tbuckley/cabot-search huggingface dataset:
Emergency room liability
Authors: A. R. Holder
Journal: JAMA (1972)

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
Psychological factors in breast cancer.
Authors: S Lovestone, T Fahy
Journal: BMJ (1991)

Psychological factors in breast cancerTwo way traffic between the mind and the body Conservative surgery for early breast cancer is now common- place,' a development that at least partly reflects greater appreciation of the psychological sequelae of radical treat- ment.Patients receiving cytotoxic drugs, especially those receiving combination treatments, also constitute a group at high risk of psychological symptoms.2It is now clear, however, that significant psychiatric morbidity is not confined to subgroups of patients who experience unpleasant side effects of treatment or those with advanced disease.A recent study found that one in four women had significant psychological symptoms 12 months after mastectomy, the com- monest complaints being depression, anxiety, and sexual dysfunction.3Increased risk is associated with poor marital relationships, unsupportive social networks, recent adverse life events, and previous psychiatric illness.4
Triglyceride Synthesis and Hepatitis C Virus Production: Identification of a Novel Host Factor as Antiviral Target Δσ
Authors: Catherine Schuster, Mathieu Lefèvre, Thomas F. Baumert
Journal: Hepatology (2011)

Hepatitis C virus (HCV) infection is closely tied to the lipid metabolism of liver cells. Here we identify the triglyceride-synthesizing enzyme diacylglycerol acyltransferase-1 (DGAT1) as a key host factor for HCV infection. DGAT1 interacts with the viral nucleocapsid core and is required for the trafficking of core to lipid droplets. Inhibition of DGAT1 activity or RNAi-mediated knockdown of DGAT1 severely impairs infectious virion production, implicating DGAT1 as a new target for antiviral therapy.
Alcohol and drug misuse is taking a "daily toll" on US adolescents
Authors: D. Spurgeon
Journal: BMJ (2010)

The effects of the insulin-releasing sulfonylurea tolbutamide on the cytoplasmic Ca2+ concentration [( Ca2+]i) in individual pancreatic beta-cells or suspensions of beta-cells were analyzed using the probe fura-2 and dual-wavelength fluorometry. Subsequent additions of 1, 10, and 100 microM tolbutamide induced a graded response, ranging from a single [Ca2+]i peak to a sustained increase. These effects depended on the presence of extracellular Ca2+ and were reversed by the hyperglycemic sulfonamide diazoxide. The responses were diminished in the presence of albumin and varied considerably between different cells. Sometimes tolbutamide triggered slow large amplitude oscillations in [Ca2+]i similar to those induced by glucose. The increase in [Ca2+]i during each tolbutamide-induced oscillation was often more rapid than for glucose-induced oscillations. Oscillations or steady state increases in [Ca2+]i induced by glucose were little influenced by tolbutamide. However, subthreshold concentrations of glucose could reactivate [Ca2+]i response to tolbutamide that had declined. Although in several ways the abilities of glucose and tolbutamide to raise [Ca2+]i were similar, the sulfonylurea lacked a [Ca2+]i-lowering component. The latter effect of glucose was so pronounced that an increase of its concentration from 3 to 20 mM caused temporary lowering of [Ca2+]i to the basal level, even during tolbutamide stimulation. The results indicate that closure of the ATP-sensitive K(+)-channels is important for the large amplitude oscillations of [Ca2+]i the appearance of which reflects the balance between entry of Ca2+ through the voltage-dependent channels and its removal from the cytoplasm.
Crossover study of glyceryl trinitrate patches for controlling pain in women with severe dysmenorrhoea
Authors: R Pittrof, C Lees, C Thompson, A Pickles, J F Martin, S Campbell
Journal: BMJ (1996)

Primary dysmenorrhoea affects up to half of postpubescent women and is one of the commonest gynaecological complaints. Combined oral contraceptives and non-steroidal anti-inflammatory drugs are often used to treat dysmenorrhoea but are not effective in 10-20% of patients1 and are contraindicated or unsuitable for many others. There is a need for a simple and safe new treatment for this condition.

The pain of dysmenorrhoea is associated with increased intrauterine resting pressures and peak pressures,2 and effective treatment is associated with uterine relaxation.3 Glyceryl trinitrate seems to relax uterine contractions in preterm labour,4 and we investigated whether it could be used to treat dysmenorrhoea.

