tbuckley/cabot-search huggingface dataset:
Economics notes: Opportunity cost
Authors: S. Palmer, J. Raftery
Journal: BMJ (1999)

<h3>Objectives</h3> The association between obesity and prognosis in patients with coronary artery disease (CAD) remains uncertain. We undertook a meta-analysis for the effects of body mass index (BMI) on mortality and cardiovascular events in these patients. <h3>Methods</h3> We identified studies that provided risk estimates for mortality or cardiovascular events on the basis of BMI in patients with CAD. Summary estimates of relative risks were obtained for five BMI groups: underweight, normal-weight, overweight, obese and grade II/III obese. Mortality was analysed separately as short-term (&lt;6 months) and long-term (≥6 months). <h3>Results</h3> Data from 89 studies with 1 300 794 patients were included. Mean follow-up of long-term estimates was 3.2 years. Using normal-weight as the reference, underweight was associated with higher risk of short-term mortality (2.24 (1.85 to 2.72)) and long-term mortality (1.70 (1.56 to 1.86)), overweight and obesity were both associated with lower risk of short-term mortality (0.69 (0.64 to 0.75); 0.68 (0.61 to 0.75)) and long-term mortality (0.78 (0.74 to 0.82); 0.79 (0.73 to 0.85)), but the long-term benefit of obesity disappeared after 5 years of follow-up (0.99 (0.91 to 1.08)). Grade II/III obesity was associated with lower risk of mortality in the short term (0.76 (0.62 to 0.91)) but higher risk after 5 years of follow-up (1.25 (1.14 to 1.38)). The similar J-shaped pattern was also seen for cardiovascular mortality and across different treatment strategies. Meta-regression found an attenuation of the inverse association between BMI and risk of mortality over longer follow-up. <h3>Conclusions</h3> Our data support a J-shaped relationship between mortality and BMI in patients with CAD. The limitation of current literature warrants better design of future studies.
Extreme Altitude Mountaineering and Type 1 Diabetes
Authors: Paola Pavan, Patrizio Sarto, Laura Merlo, Dario Casara, Andrea Ponchia, Renata Biasin, Donatella Noventa, Angelo Avogaro
Journal: Diabetes Care (2003)

The American Diabetes Association states that all levels of physical activity can be performed by people with type 1 diabetes who do not have complications and are in good blood glucose control (1). Extreme altitude mountaineering, defined as climbing at altitudes in excess of 5,000 m, creates physiological demands, especially in type 1 diabetic subjects, who might experience impaired pulmonary function (2). We present the metabolic control and symptoms of mountain sickness during the 2002 Alpinisti in Alta Quota (ADIQ) Expedition to Cho Oyu, which is the sixth …
Physical Rehabilitation of Young Children with Spinal Cord Lesions
Authors: Harold M. Sterling
Journal: JAMA (1961)

Many children with spinal cord lesions who now survive but remain severely disabled could be self-sufficient. Early recognition and treatment are urged to allow maximal recovery. Adequate nutrition, exercises, and prevention of complications are necessary for rehabilitation. In very young children there are special problems in carrying out the neurological examination, testing muscles, evaluating movement, giving medical care, and obtaining cooperation in therapy. For this reason a physician well acquainted with young children should participate actively in both the diagnostic and the rehabilitative program.
Moderate to vigorous physical activity volume is an important factor for managing nonalcoholic fatty liver disease: A retrospective study
Authors: Sechang Oh, Takashi Shida, Kazumasa Yamagishi, Kiyoji Tanaka, Rina So, Takehiko Tsujimoto, Junichi Shoda
Journal: Hepatology (2014)

