tbuckley/cabot-search huggingface dataset:
Syncope in the Elderly
Authors: LEWIS A. LIPSITZ
Journal: Annals of Internal Medicine (1983)

Syncope is a common, potentially dangerous manifestation of transient cerebral dysfunction that often remains unexplained despite medical evaluation. In elderly persons the cause of syncope depends on the accumulation of several age- and disease-related abnormalities that impair adaptation to minor physiologic stresses not ordinarily expected to produce syncope. The evaluation of syncope requires a careful history and physical examination to identify common conditions and physiologic stresses that may present atypically as syncope, as well as conditions such as postural hypotension, aortic stenosis, and carotid hypersensitivity that are often overlooked on routine examination. Laboratory studies have a low sensitivity and specificity in the elderly patient and should be ordered selectively. Therapy should be directed toward preventing recurrent episodes by minimizing risks for syncope and treating symptomatic abnormalities regardless of the age of the patient, but with attention to age-related changes in drug metabolism and action.
Decorin Gene Transfer Promotes Muscle Cell Differentiation and Muscle Regeneration
Authors: Yong Li, Juan Li, Jinghong Zhu, Bin Sun, Maria Branca, Ying Tang, William Foster, Xiao Xiao, Johnny Huard
Journal: Molecular Therapy (2007)

We have shown that decorin, a small leucine-rich proteoglycan, can inhibit transforming growth factor (TGF)-β1 to prevent fibrous scar formation and improve muscle healing after injury. In the decorin-treated muscle, an enhancement of muscle regeneration is observed through histological examination. In this article, we report our determination of whether decorin has a direct effect on myogenic cells' differentiation. Our results indicate that myoblasts genetically engineered to express decorin (CD cells) differentiated into myotubes at a significantly higher rate than did control myoblasts (C2C12). This enhanced differentiation led to the up-regulation of myogenic genes (Myf5, Myf6, MyoD, and myogenin) in CD cells in vitro. We speculate that the higher rate of differentiation exhibited by the CD cells is due to the up-regulation of follistatin, peroxisome-proliferator-activated receptor-gamma co-activator-1α (PGC-1α), p21, and the myogenic genes, and the down-regulation of TGF-β1 and myostatin. Decorin gene transfer in vivo promoted skeletal muscle regeneration and accelerated muscle healing after injury. These results suggest that decorin not only prevents fibrosis but also improves muscle regeneration and repair. We have shown that decorin, a small leucine-rich proteoglycan, can inhibit transforming growth factor (TGF)-β1 to prevent fibrous scar formation and improve muscle healing after injury. In the decorin-treated muscle, an enhancement of muscle regeneration is observed through histological examination. In this article, we report our determination of whether decorin has a direct effect on myogenic cells' differentiation. Our results indicate that myoblasts genetically engineered to express decorin (CD cells) differentiated into myotubes at a significantly higher rate than did control myoblasts (C2C12). This enhanced differentiation led to the up-regulation of myogenic genes (Myf5, Myf6, MyoD, and myogenin) in CD cells in vitro. We speculate that the higher rate of differentiation exhibited by the CD cells is due to the up-regulation of follistatin, peroxisome-proliferator-activated receptor-gamma co-activator-1α (PGC-1α), p21, and the myogenic genes, and the down-regulation of TGF-β1 and myostatin. Decorin gene transfer in vivo promoted skeletal muscle regeneration and accelerated muscle healing after injury. These results suggest that decorin not only prevents fibrosis but also improves muscle regeneration and repair.
Parkinson's Disease, Depression, and Electrical Stimulation of the Brain
Authors: Stuart C. Yudofsky
Journal: New England Journal of Medicine (1999)

On November 6, 1780, the Italian anatomist Luigi Galvani made an entry in his diary that recorded his observation of electrically stimulated muscle contractions in the legs of a freshly killed frog.1 Galvani performed subsequent experiments in which a similar reaction was evoked by the contact of different regions of a frog's body with two disparate metals, such as brass and iron. However, Galvani misunderstood the phenomenon as the result of the extraction of the frog's “animal electricity” by the dissimilar metals. His contemporary, Count Alessandro Volta, discovered that the muscle contraction was evoked by the passage through the frog's . . .
Skin lesions in tyrosinosis: response to dietary treatment
Authors: WITOLD A. ZALESKI, ALAN HILL, WILLIAM KUSHNIRUK
Journal: British Journal of Dermatology (2006)

