tbuckley/cabot-search huggingface dataset:
Health related quality of life after combined hormone replacement therapy: randomised controlled trial
Authors: A. J Welton, M. R Vickers, J. Kim, D. Ford, B. A Lawton, A. H MacLennan, S. K Meredith, J. Martin, T. W Meade
Journal: BMJ (2008)

<b>Objective</b> To assess the effect of combined hormone replacement therapy (HRT) on health related quality of life. <b>Design</b> Randomised placebo controlled double blind trial. <b>Setting</b> General practices in United Kingdom (384), Australia (94), and New Zealand (24). <b>Participants</b> Postmenopausal women aged 50-69 at randomisation; 3721 women with a uterus were randomised to combined oestrogen and progestogen (n=1862) or placebo (n=1859). Data on health related quality of life at one year were available from 1043 and 1087 women, respectively. <b>Interventions</b> Conjugated equine oestrogen 0.625 mg plus medroxyprogesterone acetate 2.5/5.0 mg or matched placebo orally daily for one year. <b>Main outcome measures</b> Health related quality of life and psychological wellbeing as measured by the women’s health questionnaire. Changes in emotional and physical menopausal symptoms as measured by a symptoms questionnaire and depression by the Centre for Epidemiological Studies depression scale (CES-D). Overall health related quality of life and overall quality of life as measured by the European quality of life instrument (EuroQol) and visual analogue scale, respectively. <b>Results</b> After one year small but significant improvements were observed in three of nine components of the women’s health questionnaire for those taking combined HRT compared with those taking placebo: vasomotor symptoms (P&lt;0.001), sexual functioning (P&lt;0.001), and sleep problems (P&lt;0.001). Significantly fewer women in the combined HRT group reported hot flushes (P&lt;0.001), night sweats (P&lt;0.001), aching joints and muscles (P=0.001), insomnia (P&lt;0.001), and vaginal dryness (P&lt;0.001) than in the placebo group, but greater proportions reported breast tenderness (P&lt;0.001) or vaginal discharge (P&lt;0.001). Hot flushes were experienced in the combined HRT and placebo groups by 30% and 29% at trial entry and 9% and 25% at one year, respectively. No significant differences in other menopausal symptoms, depression, or overall quality of life were observed at one year. <b>Conclusions</b> Combined HRT started many years after the menopause can improve health related quality of life. <b>Trial registration</b> ISRCTN 63718836.
Effectiveness of Bystander CPR-Reply
Authors: E. John Gallagher
Journal: JAMA (1996)

<h3>In Reply.</h3> —Dr Weil and colleagues comment on three pertinent issues in our article. First, regarding the relative importance of compressions vs ventilations in CPR, our data are entirely compatible with the hypothesis that effective ventilations are less crucial to survival than effective compressions during CPR. This concept has been suggested by Noc et al<sup>1</sup>and Berg et al,<sup>2</sup>but we did not comment on it for both methodological and statistical reasons. Exploring this hypothesis with our data would have represented a post hoc subset analysis, and we did not wish to mix hypothesis-generating work with a priori hypothesis testing. Moreover, as previously reported,<sup>3</sup>overall survival rates from cardiac arrest in New York City are so poor (1.4%) that we lacked sufficient statistical power to detect survival differences in stratified subsets or to demonstrate convincingly that no differences exist. As experienced investigators such as Weil are well
Fulminant Streptococcal Meningoencephalitis
Authors: Mark N. Rubin, Eelco F. M. Wijdicks
Journal: JAMA Neurology (2013)

