tbuckley/cabot-search huggingface dataset:
Mucin-Hypersecreting Bile Duct Tumor Characterized by a Striking Homology with an Intraductal Papillary Mucinous Tumor (IPMT) of the Pancreas
Authors: H. J. Kim, M. H. Kim, S. K. Lee, K. S Yoo, E. T. Park, B. C. Lim, H. J. Park, S. J. Myung, D. W. Seo, Y. I. Min
Journal: Endoscopy (2000)

The mucin-hypersecreting bile duct tumor, which closely resembles an intraductal papillary mucinous tumor (IPMT) of the pancreas, is rare, and its clinical features are not well known. We report our experience of nine patients with this type of tumor, and analyze the data in order to elucidate its clinicopathologic characteristics.Between 1995 and 1998, nine consecutive patients (four men, five women; mean age 54) who were diagnosed as having a mucin-hypersecreting bile duct tumor were enrolled in this study.Recent or previous attacks of biliary pain and acute cholangitis were reported by most of the patients. Characteristics included a widely open ampulla of Vater with extrusion of mucin, and a diffuse dilated intrahepatic and extrahepatic bile duct with amorphous filling defects on cholangiogram. On cholangioscopic examination, a papillary mass or minute mucosal lesion was found in the dilated bile duct containing thick viscid mucin. Nine patients were referred for an operation, and curative resection was performed in eight of them. Using histologic examination, well differentiated adenocarcinoma in the background of benign hyperplasia and adenoma was documented in all patients except one, who showed pure adenoma.The mucin-hypersecreting bile duct tumor can be characterized by a striking homology with IPMT of the pancreas in clinical, radiologic, and pathologic features.
Documenting Biospecimen Conditions in Reports of Studies—Reply
Authors: Chaitanya R. Acharya
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
Casein Kinase Iδ Mutations in Familial Migraine and Advanced Sleep Phase
Authors: K. C. Brennan, Emily A. Bates, Robert E. Shapiro, Jekaterina Zyuzin, William C. Hallows, Yong Huang, Hsien-Yang Lee, Christopher R. Jones, Ying-Hui Fu, Andrew C. Charles, Louis J. Ptáček
Journal: Science Translational Medicine (2013)

Mutations in casein kinase Iδ that are associated with migraine in patients cause changes in enzymatic function, pain behavior, cortical excitability, and astrocyte signaling in mice.
Mucocutaneous Candidiasis or Mucocutaneous Microbiosis?
Authors: Ronald R. Chappler
Journal: JAMA (1978)

CHRONIC mucocutaneous candidiasis is a clinical syndrome characterized by chronic oral candidiasis (thrush), cutaneous candidiasis, and candidal nail involvement. Endocrine abnormalities are common. The syndrome may be familial or sporadic with onset in infancy or in adulthood.<sup>1</sup> The case described represents a generally unappreciated variation in the syndrome—dermatophyte infection of the skin. Recognition of this variant has a considerable clinical relevance. This subgenus of the syndrome also suggests a different pathogenetic process than that presumed involved in chronic candidiasis. <h3>Report of a Case</h3> A 15-year-old boy has had lesions of the left eyelid, mouth, fingernails, and toenails since shortly after birth. The working diagnosis was candidiasis. Topically applied agents including tolnaftate, nystatin, and haloprogin had been given extensive trial with no benefit. Transfer factor equivalent to 1 × 108 cells was given four times with no clinical improvement. No family history of skin disease was elicited. Physical examination at
Cycling in patients with chronic airflow limitation
Authors: A Cockcroft, A Guz
Journal: BMJ (1983)

rectum at necropsy was described as ". . .much thickened in its coats, and of a hardish gristly texture, a good deal like the turtle's intestines."3Few modern human pathologists are familiar with the intestines of reptiles, and it is only relatively recently that veterinary surgeons have developed an interest in this group of animals.These and other cases exemplify Hunter's breadth of interest and experience and, at a time when there is increasing contact and cooperation between doctors and veterinary surgeons, are a timely reminder of the im- portance of comparative studies.
Sensitization to triglycidylisocyanurate (TGIC) with cutaneous and respiratory manifestations
Authors: L Meuleman, A Goossens, F Rochette, B Nemery, C Linders
Journal: Allergy (1999)

