables that change over time. By emphasizing the utility ... Author, Article, and Disclosure InformationAffiliations: Albert Einstein Medical Center, Philadelphia, Pennsylvania. (Braitman) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 6 June 2000Volume 132, Issue 11Page: 931-932KeywordsIntent to treat analysisLinear regression analysisRegression analysisSoftware toolsStatistical methods ePublished: 15 August 2000 Issue Published: 6 June 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Drug Treatment of Huntington's Chorea
Authors: D. V. Hawks, J. T. Silverstone
Journal: BMJ (1962)

<h3>Abstract</h3> Epigenetic factors related to early life adversity (ELA) in childhood are major risk factors for borderline intellectual functioning (BIF). BIF affects both adaptive and intellectual abilities, commonly leading to school failure and to an increased risk to develop mental and social problems in the adulthood. This study aimed to investigate the neurobiological underpinnings of ELA associated with BIF in terms of global topological organization and structural connectivity and their relation with intellectual functioning. BIF (N=32) and age-matched typical development (TD, N=14) children were evaluated for intelligence quotient (IQ), behavioral competencies, and ELA. Children underwent an anatomical and diffusion-weighted MR imaging (DWI) protocol. Global brain topological organization was assessed measuring segregation and integration indexes. Moreover, structural matrices, measuring normalized number of fibers (NFn), were compared between the 2 groups using network-based statistics. Finally, a linear regression model was used to explore the relationship between network parameters and clinical measures. Results showed increased behavioral difficulties and ELA, together with decreased network integration in BIF children. Moreover, significantly lower NFn was observed in the BIF group (p=.039) in a sub-network comprising anterior and posterior cingulate, the pericallosal sulcus, the orbital frontal areas, amygdala, basal ganglia, the accumbens nucleus, and the hippocampus. Linear regression showed that NFn significantly predicted IQ (p&lt;.0001). This study demonstrated that ELA in children with BIF is associated with a decreased information integration at the global level, and with an altered structural connectivity within the limbic system strictly related to the intellectual functioning.
Managing depression in primary care
Authors: Andre Tylee, Roger Jones
Journal: BMJ (2005)

Public confidence needs to be restored after concerns over the safety of SSRIs 

D epression is a condition of “particular concern, which costs lives and affects the quality of life,” according to UK prime minister Tony Blair.1 Nine out of 10 depressed patients are treated only in primary care,2 3 and up to two thirds of suicide victims contact a general practitioner in the four weeks before the death.4 For years, however, general practitioners have been criticised for failing to deal adequately with depression. Like hypertension, depression is subject to a rule of halves—only half of depressed patients seek help from doctors, half are detected in primary care, half receive treatment with only half completing it: fewer than 10% finish a therapeutic course of treatment.5 A range of initiatives, often erroneously based on educational models for general practitioners, has aimed to improve detection rates and to increase the appropriateness of prescribing in depression with variable success, including a spectacular failure, in Hampshire, to influence general practitioners' behaviour at all.6

There are many reasons why depression goes unrecognised in primary care. …
P2-051: Anti-angiogenic Therapy of Human Small-Cell Lung Cancer Cells with Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor, ZD6474
Authors: Takaaki Sasaki, Sachie Tanno, Kiyoko Shibukawa, Eri Toyoshima, Toshiyuki Ogasa, Shinobu Osanai, Yoshinobu Ohsaki
Journal: Journal of Thoracic Oncology (2007)
The Promotion of Gabapentin
Authors: Benjamin L. Sapers
Journal: Annals of Internal Medicine (2007)

