tbuckley/cabot-search huggingface dataset:
Effects of Residence in Alzheimer Disease Special Care Units on Functional Outcomes
Authors: Charles D. Phillips
Journal: JAMA (1997)

Alzheimer disease special care units (SCUs) in nursing homes are increasingly prevalent, but little is known about their effects on residents' outcomes.To analyze the effect of SCU residence on the rates at which residents decline in functional status.A cohort of nursing home residents assessed at multiple points during about 1 year. Facility staff completed all assessments using the Minimum Data Set for Nursing Home Resident Assessment and Care Screening (MDS).Medicare- or Medicaid-certified nursing facilities.All nursing home residents in 1993 and early 1994 in Kansas, Maine, Mississippi, and South Dakota. Serial MDS assessments of 77337 residents in more than 800 facilities, including 1228 residents in 48 facilities with SCUs.Decline in locomotion, transferring, toileting, eating, dressing, and a summary activities of daily living index; decline in urinary and bowel continence; and significant weight loss.No statistically significant difference was observed in the speed of decline for residents in SCUs and traditional units in any of the 9 outcomes. Residents were matched on a variety of characteristics, and subgroup analyses were performed. In none did we observe a pattern of better outcomes among SCU residents.Although SCUs may have provided unmeasured benefits to families and residents, it does not appear that those benefits included any slowing in the rates of functional decline experienced by individuals with dementia.
Sensitization to Dust Mites as a Dominant Risk Factor for Asthma among Adolescents Living in Central Virginia
Authors: SUSAN P. SQUILLACE, RICHARD B. SPORIK, GARY RAKES, NICOLLE COUTURE, ANDREW LAWRENCE, SUSAN MERRIAM, JUAN ZHANG, THOMAS A. E. PLATTS-MILLS
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Factors influencing asthma were investigated in a population of school children in central Virginia. A survey of 1,054 children in two middle schools (one urban and one suburban) identified 135 students with symptoms suggestive of asthma. Eighty-eight symptomatic children and 123 control subjects were randomly selected for further evaluation by skin testing using common indoor and outdoor allergens; serum assays for total IgE and specific IgE; dust samples assayed for mite (Der p 1 Der f 1), cat (Fel d 1), and cockroach (Bla g 2) allergens; and provocation with histamine to test for bronchial hyperreactivity. Forty-eight of the children with symptoms responded to ⩽ 3.9 μ mol of histamine and were considered to have asthma. Marginal analysis identified elevated total IgE and dust mite, cat, and cockroach sensitization as significant risk factors for asthma. Using multiple regression, only dust mite sensitization was independently associated with asthma (odds ratio = 6.6; p < 0.0001). Dust from 81% of the houses contained high levels of mite allergen ( > 2 μ g/g), while ∼ 40% of the children were exposed to cat and 17% were exposed to cockroach allergen. In this population, there was no significant association between asthma and race, socioeconomic status, home smoking, sensitization to outdoor allergens, or allergen concentration in the child's home. In an area where there is a high prevalence of asthma and most houses contain high concentrations of dust mite allergen, sensitization to this allergen is the dominant risk factor for asthma defined as symptomatic bronchial hyperreactivity.
Acute coronary reocclusion after thrombolysis with recombinant human tissue-type plasminogen activator: prevention by a maintenance infusion.
Authors: H K Gold, R C Leinbach, H D Garabedian, T Yasuda, J A Johns, E B Grossbard, I Palacios, D Collen
Journal: Circulation (1986)