The case is presented of a man with allergic contact dermatitis and occupational asthma due to triglycidylisocyanurate (TGIC), which is used as a hardener in thermosetting powder paint. The contact dermatitis was confirmed by patch testing (TGIC 0.5% and 5% in petrolatum), and the occupational asthma was confirmed by bronchial provocation testing: two challenges to an aerosol of lactose containing TGIC (0.05% and 0.1%, w/w, each for 0.5+1+2+4 min) led to a maximal decrease in FEV 1 of 22% and 31% after 6 and 4 h, respectively. Skin prick tests with unconjugated TGIC were possibly positive. This case confirms that exposure to TGIC in powder paints may cause not only contact dermatitis, but also occupational asthma.
A Survey of the Law of Medical Practice
Authors: Sidney Shindell
Journal: JAMA (1965)

There is probably no subject in the field of legal medicine about which there is more concern and more misunderstanding than the legal action called "malpractice." To the average physician "the word malpractice is almost synonymous with quack, and its very mention will cause the physician to be wary. His reputation, his livelihood, his social position, and the entire medical profession are threatened when any suspicion of malpractice is aired... Malpractice charges are, to a physician, what disbarment proceedings are to a lawyer."<sup>1</sup> That this represents the feelings of the medical profession cannot be argued. Little objective evidence exists, however, to indicate the reasons for these feelings, and while the current norms of our profession can be characterized as an "aspiration to make the practice of medicine a rational, scientific endeavor,"<sup>2</sup>attempts to examine the issues involved in "malpractice" actions in an objective fashion are relatively rare. It
Comparison of Ventilation-Perfusion Scintigraphy With MR Angiography in Patients With Swyer–James Syndrome
Authors: Mustafa Serdengecti, Mehmet E. Sakarya, Zeynep Y. Ilerisoy, Kemal Odev
Journal: Clinical Nuclear Medicine (2013)

The aim of this study was to establish the value of magnetic resonance angiography (MRA) in diagnosing) Swyer-James syndrome (SJS) and to compare MRA and ventilation-perfusion (V/Q) scan results in patients with established SJS.The V/Q scans and the MRA findings of 22 lungs of 11 patients with SJS (6 males, 5 females; age range: 17-69 years, mean: 38.4 years) were retrospectively studied. The perfusion scan was performed after the injection of Tc macroaggregated albumin. After 2 days, the ventilation scan was performed by using Tc diethylene triamine penta-acetic acid aerosol. The MRA was performed with a 1.5 T magnetic resonance unit. We compared the MRA and V/Q scan findings of the lungs of the patients.The V/Q scans showed the characteristic pattern of a matched V/Q defect on the affected lungs. The MRA displayed a smaller pulmonary artery and markedly poor peripheral vasculature on the affected side in all patients. The MRA had a sensitivity of 84.6%, a specificity of 100% for the detection SJS. Interobserver variability was minimum as indicated by a weighted kappa statistic of 0.818.This study indicates that the MRA is a fast, accurate, without radiation, and noninvasive technique for supporting the diagnosis of SJS. But, V/Q scans showed additional segmental perfusion/ventilation abnormalities on contralateral lung to reveal the segmental involvement of SJS. As a result, the MRA has no more any extra advantages for patient management.
"The Risks of Weight Training and Lifting in Young People": Functional Anatomy of the Spine
Authors: J.D.G. Troup
Journal: British Journal of Sports Medicine (1970)

