tbuckley/cabot-search huggingface dataset:
Medicine—Trade or Profession?
Authors: Lester S. King
Journal: JAMA (1985)

As with all highly charged words, the meaning of "profession" varies with the context. The original Latin root,<i>profiteor</i>, conveys a sense of public statement, which might be an avowal, promise, announcement, confession, or commitment. In English the original meaning comes out most clearly in a religious context, as when someone makes a "confession of faith." In a broader context profession came to mean a public claim (or avowal) of special knowledge or skill in some particular area. Then, by simple extension, the word indicated the specific area wherein lay the particular skill. The so-called "oldest profession" conveys by implication an activity that certainly requires special skill but differs sharply from others less old, those that we called the learned professions. These—originally medicine, law, and divinity— demanded profound academic study. The knowledge acquired by study set the members apart from the laity who, lacking such knowledge, depended on the statements
What Price Interns
Authors: James W. Wiggs
Journal: JAMA (1970)

<h3>To the Editor.—</h3> Relative to your editorial, "What Price Interns?," (<b>211</b>: 1369, 1970). To one who stands back and takes a long view of history, the present debate over the salaries of interns has a curious ring to it. The rise in their salaries is only shocking by comparison with the laughable smallness of their traditional remuneration. When one considers the relatively unskilled, easily trained for jobs that are rewarded with hourly wages and benefits totaling $15 to $25,000 a year in contemporary America, the enormous number of hours worked by the average intern certainly warrants him a living wage. The opponents of this increase simply have at the core of their argument the economic truism that it is cheaper to manufacture things using slave labor than using paid laborers. To ask "Is the intern starting his hospital service on July 1 worth so much more than he was as
Noninvasive Diagnosis of Bladder Cancer by Detection of Matrix Metalloproteinases (MMP-2 and MMP-9) and Their Inhibitor (TIMP-2) in Urine
Authors: Sanaa Eissa, Randa Ali-Labib, Menha Swellam, Manal Bassiony, Fathy Tash, Tarek Mostafa El-Zayat
Journal: European Urology (2007)
Deep-Vein Thrombosis and the Incidence of Subsequent Symptomatic Cancer
Authors: Paolo Prandoni, Anthonie W.A. Lensing, Harry R. Büller, Alberto Cogo, Martin H. Prins, Anna M. Cattelan, Stefano Cuppini, Franco Noventa, Jan W. ten Cate
Journal: New England Journal of Medicine (1992)

In contrast to the established relation between overt cancer and subsequent venous thromboembolism, it is unclear whether symptomatic deep-vein thrombosis is associated with a risk of subsequent overt malignant disease.
VIP and UIP
Authors: William M. Rafelson, Vijay Rajput
Journal: JAMA (2012)

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
T cell tolerance to non-H-2-encoded stimulatory alloantigens is induced intrathymically but not prethymically.
Authors: P J Morrissey, D Bradley, S O Sharrow, A Singer
Journal: The Journal of Experimental Medicine (1983)

The present report has evaluated the differentiation compartment in which T cells are tolerized to non-major histocompatibility complex (MHC)-encoded minor lymphocyte-stimulating locus (MLS) alloantigens. It was observed that T cell precursors are not tolerized prethymically to MLS alloantigens but are tolerized intrathymically and postthymically to MLS alloantigens. The failure of prethymic T cells to be tolerized indicates either that T cell precursors are unable to be tolerized to MLS alloantigens or that cells in the prethymic compartment are unable to induce MLS-specific tolerance. In either case, these results demonstrate that the thymus is the initial site in which T cell tolerance to MLS alloantigen is induced. The present results also demonstrate a striking disparity in the reactivity of thymocytes to MHC and MLS alloantigens expressed in the extrathymic host through which their precursors had migrated. In the experimental mice constructed for these studies, intrathymic T cells were tolerant to the MHC alloantigens but were reactive to the MLS alloantigens expressed by the extrathymic host. This observation is consistent with the concept that T cell precursors may be tolerized to MHC alloantigens at an earlier point in their differentiation than they are tolerized to non-MHC-encoded MLS alloantigens.
Users' Guides to the Medical Literature
Authors: W. Scott Richardson, Allan S. Detsky
Journal: JAMA (1995)

