tbuckley/cabot-search huggingface dataset:
DNA vaccination with all-trans retinoic acid treatment induces long-term survival and elicits specific immune responses requiring CD4+ and CD8+ T-cell activation in an acute promyelocytic leukemia mouse model
Authors: Kouichi Furugaki, Katerina Pokorna, Carole Le Pogam, Masayuki Aoki, Murielle Reboul, Véronique Bajzik, Patricia Krief, Anne Janin, Marie-Elena Noguera, Robert West, Dominique Charron, Christine Chomienne, Marika Pla, Hélène Moins-Teisserenc, Rose Ann Padua
Journal: Blood (2009)
Managing Chronic Disease in Hospitalized Patients
Authors: Michael A. Steinman, Andrew D. Auerbach
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
The Crisis in Primary Care and the Role of Medical Schools
Authors: Barry Stimmel
Journal: JAMA (1992)

While a number of issues have diminished the attractiveness of primary care residency programs to USGs, the absolute number of residents in these programs has increased rather than diminished over the past decade, although the proportion of USGs choosing these fields has decreased. In the current arena of medical practice, there are many reasons why these fields are not among the most attractive, and there are several remedies that could be applied to increase their attractiveness. Focusing on medical schools as the sole cause of this dilemma, however, is the least effective way of accomplishing this objective; in addition, this will allow those truly able to increase interest in these fields, such as state and federal governments, to have a reason for not doing so. As long as the medical marketplace is sufficiently large enough to accommodate more than the number of graduates from US medical schools in "desirable" residency training positions, one can never effectively "force" a choice of residency training, nor should one. Primary care can be among the most rewarding of specialties, if adequately supported. It is this support that is lacking and must be addressed.
Evaluation of pirenzepine on gastric acidity in healthy volunteers using ambulatory 24 hour intragastric pH-monitoring.
Authors: A Etienne, C J Fimmel, B A Bron, E Loizeau, A L Blum
Journal: Gut (1985)

The effect of pirenzepine on 24 hour intragastric acidity was studied in 10 healthy volunteers using ambulatory 24 hour intragastric pH-monitoring in a double blind crossover study. Tests were performed on the seventh day of ingestion of either placebo, 75 mg pirenzepine or 150 mg pirenzepine per day. The drugs were given at two doses at 8.30 am and 8.30 pm. Mean nocturnal hydrogen ion activity during placebo treatment was 68 mmol/l +/- 9 SEM and was reduced by 75 mg (26%, p less than 0.01) and 150 mg of pirenzepine (36%, p less than 0.01), respectively. Mean diurnal hydrogen ion activity was 32 mmol/l +/- 6 SEM and was not significantly reduced (p greater than 0.1) by either dose of pirenzepine (4% and 12% respectively). Thus, the effect of pirenzepine on intragastric acidity is small, even with high doses of the drug, and becomes apparent only during the night.
Renal Potassium Wasting in Hypercalcaemia
Authors: C. Romano, R. Pongiglione, G. Gemme, E. Raffaelli
Journal: BMJ (1967)

the Luntz series are in fact cases listed in Wright's account under the headings " Ocular Hypertension " and " Possible Early Glau- coma," with a combined prevalence of 3 %.The Luntz series clearly excluded any cases of true glaucoma, and indeed all patients with any history of previous eye disease.As the authors give no criteria for their diagnosis of glaucoma, it is impossible to say to what ex- tent their findings can be compared with either survey.They certainly cannot be compared with both.The literature of glaucoma abounds in such comparisons of in- compatible data.It is depressing also to note that the defi- ciencies of a single measurement of ocular pressure as a means of detecting glaucoma still do not appear to be fully appreciated.This aspect of the problem is discussed in the same symposium and more fully in the account of the Royal Society of Medicine's 1966 Annual Symposium on Presymptomatic Screening.2It would be interesting to know if the authors have read these papers and are aware of the objections to tonometric screen- ing.-I am, etc.,
Hospital standardised mortality rates should not be used to make interhospital comparisons
Authors: M. McKee
Journal: BMJ (2013)

