tbuckley/cabot-search huggingface dataset:
The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis
Journal: BMJ (2013)

The benefits of steroids versus steroids plus antivirals for treatment of Bell's palsy: a meta-analysisThe authors of this Research paper have informed us that they misreported data from the paper by Engstrom et al that they used as part of their meta-analysis (BMJ 2009;339:b3354, doi:10.1136/bmj.b3354).In figure 2 the number of patients receiving steroids only at follow-up should have read 186 (not "180") and the number of patients receiving steroids plus antivirals at follow-up should have read 180 (not "186").The authors state that this mix up in the denominator data changes the odds ratio (95% confidence interval) for that study from 0.93 (0.49 to 1.77) to 1.66 (0.86 to 3.22) and add that an odds ratio greater than 1 favours steroids plus antivirals.They assert that this does not change the statistical significance of the result for that study but does change the pooled odds ratio from 1.50 (0.83 to 2.69) to 1.72 (1.02 to 2.88), with the lower limit of the confidence interval now just above 1.However, the authors would like to explain that these data represent the per protocol analysis and, given that all studies were randomised controlled studies, their original plan was also to use the intention to treat data, which many believe is the most appropriate to use for randomised controlled studies.The authors did not report the intention to treat data in the original paper as this set of data showed no difference from the per protocol analysis.Using intention to treat data, the authors found the paper by Engstrom et al had an odds ratio (95% confidence interval) of 1.18 (0.75 to 1.85) and the overall pooled estimate was 1.24 (0.96 to 1.6), showing no difference between treatment groups.The authors conclude that these findings, based on the intention to treat data, show that steroids plus antivirals may not be better than steroids alone, which supports the study's original conclusions.
ABSTRACTS
Journal: Circulation (1959)

The association of shock with disseminated intravascular coagulation has been found in such entities as infantile diarrhea due to Es- cherichia coli, pseudomienbraneous enterocolitis, premature separation of the placenta and eclampsia, amniotic fluid einbolization, and incomnpatible blood transfusion reaction.These experi- mnents were designed to determine the role of intravascular clotting in the production of shock and the effect of heparinization in its preven- tion.In dogs under pentobarbital anesthesia, catheters were threaded into the aorta through either femoral artery.Through these catheters injections of incompatible blood, amniotic fluid, and heparin were made on one side and arterial pressures determined on the other.In 1 dog pulmonary artery pressure was recorded and in 10 splenic pressures were noted.In 22 dogs, injected with 100 mil. of incompatible blood, there was an average immediate fall of blood pressure of 84.4 mm.Hg.Splenic pressure was elevated in 10 of these.In 1 dog pulmonary artery pressure was measured and found in- creased.The drop in systemic blood pressure gradually returned to normal over the period of 1 hour.Three dogs died and showed post- mortem evidence of thrombosis in pulmonary arteries and capillaries; and in hepatic arterioles and central veins.In the next group of 6 dogs, heparin was initially given followed by incoin- patible blood.The average fall in blood pres- sure in this group was 45.5 mm.Hg.
SP0015 Sick Leave and Disability Pension in Working Age Women and Men with Knee Osteoarthritis
Authors: J. Hubertsson
Journal: Annals of the Rheumatic Diseases (2013)

<h3></h3> Osteoarthritis is one of the most common causes of pain and disability in the musculoskeletal system and the knee is one of the principal joints to be affected. Even if the prevalence of knee osteoarthritis is high, the prevalence, as well as the prevalence of osteoarthritis of other sites, increases rapidly with age and the disease is often seen as a "disease of the elderly". Outcomes such as work ability, sick leave and disability pension have mostly been secondary objectives and research is scarce and often based on limited numbers. Results have also been inconclusive. However knee osteoarthritis often starts before retirement age, the disease is not uncommon in working subjects and the effect on work ability, sick leave and disability pension needs attention. Furthermore, in most European countries the retirement age is changing to higher ages. The focus of the presentation is knee osteoarthritis, sick leave and disability pension. In a first study we used the Skåne Health Care Register (covering a population of 1.2 million) and the National Social Insurance register to identify all subjects seeking health care for knee osteoarthritis (ICD-10 code M17) and to calculate the share who received either sickness benefit or disability pension payment. Doing this showed that patients with knee OA had an almost two-fold increased risk of sick leave and about 40-50% increased risk of disability pension compared to the general population. Further, in the Swedish population, over 2% of the total amount of sick days in the society was attributable to knee OA or associated comorbidities, life style or socioeconomic background in the knee OA patients. In a second study we used the medical record systems to collect information on dates and diagnostic codes for a total number of 20472 sick leave periods. The group of musculoskeletal disorders was the largest group with 3371 (17%) sick leave periods. Knee osteoarthritis with 194 sick leave periods (6%) was the fourth most common diagnosis within this group. Sick leaves for knee osteoarthritis were generally longer than average. As much as 53% of all sick leaves due to knee osteoarthritis exceeded 90 days (as compared to 25% of all sick leaves). Thus, osteoarthritis, despite often being viewed as a "disease of the elderly", is an important cause for sick leave and disability pension and more research is needed on risk factors and possible interventions. Ref: Hubertsson J, Petersson IF, Thorstensson CA, Englund M, Risk of sick leave and disability pension in working age women and men with knee osteoarthritis. Ann Reum Dis, 2013 Mar;72(3):401-5 <h3>Disclosure of Interest</h3> None Declared
The artifactual electrocardiogram recorded during closed-chest massage
Authors: R. Saphir
Journal: JAMA (1967)

