tbuckley/cabot-search huggingface dataset:
High Doses of Vitamin D to Reduce Exacerbations in Chronic Obstructive Pulmonary Disease
Authors: An Lehouck, Chantal Mathieu, Claudia Carremans, Femke Baeke, Jan Verhaegen, Johan Van Eldere, Brigitte Decallonne, Roger Bouillon, Marc Decramer, Wim Janssens
Journal: Annals of Internal Medicine (2012)

Background: Low serum 25-hydroxyvitamin D (25-[OH]D) levels have been associated with lower FEV1, impaired immunologic control, and increased airway inflammation. Because many patients with chronic obstructive pulmonary disease (COPD) have vitamin D deficiency, effects of vitamin D supplementation may extend beyond preventing osteoporosis. Objective: To explore whether supplementation with high doses of vitamin D could reduce the incidence of COPD exacerbations. Design: Randomized, single-center, double-blind, placebo-controlled trial. (ClinicalTrials.gov registration number: NCT00666367) Setting: University Hospitals Leuven, Leuven, Belgium. Patients: 182 patients with moderate to very severe COPD and a history of recent exacerbations. Intervention: 100 000 IU of vitamin D supplementation or placebo every 4 weeks for 1 year. Measurements: The primary outcome was time to first exacerbation. Secondary outcomes were exacerbation rate, time to first hospitalization, time to second exacerbation, FEV1, quality of life, and death. Results: Mean serum 25-(OH)D levels increased significantly in the vitamin D group compared with the placebo group (mean between-group difference, 30 ng/mL [95% CI, 27 to 33 ng/mL]; P < 0.001). The median time to first exacerbation did not significantly differ between the groups (hazard ratio, 1.1 [CI, 0.82 to 1.56]; P = 0.41), nor did exacerbation rates, FEV1, hospitalization, quality of life, and death. However, a post hoc analysis in 30 participants with severe vitamin D deficiency (serum 25-[OH]D levels <10 ng/mL) at baseline showed a significant reduction in exacerbations in the vitamin D group (rate ratio, 0.57 [CI, 0.33 to 0.98]; P = 0.042). Limitation: This was a single-center study with a small sample size. Conclusion: High-dose vitamin D supplementation in a sample of patients with COPD did not reduce the incidence of exacerbations. In participants with severe vitamin D deficiency at baseline, supplementation may reduce exacerbations. Primary Funding Source: Applied Biomedical Research Program, Agency for Innovation by Science and Technology (IWT-TBM).
Further Evaluation of the Tyramine Test for Pheochromocytoma
Authors: Karl Engelman, David Horwitz, Isabelle M. Ambrose, Albert Sjoerdsma
Journal: New England Journal of Medicine (1968)

Nineteen (73 per cent) of 26 patients with pheochromocytoma had positive responses to pharmacologic testing with tyramine whereas only three (3 per cent) of 88 patients with other forms of hypertension had false-positive responses. False-negative responses were more frequent among patients with the familial variety of pheochromocytoma associated with medullary carcinoma of the thyroid gland and in patients receiving hydrochlorothiazide or phenoxybenzamine. The inhibitory effect of these drugs lasted up to four days and two weeks, respectively, after their discontinuation. Except for palpitation, there were no untoward effects from the tyramine tests. No correlation was found between either the urinary excretion of free catecholamines or total catecholamine metabolites and tyramine responses among patients with pheochromocytoma. The tyramine test appears to offer specificity as a pharmacologic test for pheochromocytoma comparable to other provocative tests, with the advantage of safety and absence of morbidity.
Mode of referral to hospital of patients with heart attacks: relevance to home care and special ambulance services.
Authors: J D Hill, J R Hampton
Journal: BMJ (1976)

