tbuckley/cabot-search huggingface dataset:
BIMALLEOLAR FRACTURES
Authors: Barclay W. Moffat
Journal: JAMA (1928)

Bimalleolar fractures, in my experience, are the most disabling fractures of the leg when improperly treated. In children it is sometimes possible to restore the anatomic relations and to maintain the position by the use of plaster. In adults, however, it is generally impossible since, though the fragments may be approximated under anesthesia, the pull of the stronger muscles will displace the foot when the patient regains consciousness. In the latter type, I believe that early open operation is indicated. The alternative treatment is traction applied to the foot either by the use of the Sinclair skate which is glued to the sole of the foot, or a plaster shoe, grasping the foot as does an oxford in which have been incorporated straps for the fixation of weights applied by traction. The difficulty of the latter methods is that, in all ankle fractures, marked inversion of the foot must be maintained
TERRAIN.
Authors: Simon Chowdhury, Axel Heidenreich, Arnauld Villers, Laurence Klotz, D. Robert Siemens, De Phung, Fong Wang, David Forer, Steve Van Os, Neal D. Shore
Journal: Journal of Clinical Oncology (2015)

5049 Background: Enzalutamide (ENZA), an androgen receptor inhibitor, improves survival and radiographic progression-free survival (rPFS) in patients (pts) with mCRPC. TERRAIN (NCT01288911) compared ENZA to bicalutamide (BIC), which is frequently added to androgen deprivation therapy upon progression in pts with mCRPC. Methods: Pts with mCRPC were randomized 1:1 to ENZA 160 mg/day or BIC 50 mg/day. Primary endpoint was progression-free survival (PFS), defined as time to centrally confirmed radiographic progression, skeletal-related event, initiation of new anti-neoplastic or death (any cause), whichever occurred first. Radiographic progression was also assessed by investigators. Circulating tumor cell (CTC) counts were evaluated at baseline and on treatment. Favorable conversion was defined as decline from ≥5 to <5 CTCs/7.5 mL of blood from baseline. Results: 375 pts were enrolled. The median time on ENZA treatment was 11.7 months and 5.8 months on BIC. PFS (primary endpoint) and rPFS outcomes are shown (Table). Among pts with measurable soft tissue disease, objective tumor response rates were 54% (38/70) with ENZA and 11% (8/71) with BIC. Favorable conversion rates at week 25 were 67% (29/43) with ENZA and 43% (16/37) with BIC. Serious adverse events (AEs) were reported for 31% of ENZA vs 23% of BIC pts. The most common (≥10%) AEs reported more frequently with ENZA than BIC were fatigue, back pain, hot flush, hypertension, diarrhea, weight decrease and pain in extremity. Grade 3 or higher cardiac AEs were observed in 5.5% of ENZA vs 2.1% of BIC pts. Conclusions: In TERRAIN, pts treated with ENZA had prolonged PFS and rPFS, a higher objective tumor response rate, and superior week 25 CTC results when compared to pts treated with BIC. ENZA demonstrated safety broadly consistent with its known safety profile in men with mCRPC. Clinical trial information: NCT01288911. ENZA (n=184) BIC (n=191) PFS Central, # events Median (mos) Investigator, # events Median (mos) 99 (54%) 15.7 141 (74%) 5.8 HR 0.44; P<0.0001 99 (54%) 15.3 146 (76%) 5.7 HR 0.42; P<0.0001 rPFS Central, # events Median (mos) Investigator, # events Median (mos) 56 (30%) NYR 69 (36%) 16.4 HR 0.51 58 (32%) 27.6 86 (45%) 11.1 HR 0.41
Arbeiten aus dem Pharmazeutischen Institut der Universität, Berlin.
Journal: JAMA (1907)

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
Audit (upper GI tract)
Authors: Stanley Forrest, ' Al*-Korpda Me, Bel Ra, ', P Connor', A Mcdonald, D Lynch, P Gratt, C Gillen'
Journal: Gut (1996)

