tbuckley/cabot-search huggingface dataset:
US Supreme Court considers Obama's health reform law
Authors: D. Kamerow
Journal: BMJ (2011)

Will it matter what the justices decide?



The big news here last week was that the Supreme Court has agreed to consider the constitutionality of the healthcare reform law. The nine justices (there have been calls on both sides for individual justices to recuse themselves because of conflicts of interest, but apparently none will) are scheduled to hear the case in March 2012.1 They have set aside an unprecedented five and a half hours for each oral argument, indicating the importance of the issue. This would put them on a course to announce their decision in late June, right in the middle of the US presidential election campaign.

The key question is whether Congress has the authority to require all US citizens to either buy health insurance or pay a fine. No one is surprised that the justices decided to take on this so called “individual mandate” provision (about which more below), but many did not expect them to invite arguments on three other issues as well. These are whether Congress can require states to expand their Medicaid programmes (which are …
Psychological factors in breast cancer.
Authors: G C Sutton
Journal: BMJ (1991)

We are grateful to Dr Martin and Mr Tweedle for their comments.It is our contention that this complication, which has been noted before,' is probably underrecognised rather than rare.We do not advocate doing therapeutic biliary endoscopy as a day case procedure, and it is certainly not our practice to do this.Other complications such as pancreatitis and septicaemia may also present after four to six hours, and our patients often come from far away as tertiary referrals.We use a similar technique to that of Dr Martin and Mr Tweedle, using an electrosurgical unit with a power output of 30 watts, although the output may have to be increased in patients with longstanding choledocholithiasis and fibrosis at the lower end of the bile duct.We prefer a plain wired sphincterotome.Interestingly, our overall rate of bleeding after sphincterotomy (3%) is virtually identical with that quoted by others,' 2 including Dr Martin and Mr Tweedle, who were among four authors who reported bleeding in six of 215 patients.'It is not apparent why this bleeding may become overt late, but the need for vigilance remains clear.
Complementation analysis of fatty acid oxidation disorders.
Authors: A Moon, W J Rhead
Journal: Journal of Clinical Investigation (1987)

We assayed [9,10(n)-3H]palmitate oxidation by fibroblast monolayers from patients with fatty acid oxidation disorders. Activities in the different disorders were (percent control): short-chain acyl-coenzyme A (CoA) dehydrogenase deficiency (115%), medium chain acyl-CoA dehydrogenase deficiency (18%), long-chain acyl-CoA dehydrogenase deficiency (28%), multiple acyl-CoA dehydrogenation disorder, mild and severe variants (49% and 7%), and palmityl-carnitine transferase deficiency (4%). Multiple acyl-CoA dehydrogenation disorder, medium chain acyl-CoA dehydrogenase-deficient lines, and long-chain acyl-CoA dehydrogenase-deficient lines all complemented one another after polyethylene glycol fusion, with average activity increases of 31-83%. We detected two complementation groups in the severe multiple acyl-CoA dehydrogenation disorder lines, consistent with deficiencies of either electron transfer flavoprotein or electron transfer flavoprotein:ubiquinone oxidoreductase. The metabolic block in the latter cell lines is threefold more severe than in the former (P less than 0.001). No intragenic complementation was observed within either group. We assigned two patients with previously unreported severe multiple acyl-CoA dehydrogenation disorder to the electron transfer flavoprotein:ubiquinone oxido-reductase-deficient group.
Advance Directives for Nursing Home Residents
Authors: Joan M. Teno
Journal: JAMA (2000)

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
Dental Discolouration and Tetracycline
Authors: L. S. Taitz
Journal: BMJ (1971)

The atd angle for the right hand is 102' and for the left hand 88', the sum of right and left being 190'.This value is very high, coming above the mean of 162' for Down's syndrome,7 yet not so high as the mean of 216' in Patau's syndrome.8Finger prints show an unusually complex pattern of six whorls, three ulnar loops, and one double loop (see Table ).
Velocity patterns in the aorta
Authors: W. A. Seed, N. B. Wood
Journal: Cardiovascular Research (1971)

Hot-film constant temperature probes, evaluated in regimes of pipe-flow, have been used to explore velocity distributions across diameters at various sites in the aorta of dogs. Velocity profiles at all levels were blunt, with boundary-layers less than 2 mm thick; marked skews occurred in the profiles at certain sites in the proximal aorta. The major factors influencing flow in these regions are discussed, and possible causative factors identified. Fully-developed turbulence occurred in only one case, which is described.
Forced oscillation technique (FOT): a new tool for epidemiology of occupational lung diseases?
Authors: QT Pham, E Bourgkard, N Chau, G Willim, SE Megherbi, D Teculescu, A Bohadana, JP Bertrand
Journal: European Respiratory Journal (1995)

