tbuckley/cabot-search huggingface dataset:
Pandemic Flu Planning Falls Short
Authors: Tracy Hampton
Journal: JAMA (2007)

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 Premature Baby Who Forgets to Breathe
Authors: John C. Sinclair
Journal: New England Journal of Medicine (1970)

EPISODES of apnea occur frequently, especially in the first days of life, in babies born prematurely. The commonest form of apnea is associated with periodic breathing, in which rhythmic ventilation is regularly interrupted by brief periods of apnea, much like Cheyne—Stokes respiration. During the apneic periods, there is no color change and little or no fall in heart rate, and ventilation resumes spontaneously. For descriptive purposes, periodic breathing can be distinguished from recurrent apneic episodes of longer duration, associated with cyanosis, accompanied by substantial fall in heart rate, and often terminated only by tactile or other stimulation. These episodes may . . .
Detection of monoclonal microsatellite alterations in atypical breast hyperplasia.
Authors: C L Rosenberg, A de las Morenas, K Huang, L A Cupples, D V Faller, P S Larson
Journal: Journal of Clinical Investigation (1996)

Atypical hyperplastic (AH) breast lesions are currently classified and treated as benign proliferative disorders, but their presence is associated with a four- to fivefold increased risk of developing breast cancer. Currently, it is not known if an AH lesion is a marker of increased risk, or is itself a premalignant lesion. To investigate this question, we used a series of 15 microsatellite loci to analyze 15 separate AH lesions microdissected from the archived pathology specimens of subjects with no coincident or previous breast malignancy. We found that a significant subset (6/15, or 40%) of these AH lesions demonstrated evidence of monoclonal microsatellite alterations, both length variation and allele loss. These monoclonal alterations suggest that the AH lesion has already undergone genetic changes conferring a growth advantage. Thus, these AH lesions may actually be early neoplasms. We also noted that monoclonality characterized AH lesions in younger as compared with older women (44 vs. 59 yrs, P < 0.05) and that a subset of monoclonal lesions (4/6) demonstrated microsatellite alterations at more than one locus, suggesting that an undetermined type of genetic instability may play a role early in the development of abnormal breast proliferations. These findings contribute to our understanding of the pathogenesis of AH lesions and may have implications regarding their relationship to breast tumors.
Searching the Medical Literature
Authors: R. BRIAN HAYNES
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 September 1986Searching the Medical LiteratureR. BRIAN HAYNES, MD., Ph.D.R. BRIAN HAYNES, MD., Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-3-472_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In a recent letter (1) that concerned our comparison of access routes to the MEDLINE literature database (2), Dr. Leininger states that "with a little planning and use of strategy to minimize online time, searches can be done at a fraction of this cost" (that is, the cost we reported of over $10 per search for six standardized searches executed on PaperChase). The author cites as an example a search on the termstimolol, myocardial infarction, andrandom allocation, which he executed on PaperChase with an online time of 2.7 minutes and a cost of $1.94 that...References1. LEININGER N. Online systems for searching MEDLINE [Letter]. Ann Intern Med. 1986;104:443. MedlineGoogle Scholar2. HAYNESMCKIBBONWALKER RKC. Computer searching of the medical literature: an evaluation of MEDLINE searching systems. Ann Intern Med. 1985;103:812-6. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPaperChase: For Medline searchingComputer Searching of the Medical LiteraturePATRICIA RYAN, M.L.S., DIANE WINAND, M.L.S., HOWARD L. BLEICH, M.D., WARNER V. SLACK, M.D., DOUGLAS PORTER, Ed.D. 1 September 1986Volume 105, Issue 3Page: 472-472KeywordsDatabasesMyocardial infarction Issue Published: 1 September 1986 PDF downloadLoading ...
Psychiatric Morbidity and Survival After Surgery for Esophageal Cancer: A Population-Based Cohort Study
Authors: Anna Wikman, Rickard Ljung, Asif Johar, Ylva Hellstadius, Jesper Lagergren, Pernilla Lagergren
Journal: Journal of Clinical Oncology (2014)

