tbuckley/cabot-search huggingface dataset:
Phototherapy using narrowband ultraviolet B and psoralen plus ultraviolet A is beneficial in steroid‐dependent antihistamine‐refractory chronic urticaria: a randomized, prospective observer‐blinded comparative study
Authors: A. Bishnoi, D. Parsad, K. Vinay, M.S. Kumaran
Journal: British Journal of Dermatology (2016)

Literature on the efficacy of phototherapy in steroid‐dependent antihistamine‐refractory chronic urticaria (CRU) is limited. To assess and compare the efficacy of psoralen plus ultraviolet A (PUVA) and narrowband ultraviolet B (NB‐UVB) in steroid‐dependent CRU. In this randomized, prospective observer‐blinded comparative study, 50 patients with steroid‐dependent CRU (6 months of spontaneous urticaria with no response after 3 consecutive months of antihistamines and steroid dependence) were administered either PUVA (group A) or NB‐UVB (group B) for 90 days, with a post‐treatment follow‐up of 90 days. The treatment efficacy was assessed using the average urticaria activity score 7 (aUAS7) and outcome scoring scale (OSS) every 2 weeks. The mean values of aUAS7 progressively decreased from 4·9 ± 0·8 and 5·0 ± 0·7 at baseline to 1·9 ± 0·7 and 1·4 ± 0·7 in groups A and B, respectively, by day 90. This further decreased to 1·5 ± 0·8 and 1·4 ± 1·0 at day 180 in both groups. The values of OSS progressively increased from baseline (1·6 ± 0·5 in group A and 1·3 ± 0·5 in group B) to 3·9 ± 0·3 and 4·0 ± 0·3 in groups A and B, respectively, by day 90, and 3·9 ± 0·5 and 4·0 ± 0·6 by day 180. NB‐UVB fared statistically better than PUVA at different time points. Adverse events encountered were minimal and did not warrant treatment discontinuation. Phototherapy, especially NB‐UVB, is an effective, safe and affordable therapeutic modality for steroid‐dependent CRU and should be tried prior to third‐line treatment options such as omalizumab, ciclosporin and other immunosuppressants.
Population-based risk of complications following transthoracic needle lung biopsy of a pulmonary nodule
Authors: Renda Soylemez Wiener, Lisa M. Schwartz, Steven Woloshin, H. Gilbert Welch
Journal: Annals of Internal Medicine (2011)

Background
Because pulmonary nodules are found in up to 25% of patients undergoing chest computed tomography, the question of whether to biopsy is becoming increasingly common. Data on complications following transthoracic needle lung biopsy are limited to case series from selected institutions.
PTU-299 Delivering cost effective management for irritable bowel syndrome (ibs) across somerset
Authors: E Greig, S Gore, K Staveley, I Phillips, R Benneyworth, R Matull, S Thole, M Williams
Journal: Gut (2015)

