tbuckley/cabot-search huggingface dataset:
Follow-up to Nonfatal Opioid Overdoses
Authors: Mitchel L. Galishoff
Journal: Annals of Internal Medicine (2016)

Letters6 September 2016Follow-up to Nonfatal Opioid OverdosesMitchel L. Galishoff, MDMitchel L. Galishoff, MDFrom Valley Medical & Surgical Clinic, Valley, Alabama.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0111 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I would like to comment on Gregg's editorial (1) about prescription of opioids after an overdose (2). It is indeed ironic that, in an age of electronic health records and modern technology, simple communication of vital information is deficient. There was a time when we called one another and ensured that this information was passed on. This problem seems to require a simple solution of changing the system such that the prescribing physician is personally contacted and a formal transfer of care achieved.Gregg rightly mentions addiction as a driving risk factor in these overdoses. How do ...References1. Gregg J. Follow-up to nonfatal opioid overdoses: more of the same or an opportunity for change? [Editorial]. Ann Intern Med. 2016;164:62-3. [PMID: 26720852]. doi:10.7326/M15-2687 LinkGoogle Scholar2. Larochelle MR, Liebschutz JM, Zhang F, Ross-Degnan D, Wharam JF. Opioid prescribing after nonfatal overdose and association with repeated overdose. A cohort study. Ann Intern Med. 2016;164:1-9. [PMID: 26720742]. doi:10.7326/M15-0038 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Valley Medical & Surgical Clinic, Valley, Alabama.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L16-0111. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFollow-up to Nonfatal Opioid Overdoses: More of the Same or an Opportunity for Change? Jessica Gregg Follow-up to Nonfatal Opioid Overdoses Richard E. Moon and Jennifer V.F. Potter Metrics 6 September 2016Volume 165, Issue 5Page: 378KeywordsLiverLungsMedical conditionsMedical risk factorsMorphineOpioidsOxycodonePain managementSepsisTheft ePublished: 6 September 2016 Issue Published: 6 September 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Near infrared spectroscopy for the assessment of peripheral tissue oxygenation in pulmonary arterial hypertension
Authors: Marios Panagiotou, Ioannis Vogiatzis, Zafeiris Louvaris, Geeshath Jayasekera, Alison MacKenzie, Neil Mcglinchey, Julien S. Baker, Alistair C. Church, Andrew J. Peacock, Martin K. Johnson
Journal: European Respiratory Journal (2016)

Pulmonary arterial hypertension (PAH) is characterised by increased pulmonary vascular resistance and results in increased morbidity and mortality due to right heart failure and a progressive decline in cardiac output [1, 2]. The latter disturbs oxygen delivery to the periphery and may lead to pathological changes in tissue oxygenation. The balance between global oxygen supply and demand is reflected in mixed venous oxygen saturation ( S vO2), an index that is generally reduced in patients with PAH [3]. S vO2 at baseline is one of the strongest predictors of survival in PAH [4–6]; this is also true for changes in S vO2 during follow-up [5]. Cut-off values of 60% [7] and 65% [5] have been used to distinguish between prognostic groups suggesting that these may be suitable treatment goals. S vO2 is measured invasively in the pulmonary artery, where venous blood mixes after circulating through the superior and inferior vena cava, coronary sinuses and the right-heart chambers. Near infrared spectroscopy offers a qualitative, noninvasive indication of mixed venous oxygen saturation in PAH <http://ow.ly/TSSx30231YO>
Patients Leaving Emergency Departments Without Being Seen by a Physician-Reply
Authors: David W. Baker
Journal: JAMA (1992)

