tbuckley/cabot-search huggingface dataset:
Anticipatory Blood Pressure Responses to Exercise Are Associated With Left Ventricular Mass in Finnish Men
Authors: Thomas W. Kamarck, Jaakko Eränen, J. Richard Jennings, Stephen B. Manuck, Susan A. Everson, George A. Kaplan, Jukka T. Salonen
Journal: Circulation (2000)

Exaggerated cardiovascular reactivity to psychological demands may contribute to the development of left ventricular (LV) hypertrophy. We examined the cross-sectional association between anticipatory blood pressure (BP) responses to bicycle exercise and LV mass in the Kuopio Ischemic Heart Disease Risk Factor Study, a population-based epidemiological sample.Among 876 men from 4 age cohorts (ages 42, 48, 58, and 64 years), we collected echocardiographic assessments of LV mass along with measures of BP response taken before bicycle ergometry testing. Anticipatory BP responses were positively associated with LV mass, with significant associations only among younger (age <50 years) subjects with elevated resting pressures (3-way interactions for anticipatory BP x age x resting pressure for systolic and diastolic BP, all P:<0.05; for younger subjects with elevated systolic BP, P:<0. 01; and for younger subjects with elevated diastolic BP, P:<0.001). Among these subgroups, exaggerated anticipatory BP responses (top quartile) were associated with an incremental increase in LV mass of 10% or greater, corrected for body surface area. Results remained significant after adjusting for age, education, salt consumption, and resting BP, and the pattern of findings was maintained among men with no previous history of cardiovascular disease.The tendency to show exaggerated pressor responses to psychological demands may be a significant independent correlate of LV mass, especially among young men with high resting pressures. This is the first study to examine such associations in a middle-aged population sample.
Technetium-99m RBC Bleeding Images in Normal Subjects: Confusion with Gastrointestinal Bleeding Sites
Authors: CHARLES M. BOYD, MICHAEL R. WILLIAMSON
Journal: Clinical Nuclear Medicine (1989)

The normal appearance of a gastrointestinal bleeding study using labeled red blood cells has been discussed frequently, but the actual appearance is not well known. In this atlas article, the authors report on unusual findings in non-bleeding subjects and have tabulated the visualization of various structures. Vascular structures other than the aorta and interior vena cava were seen in 42 of 48 patients. One or both kidneys were seen in 10 (21%) of 48 patients. The urinary bladder was seen in 23 (48%) of 48 patients, although gastric activity caused by free pertechnetate was never observed.
Minimizing Bias in Randomized Trials
Authors: Bruce M. Psaty, Ross L. Prentice
Journal: JAMA (2010)

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
Flint's Emergency Treatment and Management
Authors: Richard O. Cummins
Journal: JAMA (1986)

Emergency department libraries can now contain the two major textbooks of emergency medicine, a frequently updated yearbook of medicine, and several excellent handbooks. In addition, there are general textbooks about the numerous subspecialties whose boundaries are so often crossed by emergency medicine. If, however, some event forced an immediate evacuation of the emergency room library, the one book to turn at the door and grab would be<i>Flint's Emergency Treatment and Management</i>. This venerable softbound manual was first published over 30 years ago. The seventh edition is almost entirely the product of the staff of the Kaiser-Permanente Medical Center, Sacramento, Calif. Their principle objective is to assist the emergency medicine professional in providing adequate care from scene, field, or office to the hospital. In following this objective, the contributors have filled the book with an amazing variety of information. There is detailed information on mass civilian casualties in peace and
THE PATHOGENESIS OF ALOPECIA AREATA
Authors: JOANNA ECKERT, R. E. CHURCH, F. J. EBLING
Journal: British Journal of Dermatology (1968)

