tbuckley/cabot-search huggingface dataset:
Rheumatoid arthritis. Aetiology.
Authors: A. M. Denman
Journal: BMJ (1970)

Two fundamental questions about rheumatoid arthritis have yet to be answered.What is the nature of the stimulus which initiates inflammation of the joints?What are the factors which lead to its chronicity? Role of InfectionRecently interest has revived in the possible role of micro- organisms in rheumatoid arthritis and, indeed, in many other forms of chronic inflammatory disease accompanied by intense immunological activity.1This revival is due to two main de- velopments.Firstly, we now know that many forms of virus infection may not give rise to obvious signs.2Secondly, many apparently autoimmune phenomena are found in chronic in- flammatory diseases known to be provoked by micro- organisms.Furthermore, there have been an increasing number of reports incriminating infective agents in human inflammatory diseases of unknown aetiology and of analogous
Inhibition of renin–angiotensin system attenuates liver enzyme-altered preneoplastic lesions and fibrosis development in rats
Authors: Hitoshi Yoshiji, Junichi Yoshii, Yasuhide Ikenaka, Ryuichi Noguchi, Hirohisa Tsujinoue, Toshiya Nakatani, Hiroo Imazu, Koji Yanase, Shigeki Kuriyama, Hiroshi Fukui
Journal: Journal of Hepatology (2002)
976-12 Reduced Reflex Vagal Activity in Patients with AV Nodal Reentrant Tachycardia Compared to Patients with Atrioventricular Reentrant Tachycardia
Authors: Lawrence B. Rigden, Raul D. Mitrani, David P. Rardon, Lawrence S. Klein, William M. Miles, Douglas P. Zipes
Journal: Journal of the American College of Cardiology (1995)
231 Is prophylactic banding always safe? Randomized controlled trial for the prevention of first variceal bleeding in cirrhotic patients with contraindications or intolerance to B-blockers
Authors: C.K. Triantos, J. Vlachogiannakos, A. Armonis, A. Saveriadis, A. Kougioumtzian, G. Leandro, S. Manolakopoulos, S.A. Raptis, A.K. Burroughs, A. Avgerinos
Journal: Journal of Hepatology (2004)
Editorial: Evils of excessive application of technology in medicine
Authors: H. H. Hussey
Journal: JAMA (1975)

An earlier editorial (233:897, 1975) denounced too much laboratory testing of a patient for whom continuity of care and a direct, discriminating approach to diagnosis were not pursued. In his presidential address to the Association of American Physicians, published in the October 1975 issue of<i>Archives of Internal Medicine</i>, David E. Rogers, MD, beats the same drum when he calls for "technologic restraint." Rogers is no iconoclast; he applauds the astounding advances in technologic methods for diagnosis and for treatment that are the mark of his generation of medical scientists. He cites two cases that exemplify opposite poles: one, the case of Franklin D. Roosevelt who died of severe hypertensive vascular disease in 1944 at a time when modern-day antihypertensive drugs were not yet available, the other, the case of FDR's wife, Anna Eleanor, who died in 1960 of disseminated tuberculosis, probably as a consequence of corticosteroid therapy given for
Research Supports the View that Sentinel Node Biopsy Is the Standard of Care in High-Risk Primary Melanoma
Authors: Lutz Kretschmer, Reinhard Hilgers
Journal: Journal of Clinical Oncology (2006)

