tbuckley/cabot-search huggingface dataset:
Prescription Drug Out-of-Pocket Cost Reduction Programs
Authors: Kai Yeung, Stacie B. Dusetzina
Journal: JAMA Internal Medicine (2021)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Several faces of refractory coeliac disease type 2
Authors: Joseph A Murray
Journal: Gut (2021)

Enteropathy-associated t-cell lymphoma (EATL) is a rightly feared complication of coeliac disease (CeD) often presenting as the first manifestation of CeD or a complication of preexisting refractory coeliac disease type 2 (RCD2).1 Cording et al in Gut have provided in exquisite detail the molecular landscape of RCD2 and the resultant EATL.2 It provides not so much of a road map to guide us, but rather a sketch of what has gone wrong in this severe complication of CeD. The sequence of CeD leading to RCD2 and finally to EATL provides a rare opportunity for so much confusion. Is RCD2 a chronic inflammatory disease? Most certainly yes. Is it a lymphoma? Perhaps not yet? Thanks to this paper and another recent paper we have a clearer picture of the genotoxic somatic aberrations that occur in and cause expansion and spread of these rare lineage cells.3 Short of the often-lethal lymphoma, RCD2 itself produces substantial morbidity and even mortality.4 Intraepithelial lymphocytes (IELS) can be quite cytotoxic causing significant damage to the epithelium that has persisted despite a gluten-free diet. These aberrant IELS drive the destructive nature of the disease and its cytotoxicity.

The face of RCD2 for the gastroenterologist: gastroenterologists looking after these patients are often faced with an ill patient who has very advanced malnutrition as well as a propensity to infection.5 This face of CeD requires the clinician to confirm preexisting CeD, then detect and treat concurrent conditions such as small intestinal bacterial overgrowth, exocrine pancreatic insufficiency, microscopic colitis, motility changes, lactose or other maldigestive problems. Vigorous management of nutritional deficiencies including protection of bone health is crucial.5 Often, gastroenterologists will institute an anti-inflammatory approach to the disease on the basis that it has produced chronic inflammation. In the author’s experience, the early and …
Severe right ventricular pressure loading in fetal sheep augments global myocardial blood flow to submaximal levels.
Authors: M DReller, M JMorton, G DGiraud, D EWu, K LThornburg
Journal: Circulation (1992)

BACKGROUNDIt has previously been shown that the fetal right ventricle (RV) is sensitive to changes in arterial pressure and that its stroke volume is significantly reduced with acute increases in pulmonary arterial pressure. However, the myocardial blood flow (MBF) response to increases in pulmonary arterial pressure have not been investigated in the fetus.METHODS AND RESULTSTo assess whether the RV afterload sensitivity to arterial pressure is associated with limitation in MBF, seven fetal lambs were instrumented at 130 days of gestation with a pulmonary arterial occluder and intravascular catheters. RV stroke volume was measured by an electromagnetic flow probe and MBF by 15-microns labeled microspheres. MBF was determined at baseline and during incremental increases in pulmonary arterial pressure. Maximal MBF was determined in seven additional fetuses during adenosine infusion. The highest tolerated pressure was associated with a 50% reduction in RV stroke volume. The highest pulmonary arterial occlusi...
Role of Mahaim fibers in cardiac arrhythmias in man.
Authors: J JGallagher, W MSmith, J HKasell, D WBenson, RSterba, A OGrant
Journal: Circulation (1981)

Twelve patients with evidence of Mahaim fibers are reported, six with nodoventricular (NV) fibers and six with fasciculoventricular (FV) fibers. All patients with NV fibers had left bundle branch block morphology, and a sustained reentrant tachycardia with this morphology was proved in each case. In three of the six, ventriculoatrial dissociation occurred during tachycardia. We postulate that the mechanism of this tachycardia is a macroreentry circuit using the NV fiber for the antegrade limb and the His-Purkinje system with a portion of the atrioventricular node for the retrograde limb. ECGs of patients with FV fibers were varied, suggesting a functional relation to the right or left side of the septum. No direct relationship of FV fibers to observed arrhythmias could be found.
Is there a serotonin-induced hypertensive coronary chemoreflex in the nonhuman primate?
Authors: K GCornish, I HZucker
Journal: Circulation Research (1983)

