tbuckley/cabot-search huggingface dataset:
Tuberculosis, Vulnerability, and Access to Quality Care
Authors: Philip C. Hopewell
Journal: JAMA (2005)

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
Doctors accuse India of massaging leprosy figures
Authors: Ganapati Mudur
Journal: BMJ (2005)

Doctors in India have expressed concern that health authorities are playing down the number of patients with leprosy in a bid to declare that they have eliminated leprosy as a public health problem by the end of this year.

In line with the elimination target set by the World Health Organization, the Indian health ministry has said that the prevalence of leprosy in India is expected to reach one case per 10 000 people by December 2005.

But public health specialists cautioned last week that health authorities would meet that target only through “artful manipulation” of the definition of leprosy and by “avoiding …
Study of factors causing excess protoporphyrin accumulation in cultured skin fibroblasts from patients with protoporphyria.
Authors: J R Bloomer, D A Brenner, M J Mahoney
Journal: Journal of Clinical Investigation (1977)

The activity of heme synthetase, which catalyzes the chelation of ferrous iron to protoporphyrin to form heme, is deficient in sonicates of skin fibroblasts cultured from patients with protoporphyria. During culture in Eagle's medium supplemented with fetal calf serum, these cells do not accumulate protoporphyrin, however. This may be due to a minimal requirement for heme synthesis, since glycine is incorporated into heme at a low rate which is similar to that in normal fibroblasts. In addition, the activity of delta-aminolevulinic acid (ALA) synthetase, the first and rate-limiting enzyme of heme biosynthesis which catalyzes the formation of ALA from glycine, is normal in lysates of the fibroblasts. Cultured fibroblasts were therefore incubated with ALA in order to bypass the rate-limiting step of heme biosynthesis. In the presence of 25 muM iron, protoporphyrin was detected in protoporphyria cell lines when the concentration of ALA in the medium reached 50 muM, but not in normal lines. As the concentration of ALA was increased above 50 muM, all lines accumulated protoporphyrin. However, the amount was 2-3 times more in cultured fibroblasts from patients with protoporphyria, reflecting their deficiency of heme synthetase activity. When iron was not added to the medium, protoporphyrin accumulated to a similar degree in normal and protoporphyria fibroblasts; this was significantly more than that in the presence of iron. These studies indicate that excessive protoporphyrin accumulation in protoporphyria, which is due principally to deficient heme synthetase activity, may be modified by the rate of ALA formation in heme-producing tissues, and by the availability of iron.
Dynamic three‐dimensional morphogenesis of intrahepatic bile ducts in mouse liver development
Authors: Yasuo Takashima, Maiko Terada, Masuyo Kawabata, Atsushi Suzuki
Journal: Hepatology (2014)

During liver development, biliary epithelial cells differentiated from bipotential hepatic progenitor cells (hepatoblasts) form a cell layer, called the ductal plate surrounding portal veins (PVs), and develop into intrahepatic bile ducts (IBDs) following developmental programs. Because IBDs make duct structures in the liver, it is necessary to perform sequential and three‐dimensional (3D) analyses from the early stages of liver development to address the process of morphogenesis in detail. However, to date, the development of IBDs has mainly been investigated using tissue sections in two‐dimensional planes, and examinations of the 3D morphogenesis and quantitative analyses based on morphometrics have not been performed. Therefore, in this study, we simulated the solid structures of IBDs from mouse embryos to adults in silico , analyzed the subjects for the length and number of developing duct structures, number of predicted connections, and discrete distance from the PV, and examined the developmental process of the IBD in detail in a quantitative manner. Conclusions : Through quantitative analyses with spatiotemporal observations using a 3D structural reconstruction model and morphometrics, we succeeded in constructing a 3D dynamic model of bile duct formation. Because the 3D reconstruction technique used in this study is available for analyzing solid structures in tissues that are difficult to approach, it shows promise for wide use in the fields of biology and medicine. (H epatology 2015;61:1003–1011)
Intracellular calcium modulation of voltage-gated sodium channels in ventricular myocytes
Authors: Simona Casini, Arie O. Verkerk, Marcel M.G.J. van Borren, Antoni C.G. van Ginneken, Marieke W. Veldkamp, Jacques M.T. de Bakker, Hanno L. Tan
Journal: Cardiovascular Research (2008)