A 43-YEAR-OLD WOMAN presented to her primary physician with asoreneckonenight and was found comatose within hours of that visit. The patient had a neurologic history significant for autoimmune limbic encephalitis complicated by status epilepticus, but she had been seizure free for several years while takingstableantiepilepticmedications and had not been given immunotherapy for2yearsprior to this event. There was initial concern for recurrent status epilepticus; thus, she was treated with a continuous lorazepam infusion for 18 hours prior to transfer from her local hospital. She was in septic shock on arrival to our medical center.Lumbarpuncture revealed a cerebrospinal fluid formula consistent with bacterial meningitis. Cerebrospinal fluid culture results demonstratedgrowthofStreptococcus pneumoniae.Herneurologicexaminationonhospitaladmissionwassignificant for coma (FOUR Score was E1M0B4R1)andabsenceofnuchalrigidity.MagneticresonanceimagefindingsareshownintheFigure. Inspite ofmaximaltreatment,thepatientdemonstratednoneurologicimprovement 1 week into her admission. Coma in meningoencephalitiscanbeduetohydrocephalus,cerebraledema,cerebral thrombophlebitis, or status epilepticus. Herprognosiswasguardedatadmission; in the setting of continued lack of neurologic progress, she died after withdrawal of support.
NHS staff posted online patient reviews
Authors: J. Wise
Journal: BMJ (2014)

Half of the reviews by patients of Nottinghamshire Healthcare Trust on the NHS Choices website came from staff accounts, a BBC investigation has shown. In response to the finding, changes have been made to make it clear who is posting feedback.

The BBC news programme Newsnight found that 105 of 216 reviews about the trust had come from staff accounts. Almost half of these (47%) did not declare a conflict of interest. The reviews were originally submitted to the independent feedback website Patient Opinion and then posted on NHS Choices. As a result of the investigation NHS Choices removed all but one …
Magnetic Resonance Imaging and the Diagnosis of Spinal Infections
Authors: Jon E. Lutz
Journal: Annals of Internal Medicine (1988)

Letters and Corrections15 August 1988Magnetic Resonance Imaging and the Diagnosis of Spinal InfectionsJon E. Lutz, MDJon E. Lutz, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-4-348_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: In the review of magnetic resonance (MR) imaging (1), very brief reference was made to its role in the diagnosis of spinal infections. I report a case of anaerobic diskitis and osteomyelitis of the lumbar spine in which MR imaging was useful in establishing the diagnosis.A 26-year-old man was hospitalized with back pain of 10 days' duration and fever, chills, and sweats. The patient was febrile and had limited flexion of the spine due to back pain. Straight-leg raising elicited back pain in the lumbar region. A roentgenogram of the lumbosacral spine was normal. Initial blood...References1. KentLarson DE. Magnetic resonance imaging of the brain and the spine. Ann Intern Med. 1988;108:402-24. LinkGoogle Scholar2. PriceAllenEggersShaffJames AJFMA. Intervertebral disk-space infection. Radiology. 1983;149:725-9. CrossrefMedlineGoogle Scholar3. SchlaefferMikolichMates FDS. Technitium Tc 99m diphosphonate bone scan. Arch Intern Med. 1987;147:2024-6. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: United States Naval Hospital New York, NY 09571-0308 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe spinal complications of ankylosing spondylitis 15 August 1988Volume 109, Issue 4Page: 348-348KeywordsBloodFeversLower back painMagnetic resonance imagingOsteomyelitisSpineSweat Issue Published: 15 August 1988 PDF downloadLoading ...
The Economic Imperative to Conquer Diabetes
Authors: Judith Fradkin, Griffin P. Rodgers
Journal: Diabetes Care (2008)

The new data presented in this issue (1) estimating the 2007 economic cost of diabetes in the U.S. at $174 billion are sobering. One in five health care dollars is spent caring for someone with diabetes, and one in ten dollars spent on health care is attributable to diabetes and its complications. In addition to the $116 billion in excess medical expenditures, the loss to the nation in economic productivity is $58 billion. Yet, even these staggering totals are incomplete because the American Diabetes Association (ADA)-commissioned study excludes unknown costs such as those associated with undiagnosed diabetes (about one in four people with diabetes) and the unpaid care and associated loss of productivity of family members.

This study also does not consider the costs of pre-diabetes, which affects 54 million Americans (2) and modestly increases cardiovascular disease risk (3), because there is inadequate information to assess its impact on medical costs or productivity. Nonetheless, the looming risk of diabetes (up to 70% of individuals with pre-diabetes will progress to diabetes) (3) and longitudinal data demonstrating an association between glucose level in middle age and future Medicare charges (4) portend even higher future economic costs. In today's U.S. population, about one in five individuals over age 60 years has diabetes, but one in three Americans born in 2000 is projected to develop diabetes over their lifespan (5).

