tbuckley/cabot-search huggingface dataset:
Perioperative Assessment and Management of Risk from Coronary Artery Disease
Authors: Valerie A. Palda
Journal: Annals of Internal Medicine (1997)

Purpose: To summarize available evidence on preoperative cardiac risk stratification so that the internist may 1) use clinical and electrocardiographic findings to stratify a patient's perioperative risk for myocardial infarction and death; 2) decide which tests provide useful additional risk-related information; and 3) understand the benefits, risks, and evidence surrounding the decision to undertake coronary revascularization before elective noncardiac surgery. Data Sources: A MEDLINE search and review of the reference lists of identified articles. Sensitivities, specificities, and likelihood ratios for diagnostic tests were calculated, and a quality rating for study methods was applied. Data Extraction: Myocardial infarction and mortality were the major outcomes considered, and a quality rating for study methods was applied. Data Synthesis: Clinical and electrocardiographic findings, organized by multivariate prediction indices, accurately identify patients as having low, intermediate, or high risk for myocardial infarction or death. Pharmacologic stress imaging with thallium or echocardiography probably improves risk stratification for intermediate-risk patients having vascular surgery. These tests have not been shown to be effective prognostic indicators for patients having nonvascular surgery. No studies of angiography for risk prediction have been reported. Decision analyses and retrospective series suggest that the risks incurred by doing coronary angiography and revascularization before elective surgery outweigh the benefits. Prospective, controlled studies of coronary revascularization are lacking. Evidence from a randomized, controlled trial has shown a survival benefit with the perioperative use of β-blockers in patients at risk for coronary artery disease. Conclusions: Evaluation of all surgical patients by use of clinical indices is recommended. Low-risk patients need no further evaluation before surgery. High-risk patients need optimal management of their high-risk problems, including (if appropriate) β-blocker use, and may need to have their elective procedures canceled. Intermediate-risk patients probably benefit from further noninvasive stress testing, especially if they are having vascular surgery. Further clinical trials are needed for most areas of concern.
Effect of pamidronate 30 mg versus 90 mg on physical function in patients with newly diagnosed multiple myeloma (Nordic Myeloma Study Group): a double-blind, randomised controlled trial
Authors: Peter Gimsing, Kristina Carlson, Ingemar Turesson, Peter Fayers, Anders Waage, Annette Vangsted, Anne Mylin, Christian Gluud, Gunnar Juliusson, Henrik Gregersen, Henrik Hjorth-Hansen, Ingerid Nesthus, Inger Marie S Dahl, Jan Westin, Johan Lanng Nielsen, Lene Meldgaard Knudsen, Lucia Ahlberg, Martin Hjorth, Niels Abildgaard, Niels Frost Andersen, Olle Linder, Finn Wisløff
Journal: The Lancet Oncology (2010)
Health secretary defends plans to create foundation hospitals
Authors: S. Macdonald
Journal: BMJ (2003)

The health secretary, Alan Milburn, wants to make NHS foundation hospital status available to all NHS hospitals in England and says this should be achievable within four or five years. Speaking at a meeting of the health select committee on 4 March, he said, “It has never ever been my view that this has been a policy that will apply to elite hospitals.”

“Star ratings have shown that some hospitals are good, a few are poor, …
Feedback regulation of bile acid synthesis in primary human hepatocytes: Evidence that CDCA is the strongest inhibitor
Authors: Ewa Ellis, Magnus Axelson, Anna Abrahamsson, Gösta Eggertsen, Anders Thörne, Grzegorz Nowak, Bo-Göran Ericzon, Ingemar Björkhem, Curt Einarsson
Journal: Hepatology (2003)

