tbuckley/cabot-search huggingface dataset:
Ralph Meyrick Emrys-Roberts
Authors: A N Crowther
Journal: BMJ (2007)

<h3>PURPOSE</h3> To investigate whether exact evaluation of the dynamic contrast enhancement pattern within intracranial tumors can help to classify tumor histology and vascularity. <h3>METHOD</h3> Forty-nine patients suffering from different intra- and extraaxial intracranial tumors underwent MR-examination in a 1.5-T superconductive whole body system. After rapid injection of Gd-DTPA, 48 images were acquired during the first 1.5 to 2 minutes of contrast enhancement within the tumors. A fast snapshot-FLASH imaging technique allowed measurement times of 1 second per image. Appearance of Gd-DTPA in a venous sinus served as a temporal reference point. Transformation of 48 discrete measurement points (mean signal values of the enhancing tumor region) into a continuous curve, using a cubic spline approximation, allowed calculation of the time of maximum signal increase (Tm1) and the following time of half maximum increase (Tm2). These time parameters were compared to histopathologic findings, especially the degree of tumor vascularization. <h3>RESULTS</h3> Significantly different dynamic patterns of the early enhancement period were found for the different tumors. All eight neurinomas, typically less vascularized than most meningiomas, showed a characteristically prolonged contrast enhancement with a long Tm2. Histopathologic findings concerning the degree of vascularization showed two subtypes in meningiomas (n = 17) as well as in pituitary macroadenomas (n = 7). This was confirmed by dynamic evaluation in all cases, in the sense that short Tm1 and Tm2 were found in cases with higher degrees of vascularization. Negatives values of Tm1 were measured in two glomus jugulare tumors, reflecting the arterialization of these vascular tumors. In neuroepithelial tumors (n = 15), the glioblastomas (n = 7) showed very short Tm1 compared to the lower grade gliomas (n = 8). This is explained by histologic findings of pathologic vessels with arteriovenous shunts. <h3>CONCLUSION</h3> The evaluated dynamic time parameters can be used to narrow differential diagnostic possibilities and to infer the degree of vascularization of intracranial tumors.
Association between <i>TNFA‐308 G/A</i> polymorphism and sensitization to <i>para‐</i>phenylenediamine: a case–control study
Authors: B. Blömeke, R. Brans, H. Dickel, T. Bruckner, S. Erdmann, M. Heesen, H. F. Merk, P.‐J. Coenraads
Journal: Allergy (2008)

Background: Para ‐phenylenediamine (PPD) and related chemicals are common contact sensitizers, frequently causing allergic contact dermatitis (ACD). The cytokine tumor necrosis factor‐alpha (TNF‐α) plays a key role in contact sensitization. Methods: In this case–control study, we evaluated the distribution of variations in the regulatory region of the gene for TNF‐α ( TNFA‐308 G/A ) in 181 Caucasian individuals with a history of ACD and sensitization to PPD and 161 individuals with no history of sensitization to PPD. Results: The frequency of GA or AA TNFA genotypes was significantly higher in individuals sensitized to PPD than in age‐ and gender‐matched controls giving an odds ratio (OR) of 2.16 (95% confidence interval, CI: 1.35–3.47; P = 0.0016). This relation was even more pronounced when restricting cases to females over 45 years (OR = 3.71; 95% CI: 1.65–8.31; P = 0.0017) vs younger females (less than or equal to 45 years; OR = 2.41; 95% CI: 1.03–5.65; P = 0.044) or males (OR = 1.05; 95% CI: 0.449–2.47; P = 1.0). In addition, a logistic regression model revealed a significant effect for TNFA‐308 AA and AG vs GG genotype (point estimate = 2.152; 95% Wald CI: 1.332–3.477). Conclusions: These findings suggest a possible role for the TNFA‐308 genetic polymorphism as a susceptibility factor for chemically induced ACD.
Prehospital Care of the Multiply Injured Patient
Authors: Roger J. Lewis
Journal: JAMA (2004)

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
Ga-67 Imaging of Perisplenic Abscess After Splenic Embolization
Authors: MITHILESH KUMAR, SLEIMAN NADDAF, HANI H. ABUJUDEH, SAADET ATAY, HUSSEIN M. ABDEL-DAYEM
Journal: Clinical Nuclear Medicine (1998)

