tbuckley/cabot-search huggingface dataset:
Effects of Calcium Supplementation on Body Weight and Adiposity in Overweight and Obese Adults
Authors: Jack A. Yanovski
Journal: Annals of Internal Medicine (2009)

Background: Some data suggest that increasing calcium intake may help prevent weight gain. Objective: To test the hypothesis that calcium supplementation can prevent weight gain in persons who are overweight or obese. Design: Randomized, placebo-controlled trial. Randomization was computer-generated, and allocation was assigned by pharmacy personnel who prepared intervention and placebo capsules. Participants, providers, and those who assessed outcomes were blinded to study group assignment. Setting: Single research center. Participants: 340 overweight (body mass index [BMI], 25 to <30 kg/m2) and obese (BMI ≥30 kg/m2) adults (mean age, 38.8 years [SD, 10.5]). Intervention: Calcium carbonate (elemental calcium, 1500 mg/d) (n = 170) or placebo (n = 170) with meals for 2 years. Measurements: Changes in body weight and fat mass (primary outcomes). Results: Seventy-five percent of participants completed the trial (78% received calcium; 73% received placebo). There were no statistically or clinically significant differences between the calcium and placebo groups in change in body weight (difference, 0.02 kg [95% CI, −1.64 to 1.69 kg]; P = 0.98), BMI (difference, 0.32 kg/m2 [CI, −0.41 to 1.02 kg/m2]; P = 0.39), or body fat mass (difference, 0.39 kg [CI, −1.04 to 1.92 kg]; P = 0.55). Parathyroid hormone concentrations decreased in the calcium group compared with the placebo group (difference, −0.71 pmol/L [CI, −1.28 to −0.13 pmol/L]). Limitation: The study took place at a research center, and its sample was mostly women. Conclusion: Dietary supplementation with elemental calcium, 1500 mg/d, for 2 years had no statistically or clinically significant effects on weight in overweight and obese adults. Calcium supplementation is unlikely to have clinically significant efficacy as a preventive measure against weight gain in such patients. Primary Funding Source: Office of Dietary Supplements and Intramural Research Program of the National Institutes of Health.
The Heart, Arteries, and Veins
Authors: Arthur J. Moss
Journal: JAMA (1983)

This definitive book on the diseases of the circulatory system was first published in 1966, and the current fifth edition is the best yet. Dr Hurst and his six coeditors have enlisted the participation of 154 outstanding clinical and investigative cardiologists as contributing authors. The expertise of these authors has been superbly focused by the editors, with the result that this cardiologic textbook is now the gold standard of the profession. The almost 2,000 pages of text are divided into six parts, including three introductory sections that deal with the normal heart, the examination of the cardiovascular system, and the consequences of heart disease. The central focus of the book is the 900-page section on the primary diseases of the heart and blood vessels. The two concluding sections include a variety of diverse topics, with particular emphasis on special disgnostic and therapeutic techniques. Each of the 109 chapters has a
S29 The Proposed National Early Warning System (NEWS) Could Be Hazardous For Patients Who Are at Risk of Hypercapnic Respiratory Failure: Abstract S29 Table 1
Authors: B Kane, S Decalmer, P Murphy, P Turkington, BR O’Driscoll
Journal: Thorax (2012)

