tbuckley/cabot-search huggingface dataset:
To Dream
Authors: Norman Epstein
Journal: Annals of Internal Medicine (1999)

On Being a Patient5 October 1999To DreamNorman Epstein, MDNorman Epstein, MDTucson, AZ 85716 (Epstein)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-7-199910050-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Over 5 years ago, on a chilly November night in Putnam County, New York, my father died in his sleep, quiet and alone, while my mother slept in another room. He had suffered from Parkinson disease for many years, and its ravages, accumulating over time, had locked him ever more deeply into a prison of stiffness. The disease created a wall of illness so high and fragile that we could do little but wait with expectant dread for it to topple.The complexity of a life can never be summarized—it can only be hinted at. He experienced what many other ... Author, Article, and Disclosure InformationAffiliations: Tucson, AZ 85716 (Epstein)Corresponding Author: Norman Epstein, MD, 2820 East 4th Street, Tucson, AZ 85716; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDevelopment of the Gothenburg Well-Being Scale in Late Adolescence: The Grow Up 1990 Gothenburg StudyLife on the Receiving End: A Qualitative Analysis of Health Providers??? Illness NarrativesPhosphinoethyl-sulfonatoalkylthioethers and diphenyl-ω-sulfonatoalkyl-phosphines as ligands and polyoxyethylene–polyoxypropylene–polyoxyethylene triblock co-polymers as promoters in the rhodium-catalyzed hydroformylation of 1-dodecene in aqueous two-phase systems 5 October 1999Volume 131, Issue 7Page: 540-541KeywordsBrainChildrenEmotionsFallsMelatoninMemorySleepStiffnessTechniciansVision Issue Published: 5 October 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
FRI0246 Relapses and Predictive Factors in Henoch-Schönlein Purpura. Study of 417 Patients
Authors: N. Palmou, V. Calvo-Río, J. Loricera, J.L. Hernández, C. Mata, L. Martín, F. Ortíz-Sanjuán, L. Άlvarez, M.C. González-Vela, D. González-Lamuño, H. Fernández-Llaca, M.A. González-Lόpez, S. Armesto, M. Arias, M.A. González-Gay, R. Blanco
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Although the prognosis of Henoch-Schönlein purpura (HSP) is usually favorable, relapses are relatively frequent. <h3>Objectives</h3> Our aim was to analyze the frequency, type and risk factors for relapses in a large series of unselected patients with HSP. <h3>Methods</h3> Retrospective study of 417 patients from a single center, diagnosed with HSP according to the criteria proposed by Michel et al. (J Rheumatol 1992; 19: 721-28). Relapse was defined as a new outbreak of HSP in a previously asymptomatic patient (at least for one month). Quantitative variables were expressed as mean ± SD or as median (interquartile range), and compared with the Student t-test or the Mann-Whitney U-test, as appropriate. Dichotomous variables were expressed as percentages and compared by using the chi-square test. The variables associated with HSP relapse in the univariate analysis entered into a stepwise multivariate logistic regression. Statistical analysis was performed using SPSS 15.0. <h3>Results</h3> 417 patients (240 men/177 women) were studied; median age, 7.5 years (IQR [5.3 to 20.1]). 315 (75.5%) were children or young people (≤20 years) and 102 (24.5%) adults. Clinical manifestations (onset/HSP established,%) were: skin lesions (55.9/100), nephropathy (24/41.2), gastrointestinal involvement (13.7/64.5), joint symptoms (9.1/63.1) and fever (6.2/20.4). Corticosteroids were the most frequently used drugs (35%), followed by NSAIDs (14%), and cytotoxic agents (5%). After a median follow-up of 12 (IQR [2-38]) months, complete recovery was observed in most cases (n=346; 83.2%) and persistent and usually mild nephropathy, in 32 patients (7.7%). Relapses occurred in almost one third of the patients (n=133; 31.9%). Clinical manifestations during relapses were: cutaneous (89.6%); abdominal (27.1%); renal (25.9%) and articular (16.8%). The median number of relapses was 2.4 (IQR [1-3]). The main risk factors for the development of HSP relapse in univariate analysis are shown in the TABLE. After multivariate analyses the most powerful predictive factors for relapse were joint manifestations at disease onset, gastrointestinal manifestations during the course of the disease, and corticosteroid treatment at the time of the first episode of HSP (Table). <h3>Conclusions</h3> HSP is usually a benign entity but relapses are not uncommon. Patients with articular symptoms at onset or presenting with gastrointestinal manifestations during the course of the disease or those needing corticosteroids to control the initial episode of HSP, are more prone to develop relapses. <h3>Disclosure of Interest</h3> None declared
THE REGULATION OF BODY TEMPERATURE
Authors: S Yagi
Journal: JAMA (1918)

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
Interictal psychiatric morbidity and focus of epilepsy in treatment- refractory patients admitted to an epilepsy unit
Authors: R Manchanda, B Schaefer, R S McLachlan, W T Blume
Journal: American Journal of Psychiatry (1992)

Of 71 consecutive patients admitted to an epilepsy unit of a general hospital, 32 (45%) were classified as having psychiatric disorders by using the General Health Questionnaire. No differences were evident to support a specific relationship between the type or focus of epilepsy and psychopathology.
Treatment of Fatigue in Parkinson Disease
Authors: Roy G. Elbers, Henk W. Berendse, Gert Kwakkel
Journal: JAMA (2016)

<h3>Clinical Question</h3> Which pharmacological and nonpharmacological interventions are associated with improvement in general, physical, or mental fatigue and minimal adverse effects in patients with Parkinson disease (PD)? <h3>Bottom Line</h3> Rasagiline, modafinil, and doxepin are associated with improvement in fatigue and are not associated with increased risk of adverse effects in patients with PD. However, the quality of evidence is limited and does not provide a clear basis for treatment decisions.
Obesity
Authors: Michael Rosenbaum, Rudolph L. Leibel, Jules Hirsch
Journal: New England Journal of Medicine (1997)

Obesity is the most common and costly nutritional problem in the United States, affecting approximately 33 percent of adults.1 Health care costs directly attributable to obesity amount to approximately $68 billion per year, and an additional $30 billion per year is spent on weight-reduction programs and special foods.2 Nevertheless, treatment directed toward the long-term reduction of body weight is largely ineffective, and 90 to 95 percent of persons who lose weight subsequently regain it.3,4 The level of energy storage, or fatness, at which the risk of morbidity increases is determined on an actuarial basis. The body-mass index (the weight . . .
FRI0084 High Levels of Anti-Cyclic Citrullinated Peptide Antibodies and High Doses of Glucocorticoid are Risk Factors for Falls in Patients with Rheumatoid Arthritis: Fourth-Year Results of the Tomorrow Study
Authors: K. Mamoto, K. Inui, T. Okano, Y. Sugioka, M. Tada, T. Koike, H. Nakamura
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> Patients with rheumatoid arthritis (RA) who have muscle weakness and stiff or painful joints might be at increased risk of falls. The present study prospectively determined the incidence of falls and risk factors in patients with RA who participated in the TOMORROW study (UMIN000003876) that began in 2010. <h3>Methods</h3> We evaluated anthropometric parameters, bone mineral density, disease activity and the incidence of falls for a period of 4 years in 202 patients with RA (mean age, 58.6 years; medication with biological agents, 54.9%) and 202 age- and sex-matched healthy volunteers (Controls; mean age, 57.4 years). <h3>Results</h3> The incidence of falls did not differ significantly between patients with RA (n=96, 47.5%) and Controls (n=82, 