Splenic artery embolization is emerging as a promising alternative to surgical splenectomy for hypersplenism. Presented is the case of a patient with non-Hodgkin's lymphoma with splenomegaly, who was treated for thrombocytopenia and neutropenia with splenic artery embolization. A few days later, the patient developed a septic pattern. Abdominal CT with contrast enhancement showed an enlarged spleen with solid and cystic areas. Liver-spleen scintigraphy revealed minimal residual functioning splenic tissue, and Ga-67 scintigraphy revealed ring-shaped perisplenic uptake, suggesting a perisplenic abscess. The diagnosis was confirmed by needle aspiration of thick purulent fluid from the abscess which grew Moganella Morganii on culture.
Association Between Joint Hypermobility Syndrome and Panic Disorder
Authors: Rocío Martín-Santos, Antonio Bulbena, Miquel Porta, Jordi Gago, Lluís Molina, Juan C. Duró
Journal: American Journal of Psychiatry (1998)

Objective:The purpose of this study was to assess whether joint hypermobility syndrome is more frequent in patients with panic disorder, agoraphobia, or both than in control subjects and, if so, to determine whether mitral valve prolapse modifies or accounts in part for the association.Method:A case-control study was conducted in a general teaching hospital outpatient clinic. Subjects were 99 patients, newly diagnosed and untreated, with panic disorder, agoraphobia, or both and two groups of age- and sex-matched control subjects: 99 psychiatric patients and 64 medical patients who had never suffered from any anxiety disorder. Measures consisted of the Structured Clinical Interview for DSM-III-R, Beighton's criteria for joint hypermobility syndrome, and two-dimensional and M-mode echocardiogram. The presence of mitral valve prolapse and joint hypermobility syndrome was explored by raters who were blind to subjects' psychiatric status.Results:Joint hypermobility syndrome was found in 67.7% of patients with anxiety disorder but in only 10.1% of psychiatric and 12.5% of medical control subjects. On the basis of statistical analysis, patients with anxiety disorder were over 16 times more likely than control subjects to have joint laxity. These findings were not altered after the presence of mitral valve prolapse was taken into account. Of the patients with anxiety disorder, those who had joint hypermobility syndrome were younger and more often women and had an earlier onset of the disorder than those without joint hypermobility syndrome. Conclusions:Joint laxity is highly prevalent in patients with panic disorder, agoraphobia, or both and may reflect a constitutional disposition to suffer from anxiety. Mitral valve prolapse plays a secondary role in the association between joint hypermobility and anxiety. Am J Psychiatry 1998; 155: 1578-1583
P51 Follow-up of the incidental pulmonary nodule outcomes and costs: Abstract P51 Table 1.
Authors: J Harper, C Marchand, H Bevan, V Masani, J Suntharalingam
Journal: Thorax (2013)

