tbuckley/cabot-search huggingface dataset:
Synthesizing Evidence
Authors: M. Hassan Murad, Victor M. Montori
Journal: JAMA (2013)

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
A cluster-randomized trial to provide clinicians inhaled corticosteroid adherence information for their patients with asthma
Authors: L. Keoki Williams, Edward L. Peterson, Karen Wells, Janis Campbell, Mingqun Wang, Vimal K. Chowdhry, Matthew Walsh, Robert Enberg, David E. Lanfear, Manel Pladevall
Journal: Journal of Allergy and Clinical Immunology (2010)
Preventing Insect Sting Anaphylaxis
Authors: Helen Hollingsworth
Journal: JAMA (1997)

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
Randomised comparison of procedures for obtaining informed consent in clinical trials of treatment for cancer.
Authors: R J Simes, M H Tattersall, A S Coates, D Raghavan, H J Solomon, H Smartt
Journal: BMJ (1986)

Methods of obtaining informed consent have evolved differently in Western countries without substantive information on the impact of these different practices on the patients. A randomised study was performed to compare two commonly adopted methods of seeking consent to randomised treatment: an individual approach at the discretion of each doctor and a uniform policy of total disclosure of all relevant information. The impact of both consent procedures on the patient9s understanding and anxiety levels and on the doctor-patient relationship was assessed by means of a questionnaire given soon after the consent interview. Fifty seven patients were assigned at random to two groups: to 29 patients an individual approach to seeking consent was adopted and to 28 patients all relevant information was given. Seven patients refused consent to randomised treatment, with slightly more refusals by patients in the total disclosure group (5 v 2, p = 0.25). The main effects of total disclosure of all information compared with an individual approach to seeking consent were: a better understanding of treatment and side effects and of research aspects of the treatments; less willingness to agree to randomised treatment; and increased anxiety. No significant differences were found in patients9 perceptions of the doctor-patient relationship. A repeat questionnaire given three to four weeks later no longer showed significant differences between the two groups.
Long-Term Prognostic Value of Dobutamine-Atropine Stress Echocardiography in 1737 Patients With Known or Suspected Coronary Artery Disease
Authors: Don Poldermans, Paolo M. Fioretti, Eric Boersma, Jeroen J. Bax, Ian R. Thomson, Jos R. T. C. Roelandt, Maarten L. Simoons
Journal: Circulation (1999)

The purpose of this study was to assess the long-term value of dobutamine-atropine stress echocardiography (DSE) for prediction of late cardiac events in patients with proven or suspected coronary artery disease.Clinical data and DSE results were analyzed in 1734 consecutive patients undergoing DSE between 1989 and 1997. Seventy-four patients who underwent revascularization within 3 months of DSE and 1 patient lost to follow-up were excluded; the remaining 1659 (median age, 62 years; range, 14 to 99 years) were followed up for 36 months (range, 6 to 96 months). Wall motion abnormalities at rest and the presence and extent of stress-induced wall motion abnormalities (ischemia) were scored for each patient. Cardiac events were related to clinical and ECG data and DSE results. Four hundred twenty-eight cardiac events occurred in 366, documented cardiac death in 108 (total death, 247), nonfatal infarction in 128, and late revascularization in 192 patients. In a multivariable Cox proportional-hazards model, the ratio of documented cardiac death or (re)infarction was increased in the presence of stress-induced ischemia (hazard ratio, 3.3; 95% CI, 2.4 to 4.4) and extensive rest wall motion abnormalities (hazard ratio, 1.9; 95% CI, 1.3 to 2.6). The number of ischemic segments was predictive for late cardiac events. A normal DSE carried a relatively good prognosis, with an annual event rate of cardiac death or infarction of 1.3% over a 5-year period.In a large group of patients, DSE has an added value for predicting late cardiac events during long-term follow-up, improving the separation between high- risk and very-low-risk patients.
The Homeless Mentally III
Authors: LOREN R. MOSHER
Journal: JAMA (1985)

