tbuckley/cabot-search huggingface dataset:
Short term effects of temperature on risk of myocardial infarction in England and Wales: time series regression analysis of the Myocardial Ischaemia National Audit Project (MINAP) registry
Journal: BMJ (2010)

Objective To examine the short term relation between ambient temperature and risk of myocardial infarction.Design Daily time series regression analysis.Setting 15 conurbations in England and Wales.Participants 84 010 hospital admissions for myocardial infarction recorded in the Myocardial Ischaemia National Audit Project during 2003-6 (median 57 events a day).Main outcome measures Change in risk of myocardial infarction associated with a 1°C difference in temperature, including effects delayed by up to 28 days.Results Smoothed graphs revealed a broadly linear relation between temperature and myocardial infarction, which was well characterised by log-linear models without a temperature threshold: each 1°C reduction in daily mean temperature was associated with a 2.0% (95% confidence interval 1.1% to 2.9%) cumulative increase in risk of myocardial infarction over the current and following 28 days, the strongest effects being estimated at intermediate lags of 2-7 and 8-14 days: increase per 1°C reduction 0.6% (95% confidence interval 0.2% to 1.1%) and 0.7% (0.3% to 1.1%), respectively.Heat had no detrimental effect.Adults aged 75-84 and those with previous coronary heart disease seemed more vulnerable to the effects of cold than other age groups (P for interaction 0.001 or less in each case), whereas those taking aspirin were less vulnerable (P for interaction 0.007).Conclusions Increases in risk of myocardial infarction at colder ambient temperatures may be one driver of cold related increases in overall mortality, but an increased risk of myocardial infarction at higher temperatures was not detected.The risk of myocardial infarction in vulnerable people might be reduced by the provision of targeted advice or other interventions, triggered by forecasts of lower temperature.
Neurocardiogenic Syncope
Authors: Francois M. Abboud
Journal: New England Journal of Medicine (1993)

As is often the case, many therapies in medicine are prescribed on the basis of assumptions or logical deductions but without data to support their use. For example, in neurocardiogenic syncope, in which hypotension is associated with paradoxical bradycardia, heart block, or sinus arrest, one could argue that implantation of a pacemaker to prevent the bradycardia is a rational treatment1. In this issue of the Journal, Sra et al.2 say that it is not effective. In their study they maintained the heart rate at a level 20 percent above the resting level by means of cardiac pacing but did . . .
THE PRESIDENT'S MESSAGE
Journal: JAMA (1929)

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
Pulmonary Schistosomiasis
Authors: Héctor F. Rodríguez, Edwin Rivera
Journal: New England Journal of Medicine (1958)

INFESTATION by Schistosoma mansoni is generally known to cause gastrointestinal symptoms and, not infrequently, bilharzial hepatic fibrosis, which may lead to portal hypertension of intrahepatic origin. Other authors1 2 3 have reported and described the less frequently encountered pulmonary manifestations of bilharziasis and have classified the different types that might be identified.It is the purpose of this communication to present 2 cases of pulmonary bilharziasis with widely different clinical manifestations.Case ReportsCase 1. D.R. (P.D.H. 60 326), a 34-year-old white woman, was admitted to the Medical Service of the Ponce District Hospital on October 19, 1956, because of hemoptysis. For . . .
Feasibility of a defined exercise program for aromatase inhibitor–related arthralgia (AIRA) in breast cancer survivors.
Authors: B. W. Lash, J. Katz, P. Gilman
Journal: Journal of Clinical Oncology (2011)

