tbuckley/cabot-search huggingface dataset:
Competence Is a Habit
Authors: David C. Leach
Journal: JAMA (2002)

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
Further studies on the use of serum gastrin levels in assessing the significance of low serum B<sub>12</sub> levels
Authors: A. Miller, D. W. Slingerland, J. Cardarelli, B. A. Burrows
Journal: American Journal of Hematology (1989)

Abstract The reported incidence of low serum vitamin B 12 levels in patients ranges from 4% to 8%. In only a small percentage can this be ascribed to readily diagnosed pernicious anemia, malabsorption syndrome, or to gastrointestinal surgery. This leaves a number of patients in whom the meaning of the low serum B 12 is not immediately apparent. In 71 patients with intact gastrointestinal tracts, hematological indices did not adequately separate patients with decreased absorption of unbound B 12 from those with normal absorption. A low absorption of B 12 , either unbound or food‐bound, was found, however, when the level of serum gastrin was elevated. In contrast, a normal absorption of unbound B 12 was likely (95% of 44 patients) when the serum gastrin was normal.
The Name is Barker.
Authors: T. Ridgway Barker.
Journal: JAMA (1893)

<h3>To the Editor:</h3> —In your editorial of October 7, entitled "The Place of Ergot in Obstetrics," you speak of a paper on this subject published in your issue of September 23 by Bohn. I think there is a mistake on this point, and judge it is my paper you refer to—"The Routine Administration of Ergot after Labor." Please make correction and oblige, Yours truly,
Alterations in steroidogenesis in alligators (Alligator mississippiensis) exposed naturally and experimentally to environmental contaminants.
Authors: D A Crain, L J Guillette, A A Rooney, D B Pickford
Journal: Environmental Health Perspectives (1997)

Many environmental contaminants alter the reproduction of animals by altering the development and function of the endocrine system. The ability of environmental contaminants to alter the endocrine system of alligators was studied both in a descriptive study in which juvenile alligators from a historically contaminated lake were compared to animals from a control lake and in an experimental study in which hatchling control alligators were exposed in ovo to several endocrine-disrupting standards and two modern-use herbicides. Endocrine status was assessed by examining plasma hormone concentrations, gonadal-adrenal mesonephros (GAM) aromatase activity, and gonadal histopathology. In the descriptive study, juvenile alligators from the contaminated lake had significantly lower plasma testosterone concentrations (29.2 pg/ml compared to 51.3 pg/ml), whereas plasma 17 beta-estradiol concentrations did not vary when compared to controls. GAM aromatase activity was significantly decreased n the alligators from the contaminated lake (7.6 pmol/g/hr compared to 11.4 pmol/g/hr). In the experimental study, the endocrine-disrupting standards had the expected effects. 17 beta-Estradiol and tamoxifen caused sex reversal from male to female, with a corresponding increase in aromatase activity. Vinclozolin had no apparent effect on male or female alligators. Among the herbicides tested, atrazine induced GAM aromatase activity in male hatchling alligators that was neither characteristic of males nor females, although testicular differentiation was not altered. Exposure to 2,4-dichlorophenoxyacetic acid had no effect on the endocrine parameters that were measured. Together, these studies show that exposure to some environmental chemicals (such as atrazine) can alter steroidogenesis in alligators, but the endocrine alterations previously noted for Lake Apopka, Florida, alligators can not be fully explained by this mechanism.
The Integrin Very Late Antigen-4 Is Expressed in Human Smooth Muscle Cell
Authors: Ce´cile Dupla`a, Thierry Couffinhal, Pascale Dufourcq, Brigitte Llanas, Catherine Moreau, Jacques Bonnet
Journal: Circulation Research (1997)