Finding this book on the dining room table, my 19-year-old son remarked to his friend, "Now there's folks with two strikes against them." Home is where the heart is. Home is where you're from. Home is family and friends. Home is shelter. Home is safety. Home is privacy. Home is freedom to be yourself. Home is each person's castle. Homelessness is none of these. To be "mentally ill" is to be distressed, shunned, labeled, stigmatized, institutionalized, zombiized, cipherized, marginalized, and made powerless and dependent. Mental illness may be all of these. Safely sequestered in my sturdy home on a tree-lined street in northwest Washington, DC, I rarely witness the problems of these million or more Americans. Each week, on my way to a course on Puccini operas, I pass a Washington grate man. He "owns" his grate and its warmth in winter. I say hello; he nods in recognition and
A man of wit and clinical wisdom
Authors: Theodore Dalrymple
Journal: BMJ (2008)

One does not turn to medical journals for the delights of literature, or for blinding shafts of insight conveyed by aphorism. No one expects a double-decker bus to perform like a Maserati: which is not, of course, to denigrate double-decker buses. They are good at what they do.

The British endocrinologist and haematologist Richard Asher (1912-69), however, managed to combine wit and clinical wisdom with literary felicity. He it was who first thought of the adventures of Baron Munchausen in connection with that small group of patients who go from hospital to hospital with tales of dramatic symptomatology. I was pottering about my books the other day, as old men do, when I pulled …
A PHYSIOLOGICO-PATHOLOGICAL STUDY OF A CASE OF HEART-BLOCK OCCURRING IN A DOG AS A RESULT OF NATURAL CAUSES
Authors: George Bachmann
Journal: The Journal of Experimental Medicine (1912)

What is believed to be the first known case of heart-block arising in a dog as a result of an ingenerate pathological lesion is here reported. The auriculo-ventricular dissociation was of that degree known as relatively complete block and became apparent on section of the right vagus nerve. Stimulation of the peripheral end of the cut vagus failed to inhibit the ventricles, although complete inhibition of the auricles occurred. The same results were obtained during the ventricular acceleration produced by strophanthin, so that the failure of the vagus to inhibit the ventricles is not due to the latter's infrequent action, but more probably to a normal lack of direct chronotropic influence upon the ventricular muscle. These findings are similar to those obtained by Erlanger in experimental heart-block. To small repeated doses of strophanthin injected intravenously the heart reacted as follows: (a) irregular slowing of the auricles and conversion of the relatively complete into an absolutely complete a-v block; (b) a rise in the irritability of the cardiac muscle manifested by a rapidly progressing auricular and ventricular frequency, the ventricular frequency surpassing ultimately the auricular frequency; (c) complete arrest of the auricles, the ventricles continuing at their high rate; (d) sudden fibrillation of the ventricles and shortly afterwards arrest in diastole. There were found post mortem myxomatous-like thickenings at the free edge of the septal tricuspid leaflet and at the attached margin of the posterior aortic leaflet and along part of the right anterior aortic leaflet. There was also a grayish patch on the right side of the auricular septum above the auriculo-ventricular junction. The thickenings at the edge of the valves consisted of dense, circumscribed masses of what appeared to be new connective tissue. The same tissue was found pressing against the bundle along the greater part of the latter's course. There was considerable fatty infiltration of the auricular musculature immediately above the bundle and, to a slight extent, of the bundle itself. The fibers of communication between the auricular muscle and the node of Tawara were relatively few as compared with those of the normal heart. A review of the pathology of heart-block is appended, showing the present status of the question, concerning the relationship existing between disease of the a-v conducting system and the various grades of heart-block.
GFAP Is Necessary for the Integrity of CNS White Matter Architecture and Long-Term Maintenance of Myelination
Authors: Wolfgang Liedtke, Winfried Edelmann, Phyllis L. Bieri, Fung-Chow Chiu, Nicholas J. Cowan, Raju Kucherlapati, Cedric S. Raine
Journal: Neuron (1996)