Recently, the beneficial effects of increased physical activity (PA) on nonalcoholic fatty liver disease (NAFLD) in obese subjects were reported. However, the optimal strength and volume of PA in lifestyle modification to improve NAFLD pathophysiology and be recommended as an appropriate management of this condition are unclear. The primary goal of this retrospective study was to estimate the beneficial effects of a varying volume of moderate to vigorous intensity PA (MVPA) on the improvement of NAFLD. A total of 169 obese, middle‐aged men were enrolled in a 12‐week weight reduction program through lifestyle modification consisting of dietary restrictions plus aerobic exercise. Among these obese subjects, 40 performed MVPA for &lt;150 min·wk −1 , 42 performed MVPA for 150‐250 min·wk −1 , and 87 performed MVPA for &gt;250 min·wk −1 . The subjects in the MVPA ≥250 min·wk −1 group, in comparison with those in the MVPA &lt;250 min·wk −1 group, showed significantly attenuated levels of hepatic steatosis (−31.8% versus −23.2%). This attenuation was likely independent of the detectable weight reduction. MVPA for ≥250 min·wk −1 in comparison with that for &lt;150 min·wk −1 led to a significant decrease in the abdominal visceral adipose tissue severity (−40.6% versus −12.9%), levels of ferritin (−13.6% versus +1.5%), and lipid peroxidation (−15.1% versus −2.8%), and a significant increase in the adiponectin levels (+17.1% versus +5.6%). In association with these changes, the gene expression levels of sterol regulatory element‐binding protein‐1c and carnitine palmitoyltransferase‐1 in peripheral blood mononuclear cells also significantly decreased and increased, respectively. Conclusion : MVPA for ≥250 min·wk −1 as part of lifestyle management improves NAFLD pathophysiology in obese men. The benefits seem to be acquired through reducing inflammation and oxidative stress levels and altering fatty acid metabolism. (H epatology 2015;61:1205–1215)
Fibrous proteins of normal and abnormal human epidermis
Authors: M. LEVINE, A. McLEOD
Journal: British Journal of Dermatology (1979)

Keratin proteins of human epidermis have been isolated from normal and abnormal tissues. The normal proteins whether removed from living layers (prekeratin) or from the stratum corneum (keratin) are shown to consist of three chains, molecular weights 65,000 (A), 60,000 (B) and 52,000 (C). When compared with the epidermal proteins isolated from abnormal tissues, differences can be detected in the electrophoretic pattern of the subunits. In general, relative amounts of the individual chains are altered and in specific cases or two of the polypeptides found normally are missing. All the alpha-fibrous proteins extracted are found to be very similar in amino acid composition.
Effect of azelastine on bronchoconstriction induced by histamine and leukotriene C4 in patients with extrinsic asthma.
Authors: M K Albazzaz, K R Patel
Journal: Thorax (1988)

Azelastine, a new oral agent with antiallergic and antihistamine properties, has been shown to inhibit the effect of histamine and leukotriene (LT) in vitro, though not a specific leukotriene receptor antagonist. The effect of both a single dose (8.8 mg) and 14 days9 treatment (8.8 mg twice daily) with azelastine on bronchoconstriction induced by LTC4 and histamine has been examined in 10 patients with mild asthma in a placebo controlled, double blind, crossover study. LTC4 and histamine were inhaled in doubling concentrations from a dosimeter and the results expressed as the cumulative dose (PD) producing a 20% fall in FEV1 (PD20FEV1) and 35% fall in specific airways conductance (PD35sGaw). The single dose of azelastine produced a significantly greater FEV1 and sGaw values than placebo at 3 hours, but this bronchodilator effect was not present after 14 days of treatment. Azelastine was an effective H1 antagonist; after a single dose and 14 days9 treatment with placebo the geometric mean PD20FEV1 histamine values (mumol) were 0.52 (95% confidence interval 0.14-1.83) and 0.54 (0.12-2.38), compared with 22.9 (11.5-38.3) and 15.2 (6.47-35.6) after azelastine (p less than 0.01 for both). LTC4 was on average 1000 times more potent than histamine in inducing bronchoconstriction. Azelastine did not inhibit the effect of inhaled LTC4; the geometric mean PD20FEV1 LTC4 (nmol) after a single dose and 14 days9 treatment was 0.60 and 0.59 with placebo compared with 0.65 and 0.75 with azelastine. The PD35sGaw LTC4 was also unchanged at 0.66 and 0.73 for placebo compared with 0.83 and 0.74 for azelastine. Thus prolonged blockade of H1 receptors did not attenuate the response to LTC4, suggesting that histamine and LTC4 act on bronchial smooth muscle through different receptors. Four patients complained of drowsiness while taking azelastine but only one who was taking placebo and three patients complained of a bitter, metallic taste while taking azelastine.
Highly active antiretroviral therapy
Authors: Filip Moerman, Alfons Van Gompel, Jan Nimmegeers, Johan Moerman
Journal: BMJ (2005)

