tbuckley/cabot-search huggingface dataset:
Modeling the Independent Effects of Gestational Diabetes Mellitus on Maternity Care and Costs
Authors: Paddy Gillespie, John Cullinan, Ciaran O’Neill, Fidelma Dunne
Journal: Diabetes Care (2012)

To explore the independent effects of gestational diabetes mellitus (GDM) on maternity care and costs.Estimates for maternity care resource activity and costs for 4,372 women, of whom 354 (8.1%) were diagnosed with GDM, were generated from data from the Atlantic Diabetes in Pregnancy (ATLANTIC DIP) database. Multivariate regression analysis was applied to explore the effects of GDM on 1) mode of delivery, 2) neonatal unit admission, and 3) maternity care cost, while controlling for a range of other demographic and clinical variables.Women with a diagnosis of GDM had significantly higher levels of emergency caesarean section (odds ratio [OR] 1.75 [95% CI 1.08-2.81]), their infants had significantly higher levels of neonatal unit admission (3.14 [2.27-4.34]), and costs of care were 34% greater (25-43) than in women without GDM. Other variables that significantly increased costs were weight, age, primiparity, and premature delivery.GDM plays an independent role in explaining variations in rates of emergency caesarean section, neonatal unit admission, and costs of care, placing a substantial economic burden on maternity care services. Interventions that prevent the onset of GDM have the potential to yield substantial economic and clinical benefits.
Long-term Consequences of Kawasaki Disease
Authors: Hirohisa Kato, Tetsu Sugimura, Teiji Akagi, Noboru Sato, Kanoko Hashino, Yasuki Maeno, Takeyo Kazue, Genzyu Eto, Rumi Yamakawa
Journal: Circulation (1996)

Background The long-term consequences of the cardiovascular sequelae in Kawasaki disease remain uncertain. Methods and Results We identified 594 consecutive children with acute Kawasaki disease between 1973 and 1983, and this cohort was followed up for 10 to 21 years (mean, 13.6 years). In all patients, we evaluated coronary lesions by coronary angiography just after the acute stage. One hundred and forty-six patients (24.6%) were diagnosed as having coronary aneurysms. A second angiogram was performed 1 to 2 years later in all 146 patients who previously had coronary aneurysms, which demonstrated that 72 (49.3%) of these 146 had regression in the coronary aneurysm. A third angiogram was performed for 62 patients, a fourth for 29, and a fifth for 17. By 10 to 21 years after the onset of the illness, stenosis in the coronary aneurysm had developed in 28 patients. Myocardial infarction occurred in 11 patients, 5 of whom died. In the 26 patients with giant coronary aneurysms, stenotic lesions developed in 12, and no regression occurred. The 448 patients with normal findings at the first angiogram subsequently never developed any abnormal cardiac findings. Systemic artery aneurysms developed in 13 patients (2.2%), and valvular heart disease appeared in 7 (1.2%). Conclusions The incidence of coronary aneurysm in acute Kawasaki disease was 25%, 55% of which showed regression. During follow-up, ischemic heart disease developed in 4.7% and myocardial infarction in 1.9%. Death occurred in 0.8%.
Clinical Problems: Sextuplet Pregnancy
Authors: G. C. L. Lachelin, H. A. Brant, G. I. M. Swyer, V. Little, E. O. R. Reynolds
Journal: BMJ (1972)

In a sextuplet pregnancy which followed gonadotrophin therapy the principal problems were threatened abortion, premature labour, and placental insufficiency. Delivery was by caesarean section soon after the onset of labour at 32 weeks. The five liveborn babies thrived. The sixth was a macerated stillbirth.
Results of investigation into statin side effects due by end of year
Authors: N. Hawkes
Journal: BMJ (2015)

The Cholesterol Treatment Trials Collaboration plans to produce tabulated results of all the side effects recorded in 30 randomised controlled trials of statins by the end of this year, the Oxford University expert Rory Collins told a briefing at the Science Media Centre in London this week.

