tbuckley/cabot-search huggingface dataset:
RNA virus genomics: a world of possibilities
Authors: Edward C. Holmes
Journal: Journal of Clinical Investigation (2009)

The increasing availability of complete genome sequences of RNA viruses has the potential to shed new light on fundamental aspects of their biology. Here, I use case studies of 3 RNA viruses to explore the impact of genomic sequence data, with particular emphasis on influenza A virus. Notably, the studies of RNA virus genomics undertaken to date largely focused on issues of evolution and epidemiology, and they have given these disciplines new impetus. However, genomic data have so far made fewer inroads into areas of more direct importance for disease, prevention, and control; thus, harnessing their full potential remains an important goal.
Skin — The Ultimate Solution for the Burn Wound
Authors: Jack C. Fisher
Journal: New England Journal of Medicine (1984)

When the history of 20th-century burn care is written, topical antibacterial agents are unlikely to receive the credit for contributing to progress in burn care that they have been awarded during the past two decades. Modern-day burn salves are probably no different in principle from the oils, foodstuffs, and escharotic agents that were applied throughout the 19th century; they hide the problem and delay the surgeon's primary task — skin replacement. The deficit in any full-thickness burn injury is skin, and that problem cannot be addressed by obscuring the wound with even the most pharmacologically refined lather.The widespread clinical . . .
Overbilling vs. Downcoding — The Battle between Physicians and Insurers
Authors: Aaron S. Kesselheim, Troyen A. Brennan
Journal: New England Journal of Medicine (2005)

In September 2004, a federal appeals court upheld a class-action lawsuit on behalf of physicians who charged that their patients' insurance companies had conspired to curb reimbursement for the physicians' services. The judge described the case as "almost all doctors versus almost all major health maintenance organizations"1 (see table). The case has revealed issues that have long lurked beneath the surface of the managed-care revolution. Physicians are accused of driving up costs and exploiting the third-party–payer system by overcharging for their work. Managed-care organizations are accused of systematically obstructing and delaying payment for legitimate services in order to improve their . . .
25-Year Mortality After Surgical Repair of Congenital Heart Defect in Childhood
Authors: Cynthia D. Morris
Journal: JAMA (1991)

To determine long-term survival and the cause of death after repair of one of eight congenital heart defects in childhood.Cohort study.General community.All Oregon residents with one of eight congenital heart defects, which was repaired surgically between 1958 and 1989 when the patient was aged 18 years or younger, including (1) tetralogy of Fallot; (2) isolated ventricular septal defect; (3) isolated atrial septal defect; (4) coarctation of the aorta; (5) aortic valvular stenosis; (6) pulmonary valvular stenosis; (7) transposition of the great arteries; and (8) patent ductus arteriosus. Follow-up of this cohort of 2701 individuals was obtained from 94%.Mortality from cardiac and noncardiac causes.Age at surgery and operative mortality have decreased significantly over the last 30 years. Late cardiac mortality at 25 years after surgery was 5% for tetralogy of Fallot and isolated ventricular septal defect, 10% for coarctation of the aorta, 17% for aortic stenosis, 5% for pulmonic stenosis, and less than 1% for patent ductus arteriosus; there were no late cardiac deaths after atrial septal defect repair. For transposition, late cardiac mortality was 15% at 15 years after the Mustard operation and was 2% at 10 years after the Senning operation.Surgical repair of most congenital heart defects is associated with lingering cardiac mortality, particularly for aortic stenosis, coarctation, and transposition.
Clinical and Pathological Aspects of Encephalitis
Authors: Raymond D. Adams, Louis Weinstein
Journal: New England Journal of Medicine (1948)

A GREAT deal of confusion appears to exist in the minds of many physicians regarding the criteria necessary for the diagnosis of encephalitis. There is a common tendency on the part of clinicians to designate as encephalitis any disease in which fever and neurologic symptoms are conjoined. In the New England states and probably in many other areas of the United States this diagnosis almost invariably proves to be incorrect at autopsy. The pathology in such cases usually turns out to be bacterial endocarditis with multiple brain emboli, tuberculosis or torulosis of the meninges, thrombophlebitis of cerebral vessels, tumor, vascular . . .
Expression of the human histocompatibility leukocyte antigen DR3 transgene reduces the severity of demyelination in a murine model of multiple sclerosis.
Authors: K M Drescher, L T Nguyen, V Taneja, M J Coenen, J L Leibowitz, G Strauss, G J Hammerling, C S David, M Rodriguez
Journal: Journal of Clinical Investigation (1998)

