tbuckley/cabot-search huggingface dataset:
Growth hormone, insulin-like growth factor-1 and insulin resistance in cirrhosis
Authors: E Shmueli
Journal: Hepatology (1994)

Cirrhosis is characterized by paradoxical growth hormone secretion in response to glucose and insulin infusion. To ascertain whether this abnormality contributes to insulin resistance, euglycemic hyperinsulinemic glucose clamps were performed on six patients with cirrhosis and six normal control subjects. Each patient with cirrhosis underwent two clamps in random order, a clamp with somatostatin (250 μg/hr) together with insulin and glucagon replacement, and a control clamp without somatostatin. The normal subjects underwent the control clamp only. During the control clamp, growth hormone levels were considerably higher in the patients with cirrhosis (6.1 ± 0.4 vs. 0.5 ± 0.4 mU/L, p < 0.02), and glucose uptake was considerably lower (3.29 ± 0.56 vs. 9.52 ± 1.14 mg/kg/min, p < 0.001). Indirect calorimetry indicated that the defect was accounted for by lower nonoxidative glucose disposal (1.23 ± 0.45 vs. 6.00 ± 0.73, p < 0.001). Peripheral glucose uptake, exemplified by forearm glucose uptake (0.27 ± 0.04 vs. 1.22 ± 0.42 mg/100 ml/min, p < 0.02), and calculated insulin sensitivity (24 ± 8 vs. 114 ± 20 μl/kg/min per mU/L) were particularly diminished. In the patients with cirrhosis somatostatin suppressed growth hormone levels (6.1 ± 1.2 to 1.2 ± 0.4 mU/L, p < 0.05). However, no significant changes occurred in whole-body glucose uptake (3.29 ± 0.56 vs 3.01 ± 0.54 mg/kg/min), forearm glucose uptake (0.27 ± 0.04 vs 0.30 ± 0.01 mg/100 ml/min) or insulin sensitivity (24 ± 8 vs. 35 ± 10 μl/kg/min/mU/L, p = 0.42). Suppression of abnormal growth hormone secretion by somatostatin over 5 hr does not alter insulin sensitivity or glucose uptake in cirrhosis. (Hepatology 1994;19:322–328).
Recurrent Mucoceles
Authors: Joel M. Salon
Journal: JAMA (1985)

<h3>To the Editor.—</h3> In the April 12 issue of<i>JAMA</i>,<sup>1</sup>Dr Polsley asked for information regarding the significance and treatment of recurrent mucocysts. I agree with Dr Binnick's explanation of the cause of mucocysts or mucoceles. However, the treatment that is most commonly used by oral and maxillofacial surgeons differs from Dr Binnick's and yields a very low recurrence rate. Specifically, the area around the mucocele is infiltrated with local anesthetic. Only the mucosa over the mucocele is then incised. Care is taken not to perforate the mucocele itself. The mucocele is then excised or enucleated from the adjacent normal tissue. Several simple black silk sutures are then placed to close the incision. Recurrence rate is low. Usually, recurrence results from incomplete removal of the offending minor salivary gland or injury of an adjacent gland during the surgical procedure or application of local anesthesia. In over ten years of
Randomized, Placebo-Controlled Trial of Fluoxetine for Acute Treatment of Minor Depressive Disorder
Authors: L. L. Judd
Journal: American Journal of Psychiatry (2004)

OBJECTIVE: Minor depressive disorder is both common and associated with significant psychosocial impairment. This study examined antidepressant treatment efficacy in a large group of patients with minor depressive disorder. METHOD: One hundred sixty-two patients with minor depressive disorder were randomly assigned to receive fluoxetine or placebo in a 12-week, double-blind study; 73% (59 of 81) of the patients in each treatment group completed the study. Patients were evaluated weekly with standard depression rating instruments and measures of psychosocial impairment. Hypotheses were tested by last-observation-carried-forward analysis of variance (ANOVA) and confirmed by mixed (random-effects) regression analysis. RESULTS: At baseline, minor depressive disorder patients were mildly to moderately depressed, with a corresponding degree of functional impairment. Over 12 weeks of treatment, both ANOVA and mixed regression showed fluoxetine to be superior to placebo as indicated by significantly greater improvement of fluoxetine-treated patients in scores on the 30-item clinician-rated Inventory of Depressive Symptomatology, the 17-item and 21-item Hamilton Depression Rating Scale, the Beck Depression Inventory, and the Clinical Global Impression severity scale. Improvement in Global Assessment of Functioning Scale score was significantly greater for the fluoxetine group in mixed regression analysis only. Patients in both treatment groups reported a similar number and severity of adverse events during the 12-week treatment period. CONCLUSIONS: Clinicians frequently encounter minor depressive disorder either as a prodromal or residual phase of illness in major depressive disorder or as de novo minor depressive disorder episodes. Fluoxetine is significantly superior to placebo in reducing minor depressive disorder symptoms within a 12-week period. Improvement in psychosocial function with fluoxetine may take longer than 12 weeks.
Camphor intoxication treated by lipid dialysis
Authors: H. E. Ginn
Journal: JAMA (1968)

