tbuckley/cabot-search huggingface dataset:
Intravascular Ultrasound
Authors: Steven E. Nissen, Paul Yock
Journal: Circulation (2001)

Abstract —Intravascular ultrasound (IVUS) is a valuable adjunct to angiography, providing new insights in the diagnosis of and therapy for coronary disease. Angiography depicts only a 2D silhouette of the lumen, whereas IVUS allows tomographic assessment of lumen area, plaque size, distribution, and composition. The safety of IVUS is well documented, and the assessment of luminal dimensions represents an important application of this modality. Comparative studies show the greatest disparities between angiography and ultrasound after mechanical interventions. In young subjects, normal intimal thickness is typically ≈0.15 mm. With IVUS, lipid-laden lesions appear hypoechoic, fibromuscular lesions generate low-intensity echoes, and fibrous or calcified tissues are echogenic. Calcium obscures the underlying wall (acoustic shadowing). The extent and severity of disease by angiography and ultrasound are frequently discrepant. Arterial remodeling refers to changes in vascular dimensions during the development of atherosclerosis. At diseased sites, the external elastic membrane may actually shrink in size, contributing to luminal stenosis. The interpretation of IVUS relies on simple visual inspection of acoustic reflections to determine plaque composition. However, different tissue components may look quite similar, and artifacts may adversely affect ultrasound images. IVUS commonly detects occult disease in angiographically “normal” sites. In ambiguous lesions, ultrasound permits lesion quantification, particularly for left main coronary disease. IVUS has emerged as the optimal method for the detection of transplant vasculopathy. An important potential application of ultrasound is the identification of atheromas at risk of rupture. The mechanisms of action of interventional devices have been elucidated using IVUS, and ultrasound is used by some operators to select the most suitable interventional device. IVUS-derived residual plaque burden is the most useful predictor of clinical outcome. In restenosis after balloon angioplasty, negative remodeling is a major mechanism of late lumen loss. IVUS is not routinely used for stent optimization, and there is no consensus regarding optimal procedural end points. Ultrasound has proven useful in evaluating brachytherapy. New and emerging applications for IVUS are continuing to evolve, particularly in atherosclerosis regression-progression trials.
Psychiatric Standards in Driver Licensing
Authors: Ronald Shlensky
Journal: JAMA (1976)

THERE are 130 million cars on the road in the United States, and each year in the early 1970s, there were 48,000 fatal accidents, in which 55,000 people were killed.<sup>1</sup>Two million more people were disabled annually, and an inestimable amount of property was destroyed or damaged. We know that some of these deaths are intended suicides, and it is likely that many more are unconsciously motivated self-destructive acts. Undoubtedly, many accidents have some less definitive relationship to the emotional state of the drivers involved. The states have a constitutionally ordained police power to regulate the public safety and health. Everyone has a right to be as free as possible from the threat of sudden death or mutilation, and the states have the responsibility to restrict the licensing of automobile drivers to this end. On the other hand, driving privileges profoundly affect the quality of life in our society.
Changes in Diastolic Stiffness and Tone of the Left Ventricle During Angina Pectoris
Authors: WILLIAM H. BARRY, JEFF Z. BROOKER, EDWIN L. ALDERMAN, DONALD C. HARRISON
Journal: Circulation (1974)

Reported elevations of left ventricular filling pressures during angina suggest increased myocardial stiffness. Both left ventricular beginning- and end-diastolic pressures and volumes were measured in seven patients before, during, and after angina induced by atrial pacing. During nine episodes of angina, mean end-diastolic pressure rose from 12 to 29 mm Hg and ejection fraction fell from 0.47 to 0.37. Logarithms of beginning and end-diastolic pressures were plotted against the corresponding volumes for each angiogram. During angina, there was a marked increase in beginning as well as end-diastolic stiffness of the ventricle. These changes, which were reversible with resolution of angina, may be due to sustained contraction or failure of relaxation of a portion of the left ventricular myocardium during angina pectoris.
Aluminum Is Associated with Low Bone Formation in Patients Receiving Chronic Parenteral Nutrition
Authors: SUSAN M. OTT
Journal: Annals of Internal Medicine (1983)

