tbuckley/cabot-search huggingface dataset:
Long-Term Methadone Maintenance Therapy: Effects on Liver Function
Authors: MARY JEANNE KREEK
Journal: Annals of Internal Medicine (1972)

To determine whether chronic high-dose (80 to 120 mg/day) methadone treatment would exert hepatotoxic effects on patients with or without liver disease, the first 214 patients admitted for maintenance therapy were studied prospectively; 129 were still in treatment after 3 or more years. There were no significant changes in tests of liver function with time and, therefore, no evidence of methadone hepatotoxicity. Of the group 23% had a history of hepatitis, and 25% were moderate to heavy users of ethanol. Minimal to moderate abnormalities of liver function tests were present in 57% at admission and in 51% after 3 or more years of treatment. Up to 49% had abnormalities in some protein tests throughout. The liver function abnormalities may be caused by chronic persistent or, less frequently, chronic aggressive hepatitis and, in some, by excessive usage of ethanol. Protein abnormalities may be owing to liver disease and altered immune status caused by injection of foreign substances.
Rose Margaret Fraser Stellman
Authors: C. M. Stellman
Journal: BMJ (2011)

Rose Margaret Fraser was born in Aberdeen, the elder of two daughters. Apart from a few years in Vancouver, she spent most of her early years there. Rose attended Central School, Aberdeen, from 1928 to 1934. She went on to obtain an MB ChB medical degree from Aberdeen University (1934-9). Her medical career thus started at a time before the NHS or the availability of antibiotics.

Childhood infectious diseases were rife, and vaccinations had not been introduced for most of them. Rose was therefore to witness many deaths and disabilities which today would be avoidable. Her first job was at Tor-na-Dee Sanatorium for patients with tuberculosis (TB). The second world war was declared two days later. In …
Leukemia and Radium Groundwater Contamination
Authors: James H. Stebbings
Journal: JAMA (1986)

<h3>To the Editor.—</h3> The article by Lyman et al<sup>1</sup>associating radium in groundwater with leukemia has major flaws. Ecological correlation studies are considered useful explorations of disease causality only where data from cohort (or case-control) studies are lacking. Consistency of correlations over time and space and the effects of socioeconomic and other variables as confounders, and also as "control" variables, are investigated whenever possible. Statistical significance levels cannot be taken literally when spatial autocorrelations exist. Lyman et al<sup>1</sup>appear unaware of this. Two further weaknesses appear in their article. The difficulties, inherent in ecological correlation studies, in linking environmental agents to actual population exposures will not be pursued herein. But the authors' failure to discuss the bone sarcomas and carcinomas of nasal sinuses and mastoid air cells, long known to be induced by radium and present in far larger numbers than are leukemias in the radium-exposed cohorts they
B Vitamins for the Prevention of Vascular Disease
Authors: Colin Baigent, Robert Clarke
Journal: JAMA (2007)

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
Patients: the bigger picture
Authors: Kamran Abbasi
Journal: Journal of the Royal Society of Medicine (2014)

What is the role of patients in research? Initiatives like the James Lind Alliance, in which the Royal Society of Medicine is involved, place patients at the heart of the research process by inviting them to help define the questions that need to be answered. Clearly, patients need to have a role throughout, and this month's JRSM explores dilemmas at the beginning and the end of research.

Outcomes research is increasing in prominence, with recommendations from the National Institute of Health and Clinical Excellence. The Affordable Care Act in the United States has prompted creation of the Patient-Centred Outcomes Research Institute. Assessment of outcomes matters, and it is patient-centred outcomes that matter the most. Sanjay Budhdeo et al. discuss the value of using a core set of outcomes that are assessed and reported in all trials for a particular condition.1 It seems a logical approach, but how to get there? Collaborations between patient groups, clinicians, health economists, policy makers and academics look to be the way forward.

Research ethics committees make difficult choices but since patients face the risks, should decisions be made without their input? David Shaw and Bernice Elger argue that patients must participate in research ethics committee meetings, indeed two patients must be involved to avoid feelings of intimidation and isolation.2 They must be healthy enough to attend, of course, but also meet the inclusion criteria for the study. These measures are essential for first in human trials, argue the authors, and particularly so for those involving novel biotechnology.