40.6%) within the 4-year period. However, patients with RA fell significantly more frequently than controls (1.39 vs. 0.83 falls/4 years; <i>p</i> &lt;0.05). After adjusting for risk factors for falls, including age, sex, smoking and body mass index, multiple regression analysis revealed history of falls as the parameter most significantly associated with incidence of falls (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.54–6.16; <i>p</i> =0.01) in patients with RA. Furthermore, anti-cyclic citrullinated peptide antibody (CCP) and matrix metalloproteinase (MMP)-3 levels at entry and mean values for MMP-3, modified Health Assessment Questionnaire (mHAQ) score and glucocorticoid dosage (GC) over the 4 years were apparently related to the number of falls after adjusting for fall risk factors among patients (CCP, β =0.294; <i>p</i> &lt;0.005; MMP-3 at entry, β =0.184, <i>p</i> =0.008; mean MMP-3, β =0.149, <i>p</i> =0.042; mean mHAQ, β =0.151, <i>p</i> =0.044; mean GC, β =0.154, <i>p</i> =0.029). <h3>Conclusions</h3> Incidence of falls did not differ significantly between patients with RA and Controls during a 4-year period, but more patients than Controls fell repeatedly. High levels of CCP and high doses of GC appear significantly associated with an increased frequency of falls among patients with RA. <h3>Disclosure of Interest</h3> K. Mamoto: None declared, K. Inui: None declared, T. Okano: None declared, Y. Sugioka: None declared, M. Tada: None declared, T. Koike Grant/research support from: Takeda Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Chugai Pharmaceutical, Eisai, Abbott Japan, Teijin Pharma, Banyu Pharmaceutical and Ono Pharmaceutical, H. Nakamura: None declared
SAT0471 Autologous Hematopoietic Stem Cell Transplantation in Rapidly Progressive Systemic Sclerosis is More Effective Than Conventional Therapies in Inducing Disease Remission and Prologing Survival: Table 1
Authors: N. Del Papa, E. Zaccara, W. Maglione, D. Sambataro, G. Sambataro, R. Andracco, G. Saporiti, R. Giordano, C. Vitali, A. Cortelezzi, F. Onida
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Autologous haematopoietic stem cell transplantation (AHSCT) has shown to be an effective therapeutic option to prolong survival of patients (pts) suffering from rapidly progressive diffuse cutaneous systemic sclerosis (rp-dcSSc). <h3>Objectives</h3> This study was aimed at retrospectively comparing the disease outcome of pts with rp-dcSSc treated with AHSCT to that of age-, and sex-matched group of clinically similar pts selected from our cohort and treated with conventional therapies. <h3>Methods</h3> Eighteen pts (5 M, 13F; median age 40, 20-62 yrs) that underwent AHSCT were compared to 36 age- and sex-matched pts (10 M, 26 F; median age 44, 19-62 yrs), all of them suffering from rp-dcSSc. At the starting evaluation point the two groups were also exactly comparable for disease-duration and clinical findings, in term of skin involvement (mRSS), DLCO as % of predicted value and disease activity (ESSG scoring system). AHSCT was performed by mobilisation with cyclophosphamide (CTX) and G-CSF, selection of CD34+ cells and conditioning regimen with CTX and rabbit ATG. Twenty-five pts in the control group received 6 monthly pulses of intravenous CTX (750mg/m<sup>2</sup>), 11 received steroids, DMARDS (Methotrexate and Azathioprine) and vasoactive therapies (noCTX). The clinical course in AHSCT and control groups was evaluated from time 0 to 5 years by using Kaplan Meyer survival curves, computing the Hazard Ratio (HR) and Chi square distribution. <h3>Results</h3> Results of the survival curve analysis of different groups, expressed as HR (95%CI) are reported in the table. <h3>Conclusions</h3> This retrospective study confirms that AHSCT approach is more effective to induce a longer survival (p=0.0004), and shows that is also able to more rapidly reduce the mRss (p&lt;0.0001), disease activity (p&lt;0.0001), and preserve lung function (p=0.0004), with respect to conventional therapies in rp-dcSSc. <h3>Disclosure of Interest</h3> None declared
