tbuckley/cabot-search huggingface dataset:
Despite Effectiveness, Behavioral Therapy for Chronic Insomnia Still Underused
Authors: Lynne Lamberg
Journal: JAMA (2008)

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
Does 3D-Ultrasound Imaging Improve Target Delineation for Breast Boost Radiation Therapy Planning.
Authors: A. Young, M. Chadha, C. Geraghty, L. Harrison
Journal: Cancer Research (2009)

Abstract Background: Conformal volume-based breast dosimetry using CT-simulation is the most widely used technique for treatment planning. As part of a prospective protocol we studied the role of 3D-Ultrasound (US) technique for Image-Guided Radiation Therapy in breast cancer. In this paper we explore if there is additional value to utilizing seroma images on 3D-US for defining the target volume for breast boost.Materials and Methods: The IRB-approved prospective study used the ClarityTM 3D-US breast system (Resonant Medical). At simulation, concurrent CT and 3D-US images were obtained then fused. The boost lumpectomy volume (GTV) was contoured on CT by a single physician blinded to the results of the US (MC). To create the planning target volume (PTV), the GTV was expanded circumferentially by 1.5 to 2.0 cm, with the exception of its relation to skin and chest wall which were excluded from the PTV. For this analysis, the fused images of the concurrent CT simulation and 3D-US obtained on 25 patients were evaluated for concordance in the coverage of the CT contoured GTV and PTV to that of the 3D-US seroma image.Results: In 1 patient the CT images were limited in identifying the lumpectomy cavity because of the dense nature of the breast. The cavity not appreciated on CT image was visible on US. In this case the application of 3D-US would have provided superior target definition. In 22 of the remaining 24 patients the seroma cavity seen on the US was also seen on CT and was included in the lumpectomy GTV contoured on the images from CT simulation. In 2 patients, approximately 5% of the US seroma was not part of the GTV but was encompassed in the expanded PTV. In these 2 patients the US seroma was in proximity to the edge. This eccentric location of the US seroma cavity in 1 out of the 2 patients would have resulted in a change in the PTV. While in the other patient even though the seroma cavity was close to the edge of the PTV, the proximity to the chest wall would have precluded any major modification of the PTV. Overall, in all cases the 3D-US seroma cavity was encompassed in the expanded PTV. In 2/25 patients the target volume would have been revised based on the additional data provided by the 3D-US images.Conclusions: In summary, from this experience we observed that the use of 3D-US images in addition to CT simulation can alter the target delineation in 8% of cases. The 3D-US is a non-ionizing imaging modality that may add benefit for improving target delineation when used concurrently with CT simulation. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4107.
The ACTIVE Pursuit of Stroke Prevention in Patients with Atrial Fibrillation
Authors: Alan S. Go
Journal: New England Journal of Medicine (2009)

Approximately 1% of Americans have atrial fibrillation, and the prevalence of this arrhythmia increases sharply with older age (being approximately 10% among persons 80 years of age or older).1 Worldwide population trends of increasing life expectancy and increasing prevalence of selected risk factors for atrial fibrillation portend a worsening epidemic. Atrial fibrillation raises the risk of ischemic stroke by a factor of four to five, primarily as a result of cardioembolism of a fibrin-rich thrombus (Figure 1). Given the epidemiologic characteristics of atrial fibrillation and the importance of stroke as a leading cause of death and disability, multiple large-scale, randomized . . .
Spontaneous Calcaneal Fracture in Osteoporosis without Fluoride Therapy
Authors: H VERLOOY, R R. WESTHOVES, L MORTELMANS, M De Roo
Journal: Clinical Nuclear Medicine (1991)

Tc-99m MDP imaging was helpful in the early diagnosis of calcaneal stress fracture in a patient with osteoporosis. As illustrated here, the radionuclide scan was positive 4 weeks before radiology.
Acute viral encephalitis.
Authors: H Smith
Journal: BMJ (1981)