<h3>Introduction</h3> Early Warning Scoring systems (EWS) identify critical illness at an early stage. The Royal College of Physicians has proposed use of a 'National Early Warning Score' (NEWS) across UK hospitals. The NEWS allocates EWS points for oxygen saturation &lt;96% (see Table) and does not take account of target oxygen saturation range which should be set for each patient according to the BTS oxygen guidelines. This is particularly important for patients at risk of hypercapnic respiratory failure (T2RF) who are safest with a target range of 88–92% or less. We compared the NEWS with a proposed alternative based on the Salford Royal Hospital EWS system (AltNEWS, see Table) to identify how many patients with COPD would be placed at risk of hyperoxaemia using the NEWS system. <h3>Methods</h3> We calculated EWS scores using the NEWS and AltNEWS for 108 unselected acute medical patients at a single time point. <h3>Results</h3> 34/108 general medical patients (31%) had risk factors for T2RF (30 COPD, 4 obstructive sleep apnoea). Nineteen of these 34 patients had saturations within their target range of 88–92% either on air or oxygen. The NEWS system allocated these patients 2 or 3 EWS points for "low" oxygen levels which could prompt nursing staff to increase supplemental oxygen, potentially precipitating dangerous hypercapnia. Three of these 34 patients had saturations &gt;92% on oxygen. The NEWS did not alert nursing staff that supplemental oxygen should be reduced for these patients; saturations of 93–94% were actually scored as "too low". This could prompt nursing staff to further increase supplemental oxygen which could harm these patients. The AltNEWS allocated EWS points according to whether patients were in or out of range and no patients were placed at risk of T2RF. <h3>Conclusion</h3> The NEWS system makes no allowance for patients at risk of T2RF. This may lead to potentially dangerous use of oxygen in this substantial group of patients. We recommend that a target oxygen saturation range should be set for all hospital patients on admission and oxygen scores within EWS systems should be adjusted to alert clinicians to scores above and below the target range.
Genome-wide association study and meta-analysis find that over 40 loci affect risk of type 1 diabetes
Authors: Jeffrey C Barrett, David G Clayton, Patrick Concannon, Beena Akolkar, Jason D Cooper, Henry A Erlich, Cécile Julier, Grant Morahan, Jørn Nerup, Concepcion Nierras, Vincent Plagnol, Flemming Pociot, Helen Schuilenburg, Deborah J Smyth, Helen Stevens, John A Todd, Neil M Walker, Stephen S Rich
Journal: Nature Genetics (2009)
False-Positive Test For Hemoglobin S
Authors: Milton J. Arras
Journal: JAMA (1972)

To the Editor.—  The recent critique,  Test for Hemoglobin S ( 218 :1679-1680, 1971), lists several conditions which will produce a false-positive Sickledex test result. This includes polycythemia, protein abnormalities, and certain abnormal hemoglobinopathies.  We recently observed a false-positive Sickledex test result in a patient who would not fit in the above categories.  Report of a Case.—  A 16-year-old Negro girl came to our emergency room with complaints of lethargy and menometrorrhagia. Past and family history were not pertinent. Review of systems disclosed only excessive menses and heavy vaginal bleeding between menstrual periods. Results of physical examination were unremarkable except for pale nail beds and conjunctivae. Values from laboratory studies were as follows: hemoglobin, 2.7 gm/100 ml; hematocrit, 9.7%; red blood cell count, 1,640,000/cu mm; white blood cell count, 2,000/cu mm; differential cell count, normal; red blood cell morphological analysis, marked hypochromia and microcytosis; serum iron, 12 mg/100 ml; total
William Waldegrave: thinking on the NHS. Interview by Richard Smith.
Authors: W Waldegrave
Journal: BMJ (1991)

RS:We are now a month away from the NHS reforms.Are you confident that they are going to work, or might you find yourself presiding over the collapse of a major British institution?ww: The reforms are going to work.There will be no collapse, but there will be plenty of teething troubles.There's a longish way to go to get the information base fully established, and there's more to do to get real costings.But no matter how long we had taken to prepare we would still have a lot to learn when we started: we will need to learn by doing.RS: Does that mean that a month into the new health service things won't be much different from now? ww: That's probably right.But I hope that even in that time we will begin to see some positive things, but it will take longer than that for the benefits to come through.RS: Will things be very different in two years?ww: Two years in, we will have seen considerable changes.And there will be new problems.For example, shifting referral patterns may mean difficult decisions for whoever sits in my chair-me, I hope.Thus, what should we do about hospitals that are not getting support?Should they have more investment or should money be invested in different places?RS: Do you think that the changes will have a lot more impact in some places than others?ww: They are bound to have more effect where there is real choice in provider units.Eventually the reforms will mean that we will have to address the problems of London, which have been postponed far too long.RS: Is that the reason for the changes?
Early Confirmation of Stress Fractures in Joggers
Authors: Joseph F. Norfray
Journal: JAMA (1980)