<h3></h3> A retrospective study to analyse the outcomes and costs of follow-up of incidental nodules (solitary and multiple) referred to our Department from 2010 2011. <h3>Method</h3> Consecutive nodule cases were identified by reviewing CT reports of 619 patients discussed at our Lung Cancer MDT from 2010 2011. Only clinically incidental nodules were included. Information was gathered using PACS and hospital records. In our department incidental nodules are seen once in clinic and then largely managed ‘remotely’ via correspondence. All nodules are managed to Fleischner guidelines. Costs for investigations/procedures/appointments were calculated using local 2012 13 reference costs. Manpower costs for MDTs and correspondence were calculated using a ‘bottom-up’ costing approach. <h3>Results</h3> 62 patients were referred with a new incidental nodule (s). Mean age was 66(34 92) with a 1:1 male:female ratio. 56%(35/62) had PS 0 1 and 56%(35/62) were current/ex-smokers. 66%(41/62) had a SPN. Mean size of largest nodule was 9mm. 11%(7/62) were diagnosed with malignancy, 6%(4/62) of pulmonary origin. The 3 non-pulmonary malignancies were renal, breast and metastatic squamous cell. New clinically important diagnoses were made in a further 11%(7/62) including TB/amyloid/ILD, whilst 78%(48/62) were benign. In the malignancy group, 71% (5/7) were current/ex-smokers, 86% (6/7) had a SPN with mean size 7.7mm and there was a higher likelihood of nodules enlarging on follow-up CTs (40% versus 2% at 2nd CT). 75%(3/4) of patients with lung malignancy underwent curative treatment. In the benign group (48), the mean number of follow-up CTs/patient (excluding baseline CT) was 1.8. 21 ultimately unnecessary investigations were performed, including 9 invasive procedures. (Table) The cost of screening to the NHS to identify a single malignancy was £5805. The cost to our service per patient screened was £655 resulting in a shortfall of £455/patient compared with the £200 charge to the PCT for an initial appointment. <h3>Conclusions</h3> In our study, incidental nodule follow-up led to a clinically relevant diagnosis in 22% of patients, including identification of malignancy in 11%. Whilst the study had a high yield, those who received a benign diagnosis underwent a number of ultimately unnecessary investigations, some invasive, with no gain. Our ‘remote management’ model of care is efficient but requires an appropriate tariff.
Serum hepatitis B surface antigen levels help predict disease progression in patients with low hepatitis B virus loads
Authors: Tai-Chung Tseng, Chun-Jen Liu, Hung-Chih Yang, Tung-Hung Su, Chia-Chi Wang, Chi-Ling Chen, Cheng-An Hsu, Stephanie Fang-Tzu Kuo, Chen-Hua Liu, Pei-Jer Chen, Ding-Shinn Chen, Jia-Horng Kao
Journal: Hepatology (2012)

Chronic hepatitis B patients with high viral loads are at increased risk of cirrhosis and hepatocellular carcinoma (HCC). In patients with low viral loads, higher hepatitis B surface antigen (HBsAg) levels have been shown to predict HCC development. However, little is known about the difference in risk for other hepatitis B virus (HBV)-related adverse outcomes with varying HBsAg levels. A total of 1,068 Taiwanese hepatitis B e antigen (HBeAg)-negative HBV carriers with serum HBV DNA level <2,000 IU/mL at baseline were followed for a mean duration of 13.0 years. Patients were categorized based on their HBsAg levels, and the relationships between HBsAg level and development of HBeAg-negative hepatitis, hepatitis flare, and cirrhosis were investigated. Of the 1068 patients with low viral loads, 280 developed HBeAg-negative hepatitis, with an annual incidence rate of 2.0%. HBsAg level, but not HBV DNA level, was found to be a risk factor for HBeAg-negative hepatitis. Multivariate analysis showed that the adjusted hazard ratio in patients with an HBsAg level ≥ 1,000 versus <1000 IU/mL was 1.5 (95% confidence interval, 1.2-1.9). The positive correlation was present when evaluating other endpoints, including hepatitis flare and cirrhosis, and remained consistent when the study population was restricted to those with normal alanine aminotransferase (ALT) level at baseline. The annual incidence rate of HBeAg-negative hepatitis was lowered to 1.1% in patients with low levels of HBV DNA, HBsAg, and ALT.In HBeAg-negative patients with low viral loads and genotype B or C virus infection, a higher HBsAg level can predict disease progression. HBsAg <1,000 IU/mL in combination with low levels of HBV DNA and ALT help define minimal-risk HBV carriers.
THE FUTURE OF THE DIABETIC CHILD
Authors: PRISCILLA WHITE
Journal: JAMA (1930)

The twenty thousand children in the United States who today are diabetic or potentially diabetic compel us to ask the question What does the future promise the diabetic child? Growth, development, and duration of life are no longer the outstanding problems of the diabetic child treated with insulin. In the nineteen months ended Feb. 1, 1930, among 423 children living in that period there were only 10 fatalities, and 5 of these were due to coma untreated. The growth in height and weight was essentially normal and but one girl over 20 years of age has failed to mature.  Yet with increasing age the diabetic child who has demonstrated his ability to carry on the normal functions of childhood and youth faces a new problem in the possible transmission of his disease. The hereditary taint in the diabetic child is evident. Repeated questioning and the fact that diabetes may be
The risk of hepatitis B transmission from health care workers to patients in a hospital setting—A prospective study
Authors: Douglas R. Labrecque, Joan M. Muhs, Larry I. Lutwick, Robert F. Woolson, Walter R. Hierholzer
Journal: Hepatology (1986)

