tbuckley/cabot-search huggingface dataset:
Behavioral Treatment of Obesity in Patients Encountered in Primary Care Settings
Authors: Thomas A. Wadden, Meghan L. Butryn, Patricia S. Hong, Adam G. Tsai
Journal: JAMA (2014)

In 2011, the Centers for Medicare & Medicaid Services (CMS) approved intensive behavioral weight loss counseling for approximately 14 face-to-face, 10- to 15-minute sessions over 6 months for obese beneficiaries in primary care settings, when delivered by physicians and other CMS-defined primary care practitioners.To conduct a systematic review of behavioral counseling for overweight and obese patients recruited from primary care, as delivered by primary care practitioners working alone or with trained interventionists (eg, medical assistants, registered dietitians), or by trained interventionists working independently.We searched PubMed, CINAHL, and EMBASE for randomized controlled trials published between January 1980 and June 2014 that recruited overweight and obese patients from primary care; provided behavioral counseling (ie, diet, exercise, and behavioral therapy) for at least 3 months, with at least 6 months of postrandomization follow-up; included at least 15 participants per treatment group and objectively measured weights; and had a comparator, an intention-to-treat analysis, and attrition of less than 30% at 1 year or less than 40% at longer follow-up.Review of 3304 abstracts yielded 12 trials, involving 3893 participants, that met inclusion-exclusion criteria and prespecified quality ratings. No studies were found in which primary care practitioners delivered counseling that followed the CMS guidelines. Mean 6-month weight changes from baseline in the intervention groups ranged from a loss of 0.3 kg to 6.6 kg. In the control group, mean change ranged from a gain of 0.9 kg to a loss of 2.0 kg. Weight loss in both groups generally declined with longer follow-up (12-24 months). Interventions that prescribed both reduced energy intake (eg, ≥ 500 kcal/d) and increased physical activity (eg, ≥150 minutes a week of walking), with traditional behavioral therapy, generally produced larger weight loss than interventions without all 3 specific components. In the former trials, more treatment sessions, delivered in person or by telephone by trained interventionists, were associated with greater mean weight loss and likelihood of patients losing 5% or more of baseline weight.Intensive behavioral counseling can induce clinically meaningful weight loss, but there is little research on primary care practitioners providing such care. The present findings suggest that a range of trained interventionists, who deliver counseling in person or by telephone, could be considered for treating overweight or obesity in patients encountered in primary care settings.
Spinal Drainage in Poliomyelitis and Meningitis
Authors: H. V. Drew
Journal: BMJ (1935)

<h3>ABSTRACT</h3> Meditation has been practised for millennia but the neuroscientific understanding of the dynamics is still lacking. Sudarshan Kriya Yoga (SKY) is an evidence based breathing based meditation technique that utilizes rhythmic breathing to induce a deep state of relaxation and calm. Multiple studies have found benefits of the SKY technique from genetic, physiological, psychological to behaviour levels. We collected Electroencephalographic (EEG) data in 43 subjects who underwent the SKY technique and analysed the brain rhythms at different stages of the technique namely preparatory breathing (Pranayama), rhythmic breathing (Kriya) and meditation (Yoga Nidra) using newly developed methods to analyse periodic and aperiodic components. Alpha waves amplitude in the parieto-occipital region decreased as the rhythmic breathing progressed and dropped sharply during the meditation period. Theta amplitudes and peak frequency increased in the centro-frontal region during the rhythmic breathing period but were marked by sustained low theta waves during the meditation period. The delta wave amplitude was not affected by breathing but both delta band power and peak frequency increased during the meditation period in the centro-frontal region. We also saw a decrease in the 1/f aperiodic signal across the brain during the meditation period suggesting a modification of excitation-inhibition balance. We see an overall slowing down of brain oscillations from alpha to theta to delta as the meditation progressed. The paper studies in depth the transitional dynamics of the SKY technique analysing the alpha, theta, delta waves and aperiodic signals and demonstrates that each phase in a breathing based meditation has a unique electrophysiological signature.
NI-16 * INTRA-OPERATIVE USE OF FLUORESCEIN FOR MALIGNANT GLIOMA RESECTION DIFFERENTIATES TUMOR FROM NORMAL BRAIN TISSUE BASED ON HISTOPATHOLOGIC ANALYSIS
Authors: M. Decker, J. Kresak, A. Yachnis, F. Bova, M. Rahman
Journal: Neuro-Oncology (2014)

