tbuckley/cabot-search huggingface dataset:
Seizures related to blood transfusion and erythropoietin treatment in patients undergoing dialysis.
Authors: A. L. Brown, B. Tucker, L. R. Baker, A. E. Raine
Journal: BMJ (1989)

Correction of the anaemia of chronic renal failure by recombinant human erythropoietin results in a rise in packed cell volume with a consequent increase in blood viscosity, predisposing to increased vascular resistance and the development of hypertension.Increases in blood pressure have occurred in almost half the patients treated so far with erythropoietin,' but of more serious concern is the development of seizures in seven of these patients in the United Kingdom.2Although these bear similarities to hypertensive encephalopathy, their mechanism remains unclear.An episode of seizures associated with erythro- poietin treatment in one of our patients has been reported.We describe here a subsequent seizure suffered by this patient 11 days after a blood transfusion and two similar episodes suffered by an anephric patient undergoing continuous ambulatory peritoneal dialysis.These episodes are of interest because of their resemblance to the seizures reported in association with erythropoietin treatment.
Attenti Alle Bufale ('Beware of Red Herrings'), or, How toMake Evidence-Based Medicine Work for You
Authors: T. Jefferson, L. Zarra, L. Stoica
Journal: Journal of the Royal Society of Medicine (2006)

During the year, busy healthcare workers have little time for reading or reflecting. This fact conflicts with the need to keep up-to-date with what is going on in medicine and to track the avalanche of paper, audio and electronic inputs we receive. The obvious starting point is a topic of interest, but we also need to select something which has some kind of credibility, either scientific or ethical or both (although some tell me there is no difference between the two). So we now have two linked problems: the quantity and the quality of the scientific works that we read.

The quality issue seems to be an easy one to solve: if something is in print it has undergone ‘routine quality control measures’ such as peer review and should be good enough, especially if published on the more prestigious journals. And if something has passed peer review then the quantity issue can be solved quickly by reliance on reviews, meta-analyses, editorials, evidence-based journals and the good old network of friends and colleagues who ‘give you the wink’ on a good piece of research.

Alas, not everything is so easy in life, research or medical practice. Often what seems is not what is. Let's start from quality control mechanisms as they apply to the publication of research papers and then move on to the issue of quantity. Quality (essentially editorial peer review, publishing's main quality control mechanism) is the key to understanding the issue of quantity.
Chlorpheniramine or Diphenylhydantoin
Authors: David M. Holloway
Journal: JAMA (1969)

To the Editor:—  This is a case report relevant to the letter of Russel and Bousvaros of Albany, NY, regarding the possible toxic effects of diphenylhydantoin (206:2118, 1968). Chlorpheniramine maleate rather than diphenylhydantoin might be considered to have played the more significant role.  Report of a Case:—  A 36-year-old man appeared at this office with symptoms consistent with recurrent sinusitus, because of focal signs over the left maxillary area. Phenylephrine. 0.25%, three times a day for four days; an antihistaminic preparation containing chlorpheniramine maleate, two times a day for five days; tetracycline, 250 mg, four times a day for ten days; and topical warm, moist packs, 20 minutes three times a day for five days were administered.  After five days the patient improved. Administration of tetracycline was continued. An additional five-day course of antihistamines was ordered. On the tenth day of treatment he presented in this office in extreme lethargy
"Lost" Contact Lens Encysted in Orbit
Authors: Herbert M. Alston
Journal: JAMA (1968)

<h3>To the Editor:—</h3> A 23-year-old woman complained of a growth in the nasal portion of her left orbit which had enlarged in size to such a degree as to produce a partial ptosis of her left upper eyelid. The "growth" was a visible and palpable, freely movable mass measuring about 15 × 15 mm in size, located in the nasal portion of the left orbit above the level of the upper cul-desac of the eyelid. She had a partial ptosis of the left upper eyelid, without evidence of any extraocular muscular involvement. The visual acuity was excellent, and no active ocular disease was present. At the time of examination the patient was wearing spectacles, and only after surgery did she reveal that she had worn contact lenses for the previous three years. She had had three different sets made and had obtained altogether a total of eight lenses for her
Dynamic Relationship of Cycle Length to Reentrant Circuit Geometry and to the Slow Conduction Zone During Ventricular Tachycardia
Authors: Edward J. Ciaccio
Journal: Circulation (2001)

