tbuckley/cabot-search huggingface dataset:
Barium examination of the small intestine.
Authors: D J Nolan
Journal: Gut (1981)

Progress reportBarium examination of the small intestine Radiological studies showing the small intestine were first performed at the beginning of this century.In 1901 Cannon observed radiographically the stomach and small intestine of animals after they had ingested food mixed with bismuth subnitrate.' Rieder2 observed the small intestine in human subjects when he performed his bismuth meal examination.The small intestine was also visualised radiographically by Hulst using bismuth sub- nitrate.3Little attention was given to the radiological investigation of the small intestine with contrast medium until papers by Morse and Cole in 19274 and Pesquera in 1929.5 Since then barium studies have become well- established in the diagnosis of diseases of the small intestine.This report is a review of the different techniques available for examining the small intestine with barium-their development, advantages, and shortcomings. Indirect techniques FOLLOW-THROUGH OF ORAL BARIUMThe anatomy of the small intestine as shown on the barium follow-through was described by Cole and his colleagues.46A moderately thick paste using 227 ml (8 oz) barium mixed with 142 ml (5 oz) water was given.This consistency of contrast medium was chosen so that it would pass out of the stomach at a fairly rapid and uniform rate and be of sufficient consistency to pass evenly, and preferably very slowly, through the small intestine.Large films were taken, mostly in the prone position, one half hour after the upper gastrointestinal tract examination and then at two, four, and six hours.The time interval was varied according to the rate of gastric emptying.The importance of carrying out a special study of the jejunum and ileum with barium was emphasised in 1936 by Golden7 and also by Pendergrass and his colleagues.8Golden perfected the barium follow-through technique.He pointed out that the small intestine could be the source of the trouble in patients with diarrhoea and deserved a radiological study if the large intestine were found to be normal.'At that time he recommended that 57 ml (2 oz) of barium sulphate mixed with water should be given on an empty stomach first thing in the morning.With the patient prone, films were taken at half-hourly intervals, sometimes quarter-hourly, until barium reached the ascending colon or until adequate information concerning the small intestine was obtained.Films were taken routinely after five, six, nine, and 24 hours.Fluoroscopic observations of the intestinal movements, mobility and ten- derness, were made two or three times during the examination.He noted that the opaque material began to pass through the ileocaecal valve one-and- a-half to four hours after ingestion in normal individuals.In later years he recommended a large amount of barium, (113 g; 4 oz) pure barium sulphate suspended in 114 or 142 ml (4 or 5 oz) of normal saline solution or the equivalent quantity of a non-flocculating barium suspended in 682 on July 14,
The lungs in lymphangiomyomatosis and in tuberous sclerosis.
Authors: P G Stovin, L C Lum, C D Flower, C S Darke, M Beeley
Journal: Thorax (1975)

Two cases of pulmonary lymphangiomyomatosis (PL) are described and 33 other cases from the literature are reviewed. These are compared with one case of tuberous sclerosis with pulmonary involvement (PTS) and 32 other cases from the literature. There are no differences in lung function between these two conditions, both of which show airways obstruction associated with diffuse radiological lung changes. There are, however, both clinical and radiological differences and also differences in the distribution of the lesions and the histological location of the excessive smooth muscle; these indicate that PL and PTS are probably different entities and not polar forms of one condition. Finally, the strictly female incidence of PL suggests a sex-linked disorder, and it is postulated that this may be related to congenital pulmonary lymphangiectases.
Financial Barriers to Health Care and Outcomes After Acute Myocardial Infarction
Authors: Ali R. Rahimi, John A. Spertus, Kimberly J. Reid, Susannah M. Bernheim, Harlan M. Krumholz
Journal: JAMA (2007)

