tbuckley/cabot-search huggingface dataset:
Cholinesterase inhibitors for patients with Alzheimer's disease: systematic review of randomised clinical trials
Authors: Hanna Kaduszkiewicz, Thomas Zimmermann, Hans-Peter Beck-Bornholdt, Hendrik van den Bussche
Journal: BMJ (2005)

<h3>Abstract</h3> <b>Objectives</b> Pharmacological treatment of Alzheimer9s disease focuses on correcting the cholinergic deficiency in the central nervous system with cholinesterase inhibitors. Three cholinesterase inhibitors are currently recommended: donepezil, rivastigmine, and galantamine. This review assessed the scientific evidence for the recommendation of these agents. <b>Data sources</b> The terms "donepezil", "rivastigmine", and "galantamine", limited by "randomized-controlled-trials" were searched in Medline (1989-November 2004), Embase (1989-November 2004), and the Cochrane Database of Systematic Reviews without restriction for language. <b>Study selection</b> All published, double blind, randomised controlled trials examining efficacy on the basis of clinical outcomes, in which treatment with donepezil, rivastigmine, or galantamine was compared with placebo in patients with Alzheimer9s disease, were included. Each study was assessed independently, following a predefined checklist of criteria of methodological quality. <b>Results</b> 22 trials met the inclusion criteria. Follow-up ranged from six weeks to three years. 12 of 14 studies measuring the cognitive outcome by means of the 70 point Alzheimer9s disease assessment scale—cognitive subscale showed differences ranging from 1.5 points to 3.9 points in favour of the respective cholinesterase inhibitors. Benefits were also reported from all 12 trials that used the clinician9s interview based impression of change scale with input from caregivers. Methodological assessment of all studies found considerable flaws—for example, multiple testing without correction for multiplicity or exclusion of patients after randomisation. <b>Conclusion</b> Because of flawed methods and small clinical benefits, the scientific basis for recommendations of cholinesterase inhibitors for the treatment of Alzheimer9s disease is questionable.
<i>CALR</i> mutation studies in chronic neutrophilic leukemia
Authors: Terra L. Lasho, Michelle A. Elliott, Animesh Pardanani, Ayalew Tefferi
Journal: American Journal of Hematology (2014)

Somatic mutations in calreticulin (CALR), a gene which has not previously been shown to be oncogenic, has recently been identified in BCR-ABL1-negative myeloproliferative neoplasms (MPN) 1, 2. These mutations were mutually exclusive of JAK2 and MPL mutations and their frequencies in strictly World Health Organization (WHO)-defined disease were 49 and 74% in JAK2/MPL-unmutated ET and PMF, respectively 3, 4. CALR mutations have infrequently been reported in other myeloid malignancies including refractory anemia with ring sideroblasts and marked thrombocytosis (13% of 24 patients), myelodysplastic syndromes (8.3% of 120 patients), chronic myelomonocytic leukemia (3% of 33 patients), and atypical chronic myelomonocytic leukemia (3.4% of 29 patients) 1, 2. Considering the fact that chronic neutrophilic leukemia (CNL) is morphologically akin to other MPN, it is important to examine its potential association with CALR mutations. We performed CALR mutation analysis in 26 cases of clinically suspected CNL, including eight patients whose diagnosis was confirmed by strict WHO criteria 5. All (100%) of the eight WHO-defined CNL cases carried a CSF3R mutation, including six patients with CSF3RT618I 5. Three of the latter six patients also expressed SETBP1 mutations. Bone marrow-derived DNA was used for CALR mutation screening using previously published methods 4. Our results revealed a novel CALR nucleotide variant (CALRE398D c.1194 G>T) in one case of CNL who was also harboring CSF3RT618I and SETBP1G870D (Fig. 1), resulting in the amino acid substitution of glutamic acid with aspartic acid at amino acid position 398. All CALR mutations currently described in MPN affect exon 9 and were somatic insertions or deletions that resulted in a 1+ base pair frame shift, and generation of an altered C-terminal. CALR exon 9 point mutations have rarely been reported in lymphoma (CALRE405Q and CALRE403X) 6 and PMF (CALRE379D) 1. The consequences of an amino acid substitution is not yet known, but the identification of mutations that do not result in generation of a unique C-terminus is suggestive of a different pathogenetic mechanism. Terra L. Lasho Michelle A. Elliott Animesh Pardanani Ayalew Tefferi* Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
Identification of a peptide ligand recognizing dysfunctional endothelial cells for targeting atherosclerosis
Authors: Narendra Thapa, Hai-Yan Hong, Purushotham Sangeetha, In-San Kim, Jeongsoo Yoo, Kyehan Rhee, Goo Taeg Oh, Ick Chan Kwon, Byung-Heon Lee
Journal: Journal of Controlled Release (2008)
Response of "idiopathic" recurrent angioneurotic oedema to tranexamic acid.
Authors: R A Thompson, D D Felix-Davies
Journal: BMJ (1978)