To determine the cumulative incidence of and risk factors for psychiatric morbidity and establish the impact on survival among surgically treated patients with esophageal cancer.A nationwide Swedish cohort of 1,615 patients who underwent surgery for esophageal cancer between 1987 and 2010 with follow-up until 2012 was linked to national health registries for information on psychiatric morbidity (inferred from mental health care use). Multivariable logistic regressions were used to determine potential risk factors for postoperative psychiatric morbidity. A multivariable-adjusted Cox proportional hazard model was used to analyze overall survival.In patients without a history of psychiatric morbidity, the 2-year cumulative incidence for treatment in psychiatric in-patient care was 2.5%, for psychiatric out-patient care was 4.2%, and for treatment with psychotropic drugs was 32.3%. Married patients were less likely to be treated postoperatively in psychiatric in-patient care (odds ratio [OR], 0.42; 95% CI, 0.22 to 0.80) or out-patient care (OR, 0.41; 95% CI, 0.17 to 1.02), whereas patients with higher tumor stage were more likely to be treated in psychiatric out-patient care (OR, 4.99; 95% CI, 1.16 to 21.38) or with psychotropic drugs (OR, 2.78; 95% CI, 1.10 to 7.01). Bearing in mind possible residual confounding, new-onset psychiatric morbidity was associated with mortality (hazard ratio [HR], 1.65 [95% CI, 1.17 to 2.33] for treatment in psychiatric in-patient care; HR, 1.93 [95% CI, 1.18 to 3.16] for treatment in psychiatric out-patient care; and HR, 2.77 [95% CI, 1.72 to 4.44] for treatment with psychotropic drugs).These results highlight the importance of recognizing and addressing psychiatric morbidity in surgically treated patients with esophageal cancer.
Predicting the unpredictable: autoantibody profile as parameter to foretell individual responses to infliximab treatment?
Authors: M.P. Schön
Journal: British Journal of Dermatology (2011)

Conflicts of interest None declared. Few dermatological diseases highlight the rapid and exciting development of pathogenesis‐oriented therapies as vividly as psoriasis. Outstanding among such developments are biologics, which inhibit key mediators of the psoriatic disease process. On the one hand, new insight into the pathogenesis of psoriasis has led to the marketing of novel targeted therapies, such as compounds directed against tumour necrosis factor (TNF)‐α or interleukin (IL)‐12/23 (p40). Others, including IL‐17‐directed biologics, are in the late stages of clinical development. Considering the relatively long period of time needed to evaluate the clinical response of individual patients and the high price for such therapeutics, the identification of biomarkers predicting individual responses to therapy is a goal worth pursuing. On the other hand, the clinical use of new antipsoriatic agents has taught us a great deal about complex pathophysiological interactions, including some that are not easily discernable from the primary mode of action. A prominent example for the latter notion is the development of autoantibodies and autoimmune‐related symptoms in patients treated with TNF‐α antagonists, the chimeric antibody infliximab in particular.1 New antidouble‐stranded DNA (dsDNA) antibodies were induced in 20% of infliximab‐treated patients in placebo‐controlled prospective trials.2 While the exact mechanism of autoantibody induction by infliximab is not completely known, several hypotheses can be delineated, which are not mutually exclusive. Firstly, through induction of apoptosis in inflammatory cells TNF‐α‐inhibiting compounds may release antigenic nucleosomes which may then induce autoantibodies in susceptible individuals.3, 4 It is also conceivable that inhibition of DNA repair in keratinocytes by TNF inhibitors contributes to the generation of antigenic DNA fragments.5 Secondly, increased rates of infection caused by TNF inhibition may activate B cells, which then contribute to autoantibody production. Along this line, antibiotic treatment may normalize levels of anti‐TNF‐induced autoantibodies.6 Finally, as evidenced by both animal and human studies, inhibition of TNF‐α may shift the immunological milieu from a Th1‐ to a more Th2‐weighted reaction pattern, which reduces Th1‐driven cytotoxic T cells required for the depletion of autoreactive B cells.3, 7, 8
Hepatocellular Carcinoma and Oral Contraceptives
Authors: Brian E. Henderson
Journal: JAMA (1976)

