tbuckley/cabot-search huggingface dataset:
Ventilation Strategies for Acute Lung Injury and Acute Respiratory Distress Syndrome
Authors: Jack J. Haitsma
Journal: JAMA (2008)

To the Editor: Limiting plateau pressures in the respiratory system of patients with acute lung injury and acute respiratory distress syndrome (ALI/ARDS) to 28 to 30 cm H 2 O may help guarantee lung protection. 1 In the large multicenter Express trial, Dr Mercat and colleagues 2 set positive end-expiratory pressure (PEEP) as high as possible to avoid plateau pressure above 28 to 30 cm H 2 O (mean, 27.5 cm H 2 O).In the lower PEEP (minimal distention) group in the Express trial, plateau pressure was kept as low as possible to maintain oxygenation targets (mean, 21 cm H 2 O).There was no difference in mortality between the 2 groups, but the higher PEEP/plateau pressure (increased recruitment) group showed a greater number of ventilator-free and organ failure-free days.Plateau pressure in the increased recruitment group dropped to 24 cm H 2 O within the first week.Two smaller trials (n=53 3 and n=103 4 ) showed that higher PEEP levels, comparable with the Express trial (14-16 cm H 2 O), can reduce mortality in ARDS, despite using plateau pressures that have been considered unsafe.Both studies started out with a plateau pressure of 32 and 31 cm H 2 O, respectively, but within 1 week they only needed a plateau pressure of 24 to 26 cm H 2 O.There are 2 main differences between these studies and the Express trial.In the smaller trials, plateau pressure before lung protective ventilation was 30 to 32 cm H 2 O compared with 23 cm H 2 O in the Express study, at comparable PEEP levels (8 cm H 2 O) and tidal volumes.Also, both smaller studies used standardized ventilator settings with the patients to see whether ARDS criteria (ratio of partial pressure of arterial oxygen over fraction of inspired oxygen [PaO 2 :FIO 2 ]Ͻ200 mm Hg) were maintained over a set time period.Alterations in chest wall mechanics may also result in marked differences in the real transpulmonary pressure, leading to progressive lung derecruitment and ventilatorinduced lung injury (VILI). 5Recruitment maneuvers may improve lung function by allowing ventilation on the deflation limb of the pressure-volume curve, resulting in higher end-expiratory lung volumes at similar airway pressures and potentially minimizing VILI. 5 Arbitrarily limiting plateau pressure without individualized settings, with potential resultant progressive lung derecruitment, may prevent advances in lung protective ventilation.An individually titrated recruitment maneuver leading to an early short-term increase in plateau pressure, especially in more severely hypoxemic patients with altered chest wall mechanics, may result in better oxygenation, rapid lowering of plateau pressure in the first week, and possibly improved outcome.
Is laryngeal preservation (LP) with induction chemotherapy (ICT) safe in the treatment of hypopharyngeal SCC? Final results of the phase III EORTC 24891 trial
Authors: J. L. Lefebvre, D. Chevalier, B. Luboinski, L. Traissac, G. Andry, D. De Raucourt, L. Collette, J. Bernier
Journal: Journal of Clinical Oncology (2004)

5531 Background: In 1986, the EORTC HNCCG initiated a randomized phase III trial to assess whether LP using ICT followed by radiation therapy (XRT) was as safe as the conventional treatment: total laryngectomy with partial pharyngectomy (TLP), radical neck dissection (RND) and postop XRT. Preliminary results were published in 1996; this updated analysis has been carried with a median follow-up of 10 years. Methods: 202 patients (pts) candidates for TLP + RND + XRT were randomly assigned to receive in the surgery arm (arm 1) this treatment or in the ICT arm (arm 2) up to 3 cycles of CDDP (100mg/m2 day 1) and 5FU (1000 mg/m2 days 1–5) followed in case of complete response by XRT or by TPL + RND + XRT in the other cases. The endpoints were survival (OS and PFS) and LP defined as a functional larynx free of disease (larynx in place without tracheotomy, feeding tube or gastrostomy, and without evidence of local disease). Results: this final analysis was carried out on 194 eligible pts (arm 1: 94, arm 2: 100). There were 92 males (98%) in arm 1 and 94 (94%) in arm 2. Stage II, III and IV respectively numbered 6, 51 and 37 in arm 1 and 7, 59 and 34 in arm 2. Postop courses and quality of surgical resections did not differ between both arms (ie. initial surgery in arm 1or surgery after ICT in arm 2) as well as tolerance to XRTwhatever its schedule. Ultimate disease control, including successful salvage surgeries after XRT, was not significantly different between both arms. As of December 2003, 14 % of pts in arm 1 and 17 % of pts in arm 2 were still alive. The hypopharynx SCC evolution was the cause of death in 43 pts in arm 1 and in 41 pts in arm 2. The 5-yr.OS was 33 % in arm 1 and 38 % in arm 2, the 10-yr. OS was respectively 14 % and 13 %. The 5-yr. PFS was 26 % in arm 1 and 32 % in arm 2, the 10-yr. PFS was respectively 8.5 % and 11 %. In arm 2 survival with a functional larynx in place was 22 % at 5 years and 9 % at 10 years. Conclusions: this final analysis has confirmed the preliminary results. This LP strategy provided similar survival curves as compared with conventional treatment and allowed 2/3 of the survivors to retain their larynx. No significant financial relationships to disclose.
Mandatory National Health Service
Authors: Banning G. Lary
Journal: JAMA (1993)

