tbuckley/cabot-search huggingface dataset:
The Risk of Long-term Morbidity and Mortality in Patients With Chronic Hepatitis C
Authors: Jeffrey McCombs, Tara Matsuda, Ivy Tonnu-Mihara, Sammy Saab, Patricia Hines, Gilbert L’Italien, Timothy Juday, Yong Yuan
Journal: JAMA Internal Medicine (2013)

The impact of viral load suppression, genotype, race, and other factors on the risk of late-stage liver-related events in patients with hepatitis C (HCV) has been assessed previously using data from small observational cohorts or clinical trials. Data from large real-world practice samples are needed to improve risk factor estimates for late-stage liver events and death in HCV.To describe the natural history of HCV in real-world clinical practice.Observational cohort study. Patients with a detectable viral load (>25 IU/mL) and a recorded baseline genotype were selected from the Veterans Affairs (VA) HCV clinical registry (CCR), which compiles electronic medical records data from 1999 to present.Risk factors included genotype, race, age, sex, and time to achieving an observed undetected viral load.The primary outcomes were time to death and time to a composite of liver-related clinical events. Secondary outcomes included the components of the composite clinical outcome. Outcomes were measured using a time-to-event format and were analyzed using Cox proportional hazards models. RESULTS A total of 28,769 of 360,857 unique HCV CCR patients met all study criteria. Only 24.3% of patients received treatment, and 16.4% of treated patients (4.0% of all patients) achieved an undetectable viral load. The unadjusted death rates were 6.8 (95% CI, 6.0-7.7) per 1000 person-years for patients who achieved viral load suppression vs 21.8 (95% CI, 21.5-22.2) deaths per 1000 person-years in patients who did not achieve this goal. Cox model results found that achieving viral suppression reduced risk of the composite clinical end point by 27% (hazard ratio [HR], 0.73 [95% CI, 0.66-0.82]) and the risk of death by 45% (HR, 0.55 [95% CI, 0.47-0.64]). Genotype 2 patients were at significantly lower risk, and genotype 3 patients were at higher risk for all study outcomes relative to genotype 1. Black patients were at lower risk for all liver events than white patients.Achieving an undetectable viral load was associated with decreased hepatic morbidity and mortality. It remains to be determined whether newer treatment regimens can offer higher response rates with fewer adverse effects in real-world settings.
Acute and Reversible Cardiomyopathy Provoked by Stress in Women From the United States
Authors: Scott W. Sharkey, John R. Lesser, Andrey G. Zenovich, Martin S. Maron, Jana Lindberg, Terrence F. Longe, Barry J. Maron
Journal: Circulation (2005)

Background— A clinical entity characterized by acute but rapidly reversible left ventricular (LV) systolic dysfunction and triggered by psychological stress is emerging, with reports largely confined to Japan. Methods and Results— Over a 32-month period, 22 consecutive patients with this novel cardiomyopathy were prospectively identified within a community-based practice in the Minneapolis–St. Paul, Minn, area. All patients were women aged 32 to 89 years old (mean 65±13 years); 21 (96%) were ≥50 years of age. The syndrome is characterized by (1) acute substernal chest pain with ST-segment elevation and/or T-wave inversion; (2) absence of significant coronary arterial narrowing by angiography; (3) systolic dysfunction (ejection fraction 29±9%), with abnormal wall motion of the mid and distal LV, ie, “apical ballooning”; and (4) profound psychological stress (eg, death of relatives, domestic abuse, arguments, catastrophic medical diagnoses, devastating financial or gambling losses) immediately preceding and triggering the cardiac events. A significant proportion of patients (37%) had hemodynamic compromise and required vasopressor agents and intra-aortic balloon counterpulsation. Each patient survived with normalized ejection fraction (63±6%; P &lt;0.001) and rapid restoration to previous functional cardiovascular status within 6±3 days. In 95%, MRI identified diffusely distributed segmental wall-motion abnormalities that encompassed LV myocardium in multiple coronary arterial vascular territories. Conclusions— A reversible cardiomyopathy triggered by psychologically stressful events occurs in older women and may mimic evolving acute myocardial infarction or coronary syndrome. This condition is characterized by a distinctive form of systolic dysfunction that predominantly affects the distal LV chamber and a favorable outcome with appropriate medical therapy.
Serum Lipid Levels in Normal Persons
Authors: LENA A. LEWIS, FREDERICK OLMSTED, IRVINE H. PAGE, ELEANOR Y. LAWRY, GEORGE V. MANN, FREDRICK J. STARE, MARTIN HANIG, MAX A. LAUFFER, TAVIA GORDON, FELIX E. MOORE
Journal: Circulation (1957)