Primary human hepatocytes were used to elucidate the effect of individual bile acids on bile acid formation in human liver. Hepatocytes were treated with free as well as glycine–conjugated bile acids. Bile acid formation and messenger RNA (mRNA) levels of key enzymes and the nuclear receptor short heterodimer partner (SHP) were measured after 24 hours. Glycochenodeoxycholic acid (GCDCA; 100 μmol/L) significantly decreased formation of cholic acid (CA) to 44% ± 4% of controls and glycodeoxycholic acid (GDCA) decreased formation of CA to 67% ± 11% of controls. Glycoursodeoxycholic acid (GUDCA; 100 μmol/L) had no effect. GDCA or glycocholic acid (GCA) had no significant effect on chenodeoxycholic acid (CDCA) synthesis. Free bile acids had a similar effect as glycine–conjugated bile acids. Addition of GCDCA, GDCA, and GCA (100 μmol/L) markedly decreased cholesterol 7α–hydroxylase (CYP7A1) mRNA levels to 2% ± 1%, 2% ± 1%, and 29% ± 11% of controls, respectively, whereas GUDCA had no effect. Addition of GDCA and GCDCA (100 μmol/L) significantly decreased sterol 12α–hydroxylase (CYP8B1) mRNA levels to 48% ± 5% and 61% ± 4% of controls, respectively, whereas GCA and GUDCA had no effect. Addition of GCDCA and GDCA (100 μmol/L) significantly decreased sterol 27–hydroxylase (CYP27A1) mRNA levels to 59% ± 3% and 60% ± 7% of controls, respectively, whereas GUDCA and GCA had no significant effect. Addition of both GCDCA and GDCA markedly increased the mRNA levels of SHP to 298% ± 43% and 273% ± 30% of controls, respectively. In conclusion, glycine–conjugated and free bile acids suppress bile acid synthesis and mRNA levels of CYP7A1 in the order CDCA &gt; DCA &gt; CA &gt; UDCA. mRNA levels of CYP8B1 and CYP27A1 are suppressed to a much lower degree than CYP7A1. (Hepatology 2003;38:930–938).
Pharmacokinetic observations on dapsone in dermatitis herpetiformis
Authors: A.F. SWAIN, R.A. AHMAD, H.J. ROGERS, J.N. LEONARD, L. FRY
Journal: British Journal of Dermatology (1983)

The pharmacokinetics of dapsone (DDS) and monoacetyldapsone (MADDS) following an oral dose of 150 mg DDS were studied in sixteen patients with dermatitis herpetiformis and seven normal subjects. No differences in DDS disposition were observed between the two groups. The maintenance dose of DDS for individual patients was not significantly correlated with jejunal biopsy morphology, DDS or MADDS half-lives, or the area under the plasma concentration-time curves for DDS or MADDS. DDS plasma protein binding was normal in patients and did not apparently determine the concentration of DDS in skin biopsies, for which the skin/plasma DDS concentration ratio was approximately unity. There was no undue representation of acetylator phenotype in the patient group and no correlation between maintenance dose and MADDS/DDS ratio was noted. The determinants of the maintenance DDS dose have not been found. This may relate to pharmacodynamic differences, but alternatively the concentration of oxidative metabolites rather than DDS or MADDS could be responsible for the therapeutic activity of DDS in dermatitis herpetiformis.
The natural history of compensated cirrhosis due to hepatitis C virus: A 17-year cohort study of 214 patients
Authors: Angelo Sangiovanni, Gian Maria Prati, Pierangelo Fasani, Guido Ronchi, Raffaella Romeo, Matteo Manini, Ersilio Del Ninno, Alberto Morabito, Massimo Colombo
Journal: Hepatology (2006)