<h3>CLINICAL SCENARIO</h3> You are the attending physician on an inpatient service where a 51-year-old man is admitted with congestive heart failure of recent onset. You find he has a dilated cardiomyopathy, the cause of which remains unknown after a thorough evaluation. He is in sinus rhythm. The team's resident asks you whether the patient should be anticoagulated with warfarin, enough to keep his international normalized ratio from 2.0 to 3.0, in order to prevent systemic emboli, even though his echocardiogram does not show left ventricular thrombus. You are not sure about the evidence concerning this issue, so you admit your shared knowledge gap and resolve to search together for the relevant information. <h3>THE SEARCH</h3> In the hospital's library, the two of you search the MEDLINE system us
Implementing shared decision making in the NHS
Authors: G. Elwyn, S. Laitner, A. Coulter, E. Walker, P. Watson, R. Thomson
Journal: BMJ (2010)

<h3>BACKGROUND AND PURPOSE:</h3> During thyroidectomy incomplete resection of the thyroid gland may occur. This complicates the imaging surveillance of these patients as residual thyroid needs to be distinguished from local recurrence. Therefore, the purpose of this study was to determine if multiphasic multi-detector computed tomography (4D-MDCT) can differentiate residual nonmalignant thyroid tissue and recurrent thyroid carcinoma after thyroidectomy. <h3>MATERIALS AND METHODS:</h3> In this retrospective study, Hounsfield unit values on multiphasic multidetector CT in precontrast, arterial (25 seconds), venous (55 seconds), and delayed (85 seconds) phases were compared in 29 lesions of recurrent thyroid cancer, 29 with normal thyroid, and 29 with diseased thyroid (thyroiditis/multinodular thyroid). The comparison of Hounsfield unit values among lesion types by phase was performed using ANOVA. The performance of Hounsfield unit values to predict recurrence was evaluated by logistic regression and receiver operating characteristic analysis. <h3>RESULTS:</h3> All 3 tissue types had near-parallel enhancement characteristics, with a wash-in–washout pattern. Statistically different Hounsfield unit density was noted between the recurrence (lowest Hounsfield unit), diseased (intermediate Hounsfield unit), and normal (highest Hounsfield unit) thyroid groups throughout all 4 phases (<i>P </i>&lt; .001 for each group and in each phase). Dichotomized recurrence-versus-diseased/normal thyroid tissue with univariate logistic regression analysis demonstrated that the area under the receiver operating characteristic curve for differentiating benign from malignant thyroid for the various phases of enhancement was greatest in the precontrast phase at 0.983 (95% CI, 0.954–1), with a cutoff value of ≤62 (sensitivity/specificity, 0.966/0.983) followed by the arterial phase. <h3>CONCLUSIONS:</h3> Recurrent thyroid carcinoma can be distinguished from residual nonmalignant thyroid tissue using multiphasic multidetector CT with high accuracy. The maximum information for discrimination is in the precontrast images, then the arterial phase. An optimal clinical protocol could be built from any number of phases but should include a precontrast phase.
Subcellular localization of the superoxide-forming enzyme in human neutrophils.
Authors: B Dewald, M Baggiolini, J T Curnutte, B M Babior
Journal: Journal of Clinical Investigation (1979)

The subcellular distribution of the superoxide (O2-)-forming enzyme in human neutrophils was investigated. Cells were activated by phorbolmyristate acetate or by opsonized zymosan, and were then fractionated by zonal-rate sedimentation at two different speeds. At high speed, the specific granules were resolved from the azurophils and the membrane fraction, while at low speed, the azurophil granules could be separated from fast-sedimenting particle aggregates. Under both conditions, the major portion of the O-2--forming activity (60--70% of the total) was found to be associated with the membrane fraction which was characterized by the presence of alkaline phosphatase, alkaline phosphodiesterase I, and acid aryl phosphatase. No significant O-2--forming activity was found in either specific or azurophil granules. Some activity was present in the fastest sedimenting fractions which, as shown by electron microscopy, were heterogeneous and contained aggregated material which included membrane fragments. These fractionation results provide strong additional support for the current view that the activable O-2--forming system is localized in the plasma membrane of human neutrophils.
Gastrointestinal intraepithelial lymphocytes and T cell lymphomas
Authors: I N Farstad, K E A Lundin
Journal: Gut (2003)