Four joggers had early confirmation of clinically suspected stress fractures by radionuclide bone scans. The radioactive bone scan was abnormal as early as six weeks prior to the appearance of conventional roentgenographic changes. The stress fractures involved the bones of the lower extremities and included the femur, tibia, and calcaneus. Radioactive bone scanning also correctly identified stress fractures with bilateral involvement and referred pain. In joggers, when a stress fracture is clinically suspected and the conventional radiographs are negative, a radioactive bone scan is indicated for early confirmation and institution of appropriate treatment.
Strategies for setting occupational exposure limits for particles.
Authors: H A Greim, K Ziegler-Skylakakis
Journal: Environmental Health Perspectives (1997)

To set occupational exposure limits (OELs) for aerosol particles, dusts, or chemicals, one has to evaluate whether mechanistic considerations permit identification of a no observed effect level (NOEL). In the case of carcinogenic effects, this can be assumed if no genotoxicity is involved, and exposure is considered safe if it does not exceed the NOEL. If tumor induction is associated with genotoxicity, any exposure is considered to be of risk, although a NOEL may be identified in the animal or human exposure studies. This must also be assumed when no information on the carcinogenic mechanism, including genotoxicity, is available. Aerosol particles, especially fibrous dusts, which include man-made mineral fiber(s) (MMMF), present a challenge for toxicological evaluation. Many MMMF that have been investigated have induced tumors in animals and genotoxicity in vitro. Since these effects have been associated with long-thin fiber geometry and high durability in vivo, all fibers meeting such criteria are considered carcinogenic unless the opposite has been demonstrated. This approach is practicable. Investigations on fiber tumorigenicity/genotoxicity should include information on dose response, pathobiochemistry, particle clearance, and persistence of the material in the target organ. Such information will introduce quantitative aspects into the qualitative approach that has so far been used to classify fibrous dusts as carcinogens. The rationales for classifying the potential carcinogenicity of MMMF and for setting OELs used by the different European committees and regulatory agencies are described.
Statistical significance testing, hypothetico-deductive method, and theory evaluation
Authors: Brian D. Haig
Journal: Behavioral and Brain Sciences (2000)

Chow's endorsement of a limited role for null hypothesis significance testing is a needed corrective of research malpractice, but his decision to place this procedure in a hypothetico-deductive framework of Popperian cast is unwise. Various failures of this version of the hypothetico-deductive method have negative implications for Chow's treatment of significance testing, meta-analysis, and theory evaluation.
Family Practice On and Off the Campus
Authors: Alan Blum
Journal: JAMA (1981)

1969 is most fondly remembered as the year the New York Mets came from last place to win the World Series, a miracle topped only by America's having sent a man to the moon a few months earlier. Although less well recalled as having been officially recognized that year as the 20th medical specialty, family practice appears to have fared far better in the past decade than either the Mets or the manned space program. Not that the newcomer to the health care team was ever a 98-lb weakling. Rather, largely due to "powerful political forces external to academia," family practice made a "forced entry" on the medical scene.<sup>1</sup>That it has since caught on among medical students—much to academe's surprise and, in some quarters, chagrin—is an understatement. Wherever exposure to family practice is offered in the undergraduate medical curriculum, upward of 15% of students choose residencies in the field;
Proprotein convertase subtilisin/kexin type 9 (PCSK9): Hepatocyte-specific low-density lipoprotein receptor degradation and critical role in mouse liver regeneration
Authors: Ahmed Zaid, Anna Roubtsova, Rachid Essalmani, Jadwiga Marcinkiewicz, Ann Chamberland, Josée Hamelin, Michel Tremblay, Hélène Jacques, Weijun Jin, Jean Davignon, Nabil G. Seidah, Annik Prat
Journal: Hepatology (2008)

