tbuckley/cabot-search huggingface dataset:
Diabetes in Urban African-Americans. VI. Utility of Fasting or Random Glucose in Identifying Poor Glycemic Control
Authors: Imad M El-Kebbi, David C Ziemer, Daniel L Gallina, Lawrence S Phillips
Journal: Diabetes Care (1998)

OBJECTIVE African-Americans have an increased prevalence of both diabetes and diabetes complications, creating an imperative for improved metabolic control. Because American Diabetes Association guidelines recommend that action be taken when HbA1c is &amp;gt;8.0', but access to rapid-turnaround HbA1c assays remains limited, we tested the utility of fasting and random plasma glucose cutoffs as indicators of HbA1c &amp;gt;8.0%. RESEARCH DESIGN AND METHODS Using receiver operating characteristics (ROC) analysis, we evaluated the sensitivity, specificity, and predictive value of fasting and random plasma glucose measurements in identifying an HbA1c &amp;gt;8.0% (fasting n = 974, random n = 552). The population studied was predominantly African-American, middle-aged, and noninsulin-dependent. RESULTS Fasting plasma glucose was a significant indicator of HbA1c &amp;gt;8.0%, both in the whole group and in subgroups for diet, sulfonylureas, and insulin; the corresponding areas under the ROC curve were 0.87, 0.90, 0.87, and 0.84, respectively (all P &amp;lt; 0.0001). A fasting plasma glucose cutoff of &amp;gt;9.2 mmol/1 (165 mg/dl) provided a sensitivity of 80% and a specificity of 83% for the whole group and a 77% positive predictive value. Random plasma glucose was also a good indicator of HbA1c &amp;gt;8.0%, both in the whole group and in subgroups for diet, sulfonylureas, and insulin; the corresponding areas under the ROC curve were 0.85, 0.91, 0.85, and 0.77, respectively (all P &amp;lt; 0.0001). A cutoff &amp;gt;9.8 mmol/1 (177 mg/dl) provided a sensitivity of 78% and a specificity of 77% for the whole group and a 78% positive predictive value. Overall, a plasma glucose &amp;gt;11.1 mmol/1 (200 mg/dl) identified an HbA1c &amp;gt;8.0% with a predictive value of ∼90% if done while fasting and a predictive value of ∼80–85% if random. The utility of both fasting and random plasma glucose cutoffs was subsequently confirmed in a prospective study of another 2,309 and 1,396 patients, respectively. CONCLUSIONS Although glucose levels cannot replace HbA1c determinations, measurement of fasting or random plasma glucose may be used during a clinic visit to identify poorly controlled type 2 patients with reasonable certainty and allow timely patient education and therapeutic intervention.
Prospective cohort study of retinal vessel diameters and risk of hypertension
Authors: Tien Yin Wong, Anoop Shankar, Ronald Klein, Barbara E K Klein, Larry D Hubbard
Journal: BMJ (2004)

<h3>Abstract</h3> <b>Objective</b> To examine the relation between diameters of the retinal arterioles and 10 year incidence of hypertension. <b>Design</b> Population based prospective cohort study. <b>Setting</b> Beaver Dam eye study. <b>Participants</b> 2451 normotensive people aged 43 to 84 years. <b>Main outcome measures</b> Diameters of retinal arterioles and venules measured from digitised photographs of the retina taken at baseline. Measurements summarised as the arteriole:venule ratio, with a lower ratio indicating smaller arteriolar diameters. Incident hypertension, defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive drugs during follow up. <b>Results</b> 721 participants developed hypertension over a 10 year period. Those with lower arteriole:venule ratio had a higher cumulative incidence of hypertension (incidences of 17.4%, 24.1%, 31.0%, and 45.1%, respectively, for decreasing quarters of distribution of arteriole:venule ratio). After adjustment for age and sex, participants with arteriole:venule ratios in the lowest quarter had a threefold higher risk of hypertension (odds ratio 2.95, 95% confidence interval 2.77 to 3.88) than those with ratios in the highest quarter. This association remained significant after further adjustment for baseline systolic and diastolic blood pressure and other risk factors (1.82, 1.39 to 2.40, for lowest versus highest ratio quarters). <b>Conclusions</b> Narrowed retinal arterioles are associated with long term risk of hypertension, suggesting that structural alterations of the microvasculature may be linked to the development of hypertension.
Incidental Detection of Rounded Atelectasis During Tc-99m MIBI Scintimammography
Authors: Myung-Hee Sohn, Min-Woo Kim, Seok Tae Lim, Na-Ri Lee, Eun-Kee Song, Chang-Yeol Yim
Journal: Clinical Nuclear Medicine (2005)

