tbuckley/cabot-search huggingface dataset:
Diagnostic Tests for Renal Artery Stenosis in Patients Suspected of Having Renovascular Hypertension
Authors: G. Boudewijn C. Vasbinder, Patricia J. Nelemans, Alfons G.H. Kessels, Abraham A. Kroon, Peter W. de Leeuw, Jos M.A. van Engelshoven
Journal: Annals of Internal Medicine (2001)

Purpose: To summarize and compare the validity of computed tomography angiography, magnetic resonance angiography, ultrasonography, captopril renal scintigraphy, and the captopril test for diagnosis of renal artery stenosis in patients suspected of having renovascular hypertension. Data Sources: For each diagnostic modality, published studies were identified by MEDLINE literature searches. Study Selection: Original studies were selected if they met the following criteria: 1) suspicion of renovascular hypertension was the indication for the test; 2) intra-arterial x-ray angiography was used as the gold standard; 3) a cutoff point for a positive test result was explicitly defined; and 4) absolute numbers of true-positive, false-negative, true-negative, and false-positive results were available or could be derived from the presented data. Data Extraction: A standard form was used to extract relevant data. Data Synthesis: Data on the accuracy of the different diagnostic methods were analyzed and compared by constructing summary receiver-operating characteristic (ROC) curves and by computing areas under the summary ROC curves. Results: Although accuracy varied greatly for all diagnostic modalities, summary ROC curves found that computed tomography angiography and gadolinium-enhanced, three-dimensional magnetic resonance angiography performed significantly better than the other diagnostic tests. Conclusions: Computed tomography angiography and gadolinium-enhanced three-dimensional magnetic resonance angiography seem to be preferred in patients referred for evaluation of renovascular hypertension. However, because few studies of these tests have been published, further research is recommended.
Population-based incidence of basal cell carcinoma in a Spanish Mediterranean area
Authors: I. Bielsa, X. Soria, M. Esteve, C. Ferrándiz
Journal: British Journal of Dermatology (2009)

Background Considering the latitude of Spain, the reported age-adjusted incidence rates of basal cell carcinoma (BCC) in this country, similar to those of Northern Europe, are lower than expected. Objectives To estimate the actual incidence of BCC in a Mediterranean population from the eastern coast of Spain. Methods A registry of BCC cases newly diagnosed between 16 January 2006 and 16 January 2007 was established for the population of residents in the Barcelonès Nord county (369 622 inhabitants). All dermatologists of this area agreed to register their patients. All tumours were registered as 'definite' or 'probable' BCC cases according the existence or not of a proven microscopic diagnosis. If a patient had more than one tumour at different sites, each was counted and registered separately. Sex-specific, age-specific and age-standardized incidence rates were calculated by direct standardization to the World and European Standard Population. Results Among the 936 cases registered, 81·2% were classified as 'definite' BCC and 18·8% as 'probable' BCC. The overall crude incidence rate was 253·2 per 100 000 person-years, and was 128 per 100 000 person-years and 195·5 per 100 000 person-years after standardizing for the World and European population, respectively. After the age of 65 years, the BCC age-adjusted incidence rates showed a significantly higher increase in men than in women (P = 0·01). Conclusions The incidence rates found in our study are higher than those previously reported in Spain. Age-adjusted incidence rates revealed that BCC increases with age in both sexes, this increase being particularly evident in men older than 65 years.
Antimalarial drugs and malignancy: no evidence of a protective effect in rheumatoid arthritis
Authors: S Bernatsky, A Clarke, S Suissa
Journal: Annals of the Rheumatic Diseases (2008)

Antimalarial agents, particularly hydroxychloroquine, are frequently used drugs in rheumatology, particularly in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). A growing awareness of increased malignancies in these autoimmune rheumatic conditions has raised suspicions that drugs may alter cancer risk in such patients. In vitro, antimalarial agents have been invoked as potentially increasing1 or decreasing2 neoplastic processes in breast cancer cells. It has also been suggested that these drugs may decrease the in vitro activity of lymphocytic leukaemia cells.3 However, there exists no definitive literature to show any explicit effect of antimalarial agents on cancer risk in clinical populations.