<h3>To the Editor.—</h3> In their article, "Hepatic Changes in Young Women Ingesting Contraceptive Steroids: Hepatic Hemorrhage and Primary Hepatic Tumors" (235:730, 1976), Mays et al describe both benign and malignant liver tumors in association with oral contraceptive use. As the authors state, there have been several recent articles suggesting an association between oral contraceptive use and benign adenomas of the liver. We have recently published a casecontrol study demonstrating the causality of this association.<sup>1</sup>None of the tumors in our series of 42 cases was malignant. The inclusion of four cases of liver cell carcinoma in the series by Mays et al, if confirmed, has profound implications. However, the information in the article raises serious doubt that there is a causal relationship between oral contraceptive use and the liver carcinomas. Three of the four patients (No. 5,11, and 12) took oral contraceptives for no more than one year; in
THE UNIVERSITY—A SOURCE OF SCHOLARLY STRENGTH FOR THE MEDICAL SCHOOL
Authors: John S. Millis
Journal: JAMA (1960)

The university is a scholarly resource for the medical school because of its particular nature and because it is organized for and operates to achieve certain specific goals. Hence I shall attempt to express my beliefs on the subject of the university as a source of scholarly strength for the medical school by considering the nature of the university and by deriving from a definition of the university the specific scholarly contributions it makes. There are nearly as many definitions of a university as there are speakers who attempt to define it. This fact is not due to any uncertainty about the matter but rather bears testimony to the great complexity of the entity which we call "university" and to the fact that each one of us sees it from a specialized point of view which reflects our personal participation within the complex and dynamic institution. Among the important aspects
Treatment of Periocular Infantile Hemangiomas with Propranolol: Case Series of 18 Children
Authors: Rola Al Dhaybi, Rosanne Superstein, Ariane Milet, Julie Powell, Josée Dubois, Catherine McCuaig, François Codère, Afshin Hatami, Line Chevrette, Nicole Fallaha, Patrick Hamel, Luis H. Ospina
Journal: Ophthalmology (2011)
TCT-311 Rate of Plaque Negative to Plaque Positive Conversion in Patients by Serial 64-Slice Computed Tomography Coronary Angiography (CTCA)
Authors: Norman Lepor, Laurn Contreras, Philip Bretsky, Gerald Friede, Joel Freedman, Michael Duffy, Hooman Madyoon
Journal: Journal of the American College of Cardiology (2012)
We know why they die
Authors: J. O. Drife
Journal: BMJ (1996)

Last month I was photographed in front of the Taj Mahal. All British tourists pose soulfully on Princess Di's bench, but our giggles were soon stifled by the beauty of the building. It commemorates a queen who, in 1630, died in childbirth. In 1996 over 100000 Indian women will do the same.

Later, in a Delhi conference hall filled with obstetricians, a small Indian doctor in a green sari asked us to imagine a jumbo crashing every 30 hours. She pointed out that India has world class hospitals and many doctors. The problem of maternal mortality lies in primary care.

About 40% of the deaths …
Hemophagocytic lymphohistiocytosis caused by dominant-negative mutations in STXBP2 that inhibit SNARE-mediated membrane fusion
Authors: Waldo A. Spessott, Maria L. Sanmillan, Margaret E. McCormick, Nishant Patel, Joyce Villanueva, Kejian Zhang, Kim E. Nichols, Claudio G. Giraudo
Journal: Blood (2015)
Drug therapy and perforated peptic ulcer.
Authors: R M Watkins, A R Dennison, J Collin
Journal: Gut (1985)

symptoms were attributable to psychogenic causes.We do feel, however, that there is sufficient evidence in our data to support the notion that symptoms may be attributable to psychogenic causes in appreciable numbers of patients -greater num- bers than we were able to prove had specific food intolerance.
Doctors divided in their attitude to military strikes on Afghganistan
Authors: A. Ferriman
Journal: BMJ (2001)

Only two national medical associations have so far come out unequivocally in support of the military action being taken by the United States and its allies to try to root out terrorism.

