tbuckley/cabot-search huggingface dataset:
Effect of Routine Assessment of Specific Psychosocial Problems on Personalized Communication, Counselors' Awareness, and Distress Levels in Cancer Genetic Counseling Practice: A Randomized Controlled Trial
Authors: Willem Eijzenga, Neil K. Aaronson, Daniela E.E. Hahn, Grace N. Sidharta, Lizet E. van der Kolk, Mary E. Velthuizen, Margreet G.E.M. Ausems, Eveline M.A. Bleiker
Journal: Journal of Clinical Oncology (2014)

Purpose This study evaluated the efficacy of a cancer genetics–specific questionnaire in facilitating communication about, awareness of, and management of psychosocial problems, as well as in lowering distress levels. Methods Individuals referred to genetic counseling for cancer at two family cancer clinics in the Netherlands were randomly assigned to an intervention or a control group. All participants completed the psychosocial questionnaire before counseling. In the intervention group, the counselors received the results of this questionnaire before the counseling session. All sessions were audiotaped for content analysis. Primary outcomes were the frequency with which psychosocial problems were discussed, the genetic counselors' awareness of these problems, and their management. Secondary outcomes included cancer worries and psychological distress, duration and dynamics of the counseling, and satisfaction. Results The frequency with which psychosocial problems were discussed with 246 participating counselees was significantly higher in the intervention group (n = 127) than in the control group (n = 119; P = .004), as was the counselors' awareness of psychosocial problems regarding hereditary predisposition (P &lt; .001), living with cancer (P = .01), and general emotions (P &lt; .001). Counselors initiated more discussion of psychosocial problems in the intervention group (P &lt; .001), without affecting the length of the counseling session. No significant differences were found on management (P = .19). The intervention group reported significantly lower levels of cancer worries (P = .005) and distress (P = .02) after counseling. Conclusion The routine assessment of psychosocial problems by questionnaire facilitates genetic counselors' recognition and discussion of their clients' psychosocial problems and reduces clients' distress levels.
Removal from a GP's list: qualitative research is needed
Authors: T. Stokes, R. K McKinley, M. Dixon-Woods
Journal: BMJ (2001)

EDITOR—Pickin et al offer a postal questionnaire survey of general practitioners' reasons for removing patients from their lists.1 To date, published research on removals has relied on an analysis of routinely collected health authority data that do not allow the reasons for removal to be ascertained except for immediate removals on the grounds of violence. 2 3

We think, however, that there are important problems with the methods adopted by Pickin et al. They …
Psychiatric Consequences of September 11—Reply
Authors: William E. Schlenger, Juesta M. Caddell, Lori Ebert, B. Kathleen Jordan, Kathryn Rourke Batts
Journal: JAMA (2002)

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
Propoxyphene Hydrochloride, a Drug of Abuse
Authors: James L. Claghorn
Journal: JAMA (1966)

MOST DRUGS which relieve pain or exert a sedative effect on the central nervous system are subject to abuse, even though they do not cause rapid tolerance development or withdrawal symptoms. Propoxyphene hydrochloride appears to occupy an intermediate position between this group and the narcotic drugs proper. While there is, as yet, no large social problem with propoxyphene abuse, the possibility may well exist. Propoxyphene is a frequently used analgesic chemically similar to meperidine hydrochloride, methadone hydrochloride, and alphaprodine hydrochloride. This drug, regarded as presenting a minimal addiction liability by the expert committee of the World Health Organization<sup>1</sup>and not subject to control domestically, was first shown to produce physical dependence by Fraser and Isbell in 1960.<sup>2</sup>Euphoria is reported by some patients. Among 14 patients in a double-blind comparison of placebo, codeine, propoxyphene and aspirin, propoxyphene was selected most often as being a euphoriant, and its frequency
Qp/Qs in atrial septal defects by cardiac magnetic resonance imaging is comparable to Qp/Qs by cardiac catheterization
Authors: Uzma Iqbal, Anthon R. Fuisz, Lowell Satler, Augusto Pichard, Srirama Swaminathan, Sue Apple, Ellen Pinnow, Joseph Lindsay
Journal: Journal of the American College of Cardiology (2003)
Selective induction of rheumatoid factors by superantigens and human helper T cells.
Authors: X W He, J Goronzy, C Weyand
Journal: Journal of Clinical Investigation (1992)