Large databases of consecutive patients followed for sufficiently long periods are needed to establish the rates, chronology, and hierarchy of complications of cirrhosis as well as the importance of other potential causes of liver disease. In accordance with this goal, a cohort of patients with compensated cirrhosis due to hepatitis C virus (HCV) was followed for 17 years. Two hundred and fourteen HCV RNA–seropositive patients with Child-Pugh class A cirrhosis who had no previous clinical decompensation were prospectively recruited and followed up with periodic clinical and abdominal ultrasound examinations. During 114 months (range 1–199), hepatocellular carcinoma (HCC) developed in 68 (32%), ascites in 50 (23%), jaundice in 36 (17%), upper gastrointestinal bleeding in 13 (6%), and encephalopathy in 2 (1%), with annual incidence rates of 3.9%, 2.9%, 2.0%, 0.7%, and 0.1%, respectively. Clinical status remained unchanged in 154 (72%) and progressed to Child-Pugh class B in 45 (21%) and class C in 15 (7%). HCC was the main cause of death (44%) and the first complication to develop in 58 (27%) patients, followed by ascites in 29 (14%), jaundice in 20 (9%), and upper gastrointestinal bleeding in 3 (1%). The annual mortality rate was 4.0% per year and was higher in patients with other potential causes of liver disease than in those without them (5.7% vs. 3.6%; P = .04). In conclusion, hepatitis C–related cirrhosis is a slowly progressive disease that may be accelerated by other potential causes of liver disease. HCC was the first complication to develop and the dominant cause for increased mortality. (HEPATOLOGY 2006;43:1303–1310.)
Nifedipine and Erythromelalgia
Authors: GEORGE J. BRODMERKEL
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 September 1983Nifedipine and ErythromelalgiaGEORGE J. BRODMERKEL JR., M.D.GEORGE J. BRODMERKEL JR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-3-415_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I read with interest Fisher and associates' letter (1) of May 1983 on nifedipine and the possibility that it causes erythromelalgia.Within the last month, a patient who was being treated with nifedipine, 10 mg four times a day, for alleviation of esophageal dysmotility associated pain reported the development of redness on both legs extending from the feet to the knees. She had discomfort, including warmness and a burning sensation. Discontinuation of therapy resulted in immediate amelioration of the symptoms and redness.Because of the apparent benefit of nifedipine in the treatment of her esophageal pain, the...Reference1. FISHERPADNICKOLSTEIN JMS. Nifedipine and erythromelalgia [Letter]. Ann Intern Med. 1983;98(5 pt 1):671-2. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Allegheny General Hospital Pittsburgh, PA PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byErythromelalgie: rote Haut und SchmerzCoexistence of Erythromelalgia and Raynaud's Phenomenon in a Systemic Lupus Erythematosus PatientErythromelalgiaDrug ReactionsErythromelalgiaCoexistence of erythromelalgia and Raynaud's phenomenonHigh-Dose Oral Magnesium Treatment of Chronic, Intractable ErythromelalgiaErythromelalgia: New theories and new therapiesPossible Erythromelalgia-Like Syndrome Associated with Nifedipine in a Patient with Raynaud's PhenomenonVerapamil-induced secondary erythermalgiaErythromelalgia: Symptom or Syndrome?Erythromelalgia: a personal perspectiveErythromelalgia: Review of clinical characteristics and pathophysiologyProbleme bei der Behandlung mit KalziumantagonistenSide Effects — Overdosage — Contraindications — Drug InteractionsNifedipine-Induced Nonthrombocytopenic PurpuraNebenwirkungen — Überdosierung (Vergiftung) — Kontraindikationen — ArzneimittelinteraktionenCalcium Channel blockers: Spectrum of Side Effects and Drug Interactions 1 September 1983Volume 99, Issue 3Page: 415-415KeywordsKnees Issue Published: 1 September 1983 PDF downloadLoading ...
Systematic neonatal screening for severe combined immunodeficiency and severe T-cell lymphopenia: Analysis of cost-effectiveness based on French real field data
Authors: Marie Caroline Clément, Nizar Mahlaoui, Cécile Mignot, Christine Le Bihan, Hasina Rabetrano, Ly Hoang, Bénédicte Neven, Despina Moshous, Marina Cavazzana, Stéphane Blanche, Alain Fischer, Marie Audrain, Isabelle Durand-Zaleski
Journal: Journal of Allergy and Clinical Immunology (2015)
Postnatal sexual health
Authors: G. Barret, C. Victor
Journal: BMJ (1994)

EDITOR,—The author of the personal view who believed that she could not be the only woman to have felt “physically and mentally broken by the experience of childbirth and its aftermath”1 strongly echoed findings from our survey of sex after childbirth undertaken for the National Childbirth Trust earlier this year (G Barrett and C Victor, British Sociological Association's medical sociology conference, York, 1994). Altogether 1010 women replied to a questionnaire placed in the winter edition of the trust's magazine (circulation roughly 10000). They gave details of …
Broad Ligament Cyst in a Strangulated Hernia
Authors: K. N. Berger
Journal: BMJ (1944)

M{EDICBAL JIOURNAL 435 sympathetic is equivalent in its physiological effect to a peri- pheral inhibition.Further experiments will be required to solve this question.- ConclusionThis short review of the literature and my own experiments should suffice to indicate the significance of the sympathetic nervous system in shock.It is the purpose of this article to lay down principles which, if put into practice, may prove to be of value.It is not advocated that other methods which have proved, so far, to be indispensable (blood transfusion, etc.) should be neglected.The combination of both should be tried in suitable cases.They are certainly harmless, and may be of great advantage to the patient.Only clinical experience will enable us to accept or reject these recommendations.
904 IMIDAZOLYL DERIVATIVES IMPROVED RAT ALCOHOLIC (ASH) AND NON-ALCOHOLIC (NASH) STEATOHEPATITIS INDUCED BY LIQUID DIETS
Authors: V.U. Buko, T. Haehner, E. Belonovskaya, O. Lukivskaya, E. Naruta, I. Nikolaeva, T. Diesinger, H.-D. Tauschel
Journal: Journal of Hepatology (2008)
Continuing Progress in the Treatment of Severe Congestive Heart Failure
Authors: Sergio L. Pinski
Journal: JAMA (2003)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 2022 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
Impaired Peripheral Vasomotion in Diabetes
Authors: Kevin B Stansberry, Shane A Shapiro, Michael A Hill, Patricia M McNitt, Martin D Meyer, Aaron I Vinik
Journal: Diabetes Care (1996)