e19725 Background: Aromatase Inhibitors (AIs) are standard adjuvant therapy for post-menopausal women (PMW) with hormone sensitive breast cancer. Up to 40% of women taking AIs develop AIRA. While most women have mild/moderate symptoms, up to 25% have severe symptoms, which results in drug discontinuation. The etiology of AIRA is not known. While conventional therapies are beneficial, the effect is not universal. We hypothesized that a structured exercise program may attenuate AIRA. A feasibility study in 14 women being treated in a community oncology practice was performed. Methods: The primary objective was retention to a structured exercise program. The secondary objective was to assess the effect on AIRA. PMW with breast cancer being treated with an AI were eligible. Each woman had medical clearance for exercise. Exclusion criteria were significant co-morbidities, disease progression, participation in another exercise program, inability to attend the program, or uncontrolled lymphedema. Once enrolled they started a reproducible program 2-3 times/week for 8 weeks; each 45 minute session was supervised by a trainer who emphasized strength and aerobic training. The participants completed a 5-point Likert item questionnaire at 0, 4 and 8 weeks. The data were analyzed using ANOVA with repeated measurements and analyzed for correlation of results. Results: 11 of 14 women completed 8 weeks. The following were found to be significantly decreased compared to baseline (p<0.05): pain involving the feet, ankles, knees, hands, wrists and elbows; joint pain throughout the day; generalized joint pain; morning and daytime stiffness; pain with activity. In addition, the patients felt overall improvement in symptoms. The changes occurred within the first 4 weeks and persisted. There was no effect on fatigue, mood changes, or hot flashes. There were no adverse events. Overall satisfaction was high. Conclusions: This study shows that a supervised exercise program is feasible and has a benefit on AIRA. The program was well tolerated and resulted in significant improvement in clinically relevant end-points. A randomized trial is warranted.
Death in Springtime
Authors: Lawrence Smith
Journal: Annals of Internal Medicine (1999)

Letters2 February 1999Death in SpringtimeLawrence Smith, MDLawrence Smith, MDMount Sinai School of Medicine; New York, NY 10029Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-3-199902020-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Since the publication of my essay, I have received numerous calls and notes from educators and residents telling their own stories of personal loss during training. All have expressed deep feelings of grief that may well have not been adequately resolved.As medical educators and physicians, we have to take more responsibility for helping residents positively resolve these difficult emotions rather than learn potentially negative strategies to deal with them. Author, Article, and Disclosure InformationAffiliations: Mount Sinai School of Medicine; New York, NY 10029 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 2 February 1999Volume 130, Issue 3Page: 243KeywordsEmotions Issue Published: 2 February 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Pediatrics
Authors: V. A. Fulginiti
Journal: JAMA (1993)

In the last two decades, remarkable progress has been made in our understanding of the etiology, pathogenesis, and basic molecular processes that result in disease. Cystic fibrosis is the most common lethal gene in our population, occurring in the carrier state in one person of every 20 to 25, and resulting in one in 2500 births of a child with the disease. The defect has now been clearly identified as a mutation of a specific gene, the cystic fibrosis transmembrane regulator (<i>CFTR</i>) gene, on chromosome 7.<sup>1</sup>The most common mutation results in a protein defective in phenylalanine at position 508, referred to as ΔF508; in addition, more than 120 other mutations have been identified. Variance in the mutation does result in some phenotypic variation, but concordance for ΔF508 leads to both pancreatic deficiency and pulmonary disease. The<i>CFTR</i>defect leads to altered transport of sodium and chloride through the
Anatomy.
Journal: JAMA (1930)

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
Off-label uses of anticancer drugs
Authors: M. D. Abeloff
Journal: JAMA (1992)

<h3>In Reply.</h3> —Hamilton et al state that the data provided in the articles by Lagakos et al<sup>1</sup>and Easterbrook et al<sup>2</sup>"are insufficient because they were unplanned and they either involved too few events for one to be comfortable with the conclusions or dealt with patients at more advanced stages of HIV disease, for whom the benefits of prompt zidovudine treatment have already been demonstrated." The finding in the VA study that zidovudine may be ineffective in blacks and Hispanics was not specified before the data were examined, but rather noticed only after several subgroup analyses of their data. It is well known that results observed in this manner often are spurious,<sup>3</sup>and Hamilton et al correctly caution about overinterpretation of this finding. However, this bias is not applicable to the findings of Lagakos et al and Easterbrook et al because these analyses were motivated by an
EDITORIAL POLICY
Authors: Herman F. Meyer
Journal: JAMA (1960)

<h3>To the Editor:—</h3> It is refreshing to note that with the alterations in the editorial staff ofThe Journalthere are also other changes, such as variations of the format, the tasteful design of the cover, and, more significantly, the implications in the editorial tone and scholarly flavor. It is not undue optimism to hope that this new policy will include the acceptance of the original literary style of the authors of scientific and other contributions toThe Journal. In fact, Dr. Talbott, from his editorial chair, portends this enlightenment in a frank statement of future policy (July 2, p. 1031) which promises such acceptance. "There is no desire on my part to process a manuscript through a mental machine in order to conform to an established pattern or prototype.... A physician's style and word composition reflect his personality. I believe that it should not be altered any more than
OC-026 Eosinophilic Oesophagitis in Patients Presenting with Dysphagia- a Prospective Analysis
Authors: M Kumar, F Khan, R Sweis, T Wong
Journal: Gut (2013)

