tbuckley/cabot-search huggingface dataset:
Evaluation of the Benefit of Corticosteroid Injection Before Exercise Therapy in Patients With Osteoarthritis of the Knee
Authors: Marius Henriksen, Robin Christensen, Louise Klokker, Cecilie Bartholdy, Elisabeth Bandak, Karen Ellegaard, Mikael P. Boesen, Robert G. Coumine Riis, Else M. Bartels, Henning Bliddal
Journal: JAMA Internal Medicine (2015)

Osteoarthritis (OA) of the knee is the most frequent form of arthritis and a cause of pain and disability. Combined nonpharmacologic and pharmacologic treatments are recommended as the optimal treatment approach, but no evidence supports the recommendation.To assess the clinical benefits of an intra-articular corticosteroid injection given before exercise therapy in patients with OA of the knee.We performed a randomized, blinded, placebo-controlled clinical trial evaluating the benefit of intra-articular corticosteroid injection vs placebo injection given before exercise therapy at an OA outpatient clinic from October 1, 2012, through April 2, 2014. The participants had radiographic confirmation of clinical OA of the knee, clinical signs of localized inflammation in the knee, and knee pain during walking (score >4 on a scale of 0 to 10).Participants were randomly allocated (1:1) to an intra-articular 1-mL injection of the knee with methylprednisolone acetate (Depo-Medrol), 40 mg/mL, dissolved in 4 mL of lidocaine hydrochloride (10 mg/mL) (corticosteroid group) or a 1-mL isotonic saline injection mixed with 4 mL of lidocaine hydrochloride (10 mg/mL) (placebo group). Two weeks after the injections, all participants started a 12-week supervised exercise program.The primary outcome was change in the Pain subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire (range, 0-100; higher scores indicate greater improvement) at week 14. Secondary outcomes included the remaining KOOS subscales and objective measures of physical function and inflammation. Outcomes were measured at baseline, week 2 (exercise start), week 14 (exercise stop), and week 26 (follow-up).One hundred patients were randomized to the corticosteroid group (n = 50) or the placebo group (n = 50); 45 and 44 patients, respectively, completed the trial. The mean (SE) changes in the KOOS Pain subscale score at week 14 were 13.6 (1.8) and 14.8 (1.8) points in the corticosteroid and placebo groups, respectively, corresponding to a statistically insignificant mean difference of 1.2 points (95% CI, -3.8 to 6.2; P = .64). We found no statistically significant group differences in any of the secondary outcomes at any time point.No additional benefit results from adding an intra-articular injection of 40 mg of corticosteroid before exercise in patients with painful OA of the knee. Further research is needed to establish optimal and potentially synergistic combinations of conservative treatments.clinicaltrialsregister.eu Identifier: 2012-002607-18; clinicaltrials.gov Identifier: NCT01945749.
Effect of Sibutramine on Weight Management and Metabolic Control in Type 2 Diabetes
Authors: Roberto Vettor, Roberto Serra, Roberto Fabris, Claudio Pagano, Giovanni Federspil
Journal: Diabetes Care (2005)

OBJECTIVE—The aim of this study was to provide a comprehensive meta-analysis of randomized controlled clinical studies on the effects of sibutramine on weight loss and glycemic control in obese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS—Controlled clinical trials assessing the effect sizes of sibutramine on weight loss effects on glycemia in obese subjects with type 2 diabetes were identified and reviewed using the Cochrane Library, Medline, EMBASE, and a manual search. RESULTS—Eight placebo-controlled, double-blind, randomized trials of sibutramine were included. After sibutramine treatment, the decrease in body weight and waist circumference was significantly greater than in the placebo group. Fasting blood glucose and HbA1c significantly decreased after sibutramine treatment. Treatment benefits were seen in plasma triglycerides and HDL, without significant variations in serum total and LDL cholesterol. No differences in systolic blood pressure between the sibutramine and the placebo groups were seen, while recording of diastolic blood pressure and heart rate showed that sibutramine produced a small increase relative to placebo. CONCLUSIONS—A pharmacological approach in a weight management program for patients with type 2 diabetes may be helpful in glycemic control and in the management of other risk factors. Sibutramine may help improve glucose control because it is conducive to weight loss. The reviewed data on the effect of sibutramine further enforce the recommendations that weight management may be the most important therapeutic task for most obese subjects with type 2 diabetes.
HEART DISEASES IN CHILDREN
Authors: G. R. Graham
Journal: BMJ (1957)