<h3>Abstract</h3> There is a worldwide shortage of reagents to perform detection of SARS-CoV-2. Many clinical diagnostic laboratories rely on commercial platforms that provide integrated end-to-end solutions. While this provides established robust pipelines, there is a clear bottleneck in the supply of reagents given the current situation of extraordinary high demand. Some laboratories resort to implementing kit-free handling procedures, but many other small laboratories will not have the capacity to develop those and/or will perform manual handling of their samples. In order to provide multiple workflows for SARS-CoV-2 nucleic acid detection we compared several commercially available RNA extraction methods: QIAamp Viral RNA Mini Kit (QIAGEN), the recently developed RNAdvance Blood (Beckman) and Mag-Bind Viral DNA/RNA 96 Kit (Omega Bio-tek). We also compared different 1-step RT-qPCR Master Mix brands: TaqMan™ Fast Virus 1-Step Master Mix (ThermoFisher Scientific), qPCRBIO Probe 1-Step Go Lo-ROX (PCR Biosystems) and Luna® Universal Probe One-Step RT-qPCR Kit (NEB). We used the Centre for Disease Control (CDC) recommended primers that detect two regions of the viral N gene as well as those that detect the RdRP gene region as per Public Health England (PHE) guidelines (Charité/WHO/PHE). Our data show that the RNA extraction methods provide similar results. Amongst the qPCR reagents tested, TaqMan™ Fast Virus 1-Step Master Mix and Luna® Universal Probe One-Step RT-qPCR Kit proved most sensitive. The N1 and N2 primer-probes provide a more reliable detection than the RdRP_SARSr primer-probe set, particularly in samples with low viral titres. Importantly, we have implemented a protocol using heat inactivation and demonstrate that it has minimal impact on the sensitivity of the qPCR in clinical samples – potentially making SARS-CoV-2 testing portable to settings that do not have CL-3 facilities. In summary, we provide several testing pipelines that can be easily implemented in other laboratories and have made all our protocols and SOPs freely available at https://osf.io/uebvj/.
Guanylyl cyclase inhibition reduces contractility and decreases cGMP and cAMP in isolated rat hearts
Authors: Richard E Klabunde, James Tse, Harvey R Weiss
Journal: Cardiovascular Research (1998)

Objective: Several studies have shown that increasing cGMP in the heart reduces contractility, however, decreasing basal cGMP levels have also been shown in some studies to reduce contractility. This study was designed to evaluate the hypothesis that decreasing basal levels of cGMP decreases ventricular contractility, and that this depressed function is associated with a decrease in cAMP. Methods: Using paced, constant flow, buffer-perfused rat hearts, we determined the effects of intracoronary infusions of the guanylyl cyclase inhibitor, LY83583 (10−5 M), on ventricular function, oxygen consumption, and ventricular content of cGMP and cAMP. These experiments were conducted in the absence and presence of isoproterenol (ISO) to increase baseline left ventricular developed pressure (LVDP) and cAMP. Results: LY83583, infused for 25 min, decreased LVDP by 44±3 (SE), 77±20 and 120±38 mmHg, in control, 10−9 M, and 10−8 M ISO-stimulated hearts, respectively. Regardless of the level of ISO stimulation, LY83583 reduced LVDP to the same sub-basal level. Oxygen consumption also decreased, but proportionately less than LVDP. ISO increased cAMP without changing cGMP. LY83583 decreased cGMP by about 25% at all levels of ISO, and decreased cAMP by 22% in the 10−8 M ISO-stimulated group. Conclusion: Guanylyl cyclase inhibition by LY83583 decreased cGMP, cAMP and ventricular contractility. However, LY83583 depression of contractility was not always associated with a reduction in cAMP, suggesting that LY83583 can depress contractility by both cAMP-dependent and independent mechanisms.
789. Stable Genome Alteration of the Dystrophin Gene for the Treatment of Duchenne Muscular Dystrophy (DMD) Due to Frame-Shift Mutations Using Oligonucleotide-Mediated Gene Editing
Authors: Carmen Bertoni, Thomas A. Rando
Journal: Molecular Therapy (2005)

