tbuckley/cabot-search huggingface dataset:
Evidence-Based Approach to the Introduction of Positron Emission Tomography in Ontario, Canada
Authors: William K. Evans, Andreas Laupacis, Karen Y. Gulenchyn, Les Levin, Mark Levine
Journal: Journal of Clinical Oncology (2009)

Purpose The uptake of new health care technologies is usually driven by industry promotion, physician interest, patient demand, and institutional ability to acquire the technology. The introduction of positron emission tomography (PET) scanning in the province of Ontario, Canada, followed a different path. Methods The Ontario provincial government, through its Ministry of Health and Long-Term Care, commissioned a systematic review of the literature. When this found only weak evidence that PET has a positive impact on clinical outcomes, the Ministry introduced a provincial PET evaluation program to close the evidence gap. Results This article describes the challenges encountered establishing the PET evaluation program. These included the design and conduct of the initial clinical trials, the establishment of a PET cancer registry, standardizing how PET scans were performed and reported, and gaining acceptance by health professionals for the evaluative program. Conclusion The proliferation of health technologies is a key driver of increasing health care costs. The Ontario approach to the introduction of PET is a model worth consideration by health systems seeking to ensure that they receive value for money based on a strong evidentiary base when introducing new health technologies.
Psychological and Knowledge Factors Related to Delay of Help-Seeking by Patients with Acute Myocardial Infarction
Authors: Jan K. Bleeker, Leida M. Lamers, Ineke M. Leenders, Dick C. Kruyssen, Maarten L. Simoons, Rutger W. Trijsburg, Ruud A. Erdman
Journal: Psychotherapy and Psychosomatics (1995)

Survival of an acute myocardial infarction (AMI) and subsequent prognosis are highly dependent on the time between onset of symptoms and medical intervention. The purpose of this study is to investigate which psychological and cardiovascular knowledge factors may contribute to the time the AMI patient takes to decide to seek medical help (patient delay). Three hundred patients took part in the study. They were interviewed and filled out several psychological questionnaires. The results show that patients who ask for medical help within half an hour have more cardiovascular knowledge, seek less distraction and more social support during the acute phase, compared to patients waiting longer. In general those who call soon appear to have easing thoughts in case of personal difficulties. They also deny their feelings of resentment to a lesser degree and interpret the symptoms of an AMI more often as originating in the heart. Future education campaigns should therefore not only address cardiovascular knowledge, but also coping and defense mechanisms.
No mortality benefit of primary angioplasty over thrombolytic therapy in patients with nonanterior myocardial infarction at long-term follow-up: Results of the zwolle trial
Authors: Arnoud W. ban 'tHof, Jose Henriques, Jan-Paul Otterbanger, Jan Henk Dambrink, Marcel Gosselink, Jan C. Hoorntje, Menko Jan de Boer, Felix Zijlstra
Journal: Journal of the American College of Cardiology (2003)
Same-Day Discharge and Risks of Mortality and Readmission After Elective ICD Placement for Primary Prevention
Authors: Paul L. Hess, Melissa A. Greiner, Sana M. Al-Khatib, Frederick A. Masoudi, Paul D. Varosy, Richard I. Fogel, Lesley H. Curtis, Adrian F. Hernandez
Journal: Journal of the American College of Cardiology (2015)
THE INDICATIONS FOR, AND THE ADVANTAGES AND TECHNIQUE OF, MUSCLE SHORTENING.
Authors: G. C. SAVAGE
Journal: JAMA (1895)

In the judgment of the author of this paper, muscle shortening is indicated in all cases of heterotropia, regardless of the direction or extent of the turning. In many cases of low degrees of squint the shortening operation alone will effect a cure; while, in a greater number of cases, the shortening of the weaker muscle should be associated with a partial division of the tendon of the stronger muscle in order to the attainment of the best results. In cases of high degree of exophoria in which a partial tenotomy of both external recti does not reduce the exophoria within the range of possibility of completing the cure by rhythmic exercise of the interni, the latter should be shortened. In all cases of exophoria with less than 8° of abduction, shortening of the interni is indicated, not to be associated with even the slightest tenotomy of the externi. In
Psychomotor and physiological responses to prolong walking in the heat in hydrated and dehydrated conditions among relaxation-trained army reserved personnel
Authors: Hairul Anuar Hashim, Zabidi Azhar Hussin, Chen Chee Keong, Asok Kumar Ghosh
Journal: British Journal of Sports Medicine (2010)

