tbuckley/cabot-search huggingface dataset:
Building a National Strategy for the Prevention and Management of and Research in Chronic Obstructive Pulmonary Disease&lt;subtitle&gt;National Heart, Lung, and Blood Institute Workshop Summary&lt;/subtitle&gt;
Authors: Thomas L. Petty
Journal: JAMA (1997)

CHRONIC obstructive pulmonary disease (COPD) is now the fourth leading cause of death in the United States, exceeded only by heart attacks, cancers, and stroke. It is estimated that in 1996 more than 100 000 people will die of COPD alone, though for many more COPD will be a contributing cause of death. The recently completed Lung Health Study, sponsored by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) showed that sustained smoking cessation can be successful with coordinated intervention in up to 22% of subjects at risk of developing COPD.<sup>1</sup>During the 5-year follow up period, smoking cessation resulted in a initial slight improvement then a slower rate of FEV<sub>1</sub>decline compared with continued smokers. Since the rate of FEV<sub>1</sub>decline is a powerful prognostic indicator, these results show not only the potential importance of early intervention, but also the
Independence is key to better regulation
Authors: James Johnson
Journal: BMJ (2006)

The chief medical officer's proposals represent an important shift away from the principles of professionally led regulation.1 They dispense with elected medical representation on the General Medical Council, remove the medical majority, and transfer the GMC's adjudication function to an independent tribunal. The GMC now also espouses the concept of independent rather than professionally led regulation. Independence is fundamental to any profession. Neither the public nor practitioners are best served if medicine cannot marshal its own evidence and expertise against a near monopoly employer and the twists and turns of government policy.

Independence is not, however, a sufficient bulwark. The five principles of better regulation are accountability, consistency, proportionality, transparency, and targeting.2 Donaldson proposes that the GMC be directly accountable to parliament, and that is welcome. The GMC must be accountable to patients, but it must also maintain a strong line of accountability to the profession that campaigned for it, submits to it, and funds it. If, as a society, we look to doctors to lead developments and innovation in clinical care for the benefit of patients, we must proceed with great caution before embracing a set of measures that may seriously undermine doctors' sense of ownership of their profession. That …
Generic or disease‐specific quality of life scales to characterize health status in all_ergic rhinitis?
Authors: B. Kremer, L. Klimek, M. Bullinger, R. Mösges
Journal: Allergy (2001)

Background: In patients with all_ergic rhinitis (AR), various instruments have been validated for the measurement of quality of life (QOL), which may be greatly reduced. However, it is not clear which QOL instruments should be used for the different types of AR and whether they are sensitive to treatment. Methods: The QOL of patients suffering from symptomatic seasonal AR (sSAR) (before and during treatment with a topical or systemic antihistamine), symptomatic perennial AR (sPAR), and asymptomatic seasonal AR (aSAR) was determined with the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) as disease specific and with the Munich Life Dimension List (MLDL) and the Visual Analogue Scale for Quality of Life (VAS‐QOL) as generic QOL instruments. Results: The different forms of AR were associated with typical QOL patterns. In sSAR, we found severe limitation of the global QOL, reduced global life satisfaction, high ranking of practical problems, high limitation of activity, and a high degree of disturbance in all_ subscales of the RQLQ. In sPAR, there were moderate limitation of the global QOL, normal global life satisfaction, high ranking of practical problems, moderate limitation of activity, and a high degree of disturbance by common symptoms. Under antihistamine treatment, both systemic and nasal, a significant improvement of QOL parameters was found, reaching the levels of patients with aSAR after 2 weeks. Conclusions: QOL instruments can distinguish the impairment resulting from sSAR from that of sPAR and are sensitive to treatment with topical and systemic antihistamines. However, as the RQLQ was not designed to measure the short‐term variations of disease status that appear in SAR, it may not demonstrate the rapid improvement of QOL under antihistamine treatment.
Impact of Measurement and Feedback on Vaccination Coverage in Public Clinics, 1988-1994
Authors: Charles W. LeBaron
Journal: JAMA (1997)

