tbuckley/cabot-search huggingface dataset:
Chikungunya Virus Transmission Found in the United States
Authors: Bridget M. Kuehn
Journal: JAMA (2014)

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
Measuring morbidity for resource allocation.
Authors: N Mays
Journal: BMJ (1987)

The RAWP (Resource Allocation Working Party) report used population weightings based on standardised mortality ratios (SMRs) as a proxy measure of differences in morbidity (and therefore in the need for health care resources) that existed between geographical areas after allowing for the age and sex structure of their populations. The adequacy of SMRs as a proxy for morbidity has aroused controversy, particularly from RAWP losers in London, and is one of the main themes of the National Health Service Management Board9s current review of RAWP. Critics have argued, firstly, that the nature of the relation between morbidity and mortality is unknown; and, secondly, that SMRs are incomplete because they fail to take account of the effect of social deprivation on the need for health care. As a result several alternative proxies for morbidity based on social indicators have been proposed. One of their principal drawbacks is that their use is justified by their relation to measures of use of services known to be affected by the prevailing level of supply. Furthermore, the evidence suggests that mortality data actually correlate quite well with the available measures of both morbidity and social deprivation. But without access to comprehensive morbidity data the SMR debate is bound to remain inconclusive. As measures of health need, however, SMRs have the twin merits of being (a) independent of supply, and (b) more direct measures of health state than social indicators.
Successful treatment of post-partum renal failure with heparin.
Authors: I. Timor-Tritsch, O. S. Better, I. Tatarsky, C. Chaimowitz, A. Peretz, H. Abramovici
Journal: BMJ (1970)

increase in the direct bilirubin.SGOT level was 256 units (nor- mal below 40 units).There was a sustained rise in fibrinogen degeneration products which lasted until about the seventh week after delivery, when it returned to normal.Six months after the event a 24-hour endogenous creatinine test was 115ml./min.and
<i>TP53</i> Mutation and Microsatellite Instability Status for the Prediction of Survival in Adjuvant-Treated Colon Cancer Patients
Authors: Toshiaki Watanabe, Takamitsu Kanazawa, Yoshihiro Kazama, Junichiro Tanaka, Toshiaki Tanaka, Soichiro Ishihara, Hirokazu Nagawa
Journal: Journal of Clinical Oncology (2005)

Journal of Clinical Oncology by Westra et al. 1 The authors reported that TP53 status is a significant prognostic factor for patients with colorectal cancer after chemotherapy, whereas high-frequency microsatellite instability (MSI-H) is not.Westra et al introduced our results in their report; we have similar research that was published in the issue of the New England Journal of Medicine, but reached different conclusions. 2Westra et al showed that there was improved survival in MSI-H patients after fluorouracilbased chemotherapy as compared with microsatellite stable (MSS) patients (P Z .034).This is in agreement with the results of past reports, including our study. 2-6However, Westra et al reported that in a multivariate model, the MSI status was not significantly associated with disease-free survival (DFS), whereas the TP53 status reached borderline significance.From these results, they concluded that presence or absence of a TP53 mutation, and not MSI, seems a better predictor for DFS in adjuvant-treated colon cancer patients.However, to draw this conclusion, there are two major issues to be discussed in their study.The first point is the number of patients.In a univariate analysis, they examined 273 patients, including 44 MSI-H and 229 MSS patients, and successfully showed
Do patients need to read research?
Authors: R. Smith
Journal: BMJ (2003)

Most patients wouldn't dream of reading medical research. They probably imagine it to be arcane, mystical material full of numbers, formulas, and Greek symbols—the kind of stuff that Merlin used to cast his spells. They aren't far wrong, but it is possible to get to grips with medical research without being as clever as Wittgenstein. If it's any comfort, most doctors don't read or understand medical research either—but they can be trained to do so without too much effort. Patients and journalists can also be trained—and many are now much more competent at appraising research than the average doctor.

The main reason for reading medical research is that it underpins all of medicine. The drugs that doctors use are the result of research, but what we understand about the course of a disease and how to diagnose and treat it also comes increasingly from research.