To investigate the structural role of glial fibrillary acidic protein (GFAP) in vivo, mice carrying a null mutation in GFAP were generated. In 7/14 mutant animals older than 18 months of age, hydrocephalus associated with white matter loss was detected. Mutant mice displayed abnormal myelination including the presence of actively myelinating oligodendrocytes in adults, nonmyelinated axons in optic nerve, and reduced myelin thickness in spinal cord. White matter was poorly vascularized and the blood–brain barrier was structurally and functionally impaired. Astrocytic structure and function were abnormal, consisting of shortened astrocytic cell processes, decreased septation of white matter, and increased CNS extracellular space. Thus, GFAP expression is essential for normal white matter architecture and blood–brain barrier integrity, and its absence leads to late-onset CNS dysmyelination.
Health centre design--a criticism.
Authors: J R James
Journal: BMJ (1971)

Southsea, Hants J. R. JAMES, B.M., D.OBST.R.CO.G., General Practitioner matters it seems obvious that the lessons of experience should be fed back to the appropriate design department in order to obtain a steady improvement in buildings of the same type. Yet the official guide for health centres1 reproduces, with implicit approval, the plans of 19 health centres, built by 16 different local authorities, without any criticism of them or any report on how they have worked out in practice. As it happens, no hindsight is needed to see faults in all of them, nor is there need to ask how they are working to be sure that nearly all are wasting many manhours, including doctorhours, every day. The exceptions are those which have been designed in disregard of some of the specific advice given in the guide.
Large-diameter balloon dilation after endoscopic sphincterotomy for removal of difficult bile duct stones
Authors: S. Misra, M. Dwivedi
Journal: Endoscopy (2008)

Endoscopic sphincterotomy followed by extraction using a Dormia basket or an extraction balloon catheter is the procedure that is generally used for the removal of bile duct stones. This is not successful in all patients, however, and some stones have to be extracted using lithotripsy devices. In an attempt to avoid mechanical lithotripsy, we used large-diameter balloons after sphincterotomy for removing stones that could not be extracted using the conventional methods.In this retrospective pilot study, large-diameter (15-mm, 18-mm, or 20-mm maximum sizes) balloon dilation of the sphincterotomy site was performed in 50 patients in whom bile duct stones could not be removed by endoscopic sphincterotomy and Dormia basket or balloon catheter extraction.The stones varied in size from < 15 mm to 25 mm. Common bile duct stones could be removed in all the patients using the large-diameter balloon technique. A Dormia basket or an extraction balloon catheter was required for removal of stones in 29 patients (58 %); and mechanical lithotripsy was required in five patients (10 %). Minor oozing of blood was seen in 16 patients (32 %), but the ooze stopped spontaneously during the endoscopy. Melena occurred in two patients and major bleeding requiring surgery occurred in one patient. Mild acute pancreatitis that resolved with conservative management occurred in four patients (8 %). There were no perforations and no deaths.Large-diameter balloon dilation of the sphincterotomy site is an effective procedure for removal of bile duct stones that cannot be extracted by endoscopic sphincterotomy and conventional extraction devices. Mechanical lithotripsy could be avoided in the majority of these patients using this approach.
Salpingitis Due to<i>Enterobius vermicularis</i>
Authors: Edmund J. Croce, William F. MacGillivray, Clarence J. Murphy
Journal: New England Journal of Medicine (1956)

ENTEROBIUS (formerly called "Oxyuris") vermicularis is the most common metazoan parasite of man. Despite its world-wide prevalence, its pathogenicity is very low, and it rarely strays from its usual habitat in the intestinal tract and the perianal skin. It is our purpose to report the case of a girl in whom the organism apparently caused a salpingooöphoritis, and to review briefly the literature of atypical infestation.The infestation, though extremely prevalent, is quite variable throughout the world, in various sections of the country, and even in various social classes. Thus, Weller and Sorenson1 reported a prevalence of 19 per . . .
Accountability for reasonableness: an update
Authors: N. Daniels, J. E Sabin
Journal: BMJ (2008)

Twelve years ago (<i>BMJ</i> 1996;312:1553-4) the <i>BMJ</i> argued that health systems needed to be explicit about rationing and published articles describing different ways of rationing fairly. Here a clinician (doi:10.1136/bmj.a1846), two ethicists, and four health economists (doi:10.1136/bmj.a1872) discuss how their ideas have developed—and been put into practice—since then
Conceptions in England and Wales are falling in women under 18 but rising overall
Authors: Susan Mayor
Journal: BMJ (2006)

The conception rate in girls aged 15-17 in England and Wales fell from 42.3 conceptions per 1000 to 41.7, between 2003 and 2004. But overall there was a 2.4% increase in estimated conceptions from 73.7 to 75.2 conceptions per 1000 women aged 15-44.