A prospective study was designed to determine the risk of hepatitis B transmission from health care deliverers to patients in the hospital setting. Six chronic carriers of hepatitis B were identified: 2 surgeons, 1 dialysis nurse, 1 pediatric ICU nurse, 1 pharmacist and 1 orderly. Three of the six were HBeAg–positive. Two of the HBeAG–positive chronic carriers also had circulating hepatitis B virus DNA and accounted for approximately two–thirds of the total patient contacts. Two hundred thirteen patients were exposed 450 times to these six hepatitis B carrier staff without evidence of hepatitis B acquisition over a 6–month follow up. One–hundred nineteen control patients, exposed 789 times to noncarrier health care deliverers, were also negative. Another 33 patients were exposed to three additional individuals who were in the prodrome of acute hepatitis B: an intensive care nurse, a dental hygienist and amedical student. These patients showed no evidence of hepatitis B during 6 months of follow–up, nor did 25 separate control patients. Thus, 246 patients were exposed atotal of 483 times to nine health care personnel who had either acute or chronic hepatitis B. No evidence of hepatitis B transmission was found. One–hundred forty–four controls revealed similar results after 814 exposures. Based on the number of exposures to chronic carriers alone, the risk of hepatitis B transmission is estimated to be less than 1%. Our data suggest that, with observation of appropriate hospital technique, the risk of hepatitis B transmission by health care workers is relatively low, even in the high risk settings of surgery or renal dialysis performed by an HBeAg–positive hepatitis B virus DNA–positive carrier. Available accumulated data do not support the automatic exclusion of chronic HBsAg carrier health care workers from any area of primary patient care.
Predicting Shrimp Allergy Using Skin Prick Test, Specific IgE to Shrimp and Rpen a1 in Area with High Prevalence of House Dust Mite Sensitization
Authors: Jaichat Mekaroonkamol, Pantipa Chatchatee, Jarungchit Ngamphaiboon, Piyawadee Lertchanaruengrith, Narissara Suratannon
Journal: Journal of Allergy and Clinical Immunology (2015)
A-consciousness: The local newspaper of the mind?
Authors: David Navon
Journal: Behavioral and Brain Sciences (1995)

Abstract A-consciousness may be regarded as the visibility of information that is the output of a process within a community of other processes. The most prominent function of “public” dissemination of information is giving access to it to processes whose relevance is not clear at the moment of dissemination. The function of P-consciousness may be outside the realm of cognition.
Use of Cardiac Biomarker Testing in the Emergency Department
Authors: Anil N. Makam, Oanh K. Nguyen
Journal: JAMA Internal Medicine (2014)

<h3>Importance</h3> Cardiac biomarker testing is not routinely indicated in the emergency department (ED) because of low utility and potential downstream harms from false-positive results. However, current rates of testing are unknown. <h3>Objective</h3> To determine the use of cardiac biomarker testing overall, as well as stratified by disposition status and selected characteristics. <h3>Design, Setting, and Participants</h3> Retrospective study of ED visits by adults (≥18 years old) selected from the 2009 and 2010 National Hospital Ambulatory Medical Care Survey, a probability sample of ED visits in the United States. <h3>Exposures</h3> Selected patient, visit, and ED characteristics. <h3>Main Outcomes and Measures</h3> Receipt of cardiac biomarker testing during the ED visit. <h3>Results</h3> Of 44 448 ED visits, cardiac biomarkers were tested in 16.9% of visits, representing 28.6 million visits. Biomarker testing occurred in 8.2% of visits in the absence of acute coronary syndrome (ACS)–related symptoms, representing 8.5 million visits, almost one-third of all visits with biomarker testing. Among individuals subsequently hospitalized, cardiac biomarkers were tested in 47.0% of all visits. In this group, biomarkers were tested in 35.4% of visits despite the absence of ACS-related symptoms. Among all ED visits, the number of other tests or services performed was the strongest predictor of biomarker testing independent of symptoms of ACS. Compared with 0 to 5 other tests or services performed, more than 10 other tests or services performed was associated with 59.55 (95% CI, 39.23-90.40) times the odds of biomarker testing. The adjusted probabilities of biomarker testing if 0 to 5, 6 to 10, or more than 10 other tests or services performed were 6.3%, 34.3%, and 62.3%, respectively. <h3>Conclusions and Relevance</h3> Cardiac biomarker testing in the ED is common even among those without symptoms suggestive of ACS. Cardiac biomarker testing is also frequently used during visits with a high volume of other tests or services independent of the clinical presentation. More attention is needed to develop strategies for appropriate use of cardiac biomarkers.
Utilisation by homeless people of acute hospital services in London.
Authors: M E Black, M A Scheuer, C Victor, M Benzeval, M Gill, K Judge
Journal: BMJ (1991)