I belong to a generation who had our tonsils removed for recurrent snotty noses. The treatment was useless. Thirty years ago patients who had heart attacks were kept in bed for days. The treatment killed them. When my first son …
Subgaleal Hematoma
Authors: Warren C. Plauché
Journal: JAMA (1980)

Subgaleal hematomas (SGH) are rare but potentially fatal accumulations of blood beneath the galea aponeurotica of the scalp in the newborn. One hundred twenty-three SGH cases are summarized from the literature. Sixty-four percent occurred after instrumental delivery. The lesion is most often associated with mid-forceps operations (14 cases) and vacuum extraction (60 cases), but SGH also has been recorded after spontaneous vaginal delivery (35 cases) and after cesarean section (11 cases). Intrapartal hypoxia of the fetus and neonatal coagulopathies are prominent features of both spontaneous and instrumental delivery cases. Other risk factors include prematurity, macrosomia, prolonged labor, cephalopelvic disproportion, primiparity, male sex, and African lineage. Mortality for SGH is 22.8%. Early recognition, differentiation from benign cephalohematoma, and prompt treatment by adequate blood replacement and correction of coagulopathies are the major determinants of successful management. (<i>JAMA</i>244:1597-1598, 1980)
TCT-211 Stenting and Delivery of Paclitaxel via Iopromide-Based Balloon Coating versus Durable Polymeric Matrix for De-Novo Coronary Lesions: Clinical and Angiographic Results from the Prospective Randomized Trial.
Authors: Aleksander Zurakowski, Piotr P. Buszman, Krzysztof Milewski, Bogdan Gorycki, Adam Janas, Marek Kondys, Marek Krol, Janusz Prokopczuk, Anna Turek, Juan Granada, Buszman E. Pawel
Journal: Journal of the American College of Cardiology (2013)
Histamine Excess in Plasma Cell Leukemia
Authors: Tanomsri Srichaikul
Journal: JAMA (1975)

PLASMA cell leukemia is a very rare form of immunocytic dyscrasia. Clinical course, laboratory findings, therapy, and prognosis of the disease were discussed recently by Pruzanski et al,<sup>1</sup>who reviewed 57 cases reported in the literature during the last 20 years. The clinical picture varies from the terminal leukemic stage of an otherwise classical multiple myeloma to a fulminating course of acute leukemia. On initial examination, our patient had episodes of vascular hyperactivity and high-output cardiac failure. Blood histamine level was found to be strikingly elevated with each episode. To our knowledge, this clinical manifestation has not been reported previously. <h3>Report of a Case</h3> A 27-year-old man was admitted on April 7, 1970, with a four-month history of intractable ascites and congestive cardiac failure. Physical examination showed an orthopneic young man with a blood pressure of 100/70 mm Hg; pulse, 96 beats per minute; respirations, 26/min; temperature, 36.8 C
Role of T cell subsets in lethal graft-versus-host disease (GVHD) directed to class I versus class II H-2 differences. I. L3T4+ cells can either augment or retard GVHD elicited by Lyt-2+ cells in class I different hosts.
Authors: J Sprent, M Schaefer, E K Gao, R Korngold
Journal: The Journal of Experimental Medicine (1988)

Detailed information was sought on the capacity of purified Lyt-2+ cells to mediate lethal graft-versus-host disease (GVHD) directed to class I H-2 differences. When B6 Lyt-2+ cells were transferred to irradiated class I-different (B6 x bm 1)F1 mice, three different patterns of lethal GVHD were observed. First, rapid death from hematopoietic failure occurred when Lyt-2+ cells were transferred together with host-type marrow cells; this form of GVHD probably reflected direct destruction of stem cells by Lyt-2+ cytotoxic cells. Second, a pattern of late-onset, chronic GVHD resulting in death only after 4-6 wk occurred when Lyt-2+ cells were supplemented with donor marrow. This syndrome developed in the apparent absence of L3T4+ cells and was observed with either high or low doses of Lyt-2+ cells and with either light or heavy irradiation of the host. Third, an acute form of GVHD resulted when Lyt-2+ cells plus donor marrow cells were supplemented with exogenous help, i.e., by adding small doses of donor L3T4+ cells or injecting the hosts with rIL-2. Although L3T4+ cells potentiated GVHD when injected in small doses, supplementing Lyt-2+ cells with large doses of L3T4+ cells paradoxically led to marked protection; symptoms of GVHD were mild and no deaths occurred.
Activation of coagulation factor VII by tissue-type plasminogen activator
Authors: Hiroshi Tsujioka, Akira Suehiro, Eizo Kakishita
Journal: American Journal of Hematology (1999)