The greatest increase in conception rate was seen in women aged at least 40; the rate increased by 6%, from 10.7 to 11.3 conceptions per 1000 women aged 40-44.

Nirupta Dattani, a statistician with the Office for National Statistics, said that the data had not been analysed for the reasons underlying the increase in conceptions in older women. However, …
CathCam Guide Wire-Directed Colonoscopy: First Pilot Study in Patients with a Previous Incomplete Colonoscopy
Authors: A. Fritscher-Ravens, S. Fox, C. Swain, P. Milla, G. Long
Journal: Endoscopy (2006)

Background and Study Aims: Conventional colonoscopy as the gold standard for large-bowel diagnostics and therapy may fail in 5 % - 20 % of cases, depending on the experience of the examiner. Colonoscopy is regarded as difficult and painful by many patients. In an attempt to overcome the limitations of conventional colonoscopes, a guide wire-directed, thin, flexible diagnostic colonoscope, the CathCam was developed. In this prospective pilot study, we report its use in patients in whom conventional colonoscopy had failed. Patients and Methods: 49 patients with a previous or current failure of complete colonoscopy were invited to participate in a trial using the new CathCam system, and 14 (nine men; mean age 59 years) accepted. The CathCam is an 11-mm diameter disposable, multilumen catheter, with visualization by a 3-mm camera with six light-emitting diodes. In the first five patients, the CathCam was inserted over a newly developed 0.024-inch, hinged, lumen-seeking guide wire. Subsequently, a modified combined approach was used: a conventional colonoscope was introduced into the sigmoid or left colon, then the guide wire was advanced as far as possible, followed by CathCam insertion over it. Caecal intubation rate, insertion times and patient discomfort were recorded; patients received low-dose midazolam sedation (2 - 5 mg). Results: One patient was excluded during colonoscopy. The caecum could be eventually reached in 12 of 13 patients; in the remaining patient a significant sigmoid stricture could be passed, but further advancement appeared too risky. The mean caecal intubation time was 24 minutes (range 3 - 105 min). Only two patients experienced pain and discomfort during the procedure (one immediate assessment and one case reported at later telephone interview). No complications occurred, and previously undiagnosed important findings were obtained in 9 cases. Conclusions: A combined approach, consisting of guide wire insertion via a partially introduced colonoscope followed by CathCam or colonoscope insertion into the caecum was successful in over 90 % of patients with previous failure of complete colonoscopy. Further improvements may make this system suitable for use as a standard diagnostic colonoscope, either as a single unit (CathCam plus guide wire) or using the guide wire alone with a standard colonoscope in difficult cases.
PET/CT Examination in an Anaplastic Malignant Lymphoma With Extensive Reactive Involvement
Authors: Patric Larsson, Bernhard Holzgraefe, Håkan Kalzén, Maria Donnelly, Anna Porwit, Hans Jacobsson
Journal: Clinical Nuclear Medicine (2008)

A woman with leukocytosis, increased C-reactive protein (CRP), and clinical pneumonia exhibited overactivation of the immunologic system with elevated interleukin (IL)-6 and IL-17 levels. A PET/CT FDG imaging demonstrated an unusual finding with extensive lymphadenopathy with intense tracer uptake and increased uptake by the bone marrow and spleen. Biopsy showed an anaplastic large cell lymphoma. This may especially produce IL-6, which is a potent pyrogen and an inducer of CRP. It is also associated with systemic inflammatory features and probably mediated the inflammatory presentation. The bulk of the extensive tumor consisted of reactive lymphatic cells probably giving rise to most of the tracer accumulation with the spectacular findings on F-18 FDG PET/CT imaging.
Dietary Protein Intake and Progressive Glomerular Sclerosis: The Role of Capillary Hypertension and Hyperperfusion in the Progression of Renal Disease
Authors: TIMOTHY W. MEYER
Journal: Annals of Internal Medicine (1983)

