tbuckley/cabot-search huggingface dataset:
Substituting Walnuts for Monounsaturated Fat Improves the Serum Lipid Profile of Hypercholesterolemic Men and Women
Authors: Daniel Zambón, Joan Sabaté, Sonia Muñoz, Betina Campero, Elena Casals, Manuel Merlos, Juan C. Laguna, Emilio Ros
Journal: Annals of Internal Medicine (2000)

Background: It has been reported that walnuts reduce serum cholesterol levels in normal young men. Objective: To assess the acceptability of walnuts and their effects on serum lipid levels and low-density lipoprotein (LDL) oxidizability in free-living hypercholesterolemic persons. Design: Randomized, crossover feeding trial. Setting: Lipid clinic at a university hospital. Patients: 55 men and women (mean age, 56 years) with polygenic hypercholesterolemia. Intervention: A cholesterol-lowering Mediterranean diet and a diet of similar energy and fat content in which walnuts replaced approximately 35% of the energy obtained from monounsaturated fat. Patients followed each diet for 6 weeks. Measurements: Low-density lipoprotein fatty acids (to assess compliance), serum lipid levels, lipoprotein(a) levels, and LDL resistance to in vitro oxidative stress. Results: 49 persons completed the trial. The walnut diet was well tolerated. Planned and observed diets were closely matched. Compared with the Mediterranean diet, the walnut diet produced mean changes of −4.1% in total cholesterol level, −5.9% in LDL cholesterol level, and −6.2% in lipoprotein(a) level. The mean differences in the changes in serum lipid levels were −0.28 mmol/L (95% CI, −0.43 to −0.12 mmol/L) (−10.8 mg/dL [−16.8 to −4.8 mg/dL]) (P < 0.001) for total cholesterol level, −0.29 mmol/L (CI, −0.41 to −0.15 mmol/L) (−11.2 mg/dL [−16.3 to −6.1 mg/dL]) (P < 0.001) for LDL cholesterol level, and −0.021 g/L (CI, −0.042 to −0.001 g/L) (P = 0.042) for lipoprotein(a) level. Lipid changes were similar in men and women except for lipoprotein(a) levels, which decreased only in men. Low-density lipoprotein particles were enriched with polyunsaturated fatty acids from walnuts, but their resistance to oxidation was preserved. Conclusion: Substituting walnuts for part of the monounsaturated fat in a cholesterol-lowering Mediterranean diet further reduced total and LDL cholesterol levels in men and women with hypercholesterolemia.
Behaviour of Standard Gravity-fed Administration Sets Used for Intravenous Infusion
Authors: F. C. Flack, T. D. Whyte
Journal: BMJ (1974)

The major factor influencing drip rate during intravenous infusion using a standard administration set is the variation in the venous pressure of the patient. Creep in the plastic material, though present, is shown to be unimportant. For steady and accurate infusion it is necessary to provide the ordinary gravity-fed administration set with some form of servo-control mechanism.
Defining and Regulating the Professions: The Quebec Experience
Authors: CHARLES L. BOSK
Journal: Annals of Internal Medicine (1977)

Editorial Notes1 November 1977Defining and Regulating the Professions: The Quebec ExperienceCHARLES L. BOSK, PH.D.CHARLES L. BOSK, PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-87-5-628 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe autonomy of workers in the professions invariably leads some to ask the Platonic question: who guards the guardians? This is hardly a new question, but it is now being asked more insistently in the United States. Demands are rising for accountability from all who provide professional services; expert authority is increasingly distrusted. This new consumerism is putting pressures on government agencies charged with effective use of tax monies. These pressures have led to an ad hoc approach to regulation, with quality-control mechanisms usually devised for particular programs. The Quebec government, in sharp contrast, adopted in 1973 a new Professional...References1. : The Evolution of Professionalism in Quebec. Quebec, Office des Professions de Québec, 1976 Google Scholar2. JOHNSON T: Professions and Power. London, MacMillan Publishing Co., Inc., 1972, pp. 19-39 Google Scholar3. WILENSKY H: The professionalization of everyone?" Am J Soc 70:137-158, 1964 CrossrefGoogle Scholar4. ETZIONI A (ed): The Semi-Professions and Their Organization. New York, The Free Press, 1969 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: CHARLES L. BOSK, PH.D.Affiliations: University of Pennsylvania Philadelphia, Pennsylvania PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1977Volume 87, Issue 5Page: 628-629KeywordsTaxes ePublished: 1 December 2008 Issue Published: 1 November 1977 PDF downloadLoading ...
Patients With Unusual Bladder Malignancies and a Rare Cause of Splenomegaly
Authors: Mohammadbagher Ziari, Guru Sonpavde, Steven Shen, Jim Zhai, Bin S. Teh, Seth P. Lerner
Journal: Journal of Clinical Oncology (2005)