<h3>In Reply.</h3> —Dr Hass argues that many physicians have stopped providing charity care because of decreasing reimbursements from public and private insurers. If this has occurred, then reduced payments for insured patients cannot be the whole explanation. Family practitioners, internists, and pediatricians all had an increase in their net incomes from 1982 through 1987, and in 1990, office-based physicians in private practice reported a 6.9% increase. 1 Most of this increase was due to higher fees rather than an increased volume of services. It is doubtful that further increases will augment physicians' willingness to provide charity care. Providing health insurance would appear to be a more reliable way of guaranteeing access to care. It seems unlikely that national health insurance would worsen overcrowding as Dr Kunst suggests. While the hospitals and clinics that care for the uninsured are overcrowded, other providers are underutilized. Expanding health insurance coverage would allow those
Recipient Genotype for the IL-10 -1064 Promoter Gene STR Polymorphism Influences the Risk of Graft Failure/Rejection after HLA Matched Allogeneic Hematopoietic Stem Cell Transplant in a Chimerism Mediated Fashion.
Authors: Cintia Manzano, Pascual Balsalobre, Alfonso Gomez-Pineda, Jose L. Diez-Martin, Ismael Buño
Journal: Blood (2007)
Health System Reform: The Case for a Single-Payer Approach
Authors: Matthew L. Howard
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Representative McDermott's<sup>1</sup>article advises us to throw out the myths of the past to embrace a single-payer system. If we first throw out the Madison Avenue nomenclature, then we can turn to the lessons of the past, not the myths, to consider the supposed virtues of socialized medicine. One of those lessons is that socialized medicine leads to rationing as surely as our current system.<sup>2</sup>A second lesson is that government does not keep its promises. If you doubt this, recall that governmental promises that Medicare would pay usual, customary, and reasonable fees were out the window in less than 20 years. Budget pressures have led Medicare to progressive restrictions on allowable procedures and use of assistants and to reduced fees for many procedures. Once there is full government control of the entire health sector of the economy, all promises made now about how the
Polymorphisms in<i>CD84</i>,<i>IL12B</i>and<i>TNFAIP3</i>are associated with response to biologics in patients with psoriasis
Authors: J.M.P.A. van den Reek, M.J.H. Coenen, M. van de L'Isle Arias, J. Zweegers, D. Rodijk-Olthuis, J. Schalkwijk, S.H. Vermeulen, I. Joosten, P.C.M. van de Kerkhof, M.M.B. Seyger, P.L.J.M. Zeeuwen, E.M.G.J. de Jong
Journal: British Journal of Dermatology (2016)

The effectiveness of biologics for psoriasis shows heterogeneity among patients. With pharmacogenetic markers, it might be possible to predict treatment response. We aimed to test the association between genetic markers and the response to biologics in psoriasis (etanercept, adalimumab, ustekinumab) in a prospective cohort. We investigated the copy number variation in the LCE3B and LCE3C genes, and eight single‐nucleotide polymorphisms (SNPs) in HLA‐C*06, CD84, IL12B, IL23R, TRAF3IP2, ERAP1, IFIH1 and TNFAIP3. The decrease in Psoriasis Area and Severity Index (PASI) was calculated as ∆PASI (absolute PASI decrease compared with baseline) and PASI 75 (proportion of patients with ≥ 75% improvement vs. baseline). Associations between genetic variants and treatment outcome were assessed using multivariable linear regression analysis (∆PASI corrected for baseline PASI, primary analysis) and Pearson's χ2‐test or Fisher's exact test (PASI 75, secondary analysis). We included 348 treatment episodes in 234 patients. Patients heterozygous (GA) for the SNP in CD84 (rs6427528) had a better ∆PASI response to etanercept after 3 months (P =0·025) than the homozygous reference group (GG). In addition, patients heterozygous (CT) for the IL12B variant showed a better response (∆PASI) to ustekinumab (P =0·017) than the reference group (CC). Patients homozygous (GG) for the SNP in TNFAIP3 showed a worse response (∆PASI) to ustekinumab (P =0·031) than the reference group (TT). The associations with ustekinumab resulting from the primary analysis were not confirmed in the secondary (PASI 75) analysis. We demonstrated a strong association between etanercept use in psoriasis and variations in CD84, a gene that was previously found to be a predictor of response to etanercept in rheumatoid arthritis.
Natural history of isolated nail psoriasis and its role as a risk factor for the development of psoriatic arthritis: a single-centre cross-sectional study
Authors: R. Balestri, G. Rech, E. Rossi, M. Starace, N. Malavolta, F. Bardazzi, A. Patrizi, B.M. Piraccini
Journal: British Journal of Dermatology (2016)

The severity and clinical appearance of psoriatic arthritis(PsA) is markedly variable and the dermatologist plays an important role in identifying it at an early stage, before the joint damage becomes irreversible.1

Nail psoriasis(NP) is more frequent in patients with PsA than skin psoriasis2,3: about 50% of patients with NP complain of pain, stiffness or swelling of the interphalangeal joint in the absence of a diagnosis of arthropathy, suggesting that these symptoms may be a manifestation of a subclinical enthesitis potentially preceding PsA.4