The gene encoding the proprotein convertase subtilisin/kexin type 9 (PCSK9) is linked to familial hypercholesterolemia, as are those of the low-density lipoprotein receptor (LDLR) and apolipoprotein B. PCSK9 enhances LDLR degradation, resulting in low-density lipoprotein accumulation in plasma. To analyze the role of hepatic PCSK9, total and hepatocyte-specific knockout mice were generated. They exhibit 42% and 27% less circulating cholesterol, respectively, showing that liver PCSK9 was responsible for two thirds of the phenotype. We also demonstrated that, in liver, PCSK9 is exclusively expressed in hepatocytes, representing the main source of circulating PCSK9. The data suggest that local but not circulating PCSK9 regulates cholesterol levels. Although transgenic mice overexpressing high levels of liver and circulating PCSK9 led to the almost complete disappearance of the hepatic LDLR, they did not recapitulate the plasma cholesterol levels observed in LDLR-deficient mice. Single LDLR or double LDLR/PCSK9 knockout mice exhibited similar cholesterol profiles, indicating that PCSK9 regulates cholesterol homeostasis exclusively through the LDLR. Finally, the regenerating liver of PCSK9-deficient mice exhibited necrotic lesions, which were prevented by a high-cholesterol diet. However, lipid accumulation in hepatocytes of these mice was markedly reduced under both chow and high-cholesterol diets, revealing that PCSK9 deficiency confers resistance to liver steatosis. Conclusion: Although PCSK9 is a target for controlling hypercholesterolemia, our data indicate that upon hepatic damage, patients lacking PCSK9 could be at risk. (HEPATOLOGY 2008;48:646–554.)
Rates of Cardiac Catheterization Cancelation for ST-Segment Elevation Myocardial Infarction After Activation by Emergency Medical Services or Emergency Physicians
Authors: J. Lee Garvey, Lisa Monk, Christopher B. Granger, Jonathan R. Studnek, Mayme Lou Roettig, Claire C. Corbett, James G. Jollis
Journal: Circulation (2011)

Background— For patients with an acute ST-segment elevation myocardial infarction, cardiac catheterization laboratory (CCL) activation by emergency medical technicians or emergency physicians has been shown to substantially reduce treatment times. One drawback to this approach involves overtriage, whereby CCL staffs are activated for patients who ultimately do not require emergent coronary angiography or for patients who undergo angiography but are not found to have coronary artery occlusion. Methods and Results— We examined CCL activation at 14 primary angioplasty hospitals to determine the course of management, including the rate of inappropriate activation. Among 3973 activations (29% by emergency medical technicians, 71% by emergency physicians) between December 2008 and December 2009, appropriate CCL activations occurred for 3377 patients (85%), with 2598 patients (76.9% of appropriate activations) receiving primary percutaneous coronary intervention. Reasons for inappropriate activations (596 patients; 15%) included ECG reinterpretations (427 patients; 72%) or the fact that the patient was not a CCL candidate (169 patients; 28%). The rate of cancellation because of reinterpretation of emergency medical technicians' ECG (6% of all activations) was more common than for cancellation because of reinterpretation of emergency physicians' ECG (4.6%). Conclusions— This represents the first report of the rates of CCL cancellation for ST-segment elevation myocardial infarction system activation by emergency medical technicians and emergency physicians in a large group of hospitals organized within a statewide program. The high rate of coronary intervention and relatively low rate of inappropriate activation suggest that systematic CCL activation by emergency personnel on a broad scale is feasible and accurate, and these rates set a benchmark for ST-segment elevation myocardial infarction systems.
Pulmonary hypertension and β-thalassemia major: Report of a case, its treatment, and a review of the literature
Authors: Denise H. Tam, Harrison W. Farber
Journal: American Journal of Hematology (2006)

Pulmonary hypertension is a common complication of beta-thalassemia major. We report a case of successful treatment of pulmonary hypertension in a patient with beta-thalassemia major and review the literature on pulmonary hypertension and beta-thalassemia major. A 28-year-old man with beta-thalassemia major, splenectomy, hepatitis C, and hemosiderosis who presented with increasing dyspnea on exertion was diagnosed with pulmonary hypertension. After receiving continuous epoprostenol infusion and desferoxamine, his functional capacity and hemodynamic status improved. To our knowledge, this is the first case of pulmonary hypertension associated with beta-thalassemia treated with continuous epoprostenol infusion and desferoxamine. Epoprostenol, beneficial in the treatment of other types of pulmonary hypertension, may ameliorate the morbidity and mortality of pulmonary hypertension associated with thalassemia.
Dystrophic calcinosis cutis in venous ulcers: a cause of treatment failure.
Authors: T.A. Chave, S. Varma, A.G. Knight
Journal: British Journal of Dermatology (2001)

