tbuckley/cabot-search huggingface dataset:
Diseases of the Lungs. Designed to be a Practical Presentation of the Subject for the Use of Students and Practitioners of Medicine.
Authors: Robert Hall Babcock
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 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
Newer Methods of Ophthalmic Plastic Surgery.
Authors: Edmund Benjamin Spaeth
Journal: JAMA (1925)

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 1469: Diastolic dysfunction induced by Flecainide but not Amiodarone
Authors: Egbert Bisping, Christian Pagel, Andre Wilken, Karl Toischer, Burkert Pieske
Journal: Circulation (2007)

Diastolic dysfunction is a significant risk factor for the development and progression of atrial fibrillation. Flecainide (Flec) and Amiodarone (AM) are frequently used in patients with atrial fibrillation but their impact on diastolic function has not been evaluated yet. We tested the effect of Flec and AM on systolic and diastolic performance in isolated muscle strips from failing human and nonfailing rabbit myocardium. Isolated ventricular trabeculae contracted isometrically at 1 Hz, Ca2+ 2.5 mmol/L, 37°C. Flec (0.01 – 100 μmol/L, dissolved in water) showed a concentration dependent negative inotropic effect in human myocardium (13 ± 2 vs. 3 ± 0.5 mN/mm 2 at base vs. 100 μmol/L; p&lt; 0.05). This was associated with a significant prolongation of the relaxation time RT95 and an increase of diastolic tension (Dias) by 35 ± 9 % (at 100 μmol/L; p&lt; 0.05). Water alone had no effect. Calcium transients measured by Aequorin technique declined proportionally to developed force after Flec. In contrast, AM (0.01 – 100 μmol/L, dissolved in 2% benzyl alcohol and 10% polsorbate) showed identical negative inotropic effects to solvent alone (maximally by 16 ± 8 %), and neither AM nor its solvent affected diastolic tension or relaxation times. Flec (3 μmol/L) resulted in a significant impairment of the Force frequency relationship (FFR) at 0.5–3.0 Hz in human myocardium. This was related to a decline in systolic force and a rise in Dias at high frequencies (at 3 Hz by 32 ± 12 % in control and 87 ± 25 % after Flec, p &lt; 0.05 vs. control). In nonfailing rabbit myocardium (1.0–5.0 Hz) Dias decreased by 11 ± 10 % (n.s.) in control but raised by 65 ± 25 % after Flec, p &lt; 0.05). AM (100 μmol/L) had no significant effect on FFR, whereas its solvent tended to impair the FFR by a decline in systolic performance. Conclusion: Flec exerts calcium dependent negative inotropic effects in human myocardium and significantly impairs diastolic function. The latter is observable not only in human failing myocardium with preexisting diastolic dysfunction but also in nonfailing animal myocardium. In contrast AM shows no compound specific negative inotropic effect and no change in diastolic function. In patients treated with Flec attention should be turned to the potential of the drug to deteriorate diastolic function.
Abstract 3013: Myocardium at Risk of Infarction during Acute Ischemia is Accurately Measured after Revascularization by MRI in Humans
Authors: Marcus Carlsson, Erik Hedstrom, Einar Heiberg, Hakan Arheden
Journal: Circulation (2007)

PURPOSE: The size of an infarct caused by coronary occlusion mainly depends on the duration of ischemia and the size of the ischemic myocardium, called myocardium at risk (MaR). T2-STIR imaging (visualizing oedema) has been shown to depict MaR in dogs. However, this has not been validated in humans. Therefore the purpose of this study was to validate the measurement of MaR by MRI against SPECT. METHODS: 7 patients (69±8 years, all male) with ST-elevation infarction treated by PCI were included. Technetium-labelled tetrofosmin was injected during ongoing ischemia before opening of the occluded vessel. SPECT was performed after concluded PCI and cardiac MRI after 3±3 days. MaR was measured as absent perfusion on SPECT and oedema on MRI, and expressed in percent of the left ventricular myocardium. The observer of the MRI data was blinded to the SPECT results. The localisation of transmural ischemia by the two methods was compared by visual assessment. RESULTS: The difference between SPECT and MRI for measurement of MaR was 0±9 % (mean±SD). The localization of transmural ischemia agreed between the two methods (Fig. 1 ) and expressed on vessel basis, MRI and SPECT showed 100 % concordant results. CONCLUSIONS: This study has showed for the first time in humans that T2-STIR accurately can determine myocardium at risk. This can be used in clinical research when studying new therapies for reducing infarct size. Fig 1 : Short axis slices of left ventricle showing inferior defect on SPECT (arrows, left panel) corresponding to the oedema signal on T2-STIR MRI (arrows, middle panel). For comparison, delayed enhancement in right panel shows subendocardial infarction (arrows).
Abstract MP59: Mediating the Medical, Economic and Social Impact of HF: There is an APP for That
Authors: Linda Houston-Feenstra, Mercy Kagoda, Wayne Dysinger, Samir Chatterjee, Nagla Alnosayan, Ala Alluhaidan, Sharon Fabbri, Denise Peterson
Journal: Circulation (2015)

