tbuckley/cabot-search huggingface dataset:
SAT0540 Assessment of Factors Protective of Bone Mineral Density in a New Orleans Sarcoidosis Population
Authors: M. Walker, A. Janot, H. Grewal, M. Yu, M.R. Lammi, L.A. Saketkoo
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Sarcoidosis often involves pathological dysregulation of dependent factors of bone metabolism, e.g. calcitriol /calcium, and administration of high dose glucocorticoids (GCs) leading to low bone mineral density (LBMD). Traditional risk factors for LBMD include advancing age, female sex, low body mass index (BMI), smoking, white race and GCs. LBMD in sarcoidosis is presumed but not yet described. <h3>Methods</h3> A retrospective chart review of biopsy-diagnosed patients with sarcoidosis for &gt;1 year extracted and compared variables of prevalence, age (at chart review), sex, race, smoking status and designation of LBMD defined as osteopenia or osteoporosis with a T-score of ≤ -1 on DXA. Calculations were performed by non-parametric analyses using Fisher9s exact for categorical data and Mann Whitney tests for continuous variables. <h3>Results</h3> 269 charts were reviewed and 109 had documentation of biopsy. Of these 109, 61 patients (86.9% Black) had documentation of DXA, 38 (62.3%) with LBMD (30 with osteopenia and 8 with osteoporosis). Although patients with BMI ≥30 had a significantly lower incidence of LBMD vs. those with BMI &lt;30, LBMD incidence exceeded reported in CDC data for overweight subjects. No differences (table) were seen in incident LBMD in patients age ≥ vs &lt;65, in ever vs never smokers (no significant age difference between groups), nor in males vs females (despite females being significantly older than males with median 54 and 48 respectively). <h3>Conclusions</h3> Factors protective against LBMD in the general population were not demonstrated in this retrospective sarcoidosis predominantly black cohort. A lower risk of LBMD was not conferred by age &lt;65, male gender, or non-smoking status. While BMI appeared to confer protection, the prevalence in obese sarcoidosis patients supersedes that in CDC reported data. These trends suggest an abnormal signal of incident LBMD in this population differing from the general population. Lack of uniformity of documentation inherent in retrospective methods limits the assessment of important associative and causative influences such as duration and dose of GCs, biomarkers of bone metabolism (e.g. calcium, calcitriol, etc) and fracture risk which will be examined in our prospective sarcoid registry. Nevertheless these findings are important and support increased vigilance in GC use and perhaps consideration to initiate GC sparing agents earlier in the disease course, as well as routine DXA screening in sarcoidosis. <h3>Acknowledgements</h3> This research was funded by grant #T35HL105350 from the National Heart, Lung and Blood Institute. <h3>Disclosure of Interest</h3> M. Walker: None declared, A. Janot: None declared, H. Grewal: None declared, M. Yu: None declared, M. Lammi: None declared, L. A. Saketkoo Grant/research support from: ACR/EULAR Exchange Awardee
Investigation of an unexplained skin disorder in a prison clinic in the Netherlands in 2002
Authors: J G Breugelmans, A Bosman, A. K van der Heide, E. Y.R Roeleveld-Kuijper, D P Bruynzeel
Journal: Eurosurveillance (2003)

An unexplained outbreak of skin disorder with itching papules or pustules occurred among drugs body packers in a detention clinic in the Netherlands in October-November 2002. The descriptive cohort study suggests this outbreak could be associated with an expired batch of disposable linens, with an overall attack rate of 30% in the study population (n=118). No additionnal cases have been noted since this expired batch was replaced.
Estimated distribution of effort by providers of mental health services to U.S. adults in 1982 and 1983
Authors: D J Knesper, D J Pagnucco
Journal: American Journal of Psychiatry (1987)

A national sample of psychiatrists, psychologists, social workers, and primary care physicians responded to a survey of their professional activities. From these data, the authors estimate that during a representative 60-day period, 6.7% of U.S. adults visited one of these types of professionals for a mental or emotional condition. All four groups spent the largest portion of their time with nonpsychotic patients. Most patients with schizophrenia, mania, or major depression were treated by psychiatrists. Services from primary care physicians were usually provided in the context of a concurrent physical condition. Psychologists and social workers tended to treat the less severe mental and emotional conditions.
Authors’ reply to Tufan and colleagues and Boucaud-Maitre
Authors: Francesco Salvo, Nicholas Moore, Mickael Arnaud, Philip Robinson, Emanuel Raschi, Fabrizio De Ponti, Bernard Bégaud, Antoine Pariente
Journal: BMJ (2016)