Production of autoantibodies specific for the Fc region of autologous IgG, called rheumatoid factors (RF), is a characteristic finding in patients with rheumatoid arthritis (RA). To study the requirements regulating the synthesis of these autoantibodies, we have cloned human helper T cells and co-cultured them with purified B cells. To mimic cognate T-B cell interaction, we have used bacterial superantigens that function by cross-linking HLA molecules on the B cell with selected T cell receptor (TCR) molecules expressing a particular polymorphism of the V beta gene segment. Data presented here demonstrate that the staphylococcal enterotoxin D (SE D), but not other bacterial superantigens, exhibits an ability to induce IgM, IgG, and especially RF production, in B cells from RA patients and normal individuals. Comparison with the polyclonal antibody production in B cell cultures driven by anti-CD3-stimulated T cell clones confirmed that SE D shifted the repertoire of secreted antibodies toward immunoglobulins with Fc binding specificity, suggesting that SE D preferentially stimulates RF+ B lymphocytes. B cells with the potential to secrete RF were highly frequent in RA patients, requiring as few as 150 peripheral B cells/culture to detect RF in the culture supernatants. SE D-induced RF synthesis was strictly dependent on the presence of selected CD4+T helper cells and required a direct membrane contact between B cells and T helper cells. Here, we propose a model that SE D selectively induces RF production depending on the availability of SE D responsive T cells in the TCR repertoire of the responder.
Hematogenous spreading of hepatocellular carcinoma cells: Possible participation in recurrence in the liver
Authors: N O Funaki, J Tanaka, S I Seto, T Kasamatsu, T Kaido, M Imamura
Journal: Hepatology (1997)

To detect hepatocellular carcinoma (HCC) cells in the circulating peripheral blood, we previously designed a highly sensitive reverse-transcription polymerase chain reaction (RT-PCR) method targeting alpha-fetoprotein (AFP) messenger RNA (mRNA). Using this method, we analyzed peripheral blood of in- and out-patients bearing HCC for 2 months consecutively and examined the outcome thereafter. All 11 patients with recurrence either in the liver alone or in both the liver and the lung were positive for AFP mRNA. Among 10 recurrence-free patients, 2 patients were AFP mRNA-negative and remained recurrence-free during a period of 22 months observed. Four of 8 AFP mRNA-positive, recurrence-free patients developed a clinically evident recurrence in the liver after 2 to 16 months. Seven of 8 preoperative patients were already positive for AFP mRNA and the remaining negative patient became positive during surgery. Four of 6 preoperatively positive and still-alive patients had recurrence in the liver after 2 to 9 months. None of the HCC-negative patients were positive for AFP mRNA. We actually found an AFP protein-positive cell in peripheral blood obtained from one of the AFP mRNA-positive patients by immunostaining. The present results suggest that circulating HCC cells may have some relationship with the recurrence of HCC in the liver.
ELITE ATHLETES AND ORAL HEALTH: A REVIEW
Authors: P Ashley, E Cole, A Diorio, A Tanday, I Needleman
Journal: British Journal of Sports Medicine (2014)

Background Data on the impact of oral health on sporting performance is missing and the epidemiology of oral diseases in the elite athlete population is poorly understood. Objective To systematically review available evidence to determine the epidemiology of oral diseases in the elite athlete population and the impact of oral health on sporting performance. Design Systematic review of the available literature. We searched Ovid MEDLINE, Ovid EMBASE, EBSCO SPORTDiscus and OpenGrey up to February 2013. Data extraction was carried out with a specially developed form. Data extracted related to the type of study (eg case control, cohort study etc.), methodological quality, sports included and oral health (including its impact on performance). Methodological quality was assessed using a modification of the Newcastle–Ottawa scale and CASP critical appraisal checklist. Setting Elite division. Participants Randomised controlled trials (RCTs) or observational studies with some measure of oral health used as an outcome. Studies assessing the impact of interventions on oral health were not included. Main outcome measurements Oral health, methodological quality of included studies. Results After screening 9208 citations, 38 studies remained. Most studies investigated trauma (n=31 papers, 82% of all included studies) with the remainder looking at oral health and other outcomes. Studies were subject to multiple methodological biases and use of a wide range of outcomes limited comparison between studies. In general head/face/dental trauma made up a very small proportion of injuries received by athletes during specific tournaments or over a fixed timespan with the exception of wrestling, ice hockey and football. Oral health as expressed by caries was poor in athletes. No studies to date had been designed to assess impact. Conclusions There is a lack of data on the oral health of elite athletes and its impact on performance.
In Defense of the Reintroduction of Heroin into American Medical Practice and H.R. 5290 — The Compassionate Pain Relief Act
Authors: Allen M. Mondzac
Journal: New England Journal of Medicine (1984)