We appreciate the interest by Duchesne et al in our recent article regarding the timing of androgen deprivation therapy. 1 They correctly point out that certain aspects of the trials cited in our review were flawed methodologically and that trials within certain patient populations have yet to be conducted.In addition, Duchesne et al cite a study of early deprivation versus deferred androgen deprivation that yielded negative results.The study cited by Studer et al 2 failed to show a survival benefit for early androgen deprivation.It is worth noting that this study enrolled patients who were deemed incurable with local therapy and that 24% of the patients in the study had metastases at the time of enrollment.Treatment was either immediate orchiectomy or deferred orchiectomy on progression of disease associated with symptoms.In the final analysis, this study demonstrated a trend towards significance in terms of prostate cancer specific survival for those receiving immediate androgen deprivation (P ϭ .09)but found no difference in terms of overall survival-perhaps reflecting the advanced age in this patient population (median age at enrollment, 76 years).We acknowledge that the issue of the timing of androgen deprivation has not been entirely resolved for all situations.Despite this, when viewed in aggregate, we feel the evidence in support of early androgen deprivation justifies consideration of its use, particularly in intermediate-risk and high-risk patient populations.Finally, Duchesne et al cite their ongoing work in Australia and New Zealand, which addresses the dilemma of the timing of androgen deprivation in the setting of prostate-specific antigen only relapse.We applaud these efforts as well as the design of the trial, which appropriately stratifies patients at enrollment based on prostate-specific antigen doubling time and time elapsed since definitive local therapy.Enrollment in trials such as this should be a high priority and we look forward to seeing the results.
One person's innovation is another's experiment
Authors: R. Wheeler
Journal: BMJ (2000)

Surgical innovation is necessary, but there is pressure to impose standards on to the innovator normally associated with formal research.

Developments in surgery often involve minor refinements and adaptations of well recognised techniques. For such developments, a surgeon can rely on his good standing, peers, and peripheral evidence for support if complications arise.

> There is a conflict of interest between the innovator and the doctor 

Occasionally, however, surgeons may be faced with an emergency situation for which there is no complete conventional solution. The ingrained teaching would be to do nothing controversial. This doctrine, however, may result in the prospect of further surgery, and possible complications. The operating surgeon may have a bright idea offering a better solution, albeit neither tried nor tested.

Alternatively, a specialist surgeon may be struggling with a small population of elective patients with a particular unsolved surgical dilemma. The surgeon has …
Emergency Coronary Artery Bypass Grafts in the Treatment of Myocardial Infarction
Authors: GEORGE J. REUL, GEORGE C. MORRIS, JIMMY F. HOWELL, E. STANLEY CRAWFORD, WOLF J. STELTER
Journal: Circulation (1973)

Of the more than 1,900 patients undergoing coronary artery bypass procedures for coronary artery disease, a selected group of 17 patients underwent emergency coronary artery bypass because of the tentative diagnosis of acute myocardial infarction. Almost all patients had status angina prior to cardiac catheterization as was proven by electrocardiographic evidence and serum enzyme changes. When further verification was obtained by gross examination at surgery and autopsy in the patients who expired, most patients had severe end stage coronary artery disease manifested by functional classification and severe anatomical lesions. Cardiac catheterization was done in all patients prior to myocardial infarction. Because of the combination of pre-existing severe anatomical disease and status angina, coronary artery bypass surgery was done despite the presence of acute myocardial infarction in the three groups of patients. Group I consisted of patients with myocardial infarction without hypotension but persistent chest pain and clinical symptoms. Group II patients had similar findings plus hypotension. Group III patients experienced actual cardiac arrest and were resuscitated by portable femoral arteriovenous cardiopulmonary bypass. In group I three of eight patients died, in group II one of six patients, and in group III two of three patients. There were two late deaths at two and three months postoperatively. Operation in the face of acute myocardial infarction has been successfully employed in a selected group of patients.
Counseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence
Authors: David A. Fiellin, Michael V. Pantalon, Marek C. Chawarski, Brent A. Moore, Lynn E. Sullivan, Patrick G. O'Connor, Richard S. Schottenfeld
Journal: New England Journal of Medicine (2006)