Enteropathy-type intestinal T cell lymphoma is assumed to derive from intraepithelial lymphocytes and recent reports describing an intermediate or “cryptic” stage of this lymphoma in patients with many characteristics of coeliac disease have challenged aspects of our understanding of coeliac disease and lymphoma development

Gastrointestinal T cell lymphomas occur less often than those of B cells but have a much more unfavourable prognosis.1 Enteropathy-associated T cell lymphoma (EATL) is the predominant subtype,1 “enteropathy” indicating a link to coeliac disease (CD).1 More recently, enteropathy-type intestinal T cell lymphoma (EITCL) seems to be the preferred term for this entity.2,3 EITCL is assumed to derive from intraepithelial lymphocytes (IELs) and recent reports describing an intermediate or “cryptic” stage of this lymphoma in patients with many characteristics of CD have provided a “missing link” in our understanding of the pathogenesis of EITCL.4,5

Refractory coeliac sprue (RCS) is diagnosed in patients with CD-like enteropathy who do not respond to a gluten free diet, primarily or some time after an initial response.6 RCS patients with phenotypically normal and polyclonal IELs may respond to immunosuppressive therapy.5 However, a large fraction of RCS patients have heavily increased IEL numbers lacking surface CD3 (cytoplasmic e chains being present) and usually also CD8, in addition to being monoclonal.5,6 Loss of …
First Clinical Application of an Actively Reversible Direct Factor IXa Inhibitor as an Anticoagulation Strategy in Patients Undergoing Percutaneous Coronary Intervention
Authors: Mauricio G. Cohen, Drew A. Purdy, Joseph S. Rossi, Liliana R. Grinfeld, Shelley K. Myles, Laura H. Aberle, Adam B. Greenbaum, Edward Fry, Mark Y. Chan, Ross M. Tonkens, Steven Zelenkofske, John H. Alexander, Robert A. Harrington, Christopher P. Rusconi, Richard C. Becker
Journal: Circulation (2010)

The ideal anticoagulant should prevent ischemic complications without increasing the risk of bleeding. Controlled anticoagulation is possible with the REG1 system, an RNA aptamer pair comprising the direct factor IXa inhibitor RB006 and its active control agent RB007.This phase 2a study included a roll-in group (n=2) treated with REG1 plus glycoprotein IIb/IIIa inhibitors followed by 2 groups randomized 5:1 to REG1 or unfractionated heparin. In group 1 (n=12), RB006 was partially reversed with RB007 after percutaneous coronary intervention and fully reversed 4 hours later. In group 2 (n=12), RB006 was fully reversed with RB007 immediately after percutaneous coronary intervention. Femoral sheaths were removed after complete reversal. Patients were pretreated with aspirin and clopidogrel. End points included major bleeding within 48 hours; composite of death, myocardial infarction, or urgent target vessel revascularization within 14 days; and pharmacodynamic measures. All cases were successful, with final Thrombolysis in Myocardial Infarction grade 3 flow and no angiographic thrombotic complications. There were 2 ischemic end points in the REG1 group and 1 in the unfractionated heparin group, with 1 major bleed in the unfractionated heparin group. Median activated clotting time values rose from 151 to 236 seconds after RB006. Administration of the partial RB007 dose reversed anticoagulation to an intermediate activated clotting time value of 186 seconds. Complete reversal with RB007 returned the median activated clotting time value to 144 seconds. Both reversal strategies enabled scheduled femoral sheath removal.This study demonstrates the clinical translation of a novel platform of anticoagulation targeting factor IXa and its active reversal to percutaneous coronary intervention and provides the basis for further investigation.URL: http://www.clinicaltrials.gov. Unique identifier: NCT00715455.
Studies of the In Vivo Behavior of Human C′3 in Normal Subjects and Patients*
Authors: Chester A. Alper, Fred S. Rosen
Journal: Journal of Clinical Investigation (1967)