<h3>Introduction</h3> Eosinophilic oesophagitis (EO) is a chronic relapsing,immune/antigen mediated disease of the oesophagus with rapidly increasing incidence and prevalence; however EO often remains under-diagnosed. Early detection and appropriate therapy improves quality of life and may prevent development of chronic oesophageal changes. A diagnosis can only be made when a dense eosinophilia is confirmed on histology in the context of typical symptoms (e.g.solid food dysphagia)<sup>1</sup>.We prospectively assessed the prevalence of EO in patients presenting to endoscopy at a tertiary referral centre with solid food dysphagia over 2 years. <h3>Methods</h3> Between Jan 2010 and Dec 2011,746 patients with dysphagia (including food bolus obstruction)had high definition white light endoscopy performed. Patient demographics,symptomatology,endoscopic and histological findings were recorded.EO was defined as the presence of &gt; 15 eosinophils per high power field <h3>Results</h3> Patients with oesophageal malignancy (n = 65),barrett’s oesophagus(n = 48) and post-oesophageal surgery complications (n = 16) were excluded. Of the 628 remaining patients,388(62%) (254 male; mean age 59; range 18–88) had mid-oesophageal biopsies taken.23/388 (5.9%)were diagnosed with EO 19 male; mean age 40; range 26–56).Endoscopy showed mucosal pathology in 12/23 (52%)patients with confirmed EO; oesophagitis (n = 3),red furrows (n = 3),distal narrowing (n = 2),corrugated rings (n = 2),mucosal tear (n = 1) and white exudates (n = 1).250 of the remaining patients had grade A or B oesophagitis. Overall 17 patients had food bolus obstruction.11/17 patients had biopsies taken and 5/11(46%) showed histological evidence of EO.4/5 patients with bolus obstruction had distal oesophagitis on endoscopy but EO was confirmed following ≥4 mid-oesophageal biopsies. There was a trend towards those with EO having had a greater number of biopsies taken (mean 6.14; range 2–12) compared to those without EO (mean 5.02; range 2–8; p = 0.082).28% and 51% had ≤3 and ≤4 biopsies collected respectively. The mean (±SD) number of eosinophils/hpf in the EO group was 64.3 (51.3). <h3>Conclusion</h3> Mid-oesophageal biopsies can diagnose EO in at least 1 in 16 cases of patients with unexplained solid food dysphagia.However,1/3 of patients in whom EO should have been considered (including 6 with food bolus obstruction)did not have biopsies collected.Furthermore, 1/4 had less than the recommended minimum 4 mid-oesophageal biopsies. In summary, our experience has shown that EO detection is likely to improve further if all patients with symptoms conducive with EO (e.g.solid food dysphagia) routinely trigger an EO biopsy protocol of ≥4 from the mid-oesophagus regardless of endoscopic findings. <h3>Disclosure of Interest</h3> None Declared <h3>Reference</h3> Liacouras CA, Furuta GT <i>et al.</i> Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol 2011; 128(1):3–20 e6.
Determining N7-Alkylguanine Adducts by Immunochemical Methods and HPLC with Electrochemical Detection: Applications in Animal Studies and in Monitoring Human Exposure to Alkylating Agents
Authors: Joost H. M. van Delft, Monic J. M. van Winden, Angela M. C. van den Ende, Robert A. Baan
Journal: Environmental Health Perspectives (1993)

Many xenobiotics exert their toxic effects through interaction with DNA in the cells of the exposed organism. This interaction may lead to the formation DNA adducts. Some of these may give rise to mutations that initiate cell transformation and, ultimately, the formation of tumors. Sensitive methods for determining DNA adducts are indispensable for the study of chemical mutagenesis and carcinogenesis and for biomonitoring human exposure to genotoxic agents. Alkylating agents form an important class of genotoxic compounds. They react preferentially at the N7-position of guanine. Under neutral or acidic conditions, the adducts can be readily released from the DNA backbone as the free base N7-alkylguanine (N7-AlkGua). The imidazole ring of N7-alkyldeoxyguanosine (N7-AlkdGuo) can be opened under alkaline conditions, which results in formation of a more stable adduct in DNA. To develop immunochemical methods for the detection of N7-alkylations, we immunized mice with various alkylguanosines in the ring-opened form (RON7-AlkdGuo). Antibodies were selected to detect adducts in isolated DNA by competitive ELISA and in single cells by immunofluorescence microscopy (IFM). Various monoclonal antibodies were characterized in detail with respect to specificity and sensitivity toward methylated, ethylated, and hydroxyethylated DNAs. The antibodies showed extensive cross-reactivity toward N7-(m)ethyl- and N7-(2-hydroxyethyl)guanine modifications in the ring-opened form. The limits of detection in the direct and competitive ELISA were 5-10 and 1-2 adducts per 10(6) nucleotides, respectively. The detection limit of the IFM method was about 20 adducts per 10(6) nucleotides(ABSTRACT TRUNCATED AT 250 WORDS)
Abstract 225: Ischemic Cardiomyopathy Perturbs GSK-3β Myofilament Localization and Reduces Function
Authors: Marisa J Stachowski, Maria Papadaki, Jody L Martin, Christine S Moravec, Jonathan A Kirk
Journal: Circulation Research (2017)