Letters20 February 2007The Promotion of GabapentinBenjamin L. Sapers, MDBenjamin L. Sapers, MDFrom Rhode Island Hospital, Providence, Rhode Island.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-4-200702200-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: In the great 1942 movie Casablanca, Captain Renault (Claude Rains) orders his men to close Rick's bar, saying he was “shocked, shocked! to find that gambling [was] going on” at the bar. The cashier hands him his winnings. In the 15 August 2006 issue of Annals, Petersen and colleagues discuss the value of financial incentives and paying for performance to make physicians do the right thing (1). Twelve pages later is Steinman and colleagues' well-researched indictment of a drug company trying to sell its product (2). Do we see ourselves as physicians and patients or as health ...References1. Petersen LA, Woodard LD, Urech T, Daw C, Sookanan S. Does pay-for-performance improve the quality of health care? Ann Intern Med. 2006;145:265-72. [PMID: 16908917] LinkGoogle Scholar2. Steinman MA, Bero LA, Chren MM, Landefeld CS. Narrative review: the promotion of gabapentin: an analysis of internal industry documents. Ann Intern Med. 2006;145:284-93. [PMID: 16908919] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Rhode Island Hospital, Providence, Rhode Island.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNarrative Review: The Promotion of Gabapentin: An Analysis of Internal Industry Documents Michael A. Steinman , Lisa A. Bero , Mary-Margaret Chren , and C. Seth Landefeld Does Pay-for-Performance Improve the Quality of Health Care? Laura A. Petersen , LeChauncy D. Woodard , Tracy Urech , Christina Daw , and Supicha Sookanan The Promotion of Gabapentin Michael A. Steinman , Mary-Margaret Chren , C. Seth Landefeld , and Lisa A. Bero The Promotion of Gabapentin Thomas E. Finucane The Promotion of Gabapentin Eric D. Peterson , Kurt Boyce , and Karen Overstreet Metrics 20 February 2007Volume 146, Issue 4Page: 313KeywordsConflicts of interestDrugsHealth careHealth care sectorMotivation ePublished: 20 February 2007 Issue Published: 20 February 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
TREATMENT OF ULCER OF THE STOMACH, WITH A RECORD OF CASES.
Authors: HENRY F. HEWES
Journal: JAMA (1906)

In the treatment of ulcer of the stomach in its various forms we have to-day two general methods—medical treatment and surgical treatment. In cases of simple, uncomplicated ulcer, that is, ulcer with or without hemorrhage, uncomplicated by permanent obstruction of the pylorus, or perforation, medical treatment offers an efficient, though not an absolutely certain, means of cure. This treatment gives in this class of cases almost universally good results as regards immediate relief or temporary and, if the treatment is thoroughly carried out, excellent results as regards permanent cure. The efficiency of the treatment as regards the after-results or permanent cure is dependent to a large extent on its thoroughness. In cases in which treatment is completely carried out, that is, when strict treatment is enforced for a considerable period, a period of at least four months, and when a proper manner of living is pursued subsequently, complete cure may
The BBC diet trials
Authors: David Arterburn
Journal: BMJ (2006)

Reality television and academic researchers jointly tackle the weight loss industry 

I n 2000, 46% of women and 33% of men in the United States were trying to lose weight1; they spent an estimated $34.7bn (£18.5bn; €27bn) on weight loss products and programmes.2 Did they get their money's worth? Unfortunately, the answer is probably no. The prevalence of obesity increased from 30.5% to 32.2% between 1999 and 2004 in the United States,3 and expenditures on health care associated with excess body weight exceeded $56bn.4 Further, the Federal Trade Commission found four years ago that 40% of all advertisements for weight loss products made false or misleading claims.2

There has been little rigorous scientific research on the efficacy and safety of commercial products and programmes5—but in this week's BMJ Truby and colleagues report their findings from such a study (p 1309).6 Participants were recruited by national advertisements to take part in …
T cell–independent restimulation of FVIII-specific murine memory B cells is facilitated by dendritic cells together with toll-like receptor 7 agonist
Authors: Aniko G. Pordes, Christina K. Baumgartner, Peter Allacher, Rafi U. Ahmad, Markus Weiller, Alexandra N. Schiviz, Hans Peter Schwarz, Birgit M. Reipert
Journal: Blood (2011)
Renal Tubular Necrosis and Papillary Necrosis after Gastroenteritis in Infants
Authors: A. R. Chrispin, D. Hull, J. G. Lillie, R. A. Ridson
Journal: BMJ (1970)

Three young infants who had severe gastroenteritis developed radiological and histological features of renal tubular necrosis. Characteristically the excretion urogram showed renal enlargement with prolonged and heavy opacification of the renal parenchyma and a pronounced increase in density of the pyramids. Subsequent radiological studies showed extensive papillary necrosis. Though these infants are now apparently fit, renal damage has occurred and this may eventually give rise to features indistinguishable from chronic pyelonephritis.
Antinuclear Factors in Synovia
Authors: Eugene V. Barnett
Journal: JAMA (1966)

Antinuclear factors (ANF) of one or more immunoglobulin classes were identified in synovia of nine of 21 patients with rheumatoid arthritis. In most instances, ANF were also present in serum, but in some patients ANF were identified only in synovia. Rheumatoid factor (RF) was detected in serum or synovia of 17 of 21 patients with rheumatoid arthritis. The levels of synovial hemolytic complement and second component of complement (C'2) activity in patients with rheumatoid arthritis was consistently reduced. ANF, RF, and depressed levels of synovial hemolytic complement or C'2 activity were occasionally found in patients with other arthritides. Synovial leukocytic inclusion bodies containing γG, γM, and β<sub>1c</sub>globulin were more frequent in four patients with rheumatoid arthritis than in three patients with other arthritides. Reaction of antinuclear factors in synovia with nuclear antigens may contribute to the depressed synovial complement and complexes of these constituents may be present in some rheumatoid synovial inclusion bodies.
The assessment and management of rectal prolapse, rectal intussusception, rectocoele, and enterocoele in adults
Authors: O. M. Jones, C. Cunningham, I. Lindsey
Journal: BMJ (2011)