To investigate the effect of tissue-type plasminogen activator (t-PA) on blood coagulation, we examined the effects of the addition of t-PA to normal pool plasma (NPP) on clotting times such as diluted prothrombin time (PT) and kaolin clotting time (KCT). The diluted PT but not the KCT was significantly shortened by the addition of t-PA to NPP compared with the normal controls, suggesting a t-PA-induced activation of blood coagulation through factor VII (FVII) activation. The activated factor VII (FVIIa) concentration in the NPP was significantly increased by the addition of t-PA. Although the FVIIa formation was not observed following the incubation of purified FVII with only t-PA or plasminogen, an increase in the FVIIa level was observed after the incubation of purified FVII with t-PA together with plasminogen, or only plasmin. This plasmin-mediated FVIIa formation was also confirmed by Western blotting. These findings suggest that t-PA enhances the activation of the coagulation system through FVII activation.
Ultrastructural changes in epidermal Langerhans cells and melanocytes in response to ultraviolet irradiation, in Australians of Aboriginal and Celtic descent
Authors: D. E. HOLLIS, A. SCHEIBNER
Journal: British Journal of Dermatology (1988)

The effects of exposure to small doses of artificial ultraviolet radiation (UVR) on the ultrastructure of epidermal Langerhans cells (LC) and melanocytes were studied in two groups of Australian subjects, one of Aboriginal and the other of Celtic descent. UV exposure induced an apparent depletion of LC in the epidermis of both groups. However, LC depletion in the Aboriginal subjects was associated with apoptosis, whereas organelle and membrane disruption in the LC of Celtic subjects suggested a reduction by direct cellular damage. LC in Aboriginal epidermis tended to become relocated at more superficial levels following UV exposure, and their Birbeck granules became more numerous. LC in Celtic epidermis appeared to become relocated in a basal location and contained fewer Birbeck granules. The central lamina of the Birbeck granules in Aboriginal LC, which was more electron‐dense than that in Celtic subjects prior to UV treatment, was temporarily lost following treatment, while the ultrastructure of Birbeck granules in Celtic LC was unchanged. LC and ‘indeterminate cells’ in intimate association with lympocyte‐like cells occurred in the basal layer of Celtic epidermis 5 days after exposure. These complexes were not observed in Aboriginal epidermis although isolated lymphocyte‐like cells were observed in the same location. Melanocytes in Aboriginal epidermis contained greater numbers of melanosomes than those in Celtic epidermis throughout the experiment. Inactive epidermal melanocytes in Celtic subjects initially responded to UV exposure with a slight increase in melanosome content followed by a substantial further increase, whereas active melanocytes in the Aboriginal subjects showed the opposite response. The implications of the different responses of LC and melanocytes in the two groups, in relation to immunological function of the epidermis and the marked racial difference in the incidence of skin cancer, are discussed.
Effects of therapy on maximal walking time following femoral ligation in the rat.
Authors: M C Conrad
Journal: Circulation Research (1977)

Maximal walking times at a constant rate of 10 m/min were compared in normal rats, normal rats that had been exercised daily for 6 weeks, and rats that had undergone bilateral femoral artery ligation followed by 6 weeks of either an oral vasodilator, absence of sympathetic impulses to the extremities, cold exposure, or daily exercise. Rats maintained on the vasodilator could walk no farther than untreated, ligated rats. Both chronic cold exposure and sympathectomy significantly increased maximal walking distances of ligated rats and daily exercise increased maximal walking distances 7-fold. Rats that had received 6 weeks of exercise training following femoral artery ligation could walk longer than normal untrained rats; therefore, the increased exercise tolerance could not be explained solely by the restoration of normal large artery conductance by enlargement of collaterals bypassing the femoral occlusion.
A Reply to Dr Spodick
Authors: Jack W. Love
Journal: JAMA (1975)