Patients treated with chronic total parenteral nutrition may develop metabolic bone disease. We evaluated 22 bone biopsy specimens from 16 patients. Compared with those of age- and sex-matched normal controls, these specimens had significantly higher osteoid area and lower total bone area and bone formation rate, as measured by double tetracycline labels. Aluminum was found in specimens from the 14 patients receiving casein hydrolysate but not in the two receiving amino acids as their nitrogen source. The reduced bone formation correlated inversely with the logarithm of the aluminum level. Aluminum was localized to the surface of mineralized bone; tetracycline uptake was absent at those sites. These bone findings are similar to those from aluminum intoxicated patients on hemodialysis. Both groups also have low parathyroid hormone levels. Thus, aluminum appears to be an important pathogenic factor in the osteodystrophy of patients receiving dialysis or total parenteral nutrition.
Epidemiology of invasive mycosis in ICU patients: a prospective multicenter study in 435 non-neutropenic patients
Authors: M. G. Petri, J. König, H. P. Moecke, H. J. Gramm, H. Barkow, P. Kujath, R. Dennhart, H. Schäfer, N. Meyer, P. Kalmar, P. Thülig, J. Müller, H. Lode
Journal: Intensive Care Medicine (1997)
THE MECHANISM OF SPINAL BLOCK IN EPIDEMIC MENINGITIS
Authors: PAUL F. STOOKEY
Journal: JAMA (1930)

Spinal block is but one of the disturbances of the circulation of the cerebrospinal fluid that the physician encounters in the treatment of epidemic meningitis. From a clinical standpoint, spinal block is the obstruction of the circulation of the cerebrospinal fluid most frequently encountered. In this brief preliminary report, we will confine our observations to spinal block to the exclusion of the other disturbances of circulation or reabsorption of the spinal fluid encountered as a complication of epidemic meningitis. The question as to the existence of a true circulation of the spinal fluid, or the possibility of the distribution of spinal fluid by diffusion as emphasized by Sachs,<sup>1</sup>has little bearing on a clinical description of spinal block. Spinal block results in an absence of spinal fluid in the canal whether the spinal fluid is distributed by a true circulatory impulse or by diffusions. When in the course of
Famine in southern Ethiopia 1985-6: population structure, nutritional state, and incidence of death among children.
Authors: B Lindtjorn
Journal: BMJ (1990)

To assess the effects of drought on mortality in children.Prospective epidemiological study forming part of nutritional monitoring during famine relief work.24 Food distribution sites in Arero and Borana provinces in southern Ethiopia.A monthly average of 14,173 and 5,334 children under 5 were examined in 1985 and 1986, respectively. Altogether 148,966 child months (105,872 for 1985 and 43,094 for 1986) were available for analysis.The families of all children were supplied with food each month. Basic medical care was also provided.Mortality in children under 5.A 40% increase in crude mortality was observed among children living in traditional and stable societies. The severe consequences were observed mainly among children living in relief shelters, where a threefold to fourfold increase in crude mortality was recorded among children. Increased childhood mortality was also associated with high prevalence of malnutrition, living in the most arid areas, and the dry season. A long period of food aid was needed to normalise the nutritional state, especially for children living in relief shelters.The most severe consequences of the widespread famine that occurred in the Arero and Borana provinces of southern Ethiopia during 1985-6 were seen among children living in relief shelters. Early food intervention may decrease the scale of migration and thus also reduce the severe consequences of a famine.
Fracture Risk in Woman With Osteoporosis: Must Tennis Cease?
Authors: Susan L. Greenspan
Journal: JAMA (1993)

