tbuckley/cabot-search huggingface dataset:
Guide to Diagnostic Imaging, vol 1: The Liver and Spleen
Authors: Yolanda T. Adler
Journal: JAMA (1983)

The preface to this book states "the question is frequently asked (especially by interns and residents), which imaging modality would be most applicable, or, if more than one examination is needed, what should the sequence be? This book was written with the precedent question in mind." In its opening chapters, this work succeeds in giving a good description of the imaging modalities available and the type of lesions that can be expected to be demonstrated with each of them. However, I think that the intern and resident seeking an answer to the question as stated can be bogged down by an excess of information and find it rather difficult to get oriented. There are too many reviews of basic concepts, such as the metabolism of bilirubin or the different viruses in hepatitis. They are not pertinent and tend to distract the readers from the main purpose. After all, the physician
Role of Sentinel Lymphadenectomy in Thin Invasive Cutaneous Melanomas
Authors: Richard J. Bleicher, Richard Essner, Leland J. Foshag, Leslie A. Wanek, Donald L. Morton
Journal: Journal of Clinical Oncology (2003)

Purpose: Regional lymph node status is the strongest prognostic determinant in early-stage melanoma. Lymphatic mapping and sentinel lymphadenectomy (LM/SL) is standard to stage regional nodes because it is accurate and minimally morbid, yet its role for thin (≤ 1.5 mm) primary melanomas is unknown. Patients and Methods: Our melanoma database of more than 10,000 patients was reviewed for patients with melanomas ≤ 1.50 mm thick who underwent LM/SL. All had lymphoscintigrams and LM/SL via dye alone or with radiopharmaceutical. Patients with tumor-positive sentinel nodes (SNs) underwent completion dissections. Results: Five hundred twelve patients underwent LM/SL. Most were men (57%), and median age was 49 years. Most primary melanomas were on the torso (44%). Twenty-five patients (4.9%) had tumor-positive SNs. The thinnest lesion with a nodal metastasis was 0.35 mm. The SN-negative and SN-positive cohorts were equivalent by sex, but SN+ patients tended to be younger (P = .053), with significantly more SN metastases in those younger than 44 years (P = .005). No consistent pathology among SN-positive primary melanomas was found. Among those with 1.01- to 1.05-mm primaries, 7.1% were SN-positive. Among 272 patients with lesions ≤ 1.00 mm, 2.9% had positive SNs and 1.7% with lesions ≤ 0.75 mm had SN metastases. All 13 deaths were in SN-negative patients. Median follow-up durations in SN-positive and SN-negative patients were 25 and 45 months, respectively. Conclusion: The high nodal positivity rate associated with primary melanomas 1.01 to 1.50 mm thick suggests that LM/SL is indicated in this group. Younger age may be correlated with nodal metastases in patients with lesions ≤ 1.00 mm. Lesions ≤ 0.75 mm have minimal metastatic potential, and therefore LM/SL is rarely indicated.
TODAY'S MEDICINE IN UNDERDEVELOPED AREAS
Authors: John Z. Bowers
Journal: JAMA (1953)

Recently there has been a growing interest in the economic plight of village people in distant lands. Bold new programs to increase food production, to provide opportunities for education, and to improve health have been launched with the support of the United States Government and private foundations. During the past year, I have spent about four months in India as medical advisor to the government of India and the Ford Foundation. The primary purpose of these visits was to assist in the development of a village health program that would integrate with the other aspects of the community development program in India.  The health of a villager in India is the result of the interplay of a number of factors, some of which would at first glance seem far removed from health. Any endeavor to improve the health of an Indian villager must consider existing health practices and prejudices, the
THE RELATIONS OF THE COLON TO INTRAABDOMINAL TUMORS.
Authors: M. L. HARRIS
Journal: JAMA (1899)

