tbuckley/cabot-search huggingface dataset:
Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis
Authors: Paul Angulo, Kenneth P. Batts, Terry M. Therneau, Roberta A. Jorgensen, Rolland E. Dickson, Keith D. Lindor
Journal: Hepatology (1999)

Primary biliary cirrhosis (PBC) is a progressive cholestatic liver disease frequently leading to development of cirrhosis and its complications. Ursodeoxycholic acid (UDCA) is a beneficial medical therapy for patients with PBC. Improvement in some histological features, but not in histological stage, has been reported after 2 years of UDCA therapy. Thus, longer follow–up may be necessary to determine whether UDCA has a favorable effect on histological stage of disease and progression to cirrhosis. Our aim was to determine the long–term effects of UDCA therapy on histological stage and progression to cirrhosis in patients with PBC. Sixteen unselected patients with noncirrhotic PBC who had been on long–term UDCA therapy (13–15 mg/kg/d) for 6.6 ± 0.4 years (range, 5–9 years) were identified and their histological finding during treatment compared with that of 51 noncirrhotic patients with PBC who had received ineffective therapy ( d –penicillamine [DPCA] or placebo) for 5.6 ± 0.07 years (range, 5–8 years). Histological stage was determined using the Ludwig classification. The rate of progression to cirrhosis (stage 4) was significantly less in the UDCA group than in the control group (13% vs. 49% P = .009). Although the overall rate of progression of histological stage was less in the UDCA group than in the control group (50% vs. 71%), this difference was not significant ( P = .1). A marked improvement in liver biochemistries and Mayo risk score was noted in all patients during UDCA therapy; however, this improvement was not significantly different between patients who progressed and those who did not. In conclusion, long–term UDCA therapy appeared to delay the development of cirrhosis in PBC.
Abortion Act in Somerset
Authors: A. P. Jones, M. R. Grimoldby
Journal: BMJ (1973)

A survey conducted with a sample of 20% of general practitioners over six months in 1972 disclosed a request rate for termination approaching 10% of all pregnancies. The attitude and performance of the practitioner were considered to be important in the patient9s requests for this, and patients were thought to know about these. This implies that in three-quarters of the practices there was a sizeable demand for abortion which remained latent. Altogether, 20% of specialist consultations were made privately and in none of these cases was abortion refused. Under the Health Service the refusal rate was 19%, but 7 of the 12 women refused N.H.S. abortions subsequently obtained it privately.
Translational Research Working Group Developmental Pathway for Biospecimen-Based Assessment Modalities
Authors: Sudhir Srivastava, Joe W. Gray, Brian J. Reid, Oren Grad, Addison Greenwood, Ernest T. Hawk
Journal: Clinical Cancer Research (2008)

Abstract The Translational Research Working Group (TRWG) was created as a national initiative to evaluate the current status of National Cancer Institute's investment in translational research and envision its future. The TRWG conceptualized translational research as a set of six developmental processes or pathways focused on various clinical goals. One of those pathways describes the development of biospecimen-based assays that use biomarkers for the detection, diagnosis, and prognosis of cancer and the assessment of response to cancer treatment. The biospecimen-based assessment modality pathway was conceived not as comprehensive description of the corresponding real-world processes but rather as a tool designed to facilitate movement of a candidate assay through the translational process to the point where it can be handed off for definitive clinical testing. This paper introduces the pathway in the context of prior work and discusses key challenges associated with the biomarker development process in light of the pathway.
Post-Graduate Extension Lectures.
Authors: J. Sutcliffe Hill
Journal: JAMA (1898)