The continued rise in cost of Heart failure (HF) management, begs the question, why can advances in science and medicine not stem this rising cost? Why do patients fail to adhere to prescribed medications and lifestyle recommendations? Lack of effective training for patient/families challenge successful transition to home due to conflicts generated by pressure within the patient’s home environment reinforced by societal attitudes about food. This pilot was designed as a multidisciplinary project, including information systems professionals, clinicians, and patients working together to develop/evaluate a customized mobile phone application (app). Using, home based monitoring of daily weights, blood pressure, heart rate, blood glucose, and a dash board of cumulative data accessed daily by clinicians. A built in algorithm identifies patients’ risk for re-admission based on changes in their vital signs or self-reported symptoms defined by clinical staff as representing best practices pathways decision points. 7 patients with a clinical diagnosis of HF who had documentation of at least one HF related admission in the past 14 months were recruited to trial the App. Patients have been followed for 120 days with an endpoint of 365 days. Data points for outcomes are: HF related hospitalizations; emergency department and urgent care visits, weight, blood pressure, and Minnesota living with heart failure quality of life. Preliminary data analysis shows mean compliance rate for daily measurements = 68.5%. Utilization has prevented one HF readmission, changed one admission from an acute ICU readmission into a short stay guided HF admission, accomplished by early identification of symptoms that unmanaged would have resulted in a more serious and lengthy admission. This integrated innovative system has demonstrated improved accountability and outcomes in the enrolled participants. Patient input at 120 days resulted in system revisions. Data collection will restart and continue to the 365 day end point.
Administration of sunitinib to patients with non-small cell lung cancer and irradiated brain metastases: A phase II trial
Authors: S. Novello, L. E. Abrey, F. Grossi, C. Camps, J. Mazieres, P. Selaru, S. Patyna, Y. Torigoe, R. Chao, G. Scagliotti
Journal: Journal of Clinical Oncology (2009)

