tbuckley/cabot-search huggingface dataset:
Predictive Value of Factor V Leiden and Prothrombin G20210A in Adults With Venous Thromboembolism and in Family Members of Those With a Mutation
Authors: Jodi B. Segal, Daniel J. Brotman, Alejandro J. Necochea, Ashkan Emadi, Lipika Samal, Lisa M. Wilson, Matthew T. Crim, Eric B. Bass
Journal: JAMA (2009)

Testing for genetic risks for venous thromboembolism (VTE) is common, but the safety and utility of such testing need review.To define rates of recurrent VTE among adults with VTE with a factor V Leiden (FVL) or prothrombin G20210A mutation compared with those without such mutations; to define rates of VTE among family members of adults with a FVL or prothrombin G20210A mutation according to presence or absence of a mutation; and to assess whether testing adults with VTE for FVL or prothrombin G20210A improves outcomes.We searched MEDLINE, EMBASE, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, and PsycInfo through December 2008.Studies were included if they assessed rates of VTE in individuals with a history of VTE who were tested for FVL or prothrombin G20210A or in family members of individuals with these mutations. Studies assessing the harms and benefits associated with testing were also included.Two investigators abstracted data and assessed study quality. We pooled the odds of VTE associated with the mutations using random-effects models. We assessed the strength of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.We reviewed 7777 titles and included 46 articles. Heterozygosity (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.14-2.12) and homozygosity (OR, 2.65; 95% CI, 1.2-6.0) for FVL in probands are predictive of recurrent VTE compared with individuals without FVL. Heterozygosity for FVL predicts VTE in family members (OR, 3.5; 95% CI, 2.5-5.0), as does homozygosity for FVL (OR, 18; 95% CI, 7.8-40) compared with family members of adults without FVL. Heterozygosity for prothrombin G20210A is not predictive of recurrent VTE in probands compared with individuals without prothrombin G20210A (OR, 1.45; 95% CI, 0.96-2.2). Evidence is insufficient regarding the predictive value of prothrombin G20210A homozygosity for recurrent VTE and the risk of VTE in family members of individuals with prothrombin G20210A. High-grade evidence supports that anticoagulation reduces recurrent VTE events in probands with either mutation. Low-grade evidence supports that this risk reduction is similar to that in individuals with a history of VTE and without mutations.Patients with FVL are at increased risk of recurrent VTE compared with patients with VTE without this mutation. However, it is unknown whether testing for FVL or prothrombin G20210A improves outcomes in adults with VTE or in family members of those with a mutation.
UK review finds statins are cost effective in secondary prevention
Authors: Z. Kmietowicz
Journal: BMJ (1999)

Statins are most cost effective when used in patients with evidence of cardiovascular disease, in whom they reduce mortality as well as morbidity, according to a review by an advisory body to the NHS, the Health Technology Assessment.

The review is the 53rd in a series produced by the Health Technology Assessment designed to provide the NHS with information on the most efficient way of using new technologies. Data from five major trials of statins and 18 randomised controlled trials showed that statins reduced overall mortality in people …
A piece of my mind. Native borne
Authors: T. E. Richtsmeier
Journal: JAMA (1989)

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
An Approach to the Surgical Treatment of Pulmonary Embolism
Authors: Robert W.M. Frater
Journal: JAMA (1966)

In a series of cases of acute pulmonary embolism, the value of hemodynamic and angiographic studies as aids to diagnosis and prognosis and the planning of therapy is illustrated. In three patients hemodynamic changes indicative of a potentially fatal outcome were produced by massive embolization on one side accompanied by previous pulmonary disease or minor embolization on the other side. These changes were restored to normal by unilateral embolectomy without the aid of cardiopulmonary bypass. The possibility of using a unilateral extraction of emboli as a part of open-chest resuscitative procedures in the patient who has had sudden massive "fatal" embolism was seen in two further patients in whom this was done although without survival.
Clinical severity of human infections with avian influenza A(H7N9) virus, China, 2013/14
Authors: L Feng, J T Wu, X Liu, P Yang, T K Tsang, H Jiang, P Wu, J Yang, V J Fang, Y Qin, E H Lau, M Li, J Zheng, Z Peng, Y Xie, Q Wang, Z Li, G M Leung, G F Gao, H Yu, B J Cowling
Journal: Eurosurveillance (2014)