The metabolic behavior of C'3 labeled with radioactive iodine was investigated in 10 normal subjects and in 20 patients with diseases in which complement is thought to play a pathophysiological role. The mean fractional catabolic rate of C'3 in normal subjects was 2.3 +/- 1.0% of the plasma pool per hr, whereas the fractional catabolic rate of C'3(i), the inactive conversion product of C'3 produced by complement activation, was at least five times as great. Increased catabolic rates were found in some patients with acute glomerulonephritis, systemic lupus erythematosus, idiopathic nephrotic syndrome of childhood, and progressive glomerulonephritis. Depressed synthesis was found in each of four studies of patients with progressive glomerulonephritis and seemed to be the major factor in the lowering of plasma C'3 concentrations regularly observed in patients with this disease. Of three patients with acute glomerulonephritis, synthesis rates of C'3 were markedly depressed in one subject, at the lower limit of normal in another, and entirely normal in the third. Increased extravascular: plasma pool ratios were observed in the studies of C'3(i) metabolism in a normal subject, and of C'3 metabolism in two of three patients with acute glomerulonephritis, in one of four patients with systemic lupus erythematosus, and in one patient with idiopathic nephrotic syndrome. The increased pool ratios are possibly compatible with tissue attachment of part of the injected C'3 or its conversion products. No important abnormalities of metabolism were found in patients with acquired hemolytic anemia, paroxysmal nocturnal hemoglobinuria, hereditary angioneurotic edema, or rheumatoid arthritis.By means of antigen-antibody crossed electrophoresis, C'3(i) could be demonstrated in the fresh plasma of three of eight patients who had acute glomerulonephritis. This finding was used as evidence for in vivo complement activation in this disease. Since C'3(i) was demonstrated only in plasma from patients with very low plasma concentrations whose onset of symptoms was very recent, there may be two phases in the metabolism of C'3: early complement activation with resultant increased catabolism and later depressed synthesis, both of which lead to lowered serum concentrations.
Extracorporeal Piezoelectric Shockwave Lithotripsy of Multiple Pancreatic Duct Stones under Ultrasonographic Control
Authors: W. Kerzel, Ch. Ell, H. Th. Schneider, W. Matek, N. Heyder, E. G. Hahn
Journal: Endoscopy (1989)

The first ultrasonographically controlled fragmentation of multiple pancreatic duct stones of up to 14 mm size by means of extracorporeal, piezoelectric shock-wave lithotripsy is reported. On account of the ultrasound localization and continuous control during therapy a nasopancreatic tube for instillation of contrast medium and frequent x-ray checks were not necessary. The 48-year-old patient did not experience any pain during the four treatment sessions and during the follow-up period. No complications were noted.
No acute changes in postural control after soccer heading
Authors: S P Broglio, K M Guskiewicz, T C Sell, S M Lephart
Journal: British Journal of Sports Medicine (2004)

Background: Soccer heading has been proposed as a potential cause of cerebral dysfunction. Objective: To examine the acute effects of two types of soccer heading on postural control. Methods: Collegiate soccer players were randomly assigned to one of four groups: control, linear heading, simulated rotational heading, or rotational heading. Each subject completed a baseline postural stability assessment on day 1. On day 2 the same assessment was completed for the control subjects. The simulated rotational heading group completed a simulated heading drill before postural stability testing. The linear and rotational heading groups performed a heading drill with 20 balls at 88.71 km/h (55 mph), before postural stability testing. Separate one between (group), three within (surface, eyes, and day), mixed model, repeated measures analyses of variance were conducted on values for total sway and mean centre of pressure. Results: The mixed model analysis of variance of results showed no significant differences (p&gt;0.05) for the interactions of interest for either variable. Results suggest no acute changes in measures of postural control in soccer players completing either a linear or rotational soccer heading drill of 20 balls at a fixed speed. Conclusion: Non-significant interactions between surface, eyes, day, and group indicate that sensory interaction of the balance mechanism components are not be compromised by the heading drill. This research supports previous studies suggesting that there are no acute risks associated with routine soccer heading. A direct comparison between these findings and those suggesting long term chronic deficits, however, cannot be made. Other studies that report chronic cerebral deficits in soccer players may have resulted from factors other than soccer heading and warrant further examination.
Delta-9-Tetrahydrocannabinol
Authors: Louis Lemberger, James L. Weiss, August M. Watanabe, I. Marc Galanter, Richard J. Wyatt, Philippe V. Cardon
Journal: New England Journal of Medicine (1972)

