tbuckley/cabot-search huggingface dataset:
Independent Associations of Fasting Insulin, Glucose, and Glycated Haemoglobin with Stroke and Coronary Heart Disease in Older Women
Authors: Debbie A Lawlor, Abigail Fraser, Shah Ebrahim, George Davey Smith
Journal: PLoS Medicine (2007)

Background Evidence suggests that variations in fasting glucose and insulin amongst those without frank type 2 diabetes mellitus are important determinants of cardiovascular disease. However, the relative importance of variations in fasting insulin, glucose, and glycated haemoglobin as risk factors for cardiovascular disease in women without diabetes is unclear. Our aim was to determine the independent associations of fasting insulin, glucose, and glycated haemoglobin with coronary heart disease and stroke in older women. Methods and Findings We undertook a prospective cohort study of 3,246 British women aged 60–79 y, all of whom were free of baseline coronary heart disease, stroke, and diabetes, and all of whom had fasting glucose levels below 7 mmol/l. Fasting insulin and homeostasis model assessment for insulin sensitivity (HOMA-S) were linearly associated with a combined outcome of coronary heart disease or stroke (n = 219 events), but there was no association of fasting glucose or glycated haemoglobin with these outcomes. Results were similar for coronary heart disease and stroke as separate outcomes. The age, life-course socioeconomic position, smoking, and physical activity adjusted hazard ratio for a combined outcome of incident coronary heart disease or stroke per one standard deviation of fasting insulin was 1.14 (95% CI 1.02–1.33). Additional adjustment for other components of metabolic syndrome, low-density lipoprotein cholesterol, fasting glucose, and glycated haemoglobin had little effect on this result. Conclusions Our findings suggest that in women in the 60–79 y age range, insulin resistance, rather than insulin secretion or chronic hyperglycaemia, is a more important risk factor for coronary heart disease and stroke. Below currently used thresholds of fasting glucose for defining diabetes, neither fasting glucose nor glycated haemoglobin are associated with cardiovascular disease.
Late results of endoscopic sphincterotomy for bile duct stones in elderly patients with gall bladders in situ.
Authors: C J Ingoldby, J el-Saadi, R I Hall, M E Denyer
Journal: Gut (1989)

Endoscopic sphincterotomy was undertaken in 186 patients with common bile duct stones and an intact gall bladder who were considered unfit for surgery. One hundred and seventy one patients had jaundice of whom 18 also had clinical cholangitis. The mean age of treated patients was 79.7 years (range 27-92) and only 13 were aged less than 60. Sphincterotomy was successful in 185 (99%) and complete clearance achieved in 172 (92.5%). Early complications occurred in nine patients (4.8%) of whom three died (1.6%). The patients have been followed on average for 32 months (range six to 72 months). Eighteen patients have subsequently required cholecystectomy (9.6%), with six major complications, but no deaths. There have been 27 natural deaths and 156 patients remain alive and symptom free. Endoscopic treatment alone is safe and effective in the majority of frail and elderly patients and can reduce the need for surgery in this high risk group.
TV: The execution of Timothy McVeigh: must see TV?
Authors: S. W G Derbyshire
Journal: BMJ (2001)

On 19 April 1995, 7000 lbs of explosives detonated alongside the Alfred P Murrah Federal Office Building in Oklahoma City. Without warning the bomb punched a gaping hole through offices and a daycare centre, killing adults and children; 163 died inside the building, four more died outside, and a final victim was killed entering the scene to help the wounded.

Timothy McVeigh, despite his earplugs, heard the deafening roar of the blast and felt the thump of air lift him an inch off the ground. Falling bricks hit him in the leg and a snapped live wire threatened his life. McVeigh, who lit the fuse creating the bloody, horrifying, hideous scene behind him, did not look back. He first saw the devastation via CNN and was momentarily irritated at the sight of the building still standing.

McVeigh is scheduled to die via lethal injection on Monday 11 June, barring further delay. The large number of survivors and those with deceased relatives who wish to see McVeigh die led attorney general …
The Stool DNA Test Is More Accurate Than the Plasma Septin 9 Test in Detecting Colorectal Neoplasia
Authors: David A. Ahlquist, William R. Taylor, Douglas W. Mahoney, Hongzhi Zou, Michael Domanico, Stephen N. Thibodeau, Lisa A. Boardman, Barry M. Berger, Graham P. Lidgard
Journal: Clinical Gastroenterology and Hepatology (2011)
Cardiac Risk Stratification for High-Risk Vascular Surgery
Authors: Claus Bartels, J. F. Matthias Bechtel, Volker Hossmann, Svante Horsch
Journal: Circulation (1997)