Duchenne muscular dystrophy is an X linked neuromuscular disorder characterized by lack of dystrophin gene expression. Mutations in the dystrophin gene include single point mutations, large deletions and frame shift mutations. Genome editing of the dystrophin gene represents an attractive approach to restoration of dystrophin into skeletal muscle of DMD patients. Oligonucleotide-mediated single base substitution has the potential to completely correct the mutation in the case of single point mutations, or to restore the reading frame of the dystrophin gene to correct frame shift mutations. Furthermore oligonucleotide-mediated gene correction allows the gene to remain under the control of its own regulatory mechanisms.
Rapid Rates During Bradycardia Prolong Ventricular Refractoriness and Facilitate Ventricular Tachycardia Induction With Cesium in Dogs
Authors: Tadashi Satoh, Douglas P. Zipes
Journal: Circulation (1996)

Background Bradycardia can promote the development of some ventricular tachycardias (VTs). We investigated whether relative bradycardia per se or the transition from a rapid to a slower ventricular rate might be important in developing VT. Methods and Results We studied groups of anesthetized closed-chest dogs that had AV block produced by radiofrequency catheter ablation of the AV junction. One group had uninterrupted AV block; the other group underwent a period of rapid left ventricular pacing. Both groups then received incremental doses of CsCl until sustained VT resulted. We also measured ventricular effective refractory period (V-ERP) and QT interval in separate groups of dogs that had AV block for 1 week or 3 days with and without rapid pacing (pacing cycle length [PCL]=500 or 250 ms) for 1 hour or 30 minutes. Finally, we investigated the effects of rapid pacing on V-ERP by testing the effects of verapamil and autonomic denervation on these changes. We found that CsCl induced larger early afterdepolarizations and a greater prevalence of VT in dogs with rapid pacing than in dogs without. In dogs that had AV block for 1 week, 1 hour of rapid pacing prolonged V-ERP and QT interval compared with V-ERP and QT interval before pacing. Changes persisted for at least 3 hours. Rapid pacing for only 30 minutes and at a PCL of 250 ms, as well as superimposition on sinus rhythm, each prolonged V-ERP but to a lesser extent. Only 3 days of complete AV block and autonomic denervation did not affect the prolongation of V-ERP produced by rapid pacing, whereas verapamil significantly blunted but did not eliminate the prolongation. Conclusions At the same PCLs, the heart exposed to transient tachycardia superimposed on bradycardia exhibited a longer V-ERP, QT interval, and monophasic action potential duration and greater ease for developing VT than the heart exposed only to bradycardia. The prolongation of refractoriness lasted for at least 3 hours, and the Δ-ERP was influenced by the heart rate before pacing, the duration of pacing, and the PCL. The mechanism for this response to rapid rates appears to involve calcium, at least in part.
Intrathecal synthesis of antibodies to HTLV-III in patients without AIDS or AIDS related complex.
Authors: J Goudsmit, E C Wolters, M Bakker, L Smit, J Van der Noordaa, E A Hische, J A Tutuarima, H J Van der Helm
Journal: BMJ (1986)

De novo synthesis in the central nervous system of IgG antibodies to human T cell lymphotropic virus type III (HTLV-III) (lymphadenopathy associated virus) was shown in seven of 10 seropositive men who had syphilis but not the acquired immune deficiency syndrome (AIDS) or AIDS related complex. None of these men showed neurological symptoms when the serum and cerebrospinal fluid were collected. Pleocytosis was present in all 10. Of the seven men who showed evidence of intrathecal synthesis of antibodies, five had increased total concentrations of IgG and four had oligoclonal IgG bands in their cerebrospinal fluid. Oligoclonal bands were also present in one man who did not have any antibodies. Longitudinal study of one man showed that seroconversion preceded intrathecal synthesis of antibody specific to HTLV-III. The appearance of antibody in the cerebrospinal fluid was accompanied by a transient rise in mononuclear cell count and the appearance of oligoclonal bands. The presence of clones of B cells specific to HTLV-III in the central nervous system of these patients without persisting neurological symptoms suggests that HTLV-III enters the central nervous system in the early stages of infection.
The Prospects for Red-Cell Substitutes
Authors: Harvey G. Klein
Journal: New England Journal of Medicine (2000)