<h3>To the Editor.</h3> —The plan proposed by Dr Johns<sup>1</sup>is a most interesting concept for peacetime medicine. Few physicians have ever failed to serve the poor when called on, and his concepts might work for those willing freely to try them, but for his concepts to be mandatory strikes not only at the heart of medicine, but also the guarantees provided by the Constitution. Perhaps Johns and interested cohorts could test his hypothesis by leaving their positions at Johns Hopkins and practicing in the location and manner he suggests. Two years may not be enough time to really come to a scientific, definitive conclusion, and I would suggest it be increased to 4 years. Certainly valuable information could be gained if proper statistics were kept and would be invaluable to the physicians who treat patients on a day-to-day basis. If his experiment succeeds, perhaps it can be continued by
Methanol Extract of Grain Dust Shows Complement Fixing Activity and Other Characteristics Similar to Tannic Acid
Authors: Danna Skea, Irvin Broder
Journal: Environmental Health Perspectives (1986)

We have found several similarities between tannic acid and grain dust extract prepared with methanol. Both formed a precipitate with IgG, and these interactions were inhibited by albumin. In addition, both preparations fixed complement; this activity was heat stable and was removed by prior adsorption of the preparations with hide powder. Adsorption with polyvinyl polypyrrolidone reduced the complement-fixing activity of tannic acid but not that of the methanol grain dust extract. The similarities between tannic acid and the methanol grain dust extract are consistent with the presence of a tannin or tanninlike material in grain dust.
Catheter-induced ablation of the atrioventricular junction to control refractory supraventricular arrhythmias
Authors: M. M. Scheinman
Journal: JAMA (1982)

Five patients with recurrent bouts of supraventricular tachycardia proved resistant or became intolerant of both conventional and experimental drugs. These patients were subjected to a new procedure involving delivery of DC shocks to an electrode catheter positioned adjacent to the His bundle. Complete atrioventricular (AV) block was produced in all, one patient died suddenly six weeks after shock therapy, and the remainder had complete AV block with follow-up intervals ranging from four to 12 months. Shock therapy was associated with mild elevations of creatine phosphokinase MB (31± 18 units), but there was no hemodynamic evidence of tricuspid insufficiency. If this new technique proves safe and effective, it should supplant the need for open heart surgical procedures for His-bundle ablation. (<i>JAMA</i>1982;248:851-855)
Bone Fractures in Patients with Inflammatory Bowel Disease
Journal: Annals of Internal Medicine (2000)

Summaries for Patients21 November 2000Bone Fractures in Patients with Inflammatory Bowel DiseaseSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-10-200011210-00007 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail What is the problem and what is known about it so far?Inflammatory bowel disease is an illness that involves inflammation (swelling and irritation) of the lining of the digestive tract. There are two types of inflammatory bowel disease: Crohn disease and ulcerative colitis. Crohn disease can affect any part of the digestive tract, while ulcerative colitis affects only the large intestine. People with inflammatory bowel disease can become very ill with abdominal pain and diarrhea. They often have difficulty eating and can become undernourished. One of the health consequences of inflammatory bowel disease is osteopenia and osteoporosis. Osteopenia means ... Author, Article, and Disclosure InformationThe summary below is from the full report titled “The Incidence of Fracture among Patients with Inflammatory Bowel Disease. A Population-Based Cohort Study.” It is in the 21 November 2000 issue of Annals of Internal Medicine (volume 133, pages 795-799). The authors are CN Bernstein, JF Blanchard, W Leslie, A Wajda, and BN Yu.Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. Previousarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Incidence of Fracture among Patients with Inflammatory Bowel Disease: A Population-Based Cohort Study Charles N. Bernstein , James F. Blanchard , William Leslie , Andre Wajda , and B. Nancy Yu Metrics 21 November 2000Volume 133, Issue 10Page: I-54KeywordsBone fractureComputersCrohn's diseaseDatabasesGastrointestinal tractInflammationInflammatory bowel diseaseOsteopeniaOsteoporosisUlcerative colitis ePublished: 21 November 2000 Issue Published: 21 November 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Chernobyl Fallout and Outcome of Pregnancy in Finland
Authors: Anssi Auvinen, Mikko Vahteristo, Hannu Arvela, Matti Suomela, Tua Rahola, Matti Hakama, Tapio Rytomaa
Journal: Environmental Health Perspectives (2001)