8077 Background: Sunitinib (SU), an oral, multitargeted inhibitor of VEGFRs, PDGFRs, KIT, FLT3, CSF-1R, and RET has promising single-agent antitumor activity in refractory non-small cell lung cancer (NSCLC) (Socinski JCO 2008). Brain metastases (BrMs) occur in ≥25% of NSCLC patients (pts); preclinical data suggest that VEGF signaling is required for the growth of BrMs, and that SU can cross the blood-brain barrier. This study assessed the safety and preliminary efficacy of SU in NSCLC pts with BrMs. Methods: NSCLC pts who had received ≤2 prior systemic therapies and prior whole brain radiation therapy (WBRT) were eligible to receive SU at a starting dose of 37.5 mg with continuous daily dosing (CDD) in 4-wk cycles. Antitumor efficacy was based on overall (RECIST) and intracranial (WHO) tumor assessments. Intracranial disease was assessed by MRI. Safety was assessed by monitoring adverse events (AEs) and health-related quality of life was assessed using FACT/NCCN Lung Symptom Index (FLSI) and Brain Symptom Index (FBrSI). Study termination was to occur when 3 cases of intracranial hemorrhage (ICH) associated with neurologic deficit were noted. Results: To date, 47 pts, including 28 with adenocarcinoma and 10 with squamous cell carcinoma, received SU for a median of 2 cycles (range: 1, 9). The median age of pts was 61 yrs (range: 35, 75), most were male (n=26, 55%), were ever smokers (n=36, 77%) and all had good performance status (ECOG 0/1). In total, 25 pts (53%) experienced non-neurologic grade (G) 3/4 AEs; the most frequent were fatigue/asthenia and dyspnea. Neurologic AEs occurred in 4 pts (9%), including intracranial pressure increased, mental impairment, and gait disturbance (each n=1 and G1) and 1 pt with G3 convulsion and peripheral motor neuropathy. Importantly, no cases of ICH were noted. Stable disease occurred in 7 (19%) of 36 measurable pts. Median PFS was 10.9 wks (95% CI: 6.4,15.4). Median OS was 19.6 wks (95% CI:13.1, NR). Mean change from baseline in FLSI and FBrSI scores did not differ significantly at any time point. Conclusions: Oral SU 37.5 mg on a CDD schedule had a manageable safety profile in NSCLC pts with BrMs. These data support the investigation of SU in combination with agents with known antitumor activity in pts with BrMs. [Table: see text]
Fused Whole-Heart Coronary and Myocardial Scar Imaging Using 3-T CMR
Authors: James A. White, Nowell Fine, Lorne J. Gula, Raymond Yee, Mohammed Al-Admawi, Qi Zhang, Andrew Krahn, Allan Skanes, Anna MacDonald, Terry Peters, Maria Drangova
Journal: JACC. Cardiovascular imaging (2010)
Abstract 327: Basic Life Support and Defibrillation Are Changing the Prognosis of Hypertrophic Cardiomyopathy in School Students
Authors: Mamoru Ayusawa, Masataka Kato, Ami Chou, Hirofumi Watanabe, Akiko Komori, Yuriko Abe, Hiroshi Kamiyama, Naokata Sumitomo, Shori Takahashi
Journal: Circulation (2014)

OBJECTIVES: Hypertrophic cardiomyopathy (HCM) has been one of the leading causes of sudden cardiac death in school students. However, recent spread of basic life support combined with public access defibrillation and implantable cardioverter-defibrillator (ICD) has a possibility of a paradigm shift for prognosis of HCM in young. METHODS: In Japan, more than 98% of all students in primary, middle, and high schools subscribe in the mutual aid system, and a school that experienced event relating sudden death is obliged to submit all health checking documents to refund for the affected student. Submitted reports were investigated for 8 years between 2004 and 2011. All victims or survivors diagnosed as HCM were extracted from those reports. Demographic data, presence of diagnosis before event, and intensity of physical activity at event were compared between them. RESULTS: Though data in 2011 is still tentative, annual numbers of victims with HCM from 2004 to 2011 were 4, 4, 5, 6, 3, 2, 4, 1, respectively. The first resuscitated survivor with HCM was reported in 2007, thereafter from 2008 until 2011, those were 6, 2, 4, 2, respectively. Therefore, totals of 29 victims and 15 survivors were enrolled in this study. All survivors were middle or high school students. Three primary school students were all victims. The male-to-female ratio was 4.8 and 2.0, respectively (NS). Ratio of students who were previously diagnosed as HCM was 48% and 20%, respectively (p=0.06). Concerning exercise intensity at cardiac event, 24% and 6.7% were occurred without exercise, respectively (p=0.08). ICD insertion after successful resuscitation was reported in 80% of survivors. CONCLUSIONS: Induction of basic life support and defibrillator has a certain impact for increasing survivors with HCM in school students. After 2008, survivors become equal or more than victims. Majority of survivors were disclosed by initial cardiac event by strenuous exercise, and cardioverter-defibrillator was implanted after resuscitation. Strategy for survival of HCM students with previously diagnosed should be reviewed. School caregivers including general physicians should acquire the management of students with ICD.
Abstract 8544: Axillary Vein is a Better Access than Subclavian Vein or Cephalic Vein with Respect to Long-Term Pacemaker Lead Survival
Authors: Ngai Y Chan, Yan Y Cheong, Nim P Kwong, Tin C Law, Ngai S Mok, Ping T Tsui, Chi C Choy, Chun L Lau, Ying K Lo, Pui S Chu, Ho C Yuen, Hoi F Chow, Suet T Lau
Journal: Circulation (2011)