The prevalence and consequences of financial barriers to health care services and medications are not well documented for patients with an acute myocardial infarction (AMI).To measure the baseline prevalence of self-reported financial barriers to health care services or medication (as defined by avoidance due to cost) among individuals following AMI and their association with subsequent health care outcomes.The Prospective Registry Evaluating Myocardial Infarction: Event and Recovery (PREMIER), an observational, multicenter US study of patients with AMI over 12 months in 2498 individuals enrolled from January 2003 through June 2004.Health status symptoms (Seattle Angina Questionnaire [SAQ]), overall health status function (Short Form-12), and rehospitalization.The prevalence of self-reported financial barriers to health care services or medication was 18.1% and 12.9%, respectively. Among individuals who reported financial barriers to health care services or medication, 68.9% and 68.5%, respectively, were insured. At 1-year follow-up, individuals with financial barriers to health care services were more likely to have lower SAQ quality-of-life score (77.9 vs 86.2; adjusted mean difference= -4.0; 95% confidence interval [CI], -6.3 to -1.8), and increased rates of all-cause rehospitalization (49.3% vs 38.1%; adjusted hazard ratio [HR], 1.3; 95% CI, 1.1-1.5) and cardiac rehospitalization (25.7% vs 17.7%; adjusted HR, 1.3; 95% CI, 1.0-1.6). At 1-year follow-up, individuals with financial barriers to medication were more likely to have angina (34.9% vs 17.9%; adjusted odds ratio, 1.55; 95% CI, 1.1-2.2), lower SAQ quality-of-life score (74.0 vs 86.1; adjusted mean difference = -7.6; 95% CI, -10.2 to -4.9), and increased rates of all-cause rehospitalization (57.0% vs 37.8%; risk-adjusted HR, 1.5; 95% CI, 1.2-1.8) and cardiac rehospitalization (33.7% vs 17.3%; adjusted HR, 1.7; 95% CI, 1.3-2.2).Financial barriers to health care services and medications are associated with worse recovery after AMI, manifested as more angina, poorer quality of life, and higher risk of rehospitalization.
Blood-Based Biomarkers in Alzheimer Disease: Where Are We Now and Where Have We to Go?
Authors: Christoph Laske
Journal: JAMA Neurology (2013)

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 Neurology HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Neurology journal
The use of self-expanding metal stents to treat acute esophageal variceal bleeding
Authors: R. Hubmann, G. Bodlaj, M. Czompo, L. Benkö, P. Pichler, S. Al-Kathib, P. Kiblböck, A. Shamyieh, G. Biesenbach
Journal: Endoscopy (2006)

Background and study aims: Acute variceal bleeding is a life-threatening complication of liver cirrhosis. Essential factors for survival after variceal bleeding are the rapidity and efficacy of initial primary hemostasis. Endoscopic and vasoactive therapy is the gold standard in the management of acute variceal hemorrhage. The primary aim of this study was to evaluate the use of self-expandable metallic stents to arrest uncontrollable acute variceal bleeding. Patients and methods: Between November 2002 and May 2005, esophageal stents were implanted in 20 patients (18 men, two women; mean age 52, range 27 - 87) with massive ongoing bleeding from esophageal varices, as an alternative treatment to balloon tamponade. The patients had not been successfully managed with prior pharmacologic or endoscopic therapy. They had had one to five previous bleeding episodes (mean 2.4). Eight of the patients were in Child-Pugh grade B and 12 in grade C. A new type of stent with special introducers was developed that allowed placement without radiographic assistance. Results: The stents were successfully placed in all of the patients and were left in place for 2 - 14 days. Bleeding from the esophageal varices ceased immediately after implantation of the stent in all cases. While the stent was in place, further diagnostic steps were carried out to optimize management of the patients' illness and portal hypertension. No recurrent bleeding, morbidity, or mortality occurred during treatment with the esophageal stent. All of the stents were extracted without any complications after definitive treatment had been started. Conclusions: In this pilot study, the new method of implantation of an esophageal stent was found to be a safe and effective treatment for massive bleeding from esophageal varices in patients with liver cirrhosis. These initial clinical results will of course have to be confirmed in comparative studies including a large number of patients.
Arthroscopy for degenerate meniscal tears of the knee
Authors: A. Price, D. Beard
Journal: BMJ (2014)

New evidence argues against meniscectomy for all patients with non-traumatic tears and medial joint pain 

The NHS performs around 150 000 arthroscopic knee operations a year, with more than half involving resection of the meniscus. Therefore, close scrutiny of this intervention in the United Kingdom is entirely appropriate, particularly in the context of the ongoing drive towards providing evidence based and value based care.