Twenty-nine patients with acute myocardial infarction were treated with recombinant human tissue-type plasminogen activator (rt-PA). The incidence of acute coronary reocclusion and its prevention by a maintenance infusion of rt-PA were studied. Intravenous rt-PA was given at a rate of 0.4 to 0.75 mg/kg over 60 to 120 min after angiographic documentation of complete coronary occlusion. Reperfusion was accomplished within 1 hr in 24 of 29 patients (83%) and was associated with a decrease of the plasma fibrinogen level by 20%. In a first group of 13 patients, 11 of whom were successfully reperfused, prevention of reocclusion was attempted with heparin anticoagulation. However, acute reocclusion within 1 hr after cessation of rt-PA was demonstrated angiographically in five of these patients (45%). Quantitative angiographic analysis indicated that acute reocclusion only occurred in patients with 80% or greater residual stenosis. In patients with less than 80% residual stenosis, heparin anticoagulation was sufficient to maintain patency during the hospital stay in four of five patients. In a second group of patients (n = 16), 13 of whom underwent reperfusion with intravenous rt-PA, seven demonstrated a residual stenosis of 80% or greater. These patients were given heparin and, in addition, 10 mg of rt-PA per hour for 4 hr. None developed acute angiographic reocclusion or clinical signs of reocclusion during the hospital stay. Repeat angiography at 10 to 14 days confirmed persistent patency in six of the seven patients. The maintenance infusion resulted in only a moderate additional drop in fibrinogen, while a steady-state plasma rt-PA level of 750 +/- 250 ng/ml was maintained.(ABSTRACT TRUNCATED AT 250 WORDS)
Strategies for the prevention of volleyball related injuries
Authors: J C Reeser, E Verhagen, W W Briner, T I Askeland, R Bahr
Journal: British Journal of Sports Medicine (2006)

Although the overall injury rate in volleyball and beach volleyball is relatively low compared with other team sports, injuries do occur in a discipline specific pattern. Epidemiological research has revealed that volleyball athletes are, in general, at greatest risk of acute ankle injuries and overuse conditions of the knee and shoulder. This structured review discusses both the known and suspected risk factors and potential strategies for preventing the most common volleyball related injuries: ankle sprains, patellar tendinopathy, and shoulder overuse.
Psychological stress and coping in IBD
Authors: J. Goodhand, D. Rampton
Journal: Gut (2008)

In recent years there has been increasing recognition by doctors as well as patients that psychological stress can worsen the course of inflammatory bowel disease (IBD).1–3 In this issue, Bitton et al ( see page 1386 ) report that the way in which some patients cope increases the risk of relapse of their Crohn’s disease after 1 year4: in other words, the wrong sort of coping can be bad for your health.

Stress can be defined as a threat, whether physical or psychological, to an organism’s homeostasis.5 The term coping describes the thoughts and behaviours used to manage the internal and external demands of situations that are perceived as taxing.6 Coping theory states that an individual’s ability to deal with stress depends both on their coping resources and on the strategies they employ when stressed. Resources include not only the social support a patient has, but also their stable personality traits: people who cope well are optimistic and have a strong sense of self-control and high self-esteem.7

Coping strategies have been variously classified and may change with the passage of time. Commonly quoted categories of coping behaviour, which are not mutually exclusive, include problem-solving, emotion-oriented, avoidance-oriented and supportant (table 1).8–11 While most gastroenterologists will have experience of questionnaires for assessing patients’ psychological state and perceived stress levels,12 fewer will be familiar with those devised to identify people’s coping strategies.13

View this table:

Table 1 Common coping strategies (adapted from references8–11)

A recent meta-analysis examining coping strategies in health and disease returned heterogeneous results, but in general emotion-focused strategies such as distancing and avoidance were negatively associated with health outcome, while problem-solving approaches were more beneficial.9 It is possible that, by attempting to problem-solve, an individual may reduce the length or intensity of the stressor, and the consequent psychoneuroimmunological …
The Mitochondrial Apoptotic Pathway Is Activated by Serum and Glucose Deprivation in Cardiac Myocytes
Authors: Shani Bialik, Vincent L. Cryns, Andjela Drincic, Setsuya Miyata, Adam L. Wollowick, Anu Srinivasan, Richard N. Kitsis
Journal: Circulation Research (1999)

