tbuckley/cabot-search huggingface dataset:
Efficacy and Comparative Effectiveness of Atypical Antipsychotic Medications for Off-Label Uses in Adults
Authors: Alicia Ruelaz Maher, Margaret Maglione, Steven Bagley, Marika Suttorp, Jian-Hui Hu, Brett Ewing, Zhen Wang, Martha Timmer, David Sultzer, Paul G. Shekelle
Journal: JAMA (2011)

Atypical antipsychotic medications are commonly used for off-label conditions such as agitation in dementia, anxiety, and obsessive-compulsive disorder.To perform a systematic review on the efficacy and safety of atypical antipsychotic medications for use in conditions lacking approval for labeling and marketing by the US Food and Drug Administration.Relevant studies published in the English language were identified by searches of 6 databases (PubMed, EMBASE, CINAHL, PsycInfo, Cochrane DARE, and CENTRAL) from inception through May 2011. Controlled trials comparing an atypical antipsychotic medication (risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone, asenapine, iloperidone, or paliperidone) with placebo, another atypical antipsychotic medication, or other pharmacotherapy for adult off-label conditions were included. Observational studies with sample sizes of greater than 1000 patients were included to assess adverse events.Independent article review and study quality assessment by 2 investigators.Of 12 228 citations identified, 162 contributed data to the efficacy review. Among 14 placebo-controlled trials of elderly patients with dementia reporting a total global outcome score that includes symptoms such as psychosis, mood alterations, and aggression, small but statistically significant effects sizes ranging from 0.12 and 0.20 were observed for aripiprazole, olanzapine, and risperidone. For generalized anxiety disorder, a pooled analysis of 3 trials showed that quetiapine was associated with a 26% greater likelihood of a favorable response (defined as at least 50% improvement on the Hamilton Anxiety Scale) compared with placebo. For obsessive-compulsive disorder, risperidone was associated with a 3.9-fold greater likelihood of a favorable response (defined as a 25% improvement on the Yale-Brown Obsessive Compulsive Scale) compared with placebo. In elderly patients, adverse events included an increased risk of death (number needed to harm [NNH] = 87), stroke (NNH = 53 for risperidone), extrapyramidal symptoms (NNH = 10 for olanzapine; NNH = 20 for risperidone), and urinary tract symptoms (NNH range = 16-36). In nonelderly adults, adverse events included weight gain (particularly with olanzapine), fatigue, sedation, akathisia (for aripiprazole), and extrapyramidal symptoms.Benefits and harms vary among atypical antipsychotic medications for off-label use. For global behavioral symptom scores associated with dementia in elderly patients, small but statistically significant benefits were observed for aripiprazole, olanzapine, and risperidone. Quetiapine was associated with benefits in the treatment of generalized anxiety disorder, and risperidone was associated with benefits in the treatment of obsessive-compulsive disorder; however, adverse events were common.
Autoerythrocyte Sensitization Successfully Treated With Antidepressants
Authors: Edmund C. Settle
Journal: JAMA (1983)

AUTOERYTHROCYTE sensitization was first described in 1955 by Gardner and Diamond<sup>1</sup>as a syndrome of recurrent, painful bruising largely confined to the extremities. An autoimmune sensitization to the patient's own RBCs was postulated as the underlying mechanism, since typical symptoms were reproduced by intracutaneous injection of patients with their own RBCs but not by other injected agents. Neither normal individuals nor patients with erythema nodosum reacted to autologous RBC injection. In an extensive review of this disorder, Ratnoff<sup>2</sup>noted 100 cases, 95% of them female, with the most common age at onset of 14 to 40 years. Trauma or surgery, originally thought to be precipitants, has been absent in many subsequent patients. Bruising is usually preceded by a prodrome of burning, painful paresthesias in the involved extremity or by some systemic symptom such as malaise, headache, or gastrointestinal (GI) disturbance. Lesions begin with an area of warmth, erythema, and
Mental Retardation Clue
Authors: Tracy Hampton
Journal: JAMA (2007)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Advert for breast cancer gene test triggers inquiry
Authors: Jeanne Lenzer
Journal: BMJ (2007)

A controversial television advertisement in the United States encouraging women to undergo genetic testing to determine their risk of breast cancer has triggered an inquiry into claims made by the advertiser, Myriad Genetics.