SUMMARY.— The pathogenesis of alopecia areata was studied by plucking hairs from each of a series of concentric zones, using felt patterns placed over lesions. It was possible to group lesions according to the zone with the greatest proportion of club hairs. The results are logically interpreted to mean that a wave of hair follicle damage or arrest moves centrifugally from a focal point beyond the area of alopecia. It is suggested that follicles may react in I of 3 ways. Firstly, severe damage may weaken the hair in the keratogenous zone, this being followed by breakage when the weak zone reaches the plane of the scalp; at the same time the follicle is precipitated into catagen and the hair is extruded as an exclamation mark. Secondly, the follicle may be precipitated into catagen with loss of the club in a normal manner, followed by replacement with a dystrophic anagen hair. Thirdly, the follicle may become dystrophic without a catagen phase.
Liver Biopsy During Peritoneoscopy
Authors: Philip Edlin
Journal: JAMA (1968)

<h3>To the Editor:—</h3> Dr. Robert Wilber and Dr. William Faulk's otherwise excellent review of liver biopsy (<b>202</b>:53, 1967) is remiss, I believe, in not including reference to biopsy under direct vision at peritoneoscopy. Among its other advantages, peritoneoscopy allows one to aim the biopsy needle directly into a mass or other area of abnormality, thus increasing the likelihood of accurate diagnosis. Avoiding the liver edge lessens the chance of inadvertent penetration through the liver into colon or other viscus. If bleeding at the biopsy site does not cease in three to four minutes, direct pressure with the peritoneoscope or externally can be helpful, contributing further to safety. While not indicated in every patient requiring liver biopsy, peritoneoscopy can often enhance diagnostic accuracy and safety.
Cold-Activated Brown Adipose Tissue in Healthy Men
Authors: Wouter D. van Marken Lichtenbelt, Joost W. Vanhommerig, Nanda M. Smulders, Jamie M.A.F.L. Drossaerts, Gerrit J. Kemerink, Nicole D. Bouvy, Patrick Schrauwen, G.J. Jaap Teule
Journal: New England Journal of Medicine (2009)

Studies in animals indicate that brown adipose tissue is important in the regulation of body weight, and it is possible that individual variation in adaptive thermogenesis can be attributed to variations in the amount or activity of brown adipose tissue. Until recently, the presence of brown adipose tissue was thought to be relevant only in small mammals and infants, with negligible physiologic relevance in adult humans. We performed a systematic examination of the presence, distribution, and activity of brown adipose tissue in lean and obese men during exposure to cold temperature. Brown-adipose-tissue activity was studied in relation to body composition and energy metabolism.We studied 24 healthy men--10 who were lean (body-mass index [BMI] [the weight in kilograms divided by the square of the height in meters], < 25) and 14 who were overweight or obese (BMI, > or = 25)--under thermoneutral conditions (22 degrees C) and during mild cold exposure (16 degrees C). Putative brown-adipose-tissue activity was determined with the use of integrated (18)F-fluorodeoxyglucose positron-emission tomography and computed tomography. Body composition and energy expenditure were measured with the use of dual-energy x-ray absorptiometry and indirect calorimetry.Brown-adipose-tissue activity was observed in 23 of the 24 subjects (96%) during cold exposure but not under thermoneutral conditions. The activity was significantly lower in the overweight or obese subjects than in the lean subjects (P=0.007). BMI and percentage of body fat both had significant negative correlations with brown adipose tissue, whereas resting metabolic rate had a significant positive correlation.The percentage of young men with brown adipose tissue is high, but its activity is reduced in men who are overweight or obese. Brown adipose tissue may be metabolically important in men, and the fact that it is reduced yet present in most overweight or obese subjects may make it a target for the treatment of obesity.
Experiments on the Influence of Drugs on the Excretion of Urea and Uric Acid
Authors: E. A. Cook
Journal: BMJ (1883)

may It 1883.TiB BP4I$ C4L4 i T4J1,.X E seribed, and inbe: tbintfihave made ;mdre than seventy successul operations for perineal duhdering, including the pre-anal, perineal,.and perineo-anal laerations,as.wellassixforpartialand (ig.10>omplete procidentia.The t1wo last eases-for complete procidentis were madeinthe amphitheatre of the NewYorkUniversityMedicalColleg% and the patients then' remoed Xto their homes in an-,.amance..Both cases were most satisfactory; one i a&woman age4, pS, who had suffered from -complete uterine extrusion for nearly twenty years, the other in a woman aged 71, who had carried her womb in a sling between her thighs -for thirty-four years.It is now quite four years since the, last was.operated iipon.and more than torty months since te former.Both women are well.
Proposed US food labels would highlight calories, added sugars, and serving sizes
Authors: M. McCarthy
Journal: BMJ (2014)