An 82-year-old white woman with a congenital coccygeal deformity and neurogenic bladder, who had been on intermittent catheterization for the previous 20 years presented with gross hematuria. The warfarin that she was taking for atrial fibrillation was stopped. Intravenous urography showed a filling defect in the bladder. Cystoscopy was performed and revealed a large necrotic mass inside the bladder neck on the left side extending within the bladder for several centimeters. Tissue biopsy revealed transitional cell carcinoma of the bladder. A review of her computed tomography (CT) scan revealed asymmetric urinary bladder wall thickening with a large partially calcified soft tissue mass along the inferolateral left side of the floor, with displacement of the urethra. Numerous bladder diverticula were noted. Radical cystectomy was performed and revealed a high-grade invasive undifferentiated small-cell carcinoma of the bladder (Fig 1) with positive synaptophysin staining (Fig 2), which invaded through muscularis propria and into perivesical soft tissue with a positive margin. The tumor rapidly recurred in the pelvis on a CT scan performed during the first cycle of chemotherapy (Fig 3, arrow). The patient received two cycles of chemotherapy with carboplatin and etoposide, followed by two more cycles with concurrent radiotherapy for 5 weeks. Small-cell carcinoma of the bladder is a rare tumor, and a few cases have been reported in the English medical literature. In more than half of these cases, the tumor has been a mixture of small-cell carcinoma with transitional cell carcinoma, adenocarcinoma, or both. Histologically, the tumor is similar to small-cell carcinoma of the lung, with comparable immunoreactivity and the presence of neurosecretory granules on electron microscopy. Hematuria is the most frequent presenting symptom. Small-cell carcinoma of bladder usually has an aggressive clinical course characterized by early systemic dissemination and death from metastatic disease. Long-term disease-free intervals are rare, and most patients experience systemic disease recurrence within 2 years. Because of the rarity of
Reducing Relapse in Depressed Outpatients with Atypical Features: A Pilot Study
Authors: Robin B. Jarrett, Dolores Kraft, Martin Schaffer, Amy Witt-Browder, Richard Risser, Deborah H. Atkins, Jeanette Doyle
Journal: Psychotherapy and Psychosomatics (2000)

&lt;i&gt;Background:&lt;/i&gt; Patients with major depressive disorder (MDD) and atypical features have reactive mood plus at least two sympoms: hypersomnia, hyperphagia, leaden paralysis or a lifetime sensitivity to rejection. These patients respond to cognitive therapy (CT) or phenelzine (PHZ) significantly more than pill placebo (PBO). The purpose of this report is to motivate research on tolerable continuation phase treatment designed to reduce the significant risk of relapse and recurrence which depressed patients with atypical features face. &lt;i&gt;Methods:&lt;/i&gt; Outpatients with DSM-III-R MDD and atypical features who responded to acute-phase CT, clinical management plus PHZ or PBO (n = 31) were randomized to continue or discontinue treatment for 8 months and participate in 16 months or treatment-free follow-up. &lt;i&gt;Results:&lt;/i&gt; A log-rank test showed that the relapse and recurrence-free survival over the 24 months after the acute phase was significantly greater for the responders who continued treatment than for those who discontinued treatment. Kaplan-Meier estimates of relapse and recurrence were significantly higher for patients whose treatment was discontinued than for those whose treatment continued (83 vs 49% based on unblinded ratings of the Research Diagnostic Criteria for MDD or of self/other referral for treatment of depressive symptoms). &lt;i&gt;Conclusions:&lt;/i&gt; We note several important limitations of the design and analysis of these pilot data. We hypothesize that not only pharmacotherapy, but also CT used as a continuation phase threatment may reduce relapse in this population. This hypothesis warrants rigorous evaluation in samples of outpatients with MDD and atypical features that are large enough to allow comparative tests.
The number needed to treat: a clinically useful nomogram in its proper context
Authors: G. Chatellier, E. Zapletal, D. Lemaitre, J. Menard, P. Degoulet
Journal: BMJ (1996)