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Efficacy and safety of the human glucagon-like peptide-1 analog liraglutide in combination with metformin and thiazolidinedione in patients with type 2 diabetes (LEAD-4 Met + TZD) (Diabetes Care (2009) 32, (1224-1230))
Authors: B. Zinman, J. Gerich, J. B. Buse, A. Lewin, S. Schwartz, Philip Raskin, P. M. Hale, M. Zdravkovic, L. Blonde
Journal: Diabetes Care (2010)
Data feedback and behavioural change intervention to improve primary care prescribing safety (EFIPPS): multicentre, three arm, cluster randomised controlled trial
Authors: Bruce Guthrie, Kimberley Kavanagh, Chris Robertson, Karen Barnett, Shaun Treweek, Dennis Petrie, Lewis Ritchie, Marion Bennie
Journal: BMJ (2016)

<b>Objective</b>&nbsp;To evaluate the effectiveness of feedback on safety of prescribing compared with moderately enhanced usual care. <b>Design</b>&nbsp;Three arm, highly pragmatic cluster randomised trial. <b>Setting and participants</b>&nbsp;262/278 (94%) primary care practices in three Scottish health boards. <b>Interventions</b>&nbsp;Practices were randomised to: "usual care," consisting of emailed educational material with support for searching to identify patients (88 practices at baseline, 86 analysed); usual care plus feedback on practice's high risk prescribing sent quarterly on five occasions (87 practices, 86 analysed); or usual care plus the same feedback incorporating a behavioural change component (87 practices, 86 analysed). <b>Main outcome measures</b>&nbsp;The primary outcome was a patient level composite of six prescribing measures relating to high risk use of antipsychotics, non-steroidal anti-inflammatories, and antiplatelets. Secondary outcomes were the six individual measures. The primary analysis compared high risk prescribing in the two feedback arms against usual care at 15 months. Secondary analyses examined immediate change and change in trend of high risk prescribing associated with implementation of the intervention within each arm. <b>Results</b>&nbsp;In the primary analysis, high risk prescribing as measured by the primary outcome fell from 6.0% (3332/55 896) to 5.1% (2845/55 872) in the usual care arm, compared with 5.9% (3341/56 194) to 4.6% (2587/56 478) in the feedback only arm (odds ratio 0.88 (95% confidence interval 0.80 to 0.96) compared with usual care; P=0.007) and 6.2% (3634/58 569) to 4.6% (2686/58 582) in the feedback plus behavioural change component arm (0.86 (0.78 to 0.95); P=0.002). In the pre-specified secondary analysis of change in trend within each arm, the usual care educational intervention had no effect on the existing declining trend in high risk prescribing. Both types of feedback were associated with significantly more rapid decline in high risk prescribing after the intervention compared with before. <b>Conclusions</b>&nbsp;Feedback of prescribing safety data was effective at reducing high risk prescribing. The intervention would be feasible to implement at scale in contexts where electronic health records are in general use. <b>Trial registration</b>&nbsp;Clinical trials NCT01602705.
Comment on Yang et al. Association of Statin Use and Reduced Risk of Lower-Extremity Amputation Among Patients With Diabetes: A Nationwide Population-Based Cohort Observation. Diabetes Care 2016;39:e54–e55
Authors: Joshua D. Fox, Katherine L. Baquerizo-Nole, Flor Macquhae, Ingrid Herskovitz, Jeremy B. Freedman, Loretta Vileikyte, David J. Margolis, Robert S. Kirsner
Journal: Diabetes Care (2016)

It is estimated that 2 million Americans, two-thirds of whom have diabetes mellitus (DM), are currently living with a limb amputation (1). Patients with DM are at significant risk for limb amputation, as one in four will develop a diabetic foot ulcer (DFU) over their lifetime and nearly one in six will require amputation (2). In 2009, U.S. hospital costs due to amputation exceeded $8.3 billion, and annual U.S. DFU treatment costs are approaching $13 billion (1–3).

With this in mind, we were pleased to read the study by Yang et al. (4) investigating the association between statin use and reduced risk of lower-limb amputation (LLA) in patients with DM. Yang et al. studied a population-based cohort …
Striving for multidisciplinary consensus on the diagnosis and management of patients with femoroacetabular impingement: more evidence is needed
Authors: David J Hunter, Oliver Marín-Peña
Journal: British Journal of Sports Medicine (2016)

In recent years, abnormal hip joint morphology has emerged as a significant factor responsible for the onset of hip osteoarthritis (OA). This is believed to lead to pathological loading patterns that produce shear stresses on the hip joint over time.1 Ganz et al 2 described two different morphological patterns of femoroacetabular impingement (FAI): cam and pincer FAI.