Binary file ES_Abstracts_Final_ECDC.txt matches
Effects of Weight Reduction on Obesity STUDIES OF LIPID AND CARBOHYDRATE METABOLISM IN NORMAL AND HYPERLIPOPROTEINEMIC SUBJECTS
Authors: Jerrold Olefsky, Gerald M. Reaven, John W. Farquhar
Journal: Journal of Clinical Investigation (1974)

Considerable controversy exists over the purported role of obesity in causing hyperglycemia, hyperlipemia, hyperinsulinemia, and insulin resistance; and the potential beneficial effects of weight reduction remain incompletely defined. Hypertriglyceridemia is one of the metabolic abnormalities proposed to accompany obesity, and in order to help explain the mechanisms leading to this abnormality we have proposed the following sequential hypothesis: insulin resistance --> hyperinsulinemia --> accelerated hepatic triglyceride(TG) production --> elevated plasma TG concentrations. To test this hypothesis and to gain insight into both the possible role of obesity in causing the above metabolic abnormalities and the potential benefit of weight reduction we studied the effects of weight loss on various aspects of carbohydrate and lipid metabolism in a group of 36 normal and hyperlipoproteinemic subjects. Only weak to absent correlations (r = 0.03 - 0.46) were noted between obesity and the metabolic variables measured. This points out that in our study group obesity cannot be the sole, or even the major, cause of these abnormalities in the first place. Further, we have observed marked decreases after weight reduction in fasting plasma TG (mean value: pre-weight reduction, 319 mg/100 ml; post-weight reduction, 180 mg/100 ml) and cholesterol (mean values: pre-weight reduction, 282 mg/100 ml; post-weight reduction, 223 mg/100 ml) levels, with a direct relationship between the magnitude of the fall in plasma lipid values and the height of the initial plasma TG level. We have also noted significant decreases after weight reduction in the insulin and glucose responses during the oral glucose tolerance test (37% decrease and 12% decrease, respectively). Insulin and glucose responses to liquid food before and after weight reduction were also measured and the overall post-weight reduction decrease in insulin response was 48% while the glucose response was relatively unchanged. In a subgroup of patients we studied both the degree of cellular insulin resistance and the rate of hepatic very low density (VLDL) TG production before and after weight reduction. These subjects demonstrated significant decreases after weight reduction in both degree of insulin resistance (33% decrease) and VLDL-TG production rates (40% decrease). Thus, weight reduction has lowered each of the antecedent variables (insulin resistance, hyperinsulinemia, and VLDL-TG production) that according to the above hypothesis lead to hypertriglyceridemia, and we believe the overall scheme is greatly strengthened. Furthermore, the consistent decreases in plasma TG and cholesterol levels seen in all subjects lead us to conclude that weight reduction is an important therapeutic modality for patients with endogenous hypertriglyceridemia.
The Cost of Health Care — Highlights from a Discussion about Economics and Reform
Authors: Atul A. Gawande, Elliott S. Fisher, Jonathan Gruber, Meredith B. Rosenthal
Journal: New England Journal of Medicine (2009)

President Barack Obama has argued that health care reform is essential to the future economic health of the United States. But the economics of both health care and reform are daunting. Is it possible to pay for health care coverage for all Americans without moderating our rapidly rising health care costs? And what do we know about the best ways of achieving cost savings? On September 14, 2009, the Journal hosted a roundtable discussion about the most promising ways of slowing the growth of health care costs, their potential effects on medical practice, and the likelihood that the current health . . .
Sono‐Assembly of Highly Biocompatible Polysaccharide Capsules for Hydrophobic Drug Delivery
Authors: Hongqiang Wang, Xuehai Yan, Guo Liang Li, Christine Pilz‐Allen, Helmuth Möhwald, Dmitry Shchukin
Journal: Advanced Healthcare Materials (2013)

Cells like sugar. General synthesis and potential of intracellular hydrophobic drug delivery of single-component polysaccharide capsules are pursued. The capsules can be generally assembled through hydrogen bonding networks but show striking shell robustness. The evidenced cell internalization, stimuli-responsiveness to local pH changes and high biocompatibilities of the capsules specifically favor their potential intracellular drug delivery
Patient With Gorlin Syndrome and Metastatic Basal Cell Carcinoma Refractory to Smoothened Inhibitors
Authors: Gefei A. Zhu, Angela S. Li, Anne Lynn S. Chang
Journal: JAMA Dermatology (2014)