Purpose: To investigate the relationship between venous access and long-term pacemaker lead failure (PLF) Methods: This is a retrospective cohort study. Case records of 409 patients (221 women, mean age 72.2±10.5 years) undergoing pacemaker implantation in 2 hospitals in the period between January 2000 and December 2004 were reviewed. PLF was defined as abnormal impedance and/or high pacing threshold and/or low sensing threshold leading to replacement or abandonment of the lead. Results: A total of 682 (274 atrial and 408 ventricular) leads were implanted with contrast-guided axillary vein puncture (AP, 252), subclavian vein puncture (SP, 212) or cephalic vein cutdown (CP, 218). Over a mean follow-up of 73.7±33.2 months, 25 PLF were documented. Three (1.2%) were in AP group, 9 (4.1%) were in CP group and 13 (6.1%) were in the SP group. Using Cox regression, only the use of AP (RR=0.25, 95% CI 0.07-0.92; p=0.037), but not the other variables (age, sex, aetiology of bradycardia, cardiac chamber of lead implantation, lead size, lead material and lead fixation mechanism) was an independent predictor of PLF. With Kaplan-Meier analysis, AP results in significantly less PLF than SP (p=0.013) or CP (p=0.047). Conclusions: The use of AP is an independent predictor of PLF. AP results in less PLF than SP or CP.
Correlation of blood and physiologic markers with effect of bevacizumab (BV) with chemoradiation therapy in rectal cancer (RC)
Authors: C. G. Willett, D. G. Duda, L. Xu, E. diTomaso, Y. Boucher, B. Czito, M. Ancukiewicz, J. Clark, M. Carroll, G. Lauwers, R. K. Jain
Journal: Journal of Clinical Oncology (2008)

4096 Background: A phase I/II study of neoadjuvant BV with 5-fluorouracil (5-FU) and radiation therapy (RT) in patients with locally advanced RC tested the hypothesis that standard therapy plus inhibition of VEGF results in clinical benefit and that this effect is correlated with a set of angiogenic biomarkers. Methods: 25 patients with endoscopic US or surface coil MRI staged T3/4 RC were enrolled on this trial from 2002. Patients received 4 cycles of neoadjuvant therapy consisting of: 1) BV infusion on day 1 (cycles 1–4); 2) infusional 5-FU (225 mg/m2/24 hours, cycles 2–4); 3) external beam RT (50.4 Gy in 28 fractions, cycles 2–4; and 4) surgery 7–9 weeks after completion of neoadjuvant therapy. Correlative studies were undertaken to explore the biomarker value of angiogenic markers for this neoadjuvant therapy regimen in RC. Results: Histologic examination of the surgical specimen showed no residual cancer in the primary site in 5 patients (20%), 8 patients had rare scattered tumor cells (32%) and 6 patients exhibited more fibrosis than residual tumor (24%). In 14 patients all the lymph nodes were negative for malignancy, whereas 11 patients had microscopic nodal metastases. 3-year actuarial overall survival, disease free survival, and local control of these 25 patients were 100%, 88%, and 100%, respectively. There were no acute grade 4 toxicity events. The change in PlGF on BV alone and the pretreatment sVEGFR-1 in plasma correlated significantly (p<0.05) with extent of primary tumor regression. Presurgery CECs correlated with the extent of PET-FDG uptake decrease and was significantly higher in patients with residual disease compared to patients with pathCR (p<0.05). Changes in plasma VEGF and in tumor interstitial pressure correlated significantly (p<0.05) to extent of nodal regression in the surgical specimen. Conclusions: BV with standard chemo- radiation yields promising clinical results. The biomarkers identified in this study are the first ones shown to correlate with tumor response to combination of anti-VEGF and cytotoxic therapy. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration AstraZeneca, Dyax, Pfizer, Takeda AstraZeneca, Genentech
Fever in cancer patients as a cause of attendance in emergency room
Authors: M. Vidal, A. Ferrer, S. Serrano, M. Tobeña, I. Pajares, D. Lopez, E. Millastre, M. Ruiz-Echarri, J. Lambea, A. Tres
Journal: Journal of Clinical Oncology (2009)