The women in the advertisement appear to be in their early 20s to late 50s, and each says she has a relative with breast cancer. A couple of the women say they want to get “BRACAnalysis” to learn about their risk of breast cancer and “do something about it.”

Some cancer specialists say that this “direct to consumer” campaign is unnecessarily alarmist. A New York Times …
Osteoporosis in inflammatory bowel disease
Authors: J Compston
Journal: Gut (2002)

Inflammatory bowel disease (IBD) is associated with an increased prevalence of osteoporosis, a condition characterised by reduced bone mineral density and increased risk of fragility fracture. Although in the majority of patients the absolute risk of fracture is low, a few suffer significant morbidity as a result of fractures. Prediction of those at highest risk remains problematic; glucocorticoid therapy and hypogonadism are likely to be important contributory factors and the increase in risk may be greater in patients with Crohn’s disease. Both men and women may be affected and younger age groups are not immune.1,2

A range of therapeutic interventions has been shown to reduce fracture risk in postmenopausal women with osteoporosis.3 These include the bisphosphonates (cyclic etidronate, alendronate, and risedronate), hormone replacement therapy, raloxifene, and combined calcium and vitamin D. Bisphosphonates also prevent bone loss in glucocorticoid treated individuals and in men with idiopathic osteoporosis. All of …
An Evaluation of Roentgen Signs of Pancreatic Enlargement
Authors: William R. Eyler
Journal: JAMA (1962)

The original routine interpretation of the upper gastrointestinal series in 100 cases of carcinoma of the pancreas resulted in a positive diagnosis in only 24 cases. In a controlled retrospective study, a positive diagnosis of pancreatic enlargement was made in 57 of the 100 cases; an additional 9 were thought sufficiently suspicious to warrant reexamination with particular attention to this possibility, usually when the routine films had not shown the duodenal loop well filled. A review was made of various signs of pancreatic abnormality and each sign was evaluated for validity. A group of cases of pancreatitis associated with duodenal ulcer was also analyzed. The use of cases explored for some other cause prevented "over-interpretation."
CONTACT DERMATITIS FROM NEOMYCIN.
Authors: C. D. CALNAL, I. SARKANY
Journal: British Journal of Dermatology (1958)

Journal Article CONTACT DERMATITIS FROM NEOMYCIN. Get access C. D. CALNAL, M.R.C.P., C. D. CALNAL, M.R.C.P. PhysicianSt. John's Hospital for Diseases of the Skin, London Search for other works by this author on: Oxford Academic Google Scholar I. SARKANY, M.R.C.P. I. SARKANY, M.R.C.P. RegistrarSt. John's Hospital for Diseases of the Skin, London Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 70, Issue 12, 1 December 1958, Pages 435–445, https://doi.org/10.1111/j.1365-2133.1958.tb13283.x Published: 01 December 1958
The role of the multichain IL-2 receptor complex in the control of normal and malignant T-cell proliferation.
Authors: T A Waldmann
Journal: Environmental Health Perspectives (1987)

Antigen-induced activation of resting T-cells induces the synthesis of interleukin-2 (IL-2), as well as the expression of specific cell surface receptors for this lymphokine. There are at least two forms of the cellular receptors for IL-2, one with a very high affinity and the other with a lower affinity. We have identified two IL-2 binding peptides, a 55-kd peptide reactive with the anti-Tac monoclonal antibody, and a novel 75-kd non-Tac IL-2 binding peptide. Cell lines bearing either the p55, Tac, or the p75 peptide alone manifested low-affinity IL-2 binding, whereas cell lines bearing both peptides manifested both high- and low-affinity receptors. Fusion of cell membranes from low-affinity IL-2 binding cells bearing the Tac peptide alone with membranes from a cell line bearing the p75 peptide alone generates hybrid membranes bearing high-affinity receptors. We propose a multichain model for the high-affinity IL-2 receptor in which both the Tac and the p75 IL-2 binding peptides are associated in a receptor complex. In contrast to resting T-cells, human T-cell lymphotropic virus I-associated adult T-cell leukemia cells constitutively express large numbers of IL-2 receptors. Because IL-2 receptors are present on the malignant T-cells but not on normal resting cells, clinical trials have been initiated in which patients with adult T-cell leukemia are being treated with either unmodified or toxin-conjugated forms of anti-Tac monoclonal antibody directed toward this growth factor receptor.
Sustained ventricular tachycardia in patients with idiopathic dilated cardiomyopathy: electrophysiologic testing and lack of response to antiarrhythmic drug therapy.
Authors: D S Poll, F E Marchlinski, A E Buxton, J U Doherty, H L Waxman, M E Josephson
Journal: Circulation (1984)