Bellows Falls, Vt., April 9, 1898. <h3>To the Editor:</h3> —In reading your editorial of March 26 (page 739), on "Post-Graduate Lectures at Home," I was much pleased with the suggestions you offered. It is a plan that has been carried out, in part, by our Society for a good many years. We have had such men as Prof. Conner of Cincinnati, Prof. Hanks of New York, and others. Of late years we have had in operation a plan that has been more fruitful of results in every particular. The Society of which I am Secretary, viz., the Connecticut River Valley Medical Association, with White River Medical Association and the White Mountains Medical Association, have, through the kindness and generosity of Dartmouth Medical College, held a joint meeting at Hanover, and the Professors have given us lectures on their special branches. We have also had some specialists from outside. The expense
A U-SHAPED RELATIONSHIP BETWEEN TOTAL CHOLESTEROL AND 90-DAY MORTALITY AFTER ACUTE MYOCARDIAL INFARCTION IN PATIENTS NOT ON STATINS: RESULTS FROM THE OPTIMAAL RANDOMIZED TRIAL
Authors: Bhrigu R. Parmar, Kenneth Dickstein, John Kjekshus, Wayne C. Levy
Journal: Journal of the American College of Cardiology (2011)
Myxoma of the Right Atrium, with Variable Right-to-Left Shunt
Authors: E. Osborne Coates, Ellet H. Drake
Journal: New England Journal of Medicine (1958)

ABOUT 150 cases of myxoma of the heart have been described in the world literature, but until recently most of these cases have been of academic interest, demonstrable mainly at post-mortem examination. Cardiac surgery has now made it possible to remove these tumors from the open heart, and 3 successful excisions have already been reported.1 2 3 Preoperative diagnosis thus becomes a matter of major concern. The case reported below illustrates well some of the problems of differential diagnosis, and the help, as well as the occasional confusion, to be obtained from a co-ordinated interdepartmental approach, employing pulmonary-function studies, cardiac catheterization and . . .
Effects of Intermittent Exercise and Use of Home Exercise Equipment on Adherence, Weight Loss, and Fitness in Overweight Women
Authors: John M. Jakicic, Carena Winters, Wei Lang, Rena R. Wing
Journal: JAMA (1999)

ContextEnhancing participation in long-term exercise may translate into improved long-term weight loss in overweight adults.ObjectivesTo compare the effects of intermittent with traditional continuous exercise on weight loss, adherence, and fitness, and to examine the effect of combining intermittent exercise with that using home exercise equipment.DesignRandomized trial from September 1996 through September 1998.Setting and ParticipantsA total of 148 sedentary, overweight (mean [SD] body mass index, 32.8 [4.0] kg/m2) women (mean [SD] age, 36.7 [5.6] years) in a university-based weight control program.InterventionsEighteen-month behavioral weight control program with 3 groups: long-bout exercise (LB), multiple short-bout exercise (SB), or multiple short-bout exercise with home exercise equipment (SBEQ) using a treadmill.Main Outcome MeasuresBody weight, body composition, cardiorespiratory fitness, and exercise adherence.ResultsOf 148 subjects, 115 (78%) completed the 18-month program. At 18 months, mean (SD) weight loss was significantly greater in subjects in the SBEQ group compared with subjects in the SB group (−7.4 [7.8] kg vs −3.7 [6.6] kg; P&lt;.05). Mean (SD) weight loss for subjects in the LB group (−5.8 [7.1] kg) was not significantly different than for subjects in the SB or SBEQ groups. Subjects in the SBEQ group maintained a higher level of exercise than subjects in both the SB and LB groups (P&lt;.05) at 13 to 18 months of treatment. All groups showed an increase in cardiorespiratory fitness from baseline to 18 months, with no difference between groups. Mean (SD) weight loss at 18 months was significantly greater in individuals exercising more than 200 min/wk throughout the intervention (−13.1 [8.0] kg) compared with individuals exercising 150 to 200 min/wk (−8.5 [5.8] kg) or less than 150 min/wk (−3.5 [6.5] kg) (P&lt;.05).ConclusionsCompared with the LB group, subjects in the SB group did not experience improved long-term weight loss, exercise participation, or cardiorespiratory fitness. Access to home exercise equipment facilitated the maintenance of SB, which may improve long-term weight loss. A dose-response relationship exists between amount of exercise and long-term weight loss in overweight adult women.
Bortezomib consolidation after autologous stem cell transplantation in multiple myeloma: a Nordic Myeloma Study Group randomized phase 3 trial
Authors: Ulf-Henrik Mellqvist, Peter Gimsing, Oyvind Hjertner, Stig Lenhoff, Edward Laane, Kari Remes, Hlif Steingrimsdottir, Niels Abildgaard, Lucia Ahlberg, Cecilie Blimark, Inger Marie Dahl, Karin Forsberg, Tobias Gedde-Dahl, Henrik Gregersen, Astrid Gruber, Nina Guldbrandsen, Einar Haukås, Kristina Carlson, Ann Kristin Kvam, Hareth Nahi, Roald Lindås, Niels Frost Andersen, Ingemar Turesson, Anders Waage, Jan Westin
Journal: Blood (2013)
Pericardial Fat, Intrathoracic Fat, and Measures of Left Ventricular Structure and Function
Authors: Caroline S. Fox, Philimon Gona, Udo Hoffmann, Stacy A. Porter, Carol J. Salton, Joseph M. Massaro, Daniel Levy, Martin G. Larson, Ralph B. D'Agostino, Christopher J. O'Donnell, Warren J. Manning
Journal: Circulation (2009)