Post-prandial changes in portal haemodynamics have been reported using derived methods or doppler ultrasonography.The presence of TIPSS allows direct assessment of portal venous response to a protein meal.Methods: We assessed the portal and systemic haemodynamic response to a protein meal in 10 cirrhotic patients with TIPSS in situ (mean age 60.2 (3.7) years, mean Childs-Pugh score 7.8 (0.6)).Portal venous pressure (PVP) and flow (PVF) (measured by direct reverse thermodilution method with double thermistor catheter inserted in portal vein), right atrial pressurc (RAP) and mean arterial pressure (MAP) were recorded whilst fasting and every 15 minutes for one hour following a 505 kcal.protein based meal.Pre-and post- prandial portal venous blood gas measurements were obtained.Results: The maximal change in haemodynamic parameters from fasting levels are shown below.All measurements returned to normal 60 minutes following the meal and there were no significant changes between pre-and post-prandial portal venous blood gas analyses. MAPRAP PVP PVF Fasting: 79.5(2.6)1.9 (0.8) 9.9 (1.2) 1137.7 (162.1)Post-prandial: 78.8 (1.9) 2.6 (0.7) 13.0(1.3) 1642.2 (256.6)p. value: NS NS p<0.001 p<0.01 Results are expressed as mean (standard error).Pressures are shown in mmHg and flow in ml/min.Conclusion: After a protein meal, PVP and PVF increase significantly whilst MAP and RAP remain unchanged.This technique allows direct assessment of therapeutic strategies to reduce post- prandial hyperaemia.
Pupil Perimetry in the Diagnosis of Functional Visual Field Loss
Authors: M S Rajan, F D Bremner, P Riordan-Eva
Journal: Journal of the Royal Society of Medicine (2002)

The diagnosis of functional visual loss—reduced visual performance in the absence of an organic cause—is usually made by exclusion. We conducted a pilot study to evaluate pupil perimetry in three patients (aged 14, 43 and 50) with visual field loss presumed to be functional on clinical grounds and having no cause identified by visual electro-physiology or magnetic resonance imaging. A modified automated perimeter was used to examine visual and pupil responses to a light stimulus (size 1.7°) presented at five locations in the visual field (fixation and in each of the four quadrants). In each patient, the pupil responses were normal in those test quadrants which showed apparent visual field loss. Pupil perimetry provides objective evidence for a diagnosis of functional visual field loss in selected patients and may circumvent the need for other investigations.
Exploratory analysis of adjuvant chemotherapy effects after preoperative chemoradiotherapy and radical resection for rectal cancer.
Authors: In Ja Park, Cathy Eng, Y. Nancy You, Scott Kopetz, Miguel A. Rodriguez-Bigas, Michael J. Overman, John Michael Skibber, George J. Chang
Journal: Journal of Clinical Oncology (2012)

557 Background: Evidence regarding adjuvant chemotherapy (CTx) for patients with rectal cancer after preoperative chemoradiotherapy (CXRT) is limited. The aim of study was to explore the relationship between CXRT response and adjuvant CTx for patients with rectal cancer treated by CXRT and radical resection. Methods: We performed a retrospective consecutive cohort study of patients with locally advanced (cStage II-III by EUS, CT, or MRI) rectal carcinoma treated with preoperative CXRT and radical resection, 1993 to 2008. To explore the late effects, we performed a landmark analysis of patients alive without recurrence at 24 months. The duration free from recurrence (FFR) was compared among patients with complete (CR, ypT0N0), intermediate (IR, ypT1-2N0), or poor (PR, ypT3-4 or N+) response according to adjuvant CTx use and type using multivariate Cox regression. Results: A total of 725 patients met criteria and were evaluated. Median follow-up was 69 months (IQR: 39-104 months). 611 patients received adjuvant CTx: 447 with fluoropyrimidine only (FP), and 139 also received oxaliplatin (Ox). Although receipt of adjuvant chemotherapy was not associated with 5-year FFR overall, (HR: 0.91, 95% CI: 0.58-1.43), adjuvant therapy did appear to suggest a benefit in the IR group (HR, 0.49; 95%CI, 0.21-1.19). Adjusted landmark analysis showed that adjuvant CTx was associated with a significant improvement in FFR among the IR patients only (HR, 0.28; 95% CI, 0.08-1.00, P=.04). Among PR patients FP alone did not improve FFR (HR, 1.22; 95% CI, 0.7-2.12) but the addition of Ox was associated with a non-significant reversal in the direction of the effect (HR, 0.53; 95% CI, 0.16-1.79). Conclusions: In this exploratory analysis, the addition of adjuvant FP CTx appeared to favorably affect the duration FFR only for patients with rectal cancer and intermediate response to CXRT followed by radical resection. These data support the investigation of the role for adjuvant fluoropyrimidine therapy among patients with CR or IR and oxaliplatin for PR patients.
Commentaire de travail de J. M. Buscaglia et al., pp. 670
Journal: Endoscopy (2008)