Increased prevalence of overweight and obesity and sedentary lifestyle are well-recognized drivers of the epidemic of type 2 diabetes in the U.S. and worldwide, together with an aging and more diverse American population. While attention has focused on increasing rates of obesity and, consequently, type 2 diabetes in children and young adults, the incidence of type 1 diabetes is also rising and the age of onset falling in the U.S. and Europe (6 …
Psychological Dependency on Steroids?
Authors: CHASE PATTERSON KIMBALL
Journal: Annals of Internal Medicine (1971)

Clinical experience suggests that many individuals treated with corticoids become psychologically dependent on their euphoric side effects. This dependency, which may result from a number of factors, frequently interferes with the physician's efforts to withdraw the drug when the disease process under treatment objectively improves. It may also contribute to other debilitating side effects of the drug. A discussion of these based on two case vignettes is presented. Research is needed to further define and clarify this phenomenon.
Sniffing Up Trouble: Inhalation of Volatile Substances
Authors: William E. R. Greer
Journal: JAMA (1985)

<h3>To the Editor.—</h3> We read with interest the article entitled "Sudden Death in Adolescents Resulting From the Inhalation of Typewriter Correction Fluid"<sup>1</sup>in the March 15,1985, issue of<i>JAMA</i>. Your readers should be made aware that children perverting the use of commercially available consumer products ("sniffing") has become a worldwide problem. A recent issue of the<i>British Medical Journal</i><sup>2</sup>reported 282 deaths in the United Kingdom from abuse of volatile substances during 1971 to 1983. The substances abused were gas fuels (24%), aerosol sprays (17% ), solvents in glue (27%), and other volatile substances such as cleaning agents (31%). In 51% of the cases the authors reported that death was attributed to the direct toxic effects of the substances abused. Therefore, we must disagree with the authors. There is nothing unique about correction fluid deaths when the product's use is perverted. There appears to be a gasoline sniffing epidemic
Management of hyponatraemia.
Authors: A I Arieff
Journal: BMJ (1993)

Hyponatraemia occurs in many different systemic disease states and is the most frequent electrolyte abnormality seen in a general hospital population, with an incidence of about 1%.' 2 Hyponatraemia is usually the result of dilution, although both total body water and extracellular volume may be high, low, or normal.Asymptomatic hyponatraemia is often benign, but when patients have central nervous system symptoms treatment is mandatory to prevent permanent brain damage.Almost all of the morbidity associated with hyponatraemia is due to brain damage, and recent studies show that the age and sex of the patient are major determinants of such brain damage.The Division of Geriatrics, incidence of symptomatic hyponatraemia is similar Department ofMedicine, among men and women,2 but most patients who Veterans Affairs Medical develop permanent brain injury are children and Center, and University of menstruant women (tables I and IH).I Earlier studies California School of suggesting that severe hyponatraemia was often benign Medicine, San Francisco, had generally evaluated only postmenopausal women California 94121, USA and older men,4 groups not generally susceptible to Allen I Arieff, professor of hyponatraemia induced brain injury.23 medicine
Albert Bruce Sabin
Authors: L. D. Grouse
Journal: JAMA (1993)

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
Muscle-Specific Deletion of Carnitine Acetyltransferase Compromises Glucose Tolerance and Metabolic Flexibility
Authors: Deborah M. Muoio, Robert C. Noland, Jean-Paul Kovalik, Sarah E. Seiler, Michael N. Davies, Karen L. DeBalsi, Olga R. Ilkayeva, Robert D. Stevens, Indu Kheterpal, Jingying Zhang, Jeffrey D. Covington, Sudip Bajpeyi, Eric Ravussin, William Kraus, Timothy R. Koves, Randall L. Mynatt
Journal: Cell Metabolism (2012)
Effect of Raising Injection-Site Skin Temperature on Isophane (NPH) Insulin Crystal Dissociation
Authors: Jonathan C Thow, Andrew B Johnson, Mikhail Antsiferov, Philip D Home
Journal: Diabetes Care (1989)

