tbuckley/cabot-search huggingface dataset:
Feasibility of oncoplastic techniques in the surgical management of locally advanced breast cancer
Authors: Angelo Gustavo Zucca Matthes, Gilberto Uemura, Ligia Kerr, Ângelo Carmo Silva Matthes, Rodrigo Augusto D. Michelli, Maria Aparecida Azevedo Koike Folgueira, Rene Aloísio da Costa Viera
Journal: International Journal of Surgery (2012)
Electrophysiologic actions of high plasma concentrations of propranolol in human subjects
Authors: Henry J. Duff, Dan M. Roden, Leif Brorson, Alastair J.J. Wood, Albert K. Dawson, R. Kirby Primm, John A. Oates, Raphael F. Smith, Raymond L. Woosley
Journal: Journal of the American College of Cardiology (1983)
Protecting Research Subjects — What Must Be Done
Authors: D Shalala
Journal: New England Journal of Medicine (2000)

As we race toward the as yet unimagined scientific and medical triumphs of the 21st century, no one is more hopeful about the journey than I am. Nevertheless, moving ahead with cutting-edge research must not mean leaving behind well-established international standards for protecting human subjects in clinical trials. None of these principles is more important than the protection of research subjects by informed consent based on full disclosure of potential risks and benefits.I did not expect, or want, to complete my tenure as secretary of health and human services by raising questions about the safety of patients in clinical . . .
MINDING THE GAP – DROP-OUT OF HEPATITIS C PCR POSITIVE PATIENTS BETWEEN DIAGNOSIS AND ATTENDANCE AT THE LIVER CLINIC
Authors: A McCurley, S Murray, M McCartney, P Coyle, N McDougall, I Cadden
Journal: Gut (2013)

<h3>Introduction</h3> In 2009 we identified a sizeable gap between those diagnosed with Hepatitis C (HCV) and those seen at clinic. The Northern Ireland Managed Clinical Network (MCN) has reviewed all polymerase chain reaction (PCR) positive cases with respect to referral to/attendance at clinic. <h3>Aims/Background</h3> To review referral to/attendance at Liver Clinic for confirmed HCV PCR positive cases. <h3>Method</h3> Confirmed cases between September 2009 and June 2012 were cross-referenced with the Patient Administration System to assess clinic attendance. In cases why patients were not referred, the originator of the test was contacted, for an explanation and to encourage referral to the clinic. <h3>Results</h3> 219 cases were confirmed. 118 (53%) cases were referred before MCN intervention. After this,193 referrals were received (88%). 26 (12%) individuals were never referred. 6 persons died following referral, leaving 187 referred cases. 149(77%) individuals currently attend the liver clinic; 1 awaits appointment. 42% of referrals were from ethnic minority groups. Annual non-attendance rates dropped from 22% in 2009 to 16% in 2011. 37 patients referred did not attend clinic; 18 from ethnic minority backgrounds. 19 were from UK/Northern Ireland. There was no significant difference between non-attendance rate amongst ethnic minority groups (22.8%) and for those with a UK/Northern Ireland origin (17.9%) (Fishers Exact Test; p= 0.46). <h3>Conclusion</h3> Involvement of the NI Hepatitis B&amp;C MCN has increased rates of referral of HCV PCR positive patients for assessment. Surprisingly, ethnic background did not impact upon the rate of clinic non-attendance.
Methemoglobinemia as a Rare Complication During a Transesophageal Echocardiogram
Authors: Rami N. Khouzam
Journal: Circulation (2006)

A transesophageal echocardiogram was performed on a 44-year-old patient to rule out endocarditis.After local benzocaine spray was applied to the throat and intravenous sedation was administered, the pulsoximeter showed a drop in oxygen saturation to 84% on room air, not responding to supplemental oxygen.Despite the use of flumazenil and naloxone for benzodiazepine (midazolam) and opiate (meperidine) reversal, respectively, the patient was still drowsy and cyanotic.The blood sample withdrawn from the femoral artery was very dark in color, "chocolate brown" compared with his blood after recovery (Figure, right and left tubes).It showed an oxygen saturation of 99%; constituting a "saturation gap" of 15% between the pulsoximeter and the blood sample readings.Methemoglobinemia was suspected and later confirmed by blood levels.Methylene blue (70 mg) in a solution given intravenously over 15 minutes was used for reversal with excellent results.(The recommended dose is 1 to 2 mg/kg intravenously administered over several minutes.)This is believed to be a reaction to the local anesthetic spray, 20% benzocaine.
Abstract 750: Impairment of clofarabine (CLO) clearance (CL) in the presence of cimetidine: Evidence of a drug-drug interaction between clofarabine and inhibitors of human organic cation transporter-2 (hOCT2)
Authors: Matthew C. Foster, Christine Walko, Parag Kumar, Jeffrey Huang, Anastasia Ivanova, Reynaldo Garcia, Hendrik Van Deventer, Reginald Ewesuedo, Thomas C. Shea
Journal: Cancer Research (2012)