Measurements of S f 12-20, S f 20-100, and total serum cholesterol made on 10,690 men and 3,404 women are reported and the relation of lipid level to race, source, age, sex, blood pressure, and weight is described. Distributions for men 40 to 59 are reported in detail. The groups studied, while not selected as representative of the population at large, were remarkably similar in their lipid levels. The lipid levels of only 2 of the 33 groups—Los Angeles and the prisoners—differed significantly from the average. No convincing explanation for either of these exceptions was discovered. The data in this study were mainly from a white population. Data for nonwhites came primarily from 2 aberrant groups and were too meager to allow a clear characterization of lipid levels. The levels for nonwhites from these 2 sources were closer to those of the white members of these groups than to the levels of the general population. Cholesterol levels for men and women were found to be about the same at age 20. For both sexes the level rises with age but at first the rise is much greater for men than women. Above age 50, however, the level is higher for women than men and the level for women continues to rise after that age—at least within the age series for this study. The level for men reaches a peak at age 55, after which it declines. The relation of age and sex with lipid level for S f 12-20 and S f 20-100 appeared to be similar to that for cholesterol. Correlations of lipid levels with blood pressure and weight were positive but very low. Hypertension or obesity, however, is associated with some elevation of lipid levels. S f 20-100 was found to be the most sensitive of the 3 lipid measures to sex and race differences. In the age group 40 to 59 it was the only one that exhibited a definite race and sex differential. In addition, it had the highest correlation with weight and with blood pressure.
A prospective study of protein excretion using short-interval timed urine collections in patients with lupus nephritis
Authors: Derek M. Fine, Martina Ziegenbein, Michelle Petri, Ernest C. Han, Alison M. McKinley, Jerry W. Chellini, Haikady N. Nagaraja, Kathryn A. Carson, Brad H. Rovin
Journal: Kidney International (2009)
Flail Chest and Multiple Myeloma
Authors: Ali Mansouri
Journal: JAMA (1980)

To the Editor.—  Multiple myeloma is a common disease that universally involves the skeletal system. Although rib lesions are common, flail chest resulting from multiple rib fractures or disarticulation is extremely rare. The occurrence of such a complication in a patient with multiple myeloma prompted this report and a review of the literature of the past 20 years.  Report of a Case.—  A 54-year-old man was admitted to the hospital because of low back pain of four months' duration. Diagnosis of multiple myeloma was established on the basis of multiple lytic bone lesions and bone marrow plasmacytosis (80% of the nucleated cells) associated with hypercalcemia. He was transferred to Little Rock Veterans Administration Medical Center for treatment.  On arrival he had dyspnea secondary to flail chest resulting from spontaneous disarticulation of several ribs from the sternum. The rest of the findings from the physical examination were within the normal range.
Postherpetic Neuralgia After Herpes Zoster Vaccination—Reply
Authors: Jie Zhang, Elizabeth Delzell, Jeffrey R. Curtis
Journal: JAMA (2012)

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
Analysis of Occlusive Disease of the Carotid Artery and the Stroke Syndrome
Authors: E. S. Gurdjian
Journal: JAMA (1961)

The association of cervical carotid artery disease and the stroke syndrome was studied in 300 patients with carotid stenosis and occlusion. In 157 patients there was unilateral or bilateral stenosis; in 143 there was complete occlusion of one or both internal carotids near the bifurcation. Endarterectomy or exploration to establish flow was accomplished in 37 of the 157 cases of stenosis. In cases of complete occlusion, a portion of the artery was excised and cervical sympathectomy performed. Although 41% of the 720 patients with cerebrovascular disease had stenotic or occlusive disease of the carotid with vertebral-basilar systems, procedures to establish better blood flow were undertaken in only 5%. In the majority of cases the multiplicity of abnormalities made it seem inadvisable to attempt surgical correction.
Government reverses policy on public health campaigns after numbers seeking advice fall sharply
Authors: Z. Kmietowicz
Journal: BMJ (2011)

The government has backtracked on its policy to slash spending on campaigns to encourage people to quit smoking and take up healthy living advice after finding that the cuts have led to a substantial drop in the number of people stopping smoking and signing up to a better lifestyle.