Eleven consecutive patients with idiopathic dilated cardiomyopathy and spontaneous, sustained ventricular tachycardia (VT) of uniform morphology underwent programmed ventricular stimulation and serial antiarrhythmic drug testing. The mean ejection fraction was 30 +/- 6.4%. Sustained VT was induced by programmed electrical stimulation in all 11 patients. A mean of 3.7 +/- 2.4 antiarrhythmic drugs were evaluated by programmed stimulation, including at least one experimental agent in eight patients. In nine of 11 patients VT remained inducible on all drug therapy. During a mean follow-up period of 21 +/- 14 months there were four sudden deaths and two patients with recurrences of VT. In all six patients with sudden death or recurrence of VT, the arrhythmia remained inducible on drug therapy. Three patients who died suddenly had a hemodynamically stable, induced tachycardia on antiarrhythmic therapy. Of eight patients treated with amiodarone, only two were successfully treated. We conclude that in patients with sustained VT and idiopathic dilated cardiomyopathy, VT can be induced by programmed electrical stimulation. VT will usually remain inducible on antiarrhythmic therapy, and sudden death can occur despite slowing and improved tolerance of the induced arrhythmia. Amiodarone may have limited efficacy, and more aggressive therapy, such as surgery or implantation of an automatic internal defibrillator, should be considered in this patient population.
SURVEY OF X-RAY EXPOSURES IN HOSPITAL PERSONNEL
Authors: Egilda DeAmicis
Journal: JAMA (1952)

Considerable interest in the problem of proper protection for x-ray personnel has been advanced since the rules and regulations pertinent to the use of isotopes as outlined by the Atomic Energy Commission have become widely known. As of March, 1949, the permissible dosage rate<sup>1</sup>as recommended by the National Bureau of Standards was "the maximum total dose to which any part of the body of a person shall be permitted to be exposed continuously or intermittently in a given time. It shall be 0.300 r per week. On the basis of 48 hours per week of uniform exposure, the permissible dosage rates are: 0.00625 r per hour (6.25 mr per hour)...." In 1922 Pfahler,<sup>2</sup>in a study of the general health of radiologists, examined films worn by several hundred workers and observed darkening correlated to the erythema dose received by a worker. In 1926 Quimby<sup>3</sup>developed a
A Comparison of the Growth Responses Following Intramuscular GHRH Plasmid Administration Versus Daily Growth Hormone Injections in Young Pigs
Authors: Amir S Khan, Ruxandra Draghia-Akli, Roman J Shypailo, Kenneth I Ellis, Harry Mersmann, Marta L Fiorotto
Journal: Molecular Therapy (2009)

