tbuckley/cabot-search huggingface dataset:
"Downwinders" Angry About Medical Screening Lack
Authors: A. A. Skolnick
Journal: JAMA (1998)

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
Effect of palliative surgery, chemotherapy, and radiation in stage IV pancreatic cancer.
Authors: Brooke Vuong, Ahmed Dehal, Amanda Graff-Baker, Shu-Ching Chang, Leland Jay Foshag, Anton Bilchik, Melanie Goldfarb
Journal: Journal of Clinical Oncology (2017)

233 Background: Despite significant advances in multi-modality treatment for pancreatic adenocarcinoma (PC), prognosis for stage IV PC remains poor. While reducing suffering and optimizing quality of life are the primary goals of palliative therapies, these interventions may extend overall survival. We examined the impact on survival when aggressive palliative treatments including surgery, chemotherapy, or radiation were employed in end-of-life care. Methods: The 2004-2014 National Cancer Data Base (NCDB) was queried to identify patients with stage IV PC that did not undergo primary surgical resection. Univariate (Kaplan Meier and log-rank) and multivariable (Cox proportional hazard) analyses were used to assess the associations between patient characteristics, use of palliative therapies, and overall survival. Results: Of 72,736 patients identified with metastatic stage IV PC, 2,097 (3%) underwent surgical palliation (ST), 5,615 (8%) received palliative chemotherapy (CT), 940 (1%) received palliative radiation (RT), 1,163 (2%) received multimodality treatment (MMT), and 62,921 (87%) had no aggressive palliative intervention (NT). The choice of palliative therapy, if any, was influenced by all demographic and tumor variables except for gender (all p &lt; 0.001). Median OS was greatest after CT (5.09 months, p &lt; 0.001) compared to any other modality (NT: 3.45months, ST: 3.71months, RT: 3.25months, MMT: 4.47months). This remained true regardless of age, gender, race/ethnicity, insurance, and facility type. After adjusting for all demographic and tumor factors, use of CT decreased the annual risk of death by 20% (HR = 0.8; 95%CI [0.77, 0.82]) and MMT by 10% (HR = 0.9; 95%CI [0.84, 0.96]). Employment of RT increased risk of death by 9% (HR = 1.09; 95%CI [1.01, 1.17]) and ST did not affect OS (HR = 1.01; 95%CI [0.96,1.06]). Conclusions: Despite advances in palliative treatments, Stage IV PC arries a dismal prognosis. Palliative RT may shorten survival. Equivalent survival for ST versus NT suggests that this may be beneficial in the appropriate patient. Palliative CT independently improved survival by approximately 6 weeks and should be considered in patients that want to extend survival and can tolerate the toxicity.
The association between orthostatic hypotension and the six-year incidence of hypertension:
Authors: Kathryn M Rose, Kathleen C Light, A R Sharrett, Herman A Tyroler
Journal: Circulation (2001)

0020 This study examined the association between orthostatic hypotension (OH) and the six-year incidence of hypertension and isolated systolic hypertension (ISH) in 6,951 normotensive men and women free of CHD who participated in the baseline examination of the Atherosclerosis Risk in Communities (ARIC) study. OH, measured at baseline, was defined as a decrease in SBP ≥ 20 mm Hg or a decrease in DBP ≥ 10 mm Hg after changing from the supine to the standing position. Hypertension (SBP ≥ 140 mm Hg or DBP ≥ 90 mm Hg or current use of antihypertensive medications) and ISH (SBP ≥ 140 mm Hg and DBP &lt; 90 mm Hg) status were ascertained at the second follow-up examination, which occurred approximately six years later. In unadjusted analyses, OH was associated with an increased risk of both hypertension (Odds Ratio (OR)= 2.07, 95% confidence interval (CI) = 1.51, 2.84) and ISH (OR=2.28, 95% CI = 1.53, 3.41). These associations were modestly attenuated after controlling for age, race, gender, BMI, and carotid intima media thickness. Baseline seated SBP was a significant effect modifier of both the OH - hypertension and the OH - ISH associations. Specifically, associations of OH with each of the outcomes were strongest among those with the lowest levels of baseline seated SBP (e.g., seated SBP of 90 mm Hg: OR = 4.8 for hyperetnsion and OR = 9.4 for ISH) and did not persist among those with the highest levels of baseline seated SBP (e.g., seated SBP of 130 mm Hg: OR = 1.1 for hypertension and OR = 1.0 for ISH). We conclude that OH is a strong predictor of hypertension and ISH in persons with low normal blood pressure at baseline and that OH in combination with low normal blood pressure may be an early indicator of impaired blood pressure regulatory systems.
On the Influence of the Alpine Climates on Pulmonary Consumption
Authors: H. Weber
Journal: BMJ (1867)