<h3>Importance</h3> Basal cell carcinomas (BCCs) in patients with Gorlin syndrome have been reported to be extremely sensitive to Smoothened (SMO) inhibitors, a novel targeted therapy against the Hedgehog pathway, because of characteristic mutations in these patients. A few cases of disease refractory to oral therapy with SMO inhibitors have been reported in patients with Gorlin syndrome and nonmetastatic BCCs, but refractory disease in distantly metastatic tumors has not been documented in this high-risk group. <h3>Observations</h3> A man with Gorlin syndrome and innumerable cutaneous BCCs presented with biopsy-proven BCC in his lungs. After SMO inhibitor therapy, almost all of his cutaneous tumors shrank, but his lung metastases did not. These lung metastases remained refractory to treatment despite institution of a second SMO inhibitor. <h3>Conclusions and Relevance</h3> We report a case of Gorlin syndrome in a patient with metastatic BCC refractory to SMO inhibitors. Furthermore, clinical responses in this patient's cutaneous tumors did not parallel the responses in the distant site. However, serial imaging after diagnosis of metastatic disease can be critical to monitor for response to therapy.
Muscle cramps during prednisolone treatment.
Authors: S O Mcligeyo
Journal: BMJ (1993)

<b>Background: </b> Both in vitro and in vivo studies indicate that homocysteine (Hcy) may be directly involved in the damage of motor neurons and in several pathways implicated in amyotrophic lateral sclerosis (ALS) pathogenesis. <b>Objective: </b> To determine whether plasma Hcy levels were higher in ALS patients than healthy controls and to examine the relationship between Hcy levels and clinical ALS phenotypes. <b>Methods: </b> In a cross-sectional study, we compared Hcy, B<sub>12</sub>, and folate levels in 62 patients with ALS and 88 age- and sex-matched controls recruited as outpatients in a tertiary clinical center. <b>Results: </b> Patients with ALS had higher median plasma Hcy levels (11.2 [range 5.8 to 46] vs 9.7 [range 4.5 to 15.9] μmol/L; <i>p</i> = 0.0004) and lower folate levels (4.4 [range 1.7 to 22.1] vs 5.8 [range 2.3 to 21.1] ng/mL; <i>p</i> = 0.0003), compared with controls. Multivariate logistic regression revealed a strong direct association between plasma Hcy levels and presence of ALS (odds ratios adjusted for age, sex, and B-vitamin levels comparing the top tertile [Hcy levels ≥ 11.6 μmol/L] with the bottom tertile [Hcy levels &lt; 9.2 μmol/L]: 6.4; 95% CI 2.2 to 19.1; <i>p</i> for trend = 0.0008). We also found a trend for higher Hcy levels in patients with shorter interval from symptom onset to diagnosis (ODI; &lt;14 months), compared with patients with longer ODI (&gt;14 months; median Hcy levels 11.8 [range 5.8 to 46] vs 10.1 [range 7.2 to 17.6] μmol/L; <i>p</i> = 0.09). In a multivariate model, Hcy levels strongly correlated with shorter interval onset diagnosis (<i>r</i><sup>2</sup> = 0.18; <i>p</i> = 0.01). <b>Conclusions: </b> Plasma homocysteine (Hcy) levels were significantly increased in patients with amyotrophic lateral sclerosis (ALS) compared with healthy controls. ALS cases with shorter time to diagnosis presented higher Hcy levels, suggesting that higher Hcy may be linked to faster progression of the disease.
Points: Drowning and near drowning
Authors: M. Harries
Journal: BMJ (1986)

August, p 395) make an important point which deserves highlighting.Fracture dislocation of the cervical spine complicating near drowning is a rare event in Britain but is seen more commonly in Australia, where body surfing is a popular sport.The advice given to rescuers in Britain is that any unconscious patient found in standing depth water should be handled as though he or she had suffered fracture dislocation of the neck.It is possible on occasions to ventilate adequately without extending the neck, but if this is not the case then the rescuer has no alternative but to tilt the head back.
Nudging Medical Practice Change One Regulation at a Time
Authors: Andrew B. Bindman
Journal: JAMA (2015)