The present study examined the effects of prolonged walking in the heat on choice reaction time, heart rate and rectal temperature among army reserved personnel. Using purposive sampling, 23 male reserved army personnel were recruited for this study and they were randomly assigned into hydrated and dehydrated groups. The experimental protocols consist of two experimental sessions (pre- and post-relaxation training). Within each session, subjects were required to walk on a treadmill for 3 h while wearing a backpack of 20 kg. Measurement of parameters was performed four times (0, 1, 2 and 3 h). In between the experimental sessions, subjects underwent eight sessions of 30-min progressive muscle relaxation trainings. The difference in the measured parameters between the group across the testing sessions and trials were analysed using a three-way repeated measure analysis of variance. The results indicated an interaction effect between the groups across experimental trials in choice reaction time. Hydrated group performed significantly faster in choice reaction time test in trial 1 (0 h) of the second experimental session. For heart rate, only main effect of group was found. Heart rate of the dehydrated group was significantly higher than the hydrated group across the experimental trials. Although not statistically significant for the rectal temperature, a pattern exists indicating that that the hydrated group exhibited lower rectal temperature across the experimental trials. In conclusion, our study highlighted that prolonged walking in the heat imparted a significant load on the heart rate in reserved army personnel. Our findings suggest that the army personnel should maintain hydration status during prolonged walking in the heat to reduce stress on the heart at least after every hour of exercise. Contrary to our expectation, progressive muscle relaxation training did not produce any significant effects on the measured parameters in our study.
Deaths from tuberculosis.
Authors: B H Stack
Journal: BMJ (1971)

Deaths from Tuberculosis SIR,-I have recently conducted an analysis of 71 new cases of tuberculosis diagnosed in a large general hospital over a six-year period.The results confirm some of the comments in your leading article on this subject (22 May, p. 419).In 17 (24%') there was undue delay in making the correct diag- nosis.In 15 an interval of more than three weeks elapsed between hospital admission and diagnosis, and in two tuberculosis was not discovered until necropsy.In these two cases and in seven others, failure to con- sider tuberculosis in the initial differential diagnosis was a major factor in causing this delay.Three of these nine patients had recognized predisposing factors (one was an alcoholic and two were receiving cortico- steroid drugs), and four had extrathoracic tuberculosis.None were immigrants.The necessity of considering tuberculosis in the elderly is confirmed by the case of an 80-year-old woman who presented with weakness, anorexia, abdominal discomfort, and weight loss.Though there was a diffuse bilateral abnormality on chest radiograph, a diagnosis of intra-abdominal malignant disease was made.At necropsy, disseminated miliary tuberculosis was found.These findings and the report of the Research Committee of the British Thoracic and Tuberculosis Association' stress the im- portance of communicating to medical students and postgraduates the continuing need to consider tuberculosis in the differen- tial diagnosis of any unexplained illness, particularly where this occurs in the elderly, in immigrants, and in patients with recog- nized predisposing factors such as diabetes, alcoholism, and corticosteroid therapy.-I
Integrative Epidemiology: From Risk Assessment to Outcome Prediction
Authors: Margaret R. Spitz, Xifeng Wu, Gordon Mills
Journal: Journal of Clinical Oncology (2005)