Abstract —Many cell types undergo apoptosis under conditions of ischemia. Little is known, however, about the molecular pathways that mediate this response. A cellular and biochemical approach to elucidate such signaling pathways was undertaken in primary cultures of cardiac myocytes, a cell type that is especially sensitive to ischemia-induced apoptosis. Deprivation of serum and glucose, components of ischemia in vivo, resulted in myocyte apoptosis, as determined by nuclear fragmentation, internucleosomal cleavage of DNA, and processing of caspase substrates. These manifestations of apoptosis were blocked by zVAD-fmk, a peptide caspase inhibitor, indicating that caspase activity is necessary for the progression of apoptosis in this model. In contrast to control cells, apoptotic myocytes exhibited cytoplasmic accumulation of cytochrome c , indicating release from the mitochondria. Furthermore, both caspase-9 and caspase-3 were processed to their active forms in serum-/glucose-deprived myocytes. Caspase processing, but not cytochrome c release, was inhibited by zVAD-fmk, placing the latter event upstream of caspase activation. This evidence demonstrates that components of ischemia activate the mitochondrial death pathway in cardiac myocytes.
Testing for maximum oxygen consumption has produced a brainless mode of human exercise performance
Authors: Timothy David Noakes
Journal: British Journal of Sports Medicine (2008)

The measurement of the maximum oxygen consumption (VO 2 max) is probably the most widely used test in the applied sports sciences. Yet this test includes three features that are foreign to the manner in which humans usually exercise. First, the tested subject does not know the expected duration of the exercise bout when it begins. Second the intensity of the imposed exercise increases progressively, sometimes rapidly from low to “maximal” work rates. Third the imposed work rate is predetermined and immutable, beyond the control of the experimental subject’s brain. As a result the tested subject’s brain merely responds to changes in work rate imposed by the experimenter and is therefore the controlled variable in the experiment. In contrast when subjects are informed beforehand of either the expected exercise duration or the distance to be covered, they will choose to run at different paces depending on the known exercise duration. The brain achieves this by recruiting the exactly appropriate number of motor units in the exercising muscles. The goal of this strategy is to complete the activity without homeostatic failure whilst still allowing an increase in pace near the end of exercise, the “endspurt”. Since the tested subject’s brain is the controlled variable during the VO 2 max test merely responding passively to the externally-directed changes in work rate, so it has been assumed that the brain plays no part in “limiting” maximal exercise performance. This has in turn developed a “brainless” model of human exercise performance in which the “limiting” factors are described almost exclusively in terms of cardiovascular function. But the outstanding feature of effective human exercise performance is the adoption of the optimum pacing strategy that will avoid, not cause, homeostatic failure and profound skeletal muscle failure. Since the VO 2 max test does not evaluate the athlete’s ability to choose and sustain the optimum pace during exercise of different durations, it cannot be the optimum test either to evaluate a subject’s athletic potential or to understand the biological basis of superior athletic performance.
Implementation of Guidelines for the Prevention of Diabetic Nephropathy
Authors: Johan Fagerudd, Carol Forsblom, Kim Pettersson-Fernholm, Per-Henrik Groop
Journal: Diabetes Care (2004)

Effective treatment of hyperglycemia, cessation of smoking, and treatment of elevated blood pressure are important means to prevent and retard the progression of diabetic kidney disease in type 1 diabetes (1–4). Guidelines regarding management of these risk factors have become increasingly common, but little is known about how efficiently they are implemented in clinical practice.

The national guidelines for the prevention of diabetic nephropathy published in 1991 by the Finnish Diabetes Association state the following: 1 ) aim for strict glycemic control (HbA1c 7.0–7.5%); 2 ) encourage the patient to stop smoking; 3 ) in patients with elevated albuminuria, initiate antihypertensive therapy with ACE inhibitors as first-line agents if blood pressure exceeds 140/90 mmHg, with the target for treatment <130/80–85 mmHg. The aim of the present study was to examine to what extent these guidelines are implemented in a large cohort of adult type 1 diabetic patients.