Once patients become experienced, they might mentor others in the role of participating in research ethics committee meetings? A research paper in this issue explores the role of mentoring in academic career progression and finds that both the mentor and mentee value mentoring, but that careful planning, training and ongoing support are required.3 An important benefit is that mentees are able to pull their heads out of the day to day grind and see the bigger picture in relation to their careers. The bigger picture analogy also applies to the role of patients in research design and outcomes assessment, the bigger picture in that scenario is that patients matter more than career advancement.
Clinical Effectiveness of Influenza Vaccination in Manitoba
Authors: David S. Fedson
Journal: JAMA (1993)

<h3>Objective.</h3> —To assess the clinical effectiveness of influenza vaccination in preventing influenza-associated hospitalization and death. <h3>Design.</h3> —Case-control study. <h3>Setting and Patients.</h3> —Noninstitutionalized persons aged 45 years or older living in Manitoba, on December 1, 1982, and December 1, 1985. <h3>Methods.</h3> —Linked records of the Manitoba population registry, hospital-discharge abstracts, physician claims for ambulatory-patient visits and influenza vaccination, and vital statistics were used. A matched-set analysis estimated the clinical effectiveness of influenza vaccination in preventing hospital admissions and deaths from influenza-associated conditions during influenza A (H3N2) outbreak periods in 1982 to 1983 (12 weeks) and 1985 to 1986 (10 weeks). The analysis adjusted for hospital discharge and ambulatory care for high-risk conditions within the previous 15 months and 3 months, respectively. <h3>Results.</h3> —Influenza vaccination prevented 32% to 39% of hospital admissions with pneumonia and influenza and 15% to 34% of admissions with all respiratory conditions. Vaccination was 43% to 65% effective in preventing hospital deaths with these conditions (all listed diagnoses) and 27% to 30% effective in preventing deaths from all causes. <h3>Conclusion.</h3> —Influenza vaccination has substantial clinical effectiveness in preventing hospital admission and death from influenza-associated conditions in noninstitutionalized individuals. (<i>JAMA</i>. 1993;270:1956-1961)
Base-modification mRNA editing through deamination — the good, the bad and the unregulated
Authors: Harold C. Smith, Mark P. Sowden
Journal: Trends in Genetics (1996)

RNA editing is a co- or post-transcriptional process in which select nucleotide sequences in RNA are altered from that originally encoded in the genome. The mRNAs encoding apolipoprotein B and some glutamate receptor subunits of ionotropic membrane channels are edited by site-specific base-deamination systems. Although these editing systems differ markedly in their mechanism for RNA-substrate binding and in their catalytic subunits, recent results suggest potentially common solutions to the problem of editing-site selectivity. The data suggest that there are multiple editing complexes or 'editosomes', which manifest editing-site preferences due to their macromolecular composition.
Personality Disorders: Diagnosis and Management (Revised for DSM III)
Authors: John R. Neill
Journal: JAMA (1982)

We now have a second edition of what may be considered<i>the</i>standard work on the subject of personality disorders, here rewritten to conform to the American Psychiatric Association's new and controversial<i>Diagnostic and Treatment Manual</i>(ed 3). Dr Lion has more than achieved his stated goal: to provide a text on the subject that is clinical in orientation but does not succumb to the superficial "pragmatism" of many such attempts. Unfortunately for some readers, he overshoots his mark, and this second edition strains toward encyclopedic coverage. A majority of the new chapters are congruent with his aim in focus and depth. Personality disorders in adolescence and the elderly are covered by Marohn and Solomon, respectively. Harbin's chapter on family therapy is a gem. We also see the personality disorders in wider clinical contexts in the chapters examining personality disorders in military, conventional, private practice, and court settings. The problem
Computed Tomography to Evaluate Chronic Sinusitis-Reply
Authors: Thomas A. E. Platts-Mills
Journal: JAMA (1994)