Background —Knowledge of cycle-to-cycle changes in isthmus geometry is of potential importance for radiofrequency catheter ablation to stop reentrant ventricular tachycardia. It was hypothesized that isthmus geometry often undergoes continuous evolution throughout reentry and that cycle-length variability measurements could be used to segment reentry into distinct phases and to predict changes in isthmus geometry. Methods and Results —A canine infarct model of reentrant ventricular tachycardia in the epicardial border zone with a figure 8 pattern of conduction was used for analysis (25 monomorphic reentry episodes, 20 experiments). Tachycardias were segmented, on the basis of cycle-length variations, into 2 to 3 distinct phases corresponding to onset, maintenance, and spontaneous termination, when it occurred (6/25 episodes). Trends of linear cycle-length change occurred throughout the maintenance phase in all tachycardias. For each trend, quantitative geometric parameters of the isthmus were measured, and the following linear relationships were established. During a trend, the slow conduction zone activation interval and tachycardia cycle length increased, while isthmus length decreased. When isthmus length decreased, isthmus width decreased at its narrowed portion. Larger decreases in isthmus length corresponded to higher rates of linear cycle-length prolongation. Also, greater cycle-length variability tended to prolong tachycardia. Conclusions —Cycle-length alterations occur throughout reentry in this canine model and are predictive of isthmus geometry changes. Because similar reentry dynamics, which affect catheter ablation efficacy, have been observed clinically, estimation of changes in geometry during electrophysiological study may help target ablation sites.
Revolution in Mind: The Creation of Psychoanalysis
Authors: Elaine W. Cotlove
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 Journals 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 2024 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
Diaphragmatic Paralysis-Reply
Authors: BALU H. ATHREYA
Journal: JAMA (1977)

We wish to thank Dr Korczyn for his thoughful criticism. He is correct. We were referring to the paper by Korczyn et al, 1 and our reference No. 4 should have referred to that paper. 1 There is an explanation, but no explanation is good enough for such an error.  We are aware of Dr Korczyn's various papers. We referred to his first paper on hemiplegia and diaphragmatic paralysis for our discussion and dismissed this as irrelevant to our situation since the children reported in our study had bilateral cortical injury and unilateral diaphragmatic paralysis. One of Dr Korczyn's 2 patients with brain-stem infarction had vertigo and another had seventh nerve palsy. Though the nature of the injury and clinical picture in the children reported in our study suggest brain-stem damage of some kind, there were no nuclear lesions. Thus, our patients were different from the ones reported
The Potential for Increasing Quality and Reducing Costs
Authors: Ravi Varadhan, Carlos O. Weiss, Cynthia M. Boyd
Journal: Annals of Internal Medicine (2011)

