tbuckley/cabot-search huggingface dataset:
Do Physicians Have an Obligation to Disclose the Uncertainty About Harms or Just the Harms?—Reply
Authors: Tanner J. Caverly, Allan V. Prochazka, Chad Stickrath
Journal: JAMA Internal Medicine (2013)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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 Internal Medicine journal
Management of the Asymptomatic Patient With an Abnormal Exercise Electrocardiogram-Reply
Authors: Lawrence J. Laslett
Journal: JAMA (1985)

<h3>In Reply.—</h3> We appreciate the comments of Dr Lewis, but a careful reading of our article demonstrates that we did not advocate the approaches attributed to us by him. First, we do not recommend performing exercise electrocardiography on asymptomatic individuals in most circumstances. In fact, we explicitly stated that "because of the inefficiencies of testing for coronary disease in people at low risk for having this disease... [they] probably should not undergo stress ECG testing unless public safety demands it." The article deals with how to manage the patient who<i>already</i>has undergone a stress ECG that is "positive." Even here, we do not advocate, in Dr Lewis' words, "an array of further testing." Rather, we discuss a reasoned approach to deciding for whom further testing is indicated; this approach, of course, includes the history taking mentioned by Dr Lewis. Additionally, we state that with a low-risk subset of asymptomatic
Book Review Primary Care of Women Second edition. Edited by Karen J. Carlson, Stephanie Eisenstat, Fredric D. Frigoletto, Jr., and Isaac Schiff. 776 pp., illustrated. St. Louis, Mosby, 2002. $79.95. 0-323-01065-2
Authors: Marjorie A. Bowman
Journal: New England Journal of Medicine (2002)
Transdifferentiation of Blood-Derived Human Adult Endothelial Progenitor Cells Into Functionally Active Cardiomyocytes
Authors: Cornel Badorff, Ralf P. Brandes, Rüdiger Popp, Stefan Rupp, Carmen Urbich, Alexandra Aicher, Ingrid Fleming, Rudi Busse, Andreas M. Zeiher, Stefanie Dimmeler
Journal: Circulation (2003)

Further to promoting angiogenesis, cell therapy may be an approach for cardiac regeneration. Recent studies suggest that progenitor cells can transdifferentiate into other lineages. However, the transdifferentiation potential of endothelial progenitor cells (EPCs) is unknown.EPCs were obtained from peripheral blood mononuclear cells of healthy adults or coronary artery disease (CAD) patients by cultivating with endothelial cell medium and growth factors. After 3 days, >95% of adherent cells were functionally and phenotypically EPCs. Diacetylated LDL-labeled EPCs were then cocultivated with rat cardiomyocytes for 6 days, resulting in significant increases of EPC cell length and size to a cardiomyocyte-like morphology. Biochemically, 9.94+/-1.39% and 5.04+/-1.09% of EPCs from healthy adults (n=15) or CAD patients (n=14, P<0.01 versus healthy adults), respectively, expressed alpha-sarcomeric actinin as measured by flow cytometry. Immunocytochemistry showed that human EPCs expressed alpha-sarcomeric actinin, cardiac troponin I (both with partial sarcomeric organization), atrial natriuretic peptide, and myocyte enhancer factor 2. Fluo 4 imaging demonstrated calcium transients synchronized with adjacent rat cardiomyocytes in transdifferentiated human EPCs. Single-cell microinjection of Lucifer yellow and calcein-AM labeling of cardiomyocytes demonstrated gap junctional communication between 51+/-7% of EPCs (16 hours after labeling, n=4) and cardiomyocytes. EPC transdifferentiation into cardiomyocytes was not observed with conditioned medium but in coculture with paraformaldehyde-fixed cardiomyocytes.EPCs from healthy volunteers and CAD patients can transdifferentiate in vitro into functionally active cardiomyocytes when cocultivated with rat cardiomyocytes. Cell-to-cell contact but not cellular fusion mediates EPC transdifferentiation. The therapeutic use of autologous EPCs may aid cardiomyocyte regeneration in patients with ischemic heart disease.
Dealing with dying patients and their relatives.
Authors: E Earnshaw-Smith
Journal: BMJ (1981)