The purpose of this study was to investigate the nature of the serotonin-induced coronary chemoreflex in the conscious monkey. Ten chronically prepared and four acute monkeys were used in this study. Five chronically prepared animals had catheters in the left atrium, ascending aorta, descending aorta, and, bilaterally, in the common carotid arteries. In addition, Silastic catheters were placed next to both vagi to permit vagal block with 2% lidocaine. Serotonin was injected (12-200 micrograms/kg) into the left atrium, ascending aorta, descending aorta, or, bilaterally, into the carotid arteries while blood pressure, heart rate, and respiratory movements were recorded. Injections of serotonin were associated with hypertension and bradycardia followed by tachycardia, all of which were preceded by a cough response. Atropine blocked the bradycardia, whereas atropine and phentolamine eliminated the cardiovascular components of the reflex. Vagal blockade eliminated the bradycardia but otherwise did not alter th...
Influence of right ventricular hemodynamics on left ventricular diastolic pressure-volume relations in man.
Authors: P ALudbrook, J DByrne, R CMcKnight
Journal: Circulation (1979)

To clarify the mechanism of displacement of the left ventricular diastolic pressure-volume function with alteration of loading conditions, the effects of nitroglycerin on pressure-volume relations in 13 patients were compared with those of amyl nitrite in 13 other patients during cardiac catheterization. After nitroglycerin, average systemic mean arterial pressure declined by 15.1 mm Hg (17%) and left ventricular end-diastolic pressure by 9.4 mm Hg (49%); right ventricular systolic and end-diastolic pressures fell 11.6 mm Hg (36%) and 5 mm Hg (41%), respectively. In all patients diastolic pressure-volume curves were significantly displaced downward and leftward. After amyl nitrite, average systemic mean arterial pressure fell 20.1 mm Hg (22%), but left ventricular end-diastolic pressure and right ventricular systolic and end-diastolic pressures were not significantly reduced. No significant displacement of diastolic pressure-volume curves occurred. Both the rate constant of the exponentially fit diastolic...
DOOMSDAY, A. D. 2026?
Authors: J. R. E.
Journal: Annals of Internal Medicine (1961)

Editorials1 February 1961DOOMSDAY, A. D. 2026?J. R. E.J. R. E.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-54-2-343 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFrom my study I look across the valley to my son's brand-new junior high school gleaming on the hill. Built to relieve the crowding in the recently constructed high school, this new building is surrounded already by a multitude of even newer houses mushrooming up in fields and woods that were wild and empty in my own boyhood. Where there was solitude there now are people; where there are people there soon will be babies; where there are babies there are more people. The view from my window encompasses a tiny but definite segment of one of the great crises...1 Hauser PM: Demographic dimensions of world politics. Science 131: 1641-1647, June 3, 1960. CrossrefMedlineGoogle Scholar2 Sears PB: The inexorable problem of space. Science 127: 9-16, Jan. 3, 1958. CrossrefMedlineGoogle Scholar3 von FoersterMoraAmiot HPMLW: Doomsday: Friday, 13 November, A.D. 2026. Science 132: 1291-1295, Nov. 4, 1960. CrossrefMedlineGoogle Scholar4 Evolution after Darwin, Vol. III, Issues in Evolution, edited by Tax, S., and Callender, C., pp. 49, 64. The University of Chicago Press, Chicago, 1960. Google Scholar5 McKelvey VE: Resources, population growth, and level of living. Science 129: 875-881, April 3, 1959. CrossrefMedlineGoogle Scholar6 Darwin CG: Can man control his numbers? Perspect. Biol. Med. 3: 252-263, Winter 1960. CrossrefMedlineGoogle Scholar7 Deevey ES: The human population. Sci. Amer. 203: 195-204, Sept. 1960. CrossrefMedlineGoogle Scholar8 Huxley J: The emergence of Darwinism. Perspect. Biol. Med. 3: 321-342, Spring 1960. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. R. E. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byToo Many PeopleSTUART MUDD, M.D. 1 February 1961Volume 54, Issue 2Page: 343-345 ePublished: 1 December 2008 Issue Published: 1 February 1961 PDF downloadLoading ...
Body-Mass Index and Mortality in Korean Men and Women
Authors: Sang Woo Oh
Journal: New England Journal of Medicine (2006)