Letters18 October 2011The Potential for Increasing Quality and Reducing CostsRavi Varadhan, PhD, Carlos O. Weiss, MD, and Cynthia M. Boyd, MDRavi Varadhan, PhDFrom Johns Hopkins University, Baltimore, MD 21205.Search for more papers by this author, Carlos O. Weiss, MDFrom Johns Hopkins University, Baltimore, MD 21205.Search for more papers by this author, and Cynthia M. Boyd, MDFrom Johns Hopkins University, Baltimore, MD 21205.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-8-201110180-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The recent article by Eddy and colleagues (1) proposes to guide treatment on the basis of the individual's underlying risk for the primary outcome. Identifying individuals who will derive more benefit than harm from treatment is the primary goal of evidence-based medicine. Medicare spends a fortune each year on procedures whose benefits for the recipient are highly questionable (2). One fifth of all implantable cardiac defibrillators are placed in patients who will not clearly benefit from them (3). Therefore, we welcome the authors' proposal, which is sensible and has face validity. There is a fundamental problem, however: ...References1. Eddy DM, Adler J, Patterson B, Lucas D, Smith KA, Morris M. Individualized guidelines: the potential for increasing quality and reducing costs. Ann Intern Med. 2011;154:627-34. [PMID: 21536939] LinkGoogle Scholar2. Redberg RF. The opinion pages: squandering Medicare's money. The New York Times. 25 May 2011. Google Scholar3. Al-Khatib SM, Hellkamp A, Curtis J, Mark D, Peterson E, Sanders GD, et al. Non-evidence-based ICD implantations in the United States. JAMA. 2011;305:43-9. [PMID: 21205965] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Ravi Varadhan, PhD; Carlos O. Weiss, MD; Cynthia M. Boyd, MDAffiliations: From Johns Hopkins University, Baltimore, MD 21205.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIndividualized Guidelines: The Potential for Increasing Quality and Reducing Costs David M. Eddy , Joshua Adler , Bradley Patterson , Don Lucas , Kurt A. Smith , and Macdonald Morris The Potential for Increasing Quality and Reducing Costs Craig A. Umscheid The Potential for Increasing Quality and Reducing Costs David M. Eddy Metrics 18 October 2011Volume 155, Issue 8Page: 564KeywordsAtherosclerosisConflicts of interestEvidence based medicineMedical risk factorsMedicareReproducibilityStroke ePublished: 18 October 2011 Issue Published: 18 October 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Tc-99m Labeled Nonspecific Polyclonal Human Immunoglobulin G Taken Up by a Uterine Myoma
Authors: FRANCISCA PONS, RAIMON SANMARTI, FRANCISCO JAVIER SETOAIN, ANTONIO COLLADO, SERGI VIDAL-SICART, RAMÓN HERRANZ
Journal: Clinical Nuclear Medicine (1997)

A 71-year-old woman had a Tc-99m labeled nonspecific polyclonal human immunoglobin G (HIG) scintigraphy to test for synovitis. The scans showed an intense uptake in a pelvic mass, which was confirmed to be a calcified uterine myoma. Labeled HIG scintigraphy was introduced for the detection of inflammation. Although uptake of Tc-99m HIG has been shown in malignant lesions in patients without inflammation, this case indicates that uptake in benign tumors must also be taken into account.
Infective Agents and Multiple Sclerosis
Authors: C. A. C. Ross, J. A. R. Lenman, C. Rutter
Journal: BMJ (1965)

Although the pathogenesis of multiple sclerosis remains obscure, much pathological and clinical evidence suggests an infective agent as a possible aetiological factor. If such an agent is responsible for initiating the disease it seems probable that there is a latent period of several years before the develop ment of clinical features of multiple sclerosis. By that time it might be impossible to obtain laboratory evidence of the incriminating organism. However, if the agent remained latent in the central nervous system it might provide a constant anti genic stimulus manifesting itself in high antibody levels. In a previous study (Ross, 1962) sera from 40 cases of multiple sclerosis were examined by complement-fixation (C.F.) technique for antibodies to several viral and rickettsial antigens. Mainly negative findings were obtained for lymphocytic chorio meningitis, louping-ill, Q fever, murine typhus, and rickettsial pox. Antibodies were detected for herpes in 33 (82%), for mumps in 29 (72%), and for the psittacosis-lymphogranuloma group (P-LGV) in 4 (10%). However, the absence of controls in this investigation meant that no significance could be placed on the positive findings. Thus a further investigation was required to compare antibody levels in a series of cases of multiple sclerosis with those obtained in a series of carefully matched controls.
Medicare Program Expenditures Associated with Hospice Use
Authors: Diane E. Campbell, Joanne Lynn, Tom A. Louis, Lisa R. Shugarman
Journal: Annals of Internal Medicine (2004)

