tbuckley/cabot-search huggingface dataset:
Outcomes After Carotid Artery Stenting in Medicare Beneficiaries, 2005 to 2009
Authors: Jessica J. Jalbert, Louis L. Nguyen, Marie D. Gerhard-Herman, Michael R. Jaff, Christopher J. White, Andrew T. Rothman, John D. Seeger, Hiraku Kumamaru, Lauren A. Williams, Chih-Ying Chen, Jun Liu, Thomas T. Tsai, Herbert D. Aronow, Joseph A. Johnston, Thomas G. Brott, Soko Setoguchi
Journal: JAMA Neurology (2015)

Despite increased carotid artery stenting (CAS) dissemination following the 2005 National Coverage Determination, to our knowledge, periprocedural and long-term outcomes have not been described among Medicare beneficiaries.To describe the incidence of outcomes during and after the periprocedural period among Medicare beneficiaries undergoing CAS.Observational study with a mean follow-up time of approximately 2 years among 22,516 fee-for-service Medicare beneficiaries at least 66 years old undergoing CAS (2005-2009) who were linked to the Centers for Medicare & Medicaid Services' CAS database. Database procedure dates were required to fall during a Medicare hospitalization for CAS.Periprocedural (30-day) and long-term risks of mortality and stroke or transient ischemic attack, as well as periprocedural myocardial infarction. Subgroups were based on sociodemographic, clinical, and center-level factors, as well as the Stenting and Angioplasty With Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) trial or Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) enrollment criteria.The mean patient age was 76.3 years, 60.5% were male, 93.8% were of white race, 91.2% were at high surgical risk, 47.4% were symptomatic, and 97.4% had carotid stenosis of at least 70%. Crude 30-day mortality, stroke or transient ischemic attack, and myocardial infarction risks were 1.7% (95% CI, 1.5%-1.8%), 3.3% (95% CI, 3.0%-3.5%), and 2.5% (95% CI, 2.3%-2.7%), respectively. Mortality during a mean follow-up time of 2 years was 32.0% (95% CI, 31.0%-33.0%), with rates of 37.3% (95% CI, 35.8%-38.7%) among symptomatic patients and 27.7% (95% CI, 26.4%-28.9%) among asymptomatic patients. Older age, symptomatic carotid stenosis, and nonelective hospital admission were associated with increased adjusted hazards of mortality and stroke or transient ischemic attack during and after the periprocedural period. The presence of a stroke center, government ownership, and a hospital bed capacity of 500 or more were associated with increased adjusted hazards of periprocedural mortality and stroke or transient ischemic attack. Few patients met the SAPPHIRE trial or CREST enrollment criteria primarily because physicians did not meet proficiency requirements either due to exceeding periprocedural complication trial thresholds or not meeting minimum CAS volume requirements.Competing risks may limit the benefits of CAS in certain Medicare beneficiaries, particularly among older and symptomatic patients who have higher periprocedural and long-term mortality risks. The generalizability of trials like the SAPPHIRE or CREST to the Medicare population may be limited, underscoring the need to evaluate real-world effectiveness of carotid stenosis treatments.
Intussusception
Authors: Herbert J. Kaufmann
Journal: JAMA (1967)

For two years a young man had intermittent, severe abdominal pain. Three years ago, a small-bowel bypass was made for obesity elsewhere. Results of examination showed an abdominal mass and occult blood in the stool. Operation revealed that the free end of the jejunum had chronically intussuscepted itself and was the source of his problems. Resection of the intussuscepted gut and fixation of the remaining defunctionalized small bowel was performed. To our knowledge, no similar case has been reported previously.
National Patterns in the Treatment of Smokers by Physicians
Authors: Anne N. Thorndike
Journal: JAMA (1998)