#### Summary points

Rectal prolapse is an extrusion of the full thickness of the wall of the rectum beyond the anal verge. Internal rectal prolapse, or intussusception, is defined as a full thickness prolapse of the rectum that does not protrude through the anus. Rectal prolapse and intussusception often coexist with a rectocoele (herniation of the rectovaginal septum anteriorly into the vagina) and an enterocoele (deep herniation of the rectovaginal peritoneum). Globally, these problems are often referred to as “pelvic floor dysfunction,” and this review focuses on the posterior compartment, the rectum, around which these pathologies occur.

Patients with these conditions are often unable to empty the rectum effectively (obstructed defecation syndrome) and make up about half of the estimated 2-27% of the population with constipation; the remainder have a problem of colonic inertia.1 They may also get additional symptoms including faecal incontinence and pain.

Interest in rectal prolapse has recently increased, with a multicentre randomised trial (PROSPER) now completed comparing surgical techniques. The advent of laparoscopic surgery also offers a potentially less invasive, better tolerated, and more durable surgical solution. Initial surgical attempts at treating intussusception were disappointing and led to its virtual abandonment for many years in favour of conservative measures. However, in recent years, good results with acceptable morbidity have been reported for perineal and laparoscopic/abdominal approaches, so that patients with substantial symptoms should be referred for consideration for surgery. We review evidence from epidemiological studies, observation …
Regulation in complementary and alternative medicine
Authors: S. Y Mills
Journal: BMJ (2001)

Complementary and alternative therapies have become more widely used over the past two decades, but many practitioners in the United Kingdom are largely unregulated. One of the recommendations of last year's report on complementary and alternative medicine by the House of Lords Select Committee on Science and Technology was that “in order to protect the public, professions with more than one regulatory body make a concerted effort to bring their various bodies together and to develop a clear professional structure.”1 That some health professions remain unregulated in a developed country seems extraordinary, and I shall review how this situation has arisen before considering the prospects for change.

In the United Kingdom the common law right to choose one's own treatment for illness has been barely constrained by law.2 It is thus legal for practitioners to set themselves up in a wide variety of healthcare professions, as long as they do not claim to be registered medical practitioners and do not practise protected disciplines such as dentistry, midwifery, and veterinary medicine or supply medicines limited to prescription. By contrast, in most other European Union countries, as well as the United States, there are few healthcare activities that are allowed without state authorisation. Acupuncturists, herbalists, osteopaths, and naturopaths have been prosecuted for practising without medical qualifications, and the technical illegality of much complementary practice has meant that it has been pursued informally and disparately, with less opportunity for professional organisations to develop. The increasing demand for alternative health care across the developed world has, therefore, sometimes been met by practitioners outside the law and without recognisable training qualifications, professional standards, or insurance.

#### Summary points

Practitioners of complementary and alternative medicine in the United Kingdom are free to practice as they wish

Most therapies have set up professional bodies, but the educational standards …
Triiodothyronine Levels in Athyreotic Individuals During Levothyroxine Therapy
Authors: Jacqueline Jonklaas
Journal: JAMA (2008)