Vascular cell adhesion molecule-1 (VCAM-1) and its counterreceptor, the integrin very late antigen-4 (VLA-4), have recently been identified in smooth muscle cells during intimal thickening in humans and in newly forming vessels during ontogeny in mice, respectively. We examined the coexpression of VCAM-1 and the alpha 4 integrin subunit in human smooth muscle cells. The expression of VCAM-1 and alpha 4 subunit were studied during development of the aorta. In the 10-week-old human fetal aorta, VCAM-1 and alpha 4 were strongly expressed in smooth muscle cells. Their expression was dramatically reduced within the 24th week of gestation and disappeared in the adult aortic media. However, smooth muscle cells from intimal atherosclerotic thickening of adult aorta reexpressed both VCAM-1 and alpha 4. In a culture model mimicking smooth muscle differentiation, VCAM-1 mRNA and protein and alpha 4 integrin protein were coexpressed with smooth muscle-specific variants of cytoskeletal and contractile proteins, smooth muscle myosin heavy chain, caldesmon heavy chain, and desmin. Treatment with antibodies against VCAM-1 or alpha 4 integrin subunit interfered with the mRNA induction of smooth muscle-specific markers of differentiation. These results in vitro, associated with the transitory expression of VCAM-1 and VLA-4 during vascular ontogeny and the atherosclerosis process, point to a possible role of VCAM-1 and VLA-4 in the induction of smooth muscle differentiation.
Do geriatricians need guidelines?
Authors: V. Aylett
Journal: BMJ (2010)

What does a geriatrician do? It is easy for most specialists to define themselves: a cardiologist looks after the heart, a respiratory physician the chest. But for a geriatrician it can be surprisingly difficult. Are we simply general physicians for older people, or do we have a more specialist skill?

This has recently been a cause for (occasionally heated) debate in our department. We are in the process of making plans to merge two large departments of medicine for the elderly from opposite sides of our city. On one side there is a specific cut-off age for acute admissions, while the other has a “needs related” policy. At first glance the second would seem to be preferable: older patients with a “single organ” problem are sent to the relevant specialty, while patients with more complex needs are admitted under our care. But the problem with this is that it is open to abuse by our specialty colleagues, and referrals are all one way in our …
Generating mouse models of degenerative diseases using Cre/lox-mediated in vivo mosaic cell ablation
Authors: Masato Fujioka, Hisashi Tokano, Keiko Shiina Fujioka, Hideyuki Okano, Albert S.B. Edge
Journal: Journal of Clinical Investigation (2011)

Most degenerative diseases begin with a gradual loss of specific cell types before reaching a threshold for symptomatic onset. However, the endogenous regenerative capacities of different tissues are difficult to study, because of the limitations of models for early stages of cell loss. Therefore, we generated a transgenic mouse line (Mos-iCsp3) in which a lox-mismatched Cre/lox cassette can be activated to produce a drug-regulated dimerizable caspase-3. Tissue-restricted Cre expression yielded stochastic Casp3 expression, randomly ablating a subset of specific cell types in a defined domain. The limited and mosaic cell loss led to distinct responses in 3 different tissues targeted using respective Cre mice: reversible, impaired glucose tolerance with normoglycemia in pancreatic β cells; wound healing and irreversible hair loss in the skin; and permanent moderate deafness due to the loss of auditory hair cells in the inner ear. These mice will be important for assessing the repair capacities of tissues and the potential effectiveness of new regenerative therapies.
Acidic oligosaccharides enhance systemic cellular immune responsiveness in mice via a different mechanism than galacto- and fructooligosaccharides
Authors: A.P. Vos, A. Buco, M. Haarman, J. Knol, M. Govers, B. Stahl, G. Boehm, J. Garssen, L. M'Rabet
Journal: Journal of Allergy and Clinical Immunology (2005)
Biochemical tests for diagnosis of phaeochromocytoma: urinary versus plasma determinations.
Authors: P F Plouin, J M Duclos, J Menard, E Comoy, C Bohuon, J M Alexandre
Journal: BMJ (1981)

Fifteen patients with hypertension due to phaeochromocytoma and 35 controls with essential hypertension were studied to assess the diagnostic value of urinary and plasma biochemical determinations in phaeochromocytoma. In every case of phaeochromocytoma the urinary concentration of vanillylmandelate, metanephrines, or adrenaline plus noradrenaline was diagnostic of the disease irrespective of whether the patient was normotensive or hypertensive at the time. Plasma determinations of adrenaline and noradrenaline, however, gave falsely negative results on three occasions. These findings suggest that urinary biochemical determinations--particularly of metanephrines--are more reliable than plasma catecholamine measurements as a test for phaeochromocytoma. The test is particularly useful in patients with intermittent hypertension.
Women fail to recognise risk of heart disease
Authors: Z. Kmietowicz
Journal: BMJ (2003)

Women in the United Kingdom are failing to protect themselves from heart disease because they wrongly believe that they are more likely to die from breast cancer than from a heart attack.