Background: Hospice providers contend that enrollment reduces the cost of the Medicare programs, but estimates of effects are dated, methodologically limited, and focused on persons with cancer. Objective: To estimate the effects of hospice care on Medicare program payments during the last year of life from 1996 to 1999 within cohorts defined by age and diagnosis. Design: Retrospective cohort. Setting: Deceased Medicare enrollees. Participants: Elderly Medicare fee-for-service beneficiaries who received 36 months of continuous Part A and B coverage before death during 1996 to 1999 (n = 245 326). Age- and condition-specific (cancer or noncancer and principal condition) cohorts were defined. Measurements: Medicare expenditures in the last year of life, as a total figure and by service type. The cost effects of hospice were estimated by using linear regression within the cohorts for hospice enrollees compared with nonenrollees after adjustment for propensity to use hospice, gender, race, enrollment in Medicaid, urban setting, duration of illness, comorbid conditions, low use of Medicare, nursing home residence, and year of death. Results: Adjusted mean expenditures were 4.0% higher overall among hospice enrollees than among nonenrollees. Adjusted mean expenditures were 1% lower for hospice enrollees with cancer than for patients with cancer who did not use hospice. Savings were highest (7% to 17%) among enrollees with lung cancer and other very aggressive types of cancer diagnosed in the last year of life. Expenditures for hospice enrollees without cancer were 11% higher than for nonenrollees, ranging from 20% to 44% for patients with dementia and 0% to 16% for those with chronic heart failure or failure of most other organ systems. Hospice-related savings decreased and relative costs increased with age. Conclusion: Hospice enrollment correlates with reduced Medicare expenditures among younger decedents with cancer but increased expenditures among decedents without cancer and those older than 84 years of age. Future studies should assess the effects of hospice on quality and on expenditures from all payment sources.
More patients wait but for shorter time
Authors: S Kingman
Journal: BMJ (1994)

The number of patients who have been waiting more than a year for treatment in England has gone up slightly since March but is down compared with this time last year, according to government figures published last week. Provisional figures on waiting times show that 0.1% more patients had been waiting for treatment for between one and two years at the end of June than at the end of March. The total number of patients waiting for treatment at the end of the second quarter of this year was 1 070 887. This figure is up by 0.5% on the first quarter, compared with …
Festive medical myths
Authors: R. C. Vreeman, A. E. Carroll
Journal: BMJ (2008)

More medical myths hit the dust, thanks to Rachel C Vreeman and Aaron E Carroll 

In the pursuit of scientific truth, even widely held medical beliefs require examination or re-examination. Both physicians and non-physicians sometimes believe things about our bodies that just are not true. As a reminder of the need to apply scientific investigation to conventional wisdom, we previously discussed the evidence disputing seven commonly held medical myths.1 The holiday season presents a further opportunity to probe medical beliefs recounted during this time of the year.

We generated a list of common medical or health beliefs related to the holidays and winter season and searched Medline for scientific evidence to support or refute these beliefs. If we couldn’t find any evidence in the medical literature, we searched the internet using Google.

While sugarplums may dance in children’s heads, visions of holiday sweets terrorise parents with anticipation of hyperactive behaviour. Regardless of what parents might believe, however, sugar is not to blame for out of control little ones. At least 12 double blind randomised controlled trials have examined how children react to diets containing different levels of sugar.2 None of these studies, not even studies looking specifically at children with attention-deficit/hyperactivity disorder, could detect any differences in behaviour between the children who had sugar and those who did not.3 This includes sugar from sweets, chocolate, and natural sources. Even in studies of those who were considered “sensitive” to sugar, children did not behave differently after eating sugar full or sugar-free diets.3

Scientists have even studied how parents react to the sugar myth. When parents think their children have been given a drink containing sugar (even if it is really sugar-free), they rate their children’s behaviour as more hyperactive.4 The differences in the children’s behaviour were …
Treatment needs of prisoners with psychiatric disorders.
Authors: J Gunn, A Maden, M Swinton
Journal: BMJ (1991)