Cardiac voltage-gated sodium channels control action potential (AP) upstroke and cell excitability. Intracellular calcium (Cai2+) regulates AP properties by modulating various ion channels. Whether Cai2+ modulates sodium channels in ventricular myocytes is unresolved. We studied whether Cai2+ modulates sodium channels in ventricular myocytes at Cai2+ concentrations ([Cai2+]) present during the cardiac AP (0–500 nM), and how this modulation affects sodium channel properties in heart failure (HF), a condition in which Cai2+ homeostasis is disturbed. Sodium current (INa) and maximal AP upstroke velocity (dV/dtmax), a measure of INa, were studied at 20 and 37°C, respectively, in freshly isolated left ventricular myocytes of control and HF rabbits, using whole-cell patch-clamp methodology. [Cai2+] was varied using different pipette solutions, the Cai2+ buffer BAPTA, and caffeine administration. Elevated [Cai2+] reduced INa density and dV/dtmax, but caused no INa gating changes. Reductions in INa density occurred simultaneously with increase in [Cai2+], suggesting that these effects were due to permeation block. Accordingly, unitary sodium current amplitudes were reduced at higher [Cai2+]. While INa density and gating at fixed [Cai2+] were not different between HF and control, reductions in dV/dtmax upon increases in stimulation rate were larger in HF than in control; these differences were abolished by BAPTA. Cai2+ exerts acute modulation of INa density in ventricular myocytes, but does not modify INa gating. These effects, occurring rapidly and in the [Cai2+] range observed physiologically, may contribute to beat-to-beat regulation of cardiac excitability in health and disease.
Genetics of Type 1A Diabetes
Authors: Patrick Concannon, Stephen S. Rich, Gerald T. Nepom
Journal: New England Journal of Medicine (2009)

Genetic contributions to the cause of type 1 diabetes have been studied for more than 30 years, but only recently, with modern genetic tools, has the importance of seemingly minor contributors been appreciated. This article reviews recent advances in knowledge of the genetics of type 1 diabetes and shows how this information could find clinical applications of considerable consequence.
Ethics of screening for asymptomatic herpes virus type 2 infection
Authors: Ingela Krantz, Gun-Britt Löwhagen, Beth Maina Ahlberg, Tore Nilstun
Journal: BMJ (2004)

<i>Commercial tests for herpes simplex virus are now widely available, and some experts have advocated screening. But can screening be ethical when false positive results occur, many infected people are asymptomatic, and no cure is available?</i>
Enhancing discovery and saving money with MERIT
Authors: Jonathan A. Epstein
Journal: Journal of Clinical Investigation (2011)

The National Institutes of Health and many of our biomedical institutions face significant budgetary challenges that are likely to persist for the foreseeable future. The paylines for Research Project Grant (RO1) applications to the NIH will be near or below the tenth percentile, and many investigators are growing increasingly concerned about maintaining their research programs. One of the most concerning potential results of limited grant dollars is the natural tendency for researchers to propose conservative projects that are more likely to succeed, to do well in peer review, and to be funded, but that may not dramatically advance the field, and a concurrent tendency among study sections to reward proposals that are seen as safe, if uninspiring. Established and well-respected investigators may be (perhaps appropriately) given the benefit of the doubt when compared with less-established colleagues and may therefore command a growing percentage of the total available grant dollars, while simultaneously avoiding bold and potentially groundbreaking approaches. At the same time, fewer dollars are available for new investigators with unproven track records and for the expansion of newly successful programs.
Empirical Derivation of an Electronic Clinically Useful Problem Statement System
Authors: Steven H. Brown, Randolph A. Miller, Henry N. Camp, Dario A. Guise, H. Kenneth Walker
Journal: Annals of Internal Medicine (1999)