We enrolled 14 women in a randomised, double blind, placebo controlled, two period crossover trial for two successive menstrual cycles. All had persistent and regular severe dysmenorrhoea which …
Should Rates of Cataract Surgery Vary by Insurance Status?
Authors: Stephen A. Obstbaum
Journal: JAMA (1997)

In this issue of<i>JAMA</i>, Dr Goldzweig and colleagues<sup>1</sup>report their findings on the rates of cataract surgery in 2 prepaid settings and in a fee-for-service setting, all in Southern California. The results of this retrospective analysis of encounter and claims data, of a beneficiary population aged 65 years and older, indicate that cataract surgery is performed at lower rates in the 2 prepaid settings compared with the fee-for-service model. Since cataract surgery is performed on about 1.4 million patients each year and is the greatest single Medicare expenditure annually, an analysis of its frequency in various settings is fitting.<sup>2</sup>(An overview of the natural history, risk factors, signs and symptoms, indications for surgery, techniques of cataract surgery, complications, and postoperative care was recently published in Clinical Crossroads.<sup>3</sup>) The study by Goldzweig et al<sup>1</sup>raises the issue of whether the lower rate of cataract surgery in
Efficacy and safety of a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with its components given alone: results of a phase 3, open-label, randomised, 26-week, treat-to-target trial in insulin-naive patients with type 2 diabetes
Authors: Stephen C L Gough, Bruce Bode, Vincent Woo, Helena W Rodbard, Sultan Linjawi, Pernille Poulsen, Lars H Damgaard, John B Buse
Journal: The Lancet Diabetes & Endocrinology (2014)
Ants distinguish diabetes mellitus from diabetes insipidus.
Authors: H C Trowell
Journal: BMJ (1982)

hospital sectors" should also be adopted.For, while no one should denigrate the British achievement in supporting people in their own homes, there can be no argument but that this virtue is abused when prolonged into necessity and where alternative (residential) care becomes desirable but is not available.Part III homes already accommodate many disabled and potentially disturbed residents.Given more staff, including more appropriately trained staff, it is likely that these local care centres would cater for all but a very few very difficult long-term patients/residents and facilitate family support of frail old people still in private households.The role of sheltered housing as a caring rather than a housing resource seems to us unproved,3 and money spent in this sector is less likely to influence the lives of the very impaired elderly that give rise to the greatest concern.
Glomerular Filtration Rate and Renal Plasma Flow in Long-term Juvenile Diabetics without Proteinuria
Authors: C. E. Mogensen
Journal: BMJ (1972)

Glomerular filtration rate and renal plasma flow were examined in 16 young male non-proteinuric diabetics (mean age 28.4 years) with a duration of diabetes of over 15 years (mean duration 21.5 years.) In this selected group of long-term diabetics the glomerular filtration rate was clearly increased, the mean being 136 ml/min (+/-S.D. 11.8) (normal value 114 ml/min (+/-14.1), being comparable to that found earlier in short-term diabetics. There was no change in renal plasma flow. It is concluded that kidney function is generally well preserved in long-term diabetics who have not developed proteinuria.
Cancer epidemiology in Japan.
Authors: T Hirayama
Journal: Environmental Health Perspectives (1979)

Patterns, change in occurrence, causative risk factors, and control strategy for cancer of each site in Japanese populations were studied by applying standard methods and techniques of biostatistics and epidemiology. As the results, cancers in Japan were classified into two groups: one on the decrease (stomach, cervix) and the other on the increase (lung, colon, pancreas, breast, prostate, urinary organs, leukemia). Analysis of vital statistics, national nutrition survey data, and on-going prospective study data revealed change in selective dietary intake and increase in cigarette consumption are the major factors responsible for such trend. Epidemiological characteristics and major risk factors of cancers of stomach, colon, pancreas, lung, breast, uterine cervix, ovary, endometrium, prostate, urinary bladder, and leukemia in Japan were summarized. A limited effect of mass screening was observed in the case of stomach cancer in addition to the strong effect of diet and nutrition. Cigarette smoking was confirmed to be the major causative factor of lung cancer in Japan. A close association of increased intake of animal fat and breast cancer risk in Japanese women was also observed.
Tamoxifen (Antiestrogen) Therapy in Advanced Breast Cancer
Authors: DAVID T. KIANG
Journal: Annals of Internal Medicine (1977)