<h3>To the Editor.—</h3> Dr Spodick's reply (232:809, 1975) to my commentary (232:37, 1975) on his earlier article (232:35, 1975) makes one wonder how much of my commentary he actually read. He questions the validity of only one of several points I made and refers to that one point as my "main argument." That one point, the skill factor, was clearly stated to be merely "a variable to be considered in assessing results," a previously overrated one at that. Regarding that single point, Dr Spodick is correct in suggesting that surgical skill may be of little importance in "large series... over time." Unfortunately, the skill factor may be of enormous importance when a new procedure is introduced—the very time Dr Spodick would like to use a controlled clinical trial to evaluate the procedure. The history of cardiovascular surgery has been a story of decreasing mortality and increasingly better results with more
Herbal medicines: where is the evidence?
Authors: E Ernst
Journal: BMJ (2000)

Sales of herbal medicines are booming. This is particularly true in the United States, where the market for herbal supplements is now approaching $4bn a year. The fastest growth has been recorded for St John's wort, a herbal antidepressant whose sales increased in one year by 2800%.1 Faced with such figures doctors are inclined to ask where the evidence is. Are there rigorous trials to show that herbal treatments work?

Single studies are unlikely to convince sceptics, but an increasing body of evidence is now emerging from systematic reviews and meta-analyses of randomised clinical trials. These suggest that some herbal medicines are efficacious. The increased demand for St John's wort, for instance, was triggered by press reports of a meta-analysis of 23 randomised trials of 1757 patients with mild or moderate depression. The authors concluded that extracts of hypericum were significantly more effective than placebo (odds ratio 2.67; 95% confidence interval 1.78 to 4.01) and as effective as conventional antidepressants (odds ratio 1.10; 93 to 1.31) in alleviating the symptoms of mild to moderate depression.2 Since this article was published, at least …
Pacific Ocean–Wide Profile of CYP1A1 Expression, Stable Carbon and Nitrogen Isotope Ratios, and Organic Contaminant Burden in Sperm Whale Skin Biopsies
Authors: Céline A.J. Godard-Codding, Rebecca Clark, Maria Cristina Fossi, Letizia Marsili, Silvia Maltese, Adam G. West, Luciano Valenzuela, Victoria Rowntree, Ildiko Polyak, John C. Cannon, Kim Pinkerton, Nadia Rubio-Cisneros, Sarah L. Mesnick, Stephen B. Cox, Iain Kerr, Roger Payne, John J. Stegeman
Journal: Environmental Health Perspectives (2010)

Ocean pollution affects marine organisms and ecosystems as well as humans. The International Oceanographic Commission recommends ocean health monitoring programs to investigate the presence of marine contaminants and the health of threatened species and the use of multiple and early-warning biomarker approaches.We explored the hypothesis that biomarker and contaminant analyses in skin biopsies of the threatened sperm whale (Physeter macrocephalus) could reveal geographical trends in exposure on an oceanwide scale.We analyzed cytochrome P450 1A1 (CYP1A1) expression (by immunohistochemistry), stable nitrogen and carbon isotope ratios (as general indicators of trophic position and latitude, respectively), and contaminant burdens in skin biopsies to explore regional trends in the Pacific Ocean.Biomarker analyses revealed significant regional differences within the Pacific Ocean. CYP1A1 expression was highest in whales from the Galapagos, a United Nations Educational, Scientific, and Cultural Organization World Heritage marine reserve, and was lowest in the sampling sites farthest away from continents. We examined the possible influence of the whales' sex, diet, or range and other parameters on regional variation in CYP1A1 expression, but data were inconclusive. In general, CYP1A1 expression was not significantly correlated with contaminant burdens in blubber. However, small sample sizes precluded detailed chemical analyses, and power to detect significant associations was limited.Our large-scale monitoring study was successful at identifying regional differences in CYP1A1 expression, providing a baseline for this known biomarker of exposure to aryl hydrocarbon receptor agonists. However, we could not identify factors that explained this variation. Future oceanwide CYP1A1 expression profiles in cetacean skin biopsies are warranted and could reveal whether globally distributed chemicals occur at biochemically relevant concentrations on a global basis, which may provide a measure of ocean integrity.
Toxoplasma and the eye
Authors: J Hay, G N Dutton
Journal: BMJ (1995)

The dual role of small rodents and domestic cats in the natural course of toxoplasma infection has been known for some 25 years,1 but the nature of the interplay between the protozoan and its human host remains elusive. Nowhere is this more evident than in ocular toxoplasmosis.