What is the prevalence of FAI morphology in the general population? Estimates vary wildly owing to disparity in the definition of FAI morphology used and in the populations sampled. The proportion of the population with symptoms related to FAI is only a fraction of those with FAI morphology. Furthermore, the presence of severe morphological abnormalities does not always bring about hip OA, suggesting that there are other factors at play in hip OA pathogenesis than just joint morphology.

This recently defined clinical problem of FAI with widely disparate definitions available and controversy about management motivated the need for some consensus. This international consensus ( see page 1169 ) provides a broad overview of important questions in this challenging field …
Identification of subtypes of triple negative breast cancer (TNBC) that are sensitive to CDK4/6 inhibition.
Authors: Uzma Asghar, Maria Teresa Herrera-Abreu, Ros Cutts, Irina Babina, Alex Pearson, Nicholas C. Turner
Journal: Journal of Clinical Oncology (2015)

11098 Background: CDK4/6 inhibitors in combination with hormone therapies have shown activity in estrogen receptor positive (ER+ve) breast cancers. We investigated whether CDK4/6 inhibitors have activity in subsets of Triple Negative Breast Cancer (TNBC), and assessed combination therapeutic approaches. Methods: We screened 18 TNBC cell lines for sensitivity to the CDK4/6 inhibitor palbocicilb in long-term clonogenic assays, with assessment of combination effect with Combination Index and Bliss Independence (BI). Cell lines were ascribed to Lehmann subtypes. BRDU proliferation assays, mRNA expression and western blots were conducted to investigate the mechanisms of sensitivity to CDK4/6 inhibition in specific subsets. In addition we interrogated datasets from the TCGA breast cancer cohort to compare gene expression, copy number alterations or cell cycle genes across the different TNBC subtypes. Results: TNBC cell lines of the luminal-androgen (LAR) and mesenchymal-stem like (MSL) subsets were sensitive to palbociclib in both in clonogenic and BRDU proliferation assays [p = < 0.0001 LAR vs basal-like subtypes]. Sensitivity was associated with expression of androgen receptor (p = 0.0013), and the absence/or low levels of cyclin E1 (p = 0.01). Resistant mesenchymal (M) and basal TNBC cell lines had elevated levels of cyclin E1 mRNA and protein. Analysis of TCGA data revealed that high-level amplification of cyclin E1 is more common in basal tumours compared to the luminal subgroups (p = 0.0069). Sensitivity of TNBC LAR/MSL cell lines to palbociclib was limited by low-level cell cycle entry despite CDK4/6 inhibition. Combination studies highlighted PI3K inhibition was synergistic with CDK4/6 inhibition in PIK3CAmutated TNBC cell lines (BI score: < 1.0), with a greater effect in LAR/MSL subgroups compared to M/basal subgroups (p = 0.015). The combination induced sustained proliferative arrest compared to palbociclib alone in LAR sub group (p = 0.0007). Conclusions: We demonstrate that LAR cell lines represent a TNBC subgroup that may benefit from CDK4/6 inhibition. Interestingly, TNBC with PIK3CA mutations could also benefit by targeting both cell cycle and PI3K-mTOR signaling.
Nutritional Supplements in Sports and Exercise
Authors: Cynthia A. Thomson
Journal: JAMA (2010)

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
Are patients with advanced cancer concerned about financial toxicity?
Authors: Dhakshila Paramanathan, Sukhi Kaur, Samira Daswani, Kathyrn Tanenbaum, Matthew Axelrod, Kelly Choi, William Kea, Eric V Schultz, Andrew Pecora, Andre Goy, Usha Niranjan, Denis Fitzgerald, Julianne Wilkins Childs, James W. Lee, May D. Abdo-Matkiwsky, Stuart L. Goldberg
Journal: Journal of Clinical Oncology (2016)