The correct diagnosis of an abdominal tumor is often one of the most difficult problems that confront the surgeon. Nor can the importance of the question be in any way diminished by the statement that an exploratory operation will decide. Notwithstanding the comparative harmlessness of an exploratory celiotomy under proper precautions, no surgeon is proud of having to open the abdomen to diagnose a pregnant uterus, or after thrusting his trocar into a supposed ovarian cyst and drawing it up to find an inextricable mass leading to the pancreas. Still, incidents similar to these are common in the history of surgery. The object of this paper is not to consider the many means employed in making a diagnosis of an abdominal tumor, but simply to illustrate and emphasize the importance of a simple procedure which is too often neglected. In arriving at a conclusion as to the nature of an
Vulnerabilities to addiction must have their impact through the common currency of discounted reward
Authors: George Ainslie
Journal: Behavioral and Brain Sciences (2008)

Abstract The ten vulnerabilities discussed in the target article vary in their likelihood of producing temporary preference for addictive activities – which is the phenomenon that puzzles conventional motivational theory. Direct dopaminergic stimulation, but probably not the other vulnerabilities, may contribute to the necessary concavity of addicts' delay discounting curves, as may factors that the senior author analyzes elsewhere. Whatever their origins, these curves can themselves account for temporary preference, sudden craving, and the “automatic” habits discussed here.
A Perspective on US Drug Reimportation
Authors: Niteesh K. Choudhry
Journal: JAMA (2005)

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
Book Review Phages: Their Role in Bacterial Pathogenesis and Biotechnology Edited by Matthew K. Waldor, David I. Friedman, and Sankar L. Adhya. 450 pp., illustrated. Washington, D.C., ASM Press, 2005. $119.95. 1-55581-307-0
Authors: Christian T.K.-H. Stadtländer
Journal: New England Journal of Medicine (2006)
Preservation of glomerular filtration rate in human heart failure by activation of the renin-angiotensin system.
Authors: M Packer, W H Lee, P D Kessler
Journal: Circulation (1986)

When renal perfusion pressure is reduced in experimentally induced low-output states, glomerular filtration rate is preserved by angiotensin II-mediated efferent arteriolar vasoconstriction, but available evidence in man suggests that angiotensin II supports renal function only to the extent that it preserves systemic blood pressure. We performed simultaneous assessments of cardiac and renal function in 56 patients with severe chronic heart failure before and after 1 to 3 months of converting-enzyme inhibition. Among the 29 patients with a pretreatment renal perfusion pressure under 70 mm Hg, patients with preserved renal function (creatinine clearance greater than 50 ml/min/1.73 m2) had markedly elevated values for plasma renin activity (11.8 +/- 3.8 ng/ml/hr) and showed a significant decline in creatinine clearance after converting-enzyme inhibition (61.1 +/- 3.0 to 45.9 +/- 5.3 ml/min/1.73 m2; p less than .05). In contrast, although similar with respect to all pretreatment demographic, hemodynamic, and clinical variables, patients with a creatinine clearance under 50 ml/min/1.73 m2 had low values for plasma renin activity (3.4 +/- 0.8 ng/ml/hr) and, despite similar drug-induced decreases in systemic blood pressure, showed no change in creatinine clearance after therapy with captopril or enalapril (32.6 +/- 2.5 to 41.4 +/- 3.8 ml/min/1.73 m2). Changes in creatinine clearance varied linearly and inversely with pretreatment values for plasma renin activity (r = - .64, p less than .001); converting-enzyme inhibition effectively abolished the pretreatment difference in renal function seen in the high- and low-renin subgroups. In the 27 patients with a renal perfusion pressure of 70 mm Hg or greater, creatinine clearance did not vary significantly with plasma renin activity and was not altered by therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
99mTc-Sestamibi Thigh SPECT/CT Imaging for Assessment of Myopathy in Cerebrotendinous Xanthomatosis With Histopathological and Immunohistochemical Correlation
Authors: Shu-Fang Chen, Chiung-Chih Chang, Shu-Hua Huang, Chen-Hisen Lu, Yao-Chung Chuang, Tai-Long Pan, Wen-Neng Chang
Journal: Clinical Nuclear Medicine (2013)