<h3>Abstract</h3> <h3>Purpose</h3> To investigate the effects of ageing, sex and body mass index (BMI) on translocator protein (TSPO) availability in healthy subjects using positron emission tomography (PET) and the radioligand [<sup>11</sup>C]PBR28. <h3>Methods</h3> [<sup>11</sup>C]PBR28 data from 140 healthy volunteers (72 males and 68 females; n=78 with HAB and n=62 MAB genotype; age range 19-80 years; BMI range 17.6 - 36.9) were acquired with High Resolution Research Tomograph at three centres: Karolinska Institutet (n=53), Turku PET centre (n=62) and Yale University PET Center (n=25). The total volume of distribution (V<sub>T</sub>) was estimated in global grey matter, frontal, temporal, occipital and parietal cortices, hippocampus and thalamus using multilinear analysis 1. The effects of age, BMI and sex on TSPO availability were investigated using linear mixed effects model, with TSPO genotype and PET centre specified as random intercepts. <h3>Results</h3> There were significant positive correlations between age and V<sub>T</sub> in the frontal and temporal cortex. BMI showed a significant negative correlation with V<sub>T</sub> in all regions. Additionally, significant differences between males and females were observed in all regions, with females showing higher V<sub>T</sub>. A subgroup analysis revealed a positive correlation between V<sub>T</sub> and age in all regions in male subjects, whereas age showed no effect on TSPO levels in female subjects. <h3>Conclusion</h3> These findings provide evidence that individual biological properties may contribute significantly to the high variation shown in TSPO binding estimates, and suggest that age, BMI and sex can be confounding factors in clinical studies.
Radiofrequency Catheter Ablation of Type 1 Atrial Flutter
Authors: Herve Poty, Nadir Saoudi, Ahmed Abdel Aziz, Mohan Nair, Brice Letac
Journal: Circulation (1995)

Background Radiofrequency energy has demonstrated its efficacy in catheter ablation of atrial flutter (AFl). However, long-term recurrences of AFl have been reported frequently after initial, apparently successful ablation. To date, criteria for prediction of late recurrences are lacking. Methods and Results Twelve patients (10 men; mean age, 53.6 years; range, 26 to 69 years) were referred for AFl ablation. Duodecapolar and decapolar catheters were used for detailed mapping of the tricuspid ring, the inferior vena cava–tricuspid annulus (IVC-TA) isthmus, and the coronary sinus ostium (CSOs) area. Additional multipolar catheters were used for recording activation of the coronary sinus and the CSOs-TA isthmus. AFl was present at baseline in 9 patients and was induced by proximal coronary sinus (PCS) pacing in 3. Counterclockwise right atrial activation was recorded in all patients. Primary success of ablation was defined as when AFl was no longer inducible even during isoproterenol infusion. AFl was successfully ablated in all 12 patients, with a median of 4 pulses delivered at the IVC-TA isthmus. In the 3 patients in whom AFl was induced, during PCS pacing in sinus rhythm before ablation, a collision of descending and ascending wave fronts was observed at the middle lateral right atrium (LRA). This activation pattern of the LRA also was noted after unsuccessful radiofrequency applications. Noninducibility of AFl after radiofrequency applications was associated with a change of activation pattern at the LRA and with an inversion of the activation sequence of the IVC-TA isthmus (from clockwise to counterclockwise) in 9 patients when pacing from the PCS. In 2 of 3 patients, despite noninducibility of atrial flutter, ablation was pursued to obtain evidence of permanent block of conduction at the IVC-TA isthmus. Finally, a completely descending LRA wave front was observed when pacing from the PCS in all patients except one. Low LRA pacing was also performed in 4 patients and showed evidence for block in the counterclockwise direction at the isthmus. During a follow-up of 9±3 months, AFl recurred in 1 patient; this was the only patient who showed no conduction block at the isthmus after the procedure. Conclusions Direction of impulse propagation at LRA and block of propagation at the IVC-TA isthmus during PCS and low LRA pacing appear to be of interest in predicting long-term success of AFl ablation.
Supervised Patient-Management of Hemophilia
Authors: Peter H. Levine, Anthony F. H. Britten
Journal: Annals of Internal Medicine (1973)

Forty-five patients with hemophilia A and B were formally instructed in the management of their bleeding problems. Home infusion was permitted without prior consultation with a physician. Data from 12 months of this program were compared with results from the previous year. There was 74% reduction in absenteeism, 89% reduction in days hospitalized, 76% reduction in outpatient visits, and 45% decrease in health care costs. Use of factor VIII or IX decreased slightly. No patients had morbidity attributable to this program. The only important hazard was the exposure of family members to hepatitis from contaminated needles; one case occurred. These results, coupled with a gratifying trend towards more normal life patterns, suggest that the more widespread application of this form of therapy is justified. Hemophilia self-therapy may provide a useful model for improving the delivery of health care in certain other chronic illnesses.
Points: Hyperlipidaemia advances and retreats
Authors: A Lewis
Journal: BMJ (1980)