Heroin has been in continuous use since its creation in England by Wright in 1874. The drug was synthesized by acetylating morphine and is therefore a semisynthetic narcotic. Its chemical name is diacetylmorphine, or diamorphine. It was named heroin by the Bayer Company of Germany, which first marketed it widely, in 1898. The drug met with great success and was used as a narcotic analgesic, antitussive, and antidyspnea agent. Heroin was widely prescribed, and many users became addicted. This result was inevitable since little was understood about narcotics and drug addiction.In what can be described as a panic reaction . . .
Use of Gamma Globulin for Control of Infectious Hepatitis in an Institution for the Mentally Retarded
Authors: Alta Ashley
Journal: New England Journal of Medicine (1955)

EARLY in 1954 there were 2 cases of jaundice in a state institution for the mentally retarded in Maine. During the ensuing six months 157 cases of frank jaundice and a large but unknown number of cases of digestive upset with abdominal pain without jaundice occurred. When it was realized that this was an epidemic of infectious hepatitis gamma globulin was used apparently with dramatic results.The institution has a capacity of 1507, and admits persons from five to forty-five years of age. There are 5 buildings housing females and 4 buildings, as well as 2 farms, that house males. . . .
Practical Closed-Loop Insulin Delivery
Authors: NEIL H. WHITE
Journal: Annals of Internal Medicine (1982)

We evaluated a practical closed-loop system of insulin delivery consisting of hourly blood glucose determinations using glucose oxidase reagent strips and an intravenous infusion of insulin controlled by a commonly available controller. In 25 insulin-dependent diabetic subjects, this system was successful in achieving and maintaining near euglycemia (blood glucose, 101 ± 2 mg/dL, mean ± SE) in the fasting state between 0200 and 0800 hours. This system may be useful in the management of insulin-dependent diabetic patients in various hospital settings. Also, in 10 subjects treated subsequently using a continuous subcutaneous insulin infusion, the mean hourly insulin infusion rate using the described system correlated well (r = 0.92) with the optimal overnight basal rate needed during continous subcutaneous insulin infusion therapy.
Transthoracic resistance in human defibrillation. Influence of body weight, chest size, serial shocks, paddle size and paddle contact pressure.
Authors: R E Kerber, J Grayzel, R Hoyt, M Marcus, J Kennedy
Journal: Circulation (1981)

Successful defibrillation depends on delivery of adequate electrical current to the heart; one of the major determinants of current flow is transthoracic resistance (TTR). To study the factors influencing TTR, we prospectively collected data from 44 patients undergoing emergency defibrillation. Shocks of 94-450 J delivered energy were administered from specially calibrated Datascope defibrillators that displayed peak current flow, thereby permitting determination of TTR. Shocks were applied from standard (8.5-cm diameter) or large (13 cm) paddles placed anteriorly and laterally. First-shock TTR ranged from 15-143 omega. There was a weak correlation between TTR and body weight (r = 0.45, p less than 0.05) and a stronger correlation between TTR and chest width (r = 0.80, p less than 0.01). Twenty-three patients who were defibrillated using standard 8.5-cm paddles had a mean TTR of 67 +/- 36 omega (+/- SD), whereas 21 patients who received shocks using paddle pairs with at least one large (13 cm) paddle had a 21% lower TTR of 53 +/- 24 omega (p = 0.05, unpaired t test). Ten patients received first and second shocks at the same energy level; TTR declined only 8%, from 52 +/- 19 to 48 +/- 16 omega (p less than 0.01, paired t test). In closed chest dogs, shocks were administered using a spring apparatus that regulated paddle contact pressure against the thorax. Firmer contact pressure caused TTR to decrease 25%, from 48 +/- 22 to 36 +/- 17 omega (p less than 0.01, paired t test). Thus, human TTR varies widely and is related most closely to chest size. TTR declines only slightly with a second shock at the same energy level. More substantial reductions in TTR and declines only slightly with a second shock at the same energy level. More substantial reductions in TTR and increases in current flow can be achieved by using large paddles and applying firm paddle contact pressure.
William Marson Maidlow
Authors: J. Crossley
Journal: BMJ (2002)

Former consultant anaesthetist Southmead Hospital, Bristol (b Ilminster 1912; q St Bartholomew's Hospital 1938), d 2 August 2002.