By studying compression and by analyzing instantaneous vectors of electrocardiographic artifacts produced by closed-chest cardiac massage in 12 patients, a primary mechanical etiology for the complexes was apparent. The recognition of the artifactual electrocardiogram proved useful in the differentiation of intrinsic from extrinsic electrical cardiac activity. Since the configuration of the electrocardiographic artifact is directly related to the method of sternal compression, it is of value in the instruction of proper technique for closed-chest cardiac massage.
Premedical science
Authors: G. Dunea
Journal: BMJ (1999)

This information came over the internet some years ago. It purports to be the answers given by students in science exams around the world. It came with the comment that “it is truly astonishing what weird science our young scholars can create under the pressure of time and grades.” I was unable to trace the author, but as the work deserves wider dissemination, I present here the answers of most interest to a medical audience.
Roentgen Anatomy of the Ilio-Pelvic-Aortic Lymphatic System
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
<i>Announcement:</i> National Arthritis Awareness Month — May 2017
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

May is National Arthritis Awareness Month.In the United States, approximately 54 million (1) adults have some form of doctor-diagnosed arthritis; this number is projected to increase to 78 million by 2040 (2).In addition, arthritis-attributable activity limitation currently affects an estimated 24 million adults with arthritis (1), and this is expected to rise to 35 million by 2040 (2).Approximately one in three adults with arthritis have severe joint pain (1).Arthritis is a leading cause of disability and makes it harder to manage other co-occurring conditions, such as diabetes, heart disease, and obesity.A Vital Signs report on arthritis prevalence (1) was published in MMWR in March 2017 to increase awareness of arthritis, its impact in the United States, and what can be done by health care providers, adults with arthritis, and state and community leaders to address these issues.CDC recommends physical activity and a variety of evidence-based physical activity and self-management education programs.Physical activity can reduce arthritis pain and improve function by about 40%, and self-management education workshops, such as the Chronic Disease Self-Management Program, have shown 10%-20% improvements in pain, fatigue, and depression in adults with arthritis (3).CDC funds 12 state health departments and several national organizations to disseminate these programs in local communities.
Microneurosurgery
Authors: Oscar Sugar
Journal: JAMA (1976)

High magnification, strong illumination, and miniaturized instruments have been applied in neurosurgery only since 1962 but have greatly changed the techniques and outcome in this specialized field. New procedures have been introduced, such as anastomosis of a branch of the superficial temporal artery to a branch of the middle cerebral artery, each 1.5 mm in diameter, to improve circulation in the brain in some patients with stroke. This is one of the six subjects dealt with in the two-day meeting whose participants contributed to this book. Instrumentation, cerebral aneurysms, arterial malformations of the brain and spinal cord, peripheral and cranial nerves, sellar and suprasellar tumors, and other lesions of the spinal cord are other subjects discussed in the 16 articles and 29 abstracts. Production costs made it necessary to summarize many interesting presentations, but some of these have appeared in journals in the two years since the meeting. The chapters
Vectorcardiographic Criteria for the Diagnosis of Inferior Myocardial Infarction
Authors: JOHN W. STARR, GALEN S. WAGNER, VICTOR S. BEHAR, ABE WALSTON, JOSEPH C. GREENFIELD
Journal: Circulation (1974)