The Finnish Diabetic Nephropathy (FinnDiane) study is a nation-wide, prospective, multicenter study initiated in November 1997 with the primary aim to identify genetic and environmental risk factors for diabetic nephropathy in type 1 diabetes (5 …
Clinical management of low ovarian response to stimulation for IVF: a systematic review
Authors: B.C. Tarlatzis
Journal: Human Reproduction Update (2003)

Poor response is not a rare occurrence in ovarian stimulation. Although not fully accepted, the most dominant criteria for poor ovarian response are small numbers of follicles developed or oocytes retrieved, and low estradiol (E2) levels after the use of a standard stimulation protocol. There is no ideal predictive test as the poor responder is revealed only during ovulation induction; however, increased levels of day 3 FSH and E2 as well as decreased levels of inhibin B can be used to assess ovarian reserve. Several protocols have been proposed for clinical management of low ovarian response in IVF. Although high doses of gonadotrophins have been used by the vast majority of authors, results have been controversial and prospective randomized studies have shown little or no benefit. The few available relevant studies do not indicate that recombinant FSH improves outcome. Flare-up GnRH agonist protocols (including all dosage varieties) produce better results than standard long luteal protocols. Luteal initiation GnRH agonist ‘stop’ protocols were shown to improve ovarian response according to prospective studies with historical controls, but this was not confirmed by well-designed prospective, randomized, controlled studies. The few available data obtained with GnRH antagonists have not shown any benefits. Adjuvant therapy with growth hormone (GH) or GH-releasing factors results in no significant improvement. The use of corticosteroids reduces the incidence of poor ovarian response in women undergoing IVF treatment. The limited data obtained with nitric oxide donors are encouraging. Pretreatment with combined oral contraceptives prior to stimulation may help ovarian response. No benefit was observed with standard use of ICSI or assisted hatching of zona pellucida. Finally, natural cycle IVF has produced results which are comparable with those obtained with stimulated cycles in true poor responders. Well-designed, large-scale, randomized, controlled trials are needed to assess the efficacy of these different management strategies.
A Quick Review of the Cutaneous Findings of the Deadly Scourge Ebola Virus
Authors: Brian J. Simmons, Robert D. Griffith, Leyre A. Falto-Aizpurua, Keyvan Nouri
Journal: JAMA Dermatology (2015)

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 Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast 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 Dermatology journal
Evaluation of AJCC Tumor Staging for Cutaneous Squamous Cell Carcinoma and a Proposed Alternative Tumor Staging System
Authors: Anokhi Jambusaria-Pahlajani, Peter A. Kanetsky, Pritesh S. Karia, Wei-Ting Hwang, Joel M. Gelfand, Faith M. Whalen, Rosalie Elenitsas, Xiaowei Xu, Chrysalyne D. Schmults
Journal: JAMA Dermatology (2013)

<h3>Importance</h3>This study proposes an alternative tumor staging system for cutaneous squamous cell carcinoma (CSCC) that more precisely defines the small subset of tumors with a high risk of metastasis and death.<h3>Objective</h3>To identify risk factors for poor outcomes in CSCC and evaluate the 2010 American Joint Committee on Cancer (AJCC) tumor (T) staging system's ability to stratify occurrence of these outcomes.<h3>Design</h3>Retrospective cohort study.<h3>Setting</h3>A single academic hospital.<h3>Participants</h3>Study participants were identified via a pathology and dermatopathology database search for patients diagnosed as having high-risk CSCC.<h3>Results</h3>Two hundred fifty-six primary high-risk CSCCs were included. Outcomes for AJCC tumor stages T2 to T4 were statistically indistinguishable because only 4 cases (&lt;2% of the cohort) were AJCC stages T3 or T4, which require bone invasion. Subsequently, the bulk of poor outcomes (83% of nodal metastases, 92% of deaths from CSCC) occurred in AJCC stage T2 cases. An alternative tumor staging system was developed with the aim of better stratifying this stage T2 group. Four risk factors were found to be statistically independent prognostic factors for at least 2 outcomes of interest in multivariate modeling. These factors (poor differentiation, perineural invasion, tumor diameter ≥2 cm, invasion beyond subcutaneous fat) were incorporated in the alternative staging with 0 factors indicating T1, 1 factor indicating T2a; 2 to 3 factors, T2b; and 4 factors or bone invasion, T3. Stages T2a and T2b significantly differed in incidences of all 4 end points. Stage T2b tumors comprised only 19% of the cohort but accounted for 72% of nodal metastases and 83% of deaths from CSCC.<h3>Conclusions and Relevance</h3>The proposed alternative tumor staging system offers improved prognostic discrimination via stratification of stage T2 tumors. Validation in other cohorts is needed. Meanwhile, stage T2b tumors are responsible for most poor outcomes and may be a focus of high-risk CSCC study.
Elastic pressure-volume curves: what information do they convey?
Authors: B. Jonson, C. Svantesson
Journal: Thorax (1999)