A chronic form of tyrosinosis was diagnosed in a mentally retarded girl, aged 13. Concomitant findings were skin lesions of localized epidermolytic hyperkeratosis existing without remission from infancy. A diet low in phenylalanine and tyrosine was started to reduce the patient's blood tyrosine to a normal level. After 6 months of successful dietary control of blood tyrosine, an unexpected result was a complete remission of the skin lesions. The diet was abandoned after a total period of 14 months and the abnormality of tyrosine metabolism became immediately prominent again. Some 4 months later, the skin lesions have recurred. A possible relationship between the congenital skin disorder and the abnormal tyrosine metabolism in this case is considered.
Surgery and water
Authors: Maryam Alfa-Wali
Journal: Journal of the Royal Society of Medicine (2009)

Climate change, greenhouse gases, carbon footprints: these are words we hear almost everyday.The tsunamis in South{East Asia, hurricanes such as Katrina, floods in Europe: all are natural disasters that are becoming almost second nature to today's world.Water is something we sometimes take for granted.Water is an essential natural resource for the surgeon in order to be able to start the journey to the sterile surgical field before operating.With a surgical scrub sink producing 1 litre in 5-6 seconds and the recommended scrubbing time to be 5 minutes, a surgeon per operation could use up to 50 litres of water at a cost of approximately 0.036 pence per litre; it would be 0.71 pence per cubic metre.This is a lot of water being wasted not to mention the cost of the water not used.'Water, water everywhere but not enough to drink', should make us think and remember the future and also what is currently happening in other parts of the world.Water is potentially the next fuel to be in demand globally.We think about how to cut our water bills at home and tend to think of the cost incurred by running a domestic tap when it flows at about 15 litres per minute but not much thought when we are at work.We have a good source of water in the UK and it is time to take action and responsibility to preserve it as wasting it will eventually harm the environment.Surgeons make use of water daily but the amount is variable based on the type of water
Residual Treatment Disparities After Oncology Referral for Rectal Cancer
Authors: A. M. Morris, K. G. Billingsley, A. J. Hayanga, B. Matthews, L.-M. Baldwin, J. D. Birkmeyer
Journal: JNCI Journal of the National Cancer Institute (2008)

Black patients with rectal cancer are considerably less likely than white patients to receive adjuvant therapy. We examined the hypothesis that the lower treatment rate for blacks is due to underreferral to medical and radiation oncologists. We used 1992–1999 Surveillance, Epidemiology, and End Results–Medicare data to identify elderly (≥66 years of age) patients who had been hospitalized for resection of stage II or III rectal cancer (n = 2716). We used χ 2 tests to examine associations between race and 1) consultation with an oncologist and 2) receipt of adjuvant therapy. We then used logistic regression to analyze the influence of sociodemographic and clinical characteristics (age at diagnosis, sex, marital status, median income and education in area of residence, comorbidity, and cancer stage) on black–white differences in the receipt of adjuvant therapy. All statistical tests were two-sided. There was no statistically significant difference between the 134 black patients and the 2582 white patients in the frequency of consultation with a medical oncologist (73.1% for blacks vs 74.9% for whites, difference = 1.8%, 95% confidence interval [CI] = >5.9% to 9.5%, P = .64) or radiation oncologist (56.7% vs 64.8%, difference = 8.1%, 95% CI = >0.5% to 16.7%, P = .06), but blacks were less likely than whites to consult with both a medical oncologist and a radiation oncologist (49.2% vs 58.8%, difference = 9.6%, 95% CI = 0.9% to 18.2%, P = .03). Among patients who saw an oncologist, black patients were less likely than white patients to receive chemotherapy (54.1% vs 70.2%, difference = 16.1%, 95% CI = 6.0% to 26.2%, P = .006), radiation therapy (73.7% vs 83.4%, difference = 9.7%, 95% CI = 0.4% to 19.8%, P = .06), or both (60.6% vs 76.9%, difference = 16.3%, 95% CI = 4.3% to 28.3%, P = .008). Patient and provider characteristics had minimal influence on the racial disparity in the use of adjuvant therapy. Racial differences in oncologist consultation rates do not explain disparities in the use of adjuvant treatment for rectal cancer. A better understanding of patient preferences, patient–provider interactions, and potential influences on provider decision making is necessary to develop strategies to increase the use of adjuvant treatment for rectal cancer among black patients.
Meeting Report: Summary of <i>IARC Monographs</i> on Formaldehyde, 2-Butoxyethanol, and 1- <i>tert</i> -Butoxy-2-Propanol
Authors: Vincent James Cogliano, Yann Grosse, Robert A. Baan, Kurt Straif, Marie Béatrice Secretan, Fatiha El Ghissassi
Journal: Environmental Health Perspectives (2005)