Ss_.WE ZRRITSH fEDICAL 7OURNAL.tUIY 27, ; .tion,n idedin all atonic pule, sert entirely suppressed or dficult to distnguish, iS here extremely well marked; and the form of that pat of the pulse-curve which represents it shews that the systolic expansion of the artery is of ncarly equal dration with the diastolic i.
Outcomes based on age in the phase 3 METEOR trial of cabozantinib (cabo) vs everolimus (eve) in patients with advanced renal cell carcinoma (RCC).
Authors: Frede Donskov, Robert J. Motzer, Eric Voog, Elizabeth J. Hovey, Carsten Grüllich, Louise M. Nott, Katharine Ellen Cuff, Thierry Gil, Niels Viggo Jensen, Christine Chevreau, Sylvie Negrier, Reinhard Depenbusch, Lothar Bergmann, Izzy Cornelio, Anne Champsaur, Bernard J. Escudier, Sumanta K. Pal, Thomas Powles, Toni K. Choueiri
Journal: Journal of Clinical Oncology (2017)

4578 Background: The incidence of RCC increases with age with the highest incidence at ~75 years of age (Znaor, Eur Urol 2015). The Phase 3 METEOR trial (NCT01865747) showed a significant improvement in progression-free survival (PFS; HR 0.58, 95% CI 0.45–0.74; P &lt; 0.0001), overall survival (OS; HR 0.66, 95% CI 0.53–0.83, P = 0.0003), and objective response rate (ORR; 17% vs 3%; P &lt; 0.0001) for cabo compared with eve in patients with advanced RCC previously treated with VEGFR TKIs (Choueiri, NEJM 2015, Lancet Oncol 2016). Here we present outcomes by 3 categories of age for the METEOR trial. Methods: 658 patients were randomized 1:1 to cabo (60 mg qd) or eve (10 mg qd). Stratification factors were MSKCC risk group and number of prior VEGFR TKIs. Endpoints included PFS, OS, and ORR. Subgroup analyses by age ( &lt; 65, 65 to 74, and ≥75 years) are presented. Results: At baseline, 60% of patients were &lt; 65 years old, 31% were 65 to 74 years old, and 10% were ≥75 years old. Subgroups by age generally had similar baseline characteristics in both arms. The HRs for PFS favored cabo for all age groups (HR 0.53, 95% CI 0.41–0.68 for &lt; 65 years old; 0.53, 95% CI 0.37–0.77 for 65 to 74 years old; and 0.38, 95% CI 0.18–0.79 for ≥75 years old). ORR per independent radiology committee for cabo vs eve was 15% vs 5% for &lt; 65 years old, 21% vs 2% for 65 to 74 years old, and 19% vs 0% for ≥75 years old. HRs for OS also favored cabo (HR 0.72, 95% CI 0.54–0.95 for &lt; 65 years old; 0.66, 95% CI 0.44–0.99 for 65 to 74 years old; and 0.57, 95% CI 0.28–1.14 for ≥75 years old). Median OS for cabo vs eve was 21.4 mo vs 17.1 mo for &lt; 65 years old, not reached vs 18.0 mo for 65 to 74 years old, and 18.4 mo vs 14.0 mo for ≥75 years old. Older patients more frequently had dose reductions (60% with cabo and 22% with eve for &lt; 65 years old vs 85% with cabo and 36% with eve for ≥75 years old). Grade 3 or 4 adverse events were generally consistent with the safety profiles in the overall population although some events such as fatigue and hypertension occurred at a higher rate in older patients. Conclusions: Treatment with cabo improved PFS, ORR, and OS compared with eve in patients with advanced RCC irrespective of age. Adverse events in older patients were more frequently managed with dose reductions. Clinical trial information: NCT01865747.
Dermatopathology
Journal: JAMA (2005)

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
Travel associated legionnaires' disease in Europe: 2002
Authors: K D Ricketts, C Joseph
Journal: Eurosurveillance (2004)