Out of 1250 consecutive patients brought to hospital with heart attacks 956 (76%) were at home when their symptoms began. Of these, 587 (61%) called their general practitioner, and for the remainder an ambulance was summoned by a member of the public. Of the 294 patients who were away from home when the attack occurred 291 were brought to hospital by ambulance. Of these, only 70 (24%) were attended by a general practitioner. Patients for whom ambulances were called by a general practitioner had had their symptoms significantly longer and had significantly lower prehospital and hospital mortalities than those for whom ambulances were summoned by members of the public. Special "cardiac" ambulances appear to be inappropriate for patients who have been seen by a general practitioner, and for this group home care may well be as effective as hospital admission.
THE CRITERIA OF CURE OF GONORRHEA IN THE MALE
Authors: AMBROSE J. KING
Journal: JAMA (1935)

There is no phase of the management of cases of gonorrhea that gives rise to more anxiety to the clinician than the period of probation preceding the decision as to cure. There are few errors that may be fraught with such disastrous consequences to the patient and his family, and to the reputation of the doctor, than an error in this important decision. Yet only too commonly it is found that, without adequate thought and without careful observation, this heavy responsibility is readily and lightly accepted. In the time at my disposal I propose to enumerate the various points that must be considered in approaching such a decision, to give my views based on clinical observations in conjunction with certain improved pathologic tests, and to provoke discussion of those controversial points by which new light may be thrown on this old problem. The tests of cure may with propriety be
Association Between<i>NRAS</i>and<i>BRAF</i>Mutational Status and Melanoma-Specific Survival Among Patients With Higher-Risk Primary Melanoma
Authors: Nancy E. Thomas, Sharon N. Edmiston, Audrey Alexander, Pamela A. Groben, Eloise Parrish, Anne Kricker, Bruce K. Armstrong, Hoda Anton-Culver, Stephen B. Gruber, Lynn From, Klaus J. Busam, Honglin Hao, Irene Orlow, Peter A. Kanetsky, Li Luo, Anne S. Reiner, Susan Paine, Jill S. Frank, Jennifer I. Bramson, Lorraine D. Marrett, Richard P. Gallagher, Roberto Zanetti, Stefano Rosso, Terence Dwyer, Anne E. Cust, David W. Ollila, Colin B. Begg, Marianne Berwick, Kathleen Conway
Journal: JAMA Oncology (2015)

NRAS and BRAF mutations in melanoma inform current treatment paradigms, but their role in survival from primary melanoma has not been established. Identification of patients at high risk of melanoma-related death based on their primary melanoma characteristics before evidence of recurrence could inform recommendations for patient follow-up and eligibility for adjuvant trials.
Serological Investigations on Addison's Disease
Authors: Juan A. Andrada
Journal: JAMA (1968)

Sera of 50 patients suffering from Addison's disease were studied for antibodies to human adrenal antigens by complement fixation, tanned cell hemagglutination, precipitation, and indirect immunofluorescence techniques. Positive results in one or more tests were obtained with 22 sera. Adrenal antibodies of exquisite organ specificity were found. However, a few of the positive sera cross-reacted with extracts of human testis and thyroid. Nuclear antibodies were encountered in nine addisonian sera; their occurrence was unrelated to adrenal antibodies.
Abstract 2168: Components of metabolic syndrome and total cancer mortality
Authors: Wambui G. Gathirua-Mwangi, Jianjun Zhang
Journal: Cancer Research (2014)