Blood is still the best thing possible to have in our veins, according to Woody Allen, and that is certainly the case when the blood is our own. We are not so confident, however, about other people's blood, the transfusion of which can cause unexpected, unexplained, and occasionally lethal complications. It is little wonder, then, that there are such high hopes for the development of safe alternatives to blood.The term “blood substitute” is a misnomer. So-called blood substitutes replace just one or possibly two functions of transfused blood — oxygen delivery and volume expansion — and thus are more . . .
Assessment of the beta-adrenergic receptor pathway in the intact failing human heart: progressive receptor down-regulation and subsensitivity to agonist response.
Authors: M B Fowler, J A Laser, G L Hopkins, W Minobe, M R Bristow
Journal: Circulation (1986)

We developed methods for identifying beta-adrenergic receptors in human right ventricular endomyocardial biopsy tissue with the radioligand (-)[125I]iodocyanopindolol (ICYP). Specific ICYP binding in a crude, high-yield membrane preparation derived from endomyocardial biopsy tissue was high (specificity greater than 90%), of high affinity (KD around 20 pM), saturable and stereospecific for the (-) vs the (+) isomer of isoproterenol. Subjects with mild-moderate and severe biventricular dysfunction had respective decreases in beta-adrenergic receptor density of 38.2% and 57.7% when normalization methods were averaged, with no significant differences in ICYP dissociation constant. A subgroup of subjects was subdivided by left ventricular ejection fraction (LVEF) into those with mild cardiac dysfunction (LVEF less than 0.50 greater than 0.40) and severe heart failure (LVEF less than 0.20) and given graded sequential infusions of dobutamine and calcium gluconate. Those with severe cardiac dysfunction had marked impairment of the dobutamine dP/dt and stroke work index response, whereas these responses to calcium did not differ in the two groups. These data indicate that in the intact human heart endomyocardial biopsy may be used for direct analysis of beta-adrenergic receptors, heart failure-associated myocardial beta-adrenergic down-regulation begins with mild-moderate ventricular dysfunction, reduction in myocardial beta-receptor density is related to degree of heart failure, and beta-receptor down-regulation is associated with pharmacologically specific impairment of the beta-agonist-mediated contractile response.
Initial Experience with New Dedicated Needles for Laparoscopic Ultrasound-Guided Fine-Needle Aspiration and Histological Biopsies
Authors: M. B. Mortensen, J. Durup, T. Pless, G. J. Plagborg, A. P. Ainsworth, H. O. Nielsen, C. Hovendal
Journal: Endoscopy (2001)

Laparoscopic ultrasonography (LUS) is an important imaging modality during laparoscopic staging of intra-abdominal malignancies, but LUS-assisted biopsy is often difficult or impossible. We report a newly developed inbuilt biopsy system for direct LUS-guided fine-needle aspiration (FNA) and Tru-cut biopsies.LUS-guided biopsy was performed in 20 patients with upper gastrointestinal tract tumors. The biopsied lesions had either not been previously detected by other imaging modalities or had been inaccessible, or the biopsy sample had been inadequate. Primary diagnosis, duration of biopsy procedure, needle monitoring (visibility, penetration, and deviation), complications, technical failures, and pathological findings were prospectively recorded.44 biopsies were performed with 25 needles (19, 20, and 22-G). Needle monitoring and penetration were good or acceptable in 18 patients (90%). Slight needle deviation (<10 mm) was seen in eight patients (40%). The LUS-guided biopsy specimen was sufficient for analysis in 13 patients (65%). In two additional patients, adequate material was obtained, but pathological examination was impossible owing to incorrect handling of the specimen. The biopsy procedures lasted 16.3 minutes (range 10-20 minutes) and no complications were seen.LUS-guided fine-needle aspiration or Trucut biopsy is possible using this newly developed biopsy system. These preliminary data suggest that LUS-guided biopsy may further improve the diagnostic possibilities of LUS.
Effect of Frequency of Prenatal Care Visits on Perinatal Outcome Among Low-Risk Women
Authors: Robert S. McDuffie
Journal: JAMA (1996)