An international, interdisciplinary working group of expert scientists met in June 2004 to develop IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans (IARC Monographs) on formaldehyde, 2-butoxyethanol, and 1-tert-butoxy-2-propanol. Each IARC Monograph includes a critical review of the pertinent scientific literature and an evaluation of an agent's potential to cause cancer in humans. After a thorough discussion of the epidemiologic, experimental, and other relevant data, the working group concluded that formaldehyde is carcinogenic to humans, based on sufficient evidence in humans and in experimental animals. In the epidemiologic studies, there was sufficient evidence that formaldehyde causes nasopharyngeal cancer, "strong but not sufficient" evidence of leukemia, and limited evidence of sinonasal cancer. The working group also concluded that 2-butoxyethanol and 1-tert-butoxy-2-propanol are not classifiable as to their carcinogenicity to humans, each having limited evidence in experimental animals and inadequate evidence in humans. These three evaluations and the supporting data will be-published as Volume 88 of the IARC Monographs.
Differences in Breast Cancer Stage at Diagnosis and Cancer-Specific Survival by Race and Ethnicity in the United States
Authors: Javaid Iqbal, Ophira Ginsburg, Paula A. Rochon, Ping Sun, Steven A. Narod
Journal: JAMA (2015)

<h3>Importance</h3> Women with early-stage breast cancers are expected to have excellent survival rates. It is important to identify factors that predict diagnosis of early-stage breast cancers. <h3>Objective</h3> To determine the proportion of breast cancers that were identified at an early stage (stage I) in different racial/ethnic groups and whether ethnic differences may be better explained by early detection or by intrinsic biological differences in tumor aggressiveness. <h3>Design, Setting, and Participants</h3> Observational study of women diagnosed with invasive breast cancer from 2004 to 2011 who were identified in the Surveillance, Epidemiology, and End Results (SEER) 18 registries database (N = 452 215). For each of 8 racial/ethnic groups, biological aggressiveness (triple-negative cancers, lymph node metastases, and distant metastases) of small-sized tumors of 2.0 cm or less was estimated. The odds ratio (OR) for being diagnosed at stage I compared with a later stage and the hazard ratio (HR) for death from stage I breast cancer by racial/ethnic group were determined. The date of final follow-up was December 31, 2011. <h3>Main Outcomes and Measures</h3> Breast cancer stage at diagnosis and 7-year breast cancer–specific survival, adjusted for age at diagnosis, income, and estrogen receptor status. <h3>Results</h3> Of 373 563 women with invasive breast cancer, 268 675 (71.9%) were non-Hispanic white; 34 928 (9.4%), Hispanic white; 38 751 (10.4%), black; 25 211 (6.7%), Asian; and 5998 (1.6%), other ethnicities. Mean follow-up time was 40.6 months (median, 38 months). Compared with non-Hispanic white women diagnosed with stage I breast cancer (50.8%), Japanese women (56.1%) were more likely to be diagnosed (OR, 1.23 [95% CI, 1.15-1.31],<i>P</i> &lt; .001) and black women (37.0%) were less likely to be diagnosed (OR, 0.65 [95% CI, 0.64-0.67],<i>P</i> &lt; .001). Actuarial risk of death from stage I breast cancer at 7 years was higher among black women (6.2%) than non-Hispanic white women (3.0%) (HR, 1.57 [95% CI, 1.40-1.75];<i>P</i> &lt; .001), and lower among South Asian women (1.7%) (HR, 0.48 [95% CI, 0.20-1.15];<i>P</i> = .10). Black women were more likely to die of breast cancer with small-sized tumors (9.0%) than non-Hispanic white women (4.6%) (HR, 1.96 [95% CI, 1.82-2.12];<i>P</i> &lt; .001); the difference remained after adjustment for income and estrogen receptor status (HR, 1.56 [95% CI, 1.45-1.69];<i>P</i> &lt; .001). <h3>Conclusions and Relevance</h3> Among US women diagnosed with invasive breast cancer, the likelihood of diagnosis at an early stage, and survival after stage I diagnosis, varied by race and ethnicity. Much of the difference could be statistically accounted for by intrinsic biological differences such as lymph node metastasis, distant metastasis, and triple-negative behavior of tumors.
Malignancies occurring during therapy with tyrosine kinase inhibitors (TKIs) for chronic myeloid leukemia (CML) and other hematologic malignancies
Authors: Dushyant Verma, Hagop Kantarjian, Sara S. Strom, Mary Beth Rios, Elias Jabbour, Alfonso Quintas-Cardama, Srdan Verstovsek, Farhad Ravandi, Susan O'Brien, Jorge Cortes
Journal: Blood (2011)
Fragile X chromosome related to mental retardation in males
Authors: G. McBride
Journal: JAMA (1979)