The best strategy for cardiac risk assessment before high-risk vascular surgery remains controversial. A cardiac risk stratification protocol was evaluated in patients undergoing high-risk vascular surgery. Our investigation paralleled the elaboration of the American College of Cardiology/ American Heart Association (ACC/AHA) Guidelines for Perioperative Cardiovascular Evaluation for Noncardiac Surgery and is highly comparable to the proposed guidelines.A cardiac risk stratification protocol was evaluated prospectively in 203 patients scheduled for aortic surgery. Key points of the study were cardiac mortality/morbidity and cost-effectiveness. Patients were stratified into low (n = 101), intermediate (n = 79), and high (n = 23) cardiac risk after clinical predictors. After stratification, the degree of estimated functional capacity assessed by treadmill exercise and daily living activities and expressed by metabolic equivalents (METs) was critical for further cardiac evaluation. In intermediate-risk patients with an estimated functional capacity < 5 METs and in all high-risk patients, noninvasive cardiac testing and/or subsequent medical care were performed. Noninvasive testing was considered necessary in 41 patients, coronary angiography in 7, and myocardial revascularization in 1. Overall hospital mortality was 3.5%. Cardiac mortality and morbidity were 1% and 12.4%, respectively.Cardiac risk stratification for high-risk vascular surgery patients, according to a protocol similar to the ACC/AHA Guidelines for Cardiovascular Evaluation for Noncardiac Surgery, demonstrated excellent clinical outcome. This approach appears to be a safe and economical strategy for preoperative cardiac evaluation.
HAIR LOSS IN WOMEN
Authors: JOANNA ECKERT, R. E. CHURCH, F. J. EBLING, D. S. MUNRO
Journal: British Journal of Dermatology (1967)

We are grateful to Dr. I. B. Sneddon for allowing us to see patients under his care and to Mrs. P. J. Hemsley, S.R.M.L.T. for her invaluable assistance.
Coronary stent thrombosis in the perioperative period
Authors: N. L M Cruden, S. A Harding, D. E Newby
Journal: BMJ (2008)

Suicide risk after a suicide attemptIs highest in people with bipolar disorder and schizophrenia Two linked studies explore the risk of non-fatal self harm after discharge from a psychiatric hospital and the factors associated with the risk of suicide after a suicide attempt. 1 2 Suicide is one of the 10 leading causes of death worldwide and will represent about 2.4% of the global burden of disease by 2020, with about 1.5 million people dying from suicide each year. 3 Making the prevention of suicide a health service and public health priority is justified on medical, ethical, and cost effectiveness grounds. 4 5 Previous attempts at suicide increase the risk of suicide 30-40 times. 6A history of deliberate self harm is the strongest predictor of future suicidal behaviour. 7 A systematic review found that 16% of patients who attended an accident and emergency department as a result of deliberate self harm repeated this behaviour and 1.8% died by suicide. 8 On the basis of a large Swedish cohort study of almost 40 000 people admitted to hospital because of attempted suicide, Tidemalm and colleagues report how many suicides were completed over 30 years. 1 They found that the type of co-occurring psychiatric disorder was an important factor for the overall risk of a completed suicide after an attempted one.The strongest predictors of completed suicide throughout the follow-up period were schizophrenia (men: adjusted hazard ratio 4.1, 95% confidence interval 3.5 to 4.8; women: 3.5, 2.8 to 4.4) and bipolar disorder (men: 3.5, 3.0 to 4.2; women: 2.5, 2.1 to 3.0).The authors also explored the population attributable fractions for suicide.In line with previous evidence, they found that women with depression or bipolar disorder and men with schizophrenia have a significantly increased risk of death by suicide.The risk assessment of suicidal behaviour should not only include psychiatric comorbidity because other factors such as previous self harm are important.The second linked study, by Gunnell and colleagues, assesses the risk of non-fatal self harm in about 75 000 patients for up to one year after their discharge from psychiatric inpatient care. 2 Of the total sample, 6% were admitted to hospital because of self harm within 12 months of discharge.Further evidence of the need for intensive aftercare is that a third of these episodes occurred in the first four weeks after discharge.As expected, admission for self harm to a psychiatric unit during the year before admission was one of the strongest risk factors for self harm after discharge.The risk was higher for women than for men.It was also higher in younger patients and in
Clinical Trials 102: New Strategies in Targeted Therapy Clinical Trials.
Authors: S. Hilsenbeck, M. Piccart
Journal: Cancer Research (2009)