See also: Endoscopic retrograde cholangiopancreatography, but not esophagogastroduodenoscopy or colonoscopy, significantly increases portal venous pressure: direct portal pressure measurements through endoscopic ultrasound-guided cannulationEndoscopy 2008; 40(08): 670-674DOI: 10.1055/s-2008-1077341
Bile acids and the hepatobiliary system. From basic science to clinical practice Edited by Gustav Paumgartner, Adolph Stiehl, and Wolfgang Gerok, 328 pp. Dordrecht: Kluwer Academic Publishers, 1994. $100
Authors: R KOFF
Journal: Hepatology (1995)

It was recently reported that both cholesterol 7α-hydroxylase CYP7 and sterol 27-hydroxylase CYP27 are subject to negative feedback control by bile acids in isolated rat hepatocytes and rat liver (Twisk et al., (1995) Biochem. J. 305, 505-511; Vlahcevic et al. XIII International Bile Acid Meeting, September 30 - October 2, 1994, Abstract 17). In the present work a series of experiments was performed to study whether there is a coordinate regulation of CYP7 and CYP27 also in rabbit liver. Treatments of rabbits with cholic acid or cholestyramine resulted in marked suppression and induction, respectively, of CYP7 mRNA. In contrast, there were no significant effects on the CYP27 mRNA expression, amount of CYP27 protein or mitochondrial 27-hydroxylase activity. Thus, there is an apparent difference between rat and rabbit with respect to regulation of CYP27 by bile acids. It is concluded that, in rabbit, there is little or no coordinate regulation of CYP7 and CYP27 at a transcriptional level, and that CYP27 is not subject to a negative feedback control by bile acids neither at a transcriptional nor at a posttranscriptional level.
The Toxicity of Tricyclic Antidepressants
Authors: Susan Rozek
Journal: JAMA (1987)

<h3>To the Editor.—</h3> The article entitled "Tricyclic Antidepressant Overdose: A Review"<sup>1</sup>provides a useful reference for the management of antidepressant overdose. However, several important issues relating to the newer antidepressants deserve mention. In addition to the significant central nervous system toxicity observed with amoxapine overdosage,<sup>1</sup>renal failure may develop several days after acute ingestion in patients who otherwise appear to have recovered.<sup>2</sup>In a series of 112 cases of amoxapine overdosage reported by Jennings et al,<sup>2</sup>13 cases of acute renal failure developed. Evidence of acute tubular necrosis with rhabdomyolysis and myoglobinuria was a frequent finding in these patients and approximately 40% of these patients required dialysis.<sup>2</sup> With regard to trazodone hydrochloride, the authors note that "trazodone appears to be much less toxic than TCAs [tricyclic antidepressants] after acute overdose." Although an earlier report of 206 cases of trazodone overdosage<sup>3</sup>found no fatalities, a
Clinic Doctors
Authors: B. L. Heydon
Journal: BMJ (1961)

