tbuckley/cabot-search huggingface dataset:
Reply:
Authors: Richard K. Sterling
Journal: Hepatology (2007)

We thank Kurosaki and colleagues for interest in our article that developed a simple noninvasive index, FIB-4, to accurately assess fibrosis in patients coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV).1 This model was recently validated in a large cohort of patients monoinfected with HCV, and had similar accuracy and was found to be as good as or better than other noninvasive models that use nonroutine tests.2 In these 2 studies, the mean ages were 40 and 44 years, respectively. Therefore, the utility of this index in older patients is not known. The current report in a large cohort of Japanese patients with HCV found that although FIB-4 had excellent accuracy (90%) in those < 50 years of age, it did not perform well in those > 50 (56% in those 51-60 years of age and 51% in those > 60 years old) despite an increasing proportion of advanced fibrosis in the older patients (25%-30% versus 16% in those < 50). The reason for the drop in performance of FIB-4 in older patients in the present study is not clear but may be due in part to patient demographics. Although the overall proportion of patients with advanced fibrosis were similar in the 3 cohorts, the proportion of patients with cirrhosis in the Japanese cohort was only 3.9% compared to 7.2% in the study by Vallet-Pichard2 and 15% in our coinfected population.1 Furthermore, we are not told the distribution of F4 cirrhosis among the 3 age groups in the current study, which could have affected their results. Whenever an index includes both a numerator and denominator, changes in either can affect the results. Age was included in the numerator due to the observation that increasing age is associated with increasing fibrosis.3 This is supported in the current analysis, which found increasing advanced fibrosis in those > 50 years of age. Another potential explanation for the discrepancy was the impact of age on liver enzymes. We and others have shown that liver enzymes, especially alanine aminotransferase, may be lower in older patients with HCV3, 4 despite having increased fibrosis. Because alanine aminotransferase is in the denominator, it may also explain the poor performance in older patients. Unfortunately, we are not given this information in the current report. We do agree that FIB-4 may not be applicable to all patients with HCV and congratulate Kurosaki and associates for their important observation. Until FIB-4 is validated in additional populations, it should be used with caution in making clinical decisions in patients with chronic HCV. Nevertheless, this study does provide additional support for its use as a noninvasive index to accurately assess fibrosis in the majority of patients chronically infected with HCV, especially those under 50 years of age. Richard K. Sterling M.D.*, * Virginia Commonwealth University Health System, Section of Hepatology, Richmond, VA.
Evaluation of Standard ECG Leads for Mass Scanning
Authors: Paul J. Schneider
Journal: JAMA (1968)

The accuracy in analysis of the six standard electrocardiographic leads for mass screening was evaluated from 2,000 randomly selected tracings. The ECGs were interpreted as normal or abnormal by generally accepted criteria without benefit of clinical history. Comparison with the full 12-lead ECG was made. Twelve hundred and sixteen (60.8%) were normal and 730 (36.5%) were abnormal. Twenty-six (3.44%) false-negative and 28 (2.25%) false-positive results occurred. The sensitivity and specificity of the method were 96.56% and 97.75%, respectively. The use of the standard ECG leads for mass screening is feasible for the following reasons: (1) It is a rapid technique necessitating no change in pattern or vector approaches to interpretation. (2) The patient need not be recumbent or undressed. (3) The accuracy compares favorably with that of 12-lead analysis. (4) The method is readily adaptable to computer interpretation.
基于人群的临床实践研究数据链研究使用算法模型来鉴定化脓性汗腺炎的真正负担
Authors: J.R. Ingram, S. Jenkins-Jones, D.W. Knipe, C.L.I. Morgan, R. Cannings-John, V. Piguet
Journal: British Journal of Dermatology (2018)

