tbuckley/cabot-search huggingface dataset:
Will the History and Physical Examination Help Establish That Irritable Bowel Syndrome Is Causing This Patient's Lower Gastrointestinal Tract Symptoms?
Authors: Alexander C. Ford
Journal: JAMA (2008)

Many individuals experience lower gastrointestinal tract symptoms, most commonly attributable to functional conditions. These individuals are frequently diagnosed with irritable bowel syndrome (IBS) based on their symptoms; however, some may require additional testing or referral to specialists before this diagnosis is made.To systematically review the literature of the accuracy of individual symptoms and combinations of findings in diagnosing IBS.Search of MEDLINE and EMBASE (up to June 2008) for prospective studies reporting on unselected cohorts of adult patients with lower gastrointestinal tract symptoms recorded before investigation.Studies prospectively evaluating accuracy of individual symptoms or combinations of findings compared with results from investigations of the lower gastrointestinal tract.Two authors independently assessed studies and extracted data to estimate likelihood ratios (LRs) of individual symptoms and combinations of findings in diagnosing IBS.Ten studies evaluating 2355 patients were identified, with a summary prevalence of IBS following investigation of 57%. Individual symptom items yielded positive LRs from 1.2 (95% confidence interval [CI], 0.93-1.6) for passage of mucus per rectum to 2.1 (95% CI, 1.4-3.0) for looser stools at onset of abdominal pain and negative LRs from 0.29 (95% CI, 0.12-0.72) for no lower abdominal pain to 0.88 (95% CI, 0.72-1.1) for no passage of mucus per rectum in diagnosing IBS. The Manning criteria had a summary positive LR of 2.9 (95% CI, 1.3-6.4) and a summary negative LR of 0.29 (95% CI, 0.12-0.71). The Rome I criteria had a positive LR of 4.8 (95% CI, 3.6-6.5) and a negative LR of 0.34 (95% CI, 0.29-0.41). The Kruis scoring system provided a summary positive LR of 8.6 (95% CI, 2.9-26.0) and a summary negative LR of 0.26 (95% CI, 0.17-0.41). The Rome II and III criteria have not been studied.Individual symptoms have limited accuracy for diagnosing IBS in patients referred with lower gastrointestinal tract symptoms. The accuracy of the Manning criteria and Kruis scoring system were only modest. Despite strong advocacy for use of the Rome criteria, only the Rome I classification has been validated. Future research should concentrate on validating existing diagnostic criteria or developing more accurate ways of predicting a diagnosis of IBS without the need for investigation of the lower gastrointestinal tract.
Legal Guidebook in Mental Health
Authors: Moshe Torem
Journal: JAMA (1983)

This book is the result of a rare collaborative effort between a psychologist (Ronald J. Cohen) and an attorney (William E. Mariano). Both have much experience in a field where psychotherapy, law, and regulations interact. The authors point out that, whereas the average neurosurgeon could expect to be sued once in every two years of practice, the average psychiatrist could expect to be sued once in every 50 to 100 years of practice. The risk for nonmedical mental health professionals used to be even lower than that of the psychiatrist. However, this relative immunity from litigation, say the authors, has begun to erode. The authors list ten reasons for such an erosion, which include the following:  1. A declining respect for authority in general following such national scandals as Watergate, Koreagate, Lancegate, Billygate, and Abscam. No segment of the professional community, not even the clergy, is immune. The days of
ELECTROCARDIOGRAPHIC STUDIES DURING ATTACKS OF ANGINA PECTORIS AND OF OTHER PAROXYSMAL PAIN
Authors: Mortimer L. Siegel, Harold Feil
Journal: Journal of Clinical Investigation (1931)