Routine treatment of smokers by physicians is a national health objective for the year 2000, a quality measure for health care plans, and the subject of evidence-based clinical guidelines. There are few national data on how physicians' practices compare with these standards.To assess recent trends in the treatment of smokers by US physicians in ambulatory care and to determine whether physicians' practices meet current standards.Analysis of 1991-1995 data from the National Ambulatory Medical Care Survey, an annual survey of a random sample of US office-based physicians.Physicians' offices.A total of 3254 physicians recorded data on 145716 adult patient visits.The proportion of visits at which physicians (1) identified a patient's smoking status, (2) counseled a smoker to quit, and (3) used nicotine replacement therapy.Smoking counseling by physicians increased from 16% of smokers' visits in 1991 to 29% in 1993 (P<.001) and then decreased to 21% of smokers' visits in 1995 (P<.001). Nicotine replacement therapy use followed a similar pattern, increasing from 0.4% of smokers' visits in 1991 to 2.2% in 1993 (P<.001) and decreasing to 1.3% of smokers' visits in 1995 (P=.007). Physicians identified patients' smoking status at 67% of all visits in 1991; this proportion did not increase over time. Primary care physicians were more likely to provide treatment to smokers than were specialists. All physicians were more likely to treat patients with smoking-related diagnoses.US physicians' treatment of smokers improved little in the first half of the 1990s, although a transient peak in counseling and nicotine replacement use occurred in 1993 after the introduction of the nicotine patch. Physicians' practices fell far short of national health objectives and practice guidelines. In particular, patient visits for diagnoses not related to smoking represent important missed opportunities for intervention.
Very Late Clinical Cardiac Event After BMS Implantation: In Vivo Optical Coherence Tomography Examination
Authors: Manabu Kashiwagi, Hironori Kitabata, Atsushi Tanaka, Keishi Okochi, Kohei Ishibashi, Kenichi Komukai, Takashi Tanimoto, Yasushi Ino, Shigeho Takarada, Takashi Kubo, Kumiko Hirata, Masato Mizukoshi, Toshio Imanishi, Takashi Akasaka
Journal: JACC. Cardiovascular imaging (2010)
The Anatomy of Our Melancholy
Authors: George Himler
Journal: New England Journal of Medicine (1971)

Abstract Events in health care since Medicare and Medicaid, and a public determination to control quality, cost and distribution of medical services, are moving the medical profession from a loose, implicit contract with the public to a structured, formal one. The responses of organized medicine to this trend are deficient in certain respects, particularly in the lack of systematic and positive planning. Medical societies have neither recognized the need nor prepared for negotiation with government. Because of the structure of medical societies, and because of medicine's socioeconomic objectives, medical societies do not appear to be appropriate bodies for health-care planning or negotiation. More effective would be statewide institutes that would complement local health-care delivery organizations, would develop uniform data-collecting systems, would analyze and interpret such data and would act as intermediaries between physicians and third parties in negotiations at super-regional levels.
Atrial Fibrillation and Risk of ST-Segment–Elevation Versus Non–ST-Segment–Elevation Myocardial Infarction
Authors: Elsayed Z. Soliman, Faye Lopez, Wesley T. O’Neal, Lin Y. Chen, Lindsay Bengtson, Zhu-Ming Zhang, Laura Loehr, Mary Cushman, Alvaro Alonso
Journal: Circulation (2015)

Background— It has recently been reported that atrial fibrillation (AF) is associated with an increased risk of myocardial infarction (MI). However, the mechanism underlying this association is currently unknown. Further study of the relationship of AF with the type of MI (ST-segment–elevation MI [STEMI] versus non–ST-segment–elevation MI [NSTEMI]) might shed light on the potential mechanisms. Methods and Results— We examined the association between AF and incident MI in 14 462 participants (mean age, 54 years; 56% women; 26% blacks) from the Atherosclerosis Risk in Communities (ARIC) study who were free of coronary heart disease at baseline (1987–1989) with follow-up through December 31, 2010. AF cases were identified from study visit ECGs and by review of hospital discharge records. Incident MI and its types were ascertained by an independent adjudication committee. Over a median follow-up of 21.6 years, 1374 MI events occurred (829 NSTEMIs, 249 STEMIs, 296 unclassifiable MIs). In a multivariable-adjusted model, AF (n=1545) as a time-varying variable was associated with a 63% increased risk of MI (hazard ratio,1.63; 95% confidence interval, 1.32–2.02). However, AF was associated with NSTEMI (hazard ratio, 1.80; 95% confidence interval, 1.39–2.31) but not STEMI (hazard ratio, 0.49; 95% confidence interval, 0.18–1.34; P for hazard ratio comparison=0.004). Combining the unclassifiable MI group with either STEMI or NSTEMI did not change this conclusion. The association between AF and MI, total and NSTEMI, was stronger in women than in men ( P for interaction &lt;0.01 for both). Conclusions— AF is associated with an increased risk of incident MI, especially in women. However, this association is limited to NSTEMI.
Better mental health services
Authors: A C P Sims
Journal: BMJ (1991)