Health secretary Andrew Lansley announced last year that spending on non-essential marketing and all social marketing programmes would cease. Findings on the impact of the move, however, have forced the government to rethink.

A new strategy for Public Health England—the body which will be set up within the Department of …
Measles and rubella immunisation: information and consent in children
Authors: G. Rylance, C. Bowen, J. Rylance
Journal: BMJ (1995)

As Alderson found for surgical procedures,2 most children aged [11][12][13][14][15] believed they had sufficient maturity and understanding to make decisions about immunisation.The finding of increasing "decision making" age with increasing chronological age also supports her findings in a different area of consent.The starting point, or change in slope direction, of this relation to age has not been defined.Although the Department of Health has recognised that children can give or withhold consent, information for health professionals'4 seems to have been directed towards parents as sole decision makers.Less than 1% of the children considered the information leaflet, which included the parent consent form,' to be directed at children.Questionnaire responses*.Values are numbers (percentages) ofchildren unless stated otherwise Boys Girls Boys and girls aged Age 11 Age 12 Age 13 Age 14 Age 15 Age 11-15 Age 11 Age 12 Age 13 Age 14 Age 15 Age 11-15 11-15 QuestionnaireChild believed that he or she had enough maturity and understanding to decide 30 (68) 44 (76) 55 (89) 35 (85) 20 (91) 184 (81) 39 (67) 63 (85) 47 (96) 58 (95) 44 (100) 251 (88) 435 (85) Child believed his or her parents thought that he or she had enough maturity and understanding 26 (59) 41 (71) 49 (79) 33 (80) 19 (86) 168 (74) 33 (57) 49 (66) 44 (90) 52 (85) 35 (80) 213 (74) 381 (74)
Endoscopy in general practice
Authors: R. Jones
Journal: BMJ (1995)

those who have some experience of developing schemes.Furthermore, it would signal potential topics for systematic reviews by the NHS Reviews and Dissemination Centre.Additionally, the register would be a resource for health service researchers wishing to study specific innovations in cooperation with purchasers and providers and for potential funders of such research.As far as possible, multicentre trials of innovations should be promoted to deternine whether innovations are generalisable and, if they are not, in which circumstances they are most appropriate.Entry to the register could be by notification to the regional research and development directorate, which could also try to ensure that funds were made available to evaluate innovations consuming substantial NHS resources.This should act as an incentive for notification.Innovations have the potential for both good and harm.They entail the expenditure of scarce resources that could be used in other ways.A strong case therefore exists for avoiding premature dissemination, improving coordination, and ensuring that effort is focused where it is most likely to benefit the NHS.This could be achieved by a mechanism such as that of the current Standing Group on Health Technology, which takes stock of existing, proposed, and possible future inno- vations and advises on where development and research efforts might best be concentrated.Such a mechanism should not stifle innovation but channel it to maximise the experience of those who innovate.It could promote the dissemination of successful examples to the rest of the NHS without delay."2Doctors are under increasing pressure to take account of evidence of clinical effectiveness when treating patients.Similarly, managers should seek out and heed information about the cost effective organisation ofhealth care.
Effect of nebulised salbutamol on maximal exercise performance in men with mild asthma.
Authors: W Freeman, G E Packe, R M Cayton
Journal: Thorax (1989)