Focal pulmonary uptake resembling a malignant tumor was incidentally detected in a 37-year-old woman with recurrent breast cancer during Tc-99m MIBI scintimammography. The lesion had the characteristic computed tomography (CT) features of rounded atelectasis with a relatively low uptake on FDG-PET. The lesion was unchanged on follow-up CT and scintimammography performed 1 year later.
Advanced Breast Cancer: Additive Hormonal Therapy
Authors: R. J. Kaufman
Journal: CA A Cancer Journal for Clinicians (1981)

Increased response rates with nonhormonal combination chemotherapy have led many oncologists to deprecate the use of hormonal therapy in the management of advanced breast cancer. The estrogen and progesterone receptor assay, on the one hand, has restimulated the enthusiasm for hormonal therapy when positive, but conversely when negative suggests that their use is precluded from further consideration. The author's thoughts on the continuing employment of additive hormonal therapy for almost all patients, either singly or in combination with other hormonal and nonhormonal drugs, with minimal restrictions imposed by hormonal assays or sites of disease will be presented. A short review of estrogens, androgens, progestins, testololactone (Teslac), and corticosteroids will be offered. The ease of administration of hormones and the increase in recurrent disease survival in responders compared with nonhormonal therapy strongly indicate that additive hormonal therapy still has a major role in the management of the advanced breast cancer patient.
Care for Transgender Persons
Authors: Ann Danoff, Demetre Daskalakis, Judith A. Aberg
Journal: JAMA (2013)

To the Editor: In a Clinical Crossroads article, Dr Spack1 reviewed key elements of psychological, hormonal, and surgical management of transgender and transsexual individuals. We suggest that testing for human immunodeficiency virus (HIV) also should be included as an integral component of transgender care.
Risk Factors for Gestational Diabetes in Black Population
Authors: David SH Bell, Bruce O Barger, Rodney CP Go, Robert L Goldenberg, Laura L Perkins, Chotip J Vanichanan, Jeffrey Roseman, Ronald T Acton
Journal: Diabetes Care (1990)

In a long-term longitudinal study of gestational diabetes mellitus in Black women, risk factors that were identified were age, obesity, a family history of diabetes, and the presence of hypertension. Poor predictors were a history of a previous large-for-date infant, parity, and age at first pregnancy. The prevalence of smooth muscle and nuclear autoantibodies was higher in gestational diabetic subjects. Gestational diabetic subjects who required insulin for glycemic control were more obese, had a lower frequency of the Bf-F phenotype and a higher frequency of the Bf-F1 phenotype, and had a lower frequency of the type 2 allele at the polymorphic locus adjacent to the insulin gene. Restriction-fragmentlength polymorphisms flanking the insulin and apolipoprotein A-l and C-MI genes, although not associated with gestational diabetes mellitus, may be associated with hyperlipidemia and subsequent atherosclerosis.
Cerebro-Spinal Meningitis--A Correction.
Authors: J. F. Shelley
Journal: JAMA (1898)

Elmdale, Kans., June 28, 1898. <h3>To the Editor:</h3> —An oversight in reading the proof of "Cerebro-Spinal Meningitis" allowed sixth line from bottom, first column, page 1499, Vol. xxx, to read "50 per cent." instead of "20 per cent." Very respectfully,
Bleeding Less for Diagnostics
Authors: Fred Hashimoto
Journal: JAMA (1982)