But he did not expect the results to “materially alter the evidence,” which he said strongly favoured statins. “It may reassure some people,” he said. “We thought it was necessary to get the …
Obituary Listing
Authors: Diane Sze Wei
Journal: JAMA (1999)

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
EFFECT OF RACE ON LONGTERM OUTCOMES IN PATIENTS ADMITTED WITH ACUTE CORONARY SYNDROME: AN ACAP-PAIN REGISTRY ANALYSIS
Authors: Emad F. Aziz, Chaithanya Pamidimukala, Balaji Pratap, Urvi Pai, Joseph Bastawrose, Shuaib Mohamed, Neel Patel, Alyosha Smolarski, Rishad Usmani, Ramya Bharathi, Eun S. John, Alexandre Benjo, Eyal Herzog
Journal: Journal of the American College of Cardiology (2013)
Community health councils and the public
Authors: E. Porter
Journal: BMJ (1976)

different order.Such false-positive reactions will not, of course, explain the fact that 36 out of the 37 patients reported by Dr Solomon and Miss Macaulay did not respond to test doses of aspirin.Only one of their patients had an immediate response (type 1) to candida antigen and I wonder if any had a type 3 response, as it was this type which occurred in 25 out of the 36 patients reacting to candida in our series."I look forward to hearing further details about the tests and the further experience of Dr Solomon and Miss Macaulay.I do wish them every success in their work in this field.
Temporal Trends in Patient Characteristics and Outcomes Among Medicare Beneficiaries Undergoing Primary Prevention Implantable Cardioverter-Defibrillator Placement in the United States, 2006–2010
Authors: Ryan T. Borne, Pamela N. Peterson, Robert Greenlee, Paul A. Heidenreich, Yongfei Wang, Jeptha P. Curtis, Wendy S. Tzou, Paul D. Varosy, Mark S. Kremers, Frederick A. Masoudi
Journal: Circulation (2014)

Contemporary patterns of use and outcomes of implantable cardioverter-defibrillators (ICDs) in community practice settings are not well characterized. We assessed temporal trends in patient characteristics and outcomes among older patients undergoing primary prevention ICD therapy in US hospitals between 2006 and 2010.Using the National Cardiovascular Data Registry's ICD Registry, we identified Medicare fee-for-service beneficiaries aged ≥65 years and older with left ventricular ejection fraction ≤35% who underwent primary prevention ICD implantation, including those receiving concomitant cardiac resynchronization therapy between 2006 and 2010 and could be matched to Medicare claims. Outcomes were mortality and hospitalization (all-cause and heart failure) at 180 days, and device-related complications. We used multivariable hierarchical logistic regression to assess temporal trends in outcomes accounting for changes in patient, physician, and hospital characteristics. The cohort included 117 100 patients. Between 2006 and 2010, only modest changes in patient characteristics were noted. Fewer single lead devices and more cardiac resynchronization therapy devices were used over time. Between 2006 and 2010, there were significant improvements in all outcomes, including 6-month all cause mortality (7.1% in 2006, 6.5% 2010; adjusted odds ratio, 0.88; 95% confidence interval, 0.82-0.95), 6-month rehospitalization (36.3% in 2006, 33.7% in 2010; adjusted odds ratio, 0.87; 95% confidence interval, 0.83-0.91), and device-related complications (5.8% in 2006, 4.8% in 2010; adjusted odds ratio, 0.80; 95% confidence interval, 0.74-0.88).The clinical characteristics of this national population of Medicare patients undergoing primary prevention ICD implantation were stable between 2006 and 2010. Simultaneous improvements in outcomes suggest meaningful advances in the care for this patient population.
Effects of Chronic Digoxin Administration on Left Ventricular Performance in the Normal Conscious Dog
Authors: FELIX MAHLER, JOEL S. KARLINER, ROBERT A. O'ROURKE
Journal: Circulation (1974)