Abstract Background: CLO is a nucleoside analog with efficacy in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Preclinical studies using an isolated, perfused rat-kidney model suggested that CLO may be a substrate of OCT2, a channel that mediates the transport of cations across the renal tubular basolateral membrane. Evidence of this mechanism is lacking in humans, though this property could contribute to drug interactions with compounds such as cimetidine that inhibit hOCT2. Methods: Eligible patients were: 1) untreated AML ≤ 60 years of age unsuited for intensive induction therapies, 2) relapsed or refractory AML, or 3) MDS patients who failed ≤ 1 prior regimen. Patients were treated with CLO according to the schedule: CLO 15 mg/m2 IV day 1, CLO 30 mg/m2 PO day 3, CLO 15 mg/m2 IV day 5 preceded by two doses of oral cimetidine (800 mg PO 8-10 hours apart), and CLO 30 mg/m2 PO on days 6 and 7. Pharmacokinetic (PK) studies were obtained after CLO dosing on days 1, 3 and 5. CLO plasma concentration was determined, and concentration-time data was analyzed by non-compartmental methods. Oral bioavailability (F) was determined for each patient. The geometric means of area under the curve, 0-infinity (AUC), and CL for intravenous CLO administered after cimetidine doses were compared with AUC and CL for intravenous CLO administered without cimetidine. Results: To date, 8 patients have been treated. Mean F = 0.66, 90% confidence interval (CI) (0.49, 0.87). Comparisons of PK parameters between IV dosing with and without cimetidine are shown in the table. Conclusions: Co-administration of the hOCT2 inhibitor cimetidine with CLO appears to increase CLO AUC by impairing renal CL. Enrollment continues in an attempt to further support the putative mechanism of CLO renal clearance by hOCT2-mediated tubular secretion, and to further investigate the clinical import of this drug-drug interaction. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 750. doi:1538-7445.AM2012-750
Response of Favus to Griseofulvin
Authors: A. G. Fergusson, J. C. P. Logan, P. R. Derblay
Journal: BMJ (1960)

SmmaryA case is described in which both hyperthyroidism -and Addison's disease were present.Exacerbation of hyperthyroidism resulted in an adrenal crisis.The relationship between thyroid and adrenal cortical function is discussed.We thank Dr. J. R.
The Electrocardiogram in Population Studies
Authors: HENRY BLACKBURN, ANCEL KEYS, ERNST SIMONSON, PENTTI RAUTAHARJU, SVEN PUNSAR
Journal: Circulation (1960)

Information now available about the prevalence and incidence of coronary heart disease is seriously deficient because of the lack of standardized and objective methods of collection, tabulation, interpretation, and reporting of survey data. Chief reliance in the objective diagnosis of coronary heart disease rests on the electrocardiogram, a crucial tool in population studies. A classification system for the electrocardiogram in epidemiologic studies has been developed, tested, and herein presented. It is adapted to the usual clinical reading technics of the electrocardiographer. It embodies criteria widely employed and of diagnostic and prognostic import, but no stipulations about interpretation are made. The system permits more valid comparisons of data on heart disease between populations. It is susceptible to modern methods of data processing.
Gallium SPECT Detection of Neoplastic Intravascular Obstruction of the Superior Vena Cava
Authors: LAWRENCE C. SWAYNE, ISAAC L. KAPLAN
Journal: Clinical Nuclear Medicine (1989)