Abstract The practice of clinical oncology is guided by randomized phase III clinical trials that are powered to detect average benefit of a therapeutic intervention when compared to standard treatment in large group of breast cancer patients. Although such “evidence-based” practice has moved clinical oncology from empiricism to scientific rigor, it is difficult for oncologists to apply these standards and predict whether a particular treatment will be effective for an individual patient. Recent advances in molecular profiling have begun to unravel the biological variations that underlie individual susceptibility, disease behavior, and response to therapy. Our improved understanding of the biological basis of breast cancer has coincided with the development of rationally designed “targeted therapies” that modulate specific oncogenic signaling pathways. The clinical development of trastuzumab, a monoclonal antibody against the HER2 receptor, illustrates how a targeted therapy that is associated with a well-defined predictive marker can produce dramatic gains in clinical effectiveness. In contrast, bevacizumab, a monoclonal antibody against the vascular endothelial growth factor, has shown promising activity in advanced breast cancer, although its clinical development has been hindered by the lack of a clear predictive marker that can be used to guide therapy. In the future, the clinical testing of targeted therapies must be linked with biomarker discovery and validation at earlier stages of clinical development so that patients likely to benefit can be identified. In addition, the traditional approach of conducting early development trials in the second-line metastatic setting where relevant tissue for biomarker development is often not available, and where resistance may have developed, also hampers targeted therapy development. Neoadjuvant and "window of opportunity" studies coupled with biopsy of the primary tumor, offer possible solutions, and are being used more oftern. The Breast International Group (BIG) will launch a program of randomized phase II neo-adjuvant clinical trials (NeoBIG) to accelerate drug and biomarker development. These studies will integrate emerging technologies, such as genomics, proteomics, metabolomics, pharmacogenetics and functional imaging, to identify predictive markers of efficacy that can be validated in subsequent adjuvant registration trials. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr ES5-1.
Status of Anesthesiology, 1965
Authors: Kenneth K. Keown
Journal: JAMA (1966)

Anesthesiology is a distinct medical discipline. It has long been classified by the American Medical Association as the practice of medicine. A description of the subject matter and the professional responsibilities of anesthesiology would encompass at least the following: (1) the rendition of a state of insensibility to pain during surgical, obstetrical, and dental intervention, (2) the support of life's function under the stress of anesthesia and surgery, (3) the management of the patient unconscious from whatever cause, (4) the teaching and management of respiratory and cardiac resuscitation, and (5) the supervision of and instruction in inhalation therapy departments. Prior to the inauguration of anesthesia, the omnipresence of pain and discomfort decreased the will of the sufferer to live. Great surgical procedures were planned and carried out on cadavers, but not in the clinics, a fact often overlooked by contemporary surgeons or, perhaps even worse, never realized. Therefore, most of
Aseptic Meningitis Among Members of a High School Football Team
Authors: Roy C. Baron
Journal: JAMA (1982)

During the period Sept 1 through Oct 1, 1978, an outbreak of enteroviral illness affected 43 (70%) of the 61 members of a high school football team. Thirty-three (54%) had symptoms of aseptic meningitis, a diagnosis confirmed for each of seven players hospitalized. Echovirus 16 was recovered from a throat swab of one hospitalized player and from the CSF of another. Enteroviruses isolated from stool specimens taken after the illness from other ill players and from stool specimens of non-ill team members were also identified as echovirus 16. A survey among students not on the team showed an attack rate for enteroviral-like illness that was half that experienced by team members during the same period. Symptoms reported by nonteam members were less severe. Only 10% had an aseptic meningitis-like syndrome, and none were hospitalized. Membership on the school football team was associated with an increased attack rate of illness and a greater risk for aseptic meningitis developing.
The cJun N-terminal kinase (JNK) signaling pathway mediates induction of urokinase-type plasminogen activator (uPA) by the alkylating agent MNNG
Authors: Maribel Parra, Frederic Lluı́s, Francesc Miralles, Carme Caelles, Pura Muñoz-Cánoves
Journal: Blood (2000)
Do-Not-Resuscitate Orders in the Operating Room
Authors: C B Cohen, P J Cohen
Journal: New England Journal of Medicine (1991)

Do-not-resuscitate (DNR) orders have been implemented in every setting in the hospital during the past two decades. Because of ethical concern about the inappropriate application of cardiopulmonary resuscitation (CPR),1 , 2 their use has spread from the wards to the intensive care unit and thence to the entire hospital. DNR policies, required of all hospitals seeking accreditation from the Joint Commission on Accreditation of Healthcare Organizations,3 are usually presumed to apply to every treatment setting. The Patient Self-Determination Act of 19904 provides that any patient who enters an institution receiving Medicare or Medicaid funds must be advised of his or her right . . .
Health Bills Pending in Congress
Authors: Franz Goldmann
Journal: New England Journal of Medicine (1946)

JULIAN HUXLEY once wrote, "To speculate without facts is to attempt to enter a house of which one has not the key." The desire to avoid speculation and obtain factual information on pending health legislation seems to be strong, judging from the fact that some of the bills are on the best-seller list of the Superintendent of Documents in Washington.Important organizations, representing large groups of the population, have officially endorsed the major legislative proposals now in Congress. Many people from all walks of life favor government action in the whole field of health service, on the ground that protection . . .
Rosai-Dorfman disease of the lung
Authors: A Ali, D Mackay
Journal: Thorax (2009)

