tbuckley/cabot-search huggingface dataset:
Measure of function in rheumatoid arthritis: individualised or classical scales?
Authors: R Seror, F Tubach, G Baron, F Guillemin, P Ravaud
Journal: Annals of the Rheumatic Diseases (2009)

Background: The Health Assessment Questionnaire Disability Index (HAQ-DI) is the most widely used measure of function in rheumatoid arthritis (RA). Objective: To evaluate individualised forms of the HAQ-DI and thus enhance the incorporation of patients’ views in outcome assessment. Patients and methods: HAQ-DI data were prospectively obtained from 370 outpatients with RA treated with leflunomide over a 6-month period. At baseline and final visits, patients had to rate the importance they attached to each activity addressed by the 20 HAQ-DI items, and to select the five activities they considered the most important. Different individualised scales were evaluated: scales preserving all domains, in which the score for each item is multiplied by or added to its importance; and scales involving, for each patient, only the five most important items. The psychometric properties of these scales were compared with those of the HAQ-DI. Results: For each HAQ-DI item, severity and importance scores were weakly correlated. Scores for all individualised scales were highly correlated with the HAQ-DI score (r s &gt;0.75). All scales had a good internal consistency (Cronbach’s α 0.87–0.88). Compared with the HAQ-DI, individualised scales did not have better sensitivity to change (standardised response mean 0.64–0.69 vs 0.74). Conclusion: Individualised scales have similar properties to the HAQ-DI. However, individualised questionnaires measuring importance gave complementary information to the measure of disability. Individualisation is probably not needed for group assessment in all randomised controlled trials but, the use of individualised questionnaires may be clinically relevant for individual patients with RA.
Altered Temporal Profile of Heat Shock Factor 1 Phosphorylation and Heat Shock Protein 70 Expression Induced by Heat Shock in Nucleus Tractus Solitarii of Spontaneously Hypertensive Rats
Authors: Samuel H.H. Chan, Ling-Lin Wang, Kuei-Feng Chang, Chen-Chun Ou, Julie Y.H. Chan
Journal: Circulation (2003)

Background— We demonstrated recently that heat shock (HS)–induced heat shock protein 70 (HSP70) expression in bilateral nucleus tractus solitarii (NTS), the terminal site in the brain stem for primary baroreceptor afferents, confers cardiovascular protection against heatstroke by potentiating baroreceptor reflex (BRR) response. This study evaluated the hypothesis that altered regulation of HSP70 expression may be associated with the heightened susceptibility to heatstroke during hypertension. Methods and Results— Spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats anesthetized with propofol were used. Compared with WKY rats, significant induction in HSP70 or phosphorylation of heat shock factor 1 (HSF1), but not HSF2, in the NTS and potentiation of BRR response in SHR occurred earlier (4 versus 8 hours), reaching peak magnitude sooner (16 versus 24 hours), and declined more rapidly after a brief hyperthermic HS (42±0.5°C for 15 minutes). The protection conferred by HS against hypotension and bradycardia during the onset of heatstroke (45°C for 60 minutes), although effective, was less effective in SHR. Microinjection bilaterally into the NTS of the selective protein kinase A (PKA) inhibitor H-89 (100 pmol) or the selective PKC inhibitor calphostin C (100 pmol) significantly attenuated all of the above events induced in SHR by HS. However, only H-89 was effective in WKY rats. Conclusions— An altered temporal profile of HS-induced HSP70 expression or potentiation of BRR response by concurrent activation via both PKA and PKC pathways of phosphorylation of HSF1 in the NTS may be associated with greater susceptibility to heatstroke during hypertension.
THE DEVELOPMENT OF CANCER IN ACRODERMATITIS CHRONICA ATROPHICANS
Authors: GEORGE T. PACK
Journal: JAMA (1942)