To the Editor.—  In centuries past, phlebotomies were performed to treat almost every disease, but in recent times, deliberate bloodlettings have generally been used to obtain samples for diagnostic examinations. Frequently, large volumes of blood have been let, resulting in iatrogenic anemias. Approximately a decade ago inThe Journal(1973;223:73), Eyster and Bernene reported that patients in their intensive care units lost an average of 54 mL (SD, 14 mL) of blood per day. They hypothesized that many hospitalized patients would lose between 10% and 20% of their blood volume. To see what progress might have been made in not bleeding patients to illness, we documented blood loss from patients in our medical intensive care unit during one week, observing 59 patient-days. Besides volumes sent to the laboratory, we included in our calculations blood lost during the placement of intravascular lines and blood discarded in obtaining specimens from them. Each
Impact of Fetal Drug Exposures on the Adolescent Brain
Authors: Nora D. Volkow
Journal: JAMA Pediatrics (2013)

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 Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Pediatrics journal
Quantitative Determination of Nuclear and Cytoplasmic Epidermal Growth Factor Receptor Expression in Oropharyngeal Squamous Cell Cancer by Using Automated Quantitative Analysis
Authors: Amanda Psyrri, Ziwei Yu, Paul M. Weinberger, Clarence Sasaki, Bruce Haffty, Robert Camp, David Rimm, Barbara Ann Burtness
Journal: Clinical Cancer Research (2005)

Abstract Background: Several lines of evidence support the epidermal growth factor receptor (EGFR) as a molecular target for therapy in head and neck squamous cell carcinomas (HNSCC). Determination of tumor EGFR levels by conventional immunohistochemistry has not always predicted antitumor efficacy. Quantitative assays may provide more accurate assessment of the level of EGFR receptor in the tumor, which may thus provide more reliable prognostic and predictive information. We studied the prognostic value of quantitative assessment of EGFR in oropharyngeal squamous cell cancers treated with radiotherapy. Experimental Design: We studied EGFR protein expression on a tissue microarray composed of 95 oropharyngeal cancer cases using an in situ molecular-based method of quantitative assessment of protein expression (AQUA) and correlated those with clinical and pathologic data. Automated, quantitative analysis uses cytokeratin to define pixels as cancer (tumor mask) within the array spot and measures intensity of EGFR expression using a Cy5-conjugated antibody within the mask. A continuous index score is generated, which is directly proportional to the number of molecules per unit area, and cases were defined as high expressing if they were above the median expression level. Results: The mean follow-up time for survivors was 44.9 months, and for the entire cohort was 34.8 months. Patients with high tumor EGFR expression levels had a local recurrence rate of 58% compared with 17% for patients with low EGFR tumor expression (P &amp;lt; 0.01). Similarly, patients with high nuclear EGFR expression had a local recurrence rate of 54% compared with 21% for patients with low EGFR nuclear expression (P &amp;lt; 0.05). Additionally, patients with high tumor and nuclear EGFR levels had inferior disease-free survival compared with low expressors (19% versus 43% and 19% versus 45%, respectively. P &amp;lt; 0.05 for each). In multivariate analysis adjusting for well-characterized prognostic variables, high tumor and nuclear EGFR expression levels retained their prognostic significance. Conclusion: The AQUA system provides a continuous measurement of EGFR on paraffin-embedded tissue and was able to reveal the association between EGFR expression and outcome expected from the biological role of EGFR. In the future, EGFR AQUA score may be useful in predicting response to EGFR-targeted therapies.
P146 Validation of the COPD assessment test (CAT) in pulmonary rehabilitation: application to a cohort of mixed pulmonary diseases
Authors: P. Lachapelle, M. Brosseau, M. Houle-Peloquin, C. Poirier
Journal: Thorax (2011)