Two out of five women think that cancer is the greatest threat to health and only one in four realise that heart disease is the single biggest killer of women, the report from the British Heart Foundation says.

Most people see …
Down Syndrome: Living and Learning in the Community
Authors: I. McKinlay
Journal: BMJ (1995)

Ed Lynn Nadel, Donna Rosenthal Wiley-Liss, pounds sterling13.95, pp 297 ISBN 0 471 02201 2

People with Down syndrome live longer and are more likely to spend their lives in the community than at any previous period this century. They have better rights to health services and have more opportunities for mainstream education than ever before. The expression of the disorder has a wide range, from those who become independent and self supporting to those who are autistic, non-ambulant, and have severe learning disability.

Representatives from 47 countries attended the fifth international Down syndrome conference, …
Toxicity of Familial ALS-Linked SOD1 Mutants from Selective Recruitment to Spinal Mitochondria
Authors: Jian Liu, Concepción Lillo, P.Andreas Jonsson, Christine Vande Velde, Christopher M Ward, Timothy M Miller, Jamuna R Subramaniam, Jeffery D Rothstein, Stefan Marklund, Peter M Andersen, Thomas Brännström, Ole Gredal, Philip C Wong, David S Williams, Don W Cleveland
Journal: Neuron (2004)
Clinical Medical Librarians
Authors: JOSEPHINE W. YEOH
Journal: JAMA (1976)

<h3>To the Editor.—</h3> My letter discussing implementation of a new clinical medical librarian program (235:374, 1976) was confined to a hospital situation only—employing one professional librarian and not connected with a medical school, whereas the programs mentioned in Ms Algermissen's letter (235:2286, 1976) were conducted by large medical libraries employing several specialized medical librarians. The two working situations are quite different. The purpose of my earlier letter was to point out that it would be feasible for hospital librarians to manage their time in such a way as to offer this service part-time to their medical staff. Any misunderstanding is regretted.
A modification of charcoal adsorption immunoassay of gastric intrinsic factor
Authors: H. A. Ghazi, V. Annerson
Journal: Gut (1971)

Gastric intrinsic factor by immunoassay is measured as the reduction in vitamin B12-binding capacity of gastric juice after the addition of pernicious anaemia serum containing intrinsic factor antibody.The anti- body serum itself binds a small amount ofvitamin B12.
Regular Decline in Physical Working Capacity with Age
Authors: L. E. Bottiger
Journal: BMJ (1973)

Analysis of the results of two cross country races, one on foot and one on skis, in which nearly 10,000 men competed showed that performance is very closely matched with age. There is a decrease of 5-10% in the performance every 10 years from optimum age for the event. This optimum varies for different types of physical activity. Studies in a small group of women showed similar variations.
Abstract 2554: Constitutive short telomere length and lung cancer risk: a large case- control study.
Authors: Beatriz Sanchez-Espiridion, Jian Gu, David W. Chang, Joe Y. Chang, Charles Lu, Jack A. Roth, Xifeng Wu
Journal: Cancer Research (2013)