to different ways of framing decisions on rationing.From this flowed recognition of the importance of "ensuring that the processes by which decisions are reached have legitimacy" and that there should be "accountability for reasonableness." 6 It remains to be seen how this new strategic emphasis will work out.There remains, however, the problem-already touched on-of how macrodecisions about rationing are translated into microdecisions at the delivery end of health care.Economic analysis depends on information about effectiveness produced by clinical trials.And the limitation of most clinical trials is that "they fail to reveal the potentially complex mixture of substantial benefits for some, little benefit for many, and harm for a few." 7 This is why systems level rationing decisions almost invariably-across different healthcare systems-allow for clinical discretion in the interpretation of such guidance.But this leaves us with the so far unanswered question of how, and to whom, individual clinicians should be held accountable for "reasonableness" in the exercise of their discretion.
Collagen type I and III occur together in hybrid fibrils in the space of disse of normal rat liver
Authors: Albert Geerts, Detlef Schuppan, Sylvia Lazeroms, Ronald De Zanger, Eddie Wisse
Journal: Hepatology (1990)

Collagen type I and procollagen type III were localized at the ultrastructural level on ultrathin frozen sections of rat liver by the protein A-gold technique using affinity–purified primary antibodies. Both collagen type I and procollagen type III were localized on nearly all solitary and bundled fibrils in the space of Disse. Simultaneous localization of collagen type I and procollagen type III by a double–labeling procedure using protein A-gold probes of different sizes unequivocally demonstrated the presence of both collagens in the same fibrils. Measurement of the diameter of large numbers of collagen fibrils in the space of Disse of the rat liver showed a unimodal distribution of the fibril diameters around an average value of 62.4 nm (S.D. = 12.8 nm), and 91% of the collagen bundles contained less than 30 fibrils. Additional measurements on epoxy resin-embedded material of five biopsy specimens of normal human liver showed a comparable unimodal distribution of the fibril diameters around an average value of 57.2 nm (S.D. = 9.6 nm), and 74% of the bundles contained less than 60 fibrils. The latter observation demonstrates that human liver contains broader interstitial collagen bundles than rat liver. From these results, we conclude that the space of Disse of normal rat and human liver contains a uniform population of striated interstitial collagen fibrils. In the rat liver, these fibrils contain both collagen type I and procollagen type III. Therefore the concept that procollagen type III is predominantly localized in small diameter fibrils or bundles, whereas collagen type I is preferentially localized in thick ones, does not hold. (Hepatology 1990;12:233-241).
SARCOMA OF THE PANCREAS.
Authors: GEORGE A. BOYD
Journal: JAMA (1901)

Litten<sup>1</sup>was the first to report a primary sarcoma of the pancreas in which the microscopic findings were recorded. His case occurred in a boy 4 years old. The tumor weighed fifteen pounds. Virchow made the microscopic examination and found a small round-celled sarcoma. This was in 1889. Senn,<sup>2</sup>in 1886, reported two cases of sarcoma of the pancreas; one from Mayo's "Outlines of Human Pathology," published in 1836. As this was probably the first case of primary sarcoma of the pancreas it will be given with some detail. Quoting<sup>3</sup>from the original work: Malignant disease rarely attacks the pancreas alone but involves in common with it either the stomach or liver or both. A gentleman, aged 35, died after an illness of about eighteen months duration in which it was to the last impossible to say what organ was the seat of the disease. His complaint began
Richard Leslie Woodhead
Authors: A. Shaw
Journal: BMJ (2010)

Richard Richard Leslie Woodhead (“Dick”) was born in Leeds in 1941; he qualified in 1966 and was consultant physician in Bradford from 1975 to 1997. He died on 7 November 2009.