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
Control of food intake in older men
Authors: S. B. Roberts
Journal: JAMA (1994)

<h3>Objective.</h3> —To investigate the effects of aging on mechanisms of body energy regulation and thereby determine the causes of unexplained weight loss in older persons, a factor predisposing to premature death and disability. <h3>Design.</h3> —Dietary intervention study. <h3>Setting.</h3> —Metabolic ward and outpatient. <h3>Participants.</h3> —The subjects were 35 healthy younger and older men of normal body weight consuming a diet of typical composition and performing usual activities. <h3>Main Outcome Measures.</h3> —Subjects were either overfed by a mean (±SD) of 4.09 (±0.26) MJ/d (n=17) or underfed by 3.17 (±0.68) MJ/d (n=18) for 21 days. Measurements were made of changes in body weight, body composition, and energy expenditure during overfeeding or underfeeding, and of subsequent voluntary nutrient intakes and changes in body weight. <h3>Results.</h3> —There was no significant effect of aging on changes in body composition, body weight, or energy expenditure with overfeeding or underfeeding. However, following overfeeding, younger men exhibited spontaneous hypophagia, whereas the older men did not (mean [±SD] changes in energy intake relative to control values were -2.11 [±2.18] and 1.55 [±2.11] MJ/d, respectively;<i>P</i>=.006). As a result, the younger men lost the excess body weight gained during overfeeding but the older men did not. Similarly, following underfeeding, the younger men exhibited hyperphagia while the older men did not (mean [±SD] changes in energy intake relative to control values were 1.88 [±2.31]and -0.52 [±1.54] MJ/d, respectively;<i>P</i>=.02), and as a result the older men failed to regain the weight lost during underfeeding. <h3>Conclusions.</h3> —These results in 35 men suggest that aging may be associated with a significant impairment in the ability to control food intake following overeating or undereating. Since overeating and undereating occur routinely as part of the normal pattern of energy regulation, the findings reported herein may help to explain the vulnerability of older persons to unexplained weight gain and weight loss. (<i>JAMA</i>. 1994;272:1601-1606)
Simplified Staging for Hepatocellular Carcinoma
Authors: Jean-Nicolas Vauthey, Gregory Y. Lauwers, Nestor F. Esnaola, Kim-Anh Do, Jacques Belghiti, Nadeem Mirza, Steven A. Curley, Lee M. Ellis, Jean-Marc Regimbeau, Asif Rashid, Karen R. Cleary, David M. Nagorney
Journal: Journal of Clinical Oncology (2002)

PURPOSE: The current American Joint Committee on Cancer (AJCC) staging system for hepatocellular carcinoma (HCC) fails to stratify patients adequately with respect to prognosis. PATIENTS AND METHODS: The ability of the currently proposed tumor (T) categories to effectively stratify the survival of 557 patients who underwent complete resection for HCC at four centers was examined. Independent predictors of survival were combined into a new staging system. RESULTS: Using the current AJCC T classification, patients with T1 and T2 tumors had similar 5-year survivals (P = .6). In addition, the survival of patients with multiple bilobar tumors (T4) matched that of T3 patients (P = .5). Independent predictors of death were major vascular invasion (P &lt; .001), microvascular invasion (P = .001), severe fibrosis/cirrhosis of the host liver (P = .001), multiple tumors (P = .007), and tumor size greater than 5 cm (P = .01). Based on our results, a simplified stratification is proposed: (a) patients with a single tumor and no microvascular invasion, (b) patients with a single tumor and microvascular invasion or multiple tumors, none more than 5 cm, and (c) patients with either multiple tumors, any more than 5 cm, or tumor with major vascular invasion (P &lt; .001). Severe fibrosis/cirrhosis had a negative impact on survival within all categories. The survival of patients with lymph node involvement matched that of patients with major vascular invasion (P = .3). CONCLUSION: The current AJCC staging system for HCC is unnecessarily complex. We propose a simplified model of stratification that is based on vascular invasion, tumor number, and tumor size and incorporates the effect of fibrosis on survival.
Corneal Decompensation After Intraocular Ophthalmic Surgery—Missouri, 1998
Journal: JAMA (1998)