Abstract Metabolic syndrome becomes more and more common primarily due to the epidemic of overweight and obesity in both developed and developing countries. Epidemiologic studies have shown that obesity increases the risk of several cancers. However, it largely remains unclear whether the components of metabolic syndrome are associated with total cancer mortality. Therefore, we sought to evaluate this important question in the Third National Health and Nutrition Examination Survey (NHANES). Data on demographics, socioeconomics, lifestyle factors, and the components of metabolic syndrome were collected among 19,296 men and women aged 18 years or older (pregnant women excluded). Cancer mortality outcomes of these subjects were determined by linkage to the National Death Index (NDI), and the most recent year of the linkage was in 2010. A total of 1,111 cases of all sites of cancer have been documented during this period of time. Weighted Cox proportional hazards regression was used to compute relative risks (RR) with 95% confidence intervals (CIs) for total cancer mortality in relation to the components of metabolic syndrome. After adjustment for age, sex, race, education, marital status, and cigarette smoking, subjects in the highest quartile (Q) of serum glucose experienced a 25% increased risk of total cancer when compared with those in the lowest quartile [RR (95% CI): 1.250 (1.247-1.253)]. The significant positive association was also observed for systolic blood pressure [Q4 vs. Q1: RR (95% CI): 1.278 (1.274-1.282)]. Conversely, a reduced risk of total cancer was found for high-density lipoprotein (HDL) cholesterol [Q4 vs. Q1: RR (95% CI): 0.798 (0.796-0.800)]. No apparent effect was detected for waist circumference and serum triglyceride. To our knowledge, the present study is among the first to demonstrate that some components of metabolic syndrome modulate the risk of total cancer among a representative population in the US. Our findings offer novel evidence for the potential role of metabolic syndrome in cancer carcinogenesis and mechanistic data for the associations between obesity and the risk of some cancers. Citation Format: Wambui G. Gathirua-Mwangi, Jianjun Zhang. Components of metabolic syndrome and total cancer mortality. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2168. doi:10.1158/1538-7445.AM2014-2168
P30 Use Of A Regional Copd Dashboard To Effect Large Scale Change J Congleton, J Wookey, J Bott Kss Ahsn Respiratory Programme
Authors: J. Congleton, J. Wookey, J. Bott
Journal: Thorax (2014)

<h3></h3> Large scale change is difficult to bring about. The regional Respiratory Programme began in 2011 with the aim of improving outcomes in COPD and asthma. We designed a COPD dashboard with key metrics aiming to track progress and encourage involvement in service improvement. The Quality Observatory maintain the dashboard and release quarterly updates which we email out to our network members and other key people (n = 396) accompanied by commentary indicating issues for consideration and highlighting trends. The target audience includes clinicians in primary, secondary and community care plus managers and commissioners. This work is supplemented by running oxygen and pulmonary rehabilitation clinical networks which provide support and training to clinicians plus a quarterly educational and information sharing <i>e</i>publication ‘Breathing Matters’. We track trends in metrics. COPD bed days are a key outcome measure and the table below shows the yearly value since the program commenced. Looking at the admission figures on a population basis i.e. admissions per 1,000 COPD population (population weighted for prevalence of COPD using ERPHO modelled estimates and projections) there is a similar trend: County 1 2010/11 17.9 per 1000 vs 13.2 per 1000 in 2013/14 County 2 2010/11: 12.5 per 1000 vs 10.3 per 1000 in 2013/14 County 3 2010/11: 15.8 per 1000 vs 13.8 per 1000 2013/14 There has been a reduction in variation between acute trusts in the number of admissions and length of stay (without an increase in re-admission rate). We believe our COPD Dashboard has helped drive this change.
Revisiting the Clinical Value of 18F-FDG PET/CT in Detection of Recurrent Epithelial Ovarian Carcinomas
Authors: Lidija Antunovic, Marino Cimitan, Eugenio Borsatti, Tanja Baresic, Roberto Sorio, Giorgio Giorda, Agostino Steffan, Luca Balestreri, Rosa Tatta, Giovanna Pepe, Domenico Rubello, Diego Cecchin, Vincenzo Canzonieri
Journal: Clinical Nuclear Medicine (2012)