Background— Pericardial fat has been implicated in the pathogenesis of obesity-related cardiovascular disease. Whether the associations of pericardial fat and measures of cardiac structure and function are independent of the systemic effects of obesity and visceral adiposity has not been fully explored. Methods and Results— Participants from the Framingham Heart Study (n=997; 54.4% women) underwent chest and abdominal computed tomography and cardiovascular magnetic resonance imaging between 2002 and 2005. Pericardial fat, intrathoracic fat, and visceral adipose tissue quantified from multidetector computed tomography, along with body mass index and waist circumference, were examined in relation to cardiovascular magnetic resonance measures of left ventricular (LV) mass, LV end-diastolic volume, and left atrial dimension. In women, pericardial fat ( r =0.20 to 0.35, P &lt;0.001), intrathoracic fat ( r =0.25 to 0.37, P &lt;0.001), visceral adipose tissue ( r =0.24 to 0.45, P &lt;0.001), body mass index ( r =0.36 to 0.53, P &lt;0.001), and waist circumference ( r =0.30 to 0.48, P &lt;0.001) were directly correlated with LV mass, LV end-diastolic volume, and left atrial dimension. In men, pericardial fat ( r =0.19 to 0.37, P &lt;0.001), intrathoracic fat ( r =0.17 to 0.31, P &lt;0.001), visceral adipose tissue ( r =0.19 to 0.36, P &lt;0.001), body mass index ( r =0.32 to 0.44, P &lt;0.001), and waist circumference ( r =0.34 to 0.44, P &lt;0.001) were directly correlated with LV mass and left atrial dimension, but LV end-diastolic volume was not consistently associated with adiposity measures. Associations persisted after multivariable adjustment but not after additional adjustment for body weight and visceral adipose tissue, except for pericardial fat and left atrial dimension in men. Conclusions— Pericardial fat is correlated with cardiovascular magnetic resonance measures, but the association is not independent of or stronger than other ectopic fat stores or proxy measures of visceral adiposity. An important exception is left atrial dimension in men. These results suggest that the systemic effects of obesity on cardiac structure and function may outweigh the local pathogenic effects of pericardial fat.
Influenza in 2009
Authors: Julie Louise Gerberding
Journal: JAMA (2009)

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
Cardiovascular Risk with Non-Steroidal Anti-Inflammatory Drugs: Systematic Review of Population-Based Controlled Observational Studies
Authors: Patricia McGettigan, David Henry
Journal: PLoS Medicine (2011)