Sir, An 83‐year‐old woman had an 8‐month history of painless ulceration on the lateral aspect of the left leg, which had been unresponsive to treatment with regular dressings. She had a past medical history of bilateral sclerotherapy for varicose veins in 1969, hypertension, type 2 diabetes, and carcinoma of the left breast in 1994 treated by mastectomy and axillary node clearance, with no evidence of recurrence. Medication comprised tamoxifen, metformin, nifedipine and indomethacin. Examination revealed an area of ulceration on the outer aspect of the lower left leg measuring 8 × 5 cm. There was chalky material extruding from the wound (Fig. 1a). Clinically she had bilateral chronic venous insufficiency with varicose veins. X‐ray confirmed the presence of extensive subcutaneous calcification in both legs (Fig. 1b). Investigations including full blood count, erythrocyte sedimentation rate, C‐reactive protein, urea and electrolytes, liver function tests, thyroid function, calcium, phosphate and parathyroid hormone were all normal. The ankle/brachial pressure index was > 0·8 in both legs. She was treated on an outpatient basis with four‐layer compression bandaging, but 6 months later her ulcer had failed to heal and continued to express chalky material.
Tobacco Control Policy and Electronic Cigarettes
Authors: Frank J. Chaloupka
Journal: JAMA Pediatrics (2014)

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 Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast 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 Pediatrics journal
Overexpression of IGF-1 in Muscle Attenuates Disease in a Mouse Model of Spinal and Bulbar Muscular Atrophy
Authors: Isabella Palazzolo, Conor Stack, Lingling Kong, Antonio Musaro, Hiroaki Adachi, Masahisa Katsuno, Gen Sobue, J. Paul Taylor, Charlotte J. Sumner, Kenneth H. Fischbeck, Maria Pennuto
Journal: Neuron (2009)
The expression of c-erbB-2 protein in the keratinocytes of oral mucosal lichen planus
Authors: A. KILPI, A.M. RICH, Y.T. KONTTINEN, P.C. READE
Journal: British Journal of Dermatology (1995)

The expression of the c‐crbB‐2 protein was studied in the keratinocytes from patients with: (i) oral mucosal lichen planus (OLP) (n=2(S): (ii) oral mucosal squamous cell carcinoma (OMSCC) which had arisen in mucosa affected by OLP (n=5); and (iii) normal oral mucosa (n=5). C‐erbB‐2 protein was expressed on the cell membranes of the keratinocytes of nucleated epithelium in the stratum spinosum. The antigenic determinant recognized represents the cytoplasmic domain of a cell surface receptor which binds an as yet uncharacterized heparin binding ligand of unknown function.1.2 The specimens from the live normal subjects showed positive immunohistochemical staining with the monoclonal c‐erbB‐2 protein antibody, the OMSCC specimens were negative, and 23 of 26 of the OLP specimens were positive. The lack of c‐cerbB‐2 expression in the three OLP and in the five OMSCC specimens may indicate a genetic alteration, or masking of the expression of c‐cerbB‐2. The absence of expression in OLP specimens might be an indicator of the possibility of future neoplastic transformation.
Comments on Theory and Therapy of Psychosomatic Patients with a Follow-Up Study
Authors: M. von Rad
Journal: Psychotherapy and Psychosomatics (1979)

Given the specific problems of the physically sick, the psychoanalytic therapy of psychosomatic patients normally calls for modification of treatment concepts that have proved viable for patients with mental disorders (neuroses) alone. The patients' difficulty in experiencing and expressing the experience of feelings as well as the fixation on one kind of physical complaint make it essential that the patient be unconditionally 'accepted' and offered translation aids so that within the patient–doctor relationship the 'mute' physical complaints can be assisted towards verbalisation and new emotional experiencing. The kind of special treatment forms indicated is determined by the extent of healthy personality elements. Here, in addition to nonverbal procedures, such techniques as combined inpatient-outpatient group psychotherapy, the subject of the present follow-up study, have proved to be helpful.