It has often been said that cancer never develops spontaneously in an otherwise healthy, normal skin. The onset of cancer of the skin is usually preceded by certain changes which could be called precancerous. The process is initiated by two factors at work: one an intrinsic change in the structure and functioning of the skin whereby it loses in some degree its protective capacity against injuries and the other an extrinsic factor such as mechanical trauma or chemical irritation. In experimental animals the extrinsic factor in the form of certain very potent carcinogenic hydrocarbons has proved sufficient in itself to cause the development of cancer in an apparently normal skin following a single application of the agent. Again, the ingestion of arsenic in therapeutic quantities over sufficient time may bring about the previously mentioned intrinsic changes of the skin with resultant hyperkeratinization and often multiple epitheliomas. Nevertheless, if we exclude
The Adrenergic Nervous System in Heart Failure
Authors: Michael R. Bristow
Journal: New England Journal of Medicine (1984)

IN this issue of the Journal Cohn et al. report that in heart failure central venous plasma norepinephrine is directly related to mortality, and that plasma norepinephrine is the only one of several univariate predictors that independently correlates with mortality risk.1 These observations contribute to an expanding body of information that suggests that the behavior of the adrenergic nervous system may be an important variable in the natural history of heart-muscle disease and heart failure.Cardiovascular function is under the regulatory control of the adrenergic or sympathetic nervous system. As first noted by Cannon,2 increases in heart rate, force of . . .
Letter: Treatment of alcoholism.
Authors: R Maggs
Journal: BMJ (1975)

aetiology, largely as a result of the many publications on the subject to which the working party's report refers.Any reduction in the incidence and severity of the intraoperative cardiovascular disturbances is prin- cipally due to the careful preoperative assess- ment and preparation of the patients, the use, when indicated, of alternative operations which do not require methylmethacrylate, and the meticulous care and vigilance exercised by the surgeons and anaesthetists during the procedure itself.If the importance of these simple but effective steps is overlooked again, then plainly the risks of total hip replacement will increase once more.-I am, etc.,
Time course of changes in bilateral arm power of swimmers during recovery from injury using a swim bench.
Authors: I L Swaine
Journal: British Journal of Sports Medicine (1997)

OBJECTIVES: There has been little research on the time course of recovery from injury in athletes. This is especially the case for recovery in arm power in injured swimmers. The purpose of this study was to compare the power output of the injured and non-injured arms of swimmers during recovery from injury by use of a maximal exercise test on a computer interfaced isokinetic swim bench. METHODS: Thirteen swimmers (five men and eight women; age 18.8 (3.2) years; stature 1.76 (0.05) m; body mass 61.7 (5.9) kg; mean (SD)) gave written informed consent and were recruited to this study throughout a three year period. All subjects had experienced non-aquatic soft tissue injury to their dominant-side shoulder or upper arm in the three months before participation, but had been allowed to return to swimming training. All of the subjects had injured their dominant arm and the mean time for absence from training was 3.7 (1.1) weeks. At return to training and at four, eight, and twelve weeks thereafter, subjects performed two all-out 30 second tests on the swim bench by simulating the swimming arm action. From these tests, peak power output (PPO), mean power output (MPO), and power decay (PD) for each arm during the 30 seconds of exercise could be determined by averaging the two tests. The differences between return to training and the four, eight, and twelve week periods were analysed using repeated measures analysis of variance with Tukey b post hoc test. RESULTS: The repeated testing showed 95% confidence intervals of +/- 11.4 W for PPO, +/- 9.5 W for MPO and +/- 0.5 for PD. When the swimmers returned to training the results showed that PPO was 179 (21.9) v 111 (18.1) W (P = 0.02), MPO was 122 (9.8) v 101 (8.8) W (P = 0.01), and PD was 2.5 (0.6) v 5.2 (1.9) (P = 0.001) for non-injured and injured arms respectively (all values mean (SEM)). There were similar differences at four weeks which disappeared after eight weeks, except for that of PPO which was still evident (187.3 (21.9) v 156.8 (18.1) W; P = 0.01). At 12 weeks there were no differences between the non-injured and injured arm on any of the indices of arm power (P &gt; 0.05). CONCLUSIONS: These results suggest that, using the swim bench power test, differences in bilateral arm power output after injury persist for at least eight weeks after return to swimming training. These findings support the need for prolonged rehabilitation after such injury. This would best include physiotherapy and a training programme within which special consideration is given to the recuperation process.
VA, Military Seek Office-Based PTSD Care
Authors: Bridget M. Kuehn
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
Central Sympathetic Inhibition to Reduce Postablation Atrial Fibrillation Recurrences in Hypertensive Patients
Authors: Georgios Giannopoulos, Charalampos Kossyvakis, Michael Efremidis, Apostolos Katsivas, Vasiliki Panagopoulou, Konstantinos Doudoumis, Konstantinos Raisakis, Konstantinos Letsas, Ilias Rentoukas, Vlasios Pyrgakis, Antonis S. Manolis, Dimitrios Tousoulis, Christodoulos Stefanadis, Spyridon Deftereos
Journal: Circulation (2014)