OBJECTIVES--To estimate the numbers and distribution of homeless people in London; to quantify the utilisation of acute inpatient services by homeless people in two health authorities; and to predict the total numbers of admissions in homeless people in district health authorities across London. DESIGN--Data were collected from various sources on the distribution of homeless people across London boroughs. All unplanned acute inpatient admissions during November 1990 to relevant hospitals were identified. SETTING--Bloomsbury and Paddington and North Kensington, two former inner London district health authorities. SUBJECTS--Homeless people in London residing in bed and breakfast and private sector leased accommodation, residing in hostels, and of no fixed abode. MAIN OUTCOME MEASURES--Number and cost of acute unplanned admissions in homeless people in two health authorities in November 1990; predicted number of such admissions each year in district health authorities in London. RESULTS--There were at least 60,000 homeless people in London in March 1990. The majority were housed in temporary accommodation (55,412). There were at least 3295 hostel dwellers and 651 people sleeping rough. Homeless people accounted for 105 (8%) of the 1256 acute unbooked admissions in residents of Bloomsbury and Paddington and North Kensington health authorities in November 1990. Considerable variations in the pattern of acute unplanned admissions in homeless people were observed in the two districts with respect to housing status and specialty of admission. The total number of acute unplanned admissions in homeless people across London each year was estimated at 7598, ranging from 38 in Bexley to 1515 in Parkside. CONCLUSIONS--The results have fundamental implications for resource allocation across London. Allocation must take better account of the heterogeneity, uneven distribution, and extra health needs of homeless people.
ATTENTION, AN ADJUVANT IN THERAPEUSIS.
Authors: GEO. V. I. BROWN
Journal: JAMA (1896)

A careful scrutiny of the pathway along which has traveled to us, almost from the beginning of history, the knowledge of that state known variously as hypnotism, mesmerism, bradism, animal magnetism, electro-biology, etc., on through an almost interminable list of isms, ics and ologies, brought forward from time to time by its many champions, now bright with the brilliance of popular excitement and approval, again darkened with the severity of general condemnation, hailed as a universal deliverance from all the ills of mankind's heirdom, or crushed under the ban of responsibility for crime or direful mental injury, must, I think, convince most students that the answer of the scientific bodies of to-day can be but slightly different from that given by the Roi Medical Society and the French Academy of Sciences, at Paris in 1778, which, as everyone knows, was a refusal to accept the so-called truths en masse. Yet
Affect systems and neural systems
Authors: Eric A. Salzen
Journal: Behavioral and Brain Sciences (2000)

The “reward” systems described by Rolls are systems for drive-reinforced associations of contact and distant stimuli and not for emotional behaviours. The neural systems delineated may be associated with distinct categories of “affect,” namely “hedonic feelings,” “moods,” and “emotions.” Awareness of these affects requires external perceptual as well as internal feedback. Levels of feedback in evolution and development suggest sensory qualia may not require language.
Maternal and Umbilical-Cord Serum Leptin Concentrations in Normal, Full-Term Pregnancies
Authors: Beda W. Hartmann, Peter Wagenbichler, Gabor Söregi
Journal: New England Journal of Medicine (1997)

To the Editor: Serum concentrations of leptin, a hormonal product of adipose tissue, correlate closely with body-mass index and adipose-tissue mass in adults1 and children,2 but these relations have not been studied in pregnant women and their neonates. We measured serum leptin immediately after delivery in 76 normal women (mean [±SD] age, 28±4 years), with singleton pregnancies and in their newborn infants. All the women had normal, full-term pregnancies and normal vaginal deliveries. Women who smoked more than nine cigarettes per day or who had perinatal obstetrical complications were excluded. Serum concentrations of leptin, insulin, and insulin-like growth factor I . . .