<h3>In Reply.</h3> —Drs Ferguson and Eibling have raised some important issues with regard to the interpretation of sinus CT scans. The patient we reported had been prepared with a minimum of 3 weeks of antibiotics, oral decongestant, and nasal steroids. In addition, patients received nasal decongestant spray (Afrin) prior to the CT scan. We do not scan patients with an obvious acute infection. By contrast, the patients scanned for the common cold study<sup>1</sup>had received no medications prior to the study and were not given a nasal decongestant. Thus, the results of the two studies are not directly comparable. Nasal cavity disease is read as an overall assessment (unilateral obstruction would score 2). Drs Metson and Gliklich suggest that our data are better explained by nasal polyposis. However, they do not define how nasal polyps were evaluated. Nasal polyps fluctuate notoriously, and clinical evaluation of polyps vs polypoid tissue
Diabetes poorly controlled by sulphonylureas
Authors: A R Scott
Journal: BMJ (1988)

cases diagnosis was established on finding the pathogen in the liquid of bronchoalveolar lavage.Except in the patient who was already known to be seropositive for HIV, diagnosis was delayed and bronchoscopy was performed only when the clinical and radiological findings showed deterioration despite conventional antimicrobial treatment.In our region 15% of patients with AIDS are over 60 because of the high prevalence of the disease (129 cases per million inhabitants) and the mean age of the population (27% over 60).P canrnii pneumonia is the most common opportunistic infection in patients with AIDS.We agree with Dr Hargreaves and colleagues that P cannii pneumonia should be systematically considered in elderly patients with atypical, unresponsive chest infection.
A DOUBLE ACTIVE ELECTRODE FOR DIATHERMIC COAGULATION IN CANCER
Authors: Isaac Levin
Journal: JAMA (1928)

Diathermic coagulation means the destruction of tissue brought about by the heat that is developed within the tissue when a high potential, high frequency diathermy current passes through it. The intensity of the heat which develops under the influence of the high frequency current of the diathermy machine when a small electrode is used is such that the tissue undergoes coagulation necrosis. Diathermic coagulation of tissue in malignant tumors may be accomplished in two ways. Two small active electrodes of the same size and shape may be placed over two opposite ends of a tumor, and then coagulation takes place in the part of the tumor located between the two electrodes. With the present types of diathermy machines this method can be used only in bulky tumors elevated over the surface of the skin. When the two electrodes are brought too close together, sparking takes place with carbonization of surrounding
Prophylaxis of hepatitis B reactivation using lamivudine in a patient receiving rituximab
Authors: Tamae Hamaki, Masahiro Kami, Eiji Kusumi, Jun‐ichi Ueyama, Shigesaburo Miyakoshi, Shin‐ichi Morinaga, Yoshitomo Mutou
Journal: American Journal of Hematology (2001)

A 53-year-old man who had a history of fluminant hepatitis caused by precore mutant hepatitis B virus (HBV) was admitted to our hospital for the treatment of relapsed non-Hodgkin's lymphoma in July 2000. At admission, serum levels of aspartate aminotransferase and alanine aminotransferase were normal, but he tested positive for HBs antigen. The titer was 64-fold by radioimmunoassay. We initiated lamivudine at a daily dose of 75 mg to prevent HBV proliferation during chemotherapy. By September 2000, he had received six courses of rituximab at 375 mg/m(2) and four courses of fludarabine and mitoxantrone. No hepatic damage was observed from the initiation of treatment until March 2001. At present, four months after the completion of chemotherapy, he continues lamivudine, and the titer of HBs antigen is low at 4-fold. Rituximab is usually associated with mild toxicity, usually limited to infusion periods. The drug is not generally associated with increased incidence of opportunistic infections. However, some case reports have been recently published on severe viral infections following administration of rituximab. These include fluminant hepatitis caused by HBV, pure red cell aplasia due to parvovirus B19 and fatal varicella-zoster infection. While it remains unknown whether rituximab can be safely administered in patients with chronic HBV infection, this case report suggested that prophylactic administration of lamivudine is beneficial for suppressing reactivation of HBV during chemotherapy including rituximab. Rituximab should be used cautiously for patients with HBV infection, but prophylactic administration of lamivudine may be beneficial for preventing reactivation of HBV.
Nonrandomized Comparison of Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention for the Treatment of Unprotected Left Main Coronary Artery Disease in Octogenarians
Authors: Josep Rodés-Cabau, Jonathan DeBlois, Olivier F. Bertrand, Siamak Mohammadi, Javier Courtis, Eric Larose, François Dagenais, Jean-Pierre Déry, Patrick Mathieu, Melanie Rousseau, Gérald Barbeau, Richard Baillot, Onil Gleeton, Jean Perron, Can M. Nguyen, Louis Roy, Daniel Doyle, Robert De Larochellière, Peter Bogaty, Pierre Voisine
Journal: Circulation (2008)