Background— The autonomic system is an important determinant of atrial arrhythmogenesis. Current evidence indicates that a combined sympathovagal drive is most commonly responsible for eliciting atrial fibrillation (AF) episodes. The purpose of this study was to test whether moxonidine, a centrally acting sympathoinhibitory agent, can lead to a reduction in postablation AF recurrence. Methods and Results— This was a prospective, double-blinded, randomized study of 291 hypertensive patients with symptomatic paroxysmal AF who were scheduled to undergo pulmonary vein isolation. Patients were randomly assigned to receive either moxonidine (0.2–0.4 mg daily) or placebo, along with standard antihypertensive treatment. No significant differences in blood pressure levels were observed between the 2 groups. In the primary outcome analysis, mean recurrence-free survival was 467 days (95% CI, 445–489 days) in the moxonidine group as compared with 409 days (95% CI, 381–437 days) in control subjects (log rank test, P =0.006). The calculated 12-month recurrence rate estimates were 36.9% in the control group and 20.0% in the moxonidine group ( P =0.007). Moxonidine treatment was associated with lower recurrence risk after adjustment for age, body mass index, number of AF episodes in the previous year, and left atrial diameter (adjusted hazard ratio, 0.35 [95% CI, 0.22–0.55]; P &lt;0.001). Conclusions— Treatment with moxonidine is associated with less AF recurrences after ablation treatment for drug-refractory AF in patients with hypertension. The observed effect does not appear to depend on the antihypertensive action of this agent. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01791699.
Reviews, Notes, and Listings: Cardiology: The Power of Clan: The Influence of Human Relationships on Heart Disease
Authors: Gerdi Weidner
Journal: Annals of Internal Medicine (1993)

Literature of Medicine15 December 1993Reviews, Notes, and Listings: Cardiology: The Power of Clan: The Influence of Human Relationships on Heart DiseaseGerdi Weidner, MDGerdi Weidner, MDState University of New York at Stony Brook, Stony Brook, NY 11794-2500.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-12-199312150-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Power of Clan: The Influence of Human Relationships on Heart DiseaseStewart Wolf and John G. Bruhn. 171 pages. New Brunswick, New Jersey: Transaction Publishers; 1993. $29.95.The notion that the quality of our social relationships may have a profound effect on our health and longevity has a long history but a short scientific past. A much publicized study that set out to show an association between social cohesion in the community and coronary heart disease mortality was begun in 1962 by Drs. Bruhn and Wolf. Their focus was on the town of Roseto, a cohesive and relatively stable Italian-American community ... Author, Article, and Disclosure InformationAffiliations: State University of New York at Stony Brook, Stony Brook, NY 11794-2500. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1993Volume 119, Issue 12Page: 1234KeywordsCardiovascular therapyCoronary heart diseaseDeath ratesHealth information technologyLongitudinal studiesMortalityMyocardial infarctionPsychometrics ePublished: 15 August 2000 Issue Published: 15 December 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Fine-needle Aspiration Biopsy of Spleen in Diagnosis of Generalized Amyloidosis
Authors: A. Pasternack
Journal: BMJ (1974)