BackgroundObesity is associated with diverse health risks, but the role of body weight as a risk factor for death remains controversial. MethodsWe examined the association between body weight and the risk of death in a 12year prospective cohort study of 1,213,829 Koreans between the ages of 30 and 95 years.We examined 82,372 deaths from any cause and 48,731 deaths from specific diseases (including 29,123 from cancer, 16,426 from atherosclerotic cardiovascular disease, and 3362 from respiratory disease) in relation to the body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters). ResultsIn both sexes, the average baseline BMI was 23.2, and the rate of death from any cause had a J-shaped association with the BMI, regardless of cigarette-smoking history.The risk of death from any cause was lowest among patients with a BMI of 23.0 to 24.9.In all groups, the risk of death from respiratory causes was higher among subjects with a lower BMI, and the risk of death from atherosclerotic cardiovascular disease or cancer was higher among subjects with a higher BMI.The relative risk of death associated with BMI declined with increasing age. ConclusionsUnderweight, overweight, and obese men and women had higher rates of death than men and women of normal weight.The association of BMI with death varied according to the cause of death and was modified by age, sex, and smoking history.
The Inter- and Intra- Observer Agreement in Confocal Endomicroscopy Guided Diagnosis Of Pancreatic Cysts and Evaluation of Diagnostic Accuracy Compared to Histopathology
Authors: J Machicado, B Napoleon, AM Lennon, D Tan Meng Yew, S Pereira, S Eldika, R Pannala, M Girotra, P Kongkam, H Bertani, Y Feng, H Sijie, N Zhong, V Valantin, S Leblanc, A Hilton, S Krishna
Journal: Endoscopy (2021)

Aims Previous studies have suggested that EUS-guided needle based confocal laser endomicroscopy (nCLE) can diagnose pancreatic cystic lesions (PCLs) with high accuracy, inter-observer agreement (IOA), and intra-observer reliability (IOR). However, prior studies were small, and didn’t use histopathology as the ‘reference standard’. We aimed to assess the IOA, IOR, and performance of EUS-nCLE for differentiating PCLs in a larger cohort.
Noninvasive assessment and differentiation of left ventricular outflow obstruction with Doppler ultrasound.
Authors: LHatle
Journal: Circulation (1981)

Blood flow velocities in the left ventricle and the ascending aorta were recorded noninvasively with Doppler ultrasound. The ultrasound beam was aligned as much as possible to the direction of velocity, using the frequency shift in the audio signal as a guide to obtain velocities as close as possible to those present. From the maximal velocity recorded by continuous-wave Doppler, a peak pressure drop was calculated in 24 patients with aortic valve stenosis and nine with fixed subaortic stenosis. Fourteen patients with aortic stenosis and three with fixed subaortic stenosis were catheterized. In these patients, the correlation between calculated pressure drops and those obtained by pressure recording was good (r = 0.85). The pressure drop can be underestimated by underestimating velocity, but cannot be overestimated. With pulsed Doppler, the level of obstruction can be determined.
Assessment of aortic regurgitation by the acceleration flow signal void proximal to the leaking orifice in cinemagnetic resonance imaging.
Authors: KYoshida, JYoshikawa, THozumi, TAkasaka, YYamaura, SMinagoe, HNakajima, TMiyamoto
Journal: Circulation (1991)