The effects of chronic digoxin administration on left ventricular (LV) function were studied in six healthy conscious dogs, instrumented with high-fidelity LV manometers and endocardial ultrasonic diameter gauges. Studies were performed at an average of eight days after a therapeutic serum level of digoxin had been achieved by daily intramuscular injections. In the resting state, at matched heart rates and at unchanged LV end-diastolic pressures, LV systolic pressure increased after digoxin by a mean of 9 mm Hg ( P &lt; 0.008), while peak LV dP/dt was augmented by 38% ( P &lt; 0.006). Mean and maximal velocity of circumferential fiber shortening (VCF) increased by 22% and 21%, respectively (both P &lt; 0.02), and LV systolic diameter excursion (ΔLVD) increased by 10% ( P &lt; 0.05) above control values. Intravenous propranolol did not alter these responses significantly. Elevation of LV systolic pressure to an average of 206 mm Hg by phenylephrine infusion did not change the previous basal augmentation of LV dP/dt and VCF produced by digoxin, but ΔLVD exceeded the control values by 25% as compared with the increase of 10% produced by digoxin alone ( P &lt; 0.02). Thus, chronic digoxin administration in the normal conscious dog exerts a potent positive inotropic effect in the resting state and markedly improves cardiac reserve as evidenced by enhanced LV performance during acute pressure overloading.
Hepatocellular carcinoma and nodular regenerative hyperplasia after chemotherapy for metastatic colorectal carcinoma
Authors: Julien Calderaro, Daniel Azoulay, Elie-Serge Zafrani
Journal: Hepatology (2014)

Colorectal carcinoma (CRC) is the third-most common cancer worldwide.1 Liver is the dominant metastatic site and synchronous hepatic metastases are identified in approximately 40%-50% of patients2 during diagnostic evaluation or in the course of treatment. Neoadjuvant oxaliplatin-based chemotherapy is widely used to reduce the risk of cancer relapse after surgery and, in many cases, to reduce tumor burden in order to allow complete resection.2 However, oxaliplatin-based chemotherapy may induce vascular liver injury, namely, sinusoidal obstruction syndrome (SOS), with or without nodular regenerative hyperplasia (NRH).3 We report on the case of a patient with oxaliplatin-induced vascular liver injury with NRH, in which several foci of hepatocellular carcinoma (HCC) developed. A 50-year-old man underwent partial hepatectomy for CRC metastasis. Preoperative chemotherapy included folic acid, 5-fluorouracil, and oxaliplatin (12 courses). No nodule suggestive of HCC was identified on preoperative magnetic resonance imaging. Gross examination of the surgical specimen revealed a firm nodule measuring 5 mm in diameter and located at the site of the metastatic tumor, as well as widespread hemorrhagic foci and marked nodularity. Histologically, the small nodule consisted of fibrous tissue with no remaining neoplastic cells. Also noted were moderate intimal thickening and partial occlusion of occasional terminal hepatic veins (SOS), marked centrilobular sinusoidal dilatation (Fig. 1A), and diffuse NRH, with small regenerative nodules distributed evenly throughout the liver (Fig. 1B). Within regenerative nodules, three areas of malignant transformation into well-differentiated HCC, measuring 4, 2, and 2 mm in diameter, respectively, were fortuitously identified: Cytological abnormalities included thickened trabeculae and canalicular pseudoglands (Fig. 1C,D). Immunohistochemistry revealed diffuse glutamine synthetase expression in areas of malignant transformation, in contrast to the staining of few layers of perivenular hepatocytes in the adjacent liver (Fig. 1E,F), a feature that further supports the diagnosis of HCC.4 There was no nuclear translocation of β-catenin, and glypican 3 was not detected. Nodular regenerative hyperplasia is part of the spectrum of hepatic vascular lesions that may develop in patients with CRC treated by chemotherapy, especially with oxaliplatin-based regimens.3 HCC has very rarely been reported as a complication of NRH.5 The present case is, to the best of our knowledge, the first HCC reported in a patient with metastatic CRC with oxaliplatin-induced NRH. It suggests that such patients might be at higher risk of HCC development. Julien Calderaro, M.D.1,2 Daniel Azoulay, M.D., Ph.D.2,3 Elie-Serge Zafrani, M.D.1,2 1Department of Pathology Henri Mondor Hospital Créteil, France 2Université Paris-Est Créteil Créteil, France 3Department of Digestive and Hepatobiliary Surgery Henri Mondor Hospital Créteil, France
Napoleon probably died of stomach cancer
Authors: Roger Dobson
Journal: BMJ (2005)