This study aimed to evaluate the efficiency of 18F-FDG PET/CT in suspected recurrence of epithelial ovarian cancer, after treatment, comparing outcomes of PET/CT with histological tumor subtype, CA-125 serum levels, and findings of conventional diagnostic imaging modalities (CI).Data from 121 women who underwent FDG PET/CT for suspected recurrence of epithelial ovarian cancer after treatment were reviewed retrospectively.Of all patients, 80% had recurrent disease and 20% were disease-free on the final clinical diagnosis. PET/CT showed true-positive findings in 82% of patients, whereas CI demonstrated true-positives in 70% of cases. At the time of PET/CT scanning, only 55 patients had serum CA-125 level greater than 35 U/mL, whereas 52 patients presented with CA-125 levels in a reference range. PET/CT sensitivity (82%) was significantly higher than that of CA-125 (59%), whereas difference in sensitivity between PET/CT and CI (69%) was limited. PET/CT specificity (87%) was significantly better than that of CI (47%), although no difference in specificity between PET/CT and CA-125 (80%) was found. However, no difference in CA-125 serum levels between patients with local tumor relapse and those with distant metastases was found. PET/CT showed the highest positive predictive value (96%) and negative predictive value (55%) when compared with other modalities. In high-grade tumors (n = 66), PET/CT accuracy was 80%, better than that of serum CA-125 (64%) and that of CI (62%). Equally in low-grade ovarian carcinomas (n = 55), PET/CT accuracy (87%) was significantly higher than that of the tumor marker (60%) and also higher than that of CI (70%).FDG PET/CT was proven to be more efficient than serum CA-125 assay and CI in detecting recurrences of ovarian cancer after treatment. The sensitivity of FDG PET/CT is not influenced by tumor histology. FDG PET/CT should be considered a useful diagnostic tool in the surveillance of patients that received treatment for epithelial ovarian carcinoma.
Protein S Deficiency Occurs in the Nephrotic Syndrome
Authors: SILVANA VIGANO-D'ANGELO
Journal: Annals of Internal Medicine (1987)

Protein S activity may be compromised in patients with the nephrotic syndrome and contribute to a thrombotic diathesis. Protein S is found in two forms in plasma as free and functionally active protein S, and complexed to C4b-binding protein. When compared with controls, patients with nephrotic syndrome had reduced functional levels of protein S (69% ± 27% [SD], p < 0.001) despite having elevated levels of total protein S antigen (139% ± 42%, p < 0.001). Decreased protein S activity was caused by significant reductions in free (active) protein S levels (90% ± 38%, p < 0.05) due to the selective urinary loss of free protein S and elevation of C4b-binding protein levels (170% ± 52%, p < 0.001) that favors complex formation; and in the specific activity of the circulating free protein S (0.76; p < 0.001). Along with this reduction in specific activity, we noted the abnormal electrophoretic mobility of the protein S in the presence of calcium ions. We conclude that acquired protein S deficiency occurs in the nephrotic syndrome and may be a risk factor for the development of the thromboembolic complications.
The meaning of "partnership working" to the alcohol industry
Authors: E. Gillan
Journal: BMJ (2013)

It is an oversimplification to say that the “ideological schism” that divides the public health community is between those who are prepared to work alongside the industry and those who are not.1 The community recognises that the alcohol industry is a stakeholder and can help reduce harm in its role as producer and retailer. However, the industry seeks a …
Clinical Observations of Exenatide Treatment
Authors: Allen B. King, Gary Wolfe, Susan Healy
Journal: Diabetes Care (2006)

Controlled clinical trials have demonstrated the effectiveness of exenatide in reducing glucose and weight (1,2,3,4). We herein report our initial clinical experience.

Clinic charts of the first 200 patients consecutively treated were retrospectively analyzed. Of these patients, 22% were lost to follow-up, noncompliant, or chose not to continue for reasons other than side effects. Thirteen percent discontinued treatment due to side effects including nausea …
CORTICOSTEROIDS AS ADJUNCTIVE THERAPY IN TREATMENT OF PNEUMOCYSTIS CARINII PNEUMONIA IN PATIENTS WITH ACQUIRED IMMUNODEFICIENCY SYNDROME
Authors: D.K. Macfadden, R.H. Hyland, T. Inouye, J.D. Edelson, C.H. Rodriguez, A.S. Rebuck
Journal: The Lancet (1987)
Pulmonary hypertension complicating pulmonary fibrosis: bad and ugly, but good to treat?
Authors: Steven D Nathan
Journal: Thorax (2014)

Pulmonary hypertension (PH) often complicates the course of patients with many forms of advanced lung disease, including those with pulmonary fibrosis.1 There is a growing appreciation of the association of PH with greater functional impairment, higher oxygen needs and poorer outcomes.2 What remains unknown is how much of a role PH has in these detrimental outcomes or whether it is an adaptive phenomenon and a surrogate for other untoward consequences of the parenchymal lung disease. Indeed, it is conceivable that, at its outset, PH is adaptive or reactive and in some patients evolves to a maladaptive phenomenon. This two-compartment concept is central to the notion of disproportionate PH, which is often spoken about but remains ill-defined. By implication, PH is ‘disproportionate’ when it is felt unlikely to be explained by the extent of the parenchymal lung disease alone, is functionally limiting, and/or is the primary driver of outcomes. This inevitably leads to the question of whether or not such patients might benefit from pulmonary vasoactive medications.