A rare case of an intravascular neoplastic obstruction of the superior vena cava is discussed. The lesion was detected with gallium single photon emission computed tomography (SPECT) despite a normal appearance on a concurrent radiographic CT study. A computer-generated composite SPECT-CT image confirmed the intravascuiar localization of the radioisotope, and a subsequent CT-guided transthoracic needle biopsy revealed a poorly differentiated adenocarcinoma.
Occult advanced cervical cancer
Authors: A. Curtain, D. Jenkins
Journal: BMJ (1985)

result.6With this technique cure rates of 97-99% are to be expected even when dealing with the most recidivist of tumours.Microscopically controlled excision is now used extensively in the USA, where the surgery is carried out by properly trained dermatological surgeons.Otolaryngologists and ophthalmic and plastic surgeons commonly refer patients for Mohs's surgery.78We hope that the facilities for this procedure will soon be more widely available in the United Kingdom so that full advantage can be taken of this important technique in the management of difficult cutaneous tumours.
Carbon in Airway Macrophages and Lung Function in Children
Authors: Neeta Kulkarni, Nevil Pierse, Lesley Rushton, Jonathan Grigg
Journal: New England Journal of Medicine (2006)

Epidemiologic studies indirectly suggest that the inhalation of carbonaceous particulate matter impairs lung function in children. Using the carbon content of airway macrophages as a marker of individual exposure to particulate matter derived from fossil fuel, we sought direct evidence of this association.
Renal Metastases From Follicular Thyroid Cancer on SPECT/CT
Authors: Christian von Falck, Gregor Beer, Klaus F. Gratz, Michael Galanski
Journal: Clinical Nuclear Medicine (2007)

In well-differentiated thyroid carcinoma, only a subset of patients develop distant metastases, predominantly to the lungs and the skeletal system. Only a few cases of metastatic spread to the kidneys are described in the literature. We report the case of a 64-year-old woman with a long history of follicular thyroid cancer who developed renal metastases. The lesions were detected with I-131 scintigraphy, SPECT/CT and thin-collimated contrast-enhanced CT. Subsequent surgery and histopathologic analysis of the renal lesions confirmed the diagnosis.
Low-Molecular-Weight Tumor Necrosis Factor Receptor p55 Controls Induction of Autoimmune Heart Disease
Authors: Kurt Bachmaier, Christian Pummerer, Ivona Kozieradzki, Klaus Pfeffer, Tak W. Mak, Nikolaus Neu, Josef M. Penninger
Journal: Circulation (1997)

Tumor necrosis factor-alpha (TNF-alpha) is involved in the pathogenesis of myocarditis and can bind to either tumor necrosis factor receptor (TNF-R) p55 or TNF-Rp75. However, it is not known which TNF-R mediates the specific functions of TNF in disease. To determine the role of the TNF/TNF-R system in chronic heart disease, we used a murine model of cardiac myosin-induced myocarditis that closely resembles the chronic stages of virus-induced myocarditis in humans.Mice lacking TNF-Rp55 expression after targeted disruption of the TNF-Rp55 gene were backcrossed into a genetic background susceptible to the induction of myocarditis with cardiac myosin. Here, we demonstrate that TNF-Rp55 gene-deficient mice did not develop any inflammatory infiltration into the heart after autoantigen injection, whereas control littermates showed autoimmune myocarditis at high prevalence and severity. Despite the absence of autoimmune heart disease, TNF-Rp55-/- mice produced cardiac myosin-specific IgG autoantibodies, indicating that activation of autoaggressive T and B lymphocytes had occurred. However, heart interstitial cells failed to express major histocompatibility complex (MHC) class II molecules in TNF-Rp55-/- animals, and adoptive transfer of autoreactive T cells resulted in heart disease only in TNF-Rp55-/- but not in TNF-Rp55-/- littermates.Cardiac myosin-induced myocarditis is dependent on autoaggressive T cells and on autoantigen presentation in association with MHC class II molecules within the heart. Thus, lack of TNF-Rp55 expression could interfere with either lymphocyte activation or target organ susceptibility. The data presented here show that the TNF-Rp55 is a key regulator for the induction of autoimmune heart disease by its controlling target organ susceptibility.
Defective glycosylation of α-dystroglycan contributes to podocyte flattening
Authors: Kenichiro Kojima, Hitonari Nosaka, Yuki Kishimoto, Yuri Nishiyama, Seiichi Fukuda, Masaru Shimada, Kenzo Kodaka, Fumiaki Saito, Kiichiro Matsumura, Teruo Shimizu, Tatsushi Toda, Satoshi Takeda, Hiroshi Kawachi, Shunya Uchida
Journal: Kidney International (2010)
Problems With Prioritization: Exploring Ethical Solutions to Inequalities in HIV Care
Authors: Kjell Arne Johansson, Ole Frithjof Norheim
Journal: The American Journal of Bioethics (2011)