We don't know how big a problem it is," said Susan P. Montgomery, DVM, MPH, epidemiology team lead in the CDC's parasitic diseases branch.Of the 17 Texas blood donors with confirmed Chagas disease in her study, Garcia noted 6 were suspected to have acquired the infection close to home.However, blood donor screening likely detects only a small percentage of local or imported US cases, because those at highest risk are underrepresented among donors, Garcia said.Furthermore, not all those with confirmed Chagas had traditional risk factors, such as spending time in an endemic country and staying in areas with substandard housing (Garcia MN et al.Am J Trop Med Hyg.2015;92[2]:325-330).The researchers have found locally transmitted cases among people who live in rural areas or spend substantial amounts of time outdoors.Garcia explained that local transmission in the United States likely can be traced back to small mammals, such as wood rats, squirrels, possums, and skunks that act as reservoirs for T cruzi and serve as a source of constant blood meals for the triatomine bugs with which they tend to cohabitate.These animals then make their homes in substandard human housing and bring the insects with them, leading to human exposure to the parasite.In line with this mode of local transmission, Garcia and her colleagues found a high prevalence of T cruzi infection among triatomine bugs in southwestern Texas.They reported at the ASTMH meeting that three-quarters of the 40 bugs collected from June 2013 to January 2014 were infected.
Nuclear Wastelands: A Global Guide to Nuclear Weapons Production and its Health and Environmental Effects
Authors: J. Slater
Journal: BMJ (1995)

Ed Arjun Makhijani, Howard Hu, Katherine Yih MIT Press, pounds sterling34.95, pp 643 ISBN 0 262 13307 5

The first time I set eyes on Arjun Makhijani he was kneeling by a blackboard in the village hall of Lava Hot Springs in Idaho. An unlikely but beautiful setting, with the first snows of the year drifting over the mountains, for a conference examining the effects of nuclear weapons production sites in America. He was explaining with the greatest clarity the life histories of the various isotopes of uranium. It was late on the third day and although many of the lay audience were keen to get into the hot springs no one moved. They were gripped by …
The Acquired Immunodeficiency Syndrome-Related Complex (ARC) in a Child of Drug-Addicted Parents
Authors: ANTOINE THYSS
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 December 1987The Acquired Immunodeficiency Syndrome-Related Complex (ARC) in a Child of Drug-Addicted ParentsANTOINE THYSS, M.D., ELISABETH BAECHLER-SADOUL, M.D., DIDIER DUPONT, M.D., PATRICK P. VELIN, M.D., ANN DEVILLE, M.D., MARIE-LOUISE GASIGLIA, M.D.ANTOINE THYSS, M.D.Search for more papers by this author, ELISABETH BAECHLER-SADOUL, M.D.Search for more papers by this author, DIDIER DUPONT, M.D.Search for more papers by this author, PATRICK P. VELIN, M.D.Search for more papers by this author, ANN DEVILLE, M.D.Search for more papers by this author, MARIE-LOUISE GASIGLIA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-107-6-943_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The earliest pediatric case reports of human immunodeficiency virus (HIV) related pathologic findings involve American children born during 1980 (1). We report the case of a French child with the acquired immunodeficiency syndrome (AIDS) related complex (ARC) since birth in October 1981. Several lymphadenopathies, later ascribed to HIV, were first seen in drug addicts on the French Riviera in the last quarter of 1981.A male child was born at term weighing 3.150 kg. Both parents are intravenous drug abusers. The mother reportedly stopped using drugs during pregnancy. At 4.5 years he was hospitalized for a mild...References1. OLESKEMINNEFORCOOPER JAR. Immune deficiency syndrome in children. JAMA. 1983;249:2345-9. CrossrefMedlineGoogle Scholar2. ZIEGLERCOOPERJOHNSONGOLD JDRJ. Post natal transmission of AIDS associated retrovirus from mother to infant. Lancet. 1985;1:89-97. MedlineGoogle Scholar3. RUBINSTEINBERSTEIN AL. The epidemiology of pediatric acquired immunodeficiency syndrome. Clin Immunol Immunopathol. 1986;40:115-21. CrossrefMedlineGoogle Scholar4. NOVICKRUBINSTEIN BA. AIDS: the paediatric perspective. AIDS. 1987;1:3-7. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Centre Antoine-Lacassagne 36, Voie Romaine; 06054 Nice Cedex France PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1987Volume 107, Issue 6Page: 943-943KeywordsAIDSAIDS related complexAddictsBirthChildrenDrugsHIVImmunodeficienciesPregnancy Issue Published: 1 December 1987 PDF DownloadLoading ...
Confidentiality of Computerized Records
Authors: Jennifer Cofer
Journal: JAMA (1985)