e20706 Background: Normal human body temperature displays a circadian rhythm, ranging from 36.1 C or lower in predawn hours to 37.4 C or higher in the afternoon. Abnormal elevation of temperature occurs as a result of hyperthermia or fever. Cancer patients frequently experience fever. Nearly two-thirds of the cases of fever in patients with prolonged neutropenia could be attributed to infection, a major cause of morbidity in cancer patients. Purpose: The aim of our study is to evaluate the prevalence of cancer patients who were attended in the emergency room for fever, the diagnosis and clinical management. Methods: From October 2007 to October 2008, 560 cancer patients were seen in the emergency department of the University Hospital of Zaragoza. The purpose of this paper is to describe the characteristics of patients who presented with fever. Results: A total of 560 patients were seen. Ninety-eight (17.5%) presented with fever. 63% of patients were stage IV. Cancer tumor type, 35 had lung cancer (35.7%), 14 had breast cancer (14.3%), 9 had colorectal cancer (9.2%), 9 had urothelial cancer (9.2%), 5 had head neck cancer (5.1%), 5 had pancreatic cancer (5.1%), 3 had esophageal cancer (3%), 2 had prostate cancer (2%), and 14,3% had other neoplasm. 18 patients (18.36%) had been received chemotherapy treatment in a period of 10 days before. they were attended in emergency room. By diagnosis: 23 patients (23,46%) were diagnosed of febrile neutropenia, and 19 of them (82,6%) required admission to the hospital. 30 were diagnosed of respiratory tract infection (30,6%), 12 were diagnosed of urinary infection (12.24%). Considering all the patients who presented with fever: 45 patients were sent home with new treatment (45,9%), 6 patients were observed for 24 hours in the emergency room (6.2%) and 47 patients required admission to the hospital (47.9%). Conclusions: Fever in cancer patients remains a challenge, and the differentiation between infectious and non-infectious causes at onset of fever is very difficult. Despite all the prophylactic measures, infection is still the principal cause. Infection in the immunocompromised host is a serious clinical situation due to high morbimortality and is one of the most frequent complications in the patient with cancer. No significant financial relationships to disclose.
Abstract 1826: Long-term Prognosis of Subjects with Brugada-type Electrocardiogram Diagnosed during a Health Examination
Authors: Hisako Tsuji, Noriko Miyake, Tadashi Sato, Hiromichi Ikuno, Munenaga Yoshida, Takahisa Uchida, Masayuki Rai, Kentaro Morisaki
Journal: Circulation (2007)

BACKGROUND:  There are few population-based studies of Brugada-type ECG with a long follow-up period. The objective of the present study was to assess a long-term prognosis of the subjects diagnosed to have Brugada-type ECG during a health examination.   METHODS:  We studied 13,904 subjects (mean age 58±10 years, men 27%) who had the annual health examination including an ECG recording offered to adult citizens of Moriguchi city, Osaka, Japan in 1997. The end of follow-up was the end of 2005. Proportional hazards regression analyses were performed to compare the difference in all cause and cardiovascular mortality between the subjects with and without Brugada-type ECG. Clinical variables used in the adjusted model were age, gender, smoking, hypertension, diabetes mellitus, drinking habit, and body mass index.   RESULTS:  The Brugada-type ECG was found in 98 subjects (mean age 58±9 years, men 81%) with 38 % of type 1. During a mean of 7.8±1.6 years (median 8.2 years), there were 4 deaths (4.1%) and 1 cardiovascular death (1.0%) among the subjects with Brugada-type ECG, whereas 612 deaths (4.4%) and 142 cardiovascular deaths (1.0%) among those without Brugada-type ECG (Table). There were no subjects with Brugada-type ECG who received implantable cardioverter defibrillator. Not only unadjusted but also adjusted proportional hazards regression analysis showed no significant difference in cardiovascular or all cause mortality between subjects with and without Brugada-type ECG. One cardiovascular death of subjects with Brugada-type ECG was sudden with autopsy in which there was no finding of myocardial infarction. He was 56 year old and had a type 2 morphology.   CONCLUSIONS:  Brugada-type ECGs diagnosed during health examination are not associated with increased risk of either cardiovascular or all cause mortality.