Considering such high rates of surgery, it would be natural to assume that this operation is backed up by adequate evidence. However, unlike knee replacement surgery, which is supported by population based patient reported outcomes (PROMs) data and the National Joint Registry, healthcare commissioners lack the necessary data to allow informed decision making for knee arthroscopy. Detailed indications for its use need further refinement. With this backdrop, any results from high quality randomised controlled trials in this area are welcome.

The recent study by Sihvonen and colleagues therefore makes interesting reading.1 In 2005, when the trial was started, investigators were worried about the increasing numbers of arthroscopic meniscectomies performed for patients with degenerative meniscal tears. At this time it was common …
New Approaches for Inflammatory Bowel Disease
Authors: Erich F. Schinagl
Journal: JAMA (1990)

To the Editor. —  I read with great interest Paul Cotton's report from the recent Digestive Disease Week meetings entitled New Approaches May Aid Patients With Inflammatory Bowel Disease, in Medical News & Perspectives.  The statements in Mr Cotton's third paragraph, unfortunately, are not completely correct. He writes: Current treatments for ulcerative colitis and Crohn's disease are as unsatisfactory as these two somewhat similar diseases are unpredictable. Sulfasalazine cannot be tolerated by one third of patients, and neither it nor steroids are proven to maintain remission.  Although this statement is true as far as steroids are concerned, Azulfidine (sulfasalazine) has long been established as the only drug effective in maintaining ulcerative colitis in remission (Misiewicz et al, 1965 2 ; Dissanayake and Truelove, 1973 3 ; Azad Khan et al, 1973 4 ). Based on these studies, the Food and Drug Administration has approved Azulfidine for the prolongation of the remission period between
Infection of Pulmonary Artery Catheters in Critically III Patients
Authors: Luc Michel
Journal: JAMA (1981)

Bacteriologic cultures were performed on the tips of pulmonary artery catheters removed from 153 critically ill patients, who had required pulmonary artery catheterization for management of hypovolemic or septicemic shock or for hemodynamic monitoring during mechanical ventilation with positive end-expiratory pressure. Positive results were obtained in 29 (19%) of the cases. Infection of indwelling pulmonary artery catheters may result from contamination during placement or removal or from transient or persistent bacteremia. Colonization was probable in 17 cases, and contamination in 12. There were no instances of sepsis definitely attributable to the catheter. Positive catheter-tip culture was associated significantly with known presence of a focus of infection before catheter insertion and with periods exceeding four days that the catheter remained in place. (<i>JAMA</i>1981;245:1032-1036)
Obituary for David Horrobin: Summary of rapid responses
Authors: S. Davies
Journal: BMJ (2003)

The response to David Horrobin's obituary is unprecedented for an obituary and among the biggest for any article.1 At the time of going to press (8 May) we had posted 108 responses, 59 of them within a week of publication in the paper journal. We posted responses on every day but two from the 18 April, when the obituary became available on bmj.com. By comparison, …
A comparison of quantitative echocardiographic methods for delineating infarct-induced abnormal wall motion.
Authors: L D Gillam, R D Hogan, R A Foale, T D Franklin, J B Newell, D E Guyer, A E Weyman
Journal: Circulation (1984)

Current echocardiographic methods for quantitating abnormal regional left ventricular wall motion rely primarily on changes in endocardial excusion from end-diastole to end-systole. Recent studies demonstrating important spatial and temporal heterogeneity in wall motion within ischemic regions, however, raise questions about the validity of this approach. To determine the optimal method for defining abnormal left ventricular wall motion, we used a canine preparation of acute experimental infarction to examine four quantitative methods of wall motion analysis. The circumferential extent of abnormal wall motion assessed by each method was compared with the circumferential extent of infarction (defined by triphenyltetrazolium chloride staining) and the circumferential extent of reduced transmural blood flow (determined by radiolabeled microsphere techniques) 6 hr after acute coronary occlusion. The following methods of quantitating abnormal wall motion were examined: (1) determination of end-diastolic to end-systolic endocardial excursion (less than 0.20 end-diastolic radius), (2) determination of the extent of maximal dyskinesis (systolic bulging), and (3) and (4) two derived correlation methods that consider the entire course of systolic radial motion by correlating the observed echocardiographic field-by-field (every 16.7 msec) motion of each of 36 evenly spaced endocardial targets with the course of normal motion established from pooled normal data. Results obtained with the correlation methods showed a better correlation with the triphenyltetrazolium chloride-defined circumferential extent of infarction (r = .87 and r = .78) than did determinations of reduced end-diastolic to end-systolic endocardial excursion (r = .35) or the extent of maximal dyskinesis (r = .37). Similarly, the best correlation with the extent of reduced flow was obtained with one of the correlation methods (r = .80). We conclude that correlation methods that "integrate" endocardial motion over the entire systolic contraction sequence provide better definition of ischemic left ventricular dysfunction than do methods that consider motion at only single points in time.
CLINICAL AND ELECTROENCEPHALOGRAPHIC OBSERVATIONS CONCERNING THE EFFECT OF TRIDIONE IN EPILEPTIC PATIENTS
Authors: EUGENE DAVIDOFF
Journal: American Journal of Psychiatry (1948)