The number needed to treat is a meaningfil way of expressing the benefit of an active treatment over a control.It can be used either for summarising the results of a therapeutic trial or for medical decision making about an individual patient, but its use at the bedside has been impeded by the need for time consuming calculations.A nomogram has therefore been devised that will greatly simpliy the calcu- lations.Since calculations are now easy, the number needed to treat can be used to assess the value of several interventions, although it does have its limitations.In particular it should not be used when it is not known whether the relative risk reduction associated with an intervention is constant for all levels of risk, or for periods of time longer than that studied in the original trials.
Effect of Condoms on Reducing the Transmission of Herpes Simplex Virus Type 2 From Men to Women
Authors: Anna Wald
Journal: JAMA (2001)

ContextHerpes simplex virus type 2 (HSV-2) is one of the most common sexually transmitted infections in the United States. No prospective study has shown the ability of condoms to reduce transmission of HSV-2.ObjectiveTo evaluate risk factors for HSV-2 acquisition and efficacy of condoms in prevention of HSV-2 transmission.DesignAnalysis of data from a randomized, double-blind, placebo-controlled trial conducted December 13, 1993, to June 28, 1996, of an ineffective candidate HSV-2 vaccine with 18 months of follow-up.SettingEighteen clinical trial centers in the United States.ParticipantsA total of 528 monogamous couples discordant for HSV-2 infection, including an HSV-2–susceptible population of 261 men and 267 women.Main Outcome MeasureAcquisition of HSV-2 infection by susceptible partners, compared with those remaining free of HSV-2 with regard to demographic characteristics, sexual activity, and condom use.ResultsTwenty-six women (9.7%) vs 5 men (1.9%) acquired HSV-2, for a rate per 10 000 sex acts (episodes of sexual intercourse) of 8.9 vs 1.5, respectively (P<.001). In multivariable analysis, younger age (adjusted hazard ratio [HR] per 5 years, 1.57; 95% confidence interval [CI], 1.22-2.04), seropositivity for HSV-1 and HSV-2 vs HSV-2 alone in the source partner (adjusted HR, 2.34; 95% CI, 1.14-4.82), and more frequent sexual activity (adjusted HR per additional sex act per week, 1.10; 95% CI, 1.01-1.19) were associated with higher risk of HSV-2 acquisition. Condom use during more than 25% of sex acts was associated with protection against HSV-2 acquisition for women (adjusted HR, 0.085; 95% CI, 0.01-0.67) but not for men (adjusted HR, 2.02; 95% CI, 0.32-12.50). Risk of HSV-2 transmission declined from 8.5 per 100 person-years in the initial 150-day interval to 0.9 per 100 person-years in the final 150-day interval (P = .002 for trend), concurrent with a decrease in sexual activity and proportion of sex acts occurring when the source partner had genital lesions.ConclusionsCondom use offers significant protection against HSV-2 infection in susceptible women. Changes in sexual behavior, correlated with counseling about avoiding sex when a partner has lesions, were associated with reduction in HSV-2 acquisition over time. These data suggest that identification of discordant couples can reduce transmission of HSV-2, especially for heterosexual couples in which the male partner has HSV-2 infection.
Vagal cardiopulmonary reflexes after left ventricular deafferentation.
Authors: A J Minisi, T L Cersley
Journal: Circulation (1994)