gonorrhoea during the first quarter of this year.As well as indicating unsafe sexual practice, gonorrhoea in women may also be a risk factor for the acquisition of HIV-I (M Laga et al, sixth international conference on AIDS, San Francisco, 1990).Surveillance of gonorrhoea in women may provide both an indication for assessing the potential for spread of HIV-I in the heterosexual community and a measure of safe sexual practice.
He's a pain in the attribute
Authors: I Robertson
Journal: BMJ (1994)

You all know someone like this. When something good happens he takes the credit, but anything bad is someone else's fault; like Bertie Wooster, for instance, who blamed his golf miss-hit on “the uproar of the butterflies in a neighbouring meadow.” And whatever it is he's taking the credit for, it's because of some permanent quality with which he has been gifted: superior intelligence, leonine good looks, ineffable charisma. …You'll never hear “I just had a good day” from this guy. And he's not circumspect: I mean, that squash victory is further evidence of a general supermensch biological makeup, and is not just due to fast reaction times and a low talent for hitting balls - in his …
Open access colonoscopy for suspected colonic neoplasia.
Authors: J J Tate, G T Royle
Journal: Gut (1988)

An open access endoscopy service for direct referral of patients suspected to have colonic neoplasia has been analysed. In the first year of the service 137 patients were referred by 52 general practitioners. The most common reason for referral was rectal bleeding (58%). Colonoscopy was done without outpatient consultation or barium enema examination in 130 patients: there were no complications. The diagnostic yield was 57%: 34 patients (25%) had neoplasia (cancer 14, adenoma 20), which was higher than the yield of neoplasia in patients referred for open access double contrast barium enema during the same period. Only nine patients (7%) needed further investigation because colonoscopy was incomplete and 21 (16%) were treated by polypectomy at the diagnostic colonoscopy.
Circulating endothelial cells and endothelial activation in essential thrombocythemia: Results from CD146<sup>+</sup> immunomagnetic enrichment—flow cytometry and soluble E‐selectin detection
Authors: Angelo Belotti, Elena Elli, Tiziana Speranza, Eraldo Lanzi, Pietro Pioltelli, Enrico Pogliani
Journal: American Journal of Hematology (2011)

Circulating endothelial cells (CECs) have been studied in cardiovascular disorders and as a marker of angiogenetic activity; clinical applications are limited by a lack of consensus on their phenotypic identification and quantification. We determined CECs in essential thrombocythemia (ET) patients, to investigate their possible pathogenetic role. We considered CECs as CD146⁺/CD45⁻ nucleated cells, detected in peripheral blood from 21 healthy controls and 39 ET patients, performing a combination of pre-enrichment of CD146⁺ circulating cells and multiparametric flow cytometry measurement (FCM). Levels of CECs in ET patients were higher with respect to controls (median 2844 CECs/mL vs. 121.3 CECs/mL, P < 0.0001). Apparently hydroxyurea treatment did not influence the levels of CECs. As another established marker of endothelial activation, we also assessed soluble E-selectin (sE-selectin) levels in 31 of the ET patients and compared with 39 healthy volunteers: median sE-selectin level in ET patients was 35.3 ng/mL, higher with respect to controls (24.48 ng/mL), P = 0.0369. Our data suggest that endothelium in ET is activated, reflecting a significant role of angiogenesis in this disorder and suggesting an important endothelial contribution in the hypercoagulable state of ET patients.
Abstract 2633: Histone deacetylase inhibitors induce CXCR4 mRNA but antagonize CXCR4 migration
Authors: Caterina Ierano, Kin Wah To, Robert W. Robey, Susan E. Bates, Stefania Scala
Journal: Cancer Research (2011)