The role of various MHC genes in determining the progression of multiple sclerosis (MS) remains controversial. The HLA-DR3 gene has been associated with benign relapsing MS in some genetic epidemiologic studies, but with disease progression in others. We induced demyelination in highly susceptible B10.M and B10.Q mice expressing the DR3 (HLA-DRB1*0301) transgene to determine directly the effects of a human transgene by infecting them with Theiler's murine encephalomyelitis virus (TMEV). DR3+ mice experienced a dramatic reduction in the extent and severity of demyelination compared with DR3- littermate controls, whereas anti-TMEV antibody titers, delayed-type hypersensitivity responses, and levels of infectious virus, virus antigen, and virus RNA were similar in both groups. To address a possible mechanism of how the human transgene is reducing virus-induced demyelination, we analyzed cytokine expression in the lesions and also determined whether B10.M mice can respond to peptides derived from the DR3 molecule. Intense staining for IFN-gamma and IL-4, T helper (TH) 1 and TH2 cytokines, respectively, was found in the lesions of TMEV-infected DR3- mice but not in the DR3+ transgenic mice at day 21 after infection. DR3 peptides elicited strong proliferative responses in B10.M mice but not in B10.M (DR3+) mice. These experiments are the first to demonstrate that a human class II DR gene can alter the severity of demyelination in an animal model of MS without influencing viral load. These experiments are consistent with a mechanism by which DR3 reduces demyelination by altering the cytokine expression in the lesions, possibly by deleting T cells involved in virus-induced pathology.
Patients with combined hypercholesterolemia-hypertriglyceridemia show an increased monocyte-endothelial cell adhesion in vitro: Triglyceride level as a major determinant
Authors: Marijke de Gruijter, Nicoline Hoogerbrugge, Marion A. van Rijn, Johan F. Koster, Wim Sluiter, Johan F. Jongkind
Journal: Metabolism (1991)
Statins, Diet, and Low Cholesterol—Reply
Authors: Christopher P. Cannon
Journal: JAMA (2006)

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
Association of Telemedicine for Remote Monitoring of Intensive Care Patients With Mortality, Complications, and Length of Stay
Authors: Eric J. Thomas
Journal: JAMA (2009)

Telemedicine technology, which can enable intensivists to simultaneously monitor several intensive care units (ICUs) from an off-site location, is increasingly common, but there is little evidence to support its use.To assess the association of remote monitoring of ICU patients (ICU telemedicine [tele-ICU]) with mortality, complications, and length of stay (LOS).Observational study conducted in 6 ICUs of 5 hospitals in a large US health care system to assess the use of tele-ICU. The study included 2034 patients in the preintervention period (January 2003 to August 2005) and 2108 patients in the postintervention period (July 2004 to July 2006).Hospital and ICU mortality, complications, and hospital and ICU survivors' LOS, with outcomes adjusted for severity of illness.Local physicians delegated full treatment authority to the tele-ICU for 655 patients (31.1%) and authority to intervene only in life-threatening events for the remainder. Observed hospital mortality rates were 12.0% (95% confidence interval [CI], 10.6% to 13.5%) in the preintervention period and 9.9% (95% CI, 8.6% to 11.2%) in the postintervention period (preintervention to postintervention decrease, 2.1%; 95% CI, 0.2% to 4.1%; P = .03); observed ICU mortality rates were 9.2% (95% CI, 8.0% to 10.5%) in the preintervention period and 7.8% (95% CI, 6.7% to 9.0%) in the postintervention period (preintervention to postintervention decrease, 1.4%; 95% CI, -0.3% to 3.2%; P = .12). After adjustment for severity of illness, there were no significant differences associated with the telemedicine intervention for hospital mortality (relative risk, 0.85; 95% CI, 0.71 to 1.03) or for ICU mortality (relative risk, 0.88; 95% CI, 0.71 to 1.08). There was a significant interaction between the tele-ICU intervention and severity of illness (P < .001), in which tele-ICU was associated with improved survival in sicker patients but with no improvement or worse outcomes in less sick patients. There were no significant differences between the preintervention and postintervention periods for hospital or ICU LOS.Remote monitoring of ICU patients was not associated with an overall improvement in mortality or LOS.
Carcinome épidermoïde superficiel de l'oesophage: Aspects endoscopiques avant et après coloration Lugol et/ou coloration électronique par Narrow band Imaging
Authors: T Tatagiba, MG Lapalus, B Napoleon, T Ponchon
Journal: Endoscopy (2007)

L'amélioration de l'imagerie, la motivation des opérateurs français et le fait de pouvoir proposer des traitements endoscopiques efficaces permettent de rassembler maintenant des séries importantes de carcinomes épidermoïdes superficiels de l'oesophage.
Initiation and follow-up of treatment for high blood pressure
Authors: J. Mant, R. J. McManus
Journal: BMJ (2015)

Delays are associated with worse outcomes for patients

High blood pressure is the leading risk factor for disease worldwide.1 Whereas strong evidence from randomised controlled trials is available for some aspects of the management of hypertension, uncertainties remain for others. In the linked article by Xu and colleagues (doi:10.1136/bmj.h158), three of these uncertainties are investigated.2 At what blood pressure threshold should treatment be intensified? How long after a high blood pressure is recorded should treatment be changed? And how long after treatment has been increased should the blood pressure be measured again?