In response to Tufan and colleagues, it is true that older frail patients are under-represented in our meta-analysis, but such patients are under-represented in clinical trials in general, not just those investigating type 2 diabetes.1 2 Even when there is no formal age limit, the common exclusion of patients with organ dysfunction and comorbidities means that most older people are excluded.3 We can but hope that further trials will provide more information on benefits and risks of drugs in older people and will update …
Herpesvirus Infections of Pregnancy
Authors: Sergio Stagno, Richard J. Whitley
Journal: New England Journal of Medicine (1985)

Herpes Simplex Virus InfectionsDURING the past decade, genital herpes simplex virus infections have attracted increasing attention because of their prevalence, the alarm associated with a chronically recurring disease, the risk of transmission to sexual partners, and concern about the transmission of virus from a pregnant woman to her offspring.67 68 69 Maternal InfectionThere is a striking paucity of data on the epidemiology and management of genital herpes simplex virus infections during pregnancy. Two patterns of maternal infection can have fetal consequences, however: disseminated infection and localized recurrent or primary genital maternal infection. Disseminated Infection Herpes simplex virus infections of pregnant . . .
Rare × Rare
Authors: George E. Thibault
Journal: New England Journal of Medicine (1992)

A 70-year-old man was referred to a cardiologist for evaluation of exertional chest pain and dyspnea.The first thing that comes to mind in a man in this age group with exertional chest pain and dyspnea is the possibility of myocardial ischemia, most probably due to coronary artery disease. The combination of exertional chest pain and dyspnea is an interesting one. Chest pain with effort is frequently angina; what about the dyspnea? Dyspnea can be one of the manifestations of myocardial ischemia, secondary to an increase in left ventricular diastolic pressure and therefore elevation of the pulmonary venous pressure. In . . .
Site Distribution of Cancer Deaths in Husband-Wife and Sibling Pairs
Authors: W Y CHEN, L B CRITTENDEN, N MANTEL, W R CAMERON
Journal: JNCI Journal of the National Cancer Institute (1961)

The problems of determining the importance of environmental and genetic factors contributing to observed familial aggregations of cancer are discussed. The distributions of 29 site classifications in 51 husband-wife pairs, 60 brother-sister pairs, 76 sister-sister pairs, and 44 brother-brother pairs dying of cancer are presented. The total number of pairs matched for detailed site on the death certificate for each type of pairing is compared to an expected number computed from the data in this study. Only the brother-sister pairing failed to show a significant excess of matched pairs. The fact that husband-wife pairings showed an excess suggests that common environment and common heredity should be considered in the explanation of observed familial aggregation of cancer. The Appendix indicates the derivation of the expectations of the sums of matched pairs and their variances for the case of the symmetrical and asymmetrical contingency table. Appropriate chi-square formulas are given for testing the deviations of the observed number of matched pairs from their expectations.
PHEOCHROMOCYTOMA AND ELECTROCONVULSIVE THERAPY
Authors: FRANK R. DRAKE, FRANKLIN G. EBAUGH
Journal: American Journal of Psychiatry (1956)

1. A case of pheochromocytoma is reported with a fatal cardiac arrest following electroconvlusive therapy. The diagnosis was particularly difficult as no paroxysm of hypertension was ever detected. In addition, there was no sustained hypertension to arouse suspicion. Although a little atypical the patient's signs and symptoms suggested a tension depression. 2. It is certain that pheochromocytoma is an absolute contraindication to electroconvulsive therapy. The authors could find no previous report in the literature on this matter. 3. This case is presented primarily so that other psychiatrists may become more aware of a tumor which can produce symptoms distressingly similar to those found in various anxiety states with or without depression.
Grafts of Venous System
Authors: W A DALE, H W SCOTT
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Exploration of cost effectiveness of active vaccination in the control of a school outbreak of hepatitis A in a deprived community in the United Kingdom
Authors: D.  C. Taylor-Robinson, M Regan, N Crowcroft, J. V. Parry, E Dardamissis
Journal: Eurosurveillance (2007)

In January 2006, an outbreak of hepatitis A occurred in a socio-economically deprived area of Liverpool, in the United Kingdom (UK), where extensive community outbreaks of hepatitis had previously occurred. A total of nine cases were confirmed. Five of these were linked within a primary school. The outbreak initially occurred among a close social contact group, but there was evidence of subsequent person-to-person transmission within a local primary school. The school was attended by 221 pupils (age range 4-12 years) with a total of 37 teaching and other staff (age range 22-71 years). Following local risk assessment, mass hepatitis A virus (HAV) vaccination was offered to all staff and pupils, as all were judged to be likely to have been in close contact with the affected pupils. A total of 188 of 217 eligible children (87%), and 33 of 37 staff (89%) were vaccinated. A salivary seroprevalence survey was conducted at the same time as vaccination to assess the benefit of this intervention in the school population. The survey confirmed high levels of susceptibility to hepatitis A in this setting (97.8%, 95% CI 91.6 to 99.62). The direct costs of intervention were estimated as £5,000. The cost effectiveness of intervention varies widely (£60.50 to £2,099 per case avoided) depending on the expected attack rate, which is difficult to estimate due to heterogeneity in published studies.
Glutamate and other CSF amino acids in Alzheimer's disease
Authors: N Pomara, R Singh, D Deptula, J C Chou, M B Schwartz, P A LeWitt
Journal: American Journal of Psychiatry (1992)