Summary 化脓性汗腺炎是一种影响年轻人的长期皮肤病,会导致皮肤褶皱部位(例如腋窝和腹股沟)多处生疮。疮非常疼痛,且可能会生脓并留下难看的疤痕。HS的普遍性如何仍存有争议,近期一些使用了美国医疗保险数据的报告表明,约有0.1%的人口受到这种疾病的影响,这个数据低于使用自我报告调查问卷(由患者填写)的欧洲研究所得出的数据。这可能是因为保险数据库漏掉了未确诊的病例。我们的研究团队位于英国,旨在使用由英国的全科医师(GP)记录的电子数据来鉴定已知和之前未确诊的HS病例。在鉴别未确诊病例时,我们查找了因至少5处皮肤疮而向医生问诊的患者,并向一些医生发送再次确认的问卷而验证诊断。在GP数据库中的430万名患者中,我们找出了23,000名确诊的HS患者和10,000名未确诊患者,这表示有0.77%的英国人口患有HS。如果包括疑似病例(患者拥有1~4次皮肤疮会诊),这个数字将升至1.19%。将HS患者与未患有HS的类似人群相比较,可以发现,前者的吸烟率和肥胖率(普遍率是后者的三倍),以及2型糖尿病、克罗恩氏病、血脂水平升高、痤疮、高血压和抑郁症的几率都较高。但未发现HS与溃疡性结肠炎或多囊卵巢综合症之间存在关联。结论是,我们发现HS相对较为普遍,比估计数量高出近十倍(使用美国保险数据)。HS患者患上心脏病和中风的风险因素比率较高,因此,检查这些状况非常重要。
World Health Day 1992
Journal: JAMA (1992)

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
Acquired immune deficiency syndrome in low-risk patients. Evidence for possible transmission by an asymptomatic carrier
Authors: A. E. Pitchenik
Journal: JAMA (1983)

Two patients who contracted acquired immune deficiency syndrome (AIDS) could not be included in any of the known high-risk groups for this syndrome (ie, they were not homosexual, intravenous [IV] drug abusers, Haitian, or hemophiliacs). Patient 1, however, had regular sexual contact with her husband, an IV drug abuser who is asymptomatic despite a severe T-cell defect (T-helper cells, 33/cu mm; T-helper/T-suppressor ratio, 0.32; and a depressed lymphoproliferative response to mitogens and antigens). We hypothesize that he may be an asymptomatic carrier of an AIDS agent that he transmitted to his wife through intimate heterosexual contact. This mode of sexual transmission may provide a vector for the spread of AIDS to low-risk populations. (<i>JAMA</i>1983;250:1310-1312)
Metabolism of Hexachlorobenzene in Humans: Association between Serum Levels and Urinary Metabolites in a Highly Exposed Population
Authors: Jordi To-Figueras, Maria Sala, Raquel Otero, Carme Barrot, Mary Santiago-Silva, Miquel Rodamilans, Carme Herrero, Joan Grimalt, Jordi Sunyer
Journal: Environmental Health Perspectives (1997)

Serum and urine from 100 subjects of a general population highly exposed to airborne hexachlorobenzene (HCB) were analyzed to obtain new insights into the metabolism of this ubiquitous compound. HCB was detected in all serum samples with concentrations ranging between 1.1 and 953 ng/ml. The major known metabolites of HCB were investigated in urine collected over 24 hr. Pentachlorophenol (PCP) was detected in all urines with values ranging between 0.58 and 13.9 micrograms excreted in 24 hr [mean +/- standard deviation (SD), 2.52 +/- 2.05; geometric mean, 2.05]. A sulfur derivative that, after hydrolysis, yielded pentachlorobenzenethiol (PCBT) could also be identified and quantified in all the urines with values ranging between 0.18 and 84.0 micrograms of PCBT excreted in 24 hr (mean +/- SD, 3.47 +/- 10.8; geometric mean, 1.39). The sulfur derivative assessed as PCBT appeared to be the main metabolite, with urinary concentrations surpassing those of PCP in the subjects with higher HCB accumulation (HCB in serum > 32 ng/ml). PCBT concentration in urine collected over 24 hr showed a very strong association with HCB concentration in serum; the association was stronger in males than in females. An increase of 1 ng/ml of HCB in serum led to an increase of 2.12 micrograms of PCBT excreted in urine collected over 24 hr in males (95% CI, 1.82-2.44) and to an increase of 0.67 microgram of PCBT in females (CI, 0.33-1.09). A weaker association was found between PCP in urine and HCB in serum, which was only statistically significant in males (an increase of 1 ng/ml of HCB in serum led to an increase of 0.63 microgram of PCP excreted in urine collected over 24 hr; (CI, 0.34-0.95). These results show that the formation of the cysteine conjugate is a quantitatively more important metabolic pathway in humans than the formation of PCP. Moreover, the association found suggests that PCBT is a good urinary marker of HCB internal dose and glutathione-mediated metabolism.
ON CERTAIN CONDITIONS IN REGARD TO THE INFECTIVE NATURE OF CARCINOMA.
Journal: JAMA (1893)

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
Kirk's Handbook of Physiology.
Journal: JAMA (1902)