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
Advanced Achievement in Internal Medicine
Authors: JOSEPH I. MATTHEWS
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 April 1987Advanced Achievement in Internal MedicineJOSEPH I. MATTHEWS, M.D.JOSEPH I. MATTHEWS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-4-641_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In response to Dr. Maynard's editorial (1), I would like to state that I believe most physicians are concerned about maintaining their clinical competence and are willing to undergo periodic recertification. However, there are legitimate concerns about cost and accessibility not addressed by the American Board of Internal Medicine when they devised the "Advanced Achievement in Internal Medicine." The cost, although not extravagant by today's standards, is more than most of us paid for our original certification. The major problem, however, is accessibility. My rough guess is that about 20% of practitioners of internal medicine have ready...Reference1. MAYNARD E. Advanced achievement in internal medicine: "the last gap of voluntarism"? Ann Intern Med. 1987;105:132-3. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JOSEPH I. MATTHEWS, M.D.Affiliations: 1011 Sugar Pine; San Antonio, TX 78232 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1987Volume 106, Issue 4Page: 641-641 ePublished: 1 December 2008 Issue Published: 1 April 1987 PDF downloadLoading ...
Renal Function in Long-Duration Type I Diabetes
Authors: Paul Mackin, Jean M Macleod, John P New, Sally M Marshall
Journal: Diabetes Care (1996)

OBJECTIVE The development of persistent proteinuria is reported to be uncommon after 30 years of type I diabetes, and the significance of microalbuminuria in patients with long-duration diabetes is unclear. We therefore undertook to study, in detail, renal function in patients with long-duration type I diabetes. RESEARCH DESIGN AND METHODS We measured albumin excretion rate (AER), glomerular filtration rate (GFR), and serum creatinine in 140 patients with ≥30 years of type I diabetes. We also assessed patients for other micro- macrovascular complications of diabetes together with factors implicated in the development of diabetic renal disease. RESULTS Of the patients, 23% had microalbuminuria (AER 20–200 μg/min and/or urinary albumin-to-creatinine ratio [ACR] &amp;gt; 2.5 mg/mmol [men] or &amp;gt; 3.5 mg/mmol [women] and dipstick negative for proteinuria), 4% had overt nephropathy (AER &amp;gt; 200 μg/min or persistent dipstick positive proteinuria), and 73% were normoalbuminuric (AER &amp;lt; 20 μg/min or ACR &amp;lt; 2.5 mg/mmol [men], &amp;lt; 3.5 mg/mmol [women]). Patients with microalbuminuria had lower GFR (81.5 ± 30.2 vs. 96.0 ± 20.3 ml · min−1 · 1.73 m−2; P = 0.06) and higher serum creatinine (104 ± 32 vs. 92 ± 16 μmol/l; P = 0.06) than those patients with normoalbuminuria. Both serum creatinine (P &amp;lt; 0.05) and tobacco consumption (P = 0.01) were significantly and independently related to elevated albumin excretion. CONCLUSIONS A substantial proportion of these patients have microalbuminuria and evidence of impaired renal function, suggesting that progression to end-stage renal failure may still be inevitable. Clinicians should continue to monitor renal function in these patients. The relationship between tobacco consumption and nephropathy also makes clear the need to reduce cigarette smoking in the diabetic population.
Cost effectiveness of self monitoring of blood glucose in patients with non-insulin treated type 2 diabetes: economic evaluation of data from the DiGEM trial
Authors: Judit Simon, Alastair Gray, Philip Clarke, Alisha Wade, Andrew Neil, Andrew Farmer
Journal: BMJ (2008)