<h3>Introduction</h3> Despite 2008 NICE guidance on managing IBS in primary care, referrals to gastroenterology persist with baseline audit finding 14% of new outpatient slots in two DGHs were used by patients aged 16–45 years with no red flag symptoms where the GP felt diagnosis at referral was IBS. Given evidence for lifestyle and diet modification, we set out to help GPs avoid referral as outpatient review and investigation cost over £160,000 annually for these patients. Using potential savings, we funded direct GP access to faecal calprotectin (FC) testing and specialist IBS dietetic-led clinics in four centres across Somerset. <h3>Method</h3> We designed new care pathways for 16–45 year olds with no red flag symptoms with county-wide GP education using Rome III criteria to make a positive diagnosis of IBS and avoid missing red flags. Instead of referring to secondary care, GPs were asked to check FC, with Coeliac screen, FBC, CRP and TFT. If FC &lt;50 mg/g with normal blood tests, GPs and community-based dietitians were encouraged to manage symptoms using first-line diet and lifestyle advice, referring to the specialist IBS dietetic clinic if needed. If FC &gt;50 µg/g, secondary care referral was appropriate to consider investigation, especially if FC &gt;150 µg/g. A management algorithm provided symptom-based drug therapies. To aid implementation, the Somerset Pathway Navigator provided a single gateway to GP referrals. <h3>Results</h3> Outpatient data: Repeating our initial audit at 1 year showed referrals to secondary care for management and investigation fall from 14% to 9% of new appointments. Faecal calprotectin: 94 patients met this protocol; 64 patients had FC &lt;50 µg/g, 19 had FC 51–150 µg/g and 11 had FC &gt;150 µg/g. Even when FC &lt;50 µg/g, 13 patients were still referred for secondary care review and investigation with no GI pathology found. Only 1/12 patients referred with FC 51–150 mg/g had Crohn’s; others had normal endoscopy/radiology. This contrasts with FC &gt;150 mg/g with 10 referred and 5 having Crohn’s or Ulcerative colitis. Specialist Dietetic outcomes: Over 12 months, 83 patients completed 8-week treatment courses including low FODMAP advice with statistically significant reductions in severity scores of all symptoms. After treatment, 65% reported satisfactory relief of IBS and 74% reported improved quality of life. <h3>Conclusion</h3> Providing GP education, developing new diagnosis and management pathways, introducing FC testing for GPs and effective dietetic treatments have encouraged self-management, provided cost-effective symptom resolution and reduced unnecessary secondary care referrals for likely IBS. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Irritable bowel syndrome in adults (2008) CG61 NICE
Secretion pattern of endogenous opioids in chronic schizophrenia
Authors: F Brambilla, F Facchinetti, F Petraglia, L Vanzulli, A R Genazzani
Journal: American Journal of Psychiatry (1984)

Baseline plasma levels of beta-endorphin, beta-lipotropin, and ACTH were assayed in 37 patients with chronic schizophrenia: 24 men and 13 women, 28 with hebephrenic and nine with paranoid schizophrenia. None of the patients had received any medication for at least 10 days. The mean values of both opioids were significantly higher in the schizophrenic patients than in 21 age- and sex-matched control subjects. Insulin stimulation and dexamethasone suppression tests were given to eight of the patients, and the circadian rhythms of beta-endorphin, beta-lipotropin, ACTH, and cortisol were assayed in the same eight patients. Insulin stimulation, dexamethasone suppression test results, or circadian rhythmicity was impaired in seven of these eight patients.
THU0310 Quantitative Assessment of Fatigue in Routine Care Using a Multidimensional Health Assessment Questionnaire (MDHAQ)
Authors: E. Nikiphorou, I. Castrejon, R. Jain, A. Huang, J.A. Block, T. Pincus
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Fatigue generally is captured as a qualitative description rather than as quantitative data to compare from one visit to the next. Fatigue is included on a multidimensional health assessment questionnaire (MDHAQ) as a 0-10 visual analogue scale (VAS), facilitating quantification. <h3>Objectives</h3> To assess fatigue VAS scores in patients with 4 different rheumatic conditions: rheumatoid arthritis (RA), osteoarthritis (OA), systemic lupus erythematosus (SLE), and fibromyalgia (FM), and to analyze possible associations of fatigue scores with other quantitative clinical scores included on the MDHAQ. <h3>Methods</h3> All patients seen in one academic clinical setting complete an MDHAQ in 5-10 minutes in the waiting area, prior to seeing the rheumatologist, as part of the infrastructure of routine care. The two-page MDHAQ includes physical function in 10 activities of daily living, three 0-10 VAS for pain, patient global estimate, and fatigue, 60-symptom checklist, and demographic data. RAPID 3 (0-30) is the sum of three 0-10 scores for function, pain, and patient global estimate. A cross-sectional study was performed in patients in 4 diagnosis groups: RA, OA, SLE, and FM. Median scores for fatigue and other MDHAQ scales were computed in the four diagnosis groups, and compared by Kruskall-Wallis one way analysis of variance. Correlations also were calculated to evaluate possible associations of fatigue with other MDHAQ scores. <h3>Results</h3> Analyses included 612 patients, 173 with RA, 199 with OA, 146 with SLE and 94 with FM. Fatigue scores were highest in FM, and differed significantly from RA, SLE, and OA (p&lt;0.001); scores for function, patient global, RAPID3, RADAI and number of symptoms also differed significantly in FM versus other diseases (Table). Fatigue scores were correlated significantly with scores for function, pain, and patient global estimate in all patients (r&gt;0.53, p&lt;0.01), RA (r&gt;0.66, p&lt;0.01), and SLE (r&gt;0.60, p&lt;0.01) patients, but at lower levels in OA (r&gt;0.33, p&lt;0.01), and FM (r&gt;0.32, p&lt;0.01), indicating stronger associations of fatigue with other measures in diseases characterized by higher levels of inflammation. <h3>Conclusions</h3> Fatigue scores may be collected in the infrastructure of routine care as quantitative data on an MDHAQ, with no extra work for the doctor and minimal interference with clinic patient flow. Fatigue scores are associated with scores on other MDHAQ scales at considerably higher levels in RA and SLE than in OA and FM. <h3>Disclosure of Interest</h3> None declared
Effects of Cold Air, Smoking on Cardiac Function Studied With Apex Cardiogram
Authors: W E HARRISON, H J LOUIS
Journal: JAMA (1964)