The aim of this study was to evaluate the usefulness of the forced oscillation technique (FOT) in the assessment of occupation-related airway changes. The forced oscillation technique and conventional lung function tests were applied in 80 underground coalface workers, aged 35-48 yrs, with chest roentgenogram films classified 0/1 or 1/0 according to the International Labour Office (ILO) classification (G group), and two control groups matched for age and smoking habits. The first control group, was made up of face-workers having normal chest radiographs, whilst the second comprised underground non-face-workers with normal chest radiographs. Spirometric, plethysmographic and transfer factor of the lungs for carbon monoxide single-breath (TL,CO,sb) indices revealed no significant differences between the three groups. As regards the forced oscillation technique, a higher value of resistance/frequency slope (Pa.L-1.s2) was found in the G group compared with the control groups; 2.11 vs 1.06 in the face-workers, and 1.58 in the underground workers. In all three groups, the forced oscillation technique indices (mean resistance (R), resistance at zero frequency (RO), resistance/frequency slope (S), and resonant frequency (fo)) were found to be higher in subjects having a decreased forced expiratory volume in one second (FEV1) (&lt; or = 90% predicted) or a mildly obstructive pattern of ventilatory function, even though this did not reach statistical significance in each of the groups. These findings together with the feasibility and acceptability of the forced oscillation technique would suggest that it may be a suitable tool for epidemiological studies of occupational respiratory diseases.
Involvement of protein kinase C-CPI-17 in androgen modulation of angiotensin II-renal vasoconstriction
Authors: Jin Song, Kathleen M. Eyster, Curtis K. Kost, Barton Kjellsen, Douglas S. Martin
Journal: Cardiovascular Research (2009)

Previous studies suggested that androgens augmented renal vascular responses to angiotensin II (Ang II). The protein kinase C (PKC)-CPI-17 pathway is involved in vascular constriction. We tested the hypothesis that this pathway may contribute to androgenic amplification of Ang II-renal vasoconstriction in the New Zealand genetically hypertensive (NZGH) rat. NZGH underwent sham operation, castration, or castration with testosterone replacement at 5 weeks of age. When the rats were 16–17 weeks of age, mean arterial pressure (MAP) and renal vascular resistance (RVR) responses to intravenous Ang II infusion (20, 40, and 80 ng/kg/min) were recorded before and after treatment with a PKC inhibitor, chelerythrine. mRNA expression of PKC isoforms and CPI-17 protein expression were analysed in renal cortex. MAP and RVR responses to Ang II were enhanced in androgen-replete NZGH. The Ang II-induced increase in RVR was significantly lower in castrated NZGH (ranged from 100 ± 8% to 161 ± 9% of baseline) than in sham-operated NZGH (ranged between 123 ± 3% and 237 ± 19% of baseline). Testosterone treatment restored RVR responses to Ang II in castrated rats. Chelerythrine treatment markedly reduced the MAP and RVR responses to Ang II in each group and attenuated the differential MAP and RVR responses to Ang II amongst the three groups. PKCδ and PKCε mRNA levels were significantly reduced by castration and increased by testosterone treatment. In contrast, no significant differences in protein expression were detected for these PKC isoforms. Castration decreased while testosterone treatment increased CPI-17 and phospho-CPI-17 expression. Collectively, these results suggest that androgens modulate renal vascular responses to Ang II in part via an effect on the PKC-CPI-17 signalling pathway.
A regulatory role for large vessels in organ circulation. Endothelial cells of the main renal artery modulate intrarenal hemodynamics in the rat.
Authors: V Kon, R C Harris, I Ichikawa
Journal: Journal of Clinical Investigation (1990)