Billie Maidlow did house jobs at St Bartholomew's and in Bristol and Southampton. From 1942 to 1946 he served in the Royal Army Medical Corps in Africa and Malta. In 1946 he was appointed as the first consultant anaesthetist to Southmead Hospital. He was a founder member of the Society of Anaesthetists of the South Western Region. A keen sportsman, gardener, photographer, and collector of church and classical music, he travelled widely in the British Isles hill climbing, birdwatching, and visiting churches. He leaves a wife, Helena; two sons; and their families.
Zinc in the treatment of homozygous sickle cell anemia: Studies in an animal model
Authors: Eric B. Schoomaker, George J. Brewer, Fred J. Oelshlegel
Journal: American Journal of Hematology (1976)

Abstract We have studied the effects of zinc on the 51 Cr survival of red blood cells (RBC) from patients with homozygous sickle cell anemia (SCA) using an animal model in which the RBC were transfused into specially prepared rats. The slope (λ s ) of a standard 51 Cr RBC survival curve was used as a measure of the rate of RBC sequestration. The effects of intravenous zinc were of considerable therapeutic interest from the standpoint of setting guidelines for effective blood levels of zinc in patients. SCA RBC were transfused into rats whose plasma zinc levels had been raised 3–6 times above normal (300–600 μg/100 ml) by prior iv injection of zinc acetate; in three experiments the mean λ s s in zinc‐treated animals breathing 15–16% oxygen was significantly lower (meaning lessened sequestration and greater survival) than saline‐treated controls. A possible explanation for the requirement to lower ambient oxygen tension in order to see this zinc effect is discussed. We have further observed an increased mean λ s for RBC from 10 SCA patients compared to 4 normal controls (0.134 vs 0.030; t = 2.8, p &lt; 0.01). The λ s values are quite patient specific (4 patients studied; F = 18.2, p = 0.002). In vitro pretransfusion treatment of SCA RBC with 1.5 mM zinc resulted in a significant increase in hemoglobin oxygen affinity and a marked reduction in λ s (0.073 vs 0.120; t = 4.5, p &lt; 0.01). The mean λ s was not affected by in vitro 0.3 mM zinc treatment; this level did not change hemoglobin oxygen affinity. We conclude that systemic zinc therapy in the animal model described, at plasma levels only slightly higher than those presently obtained in patients, prolongs SCA RBC survival. This animal model is a sensitive measure of the sicklability of SCA RBC and is useful in the testing of in vitro and in vivo antisickling agents.
Lepra Bacilli Found in the Brain.
Authors: Albert S. Ashmead
Journal: JAMA (1899)

New York, Dec. 23, 1898. <h3>To the Editor:</h3> —Hansen said the brain is never affected by leprosy. Dr. C. Brutzer (<i>St. Petersburg Med. Woch</i>., Oct. 17 and 19, 1898, No. 42, p. 363), reports ten autopsies of lepers who had died in the leprosery of Riga, and in four of these cases there were adhesions between the dura mater and the brain; in three of these four cases of adherent meningitis, he found lepra bacilli<i>au niveau de la glande pituitaire</i>. Evidently Hanson is wrong in his opinion that "the brain is never affected by leprosy."
Osteomalacia after Prolonged Glutethimide Administration
Authors: R. H. Greenwood, F. T. G. Prunty, J. Silver
Journal: BMJ (1973)

Vitamin D deficiency is a previously unreported complication of therapy with hypnotics, and we here report a case of osteomalacia associated with long-term glutethimide administration. There was evidence of pronounced hepatic enzyme induction, and the plasma half-time of (3)H vitamin D(3) was decreased by this drug. In addition, raised levels of serum gamma-glutamyl transpeptidase, 5-nucleotidase, and leucine aminopeptidase were observed and the patient excreted large amounts of xylulose. These changes were reversed by stopping the glutethimide.
Thermal modification of chrysotile asbestos: evidence for decreased cytotoxicity.
Authors: R Valentine, M J Chang, R W Hart, G L Finch, G L Fisher
Journal: Environmental Health Perspectives (1983)