1. Clinical results. Tridione was administered to 75 patients suffering from epilepsy. Clinically, tridione appears to be most effective in cases of epilepsy with spastic cerebral palsies of the milder type; 65% of this group were improved. This is particularly true in children with mild attacks or with mild organic impairment whose seizures are less severe and in whom the manifestations observed are of more recent origin. Sixty percent of the patients who had petit mal seizures were improved. Tnidione was of value in one-half of the patients who experienced psychomotor attacks. Only 30% of the patients with grand mal seizures improved. Tridione appears to be of no value in the myoclonias observed at Craig Colony. 2. EEG. observations. Thirty-eight or 51% of the patients manifested EEG. improvement. Beneficial effect on the EEG. record and clinical reduction of seizures were not always concomitant. In 17 patients in whom clinical improvement was not present, the EEG. record showed improvement, and 15 cases who showed clinical improvement showed no change in the EEG. Clinically the spastic type responded best; 65% of these cases were improved. The petit mals showed 60% improvement. Electroencephalographically, the petit mal type responded best; 67% of the petit mal cases showed improvement on the EEG. tracing, whereas only 52% of the spastic group showed diminution of abnormal waves. In the psychomotor group 50% were improved clinically and 58% showed EEG. improvement. Patients manifesting the higher amplitude, slower waves, responded best. The so-called psychomotor waves were eliminated fairly frequently. Diminution in amplitude of waves was frequently present. 3. Toxic manifestations. Toxic reactions occurred in inverse proportion to clinical improvement. Untoward effects were observed most often in the myoclonic type, grand mal, and psychomotor group. Toxic reactions were observed least in the spastic group (9%) and in the petit mal type (13%). In younger individuals only 15% showed toxic effects, while in the older group 25% experienced unfavorable reactions. However, the toxic effects did not influence EEG. improvement as adversely as they did the clinical picture.
Are we drinking our neurones away?
Authors: C Harper, J Kril, J Daly
Journal: BMJ (1987)

A quantitative neuropathological necropsy study of the human cerebral cortex showed that the number of cortical neurones in the superior frontal cortex in chronic alcoholic patients is significantly reduced compared with that in controls matched for age and sex. The number of neurones in the motor cortex did not differ significantly between the controls and alcoholics, but in both cortical regions there was evidence that alcoholic patients had smaller (shrunken) neurones than controls. Further studies are necessary to identify other regions of the cerebral cortex that are selectively damaged in brain damage associated with alcohol.
Albendazole in hydatid disease.
Authors: D L Morris, P W Dykes, B Dickson, S E Marriner, J A Bogan, F G Burrows
Journal: BMJ (1983)