After arterial denudation by external rubbing of the left main renal artery, we assessed renal plasma flow rate (RPF) and glomerular filtration rate (GFR) in left and right kidneys of Munich-Wistar rats before and after intravenous infusion of acetylcholine (ACH), atrial natriuretic peptide (ANP), or nitroprusside (NP). In the right kidney RPF and/or GFR increased in response to both endothelium-derived relaxing factor (EDRF)-dependent (i.e., ACH) and -independent vasodilators (i.e., ANP and NP); on average, RPF rose by 22 +/- 4% (P less than 0.005), 19 +/- 10% (P less than 0.005), and 37 +/- 12% (P greater than 0.05), respectively. By contrast, in the left kidney RPF failed to increase after ACH (falling by 23 +/- 10%, P less than 0.001) and rose only in response to ANP and NP. To further evaluate the main renal artery's contribution to renal vasodilation, ACH and another EDRF-dependent agent, histamine, were infused through a micropipette into either the proximal or distal portions of the endothelium-intact renal artery. Proximal infusion of ACH led to increases in RPF and GFR, on average by 8 +/- 2% (P less than 0.025) and 10 +/- 3% (P less than 0.01), while bypassing the arterial endothelium by distal infusion failed to increase RPF and GFR, which fell by 24 +/- 6% (P less than 0.025) and 22 +/- 6% (P less than 0.005), respectively. Similarly, proximal infusion of histamine increased RPF by 12 +/- 3% (P less than 0.05), while distal infusion was virtually without effects on plasma flow. Micropuncture study during intravenous ACH infusion revealed significantly higher afferent and efferent arteriolar resistances and lower ultrafiltration coefficients in denuded versus nondenuded kidneys. These data indicate that the main renal artery is a major regulator of renal blood flow and vascular resistances. Similar to other endothelium-derived substances, EDRF may be elaborated mainly by large vessels and may act on the downstream microcirculatory systems, which determine organ blood flow and transcapillary fluid transfer.
An analysis of skin prick test reactions in 656 asthmatic patients.
Authors: D J Hendrick, R J Davies, M F D'Souza, J Pepys
Journal: Thorax (1975)

Of 656 asthmatic patients referred specifically for allergy assessments, 544 (84 percent) gave positive immediate skin prick tests to at least one of 22 common allergens used routinely. Comparison of these skin test positive patients with the 102 (16 percent) who were skin test negative showed a number of significant differences. The majority of the skin test positive patients (52 percent) were less than 10 years old at the time of onset of the asthma, whereas, of the skin test negative patients, 56 percent were aged over 30 years at the time of onset. Seventy per cent report rhinitis compared with 48 per cent of the skin test negative patients, and 29 per cent reported infantile eczema compared with 9 per cent. Symptoms attributed to house dust, pollens, and animals were noted two to three times more frequently by the skin test positive patients, while corticosteroid drugs had been used more commonly by the skin test negative patients (45 percent compared with 35 percent). No significant differences were observed with the other factors studied, namely, history of urticaria or angio-oedema, family history of "allergic" disease, and awareness of sensitivity to foods, aspirin or penicillin. Prick test reactions in the skin test positive patients were most commonly seen to house dust or the acarine mite, Dermatophagoides farinae (82 percent), followed by pollens (66 percent), animal danders (38 percent), foods (16 percent), Aspergillus fumigatus (16 percent), and other moulds (21 percent). There was a highly significant association of positive history with positive prick test for all allergens studied.
Effects of adenosine on rate-dependent atrioventricular nodal function. Potential roles in tachycardia termination and physiological regulation.
Authors: M Nayebpour, J Billette, F Amellal, S Nattel
Journal: Circulation (1993)

BACKGROUND Adenosine is well known to depress atrioventricular (AV) nodal conduction, but the potential interactions between adenosine and functional AV nodal properties have not been explored. The purpose of the present study was to determine (1) whether exogenous adenosine modifies the rate-dependent properties of the AV node, (2) to what extent such changes underlie the actions of adenosine in an in vitro model of AV reentrant tachycardia (AVRT), and (3) the potential role of endogenous adenosine in rate-induced AV nodal responses. METHODS AND RESULTS The functional properties of AV nodal recovery (defining the conduction delay of a single premature activation), facilitation (effect of short cycles on subsequent nodal recovery), and fatigue (slowly developing AV nodal delay at a rapid rate) were studied selectively in isolated, superfused rabbit and guinea pig cardiac preparations. Exogenous adenosine increased AV nodal fatigue and attenuated facilitation, resulting in tachycardia-dependent increases in AH interval and AV nodal effective refractory period (AVERP). In experimental AVRT, adenosine caused greater increases in tachycardia cycle length (T) and AVERP as tachycardia rate increased. AVRT was sustained when AVERP/T was &lt; 1, and adenosine suppressed AVRT by increasing the slope of the AVERP/T versus tachycardia rate relation, causing the critical ratio of 1 to be attained at slower rates. A mathematical model incorporating quantitative descriptors of recovery, facilitation, and fatigue accounted for changes in AH interval, AVERP, tachycardia cycle length, and AVERP/T under control conditions and in the presence of adenosine. In the absence of exogenous adenosine, 8-phenyltheophylline (10 mumol/L), an adenosine receptor antagonist, did not alter recovery or facilitation but significantly reduced rate-related fatigue (by 31 +/- 8%, mean +/- SEM, P &lt; .05, in rabbit hearts; 46 +/- 5%, P &lt; .01, in guinea pig hearts). Combined inhibition of adenosine deaminase (with erythro-9-[2-hydroxy-3-nonyl]-adenine hydrochloride, 5 mumol/L) and adenosine uptake (with dipyridamole, 1 mumol/L) increased fatigue in the absence of exogenous adenosine by 57 +/- 20% (P &lt; .05). CONCLUSIONS We conclude that (1) exogenously administered adenosine increases AV nodal fatigue and reduces facilitation, without altering AV nodal recovery; (2) these changes cause rate-dependent AV nodal depression, which plays a role in adenosine's actions on experimental AVRT; and (3) endogenous adenosine receptor activation plays a role in physiological AV nodal fatigue. Adenosine's ability to terminate reentrant supraventricular tachycardia may be due, at least in part, to its ability to enhance the physiological conduction slowing that results from sustained increases in AV nodal activation rate.
A Randomized, Double-Blinded, Placebo-Controlled Trial of Oral<i>Polypodium leucotomos</i>Extract as an Adjunct to Sunscreen in the Treatment of Melasma
Authors: Ammar M. Ahmed, Isha Lopez, Francisco Perese, Rebecca Vasquez, Linda S. Hynan, Benjamin Chong, Amit G. Pandya
Journal: JAMA Dermatology (2013)
Twenty-Five Years of Urology
Authors: J. DELLINGER BARNEY, E. ROSS MINTZ
Journal: New England Journal of Medicine (1937)