Twenty countries reported 676 cases of travel associated legionnaires' disease to the EWGLINET surveillance scheme, and 94 clusters were detected. 80.5% of all cases were diagnosed by the urinary antigen test. On average there were 20.5 days between onset and report of cases, compared with 51.5 days in 1993. Between the introduction of the EWGLI investigation guidelines (on 1st July 2002) and the end of 2002, 37 six-week investigation reports were accepted as satisfactory and on time by the coordinating centre. 274 sites were investigated in total in 2002. The travel patterns of the main reporters in EWGLINET influenced the months of peak activity, and helped to determine which countries bore the greatest investigation burden.
Surgical diathermy is still not foolproof.
Journal: BMJ (1979)

penile urethra.In female pseudohermaphroditism the external genitalia of a female fetus are masculinised by exposure to high concentrations of circulating androgens-for example, in congenital adrenal hyperplasia.Giving androgens to the mother during pregnancy may have the same effect.The condition is compatible with normal female development provided it is treated early, the external genitalia being refashioned appropriately.Fortunately all these disorders are rare; together they account for fewer than 1 in 1000 births.They are, however, reason enough to advise against over-confident prediction of sex based on antenatal analysis of the karyotype.
IMPORTANT MEDICAL LEGISLATION.
Journal: JAMA (1890)

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
The Processing of Single Words Studied with Positron Emission Tomography
Authors: F. S. E. Petersen and J. A.
Journal: Annual Review of Neuroscience (1993)

The brain's default mode network consists of discrete, bilateral and symmetrical cortical areas, in the medial and lateral parietal, medial prefrontal, and medial and lateral temporal cortices of the human, nonhuman primate, cat, and rodent brains. Its ...Read More
Antenatal screening for Down's syndrome.
Authors: A. Dawson, T. Reynolds
Journal: BMJ (1992)

whole screened population the number of babies with Down's syndrome was 25.With Wald and colleagues' screening test, the number of Down's syndrome babies detected was 12.With screening by maternal age > 37 years alone, the number detected could have been 7 out of 25.These proportions are not significantly different (Fisher's exact test p=0-24; odds ratio 2-37; 95% confidence interval 0 73 to 7 68).Even with the different uptake of amniocentesis in the two groups-that is, 75% for all ages and 63% for those ¢ 37 years- there was still no significant difference in the result (p=0-2; odds ratio 2-95 (0 77 to 11-3)).Only 4 9% of women were aged ¢ 37 years; the confidential enquiries into maternal deaths in the United Kingdom 1985-7 reported that 8% of pregnant women were over 352 and in our hospital in 1991 the proportion ¢ 37 years was 9-2%.This proportion is likely to rise as women delay their families for personal and financial reasons, and as this proportion rises the detection rates from the triple test and from maternal age alone will become even more similar.In any particular district the cost of introducing this programme will depend on the proportion of women ¢ 37 years; in addition, many authorities (including our own) have now abandoned co fetoprotein testing, relying for neural tube defect screening on ultrasonography alone, and the cost of reintroducing this test would need to be accounted for in the calculations.
Medicolegal
Journal: JAMA (1926)

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
A cost analysis of topical drug regimens for dermatophyte infections
Authors: M. M. Chren
Journal: JAMA (1994)

<h3>Objective.</h3> —To examine the extra cost of using higher-priced drugs as initial therapy for dermatophyte infections, because the many available effective drugs vary considerably in cost. <h3>Design.</h3> —Cost analysis from the purchaser's perspective, comparing two prototypical regimens to treat tinea pedis: one in which all patients initially receive a lower-priced drug and those with unresponsive infections receive a higher-priced drug at a follow-up office visit, and one in which all patients receive the higher-priced drug from the outset. The reference drug was miconazole, an imidazole available without a prescription, for which reported overall efficacy rates are 70% to 100%. <h3>Main Outcome Measures.</h3> —The threshold efficacy rate (the efficacy rate of miconazole below which it is always less expensive to use a specific higher-priced drug first) and the extra cost (of beginning therapy with a higher-priced drug). <h3>Results.</h3> —Assuming the Medicare-approved charge for a follow-up visit ($21.98), it is less expensive to begin therapy with a prescription drug only if the efficacy rate of miconazole is less than 55%; this threshold efficacy rate varied from 26% (for a $0 total cost of the follow-up visit) to 79% (for an $89 total cost of the follow-up visit). If the efficacy rate of miconazole is 70%, the extra cost per patient for all patients to receive the least expensive prescription antifungal drug instead of miconazole first was $15.23 and $8.64 if total visit costs were $0 and $21.98; miconazole remained the less expensive alternative as long as the total cost of the follow-up visit was less than $50.76. <h3>Conclusion.</h3> —For reported efficacy rates and standard costs of a follow-up office visit, using miconazole first and then treating only those patients with unresponsive infections with a higher-priced prescription drug is less expensive than treating all patients with the higher-priced drug. (<i>JAMA</i>. 1994;272:1922-1925)
<i>QuickStats:</i> Percentage* of Adults Aged ≥18 Years Who Reported Having a Severe Headache or Migraine in the Past 3 Months,† by Sex and Age Group — National Health Interview Survey,§ United States, 2015
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