Fifty-nine postmenopausal women with advanced breast cancer were treated with tamoxifen (antiestrogen), 20 mg orally twice a day for at least 2 months. They had been previously treated with other types of hormonal therapy or intensive chemotherapies, or both. Nineteen of the 59 patients (32%) had either a complete response (seven patients) or partial response (12 patients). The median duration of response was 9 + months. Tumors containing estrogen receptors and those that responded to previous hormonal manipulation tended to respond to tamoxifen (60% and 69%, respectively). Patients with receptor-negative tumor or with a history of failure of previous hormonal treatments did not respond to tamoxifen therapy. Tamoxifen is effective against advanced breast cancer. Side effects of the treatment were mild.
Functional Expression of the Angiotensin II Type1 Receptor in Human Ovarian Carcinoma Cells and Its Blockade Therapy Resulting in Suppression of Tumor Invasion, Angiogenesis, and Peritoneal Dissemination
Authors: Takayasu Suganuma, Kazuhiko Ino, Kiyosumi Shibata, Hiroaki Kajiyama, Tetsuro Nagasaka, Shigehiko Mizutani, Fumitaka Kikkawa
Journal: Clinical Cancer Research (2005)

Abstract Purpose: Angiotensin II is a bioactive peptide of the renin-angiotensin system, acting not only as a vasoconstrictor but also as a growth promoter via angiotensin II type 1 receptors (AT1R). The present study examined AT1R expression in human ovarian carcinoma and attempted to determine whether AT1R blocker could suppress the tumor progression. Experimental Design: Expression of AT1R, vascular endothelial growth factor (VEGF), and CD34 was immunohistochemically analyzed in ovarian tumor tissues (n = 99). Effects of AT1R blocker on invasive potential and VEGF secretion in ovarian cancer cells were examined in vitro. Effects of AT1R blocker in vivo were evaluated in a mouse model of peritoneal carcinomatosis. Results: AT1R was expressed in 57 of 67 (85%) invasive ovarian adenocarcinomas and 12 of 18 (66%) borderline malignant tumors but in only 2 of 14 (14%) benign cystadenomas. In invasive carcinomas, VEGF expression intensity and intratumor microvessel density were significantly higher in cases that were strongly positive for AT1R (n = 37) compared with those in cases weakly positive (n = 20) or negative (n = 10) for AT1R. Angiotensin II significantly enhanced the invasive potential and VEGF secretion in AT1R-positive SKOV-3 ovarian cancer cells, both of which were completely inhibited by the AT1R blocker candesartan. Administration of candesartan into SKOV-3-transplanted athymic mice resulted in the reduction of peritoneal dissemination, decreased ascitic VEGF concentration, and suppression of tumor angiogenesis. Conclusions: AT1R is functionally expressed in ovarian carcinoma and involved in tumor progression and angiogenesis. AT1R blockade therapy may become a novel and promising strategy for ovarian cancer treatment.
Predictors of in-hospital outcome in octognenarians with acute myocardial infarction undergoing primary coronary angioplasty
Authors: Kenji Ando, Yoshihisa Nakagawa, Koyu Sakai, Shinichi Shirai, Kei Nishiyama, Satoshi Shizuta, Kazuaki Kaitani, Masashi Iwabuchi, Hiroyoshi Yokoi, Naoya Hamasaki, Takeshi Kimura, Kataumi Inoue, Hideyuki Nosaka, Masakiyo Nobuyoshi
Journal: Journal of the American College of Cardiology (2002)
Quantitative effect of early coronary artery reperfusion in baboons. Extent of salvage of the perfusion bed of an occluded artery.
Authors: G G Geary, G T Smith, J J McNamara
Journal: Circulation (1982)