We have examined malignancy risk after antimalarial drug exposures, using a case–control design nested within a population-based …
The environment of medical practice
Authors: John H. Talbott
Journal: JAMA (1963)

The physician lives in a medical environment that is far more complex than he might at first imagine. Medicine includes a great deal more than the direct contact between doctor and patient. There are accessory contacts and relationships that go far afield, and yet are of extreme importance. The physician, as soon as he enters practice, also enters a broad web of socioeconomic relationships that may be quite bewildering. The present volume, which is a composite work, orients the reader towards the many organizations and agencies and the various professional, social, economic, and political groupings that are important in medical practice. All but 2 of the 13 co-authors are physicians who have achieved prominence in organized medicine. The two laymen are an economist and an insurance executive. The contents are for the most part expository and factual. Dr. R. B. Robins, who is the editor, contributes an analysis of the
Colchicine-Quinine Therapy for Acute Falciparum Malaria Acquired in Vietnam
Authors: Richard C. Reba
Journal: JAMA (1967)

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
Seminal Discharge Dependent on Irritation of the Rectum
Authors: J. W. Keyworth
Journal: BMJ (1857)

I need scarcely say that these remarks were only intended to apply to Dr. Snow's theory of the first origin of cholera at West Ham.The after-spread of the disease among the cottagers is another matter.Mlutatis mutandis, it is the case over again of the mildew in the sealed glass, which, although not to be traced back to its progenitor, is itself infull Jruit, and bears, in this mode of providing its heirs by the law of specific propagation, present witness of its own manner of descent.
Atrial Fibrillation Produced by Atrial Stimulation
Authors: JACOB I. HAFT, SUN H. LAU, EMANUEL STEIN, BERNARD D. KOSOWSKY, ANTHONY N. DAMATO
Journal: Circulation (1968)

Twenty-six episodes of atrial fibrillation and flutter-fibrillation, each lasting less than 23 sec, were recorded in three normal subjects during atrial pacing studies. The cause of these atrial arrhythmias was determined to be the result of stimulation within the atrial vulnerable period.
1088-120 Left ventricle systolic dysfunction, total mortality, and sudden death in patients with myocardial infarction treated with N-3 polyunsaturated fatty acids
Authors: Alejandro Macchia, Aldo Pietro Maggioni, Maria Grazia Franzosi, Luigi Tavazzi, Gianni Tognoni, Franco Valagussa, Roberto Marchioli
Journal: Journal of the American College of Cardiology (2004)
Acknowledging the diversity of aesthetic experiences: Effects of style, meaning, and context
Authors: Helmut Leder
Journal: Behavioral and Brain Sciences (2013)

Abstract Art can be experienced in numerous ways, ranging from sensory pleasure to elaborated ways of finding meaning (Leder et al. 2004). However, rather ignored by Bullot &amp; Reber (B&amp;R), in empirical aesthetics several lines of research have studied how knowledge of artistic style, descriptive and elaborate information, expertise, and context all affect aesthetic experiences from art. Limiting aesthetics to rather rare experiences unnecessarily narrows the scope of a science of art.
Renal Dysfunction after Myocardial Revascularization: Risk Factors, Adverse Outcomes, and Hospital Resource Utilization
Authors: Christina Mora Mangano
Journal: Annals of Internal Medicine (1998)

Background: Acute changes in renal function after elective coronary bypass surgery are incompletely characterized and represent a challenging clinical problem. Objective: To determine the incidence and characteristics of postoperative renal dysfunction and failure, perioperative predictors of dysfunction, and the effect of renal dysfunction and failure on in-hospital resource utilization and patient disposition after discharge. Design: Prospective, observational, multicenter study. Setting: 24 university hospitals. Patients: 2222 patients having myocardial revascularization with or without concurrent valvular surgery. Measurements: Prospective histories, physical examinations, and electrocardiographic and laboratory studies. The main outcome measure was renal dysfunction (defined as a postoperative serum creatinine level ≥ 177 µmol/L with a preoperative-to-postoperative increase ≥ 62 µmol/L). Results: 171 patients (7.7%) had postoperative renal dysfunction; 30 of these (1.4% overall) had oliguric renal failure that required dialysis. In-hospital mortality, length of stay in the intensive care unit, and hospitalization were significantly increased in patients who had renal failure and those who had renal dysfunction compared with those who had neither (mortality: 63%, 19%, and 0.9%; intensive care unit stay: 14.9 days, 6.5 days, and 3.1 days; hospitalization: 28.8 days, 18.2 days, and 10.6 days, respectively). Patients with renal dysfunction were three times as likely to be discharged to an extended-care facility. Multi-variable analysis identified five independent preoperative predictors of renal dysfunction: age 70 to 79 years (relative risk [RR], 1.6 [95% CI, 1.1 to 2.3]) or age 80 to 95 years (RR, 3.5 [CI, 1.9 to 6.3]); congestive heart failure (RR, 1.8 [CI, 1.3 to 2.6]); previous myocardial revascularization (RR, 1.8 [CI, 1.2 to 2.7]); type 1 diabetes mellitus (RR, 1.8 [CI, 1.1 to 3.0]) or preoperative serum glucose levels exceeding 16.6 mmol/L (RR, 3.7 [CI, 1.7 to 7.8]); and preoperative serum creatinine levels of 124 to 177 µmol/L (RR, 2.3 [CI, 1.6 to 3.4]). Independent perioperative factors that exacerbated risk were cardiopulmonary bypass lasting 3 or more hours and three measures of ventricular dysfunction. Conclusions: Many patients having elective myocardial revascularization develop postoperative renal dysfunction and failure, which are associated with prolonged intensive care unit and hospital stays, significant increases in mortality, and greater need for specialized long-term care. Resources should be redirected to mitigate renal injury in high-risk patients.
Evolution of our understanding of methylmercury as a health threat.
Authors: C Watanabe, H Satoh
Journal: Environmental Health Perspectives (1996)