To investigate whether a reported rise in vaccination coverage in Georgia public clinics during the period 1988 through 1994 was artifactual or real and, if real, to determine the extent to which the rise could be associated with a program of measurement and feedback.Examination of data from Georgia public clinics, doses-administered records, and National Health Interview Surveys.Children attending Georgia public clinics.Measurement of vaccination coverage and feedback to providers.Vaccination coverage rates.For the period 1988 through 1994, 136 004 Georgia public clinic vaccination records for children 21 to 23 months of age were reviewed. Median series-completion rates at public clinics rose from 53% to 89%, while indexes of under-vaccination fell: missed opportunities for simultaneous vaccination (6% to 0%), lost contact for more than 12 months (14% to 1%), and first vaccination more than 1 month late (19% to 8%). According to the independent doses-administered database, the proportion of children starting the primary series very late (> or =12 months old) fell from 14% to 6%, and the series-completion index rose from 64% to 83%, suggesting that improvements could not be wholly ascribed to better clinic record keeping. In 1988, vaccination coverage of children 24 months of age in the National Health Interview Survey (NHIS) was 53%, identical to median public clinic coverage in Georgia; in 1993, NHIS coverage was 60%, while median public clinic coverage in Georgia was 90%, suggesting that the rise in coverage in Georgia public clinics exceeded national trends. Patterns within the coverage changes suggest an association with the process of measurement and feedback.A marked increase in vaccination coverage occurred in Georgia public clinics associated with a program of annual measurement and feedback.
Glargine and Cancer: Can We Now Suggest Closure?
Authors: David R. Owens
Journal: Diabetes Care (2012)

The two publications on the pharmacokinetics of insulin glargine in individuals with type 1 and type 2 diabetes in this issue of Diabetes Care (1,2) provide additional explanatory evidence in support of the definitive findings in the Outcome Reduction with Initial Glargine Intervention (ORIGIN) study in which exposure to insulin glargine for a median duration of 6.2 years did not increase the risk of any cancer (hazard ratio 1.00 [95% CI 0.88–1.13]) or death from cancer (0.94 [0.77–1.15]) (3).

Soon after glargine’s long awaited and welcome introduction into clinical practice in 2000, questions were raised about its safety profile. This conception was based on the early finding that insulin glargine had an enhanced affinity to IGF-1 receptors when tested in a human osteosarcoma cell line (Saos/B10) with a preponderance of IGF-1 receptors and associated with increased mitogenicity (proliferation in an existing tumor cell line) (4). These findings were akin to those observed with the AspB10 insulin analog, the development of which had earlier been discontinued because of an increase in both benign and malignant mammary gland tumors in Sprague-Dawley rats after 12 months’ exposure (5,6); thus AspB10 was referred to as the “carcinogenic insulin analog” (7). In contrast, detailed extensive toxicological lifetime carcinogenicity studies of insulin glargine in animals (rodent and nonrodent), albeit at lower doses, revealed no carcinogenicity signal with insulin glargine when compared with human insulin (8,9). The risk was regarded as small by the European Medicines Agency safety working party because of the lack of effect on mammary gland proliferation, absence of mammary carcinoma, and rare tumors during the lifetime studies in animals. The higher insulin receptor affinity and consequent prolonged dephosphorylation due to the increased residence time of AspB10 on insulin receptors (4) along with a predilection for the …
Decisions to Withdraw Life-Sustaining Treatment
Authors: Edmund D. Pellegrino
Journal: JAMA (2000)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Strabismus Presenting after Cataract Surgery
Authors: Latif M. Hamed
Journal: Ophthalmology (1991)