Unrestricted intake of protein-rich foods is accompanied by sustained increases in glomerular capillary pressures and flows. Intrarenal hypertension and hyperperfusion associated with protein intake may eventually cause glomerular sclerosis and account for decreased renal function seen with aging. Further elevation of glomerular capillary pressures and flows contributes to progressive glomerular destruction and eventual loss of renal function when nephron number has been reduced by renal disease. Progressive loss of renal function may be retarded by restriction of protein intake. Protein restriction appears to preserve renal function by limiting intrarenal capillary hypertension and hyperperfusion.
Methylation of <i>RASSF1A, RASSF2A</i>, and <i>HIN-1</i> Is Associated with Poor Outcome after Radiotherapy, but not Surgery, in Oral Squamous Cell Carcinoma
Authors: Kuo-Hao Huang, Shiang-Fu Huang, I-How Chen, Chun-Ta Liao, Hung-Ming Wang, Ling-Ling Hsieh
Journal: Clinical Cancer Research (2009)

Abstract Purpose: Radiotherapy is the standard adjuvant treatment for oral squamous cell carcinoma (OSCC). The Ras/PI3K/AKT pathway is the major mechanism associated with radioresistance. To evaluate the potential significance on the outcome of radiotherapy in OSCC of the Ras/PI3K/AKT pathway with respect to methylation of negative regulators, we examined the methylation status of genes known to be involved in Ras/PI3K/AKT pathway and aberrantly methylated in human cancers together with the mutation status of K-ras/H-ras. Experimental Design: PCR–denaturing high-performance liquid chromatography was used to examine the methylation status of the RASSF1A, RASSF2A, PTEN, and HIN-1 genes, and PCR-RFLP was used to determine the mutation status of K-ras/H-ras in 482 OSCCs. Associations between mutation, methylation, clinicopathologic parameters, and outcome were evaluated. Results: The frequencies of K-ras/H-ras mutation and promoter methylation of the RASSF1A, RASSF2A, PTEN, and HIN-1 genes were 6.6%, 22.4%, 27.8%, 1.2%, and 7.3%, respectively. A combination of RASSF1A and RASSF2A methylation was found to be significantly associated with poor disease-free survival (DFS). Furthermore, a gene dosage effect of the activated Ras/PI3K/AKT signal on DFS was observed in patients treated with radiotherapy after surgery but not in patients treated with surgery alone. The Ras/PI3K/AKT pathway was activated in 140 primary OSCCs among 286 patients treated with radiotherapy after surgery and methylation of RASSF1A/RASSF2A (75.7%) was the most common mechanism. Conclusion: Our study indicates that epigenetic silencing of tumor suppressor genes involved in the Ras/PI3K/AKT pathway plays an important role in OSCC radioresistance and this provides a rationale for exploring novel treatment strategies.
1108-117 Reduced bone mass in men with advanced chronic heart failure is accompanied by hyperparathyroidism, andropenia, and inflammation, and predicts poor outcome
Authors: Ewa A Jankowska, Agnieszka Kus, Justyna Jakubaszko, Jacek Majda, Waldemar Banasiak, Stefan Anker, Piotr Ponikowski
Journal: Journal of the American College of Cardiology (2004)
EBV Zta protein induces the expression of interleukin-13, promoting the proliferation of EBV-infected B cells and lymphoblastoid cell lines
Authors: Shu-Chun Tsai, Sue-Jane Lin, Po-Wen Chen, Wen-Yi Luo, Te-Huei Yeh, Hsei-Wei Wang, Chi-Ju Chen, Ching-Hwa Tsai
Journal: Blood (2009)