Transmission holography has been used to translate the Knapp and Kushner probabilistically defined “Reject Zone” for particulate contamination in parenteral products into physical measurements. Sample containers rejected with a probability of 70% (i.e., at the lower boundary of the “Reject Zone”) in a standard paced inspection using a three diopter lens and an intense diffuse light source were investigated with holography. The containers investigated showed a major relationship between the shape of a particulate and its detectability. The net effect of magnification on the relationship between particulate size and rejection probability was also investigated.
Molecular Changes in Hepatocellular Dysplastic Nodules on Microdissected Liver Biopsies
Authors: Marco Maggioni, Guido Coggi, Barbara Cassani, Paolo Bianchi, Solange Romagnoli, Alessandra Mandelli, Mauro Borzio, Piergiuseppe Colombo, Massimo Roncalli
Journal: Hepatology (2000)

The genetic profile of dysplastic hepatocellular nodules arising in cirrhosis is poorly understood. We assessed loss of heterozygosity (LOH) and microsatellite instability (MI) in 10 dysplastic nodules (4 low–grade and 6 high–grade) with surrounding cirrhosis and in 10 hepatocellular carcinomas (HCC). Six microsatellite loci were selected and investigated on microdissected needle biopsies. Twenty–four (24.4%) informative loci showed allelic loss, while MI was seen in 3 loci only (3%). The most involved sites were located on chromosomes 4q (54.5%) and 8p (50%). LOH was documented in 16.6%, cirrhotic, 50% low–grade dysplastic nodules (LGDN), 83% high–grade dysplastic nodules (HGDN), and 70% malignant nodules. LOH at multiple loci was increasingly seen from cirrhotic to HGDN, but not from the latter to HCC. The fractional allelic loss (FAL) was significantly increased in dysplastic and neoplastic nodules as compared with cirrhosis ( P &lt; .01). The progressive accumulation of genetic changes in cirrhotic, dysplastic, and malignant hepatocellular nodules is in keeping with a multistep process of carcinogenesis; within this spectrum, HGDN can be considered advanced precursors of HCC.
Immunofluorescence findings in haematoporphyrin-induced keloid
Authors: E. NUNZI, A. PARODI, A. REBORA
Journal: British Journal of Dermatology (1983)

A case of haematoporphyrin‐induced keloid is described in which immunofluorescence (IF) revealed antibodies eluted from circulating lymphoid cells directed against fibroblasts. The antibodies eluted belonged to the main Ig classes IgD and IgM and they did not bind complement in vitro. Their possible activity in stimulating fibroblasts is discussed.
Trends in survival of patients with primary plasma cell leukemia: a population-based analysis
Authors: Wilson I. Gonsalves, S. Vincent Rajkumar, Ronald S. Go, Angela Dispenzieri, Vinay Gupta, Preet P. Singh, Francis K. Buadi, Martha Q. Lacy, Prashant Kapoor, David Dingli, John A. Lust, Steven R. Zeldenrust, Suzanne R. Hayman, Robert A. Kyle, Morie A. Gertz, Shaji K. Kumar
Journal: Blood (2014)
Prurigo as a clinical prodrome to adult T-cell leukaemia/lymphoma
Authors: None Setoyama, None Mizoguchi, None Kanzaki
Journal: British Journal of Dermatology (1998)

We report a case of adult T-cell leukaemia/lymphoma (ATLL) with prurigo as a prodromal skin manifestation. The patient was a 52-year-old woman with a 2-year history of a fluctuating skin condition consisting of pruritic papules and pigmentation on her lower legs and right buttock. Prurigo was diagnosed at her first visit in October 1995, and she was found to be seropositive for human T-cell lymphotropic virus type 1 (HTLV-1). Two years later, the skin lesions had spread over the patient's forearms and dorsa of the hands, and abnormal lymphoid cells had appeared in her peripheral blood. Southern blot analysis revealed monoclonal integration of HTLV-1 provirus in the peripheral blood, but not in a skin lesion. Based on these results, a diagnosis of overt ATLL of the smouldering type was made. The findings in this case indicate that in healthy HTLV-1 seropositive carriers, prurigo requires careful follow-up as a cutaneous prodrome of ATLL.
Inadvertent Rubella Virus Vaccination during Pregnancy
Authors: H. Elliott Larson, Paul D. Parkman, William J. Davis, Hope E. Hopps, Harry M. Meyer
Journal: New England Journal of Medicine (1971)