Obesity in children in England continues to rise 334 More than one in four children in England are overweight or obese, said a government report published last week which showed that obesity in young people is continuing to rise.The report said that the prevalence of obesity in children aged 2 to 10 increased from 9.9% in 1995 to 13.7% in 2003.The total number of overweight and obese children rose from 22.7% to 27.7% in this period.Obesity increased most in older children aged 8 to 10, rising from 11.2% in 1995 to 16.5% in 2003.Levels of obesity were similar for both sexes, increasing from 9.6% in 1995 to 14.9% in 2003 for boys and from 10.3% to 12.5% for girls.Children living in households with the lowest incomes had higher rates of obesity than those from households with the highest incomes (15.8% v 13.3%).
Evidence for intranasal antinuclear autoantibodies in patients with chronic rhinosinusitis with nasal polyps
Authors: Bruce K. Tan, Quan-Zhen Li, Lydia Suh, Atsushi Kato, David B. Conley, Rakesh K. Chandra, Jinchun Zhou, James Norton, Roderick Carter, Monique Hinchcliff, Kathleen Harris, Anju Peters, Leslie C. Grammer, Robert C. Kern, Chandra Mohan, Robert P. Schleimer
Journal: Journal of Allergy and Clinical Immunology (2011)
Social Class and Psychosomatic Illness
Authors: Finn Askevold
Journal: Psychotherapy and Psychosomatics (1982)

In six diseases considered psychosomatic (asthma, angina pectoris, migraine, duodenal ulcer, ulcerative colitis and anorexia nervosa), two factors have been studied: social background and social mobility. For none of the first five has any influence of social status on the disease been demonstrated. This means that social learning (norms and values) does not influence the disease. The psychological conflict is rooted earlier in life, before formative learning takes place. For anorexia nervosa, on the other hand, there is a marked difference. Social status plays a significant role, especially middle-class values, those of sexuality being the most important.
Optimization of Human Immunodeficiency Virus Treatment During Incarceration
Authors: Jaimie P. Meyer, Javier Cepeda, Johnny Wu, Robert L. Trestman, Frederick L. Altice, Sandra A. Springer
Journal: JAMA Internal Medicine (2014)

Human immunodeficiency virus (HIV) management in correctional settings is logistically feasible, but HIV-related outcomes before release have not been recently systematically examined.To evaluate HIV treatment outcomes throughout incarceration, including jail and prison.Retrospective cohort study of longitudinally linked demographic, pharmacy, and laboratory data on 882 prisoners within the Connecticut Department of Correction (2005-2012) with confirmed HIV infection, who were continually incarcerated 90 days or more, had at least 2 HIV-1 RNA and CD4 lymphocyte measurements, and were prescribed antiretroviral therapy.Three electronic databases (correctional, laboratory, and pharmacy) were integrated to assess HIV viral suppression (HIV-1 RNA levels, <400 copies/mL) on intake and release. Secondary outcomes were mean change in log-transformed HIV-1 RNA levels and mean change in CD4 lymphocyte count during incarceration. Demographic characteristics, prescribed pharmacotherapies, receipt of directly observed therapy, and duration of incarceration were analyzed as possible explanatory variables for HIV viral suppression in logistic regression models.Among 882 HIV-infected prisoners with 1185 incarceration periods, mean HIV-1 RNA level decreased by 1.1 log10 and CD4 lymphocyte count increased by 98 cells/µL over time, with a higher proportion achieving viral suppression by release compared with entry (70.0% vs 29.8%; P < .001); 36.9% of antiretroviral therapy (ART) regimens were changed during incarceration. After adjusting for baseline HIV-1 RNA level, prerelease viral suppression correlated with female sex (adjusted odds ratio, 1.81; 95% CI, 1.26-2.59) and psychiatric disorder severity below the sample median (adjusted odds ratio, 1.50; 95% CI, 1.12-1.99), but not race/ethnicity, incarceration duration, ART regimen or dosing strategy, or directly observed therapy.Though just one-third of HIV-infected prisoners receiving ART entered correctional facilities with viral suppression, HIV treatment was optimized during incarceration, resulting in the majority achieving viral suppression by release. Treatment for HIV within prison is facilitated by a highly structured environment and, when combined with simple well-tolerated ART regimens, can result in viral suppression during incarceration. In the absence of important and effective community-based resources, incarceration can be an opportunity of last resort to initiate continuous ART for individual health and, following the "treatment as prevention" paradigm, potentially reduce the likelihood of HIV transmission to others after release if continuity of HIV care is sustained.
Recommendations for improving national data on congenital anomalies are being implemented
Authors: E. Alberman, B. Botting
Journal: BMJ (1997)