In ischemic cardiomyopathy (ICM), regions with ischemic damage are weaker than surrounding tissue, leading to contractile heterogeneity (ischemia-induced dyssynchrony, IID) that worsens function and mortality. IID is distinct from conduction abnormality-induced dyssynchrony that is treated with Cardiac Resynchronization Therapy (CRT). Our previous work found CRT reactivates glycogen synthase kinase 3β (GSK-3β) and restores myofilament function. Pacing an infarct cannot strengthen it, so CRT is ineffective in IID. However, we hypothesized GSK-3β may modulate myofilament function in ICM and could be leveraged to treat IID. We measured GSK-3β in whole tissue and myofilament-enriched samples from human rejected donor (Control), ICM, and dilated cardiomyopathy (no IID, DCM) LV. GSK-3β was detected in all the myofilament samples, but there was a 71±12% reduction in ICM. In whole tissue, there was very little phospho-Y216 GSK-3β, however it was highly enriched in the myofilament. Immunofluorescence on adult human myocytes showed weak co-localization of total GSK-3β and α-actinin at the z-disc compared to a strong correlation with p-Y216 GSK-3β. Furthermore, co-IP of GSK-3β and the myofilament show total GSK-3β had low-affinity to myofilament proteins, while p-Y216 GSK-3β binds with a high affinity. This led us to hypothesize Y216 phosphorylation modulates GSK-3β binding to the myofilament. To remove the confounding effect of antibodies, we created adenoviral constructs of myc-tagged wild-type, Y216F (unphosporylatable) and Y216E (constitutively phosphorylated) GSK-3β and transfected them into rat neonatal ventricular myocytes (NRVMs). The Y216E construct alone associated with the myofilament in co-IP experiments. We then performed skinned myocyte functional studies on human Control and ICM LV. The ICM myocytes were desensitized to calcium compared to Control and this was restored with exogenous GSK-3β treatment, but had no effect on Control myocytes. While GSK-3β is a promiscuous kinase in the myocyte, we have identified a specific regulatory mechanism involving Y216 phosphorylation, a site with a largely unknown role, that could allow precise therapeutic intervention to improve contractile function in the ICM heart.
For quick reference, here are candidates' positions on health care reform
Authors: C. Marwick
Journal: JAMA (1992)

HEALTH CARE reform—how much, in what form, and how to finance it—has become a major issue in the presidential campaign. Each candidate has his own recipe. Here, briefly summarized, are the major positions. <h3>Republicans</h3> <b>George Bush</b>offers tax credits of up to $3750 to enable low-income families to purchase basic health insurance. A similar tax deduction for health insurance premiums is provided for the middle class, members of which are defined as having annual incomes up to $80 000. Health insurance reforms are proposed that would enable small businesses to provide coverage through purchasing pools and by mandating that all health insurers provide coverage regardless of the insured's health status. Costs would be controlled by encouraging managed care, such as health maintenance organizations, and by an overhaul of the malpractice liability system. So far, Bush is the only candidate to come up with a hard figure on cost. When fully
Psoriasis
Authors: Mark Lebwohl
Journal: Annals of Internal Medicine (2018)

Psoriasis, an inherited disorder of the immune system, presents most commonly in the skin and joints but is also associated with cardiovascular, metabolic, and neuropsychiatric effects. Treatments include topical therapy for mild disease; phototherapy and oral therapy, such as retinoids and immunomodulating agents; and targeted biologic therapies that have revolutionized treatment of psoriasis and psoriatic arthritis. Primary care physicians should be aware of the systemic associations of psoriasis and the treatments available for this disorder.