Abstract The stromal cell-derived factor-1α SDF-1α (CXCL12)/CXCR4 axis has a critical role, particularly in renal cancer where CXCR4 expression has been linked to poor prognosis. Histone deacetylase inhibitors (HDIs) exert antitumor effects by targeting both histone and nonhistone proteins affecting cell migration, apoptosis, cell proliferation and angiogenesis. Thus, the aim of the present work was to evaluate the effects of the HDIs apicidin, vorinostat, MS-275 and romidepsin on the expression and function of CXCR4 in human cancer cell lines including renal, non-small cell lung, breast, colon and glioma cell lines. After treatment with romidepsin or apicidin, CXCR4 mRNA expression increased 12-fold in UOK121 and 2.5-fold in UOK143 renal cancer cell lines; treatment with vorinostat or MS-275 yielded similar effects. CXCR4 induction was also observed in H460 non-small cell lung cancer cells, and SF-295 glioblastoma cells, but not in MCF-7 breast cancer cells or SW620 colon cancer cells. To evaluate the corresponding CXCR4 functional increase, CXCL12-induced ERK1/2, STAT-3, and c-SRC activation and cell migration were examined in UOK121, SF295 and H460 cells. In general, the HDIs increased pERK1/2, while reducing pSTAT-3 and pSRC. Following CXCL12 pERK1/2 induction was maintained but STAT3 and SRC phosphorylation was impaired. These findings resulted in reduced basal and CXCL12-mediated cell migration. In conclusion, HDIs up-regulated CXCR4 mRNA expression but impaired signalling cascades CXCL12-dependent on STAT3 and c-SRC, suggesting a role for HDI in delaying or preventing metastatic process in solid tumors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2633. doi:10.1158/1538-7445.AM2011-2633
Virtual Physician Visits Venture Into Mainstream Use
Authors: Kate O’Rourke
Journal: JAMA (2014)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA 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
Ancient-modern concordance in Ayurvedic plants: some examples.
Authors: S Dev
Journal: Environmental Health Perspectives (1999)

Ayurveda is the ancient (before 2500 b.c.) Indian system of health care and longevity. It involves a holistic view of man, his health, and illness. Ayurvedic treatment of a disease consists of salubrious use of drugs, diets, and certain practices. Medicinal preparations are invariably complex mixtures, based mostly on plant products. Around 1,250 plants are currently used in various Ayurvedic preparations. Many Indian medicinal plants have come under scientific scrutiny since the middle of the nineteenth century, although in a sporadic fashion. The first significant contribution from Ayurvedic materia medica came with the isolation of the hypertensive alkaloid from the sarpagandha plant (Rouwolfia serpentina), valued in Ayurveda for the treatment of hypertension, insomnia, and insanity. This was the first important ancient-modern concordance in Ayurvedic plants. With the gradual coming of age of chemistry and biology, disciplines central to the study of biologic activities of natural products, many Ayurvedic plants have been reinvestigated. Our work on Commiphora wightti gum-resin, valued in Ayurveda for correcting lipid disorders, has been described in some detail; based on these investigations, a modern antihyperlipoproteinemic drug is on the market in India and some other countries. There has also been concordance for a few other Ayurvedic crude drugs such as Asparagus racemosus, Cedrus deodara, and Psoralea corylifolia.
ACETANILID POISONING FROM BROMOSELTZER.
Authors: ALBERT ENGLES BLACKBURN
Journal: JAMA (1906)

<h3>Patient.</h3> —I was asked by his mother to see the patient, a man, aged 22 years, recently married. The patient did not consider himself sick and did not desire medical attention. It was with great difficulty that I obtained a distinct and correct history. I do not believe there was the intent to deceive, but his marked hebetude and obtuseness made it especially difficult to obtain a connected history. When the facts were finally obtained from his wife and he was asked as to their correctness, he acknowledged their truthfulness and promised to desist taking the drug. <h3>History.</h3> —Following an acute illness some six months previous he began taking an occasional dose of bromo-seltzer for headache. The relief desired was temporarily obtained, and as the headaches recurred the bromo-seltzer was taken in larger amounts and at shorter periods. The quantity consumed grew larger and larger until the six weeks previous
Let us see the medical records of future world leaders
Authors: D. Owen
Journal: BMJ (2008)