OBJECTIVE To test the hypothesis that vasomotion, the rhythmic contraction exhibited by small arteries and arterioles, is impaired in diabetic subjects compared with healthy control subjects. RESEARCH DESIGN AND METHODS We mathematically modeled the oscillations in laser Doppler microvascular measurements taken from the pulpar surface of the index finger in 20 healthy control subjects and 20 age-matched diabetic subjects (8 with type I and 12 with type II diabetes). The mean duration of diabetes was 17.1 ± 2.3 years, and mean HbA1c was 9.1 ± 0.4%. Blood flow was measured for 5 min as subjects rested quietly in a closed room. Fast Fourier transformation was performed to provide the frequency power spectrum of each recording. Amplitude of vasomotion was correlated with six quantitative measurements of neuropathy. RESULTS Diabetic subjects had impaired low-frequency oscillation vasomotion in 75% of age-matched patients (15 of 20 patients), with mean amplitudes of 24.9 ± 6.4 vs. 129.0 ± 33.2 (P &amp;lt; 0.0039). Of six somatic and autonomic neuropathy variables, only the warm thermal sensory threshold correlated significantly with the mean amplitude of vasomotion (r = −0.75, P &amp;lt; 0.0009). CONCLUSIONS Patterns of peripheral vasomotion are clearly disordered in diabetes. The loss of low-frequency oscillations observed here suggests a peripheral vascular abnormality that extends past the capillary network to arterial vessels. It is uncertain whether the accompanying small unmyelinated nerve C-fiber dysfunction is a cause or consequence of the impaired microvascular function. Measurement of vasomotion may prove useful as a novel test for peripheral neurovascular function.
Phase I Trial Evaluating the Concurrent Combination of Radiotherapy and Capecitabine in Rectal Cancer
Authors: Jürgen Dunst, Thomas Reese, Thomas Sutter, Helmut Zühlke, Axel Hinke, Katrin Kölling-Schlebusch, Stefan Frings
Journal: Journal of Clinical Oncology (2002)

To establish the feasibility of concurrent radiotherapy and capecitabine and define the maximum-tolerated dose (MTD) in patients with rectal cancer.Thirty-six patients with rectal cancer received treatment in the adjuvant, neoadjuvant, or palliative setting with a total irradiation dose of 50.4 Gy with 1.8 Gy/d in approximately 6 weeks. Capecitabine was administered at escalating doses from 250 to 1,250 mg/m(2) bid (including weekends) for the duration of radiotherapy. The MTD was defined when two or more patients in a cohort of three or six patients experienced dose-limiting toxicities.Dose-limiting grade 3 hand-foot syndrome was observed in two of six patients treated at a capecitabine dose of 1,000 mg/m(2) bid. Other toxicities were generally rare and/or mild, with only one case of non-dose-limiting grade 3 diarrhea and a single patient with grade 3 skin toxicity. Myelosuppression consisted mainly of leukocytopenia, with a maximum severity of grade 2. Thus, a dosage of 825 mg/m(2) bid is the recommended dose level for further evaluation. One pathologic complete remission of a T3N1 tumor and nine partial remissions were observed in 10 patients treated in the neoadjuvant setting.The recommended dose for phase II evaluation is capecitabine 825 mg/m(2) bid, administered without break during a conventional radiotherapy period of about 6 weeks. This combined-modality approach proved to be a feasible and well-tolerated treatment option with promising preliminary efficacy results in rectal cancer.
Ergogenic demands of a 24 hour cycling event.
Authors: J. A. White, C. Ward, H. Nelson
Journal: British Journal of Sports Medicine (1984)