PWE-159 The role of an internal pilot rct to inform the design and conduct of a main trial: by-band to by-band-sleeve
Authors: JM Blazeby, J Byrne, C Rogers, R Welbourn
Journal: Gut (2015)

<h3>Introduction</h3> <h3>Background</h3> The NIHR By-Band Study aims to compare the effectiveness of adjustable gastric band (AGB) and Roux-en-Y gastric bypass (RYGB) for severe and complex obesity. By-Band had an internal pilot phase to establish trial recruitment and to review whether expansion into a three group trial including sleeve gastrectomy was appropriate. This paper describes how the By-Band internal pilot informed successful adaptation to By-Band-Sleeve. <h3>Methods</h3> The internal pilot phase started in two centres in November 2012. After 24.4 centre months of recruitment, data on the pre-agreed decision criteria were reported to the trial funder to inform progression to the main trial. Criteria focused on rates of referrals for surgery, trial eligibility, recruitment and cross over. Evidence from reported and open RCTs including sleeve gastrectomy (SG) was scrutinised and data on SG practice summarised. <h3>Results</h3> In two centres 333 patients were screened, 231 (69%) found eligible and 80 consented to randomisation (35%). Cross over rates were 3.5% with similar numbers crossing over from AGB to RYGB and vice versa. The updated Cochrane review of bariatric surgery identified 22 trials of AGB, RYBG or SG. All trials were at a moderate or unclear risk of bias and external validity poor. There was only one trial comparing SG with AGB. Current open trials were also at risk of bias. UK practice showed that whilst AGB was decreasing in incidence in the public sector it remained the commonest procedure undertaken in the reported private cases. An adapted three-group study was successfully proposed to the NIHR and a contract variation agreed in January 2015 to increase the sample size to 1341 to allow comparisons of all three procedures. <h3>Conclusion</h3> The study has now recruited 176 patients and is expanding into 7 more centres (total 12). By-Band-Sleeve will be therefore provide high quality evidence to examine which operation is most effective and cost effective for the treatment of severe and complex obesity. <h3>Disclosure of interest</h3> None Declared.
Hepatobiliary Cancers
Authors: Al B Benson, Tanios Bekaii-Saab, Edgar Ben-Josef, Leslie Blumgart, Bryan M Clary, Steven A Curley, Rene Davila, Craig C Earle, William D Ensminger, John F Gibbs, Daniel Laheru, Alan N Langnas, Sean J Mulvihill, Albert A Nemcek, James A Posey, Elin R Sigurdson, Mika Sinanan, Jean-Nicolas Vauthey, Alan P Venook, Lawrence D Wagman, Timothy J Yeatman
Journal: Journal of the National Comprehensive Cancer Network (2006)

Hepatobiliary cancers are common worldwide and highly lethal. Hepatocellular carcinoma is the most common hepatobiliary malignancy and the seventh most common cancer worldwide. Gallbladder cancer is the most common biliary tract malignancy, accounting for approximately 5000 newly diagnosed cases in the United States. Cholangiocarcinomas are diagnosed throughout the biliary tree and are usually classified as intrahepatic or extrahepatic. Intrahepatic cholangiocarcinomas arise from intrahepatic small-duct radicals, whereas extrahepatic cholangiocarcinomas encompass hilar carcinomas (including Klatskin's tumors). These guidelines discuss these subtypes of hepatobiliary cancer and the epidemiology, pathology, etiology, staging, diagnosis, and treatment of each subtype. For the most recent version of the guidelines, please visit NCCN.org
SAT0030 Release of Secondary Mediators of Inflammation by Human Secretory Phospholipases A2 (SPLA2's)
Authors: W. Pruzanski, A. Kuksis