OBJECTIVES: To determine whether the use of IV fluorescein during surgery for malignant glioma can reliably be used to differentiate between infiltrative tumor and normal brain tissue. BACKGROUND: Fluorescein sodium is a molecular compound with fluorescent capabilities between light wavelengths of 520-530nm, appearing yellow-green (1). Neurosurgical application of fluorescein has been studied primarily for increasing intra-operative visibility of malignant gliomas (1). The mechanism of action has been hypothesized to involve disruption of the blood brain barrier (BBB) (2). Cells in areas with disrupted BBB take up fluorescein with a sensitivity of 94% and specificity of 89% for high-grade gliomas (2). We performed histopathologic analysis on tissue obtained during fluorescein-guided tumor resections to evaluate the differences between fluorescent and non-fluorescent tissue. METHODS: Two adult patients with suspected high-grade gliomas underwent surgical resection. Prior to opening of the dura 3mg/kg of IV fluorescein was given. A Zeiss OPMI Pentero microscope (Carl Zeiss Meditech Inc.) with a yellow 560nm filter was used to visualize the tumor. At the tumor margins, tissue was identified as "bright" and "dark" and sent as separate specimens for histopathological analysis. RESULTS: Histological sections of specimens labeled "bright" contained infiltrating glioma with focal microvascular proliferation. Histological sections of specimens labeled "dark" contained gray matter and focal subcortical white matter with no high-grade glioma identified. Final grading for both patients was WHO Grade IV, glioblastoma. CONCLUSION: Intra-operative use of fluorescein in surgical resection of malignant gliomas can help to distinguish between infiltrating tumor and normal brain tissue based on histopathological analysis. Further evaluation of the utility of flurorescein during high and low-grade glioma surgery is necessary.
THE URINARY DIASTASE TEST IN A CASE OF RUPTURED DUODENUM
Authors: A. H. Lister
Journal: BMJ (1914)

MEIA_ 0-~-A ,T stiucl anaemic conditiolis w.ith splenomegaly have whollv recovered after splenectomly.S. R., aged 8, was admitte(d to the Western Itfirmary on
THE PROGRESS OF MEDICINE IN THE PHILIPPINE ISLANDS.
Authors: VICTOR G. HEISER
Journal: JAMA (1906)

The health of any community, or of any country, is its most valuable asset. The truth of this proposition applies with special force to the Philippine Islands, where so much has been lost, so much delayed, and so much is to be gained by health conditions. If cholera, rinderpest and surra had not appeared in these islands, the historian would have had quite a different story to tell. These diseases are, in a large measure, responsible for the depression in business, the timidity of capital, and the spirit of unrest of which we have already heard too much. Medical science holds the key to the prosperity of the Philippine Islands, and on every doctor here rests an individual responsibility so great that its magnitude can not be measured. Whatever may be the relative importance of the medical man in other parts of the world, he, and the profession he represents,
Granulocyte–macrophage colony-stimulating factor (GM-CSF) priming with successive concomitant low-dose Ara-C for elderly patients with secondary/refractory acute myeloid leukemia or advanced myelodysplastic syndrome
Authors: HA Rossi, J O'Donnell, F Sarcinelli, FM Stewart, PJ Quesenberry, PS Becker
Journal: Leukemia (2002)
Screening for Thyroid Dysfunction: Which Test Is Best?
Authors: Mark Helfand, John Schmittner
Journal: JAMA (1993)