was chief of the department until his resignation in 1920. Since that date, the writer has had the honor of holding this important position. The figures and tables are presented often without explanation, and always without apology. Some are apparently contradictory, but they must be taken at their face value. The work has been shared by the entire staff, each in his turn, some having more ability and experience than others. It is believed that because of this fact, and because this review cov-
A mutation in the DNA-binding domain of the androgen receptor gene causes complete testicular feminization in a patient with receptor-positive androgen resistance.
Authors: M Marcelli, S Zoppi, P B Grino, J E Griffin, J D Wilson, M J McPhaul
Journal: Journal of Clinical Investigation (1991)

Androgen resistance is associated with a wide range of quantitative and qualitative defects in the androgen receptor. However, fibroblast cultures from approximately 10% of patients with the clinical, endocrine, and genetic features characteristic of androgen resistance express normal quantities of apparently normal androgen receptor in cultured genital skin fibroblasts (receptor-positive androgen resistance). We have analyzed the androgen receptor gene of one patient (P321) with receptor-positive, complete testicular feminization and detected a single nucleotide substitution at nucleotide 2006 (G----C) within the second "zinc finger" of the DNA-binding domain that results in the conversion of the arginine residue at position 615 into a proline residue. Introduction of this mutation into the androgen receptor cDNA and transfection of the expression plasmid into eukaryotic cells lead to the synthesis of a receptor protein that displays normal binding kinetics but is inactive in functional assays of receptor activity. We conclude that substitution mutations in the DNA-binding domain of the androgen receptor are one cause of "receptor-positive" androgen resistance.
Evidence-based medicine: a new paradigm for the patient
Authors: L. Crawley
Journal: JAMA (1993)

To the Editor.  —I am responding to the Evidence-Based Medicine Working Group's imprecise use of the term paradigm shift in what otherwise was an informative article. 1 The authors stated that the old paradigm is represented by assumptions guiding clinical practice based on either empirical observations, rationalistic confirmation, Oslerian acumen, and common sense, or a combination thereof. In the purported new paradigm, these assumptions are grounded in the critical appraisal and correct interpretation of medical literature that can then provide the basis of underlying evidence to support and guide clinical decisions. How does the reconciliation of the age-old empiricist-rationalist debate through a systematic analysis of clinical literature represent a paradigm shift in the true Kuhnian sense? Rather than constituting a revolution, it would seem that evidence-based medicine is an example of further developing and professionalizing the prevailing paradigm through a refinement of concepts that increasingly lessens their resemblance to their
Public thinks health policies aim to win votes, not protect healthcare, finds BMA poll
Authors: Z. Kmietowicz
Journal: BMJ (2014)

Political parties design health policies to win votes rather than doing what is in the best interests of the NHS, a poll ahead of the BMA’s annual representatives meeting has found.

The public also believes that doctors should have a greater say in how the NHS is run, with 66% of nearly 2000 people surveyed saying that they were in favour of doctors taking a lead role in managing health services.

Mark Porter, the BMA’s chairman of council, said the results were a clear indication that the public thought the same way as doctors and wanted to see the politics taken out of the NHS. “Politicians should …
Cocktails for Two
Authors: Steve Goodacre
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