ANGINA PECTORISstudy obtained similar curves from ligature of the ramus descendens of the left coronary artery.These changes were most pronounced after further ischemia of the heart muscle was produced by obstruction of the inferior vena cava.These clinical and experimental data are strong evidence that myocardial ischemia is responsible for the changes in the T wave and S-T segment of the curves.Likewise, they indicate that the pain is probably due to or associated with myocardial ischemia.In this report are given the electrocardiographic findings in eleven additional cases with transient anginal attacks.Clinically, these cases may be divided into four groups: (1) Patients with coronary sclerosis and who were not known to have had coronary artery thrombosis; (2) Patients who had in addition, an attack of coronary thrombosis previ- ously; (3) Patients whose angina was associated with aortic regurgitation; and (4) Patients who had angina and who subsequently developed coronary artery occlusion.The results of these observations during anginal attacks are sum- marized in Table I.TABLE I Electrocardiographic changesCase Diagnosis t TI TII TIIl Depression of S-T Segment 1 C.S. Leads 2 and 3 2 C.S., R.C.T. Leads 2 and 3 3 C.S.; O.C.T. Leads 1 and 2 4 C
Pain Panacea for Opiophobia in Infants?
Authors: Kanwaljeet J. S. Anand
Journal: JAMA (2013)

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
Neurogenic Intermittent Claudication
Authors: W. A. Bourne
Journal: BMJ (1964)

great surprise that she was getting so much for her 2s.I wonder if some way could not be found to indicate to patients when they receive drugs the cost they would have to meet if they met the cost out of their own pocket.From a different point of view, however, bearing in mind my article on "On not taking P.A.
Androgen receptor–mediated inhibition of cutaneous wound healing
Authors: Gillian S. Ashcroft, Stuart J. Mills
Journal: Journal of Clinical Investigation (2002)

Impaired wound healing states in the elderly lead to substantial morbidity, mortality, and a cost to the USHealth Services of over $9 billion per annum. In addition to intrinsic aging per se causing delayed healing, studies have suggested marked sex-differences in wound repair. We report that castration of male mice results in a striking acceleration of local cutaneous wound healing, and is associated with a reduced inflammatory response and increased hair growth. Using a hairless mouse model, we have demonstrated that testosterone reduction stimulates the healing response not through hair follicle epithelial/mesenchymal cell proliferation, but directly via effects on wound cell populations. We suggest that endogenous testosterone inhibits the cutaneous wound healing response in males and is associated with an enhanced inflammatory response. The mechanisms underlying the observed effects involve a direct upregulation of proinflammatory cytokine expression by macrophages in response to testosterone. Blockade of androgen action systemically, via receptor antagonism, accelerates healing significantly, suggesting a specific target for future therapeutic intervention in impaired wound healing states in elderly males.
AT-04 * A RANDOMIZED PHASE II TRIAL OF VANDETANIB IN COMBINATION WITH CARBOPLATIN VERSUS CARBOPLATIN ALONE FOLLOWED BY VANDETANIB ALONE IN ADULTS WITH RECURRENT ANAPLASTIC ASTROCYTOMA
Authors: P. Ambady, K. Warren, J. Shih, T. Kreisl, H. Fine
Journal: Neuro-Oncology (2014)

BACKGROUND: Vandetanib is a selective VEGFR and EGFR inhibitor that targets these key pathways implicated in gliomagenesis. While single-agent vandetanib has not shown significant clinical activity in high grade glioma but preclinical experience supports potential synergistic efficacy in combination with carboplatin. METHODS: This randomized non-comparative phase-II trial evaluates the efficacy and safety of vandetanib (300 mg/d NEIAED, 400 mg/d EIAED) in combination with carboplatin (AUC 6 q 4 weeks) versus carboplatin alone (AUC 6 q 4 weeks) in adults with recurrent anaplastic glioma. Upon progression with single-agent carboplatin, single-agent vandetanib was offered. Contrast-enhanced-MRI before subsequent cycles were compared to baseline and response assessed using RANO criteria. Primary end-point was progression free survival at 6 months (PFS-6). RESULTS: 23 patients were accrued to each group (n = 46). Gender, median age, performance status, number of recurrences, 1p/19q co-deletion status, and baseline steroid doses were comparable. 60% of patients in each group had failed prior VEGF-inhibitor therapy. Most frequent treatment related grade ≥3 toxicities were lymphopenia (n = 7), thrombocytopenia (n = 4), neutropenia (n = 3), hypertension (n = 3) and transaminitis (n = 3). All grade 4 toxicities were observed in the combination-group. There were 3 partial responses in the combination group, and 1PR in the sequential-group. PFS-6 was 8.7% (95% CI: 2.3%, 32.7%) and 17.4 % (95% CI: 7.1%, 42.4%), median-PFS (months) was 1.8 (95% CI: 1.15, 2.66) and 0.95 (95% CI:0.92,2.04)while median-OS (months) was 6.5 (95% CI: 5.42, 11.7) and 9.27 (95% CI: 5.52, 43.86) in combination-group and sequential-group respectively. CONCLUSION: Although this study was not powered to detect differences between groups and did not complete accrual as planned, no meaningful differences in PFS-6, PFS or OS were observed compared to historical controls. Majority of patients were VEGF therapy resistant, which may have limited efficacy. Combination therapy was more toxic.
Choroidal Melanoma With Hematogenous Spread to the Liver: F-18 FDG PET/CT Findings
Authors: Meenu Bawa, Gurinderjit Sidhu, James R. Galt, David M. Schuster, Raghuveer K. Halkar
Journal: Clinical Nuclear Medicine (2006)