Purpose The aim of this study was to determine the effectiveness of using 99mTc-sestamibi thigh SPECT/CT imaging for evaluating myopathy in cerebrotendinous xanthomatosis (CTX). Patients and Methods Four genetically proven CTX patients (Family I, Cases I-1 and I-2; Family II, Cases II-1 and II-2) were included. They all underwent muscle biopsies for histopathologic and ultrastructural studies. Immunohistochemical staining for vinculin expression was also performed. 99mTc-sestamibi thigh SPECT/CT imaging was conducted on all 4 CTX patients, and both visual interpretation and muscle-to-background (M/B) ratio count were applied for assessment. Correlation analysis of the imaging findings and results of the ultrastructural and immunohistochemical studies was done. Results In the 99mTc-sestamibi thigh SPECT/CT imaging study, all 4 CTX cases had abnormal scores of visual interpretation and M/B ratios. The ultrastructural features of the skeletal muscle of the 4 CTX cases showed mitochondrial and membrane system abnormalities, with increased depositions of metabolites. They also had abnormal increases in vinculin expression after immunohistochemical staining of the skeletal muscle. Conclusions This is the first report on the use of 99mTc-sestamibi thigh SPECT/CT imaging to assess the mitochondrial status of CTX. The imaging findings may have a correlation with the ultrastructural and immunohistochemical findings on skeletal muscle. Although the 99mTc-sestamibi thigh SPECT/CT imaging is not specific for CTX, this noninvasive in vivo assessment can be an important tool for the detection and follow-up study of skeletal muscle involvement in CTX.
Review: Statins do not increase risk for intracerebral hemorrhage
Authors: David C. Anderson
Journal: Annals of Internal Medicine (2012)

ACP Journal Club20 March 2012Review: Statins do not increase risk for intracerebral hemorrhageDavid C. Anderson, MDDavid C. Anderson, MDHennepin County Medical Center/UMN, Minneapolis, Minnesota, USA (D.C.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-6-201202210-02006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationHackam DG, Woodward M, Newby LK, et al. Statins and intracerebral hemorrhage: collaborative systematic review and meta-analysis. Circulation. 2011;124:2233-42. https://pubmed.ncbi.nlm.nih.gov/22007076Clinical Impact RatingsCardiology: Endocrinology: Hematology: Neurology: References1 Amarenco P, Bogousslavsky J, Callahan A 3rd, et al; Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549-59. [PMID: 16899775] Google Scholar2 Westover MB, Bianchi MT, Eckman MH, Greenberg SM. Statin use following intracerebral hemorrhage: a decision analysis. Arch Neurol. 2011;68:573-9. [PMID: 21220650] Google Scholar3 Hackam DG, Austin PC, Huang A, et al. Statins and intracerebral hemorrhage: a retrospective cohort study. Arch Neurol. 2012;69:39-45. [PMID: 21911657] Google Scholar Author, Article, and Disclosure InformationAffiliations: Hennepin County Medical Center/UMN, Minneapolis, Minnesota, USA (D.C.A.)This article was published at Annals.org on 6 March 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNew Predictive Index for Survival in Symptomatic Spinal MetastasesChoices for long-term hypertensive control in patients after first-ever hemorrhagic stroke: a nationwide cohort studyPotential role for statins in sickle cell disease 20 March 2012Volume 156, Issue 6Page: JC3-6KeywordsHemorrhageHemorrhagic strokeIschemic strokeMyocardial infarctionNeurologyObservational studiesResearch designStatinsStrokeSystematic reviews ePublished: 20 March 2012 Issue Published: 20 March 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Whistleblower-Initiated Enforcement Actions against Health Care Fraud and Abuse in the United States, 1996 to 2005
Authors: Aaron S. Kesselheim, David M. Studdert
Journal: Annals of Internal Medicine (2008)