The process of dying brings into stark focus the past, the present, and the future.In a short time the past must be reconciled and consummated, the present must be fulfilled, and the future must be planned, or at least probed.The doctor or health worker will observe in his patient the outward signs of this emotionally exhausting, painful, and often triumphant process in fluctuating emotional states and the expression of apparently irrational feelings.All emotions are intensified when the end is in sight.A dying patient is increasingly dependent on family and friends.There is a complex interplay of discomfort, appre- hension, and pain between those concerned.To understand we must meet and talk unhurriedly with the patient and with those closest to him, including children.This lays a foundation of trust on which subsequent interviews can build.If a patient and family fail to make this trusting relationship, like small children, they will be bewildered, or opt out, or be demanding yet never satisfied.
Abstract LB-131: Peptide vaccine therapy for childhood gliomas: interim results of a pilot study
Authors: Ian F. Pollack, Regina I. Jakacki, Lisa H. Butterfield, Hideho Okada
Journal: Cancer Research (2012)

Abstract Introduction: Malignant astrocytomas of the brainstem and cerebral hemispheres and multiply recurrent low-grade gliomas carry a poor prognosis despite current treatments, and new therapeutic approaches are needed. Having gained significant experience with immunotherapy for adult gliomas, we extended these insights to childhood gliomas, based on our observations regarding their profiles of glioma-associated antigen (GAA) expression. Methodology: We initiated a pilot trial of subcutaneous vaccinations with peptides for GAA epitopes emulsified in Montanide-ISA-51 given every 3 weeks for 8 courses along with intramuscular injections of poly-ICLC in HLA-A2+ children with newly diagnosed brainstem gliomas (BSG), cerebral high-grade gliomas (HGG), or recurrent gliomas. GAAs were EphA2, IL13Rα2, and survivin. Primary endpoints were safety and T cell responses against vaccine-targeted GAAs, assessed by ELISPOT and tetramer analysis. Treatment response was evaluated clinically and by MR imaging. Results: To date, 24 children have been enrolled, 13 with newly diagnosed BSG, 5 with newly diagnosed HGG, and 6 with recurrent gliomas. No dose-limiting non-CNS toxicity has been encountered. One child with a BSG had transient tumor enlargement in association with acute neurological deterioration 4 months after beginning vaccination that later regressed and culminated in a sustained partial response (PR), consistent with pseudoprogression. Two other children with BSG had symptomatic pseudoprogression, with transient neurological deterioration and tumor enlargement followed by stabilization on decreasing steroid doses. Among 22 patients evaluable for response, 4 had rapidly progressive disease, 14 had stable disease for &amp;gt; 3 months, 2 had PRs, 1 had an MR, and 1 had prolonged disease-free status after surgery. ELISPOT analysis, completed in seven children, showed response to IL13Rα2 in 5, EphA2 in 3, and survivin in 3. Conclusion: Peptide vaccination in children with gliomas is generally well tolerated, and has preliminary evidence of both immunological and clinical activity. Pseudoprogression can initially be difficult to distinguish from true tumor progression and aggressive management may be warranted. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-131. doi:1538-7445.AM2012-LB-131
Reparative and Constructive Surgery of the Female Generative Tract
Authors: Stephen L. Corson
Journal: JAMA (1983)

The authors of this text have special interest and acknowledged expertise in diagnosis and surgical correction of anomalous female genital and reproductive organs. The first four chapters serve as a general introduction and cover principles, instrumentation, and diagnostic techniques. Especially welcome is the chapter on statistical evaluation of surgical results. This subject is infrequently mentioned in a text of this nature, but should be mandatory reading for all who do this type of surgery, whether they publish or not. The authors state that the approaches endorsed and described are primarily those developed at The Johns Hopkins Hospital. This type of unified philosophic approach is a quite acceptable alternative to inclusion of all the popular methods, which would have led to a weighty tome at considerable expense. The midsection of the book deals with corrective surgery of the cervix, uterus, oviduct, ovary, and of endometriosis. The procedures all are fairly standard
Ecological considerations in the treatment of <i>Actinobacillus actinomycetemcomitans</i> and <i>Porphyromonas gingivalis</i> periodontal infections
Authors: Sigmund S. Socransky, Anne D. Haffajee, Laurie Ann Ximenez‐Fyvie, Magda Feres, Donna Mager
Journal: Periodontology 2000 (1999)
CONTRIBUTIONS TO THE PATHOLOGY OF EXPERIMENTAL VIRUS ENCEPHALITIS
Authors: Simon Flexner
Journal: The Journal of Experimental Medicine (1928)