With the increasing number and availability of approved agents to treat group 1 pulmonary arterial hypertension (PAH), there has been growing interest and curiosity in treating group 3 PH. When weighing the appeal of this strategy, it is important to remember that prior advances in medicine have been punctuated with interventions that made biological and physiological sense, but did not pan out, and in some cases inflicted more harm than good. …
To Have Been or Not to Have Been
Authors: Alvan R. Feinstein
Journal: JAMA (1965)

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
ACCURACY IN DIETETICS.
Authors: DUDLEY ROBERTS
Journal: JAMA (1906)

The general trend toward accuracy in many departments of medicine serves to emphasize the prevalent disregard for a similar advance in dietetics. The importance of carefully selecting the articles of food for certain cases is very generally urged, but not as commonly practiced. Although it would seem to be a subject of equal importance, but little stress is ever laid on the necessity of regulating the amount of food to fit the exact known demands of a particular individual. That the demands and hence the supply of food should vary with the weight, shape of the body, age and condition of activity has been too well proved to permit of question. We can only account for the prevalent neglect of this factor in dietetic ordering by supposing that the matter has never been presented in practicable form. It is essential that the number of nutrients in a given food substance
Modern Medicine: Lay Perspectives and Experiences
Authors: A. Bowling
Journal: BMJ (1996)

Ed Simon J Williams, Michael Calnan UCL Press, £13.95, pp 270 ISBN 1 85728 318 X

In their preface to Modern Medicine the authors state that it is clear that critical changes are occurring in “'late' modernity” which have implications for the place of modern medicine, professional power, and the relationship between health professionals and lay people. The examples they give include “the increasingly technologized nature of modern medicine,” the fragmentation of medical knowledge, and the role of the mass media. Against this background the book's contributors discuss several key questions, each chapter being based on qualitative research …
Acute respiratory distress in diabetic ketoacidosis: possible contribution of low colloid osmotic pressure.
Authors: R C Leonard, C Asplin, C V McCormick, T D Hockaday
Journal: BMJ (1983)

The "shock lung" syndrome may occur in diabetic ketoacidosis in association with disseminated intravascular coagulation; occasionally it occurs alone after treatment of the ketoacidosis. Two patients developed pulmonary opacities with clinical features of acute respiratory distress such as are seen in the shock lung syndrome; in both, however, the findings suggested a different mechanism from that occurring in the syndrome. Hypoalbuminaemia was prominent, and it is postulated that a low plasma osmotic pressure caused by high volume crystalloid infusions may have precipitated the acute respiratory complications. Plasma osmotic pressure may be an important variable in patients given large volumes of crystalloid infusions; further studies are required to elucidate mechanisms of pulmonary oedema in such patients.
Erstwhile or Extant?
Authors: Mark Bloom
Journal: JAMA (1978)

To the Editor.—  John D. Archer, MD, in his letter to the editor (239:1608, 1978) The Confession of an Erstwhile Bureaucrat, showed he had not lost his touch. Only a bureaucrat could write a letter to a publication of which he himself is not only a senior editor but also editor of the LETTERS section. And only an erstwhile bureaucrat could write a 700-word letter with eight references when his own instructions to correspondents (preceding his letter) call for no more than 500 words and five references.
Combined Evaluation of Bedside Clinical Variables and the Electrocardiogram for the Differential Diagnosis of Paroxysmal Atrioventricular Reciprocating Tachycardias in Patients Without Pre-Excitation
Authors: Esteban González-Torrecilla, Jesús Almendral, Angel Arenal, Felipe Atienza, Leonardo F. Atea, Silvia del Castillo, Francisco Fernández-Avilés
Journal: Journal of the American College of Cardiology (2009)