<h3>To the Editor.—</h3> The American Medical Record Association appreciated Ms Ziporyn's article discussing the confidentiality of computerized health records.<sup>1</sup> The American Medical Record Association has traditionally been a champion of confidentiality of health records, and in a recent position statement, "Confidentiality and Security of Secondary Health Records," we addressed the issue of ensuring secure computerized health information. A copy of this statement, which offers methods to ensure confidentiality and security, is available on request.
Adynamic bowel syndrome. Report of a case with disturbance of the cholinergic innervation.
Authors: P Puri, B D Lake, H H Nixon
Journal: Gut (1977)

A case of adynamic bowel syndrome is described. Full thickness biopsies of the large bowel showed the presence of ganglion cells, no acetylcholinesterase positive nerves in the lamina propria, submucosa or among the smooth muscle cells of the circular and longitudinal muscle coats, and absence of the argyrophil plexus. Electron microscopic examination showed replacement of the normal axon bundle by vacuolated tracts with small round bodies in one area--probably viral. Neuronal cytoplasm also showed similar vacuolation. It is suggested that the damage to the cholinergic innervation may be caused by a neurotoxic agent.
MORE HETEROGENEOUS NEOINTIMAL COVERAGE AFTER EVEROLIMUS-ELUTING STENTS IMPLANTATION IN DIABETIC PATIENTS AS COMPARED TO NON-DIABETIC PATIENTS
Authors: Naotaka Okamoto, Masami Nishino, Akihiro Tanaka, Atsushi Kikuchi, Takeshi Masaki, Naoki Mori, Daisuke Nakamura, Takahiro Yoshimura, Yasuharu Lee, Masayuki Taniike, Nobuhiko Makino, Hiroyasu Kato, Yasuyuki Egami, Ryu Shutta, Hisaki Morita, Jun Tanouchi, Yoshio Yamada
Journal: Journal of the American College of Cardiology (2012)
Scorecard Cardiovascular Medicine: Its Impact and Future Directions
Authors: Eric J. Topol
Journal: Annals of Internal Medicine (1994)

Public release of operator-specific data for cardiovascular procedures has set a new precedent, introducing the "scorecard" era. Justification exists for public disclosure, but the mechanics of appropriate data release are complex from a clinical, statistical, and logistic standpoint. Scorecard medicine may appropriately promote regionalization of medical centers and consolidation of services, but unless the process is directed effectively, it may impair the development of new treatments because of a more restrictive clinical practice environment. We propose revamping our current system to facilitate rapid and accurate access to outcome data in the local practice environment so that improvement in practice occurs on a voluntary basis rather than in response to punitive restrictions.A rational plan needs to be developed for dealing with high-risk patients, perhaps through compensation in regression models used to calculate expected outcomes, and for the start-up of novice physicians. Special provisions are needed to promote clinical research. Before procedures are done, it would be ideal to provide a full disclosure informed consent, whereby the physician reports operator-specific data and the patient's decision-making process is facilitated. Overall, appropriate implementation of scorecards could ultimately lead to a substantial improvement in the quality of U.S. cardiovascular medicine.
DEATH RATE OF PHYSICIANS
Authors: Haven Emerson
Journal: JAMA (1923)

To the Editor:  —The statement in the editorial on the deaths of physicians in the United States in 1922 (The Journal, January 6) was to the effect that the death rate of physicians in 1922 was 17.73 per thousand, making it appear that this was a rate comparable in some respects to the death rates usually quoted for general population groups. Would it not perhaps be well in future statements with regard to physicians' death rates to indicate quite clearly that this is a selected age and sex (mainly) death rate, as physicians are still preponderantly males. As a matter of interest, I obtained, through the courtesy of Dr. Dublin of the Metropolitan Life Insurance Company the death rates for males at all occupations and at different age groups in 1920. It will appear from the table that, although the death rate of physicians is slightly higher than that of