The guinea pig is subject to cerebral and corneal inoculation of the herpes virus. The effects of the inoculations vary with the strength or degree of virulence of the virus. Weak strains of the virus are implanted on the cerebrum with difficulty and strong strains with ease. Weak strains are quickly suppressed by the brain and strong strains may be passed indefinitely from brain to brain of the guinea pig. Strains of intermediate potency can be passed for a limited number of times only. Weak strains induce keratoconjunctivitis without brain involvement, while strong strains invade the brain from the eye and produce fatal encephalitis. In the latter case, the brain contains active virus inoculable upon the cornea and into the brain of rabbits and guinea pigs. Strains of intermediate potency produce keratoconjunctivitis accompanied by mild symptoms of encephalitis, from which recovery results. The guinea pig serves even more definitely than the rabbit to distinguish grades of virus according to strength or virulence. There is no difference of kind but only of degree of response to inoculation of herpes virus in the rabbit and the guinea pig. The etiology of epidemic encephalitis has not, therefore, been brought appreciably nearer solution by experiments with herpes virus carried out in guinea pigs.
Targetable photoactivalable drugs. 3. In vitro efficacy of polymer bound chlorin e6 toward human hepatocarcinoma cell line (PLC/PRF/5) targeted with galactosamine and to mouse splenocytes targeted with anti-Thy 1.2 antibodies
Authors: Blanka Říhová, Nancy L. Krinick, Jindřich Kopeček
Journal: Journal of Controlled Release (1993)
Permeability of Membranes of Dead Fetus
Authors: L. D. Courtney, R. R. Boxall, P. Child
Journal: BMJ (1971)

Membranes of dead fetuses showed a three-fold increase in permeability to the haemoglobin molecule when compared with normal and stored membranes. The friability of some of these membranes was markedly increased and their strength and elasticity diminished. These findings may be significant in the aetiology of the hypofibrinogenaemia and the increased incidence of amniotic fluid embolism with intrauterine death of the fetus.
NRAS G12V oncogene facilitates self-renewal in a murine model of acute myelogenous leukemia
Authors: Zohar Sachs, Rebecca S. LaRue, Hanh T. Nguyen, Karen Sachs, Klara E. Noble, Nurul Azyan Mohd Hassan, Ernesto Diaz-Flores, Susan K. Rathe, Aaron L. Sarver, Sean C. Bendall, Ngoc A. Ha, Miechaleen D. Diers, Garry P. Nolan, Kevin M. Shannon, David A. Largaespada
Journal: Blood (2014)
Practical Value of Cardiac Magnetic Resonance Imaging for Clinical Quantification of Aortic Valve Stenosis
Authors: Shelton D. Caruthers, Shiow Jiuan Lin, Peggy Brown, Mary P. Watkins, Todd A. Williams, Katherine A. Lehr, Samuel A. Wickline
Journal: Circulation (2003)

Valvular pathology can be analyzed quickly and accurately through the use of Doppler ultrasound. For aortic stenosis, the continuity equation approach with Doppler velocity-time integral (VTI) data is by far the most commonly used clinical method of quantification. In view of the emerging popularity of cardiac magnetic resonance (CMR) as a routine clinical imaging tool, the purposes of this study were to define the reliability of velocity-encoded CMR as a routine method for quantifying stenotic aortic valve area, to compare this method with the accepted standard, and to evaluate its reproducibility.Patients (n=24) with aortic stenosis (ranging from 0.5 to 1.8 cm2) were imaged with CMR and echocardiography. Velocity-encoded CMR was used to obtain velocity information in the aorta and left ventricular outflow tract. From this flow data, pressure gradients were estimated by means of the modified Bernoulli equation, and VTIs were calculated to estimate aortic valve orifice dimensions by means of the continuity equation. The correlation coefficients between modalities for pressure gradients were r=0.83 for peak and r=0.87 for mean. The measurements of VTI correlated well, leading to an overall strong correlation between modalities for the estimation of valve dimension (r=0.83, by means of the identified best approach). For 5 patients, the CMR examination was repeated using the best approach. The repeat calculations of valve size correlated well (r=0.94).Velocity-encoded CMR can be used as a reliable, user-friendly tool to evaluate stenotic aortic valves. The measurements of pressure gradients, VTIs, and the valve dimension correlate well with the accepted standard of Doppler ultrasound.
Sunbed use in relation to phenotype, erythema, sunscreen use and skin diseases. A questionnaire survey among Swedish adolescents
Authors: C. BOLDEMAN, H. BEITNER, B. JANSSON, B. NILSSON, H. ULLÉN
Journal: British Journal of Dermatology (1996)