Xu and colleagues used a large electronic database of primary care records from the United Kingdom—The Health Improvement Network (THIN) database—to construct a retrospective cohort of adults with a diagnosis of hypertension. For each patient, they split the data that they had into three time periods: a run-in period of at least 12 months to define baseline characteristics, a treatment period of 10 years from which the three key parameters (intensification threshold, time to intensification, and time to follow-up after intensification) were estimated, and an outcome assessment period. The third period continued until an outcome event had occurred (a cardiovascular event or …
Randomized Comparison of Final Kissing Balloon Dilatation Versus No Final Kissing Balloon Dilatation in Patients With Coronary Bifurcation Lesions Treated With Main Vessel Stenting
Authors: Matti Niemelä, Kari Kervinen, Andrejs Erglis, Niels R. Holm, Michael Maeng, Evald H. Christiansen, Indulis Kumsars, Sanda Jegere, Andis Dombrovskis, Pål Gunnes, Sindre Stavnes, Terje K. Steigen, Thor Trovik, Markku Eskola, Saila Vikman, Hannu Romppanen, Timo Mäkikallio, Knud N. Hansen, Per Thayssen, Lars Åberge, Lisette O. Jensen, Anders Hervold, Juhani Airaksinen, Mikko Pietilä, Ole Frobert, Thomas Kellerth, Jan Ravkilde, Jens Aarøe, Jan S. Jensen, Steffen Helqvist, Iwar Sjögren, Stefan James, Heikki Miettinen, Jens F. Lassen, Leif Thuesen
Journal: Circulation (2010)

It is unknown whether the preferred 1-stent bifurcation stenting approach with stenting of the main vessel (MV) and optional side branch stenting using drug-eluting stents should be finalized by a kissing balloon dilatation (FKBD). Therefore, we compared strategies of MV stenting with and without FKBD.We randomized 477 patients with a bifurcation lesion to FKBD (n=238) or no FKBD (n=239) after MV stenting. The primary end point was major adverse cardiac events: cardiac death, non-procedure-related index lesion myocardial infarction, target lesion revascularization, or stent thrombosis within 6 months. The 6-month major adverse cardiac event rates were 2.1% and 2.5% (P=1.00) in the FKBD and no-FKBD groups, respectively. Procedure and fluoroscopy times were longer and more contrast media was needed in the FKBD group than in the no-FKBD group. Three hundred twenty-six patients had a quantitative coronary assessment. At 8 months, the rate of binary (re)stenosis in the entire bifurcation lesion (MV and side branch) was 11.0% versus 17.3% (P=0.11), in the MV was 3.1% versus 2.5% (P=0.68), and in the side branch was 7.9% versus 15.4% (P=0.039) in the FKBD versus no-FKBD groups, respectively. In patients with true bifurcation lesions, the side branch restenosis rate was 7.6% versus 20.0% (P=0.024) in the FKBD and no-FKBD groups, respectively.MV stenting strategies with and without FKBD were associated with similar clinical outcomes. FKBD reduced angiographic side branch (re)stenosis, especially in patients with true bifurcation lesions. The simple no-FKBD procedures resulted in reduced use of contrast media and shorter procedure and fluoroscopy times. Long-term data on stent thrombosis are needed. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique identifier: NCT00914199.
The Treatment of the Carotid-Sinus Syndrome by Irradiation
Authors: Hugh P. Greeley, Magnus I. Smedal, William Most
Journal: New England Journal of Medicine (1955)

THE treatment of the carotid-sinus syndrome in the past has been difficult, nonspecific and unsatisfactory. We wish to report 52 cases in which irradiation was followed by complete remission of symptoms in a large majority of patients. The chief characteristic of this syndrome is spontaneous syncope with less frequent or accompanying allied disorders. The underlying causes are unknown. The anatomy and physiology have been described elsewhere.1 2 3 Contributing factors are age and atherosclerosis, hypertension with atherosclerosis or heart disease4 , 5 and increased sensitivity of the autonomic nervous system. Hypertension without atherosclerosis does not predispose a patient to a sensitive carotid sinus. Many . . .
A mumps epidemic on St. George Island, Alaska
Authors: D. Reed
Journal: JAMA (1967)

A mumps epidemic occurred on St. George Island, Alaska, among a population which had not been exposed to mumps since 1907. During a 15-week period clinical mumps were observed in 119 of 212 native residents, while an additional 37 residents had serologic evidence of subclinical infections. Prophylactic mumps hyperimmune γ-globulin given to 56 persons who were clinically and serologically susceptible did not appear to reduce the attack rates or to prevent clinical complications.
Survival at a Gestational Age of 24 Weeks in the Netherlands
Authors: Floris Groenendaal, Rene Kornelisse, Chantal Hukkelhoven
Journal: JAMA Pediatrics (2014)