Melanomas usually metastasize through the lymphatic route. However, choroidal melanoma invariably disseminates hematogenously to the liver. Liver metastasis develops in approximately two thirds of patients with recurrent uveal melanoma. The PET scan is a sensitive tool for the detection and localization of hepatic and extrahepatic metastatic choroidal melanoma. We report a patient with a history of choroidal melanoma in the left eye. The patient had undergone a scleral plaque placement followed by an enucleation and an implant. He was referred to us for a PET scan for restaging. No prior PET scan was available for comparison. An implant in the eye with intense FDG-avid liver metastasis should raise suspicion of choroidal melanoma.
Induction of Plasminogen Activator Inhibitor Type-1 (PAI-1) by Proinsulin and Insulin In Vivo
Authors: Thomas K. Nordt, Hirofumi Sawa, Satoshi Fujii, Burton E. Sobel
Journal: Circulation (1995)

Background Fasting hyperinsulinemia (reflected by elevations in immunoreactive “insulin”) is typical of patients with non–insulin-dependent diabetes mellitus (NIDDM) and is often associated with obesity and hypertension. The elevated concentrations detected are indicative not only of insulin but also of its immunologically cross-reactive precursors, including proinsulin. Fasting hyperinsulinemia appears to be associated with decreased fibrinolytic activity in blood, which results from increased activity of plasminogen activator inhibitor type-1 (PAI-1), a potential independent risk factor for coronary artery disease. Patients who were given proinsulin in a previous clinical study by others exhibited an increased incidence of cardiovascular events. Thus, a “proinsulin–PAI-1 axis” may predispose to coronary thrombosis. To define the possible presence of such an axis, this study was designed to determine whether insulin, its precursors, or both increase the concentrations of PAI-1 in rabbits in vivo. Methods and Results Equimolar proinsulin (n=10), insulin (n=11), C-peptide (n=4), or vehicle alone (n=10) was administered intravenously over 1 hour to euglycemic, conscious rabbits. Plasma PAI-1 activity increased 3.8-fold with proinsulin ( P =.002) and 3.6-fold with insulin ( P =.002). By contrast, no increase occurred after C-peptide or vehicle was administered. The increased PAI-1 activity was shown to be attributable to PAI-1 protein by reverse fibrin autography. As judged from changes in mRNA in tissues, proinsulin and insulin increased PAI-1 gene expression within 3 hours by 2.1- and 2.1-fold, respectively, in aorta ( P =.025 each) and by 1.9- and 2.4-fold in liver ( P =.015 and P =.001), with return of values to baseline within 24 hours (n=4 experiments in each case). Conclusions These results extend our previous observations from studies in vitro and suggest that hyperinsulinemia attributable to augmented concentrations of proinsulin and insulin in plasma increase plasma PAI-1 activity and may contribute to acceleration of atherosclerosis and impairment of coronary thrombolysis in patients with NIDDM.
Occupational Physical Activity and the Degree of Coronary Atherosclerosis in "Normal" Men
Authors: DAVID M. SPAIN, VICTORIA A. BRADESS
Journal: Circulation (1960)