The effect of 5 mg nebulised salbutamol on the cardiorespiratory responses to a progressive maximal exercise test was investigated in eight asthmatic (mean forced expiratory volume in one second (FEV1) 3.48 (1.0) litres) and eight non-asthmatic men. Exercise tests were performed on a bicycle ergometer after administration of nebulised salbutamol or matched saline placebo. In the asthmatic subjects salbutamol increased the resting FEV1 by 11%. The mean (SD) percentage fall in FEV1 after exercise did not change significantly (salbutamol 9.4 (12.8); placebo 15.0 (8.0], but because the FEV1 before exercise was increased the lowest FEV1 after exercise was also significantly higher after salbutamol than placebo (3.60 (1.13) v 2.85 (0.80) litres). Despite the improvement in FEV1 before exercise there was no significant difference in maximal workload, oxygen uptake, heart rate, or ventilation during exercise after salbutamol compared with placebo in the asthmatic patients. Tidal volume was higher at maximal exercise after salbutamol but there was no change in perception of breathlessness or exertion in the asthmatic subjects. During submaximal progressive exercise the perceived rate of exertion was reduced in the asthmatic patients and oxygen pulse was reduced in both groups owing to a small and non-significant increase in heart rate. The FEV1 and cardiorespiratory response to the progressive maximal exercise test in the non-asthmatic subjects were otherwise unchanged after salbutamol. The results suggest that 5 mg nebulised salbutamol has little effect on the cardiorespiratory responses to progressive maximal exercise in patients with mild asthma and in non-asthmatic subjects. Salbutamol in this dose may reduce the severity of exercise induced asthma, but no ergogenic effect on maximal exercise performance was shown.
Evidence-Based Risk Communication
Authors: Daniella A. Zipkin, Craig A. Umscheid, Nancy L. Keating, Elizabeth Allen, KoKo Aung, Rebecca Beyth, Scott Kaatz, Devin M. Mann, Jeremy B. Sussman, Deborah Korenstein, Connie Schardt, Avishek Nagi, Richard Sloane, David A. Feldstein
Journal: Annals of Internal Medicine (2014)

Effective communication of risks and benefits to patients is critical for shared decision making.To review the comparative effectiveness of methods of communicating probabilistic information to patients that maximize their cognitive and behavioral outcomes.PubMed (1966 to March 2014) and CINAHL, EMBASE, and the Cochrane Central Register of Controlled Trials (1966 to December 2011) using several keywords and structured terms.Prospective or cross-sectional studies that recruited patients or healthy volunteers and compared any method of communicating probabilistic information with another method.Two independent reviewers extracted study characteristics and assessed risk of bias.Eighty-four articles, representing 91 unique studies, evaluated various methods of numerical and visual risk display across several risk scenarios and with diverse outcome measures. Studies showed that visual aids (icon arrays and bar graphs) improved patients' understanding and satisfaction. Presentations including absolute risk reductions were better than those including relative risk reductions for maximizing accuracy and seemed less likely than presentations with relative risk reductions to influence decisions to accept therapy. The presentation of numbers needed to treat reduced understanding. Comparative effects of presentations of frequencies (such as 1 in 5) versus event rates (percentages, such as 20%) were inconclusive.Most studies were small and highly variable in terms of setting, context, and methods of administering interventions.Visual aids and absolute risk formats can improve patients' understanding of probabilistic information, whereas numbers needed to treat can lessen their understanding. Due to study heterogeneity, the superiority of any single method for conveying probabilistic information is not established, but there are several good options to help clinicians communicate with patients.None.
An Evolutionary Perspective on Single-Nucleotide Polymorphism Screening in Molecular Cancer Epidemiology
Authors: Yong Zhu, Margaret R. Spitz, Christopher I. Amos, Jie Lin, Matthew B. Schabath, Xifeng Wu
Journal: Cancer Research (2004)