tuberculous drugs were discontinued and he was started on chlorambucil 4-6 mg daily for six months followed by 2 mg daily.He was also given a red cell transfusion and a 10-week course of prednisolone.He responded with a weight gain of 5 kg within four months, resorption of pleural fluid, and fall of serum IgM to 6 g/l in February 1978.
Medical Problems Associated with Underwater Diving
Authors: Jane F. Desforges, Yehuda Melamed, Avi Shupak, Haim Bitterman
Journal: New England Journal of Medicine (1992)

THE underwater environment, with its rapidly changing ambient pressures, presents pathophysiologic challenges that may lead to a variety of unusual diseases for which rapid diagnosis and treatment are critical. In the United States there are more than 5 million people certified as recreational scuba divers — that is, divers who use a self-contained underwater breathing apparatus. Given the popularity of scuba diving the world over and the number of diving accidents,1 every physician should be aware of the specific hazards and medical conditions encountered underwater.The barometric pressure at sea level is 100 kPa (the equivalent of 1 atmosphere absolute, . . .
Indications for Radio-iodine Treatment of Thyroid Carcinoma
Authors: E. E. Pochin, G. Hilton, N. B. Myant, A. J. Honour, B. D. Corbett
Journal: BMJ (1952)

Certain thyroid carcinomata resemble normal thyroid tissue in having the capacity to concentrate iodine. Since radioactive iodine is chemically indistinguishable from normal iodine, such tumours will selectively con centrate radio-iodine. They may therefore be selec tively irradiated by the intense local beta radiation which is emitted from radio-iodine. If the local con centration and retention of radio-iodine in the tumour is high enough relative to that in other body tissues, the local radiation within the tumour may be great enough to cause its destruction, without causing fatal or toxic effects in the body as a whole. In principle, therefore, the selection of cases for such treatment is simple. Complete surgical excision remains, of course, the treatment of choice if ever it is possible (Dobyns, 1951) ; otherwise, radio-iodine should be used to treat any thyroid carcinoma which can be shown, or can be induced, to take up radio-iodine sufficiently. In practice, this criterion is complicated by several considerations. First, the detection of radio-iodine up take, and the judgment of its adequacy, may be difficult, particularly if the tumour is adjacent to normal thyroid tissue and if repeated biopsies cannot conveniently be made. Secondly, uptake may be demonstrable after total thyroidectomy in a tumour in which no uptake could be detected before the thyroid was removed. It may therefore be necessary to select for thyroid abla tion* those cases in which uptake cannot be shown but is likely to be demonstrable after thyroidectomy. This decision will be based on such indirect evidence as the histological differentiation of the tumour and perhaps its rate of growth. In such cases tests for uptake are repeated after thyroid ablation, and radio iodine treatment is started if adequate retention can be demonstrated.
Influence of maternal asthma on the cause and severity of infant acute respiratory tract infections
Authors: Kecia N. Carroll, Tebeb Gebretsadik, Patricia Minton, Kimberly Woodward, Zhouwen Liu, E. Kathryn Miller, John V. Williams, William D. Dupont, Tina V. Hartert
Journal: Journal of Allergy and Clinical Immunology (2012)
Surgical Care Improvement
Authors: Mary T. Hawn
Journal: JAMA (2010)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors 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
Integrating Technology Into Standard Weight Loss Treatment
Authors: Bonnie Spring, Jennifer M. Duncan, E. Amy Janke, Andrea T. Kozak, H. Gene McFadden, Andrew DeMott, Alex Pictor, Leonard H. Epstein, Juned Siddique, Christine A. Pellegrini, Joanna Buscemi, Donald Hedeker
Journal: JAMA Internal Medicine (2012)