In autopsies on "normal" white men between the ages of 30 and 60, who died suddenly from accident, homicide, or suicide, there were no significant differences in the degree of coronary atherosclerosis in those engaged in sedentary occupations and those engaged in physically active occupations.
Hypoglycemia in Diabetes With Renal Insufficiency
Authors: Martin G. White
Journal: JAMA (1971)

<h3>To the Editor.—</h3> We read with great interest the article, "Spontaneous Hypoglycemia in Diabetic Patients With Renal Insufficiency" (<b>213:</b>1863, 1970), and bring our observation of a similar though nondiabetic patient to your attention. Doctors Block and Rubenstein described three patients with renal insufficiency and a history of diabetes who developed hypoglycemic episodes. We observed a similar patient with renal insufficiency and hypoglycemic episodes who did not have diabetes. This patient is a 39-year-old woman with chronic glomerulonephritis who developed progressive renal failure and hypertension. She was hospitalized for intermittent peritoneal dialysis and control of her hypertension. The patient was malnourished and was eating poorly. During this period of hospitalization, the patient had five proved episodes of hypoglycemia (blood glucose level, 28 to 52 mg/ 100 ml). Three of these episodes occurred within 24 hours of the conclusion of peritoneal dialysis. The patient's blood glucose levels during the course of
1026-60 Effects of functional coronary collateral flow on the incidence of right ventricular infarction after primary angioplasty in patients with acute inferior myocardial infarction
Authors: Koichi Tamita, Takashi Akasaka, Atsushi Yamamuro, Minako Katayama, Shunichirou Kaji, Kazuaki Tanabe, Kunihiko Nagai, Tomoko Tani, Shigefumi Morioka, Tsutomu Takagi
Journal: Journal of the American College of Cardiology (2004)
Interactions Among Dietry Fat, Protein, and Cholesterol in Atherosclerosis-susceptible Pigeons
Authors: Thomas B. Clarkson, Robert W. Prichard, Hugh B. Lofland, Harold O. Goodman
Journal: Circulation Research (1962)

Atherosclerosis-susceptible pigeons fed cholesterol developed coronary atherosclerosis much more frequently than pigeons maintained on a cholesterol-free diet. Fewer of the cholesterol-fed pigeons fed a low protein diet developed coronary atherosclerosis than did cholesterol-fed pigeons on a high protein diet. Corn oil decreased the frequency of coronary atherosclerosis in cholesterol-fed pigeons. Limited evidence suggests that the coronary arteries and aortae in noncholesterol-fed birds are independent of each other in their susceptibility to atherosclerosis.
High dose intracoronary gamma radiation for patients with diffuse in-stent restenosis: six versus one month of antiplatelet therapy
Authors: Ron Waksman, Andrew E. Ajani, Edouard Cheneau, Dong-Hun Cha, Hongsheng Wu, Chad Brown, Michael Porrazzo, Lowell F. Satler, Augusto D. Pichard, Kenneth M. Kent, Ellen Pinnow, Joseph Lindsay
Journal: Journal of the American College of Cardiology (2002)
Trusting patients with case notes
Authors: D. Elbourne, A. Lovell
Journal: BMJ (1988)

value of photic radiations) are well known, one wonders why no epidemiological survey of seasonal affective disorder has been undertaken.Presumably congenitally blind people could pro- vide controls worth exploring, other psychological drawbacks notwithstanding.Is the condition more pronounced among the Eskimos, who probably use less artificial light than Swedes?When travel- ling through Peru I was struck by the paucity of artificial illumination in rural areas.Is anything known about psychiatric conditions there or is life too hard for seasonal affective disorder to flourish?What happens near the equator, where seasonal variations ought to be minimal?Relevant expert epidemiological studies might provide a short cut to meaningful results, which might elude an apparently more direct approach.
Direct myocardial revascularisation: experience with 9364 operations.
Authors: D A Cooley, D C Wukasch, F Bruno, G J Reul, F M Sandiford, S L Zillgitt, R J Hall
Journal: Thorax (1978)