The US Food and Drug Administration has proposed the first major revision in two decades of the nutrition facts labels on packaged foods.1

The proposed changes would require the labels to highlight calories and added sugars and to show serving sizes that more accurately reflect the portions that people actually eat.

“The current nutrition label has served us well for the past 20 years, but we must be sure that what is iconic doesn’t become a relic,” said Margaret Hamburg, the FDA commissioner. “The proposed changes to the nutrition facts label should make it easier than ever to judge a food by its label and reflect the latest evidence on how what we eat affects our health.”

The proposal is due to be published in the Federal Register on 3 …
Caesarean section and asthma: alternative explanations?
Authors: J C van der Wouden, R M D Bernsen
Journal: Thorax (2009)

hay fever 4 and for raised IgE for common inhalation allergens at age 11. 5 It would therefore be most informative if the authors could provide additional data on the differences between the neonatal anthropometric data of the children with and without ceasarean section, and on the indications for caesarean sections themselves.This issue is of significant importance and of clinical relevance because, if indeed a causal relationship exists between mode of delivery and development of asthma, this would certainly make an argument against elective caesarean section for non-medical reasons.It would seem that there is currently insufficient evidence to infer a causal relationship, but it certainly seems worthwhile sorting this out.
REPORT OF A CASE OF CHRONIC NEPHRITIS COMPLICATING PREGNANCY, LABOR AND THE PUERPERIUM.
Authors: LAWRENCE H. PRINCE
Journal: JAMA (1897)

I regret very much that more accurate observations were not made in this case, and also that many of the notes recorded were lost. However, I trust that the main facts as here reported will be of interest: Mrs. H., of Irish descent, a bright, intelligent woman, 28 years old, I saw for the first time the latter part of December, 1895. She gave me the following history: As a girl she was always well and strong. She became pregnant shortly after marriage and the child was stillborn at term. When four months pregnant with this first child she began to suffer from sleeplessness, dizziness, edema and momentary attacks of blindness. After the seventh month all these symptoms became aggravated. The edema was general, even extending to the lips and to the tissues of the back. The lips and finger nails were often cyanosed. The urine was scanty throughout pregnancy.
Preoperative prediction of the outcome of coronary revascularization using positron emission tomography.
Authors: R de Silva, Y Yamamoto, C G Rhodes, H Iida, P Nihoyannopoulos, G J Davies, A A Lammertsma, T Jones, A Maseri
Journal: Circulation (1992)