BACKGROUNDThe proximal acceleration flow region is a laminar flow field that is located immediately upstream from the leaking orifice. The purpose of this study was to evaluate whether cinemagnetic resonance imaging can provide information regarding the proximal acceleration flow region in patients with aortic regurgitation and to analyze the relation between the area of the proximal acceleration flow delineated by cinemagnetic resonance imaging and the severity of aortic regurgitation delineated by angiography.METHODS AND RESULTSThirty-eight consecutive patients who underwent aortography were examined by cinemagnetic resonance imaging. The region of proximal flow acceleration was identified as a semicircular-shaped signal void in the aorta during diastole. Cinemagnetic resonance imaging detected the proximal acceleration flow region in 26 of the 30 patients who were proved to have this lesion (sensitivity, 87%). In eight patients without aortic regurgitation according to aortography, no proximal accelera...
Transgastric natural orifice transluminal endoscopic surgery (NOTES) to remove a foreign body from the abdominal cavity of a 12-year old boy
Authors: Shengbing Wang, Fu Guan, Fuqun Wang, Pingwu Wen
Journal: Endoscopy (2021)

A 12-year-old boy was admitted to our hospital with sharp upper abdominal pain for the previous 5 days. Physical examination revealed epigastric tenderness but no rebound pain. The boy revealed that, 1 year previously, he had swallowed some sharp metal and magnetic objects, without ever telling either his parents or anyone else.
Correlation between transmural high energy phosphate levels and myocardial blood flow in the presence of graded coronary stenosis.
Authors: GPath, P MRobitaille, HMerkle, MTristani, JZhang, MGarwood, A HFrom, R JBache, KUğurbil
Journal: Circulation Research (1990)

Spatially localized nuclear magnetic resonance spectroscopy was used to investigate with transmural differentiation the response of myocardial high energy phosphate compounds and inorganic orthophosphate (Pi) to graded reductions in coronary blood flow caused by sustained coronary stenosis. In an open-chest model, localized 31P nuclear magnetic resonance spectra from five layers across the left ventricular wall were obtained simultaneously with transmural blood flow measurements during control conditions and during sustained graded reductions in intracoronary pressure. Both the blood flow, and high energy phosphate and Pi contents displayed transmural heterogeneity in response to decreases in intracoronary pressure. The subendocardial creatine phosphate (CP) level remained unchanged as blood flow was reduced to approximately 0.7 ml/min/g wet wt and decreased precipitously beyond this critical flow level. The relation between CP and flow in the midmyocardium and especially in the subepicardium was more com...
Evidence for Expanding Physician Supply
Authors: Sharon I.S. Rounds, Derek C. Angus
Journal: Annals of Internal Medicine (2005)

Letters15 March 2005Evidence for Expanding Physician SupplySharon I.S. Rounds, MD and Derek C. Angus, MD, MPHSharon I.S. Rounds, MDFrom Brown Medical School, Providence, RI 02908.Search for more papers by this author and Derek C. Angus, MD, MPHFrom Brown Medical School, Providence, RI 02908.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-6-200503150-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Cooper (1) makes a compelling case for a looming physician shortage and calls for increasing the number of physicians trained in the United States. The accompanying editorial by Drs. Garber and Sox (2) cautions that training more physicians may not be the answer. Both articles make valid points; however, both agree that there is a looming shortage of physicians in the United States and that now is the time to consider how to address the problem.In the field of critical care medicine, we are already seeing evidence of a shortage of physicians. Demand for critical ...References1. Cooper RA. Weighing the evidence for expanding physician supply. Ann Intern Med. 2004;141:705-14. [PMID: 15520427] LinkGoogle Scholar2. Garber AM, Sox HC. The U.S. physician workforce: serious questions raised, answers needed [Editorial]. Ann Intern Med. 2004;141:732-4. [PMID: 15520433] LinkGoogle Scholar3. Angus DC, Kelley MA, Schmitz RJ, White A, Popovich J. Caring for the critically ill patient. Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population? JAMA. 2000;284:2762-70. [PMID: 11105183] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Brown Medical School, Providence, RI 02908. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWeighing the Evidence for Expanding Physician Supply Richard A. Cooper The U.S. Physician Workforce: Serious Questions Raised, Answers Needed Alan M. Garber and Harold C. Sox Evidence for Expanding Physician Supply Richard A. Cooper Evidence for Expanding Physician Supply W. Bruce Fye Evidence for Expanding Physician Supply Vincent M. Pedre III Evidence for Expanding Physician Supply William A. Curry and Clyde Barganier Metrics 15 March 2005Volume 142, Issue 6Page: 473-474KeywordsAgingCritical careElderlyEmotionsForecastingHealth careHealth care policyHealth care providersIntensive care unitsThorax ePublished: 15 March 2005 Issue Published: 15 March 2005 CopyrightCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Digoxin sensitivity in amyloid cardiomyopathy.
Authors: ARubinow, MSkinner, A SCohen
Journal: Circulation (1981)