The maximal aerobic performance (VO2 max) and energy costs of cycling at various power outputs and equivalent road speeds of a highly trained endurance cyclist (age 23.4 yrs, height 1.95 m, weight 73.1 kg), were measured in the laboratory on an eddy-current cycle ergometer, and the physiological responses related to determinations made during a 24 h cycling time trial event, using continuous ECG recording from which estimates of ergogenic demands were obtained. The cyclist covered a distance of 694 km during the event at an average speed of 28.9 km.h-1 which corresponded to an equivalent oxygen cost of 38.5 ml.kg-1 min-1 and represented approximately 55% of his VO2 max. During the event, the cyclist expended an estimated 82,680 kJ of energy, of which approximately 44,278 kJ (54%) were supplied by repeated feedings of liquids, solids and semi-solids and some 38,402 kJ (46%) came from the stored energy reserves which resulted in a 1.19 kg loss of body weight during the event. The energy demands of the activity were more than three times greater than the highest recorded values of severe industrial work, and similar to the hourly rates of expenditure of shorter duration competitive events, but above the highest values reported over other extreme endurance events over the same period of time. The results thus represent near maximal levels of sustainable ergogenic effort by man over a complete 24 h cycle.
The Biology of Aging
Authors: William R. Barclay
Journal: JAMA (1979)

The aging process holds a special interest for physicians, who not only experience the phenomenon within themselves but also witness it in many forms in their patients. Aging is a natural process, not a disease entity, but it is associated with and complicates so many disease processes that we often view aging as we do a disease and try to prevent it, modify it, or in some fashion treat it. Some physicians have made aging the basis of a relatively new specialty, geriatrics, but focus their attention on illnesses suffered by the elderly rather than the aging process itself. This book deals with the many basic biologic phenomena of the aging process in a series of essays, each constituting a chapter. These essays are not written in a highly technical style and can be understood by anyone with a modest background in biology. Each essay is a selfcontained unit and
THE TREATMENT AND PREVENTION OF TUBERCULOSIS IN BRITISH COLUMBIA
Authors: C. J. Fagan
Journal: BMJ (1905)

The respiratory epithelium is one of the first lines of defense utilized by the body to fend off invading pathogens. One such defense mechanism is a three-component system made up of the thiocyanate ion (SCN<sup>−</sup>), lactoperoxidase (LPO) and hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) which together create antimicrobial hypothiocyanite ions. Cell derived H<sub>2</sub>O<sub>2</sub> is produced by the NADPH oxidase, dual oxidase enzymes (DUOX1&amp;2). This system is capable of functioning with halides such as iodide as a substitute for thiocyanate. Previously we were able to show that cell derived hypothiocyanite was capable of inactivating influenza virus with a 4–5 log efficiency. We used a cell free method utilizing glucose oxidase as our source of H<sub>2</sub>O<sub>2</sub> to create a high throughput <i>in vitro</i> system to determine that hypothiocyanite inactivates Influenza in a strain independent manner and that thiocyanate is the key substrate in the reaction. We also determined that the more acidic the pH the more efficient the viral inactivation. Additionally, we substituted SCN<sup>−</sup> with I<sup>−</sup> and found that different substrates have different levels of antiviral activity. These results support the idea that <i>in vivo</i> this LPO/SCN/H<sub>2</sub>O<sub>2</sub> system plays a vital role in the initial defense against influenza virus and that this system has the potential to change the course of an IAV infection.
Large Gastric Perforation after Endoscopic Mucosal Resection Treated by Application of Metallic Clips (Video)
Authors: W. Albuquerque, V. Arantes
Journal: Endoscopy (2004)

Endoscopic mucosal resection (EMR) is an alternative approach for the curative treatment of early gastric cancer [1]. Endoscopic clipping devices have been developed to counter complications such as perforation [2].
Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions
Authors: Zoran Olivari, Paolo Rubartelli, Federico Piscione, Federica Ettori, Alessandro Fontanelli, Luigi Salemme, Corinna Giachero, Carlo Di Mario, Gabriele Gabrielli, Leonardo Spedicato, Francesco Bedogni
Journal: Journal of the American College of Cardiology (2003)
Epidemiology of Travelers' Diarrhea-Reply
Authors: R. Steffen
Journal: JAMA (1984)

<h3>In Reply.—</h3> As stated in our article and in Dr Allard's letter, there are several reasons against reporting the effect of drug prophylaxis on the incidence of diarrhea in travelers. In view of the importance of just this question, we have meanwhile started a controlled, randomized study and will report on our findings in due time.