In 1929 von Neergaard demonstrated that surface forces are responsible for a large part of the elastic recoil pressure of the lungs. 1 This was evidenced by recordings of elastic recoil during deflation of air-and liquid-filled lungs.On the basis of similar experiments, extended to include inflation (fig 1), Radford laid down concepts which still form the basis for the interpretation of elastic pressure-volume (P el -V) curves in today's intensive care units. 2 In this review these concepts will be analysed.The relevance of P el -V curves as guidelines in managing ventilation to avoid lung trauma will be discussed.Furthermore, techniques for recording and analysis of P el -V curves will be briefly commented upon.Features of the elastic pressure-volume curve P el -V curves are often recorded during an insuZation of gas which is preceded by an expiration to the elastic equilibrium volume.An example of an inspiratory P el -V curve recorded from a patient with acute lung injury (ALI) is shown in fig 2. The features of the curve are well known. 3 4The curve can be considered to consist of three segments: an initial flat segment reflects a very low compliance, indicating collapse of peripheral airways and/or lung units preventing lung inflation; there then follows a segment with a steeper slope (that is, greater compliance); the transition between these two segments, which may be more or less abrupt, can be denoted the lower inflection point (LIP).5][6][7] At large volumes and high pressures the slope-that is, the compliance-
Prevention of fall-related injuries in 7-year-old to 12-year-old children: a cluster randomised controlled trial
Authors: Joske Nauta, Dirk L Knol, Lize Adriaensens, Karin Klein Wolt, Willem van Mechelen, Evert A L M Verhagen
Journal: British Journal of Sports Medicine (2013)

Introduction To counteract the recently observed increase in forearm fractures in children worldwide, an educational programme to improve fall skills was developed. In this 8-week programme children learned basic martial arts falling techniques in their physical education classes. In this study, the effectiveness of this educational programme to improve fall skills was evaluated. Methods A cluster randomised controlled trial was conducted in 33 primary schools. The intervention group received the educational programme to improve falling skills during their physical education (PE) classes whereas the control group received their regular PE curriculum. At baseline (October 2009) and follow-up (May 2010), a questionnaire was completed by the children about their physical activity behaviours. Furthermore, fall-related injuries were registered continuously during an entire school-year. Results A total of 36 incident injuries was reported in the intervention group, equalling an injury incidence density (IID) of 0.14 fall-related injuries per 1000 h of physical activity (95% CI 0.09 to 0.18). In contrast, 96 injuries were reported by the control group corresponding to an IID of 0.26 (95% CI 0.21 to 0.32). However, because intracluster correlation was high (ICC=0.46), differences in injury incidence were not statistically significant. When activity level was taken into account, a trend was shown suggesting that the ‘falling is a sport’ programme was effective in decreasing falling-related injury risk, but only in the least active children. Discussion and conclusion Although results did not reach significance because of strong clustering effects, a trend was found suggesting that a school-based educational programme to improve falling skills may be more beneficial for the prevention of falling-related injuries in children with low levels of habitual physical activity.
A woman with neck pain and shortness of breath
Authors: R. Parekh, T. Beaconsfield, W. M. Kong
Journal: BMJ (2012)

The first case of Turner9s syndrome with the familial translocation not involving the X chromosome is described. The patient had a number of clinical signs of Turner9s syndrome and her karyotype was 45,X,t(1;2)(q32;q2)mat. Though it is speculated that the altered structure of a chromosome may influence meiotic disjunction of a non-homologous chromosome, our case suggests that there may be no relationship between the two chromosomal abnormalities.