Abstract Background: Telomeres plays a key role in the maintenance of chromosomal stability and integrity. Telomere dysfunction is a common crucial event in malignant transformation and tumorigenesis. Short telomere length in surrogate tissues (peripheral blood leukocytes, or PBLs) has been associated with increased risks of several cancers. In this study, we used a large case control study to evaluate the association of overall telomere length in PBLs with the risk of lung cancer. Methods: We measured the overall telomere lengths in PBLs using real-time quantitative PCR method in a large case-control study with 769 Caucasian lung cancer cases and 769 age, gender, and ethnicity matched healthy controls Wilcoxon rank sum test was used to compare the differences between case patients and control subjects. Unconditional multivariate logistic regression analysis was used to assess the association between telomere length and lung cancer risk. In addition, the effect of age, gender and smoking status was evaluated and correlation analyses between variables were performed. Results: As expected, telomere length was inversely correlated with age in both cases and controls. Lung cancer patients had significantly shorter overall telomere lengths (mean ± standard deviation: 1.20 ±0.37 versus 1.25 ±0.35 p =0.002) than controls, which was only evident in men (1.15 ±0.36 versus 1.24 ±0.36 p &amp;lt;0.001) but not in women. Multivariate logistic regression analysis showed that short overall telomere length was associated with a dose-dependent increase in lung cancer risk. Compared to the individuals within the highest quartile of telomere length, the OR for those within the 3rd, 2nd and 1st quartiles was 0.88 (95% CI 0.65-1.18), 1.08 (95% CI 0.80-1.44) and 1.49 (95% CI 1.12-1.99), respectively (p for trend &amp;lt; 0.001). This effect was more pronounced in current and former smokers (p for trend &amp;lt; 0.001) than in nonsmokers. There was a significant interaction between smoking and overall telomere length in elevating lung cancer risk (p for interaction &amp;lt;0.001). Conclusions: This is the largest epidemiological study to evaluate constitutive telomere length and lung cancer risk. Our data strongly support the role of telomere dysfunction in lung carcinogenesis, highlighting its specific interaction with smoking. Citation Format: Beatriz Sanchez-Espiridion, Jian Gu, David W. Chang, Joe Y. Chang, Charles Lu, Jack A. Roth, Xifeng Wu. Constitutive short telomere length and lung cancer risk: a large case- control study. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2554. doi:10.1158/1538-7445.AM2013-2554
Vaginal Spermicides and Congenital Disorders: The Validity of a Study
Authors: Richard N. Watkins
Journal: JAMA (1986)

<h3>To the Editor.—</h3> In April 1981, an article by Jick et al,<sup>1</sup>of which I was a coauthor, suggested that a mother's exposure to spermicide "near the time of conception" might cause certain birth defects. Our article was not corroborated by subsequent studies.<sup>2</sup>An expert panel assembled by the Food and Drug Administration found our study unpersuasive because of poor design and unsupported by well-designed studies (<i>Proceedings of the Fertility and Maternal Health Drugs Advisory Committee</i>, unpublished transcript. Food and Drug Administration, Dec 15, 1983). It is the purpose of this letter to allay further long-persisting concern generated by our article by showing that it was based on an inaccurate presumption of exposure to spermicide near the time of conception. In our study, a mother was "presumed to have used vaginal spermicides near the time of conception" if she had received a prescription for spermicides within 600 days
Acid-Base Management for Open-Heart Surgery
Authors: LUCIEN E. MORRIS, K. WILLIAM EDMARK, THOMAS W. JONES, GORDON A. LOGAN, LESTER R. SAUVAGE, GEORGE I. THOMAS
Journal: Circulation (1964)

An important part of managing patients during open-heart surgery is continuous monitoring of the acid-base status prior to, during, and following cardiopulmonary bypass. The use of a thermostatically controlled triple electrode system whereby arterial pH, pCO 2 , and pO 2 can be measured and base excess or base deficit quantitated by special application of the Astrup-Andersen nomogram is enthusiastically endorsed. In the opinion of the authors, respiratory alkalosis is to be avoided throughout the entire operation and postoperatively, as this appears to result in a base deficit, which is subsequently revealed as a metabolic acidosis. Particular consideration is given to the bypass phase when hypothermia is employed, since "optimal" pH appears to vary with temperature. Continued maintenance of good acid-base status with buffers is advocated. It is considered that buffer administration should be on a "titration" principle with frequent arterial blood gas analyses. Possible reasons are presented for the improved postoperative morbidity when optimal acid-base status is maintained throughout the operation and postoperatively.
Consultants in rehabilitation medicine.
Authors: D L McLellan, D Shaw
Journal: BMJ (1985)

specific guidance from the consultant with regard to exercise," although they will need a knowledge of exercise physiology and of the problems which can arise from exercising coronary patients (see Ms Gloag's references).The community sports centre is the most appropriate place for coronary rehabilitation since it can be seen by the patient as fun, not treatment, encouraging long term compliance.
Predicting presence of intestinal metaplasia and dysplasia in columnar-lined esophagus: a multivariate analysis
Authors: M. Kerkhof, E. Steyerberg, J. Kusters, E. Kuipers, P. Siersema
Journal: Endoscopy (2007)