Abstract Enormous gaps between HIV burden and health care availability in low-income countries raise severe ethical problems. This article analyzes four HIV-priority dilemmas with interest across contexts and health systems. We explore principled distributive conflicts and use the Atkinson index to make explicit trade-offs between health maximization and equality in health. We find that societies need a relatively low aversion to inequality to favor treatment for children, even with large weights assigned to extending the lives of adults: higher inequality aversion is needed to share resources equally between high-cost and low-cost treatment; higher inequality aversion is needed to favor treatment rather than prevention, and the highest inequality aversion is needed to favor sharing treatment between urban and rural regions rather than urban provision of treatment. This type of ethical sensitivity analysis may clarify the ethics of health policy choice. Keywords: ethicshealth care rationinghighly active antiretroviral therapyHIVresource allocation Acknowledgments We thank Dan Wikler for introducing us to his hypothetical ethical dilemmas at a workshop in Arusha (2009), from which some of the cases in this article are adapted. Notes A late-start strategy was chosen for this analysis since several studies show that the majority of HIV patients in low-income countries show up in HIV clinics at a late stage of the disease (CD count <200). At this stage, patients begin to experience symptoms of HIV opportunistic diseases. On the other hand, some would claim that improvements in health produce consistently lower gains in utility the older we get (diminishing marginal values of additional life to the older) (Kamm Citation1993). This would favor a higher weight for prolonging the life of children. DALY weights to health gains in different age groups are calculated by the following function: Cxe −βx , where x is age, and C and β are constants with values of 0.1658 and 0.04, respectively. This yields a mean age weight to health gains in the age between 12 and 20 years at 1.55, and to health gains in the age between 32 and 40 at 1.61. The DALY value of wa in these age groups is therefore 1.04 (1.61/1.55) (Murray and Lopez Citation1996).
Radionuclide Imaging of a Rectus Sheath Hematoma Caused by Insulin Injections
Authors: LEE H. MONSEIN, MICHAEL DAVIS
Journal: Clinical Nuclear Medicine (1990)

CT scanning, MRI, and ultrasonography are the imaging procedures of choice for the study of rectus sheath hematomas. A rectus sheath hematoma was evaluated scintigraphically after the intravenous administration of Tc-99m labeled RBC, which confirmed the hematoma, demonstrated the sites of bleeding, and revealed continued bleeding.
Failure with the new triphasic oral contraceptive Logynon.
Authors: R A Fay
Journal: BMJ (1982)

A 24-year-old woman on oral contraceptives (OCs) for 6 years had her prescription changed because of recurrent headaches from a monophasic to a triphasic preparation Logynon introduced in Britain in 1980.  The woman became pregnant during the 2nd cycle of treatment with Logynon.  The most recent literature reports a few other cases of contraceptive failure with triphasic OCs.
Adolescents and young adults who are not in employment, education, or training
Authors: J. Scott, D. Fowler, P. McGorry, M. Birchwood, E. Killackey, H. Christensen, N. Glozier, A. Yung, P. Power, M. Nordentoft, S. Singh, E. Brietzke, S. Davidson, P. Conus, F. Bellivier, R. Delorme, I. Macmillan, J. Buchanan, F. Colom, E. Vieta, M. Bauer, P. McGuire, K. Merikangas, I. Hickie
Journal: BMJ (2013)

Their problems are more than economic 

The term NEET (not in employment, education, or training) refers to economically inactive adolescents and young adults.1 2 During economic crises, youth unemployment rises faster and recovers more slowly than general unemployment.1 In 2012, there were 7.5 million 15-24 year old (13% of the age group) and 6.5 million 25-29 year old (20%) economically inactive young people in the European Union. Together, they cost €153bn (£131bn; $204bn) in welfare benefits and lost productivity—1.2% of EU gross domestic product.2 International publications confirm global rates of 10-20% youth unemployment and highlight that the optimal solution is to increase retention in education and training.1 2 3 4 5

Prolonged economic inactivity has profound effects on mental health: the risks of depression (odds ratio 2.7), alcohol or substance misuse (3.4), and suicidal attempts (3.6) are significantly increased in economically inactive young people versus their economically active peers.3 However, action plans fail to recognise subgroups within the economically inactive population who are functionally impaired because of evolving or pre-existing mental disorders. During economic downturns, these people are especially disadvantaged and risk lifelong social exclusion and economic marginalisation unless their ill health is recognised early and their needs targeted more directly.4 5