The objective of the present study was to compare the midterm follow-up results of percutaneous coronary intervention (PCI) and coronary bypass graft surgery (CABG) for the treatment of unprotected left main coronary artery disease in octogenarians.A total of 249 consecutive patients > or =80 years of age diagnosed with left main coronary artery disease underwent coronary revascularization in our center between January 2002 and January 2008; 145 patients underwent CABG, and 104 patients had PCI. Major adverse cardiac and cerebrovascular events (MACCE [cardiac death, myocardial infarction, cerebrovascular event, revascularization]) were evaluated at a mean follow-up of 23 +/- 16 months. Patients who underwent PCI were older; had higher creatinine levels, lower ejection fraction, and higher EuroSCORE; and presented more frequently with an acute coronary syndrome. Drug-eluting stents were used in 48% of PCI patients. A propensity score analysis was performed to adjust for baseline differences between the 2 groups. Survival free of cardiac death or myocardial infarction (PCI, 65.4%; CABG, 69.7%) and MACCE-free survival (PCI, 56.7%; CABG, 64.8%) at follow-up were similar between the groups (adjusted hazard ratio for survival free of cardiac death or myocardial infarction, 1.28; 95% CI, 0.64 to 2.56; P=0.47; adjusted hazard ratio for MACCE-free survival, 1.11; 95% CI, 0.59 to 2.0; P=0.73). The EuroSCORE value was an independent predictor of MACCE regardless of the type of revascularization (hazard ratio, 1.17 for each EuroSCORE increase of 1 point; 95% CI, 1.09 to 1.25; P<0.0001).In this single-center, nonrandomized study, there were no significant differences in cardiac death or myocardial infarction and MACCE between CABG and PCI for the treatment of left main coronary artery disease in octogenarians after a mean follow-up of 2 years. Baseline EuroSCORE was the most important predictor of MACCE regardless of the type of revascularization. Randomized studies comparing both revascularization strategies in this high-risk coronary population are warranted.
Olympic Athletes Face Heat, Other Health Hurdles
Authors: Martha Gaie
Journal: JAMA (1996)

A MAIN CONCERN among trainers, athletes, and health care professionals set to engage in the centennial of the modern Olympic Games is the notorious  and high humidity of an Atlanta, Ga, summer.  Hotlanta's average daily high summer temperature of 88°F and average relative humidity of 52% combine to create an apparent temperature (heat index) of 100°F, hotter than the average  indices for the past 6 Summer Olympic Games. And it may be even worse: urban areas are often substantially hotter than other areas because of the heat island effect caused by buildings, concrete, and asphalt absorbing the sun's  and radiating it throughout the day. Track-and-field Olympians may find themselves facing  indices of up to 125°F. Training generally suffers under such conditions, says Edward Coyle, PhD, director of the Human Performance Laboratory at the University of Texas-Austin.  Lawrence Armstrong, PhD, an exercise physiologist at the University
Splenectomy vs. alpha interferon: A randomized study in patients with previously untreated hairy cell leukemia
Authors: Richard V. Smalley, Susan Anderson, Joseph Connors, Richard L. Tuttle, John K. Whisnant, William Robinson
Journal: American Journal of Hematology (1992)