BACKGROUND Cardiac transplantation and chronic myocardial infarction interrupt vagal afferent nerve fibers, which originate mainly from the ventricles. Marked abnormalities of reflexes mediated by cardiopulmonary receptors with vagal afferent fibers have been demonstrated after both cardiac transplantation and chronic myocardial infarction. The relation between these reflex abnormalities and ventricular deafferentation is not known. METHODS AND RESULTS To further assess this relation, we investigated the effects of left ventricular (LV) deafferentation on the control of renal sympathetic nerve activity (RSNA) by the vagal cardiopulmonary reflex in chloralose-anesthetized, mechanically ventilated dogs with sinoaortic denervation. Responses of left atrial pressure (LAP) and RSNA to hemorrhage and volume expansion were measured before and after application of 88% phenol to either the inferoposterior LV (n = 12) or the entire LV (n = 14). In control experiments, measurements were made before and after application of saline to the LV (n = 12). Reflex sensitivity (percent change in RSNA per mm Hg change in LAP) measured during volume expansion was mildly attenuated after both total (prephenol, -9.1 +/- 0.7; postphenol, -6.6 +/- 0.7; P &lt; .05) and inferoposterior (pre, -12.5 +/- 1.8; post, -8.1 +/- 0.6; P = .055) LV deafferentation. Reflex sensitivity measured during hemorrhage was not significantly altered by inferoposterior or total LV deafferentation. Epicardial saline had no significant effect on reflex sensitivity values measured during either volume expansion or hemorrhage. Reflex inhibition of RSNA in response to intracoronary nicotine was abolished after phenol application, indicating adequate ventricular deafferentation. Phenol application had no significant effect on LAP-myocardial segment length relations measured by sonomicrometry (n = 6). CONCLUSIONS Interruption of vagal afferent input from the LV has only modest effects on the control of RSNA by the vagal cardiopulmonary reflex. These data indicate that there is considerable redundancy in the vagal cardiopulmonary reflex such that receptors from the lungs and other cardiac chambers can largely compensate for the loss of afferent input from the LV.
Impaired Inhibition by Dexamethasone of Cytokine Release by Alveolar Macrophages from Patients with Chronic Obstructive Pulmonary Disease
Authors: Sarah V. Culpitt, Duncan F. Rogers, Pallav Shah, Carmen De Matos, Richard E. K. Russell, Louise E. Donnelly, Peter J. Barnes
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Chronic obstructive pulmonary disease (COPD) is characterized by inflammation of the respiratory tract in which macrophages are the predominant inflammatory cell and for which the efficacy of treatment with corticosteroids is controversial. We investigated the effect of dexamethasone on basal and interleukin (IL)-1β or cigarette smoke media (CSM)–stimulated release of IL-8 and granulocyte macrophage-colony stimulating factor (GM-CSF) by bronchoalveolar lavage macrophages from cigarette smokers and patients with COPD (n = 15). Basal release of IL-8 was approximately fivefold greater in patients with COPD than smokers, whereas GM-CSF was similar for each group. IL-1β and CSM increased IL-8 and GM-CSF release by macrophages from both smokers and patients with COPD. Dexamethasone did not inhibit basal or stimulated IL-8 release from macrophages from patients with COPD but inhibited release in smokers. In contrast, basal and IL-1β–stimulated GM-CSF release, but not CSM-stimulated release, was inhibited by dexamethasone. We conclude that the lack of efficacy of corticosteroids in COPD might be due to the relative steroid insensitivity of macrophages in the respiratory tract.
Dispersed HIV positive asylum seekers need care throughout UK
Authors: Kathir G Yoganathan
Journal: BMJ (2004)

EDITOR—I strongly agree with Creighton et al that inappropriate dispersal of asylum seekers with HIV may lead to increased medical and psychosocial problems.1 They also point out that the national asylum support service should seek specialist advice and consider the impact on infrastructure and staffing at the receiving centre. Although the study reported …
The Essential Guide to Primary Care Procedures
Authors: Paul Gordon
Journal: JAMA (2010)

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
BMA raises opposition to market driven NHS
Authors: J. Wise
Journal: BMJ (2009)

The BMA has launched a campaign against the continuing commercialisation of the NHS, which it says risks destabilising health services, increases costs, and results in less investment in training.

The BMA is calling for the NHS to be restored as a public service that works cooperatively for patients, not a market of commercial businesses that compete with each other. It has drawn up eight key principles for the NHS and is urging doctors to sign up to the campaign on its website www.lookafterournhs.org.uk. It also wants doctors to send in examples of how market reforms are affecting them.