The optimal level of counseling and frequency of attendance for medication distribution has not been established for the primary care, office-based buprenorphine-naloxone treatment of opioid dependence.We conducted a 24-week randomized, controlled clinical trial with 166 patients assigned to one of three treatments: standard medical management and either once-weekly or thrice-weekly medication dispensing or enhanced medical management and thrice-weekly medication dispensing. Standard medical management was brief, manual-guided, medically focused counseling; enhanced management was similar, but each session was extended. The primary outcomes were the self-reported frequency of illicit opioid use, the percentage of opioid-negative urine specimens, and the maximum number of consecutive weeks of abstinence from illicit opioids.The three treatments had similar efficacies with respect to the mean percentage of opioid-negative urine specimens (standard medical management and once-weekly medication dispensing, 44 percent; standard medical management and thrice-weekly medication dispensing, 40 percent; and enhanced medical management and thrice-weekly medication dispensing, 40 percent; P=0.82) and the maximum number of consecutive weeks during which patients were abstinent from illicit opioids. All three treatments were associated with significant reductions from baseline in the frequency of illicit opioid use, but there were no significant differences among the treatments. The proportion of patients remaining in the study at 24 weeks did not differ significantly among the patients receiving standard medical management and once-weekly medication dispensing (48 percent) or thrice-weekly medication dispensing (43 percent) or enhanced medical management and thrice-weekly medication dispensing (39 percent) (P=0.64). Adherence to buprenorphine-naloxone treatment varied; increased adherence was associated with improved treatment outcomes.Among patients receiving buprenorphine-naloxone in primary care for opioid dependence, the efficacy of brief weekly counseling and once-weekly medication dispensing did not differ significantly from that of extended weekly counseling and thrice-weekly dispensing. Strategies to improve buprenorphine-naloxone adherence are needed. (ClinicalTrials.gov number, NCT00023283 [ClinicalTrials.gov].).
Antibiotic-Related Respiratory Depression
Authors: Alfred F. Parisi
Journal: JAMA (1966)

<h3>To the Editor:—</h3> I have read with interest a number of Clinical Notes inThe Journalin the past 18 months on antibiotic-related respiratory depression (<b>190</b>:421, 1964;<b>194</b>:298, 1965;<b>196</b>:181, 1966). Particularly disturbing is the consistency of the theme of reports of apnea induced by the closely related polypeptide antibiotics polymyxin B sulfate and sodium colistimethate. In each of these reports the patients were receiving<i>large or maximally recommended doses</i>of these agents; there was indication of<i>neurologic dysfunction</i>(dysphagia, circumoral paresthesias, blurred vision) hours to days prior to sustained apnea. In spite of symptoms of neurotoxicity,<i>drug administration was continued</i>in unchanged dosages. Two of the patients were<i>azotemic</i>at the inception of therapy (which is in itself an indication for lowered dosage), and the third became azotemic during treatment. In one case, serum concentration of the drug at the time of the apneic episode was
Sanitary Authorities and Hospital Accommodation
Authors: F. Bond
Journal: BMJ (1878)

Recent anatomic and physiologic experiments revealed that a major afferent to the nucleus locus coeruleus (LC) is the nucleus paragigantocellularis (PGi) in the rostral ventrolateral medulla (Aston- Jones et al., 1986). In the present studies, responses of LC neurons to electrical activation of PGi were characterized in anesthetized rats. Low-intensity stimulation of PGi synaptically activated 73% of LC neurons at short latencies (mean onset, 11.3 msec), while a smaller population (16%) of LC neurons exhibited purely inhibitory responses. The excitatory transmission from PGi to LC was pharmacologically analyzed, revealing it to be resistant to cholinergic receptor antagonism, but completely abolished by the excitatory amino acid (EAA) antagonists kynurenic acid and gamma-D-glutamylglycine. The specific N- methyl-D-aspartate antagonist 2--amino-7-phosphonoheptanoic acid (AP7) and the preferential quisqualate receptor antagonist glutamate diethyl ester (GDEE) did not block LC responses to PGi stimulation, leading us to the tentative conclusion that EAAs may operate primarily at a kainate-type receptor on LC neurons to effect excitation from PGi. In addition to their blockade of PGi-evoked activity, kynurenic acid and DGG exerted a similar, simultaneous blockade of the characteristic excitation of LC neurons evoked by electrical stimulation of the hindpaw. These and other results indicate that the proposed EAA pathway from PGi may serve as a final link in a variety of sensory inputs to LC.
An Acquired Chemotactic Defect in Neutrophils from Patients Receiving Interleukin-2 Immunotherapy
Authors: Mark S. Klempner, Richard Noring, James W. Mier, Michael B. Atkins
Journal: New England Journal of Medicine (1990)