<h3>ABSTRACT</h3> Despite advancement in treatment, prostate cancer (PCa) remains the second leading cause of death among men. Neuroendocrine prostate cancer (NEPC) represents one of the most lethal forms of PCa and lacks life-prolonging treatment. Here we identified histone lysine demethylase KDM4A as a drive in NEPC progression and an effective therapeutic target. We found that KDM4A mRNA and protein are overexpressed in human and mouse NEPC compared to adenocarcinoma. Also, we showed that knockdown or knockout of KDM4A in NEPC cell lines suppressed cancer cell growth <i>in vitro</i> and <i>in vivo</i>. Importantly, inactivation of <i>Kdm4a</i> in a genetically engineered mouse model of prostate cancer led to reduced tumor burden, reduced incidence of NEPC, and prolonged overall survival. Mechanistically, we found that <i>KDM4A</i> KD led to suppression of MYC signaling through direct transcriptional regulation of <i>MYC</i>. Importantly, MYC signaling is hyper-activated in human and mouse NEPC. Furthermore, a potent pan-KDM4 inhibitor QC6352 significantly reduced NEPC cell growth <i>in vitro</i> and <i>in vivo</i>. Taken together, we demonstrated that KDM4A drives NEPC progression through regulation of MYC and targeting KDM4A can potentially be an effective therapeutic strategy for NEPC.
Improving Subject Recruitment By Maintaining Truly Informed Consent: A Practical Benefit of Disclosing Adverse Clinical Trial Results
Authors: Kavita R. Shah, Frances R. Batzer
Journal: The American Journal of Bioethics (2009)

While Liao and colleagues (2009) make the strong and appropriate argument that the moral duty to disclose all adverse clinical trial results to participants in clinical trials supercedes the commer...
US paediatricians call for checks for childhood obesity
Authors: S. Gottlieb
Journal: BMJ (2003)

The American Academy of Pediatrics has called on its members to make obesity screening and counselling a routine part of children's check ups, like testing reflexes or administering immunisations.

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Boy at fat people's festival, USA

Credit: SIPA/REX

The report offers paediatricians procedures to identify patients and intervene before their weight problems start, rather than waiting until children are too heavy. …

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Independent effects of intestinal parasite infection and domestic allergen exposure on risk of wheeze in Ethiopia: a nested case-control study
Authors: Sarah Scrivener, Haile Yemaneberhan, Mehila Zebenigus, Daniel Tilahun, Samuel Girma, Seid Ali, Paul McElroy, Adnan Custovic, Ashley Woodcock, David Pritchard, Andrea Venn, John Britton
Journal: The Lancet (2001)
Endoscopic Resection of Submucosal Tumor of the Esophagus: Results in 62 Patients
Authors: J. H. Hyun, Y. T. Jeen, H. J. Chun, H. S. Lee, S. W. Lee, C. W. Song, J. H. Choi, S. H. Um, C. D. Kim, H. S. Ryu
Journal: Endoscopy (1997)

See also: Endoscopic Resection of Large Polypoid Leiomyoma: Case StudyEndoscopy 1998; 30(08): 740-740DOI: 10.1055/s-2007-1001401
Intervention Costs and Cost-Effectiveness of a Successful Telephonic Intervention to Promote Diabetes Control
Authors: Clyde B. Schechter, Hillel W. Cohen, Celia Shmukler, Elizabeth A. Walker
Journal: Diabetes Care (2012)

OBJECTIVE To characterize the costs and cost-effectiveness of a telephonic behavioral intervention to promote glycemic control in the Improving Diabetes Outcomes study. RESEARCH DESIGN AND METHODS Using the provider perspective and a time horizon to the end of the 1-year intervention, we calculate the costs of a telephonic intervention by health educators compared with an active control (print) intervention to improve glycemic control in adults with type 2 diabetes. We calculate the cost-effectiveness ratios for a reduction of one percentage point in hemoglobin A1c (A1C), as well as for one participant to achieve an A1C &amp;lt;7%. Base-case and sensitivity analysis results are presented. RESULTS The intervention cost $176.61 per person randomized to the telephone group to achieve a mean 0.36 percentage point of A1C improvement. The incremental cost-effectiveness ratio was $490.58 per incremental percentage point of A1C improvement and $2,617.35 per person over a 1-year intervention in achieving the A1C goal. In probabilistic sensitivity analysis, the median (interquartile range) of per capita cost, cost per percentage point reduction in A1C, and cost per person achieving the A1C goal of &amp;lt;7% are $175.82 (147.32–203.56), $487.75 (356.50–718.32), and $2,312.88 (1,785.58–3,220.78), respectively. CONCLUSIONS The costs of a telephonic intervention for diabetes self-management support are moderate and commensurate to the modest associated improvement in glycemic control.