In 2015, 20.0% of women and 9.7% of men aged ≥18 years had a severe headache or migraine in the past 3 months. Overall and for each age group, women aged ≥18 years were more likely than men to have had a severe headache or migraine in the past 3 months. For both sexes, a report of a severe headache or migraine in the the past 3 months decreased with advancing age, from 11.0% among men aged 18-44 years to 3.4% among men aged ≥75 years and from 24.7% among women aged 18-44 years to 6.3% among women aged ≥75 years.
Reply
Authors: Ping Luo, Peiyuan Yin, Guowang Xu
Journal: Hepatology (2018)

Author names in bold designate shared co‐first authors. We thank Dr. Huo et al. for their interest in our work. Serum α‐fetoprotein (AFP) is a "successful" tumor marker for the screening of hepatocellular carcinoma (HCC). However, it is still not a "perfect" marker for its limited sensitivity due to the interference from HBV induced hepatitis and cirrhosis. Therefore, many studies are trying to find new markers as a "complementary," not an "alternative" one to AFP. This is also the ultimate goal of our metabolomics study. To achieve this goal, we collected samples from six medical centers in China. In our discovery set, 108 individuals were enrolled; the AFP contents of these participants are 0.657. In fact, in our test set (684 samples), AFP is 0.725 (0.671‐0.779). 1 It is really nothing "striking" because these values were in the normal range, and can be proved from the data of a recent retrospective study among 42,573 cases of hepatectomy in China, high levels of AFP (>20 ng mL−1) can be found in only 61.89% HCC patients.2 To the best of our knowledge, the area under the receiver‐operating characteristic curve is between 0.58 and 0.839 in most of the recent studies.3 The concentration of metabolites in peripheral blood commonly maintains a steady state under internal and external influences. So, it is not easy to find the direct correlations between tumor burden and the metabolic biomarkers. As described in our study, we found a weak correlation between the level of phenylalanyl‐tryptophan and the size of tumor. We agree that the proposed metabolite biomarker has many challenges to overcome before being taken as a genuine biomarker for HCC. More work including follow‐up study is to be performed.
Metabolite-Based Internal Doses Used in a Risk Assessment of Benzene
Authors: A. John Bailer, David G. Hoel
Journal: Environmental Health Perspectives (1989)

Risk assessments of benzene have been based upon both human and animal studies. In this paper, metabolite information is used to construct an internal dose (a surrogate of the biologically effective dose) for a given administered dose. The relationship between the administered dose and this internal dose is nonlinear and is well described by a Michaelis-Menten function. The administered doses from the National Toxicology Program's rodent carcinogenicity study of benzene are transformed into internal doses, and these internal doses are used in conjunction with a multistage model to compare previous estimated virtually safe doses (VSD) associated with small added health risks. The ratio of VSD for the administered dose risk assessment to the VSD from the internal dose risk assessment was approximately 1.0 for the F344/N rats and ranged from 2.5 to 5.0 for B6C3F1 mice in the National Toxicology Program study. For an occupational exposure of 1 ppm, a risk estimate of 0.7 excess cancers/1000 exposed with an upper bound of 3.5/1000 was obtained for a total metabolite internal dose risk assessment. Risk estimates based upon internal doses constructed from levels of the toxic metabolites of benzene are also presented. The implication of a dose-rate study of benzene metabolism for risk assessment is discussed, and finally, suggestions for better characterization of the dose-response function for benzene are provided.