Hyperlipidaemia advances and retreatsDr A LEWIS (London WlN 1FJ) writes: How long will it be before the hazards of eating dairy foods (23 August, p 564) are remembered with amusement like those of eating meat.This dangerous stuff (especially red meat) "caused" kidney disease, hypertension, rheumatism, and gout because it was a source of uric acid and urea, with which these conditions were thought to be associated. Drugs and rheumatoid arthritisDr JACK BOURNE (Hornchurch, Essex) writes: In his letter on the effect of corticosteroids on the manifestations of rheumatoid arthritis,
Ecotoxicology of phenylphosphonothioates.
Authors: B M Francis, L G Hansen, T R Fukuto, P Y Lu, R L Metcalf
Journal: Environmental Health Perspectives (1980)

The phenylphosphonothioate insecticides EPN and leptophos, and several analogs, were evaluated with respect to their delayed neurotoxic effects in hens and their environmental behavior in a terrestrial-aquatic model ecosystem. Acute toxicity to insects was highly correlated with sigma sigma of the substituted phenyl group (regression coefficient r = -0.91) while acute toxicity to mammals was slightly less well correlated (regression coefficient r = -0.71), and neurotoxicity was poorly correlated with sigma sigma (regression coefficient r = -0.35). Both EPN and leptophos were markedly more persistent and bioaccumulative in the model ecosystem than parathion. Desbromoleptophos, a contaminant and metabolite of leptophos, was seen to be a highly stable and persistent terminal residue of leptophos.
Interleukin-22 induces hepatic stellate cell senescence and restricts liver fibrosis in mice
Authors: Xiaoni Kong, Dechun Feng, Hua Wang, Feng Hong, Adeline Bertola, Fu-Sheng Wang, Bin Gao
Journal: Hepatology (2012)

Interleukin (IL)-22 is known to play a key role in promoting antimicrobial immunity, inflammation, and tissue repair at barrier surfaces by binding to the receptors, IL-10R2 and IL-22R1. IL-22R1 is generally thought to be expressed exclusively in epithelial cells. In this study, we identified high levels of IL-10R2 and IL-22R1 expression on hepatic stellate cells (HSCs), the predominant cell type involved in liver fibrogenesis in response to liver damage. In vitro treatment with IL-22 induced the activation of signal transducer and activator of transcription (STAT) 3 in primary mouse and human HSCs. IL-22 administration prevented HSC apoptosis in vitro and in vivo, but surprisingly, the overexpression of IL-22 by either gene targeting (e.g., IL-22 transgenic mice) or exogenous administration of adenovirus expressing IL-22 reduced liver fibrosis and accelerated the resolution of liver fibrosis during recovery. Furthermore, IL-22 overexpression or treatment increased the number of senescence-associated beta-galactosidase-positive HSCs and decreased alpha-smooth muscle actin expression in fibrotic livers in vivo and cultured HSCs in vitro. Deletion of STAT3 prevented IL-22-induced HSC senescence in vitro, whereas the overexpression of a constitutively activated form of STAT3 promoted HSC senescence through p53- and p21-dependent pathways. Finally, IL-22 treatment up-regulated the suppressor of cytokine signaling (SOCS) 3 expression in HSCs. Immunoprecipitation analyses revealed that SOCS3 bound p53 and subsequently increased the expression of p53 and its target genes, contributing to IL-22-mediated HSC senescence. IL-22 induces the senescence of HSCs, which express both IL-10R2 and IL-22R1, thereby ameliorating liver fibrogenesis. The antifibrotic effect of IL-22 is likely mediated by the induction of HSC senescence, in addition to the previously discovered hepatoprotective functions of IL-22.
RECENT DRUG THERAPY IN DISEASES OF THE CHEST, INCLUDING TUBERCULOSIS
Authors: William S. Schwartz
Journal: JAMA (1952)