Abstract Given that there are millions of single-nucleotide polymorphisms (SNPs) in the entire human genome, a major difficulty faced by scientists in planning costly population-based genotyping is to choose target SNPs that are most likely to affect phenotypic functions and ultimately contribute to disease development. Although it is widely accepted that sequences with important functionality tend to be less variable across species because of selective pressure, to what extent evolutionary conservation is mirrored by epidemiological outcome has never been demonstrated. In this study, we surveyed odds ratios detected for 46 SNPs in 39 different cancer-related genes from 166 molecular epidemiological studies. The conservation levels of amino acid that these SNPs affected were calculated as a tolerance index by comparing sequences from different species. Our results provide evidence of a significant relationship between the detected odds ratios associated with cancer risk and the conservation levels of the SNP-affected amino acids (P = 0.002; R2 = 0.06). Tolerance indices were further calculated for 355 nonsynonymous SNPs identified in 90 human DNA repair genes, of which 103 caused amino acid changes in very conserved positions. Our findings support the concept that SNPs altering the conserved amino acids are more likely to be associated with cancer susceptibility. Using such a molecular evolutionary approach may hold great promise for prioritizing SNPs to be genotyped in future molecular epidemiological studies.
Mitochondrial nitric oxide synthase drives redox signals for proliferation and quiescence in rat liver development
Authors: María C. Carreras, Daniela P. Converso, Alicia S. Lorenti, Mariana Barbich, Damián M. Levisman, Ariel Jaitovich, Valeria G. Antico Arciuch, Soledad Galli, Juan J. Poderoso
Journal: Hepatology (2004)

Mitochondrial nitric oxide synthase (mtNOS) is a fine regulator of oxygen uptake and reactive oxygen species that eventually modulates the activity of regulatory proteins and cell cycle progression. From this perspective, we examined liver mtNOS modulation and mitochondrial redox changes in developing rats from embryonic days 17-19 and postnatal day 2 (proliferating hepatocyte phenotype) through postnatal days 15-90 (quiescent phenotype). mtNOS expression and activity were almost undetectable in fetal liver, and progressively increased after birth by tenfold up to adult stage. NO-dependent mitochondrial hydrogen peroxide (H 2 O 2 ) production and Mn-superoxide dismutase followed the developmental modulation of mtNOS and contributed to parallel variations of cytosolic H 2 O 2 concentration ([H 2 O 2 ] ss ) and cell fluorescence. mtNOS-dependent [H 2 O 2 ] ss was a good predictor of extracellular signal-regulated kinase (ERK)/p38 activity ratio, cyclin D1, and tissue proliferation. At low 10 −11 -10 −12 M [H 2 O 2 ] ss , proliferating phenotypes had high cyclin D1 and phospho-ERK1/2 and low phospho-p38 mitogen-activated protein kinase, while at 10 −9 M [H 2 O 2 ] ss , quiescent phenotypes had the opposite pattern. Accordingly, leading postnatal day 2-isolated hepatocytes to embryo or adult redox conditions with H 2 O 2 or NO-H 2 O 2 scavengers, or with ERK inhibitor U0126, p38 inhibitor SB202190 or p38 activator anisomycin resulted in correlative changes of ERK/p38 activity ratio, cyclin D1 expression, and [ 3 H] thymidine incorporation in the cells. Accordingly, p38 inhibitor SB202190 or N-acetyl-cysteine prevented H 2 O 2 inhibitory effects on proliferation. In conclusion , the results suggest that a synchronized increase of mtNOS and derived H 2 O 2 operate on hepatocyte signaling pathways to support the liver developmental transition from proliferation to quiescence. (Hepatology 2004;40:157-166.)
THE TITRATION OF YELLOW FEVER VIRUS IN STEGOMYIA MOSQUITOES
Authors: Nelson C. Davis, Martin Frobisher, Wray Lloyd
Journal: The Journal of Experimental Medicine (1933)

Titrations were made of yellow fever virus in stegomyia mosquitoes, using rhesus monkeys as test animals. It was found that: (a) The average mosquito immediately after engorging on highly infectious blood contained between 1 and 2 million lethal doses of virus. The titer of freshly ingested blood was as high as 1 billion lethal doses of virus per cubic centimeter. (b) During the fortnight succeeding a meal on infectious blood there occurred a reduction of titratable virus to not more than 1 per cent of that present in the freshly fed insects. (c) The titer was somewhat higher at later periods. This rise in titer signified possibly not a multiplication, but merely an increase of extracellular virus and of that easily freed by grinding to a titratable form. (d) At no later stage did the quantity of titratable virus equal that demonstrable in freshly fed insects.