Abstract Studies concerning nine pregnant women inadvertently inoculated with live rubella virus vaccine confirmed that the attenuated virus can produce chronic placental infection. None of the women had been tested for rubella susceptibility before vaccination; however, serologic testing of later serum specimens indicated seroconversion of one. This subject and one other reported symptoms consistent with vaccine-virus infection. In both women the attenuated virus was isolated from conceptuses collected 69 and 28 days respectively after immunization. Attempts at virus isolation were negative on specimens from the remaining six women. Histologic changes in placenta or decidua consistent with rubella infection were detected in the two virus-positive cases and in one negative case. These data underscore the need for caution in vaccinating postpubertal women.
LOCALIZED GAS INFECTIONS IN WAR WOUNDS TREATED BY MUSCLE GROUP EXCISION
Authors: KELLOGG SPEED
Journal: JAMA (1918)

In the early part of the war, the mortality from gas infections in wounds acquired in the lowlands of France and Belgium was high. Delay in treatment, unclassified knowledge, and lack of intensive study of the early symptoms were partly responsible. When the bacteriology and pathology were investigated and their interpretation was applied to the clinical manifestations, surgeons rapidly came to differentiate between early localized gas infections and the massive invasions of whole limbs. It is my intention to set forth briefly a few of the points connected with early localized infection, and to attempt to disseminate knowledge of the value of immediate treatment. The histologic studies of McNee and Dunn<sup>1</sup>have shown conclusively that the spread of these infections into living muscle is extremely rapid, so that in three and one-half hours after the reception of wounds the condition is established. If the causative wound involves the main
Preventing Interpersonal Violence
Authors: M.J. Friedrich
Journal: JAMA (2015)

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
A Creeping Suspicion about Radon
Authors: Laura Alderson
Journal: Environmental Health Perspectives (1994)

Who would expect an odorless, invisible gas that occurs nearly everywhere on earth to cause such trouble Yet radon, the gas emitted by decay of uranium in the earth's crust, is one of America's most significant environmental risks, according to the EPA, which estimates that residential radon levels lead to approximately 13,600 lung cancer deaths each year. A new National Cancer Institute analysis of multiple studies of miners confirms early estimates, putting the number at 15,000. No other risk comes close, not even environmental tobacco smoke, which is estimates to cause some 3,000 deaths each year. Hot debate surrounds the assessment of risk from radon exposure to Americans via indoor air and water supplies. The primary culprit is not radon gas itself, but its decay products, including polonium-214 and polonium-218, which have long half-lives and emit alpha particles - positively charged particles - and lung cancer when inhaled. Radon seeps into homes from the ground or is present in water supplies. Waterborne radon may be inhaled as radon or its progeny during household use - cooking or showering - or it may be ingested. But the EPA estimates that water sources contribute only about 5% of total airborne radon exposure,more » leaving indoor air as the worst offender. While the EPA estimates that approximately 200 cancer cases per year result from exposure to radon from public groundwater systems, estimates of annual lung cancer deaths from indoor air radon range from 7,000 to 30,000.« less
Changes in pericardial pressure during the perinatal period.
Authors: D A Grant, C S Kondo, J E Maloney, A M Walker, J V Tyberg
Journal: Circulation (1992)