<h3>To the Editor.</h3> —In their letter, "Optimal Use of Blood Tests for Assessment of Thyroid Function," Becker et al<sup>1</sup>reassert the American Thyroid Association (ATA) guidelines<sup>2,3</sup>that the principal diagnostic tests for thyroid dysfunction should be estimation of free thyroxine (FT<sub>4</sub>) and a sensitive thyrotropin assay (sTSH). However, published studies do not justify the conclusion that the sTSH is the best<i>initial</i>test in all clinical situations. Most studies were conducted in the referral clinic setting, where patients with clinically obvious thyroid disease and patients with misleading thyroxine test results are concentrated. Others merely report the results of all assays performed by a hospital-based referral laboratory, with very little information about the clinical setting in which the tests were ordered. Still others compare the performance of the sTSH in patients who have conditions that are known to decrease the accuracy of other tests. The design of these
Therapy with high-dose dexamethasone (HD-DXM) in previously untreated patients affected by idiopathic thrombocytopenic purpura: a GIMEMA experience
Authors: Maria Gabriella Mazzucconi, Paola Fazi, Sayla Bernasconi, Giulio De Rossi, Giuseppe Leone, Luigi Gugliotta, Nicola Vianelli, Giuseppe Avvisati, Francesco Rodeghiero, Angela Amendola, Carlo Baronci, Cecilia Carbone, Stefano Quattrin, Giuseppe Fioritoni, Giulio D'Alfonso, Franco Mandelli
Journal: Blood (2006)
Recalibrating Intellectual Property Rights to Enhance Translational Research Collaborations
Authors: Tania Bubela, Garret A. FitzGerald, E. Richard Gold
Journal: Science Translational Medicine (2012)

Multisectoral collaborative models for drug and therapeutic research and development (R&D) are emerging, requiring a recalibration of how intellectual property rights (IPRs) are used. Although these models appear promising, little study has been conducted on the optimal blend of sharing and exclusion as mediated through the proactive use or nonuse of IPRs. This Commentary is a call for a combination of theoretical and empirical analyses to build a comprehensive understanding of the interplay between formal IP laws, institutions that administer and manage IPRs, and the use of IPRs in practice to better construct and manage collaborations. Such analyses require outcome metrics formulated to measure the success of therapeutic outcomes and to capture the complexity of a highly networked R&D environment.
Preventing Vertical Transmission of HIV Infection
Authors: Catherine Peckham, Marie-Louise Newell
Journal: New England Journal of Medicine (2000)

The complex clinical trial described by Lallemant and colleagues in this issue of the Journal 1 was designed to determine the optimal duration of treatment with zidovudine to prevent the transmission of human immunodeficiency virus type 1 (HIV-1) infection from mother to child in areas where the resources for health care are poor. However, the results of the study may challenge the current policy in both developed2 and developing3 countries.In this study, four regimens of zidovudine were evaluated in 1437 non–breast-feeding women in northern Thailand. The women were given either zidovudine starting at 28 weeks' gestation (the long maternal regimen) . . .
Better Off Dead: Suicidal Thoughts in Cancer Patients
Authors: Jane Walker, Rachel A. Waters, Gordon Murray, Helen Swanson, Carina J. Hibberd, Robert W. Rush, Dawn J. Storey, Vanessa A. Strong, Marie T. Fallon, Lucy R. Wall, Michael Sharpe
Journal: Journal of Clinical Oncology (2008)

Purpose Cancer is associated with an increased risk of suicide and attempted suicide. However, we do not know how many cancer patients have thoughts that they would be better off dead or thoughts of hurting themselves. This study aimed to determine the prevalence of such thoughts in cancer outpatients and which patients are most likely to have them. Patients and Methods A survey of consecutive patients who attended the outpatient clinics of a regional cancer center in Edinburgh, United Kingdom. Patients completed the Patient Health Questionnaire-9 (PHQ-9), which included Item 9 that asks patients if they have had thoughts of being better off dead or of hurting themselves in some way in the previous 2 weeks. Those who reported having had such thoughts for at least several days in this period were labeled as positive responders. Patients also completed the Hospital Anxiety and Depression Scale (HADS) and a pain scale. The participating patients’ cancer diagnoses and treatments were obtained from the cancer center clinical database. Results Data were available on 2,924 patients; 7.8% (229 of 2,924; 95% CI, 6.9% to 8.9%) were positive responders. Clinically significant emotional distress, substantial pain, and—to a lesser extent—older age, were associated with a positive response. There was strong evidence of interactions between these effects, and emotional distress played the most important role. Conclusion A substantial number of cancer outpatients report thoughts that they would be better off dead or thoughts of hurting themselves. Management of emotional distress and pain should be a central aspect of cancer care.
Benefit of Abciximab in Patients with Refractory Unstable Angina in Relation to Serum Troponin T Levels
Authors: Christian W. Hamm, Christopher Heeschen, Britta Goldmann, Alec Vahanian, Jennifer Adgey, Carlos Macaya Miguel, Wolfgang Rutsch, Juergen Berger, Jille Kootstra, Maarten L. Simoons
Journal: New England Journal of Medicine (1999)