At present, there are a number of effective drugs available for the treatment of many of the common acute pulmonary infections; for example, Pneumococcus pneumonia can be controlled successfully by sulfadiazine, penicillin, aureomycin, chloramphenicol, or terramycin. It is desirable in many cases of pneumonia and in other types of pulmonary infection to determine the exact etiological agent and its sensitivity to the various antibiotics before beginning treatment. Unfortunately, this is frequently impossible because the patient's condition requires immediate therapy or laboratory facilities to perform the tests are lacking. Most hospitalized patients suffering from pneumonia now receive penicillin because of its low toxicity and low cost; however, in most cases, the advantage of oral administration is so great that any one of the three latter antibiotics are likely to become even more popular than they now are, if their cost is reduced. Since aureomycin, chloramphenicol, and terramycin have a broad antibacterial
HLA homozygosity and haplotype bias among patients with chronic lymphocytic leukemia: implications for disease control by physiological immune surveillance
Authors: N Shah, W K Decker, R Lapushin, D Xing, S N Robinson, H Yang, S Parmar, S S Tung, S O'Brien, M Fernandez-Viña, E J Shpall, W G Wierda
Journal: Leukemia (2011)
Pseudosarcomatous Fasciitis Revisited After 27 Years
Authors: Irving M. Reingold, Frank W. Ellis
Journal: JAMA (1978)

To the Editor.—  Twenty-seven years ago the junior author (F.W.E.) noted a 1-cm, smoothly rounded, slightly tender mass, which had become noticeably enlarged to 2 cm, in the popliteal space of his left leg following a skiing trip, but it apparently was not related to this activity. The nodule was excised from the deep subcutaneous tissue. Microscopically it consisted of loosely arranged, plump, elongated, bizarre fibroblasts, some with mitotic figures, intermingled with lymphocytes, histiocytes, capillaries, and extravasated RBCs and embedded in a loose, edematous, and somewhat myxoid stroma. In some areas the lesion had the appearance of exuberant granulation tissue.  Much concern was expressed because of the atypical microscopic features of the lesion and because the patient was a young physician, a few years out of medical school.  The lesion was examined and reexamined extremely carefully by local pathologists, many of whom considered the lesion to be a low-grade malignant
Elevated interleukin-12 in progressive multiple sclerosis correlates with disease activity and is normalized by pulse cyclophosphamide therapy.
Authors: M Comabella, K Balashov, S Issazadeh, D Smith, H L Weiner, S J Khoury
Journal: Journal of Clinical Investigation (1998)

Multiple sclerosis is postulated to be a Th1-type cell-mediated autoimmune disease. We investigated cytokine profiles in patients with progressive multiple sclerosis by using intracytoplasmic staining. We found increased IL-12 production by monocytes and increased IFN-gamma production by T cells in untreated patients as compared with controls. In patients treated with methotrexate, methylprednisolone, or cyclophosphamide/methylprednisolone (CY/MP), only CY/MP treatment normalized the elevated IL-12 production. Furthermore, CY/MP-treated patients had decreased IFN-gamma and increased IL-4, IL-5, and TGF-beta expression. Patients followed prospectively before and after starting CY/MP treatment showed a gradual decrease in IL-12 and IFN-gamma production and an increase in IL-4 and IL-5. In vitro, addition of 4-hydroperoxycyclophosphamide, a metabolite of cyclophosphamide decreased IL-12 production in mononuclear cell cultures. When patients were classified as having active or stable disease, IL-12 production correlated with disease activity. In summary, our results demonstrate a Th1-type cytokine bias in peripheral blood mononuclear cells of untreated progressive MS patients that is reversed by CY/MP treatment and is associated with Th2 and TGF-beta (Th3) type responses. These findings provide a basis for immune monitoring of patients with MS and suggest that treatments that downregulate IL-12 may prove to be beneficial in progressive MS.
Carpet Beetle Dermatitis
Authors: Frank E. Cormia
Journal: JAMA (1967)

To the Editor:—  I enjoyed the letter  'Delusions' of Parasitosis Caused by Carpet Beetles by Drs. Samuel Ayres, Jr., and Richard Mihan ( 199 :675, 1967). Often times, we dermatologists are apt to discount the statements of apprehensive and at times paranoid patients that they have bugs on their skin. Almost inevitably such patients have delusions of parasitosis, and a meticulous examination of material which they bring in reveals the presence only of cloth fibers, epithelial debris, or dirt. In this case Dr. Ayres and Dr. Mihan were able to allay the apprehension of the patient and effect a cure by identifying a harmless carpet beetle.  I should like to point out, however, that carpet beetles may rarely produce a contact type of dermatitis in man. Such a case was reported by Dr. George M. Lewis and me ( New York J Med  48 :2037, 1948). The patient was a 47-year-old nurse
Relation Between Ischemic Threshold Measured During Dobutamine Stress Echocardiography and Known Indices of Poor Prognosis in Patients With Coronary Artery Disease
Authors: Julio A. Panza, Rodolfo V. Curiel, Joy M. Laurienzo, Arshed A. Quyyumi, Vasken Dilsizian
Journal: Circulation (1995)