During January 8-14, 1998, six of eight patients undergoing elective intraocular surgery at a Veterans Affairs medical center (VAMC) in St. Louis, Missouri, developed corneal endothelial decompensation (corneal edema and opacification) < or =24 hours after surgery. All had been operated on with instruments sterilized by the Abtox Plazlyte system (Abtox, Inc., Chicago, Illinois). This report summarizes the results of the investigation of these cases and indicates that using the Abtox Plazlyte system to sterilize opthalmologic surgical equipment led to corneal decompensation.
Changes in antipsychotic drug use in nursing homes during implementation of the OBRA-87 regulations
Authors: R. I. Shorr
Journal: JAMA (1994)

<h3>Objectives.</h3> —To describe the changes in antipsychotic drug use in nursing homes during the period surrounding the implementation of federal legislation designed to reduce unnecessary use (the Omnibus Budget Reconciliation Act of 1987 [OBRA-87]) and to identify nursing home characteristics associated with such changes. <h3>Design.</h3> —Longitudinal study of 9432 Tennessee Medicaid enrollees 65 years of age or older who continuously resided in Tennessee from April 1, 1989, to September 30,1991, a 30-month period surrounding implementation of OBRA-87. <h3>Main Outcome Measures.</h3> —Changes in the use of antipsychotic and other psychotropic drugs. <h3>Results.</h3> —During the 30-month period, antipsychotic drug use decreased from 23.9 to 17.5 days per 100 days of residence, a 26.7% decline (<i>P</i>&lt;.001), which resulted from both a decrease in new users (<i>P</i>&lt;.001) and a reduction in long-term use of antipsychotic drugs (<i>P</i>&lt;.001). There was no concomitant increase in other psychotropic drug use. A multivariate analysis revealed that changes in antipsychotic use were strongly associated with baseline antipsychotic use (<i>P</i>=.001) and third-shift staffing levels (<i>P</i>=.003). Nursing homes with baseline antipsychotic drug use and third-shift staffing above the median reduced antipsychotic drug use by 41%, compared with a 2% increase in nursing homes where both of these factors were below the median (<i>P</i>&lt;.0001). <h3>Conclusions.</h3> —A substantial decrease in antipsychotic drug use coincided with the implementation of OBRA-87. Although this decrease is consistent with an improvement in quality of nursing home care, further research is needed to determine the effects of this legislation on resident outcomes. (<i>JAMA</i>. 1994;271:358-362)
The unremarkable brown recluse spider bite
Authors: R. S. Berger
Journal: JAMA (1973)

Severe cutaneous necrosis is reported commonly as a consequence of Loxosceles spider bites; however, the description of mild cutaneous reactions has been neglected. Knowledge of each extreme will increase our clinical awareness of Loxosceles envenomation. Failure to recognize the mild spider bites has led to inaccurate conclusions regarding prevalence and treatment.
Dermatology
Authors: Jeffrey S. Dover
Journal: JAMA (1987)

In the past 18 months, advances have been made in both therapeutic interventions and diagnostic techniques. Modifications in laser hardware, for example, have provided a new treatment for cutaneous vascular abnormalities. Although lasers have been used in dermatology since the 1960s, they were modifications of industrial or other medical lasers. The argon laser, which has been the standard for treatment of cutaneous vascular abnormalities, is a modification of the ophthalmic retinal photocoagulator. Despite good results in the treatment of port-wine stains (PWS) in adults, up to a 4.3% risk of scarring still exists,<sup>1</sup>and results of treatment in adults with pale, immature PWS and in children are generally poor. The argon laser, which emits light predominantly at 488 and 514 nm, achieves some selective absorption in blood vessels but, because its delivery is continuous, nonselective dermal damage also occurs. The theory of selective photothermolysis predicts that by choosing a
Bureau of Investigation
Journal: JAMA (1935)

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
Project Hope abroad
Authors: P. H. Altrocchi
Journal: JAMA (1972)