In this paper, we advance the concept of integrative epidemiology. Our unifying premise is that the same genes that are implicated in cancer risk may also be involved in a person's propensity to carcinogenic exposure and/or to modulation of therapeutic outcome. In the coming years, molecular epidemiology will play an increasingly prominent role in early detection of cancer and in identifying genetically high-risk subgroups that might benefit disproportionately from more intensive screening or chemoprevention interventions. Molecular epidemiology is also integral to pharmacogenetic research, by constructing genetic profiles that could be used to individualize therapy and to understand the functional consequences of chemoprevention, chemotherapy, or radiotherapy response. At the level of risk assessment, the focus might be on germline polymorphisms in candidate genes; for early detection, epigenetic events in these same or other genes may be relevant; and tumor tissue expression levels, loss of heterozygosity, genomic amplification, rearrangements, or somatic mutations in the same classes of genes may determine outcome. We will provide examples of how changes in the function of a single gene can contribute to susceptibility to carcinogenic exposure, predisposition to cancer development, patient prognosis, and prediction of outcome.
CUTANEOUS BASOPHIL HYPERSENSITIVITY IN CONTACT-SENSITIZED GUINEA PIGS
Authors: P. W. Askenase
Journal: The Journal of Experimental Medicine (1973)

Cutaneous basophil hypersensitivity, an immune inflammatory reaction characterized by infiltrates of basophils and a delayed time-course, was studied in guinea pigs contact sensitized with oxazolone. Routine histological techniques, employing ordinary paraffin sections, were modified to study this reaction. When biopsies of contact lesions were processed by these methods dense infiltrates of basophils could be demonstrated. Animals sensitized with complete Freund's adjuvant emulsified with oxazolone-keyhole limpet hemocyanin conjugates also developed delayed-in-time responses to contact challenge with oxazolone but not to picryl chloride. These hapten-specific delayed-in-time reactions also contained substantial numbers of basophils. Transfer of serum from actively sensitized guinea pigs resulted in specific accumulation of basophils at challenge sites of recipients. Thus, in this experimental system, cutaneous basophil hypersensitivity was found to be a hapten-specific delayed-in-time reaction that could be transferred with immune serum.
Trophic effect of gastrin on the enterochromaffin like cells of the rat stomach: establishment of a dose response relationship.
Authors: E Brenna, H L Waldum
Journal: Gut (1992)

Gastrin was given to rats by continuous subcutaneous infusion through implanted osmotic minipumps in doses covering a wide range of the dose response relationship for gastrin with regard to the trophic effect on the enterochromaffin like cells of the oxyntic mucosa. Thirty five rats were divided into five groups (each of seven rats), one group receiving a control solution of 1% albumin, the others receiving gastrin in 1% albumin at doses of 2.5, 5, 10, and 15 micrograms/kg/h, respectively. The plasma gastrin concentrations in the various groups increased in the same order of magnitude as expected from the gastrin doses given. Gastrin induced a dose dependent increase in enterochromaffin like cell density, oxyntic mucosal histamine concentration and histidine decarboxylase activity up to the dose of 5 micrograms/kg/h, where the increase levelled off. Hence, the dose response relationship for the trophic effect of gastrin on the enterochromaffin like cells seems to follow a polynomial rather than a linear function. These findings may also contribute to the understanding of the trophic effect of gastrin on enterochromaffin like cells in man with conditions associated with hypergastrinaemia.
ALK-positive plasmablastic B-cell lymphoma with expression of the NPM-ALK fusion transcript: report of 2 cases
Authors: Mihaela Onciu, Frederick G. Behm, James R. Downing, Sheila A. Shurtleff, Susana C. Raimondi, Zhigui Ma, Stephan W. Morris, Wren Kennedy, Sandra C. Jones, John T. Sandlund
Journal: Blood (2003)
Assessment of spatial variation of risks in small populations.
Authors: W B Riggan, K G Manton, J P Creason, M A Woodbury, E Stallard
Journal: Environmental Health Perspectives (1991)