Stress echocardiography has become an accepted methodology for the evaluation of coronary artery disease. One potential advantage of dobutamine over other stressors used with echocardiography is the possibility of assessing the ischemic threshold. However, whether this measurement correlates with indices associated with adverse outcome has not been established.One hundred four patients (91 men and 13 women; age, 61 +/- 9 years) with coronary artery disease were studied with transesophageal echocardiography during infusion of dobutamine 2.5 to 40 microgram/kg per minute. When regional dyssnergy developed, the dobutamine ischemic threshold (the dose of dobutamine at which induced regional wall motion abnormalities were first detected) was identified. The dobutamine stress echocardiogram was abnormal in 90 patients (sensitivity, 87%). The dobutamine ischemic threshold was 25.4 +/- 11.2 micrograms/kg per minute in patients with single-vessel disease, 14.4 +/- 7.9 in patients with two-vessel disease, and 9.1 +/- 7.9 in patients with three-vessel disease (P < .0001). The dobutamine ischemic threshold correlated with the ejection fraction response to exercise measured by radionuclide angiography: Patients with low ischemic threshold had a mean fall in ejection fraction, and patients with high ischemic threshold or normal tests had a mean increase in ejection fraction.In patients with coronary artery disease, the ischemic threshold measured during dobutamine stress echocardiography correlates with both the number of stenosed vessels and the left ventricular ejection fraction response to exercise. Because these variables are associated with poor prognosis, these findings provide further support regarding the utility of dobutamine stress echocardiography in the clinical evaluation of patients with chronic coronary artery disease.
Inherited Variation in the ATP-Binding Cassette Transporter ABCB1 and Survival after Chemotherapy for Stage III–IV Lung Cancer
Authors: Joel L. Weissfeld, Brenda Diergaarde, Tomoko Nukui, Shama Buch, Arjun Pennathur, Mark A. Socinski, Jill M. Siegfried, Marjorie Romkes
Journal: Journal of Thoracic Oncology (2014)
IgG4‐related skin disease
Authors: Y. Tokura, H. Yagi, H. Yanaguchi, Y. Majima, A. Kasuya, T. Ito, M. Maekawa, H. Hashizume
Journal: British Journal of Dermatology (2014)

IgG4-related disease (IgG4-RD) is a recently established clinical entity characterized by high levels of circulating IgG4, and tissue infiltration of IgG4(+) plasma cells. IgG4-RD exhibits a distinctive fibroinflammatory change involving multiple organs, such as the pancreas and salivary and lacrimal glands. The skin lesions of IgG4-RD have been poorly characterized and may stem not only from direct infiltration of plasma cells but also from IgG4-mediated inflammation. Based on the documented cases together with ours, we categorized the skin lesions into seven subtypes: (1) cutaneous plasmacytosis (multiple papulonodules or indurations on the trunk and proximal part of the limbs), (2) pseudolymphoma and angiolymphoid hyperplasia with eosinophilia (plaques and papulonodules mainly on the periauricular, cheek and mandible regions), (3) Mikulicz disease (palpebral swelling, sicca syndrome and exophthalmos), (4) psoriasis-like eruption (strikingly mimicking psoriasis vulgaris), (5) unspecified maculopapular or erythematous eruptions, (6) hypergammaglobulinaemic purpura (bilateral asymmetrical palpable purpuric lesions on the lower extremities) and urticarial vasculitis (prolonged urticarial lesions occasionally with purpura) and (7) ischaemic digit (Raynaud phenomenon and digital gangrene). It is considered that subtypes 1-3 are induced by direct infiltration of IgG4(+) plasma cells, while the other types (4-7) are caused by secondary mechanisms. IgG4-related skin disease is defined as IgG4(+) plasma-cell-infiltrating skin lesions that form plaques, nodules or tumours (types 1-3), but may manifest secondary lesions caused by IgG4(+) plasma cells and/or IgG4 (types 4-7).