Possible effects of Chernobyl fallout on outcome of pregnancy in Finland were evaluated in a nationwide follow-up study. The outcomes were the rate of live births and stillbirths, pregnancy loss, and induced abortions by municipality. Exposure was assessed based on nationwide surveys of radiation dose rate from the Chernobyl fallout, from both external and internal exposures. Using these measurements, we estimated the monthly dose rate for each of the 455 Finnish municipalities. On average, the dose rate from Chernobyl fallout reached 50 microSv per month in May 1986--a doubling of the natural background radiation. In the most heavily affected area, 4 times the normal background dose rates were recorded. Given the underlying regional differences in live birth, stillbirth, and abortion rates, we used longitudinal analysis comparing changes over time within municipalities. A temporary decline in the live birth rate had already begun before 1986, with no clear relationship to the level of fallout. A statistically significant increase in spontaneous abortions with dose of radiation was observed. No marked changes in induced abortions or stillbirths were observed. The decrease in the live birth rate is probably not a biological effect of radiation, but more likely related to public concerns of the fallout. The effect on spontaneous abortions should be interpreted with caution, because of potential bias or confounding. Further, there is little support in the epidemiologic literature on effects of very low doses of radiation on pregnancy outcome.
OC-043 Controlled trial of immunoablation and autologous haemopoetic stem cell transplantation in crohn's disease: interim report on behalf of the ASTIC trialists
Authors: C Hawkey
Journal: Gut (2012)

Introduction The Autologous Stem Cell Transplantation International Crohn's Disease (ASTIC) Trial is a randomised controlled evaluation of the proposition that immunoablation and hemopoietic stem cell transplantation improves the course of Crohn's disease. Recruitment of all 48 patients in the trial will complete in early 2012 and results to date are presented descriptively here. Methods Patients with impaired quality of life due to active Crohn's disease, despite at least three immunosuppressive agents all receive mobilisation treatment (intravenous cyclophosphamide 4 gm/m2 over 2 days followed by recombinant human granulocyte-colony stimulating factor [GCSF, filgrastim], 10 μ/kg daily before randomisation to immediate (1 month) or delayed (1 year) immunoablation and stem cell transplantation. The conditioning regime is intravenous cyclophosphamide 50 mg/kg per day for 4 days, anti-thymocyte globulin 2.5 mg/kg/day and methyl prednisolone 1 mg/kg on days 3–5. The bone marrow is reconstituted by infusion of an unselected graft of 3–8×106/kg CD34 positive stem cells. Results are compared 1 year after mobilisation alone or after transplantation. Results Twelve months after stem cell transplantation (early or delayed) the Crohn's Disease Activity Index (CDAI) fell from 324 (median, IQR 229–411) to 161 (85–257, n=17) compared to 351 (287–443) to 272 (214–331) following mobilisation alone (n=11). Six patients had a normal CDAI after transplantation vs one after mobilisation. C reactive protein fell from 16.6 (6.7–32.0) mg/l to 6.5 (3.5–12.5) mg/l vs 14 (8.0–27.0) mg/l to 9.0 (2.0–23.4) mg/l following mobilisation alone. The Crohn's Disease Endoscopic Index of Severity (CDEIS) (aggregate for upper and lower endoscopy) fell from 18 (10–25) to 5 (1–11) following transplantation vs 14 (12–16) to 9 (4–22) following mobilisation. Three patients achieved the goal of a normal CDAI, no drug therapy and normal upper and lower endoscopy 1 year after tranplantation but so did one patient following mobilisation alone. Serious Adverse Events were common (n=100 to date) with 42 infective episodes requiring or prolonging hospitalisation, following both mobilisation and conditioning and transplantation. There were seven episodes of viral (re)activation. Temporary flare of Crohn's disease activity or a need for surgery occurred in eight patients. Conclusion Immunoablation and hemopoietic stem cell transplantation appears to be an effective treatment for some patients with Crohn's Disease, although full results will be required for a firm conclusion. Risks are significant, making it potentially suitable for only a limited number of patients. Data from the whole trial will be needed to judge whether mobilisation alone has any benefits. Competing interests None declared.
Living Anatomy and Pathology.
Journal: JAMA (1910)

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
TRUTH AND POETRY CONCERNING URIC ACID.
Journal: JAMA (1905)

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
Changing patterns in the practice of carotid endarterectomy in a large metropolitan area
Authors: Thomas G. Brott, Richard F. Kempczinski, Robert J. Labutta
Journal: JAMA (1986)