Often environmental hazards are assessed by examining the spatial variation of disease-specific mortality or morbidity rates. These rates, when estimated for small local populations, can have a high degree of random variation or uncertainty associated with them. If those rate estimates are used to prioritize environmental clean-up actions or to allocate resources, then those decisions may be influenced by this high degree of uncertainty. Unfortunately, the effect of this uncertainty is not to add "random noise" into the decision-making process, but to systematically bias action toward the smallest populations where uncertainty is greatest and where extreme high and low rate deviations are most likely to be manifest by chance. We present a statistical procedure for adjusting rate estimates for differences in variability due to differentials in local area population sizes. Such adjustments produce rate estimates for areas that have better properties than the unadjusted rates for use in making statistically based decisions about the entire set of areas. Examples are provided for county variation in bladder, stomach, and lung cancer mortality rates for U.S. white males for the period 1970 to 1979.
THE CLINICAL APPLICATION OF SOME THYROID GLAND EXPERIMENTS.
Authors: L. BREISACHER
Journal: JAMA (1903)

In 1890, at a time when little or nothing was known of the chemical constitution of the thyroid gland and when we were unaware that it possessed any particular therapeutic action, the writer offered the first experimental proof that the thyroid gland was in some manner concerned in the general metabolism of the organism.<sup>1</sup>While even to-day we are not in possession of any positive proof of the true physiologic rôle of the thyroid gland, its action as a therapeutic agent, and further the clinical and experimental results following total extirpation along with the action of diet in various thyroid diseases and after total extirpation of this gland, indicates that it is in some manner invested with a metabolic function, but which we are not as yet able to particularly define. It would lead us too far were I to attempt to give a résumé
Protecting the Troops
Authors: Joan Stephenson
Journal: JAMA (1999)

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
Chemical Cardioversion of Atrial Fibrillation or Flutter With Ibutilide in Patients Receiving Amiodarone Therapy
Authors: Kathy Glatter, Yanfei Yang, Kanu Chatterjee, Gunnard Modin, Jie Cheng, Steve Kayser, Melvin M. Scheinman
Journal: Circulation (2001)

Background —Ibutilide is a class III drug that is used for the cardioversion of atrial arrhythmias, but it can cause torsade de pointes. Amiodarone also prolongs the QT interval but rarely causes torsade de pointes. There are no studies in which the concomitant use of the 2 agents was examined. The purpose of the present study was to assess the efficacy and safety of cardioversion with combination therapy in patients with atrial fibrillation or flutter. Methods and Results —The study included 70 patients who were treated with long-term oral amiodarone and were referred for elective cardioversion of atrial fibrillation (57 of 70, 81%) or flutter (13 of 70, 19%). Patients were taking amiodarone (153±259 days, mean±SD) and were administered 2 mg intravenous ibutilide. Left ventricular ejection fraction was measured with echocardiography. The QT intervals were measured on 12-lead ECG. Fifty-five patients (79%) had structural heart disease. Patients were in arrhythmia for 196±508 days before cardioversion, with a left ventricular ejection fraction of 50±11%. In patients with atrial fibrillation, 22 (39%) of 57 and 7 (54%) of 13 patients with flutter converted within 30 minutes of infusion. Thirty-nine patients who did not convert after ibutilide were treated with electrical cardioversion, and 35 (90%) of 39 patients were successfully converted. The QT intervals were further prolonged after ibutilide for the group from 371±61 to 479±92 ms ( P &lt;0.001). There was 1 episode of nonsustained torsade de pointes (1 of 70, 1.4%) after ibutilide. Conclusions —The use of ibutilide converted 54% of patients with atrial flutter and 39% of patients with atrial fibrillation who were treated with long-term amiodarone. Despite QT-interval prolongation after ibutilide, only 1 episode of torsade de pointes occurred. Our observations suggest that combination therapy may be a useful cardioversion method for chronic atrial fibrillation or flutter.
Educating Medical Students for Work in Culturally Diverse Societies
Authors: Rhian Frances Loudon
Journal: JAMA (1999)