The authors compared CSF amino acid levels of 10 patients with mild to moderate dementia and probable Alzheimer's disease who had never received antidepressant or neuroleptic medication with those of 10 normal subjects of similar age. The Alzheimer's patients had significantly higher levels of CSF glutamate. This finding was not related to age, sex, or severity of dementia. Elevated CSF glutamate may reflect greater glutamatergic activity early in the course of Alzheimer's disease. The authors speculate that the excitotoxic effects of glutamate may contribute to progressive neuronal loss in Alzheimer's disease.
PWE-267 Has the publication of surgeon specific data adversely affected older patients?
Authors: A Ghanbari, J Evans, P Chokkarapu, P Kang, K Khalil, D Hunter
Journal: Gut (2015)

<h3>Introduction</h3> The Association of Coloproctology first published surgeon specific outcome data in September 2013. There has been some concern this may lead to surgeons refusing to operate on higher risk patients. Furthermore, Published by the Royal College of Surgeons of England, “Access Ages 2” suggests that there is a marked decline in rates of elective surgery in over 65s. It described a 9 fold difference in the rate of colorectal cancer excision for over 75s depending on where the patient lives. We hypothesised that concern over poor outcomes may lead to a reduction in the age of patients offered elective colorectal cancer excision. <h3>Method</h3> Data was prospectively collected on all patients undergoing elective colorectal cancer resections in our unit. We compared the patient selection for one year before and after publication of surgeon specific data. <h3>Results</h3> In the 12 months prior to publication of surgeon specific data, our Unit (4 Consultant Colorectal Surgeons) operated on 114 patients with a median age of 71 (IQR 63–77.5), compared to 84 patients with a median age of 72.5 (65–77) for the subsequent 12 months (p = 0.351, Mann-Whitney). There were more patients in the 75–85 age range than in the 65–75 range. The comorbidities identified in both groups were comparable. <h3>Conclusion</h3> There was no difference in the age group of patients offered elective surgery following the publication of surgeon specific outcome data. Fears that the publication may lead to older patients being denied surgery were unfounded. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> http://www.rcseng.ac.uk/news/docs/access-all-ages-2
PTH-276 Adenocarcinoma of rectum – a composite of 3 different subtypes with varying outcomes?
Authors: KC Vallam, A Desouza, M Bal, R Engineer, P Patil, A Saklani
Journal: Gut (2015)

<h3>Introduction</h3> Considerable confusion exists with regards to the terminology of mucin secreting adenocarcinomas of the rectum. The WHO classification system needs to be followed accurately for comparing the outcomes of mucinous and signet ring cell carcinomas. We hypothesised that clinico-pathological outcome measures like margins, tumour regression grade, recurrence rates and survival vary with histology. <h3>Method</h3> We conducted a retrospective analysis of a prospectively maintained database. All Stage I-III rectal adenocarcinoma patients were included. <h3>Results</h3> Between May 2010 and August 2013, 273 patients underwent curative resection. Both the mucin secreting variants were more common in young age and presented at a more advanced stage.14%of tumours had signet ring cell histology whereas 8% had mucinous histology. 54% and 48% of signet ring cell carcinoma (SRCC) and mucinous adenocarcinoma (MAC) patients were node positive in contrast to the classical variant (30%). CRM positivity was 24% with MAC and 19% with SRCC as compared to 4% with the classical variant. The DFS among the classical and mucinous variants was 38.5 and 37.4 months, respectively, whereas it was 28.6 months in the SRCC group. OS did not differ significantly. <h3>Conclusion</h3> There is a high incidence of aggressive mucin secreting variants in India. There exists a spectrum of adenocarcinomas of rectum with progressively worsening outcomes from classical to MAC to SRCC. These aggressive variants might warrant more aggressive resections. <h3>Disclosure of interest</h3> None Declared.
Diverticulitis
Authors: R Nanda, J Amini
Journal: New England Journal of Medicine (1995)

Figure 1. A 70-year-old, previously healthy man had had sudden, colicky lower abdominal pain and increased urinary frequency for four days. He had marked suprapubic tenderness but no other abnormal physical findings. There was mild leukocytosis and a slight leftward shift; the results of urinalysis were unremarkable. A computed tomographic (CT) scan of the pelvis obtained on the first hospital day (Panel A and adjacent sketch) shows thickening of the sigmoid colon (thick arrows). The dark areas represent gas in the lumen, and the white areas represent contrast material. The small dark areas (thin arrows) represent gas in diverticula. A . . .
Dobutamine-201Tl imaging. Assessing cardiac risks associated with vascular surgery.
Authors: Elliott Bm, Robison Jg, Zellner Jl, Hendrix Gh
Journal: Circulation (1991)