BACKGROUND To determine how the tissues that surround the heart affect diastolic and systolic function during the perinatal period, we studied the pressure-diameter relation of the left ventricle in partially delivered fetal lambs. METHODS AND RESULTS We anesthetized (1.5-2.0% halothane, balance O2) and ventilated six pregnant ewes (142-144 days of gestation) and then partially delivered each lamb by cesarean section. Each lamb was instrumented to record left ventricular anteroposterior diameters (endocardial ultrasonic transducers), pericardial pressure (liquid-containing balloon), and left ventricular pressure (transducer-tipped catheter). Left ventricular pressure-diameter relations were recorded under three conditions: initially, with a closed chest and closed pericardium (before ventilation); second, after interruption of the umbilical circulation and 1 hour of ventilation; and finally, when the lungs and the pericardium were retracted from the heart. Pericardial pressure (recorded at a common diameter, i.e., the maximal end-diastolic diameter recorded before ventilation) decreased by 48% after 1 hour of ventilation (p &lt; 0.05). After ventilation, left ventricular anteroposterior diameters were 4-5% greater (p &lt; 0.05) at each end-diastolic pressure compared (12.5, 15.0, 17.5, and 20 mm Hg). Thus, ventilation appeared to increase left ventricular diastolic compliance. Contractility also appeared to increase after ventilation when evaluated using ventricular stroke work as a function of end-diastolic pressure as preload. When we used a more appropriate measure of preload (i.e., transmural end-diastolic pressure), ventilation did not change left ventricular diastolic compliance or contractility. Thus, left ventricular systolic function increased because of an increase in preload. CONCLUSIONS The tissues surrounding the fetal heart significantly augment pericardial pressure and limit left ventricular preload. The initiation of ventilation reduces pericardial pressure, increases left ventricular preload, and increases left ventricular systolic function. At birth, a decrease in pericardial pressure and the resulting increase in preload may help increase left ventricular output through the Frank-Starling mechanism.
T3 Thyrotoxicosis and the 24-Hour Uptake of Radioactive Iodine
Authors: Jan D. Wiener
Journal: JAMA (1970)

<h3>To the Editor.—</h3> Dr. Kenneth Sterling and his collaborators (<b>213:</b>571, 1970) draw attention to the fact that the 24-hour thyroidal radioactive iodine (<sup>131</sup>I) uptake is normal in many patients with thyrotoxicosis caused by increased production of triiodothyronine (T<sub>3</sub>) rather than thyroxine (T<sub>4</sub>). They justly remark that "this would be compatible with formation of T<sub>3</sub>, which requires less iodine than T<sub>4</sub>." The iodine content of T<sub>3</sub>is only three-quarters that of T<sub>4</sub>, and its potency about twice as high per unit of weight. The authors add, however, that "it is advisable to employ screening with the T<sub>3</sub>suppression test, regardless of the initial 24-hour thyroidal radioiodine uptake value." I don't think this is generally necessary. Very probably, the relatively increased production of T<sub>3</sub>only partially explains the low-normal 24-hour uptakes. Values of 8% to 18%, found in six out of 25 cases
A woman with a cough and difficulty walking
Authors: P. Foley, G. Oommen, J. O'Riordan
Journal: BMJ (2010)

A 47 year old woman was referred urgently to the out of hours neurology service with severe difficulty walking. Five weeks previously she had developed a “numb, stabbing” persistent pain in her left foot. Three weeks before admission, an identical pain developed in her right foot. One day before referral her right foot “went floppy.” Hours before admission, this weakness spread to affect the left foot, and she could not walk unaided. She had also felt short of breath and had a dry cough. Her only known medical history was asthma.

On examination, the patient was coughing. Her pulse rate was 115 beats/min (regular), respiratory rate 20 breaths/min, oxygen saturation 89% on air, and temperature 36.8°C. Respiratory examination showed globally reduced breath sounds and bibasal crepitations. Her peak expiratory flow rate was 109 l/min (predicted 400 l/min). She had an erythematous rash over the metacarpophalangeal joints. A chest radiograph was performed⇓.



Neurologically, cranial nerve and upper limb examinations were unremarkable. Lower limb examination confirmed bilateral foot drop with distal sensory loss. Ankle reflexes were absent, and plantar responses were downgoing.

Initial investigations showed normal haemoglobin concentration, platelet count, urea concentration, and electrolytes level; however, a leucocytosis of 33.4 (neutrophils 8x109/l, eosinophils 21x109/l) and a C reactive protein concentration of 162 mg/l were observed. 



### 1 What pattern of neurological disturbance best explains this patient’s difficulty in walking?

#### Short answer

Mononeuritis multiplex is the neurological disturbance that best explains this patient’s problems with walking.