Fine-needle aspiration biopsy of the spleen was performed on 18 patients shown to have amyloid deposits in other organs and on 17 control patients being investigated for proteinuria. Of the 18 patients with amyloid disease smears of splenic aspirate were positive in all cases, renal biopsy was positive in 16 out of 16 cases, and rectal biopsy was positive in seven out of 11 cases. None of the splenic smears were positive in the 17 control patients and no amyloid was found in the kidney in 15 of these patients on whom renal biopsy was performed. Splenic aspirate biopsy seems to be a simple and safe procedure for the diagnosis of amyloidosis. It is as accurate as renal biopsy and more accurate than rectal biopsy.
Ekkehard Von Kuenssberg
Authors: A. Large
Journal: BMJ (2002)

Former general practitioner Granton, Edinburgh (b 1913; q Edinburgh 1939; CBE, FRCP Ed, FRCOG, FRCGP), d 27 December 2001.

He came to the United Kingdom from Austria as a student in 1933. By the time he retired he had helped revolutionise UK general practice and equipped it to deal with the problems of the second half of the century. In the 1960s, in his capacity as chairman of the BMA's Scottish General Medical Services Committee, Ekke was one of the four representatives of the profession who negotiated the GP Charter. He was a founder member of the Royal College of General Practitioners, a fellow, chairman of council, and finally president. Before the effects of thalidomide on the fetus became obvious, Ekke, along with two neurologists at the Northern General Hospital, had drawn attention to some curious neurological disorders appearing in patients on thalidomide. It may have been as a result of this that he was invited to join the first committee on the safety of drugs, the Dunlop committee.
Prospects for Prevention of and Early Intervention Against HIV
Authors: Dani P. Bolognesi
Journal: JAMA (1989)

THE IMMUNE response that develops subsequent to infection with human immunodeficiency virus (HIV) consists of both humoral and cellular elements that, when assessed in vitro, can inhibit virus infection and lyse virus-infected target cells. If such activities were operative in vivo, one would expect that they would suppress virus replication and virus-induced cytopathic effects. The antiviral immune response may thus represent one of the primary host defense mechanisms responsible for the protracted asymptomatic phase of the disease, which, in most patients, can last several years. An important question to be answered for development of vaccine strategies against HIV is whether this response might be an effective barrier to HIV infection de novo. If the immune response can indeed control the virus even for a limited period, then the issue would not be whether it is possible to mount a protective immune response against HIV, but whether it may be necessary
Patients with degenerative aortic valve stenoses have increased thermal heterogeneity in the stenotic valve
Authors: Konstantinos Toutouzas, Eleftherios Tsiamis, Sophia Vaina, Ioannis Kallikazaros, Konstantinos Tentolouris, Costas Tsioufis, Dimitris Tousoulis, Christos Pitsavos, Pavlos Toutouzas, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2003)
Detection Bias Due to the Effect of Finasteride on Prostate Volume: A Modeling Approach for Analysis of the Prostate Cancer Prevention Trial
Authors: Y. C. Cohen, K. S. Liu, N. L. Heyden, A. D. Carides, K. M. Anderson, A. G. Daifotis, P. H. Gann
Journal: JNCI Journal of the National Cancer Institute (2007)

BackgroundThe Prostate Cancer Prevention Trial (PCPT) demonstrated a 24.8% reduction in the 7-year prevalence of prostate cancer among patients treated with finasteride (5 mg daily) compared with that among patients treated with placebo; however, a 25.5% increase in the prevalence of high–Gleason grade tumors was observed, the clinical significance of which is unknown. One hypothesized explanation for this increase is that finasteride reduced prostate volume, leading to detection of more high-grade tumors due to increased sampling density. This possibility was investigated in an observational reanalysis of the PCPT data, with adjustment for sampling density.
Clinical Concepts of Immunology
Authors: Noel R. Rose
Journal: JAMA (1979)