<h3>ABSTRACT</h3> <h3>Objectives</h3> To explore the lived experience of Long Covid with particular focus on the role of physical activity <h3>Design</h3> Qualitative study using semi-structured interviews <h3>Participants</h3> 18 people living with Long Covid (9 male, 9 female; aged between 18-74; 10 White British, 3 White Other, 3 Asian, 1 Black, 1 mixed ethnicity) recruited via a UK-based research interest database for people with Long Covid <h3>Setting</h3> Telephone interviews with 17 participants living in the UK and 1 participant living in the US <h3>Results</h3> Four themes were generated. Theme one highlights the physical and social isolation experienced by people with Long Covid, compounded by a lack of support and advice from medical professionals. Theme two describes how participants sought information and validation through online sources and communities. Theme three captures the challenges associated with managing physical and cognitive effects of Long Covid including fatigue and ‘brain fog’ whilst trying to resume and maintain activities of daily living and other forms of exercise. Theme four illustrates the battle with self-concept to accept reduced function (even temporarily) and the fear of permanent reduction in physical and cognitive ability. <h3>Conclusions</h3> This study provides insight into the challenges of managing physical activity alongside the extended symptoms associated with Long Covid. Findings highlight the need for greater consensus around physical activity-related advice for people with Long Covid and improved support to resume activities considered important for wellbeing. <h3>Article Summary</h3> <h3>Strengths and limitations of this study</h3> To our knowledge, this paper is the first to explore the role of physical activity in the lived experience of Long Covid using a qualitative approach The study design enabled in-depth inquiry of lived experiences in a diverse sample Inductive thematic analysis ensured descriptions and interpretations of the lived experience were tested and found to be grounded in the data Participants were recruited from members of a Long Covid research interest database who registered via an on-line form, meaning study findings might not capture the views of digitally excluded populations <h3>Funding statement</h3> This work was supported by Sheffield Hallam University. <h3>Competing interests</h3> All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Abstract 11790: New and Old Cardiovascular Disease Risk Models to Predict Events in HIV Infected Patients
Authors: Paolo Raggi, Davide De Francesco, Stefano Zona, Chiara Stentarelli, Federica Carli, Andrea Malagoli, Marcella Maniscardi, Antonio Bellasi, Giovanni Guaraldi
Journal: Circulation (2015)

Background: The high incidence of cardiovascular events in HIV infected patients creates the important challenge of performing an accurate risk assessment and initiating treatment in the most appropriate patients. The new Pooled Equations (PE) recommended by the recent ACC/AHA guidelines have not been tested in HIV infected patients and compared with the older Framingham Risk Score (FRS). Method: Cohort of 2,550 HIV infected patients (34% women) followed prospectively for a total of 10,695 patient-years. We compared the 10-year risk of events of 7.5% with PE versus a FRS level of 6%, for the dual purpose of assessing the validity of the new algorithm in HIV and verify whether lowering the threshold of the older algorithm may be equivalent to the new method. Results: Mean age was 49.7+/-7 years, and mean HIV exposure was 16.6+/-6 years. Total follow-up was 10,695 patient-years and 67 non-fatal myocardial infarctions and 2 CV deaths were recorded. PE&gt;7.5% and FRS&gt;6% predicted (44/69 and 49/69) and missed (25/69 and 20/69) the same number of true events. The Net Reclassification Index showed that PE&gt;7.5% is weaker than FRS&gt;6% to predict events (7% fewer events predicted) but better to predict non-events (14% more cases predicted to not occur). Table 1 shows the recommendation for statin therapy according to PE and FRS compared to current clinical practice within our institution: the 2 algorithms were not superior to what is currently implemented at our institution. Conclusions: In HIV infected patients the new PE&gt;7.5% algorithm performs similarly to a FRS&gt;6% to predict events but is better than the older algorithm to predict non-events. Neither model is superior to clinical practice as a method to select patients who should receive risk reduction therapies. (p-value for comparison of recommended vs actual statin prescription)
Use of GLP-1 receptor agonists (GLP1A) and/or SGLT-2 inhibitors (SGLT2I) in populations with NASH or at risk of NASH in US clinical practice
Authors: Michelle Lai, Jeremy Broestl, Kavita Juneja, Scott Milligan, Janna Radtchenko, Zobair Younossi, Nezam Afdhal
Journal: Journal of Hepatology (2020)
Self-induced Glycosuria
Authors: James I. Hudson
Journal: JAMA (1983)

BULIMIA is a psychiatric disorder characterized by recurrent episodes of binge-eating, usually followed by purging behavior such as self-induced vomiting or laxative abuse. Patients with bulimia typically consume large amounts of high calorie, easily ingested food over a short period, generally less than two hours. They are aware that this pattern of eating is abnormal but typically feel the urge to binge-eat as a compulsion over which they have no control. Although long noted in association with anorexia nervosa, only recently has bulimia been recognized as a distinct diagnostic entity.<sup>1</sup> Recent studies indicate that bulimia may be quite common, particularly among adolescent and young adult women.<sup>1,2</sup>Although the cause of the disorder is unknown, studies of phenomenology,<sup>2,3</sup>family history,<sup>2-4</sup>response to biologic tests,<sup>3</sup>and response to antidepressant medications<sup>5,6</sup>suggest that it may be related to major affective disorder. Patients with bulimia commonly engage in purging
Fatal ischemic brain oedema after tissue plasminogen activator.
Journal: BMJ (1989)