Although there are known hazards to the spine which arise during heavy manual work, there is little first-hand evidence of back injuries associated with olympic weight-lifting and weight-training in young people.Certainly the incidence of back injuries is probably low when the lifts are performed with skill or under supervision.However, the young are likely to be relatively unskilled and are apt to try heavy lifts in the absence of trained instructors.Theoretically, this presents a variety of dangers when they fail to lift successfully, either because they become temporarily stuck or because they lose control.The known risks to the spine from heavy manual work can be divided into short and long term effects.In the short term back injuries are exceedingly common; back muscles are pulled, spinal ligaments strained, fractures occur and discs can be ruptured.In the docks, 28% of all injuries affect the back.When heavy work is repetitive long term hazards may arise.Those engaged in heavy manual work are more prone to spinal degeneration than sedentary workers, the onset of bony changes being accelerated (Lawrence,1969).This does not appear to apply to skilled and experienced weight-lifters (Hult, 1954), but what concerns this meeting now, is the potential dangers to the unskilled and to the inexperienced.In order to illustrate the theoretical dangers to the spine which arise during weight-lifting, three lifting situations will be analysed:- sometimes marginally increased at the beginning of a lift (Davis, Troup & Burnard, 1965), but the curve is a minor one compared with the lumbar curve when fully extended.27
Postural Augmentation of Renal Vein Renin Activity
Authors: J. W. Conn
Journal: JAMA (1969)

To the Editor:—  We are delighted with the confirmation of our work 1 which is afforded by the excellent paper by Michelakis and Simmons ( 208 :659, 1969). However, nowhere in the text of this paper are our observations or conclusions mentioned in relation to the authors' main thesis, which is identical with ours, namely, that exaggerated postural augmentation of renal vein renin is characteristic of functionally significant stenosis of the main renal artery or one of its branches; and that this phenomenon is of great diagnostic importance. That these workers were aware of our report 1 is indicated by the fact that it was included in their list of references. In the text, however, this reference is cited only as follows:  Since upright posture is known to stimulate renin production, 4 [reference is here made to reference 1 below] we have studied its effect on renal venous plasma renin activity
Promises and Challenges of Stem Cell Research for Regenerative Medicine
Authors: Carl Power, John E.J. Rasko
Journal: Annals of Internal Medicine (2011)

In recent years, stem cells have generated increasing excitement, with frequent claims that they are revolutionizing medicine. For those not directly involved in stem cell research, however, it can be difficult to separate fact from fiction or realistic expectation from wishful thinking. This article aims to provide internists with a clear and concise introduction to the field. While recounting some scientific and medical milestones, the authors discuss the 3 main varieties of stem cells—adult, embryonic, and induced pluripotent—comparing their advantages and disadvantages for clinical medicine. The authors have sought to avoid the moral and political debates surrounding stem cell research, focusing instead on scientific and medical issues.
Varicella Pneumonia
Authors: David M. Weber
Journal: JAMA (1965)

THERE HAS BEEN considerable interest during the past several years in the pneumonic processes associated with viral diseases. Recurrent epidemics of influenza have provided the primary stimulus to Investigations<sup>1,2</sup>in this area. Of the viral illnesses causing pneumonia, varicella lends itself well to study, particularly because of the ease with which an accurate clinical diagnosis may be established without detailed laboratory investigation. In spite of this, there has been confusion in the medical literature as to the prevalence of varicella pneumonia. Earlier reports<sup>3,4</sup>emphasized the rarity and severity of this complication while others<sup>5-7</sup>more recently have observed that varicella pneumonitis could be mild (often unrecognized) and suggested that the condition may be more prevalent than generally suspected. That varicella pneumonia is not common in childhood was demonstrated by Bullowa and Wishik<sup>8</sup>who observed only 21 cases of pneumonia in 2,534 hospitalized children with chickenpox. Mermelstein et al
ANALYSIS OF ONE THOUSAND CONSECUTIVE RESIDENCE VISITS TO ACUTELY ILL MEDICAL PATIENTS
Authors: William T. Couter
Journal: JAMA (1953)