BACKGROUND Previous assessments of myocardial viability using positron emission tomography (PET) relied on demonstration of glucose metabolism in hypoperfused asynergic segments using the glucose analogue [18F]2-fluoro-2-deoxyglucose (FDG). Recently, it was shown that myocardial viability could be assessed by calculating the water-perfusable tissue index (PTI) for the asynergic region. PTI represents the proportion of the myocardium that is capable of rapid transsarcolemmal exchange of water and thus perfusable by water. The aim of the present study was to assess myocardial viability by PET using PTI in patients undergoing coronary revascularization. METHODS AND RESULTS Twelve patients with chronic coronary artery disease and previous myocardial infarction were studied. Analysis of transmission (tissue density) and 15O-labeled carbon monoxide (blood pool), and 15O-labeled water (myocardial blood flow [MBF]) emission PET data enabled the simultaneous quantification of MBF (ml.min-1.g perfusable tissue-1) and PTI (gram of perfusable tissue per gram of total anatomic tissue). In addition, PET imaging with FDG after 75-g oral glucose load was performed in eight patients. Preoperative echocardiography identified 33 hypocontractile and 26 control segments. Follow-up echocardiography performed 3 to 5 months later demonstrated 26 of 33 segments with improved wall motion (recovery) and seven of 33 segments without improvement (nonrecovery). MBF in the control segments (0.97 +/- 0.22 ml.min-1.g perfusable tissue-1) was significantly higher (p &lt; 0.001) than in both the recovery (0.73 +/- 0.18 ml.min-1.g perfusable tissue-1) and the nonrecovery (0.45 +/- 0.11 ml.min-1.g perfusable tissue-1) segments. PTI in the recovery regions (0.99 +/- 0.15) was &gt; or = 0.7 in all cases and slightly less than in control regions (1.10 +/- 0.15, p &lt; 0.02). FDG uptake in these regions was 92 +/- 17% (n = 13) of the uptake in control segments with normal wall motion. In the nonrecovery group, PTI was 0.62 +/- 0.06 (p &lt; 0.02 versus control and recovery) and always &lt; 0.7. In the one patient in whom a comparison with metabolic imaging was made, FDG uptake was 46% of the uptake in a reference region with normal wall motion. CONCLUSIONS These data showed that contractile recovery occurred only in segments where PTI was &gt; or = 0.7, suggesting that &gt; or = 70% of myocardial tissue in a given asynergic segment should be perfusable by water to enable contractile recovery. There was good agreement between the PTI and FDG methods for predicting improvements in regional wall motion after revascularization. Although further studies should be performed in a larger patient group, the preliminary results are promising and suggest that PTI may be a good predictor of contractile recovery after coronary revascularization.
1061-85 Trends in the use of effective cardiac medications in patients with acute myocardial infarction: The GRACE experience
Authors: Robert J Goldberg, Frederick A Spencer, Ph.Gabriel Steg, José López-Sendón, Brian M Kennelly, Marcus D Flather, Gilles Montalescot, Enrique P Gurfinkel, Polina Kuznetsova, Joel M Gore
Journal: Journal of the American College of Cardiology (2004)
The Patient-Physician Relationship: Time to Reimburse What We Preach-Reply
Authors: John A. Balint
Journal: JAMA (1996)

<h3>In Reply.</h3> —Dr Hensel raises several interesting points. First, he applies our patient-physician alliance in community model to the case we described in our article. We fully agree with the scenario Hensel describes. This is indeed how we would envisage the working of our model. As Hensel implies, third-party payers, especially managed care organizations, are not yet at the point of responding altruistically or indeed with enlightened self-interest to such situations. At the same time, not all physicians are ready to pursue matters as Hensel describes. We need to undertake significant educational efforts to move in the desired direction on both theme fronts. Second, Hensel is correct in stating that managed care organizations are willing to deny payment for expensive procedures, but are not willing to support the time it takes to educate the patient about the appropriate use of such tests. Again, this is an area where mutual education is needed.
Responding to Medical Events during Commercial Airline Flights
Authors: Mark A. Gendreau, Charles DeJohn
Journal: New England Journal of Medicine (2002)

Physicians are often asked to provide assistance when symptoms develop in a passenger during a commercial flight. This Review Article identifies the most common problems that develop during air travel. The authors recommend ways to respond to such events and describe the resources that are available to physicians and flight crews while the aircraft is still airborne.
Ex vivo histology-correlated optical coherence tomography in the detection of transmural inflammation in Crohn’s disease
Authors: Bo Shen, Gregory Zuccaro, Terry L. Gramlich, Natalie Gladkova, Bret A. Lashner, Conor P. Delaney, Jason T. Connor, Feza H. Remzi, Margaret Kareta, Charles L. Bevins, Felix Feldchtein, Scott A. Strong, Marlene L. Bambrick, Patricia Trolli, Victor W. Fazio
Journal: Clinical Gastroenterology and Hepatology (2004)
Hemodynamic Effects of Aminophylline in Cor Pulmonale
Authors: JOHN O. PARKER, KUMAR KELKAR, ROXROY O. WEST
Journal: Circulation (1966)