The effect of cigarette smoke exposure on pulmonary epithelial permeability was studied in 45 smokers and 22 non-smokers. An index of cigarette smoke exposure was obtained from the carboxyhaemoglobin concentration (HbCO%). Pulmonary epithelial permeability was proportional to the half-time clearance rate of technetium-99m-labelled diethylene triamine pentacetate (99mTc DTPA) from lung to blood (T1/2LB). The relationship between T1/2LB and HbCO% was hyperbolic in form and the data could be fitted to the quadratic formula (formula; see text) where the parameters a0, a1, and a2 represent respectively the asymptotic T1/2LB value at large carboxyhaemoglobin values and the slope and shape of the curve. The values of these parameters were a0 4.4 (2.6), a1 = 77.8 (15.5), and a2 -25.5 (9.7) (SE). This is the first demonstration of a dose-response relationship between carboxyhaemoglobin and an increased permeability of the lungs in man and provides a technique for identifying the roles of carbon monoxide and other cigarette smoke constituents in causing increased pulmonary epithelial permeability.
Reduced Sexual Activity in HIV-Infected Homosexual Men
Authors: George R. Brown
Journal: JAMA (1989)

<h3>To the Editor. —</h3> A letter in the November 18 issue of<i>JAMA</i>by Kaplan et al<sup>1</sup>discusses changes in sexual behavior in a cohort of 31 human immunodeficiency virus—seropositive homosexual men. All subjects were sexually active prior to the onset of lymphadenopathy syndrome, but 22.6% reported no sex partners after the development of lymphadenopathy syndrome and in the 6 months prior to the administration of a follow-up questionnaire. Self-report data that presumably explain the changes included "personal health concerns" as the primary factor. We are prospectively following up human immunodeficiency virus—seropositive Air Force personnel with structured psychiatric interviews and numerous standard questionnaires. In the first 95 patients randomly selected for evaluation (94.6% did not have acquired immunodeficiency syndrome), 12.6% were diagnosed as having hypoactive sexual desire disorder and 5.4% as having major depressive disorder. When a comparison group was similarly evaluated, the prevalence of hypoactive sexual desire disorder
Follow-Up Studies of Lithium and Thyroid Function in Manic-Depressive Illness
Authors: RONALD R. FIEVE, STANLEY R. PLATMAN
Journal: American Journal of Psychiatry (1969)

In an earlier study the authors reported that six out of 19 manic-depressive patients treated with lithium showed evidence of goiter, suggesting that lithium may have goitrogenic properties. They now report the finding of a similar incidence of goiter among 13 patients treated with imipramine. They conclude that three explanations are possible: the incidence of goiter among the general population might be equally high if EAI scanning instead of palpation were used routinely; the incidence of goiter detected among the two groups of patients studied may be a result of various drug treatments, periodic hospitalizations, and dietary insufficiencies; or it may be related to some characteristic of manic-depressive disease.
Vasculitis in coeliac diseases.
Authors: D. J. Holdstock, S. Oleesky
Journal: BMJ (1970)

Case 2.-Female aged 23 years.Iprindole prescribed for postinfluenzal depression.Hb and E.S.R. normal.Eight days after first taking the drug suddenly developed pain in the right hypo- chondrium and right posterior chest with transient fever (temperature taken by the patient and found to be 101 'F.(38-3'C.)).When seen on the tenth day, apyrexial, marked tenderness present in the right hypochondrium, definite clinical jaundice.Urine strongly positive for bile.
Octreotide and Graves' ophthalmopathy and pretibial myxoedema.
Authors: T. C. Chang, S. C. Kao, K. M. Huang
Journal: BMJ (1992)

Octreotide and Graves' tibial myxoedema, exophthalmos, and excessive lacri- Octreotide and Graves mation.Octreotide 100 [tg thrice daily controlled the ophthalmopathy and pretibial lacrimation after four days and the erythema of her myxoedema pretibial skin after six.After three months' treatment her eye movements and skin changes had almost fully returned to normal (table ).She remained stable six T C Chang, S C S Kao, K M Huang weeks after stopping treatment.Case 5-A 62 year old man with exophthalmos and diplopia in all directions of gaze improved on octreotide Departments ot Internal Existig treatments for severe Graves' ophthalmopathy 100 tg thrice daily for three months (table) and such as immunosuppressive agents, orbital irradiation, remained stable six weeks after stopping treatment.and Radiology, National and decompression are not fully satisfactory.The Case 6-A 43 year old woman with Graves' disease Taiwan