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
Antitumor Efficacy Of DMSA Modified Fe3O4 magnetic Nanoparticles Combined With Arsenic Trioxide and Adriamycin In Jurket Cells
Authors: Chunling Wang, Baoan Chen, Weijun Hua, Fei Shen, Liang Yu, Zhengmei He, Yue Chen, Guohua Xia, Jian Cheng, Wen Bao, Yu Zhang, Xuemei Wang, Senthilkumar Ravichandran
Journal: Blood (2013)
Teaching Medical Care
Authors: E. J. H.
Journal: Annals of Internal Medicine (1965)

Editorials1 March 1965Teaching Medical CareWho and WhereE. J. H.E. J. H.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-3-624 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptConcerned with an apparent decline in the supply of "family doctors" for "primary medical care," Dr. Kerr White proposes, in this number of the ANNALS (1), two means for encouraging faculties to shake off their disinterest in this problem. He urges, first, that primary continuing care be brought into and, hence, taught in more medical schools. Secondly, he recommends the further pursuit of medical school studies in epidemiology and in medical care with the expectation that these may attract the attention of the faculties and heighten their interest in primary care.Dr. White suggests that the patients and the facilities...References1. WHITE KL: Academic medicine, family medicine, and medical care. Ann. Intern. Med. 62: 603, 1965. LinkGoogle Scholar2. Book review, Patients Who Trouble You. Ann. Intern. Med. 62: 629, 1965. LinkGoogle Scholar3. CARMICHAEL LP: Teaching family medicine. JAMA 191: 38, 1965. CrossrefMedlineGoogle Scholar4. DIMOND EG: The long range alternative to socialized medicine is academic medicine. JAMA 190: 1118, 1964. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1965Volume 62, Issue 3Page: 624-626KeywordsEpidemiologyMotivationPrimary care ePublished: 1 December 2008 Issue Published: 1 March 1965 PDF downloadLoading ...
The Relative Precision of Dose-Response Data in the Virus and Tumor Fields as Compared with That in Certain Other Fields of Biology
Authors: W. Ray Bryan
Journal: JNCI Journal of the National Cancer Institute (1954)

The Relative Precision of Dose-Response Data in the Virus and Tumor Fields as Compared with That in Certain Other Fields of Biology Get access W. Ray Bryan W. Ray Bryan National Cancer Institute,2Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 15, Issue 2, October 1954, Pages 305–314, https://doi.org/10.1093/jnci/15.2.305 Published: 01 October 1954 Article history Received: 26 May 1954 Published: 01 October 1954
Evaluation and diagnosis of persistent insomnia
Authors: F J Zorick, T Roth, K M Hartze, P M Piccione, E J Stepanski
Journal: American Journal of Psychiatry (1981)