The efficacy of daily porcine growth hormone (GH) injections versus plasmid-driven porcine GH-releasing hormone (pGHRH) production to promote growth was assessed. Ten-day-old piglets were injected intramuscularly with 0.1, 1, or 3 mg pGHRH, or a control plasmid followed by electroporation. Plasmid constructs were driven by a synthetic muscle-specific promoter. A fifth group received daily injections of GH [0.15 mg/(kg·day)]. Control and pGHRH-treated pigs were pair-fed to GH-treated pigs. Body composition was assessed by dual-energy X-ray absorptiometry (DXA). Weight gains of GH- and pGHRH-treated pigs were greater than of controls (P < 0.001) due to greater lean mass accretion; fat accretion was similar across all treatments. Weight gain of pGHRH- and GH-treated pigs was similar for 6 weeks, but over the final 10 days, only pigs administered the highest plasmid dose maintained higher growth rates. Serum insulin-like growth factor-I (IGF-I) levels were two- to threefold higher in GH- and pGHRH-treated pigs than in controls after 4 weeks (P = 0.05), but subsequently decreased to control levels in the pGHRH-treated group. Organ weights were greater in GH- than pGHRH-treated and control piglets (P < 0.02). These results demonstrate that pGHRH transfer is effective for promoting growth and avoids the need for the frequent injections necessitated with peptide hormone use. The efficacy of daily porcine growth hormone (GH) injections versus plasmid-driven porcine GH-releasing hormone (pGHRH) production to promote growth was assessed. Ten-day-old piglets were injected intramuscularly with 0.1, 1, or 3 mg pGHRH, or a control plasmid followed by electroporation. Plasmid constructs were driven by a synthetic muscle-specific promoter. A fifth group received daily injections of GH [0.15 mg/(kg·day)]. Control and pGHRH-treated pigs were pair-fed to GH-treated pigs. Body composition was assessed by dual-energy X-ray absorptiometry (DXA). Weight gains of GH- and pGHRH-treated pigs were greater than of controls (P < 0.001) due to greater lean mass accretion; fat accretion was similar across all treatments. Weight gain of pGHRH- and GH-treated pigs was similar for 6 weeks, but over the final 10 days, only pigs administered the highest plasmid dose maintained higher growth rates. Serum insulin-like growth factor-I (IGF-I) levels were two- to threefold higher in GH- and pGHRH-treated pigs than in controls after 4 weeks (P = 0.05), but subsequently decreased to control levels in the pGHRH-treated group. Organ weights were greater in GH- than pGHRH-treated and control piglets (P < 0.02). These results demonstrate that pGHRH transfer is effective for promoting growth and avoids the need for the frequent injections necessitated with peptide hormone use.
Blood Serum of Man Injected with Gonadotropic Extracts
Authors: A. W. Spence, E. F. Scowen, I. W. Rowlands
Journal: BMJ (1938)

BimORAneither of these things and is best avoided, nor should any other form of aperient be prescribed.Opium is the most useful drug in cases of this disease, and it may be taken with bismuth or a reliable brand of kaolin.Fluids should be given so far as the vomiting permits, and as soon as there is a desire for food a bland diet may be ordered.In debilitated patients special measures to combat the de- hydration may be required.The use of anti-dysenteric serum is neither necessary nor of value in cases of Sonne dysentery.
Free radicals and reperfusion arrhythmias. Commentaries on this month's Controversy articles From Yoshiki Kusama and Hirokazu Hayakawa
Authors: Y. Kusama, H. Hayakawa
Journal: Cardiovascular Research (1994)

Journal Article Free radicals and reperfusion arrhythmias. Commentaries on this month's Controversy articles From Yoshiki Kusama and Hirokazu Hayakawa Get access Yoshiki Kusama, Yoshiki Kusama The First Department of Medicine, Nippon Medical School, Tokyo, Japan. Search for other works by this author on: Oxford Academic PubMed Google Scholar Hirokazu Hayakawa Hirokazu Hayakawa The First Department of Medicine, Nippon Medical School, Tokyo, Japan. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 28, Issue 3, March 1994, Pages 427–428, https://doi.org/10.1093/cvr/28.3.427 Published: 01 March 1994
Depressive Symptoms, Social Isolation, and Progression of Coronary Artery Atherosclerosis: The Stockholm Female Coronary Angiography Study
Authors: Hui-Xin Wang, Murray A. Mittleman, Constanze Leineweber, Kristina Orth-Gomer
Journal: Psychotherapy and Psychosomatics (2006)