Bacterial sepsis is a frequent complication in patients with cancer who are receiving high doses of interleukin-2. We evaluated the function of neutrophils from such patients to determine whether there was any abnormality in this form of host defense.
The Quality of Mercy Is Not Strained
Authors: Stuart G. Finder
Journal: JAMA (1992)

<h3>To the Editor.</h3> —Sulmasy et al<sup>1</sup>are to be applauded for attempting to demonstrate the usefulness of clinical ethics instruction. Unfortunately, while their intent is commendable, their findings do not meet the proposed objective or support the conclusion drawn. Their study has two main problems. First, the authors state that the study is a "1-year randomized, controlled trial." Calling the study "controlled," however, presumes that the connection between the content of the instruction and the increase in "concurrent care concerns" (CCCs) is both causal and primary. The authors provide no justification for this presumption. Furthermore, other connections are possible. Attending regular meetings with fellow house officers and discussing (traditionally) nonmedical issues may create a comradeship that promotes open discussion of a wide range of issues. If so, it would be the kind of dialogue between house officers that leads to the increase in CCCs addressed; the clinical ethics instruction
The Montgomery Lectures IN OPHTHALMOLOGY: Delivered in Trinity College, Dublin, June, 1919
Authors: G. Holmes
Journal: BMJ (1919)

IN my first lecture I will attempt to place before you tlle evidence we now possess as to the regions of the surface of the brain where the images of objects that fall on the retinae excite visual sensations.Owing to the decussation of a portion of tlhe fibres of the optic nerves in the clhiasma, each1 optic tract conveys impressions from the same sides of bothl eyes-that is, impressions excited by the.retinal images of objects in the opposite halves of the visual fields.And since each tract terminates in the primary optic centres of the same side, and tlle optic radiations that spring froin here pass to the same side of tle brain, a total lesion of any part of the one optic systemi above the clliasma produces lhemianopia, or blindness in the opposite lhalves of the visual fields.It lhas only been within recent years tlhat, as a result of many anatomical, physiological, clinical, and pathological investigations, we have acquired any accurate information as to tlle region of thie cortex where retinal impressions excite visual sensations.These investigations indicate that the visual centres lie within and along the lips of the posterior parts of tIme calcarine fissures, and that they probably correspond to that portion of the cortex characterized by the presence of Gennari's line, whicl Professor Elliot Smitlh ha's called the area striata.In most brains this striate araa extends around the occipital pole on to the lateral surface of the hemisphere.Until lately, too, we possessed very little evidence of the mAnner in whichl the different segments of thle retinae are rppresented in the visual cortex, but, owing to the large number of cerebral injuries that have been produced by gunslhot wounds, tlle late war lhas given us an unequalled opportunity to investigate this problem.Numerousobservations by myself and otlhers lhave provided fuller data on whiclh to discuss it.In 'March, 1916, 1 publislhed, in col- l.boration witlh mey colleague,
593 USEFULNESS OF PREDICTION OF TREATMENT RESPONSE BY 18F-FDG PET FOR HEPATOCELLULAR CARCINOMA
Authors: M.J. Song, J.D. Kim, J.H. Kwon, J.W. Jang, I.R. Yoo, S.H. Bae, J.Y. Choi, S.K. Yoon, J.M. Yang, Y.S. Lee, C.D. Lee, K.W. Chung
Journal: Journal of Hepatology (2010)
Innovation, Risk, and Patient Empowerment
Authors: Nicholas S. Downing, Joseph S. Ross
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
Abstract 2354: An E2F signature predicts benefit of adjuvant chemotherapy in early-stage non-small cell lung cancer.
Authors: Courtney A. Kurtyka, Dung-Tsa Chen, Lu Chen, William Brazelle, Eric A. Welsh, Anders E. Berglund, Steven A. Eschrich, Matthew B. Schabath, Eric B. Haura, W. Douglas Cress
Journal: Cancer Research (2013)