<b>Objective</b> To assess the cost effectiveness of self monitoring of blood glucose alone or with additional training in incorporating the results into self care, in addition to standardised usual care for patients with non-insulin treated type 2 diabetes. <b>Design</b> Incremental cost utility analysis from a healthcare perspective. Data on resource use from the randomised controlled diabetes glycaemic education and monitoring (DiGEM) trial covered 12 months before baseline and 12 months of trial follow-up. Quality of life was measured at baseline and 12 months using the EuroQol EQ-5D questionnaire. <b>Setting</b> Primary care in the United Kingdom. <b>Participants</b> 453 patients with non-insulin treated type 2 diabetes. <b>Interventions</b> Standardised usual care (control) compared with additional self monitoring of blood glucose alone (less intensive self monitoring) or with training in self interpretation of the results (more intensive self monitoring). <b>Main outcome measures</b> Quality adjusted life years and healthcare costs (sterling in 2005-6 prices). <b>Results</b> The average costs of intervention were £89 (€113; $179) for standardised usual care, £181 for less intensive self monitoring, and £173 for more intensive self monitoring, showing an additional cost per patient of £92 (95% confidence interval £80 to £103) in the less intensive group and £84 (£73 to £96) in the more intensive group. No other significant cost difference was detected between the groups. An initial negative impact of self monitoring on quality of life occurred, averaging −0.027 (95% confidence interval−0.069 to 0.015) for the less intensive self monitoring group and −0.075 (−0.119 to −0.031) for the more intensive group. <b>Conclusions</b> Self monitoring of blood glucose with or without additional training in incorporating the results into self care was associated with higher costs and lower quality of life in patients with non-insulin treated type 2 diabetes. In light of this, and no clinically significant differences in other outcomes, self monitoring of blood glucose is unlikely to be cost effective in addition to standardised usual care. <b>Trial registration</b> Current Controlled Trials ISRCTN47464659.
Abstract 4860: Chemopreventive effects of α-santalol on ultraviolet B induced skin tumorigenesis by modulating cell cycle regulators.
Authors: Sreevidya Santha, Chandradhar Dwivedi
Journal: Cancer Research (2013)

Abstract Previous studies from our laboratory have shown chemopreventive effects of 5% α-santalol, a sequiterpene isolated from the sandalwood oil in ultraviolet-B induced skin tumor multiplicity in SKH-1 hairless mice. However, this dosage did not have significant effect on tumor incidence. The objective of this study was to investigate the effects of α-santalol (10%, w/v in acetone) on UVB-induced skin tumor incidence in SKH-1 hairless mouse model and to identify the molecular targets in α-santalol mediated protection. Tumor initiation and promotion were carried out by UVB radiation (30 mJ/cm2/day for 5 days a week up to 30 week) that is in the range of human exposure to sunlight that can cause skin cancer. Topical treatment of mice with α-santalol causes a significant reduction in tumor multiplicity, tumor volume and tumor incidence, and also delayed tumor development. Histopathological analysis of hematoxylin-eosin stained skin sections showed that α-santalol pretreatment strongly inhibited UVB-induced epidermal hyperplasia and total thickness of the epidermis. The proliferation potential of skin and tumor tissue sections from UVB-induced carcinogenesis protocol was evaluated by immunohistochemical expression of proliferation marker PCNA. Both intensity of brown staining as well as the number of positively stained nuclei were reduced in skin tumors and adjacent skin tissues from α-santalol treated group when compared to control group. Western blot analysis of skin lysates showed that α-santalol decreases the level of different cyclin-dependent kinases and associated cyclins, Cdc25 phosphatases (Cdc25B and Cdc25C) together with an up-regulation of CDK inhibitor Cip1/p21. However, the level of Kip1/p27 and p53 did not show a significant difference. Our data suggested that α-santalol (10%, topical) is a safer and promising skin cancer chemopreventive agent through targeting different cell cycle regulators. (This work is supported by a Translational Cancer Center Research Grant, funded by the State of South Dakota). Citation Format: Sreevidya Santha, Chandradhar Dwivedi. Chemopreventive effects of α-santalol on ultraviolet B induced skin tumorigenesis by modulating cell cycle regulators. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4860. doi:10.1158/1538-7445.AM2013-4860
Pathophysiologic Observations in Prehospital Ventricular Fibrillation and Sudden Cardiac Death
Authors: RICHARD R. LIBERTHSON, EUGENE L. NAGEL, JIM C. HIRSCHMAN, SIDNEY R. NUSSENFELD, BRIAN D. BLACKBOURNE, JOSEPH H. DAVIS
Journal: Circulation (1974)