ContextRecent attention has focused on whether government health service institutions, particularly in the United Kingdom, reflect cultural sensitivity and competence and whether medical students receive proper guidance in this area.ObjectiveTo systematically identify educational programs for medical students on cultural diversity, in particular, racial and ethnic diversity.Data SourcesThe following databases were searched: MEDLINE (1963–August 1998); Bath International Data Service (BIDS) Institute for Scientific Information science and social science citation indexes (1981–August 1998); BIDS International Bibliography for the Social Sciences (1981–August 1998); and the Educational Resources Information Centre (1981–August 1998). In addition, the following online data sets were searched: Kings Fund; Centre for Ethnic Relations, University of Warwick; Health Education Authority; European Research Centre on Migration and Ethnic Relations, University of Utrecht; International Centre for Intercultural Studies, University of London; the Refugee Studies Programme, University of Oxford. Medical education and academic medicine journals (1994-1998) were searched manually and experts in medical education were contacted.Study SelectionStudies included in the analysis were articles published in English before August 1998 that described specific programs for medical students on racial and ethnic diversity. Of 1456 studies identified by the literature search, 17 met the criteria. Two of the authors performed the study selection independently.Data ExtractionThe following data were extracted: publication year, program setting, student year, whether a program was required or optional, the teaching staff and involvement of minority racial and ethnic communities, program length, content and teaching methods, student assessment, and nature of program evaluation.Data SynthesisOf the 17 selected programs, 13 were conducted in North America. Eleven programs were exclusively for students in years 1 or 2. Fewer than half (n=7) the programs were part of core teaching. Only 1 required program reported that the students were assessed on the session in cultural diversity.ConclusionsOur study suggests that there is limited information available on an increasingly important subject in medical education. Further research is needed to identify effective components of educational programs on cultural diversity and valid methods of student assessment and program evaluation.
Changes in serum lipid concentrations during first 24 hours after myocardial infarction.
Authors: R Jackson, R Scragg, R Marshall, H White, K O'Brien, C Small
Journal: BMJ (1987)

Results ofstudy ConsultantsJunior doctors (n=20) (n= 16) Glaucomatous discs (n=16) Doctors' mean scores (%)Correct (ie, sensitivity) 7-0 (44) 8-5 (53) Unsure 2-4 (15) 1-5 (9) incorrect (false negative) 6-6 (41) 6-0 (38) Scores on individual discs (no of discs) 75-l100%/o answers correct 2 4 50-74% answers correct 4 5 25-49% answers correct 5 3 0-24% answers correct 5 4 Non-glaucomatous discs (n=27) Doctors' mean scores (%) Correct (ie, specificity) 20-7 (77) 18-6 (69) Unsure 2-5(9) 3-4(13) Incorrect (ie, false positive) 3-8 (14) 5-0 (18) Scores on individual discs (no of discs) 75-1000/o answers correct 16 13 50-74% answers correct 8 7 2549%/o answers correct 3 3 0-24% answers correct 0 4used in isolation, direct ophthalmoscopy may be quite inaccurate.If ophthalmologists can miss 40% of cases ofearly to moderate glaucoma when examining patients under ideal circumstances it is likely that general practitioners miss many more cases, especially ifthey examine fundi without dilating the pupils.Not surprisingly, therefore, recent surveys ofthe referral source of patients with glaucoma have shown that nearly all early and moderate cases are referred by opticians, while general practitioners refer mainly advanced, symptomatic cases.34General practitioners do need further training in the use of the ophthalmoscope, but these findings suggest that when they identify patients at risk of developing glaucoma, as well as performing funduscopy themselves, they should also encourage these patients to be seen regularly by their optician.5Finally, ophthalmologists themselves should be aware of the potential inadequacy of direct ophthalmoscopy when examining patients with suspected or definite glaucoma.We are grateful to Dr David Appleton for his help with statistical analysis.1 Hitchings RA.Screening for glaucoma.
Diagnostic Tests in Endocrinology and Diabetes
Authors: F J Woodroffe
Journal: BMJ (1994)

Ed P M G Bouloux, L H Rees Chapman and Hall, £29.95, pp 315 ISBN 0-412-35200-1

Some of us can remember times when testing endocrine function was rather more exciting - if less accurate - than it is now. With the advent of radioimmunoassay in 1960 the scene suddenly changed, opening the door to the endocrine system in …