In eight healthy subjects, skin temperature at the injection site was raised from mean ± SD 31.7 ± 0.5 to 40.8 ± 0.9°C 180 min after injection of 0.25 U/kg isophane (NPH; Human Insulatard) insulin and maintained for 180 min. On the control day, skin temperature was kept constant. On warming of the injection site, serum insulin concentration rose from mean ±SE 14.4 ± 2.5 to 17.7 ± 3.1 mU/L after 40 min (P &amp;lt; .01) but did not change on the control day over the same period. The change in insulin concentration from the prewarming hour was higher on the warming day than control day in the 1st h (123 ± 8 vs. 93 ± 7%, P &amp;lt; .01), 2nd h (115 ± 14 vs. 83 ± 9%, P &amp;lt; .05), and 3rd h (113 ± 17 vs. 80 ± 10%, P &amp;lt; .05) of warming, providing evidence for both early increased absorption of the free-insulin pool surrounding the protamine-insulin complexes and continuing increased dissociation of the complexes.
Oestrogen-induced hypocalcaemia in hypoparathyroidism.
Authors: C Nagant de Deuxchaisnes
Journal: BMJ (1979)

This deplorable state of affairs, which is a cause of much wasted time and many un- necessary x-ray examinations, can be directly related to the very severe reduction in the amount of time which our medical schools allocate to the teaching and study of anatomy.In practical terms, it means that students become involved with contemplation of the abnormal before they have acquired a sound knowledge of the normal.Perhaps the tide is now beginning to turn, for, during the past year or so, there have been at least three publications affirming the importance of teaching radiological anatomy from the outset of the preclinical course.Can this really be just a coincidence ?
Effect of bronchopulmonary lavage on lung retention and clearance of particulate material in hamsters.
Authors: M Ellender, A Hodgson, K L Wood, J C Moody
Journal: Environmental Health Perspectives (1992)

Hamsters were exposed to an aerosol of fused aluminosilicate particles (FAP) labeled with 57Co. Three groups of animals were given bronchopulmonary lavage, beginning at either 1 week, 1 month, or 6 months after exposure. Each treated group was lavaged eight times over a period of 25 days. Each lavage involved 10 saline washes of the lungs. For each group, about 60-70% of the body content of 57Co at the start of lavage treatment was removed; nearly half of this was recovered in the first two lavages. A positive correlation was demonstrated between the macrophage content and 57Co activity of the washings. The subsequent fractional clearance rate of 57Co from lavaged animals was not significantly different from that in a group of untreated control animals.
Book: Science: A History 1543-2001
Authors: S. A Pai
Journal: BMJ (2003)

John Gribbin Allen Lane, £25, pp 647 ISBN 0 713 995 033 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> The year 1543 is a watershed in the history of science. It was then that science as we understand it today was born. Until then, rhetoric, superstition, and fanciful speculation about the natural world ruled. In 1543 Copernicus published his De Revolutionibus Orbium Coelestium , in which he stated that the earth moved around the sun, thereby demolishing Ptolemy's theory that the earth was the centre of the universe. Also in 1543, Vesalius, in De Humanis Corporis Fabrica , demonstrated the inaccuracies … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Abstract 4105: Nitric-oxide-mediated inhibition of Na+/H+ exchange (NHE) is a novel mechanism of bile acid induced damage: Relevance to esophageal carcinogenesis
Authors: Aaron Goldman, Mohammad Shahidullah, Hwudaurw Chen, Nicholas Delamere, Katerina Dvorak
Journal: Cancer Research (2010)