Although residence visits may occupy a large share of a physician's working day, statistical knowledge concerning these visits is largely a matter of conjecture and hearsay. This study was inspired by a great variation in opinion among the older practitioners in our community regarding their impression of residence visits. We felt that by analyzing 1,000 consecutive residence visits some useful, and to a large extent unknown, statistical information could be obtained.  In order to make such a study, its basic unit—the residence visit—had first to be defined and then that definition rigidly followed. All patients 13 and under were automatically excluded. As far as was possible over the phone, complaints belonging to specialties other than internal medicine were referred to other practitioners, and only the remainder were then seen. Only the initial visit to any patient with a medical complaint or to the same patient for a medical complaint unrelated
ETV6/RUNX1 (TEL/AML1) is a frequent prenatal first hit in childhood leukemia
Authors: Jan Zuna, Jozef Madzo, Ondrej Krejci, Zuzana Zemanova, Marketa Kalinova, Katerina Muzikova, Michal Zapotocky, Julia Starkova, Ondrej Hrusak, Jiri Horak, Jan Trka
Journal: Blood (2011)
Epidemiology of periodontal disease among older adults: a review
Authors: David Locker, Gary D. Slade, Heather Murray
Journal: Periodontology 2000 (1998)

Although many epidemiological studies have been conducted concerning periodontal disease, the majority were not included in this review because of deficiencies in the measures used. Although it is increasingly common for studies in this field to measure periodontal disease using clinical attachment level, attachment loss or bone loss, the evidence pertaining to prevalence, incidence and risk in older adult populations is limited. Although it is the best indicator to date, characterizing periodontal disease by means of attachment loss has some limitations. Prevalence and incidence rates may vary according to the number of teeth and sites probed and bias and case misclassification may occur because of the healthy survivor effect. Moreover, prevalence data that document lifetime disease experience are of little use in planning for periodontal treatment needs. Problems with sampling or subject selection and idiosyncratic ways of reporting data also limit the quality of the evidence currently available. In order to standardize the collection of data on loss of attachment and to measure it as accurately as possible, Papapanou (63) recommends that studies use full-mouth periodontal examinations and the assessment of clinical attachment level at four sites on each remaining tooth. Given the inconsistencies in and problems with the methods used in the studies reviewed above, only broad conclusions can be drawn concerning periodontal disease in older adults. These confirm the conclusions reached in other reviews of the literature. While moderate levels of attachment loss are to be found in a high percentage of middle-aged and elderly subjects, severe loss is confined to a minority, albeit a substantial one. Severe loss is evident in only a few sites and, in general, affects only a small proportion of sites examined. Nevertheless, approximately one-fifth of older individuals have experienced more generalized severe loss; the rate is much higher in the oldest subjects and subjects from minority groups. Although not universal, severe disease is common in some older populations and some population subgroups. Studies using common approaches are needed to fully elucidate the extent to which disease experience varies across different populations. Similar conclusions can be drawn from prevalence studies measuring bone loss. These show that a minority of subjects accounted for most sites with advanced loss. Studies of incidence suggest that 50-75% of older adults experience additional loss of attachment of 2 or 3 mm or more at a minimum of one site over relatively short periods of time. Rates fall dramatically when more stringent case definitions are used. Moreover, relatively few sites examined show evidence of additional loss so that, although rates are high, extent and severity are low. More detailed analyses of incidence data, although few, indicate that new lesions are more common than progressing lesions, and the pattern of loss tends to support an episodic model of periodontal disease progression.
Palpitations, Arrhythmias, and Awareness of Cardiac Activity
Authors: Arthur J. Barsky
Journal: Annals of Internal Medicine (2001)

Somatic and visceral symptoms have a surprisingly weak relationship to objective measures of tissue pathology. This is exemplified by the poor correlation found between palpitations and cardiac arrhythmias. Many factors other than extent of disease influence symptomatic distress, and since symptoms are such a crucial feature of illness and of medical practice, much more investigation of these nonbiomedical influences is needed. Although experimental laboratory paradigms facilitate such investigation, there are problems involved in generalizing from laboratory findings to the reporting of the symptoms of disease in daily life. In studying the awareness of cardiac arrhythmias and of resting heartbeat, we have found that the palpitations of patients who somatize more and have more health-related anxiety and more psychiatric distress are significantly less likely to be related to demonstrable cardiac arrhythmias than are the palpitations of other patients. The accurate awareness of arrhythmias, however, is not associated with the accurate awareness of resting heartbeat. Even more surprising, a relatively large proportion of heart transplant recipients are accurately aware of their resting heartbeat. This work poses more questions than it answers. In so doing, it underscores some of the technical difficulties of conducting research in this area and shows how little is known about symptom perception, processing, and reporting.
Mortality for Publicly Reported Conditions and Overall Hospital Mortality Rates
Authors: Marta L. McCrum, Karen E. Joynt, E. John Orav, Atul A. Gawande, Ashish K. Jha
Journal: JAMA Internal Medicine (2013)