Israeli doctors “of course support the US and British led coalition against it [terrorism],” said Dr Yoram Blachar, chairman of the Israel Medical Association, and Dr Warren Jones, president of the American Academy of Family Physicians, said that although the academy did not have an “official” position on the war, “We support our nation's elected leaders and any decisions they make.”

Inquiries by BMJ correspondents suggest that many medical organisations have decided to remain silent for the present. Others have come out with carefully worded statements expressing sympathy for the victims of the 11 September attacks and calling for humanitarian aid and a measured response.

The medical organisation that spoke out most vociferously against …
Antimicrobial activity of alexidine alone and associated with N-acetylcysteine against Enterococcus faecalis biofilm
Authors: Luiz Fernando Machado Silveira, Pilar Baca, María Teresa Arias-Moliz, Alberto Rodríguez-Archilla, Carmen María Ferrer-Luque
Journal: International Journal of Oral Science (2013)

The purpose of this study was to assess the efficacy of alexidine (ALX), alone and combined with N-acetylcysteine (NAC), in eradicating two Enterococcus faecalis strain biofilms. The biofilms of E. faecalis ATCC 29212 and the clinical isolate E. faecalis D1 were grown in the MBEC-high-throughput device for 24 h and were exposed to five twofold dilutions of ALX (2%–0.007 8%) alone and combined with 100 mg⋅mL−1 NAC, for 1 and 5 min. Eradication was defined as 100% kill of biofilm bacteria. The Student's t-test was used to compare the efficacy of the associations of the two irrigants. After 1-min contact time, ALX eradicated the biofilms at all concentrations except for 0.007 8% and 0.015 6%–0.007 8% with E. faecalis ATCC 29212 and E. faecalis D1, respectively. Similar results for eradication and concentration were obtained when it was combined with 100 mg⋅mL−1 NAC. After 5 min of contact time, ALX alone and combined with NAC eradicated all enterococci biofilms. ALX showed antimicrobial properties against the two E. faecalis strain biofilms tested at very low concentrations, and its combined use with NAC was not seen to enhance its activity. An analysis of different treatment combinations has revealed an optimal strategy for eliminating bacteria that take up residence inside teeth. Bacteria that infiltrate the root canal system establish dense communities known as biofilms, which are challenging to eradicate. Treatment typically entails irrigation of the canal with drugs such as chlorhexidine, a bisbiguanide. Researchers led by Carmen María Ferrer-Luque of the University of Granada in Spain compared the efficacy of alexidine, another bisbiguanide in killing Enterococcus faecalis biofilm. They determined that this drug efficiently kills off two different strains of E. faecalis within one minute at very low concentrations. The researchers also tested a combination of alexidine with N-acetylcysteine, a mucolytic agent that disrupts the extracellular polysaccharide matrix of biofilms, but observed that the combination did not meaningfully improve on the performance of alexidine alone.
The orthopoxvirus type I IFN binding protein is essential for virulence and an effective target for vaccination
Authors: Ren-Huan Xu, Matthew Cohen, Yong Tang, Eric Lazear, J. Charles Whitbeck, Roselyn J. Eisenberg, Gary H. Cohen, Luis J. Sigal
Journal: The Journal of Experimental Medicine (2008)

Nonliving antiviral vaccines traditionally target proteins expressed at the surface of the virion with the hope of inducing neutralizing antibodies. Orthopoxviruses (OPVs), such as the human smallpox virus and the mouse-equivalent ectromelia virus (ECTV; an agent of mousepox), encode immune response modifiers (IRMs) that can increase virulence by decreasing the host immune response. We show that one of these IRMs, the type I interferon (IFN) binding protein (bp) of ECTV, is essential for ECTV virulence and is a natural target of the antibody response. More strikingly, we demonstrate that immunization with recombinant type I IFN bp protects mice from lethal mousepox. Collectively, our experiments have important implications for our understanding of the role of IRMs in OPV virulence and of type I IFNs in OPV infections. Furthermore, our work provides proof of concept that effective antiviral vaccines can be made to prevent disease by targeting virulence factors as an alternative to the traditional approach that attempts to prevent infection by virus neutralization.
Recurrent accident and emergency department attendance for acute asthma in children.
Authors: S M O'Halloran, D P Heaf
Journal: Thorax (1989)