In patients with refractory unstable angina, the platelet glycoprotein IIb/IIIa–receptor antibody abciximab reduces the incidence of cardiac events before and during coronary angioplasty. We investigated whether serum troponin T levels identify patients most likely to benefit from therapy with this drug.
Platelet function in coronary artery disease: effects of coronary surgery and sulfinpyrazone.
Authors: J F Cade, D J Doyle, C N Chesterman, F J Morgan, G C Rennie
Journal: Circulation (1982)

Quality of life, as a concept pertaining to patients undergoing coronary artery bypass graft surgery, is explored. A theory of life quality, based on the capacity of the patient to realize his own life plans, is proposed, explaining the role of differing factors, general and individualized. Using the proposed theory, three avenues of investigation are suggested, each aimed at the more effective use of surgery in improving life quality.
Striving for Coherence
Authors: Paul R. McHugh
Journal: JAMA (2005)

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
MRC says it will invent, develop, and market its own drugs
Authors: Michael Day
Journal: BMJ (2007)

An influential group of MPs has claimed that widespread financial incompetence is adding to the cost of the United Kingdom's controversial private finance initiative (PFI).The House of Commons Committee of Public Accounts made its new attack on the PFI after it discovered that the government had clawed back £100m (€145m; $200m) less than was predicted from the new private-public profit sharing schemes.The committee's chairman, the Conservative MP Edward Leigh, blamed the loss on the failure of Treasury officials to oversee key refinancing arrangements.In 2002 ministers introduced changes so that public sector bodies could share in some of the financial gains when big PFI loans were rearranged.Typically, these loans were renegotiated on a more favourable basis once PFI projects had been completed and the risks involved were lower.However, left to their own devices, officials in local hospitals had been out of their depth negotiating with their counterparts in the private sector, the committee says.In 2003 the Office of Government Commerce, which then had responsibility for PFI policy, told the public accounts committee that it expected the public sector to receive between £175m and £200m from the voluntary sharing arrangements in early PFI deals.However, up to December 2006 the government had secured the right to gains of only £93m."Proceeds gained by the public sector from PFI debt refinancing under the voluntary code for the sharing of gains are currently well short of expectations" said Mr Leigh.
Comparative Accuracy of CT Attenuation-Corrected and Non–Attenuation-Corrected SPECT Myocardial Perfusion Imaging
Authors: Punit Sharma, Chetan D. Patel, Sellam Karunanithi, Sagar Maharjan, Arun Malhotra
Journal: Clinical Nuclear Medicine (2012)

The aim of the present study was to evaluate whether computed tomography based-attenuation correction (CT-AC) provides any advantage over non-attenuation-corrected (NAC) images for qualitative and quantitative analysis of single photon emission tomography (SPECT) myocardial perfusion imaging (MPI).We retrospectively evaluated data of 171 patients who underwent stress rest MPI SPECT/CT as per standard protocol. Angiography done within ±3 months of MPI was taken as reference standard. Two readers independently evaluated CT-AC and NAC images. Receiver operating characteristic curve analysis was done using ≥50% and ≥70% stenosis as cutoff. The size and severity of perfusion defects were also compared on CT-AC and NAC images.For both readers, the area under the receiver operating characteristic curve was larger for CT-AC images than for NAC images at both ≥50% and ≥70% cutoff, but the difference was not significant. CT-AC images had significantly lower sensitivity for detecting right coronary artery disease compared with NAC (29% vs. 50% for reader 1 and 25.8% vs. 43.2% for reader 2). However, the specificity improved with CT-AC. Inferior defects were significantly smaller in CT-AC than NAC (P = 0.0002), with no significant difference for anterior defects (P = 0.544). There was significant variation in severity between CT-AC and NAC images for both overall (P = 0.001) as well as for inferior defects (P = 0.0007), but not for anterior defects (P = 0.279).In our study, the CT-based AC improved the specificity but decreased the sensitivity leading to nonsignificant improvement in overall diagnostic accuracy of Tc-99m sestamibi/tetrofosmin MPI.
Perinatal intervention trial in Africa: effect of a birth canal cleansing intervention to prevent HIV transmission
Authors: R.J Biggar, J.J Goedert, P.G Miotti, T.E Taha, L Mtimavalye, A Justesen, J.D Chiphangwi, R Broadhead, F Yellin, G Liomba, W Miley, D Waters
Journal: The Lancet (1996)