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
Preparations and Appliances
Journal: BMJ (1939)

red and x-ray photography, and the differentiation of blood.Other chapters deal with the uses of the infra-red camera in botany and palaeontology, photomicrography, and such special applications as landscape photography, aerial survey, and long-distance ground photography.Infra-red radiation can also be measured by photographic means.which the author describes, and he includes two chapters on the pene- tration of radiation through the atmosphere.Some beautiful reproductions of infra-red photographs are included.
Vaccine-Related Diseases Affect Young Immigrants
Journal: JAMA (2014)

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 ETIOLOGY OF SYPHILIS.
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 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
Highlights from this issue
Authors: The Triumvirate
Journal: Thorax (2021)

The TriumvirateAt the time of writing we have reached a grim COVID-19 milestone with some salutary lessons, a couple described in this issue of Thorax.It is just over a year since the global pandemic was announced and there have been over 125 million confirmed infections and almost 3 million deaths worldwide.However, almost 500 million people in the world having received their first dose of COVID-19 vaccine and finally a pathway out of the pandemic seems possible.What better time to celebrate the music of one of the Triumvirate's favourite bands: "The Vaccines"?"WHAT DID YOU EXPECT FROM THE VACCINES?"
Analysis of narcotic analgesic usage in the treatment of postoperative pain
Authors: K. Sriwatanakul
Journal: JAMA (1983)

We reviewed 526 medical records of surgical patients and interviewed 81 of these patients. We also sent questionnaires to house staff (57 of 97 responded) and nurses (70 of 142 responded) involved in the care of these patients. A substantial number of patients suffered at least moderate pain during the postoperative period despite analgesic medication. Patients received 70% of the maximal ordered analgesic dose in the first 24 hours. Physicians prescribed drugs in doses that were often inadequate and to be given at inflexible intervals. The optimal doses and duration of action of meperidine, as judged by the house staff and nurses, did not agree with the accepted pharmacologic profile of this drug. (<i>JAMA</i>1983;250:926-929)
Abstract O.02: Validation of Kawasaki Disease Incidence Assessment as Derived from Health System Administrative Databases vs. Active Retrospective Surveillance in Ontario, Canada
Authors: Cedric Manlhiot, Sunita O’Shea, Bailey Bernknopf, Michael Labelle, Mathew Mathew, Nita Chahal, Brian W McCrindle
Journal: Circulation (2015)

Introduction: Historically, 2 methods have been used to determine the incidence of Kawasaki disease (KD): active or passive surveillance, or the use of administrative databases. Given the increasing regulatory requirements, mainly around patient privacy, periodic retrospective surveillances have become increasingly challenging. Administrative databases are not curated datasets and doubts have been cast on their accuracy. Methods: The Hospital for Sick Children has been conducting retrospective triennial surveillances of KD since 1995 by contacting all hospitals in Ontario and manually reviewing all cases through chart review, reconciling inter-hospital transfers and multiple readmissions. We queried the Canadian hospital discharge database (Canadian Institute for Health Information) for hospitalizations associated with a diagnosis of KD between 2004-9. The administrative dataset was manually reviewed; patient national health number, institution and dates of admission/discharge were used to identify inter-hospital transfers, readmission and follow-up episodes. Results: The Canadian hospital discharge database reported 1,685 admissions during the study period (281±44 per year) for Ontario. Manual review of the dataset identified 219 (13%) as inter-hospital transfers (56, 26%), readmissions (122, 56%), admissions for follow-up of coronary artery aneurysms (14, 6%) or hospital admissions not related to KD (27, 12%). When these admissions were removed, the total number of incident cases for the study period was 1,466 (244±45 per year). The retrospective triennial surveillance identified 1,373 KD cases during the same period (229±33 per year). The Canadian hospital discharge database overestimated the number of cases in all 6 years by an average of 6.7±5.9%. The overestimation likely comes from patients who were originally diagnosed with KD but in whom the diagnosis of KD was subsequently excluded (historically ~5-6%). Conclusions: Reliance on administrative data to determine incidence of KD is possible and accurate; data should be manually reviewed to remove non-incident cases and estimates should be adjusted to reflect the expected proportion of patients in whom the diagnosis of KD will be subsequently excluded.
Use of complementary/alternative medicine by Brazilian oncologists
Authors: E. S. Tibana Samano, A. Del Giglio, L. M. Ribeiro, A. S. Campos, F. Lewin, E. S. Valesin Filho, P. T. Goldenstein, L. J. M. Costa
Journal: Journal of Clinical Oncology (2004)