The authors placed 84 patients who complained of insomnia into 10 diagnostic categories on the basis of medical, psychiatric, and polysomnographic evaluations. Only half the patients had objectively defined difficulty inducing or maintaining sleep when compared with 20 normal control subjects. However, all but 16 patients showed polysomnographic evidence of some sleep disorder. Diagnostic categories within the insomnia groups could be distinguished from one another by polysomnography. Patients in only 3 of the 10 diagnostic categories showed evidence of psychological distress on the MMPI; patients in the other 7 categories displayed few psychological symptoms. These results have implications for the treatment of insomnia.
National Center for Health Statistics
Authors: F. J. Ingelfinger
Journal: New England Journal of Medicine (1973)

One would hardly expect Documents and Committee Report, Series 4, Number 15, of the National Center for Health Statistics (Department of Health, Education, and Welfare Publication No. [HRA] 74–1452) to start off with poetry — more specifically with a quotation from Edna St. Vincent Millay's "Huntsman, What Quarry?"1 But that is exactly what happened recently, and it is hard to imagine a more apt quotation — apt not only for the Report but also for the entire world's endeavor to comprehend and deal with the multiple problems of health."Upon this gifted age, in its dark hour, Rains from the . . .
Monitoring Chronic Myelogenous Leukemia in the Age of Tyrosine Kinase Inhibitors
Authors: Jerald P. Radich, Vivian Oehler
Journal: Journal of the National Comprehensive Cancer Network (2007)

Tyrosine kinase inhibitors (TKIs) are now standard up-front therapy for chronic myeloid leukemia (CML). Patients with newly diagnosed chronic-phase CML treated with the TKI imatinib mesylate typically experience a complete cytogenetic remission. Outcomes for patients with advanced-phase disease are distinctly worse. Unfortunately, a small proportion of chronic-phase patients experience relapse during this therapy, and most with advanced-phase disease develop resistance to imatinib mesylate after months of therapy. Hematopoietic cell transplantation remains the only curative approach for CML and can salvage patients with advanced-phase disease. Therefore, physicians must carefully monitor patients with chronic-phase CML treated with TKIs so that they can undergo hematopoietic cell transplant (or treatment with another TKI or experimental therapy) before frank progression occurs. Fortunately, monitoring CML using cytogenetic and molecular methods (i.e., quantitative polymerase chain reaction) effectively defines end points that correlate highly with outcome.
Allogeneic Hematopoietic Stem-Cell Transplantation In AML and MDS Using Myeloablative Versus Reduced Intensity Conditioning: 10 Years Later
Authors: Avichai Shimoni, Noga Shem-Tov, Yulia Volchek, Ivetta Danylesko, Ronit Yerushalmi, Arnon Nagler
Journal: Blood (2013)
Diagnosis of Hemochromatosis
Authors: Lawrie W. Powell, D. Keith George, Sharon McDonnell
Journal: Annals of Internal Medicine (1999)