Editor—The recent letters about possible changes in the prevalence of gastroschisis highlight the need for good quality national data on congenital anomalies.1 This was a major concern of the medical advisory committee of the Office of Population Censuses and Surveys (now part of the Office for National Statistics), which set up a working group …
109 CORRELATION OF LIVER “COLLAGEN PROPORTIONATE AREA” BY COMPUTER ASSISTED IMAGE ANALYSIS AND HEPATIC VENOUS PRESSURE GRADIENT IN PATIENTS WITH RECURRENT HCV INFECTION AFTER LIVER TRANSPLANTATION
Authors: V. Calvaruso, R. Standish, P. Manousou, S. Maimone, D. Patch, J. O'Beirne, M. Pleguezuelo, I. Xirouchakis, G.P. Guerrini, A.P. Dhillon, A.K. Burroughs
Journal: Journal of Hepatology (2008)
The role of renal hypoperfusion in development of renal microcirculatory dysfunction in endotoxemic rats
Authors: Matthieu Legrand, Rick Bezemer, Asli Kandil, Cihan Demirci, Didier Payen, Can Ince
Journal: Intensive Care Medicine (2011)

To study the role of renal hypoperfusion in development of renal microcirculatory dysfunction in endotoxemic rats.Rats were randomized into four groups: a sham group (n = 6), a lipopolysaccharide (LPS) group (n = 6), a group in which LPS administration was followed by immediate fluid resuscitation which prevented the drop of renal blood flow (EARLY group) (n = 6), and a group in which LPS administration was followed by delayed (i.e., a 2-h delay) fluid resuscitation (LATE group) (n = 6). Renal blood flow was measured using a transit-time ultrasound flow probe. Microvascular perfusion and oxygenation distributions in the renal cortex were assessed using laser speckle imaging and phosphorimetry, respectively. Interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α were measured as markers of systemic inflammation. Furthermore, renal tissue samples were stained for leukocyte infiltration and inducible nitric oxide synthase (iNOS) expression in the kidney.LPS infusion worsened both microvascular perfusion and oxygenation distributions. Fluid resuscitation improved perfusion histograms but not oxygenation histograms. Improvement of microvascular perfusion was more pronounced in the EARLY group compared with the LATE group. Serum cytokine levels decreased in the resuscitated groups, with no difference between the EARLY and LATE groups. However, iNOS expression and leukocyte infiltration in glomeruli were lower in the EARLY group compared with the LATE group.In our model, prevention of endotoxemia-induced systemic hypotension by immediate fluid resuscitation (EARLY group) did not prevent systemic inflammatory activation (IL-6, IL-10, TNF-α) but did reduce renal inflammation (iNOS expression and glomerular leukocyte infiltration). However, it could not prevent reduced renal microvascular oxygenation.
On the Mortality Patterns of Physicians
Authors: Robert L. Martensen
Journal: JAMA (1996)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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