Methylmercury (MeHg) is recognized as one of the most hazardous environmental pollutants, primarily due to endemic disasters that have occurred repeatedly. A review of the earlier literature on the Minamata outbreak shows how large-scale poisoning occurred and why it could not be prevented. With the repeated occurrences of MeHg poisoning, it gradually became clear that the fetus is much more susceptible to the toxicity of this compound than the adult. Thus, recent epidemiologic studies in several fish-eating populations have focused on the effects of in utero exposure to MeHg. Also, there have been many studies on neurobehavioral effects of in utero exposure to methylmercury in rodents and nonhuman primates. The results of these studies revealed that the effects encompass a wide range of behavioral categories without clear identification of the functional categories distinctively susceptible to MeHg. The overall neurotoxicity of MeHg in humans, nonhuman primates, and rodents appears to have similarities. However, several gaps exist between the human and animal studies. By using the large body of neurotoxicologic data obtained in human populations and filling in such gaps, we can use MeHg as a model agent for developing a specific battery of tests of animal behavior to predict human risks resulting from in utero exposure to other chemicals with unknown neurotoxicity. Approaches developing such a battery are also discussed.
Comparison of Cardiac Risk Indices
Authors: Peter M. Clarke
Journal: Annals of Internal Medicine (2001)

Letters21 August 2001Comparison of Cardiac Risk IndicesPeter M. Clarke, MDPeter M. Clarke, MDCook County Hospital, Chicago, IL 60612 (Clarke)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-4-200108210-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In the report by Gilbert and colleagues (1) comparing cardiac risk indices, the principal point seems to be that the receiver-operating characteristic (ROC) curve areas are rather poor and that the indices are therefore of little utility. The observed predictive values seem to contradict this point. If the clinical significance of the indices is based on their ability to generate a change in risk estimate that will assist decision making, the ROC curve areas do not seem to capture it. In general, a preoperative cardiac risk index will be used in a population with an overall “low” ...References1. Gilbert K, Larocque BJ, Patrick LT. Prospective evaluation of cardiac risk indices for patients undergoing noncardiac surgery. Ann Intern Med. 2000;133:356-9. [PMID: 10979880] LinkGoogle Scholar2. Bach DS, Eagle KA. Prediction of perioperative risk: the glass may be three-quarters full [Editorial]. Ann Intern Med. 2000;133:384-6. [PMID: 10979884] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Cook County Hospital, Chicago, IL 60612 (Clarke) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Tragic Events of April 1996 Jack Coulehan Prospective Evaluation of Cardiac Risk Indices for Patients Undergoing Noncardiac Surgery Kenneth Gilbert , Brian J. Larocque , and Lawrence T. Patrick Prediction of Perioperative Risk: The Glass May Be Three-Quarters Full David S. Bach and Kim A. Eagle Metrics 21 August 2001Volume 135, Issue 4Page: 301-302KeywordsAdverse eventsDecision makingLikelihood ratioReceiver operating characteristic curveRisk management ePublished: 21 August 2001 Issue Published: 21 August 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Negative inotropic effects of amrinone in the neonatal piglet heart.
Authors: N Ross-Ascuitto, R Ascuitto, V Chen, S E Downing
Journal: Circulation Research (1987)

Cardiac mechanical function and coronary flow (CF) were measured in isovolumically beating hearts from neonatal piglets 0.5 to 12 days of age. The hearts were perfused retrogradely at 70 cm H2O with a recirculating modified Krebs-Henseleit solution containing washed adult pig red cells (hematocrit, 25%). They were electrically paced (180 beats/min), and left ventricular developed pressure (delta P), maximum rate of rise of pressure (dP/dt), CF, and myocardial oxygen consumption were measured. These parameters were found to remain stable for at least 60 minutes. In one group, a single dose of amrinone was added to the perfusate to yield a concentration of 50 micrograms/ml. Within 5 minutes delta P decreased from 104.0 +/- 7.1 to 65.3 +/- 8.6 mm Hg (p less than 0.001), and dP/dt fell from 1,160 +/- 96 to 658 +/- 78 mm Hg/sec (p less than 0.001). In a second group, successive doses of amrinone were added to yield concentrations ranging from 5 to 50 micrograms/ml. There was a progressive decrease in delta P and dP/dt to 66.5 +/- 4.2% and 57.6 +/- 4.8% of initial values, respectively. CF increased progressively from 3.2 +/- 0.2 to 6.8 +/- 0.5 ml/min/g. In 3 experiments, amrinone was washed out after achieving the maximum concentration. Depressed mechanical function reversed and delta P and dP/dt returned to control values in each heart. Additionally, CF decreased from 7.6 +/- 0.3 to 5.0 +/- 0.2 ml/min/g. It is concluded that amrinone has concentration-dependent negative inotropic actions in the neonatal piglet heart. Hence, the drug may not be useful in treating heart failure in the human neonate.
Risk Factors in Heatstroke-Reply
Authors: Edwin M. Kilbourne
Journal: JAMA (1983)