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
Thrombophlebitis in Systemic Lupus Erythematosus
Authors: E. Angles-Cano
Journal: JAMA (1979)

<h3>To the Editor.—</h3> We read the report by Peck et al (240:1728, 1978) on thrombophlebitis in systemic lupus erythematosus (SLE), and we wish to comment on their assertions. We have recently done a prospective study searching for factors predisposing to thrombosis in patients with SLE (unpublished data), and we have reported thrombotic accidents in five of 28 patients. Four of these patients had arterial thrombosis, and only one had thrombophlebitis. The patients were tested for platelet function and coagulation, and fibrinolytic studies, including factor VIII complex activities<sup>1</sup>and fibrinolytic activity<sup>2</sup>of blood after venous stasis, were also carried out. Two major abnormalities were found: (1) an increase activity of the factor VIII complex in the absence of steroid therapy (VIII: C, 1.63 units/mL; VIII R: Ag, 1.86 units/mL; VIII R: Wf, 2.11 units/mL, mean values) and (2) an absence of plasminogen activator activity. It is possible that both abnormalities
Predictive Factors for Progression in Patients with Clinical Stage T1a Prostate Cancer in the PSA Era
Authors: Aurelien Descazeaud, Michael Peyromaure, Ambroise Salin, Delphine Amsellem-Ouazana, Thierry Flam, Annick Viellefond, Bernard Debré, Marc Zerbib
Journal: European Urology (2007)
Are rigorous evolutionary histories of human mating possible?
Authors: Harmon R. Holcomb
Journal: Behavioral and Brain Sciences (2000)

Critics of evolutionary psychology object that it is not rigorous science compared to other evolutionary science. Advocates reply that it is rigorous science, and that the critics are uninformed. Still, informed people having opposing preconceptions of what counts as rigor may reach opposing evaluative conclusions. I shall clarify the very idea of rigorous evolutionary histories in relation to the basic objection that “evolution without history” is not rigorous.
Influenza Vaccination and the Guillain–Barré Syndrome
Authors: Allan H. Ropper, Maurice Victor
Journal: New England Journal of Medicine (1998)

In about two thirds of cases, the immune neuropathy known as the Guillain–Barré syndrome is provoked by an acute infectious illness. In the autumn of 1976, there was an unexpected increase — by a factor of four to eight — in the number of cases of the Guillain–Barré syndrome after a government-sponsored mass-inoculation program in which 45 million adults in the United States received vaccine containing the A/New Jersey/76 influenzavirus (the “swine flu” virus).1 The increase in risk attributable to the vaccine was subsequently corroborated by a careful analysis of all cases of the Guillain–Barré syndrome that occurred in Michigan . . .
Mitomycin in Anal Cancer: Still the Standard of Care
Authors: Joanna Y. Chin, Theodore S. Hong, David P. Ryan
Journal: Journal of Clinical Oncology (2012)