<h3>In Reply.—</h3> Dr Graham concludes that our citywide study of carotid endarterectomy inaccurately represented the national results of surgical intervention for carotid artery disease. We disagree. The Cincinnati operative mortality of 2.8% in 1980 and 2.3% in 1983-1984 was nearly identical to the 2.8% reported for the United States in 1982.<sup>1</sup>National population-based data are not available for the US carotid endarterectomy operative stroke rate. A just-published study from 46 neurosurgical centers geographically distributed around the country reported an operative stroke rate of 4.2% for 3328 operations performed in 1981. This rate was only slightly lower than the 5.1% reported for Cincinnati in 1983-1984, and the study methods did not include a page-by-page chart review.<sup>2</sup> Dr Graham and Dr Edwards both question the influence of surgical training, experience, and caseload on operative morbidity and mortality. Our analysis of these variables for 1980<sup>3</sup>and 1983-1984<sup>4</sup>failed to
DERMATOLOGICAL SECTION
Journal: British Journal of Dermatology (1908)

British Journal of DermatologyVolume 20, Issue 3 p. 79-96 DERMATOLOGICAL SECTION First published: March 1908 https://doi.org/10.1111/j.1365-2133.1908.tb16552.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume20, Issue3March 1908Pages 79-96 RelatedInformation
Missed Opportunities in Preventive Counseling for Cardiovascular Disease--United States, 1995
Journal: JAMA (1998)

Cardiovascular disease (CVD), the leading cause of death in the United States, caused 960,592 deaths in 1995 (41.5% of all deaths). Approximately 58 million persons in the United States (20% of the total population) have one or more types of CVD, which include high blood pressure, coronary heart disease, stroke, rheumatic fever or rheumatic heart disease, and other forms of heart disease. Behavioral risk factors for CVD and other chronic diseases include physical inactivity, a diet high in fat, overweight, and smoking. The U.S. Preventive Services Task Force and the American Heart Association recommend that all primary-care providers offer their patients counseling to promote physical activity, a healthy diet, and smoking cessation as part of the preventive health examination. To characterize the provision of counseling by physicians about preventive health behaviors during office visits in 1995, data were analyzed from CDC's National Ambulatory Medical Care Survey (NAMCS). This report summarizes the results of that analysis, which indicates that a high proportion of office visits in 1995 did not include counseling for the prevention of CVD.
Methylene Chloride Poisoning in a Cabinet Worker
Authors: Mohammad Mahmud, Stefanos N. Kales
Journal: Environmental Health Perspectives (1999)

More than a million workers are at risk for methylene chloride exposure. Aerosol sprays and paint stripping may also cause significant nonoccupational exposures. After methylene chloride inhalation, significant amounts of carbon monoxide are formed in vivo as a metabolic by-product. Poisoning predominantly affects the central nervous system and results from both carboxyhemoglobin formation and direct solvent-related narcosis. In this report, we describe a case of methylene chloride intoxication probably complicated by exogenous carbon monoxide exposure. The worker's presentation of intermittent headaches was consistent with both methylene chloride intoxication and carbon monoxide poisoning. The exposures and symptoms were corroborated by elevated carboxyhemoglobin saturations and a workplace inspection that documented significant exposures to both methylene chloride and carbon monoxide. When both carbon monoxide and methylene chloride are inhaled, additional carboxyhemoglobin formation is expected. Preventive efforts should include education, air monitoring, and periodic carboxyhemoglobin determinations. Methylene chloride should never be used in enclosed or poorly ventilated areas because of the well-documented dangers of loss of consciousness and death.
Corrigendum to ‘Measures of body fatness and height in early and mid-to-late adulthood and prostate cancer: risk and mortality in The Pooling Project of Prospective Studies of Diet and Cancer’
Authors: J.M. Genkinger, K. Wu, M. Wang, D. Albanes, A. Black, P.A. van den Brandt, K.A. Burke, M.B. Cook, S.M. Gapstur, G.G. Giles, E. Giovannucci, G.G. Goodman, P.J. Goodman, N. Håkansson, T.J. Key, S. Männistö, L. Le Marchand, L.M. Liao, R.J. MacInnis, M.L. Neuhouser, E.A. Platz, N. Sawada, J.M. Schenk, V.L. Stevens, R.C. Travis, S. Tsugane, K. Visvanathan, L.R. Wilkens, A. Wolk, S.A. Smith-Warner
Journal: Annals of Oncology (2021)
Book Review Theoretical Principles and Practical Applicability of Alcohol Determination in Legal Medicine. (Die theoretischen Grundlagen und die praktische Verwendbarkeit der gerichtlich-medizinischen Alkoholbestimmung) . By Professor Dr. E. M. P. Widmark, Lund, Sweden. Berlin and Vienna: Urban and Swartzenberg. 1932.
Journal: New England Journal of Medicine (1933)