In order to better understand the problem of prehospital sudden cardiac death (SCD) two groups of individuals were studied. One group was monitored by rescue squads during attempted rescue. These subjects were defibrillated from prehospital ventricular fibrillation (VF) and hospitalized if they survived or autopsied if they could not be resuscitated. The second group were SCDs which were witnessed and described by observers. Detailed past histories of both groups were collected, and either clinical or autopsy diagnoses were obtained. On the day of death or VF, one quarter reported new symptoms (primarily chest pain and dyspnea) preceding collapse by more than 30 minutes, one quarter reported symptoms lasting from 1 to 30 minutes, and one half collapsed instantaneously or within 1 minute of acute symptoms. A history of old myocardial infarction (MI) was present in 41% and of angina pectoris in 54%, and 27% reported new or changing symptoms within four weeks. In defibrillated survivors, "would-be SCDs," electrocardiographic (ECG) changes of acute myocardial infarction (AMI) or ischemia were nearly three times more frequent than changes detected histologically in SCDs, and in the former involved predominantly the anterior wall in contrast to the inferior wall in most autopsied deaths. This disparity implicates acute myocardial lesions, particularly of the anterior wall, in the majority of SCDs. Acute coronary lesions were found in 58% of SCDs autopsied. Most of these were ruptured plaques although almost one fifth of all autopsied SCDs had thromboses without intimal rupture. Severe chronic multivessel stenosis was present in most subjects, although 15% had only disease of a single vessel and in these, the left anterior descending (LAD) or left main coronary artery were involved in three quarters. The SCD population may be subgrouped into those with recent MI, those with only myocardial ischemia, and those with no detectable myocardial change. When rescuers were able to monitor prehospital SCDs, VF was found in the majority; however, 28% did have other terminal rhythms.
Reduction of leukemia cell burden and restoration of normal hematopoiesis at 3 months of crizotinib treatment in RAN-binding protein 2 (RANBP2)–anaplastic lymphoma kinase (ALK) acute myeloid leukemia
Authors: Y Maesako, A Okumura, K Takeoka, C Kishimori, K Izumi, Y Kamoda, F Iioka, T Akasaka, H Ohno
Journal: Leukemia (2014)
Endoskopische Diagnose der Hiatusgleithernie
Authors: W. Rösch, R. Ottenjann
Journal: Endoscopy (1969)

Sliding-type hiatal hernia is a very common lesion, the pathological significance of which is very often doubtful. In addition to the radiological examination esophagoscopy and gastroscopy should be performed in every patient with symptoms suggesting hiatal hernia. The typical findings in esophagoscopy, gastroscopy with or without inversion, and peritoneoscopy are demonstrated. The discrepancy between the macroscopic findings of esophagitis and the histological examination is stressed.
How Do We Interpret the 'Bad News' About Cancer?
Authors: Anthony B. Miller
Journal: JAMA (1994)

In this issue ofThe Journal, Davis et al<sup>1</sup>report on their analyses of US cancer data for 1973 through 1987 and conclude that increases in cancer have occurred that are not solely linked to aging of the population and smoking patterns. When interpreting the findings from their analyses we should bear in mind the following: First, if the major cause of death declines (cardiovascular disease, the decline of which is one of the triumphs of this century), then other causes of death will increase proportionally. It is not clear that restricting attention to one raceage group (whites, aged 65 to 74 years, as in their Fig 1) will necessarily completely control for this phenomenon, especially the effect of competing causes of death. See also p 431. Second, categorizing smoking-related cancers as cancers of the mouth, larynx, lung, pharynx, and esophagus ignores those cancers of the bladder, kidney, pancreas,
Spontaneous rupture of the oesophagus: Endoscopic treatment in the primary stage
Authors: R. A. Harma, Y. O. Koskinen, S. O. Suurkari
Journal: Thorax (1968)

A case of spontaneous rupture of the oesophagus occurring in the right wall of the midoesophagus is reported. The treatment, conservative in the primary stage of the disease, is described. This consisted of <i>per-oesophageal drainage of the mediastinum</i>, effected endoscopically. In spite of complications—an empyema in the right pleura and an oesophagocutaneous fistula—the treatment was successful, resulting in a complete cure about two years after the accident. The patient has remained in good health since then.
Circumstances of Medically Unadvised Purposeful Exposure to Food Allergens in an Observational Study (Consortium of Food Allergy Research, COFAR)
Authors: Kim E. Mudd, Jill Ellingson, Phyllis Mayfield, Lisa P. Talarico, Janet S. Kamilaris, Scott H. Sicherer
Journal: Journal of Allergy and Clinical Immunology (2013)