Federal regulators have aggressively prosecuted health care fraud since the early 1990s, leading to billions of dollars in financial recoveries. Nearly all major cases today are qui tam actions, involving whistleblowers with inside knowledge of the allegedly illegal schemes. This article documents the outcomes of major enforcement actions and describe the schemes, defendants, and whistleblowers involved. The authors obtained an inventory of unsealed federal qui tam litigation targeting health care fraud that was resolved between 1996 and 2005 from the U.S. Department of Justice and gathered further information from publicly available sources. Among 379 cases, $9.3 billion was recovered, with more than $1.0 billion paid to whistleblowers. Case frequency peaked in 2001, but annual recoveries increased sharply from 2002 to 2005. Whistleblowers were frequently executives or physicians, and 75% were employees of defendant organizations. The 13 (4%) cases against pharmaceutical companies accounted for $3.6 billion (39%) of total recoveries. This study illuminates the scope and characteristics of qui tam fraud litigation and the whistleblowers who animate this important tool for addressing waste in the health care sector.
Effect of acute human cardiac allograft rejection on left ventricular systolic torsion and diastolic recoil measured by intramyocardial markers.
Authors: D E Hansen, G T Daughters, E L Alderman, E B Stinson, J C Baldwin, D C Miller
Journal: Circulation (1987)

Left ventricular systolic torsion and diastolic recoil were quantified in 12 human cardiac transplant recipients with surgically implanted intramyocardial markers with the use of computer-aided analysis of biplane cineradiographic images. Measurements were performed between 6 and 16 weeks after surgery and related to the presence or absence of rejection as determined by cardiac biopsy. Torsional deformation, defined as twisting about the left ventricular long axis of the apical region with respect to the base, was characterized in terms of the rate and amplitude of systolic torsion and the rate of diastolic recoil by means of an internal reference system. Comparison of measurements before, during, and after recovery from 14 rejection episodes allowed assessment of the effects of acute reversible cardiomyopathy on left ventricular torsion and recoil. Compared with prerejection values, the amplitude of torsional deformation in the maximally deforming segment (theta max) decreased by 25% from 21.1 +/- 15.2 to 16.0 +/- 5.7 degrees (p less than .005) during acute rejection with myocyte necrosis; this was associated with significant (p less than .05) decreases in the peak systolic torsion rate (+d theta/dtmax), whereas the peak diastolic recoil rate (-d theta/dtmax) was unchanged. This suggests that the stiffness of elastic components of the myocardium may have increased, maintaining the rate of diastolic recoil when these elements are stretched less. With successful treatment of rejection episodes, the torsional deformation characteristics normalized. Heart rate, mean arterial pressure, left ventricular end-diastolic volume, stroke volume, ejection fraction, and peak left ventricular filling rate were unchanged with rejection episodes, whereas left ventricular end-systolic volume increased (p less than .05) during acute rejection and returned to normal with resolution of the rejection process. These data suggest that left ventricular torsional deformation amplitude and rate are sensitive to episodes of subclinical left ventricular dysfunction and that such intramyocardial marker techniques may provide new insights regarding the elastic properties of the ventricular myocardium and their impact on left ventricular mechanics.
Examination of HLA-DR4 as a severity marker for rheumatoid arthritis in Greek patients.
Authors: K A Boki, A A Drosos, A G Tzioufas, J S Lanchbury, G S Panayi, H M Moutsopoulos
Journal: Annals of the Rheumatic Diseases (1993)