Abstract Twenty patients with previously untreated hairy cell leukemia were randomized to undergo either splenectomy or to receive interferon alfa‐N1, a highly purified natural alpha interferon, as primary therapy. A response in the peripheral blood elements to a hemoglobin greater than 110 gm/l, a granulocyte count greater than 1 × 10 9 /l, and a platelet count greater than 100 × 10 9 /l (Catovsky criteria) was noted in all ten patients receiving alpha interferon but in only three of the patients undergoing splenectomy ( P = &lt; .01). Median time to response was longer in the ten interferon patients (153 days) than in the three splenectomy responders (20 days). Median time to treatment failure was significantly greater in the alpha interferon patients (&gt; 18 months) than in the splenectomy patients (&lt; 1 month). Survival was no different since patients relapsing following splenectomy subsequently responded to alpha interferon. A significant decrease in leukemic bone marrow infiltration was observed in seven of ten patients receiving alpha interferon and in none of the patients undergoing splenectomy. Side effects, primarily infections, were more frequent in patients receiving interferon. Alpha interferon is preferable to splenectomy as initial treatment for hairy cell leukemia. © 1992 Wiley‐Liss, Inc.
Amenorrhoea, Galactorrhoea, and Primary Hypothyroidism with High Circulating Levels of Prolactin
Authors: C. R. W. Edwards, I. A. Forsyth, G. M. Besser
Journal: BMJ (1971)

A 22-year-old woman with primary hypothyroidism developed amenorrhoea and galactorrhoea during oral contraceptive therapy. Investigation showed high levels of circulating prolactin which rose in response to insulin-induced hypoglycaemia and were suppressed by an oral glucose load. After treatment with thyroxine normal periods returned, the galactorrhoea improved, and the prolactin levels fell to undetectable levels. The results of the prolactin and human growth hormone assays confirm that it is possible to distinguish between human growth hormone and human prolactin.
In vivo effects of eltrombopag on platelet function in immune thrombocytopenia: no evidence of platelet activation
Authors: Bethan Psaila, James B. Bussel, Matthew D. Linden, Bracken Babula, Youfu Li, Marc R. Barnard, Chinara Tate, Kanika Mathur, Andrew L. Frelinger, Alan D. Michelson
Journal: Blood (2012)
T-helper Type 2–driven Inflammation Defines Major Subphenotypes of Asthma
Authors: Prescott G. Woodruff, Barmak Modrek, David F. Choy, Guiquan Jia, Alexander R. Abbas, Almut Ellwanger, Joseph R. Arron, Laura L. Koth, John V. Fahy
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

T-helper type 2 (Th2) inflammation, mediated by IL-4, IL-5, and IL-13, is considered the central molecular mechanism underlying asthma, and Th2 cytokines are emerging therapeutic targets. However, clinical studies increasingly suggest that asthma is heterogeneous.To determine whether this clinical heterogeneity reflects heterogeneity in underlying molecular mechanisms related to Th2 inflammation.Using microarray and polymerase chain reaction analyses of airway epithelial brushings from 42 patients with mild-to-moderate asthma and 28 healthy control subjects, we classified subjects with asthma based on high or low expression of IL-13-inducible genes. We then validated this classification and investigated its clinical implications through analyses of cytokine expression in bronchial biopsies, markers of inflammation and remodeling, responsiveness to inhaled corticosteroids, and reproducibility on repeat examination.Gene expression analyses identified two evenly sized and distinct subgroups, "Th2-high" and "Th2-low" asthma (the latter indistinguishable from control subjects). These subgroups differed significantly in expression of IL-5 and IL-13 in bronchial biopsies and in airway hyperresponsiveness, serum IgE, blood and airway eosinophilia, subepithelial fibrosis, and airway mucin gene expression (all P < 0.03). The lung function improvements expected with inhaled corticosteroids were restricted to Th2-high asthma, and Th2 markers were reproducible on repeat evaluation.Asthma can be divided into at least two distinct molecular phenotypes defined by degree of Th2 inflammation. Th2 cytokines are likely to be a relevant therapeutic target in only a subset of patients with asthma. Furthermore, current models do not adequately explain non-Th2-driven asthma, which represents a significant proportion of patients and responds poorly to current therapies.