Strabismus presenting after cataract surgery is etiologically related to a heterogenous group of disorders. Clinical data from 63 patients so affected revealed four broad etiologic categories: 1) pre-existing disorders that preceded the cataract surgery, but were rendered asymptomatic by the occluding cataract (e.g., thyroid eye disease, cranial nerve palsy, myasthenia); 2) disorders precipitated by prolonged occlusion by a cataract (e.g., sensory deviations, decompensation of heterophorias, and central disruption of binocular vision); 3) disorders resulting from surgical trauma to extraocular muscles and orbital soft tissues. Traumatic injury to the inferior rectus muscle secondary to retrobulbar anesthesia injection, a specific subset, is postulated to result from a Volkmann's type ischemic contracture, a well-known osseofascial compartment syndrome occurring in peripheral skeletal muscles. 4) Disorders related to resulting aphakia/pseudophakia and associated optical aberrations (e.g.; anisophoria, ocular dominance reversal, and color/brightness disparity). The diagnostic and therapeutic implications of these findings are discussed.
Anemia was independently associated with mortality in very old persons
Authors: David P. Steensma
Journal: Annals of Internal Medicine (2009)

Source Citation den Elzen WP, Willems JM, Westendorp RG, et al. Effect of anemia and comorbidity on functional status and mortality in old age: results from the Leiden 85-plus Study. CMAJ. 2009;181:151−7. 19635749
The Other Medical-Manpower Problem
Authors: Samuel O. Thier, Thomas E. Morgan
Journal: New England Journal of Medicine (1979)

During the past decade, while government and the private sector have emphasized the need for primary-care physicians, another manpower problem of great importance has developed, almost unnoticed. There has been a clear decline in the number of physicians participating in biomedical research. The evidence of this decline and a discussion of its implications appear in this issue of the Journal, in a Special Article by Wyngaarden, a Sounding Board by DeGroot and Siegler, and an Occasional Note by Levine. The reasons for the trend are complex, and its implications are debatable. For example, it could be argued that the . . .
Hemorrhagic Cellulitis after Consumption of Raw Oysters
Authors: Lara M Falcon, Lan Pham
Journal: New England Journal of Medicine (2005)

A 52-year-old man from southern Louisiana with a history of nonalcoholic steatohepatitis presented to the emergency room with a report of severe bilateral lower-leg pain and swelling. He had ingested raw oysters three days before presentation. The pain had increased over the day, and a faint bluish rash had begun to develop on his shins. During the next few hours, the rash became hemorrhagic (Figure), and hypotension developed, with a blood pressure of 60/30 mm Hg. He was treated initially with broad-spectrum antimicrobial therapy, multiple pressors, and mechanical ventilation. Gram-negative rods were seen on Gram's staining (inset), and Vibrio vulnificus . . .
The Biology of Vascular Endothelial Growth Factor
Authors: Napoleone Ferrara, Terri Davis-Smyth
Journal: Endocrine Reviews (1997)

The establishment of a vascular supply is required for organ development and differentiation as well as for tissue repair and reproductive functions in the adult1. Neovascularization (angiogenesis) is also implicated in the pathogenesis of a number of disorders. These include: proliferative retinopathies, age-related macular degeneration, tumors, rheumatoid arthritis, and psoriasis1,2. A strong correlation has been noted between density of microvessels in primary breast cancers and their nodal metastases and patient survival3. Similarly, a correlation has been reported between vascularity and invasive behavior in several other tumors4–6.
YELLOW FEVER AND ITS TRANSMISSION.
Authors: CHARLES FINLAY
Journal: JAMA (1901)