Digoxin (5 mg/ml) was added to 10-mg and 20-mg pellets of purified primary and secondary amyloid fibrils, a normal human liver and heart homogenate and a homogenate from the heart of a patient with amyloid cardiomyopathy who had not received digitalis. After centrifugation, the supernatants were recovered and assayed for digoxin concentrations. Aliquots from the sediments were studied for the presence of digoxin, using rabbits antidigoxin antiserum and an indirect immunofluorescent technique. The results showed that 0.11--0.13 ng/ml of digoxin bound per milligram of fibrils and could not be separated by repeated washings. Elution with citrate or changes in the pH of the buffer. Immunofluorescent studies demonstrated diffusely bright immunofluorescence with the fibril preparation and amyloid heart homogenate when reacted with digoxin and digoxin-specific antiserum. These studies demonstrate that isolated amyloid fibrils bind digoxin and suggest that this interaction may play some role in the sensitivity to...
Critical analysis of the signal-averaged electrocardiogram. Improved identification of late potentials.
Authors: PLander, E JBerbari, C VRajagopalan, PVatterott, RLazzara
Journal: Circulation (1993)

BACKGROUNDThis study performed a critical analysis of signal-averaging methods. The objective was to optimize detection of late potentials.METHODS AND RESULTSWe studied two patient populations: a low-arrhythmia-risk group with no evidence of heart disease and a group with clinically documented ventricular tachycardia (VT). Filtered QRS duration (QRSD) and terminal QRS amplitude (RMS40) were measured from the vector magnitude. A QRS duration based on the latest detectable ventricular activity in any of the three individual XYZ leads was also measured. Because of improved signal-to-noise ratio, both individual lead analysis and extended (600-versus 200-beat) averaging yielded significant changes in signal-averaged ECG parameters. Both approaches gave an increased sensitivity for VT identification. Sensitivity, specificity, and accuracy were evaluated as functions of critical values of QRSD and RMS40. RMS measurements in the terminal QRS, ranging from 20 to 100 msec and including RMS40, did not contribute to...
TCTAP C-021 Rotablation in a Heavily Calcified, Uncrossable Chronic Total Occlusion Lesion
Authors: Afif Ashari, Shaiful Azmi Yahaya, Wan Faizal Bin Wan Rahimi Shah, Faizal Khan Abdullah, Faten Aqilah Binti Aris
Journal: Journal of the American College of Cardiology (2021)
Cryosurgical ablation of atrioventricular nodal reentry: histologic localization of the proximal common pathway.
Authors: W LHolman, D BHackel, J GLease, MIkeshita, J LCox
Journal: Circulation (1988)

A method using cryosurgery has been previously described to selectively ablate atrioventricular nodal reentry tachycardia while preserving intact atrioventricular conduction. The purpose of the present study was to define the histologic features of the cryolesions in relationship to the specialized conduction system. In 12 adult dogs a series of nine discrete cryolesions was placed along the perimeter of the triangle of Koch while continuously monitoring the His bundle electrogram. All animals survived the operation and maintained intact atrioventricular conduction. At 14 weeks after surgery the hearts were sectioned and examined. In all 12 animals there was a confluent mass of dense fibrous tissue present in the lower atrial septum that was in immediate proximity to but did not involve the atrioventricular node-His bundle. The ablation of perinodal tissue with preservation of the specialized conduction system with the use of this cryosurgical technique was confirmed. It is likely that the cryoablated per...