Problem lists are tools to improve patient management. In the medical record, they connect diagnoses to therapy, prognosis, and psychosocial issues. Computer-based problem lists enhance paper-based approaches by enabling cost-containment and quality assurance applications, but they require clinically expressive controlled vocabularies. Because existing controlled vocabularies do not represent problem statements at a clinically useful level, we derived a new canonical problem statement vocabulary through semi-automated analysis and distillation of provider-entered problem lists collected over 6 years from 74 696 patients. We combined automated and manual methods to condense 891 770 problem statements entered by 1961 care providers at Grady Memorial Hospital in Atlanta, Georgia, to 15 534 Canonical Clinical Problem Statement System (CCPSS) terms. The nature and frequency of problem statements were characterized, interrelations among them were enumerated, and a database capturing the epidemiology of problems was created. The authors identified 23 503 problem relations (co-occurrences, sign-symptom complexes, and differential diagnoses) and 22 690 modifier words that further categorized “canonical” problems. To assess completeness, CCPSS content was compared with that of the 1997 Unified Medical Language System Metathesaurus (containing terms from 44 clinical vocabularies). Unified Medical Language System terms expressed 25% of individual CCPSS terms exactly (71% of problems by frequency), 27% partially, and 48% poorly or not at all. Clinicians judged that CCPSS terms completely captured their clinical intent for 84% of 686 randomly selected free-text problem statements. The CCPSS represents clinical concepts at a level exceeding that of previous approaches. A similar national approach could create a standardized, useful, shared resource for clinical practice.
TRANSPLANTATION OF TENSOR FASCIAE FEMORIS IN CASES OF WEAKENED GLUTEUS MEDIUS
Authors: ARTHUR T. LEGG
Journal: JAMA (1923)

The limp caused by a weak gluteus medius with marked swaying of the body toward the involved side, and dropping of the hip on the opposite side (Trendelenburg sign) is very noticeable in many cases of poliomyelitis. In the endeavor to alleviate this limp, I devised the plan of transplanting the tensor fasicae femoris muscle into the outer side of the femur to increase the power in the gluteus medius. The tensor fasciae femoris is to some extent an abductor, but its greater power is in flexion. A function of the gluteus medius often overlooked is its action in holding the center of gravity of the body over the supporting leg when standing on one foot. We are all familiar with the action of the gluteus maximus in holding the body erect and preventing the trunk from falling forward, but it is not generally recognized that the gluteus medius is
Epithelial Ovarian Cancer and Combination Oral Contraceptives
Authors: Lynn Rosenberg
Journal: JAMA (1982)

The risk of epithelial ovarian cancer in relation to the use of combination oral contraceptives was evaluated in a case-control study of women younger than 60 years. Combination oral contraceptives were used by 35 (26%) of 136 cases and 187 (35%) of 539 controls. The relative risk estimate for combination oral contraceptive use was 0.6 (95% confidence interval, 0.4 to 0.9). The reduction in risk appeared to persist for as long as ten years after use had ceased and to be greater for longer durations of use, but these results were not statistically significant. The findings were not explained by parity or by other identified potential confounding factors. The results suggest that the use of combination oral contraceptives protects against epithelial ovarian cancer.The risk of epithelial ovarian cancer in relation to the use of combination oral contraceptives (OCs) was evaluated in a case-control study of women younger than 60 years. Combination OCs were used by 35 (26%) of 136 cases and 187 (35%) of 539 controls. The relative risk estimate for combination OC use was 0.6 (95% confidence interval, 0.4 to 0.9) indicating that OC users were about 60% as likely to develop epithelial ovarian cancer as never-users. The reduction in risk appeared to persist for as long as ten years after use had ceased and to be greater for longer durations of use, but these results were not statistically significant. The findings were not explained by parity or by other identified potential confounding factors. The results suggest that the use of combination OCs protects against epithelial ovarian cancer.
Superiority of Nabilone over Prochlorperazine as an Antiemetic in Patients Receiving Cancer Chemotherapy
Authors: Terence S. Herman, Lawrence H. Einhorn, Stephen E. Jones, Catherine Nagy, Aurelia B. Chester, Judith C. Dean, Becky Furnas, Stephen D. Williams, Susan A. Leigh, Robert T. Dorr, Thomas E. Moon
Journal: New England Journal of Medicine (1979)