In an editorial inThe Journalof February 23, I notice an allusion to some variances between my own views and those of Drs. Reed, Carroll and Agramonte on the subject of the transmission of yellow fever through the agency of mosquitoes. Lest this difference of opinion should be misunderstood or its purport exaggerated, I beg to make the following statements: My readiness to accept the incontrovertible demonstration brought forward by those gentlemen as to the transmissibility of yellow fever through the agency of the Culex mosquito—wrongly assimilated, it appears, to the C. fasciatus—was a foregone conclusion, inasmuch as I had asserted and experimentally demonstrated to my own satisfaction the identical fact twenty years ago. This circumstance did not influence my judgment, however, in any degree, and only added to my admiration of the very perfect manner in which the recent investigation was carried out. I also have always supposed
The metastasis-associated 67-kDa laminin receptor is involved in G-CSF–induced hematopoietic stem cell mobilization
Authors: Carmine Selleri, Pia Ragno, Patrizia Ricci, Valeria Visconte, Nicola Scarpato, Maria Vincenza Carriero, Bruno Rotoli, Guido Rossi, Nunzia Montuori
Journal: Blood (2006)
Pyridostigmin (Mestinon) in the Treatment of Myasthenia Gravis
Authors: Robert S. Schwab, William H. Timberlake
Journal: New England Journal of Medicine (1954)

BEFORE 1935 myasthenia gravis was an unfamiliar neurologic oddity, unresponsive to therapy and carrying a high mortality. In that year the injection of neostigmine was shown by Viets and Schwab1 to provide a rapid and specific diagnostic test. As a result hundreds of new cases were identified. A year later Everts2 reported that patients could be maintained on tablets of neostigmine given by mouth, and from this point on the successful treatment of myasthenia gravis began.For nearly eighteen years neostigmine has been the mainstay of therapy in restoring hopeless invalids. unable to swallow food, to nearly normal activity. In . . .
Do general practitioners "miss" depression in elderly patients?
Authors: A J MacDonald
Journal: BMJ (1986)

In a study of the prevalence of depression in 235 elderly patients who attended general practice surgeries less than 12% of the disagreement between the research assessment of depression and the general practitioner9s assessment was due to "missed" depression. There were, however, low rates of referral and of treatment with antidepressant drugs. If these findings are confirmed the study of the management and outcome of depression in such patients may be more rewarding than attempts to improve the recognition of depression.
Reply to Neeraj Kumar Goyal, Manish Garg, and Apul Goel's Letter to the Editor re: Re: Jason A. Efstathiou, Daphna Y. Spiegel, William U. Shipley, et al. Long-Term Outcomes of Selective Bladder Preservation by Combined-Modality Therapy for Invasive Bladder Cancer: The MGH Experience. Eur Urol 2012;61:705–11
Authors: Jason A. Efstathiou, William U. Shipley, Anthony L. Zietman
Journal: European Urology (2012)
The contribution of tricuspid valve closure to the first heart sound. An intracardiac micromanometer study.
Authors: J D O'Toole, S P Reddy, E I Curtiss, F W Griff, J A Shaver
Journal: Circulation (1976)

The sound-pressure correlates of the second high frequency component of a split first heart sound (S1) were investigated in 27 patients. An external phonocardiogram was recorded with high fidelity sound and pressure from the left and right atria in 21 patients, from the pulmonary artery in 14 of these, and from the central aorta in 11. In the remaining six patients, high fidelity recordings from the central aorta and right-sided chambers were obtained with an external phonocardiogram. The external component of S1 that coincided with a left atrial C wave and "internal sound" was defined as M1. In those cases where the left atrial pressure was not recorded, this component could be identified by a low frequency transient in the central aortic pressure trace. The other external high frequency component of S1 that was synchronous with a separate right atrial C wave and "internal sound" was defined as T1; with two exceptions, M1 preceded T1. The two exceptions which caused reversal of this order, so that T1 preceded M1, were due to chronic left bundle branch block and mitral stenosis. In both cases, T1 was shown to be distinctly separated from the upstroke of pressure rise in the central aorta. This finding was also demonstrated in three cases of right bundle branch block and one case with aortic valvular disease. The usual asynchrony of ventricular contraction was altered by induction of ventricular premature systoles; the separation of externally identifiable M1 and T1 components and their internal markers was predictably altered by this maneuver. The occurrence of T1 was variable in relation to the upstroke of the pulmonary artery pressure, which suggests that it is not related to pulmonic ejection. It is concluded that micromanometrically recorded right and left atrial C waves can serve as markers for externally recordable M1 and T1 components of the first heart sound. In addition, T1 is frequently an externally recordable and audible event.
D7-02: Activity of BIBW2992, an oral irreversible dual EGFR/HER2 inhibitor, in non-small cell lung cancer (NSCLC) with mutated EGFR
Authors: James Spicer, Hilary Calvert, Laura Vidal, Fathi Azribi, Rebecca Perrett, Mehdi Shahidi, Graham Temple, Andrew Futreal, Johann De Bono, Ruth Plummer
Journal: Journal of Thoracic Oncology (2007)
Osteogenesis imperfecta: fractures of the femur when testing for congenital dislocation of the hip.
Authors: C. R. Paterson, R. J. Beal, J. A. Dent
Journal: BMJ (1992)