<h3>Introduction</h3> The CAT is a new self administered questionnaire developed and validated for the assessment and monitoring of COPD patients.1 Recently, it has been showed to be sensitive to pulmonary rehabilitation (PR) in a prospective multicentric COPD study.2 The CAT has never been validated in a global PR programme with mixed pulmonary diseases. <h3>Methods</h3> We performed a retrospective study of 30 patients who completed the CAT before and after PR in 2010–2011. The cohort included seventeen patients diagnosed with COPD, seven with asthma and six with fibrosis. All participants were referred for an 8 weeks, three times weekly rehabilitation programme. Our primary objective was to validate the CAT in the cohort. We also evaluated six other outcome measures of PR as a secondary endpoint (Abstract P146 table 1). Pre and post PR variations were calculated with a nonparametric Wilcoxon test and Spearman rank correlation test was used to assess the relationship between measures. <h3>Results</h3> The CAT decreased significantly by a mean of 3.2 (p&lt;0.01) following PR. The mean CAT score change was similar in all pulmonary disease groups and between obstructive and non obstructive diseases. The pre and post CAT score negative variation was 4.16 (p&lt;0.05) for women, 3.74 (p&lt;0.05) for patients younger than 70 years old and 4.41 (p&lt;0.05) for patients with &lt;1 exacerbation yearly. No correlation between the CAT score change and the FEV<sub>1</sub> (r=−0.11) was found. Of all the outcome measures, the number of climb stairs was the most responsive with an amelioration of 250% after PR. <h3>Conclusion</h3> Even if the CAT was initially developed for the assessment of COPD patients, our study has shown that the questionnaire is responsive to a chronic lung disease9s population undergoing rehabilitation. A prospective study is now required to expand the application of the CAT to the general assessment of patients with chronic lung diseases.
Vascular endothelial growth factor: angiogenesis, atherogenesis or both?
Authors: Jozef Dulak, Alicja Jozkowicz, Matthias Frick, Hannes F. Alber, Wolfgang Dichtl, Severin P. Schwarzacher, Otmar Pachinger, Franz Weidinger
Journal: Journal of the American College of Cardiology (2001)
SALVARSAN VERSUS PROFETA'S LAW
Authors: AUGUSTUS RAVOGLI
Journal: JAMA (1913)

The theory of syphilitic immunity, as established by Ricord, has long been upset. If there is a syphilitic immunity in infected persons this is due to two circumstances combined: first, to a saturated condition of the fluids and solids of the organism with spirochetes and their toxins; second, to the capacity of the organism to produce antibodies to counteract the poisonous influence of the virus. With time the spirochetes become inactive and the disease, in a latent condition, loses its poisonous influence. The Wassermann test in these conditions turns negative, and yet the patient is not cured, and may show syphilitic signs of a late type. The attenuation of the virus is seen also by the observation of syphilitic families, when we see the first pregnancy end in miscarriage, the second in premature birth, the third child born alive, and only after a few days showing some syphilitic manifestations, and
Unsuspected Chylous Ascites in an Asymptomatic Case of Rosai Dorfman Disease
Authors: S. Padma, P. Shanmuga Sundaram, K. Sanjay Babu
Journal: Clinical Nuclear Medicine (2013)

Rosai-Dorfman disease, or sinus histiocytosis, first described in 1969, is a benign systemic disorder of histiocytes of unknown etiology characterized by massive lymphadenopathy. It predominantly involves the head and neck region, and is often associated with extranodal involvement. Patient presented to pulmonology with history of sudden onset dyspnea. Clinically and radiologically, the lungs were normal. D-dimer test was noncontributory. As the patient had a family history of lymphedema, lymphoscintigraphy was sought. We report the detection of an unsuspected case of Rosai-Dorfman disease by lower limb lymphoscintigraphy.
β2-integrins in different forms of urticaria
Authors: N. HAAS, W. IWEN, J. GRABBE, K. HAMANN, B. M. CZARNETZKI
Journal: British Journal of Dermatology (2006)