Summary Background Perinatal transmission of human immunodeficiency virus (HIV) type 1 contributes significantly to infant mortality. Exposure in the birth canal may account for some transmission. We examined the efficacy of a birth canal washing procedure in reducing perinatal transmission in Malawi.Methods The infection status of infants of 3327 control women (conventional delivery procedures) was compared with that of 3637 infants of intervention-delivered women. The infants' HIV status was determined by polymerase chain reaction on dried blood spots collected at 6 and 12 weeks of age. The intervention consisted of manual cleansing of the birth canal with a cotton pad soaked in 0·25% chlorhexidine, which was done on admission in labour and every 4 h until delivery. Findings No adverse reactions to the intervention procedure were seen. 2094 (30%) of the enrolled women were HIV-infected, and 59% of their infants were seen in follow-up. Among 982 vaginal vertex singleton deliveries to HIV-infected women, 269 (27%) infants were infected. The intervention had no significant impact on HIV transmission rates (27% in 505 intervention women compared with 28% in 477 control women), except when membranes were ruptured more than 4 h before delivery (transmission 25% in the intervention group vs 39% in the control group). Interpretation If birth canal exposure is an important risk factor, different or additional methods to reduce the risk of perinatal HIV transmission should be tested. Alternatively, perhaps birth canal exposure is not a major contributor to perinatal infection risk.
Severe autosomal dominant hypertension and brachydactyly in a unique Turkish kindred maps to human chromosome 12
Authors: Herbert Schuster, Thomas F. Wienker, Sylvia Bähring, Nihat Bilginturan, Hakan R. Toka, Heidemarie Neitzel, Eva Jeschke, Okan Toka, Dennis Gilbert, Adam Lowe, Jürg Ott, Hermann Haller, Friedrich C. Luft
Journal: Nature Genetics (1996)
Diazepam in Labour: Its Metabolism and Effect on the Clinical Condition and Thermogenesis of the Newborn
Authors: J. E. Cree, J. Meyer, D. M. Hailey
Journal: BMJ (1973)

Following the administration of diazepam to mothers in labour the clinical effects, changes in thermogenesis, and metabolism of the drug in the newborn were observed under carefully controlled conditions. A total maternal dose of 30 mg or less in the 15 hours before delivery had little effect on the infants9 state. Larger doses, however, were accompanied by low Apgar scores at birth, apnoeic spells, hypotonia, reluctance to feed, and an impaired metabolic response to a cold stress. Measurement of plasma levels of diazepam and its active metabolite showed that both products were detectable in significant concentrations in some infants for up to eight days. We conclude that greater care should be taken in the use of this otherwise effective drug for the treatment of pre-eclampsia.
Factors influencing the response to advertisements for general practice vacancies
Authors: R. Carlisle, S. Johnstone
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objectives</b>: To investigate the extent of problems in recruiting general practitioners and to determine which practice characteristics affect recruitment—in particular, to see if practices with deprived patients have more recruitment problems. <b>Design</b>: Postal questionnaire survey in August 1995. <b>Subjects</b>: 489 consecutive practices that had advertised for a partner in the BMJ from January to April 1995. <b>Main outcome measures</b>: The number of applicants, the practices9 satisfaction with their quantity and quality, and whether a successful appointment was made. <b>Results</b>: 442 (90%) practices replied. 262 practices (60%) were not very satisfied or very dissatisfied with the number of applications they received; 15 (3%) received no applications. There was a significant difference in the number of applications received by practices in different NHS regions. The 32 practices with the highest proportions of patients eligible for deprivation payments received a median of five applicants compared with 10 for practices without deprivation. <b>Conclusion</b>: There is a widespread problem in recruiting general practitioners. Recruitment is hardest in areas with the greatest health needs.