The prevalence of coronary artery disease among patients considered for vascular surgical reconstructive procedures is appreciable though often clinically not apparent. One hundred and twenty-six patients underwent dobutamine-201Tl imaging (DTI) in preparation for vascular reconstruction. Fifty-four patients (43%) had a normal study and underwent vascular reconstruction, with one postoperative myocardial ischemic event (1.8%). 30 patients (24%) had a fixed defect present on DTI, which was indicative of prior infarction. Twenty-eight of these 30 patients underwent vascular reconstruction, with three postoperative myocardial ischemic events (11%, p = NS). The presence of a fixed defect on DTI did not significantly increase the risk of ischemic events in patients undergoing vascular procedures. Forty-two (33%) patients had reperfusion of their defects on DTI, which was indicative of myocardial ischemia. Fifteen of these 42 (36%) were denied vascular reconstruction. Nine of the 42 (21%) had either coronary artery bypass graft surgery or coronary angioplasty performed before vascular reconstruction without any postoperative myocardial ischemic events. The remaining 18 patients with reversible ischemia identified by DTI underwent vascular reconstruction without preoperative cardiac intervention, and nine of these 18 (50%) suffered a postoperative myocardial ischemic event (p less than 0.0001). Although there was a difference in the incidence of ischemic events among patients undergoing peripheral vascular compared with aortic reconstruction (71% versus 36%), if there was reversible ischemia identified on DTI this did not reach statistical significance. DTI is a reliable screening test that allows for an accurate means of predicting cardiac risks associated with vascular reconstruction, as well as identifying patients that might benefit from further cardiac evaluation and preoperative intervention.
Adjunctive imipramine maintenance treatment in schizophrenic patients with remitted postpsychotic depression
Authors: S G Siris, J Cutler, K Owen, S Mason, S Gingerich, M P Lang
Journal: American Journal of Psychiatry (1989)

Ten patients with histories of postpsychotic depression responsive to adjunctive imipramine added to fluphenazine decanoate and benztropine underwent a double-blind trial of imipramine discontinuation 6 months after responding to the adjunctive imipramine. Discontinuation of imipramine was associated with depressive relapse.
Adult Sinusitis
Authors: Denise M. Goodman, Cassio Lynm, Edward L. Livingston
Journal: JAMA (2013)

Maxillary sinusNasal cavity Ethmoid sinus Sinus AnatomyRare but important symptoms may include severe headaches and redness, tenderness, or swelling in or around the eyebrow or eye.Thick nasal discharge from both nostrils that may be worse on one side Y our sinuses are air-filled cavities in your face and head, lying behind your eyebrows and your cheekbones and between your eyes.Normally, the sinuses are lined with a mucous membrane that functions to produce and circulate normal mucus into your nose, which helps filter dust and particles as well as moisten the air that you breathe.When these cavities become inflamed or swollen, you have sinusitis.This usually happens because a virus, allergy, or other inflammation creates swollen mucous membranes that block the natural drainage pathway of the sinuses.The most common cause of acute sinusitis is the common cold.
Seven-month clinical outcome of anhedonic and normally hedonic depressed inpatients
Authors: D C Clark, J Fawcett, E Salazar-Grueso, E Fawcett
Journal: American Journal of Psychiatry (1984)

Using a measure of capacity for pleasurable experiences (the Pleasure Scale), the authors compared at admission and 7-month follow-up 74 psychiatric inpatients meeting DSM-III criteria for major depression. Pleasure scores were stable over 7 months despite the fact that two-thirds of the sample recovered from depression. The subgroup of subjects who were most anhedonic at admission were more likely than the remaining subjects to show clinical recovery but persisted in exhibiting a lower pleasure score (even when the comparison was limited to recovered subjects). Pleasure scores were much better predictors of clinical recovery than were neuroticism scores.
Withdrawal responses to abrupt discontinuation of desmethyldiazepam
Authors: A Winokur, K Rickels
Journal: American Journal of Psychiatry (1984)

The authors present the results of a controlled observation of withdrawal reactions accompanying cessation of desmethyldiazepam (clorazepate) therapy. The two subjects studied had had generalized anxiety disorder for several years; both were free from manifestations of other forms of psychopathology or addictive behavior patterns. Both patients maintained stable patterns of clorazepate use at modest doses for extended periods of time. The findings suggest that the long plasma half-life of clorazepate does not offer unique protection from withdrawal reactions associated with long-term therapy. Manifestations of these withdrawal reactions are indistinguishable from reactions associated with other benzodiazepine compounds.