Drs Orton and Gruzelier argue that "laboratory evidence of the adverse effects of night duty may nevertheless underestimate their implications for the ward environment."For a variety of reasons relating to the specific nature of a doctor's workfor example, increased arousal resulting from interest, motivation, positive feedback, noise, opportunities for moving around-the contrary might equally be argued: that laboratory evidence may well overestimate the effects.We simply do not know.From our own experience of attempting to develop more appropriate tests we suggest that further research will require considerably more than simply selecting a few "off the peg" psycho- logical tests which have been developed for purposes other than those that concern us here.
Formalin Therapy for Radiation Proctitis
Authors: Diane L. Schneider
Journal: JAMA (1994)

<h3>To the Editor.</h3> —In the June 15, 1994,<i>JAMA</i>Questions and Answers<sup>1</sup>regarding radiation proctitis with prostate cancer, no mention was made of a new application of an old technique: formalin therapy has been used for hemorrhagic cystitis for years. Rubinstein et al<sup>2</sup>and Seow-Choen et al<sup>3</sup>adapted this for radiation proctitis using 4% formalin. The patient is sedated, a local block is administered, and sponges moistened with 4% formalin are applied for 4 minutes to each bleeding area of the rectum. Care is taken to protect the perianal skin from any caustic effects of the formalin. We used this method for two patients and have had excellent short-term (3-month) results. Long-term follow-up is still needed; however, our two patients have not required additional transfusions after formalin application. We believe this treatment may offer relief to patients in whom conventional measures have failed and who would otherwise
Changes in elf score during treatment with pegylated interferon and silymarin are associated with progression of histological liver disease in non-responder patients with chronic hepatitis C
Authors: S. Tanwar, E. Ellis, J. Parkes, C. Herold, W. Rosenberg
Journal: Gut (2011)

<h3>Introduction</h3> Liver biopsy remains the reference standard for monitoring changes in liver fibrosis resulting from antifibrotic therapy. While non-invasive serum markers have been validated in the detection of fibrosis in patients with chronic liver disease, their utility in tracking changes in fibrosis is not established. <h3>Methods</h3> 70 previous non-responders to pegylated interferon and ribavirin (40 male, 30 female, age range 24–67, mean 48.7) were recruited from five centres. Patients were randomised to receive pegylated interferon with or without silymarin as an antifibrotic therapy for 24 months. All patients underwent a liver biopsy and ELF tests (HA, P3NP, TIMP-1) prior to and after treatment (month 0 and 24) and area under receiver operating characteristic curves plotted. ELF tests were also taken during treatment (month 12). Changes in histological fibrosis stages before and after therapy (0–24 months) were compared with changes in ELF scores before and during therapy (0–12 months). <h3>Results</h3> ELF test results correlated well with liver histology with AUROC of 0.832 and 0.830 (F0-1 vs F2-6), 0.847 and 0.802 (F0-2 vs F3-6), 0.811 and 0.858 (F0-3 vs F4-6), 0.868 and 0.891 (F0-4 vs F5-6) pretreatment and post-treatment respectively. Following treatment, the absolute change in Ishak score ranged from −4 to +4, mean −0.027, SD 1.51 with 21 patients with increased and 24 with decreased fibrosis. At month 12 the changes in ELF score ranged from −1.02 to 2.85, mean 0.5911, SD 0.834. The change of ELF between 0 and 12 months was found to correlate with the absolute change of Ishak fibrosis stage on biopsy before and after treatment (R=0.315, p=0.004). <h3>Conclusion</h3> ELF testing performed well when compared with liver biopsy prior to and after treatment. A significant association was observed between change of ELF test at 12 months during therapy and histological change after 24 months of therapy. This suggests that a change in ELF score during therapy may predict changes in histology over a longer period. If confirmed, this may permit the refinement of ‘response guided therapy’ by identifying those patients who will benefit from both continued and prolonged treatment.