Sunbed use was studied in relation to phenotype, erythema, sunscreen use and skin disease. The study population comprised 14-19 year-old Stockholm adolescents in 60 randomly selected classes, with 1252 students providing information. More than half (57%) reported sunbed use > or = 4 times during the previous year. Skin type III dominated (64%). Excessive exposure (> or = 10 times/year) was not correlated to skin type. Sunscreens were most commonly used by sunbed users. Of all sunbed users, 44% reported erythema. Adolescents with acne/seborrhoca, eczema or psoriasis used sunbeds more than others without skin diseases. The proportion with sunbed erythema (44%) indicates an unrecognized susceptibility to artificial ultraviolet radiation (UVR) among adolescents. The association between high exposure to UVR and sunscreen use stresses the importance of sunscreens being used as supplementary protection, not as a tool for tanning.
Cancer and Mental Disorders in a National Community Sample: Findings from the National Comorbidity Survey
Authors: Keiko Honda, Renee D. Goodwin
Journal: Psychotherapy and Psychosomatics (2004)

To determine the association between cancer (past 12 months) and mental disorders (past 12 months) among community-dwelling adults.Data were drawn from the National Comorbidity Survey (n = 5,877), a representative household sample of adults aged 15-54 years in the United States. Multiple logistic regression analyses were used to determine the association between cancer and mental disorders, adjusting for differences in sociodemographic characteristics.Cancer was significantly associated with increased rates of major depression [odds ratio (OR) = 3.6, 95% confidence interval (CI) = 1.4-8.8], drug dependence (OR = 3.6, 95% CI = 1.3-9.8), simple phobia (OR = 2.5, 95% CI = 1.0-6.2) and agoraphobia (OR = 3.3, 95% CI = 1.0-10.4). These associations persisted after adjusting for major sociodemographic factors, and sex plays a significant role in the association between cancer diagnosis and mental disorder, with cancer diagnosis having a stronger influence on major depression and drug dependence in men than in women.Clinicians and community health workers working with cancer survivors need to be not only alert for signs of clinical depression but also of co-occurring drug dependence and certain anxiety disorders so that appropriate referrals to mental health professionals can be made.
Abuse-Deterrent Formulations and the Prescription Opioid Abuse Epidemic in the United States
Authors: Theodore J. Cicero, Matthew S. Ellis
Journal: JAMA Psychiatry (2015)

In an effort to reduce wide-scale abuse of the proprietary oxycodone hydrochloride formulation OxyContin, an abuse-deterrent formulation (ADF) was introduced in 2010. Although the reformulation produced an immediate drop in abuse rates, a definite ceiling effect appeared over time, beyond which no further decrease was seen.To examine the factors that led to the initial steep decline in OxyContin abuse and the substantial levels of residual abuse that have remained relatively stable since 2012.We used data from the ongoing Survey of Key Informants' Patients program, part of the Researched Abuse, Diversion and Addiction-Related Surveillance system that collects and analyzes postmarketing data on misuse and diversion of prescription opioid analgesics and heroin. For our survey study, patients with a DSM-V diagnosis of opioid use disorder and primary drug of abuse consisting of a prescription opioid or heroin (N = 10,784) at entry to 1 of 150 drug treatment programs in 48 states completed an anonymous structured survey of opioid abuse patterns (surveys completed from January 1, 2009, through June 30, 2014). A subset of these patients (n = 244) was interviewed to add context and expand on the structured survey.In addition to key demographic measures, past-month abuse of opioids was the primary measure in the structured surveys. In the interviews, the effect of the introduction of the ADF on drug-seeking behavior was examined.Reformulated OxyContin was associated with a significant reduction of past-month abuse after its introduction (45.1% [95% CI, 41.2%-49.1%] in January to June 2009 to 26.0% [95% CI, 23.6%-28.4%] in July to December 2012; P < .001; χ(2) = 230.83), apparently owing to a migration to other opioids, particularly heroin. However, this reduction leveled off, such that 25% to 30% of the sample persisted in endorsing past-month abuse from 2012 to 2014 (at study end [January to June 2014], 26.7% [95% CI, 23.7%-29.6%]). Among the 88 participants who indicated experience using pre-ADF and ADF OxyContin, this residual level of abuse reflects the following 3 phenomena: (1) a transition from nonoral routes of administration to oral use (38 participants [43%]); (2) successful efforts to defeat the ADF mechanism leading to a continuation of inhaled or injected use (30 participants [34%]); and (3) exclusive use of the oral route independent of formulation type (20 participants [23%]).Abuse-deterrent formulations can have the intended purpose of curtailing abuse, but the extent of their effectiveness has clear limits, resulting in a significant level of residual abuse. Consequently, although drug abuse policy should focus on limiting supplies of prescription analgesics for abuse, including ADF technology, efforts to reduce supply alone will not mitigate the opioid abuse problem in this country.
The in vitro effects of Bordetella pertussis lymphocytosis-promoting factor on murine lymphocytes. IV. Generation, characterization, and specificity of cytotoxic lymphocytes.
Authors: A S Kong, S I Morse
Journal: The Journal of Experimental Medicine (1979)