Nine patients with cor pulmonale due to chronic obstructive pulmonary disease were studied by means of right and left heart catheterization. Hemodynamic and respiratory observations were made during a control period and during the infusion of 1 g of aminophylline. Aminophylline produced a significant reduction in mean pulmonary artery pressure from 39.4 to 25.4 mm Hg, in right ventricular end-diastolic pressure from 8.6 to 2.1 mm Hg, in left ventricular end-diastolic pressure from 7.9 to 3.0 mm Hg, and in brachial artery mean pressure from 95.3 to 85.6 mm Hg. The heart rate and oxygen consumption increased, but there was no change in cardiac index. The alveolar ventilation increased significantly from 2.1 to 2.9 L/min/m 2 (BTPS). Evidence is presented to suggest that the decrease in pulmonary artery pressure was due to pulmonary arteriolar dilatation.
Trends Over Time in the Relative Use and Associated Mortality of On-Pump and Off-Pump Coronary Artery Bypass Grafting in the Veterans Affairs System
Authors: Faisal G. Bakaeen, Rosemary F. Kelly, Danny Chu, Michael E. Jessen, Herbert B. Ward, William L. Holman
Journal: JAMA Surgery (2013)

<h3>Importance</h3> Numerous studies have compared the results of on-pump and off-pump coronary artery bypass grafting (CABG), but little is known about how either the relative use of these procedures or their associated perioperative mortality have changed with time. <h3>Objective</h3> To examine trends in off- and on-pump CABG use and outcomes over time. <h3>Design</h3> Retrospective analysis of data from the Veterans Affairs Surgical Quality Improvement Program (VASQIP). <h3>Setting</h3> Data were collected from 42 Veterans Affairs cardiac surgery centers. <h3>Participants</h3> All Veterans Affairs patients (n = 65 097) who underwent isolated primary CABG from October 1997 to April 2011. <h3>Interventions</h3> Patients underwent either on-pump (ON) or off-pump (OFF) CABG. <h3>Main Outcomes and Measures</h3> The percentages of ON vs OFF cases as a function of time. We also evaluated trends over time in rates of conversion from OFF to ON CABG, perioperative mortality (30-day or in-hospital), and VASQIP predicted risk of mortality. <h3>Results</h3> The relative use of OFF CABG peaked at 24% in 2003, followed by a slow and mostly consistent decline to stabilize at about 19%. The conversion rate decreased with time and has stayed less than 3.5% since 2007 (<i>P</i> &lt; .001). Perioperative mortality rates decreased over time for both ON and OFF CABG (<i>P</i> &lt; .001) and have stayed less than 2% for the entire cohort since 2006. The mortality associated with converted cases was high regardless of the surgery year and exceeded the VASQIP predicted risk of mortality. <h3>Conclusions and Relevance</h3> There has been a decline in the relative use of OFF CABG in the Veterans Affairs system since 2003. This trend may affect the training of future generations in OFF surgery and influence conversion rates and outcomes.
The Rational Clinical Examination-Reply
Authors: David L. Sackett
Journal: JAMA (1992)

<h3>In Reply.</h3> —On behalf of the over 60 collaborators in The Rational Clinical Examination enterprise, I thank our correspondents for their letters, for they will show us how to improve the series. Dr Scheller echoes our call for the widespread adoption of the rational clinical examination, but identifies two possible impediments. First, he raises the spectre of being sued for failing to reduce one's assessment of today's probability of ascites (in a man who will be followed for his clear-cut alcoholism) from very unlikely, based on examining him, to virtually impossible, based on sending him for an ultrasonogram anyway. Does "defensive medicine" constitute a legitimate cause for failing to apply the science of the art of the clinical examination, or is it simply a lazy excuse for not learning it? If the former is true, what an awful way to have to practice medicine! And we are wrong to think