Preventing or limiting economic inactivity alone could reduce rates of common mental disorders by 8-17%,6 but it would not completely solve the problem of the threefold greater risk of severe mental disorders in this group.3 The explanation for this is complex, but it is noteworthy that the peak age of onset of …
Cytokeratin 18-based modification of the MELD score improves prediction of spontaneous survival after acute liver injury
Authors: Lars P. Bechmann, Christoph Jochum, Peri Kocabayoglu, Jan-Peter Sowa, Marco Kassalik, Robert K. Gieseler, Fuat Saner, Andreas Paul, Christian Trautwein, Guido Gerken, Ali Canbay
Journal: Journal of Hepatology (2010)
Translation of Research Evidence From Animals to Humans
Authors: Daniel G. Hackam, Donald A. Redelmeier
Journal: JAMA (2006)

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
Improvement in indexes of diastolic performance in patients with congestive heart failure treated with milrinone.
Authors: E S Monrad, R G McKay, D S Baim, W S Colucci, M A Fifer, G V Heller, H D Royal, W Grossman
Journal: Circulation (1984)

To elucidate the mechanisms by which the new bipyridine inotropic agent milrinone improves cardiac function, we examined multiple indexes of left ventricular diastolic function before and after administration of milrinone to patients with advanced (NYHA class III or IV) congestive heart failure. In 13 patients left ventricular pressure measurements were made with a micromanometer to permit assessment of peak negative dP/dt and the time constant of left ventricular isovolumic relaxation, T, before and after milrinone. In nine patients radionuclide ventriculographic studies were performed during left heart catheterization, allowing calculation of left ventricular peak filling rate, volumes, and the diastolic pressure-volume relationship before and after milrinone. After intravenous administration of milrinone, peak negative dP/dt increased (+ 18%; p less than .01) and T decreased (-30%; p less than .01), while heart rate increased by only 8% (87 +/- 12 to 94 +/- 15 beats/min; p less than .01), left ventricular systolic pressure did not change, and mean aortic pressure fell by 11% (p less than .01). Left ventricular peak filling rate increased (1.2 +/- 0.6 to 1.7 +/- 0.7 end-diastolic volumes/sec; p less than or equal to .02) despite a decrease in left ventricular filling pressure (mean pulmonary wedge pressure 27 +/- 7 to 18 +/- 9 mm Hg; p less than .01). There was a fall in left ventricular end-diastolic pressure (28.6 +/- 6 to 19 +/- 7 mm Hg; p less than or equal to .01), with no significant change in left ventricular end-diastolic volume. This was associated with a downward shift in the left ventricular diastolic pressure-volume relationship in most cases.(ABSTRACT TRUNCATED AT 250 WORDS)
De Subitaneis Mortibus
Authors: THOMAS N. JAMES, PETER FROGGATT, THOMAS K. MARSHALL
Journal: Circulation (1973)

The unexpected finding of a right coronary artery embolism in a human fetus of five months gestational age led to an examination of the hearts of 15 other fetuses lost at approximately the same period of pregnancy. No other examples of coronary embolism were found, indicating that this is not a frequent cause of fetal death. Possible mechanisms of death in the index case are discussed on the basis of the anatomic distribution of the coronary arteries, the blood supply to the sinus node and atrioventricular junction, and the configuration of the interatrial septum.
America's Safety Net
Authors: Andrew B. Bindman
Journal: JAMA (1992)

THE PLIGHT of Americans without adequate access to health care captures public attention when vivid instances of human suffering occur. In the 1980s, there was public outcry over "patient dumping" in response to numerous reports about uninsured patients dying after being refused care at private hospital emergency departments.<sup>1,2</sup>Congress and many state legislatures responded by enacting strict sanctions against the transfer of patients in unstable condition. Absent media stories about patients "dying in the streets," the sense of urgency about problems of access to care tends to dissipate. It becomes easy to believe that a safety net is in place and that care is available for all Americans, even the poor and uninsured, when they really need it. The article by Weissman et al<sup>3</sup>in this issue of<i>JAMA</i>confirms the presence of a health care "safety net" for the poor, but suggests that low-income patients may not