See also: Commentaire de travail de M. Kerkhof et al., pp. 772Endoscopy 2007; 39(09): 930-930DOI: 10.1055/s-0032-1308865
Pediatric Palliative Care
Authors: Bruce P. Himelstein, Joanne M. Hilden, Ann Morstad Boldt, David Weissman
Journal: New England Journal of Medicine (2004)

Each year, 500,000 children in the United States cope with life-threatening illness. These children and their families require comprehensive, compassionate, and developmentally appropriate palliative care. This review article discusses pediatric palliative care, which should intersect with the aims of curing and healing and become instrumental for improving quality of life.
Stop the Continuing Education Bandwagon
Authors: Daniel M. Baer
Journal: JAMA (1977)

AS I VIEW continuing education for physicians, nurses, and other medical personnel, it appears that a formalized structure is being developed that is constraining rather than stimulating the pursuit of knowledge. A system of recognition, certification, and accreditation is being established that stresses traditionally oriented organized programs and fails to recognize the needs, objectives, initiative, and responsibility of the individual in planning and seeking his own continuing education. Programs are generally oriented toward the needs of the urban hospital-affiliated person who practices within a traditional setting and who is not exploring new frontiers in the health care system. Programs of continuing education directed toward nurses and other nonphysicians appear to be oriented toward the needs of the employer and the interests of the regulatory agencies rather than the interests of the person seeking the education. Recognition and accreditation of education, especially for nonphysicians, appear to ignore the motivation and responsibility
Small dead space heat and moisture exchangers do not impede gas exchange during noninvasive ventilation: a comparison with a heated humidifier
Authors: Alexandre Boyer, Frederic Vargas, Gilles Hilbert, Didier Gruson, Maud Mousset-Hovaere, Yves Castaing, Didier Dreyfuss, Jean Damien Ricard
Journal: Intensive Care Medicine (2010)
Peripheral blood flow and noradrenaline responsiveness: the effect of physiological hyperinsulinemia
Authors: C de Haan
Journal: Cardiovascular Research (1997)

Objective: Insulin seems to have vasodilator properties, but it is unclear if insulin in postprandial concentrations is a specific vasodilator of skeletal muscle resistance arterioles only or that various types of vessels are affected. The aim of the present study was to determine the direct effects and the time course of regional/local physiological hyperinsulinemia on skeletal muscle arterioles, skin blood flow and peripheral venous tone and the reponsiveness of these different vascular beds to noradrenaline. Methods: In protocol 1 (n=12) we infused insulin into the brachial artery for 180 min (3.5 mU/min) and evaluated the effects on forearm (muscle) blood flow (FBF) and skin blood flow (SBF). Furthermore, noradrenaline (0.025, 0.01 and 0.4 μg/min) was infused (i.a.) at baseline, at 90 and 180 min after the start of insulin. In protocol 2 (n=10) the same regional forearm hyperinsulinemia was achieved, but now the local venous responsiveness to noradrenaline (1.7–55 ng/min, at baseline and at 90 and 180 min) was measured in a dorsal hand vein. In protocol 3 we evaluated the local effects of different doses of insulin (1–100 mU/min) infused directly into hand veins preconstricted with phenylephrine. Results: Forearm hyperinsulinemia (≈50 mU/l) led to a significant increase in FBF after 180 min (median 26%, interq. ranges 5–50, P<0.05), while SBF was not altered. Forearm hyperinsulinemia did not affect the noradrenergic responsiveness in skeletal muscle or skin. Infused locally into hand veins only the highest dose of insulin (100 mU/min) caused a minor venodilation (7% [2.4–12.5], P<0.05). Conclusion: Regional forearm physiological hyperinsulinemia has a vasodilator effect on resistance vessels in skeletal muscle, but is slow in onset (180 min). However, skin vasculature and peripheral veins are not affected by this hyperinsulinemia.