Between July 1968 and December 1976, 9364 consecutive patients with coronary insufficiency underwent direct myocardial revascularisation using aortocoronary bypass (ACB). Among these patients 8017 had ACB alone, and the remaining 1347 had ACB in addition to correction of other cardiac and vascular lesions. In the series of patients having ACB alone the hospital (early) mortality was 3.9%, but for 2383 surgical patients in 1976 this figure was 2.2%. Operative mortality was higher for women (6.85%) than for men (3.5%), but late survival was about the same for both sexes. Among surviving patients 88% were improved or symptom-free after undergoing ACB. According to our data, at the end of eight years 80% of the patients will be survivors. These results, when compared with other series of patients treated medically, indicate the superiority of surgical treatment both in terms of symptomatic relief and also in increased life expectancy.
The Experience of Losing a Job: Some Effects on Cardiovascular Functioning
Authors: S.V. Kasl, S. Cobb
Journal: Psychotherapy and Psychosomatics (1980)

Men whose jobs were abolished because of a permanent plant closing were followed for 2 years as they went through the phases of anticipation, plant closing, unemployment, and reemployment. Changes in serum cholesterol, blood pressure, body weight, cigarette smoking, and pulse rate were examined in relation to these stages of the job loss experience. In general, these indicators revealed a good deal of sensitivity to the stages, as well as to the difference in the rural-urban setting of the plants and to levels of social support. However, overall cardiovascular risk never exceeded the levels for controls and any 'stress' effects were found to be self-limiting.
General Principles of Children’s Orthopaedic Disease
Authors: Michelle S. Caird
Journal: JAMA (2011)

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
Demographic characteristics and risk behaviors associated with HIV positive injecting drug users in Xinjiang, China
Authors: Yuanzhi Zhang, Hua Shan, Jennifer Trizzino, Yuhua Ruan, Geetha Beauchamp, Benoît Mâsse, Jun Ma, Yuan Gu, Yixin He, Baoling Rui, Jun Wang, Katharine Poundstone, Yan Jiang, J. Brooks Jackson, Yiming Shao
Journal: Journal of Infection (2006)
THE PLAGUE IN SAN FRANCISCO.
Authors: DOUGLASS W. MONTGOMERY
Journal: JAMA (1900)

The Journalhas asked for the facts about the plague in San Francisco. The following are the cases, with their bacteriologic examinations, and experiments on animals as given by Dr. W. H. Kellogg, city bacteriologist, and Dr. J. J. Kinyoun, U. S. quarantine officer. I can endorse these tests and examinations, as I have taken a steady interest in them, and was deputed to follow them. Furthermore, the character of the men making these tests is above suspicion, and the scientific examinations made may be taken as correct, no matter what the conclusions drawn from them should be. They are here set before their proper jury, the medical profession. The following reports of cases are made up from notes furnished me by Drs. J. J. Kinyoun and W. H. Kellogg: (Case 1 was reported in full inThe Journalfor May 19, p. 1236, and a full report of the
The Consequences of “No”
Authors: Arthur L. Kellermann, Lawrence S. Lewin
Journal: New England Journal of Medicine (2009)

In the next few weeks, Congress will determine the fate of health care reform. An early and important objective of the Obama administration, reform once carried an air of inevitability. But a spirited anti-reform effort and concerns about the legislation's cost have raised doubts about its prospects.Congressional Republicans are united in opposition to the current reform bills. Although the Democrats hold commanding majorities in both chambers, they also face defections from within their ranks. The House bill passed with a razor-thin majority; Senate action is far from certain. Articles about reform have largely focused on various implications of the . . .
Serum Free Light Chain Levels In Children Are Higher In Females Than In Males During Eosinophilic Esophagitis
Authors: C. Dupont, K. Knipping, P. Soulaines, T. Groot Kormelink, F. Redegeld, L.M.J. Knippels, J. Garssen
Journal: Journal of Allergy and Clinical Immunology (2012)