8196 \(\underline{\mathrm{Background}}\): Complementary and alternative medicine (CAM) is defined as “drugs or therapeutic methods that are not included in the accepted orthodox biomedical framework of care for cancer patients” (Paltiel, J Clin Oncol 2001;19(9):2439–2448). We conducted an extensive survey among Brazilian cancer physicians to understand their attitude toward CAM. Methods: We sent a questionnaire to all the 657 members of Brazillian Cancer Society addressing their knowledge and attitudes concerning CAM, whether they used to ask their patients about their use of CAM, which were the various practices of CAM known by these doctors and the possible reasons that lead them to indicate or not CAM to their patients. We also questioned them regarding their degree of awareness of CAM self administration by their patients. Results: Overall 119 questionnaires were returned to us (18%). Most oncologists knew at least one type of CAM (115 or 96.6%) and 76.7% had previously made use of at least one type of CAM for themselves (individual prayers - 46.2%, vitamin supplements - 35.3%, psychotherapy - 29.4%, massage - 26%, group prayers - 24.4% and acupuncture - 24.4%) We observed that 63.8% (CI95%; 55.1–72.5) of the oncologists used to ask their patients about CAM utilization and 37.8% described at least one reason to stimulate its use (68.8% as complementary treatment). Ninety-six physicians (80.7%; CI95;73.6%–87.8%), described at least one reason to not indicate CAM, mainly, 56.2% (CI95 55.8%–56.6%) for lack of scientific proof of efficacy. Most oncologists (90%) would prescribe at least one type of CAM and this attitude correlated significantly with previous physicians' use of CAM (p=0.0001) and with being a clinical oncologist as well as with having questioned patients about CAM use (p=0.002). \(<F>\underline{\mathrm{\mathrm{Conclusions}}}</F>\): Brazilian oncologists know many kinds of CAM, had themselves frequently used some type of CAM and most of them would indicate some type of CAM to their patients. Therefore, the frequent use of CAM by Brazilian cancer patients seems to be supported by their physicians. No significant financial relationships to disclose.
Randomized, open-label, perioperative phase II study evaluating nivolumab alone versus nivolumab plus ipilimumab in patients with resectable HCC.
Authors: Ahmed Omar Kaseb, Roberto Carmagnani Pestana, Luis M. Vence, Jorge M. Blando, Shalini Singh, Naruhiko Ikoma, Jean-Nicolas Vauthey, James Patrick Allison, Padmanee Sharma
Journal: Journal of Clinical Oncology (2019)

52 Background: In HCC, surgical resection is associated with high recurrence rate, and no effective neoadjuvant or adjuvant therapies currently exist. On the basis of previous reports on the efficacy and safety of anti–PD-1 (nivolumab) and anti–CTLA-4 (ipilimumab) antibodies against HCC, we initiated a randomized pilot trial of perioperative immunotherapy for resectable HCC. Methods: This is a randomized, phase II pilot trial of nivolumab (Arm A) or nivolumab + ipilimumab (Arm B) as peri-operative treatment for patients (pt) with HCC who are eligible for surgical resection. Pt are given nivolumab 240 mg every 2 weeks (wk) for a total of 6 wk. Pt in Arm B are treated concurrently with ipilimumab 1 mg/kg every 6 wk. Surgical resection occurs within 4 weeks after last cycle of therapy. Pt continue adjuvant immunotherapy for up to 2 years after resection. Primary objective is the safety and tolerability of nivolumab +/- ipilimumab. Secondary objectives include overall response rate, complete response rate and time to progression. Exploratory objectives include evaluating the pre- and post-treatment immunological changes in tumor tissues and peripheral blood. Results: 9 pt were enrolled at the time of first interim analysis, and 8 pt were evaluable (5 in Arm A, 3 in Arm B). Most pt (78%) were 60-69 yo, and males (78%). 5 pt were HCV-positive and 1 had chronic hepatitis B infection. 7 pt proceeded with resection as planned; surgery was aborted for 1 pt due to frozen abdomen from previous surgery. Pathologic complete response (pCR) was observed in 3/8 pt – 2 in Arm A and 1 Arm B (37.5% pCR). 2 pt in Arm B and 1 in Arm A experienced grade 3 or higher toxicity. No grade 4 or higher toxicity were observed. Immune analysis of the first case with a pCR in Arm B demonstrated that clinical response correlated with an increase in CD8+ T cell infiltration, notably an increase in two effector T cell clusters. Conclusions: We report a pCR rate of 37.5% in the first interim analysis of a phase II pilot trial of perioperative immunotherapy for resectable HCC. Treatment was safe and surgical resection was not delayed. The study is ongoing and results may contribute to a paradigm shift in the perioperative treatment of HCC. Clinical trial information: NCT03222076.