At Leeds Grammar School he was the champion half miler. When he won a scholarship to Oxford, the school celebrated with a half holiday for all. He trained at Oxford and University College Hospital, London. After qualification he was a house …
DIMINISHED PAROXONASE-1 ACTIVITY, A MARKER OF DYSFUNCTIONAL HIGH-DENSITY LIPOPROTEIN CHOLESTEROL, RECLASSIFIES STABLE CARDIAC PATIENTS AT HIGHER RISK FOR DEVELOPING MAJOR ADVERSE CARDIAC EVENTS
Authors: Wai Hong Wilson Tang, Yuping Wu, Stephen J. Nicholls, Stanley L. Hazen
Journal: Journal of the American College of Cardiology (2010)
THREE CASES OF TETANUS SUCCESSFULLY TREATED.
Authors: CARLOS C. BOOTH
Journal: JAMA (1905)

<h3>Case 1.</h3> —A young man, aged 22, was referred to me by Dr. F. S. Merwin of this city, and I operated on him for tubercular peritonitis, complete recovery following. The case progressed in the usual manner, excepting that the patient had a slight rise of temperature. On the tenth day we opened the dressing and discovered a small stitch abscess, which was treated and dressed daily. On the twelfth day he began having slight twitchings of his muscles, and complained of difficulty in opening his mouth, which symptoms gradually increased until the tetanic convulsions became general and of the most violent character. On the seventeenth day, or the fifth day of the illness, we began using antitetanic serum three times daily. The spasm continued to be severe for a few days, and then became less frequent and less severe. After seventeen doses of 10 cm. each were given, his
Glucocorticoid receptors in depression: Author's Reply
Authors: L J Whalley
Journal: BMJ (1986)

the points made by Mr J E A Wickham in his letter of 26 April (p 1134) about the importance of clinical experience in the evaluation of new technology.However, clinical experience is only one component of a rigorous assessment; it is complementary to the special skill of evaluation.We are criticised for our lack of "hands on" experience with lithotripsy.We were aware of this in designing the evaluation and therefore sought the advice of urologists in selecting outcome measures.By contrast, we welcome the interest of Mr Wickham in evaluation and the paper in which he and his colleagues compare extracorporeal shock wave lithotripsy with the alternatives (29 March, p 879).We would, however, like to point out a few methodological weaknesses and errors in the article.Over and above the inappropriate use of historical controls the authors use different endpoints to compare success of lithotripsy and the alternative treatments.Simple statistical analysis of the results would have shown that the dif- ferences in the success rates -given could have arisen purely by chance.In the costing there are a number of errors.Among the most important is the use of average inpatient cost in table IV as a measure of hotel expenses.In fact this figure includes both treatment and hotel costs; treatment costs are therefore counted twice in the pricing of open and percutaneous surgery.The use of average instead of marginal costs further exaggerates the bias in favour of lithotripsy, with its shorter length of stay compared with the alternatives.We hope that these points will demonstrate the need for clinicians and those with skill in evaluation to collaborate in assessing new technology, so each can benefit from others' "hands on" experience.
A 39-Year-Old Man With a Skin Infection
Authors: Robert C. Moellering
Journal: JAMA (2007)