Vectorcardiograms (VCG) from two patient groups were analyzed to develop and test quantitative criteria for the diagnosis of inferior myocardial infarction. The first group (219 patients) consisted of four subgroups and was used to develop the criteria. Patients were placed in the normal and infarct subgroups by clinical descriptors including history, course in the coronary care unit, and cardiac catheterization findings. The criteria which were found to give the fewest false positive results with acceptable sensitivity were as follows: In the frontal plane, generally clockwise early superior QRS forces must be present, i.e., forces which are initially either a) superior (rightward or leftward) or b) inferior and completely rightward for not more than 10 msec prior to becoming superior, and which subsequently cross the X axis to the left of the 0 point (or less commonly, the entire efferent limb remaining superior to the X axis). One of the following conditions must also be present: 1) Time from the 0 point to leftward X intercept of at least 25 msec and distance from the 0 point to leftward X intercept of at least 0.30 mV; 2) A maximal frontal plane QRS vector less than 15°; 3) A maximal superior deviation of at least 0.1 mV and a ratio of maximal superior deviation to maximal inferior deviation of at least 1:5. The performance of these proposed criteria were then tested prospectively using a second group (255 patients) which was similar to the criteria group. The proposed criteria were found to be statistically superior to both ECG Q wave criteria and to the VCG initial force criteria of Young and Williams. 2 The incidence of false positive diagnosis in the test group was less than 3%.
Uncertainty
Authors: Madeline L. Fryer
Journal: JAMA Cardiology (2018)

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 Cardiology 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 Cardiology journal
Extended survival analysis of ipilimumab for the treatment of advanced malignant melanoma in pretreated patients: Five-year long-term follow-up of the South African expanded access program
Authors: B.L. Rapoport, D. Vorobiof, L. Dreosti, A. Nosworthy, G. McAdam, A. Jordaan, M. De Necker, J. De Beer, H. Duvenhage
Journal: Annals of Oncology (2017)
Imbecile Children
Authors: E. B. Lind, B. H. Kirman
Journal: BMJ (1958)

<h3>Abstract</h3> <h3>Aims</h3> Distributions of mycorrhizal guilds correlate with differences in soil nutrient availability and tend to predominate ecosystems where plant growth and development are limited by either soil phosphorus (AM, arbuscular mycorrhiza) or nitrogen (EM, ectomycorrhiza) (Read, 1991). In an effort to characterize functional trait differences, we designed a common garden greenhouse experiment to measure growth and colonization responses between two tree seedling species (<i>Acer rubrum</i> and <i>Quercus rubra</i>) that associate with the two major mycorrhizal guilds. <h3>Methods</h3> In a fully factorial, 12-week greenhouse common garden experiment, seedlings were treated to three levels of nitrogen and phosphorus availability, and grown under inter- and intra-species competition. Change in heights and stem diameters were tracked and mycorrhizal colonization was quantified by percent of total and morphology. <h3>Results</h3> Relative growth rates were higher for <i>Acer rubrum</i> seedlings across treatments and intra-species competition had a strong negative effect on height and stem diameter, especially for <i>Quercus rubra</i>. Both species were highly colonized (&gt;50%) by typically endomycorrhizal forms (arbuscules and vesicles) but varied in the distribution of morphological forms present in cells. <h3>Conclusions</h3> This study highlights the plasticity of tree seedling symbiosis during early developmental stages and challenges the strict static categorization of plant species associations with particular mycorrhizal guilds.
The office laboratory director's guide
Authors: P. Fischer
Journal: JAMA (1985)

More than 90% of primary care physicians have access to an office laboratory. These physicians serve as the director of their laboratory services and are legally responsible for test results. This responsibility has become a greater challenge as more sophisticated laboratory testing is available for office use. Yet clinicians find few reliable sources to help them face these changes. This article is intended to serve as a guide for the clinician facing the new responsibilities as laboratory director. (<i>JAMA</i>1985;254:2941-2945)
PTU-106 A prospective single centre evaluation of the intra-individual variability of faecal calprotectin in quiescent Crohn's disease patients
Authors: L A Smith, G Naismith, S Barry, J Munro, K Rankin, J Winter, A J Morris, D Gaya
Journal: Gut (2012)