Abstract Background: Barrett's esophagus (BE) is a premalignant condition that is associated with gastroesophageal reflux disease (GERD). Gastric acid and bile acids are two components of refluxate that induce proliferation, DNA damage and oxidative stress. In combination, the effects of gastric acid and bile acids are amplified and synergistic. The major goal of this study was to evaluate the effect of bile acids alone or in combination with acid on intracellular pH (pHi). A mechanism responsible for bile acid-induced pHi alterations was examined. Methods: CP-A cells (non-dysplastic Barrett's esophagus cells) were treated with medium acidified to pH 5.5 and/or 0.5mM bile acid cocktail in the presence/absence of inhibitors of nitric oxide synthase (NOS) or NHE (sodium-hydrogen exchanger). pHi was measured by BCECF microfluorimetry in perfused cells, nitric oxide by DAF-FM fluorescence and DNA damage by the comet assay. Western blot analysis was used to detect the expression of phosphorylated (activated) eNOS, iNOS and NHE1. Results: A dose-dependent decrease in pHi was observed in CP-A cells exposed to bile acids. Bile acid-induced intracellular acidification was abolished when NO production was inhibited by a nonspecific NOS inhibitor L-NAME or by thea specific iNOS inhibitor 1400W. In contrast the NHE inhibitor DMA, significantly decreased the bile acid-mediated pHi response. Exposure of the cells to acidified medium (pH5.5) containing a 0.5mM bile acid cocktail, markedly decreased pHi pHi to a value below extracellular pH. Importantly, medium acidified to pH5.5 containing 0.5mM bile acids induced a similar decrease in pHi as medium acidified to pH 4.5 without bile acids. This The same treatment resulteds in a 250% increase in acid-mediated DNA damage compared to medium acidified to pH5.5 in CP-A cells. Conclusion: In summary, a new mechanism of bile acid induced damage was identified. Bile acids alone or in combination with acidic pH significantly decrease intracellular pH in esophageal cells. The results suggest the effect ofresponse tpo bile acids is the consequence of NOS activation and that leads to NHE inhibition. The mMarked increase in DNA damage after suggests exposure to bile acids in combination with acid may play a crucial role in esophageal carcinogenesis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4105.
BLOOD VOLUME STUDIES IN SHOCK RESULTING FROM MYOCARDIAL INFARCTION. I. STUDIES WITH EVANS BLUE DYE (T-1824) 1
Authors: Clarence M. Agress, Marvin Rosenburg, Abraham Schneiderman, E. J. Brotman
Journal: Journal of Clinical Investigation (1950)

The ominous form of circulatory failure which may accompany severe myocardial infarction car- ries a distressing mortality of some 79%o (1).
Dipstick Leukocyte Esterase Activity in First-Catch Urine Specimens
Authors: Matthew D. Sadof
Journal: JAMA (1987)

Although sexually active female adolescents are often routinely screened for sexually transmitted diseases, indications for culturing adolescent males for sexually transmitted urethral infections are controversial. A study of 54 sexually active males (14 to 22 years old) was undertaken to assess the reliability of using dipstick leukocyte esterase activity in first-catch urine specimens to detect urethritis caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Eighteen males had sexually transmitted diseases: N gonorrhoeae (nine patients), C trachomatis (eight patients), and N gonorrhoeae and C trachomatis (one patient). First-catch urine specimens with a 1+ (mild) or 2+ (moderate) reaction on dipstick testing had a leukocyte (WBC) count of 10 WBCs per high-power field or greater on microscopic analysis, with an 83% sensitivity, 100% specificity, a 100% positive predictive value, and a 92% negative predictive value for the presence of N gonorrhoeae, C trachomatis, or both. Clinical criteria for screening (urethral discharge, dysuria, or exposure to a sexually transmitted infection) plus a dipstick-positive first-catch urine specimen had a 94% sensitivity, 89% specificity, an 81% positive predictive value, and a 97% negative predictive value.
Incidence of gastrointestinal side effects due to alendronate is high in clinical practice
Authors: R. Kelly, H Taggart
Journal: BMJ (1997)

The real ethics of rationing Purchasers, not surgeons, control waiting listsEditor-I applaud the BMJ's efforts to bring the important issue of rationing to the fore, but I cannot allow one aspect of Light's contribution to go without challenge. 1Under the heading "parasitic privatisation" he says, "to top it off, the surgeons control the waiting lists" (to encourage patients into the private sector).I despair that someone of his academic stature should show such a lack of understanding of the purchaser-provider split that we have had in the NHS for the past six years.In the vast majority of cases we as surgeons have a contract with purchasers that places an upper limit on the number of patients on whom we can operate.Thus surgeons have no control over the number of patients having surgery and therefore, by definition, over the waiting list.The role of the surgeon is to prioritise, on clinical grounds, within the contracted number.If surgeons are to operate on more patients then purchasers must contract for more operations.The onus to reduce waiting time, and therefore encourage patients not to use the private sector, lies solely with the purchasers.