<h3>Background</h3>A challenge in intensive obesity treatment is making care scalable. Little is known about whether the outcome of physician-directed weight loss treatment can be improved by adding mobile technology.<h3>Methods</h3>We conducted a 2-arm, 12-month study (October 1, 2007, through September 31, 2010). Seventy adults (body mass index &gt;25 and ≤40 [calculated as weight in kilograms divided by height in meters squared]) were randomly assigned either to standard-of-care group treatment alone (standard group) or to the standard and connective mobile technology system (+mobile group). Participants attended biweekly weight loss groups held by the Veterans Affairs outpatient clinic. The +mobile group was provided personal digital assistants to self-monitor diet and physical activity; they also received biweekly coaching calls for 6 months. Weight was measured at baseline and at 3-, 6-, 9-, and 12-month follow-up.<h3>Results</h3>Sixty-nine adults received intervention (mean age, 57.7 years; 85.5% were men). A longitudinal intent-to-treat analysis indicated that the +mobile group lost a mean of 3.9 kg more (representing 3.1% more weight loss relative to the control group; 95% CI, 2.2-5.5 kg) than the standard group at each postbaseline time point. Compared with the standard group, the +mobile group had significantly greater odds of having lost 5% or more of their baseline weight at each postbaseline time point (odds ratio, 6.5; 95% CI, 2.5-18.6).<h3>Conclusions</h3>The addition of a personal digital assistant and telephone coaching can enhance short-term weight loss in combination with an existing system of care. Mobile connective technology holds promise as a scalable mechanism for augmenting the effect of physician-directed weight loss treatment.<h3>Trial Registration</h3>clinicaltrials.gov Identifier: NCT00371462
An Analysis of the Knowledge Base of Practicing Internists as Measured by the 1980 Recertification Examination
Authors: JOHN J. NORCINI
Journal: Annals of Internal Medicine (1985)

The performance of practicing internists on the American Board of Internal Medicine's 1980 Recertification Examination was examined in two studies. In the first study, a psychometric common-item equating technique was used to compare the performance of 1980 recertification candidates with that of 1979 certification candidates. Results showed that the knowledge base of practicing internists was similar to that of residents completing training. The second study analyzed the performance of 1980 recertification candidates to determine whether being certified or having an interest in a subspecialty affects a physician's performance on items in that area. The results showed that subspecialists do significantly better than general internists on items pertaining to their area of specialization. Similar outcomes were found for internists with a special interest in a subspecialty area. These findings establish the importance of continued periodic evaluation and support the development of an evaluation tool tailored to the physician's area of concentration.
Long-term effects of radiation.
Authors: J Smith, T Smith
Journal: BMJ (1981)

This is the third in a series of four articles giving a medical view of nuclear war.The first two articles dealt with nuclear explosions and acute radiation sickness.In the context of nuclear power the long-term effects of environmental contamination by radioactive compounds are causing great concern.In the context of war these effects are relatively much less important.Sources of long-term damage from radiation are twofold.People who have been exposed to doses of radiation from initial early fallout but have recovered from the acute effects may, nevertheless, suffer long-term damage from their exposure.Those who have not been exposed to early fallout, however, may be exposed to delayed fallout; the hazards from delayed fallout are almost exclusively from ingesting strontium, caesium, and carbon isotopes present in food, and the damage caused is relatively unimportant compared with that caused by the brief doses from initial radiation and early fallout.Around 80% of the radioactive fallout of a ground-burst nuclear explosion descends locally, where its radioactivity decays according to the t 12 rule.Nuclear explosions high in the atmosphere-airbursts-have less fallout, since of themselves Fireball of a nuclear bomb detonated under the sea during tests at Eniwetok Atoll.
Prognostic value of baroreflex sensitivity assessed by phase IV of Valsalva manoeuvre in patients with mild‐to‐moderate heart failure
Authors: Carlo Rostagno, Giorgio Galanti, Massimo Felici, Massimo Maccherini, Guido Sani, Sabina Caciolli, Gian Franco Gensini
Journal: European Journal of Heart Failure (2000)
Phenylpropanolamine: An Over-the-Counter Amphetamine?
Authors: Alan Blum
Journal: JAMA (1981)