As urticarial lesions involve tissue invasion by inflammatory cells, and as beta 2-integrins play a central part in adhesion of leucocytes to endothelia, allowing their migration into the tissues, we have explored the distribution and sequential expression of these molecules in tissue sections from different forms of urticaria. Prick test weals (of 10 min duration) to common inhalant allergens showed only a minor increase of CD18, whereas in a case of cold urticaria CD11b and CD18 molecules were increasingly upregulated within the first 30 min after elicitation of the lesions. Skin test sites in delayed pressure urticaria, and urticarial lesions (> 6 h duration) of acute and chronic recurrent urticaria also showed marked upregulation of CD11b and CD18, and to a lesser extent of CD11a, but this did not strongly correlate with the intensity of the mixed cellular infiltrate. Non-lesional skin showed expression of beta 2-integrins in chronic urticaria, delayed pressure urticaria, and less so in acute urticaria, suggesting generalized leucocyte activation. This analysis of integrins thus suggests an early and extensive involvement of these molecules in the pathological events associated with the evolution of urticarial lesions.
Aluminum deposition at the osteoid-bone interface. An epiphenomenon of the osteomalacic state in vitamin D-deficient dogs.
Authors: L D Quarles, V W Dennis, H J Gitelman, J M Harrelson, M K Drezner
Journal: Journal of Clinical Investigation (1985)

Although aluminum excess is an apparent pathogenetic factor underlying osteomalacia in dialysis-treated patients with chronic renal failure, the mechanism by which aluminum impairs bone mineralization is unclear. However, the observation that aluminum is present at osteoid-bone interfaces in bone biopsies of affected patients suggests that its presence at calcification fronts disturbs the cellular and/or physiochemical processes underlying normal mineralization. Alternatively, aluminum at osteoid-bone interfaces may reflect deposition in preexistent osteomalacic bone without direct effects on the mineralization process. We investigated whether aluminum accumulates preferentially in osteomalacic bone and, if so, whether deposition of aluminum occurs at calcification fronts and specifically inhibits mineralization. Aluminum chloride (1 mg/kg) was administered intravenously three times per week for 3 wk to five normal and five vitamin D-deficient osteomalacic dogs. Before administration of aluminum the vitamin D-deficient dogs had biochemical and bone biopsy evidence of osteomalacia. Bone aluminum content in the osteomalacic dogs (15.1 +/- 2.2 micrograms/g) and the plasma aluminum concentration (10.4 +/- 2.1 micrograms/liter) were no different than those of normal dogs (10.5 +/- 3.5 micrograms/g and 11.9 +/- 1.2 microgram/liter, respectively). After the 3 wk of aluminum administration the plasma phosphorus, parathyroid hormone, and 25-hydroxyvitamin D concentrations were unchanged in normal and vitamin D-deficient dogs. Similarly, no alteration in bone histology occurred in either group. In contrast, bone aluminum content increased to a greater extent in the vitamin D-deficient dogs (390.3 +/- 24.3 micrograms/g) than in the normal dogs (73.6 +/- 10.6 micrograms/g). Moreover, aluminum localized at the osteoid-bone interfaces of the osteomalacic bone in the vitamin D-deficient dogs, covering 42.9 +/- 9.2% of the osteoid-bone surface. Further, in spite of continued aluminum chloride administration (1 mg/kg two times per week), vitamin D repletion of the vitamin D-deficient dogs for 11 wk resulted in normalization of their biochemistries. In addition, while normal dogs maintained normal bone histology during the period of continued aluminum administration, vitamin D repletion of the vitamin D-deficient dogs induced healing of their bones. Indeed, the appearance of aluminum in the cement lines of the healed bones indicated that mineralization had occurred at sites of prior aluminum deposition. These observations illustrate that aluminum deposition in osteomalacic bone may be a secondary event that does not influence bone mineralization. Thus, although aluminum may cause osteomalacia in chronic renal failure, its presence at mineralization fronts may not be the mechanism underlying this derangement.
Accuracy of dermoscopic criteria for discriminating superficial from other subtypes of basal cell carcinoma
Authors: Aimilios Lallas, Thrassivoulos Tzellos, Athanasios Kyrgidis, Zoe Apalla, Iris Zalaudek, Athanasios Karatolias, Gerardo Ferrara, Simonetta Piana, Caterina Longo, Elvira Moscarella, Alexander Stratigos, Giuseppe Argenziano
Journal: Journal of the American Academy of Dermatology (2013)