Cytotoxic effector lymphocytes were induced in cultures of mouse spleen or lymph node cells by lymphocytosis promoting factor (LPF). The LPF-activated cytotoxic cells: (a) were not generated unless proliferation occurred; (b) sedimented in the lighter density fraction of a bovine serum albumin gradient; (c) were large, blast-like cells; and (d) were lysed by Thy-1.2 antiserum plus complement and, therefore, were T cells. Neither LPF alone nor supernates from stimulated cultures were cytotoxic. Unlike the situation with concanavalin A and phytohemagglutinin P, LPF-stimulated cytotoxic effector lymphocytes required no further addition of mitogen for maximal cytotoxicity. The effector cells displayed specificity, destroying only allogeneic but not syngeneic normal cells; in the case of tumor cells, both allogeneic and syngeneic cells werelysed in the absence of added mitogen. The reason for differentiated cytotoxicity toward syngeneic tumor and normal cells is not clear but may have some relevance to in vivo tumor rejection initiated by Bordetella pertussis.
EFFECT OF REMOTE ISCHEMIC PRECONDITIONING ON OUTCOME OF ELECTIVE PERCUTANEOUS CORONARY INTERVENTION
Authors: Ahmed Rashed, Mohamed K. Abdeldayem, Nabil Farag, Rami Raymond, Wael Elnaggar, Sameh Sabet, Mohamed Elramly, Mohamed Elhaddad, Ahmed Torki, Ashraf Mostafa
Journal: Journal of the American College of Cardiology (2011)
PET F-18 WHOLE BODY BONE SCANS
Authors: R. A. Hawkins, T. M. Guerrero, L. Seager, E. J. Hoffman, M. Dahlbom, C. Schiepers, J. Eckhardt, M. E. Phelps
Journal: Clinical Nuclear Medicine (1989)

Hawkins, R. A.; Guerrero, T. M.; Seager, L.; Hoffman, E. J.; Dahlbom, M.; Schiepers, C.; Eckhardt, J.; Phelps, M. E. Author Information
Electrical and mechanical effects of strontium in sheep cardiac Purkinje fibres
Authors: M. D GONZALEZ, M. VASSALLE
Journal: Cardiovascular Research (1989)

The electrical and mechanical effects of strontium were studied in sheep cardiac Purkinje fibres perfused in vitro. In a nominally calcium free solution, strontium (1.35–10.8 mmol·litre−1): (1) caused a time, rate and concentration dependent shift of the plateau to more positive potentials, prolonged the action potential and decreased the maximum diastolic potential; (2) increased the time to peak and amplitude of the twitch and caused a tonic force which relaxed only on repolarisation; (3) was rapidly overcome in its effects by calcium (1.35–2.7 mmol·litre−1); (4) was antagonised by manganese (1 mmol·litre−1) and cadmium (0.1–0.2 mmol·litre−1); (5) was potentiated by noradrenaline (0.1 μmol·litre−1); (6) could induce action potentials in 27 mmol·litre−1 [K]o; (7) induced a tail following the action potential when the pacemaker potential had been blocked by caesium; (8) could induce a tail in 8 mmol·litre−1 [K]o which sustained force development and was reduced by calcium antagonists; (9) if applied to a quiescent fibre, induced a prolongation of the first resumed action potential and tonic force but a small twitch, and these effects were antagonised by calcium and manganese; and (10) induced a strong twitch after a period of quiescence in low [Na]o. It is concluded that the pronounced and progressive electrical and mechanical effects of strontium in cardiac Purkinje fibres are due to an enhanced strontium influx (due to inability of strontium to substitute for calcium in the inactivation of Isi) and to strontium extrusion through an electrogenic Na-Sr exchange.