Many asbestiform minerals exhibit temperature-dependent thermoluminescence. Since thermoluminescence involves electronic transitions within crystalline materials, the effect of temperature on asbestos cytotoxicity was evaluated. Heat pretreatment of Canadian chrysotile asbestos reduces its cytotoxicity towards cultured human fibroblasts and bovine alveolar macrophages. When monitored 44 hr after the addition of either 200 degrees C or 400 degrees C heat-pretreated asbestos, alveolar macrophage viability was approximately 40% higher than comparable amounts of unheated asbestos. Similarly, asbestos toxicity, expressed as fibroblast growth inhibition, was inversely related to the asbestos pretreatment temperature in the following manner, 70 degrees C greater than 200 degrees C greater than 400 degrees C = unexposed fibroblast controls. Pretreatment of chrysotile asbestos to 400 degrees C reduced its adsorptive capacity for bovine serum albumin by 25%. Furthermore, asbestos heated to 200 degrees C followed by irradiation with 4 MeV X-rays (4500 rads) resulted in reactivation of asbestos cytotoxicity. Scanning electron microscopy indicated that the ratios of free to fiber-associated alveolar macrophages and the fiber fragment size distributions were unaffected by either heat pretreatment or X-ray irradiation. These observations strongly suggest that the surface charge characteristics and electronic state of asbestos fibers may be responsible for its biological activity.
CONTEMPORARY CLASSIFICATIONS OF CONCUSSION SEVERITY AND SHORT TERM NEUROPSYCHOLOGICAL OUTCOME
Authors: A D Hinton-Bayre, G M Geffen
Journal: British Journal of Sports Medicine (2002)

Objective: To contrast concussion severity classifications in terms of subsequent impairment and recovery as shown by standard neuropsychological tests.

Setting: Prospective referral based neuropsychological assessment.

Patients: 21 professional rugby league players with a clinical diagnosis of concussion. Another 21 non-head injured players matched on key variables acted as controls to adjust for repeated assessment.

Method: All players were …
Adalimumab in patients with hand osteoarthritis refractory to analgesics and NSAIDs: a randomised, multicentre, double-blind, placebo-controlled trial
Authors: X Chevalier, P Ravaud, E Maheu, G Baron, A Rialland, P Vergnaud, C Roux, Y Maugars, D Mulleman, C Lukas, D Wendling, P Lafforgue, D Loeuille, V Foltz, P Richette
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Aim</h3> To test the efficiency of tumour necrosis factor blockers (adalimumab) in patients with painful refractory (non-responders to analgesics and non-steroidal anti-inflammatory drugs (NSAIDs)) hand osteoarthritis (OA). <h3>Methods</h3> We performed a randomised, double-blind, placebo-controlled, parallel group, multicentre study. Patients were randomised to: 1/1 adalimumab 40 mg for two subcutaneous injections at a 15-day interval or placebo and monitored for 6 months. The primary outcome was the percentage of patients with an improvement of more than 50% in global pain (Visual Analogue Scale) between week 0 (W0) and week 6 (W6). Secondary outcomes included the number of painful joints, swollen joints, morning stiffness duration, patient and practitioner global assessments, functional indexes for hand OA, and consumption of analgesics. Analysis on the mean primary outcome measure was done on patients who received at least one injection. <h3>Results</h3> 99 patients were recruited and 85 patients were randomised. Among them, 37 patients in the placebo group and 41 in the adalimumab group received at least one injection and were evaluated at W6 (n=78) on the main efficacy outcome. Mean age was 62 years, 85% were women, and mean level of pain was 62 mm at W0. At W6, 35.1% in the adalimumab group versus 27.3% in the placebo group had a pain reduction ≥50% (RR 1.12 (95% CI 0.82 to 1.54; p=0.48). There were no statistical differences for all secondary end points. The rate of adverse events was similar in the two groups. <h3>Conclusions</h3> Adalimumab was not superior to placebo to alleviate pain in patients with hand OA not responding to analgesics and NSAIDs. <h3>Trials registration number</h3> NCT00597623.