<h3>Objective.</h3> —In 1989, the Expert Panel on the Content of Prenatal Care established guidelines on the timing and content of prenatal care, including a schedule consisting of fewer prenatal visits than traditionally provided, for women at low risk of adverse perinatal outcomes. We tested the hypothesis that there are no significant increases in adverse perinatal outcomes when low-risk women are seen in a prenatal care visit schedule of fewer visits than routinely advised. <h3>Design.</h3> —Randomized controlled trial. <h3>Setting.</h3> —Group-model health maintenance organization. <h3>Patients.</h3> —A total of 2764 pregnant women, judged to be at low risk of adverse perinatal outcomes. <h3>Interventions.</h3> —Following risk assessment, participants were randomly assigned to an experimental schedule (nine visits) or a control schedule (14 visits) with additional visits as indicated or as desired by the patient. <h3>Main Outcome Measures.</h3> —Preterm delivery, preeclampsia, cesarean delivery, low birth weight, and patients' satisfaction with care. <h3>Results.</h3> —On average, there were 2.7 fewer visits observed in the experimental group than in the control group. There were no significant increases in the main outcomes of the experimental group: preterm delivery (relative risk [RR], 1.08; 95% confidence interval [CI], 0.92 to 1.27;<i>P</i>=.19), preeclampsia (RR, 0.94; 95% CI, 0.78 to 1.14;<i>P</i>=.74), cesarean delivery (RR, 1.04; 95% CI, 0.93 to 1.17;<i>P</i>=.25), and low birth weight (RR, 0.94; 95% CI, 0.78 to 1.12;<i>P</i>=.76). There were no differences between the two groups in patients' satisfaction with quality of prenatal care. <h3>Conclusion.</h3> —In this study, good perinatal outcomes and patient satisfaction were maintained when the prenatal visit schedule proposed by the Expert Panel on the Content of Prenatal Care was observed. (<i>JAMA</i>. 1996;275:847-851)
Sunscreens -- A Public Health Opportunity
Authors: Barbara A. Gilchrest
Journal: New England Journal of Medicine (1993)

In this issue of the Journal, investigators from the Anti-Cancer Council of Victoria, Australia, demonstrate that daily use of a sunscreen with a high sun-protection factor reduces the number of new precancerous solar keratoses and increases the rate of remission of preexisting solar keratoses in persons at high risk for skin cancer1. A total of 431 subjects with substantial sun-induced skin damage and a mean age of 63 years completed the randomized, vehicle-controlled trial. After seven months, the average subject who used the sunscreen had a net loss of approximately one keratosis, whereas the average subject who used the . . .
Protracted diarrhoea of infancy: evidence in support of an autoimmune variant.
Authors: R Mirakian, A Richardson, P J Milla, J A Walker-Smith, J Unsworth, M O Savage, G F Bottazzo
Journal: BMJ (1986)

Circulating autoantibodies to enterocytes were detected by indirect immunofluorescence in 14 out of 25 patients with idiopathic protracted diarrhoea of infancy. Similar specificities were not found in 50 control children with nongastroenterological disorders. The immunofluorescence pattern was more accentuated on the apical border of mature enterocytes. Enterocyte autoantibodies were mainly of IgG class (13/14), but 11 sera were positive for IgM and IgA classes, and five out of 14 positive sera also had the ability to fix complement. Absorption of sera positive for autoantibodies with an IgA coupled immunoabsorbent did not modify the intensity of the staining, indicating that these antibodies were not directed against secretory IgA. High titres and the complement fixing ability of enterocyte autoantibodies indicated a poorer prognosis despite the use of immunosuppressive drugs. Organ specific and non-organ specific autoimmune diseases or corresponding autoantibodies or both were often found in children with enterocyte autoantibodies and their family. These data show the existence of an autoimmune variant of protracted diarrhoea of infancy, despite the rare occurrence of autoimmune diseases in childhood.
ERIC recommendations on TP53 mutation analysis in chronic lymphocytic leukemia
Authors: S Pospisilova, D Gonzalez, J Malcikova, M Trbusek, D Rossi, A P Kater, F Cymbalista, B Eichhorst, M Hallek, H Döhner, P Hillmen, M van Oers, J Gribben, P Ghia, E Montserrat, S Stilgenbauer, T Zenz
Journal: Leukemia (2012)
Fouled Asthma Unfouled-Reply
Authors: Thomas E. Elkins
Journal: JAMA (1985)

In Reply.—  I appreciate your careful reading of the article, which included an unfortunate literary error.  The patient was treated appropriately with a variety of antiasthmatic medications, some of which are rightly termed β-sympathomimetics (eg, terbutaline) and not β-blockers.  I am sorry that this error caused confusion to readers.