Abstract Early-stage non-small cell lung cancer (NSCLC) is primarily treated by surgical resection. Unfortunately, after resection, one-third to one-half of early-stage patients will die of metastatic recurrence. Adjuvant chemotherapy (ACT) improves the survival of patients with early-stage disease and has become the standard treatment for patients with resected stage II-III NSCLC. However, the five-year survival advantage of ACT is only 4%-15% suggesting that many patients do not benefit. Given the morbidity associated with ACT, it is imperative to develop new prognostic tools to identify those patients with a high probability of relapse. Toward this end, we have used small inhibitory RNAs targeting multiple E2F pathway components to derive an E2F gene expression signature in vitro. This signature was refined by filtering for its components that were altered in non-small cell lung cancers compared to normal tissue. Principle component analysis was then used to represent the signature which was tested for correlation to overall survival in two large cohorts. The first of the two cohorts was the Molecular Classification of Lung Adenocarcinoma (MCLA) from the Director's Challenge Consortium and the second was a novel database on 444 lung adenocarcinomas treated as a part of Moffitt's Total Cancer Care Network. The E2F signature is strongly prognostic in both cohorts with P values &amp;lt;0.0001. Additionally, using data in the JBR.10 trial (GSE14814) for patients who either did or did not receive ACT we were able to determine that patients having a high E2F signature benefit from ACT (have increased overall survival), whereas patients with a low E2F signature do not. Overall, these results suggest that this approach could be optimized in the clinical setting to distinguish patients likely to benefit from ACT from those who will not. Citation Format: Courtney A. Kurtyka, Dung-Tsa Chen, Lu Chen, William Brazelle, Eric A. Welsh, Anders E. Berglund, Steven A. Eschrich, Matthew B. Schabath, Eric B. Haura, W. Douglas Cress. An E2F signature predicts benefit of adjuvant chemotherapy in early-stage non-small cell lung cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2354. doi:10.1158/1538-7445.AM2013-2354
THE RELATIONSHIP BETWEEN OXYGEN UPTAKE AND WORK RATE BELOW AND ABOVE LACTATE THRESHOLD
Authors: D Muniz-Pumares, R Godfrey, C Pedlar, M Glaister
Journal: British Journal of Sports Medicine (2013)

A projection of submaximal measures of work-rate (WR) and oxygen uptake ( ), assuming a linear relationship, is typically used to predict supramaximal intensities (&gt; ) as required to determine anaerobic capacity by maximal accumulated oxygen deficit. The aims of this study were: a) to investigate whether submaximal measures of WR and displayed a linear relationship during familiar and unfamiliar exercise below and above lactate threshold (LT); and b) to determine the reliability of predicted supramaximal WRs. Eight male cyclists (mean±SD age: 41±8 years, mass: 75.6±7.6 kg, height: 1.77±0.05 m; : 4.1±0.4 L·min −1 ) completed two identical cycling trials and a running trial. In each trial, 10×3 min incremental bouts of submaximal exercise were used to determine lines-of-best-fit for the WR- relationship for: 1) the entire test; 2) values below and above LT; and 3) rolling clusters of four consecutive values. Reliability of supramaximal cycling WR (110% ) was assessed using intraclass correlation coefficient (ICC) and coefficient of variation (CV). For the entire cycling trials, slopes (10.88±1.66 ml O 2 ·W −1 and 12.56±1.39 ml O 2 ·W −1 ), and correlation coefficients (0.99±0.02 and 0.98±0.04) were not different. The y-intercept was greater ( p =0.041) in the first cycling trial (765±230 ml O 2 ) compared with the second (494±258 ml O 2 ). Slope, intercept and correlation coefficients were not different below vs. above LT and between rolling clusters of values in any trial. The CV of the predicted supramaximal WR at 110% from each cycling trial (325±40 W and 322±43 W) was 7.0%, with ICC being 0.61. These data show that WR and display a linear relationship regardless of exercise intensity or familiarity. In conclusion, linear projection of submaximal WR- measures can be used to predict supramaximal intensities as required to determine maximal accumulated oxygen deficit.