Background Randomised trials have highlighted the cardiovascular risks of non-steroidal anti-inflammatory drugs (NSAIDs) in high doses and sometimes atypical settings. Here, we provide estimates of the comparative risks with individual NSAIDs at typical doses in community settings. Methods and Findings We performed a systematic review of community-based controlled observational studies. We conducted comprehensive literature searches, extracted adjusted relative risk (RR) estimates, and pooled the estimates for major cardiovascular events associated with use of individual NSAIDs, in different doses, and in populations with low and high background risks of cardiovascular events. We also compared individual drugs in pair-wise (within study) analyses, generating ratios of RRs (RRRs). Thirty case-control studies included 184,946 cardiovascular events, and 21 cohort studies described outcomes in >2.7 million exposed individuals. Of the extensively studied drugs (ten or more studies), the highest overall risks were seen with rofecoxib, 1.45 (95% CI 1.33, 1.59), and diclofenac, 1.40 (1.27, 1.55), and the lowest with ibuprofen, 1.18 (1.11, 1.25), and naproxen, 1.09 (1.02, 1.16). In a sub-set of studies, risk was elevated with low doses of rofecoxib, 1.37 (1.20, 1.57), celecoxib, 1.26 (1.09, 1.47), and diclofenac, 1.22 (1.12, 1.33), and rose in each case with higher doses. Ibuprofen risk was seen only with higher doses. Naproxen was risk-neutral at all doses. Of the less studied drugs etoricoxib, 2.05 (1.45, 2.88), etodolac, 1.55 (1.28, 1.87), and indomethacin, 1.30 (1.19, 1.41), had the highest risks. In pair-wise comparisons, etoricoxib had a higher RR than ibuprofen, RRR = 1.68 (99% CI 1.14, 2.49), and naproxen, RRR = 1.75 (1.16, 2.64); etodolac was not significantly different from naproxen and ibuprofen. Naproxen had a significantly lower risk than ibuprofen, RRR = 0.92 (0.87, 0.99). RR estimates were constant with different background risks for cardiovascular disease and rose early in the course of treatment. Conclusions This review suggests that among widely used NSAIDs, naproxen and low-dose ibuprofen are least likely to increase cardiovascular risk. Diclofenac in doses available without prescription elevates risk. The data for etoricoxib were sparse, but in pair-wise comparisons this drug had a significantly higher RR than naproxen or ibuprofen. Indomethacin is an older, rather toxic drug, and the evidence on cardiovascular risk casts doubt on its continued clinical use. Please see later in the article for the Editors' Summary
Miffed by Medical Musings
Authors: Jaan Pesti
Journal: JAMA (1990)

To the Editor.—  I am surprised thatJAMAwould print the antiscience diatribe found at the end of the January 5 At Large column.1As a scientist, I have grown accustomed to vitriolic attacks from the misinformed and uninformed. But from an educated man such as Dr King, I find phrases such as society will curse scientists and  will self-destruct and ideas such as that science has caused overpopulation and pollution shortsighted at best.  Dr King is certainly entitled to his own opinions and may muse on the future at his leisure, but a line is crossed when antiscience preaching is printed and is thus granted legitimacy in the eyes of your readers.
Intragastric acidity and serum gastrin after sufotidine.
Authors: G S Mela, E Caputo, G Villa, V Savarino, P Zentilin
Journal: Gut (1990)

Patients with carotid occlusive disease may develop a variety of symptoms and signs secondary to chronic ocular ischaemia. We report six cases affecting nine eyes and review the findings of teichopsia, anterior segment ischaemia, venous stasis retinopathy, and ocular neovascularisation. The assessment and surgical management of carotid obstruction are discussed. Some comments on the relevance of coexisting diabetes are made.
Doctors and managers must improve relations
Authors: L. Beecham
Journal: BMJ (1995)

More effort must be made over the next few years to improve relationships between doctors and managers. This is one aspect of the present NHS that is not healthy, the retiring chairman of the Audit Commission says in the commission's annual report for 1994-5. Sir David Cooksey calls for the role of management to be developed in conjunction with the clinical role. In some cases, he says, doctors need to come to terms with economic and organisational reality. The two groups should come together “to agree protocols, …
Was the International Randomized Trial of Extracranial-Intracranial Arterial Bypass Representative of the Population at Risk?
Authors: Thoralf M. Sundt
Journal: New England Journal of Medicine (1987)

The international, multicenter, randomized trial of extracranial–intracranial arterial anastomoses (EC–IC bypass)1 , 2 has been applauded and cited as a standard for future studies of this type.3 The eminence of the primary investigators, the multiple statistical analyses to which the data were submitted, and the eloquence of the presentation have virtually muted responsible criticism. During preparation for a formal critique of this work at a meeting of the American Association of Neurological Surgeons held in Denver in April 1986, some information was disclosed that should be shared with the readers of the Journal.I am neither an epidemiologist nor a biostatistician . . .
Innovation and Access to Medicines for Neglected Populations: Could a Treaty Address a Broken Pharmaceutical R&amp;D System?
Authors: Suerie Moon, Jorge Bermudez, Ellen 't Hoen
Journal: PLoS Medicine (2012)

Over the last two decades, recognition has grown that the current system for the research and development (R&D) of new medicines does not adequately meet the needs of the majority of the world's population [1]–[4], over 80% of which lives in low- and middle-income countries (LMICs) [5]. (We use the general term “medicines” to refer broadly to drugs, vaccines, diagnostics, and other medical products.)