Wisconsin's successful physician-led effort to thwart licit amphetamine diversion for street sale (p 1336) is an important victory in the ever-frustrating fight against drug abuse. It is all the more heartening because, contrary to the myth that the medical profession merely reacts to or ignores major controversies, the leaders of the state Controlled Substances Board and the Medical Examining Board undertook their mission with an investigative zeal and thoroughness that would have been the envy of the reporters on "Sixty Minutes." The Wisconsin action served another purpose, namely, to remind physicians and the public alike that amphetamines have no place in the management of obesity. Indeed, the Food and Drug Administration has sounded the death knell for amphetamines' use in weight control by filing a formal notice of revocation of its approval.<sup>1</sup>The high ratio of abuse as well as the risk of dependence and other potentially harmful side
Lyme Arthritis in Wisconsin
Authors: Randall F. Dryer
Journal: JAMA (1979)

Rash, severe constitutional symptoms, and arthritis developed in three persons who were bitten by ticks in Wisconsin. On comparison with other reports of arthritis related to tick bites, we found that the illness of our patients had clinical features consistent with Lyme arthritis. Lyme arthritis appears not to be restricted to New England as has been previously reported. (<i>JAMA</i>241:498-499, 1979)
“Dunkirk Spirit:” Differences Between United Kingdom and United States Responses to Pandemic Influenza
Authors: Tom Sorell, Heather Draper, Sarah Damery, Jonathan Ives
Journal: The American Journal of Bioethics (2009)

What follows is partly informed by the findings of a study we carried out to investigate the attitudes of National Health Service (NHS) employees in the West Midlands, United Kingdom (UK), towards ...
A Critical Overview of Homeopathy
Authors: Wayne B. Jonas, Ted J. Kaptchuk, Klaus Linde
Journal: Annals of Internal Medicine (2003)

Homeopathy is a 200-year-old therapeutic system that uses small doses of various substances to stimulate autoregulatory and self-healing processes. Homeopathy selects substances by matching a patient's symptoms with symptoms produced by these substances in healthy individuals. Medicines are prepared by serial dilution and shaking, which proponents claim imprints information into water. Although many conventional physicians find such notions implausible, homeopathy had a prominent place in 19th-century health care and has recently undergone a worldwide revival. In the United States, patients who seek homeopathic care are more affluent and younger and more often seek treatment for subjective symptoms than those who seek conventional care. Homeopathic remedies were allowed by the 1939 Pure Food and Drug Act and are available over the counter. Some data--both from randomized, controlled trials and laboratory research--show effects from homeopathic remedies that contradict the contemporary rational basis of medicine. Three independent systematic reviews of placebo-controlled trials on homeopathy reported that its effects seem to be more than placebo, and one review found its effects consistent with placebo. There is also evidence from randomized, controlled trials that homeopathy may be effective for the treatment of influenza, allergies, postoperative ileus, and childhood diarrhea. Evidence suggests that homeopathy is ineffective for migraine, delayed-onset muscle soreness, and influenza prevention. There is a lack of conclusive evidence on the effectiveness of homeopathy for most conditions. Homeopathy deserves an open-minded opportunity to demonstrate its value by using evidence-based principles, but it should not be substituted for proven therapies.
Quantitation of protein kinase A-mediated trafficking of cardiac sodium channels in living cells
Authors: H HALLAQ, Z YANG, P VISWANATHAN, K FUKUDA, W SHEN, D WANG, K WELLS, J ZHOU, J YI, K MURRAY
Journal: Cardiovascular Research (2006)

Objective: Na+ current derived from expression of the principal cardiac Na+ channel, Nav1.5, is increased by activation of protein kinase A (PKA). This effect is blocked by inhibitors of cell membrane recycling, or removal of a cytoplasmic endoplasmic reticulum (ER) retention motif, suggesting that PKA stimulation increases trafficking of cardiac Na+ channels to the plasma membrane.
FACTS REGARDING ALLEGED OPERATION ON SIAMESE TWINS
Authors: Morris Goldberg
Journal: JAMA (1924)