As testimony to the ever increasing role played by immunology in the practice of medicine, a number of books has recently appeared designed to explain fundamental immunologic concepts to the clinician. The latest of this series,<i>Clinical Concepts of Immunology</i>, edited by Robert H. Waldman, MD, professor of medicine at West Virginia University School of Medicine in Morgantown, is one of the most useful. In a brief 250 pages of text, Dr Waldman and his 20 collaborators have managed to cover the most relevant aspects of medical immunology. The authors chose to eschew the usual systematic approach to immunology, eg, immunologic disorders of the endocrines, of the gastrointestinal tract, and of the skin, for an organization based on mechanisms of immunologic damage and their attendant disorders. Following a brief overview of the immune system, there are major sections devoted to cellmediated immunity and humoral immunity. Each of these sections begins
Treating Clostridium difficile Infection With Fecal Microbiota Transplantation
Authors: Johan S. Bakken, Thomas Borody, Lawrence J. Brandt, Joel V. Brill, Daniel C. Demarco, Marc Alaric Franzos, Colleen Kelly, Alexander Khoruts, Thomas Louie, Lawrence P. Martinelli, Thomas A. Moore, George Russell, Christina Surawicz
Journal: Clinical Gastroenterology and Hepatology (2011)
Open science and reproducible research
Authors: T. Groves, F. Godlee
Journal: BMJ (2012)

New reports call for scientists to share data and publishers to embrace open access

“Scientists should communicate the data they collect and the models they create, to allow free and open access, and in ways that are intelligible, assessable and usable for other specialists . . . Where data justify it, scientists should make them available in an appropriate data repository.” So said the Royal Society last week, in its report Science as an Open Enterprise: Open Data for Open Science. 1 The report calls for more openness among scientists and with the public and media; greater recognition of the value of data gathering, analysis, and communication; common standards for sharing information to make it widely usable; mandatory publishing of data in a reusable form to support findings; more expertise in managing and supporting the use of digital data; and new software tools to analyse data. It is time for a big shift, says the report, from the status quo where “many scientists still pursue their research through the measured and predictable steps in which they communicate their thinking within relatively closed groups of colleagues; publish their findings, usually in peer reviewed journals; file their data and then move on.”

A few days …
Baron Munchausen and the Abused Child
Authors: Samuel Vaisrub
Journal: JAMA (1978)

Not even in the farthest reaches of his rich imagination could the great spinner of tall tales foresee that two centuries after his death his name would become eponymous. Nor did the physician, who first conferred the eponym on the wretched psychopath that beguiled him into performing unnecessary diagnostic and surgical procedures, suspect that the Munchausen effect could be exercised by proxy. Least of all did he expect that the proxy would be a child.  In a recent communication, Meadow 1 reported two cases in which children became victims of parental Munchausen syndrome. One little girl underwent innumerable investigative, manipulative, anesthetic, radiologic, and surgical procedures during the six years of her life because her parents provided false information about her symptoms, tampered with her urine specimens, and otherwise interfered with observation by physicians and nurses. Another child, a 14-month-old toddler, died of hypernatremia after repeated hospital admissions for vomiting and
Narrowband ultraviolet B phototherapy in erythropoietic protoporphyria: case series
Authors: M. Sivaramakrishnan, J. Woods, R. Dawe
Journal: British Journal of Dermatology (2013)

Funding resources: none. Conflicts of interest: none declared. Dear Editor, Erythropoietic protoporphyria (EPP) is an inherited disorder of the haem metabolic pathway. It causes disabling cutaneous photosensitivity and, sometimes, liver disease due to the accumulation of protoporphyrin in blood, liver and other tissues.1 Holme et al. reported the median age at onset and diagnosis in patients with EPP in the U.K. as 1 and 12 years, respectively, with diagnosis being delayed until the age of 20 years or more in 34% of their patients.2 However, late presentation of EPP in adults has been reported.3 The mechanism of cutaneous photosensitivity is not entirely known. The primary event appears to be endothelial damage caused by the photodynamic reaction of the accumulating protoporphyrin. Mast cell and complement activation may also be responsible for the clinical manifestations in EPP.4 Behavioural measures, wearing protective clothing and opaque sun blocks are useful in preventing photosensitivity but often unacceptable in this young group of patients. A systematic review of treatment options in EPP did not detect an efficacy of β‐carotene, vitamin C or N‐acetyl cysteine in well‐designed studies.5