Asthmatic children aged over 5 years making repeated visits to the accident and emergency department of a children's hospital were compared prospectively, on the basis of a clinical questionnaire and pulmonary function tests, with a control group of outpatients with asthma to find the reasons for their repeated attendance. Recurrent attenders (n = 145) had more severe asthma than control subjects (n = 118), with greater airway obstruction at rest (FEV1 79% v 85% predicted) and bronchial lability (47% v 38%). Significantly more of the "emergency" group used pressurised aerosols and fewer dry powder inhalers to administer bronchodilators. There were no differences in prophylactic treatment. Seventy one per cent of parents in the emergency group had feared that their child would die during an attack, compared with 56% of control subjects. Eighty one per cent of children were self referred to the accident and emergency department. Most parents had found hospital to be the quickest means of obtaining treatment in an emergency. There were no differences between the two groups in parents' knowledge about asthma, home conditions, or social disadvantage. Although children who repeatedly attend hospital accident and emergency departments for treatment of acute attacks have more severe asthma than controls and show some deficiencies in treatment, the major determinant of attendance appeared to be the parents' conviction that appropriate treatment could not be obtained elsewhere.
Itchy fingers
Authors: Des Spence
Journal: BMJ (2007)

The period between school and university was spent cutting grass at £1.80 an hour, and many a university night and any brief holiday were spent working in a bar or restaurant kitchen. But now I was on a medical career break, wandering the world. I gazed over the volcanic lake in Java. It was wonderful just to do nothing. I straddled the equator, a white emulsion line painted on broken jungle tarmac, dodged orang-utan urine, and looked nervously on to Krakatoa. I learnt what it was to be a visible minority—my hairy arms were stroked by groups of laughing Indonesians, and my wife smiled as she was told that blonde was considered a sign of intelligence. 

But doing nothing is not easy. Current medical protocols have a non-negotiation policy with patients' symptoms. We immediately blast off the doors with investigations, releasing clouds of clinically irrelevant biological variations, and then indiscriminately empty a magazine of interventions. These interventions are all in the name of “best practice” and the “patient.” But little attempt is made to understand the patient's culture, setting, or previous health seeking behavior. This is a policy of absolute total medicine; there is no art and no reflection. Outside the perimeter of our medical compound the alternative therapy militia are increasing in influence and controlling many of the streets.

Illness can be divided into self limiting conditions or an unstoppable biological cascade of degeneration or proliferation. In reality, our power to intervene in either of these scenarios is limited, and any delay in diagnosis has little impact on any eventual outcome. So it would make sense to adopt a policy of “wait and see.” But this would involve doctors putting the safety catches on the weapons of mass investigations and would involve a significant change in our aggressive medical culture. Rather than focusing on all the investigations we can do, undergraduate and postgraduate training should highlight all the investigations we shouldn't do—the forgotten craft of non-intervention. Perhaps then accepting clinical uncertainty—the core skill of a doctor—might come more easily to us and help us to free patients from unnecessary anxiety.

Meandering through Asia should be compulsory part of NHS training for all those stressed-out and battle-weary consultants and general practitioners. Let them return home with sun bleached hair, friendship bands, and yin-yang tattoos. We need to restore the ancient balance between the art and science of medicine and recognise the power of doing nothing.
Book Review Anatomic Exposures in Vascular Surgery By Gary G. Wind and R.James Valentine. 490 pp., illustrated. Baltimore, Williams and Wilkins, 1991. $150. ISBN 0–683–09140–9 . Peripheral Vascular Diseases Edited by Jess R. Young, Robert A. Graor, Jeffrey W. Olin, and John R. Bartholomew. 790 pp., illustrated. St. Louis, Mosby-Year Book, 1991. $95. ISBN 0–8016–6115–3 .
Authors: Allan D. Callow
Journal: New England Journal of Medicine (1992)