OBJECTIVES--Previous reports have shown that HLA-DR4 may be a severity marker for rheumatoid arthritis (RA) in patients of northern European origin. The aim of the present study was to investigate this relation in Greek patients with RA, as RA in Greece differs from the RA described previously on clinical, serological, and immunological grounds. METHODS--Eighty four patients were studied in whom HLA-DR typing was performed by restriction fragment length polymorphism and the subtypes of HLA-DR4 were determined by the polymerase chain reaction. The absence or presence of HLA-DR4 and its subtypes was correlated with the clinical and serological characteristics of the patients and with the side effects due to disease modifying drugs. RESULTS--Twenty one of the 84 (25%) patients with RA were DR4+. There was no difference between the DR4+ and DR4-patients with respect to duration of disease, severity of arthritis, functional grade, and joint erosion score. The DR4+ group were more likely to have side effects due to disease modifying drugs (43%) than DR4- patients (36%), but this difference was not statistically significant. DR4-patients had more extra-articular manifestations, including Sjögren9s syndrome (47 v 19%). Analysis of the DR4 subtypes showed that Dw15 was the most common variant (9/21 patients; 43%). There was no statistical difference in the clinical manifestations among patients with different DR4 subtypes. The same was also true when the clinical picture was correlated with the 9shared RA epitope9 (QKRAA/QRRAA/RRRAA), which is common to all HLA-DRB1 alleles positively associated with RA. CONCLUSIONS--These results suggest that HLA-DR4 is not a severity marker in Greek patients with RA and further indicate differences in the clinical expression of RA in Greece.
A CASE OF CHRONIC INTESTINAL OBSTRUCTION DUE TO TUBERCULOUS CICATRICIAL CONSTRICTIONS OF THE JEJUNUM
Authors: S. H. Pugh
Journal: BMJ (1915)

THE patient, a imian aged 35, wlhen admuitted to lhospital on December 26th, 1913, lvas sufferina from intense pain over the greater part of the abdomen, of whliclh the respiratory movements were somiiewhlat restricted.Thlleic was n1o visible peristalsis.On palpation there was somiie tenderiess.No tUmlloULr couLld be felt
Quantitation of absolute area of a coronary arterial stenosis: experimental validation with a preparation in vivo.
Authors: J Wiesel, A M Grunwald, C Tobiasz, B Robin, M M Bodenheimer
Journal: Circulation (1986)

The absolute cross-sectional area of a coronary stenosis measured by quantitative coronary angiography correlates well with its hemodynamic significance. We evaluated a combined approach using edge detection applied to the normal segment and videodensitometry applied to the stenosis to determine the absolute cross-sectional area of the stenosis (videodensity method). The results were then compared with those with the edge detection method applied directly to the stenosis. The area of the stenosis by the edge detection method was calculated by analyzing two orthogonal projections for irregular stenoses and with use of the formula for the area of an ellipse (ellipse method). The accuracy of both these techniques was assessed by analyzing digital angiograms acquired from closed-chest dogs in which 10 plastic cylinders with precisely machined circular and irregular lumina were inserted into the coronary arteries. Angiograms of irregular stenoses were acquired in two orthogonal views. The ellipse method applied to circular stenoses was very accurate, with r = .97, average absolute difference (AAD) = 0.21 mm2, and SEE = 0.30. For the videodensity method r = .97, AAD = 0.84 mm2, and SEE = 0.40. Irregular stenoses were better quantitated by the videodensity method applied in one view (AAD = 0.50 mm2, SEE = 0.47) than by the ellipse method applied in two orthogonal projections (AAD = 1.03 mm2, SEE = 0.87). Overall, the two methods were comparable in accuracy (for videodensity, AAD = 0.65 mm2, SEE = 0.71 vs AAD = 0.54 mm2, SEE = 0.79 for ellipse).(ABSTRACT TRUNCATED AT 250 WORDS)
Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial
Authors: Caroline AH Klazen, Paul NM Lohle, Jolanda de Vries, Frits H Jansen, Alexander V Tielbeek, Marion C Blonk, Alexander Venmans, Willem Jan J van Rooij, Marinus C Schoemaker, Job R Juttmann, Tjoen H Lo, Harald JJ Verhaar, Yolanda van der Graaf, Kaspar J van Everdingen, Alex F Muller, Otto EH Elgersma, Dirk R Halkema, Hendrik Fransen, Xavier Janssens, Erik Buskens, Willem P Th M Mali
Journal: The Lancet (2010)