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Proinflammatory and proatheromatous activity of sPLA29s IIA, V and X have been well documented. High levels of sPLA2 IIA were found in various arthritides. All 3 were found in the vascular wall. sPLA2 IIA was recovered from synovial cells, chondrocytes and cartilage. sPLA2 IIA was also found to induce joint tissue inflammation. Yet, with the exception of the effect on HDL/LDL and on mitogenic activity and the release of PGE2 and LTB4 from vascular smooth muscle cells, little is known about the cascade of events and production of secondary pro-inflammatory mediators that these sPLA29s may induce. <h3>Objectives</h3> Investigation of the cascade of events that occurs when sPLA<sub>2</sub>9s hydrolyse HDL and LDL and release proinflammatory mediators. 2. Study of chemotactic activity of vascular smooth muscle cells exposed to sPLA<sub>2</sub>9s. <h3>Methods</h3> Cultures of VSMC, origins of recombinant human sPLA<sub>2</sub>9s, IIA, V and X, source of HDL and LDL, study of lipoproteins and of products of oxidation such as hydroxides, hydroxyperoxides, isoprostanes and epoxides by LC/ESI - MS were reported (1,2). Migration of VSMC cells was tested by modified Boyden Chamber with Falcon 24-Well Insert System using PDGF-bb as a control. Statistical analysis was performed by Microsoft Excel, and data reported as the means ± SD. <h3>Results</h3> It was found that sPLA<sub>2</sub> IIA, V and X – hydrolysed HDL and LDL release to various extents free F<sub>2</sub>-isoprostanes, hydroxides, hydroxyperoxides and epoxides from lipoprotein phospholipids. sPLA<sub>2</sub>9s, V and X were more active than IIA. In turn, Ptd Cho isoprostanes promoted hydrolysis of lipoprotein Ptd Cho by sPLA<sub>2</sub> IIA. sPLA<sub>2</sub>9s differed in their preference for hydrolysis of oligoenoic and polyenoic Ptd Cho from plasma lipoproteins, V preferring linoleoyl Gro-PCHO, X preferring arachidonyl Gro-PCHO and IIA having no preference. Migration of VSMC was markedly enhanced by sPLA<sub>2</sub> IIA in the dose/time manner, whereas, sPLA<sub>2</sub>, V and X did not induce chemotaxis. <h3>Conclusions</h3> The above findings show that hydrolytic activity of various sPLA29s is not identical, but in general it induces the release of a group of substances which per se are proinflammatory and that sPLA2 IIA but not V or X induces chemotactic activity of VSMC. These results show previously unrecognized complexity of activity of human sPLA2, IIA, V and X, all of which participate in rheumatological conditions. Hydrolysis of auto-oxidized lipoproteins by sPLA29s releases secondary mediators of inflammation which were not recognized before. <h3>References</h3> Pruzanski W, et. al. Lab. Invest. 81:757, 2001. 2. Kuksis A and Pruzanski, 104 AOCS Ann. Meeting, 2013, Montreal, P.Q. Canada. <h3>Disclosure of Interest</h3> None declared
Pulmonary Actinomycosis Simulating Bronchogenic Carcinoma
Authors: H G Pritzker, J S Mackay
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 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
Interpretation of Arteriography
Authors: J VAN DER STRICHT, M GOLDSTEIN, P VANDERHOEFT
Journal: BMJ (1971)

Queen Charlotte's Hospital The Department of Health announced last week that the present Queen Charlotte's Hospital and the Chelsea Hospital for Wo- men will eventually be rebuilt as part of the new King Edward Memorial Hospital which is being developed on the site of St. Bernard's Hospital, Ealing.Queen Char- lotte's name and functions will be preserved at the new site, which, says the Department, is well placed to serve the area from which Queen Charlotte's is increasingly drawing its patients.The new unit will provide the obstetrical and gynaecological services of the new district general hospital, and Queen Charlotte's links with postgraduate medical education through its associat-on with the Institute of Obstetrics and Gynaecology will continue after the move to Ealing.Discussions will start soon between Sir Keith Joseph and the board of governors, the other hospital authorities concerned