<h3>Introduction</h3> Faecal calprotectin (FC) has become an established non-invasive, sensitive marker of intestinal inflammation in Crohn9s disease (CD). A single measurement of FC is used in clinical practice to aid decision making in the management of CD patients. Data on the day to day variation of FC levels in CD patients is sparse. If there was significant intra-individual variation of FC within CD patients, this could impact on the interpretation of single values in isolation. A prospective study to evaluate the degree of variability of FC in three consecutive days stool samples in CD patients in clinical remission was performed. <h3>Methods</h3> 143 patients with CD in remission (CDAI &lt;150, no escalation of medical therapy within 3 months) who were attending for routine follow-up were identified and enrolled. Patients were excluded if they were taking NSAIDs or developed any change in symptoms over the 3-day collection period. After informed consent, patients were asked to provide stool samples from three consecutive days for analysis. FC was analysed using the Buhlman FC ELISA as per the manufacturer9s instructions. <h3>Results</h3> Of the 143 patients recruited 34 did not return any samples, 6 returned less than the required number of stool samples, 2 withdrew consent and 2 developed clinical evidence of a flare of disease during the collection period and were excluded from analysis. Therefore 98 complete sets of three stool samples were obtained and analysed. The intraclass correlation coefficient of the 3 FC values, log-transformed, was 0.842 with corresponding 95% CI 0.788 to 0.886 showing that consistency between the three log-transformed FC measurements is high. The reliability of a “normal” FC result of &lt;50 and of &lt;100 was assessed using the κ statistic for agreement between the three measurements. For a FC result of &lt;50 κ was 0.648 (95% CI 0.508 to 0.770) and for a FC result of &lt;100, κ was 0.603 (95% CI 0.483 to 0.712) demonstrating that there is moderately good and similar levels of agreement across the 3 samples for both measures. The reliability of the cut-off of 50 is slightly better than the cut-off of 100. <h3>Conclusion</h3> The consistency of three faecal calprotectin samples over three consecutive days is high and the CI is narrow suggesting that in a larger population consistency would also be high. This indicates that there is little intra-individual variability of the test and a one off sample can indeed provide reliable information for use in clinical practice. Higher intrapatient variability of high FC values suggests that the log-transformed values are more reliable. <h3>Competing interests</h3> None declared.
Human Physiologic Factors in Respiratory Uptake of 1,3-Butadiene
Authors: Yu-Sheng Lin, Thomas J. Smith, Karl T. Kelsey, David Wypij
Journal: Environmental Health Perspectives (2001)

1,3-Butadiene (BD), a suspected human carcinogen, is used as the raw material in industries to make synthetic butyl rubber and plastics. Simulation models using experimental animal data have shown that physiologic factors play an important role in the kinetic behavior of BD. However, human data are limited. The aim of this inhalation study was to identify influential human physiologic factors in the respiratory uptake of BD. We recruited 133 healthy volunteers in Boston, Massachusetts, into this study and tested them under an approved human subjects protocol. Each subject was exposed to 2 ppm (4.42 mg/m3) BD for 20 min, followed by purified air for another 40 min. Five exhaled breath samples collected during exposure were used to determine the respiratory uptake of BD, which was defined as absorbed BD (micrograms) per kilogram of body weight during exposure. Although subjects were given identical administered doses (40 ppm x min), there was a wide range of uptake, 0.6-4.9 microg/kg. Of the studied physiologic factors, the blood:air partition coefficient and alveolar ventilation were most significant in determining the respiratory uptake (p < 0.001 for each). In addition, in the multiple regression analysis, females had significantly higher respiratory uptake of BD than males on a weight basis. For all subjects, increasing age and cigarette smoking led to significantly decreased respiratory uptake of BD. The results of this human study are consistent with previous kinetic simulations and animal studies. The findings also suggest that interindividual variation in human physiologic factors that affect the exposure-internal dose relationship should be considered while also exploring exposure-disease associations in future epidemiologic research.
Textbook of Materia Medica and Therapeutics
Journal: JAMA (1934)

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
Attention-deficit/hyperactivity disorder: are we helping or harming?
Journal: BMJ (2014)

the authors have been made aware that the published version of DSM-5 does define mild, moderate, and severe ADHD.This was not in the draft changes to DSM-5 that the authors used when writing the article.Although DSM-5 gives a framework to the labels of mild, moderate, and severe by attempting to quantify the number of symptoms required, it does not help with defining the subjectivity of impairment.For example, what is meant by "no more than minor impairment in social or occupational functioning" and how many are "few, if any symptoms" when attempting to quantify impairment?The authors therefore stand by their statement that there is no consistent way to assess severity of ADHD symptoms and remain committed to conservative diagnosis and treatment.