In Reply.—  We appreciate the thoughtful comments of Drs Parrotte and Caldroney on our exploratory case-control study of risk factors for heatstroke. We noted relatively few nonfatal cases of heatstroke among occupants of homes well shaded by trees, suggesting that such shading prevents heatstroke. Fully shaded windows reduce solar heat gain as much as 80%, 1 and the role of trees and foliage in providing shading has been recognized. 2,3 We have been wary of overinterpreting our findings. However, a causal relationship between shading and decreased heatstroke incidence seems plausible.  In undertaking our study, we were aware of previous work (including that of Shapiro et al) that suggested that survivors of past heatstrokes are more vulnerable to thermal stress than persons never before affected. Therefore, we specifically sought a history of prior heatstroke in all 156 cases and in the 462 control subjects studied. (Demographic characteristics, including age, of the
Avoidable Disability seen in Recent Amputations
Authors: W. R. D. Mitchell
Journal: BMJ (1941)

INCREASE OF TUBERCULOSIS IN GLASGOW MEDICALJSOHRNAL 4culosis had occurred in the latter year.-Therelative figures were: 561 notifications and 255 deaths for 1939, and 669 notifications and 329 deaths-for 1940.It will be seen that the increase, approximately 17%, in this group is slightly lower than among the pulmonary cases.The following table subdivides the notified cases of nonpulmonary tuberculosis into their particular types.
Senior UK researchers campaign for sensible guidelines on regulating trials
Authors: T. Groves
Journal: BMJ (2009)

The over-regulation and bureaucracy stifling the initiation and conduct of clinical trials have been well publicised, said senior clinical triallists attending a meeting in Oxford this week. What’s needed now, they said, are workable solutions.

The two codirectors of the University of Oxford’s clinical trial service unit summed up the frustration expressed by most speakers and delegates. “We don’t just need to simplify the individual rules. How many of them are needed at all?” Richard Peto asked, while Rory Collins added: “How much longer do we have to do things that don’t add value?”

An invited international audience of clinical researchers, industry leaders, regulators, funders, ethicists, and patients’ representatives debated the many barriers to the efficient running of trials, particularly multicentre international trials run by academics.

Although such trials often pose little clinical risk to patients or legal or insurance risk to institutions and sponsors, they have to …
HEMOLYTIC STREPTOCOCCUS CAUSING SEVERE INFECTIONS AT CAMP ZACHARY TAYLOR, KY.
Authors: H. L. ALEXANDER
Journal: JAMA (1918)

found not to injure leather.Both clothes and leathers are thoroughly dry after they have been given a shaking in the air, and they are immediately returned to the men in the bathing huts, who have been given numbered disks which correspond to those tied on to their clothing and leathers.The system is rapid, thor- ough, and has given perfect satisfaction.Before they take their bath, the men are regularly inspected by a junior medical officer for skin diseases, etc.There are separate cabins or rooms for the officers.
A profession on probation
Authors: C. Douglas
Journal: BMJ (1998)

Medicine is a rough old trade. From doubtful origins in botany and violence, it has grown over the ages to biomedical respectability and considerable political clout. Now there are about 100 000 of us at it in the United Kingdom—(1);saints and scientists, sinners and soaks, together, of course, with the overwhelming nondescript residuum who qualify as “None of the above.”

We live off the state, spend about £45bn of its money each year, and in return practise the trade, trying to do as much good and as little harm as possible. Mostly. We work alone and in groups, in centres of excellence and of notoriety, under close supervision or none. We vary greatly. Very few of us have any clear idea of how we are doing professionally. We are not good at handling the failures of colleagues, far less our own. And traditionally we have tried to deal with the inevitable quota of misfortunes, scandals, and rascals in ways well meaningly devised to minimise professional embarrassment and public disquiet.

But all that seems to be changing now, and those who seek to lead and represent the profession face new challenges, the difficulties of which were teasingly explored by Richard Horton in an iconoclast's guide to the upper reaches of the British medical establishment. The Citadel , slotted in the decent obscurity of Channel 4 at 11 pm on a Thursday, …