To the Editor:  —July 18 and 19, newspapers contained accounts of the birth of Siamese twins at the Borough Park Maternity Hospital; also varying accounts as to the physicians' skill in saving the life of one of the twins.  July 10, at 6 p. m., I was called to attend the patient, after the membranes had ruptured. Abdominal examination revealed a twin pregnancy with breech presentations. The right fetal heart was heard above the umbilicus, the rate being 150 a minute, and the left fetal heart above the umbilicus, the rate being 90 and the quality of sound poor. No active labor pains occurred until July 11 at 7:30 p. m., when the patient was removed to the hospital. Vaginal examination on entrance to the hospital showed the cervix fully dilated, and buttocks and foot presenting. The breech was delivered to the shoulders, and the head was extracted according to
Chronic Pelvic Peritonitis due to the Pinworm Enterobius vermicularis
Authors: Richard D. Pearson
Journal: JAMA (1981)

<i>ENTEROBIUS vermicularis</i>, the pinworm, is commonly associated with perianal and perineal pruritus in children in the United States. Although<i>E vermicularis</i>is frequently encountered in pediatric practice, most physicians are not aware that it can cause severe, ectopic disease in the adult urogenital tract. A young woman had chronic dysmenorrhea, dyspareunia, and lower abdominal discomfort. At exploratory laparotomy, she was found to have multiple pelvic granulomas that contained ova of<i>E vermicularis</i>. Her symptoms resolved completely after hysterectomy. We report this case to familiarize physicians with this rare but potentially serious complication of pinworm infestation. <h3>Report of a Case</h3> A 29-year-old (gravida 2, para 2) woman had an 18-month history of dysmenorrhea, dyspareunia, and lower abdominal and pelvic discomfort that she described as a "tremendous weight" comparable with that experienced during labor. She had had an appendectomy as a child and correction of a double ureteral collecting system several years
Pathophysiology of acute acid injury in rabbit esophageal epithelium.
Authors: R C Orlando, D W Powell, C N Carney
Journal: Journal of Clinical Investigation (1981)

To increase our understanding of the pathophysiology of reflux esophagitis, we sought the early sequence of changes in mucosal structure and function in acutely acid-damage rabbit esophagus. Using a perfused catheter technique esophageal potential difference (PD) profiles were obtained in anesthetized rabbits before, during, and after perfusion of the lower one-half of the esophagus with phosphate-buffered saline or 80 mM NaCl. When acid perfusion reduced the lower esophageal PD by 40-50% or 80-100% of the initial values, the esophagus was removed, sectioned, and the mucosa studied with light microscopy, transmission electron microscopy, and Ussing chamber technique for evaluation of sodium and mannitol transport. The earlier stage of acid damage (PD 40-50%) was associated with reduced mucosal resistance fom 2,180 +/- 199 to 673 +/- 157 ohm cm2 and increased passive transport of sodium (0.10 +/- 0.06 to 1.82 +/- 0.48 microeq/h.cm2) and mannitol (0.008 +/- 0.003 to 0.051 +/- 0.012 microM/h.cm2) (p less than 0.05). There was no significant change in shirt circuit current (0.35 +/- 0.05 to 0.35 +/- 0.04) or net sodium transport (0.32 +/- 0.06 to 0.37 +/- 0.12) at this stage, and the only morphologic finding was dilated intercellular spaces on electron microscopy. The later stage of acid damage (PD 80-100%) exhibited a further reduction in resistance to 299 +/- 65 ohm.cm2 (p less than 0.05), a finding now accompanied by a reduction in short circuit current (0.35 +/- 0.05 to 0.21 +/- 0.04 microeq/h.cm2) and complete inhibition of net sodium transport (0.32 +/- 0.06 to 0.01 +/- 0.13) (p less than 0.05). Morphologic studies at this time revealed cellular necrosis, edema, and vesicle formation in the stratum spinosum. Both gross mucosal changes and transmural necrosis were notably absent. When esophageal perfusion was performed with a combination of acid (80 mM HCl-80 mM NaCl) and pepsin (100 microgram/ml), the morphologic and physiologic findings were essentially the same as with acid alone; however, the time of perfusion to reach either the 50 or 100% reduction in PD was shortened. The findings in this model can be explained on an initial increase in cellular and/or paracellular permeability followed by inhibition of active sodium transport. The resulting loss of osmolar regulation leads to cell necrosis in the stratum spinosum.