The BMA’s chairman, …
Abstract 23: Prognostic significance of vitamin D receptor polymorphisms in head and neck squamous cell carcinoma
Authors: Takanori Hama, Chihiro Norizoe, Yuki Yuza, Toshihito Suda, Takakuni Kato, Hiroshi Moriyama, Mitsuyoshi Urashima
Journal: Cancer Research (2011)

Abstract Objective Many studies demonstrate associations between UVB rays and a lower risk of developing various cancers, implying that UVB rays induce vitamin D synthesis, which suppresses growth and induces differentiation/apoptosis of cancer. In patients with non-small-cell lung cancer, vitamin D receptor (VDR) polymorphisms and haplotypes are reported to be associated with survival. We hypothesized that a similar association would be observed in other type of cancers. In this study, we focused on head and neck squamous-cell carcinoma (HNSCC). Methods DNA was extracted from the frozen tumor and the VDR polymorphisms (Cdx2, FokI and BsmI) in 97 patients with HNSCC were genotyped by sequencing. Disease-free survival was compared between VDR polymorphisms using Kaplan-Meier survival with log-rank tests and using the Cox proportional hazard model adjusted for age, gender, primary tumor site, and postoperative stages. Adjusted hazard ratios (AHR) and 95% confidence intervals (95% CI) were determined. Results Tumor recurrence occurred in 41/97 (42%) patients during a median follow-up of 603 days. Genotype frequencies of the VDR polymorphisms were as follows: FokI: C/C, 39 (40%); C/T, 48 (50%); TT, 10 (10%); for Cdx2: G/G, 16 (17%); G/A, 41 (42%); A/A, 40 (41%) Bsm I: A/A, 5 (5.2%); A/G, 16 (16.5%); and G/G, 76 (78.3%). The FokI T/T genotype was associated with poor prognosis: median survival for T/T was 265 days compared with 959 days for C/C or C/T (log-rank: P=0.015; AHR, 2.65; 95% CI, 1.18 to 5.96; P=0.018). In contrast, Cdx2 and BsmI showed no significant association with survival. The G-T (Cdx2-FokI) haplotype was associated with worse disease-free survival compared with other haplotypes: median disease-free survival for G-T was 238 days compared with 959 days for other haplotypes (log-rank: P=0.0008; AHR, 6.67; 95% CI, 2.23 to 20.0; P=0.001). Conclusion These results suggest that VDR polymorphisms and haplotypes may be associated with prognosis of patients with HNSCC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 23. doi:10.1158/1538-7445.AM2011-23
Negative regulation of human immune deficiency virus replication in monocytes. Distinctions between restricted and latent expression in THP- 1 cells
Authors: J. A. Mikovits
Journal: The Journal of Experimental Medicine (1990)

In THP-1 monocytoid cells infected with HIV, viral expression can be regulated in several ways: (a) latency (no viral expression); (b) restricted expression (chronic low-level viral expression with little or no detectable virus released); and (c) continuous production. In cells with restricted HIV expression, nuclear factor(s) were found that blocked tat-associated DNA binding complex formation, suggesting that initiation of transcription was negatively regulated. Also, viral particles were seen budding into and accumulating within intracytoplasmic vacuoles with little virus released, suggesting multiple levels of regulation. These cells with restricted expression had no detectable viral antigens on the cell surface and were not lysed by IL-2-activated large granular lymphocytes. However, they could cause viral-mediated T cell cytolysis in cell-cell assays, suggesting viral transmission through cell contact. In addition, cells with latent HIV were identified and could still produce infectious virus after 5-azacytidine exposure 10 mo later. LPS and other treatments could increase viral production in cells with restricted but not latent expression, suggesting they occur by distinct mechanisms. These infected cells provide a reservoir for viral transmission to uninfected T cells that itself is not detected by immune surveillance mechanisms.
WHEN SHOULD WE OPERATE IN APPENDICITIS?
Authors: DOUGLAS C. MORIARTA
Journal: JAMA (1901)

possible now, when the prejudices of the people, the court proceedings, and the management of these insti- tutions are all barriers to their prompt and successful treatment.Provision for the treatment and care of the acute cases of insanity near their homes is very much better than the building of palatial institutions in favored localities in the state.