Federal efforts about public reporting and quality improvement programs for hospitals have focused primarily on a small number of medical conditions. Whether performance on these conditions accurately predicts the quality of broader hospital care is unknown.To determine whether mortality rates for publicly reported medical conditions are correlated with hospitals' overall performance.Using national Medicare data, we compared hospital performance at 2322 US acute care hospitals on 30-day risk-adjusted mortality, aggregated across the 3 publicly reported conditions (acute myocardial infarction, congestive heart failure, and pneumonia), with performance on a composite risk-adjusted mortality rate across 9 other common medical conditions, a composite mortality rate across 10 surgical conditions, and both composites combined. We also examined the relationship between alternative surrogates of quality (hospital size and teaching status) and performance on these composite outcomes.Our sample included 6,670,859 hospitalizations for Medicare fee-for-service beneficiaries from 2008 through 2009. Hospitals in the top quartile of performance on publicly reported conditions had a 3.6% lower absolute risk-adjusted mortality rate on the combined medical-surgical composite than those in the bottom quartile (9.4% vs 13.0%; P < .001). These top performers on publicly reported conditions had 5 times greater odds of being in the top quartile on the overall combined composite risk-adjusted mortality rate (odds ratio [OR], 5.3; 95% CI, 4.3-6.5). Mortality rates for the index condition were predictive of medical (OR, 8.4; 95% CI, 6.8-10.3) and surgical (2.7; 2.2-3.3) performance when these groups were considered separately. In comparison, large size (OR, 1.9; 95% CI, 1.5-2.4) and teaching status (2.4; 1.8-3.2) showed weaker relationships with overall hospital mortality rates.Hospital performance on publicly reported conditions can potentially be used as a signal of overall hospital mortality rates.
Predictors of response of U.S. veterans to treatment for the hepatitis C virus
Authors: Lisa I. Backus, Derek B. Boothroyd, Barbara R. Phillips, Larry A. Mole
Journal: Hepatology (2007)

The currently recommended treatment for hepatitis C virus (HCV) infection is pegylated interferon alfa (PEG-INF) and ribavirin, which can be difficult to tolerate. More information about predicting sustained virologic response (SVR) may allow more informed treatment decisions to be made. This retrospective observational cohort study identified predictors of SVR to PEG-INF and ribavirin in routine medical practice at 121 Department of Veterans Affairs facilities. Among 5,944 patients infected with HCV genotypes 1, 2, or 3 who had been treated with PEG-INF and ribavirin, SVR rates were 20%, 52%, and 43%, respectively, and discontinuation rates were 68% (prior to 48 weeks), 34% (24 weeks), and 41% (24 weeks), respectively. In multivariate analysis, significant predictors of decreased likelihood of genotype 1 patients having an SVR were being African American, clinical liver disease, diabetes, low cholesterol, low hemoglobin, low platelet count, and treatment at a low-volume facility. Predictors of increased likelihood of genotype 1 patients having an SVR were low-level HCV viremia, elevated ALT quotient, and receiving PEG-INF 2A (rather than 2B). For genotype 2 patients, increasing body mass index, prior use of interferon, and low platelet count were negative predictors; only low-level HCV viremia was a positive predictor. For genotype 3 patients, only receiving PEG-INF 2A affected the likelihood of an SVR; its effect was positive.Among patients for whom HCV treatment is initiated during routine medical care, multiple factors including form of PEG-INF received affect the SVR rate for genotype 1 patients. Few of these factors affect the rate for genotype 2 patients, and even fewer do so for genotype 3 patients.