We examined the extent to which ischemic myocardium was salvaged by reperfusion using a method that allowed expression of the volume of infarction as a percentage of the volume of the perfusion bed of the occluded artery (region at risk of infarction). In eight baboons, the left anterior descending coronary artery (LAD) was occluded for 2 hours, after which perfusion was restored. A control group of eight baboons underwent an identical protocol, but perfusion was not restored. Twenty-four hours after occlusion, microvascular dyes were injected into the LAD and adjacent arteries to delineate the perfusion bed of the occluded artery. The volume of infarction and volume of the perfusion bed were determined planimetrically. The mean percentage of the perfusion bed infarcted in the control baboons was 94.2 +/- 3.5% and 50.1 +/- 5.8% in the reperfused baboons. Hence, the mean percentage of the perfusion bed infarcted was reduced by 44.1% in the reperfused group compared with the control group (p less than 0.001). In reperfused baboons, hemorrhage occurred in the region of infarction but did not result in infarct extension. We conclude that reperfusion after 2 hours of coronary occlusion results in substantial salvage of ischemic myocardium in the baboon.
P63 Variability in GP Referral Rates For Chest X-Ray Does Not Appear to Affect Stage or Performance Status of Patients Diagnosed with Lung Cancer
Authors: L Cheyne, R Milton, J Fear, MEJ Callister
Journal: Thorax (2012)

<h3>Background</h3> Delays in referral of symptomatic patients for chest X-ray (CXR) has been proposed as one explanation for poorer survival from lung cancer in UK compared to other developed nations. Such delays may reflect patients not seeking medical advice for persistent respiratory symptoms, or not being referred for CXR following presentation to primary care. We sought to determine the relationship between GP CXR referral rates and patient characteristics at the time of lung cancer diagnosis. <h3>Methods</h3> Data was collected for the number of CXRs ordered by GP practises in Leeds between 2008 and 2010 (corrected for list size). Patient characteristics at presentation with lung cancer (stage and performance status), treatment and outcome (one year survival) were compared over the same three year period. GP practises were grouped into quintiles by CXR referral rate (according to population served), and lung cancer outcomes compared between quintiles. <h3>Results</h3> CXR referral rates varied from 6.7 to 62.3 CXRs per 1,000 population per year. Data was collected for 1,394 patients diagnosed with lung cancer. The number of lung cancer diagnoses per CXR quintile were 230, 276, 258, 322, 308 from lowest to highest CXR quintile respectively. The proportion of patients with early stage disease at presentation (stage I and II) did not vary by CXR quintile (29.6%, 26.1%, 28.7%, 26.7%, 25.6% from lowest to highest CXR rates). Similarly there were no differences in the distribution of performance status, the proportion of patients undergoing any anti-cancer treatment and one year survival between the quintile groups. When the cohort was split into 2 groups by CXR rates, no differences in lung cancer outcomes were seen between GP practises (number of lung cancers 660 for low CXR group vs. 734 for high CXR group). <h3>Conclusion</h3> Despite demonstrating large variability in CXR rates, our small single-centre study does not show a link between referral rates and lung cancer outcomes. This study is underpowered to detect small changes in survival or stage shift, but suggests large differences in outcome are unlikely to result from this variability in practise at primary care level.
Benign sixth-nerve palsy in children.
Authors: B. Ashworth
Journal: BMJ (1968)

the investigation of suspected myclomatosis.His formal intelligence, as assessed by medical testing, was diminished.He failed the Babcock sentence seven times and could only repeat five numbers forwards and four backwards after several attempts.On the other hand, he had a ready wit and a sharp repartee.His affect was normal.No local abnormalities of the nervous system were detected.There was a vague history of taking quinalbarbitone, amnylobarbitone, or carbromal, and also Serensil (ethchlorvynol).After admission he was given no drugs.Three days later he had his first convulsion without premonition.A tonic phase during which he was cyanosed lasted a few minutes.There was faecal, but not urinary, incontinence.After the fit he was confused and disorientated in time and space, with immediate preictal amnesia.Later the same day he had a second fit and was subsequently given phenobarbitone.Postictal examination of the central nervous system showed hypertonicity and hyperreflexia.The gait was ataxic.No focal abnormalities were found.For four days after the convulsions there was marked mood change and confusion, his affect swinging between ebullience and aggression.He swore at the nurses and tried to strike them and had visual and auditory hallucin- ations.Eleven days after the fits, on discharge, his mood was normal.Tests following the con- vulsions-serology of the blood and C.S.F., esti- mation of the blood bromide, skull' x-rays, E.E.G., echogram, and gamma scan-showed no significant abnormality.
Is the Coast Clear for Stent Angioplasty of Coarctation?
Authors: Sachin Khambadkone
Journal: Circulation (2015)

2][3][4] After successful surgical repair reported by Craafoord and Nylin, 5 the concept of angioplasty in the coronary arteries reported by Gruntzig et al 6 opened up a new strategy of treatment of native and recoarctation.
Evaluation of Ventricular Function by Radioisotopic Technics
Authors: Bertram Pitt, H. William Strauss
Journal: New England Journal of Medicine (1977)