The clearest illustration of these shortcomings is the lack of new medicines for the “neglected diseases”—those that primarily affect populations with little purchasing power, and therefore offer an insufficient incentive for industry to invest in R&D. However, the problems with the existing system extend far beyond the narrow notion of neglected diseases. The challenge is better understood as one of “neglected populations”—that is, of ensuring that the global R&D system meets the needs of all, especially of the poorest and most vulnerable populations. Such needs include not only new treatments for neglected diseases, but also access to antimicrobials, affordable medicines for diseases with global incidence such as diabetes and cancer, and products well-adapted for use in resource-limited settings. Thus far, the existing system has largely failed to deliver on these objectives.

These problems have prompted extensive international debate and proposals for reform. After a 2-year intergovernmental negotiation, in 2008 governments agreed upon the World Health Organization (WHO) Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, which recognized that the current system fell short in meeting the needs of developing countries with respect to both communicable and non-communicable diseases [4]. In April 2012, the WHO Consultative Expert Working Group on R&D: Financing and Coordination (CEWG) recommended that governments begin negotiations over a global medical R&D convention to address some of these problems in a systematic way [6] (see Box 1). Why might a binding international convention be needed?


Box 1. A Binding WHO Convention on R&D
The idea of a binding international convention on RD carry stronger normative force, even in the absence of enforcement mechanisms; and can be more enforceable at national level [65]. An important precedent was set with the 2005 Framework Convention on Tobacco Control, the first public health treaty negotiated within WHO, which has contributed significantly to global tobacco control efforts [63],[66].
We need access to data on all clinical trials, not just some
Authors: B. Wieseler, N. McGauran, T. Kaiser
Journal: BMJ (2012)

Although the BMJ and GlaxoSmithKline’s initiatives are highly commendable,1 these initiatives would not completely solve the problem of reporting bias. Comprehensive access to clinical trial data can be ensured only by the routine release of all clinical study reports (CSRs) after drug approval. In 2010, the European Medicines Agency (EMA) introduced a new policy on the release of clinical trial data submitted to the agency.2 However, the data format is …
Points: Skin necrosis after heparin injection
Authors: J Villalta, M Alsina, M Ingelmo, A Balcells
Journal: BMJ (1982)

p 4), I discussed this with the authors.In view of the fact that neither microscopic nor the earliest lymph node invasion is demonstrated by computed tomography, it appeared essential to define the track or volume within which malignant disease spread up the lym- phatics.This has been demonstrated in a series of 35-mm slides covering the lymphatic volume from the pelvis up through the abdomen and thorax to the root of the neck.This surprisingly small volume was agreed for surgical and radiotherapy planning for "cur- able" cancer with around 100 experienced consultants in surgery, radiology, and radio- therapy, on an extensive tour of Europe, Canada, and the United States.
THE PHYSIOLOGIC ACTION OF THE MYDRIATIC ALKALOIDS.
Authors: HORATIO C. WOOD
Journal: JAMA (1903)

The number of drugs which dilate the pupil is so very large, and the physiologic relations of many of them so distant, that a consideration of all those substances which might be called mydriatics would not only consume much more time than is at our disposal, but would necessitate classing together of drugs not naturally so related. I shall, therefore, confine my remarks to those alkaloids which belong to the series of tropins; and for similar reasons of brevity omit the consideration of the synthetic alkaloids of this series, such as homatropin. Before, however, taking up the consideration of the physiologic action of these substances, I wish to call attention to the very unfortunate confusion in the nomenclature of the active principles of the solanaceous plants. As various investigators have from time to time discovered in different members of this family alkaloidal principles, they have given new names to their