At a time when our own healthcare delivery system is undergoing nationwide scrutiny and is receiving critical attack from several directions, it is an enlightening and educational experience to work with an organization which, since its inception, has been totally devoted to the analysis and upgrading of health education and delivery throughout the world. The major purpose of Project Hope is medical teaching. Considering the magnitude of the medical and population problems in the countries visited by Project Hope, merely functioning as a medical-service ship could not possibly have a significant effect upon the health-welfare of any country. The purpose, therefore, has been to teach and train physicians, dentists, nurses, technicians, pharmacists, dieticians, public health workers, and all other levels of paramedical personnel in their own medical environment so that they, in turn, can train others. The educational impact thus long overlasts the tenmonth stay of the ship in a
Zeitschr Med Mikrobiol &amp;amp; Immunol, Berlin
Journal: JAMA (1966)

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
Abstract 18366: Clinical Modifiers of Renal Disease Progression in APOL1 Carriers in a Large Cardiovascular Cohort
Authors: Hanghang Wang, Patrick Pun, Lydia Kwee, Damian Craig, Carol Haynes, Megan Chryst-Ladd, Elizabeth Hauser, Simon Gregory, Martin Pollak, Laura Svetkey, Uptal Patel, William Kraus, Svati Shah
Journal: Circulation (2015)

Objective: Two alleles in the apoliprotein L1 ( APOL1 ) gene confer increased risk of chronic kidney disease (CKD) in African Americans. However, harboring these alleles is not sufficient to cause CKD. This study sought to examine clinical modifiers of kidney disease progression in APOL1 homozygote African Americans in a large cardiovascular cohort. Methods: We sequenced APOL1 in 1733 African Americans (by self-report) enrolled in the CATHGEN biorepository, which consists of sequential individuals referred for cardiac catheterization at Duke University Hospital from 2001-2010. The genotype distribution was: n = 1493 non-carriers and heterozygotes, and n = 240 homozygotes. Analysis, with a multivariable logistic regression model, was restricted to homozygotes with an eGFR ≥60 mL/min at baseline (64.6%, n = 155). The main outcome measure was development of incident CKD, defined as at least two subsequent eGFR &lt; 60 separated by at least 3 months. Potential clinical modifiers examined included age, sex, hypertension, type 2 diabetes status, smoking, HDL-C, LDL-C, ejection fraction and number of diseased coronary arteries. Results: The median age for homozygotes was 55.6 years (25th/75th: 47, 64) and 56% (n = 135) were male. During follow-up, 45.3% of homozygotes with an eGFR ≥60 at baseline developed incident CKD. For individuals without type 2 diabetes on baseline, 38.8% (n = 26) developed incident CKD; 56.1% (n = 23) individuals with baseline type 2 diabetes developed incident CKD (p = 0.08). Of clinical variables examined, only presence of type 2 diabetes at baseline was a significant predictor of developing CKD (univariate odds ratio 1.7, 95% CI 1.3-2.3, p = 0.0002), and remained significant after adjusting for the other covariables (OR 2.2, 95% CI 1.4 - 3.7, p=0.001). Conclusions: A large proportion of APOL1 homozygote African Americans with preserved kidney function at baseline enrollment in a large cardiovascular study developed incident CKD. Type 2 diabetes status was the only significant independent predictor for incident CKD in these individuals. These results highlight the potential need for greater diabetes-related efforts to prevent CKD progression in African Americans already at high-risk for adverse cardiovascular outcomes.
The Medical Significance of Lenticular Opacities (Cataract) before the Age of Fifty
Authors: Richard J. Meyer
Journal: New England Journal of Medicine (1955)

Inborn metabolic errors. This heading includes the syndrome of galactosemia in infants, Wilson's disease, and a recent syndrome described by Lowe et al.53 associated with organic aciduria. It is thought that specific metabolic defects have at least been partially identified in these particular disorders.Galactosemia. Bruck and Rapoport16 were the first to call attention to bilateral cataracts occurring in an infant with galactosemia. Their studies suggested an etiologic relation between the inability of the patient to metabolize galactose and the development of cataracts. Most important was the demonstration in their patient of clearing of the lenticular opacities when lactose was . . .
Fact and Opinion on the Present Epidemic of Respiratory Disease
Journal: JAMA (2020)

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
PD07: Prescribing and using vitiligo treatments for limited active vitiligo: lessons from a nested process evaluation within the HI‐Light Vitiligo randomized controlled trial
Authors: J Batchelor, J Chalmers, P Leighton, V Eleftheriadou, J Ravenscroft, M Santer, R Haines, G Meakin, K Thomas
Journal: British Journal of Dermatology (2021)