14C-delta-tetrahydrocannabinol (14C-Δ9THC) was administered to 12 long-term marihuana smokers intravenously, orally or by inhalation, and the drug's disposition, excretion and psychologic effects compared. Over 90 per cent of the dose was absorbed after oral administration; the psychologic effects and plasma levels of metabolites of Δ9,-THC peaked at three hours. After inhalation, the peak psychologic "high" ranged from 10 to 140 minutes (average peak "high" of 70 minutes), correlating well with the peak plasma levels of metabolites of Δ9-THC. The percentage of administered radioactive dose excreted in urine during the first day was similar after oral and intravenous routes, but the proportion of radioactivity recovered from feces (seven days) exceeded that in the one-day urine output. The fact that the psychologic effects in response to pharmacologic doses of ingested or inhaled 14C-Δ9-THC were temporally correlated with plasma levels of the metabolites of the drug supports the hypothesis that these metabolites are active compounds.
EULAR Sjögren's syndrome disease activity index: development of a consensus systemic disease activity index for primary Sjögren's syndrome
Authors: Raphaèle Seror, Philippe Ravaud, Simon J Bowman, Gabriel Baron, Athanasios Tzioufas, Elke Theander, Jacques-Eric Gottenberg, Hendrika Bootsma, Xavier Mariette, Claudio Vitali
Journal: Annals of the Rheumatic Diseases (2009)

To develop a disease activity index for patients with primary Sjögren's syndrome (SS): the European League Against Rheumatism (EULAR) Sjögren's syndrome disease activity index (ESSDAI).
HYAL1 Hyaluronidase: A Molecular Determinant of Bladder Tumor Growth and Invasion
Authors: Vinata B. Lokeshwar, Wolfgang H. Cerwinka, Bal L. Lokeshwar
Journal: Cancer Research (2005)

Abstract Hyaluronic acid and HYAL1-type hyaluronidase show high accuracy in detecting bladder cancer and evaluating its grade, respectively. Hyaluronic acid promotes tumor progression; however, the functions of hyaluronidase in cancer are largely unknown. In this study, we stably transfected HT1376 bladder cancer cells with HYAL1-sense (HYAL1-S), HYAL1-antisense (HYAL1-AS), or vector cDNA constructs. Whereas HYAL1-S transfectants produced 3-fold more HYAL1 than vector transfectants, HYAL1-AS transfectants showed ∼90% reduction in HYAL1 production. HYAL1-AS transfectants grew four times slower than vector and HYAL1-S transfectants and were blocked in the G2-M phase of the cell cycle. The expression of cdc25c and cyclin B1 and cdc2/p34-associated H1 histone kinase activity also decreased in HYAL1-AS transfectants. HYAL1-S transfectants were 30% to 44% more invasive, and HYAL1-AS transfectants were ∼50% less invasive than the vector transfectants in vitro. In xenografts, there was a 4- to 5-fold delay in the generation of palpable HYAL1-AS tumors, and the weight of HYAL1-AS tumors was 9- to 17-fold less than vector and HYAL1-S tumors, respectively (P &amp;lt; 0.001). Whereas HYAL1-S and vector tumors infiltrated skeletal muscle and blood vessels, HYAL1-AS tumors resembled benign neoplasia. HYAL1-S and vector tumors expressed significantly higher amounts of HYAL1 (in tumor cells) and hyaluronic acid (in tumor-associated stroma) than HYAL1-AS tumors. Microvessel density in HYAL1-S tumors was 3.8- and 9.5-fold higher than that in vector and HYAL1-AS tumors, respectively. These results show that HYAL1 expression in bladder cancer cells regulates tumor growth and progression and therefore serves as a marker for high-grade bladder cancer.
Setting Value-Based Payment Goals — HHS Efforts to Improve U.S. Health Care
Authors: Sylvia M. Burwell
Journal: New England Journal of Medicine (2015)

New targets have been set for value-based payment: 85% of Medicare fee-for-service payments should be tied to quality or value by 2016, and 30% of Medicare payments should be tied to quality or value through alternative payment models by 2016 (50% by 2018).