OBJECTIVE--To describe the prevalence of psychiatric disorder and the treatment needs of sentenced prisoners in England and Wales. DESIGN--Population survey based on a 5% sample of men serving prison sentences. SETTING--Sixteen prisons for adult males and nine institutions for male young offenders representative of all prisons in prison type, security levels, and length of sentences. SUBJECTS--406 young offenders and 1478 adult men, 404 and 1365 of whom agreed to be interviewed. MAIN OUTCOME MEASURES--History of psychiatric disorder, clinical diagnosis of psychiatrist, and required treatment. RESULTS--652 (37%) men had psychiatric disorders diagnosed, of whom 15 (0.8%) had organic disorders, 34 (2%) psychosis, 105 (6%) neurosis, 177 (10%) personality disorder, and 407 (23%) substance misuse. 52 (3%) were judged to require transfer to hospital for psychiatric treatment, 96 (5%) required treatment in a therapeutic community setting, and a further 176 (10%) required further psychiatric assessment or treatment within prison. CONCLUSIONS--By extrapolation the sentenced prison population includes over 700 men with psychosis, and around 1100 who would warrant transfer to hospital for psychiatric treatment. Provision of secure treatment facilities, particularly long term medium secure units, needs to be improved. Services for people with personality, sexual, and substance misuse disorders should be developed in both prisons and the health service.
<i>IDH</i>Mutation in Glioma
Authors: Zorbey Turkalp, Jason Karamchandani, Sunit Das
Journal: JAMA Neurology (2014)

<h3>Importance</h3> Over the past 4 years, our understanding of gliomagenesis and the practice of neuro-oncology have been radically changed by the discovery of mutations involving the isocitrate dehydrogenase (IDH) enzymes.<i>IDH</i>mutation has been found to be an inciting event in gliomagenesis and to have a profound effect on the molecular and genetic route of oncogenic progression and on clinical outcome. <h3>Objectives</h3> To review the role of IDH enzymes in normal physiology and describe aberrations in the<i>IDH</i>pathway that are associated with gliomagenesis, to review recent work examining the effect of<i>IDH</i>-targeted therapy in cancers harboring<i>IDH</i>mutation, and to determine how this work has expanded our understanding of the role of<i>IDH</i>in the development and progression of glioma. <h3>Evidence Review</h3> A systematic review of the literature dating from 2008, when<i>IDH</i>mutation was discovered to be clinically significant in glioma, to 2013 was performed using the PubMed database. The following search terms were used:<i>IDH</i>,<i>IDH1</i>,<i>IDH2</i>, and<i>isocitrate dehydrogenase</i>, in conjunction with<i>glioma</i>or<i>leukemia</i>. The search was limited to articles published in English. Further hand searching was performed using a review of the pertinent references from the identified publications. All identified original articles were investigated for content and critiqued by Z.T. and S.D. <h3>Findings</h3> <i>IDH</i>mutation is an early event in gliomagenesis and has significant implications for glioma progression and tumor behavior. Early evidence suggests that<i>IDH</i>may be a therapeutic target in<i>IDH</i>-mutant gliomas. <h3>Conclusions and Relevance</h3> <i>IDH</i>mutation is a central and defining event in the development and progression of glioma and may be a key target for future therapies for these types of neoplasms.
Physical Stimuli‐Induced Chondrogenic Differentiation of Mesenchymal Stem Cells Using Magnetic Nanoparticles
Authors: Boram Son, Hwan D. Kim, Minsoo Kim, Jeong Ah Kim, Jinkyu Lee, Heungsoo Shin, Nathaniel S. Hwang, Tai Hyun Park
Journal: Advanced Healthcare Materials (2015)

Chondrogenic commitments of mesenchymal stem cells (MSCs) require 3D cellular organization. Furthermore, recent progresses in bioreactor technology have contributed to the development of various biophysical stimulation platforms for efficient cartilage tissue formation. Here, an approach is reported to drive 3D cellular organization and enhance chondrogenic commitment of bone‐marrow‐derived human mesenchymal stem cells (BM‐hMSCs) via magnetic nanoparticle (MNP)‐mediated physical stimuli. MNPs isolated from Magnetospirillum sp. AMB‐1 are endocytosed by the BM‐hMSCs in a highly efficient manner. MNPs‐incorporated BM‐hMSCs are pelleted and then subjected to static magnetic field and/or magnet‐derived shear stress. Magnetic‐based stimuli enhance level of sulfated glycosaminoglycan (sGAG) and collagen synthesis, and facilitate the chondrogenic differentiation of BM‐hMSCs. In addition, both static magnetic field and magnet‐derived shear stress applied for the chondrogenic differentiation of BM‐hMSCs do not show increament of hypertrophic differentiation. This MNP‐mediated physical stimulation platform demonstrates a promising strategy for efficient cartilage tissue engineering.