Radioisotopes are finding increasing use in the evaluation of both right and left ventricular function.1 Two approaches have emerged that show promise for clinical application. Measurements of ventricular function, including ventricular ejection fraction and the rates of ventricular emptying and filling, can be performed by monitoring of the initial passage of radioactive tracer through the heart ("first pass technic") and, after the tracer has reached equilibrium in the vasculature, by physiologic triggering of the scintillation camera ("gated cardiac blood-pool technic").1 , 2 To measure ventricular function by the "first-pass technic," any radiopharmaceutical that does not diffuse out of the vascular space into . . .
Radionuclide Detection of Abnormal Ventricular Filling Patterns in Rejecting Human Allografts
Authors: JAMES L. TATUM, JAMES A. THOMPSON, UMA PRASAD, TIMOTHY S. BURKE, ROGER I. QUINT
Journal: Clinical Nuclear Medicine (1989)

Parameters of systolic and diastolic function obtained from radionuclide ventriculography (RNV) were evaluated in nine cardiac allograft recipients. In 25 examinations, left end-diastolic volume (LEDV), cardiac output (CO), left ejection fraction (LEF), right ejection fraction (REF), heart rate (HR), peak filling rate (PFR), time to peak filling rate (TPFR), peak ejection rate (PER), and average filling rate for the first half of diastole (DFRH) were determined. Endomyocardial biopsy was obtained within 48 hours. Biopsies were divided into three treatment classes (0 = normal; 1 = rejection but not requiring supplemental therapy; and 2 = rejection requiring supplemental immunotherapy). Two independent variables of diastolic function proved to be significant (DFRH P less than 0.00001, and PFR P less than 0.002) predictors of the dependent variable class when regression analysis was applied to the data. Alterations in diastolic function associated with acute rejection are detectable on RNV and simulate changes anticipated in a primary restrictive cardiomyopathy.
Mouth occlusion pressure, CO2 response and hypercapnia in severe chronic obstructive pulmonary disease
Authors: M Montes de Oca, BR Celli
Journal: European Respiratory Journal (1998)

The resting mouth occlusion pressure 0.1 s after onset of inspiration (P0.1) and minute ventilation (V'E) and their response to CO2 in patients with chronic obstructive pulmonary disease (COPD) remain controversial. The ventilatory drive and the factors that predict resting arterial CO2 tension (Pa,CO2) were studied in 19 eucapnic and 14 hypercapnic severe COPD patients, and 20 controls. The CO2 response was evaluated by the Read technique. The V'E, and P0.1 as a function of end-tidal CO2 tension (Pet,CO2) was used to study the ventilatory (deltaV'E/deltaPet,CO2) and P0.1 response (deltaP0.1/deltaPet,CO2). In the patients, respiratory muscle function and pleural occlusion pressure 0.1 s after onset of inspiration (Ppl,0.1) were evaluated with simultaneous measurement of pleural (Ppl) and gastric (Pga) pressures. Hypercapnic patients had lower forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and arterial O2 tension (Pa,O2). Resting P0.1 was higher in patients than in controls, whereas deltaP0.1/deltaPet,CO2 was similar in the three groups. There was no difference in resting P0.1 (3.6+/-2.0 versus 4.3+/-2.8 kPa (2.7+/-1.5 versus 3.2+/-2.1 cmH2O), p=0.2) and Ppl,0.1 (1.4+/-2.3 versus 5.2+/-3.3 kPa (4.08+/-1.7 versus 3.9+/-2.5 cmH2O), p=0.22) between eucapnic and hypercapnic COPD, whereas deltaV'E/deltaPet,CO2 was lower in the hypercapnic group (0.29+/-0.24 versus 0.66+/-0.5 L x min(-1) x kPa, p&lt;0.001). By logistic regression only FEVI and increased diaphragmatic load, and not respiratory drive, predicted resting Pa,CO2. Irrespective of CO2 level, baseline central drive (represented by the mouth occlusion and pleural pressures) and CO2 response are preserved in most patients with severe chronic obstructive pulmonary disease. Effective ventilation is inadequate in the more severely obstructed patients and this results in hypercapnia. Neuroventilatory coupling failure is an attractive explanation for chronic hypercapnia in these patients.