t.4 (a) Swenson operation-end to end anastomosis intussuscepting aganglionic and ganglionic bowel through anus and resection and anastomosis along dotted line.(b) Duhamel operation -anterior aganglionic and posterior ganglionic bowel.The dotted line indicates the staple closure and knife division between the two portions of bowel.(c) Soave operation-mucosa is removed, a muscular cuff of the aganglionic bowel is left and ganglionic bowel is pulled through to hang from the anus.The photographs were prepared by the medical illustration department, North Manchester General Hospital. ComplicationsThe major complication and commonest cause of death in children with Hirschsprung's disease is enterocolitis which, although commoner in infancy, may occur in older children with untreated Hirschsprung's disease.It presents as a fulminating infection (often clostridial in origin) with toxaemia, abdominal distension, and diarrhoea.Despite treatment with antibiotics, intravenous fluids, or even steroidsand emergency colostomy a third ofthese children die.Those who survive a stormy illness will have permanent mucosal damage of both ganglionic and aganglionic bowel and an increased risk of complications such as stricture and leakage after surgery.After treatment of Hirschsprung's disease many children continue to have the problem of soiling or constipation, but this eventually clears up and over 90% of these children have normal bowel habits.
Long term clinical comparison of single versus twice daily administration of inhaled budesonide in moderate asthma.
Authors: P Weiner, M Weiner, Y Azgad
Journal: Thorax (1995)

Inhaled steroids are widely used in the treatment of mild to moderate asthma. However, long term compliance with inhaled steroids is poor and administration of a single daily dose may improve compliance.A double blind, randomised study was performed to determine whether inhaled steroids given once daily at bedtime are as efficacious as a twice daily regimen in the long term maintenance of moderate asthmatic patients. Forty adults of mean age 37 years with moderate asthma (mean (SE) forced expiratory volume in one second (FEV1) 73.6 (1.4)% predicted, mean morning peak expiratory flow (PEF) 328 l/min) were randomised to receive either a twice daily dose (400 micrograms morning and bedtime) of inhaled budesonide (group A) or a once daily dose of 800 micrograms (group B) and were followed for a period of 12 months. Asthma symptom scores (assessed according to a modified Borg scale), inhaled beta 2 agonist consumption, and peak expiratory flow rates were recorded daily. Spirometry and airways responsiveness to methacholine (PC20) were measured at the end of each period of three months of treatment.There was no difference between the two groups at baseline and during the follow up period in the PC20 for methacholine. However, a difference was seen between the two groups in the mean daily number of beta 2 agonist inhalations (1.4 (0.1) puffs/patient/day in group A v 2.3 (0.1) in group B), the PEF variability (episodes of decrease in PEF of > 20%) (0.22 (0.01) episodes/patient/day in group A v 0.40 (0.02) in group B), and for asthma symptom scores (0.30 (0.04) in group A v 0.42 (0.06) in group B) for the 12 month period of the study.Although both regimens provide good clinical control, twice daily doses of 400 micrograms inhaled budesonide are more effective than a single dose of 800 micrograms at bedtime in the long term control of stable moderate asthma.