Rosai-Dorfman disease is a rare disorder which seems to involve not only the lymph nodes but most other organs of the body. The case history is presented of a woman who was thought to have atypical carcinoma of the lung but in whom a diagnosis of Rosai-Dorfman disease was eventually made following a range of investigations including CT scans, positron emission tomography (PET) and histological analysis of open lung biopsy specimens. She remains well with no further progression of the disease without treatment. Rosai-Dorfman disease can mimic lung carcinoma and shows increased activity on PET scanning, so histological confirmation should be sought in all cases.
Helicopter vs Ground Transportation for Patients With Trauma
Authors: Brian P. Walcott, Brian V. Nahed, Jean-Valery Coumans
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
Medical Treatment of Benign Gastrocolic Fistula
Authors: Erik P. Thyssen
Journal: Annals of Internal Medicine (1993)

Benign gastrocolic fistula has been reported in patients taking anti-inflammatory drugs and has been traditionally managed with surgery. We describe two patients taking nonsteroidal anti-inflammatory medications who were found to have a benign gastrocolic fistula. Because of the relatively mild symptoms, a trial of medical therapy was initiated with documented successful closure of the fistula. These findings show that some patients with benign gastrocolic fistula can be managed medically.
Cross-reactivity Between Blo t 13 Allergen and Homologues From the Mite D. farinae (Der f 13) and Human FABPs
Authors: L. Puerta, D. Mercado, S.L. Chan, S. Jimenez, A. Labrada, J.F. Glatz, F.T. Chew, L. Caraballo
Journal: Journal of Allergy and Clinical Immunology (2009)
Complement activation during OKT3 treatment: A possible explanation for respiratory side effects
Authors: Maarten H.M. Raasveld, Frederike J. Bemelman, Peter Th A. Schellekens, Frank N.J. van Diepen, Annemarie van Dongen, Eric A. van Royen, C. Erik Hack, Ineke J.M. ten Berge
Journal: Kidney International (1993)
Parental Exposure to Pesticides and Childhood Brain Cancer: U.S. Atlantic Coast Childhood Brain Cancer Study
Authors: Youn K. Shim, Steven P. Mlynarek, Edwin van Wijngaarden
Journal: Environmental Health Perspectives (2009)

BackgroundThe etiology of childhood brain cancer remains largely unknown. However, previous studies have yielded suggestive associations with parental pesticide use.ObjectivesWe aimed to evaluate parental exposure to pesticides at home and on the job in relation to the occurrence of brain cancer in children.MethodsWe included 526 one-to-one–matched case–control pairs. Brain cancer cases were diagnosed at &lt; 10 years of age, and were identified from statewide cancer registries of four U.S. Atlantic Coast states. We selected controls by random digit dialing. We conducted computer-assisted telephone interviews with mothers. Using information on residential pesticide use and jobs held by fathers during the 2-year period before the child’s birth, we assessed potential exposure to insecticides, herbicides, and fungicides. For each job, two raters independently classified the probability and intensity of exposure; 421 pairs were available for final analysis. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression, after adjustment for maternal education.ResultsA significant risk of astrocytoma was associated with exposures to herbicides from residential use (OR = 1.9; 95% CI, 1.2–3.0). Combining parental exposures to herbicides from both residential and occupational sources, the elevated risk remained significant (OR = 1.8; 95% CI, 1.1–3.1). We observed little association with primitive neuroectodermal tumors (PNET) for any of the pesticide classes or exposure sources considered.ConclusionsOur observation is consistent with a previous literature reporting suggestive associations between parental exposure to pesticides and risk of astrocytoma in offspring but not PNET. However, these findings should be viewed in light of limitations in exposure assessment and effective sample size.
OVERDRAFT OF VITAL OR NERVE POWER AS AFFECTING GENERAL AND SPECIAL HEALTH.
Authors: JACOB L. WILLIAMS
Journal: JAMA (1885)

Read in Section of Oral and Dental Surgery of American Medical Association, May, 1884. The relation of reserve strength or nerve power to the general health, and to the harmonious working of all the functions and faculties, every practitioner has constant occasion to observe. To him it is a great source of reliance for continued health, and for permanent remedy of abnormal conditions of organs. The abnormal conditions of different parts of the body have given rise to the various specialties in practice, all, when properly considered, having their relations to the general controlling laws and forces of the system. The question may be asked whether, in some departments of special practice, these general laws may not sometimes be too little thought of in all-absorbing attention to local disease? The relations referred to, it may be proper for the various specialties to elaborate and demonstrate each for itself. My present