&lt;i&gt;Background:&lt;/i&gt; Although both depressive symptoms and social isolation in relation to coronary heart disease have been studied previously, few have examined their joint effects on coronary atherosclerosis progression in women. &lt;i&gt;Method:&lt;/i&gt; Among the women enrolled in the Stockholm Female Coronary Angiography Study, Sweden, between 1991 and 1994, 102 were evaluated for coronary atherosclerosis progression using a computer-assisted standardized assessment, repeated quantitative coronary angiographic documentation, of the mean luminal diameter change over 3 years in 10 predefined coronary segments. Depressive symptoms and social isolation were assessed by standard questionnaires. &lt;i&gt;Results:&lt;/i&gt; Multivariable controlled mixed model ANOVAs revealed that women who were both depressed and socially isolated had the greatest disease progression: their absolute mean luminal diameter decreased by 0.18 mm [95% confidence interval (CI) = 0.11–0.24] and their percent narrowing was 5.5% (95% CI = 3.6–7.4), whereas in women who lacked both psychological risk factors, the mean luminal diameter decrease was 0.04 mm and their percent narrowing was 0.9%. These associations were independent of the baseline luminal diameter and standard risk factors, including age, smoking history, hypertension, and high-density lipoproteins. &lt;i&gt;Conclusions:&lt;/i&gt;In women with coronary disease, depressive symptoms and social isolation in combination accelerated disease progression, suggesting a direct psychosocial effect on the atherosclerotic process. These findings provide an additional opportunity for therapeutic and preventive efforts against progression of coronary disease in women.
The Effect of Parental History of Myopia on Children's Eye Size
Authors: Karla Zadnik
Journal: JAMA (1994)

To evaluate whether eye size and shape are different in children based on their parental history of myopia.A community-based cohort study of schoolchildren (aged 6 to 14 years), the Orinda (Calif) Longitudinal Study of Myopia.Four campuses of the Orinda Union School District, a predominantly white, high socioeconomic status community.A cross-sectional volunteer sample of 716 children (662 non-myopic) in the first, third, and sixth grades in 1989, 1990, and 1991. All children in those grades were eligible for inclusion in the study.None.Refractive error (measured by autorefraction), corneal curvature (measured by photokeratoscopy), crystalline lens power (measured by video phakometry), and axial ocular dimensions (measured by ultrasonography).With prevalent cases of myopia excluded and grade in school and "near work" controlled for, children with two myopic parents had longer eyes and less hyperopic refractive error (analysis of covariance, P < or = .01) than children with only one myopic parent or no myopic parents. A model incorporating parental history is only improved by the addition of near work for the prediction of refractive error.Even before the onset of juvenile myopia, children of myopic parents have longer eyes. These results suggest that the premyopic eye in children with a family history of myopia already resembles the elongated eye present in myopia.
Care of Pregnant Women Infected With HIV
Authors: Pascale Wortley
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Because no recognized guidelines specifically address prophylactic treatments such as zidovudine and primary<i>Pneumocystis carinii</i>pneumonia prophylaxis for pregnant women infected with the human immunodeficiency virus (HIV),<sup>1,2</sup>current physician prescribing practices for such women may vary widely. In this analysis, we reviewed medical records of a sample of pregnant women from the Adult and Adolescent Spectrum of HIV Disease Project (ASD), a large, multisite, observational study started in January 1990 in which medical records of HIV-infected persons receiving medical care are reviewed at regular intervals.<sup>3</sup>Among2050 women identified before November 1992, 367 (18%) had been pregnant during the previous year. Using information collected routinely in this project and additional information specifically abstracted for the pregnant women in this analysis (eg, exact dates of pregnancy and drug prescription), we examined physicians' prescription practices for 86 pregnant women with CD4<sup>+</sup>T-lymphocyte cell counts less than 0.50×10<sup>9</sup>
PEEPO: papular eruption with elimination of papillary oedema*
Authors: R.RUSSELL JONES
Journal: British Journal of Dermatology (1982)

Multiple biopsies from a patient with a pruritic papular eruption of endogenous origin demonstrated a sequence of histopathological changes which varied markedly with the age of the lesion. Early lesions showed marked papillary oedema but no evidence of epidermal involvement. The next phase was characterized by the appearance of focal spongiosis and intra-epidermal vesiculation without involvement of the stratum corneum. Late lesions were characterized by residual spongiosis in the epidermis and groups of pyknotic nuclei in a parakeratotic stratum corneum. It would seem that this sequence of events is due to the elimination of papillary oedema through the epidermis. The fact that this process produces changes indistinguishable from those seen in eczema may indicate the eczema itself is a condition characterized by sub-epidermal oedema in which the epidermis is involved only as a secondary event. The title TEEPO (trans-epidermal elimination of papillary oedema) is suggested as a suitable acronym for this phenomenon. The term PEEPO (papular eruption with elimination of papillary oedema) is proposed for the eruption seen in this patient.