#### Long answer

Mononeuritis …
World Health Organization Targets Insomnia
Authors: Lynne Lamberg
Journal: JAMA (1997)

IN JAPAN, patients rarely say "yes" if a physician asks, "Have you had any difficulty sleeping in the past month?" In the United States, about 30% of the population describes restless nights, while in Brazil, the country with the highest selfreported prevalence, about 40% of the population does so. While cultures vary in their perception and reporting of sleep problems, human physiology presumably is similar worldwide. Respecting cultural differences and reconciling them with objective findings is one of the challenges sleep researchers face as they embark on a worldwide initiative to optimize the management of insomnia. This project is one arm of the Worldwide Project on Sleep and Health (WPSH), a 20-year global mission to improve the treatment of sleep disorders under the aegis of the World Health Organization (WHO) and World Federation of Sleep Research Societies (WFSRS). A forum to launch the insomnia project was held at the joint
LOCAL ANTIBIOTICS IN SKIN INFECTIONS.
Authors: IAN C. LAMONT
Journal: British Journal of Dermatology (1959)

Journal Article LOCAL ANTIBIOTICS IN SKIN INFECTIONS. Get access IAN C. LAMONT, M.B., Ch. B. IAN C. LAMONT, M.B., Ch. B. Late Senior House Officer, Skin Department, Victoria Infirmary, Glasgow Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 71, Issue 6, 1 June 1959, Pages 201–210, https://doi.org/10.1111/j.1365-2133.1959.tb13408.x Published: 01 June 1959
Tracheal Extension in Respiration
Authors: R. S. Harris
Journal: Thorax (1959)

It has long been known that the lower end and bifurcation of the trachea are displaced downwards during inspiration. Macklin (1925) described a vertical respiratory displacement of 21 mm.  a healthy young adult female. Bruckner (1952),  a radiological study, demonstrated an inspiratory descent of the carina of about one thoracic vertebral body  young adults of 19 to 25 years of age. Holden and Ardran (1957),  a meticulous examination of bronchograms from subjects aged 12 to 65 years, concluded that in deep inspiration the trachea increased  length up to one fifth and  diameter by about one tenth. In a personal observation, on inspiration the carina descended 30 mm.  a young adult male with a full inspiratory movement. Thus,  young adults, the carina descends by about 1 in. (2.5 cm.) with deep inspiration, i.e., about 20% of the unextended length of the trachea. There are no references  the literature to similar observations  infants and young children  whom the technical difficulty of securing a full inspiratory and expiratory movement for radiographic investigation is obvious. Also, most observers have examined only the movement of the carina and have not considered changes  the whole length of the trachea. Keith (1909) drew attention to the fact that certain parts of the lung are expanded more readily than others. The bases and sterno-costal surfaces related to the more mobile parts of the thoracic wall expand more readily than the apices, mediastinal surfaces, and posterior margins, related to less mobile parts. These areas he described as areas of direct or of indirect expansion. The thoracic wall does not move uniformly during inspiration; the parts which move most are the diaphragmatic and sterno-costal surfaces. Thus the lung tends to expand  a downward and forward direction. Now the lung root must obviously descend to facilitate this movement. In
Transcriptome Analysis of Foraminiferan Elphidium margaritaceum Questions the Role of Gene Transfer in Kleptoplastidy
Authors: Loïc Pillet, Jan Pawlowski
Journal: Molecular Biology and Evolution (2012)

Foraminifera from the genus Elphidium are heterotrophic protists that graze on diatoms and sequester chloroplasts from their algal preys, while digesting the rest of the diatom cell. During that process, known as kleptoplastidy, the acquired plastids remain active inside the foraminiferan cell for several months. As most of the genes required to sustain the activity of the chloroplasts are encoded in the diatom nucleus, it is unknown how the host cell can maintain the photosynthetic activity without this information. It has been proposed that maintenance of kleptoplastids could be explained by horizontal gene transfer (HGT). To test this hypothesis we obtained 17,125 EST sequences of Elphidium margaritaceum, and we screened this data set for diatom nuclear-encoded proteins having a function in photosynthetic activity or plastid maintenance. Our analyses show no evidence for the presence of such transcriptionally active genes and suggest that HGT hypothesis alone cannot explain the chloroplast's longevity in Elphidium.