A 52-year-old woman presents with a 2-month history of bright red blood per rectum. Her bleeding is associated with bowel movements and a sense of incomplete evacuation. She denies fecal incontinence or change in stool caliber. On digital rectal examination, the tumor is palpated approximately 3 cm from the anal verge, posterior and slightly to the right, positioned at the top of the anal canal and extending into the rectum, measuring approximately 2.5 cm. Additionally, a firm 1.5-cm left-sided inguinal node is palpated. The patient is then referred for colonoscopy, which reveals a mass in the anal canal; biopsy of the mass shows squamous cell carcinoma. Positron emission tomography-computed tomography (PET-CT) demonstrates thickening in the low rectum with [(18)F]fluorodeoxyglucose (FDG) avidity (Figs 1A, 1B). The left inguinal node is visualized, as is a perirectal lymph node with associated FDG avidity (Figs 1C, 1D). The patient is staged as having T2N3 squamous cell carcinoma of the anal canal (Table 1). Her medical history is otherwise unremarkable, including for HIV, prior abnormal Papanicolaou smears, and other risk factors for human papillomavirus (HPV) exposure.
A magical education
Authors: Daniel K Sokol
Journal: BMJ (2006)

O ne afternoon a week, when tired of thinking about medical ethics, I put on my volunteer's badge, pick up my cards and coins, and head over to the nearby hospital. In large, black letters, the badge reads “MAGICIAN.”

For a few hours, I meander through the wards, performing tricks for the “guests” and their relatives. At the bedside, a large silk scarf vanishes and reappears before their eyes, three coins jump invisibly from one hand to the next, a £5 note changes into £20, two cards change places in a blink of an eye, a signed card disappears from the deck, only to reappear in my wallet, and so on.

In my first week as a hospital magician, I nearly vomited twice. In one oncology ward, the stench of urine and faeces was such that I could barely finish my first trick. I held my breath, rushed to the end, and briskly walked out, gasping for …
Changes in blood glucose levels during a 1005-km running race: a case study.
Authors: P J Abernethy, B Eden
Journal: British Journal of Sports Medicine (1992)

The blood glucose response of a male ultramarathon runner was monitored throughout a 1005-km race. Before the race the runner had a fasting blood glucose concentration of 5.1 mM. At no stage during the race were his mean blood glucose levels less than 5.8 mM. This was partially attributed to the eating patterns of the athlete, the times at which blood samples were taken, the glycaemic index of food ingested and hyperglycaemia. While there was no evidence of glucosuria, ketones were present in the urine on one day of the event. There were other signs suggesting that at various stages of the event the runner had a metabolic acidosis. Possible reasons for this are discussed.
When Is It Cost-effective to Change the Behavior of Health Professionals?
Authors: James Mason
Journal: JAMA (2001)

Because of the workings of health care systems, new, important, and cost-effective treatments sometimes do not become routine care while well-marketed products of equivocal value achieve widespread adoption. Should policymakers attempt to influence clinical behavior and correct for these inefficiencies? Implementation methods achieve a certain level of behavioral change but cost money to enact. These factors can be combined with the cost-effectiveness of treatments to estimate an overall policy cost-effectiveness. In general, policy cost-effectiveness is always less attractive than treatment cost-effectiveness. Consequently trying to improve the uptake of underused cost-effective care or reduce the overuse of new and expensive treatments may not always make economic sense. In this article, we present a method for calculating policy cost-effectiveness and illustrate it with examples from a recent trial, conducted during 1997 and 1998, of educational outreach by community pharmacists to influence physician prescribing in England.
A Comparison of the Mouth-to-Mouth and Mouth-to-Airway Methods of Artificial Respiration with the Chest-Pressure Arm-Lift Methods
Authors: Peter Safar, Lourdes A. Escarraga, James O. Elam
Journal: New England Journal of Medicine (1958)

QUESTIONS may be raised whether effective tidal exchange of air can be expected with the routine application of the currently taught chest-pressure arm-lift methods of resuscitation and whether the experiments upon which the recommendation of these methods were based take the behavior of the natural airway in the unconscious patient into consideration. Apparently, these methods were endorsed on the basis of comparative experiments in anesthetized and curarized adults, whose tracheas were intubated.1 , 2 Waters and Bennett,3 in 1936, and Nims and his associates,4 in 1951, were unable to provide adequate ventilation by these methods. We reinvestigated the problem and found that . . .
ELECTRICAL SELF-STIMULATION OF THE BRAIN IN MAN
Authors: ROBERT G. HEATH
Journal: American Journal of Psychiatry (1963)

Studies are described of two human patients under treatment with ICSS. Their subjective reports in association with stimulation to reward areas of the brain are presented. The data indicate that patients will [See Figure 6. in Source PDF] [See Figure 7. in Source PDF] stimulate regions of the brain at a high frequency for reasons other than to obtain a pleasurable response. These data extend information obtained from ICSS in animals.