To the Editor Verhagen and Janvier1 have described the processes involved in the medical care of neonates who died. Although their article is highly relevant, we would like to comment on one aspect of it.
The effect of intravenous thrombolytic therapy on left ventricular function: a report on tissue-type plasminogen activator and streptokinase from the Thrombolysis in Myocardial Infarction (TIMI Phase I) trial.
Authors: F H Sheehan, E Braunwald, P Canner, H T Dodge, J Gore, P Van Natta, E R Passamani, D O Williams, B Zaret
Journal: Circulation (1987)

In Phase I of the NHLBI trial of Thrombolysis in Myocardial Infarction (TIMI), 290 patients admitted within 7 hr after onset of acute infarction were randomly assigned to intravenous treatment with either streptokinase (SK) or recombinant tissue-type plasminogen activator (rt-PA). Left ventricular function was measured from contrast ventriculograms in 145 patients with both pretreatment and predischarge studies analyzable. Regional wall motion in the infarct site was measured by the centerline method and expressed in units of standard deviations (SDs) from the mean motion in 52 normal subjects. Patients treated with rt-PA (n = 77) achieved a significantly higher reperfusion rate after 90 min of treatment. Perfusion of the infarct-related artery improved from visual grade 0 or 1 (total occlusion or penetration without perfusion) to grade 2 or 3 (partial or full reperfusion) in 62% receiving rt-PA vs 31% receiving SK (n = 68) (p less than .001). However, the ejection fraction did not change significantly from before treatment to before discharge in either treatment group (+0.7 +/- 6.7% vs +1.0 +/- 8.3%, respectively). A small but significant increase in regional wall motion was observed in each of the two groups (+0.4 +/- 0.8 vs +0.3 +/- 0.8 SD/chord, respectively; each p less than .001 compared with baseline). This was countered by declines in the hyperkinesis of the noninfarct region (-0.3 +/- 1.0 SD/chord [p = .01] compared with baseline and -0.2 +/- 1.0 SD/chord [p = .23], respectively). Analysis of the combined groups revealed that the ejection fraction increased only in patients who achieved reperfusion by 90 min after onset of therapy or who had subtotal occlusions initially. There was greater recovery of left ventricular function in patients who achieved reperfusion earlier vs later than 4 hr after symptom onset and in patients with vs without some collateral circulation to the infarct-related artery.
Outcome of breech delivery at term
Authors: P. Byrne
Journal: BMJ (1992)

assessment of the mode of delivery.Another group at potentially higher risk are primigravid patients, a subgroup not considered in the report but presumably identifiable from the database.The critical question therefore remains: is a carefully planned and managed trial of vaginal delivery any less safe for the fetus than an elective caesarean section?The uncertainty is in itself an argument in favour of elective caesarean section for all breech presentations at term since this reduces the opportunity for errors of judgment.
Lethal infection by a previously unrecognised metazoan parasite
Authors: M Santamaría-Fríes, L.F Fajardo, M.L Sogin, P.D Olson, D.A Relman
Journal: The Lancet (1996)

Summary Background New microbial pathogens or variant clinical manifestations of known organisms may be first found in immunodeficient patients. An HIV-infected man developed a rapidly-enlarging abdominal mass, suggestive of a neoplasm, that subsequently invaded his liver and caused death. Initial studies showed unusual tissue morphology that could not be matched with any known disease process. Methods Tissues obtained from biopsy at laparotomy and necropsy were studied by light microscopy, immunohistochemistry, electron microscopy, and broad-range ribosomal DNA-amplification and sequence analysis. Findings Tissue lesions were characterised by peculiar cytoplasmic sacs containing minute cells with very prominent nucleoli. The pathological process was recognised as a parasitic infection, although its features were different from those of any known eukaryotic pathogen. Phylogenetic analysis of a 357 bp 18S rDNA sequence amplified directly from the involved tissue indicated that the causative agent was a previously-uncharacterised cestode. Interpretation Fatal disease produced by this newly recognised cestode may not be limited to immunodeficient hosts. Awareness of this metazoan infection may allow early diagnosis—by morphology and DNA sequence analysis—and perhaps successful treatment of subsequent cases.
TRICUSPID REPAIR AT THE TIME OF LVAD IMPLANTATION IS ASSOCIATED WITH IMPROVED SURVIVAL
Authors: Mazen El Atrache, Robert Brewer, Hassan Nemeh, Celeste Williams, Cristina Tita, Gaetano Paone, Yelena Selektor, Mauricio Velez, Jeffrey Morgan, David Lanfear
Journal: Journal of the American College of Cardiology (2012)