The case of Mr M, a previously healthy 39-year-old man with erythema and swelling of his finger, illustrates the issues involved in treating community-acquired skin and soft tissue infections since the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in the community. Most community-acquired infections of the skin and soft tissues are caused by S aureus or Streptococcus pyogenes. Until recently, infections due to such organisms in the United States could safely be treated with an oral antistaphylococcal penicillin or an oral first-generation cephalosporin. However, the emergence of methicillin-resistant staphylococci as community-acquired pathogens has changed the picture as far as empirical therapy is concerned. Not only do community-acquired MRSA bacteria cause furunculitis and cellulitis, they have also been involved in a variety of more serious and life-threatening infections. Most of these organisms are susceptible to trimethoprim-sulfamethoxazole, minocycline, doxycycline, and rifampin, and these agents, along with clindamycin, have been used in the therapy of such infections, even though no clinical trials have proven their efficacy. For more serious, life-threatening infections, linezolid or parenteral agents such as vancomycin or daptomycin should be considered.
Feasibility and efficacy of arginine 2-mercaptoethanesulfonate (ARGIMESNA) in the prevention of hemorragic cystitis from ifosfamide (IFO)
Authors: S. Frustaci, S. Foladore, A. De Pascale, A. Freschi, G. Lo Re, R. Sorio, D. Errante, S. Monfardini
Journal: Annals of Oncology (1992)
Kinetics and characterization of intercellular adhesion molecule-1 (ICAM-1) expression on keratinocytes in various inflammatory skin lesions and malignant cutaneous lymphomas
Authors: Gunhild Lange Vejlsgaard, Elisabeth Ralfkiaer, Christian Avnstorp, Michele Czajkowski, Steven D. Marlin, Robert Rothlein
Journal: Journal of the American Academy of Dermatology (1989)
Hypothyroidism followed by hyperthyroidism. Occurrence in a patient with elevated antithyroid antibody titer
Authors: M. A. Hochstein
Journal: JAMA (1977)

THE PROGRESSION from hypothyroidism to thyrotoxicosis, although uncommon, has been documented in the past.<sup>1</sup>In most of these reports, the initial phase of hypothyroidism had been caused by primary thyroid failure. A similar sequence following Hashimoto thyroiditis is, indeed, rare. To our knowledge, there have been no reports of this phenomenon in the literature other than the patient described by Zellmann et al<sup>2</sup>in 1966. In this case, a hypothyroid patient with possible Hashimoto thyroiditis became hyperthyroid two years later. Interestingly, the patient had proptosis early in the course of the illness while he was hypothyroid. <h3>Report of a Case</h3> A 36-year-old man had been in excellent health until 1969, when he began to feel apathetic and noted that his eyes "looked queer." The symptoms progressed until June 1970, when he was first seen by a physician who believed that he was clinically hypothyroid. The pulse was 48
INTERLEUKIN-33 POLYMORPHISMS ARE ASSOCIATED WITH PREMATURE CORONARY ARTERY DISEASE AND CENTRAL OBESITY: RESULTS FROM THE GENETICS OF ATHEROSCLEROTIC DISEASE MEXICAN STUDY
Authors: Gilberto Vargas-Alarcón, Javier Angeles, Edith Alvarez-Leon, Carlos Posadas-Romero, Eric Kimura-Hayama, Rosalinda Posadas-Sanchez, Guillermo Cardoso
Journal: Journal of the American College of Cardiology (2014)
FDG-PET/CT Demonstration of Baastrup Disease (“Kissing” Spine)
Authors: Luis Gorospe, Raquel Jover, Agustina Vicente-Bártulos, Cristina González-Gordaliza, César García de Llanos, Javier García-Poza
Journal: Clinical Nuclear Medicine (2008)

Baastrup disease, also known as spinous process impingement syndrome or more commonly referred to as “kissing” spine, is characterized by close apposition of contiguous spinous processes in the lumbar spine and reactive bone sclerosis and local inflammatory changes. This clinical entity typically affects elderly patients with degenerative disc disease and/or hyperlordosis, as both conditions may result in chronic contact between adjacent spinous processes. In the case presented, PET/CT was able to correctly characterize and localize the F-18 fluorodeoxyglucose (FDG) uptake between 2 adjacent spinous processes in a patient with lung opacity suspicious for cancer, thus excluding the possibility of a spinal metastasis.
The Jewel House: Elizabethan London and the Scientific Revolution
Authors: John Henry
Journal: JAMA (2008)

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