Thyroidal production of triiodothyronine (T3) is absent in athyreotic patients, leading to the suggestion that T3 deficiency may be unavoidable during levothyroxine (LT4) therapy. However, trials evaluating therapy with combined LT4 and T3 have failed to demonstrate any consistent advantage of combination therapy.To determine whether T3 levels in patients treated with LT4 therapy were truly lower than in the same patients with native thyroid function.A prospective study conducted in the General Clinical Research Center, Georgetown University Medical Center, Washington, DC, between January 30, 2004, and June 20, 2007, of 50 euthyroid study participants aged 18 to 65 years who were scheduled for total thyroidectomy for goiter, benign nodular disease, suspected thyroid cancer, or known thyroid cancer. Following thyroidectomy, patients were prescribed LT4. Patients with benign thyroid disease and thyroid cancer were treated to achieve a normal and suppressed serum thyroid-stimulating hormone (TSH) level, respectively. The LT4 dose was adjusted as necessary postoperatively to achieve the desired TSH goal.Thyroxine (tetraiodothyronine [T4]), T3, and TSH levels were measured twice preoperatively and twice postoperatively.By the end of the study, there were no significant decreases in T3 concentrations in patients receiving LT4 therapy compared with their prethyroidectomy T3 levels (mean, 127.2 ng/dL; 95% confidence interval [CI], 119.5-134.9 ng/dL vs 129.3 ng/dL; 95% CI, 121.9-136.7 ng/dL; P = .64). However, free T4 concentrations were significantly higher in patients treated with LT(4) therapy (mean, 1.41 ng/dL; 95% CI, 1.33-1.49 ng/dL) compared with their native free T4 levels (1.05 ng/dL; 95% CI, 1.00-1.10 ng/dL; P < .001). Serum TSH values of 4.5 mIU/L or less were achieved in 94% of patients by the end of the study. The T3 concentrations were lower in the subgroup of patients whose therapy had not resulted in a TSH level of 4.5 mIU/L or less (P < .001).In our study, normal T3 levels were achieved with traditional LT4 therapy alone in patients who had undergone near-total or total thyroidectomy, which suggests that T3 administration is not necessary to maintain serum T3 values at their endogenous prethyroidectomy levels.
Vaccinia-based immunization may be on the way
Authors: C. Marwick
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
Statins and Mortality Among Elderly Patients Hospitalized With Heart Failure
Authors: JoAnne Micale Foody, Rahman Shah, Deron Galusha, Frederick A. Masoudi, Edward P. Havranek, Harlan M. Krumholz
Journal: Circulation (2006)

Background— Small studies suggest that statins may improve mortality in patients with heart failure (HF). Whether these results are generalizable to a broader group of patients with HF remains unclear. Our objective was to evaluate the association between statin use and survival among a national sample of elderly patients hospitalized with HF. Methods and Results— A nationwide sample of 61 939 eligible Medicare beneficiaries ≥65 years of age who were hospitalized with a primary discharge diagnosis of HF between April 1998 and March 1999 or July 2000 and June 2001 was evaluated. The analysis was restricted to patients with no contraindications to statins (n=54 960). Of these patients, only 16.7% received statins on discharge. Older patients were less likely to receive a statin at discharge. Patients with hyperlipidemia and those cared for by a cardiologist or cared for in a teaching hospital were more likely to receive a statin at discharge. In a Cox proportional hazards model that took into account demographic, clinical characteristics, treatments, physician specialty, and hospital characteristics, discharge statin therapy was associated with significant improvements in 1- and 3-year mortality (hazard ratio, 0.80; 95% CI, 0.76 to 0.84; and hazard ratio, 0.82; 95% CI, 0.79 to 0.85, respectively). Regardless of total cholesterol level or coronary artery disease status, statin therapy was associated with significant differences in mortality. Conclusions— Our data demonstrate that statin therapy is associated with better long-term mortality in older patients with HF. This study suggests a potential role for statins as an adjunct to current HF therapy. Randomized clinical trials are required to determine the role of these agents in improving outcomes in the large and growing group of patients with HF.
The hidden genomic landscape of acute myeloid leukemia: subclonal structure revealed by undetected mutations
Authors: Margherita Bodini, Chiara Ronchini, Luciano Giacò, Anna Russo, Giorgio E. M. Melloni, Lucilla Luzi, Domenico Sardella, Sara Volorio, Syed K. Hasan, Tiziana Ottone, Serena Lavorgna, Francesco Lo-Coco, Anna Candoni, Renato Fanin, Eleonora Toffoletti, Ilaria Iacobucci, Giovanni Martinelli, Alessandro Cignetti, Corrado Tarella, Loris Bernard, Pier Giuseppe Pelicci, Laura Riva
Journal: Blood (2014)
THE ASSOCIATION BETWEEN DIABETES MELLITUS AND CHRONIC INFECTIOUS ARTHRITIS
Authors: EARL O. G. SCHMITT
Journal: JAMA (1926)

Pemberton<sup>1</sup>noted that patients with chronic arthritis seemed to improve when they were given diets low in carbohydrate, and were made worse by diets high in carbohydrate. From this he concluded that patients with diabetes should be comparatively free from arthritis because of the fact that their disturbed metabolism of sugar demanded prolonged diets low in carbohydrate. In his own experience, and in that of Allen and Joslin, diabetes and arthritis only rarely were associated. This has not, however, been our experience. During the last year at the Mayo Clinic, we have seen 474 patients with diabetes; fifty-one of these (10.8 per cent) who had well defined but, as a rule, comparatively mild diabetes had arthritis. They were all given a diet in which the available glucose did not exceed 140 Gm., and were kept in the hospital under careful supervision for at least two weeks on their first