Two double-blind, crossover trials comparing the antiemetic effectiveness of nabilone, a new synthetic cannabinoid, with that of prochlorperazine were conducted in patients with severe nausea and vomiting associated with anticancer chemotherapy. Of 113 patients evaluated, 90 (80 per cent) responded to nabilone therapy, whereas only 36 (32 per cent) responded to prochlorperazine (P less than 0.001). Complete relief of symptoms was infrequent, occurring only in nine patients (8 per cent) given nabilone. When both drugs were compared, both nausea (P less than 0.01) and vomiting episodes (P less than 0.001) were significantly lower in patients given nabilone. Moreover, patients clearly favored nabilone for continued use (P less than 0.001). Predominant side effects noted by patients were similar for both agents and included somnolence, dry mouth and dizziness but were about twice as frequent and more often severe in patients receiving nabilone. In addition, four patients (3 per cent) taking nabilone had side effects (hallucinations in three, hypotension in one) that required medical attention. Euphoria associated with nabilone was infrequent (16 per cent) and mild.
PHENOMENON OF LOCAL SKIN REACTIVITY TO BACTERIAL FILTRATES: FORMATION OF REACTING FACTORS IN VIVO
Authors: Gregory Shwartzman
Journal: The Journal of Experimental Medicine (1932)

In this paper there is described a new method for the demonstration of antigen-antibody combination, as follows: A rabbit sensitized a week previously to some animal protein receives a skin-preparatory injection of a potent bacterial filtrate. 24 hours after the skin preparation the rabbit is injected intravenously with the same animal protein. From 4 to 5 hours later there appears severe hemorrhagic necrosis at the prepared skin site. The incidence of positive results is high. A single sensitizing injection and 1 week incubation period are sufficient. The test is highly specific unless repeated sensitizing injections of large doses of antigen are made. The necessary sensitization can be elicited with minute quantities of animal proteins. It is also possible to elicit severe reactions in the prepared skin sites of non-sensitized rabbits upon separate intravenous injections of non-bacterial and bacterial antigens and homologous antibodies (i.e., passive transfer). The relation of the phenomenon of local skin reactivity to bacterial filtrates to various fields of immunology is discussed in the light of the above observations.
Validation of a new prognostic staging system for hepatocellular carcinoma: The JIS score compared with the CLIP score
Authors: Masatoshi Kudo, Hobyung Chung, Seiji Haji, Yukio Osaki, Hiroko Oka, Toshihito Seki, Hiroshi Kasugai, Yo Sasaki, Takashi Matsunaga
Journal: Hepatology (2004)

The Japan Integrated Staging score (JIS score), which combines the Child–Turcotte–Pugh classification and tumor–node–metastasis staging, has been proposed as a better prognostic staging system for hepatocellular carcinoma (HCC) than the Cancer of the Liver Italian Program (CLIP) scoring system. In this study, validation was performed among a larger patient population. A total of 4,525 consecutive patients with HCC who had been diagnosed at five institutions were included. Stratification ability, prognostic predictive power, and reproducibility were analyzed and compared with results from the CLIP scoring system. Only 45% (1,951 of 4,525) of all patients were categorized as early stage HCC according to JIS score (0 or 1), whereas 63% (2,878 of 4,525) of the patients were categorized as having a CLIP score of 0 or 1. Significant differences in survival curves were not observed among CLIP scores 3 to 6. In contrast, survival curves showed significant differences among all the JIS scores. The same JIS scoring subgroups showed a similar prognosis, and good internal reproducibility was observed in each of the institutions. Multivariate analysis of the prognosis in all 4,525 patients proved the JIS score to be the best prognostic factor. Furthermore, the Akaike information criteria proved that the JIS scoring system was statistically a better model for predicting outcome than the CLIP scoring system. In conclusion , the stratification ability and prognostic predictive power of the JIS score were much better than that of the CLIP score and were simple to obtain and remember. (Hepatology 2004; 40:1396-1405.)
Proposals for Reform of the British National Health Service
Authors: John Lister
Journal: New England Journal of Medicine (1989)