Letters17 August 1999Diagnosis of HemochromatosisLawrie W. Powell, MD, PhD, D. Keith George, MBChB, MRCP, and Sharon McDonnell, MDLawrie W. Powell, MD, PhDThe Queensland Institute of Medical Research; Brisbane, Australia (Powell)The Queensland Institute of Medical Research; Brisbane, Australia (George)Centers for Disease Control and Prevention; Atlanta, GA 30333 (McDonnell)Search for more papers by this author, D. Keith George, MBChB, MRCPThe Queensland Institute of Medical Research; Brisbane, Australia (Powell)The Queensland Institute of Medical Research; Brisbane, Australia (George)Centers for Disease Control and Prevention; Atlanta, GA 30333 (McDonnell)Search for more papers by this author, and Sharon McDonnell, MDThe Queensland Institute of Medical Research; Brisbane, Australia (Powell)The Queensland Institute of Medical Research; Brisbane, Australia (George)Centers for Disease Control and Prevention; Atlanta, GA 30333 (McDonnell)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-4-199908170-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Our discussion of the laboratory criteria for hemochromatosis was clearly in the context of an otherwise healthy person or one with clinical features suggestive of the disease. We stated that in this situation “the serum ferritin level defines the point at which hemochromatosis is expressing iron overload and treatment should be initiated.” It is then that the serum ferritin level exquisitely reflects body iron stores. Other conditions can indeed cause an elevation in serum ferritin level out of proportion to iron stores, and we listed inflammation, infection, and cancer because they can complicate hemochromatosis. Renal disease is rare ... Author, Article, and Disclosure InformationAffiliations: The Queensland Institute of Medical Research; Brisbane, Australia (Powell)The Queensland Institute of Medical Research; Brisbane, Australia (George)Centers for Disease Control and Prevention; Atlanta, GA 30333 (McDonnell) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnosis of Hemochromatosis Lawrie W. Powell , D. Keith George , Sharon M. McDonnell , and Kris V. Kowdley Diagnosis of Hemochromatosis Lawrie W. Powell , D. Keith George , Sharon M. McDonnell , and Kris V. Kowdley Diagnosis of Hemochromatosis Kamyar Kalantar-Zadeh and Friedrich C. Luft Metrics 17 August 1999Volume 131, Issue 4Page: 311-312KeywordsAttentionBone marrowHemochromatosisInflammationRenal diseasesRenal failureResearch laboratoriesSerum ferritin levels Issue Published: 17 August 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
European Perspectives
Authors: Sabine Ernst
Journal: Circulation (2008)

who has the distinction of having performed the first truly remote catheter ablation in the world, has just taken up a new appointment at the Royal Brompton Hospital, London.Here, she hopes to fulfil her ambition of teaching, to as many cardiologists as possible, the pioneering technique of magnetic catheter ablation and to develop exciting new applications for the technology.She comes from Bad Ganderheim, Germany, and she always had a high technical aptitude."From the age of 5, my father taught me how to solder, and, later, how to programme a computer," she says.When she applied to enter medical school in Germany, she achieved outstanding scores in 3-dimensional thinking, speed, and concentration."Who knows-perhaps I'd have done even better as a pilot," she jokes.Trained at the University of Ulm, in southern Germany, Dr Ernst remains a harsh critic of German medical education, a system she feels fosters an unnurturing environment."There's just no culture of sharing knowledge with students.It is as though senior doctors feel that by doing this they'd be giving away their position of strength.They don't encourage questions."In Germany, students do a PhD thesis concurrently with medical training; for hers, Dr Ernst looked at the role of substance-P antagonists in a rat model of colitis.This presented an opportunity, as she puts it, of "escaping to the University of California, Los Angeles, to learn about radio immunoassays."There, and later in an exchange programme working in Boston, Mass, Dr Ernst relished the US culture of sharing knowledge, and the fact that students' mentors expected them to study their patients in depth, undertake background research, and keep abreast of the literature."It was a real eye-opener.I was most impressed by the fact that juniors were so involved with patients," she says, pointing out that her overriding philosophy in the way she tutors now stresses the sharing of knowledge.While training in Ulm, Dr Ernst had some of her best clinical experiences working with Henning Nissen, MD, a cardiologist in private practice in the city."He treated me like a human being, and he took the risk of letting me see new patients and presenting them.Cardiology offered a civilised environment that was intellectually challenging," she says.But Dr Ernst had already set her sights on becoming a gastroenterologist, and with her curriculum vitae, she considered herself all set for a prestigious training post."In the interview, I asked lots of questions and suggested improvements they could make.It didn't go down at all well-I spelt trouble."Hugely discouraged, she put out applications for other medical jobs all over Germany.The best offer came from a cardiology department in Hamburg.The department, by complete chance, turned out to be the largest and most
Congenital Indifference to Pain
Authors: A Jørgensen
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