Active peripheral toxoplasmic retinochoroiditis may impair vision in the short term because of deposition of inflammatory debris in the vitreous humor. Involvement of the macula or optic nerve may result in permanent visual loss in one eye, or occasionally both eyes. Ocular infection with toxoplasma is one of the commonest causes of postnatal posterior granulomatous uveitis in immunocompetent people, accounting for between a third and a half of cases in the West. Despite this frequency and considerable research, strategies for accurate diagnosis and effective treatment have yet to be devised.

Although toxoplasma was first observed in the eye of an infant in 1923, focal retinochoroiditis in adults was usually considered to result from tuberculosis or syphilis until tissue cysts containing toxoplasma were found in the retinas of enucleated eyes.2 Since then toxoplasmic retinochoroiditis has remained primarily a clinical diagnosis dependent on the characteristic clinical appearance in …
Retrospective study of maternal HIV-1 and HIV-2 infections and child survival in Abidjan, Cote d'Ivoire
Authors: K M De Cock, F Zadi, G Adjorolo, M O Diallo, M Sassan-Morokro, E Ekpini, T Sibailly, R Doorly, V Batter, K Brattegaard, H Gayle
Journal: BMJ (1994)

<b>Objectives</b> : To compare the effects of maternal HIV-1 and HIV-2 infections on outcome of pregnancy, infant mortality, and child survival, and to measure serological concordance between mothers and children. <b>Design</b> : Retrospective cohort study with cross sectional study of concordance for HIV antibodies. Setting - Hospital, tuberculosis clinic, and maternal and child health centre in Abidjan, Cote d9Ivoire, west Africa. <b>Subjects</b> : 986 women who had had a total of 2758 pregnancies since 1980. The last born children of 194 of these women. <b>Main outcome measures</b> : Pregnancy outcomes; mortality for all children born since 1980; and outcome for last born children. Serological concordance between mothers and last born children. <b>Results</b> : Women with HIV-1 and HIV-2 infections had higher rates of spontaneous abortion and stillbirth than uninfected women (86/769 in HIV-1 positive women, 48/421 in HIV-2 positive, 31/234 in dually reactive, and 96/1131 in uninfected). Compared with children born to uninfected mothers (mortality 10.3%), greater proportions of children of HIV-1 positive (20.6%) and dually reactive (20.3%) mothers had died; mortality in children of HIV-2 infected women (13.1%) was not significantly increased. Infant mortalities for the last born children of HIV-1 positive, dually reactive, HIV-2 positive, and seronegative women were, respectively, 133, 82, 32, and 40 per 1000 live births. Nine of 77 last born children of HIV-1 positive mothers were concordantly seropositive compared with none of 21 children of HIV-2 infected mothers. <b>Conclusions</b> : Maternal HIV-2 infection has less influence on child survival than infection with HIV-1, probably because of a lower vertical transmission rate.
Desialation of transferrin by rat liver endothelium.
Authors: S Irie, T Kishimoto, M Tavassoli
Journal: Journal of Clinical Investigation (1988)

To examine the role of liver endothelium in desialation of transferrin (TF), pulse-chase studies were done by incubation of either 3H (sialic acid labeled)-, or 125I, or 59Fe (protein core labeled)-TF with fractionated liver endothelium. While 125I or 59Fe labels were externalized after initial binding and internalization, a large proportion of 3H label was internalized and remained within the cell. When the supernatant of these experiments was studied by isoelectricfocusing and Ricinus communis agglutinin (RCA120) affinity chromatography, generation of asialotransferrin was noted by both techniques. Incubation of liver endothelium with double-labeled TF (sialic acids with 3H and protein core with 125I or 59Fe) led initially to a concordant uptake of the two labels, which were then dissociated and 3H was retained by the cell. These findings indicate desialation of TF by liver endothelium. The significance of these findings in the pathogenesis of hepatic siderosis is discussed.