10065 Background: Cancer patients (pts) are more than twice as likely to enter bankruptcy as the general US population. It is unknown how often pts with metastatic cancer are concerned about the financial toxicities (FTox) of treatment. Methods: As part of the larger “Living with Cancer” project we prospectively surveyed 941 pts with advanced malignancies receiving treatment with non-curative intent at 6 New Jersey cancer programs within the Regional Cancer Care Associates network. Pts were asked 2 questions about the financial burden and pain associated with cancer (5-point Likert scale). Results: Pts felt that “Living with Cancer has impacted the financial well-being of me or my family” severely 44 pts (5%), significantly 124 pts (14%) moderately 193 pts (21%), minimally 250 pts (28%) or not at all 292 pts (32%). For comparison, pts felt “Living with Cancer the pain I experience is” unbearable/constant 12 pts (1%), severe 82 pts (9%), moderate 209 pts (23%), mild 306 pts (34%), non-existent 294 pts (33%). Responses were flagged as concerned if rated severe, significant or moderate. Concern about FTox was more prevalent than about pain (p < 0.005). FTox and pain responses had a weak positive correlation (r = 0.370; p < 0.001). Utilizing median household income per zip code as a surrogate (n = 867), logistic regression demonstrated that as income increases the probability of being concerned about FTox decreases significantly (p < 0.001). A pt with median US income of $51,000 has a 48% chance of being concerned about FTox, whereas a pt with income of $151,000 has a 23% chance. Younger pts also were significantly (p < 0.001) more concerned about FTox; 30 yr 82%, 60 yr 48% and 80 yr 24%. Pts with liquid malignancies had a higher proportion of concerned pts than solid malignancies (liquid 104/218 concerned, solid 241/644 concerned, p < 0.005). Conclusions: Financial toxicity concerns are common among pts with metastatic/advanced cancers, being self-reported in 40% of pts of this NJ series. FTox concerns were more prevalent than concern about pain, and were more common in pts with liquid rather than solid malignancies. Younger pts and those who live in less affluent neighborhoods are more likely to be concerned about the FTox of cancer care.
Natural History of Wild-Type Transthyretin Cardiac Amyloidosis and Risk Stratification Using a Novel Staging System
Authors: Martha Grogan, Christopher G. Scott, Robert A. Kyle, Steven R. Zeldenrust, Morie A. Gertz, Grace Lin, Kyle W. Klarich, Wayne L. Miller, Joseph J. Maleszewski, Angela Dispenzieri
Journal: Journal of the American College of Cardiology (2016)
Sexual Dimorphism in Whole Blood Nitrite and Susceptibility to Hypoxic Sickle Cell Vaso-Occlusive Injury in Mice.
Authors: Lewis L. Hsu, Andre Dejam, Mildred Pelletier, Audrey E. Cochard, Bhalchandra Diwan, Mark Gladwin, Alan N. Schechter, Constance Noguchi
Journal: Blood (2005)
Timing of Second Autologous Transplantations in Multiple Myeloma: Results of a Multicenter Sequential Randomized Clinical Trial.
Authors: Abderrahman Abdelkefi, Saloua Ladeb, Tarek Ben Othman, Lamia Torjman, Amel Lakhal, Neila Ben Romdhane, Halima El Omri, Moez Elloumi, Hatem Bellaj, Ramzi Jeddi, Lamia Aissaoui, Fahmi Msadek, Ali Saad, Mohamed Hsairi, Kamel Boukef, Ahlem Amouri, Hechmi Louzir, Koussay Dellagi, Abdeladhim Ben Abdeladhim
Journal: Blood (2006)
Radiation oncologist density and colorectal cancer mortality.
Authors: S. Aneja, J. B. Yu
Journal: Journal of Clinical Oncology (2011)

605 Background: Although the use of radiation therapy is increasing, there exists geographic variation among the distribution of radiation oncologists. The impact of this variation on colorectal cancer (CRC) outcomes remains unexplored. The goal of this study was to determine the effect of radiation oncologist density on CRC mortality. Methods: Using county-level data from the 2008 Area Resource File, National Program for Cancer Registries, and US Centers for Disease Control, a regression model was constructed for CRC mortality, controlling for county-level categorized radiation oncologists density, demographics, socioeconomic status and existing healthcare facilities. Results: There was a statistically significant reduction in CRC mortality (reduction in mortality ranging from 12% to 47%, p&lt;0.001) associated with counties that possessed at least one radiation oncologist. However, increasing the county density to greater than two radiation oncologists per 100,000 people had no statistically significant reduction in CRC mortality. Conclusions: The presence of a radiation oncologist is associated with lowered mortality for CRC within that county, but increasing radiation oncologist density does not yield further improvements. Therefore, as the use of radiation therapy to treat CRC increases, a detailed understanding of distribution of the radiation oncologists is essential for providing the greatest improvement in cancer mortality outcomes. [Table: see text] No significant financial relationships to disclose.