As I have reported previously in the Journal,1 there has been concern in Britain for several years about the state of the National Health Service (NHS). Long waiting lists for elective surgical procedures such as hip replacement and cataract operations, a shortage of nursing staff, and the elimination of many beds for acutely ill patients are among the more serious complaints. Many see persistent underfunding as the chief cause of the problem, but the government has protested that more money is being spent on the NHS than ever before and has repeatedly emphasized the need to obtain the best . . .
Atlas of Hernia Repair
Authors: John H. Wulsin
Journal: JAMA (1970)

Compared to the rest of medical knowledge, very little has changed in the description of surgical repair of hernia over the past 80 odd years since Bassini defined the anatomical principles of inguinal hernioplasty. But because hernia continues to plague mankind there remains a periodic need for articles, books, and atlases dealing with the topic. It is all the more incumbent that the efforts be sound and well done. The demands of producing a competent atlas exceed those of a text, for surgeons are accustomed to visual learning of techniques at the operating table, and hence the popularity of cine films for communicating such knowledge. Unless the illustrations of an atlas convey a high order of clarity and artistic skill, the reader is forced back onto his own visual imagination, leading to frustration and impatience. This particular atlas is not outdated and covers the field of hernia repair in a
The prevalence of anal sphincter defects in faecal incontinence: a prospective endosonic study.
Authors: K I Deen, D Kumar, J G Williams, J Olliff, M R Keighley
Journal: Gut (1993)

Forty six patients (median age 61 years; 42 women) with faecal incontinence and 16 age and sex matched controls undergoing a restorative proctocolectomy were assessed by clinical examination, anorectal physiology, and anal endosonography. Forty patients (87%) with faecal incontinence had a sphincter defect demonstrated on anal endosonography (31 external and 21 internal anal sphincter defects). The commonest cause of faecal incontinence was obstetric trauma. This occurred in 35 women, 30 of whom exhibited a morphological defect in the anorectal sphincter complex. In 22 of these patients with a history of a perineal tear or episiotomy, 21 (95%) had a sphincter defect. Sphincter defects were commonly located at the level of the midanal canal.
Long term prognosis in preschool children with wheeze: longitudinal postal questionnaire study 1993-2004
Authors: Peter I Frank, Julie A Morris, Michelle L Hazell, Mary F Linehan, Timothy L Frank
Journal: BMJ (2008)

<b>Objectives</b> To follow a population of preschool children with and without parent reported wheeze over a period of 6-11 years to determine prognosis and its important predictive factors. <b>Design</b> Longitudinal series of five postal surveys based on the international study of asthma and allergies in childhood questionnaire carried out between 1993 and 2004. <b>Setting</b> Two general practice populations, south Manchester. <b>Participants</b> 628 children aged less than 5 years at recruitment and those with at least six years’ follow-up data. <b>Main outcome measures</b> Parent completed questionnaire data for respiratory symptoms and associated features. <b>Results</b> Of 628 children included in the study, 201 (32%) had parent reported wheeze at the first observation (baseline), of whom 27% also reported the symptom on the second occasion (persistent asthma). The only important baseline predictors of persistent asthma were exercise induced wheeze (odds ratio 3.94, 95% confidence interval 1.72 to 9.00) and a history of atopic disorders (4.44, 1.94 to 10.13). The presence of both predictors indicated a likelihood of 53.2% of developing asthma; if only one feature was present this decreased to 17.2%, whereas if neither was present the likelihood was 10.9%. Family history of asthma was not predictive of persistent asthma among children with preschool wheeze. <b>Conclusion</b> Using two simple predictive factors (baseline parent reported exercise induced wheeze and a history of atopic disorders), it is possible to estimate the likelihood of future asthma in children presenting with preschool wheeze. The absence of baseline exercise induced wheeze and a history of atopic disorders reduces the likelihood of subsequent asthma by a factor of five.