tbuckley/cabot-search huggingface dataset:
Platelet-TLR7 mediates host survival and platelet count during viral infection in the absence of platelet-dependent thrombosis
Authors: Milka Koupenova, Olga Vitseva, Christopher R. MacKay, Lea M. Beaulieu, Emelia J. Benjamin, Eric Mick, Evelyn A. Kurt-Jones, Katya Ravid, Jane E. Freedman
Journal: Blood (2014)
Contribution of randomised controlled trials to understanding and management of early breast cancer
Authors: M. Baum, J. Houghton
Journal: BMJ (1999)

The randomised controlled trial has become the gold standard for evidence based medicine; through the unbiased comparison of competing treatments it is possible to accurately quantify the cost-benefits and harm of individual treatments. This allows clinicians to offer patients an informed choice and provides the data on which purchasing authorities can make financial decisions. We, of course, subscribe to this view but also recognise this as a gross oversimplification of the power of the randomised controlled trial. The randomised controlled trial is the expression of deductive science in clinical medicine. Not only is it the most powerful tool we have for subjecting therapeutic hypotheses to the hazard of refutation1 but also the biological fallout from such trials should allow clinical scientists to refine biological hypotheses. Trials of treatments for breast cancer have, at least twice, contributed substantially to a paradigm shift in our understanding of the disease.2

#### Summary points

Clinical trials allow clinicians to accurately inform patients with breast cancer of the benefits and harm of different treatments

Breast conserving techniques produce equivalent survival outcomes as more radical operations, but without the anticipated improvement in psychosocial morbidity

The introduction of adjuvant systemic treatments has been associated with a significant fall in mortality from breast cancer in all age groups antedating the start of the national breast screening programme

Counterintuitive results from clinical trials are being incorporated into an emerging conceptual model of the disease



The first randomised trial in the management of early breast cancer can be credited to the Christie Hospital in Manchester. Patients undergoing radical mastectomy were randomised to receive postoperative radiotherapy or not.3 The study found no difference in survival, although the morbidity of the combined procedure was substantial, with 30% of patients who received radiotherapy suffering lymphoedema. It took nearly two decades for the biological …
The Detection of Depression and the Financing of Medical Care
Authors: Mark Zimmerman
Journal: JAMA (1990)

To the Editor.—  The report by Wells and colleagues 1 highlighted the problem of underdiagnosing depressive disorder in general medical practice. The purpose of this letter is to bring to the readers' attention the availability of a self-administered paper-and-pencil questionnaire for diagnosing major depressive disorder (MDD) that my colleagues and I have developed and validated during the past few years. 2-4   The Inventory to Diagnose Depression (IDD) is a self-administered scale specifically designed to diagnose MDD in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) and the revised DSM-III . The scale takes approximately 10 minutes to complete and less than a minute to hand score to determine whether the MDD criteria are met.  The IDD assesses depression with 22 groups of five statements. One symptom of depression is assessed by each group and the statements are arranged in order of increasing symptom severity. The IDD differs from other
Eligibility for and Prescription of Urate-Lowering Treatment in Patients With Incident Gout in England
Authors: Chang-Fu Kuo, Matthew J. Grainge, Christian Mallen, Weiya Zhang, Michael Doherty
Journal: JAMA (2014)

Gout is caused by urate crystal deposition secondary to persistent hyperuricemia. Current guidelines recommend urate-lowering treatment to prevent crystal deposition and encourage crystal dissolution for patients with more severe gout or concomitant conditions.1,2 However, after the first diagnosis, it remains unclear when such treatment is appropriate. We investigated the timing of eligibility for and prescription of urate-lowering treatment following first gout diagnosis and factors associated with prescription.
Synergistic Enhancement of CD8+ T Cell–Mediated Tumor Vaccine Efficacy by an Anti–Transforming Growth Factor-β Monoclonal Antibody
Authors: Masaki Terabe, Elena Ambrosino, Shun Takaku, Jessica J. O'Konek, David Venzon, Scott Lonning, John M. McPherson, Jay A. Berzofsky
Journal: Clinical Cancer Research (2009)

Abstract Purpose: Transforming growth factor-β (TGF-β) is an immunosuppressive cytokine, having direct suppressive activity against conventional CD4+ and CD8+T cells and natural killer cells, thereby inhibiting tumor immunosurveillance. Here, we investigated possible synergy between anti–TGF-β (1D11) and a peptide vaccine on induction of antitumor immunity, and the mechanisms accounting for synergistic efficacy. Experimental Design: The effect of combination treatment with a peptide vaccine and anti–TGF-β was examined in a subcutaneous TC1 tumor model, as well as the mechanisms of protection induced by this treatment. Results: Anti–TGF-β significantly and synergistically improved vaccine efficacy as measured by reduction in primary tumor growth, although anti–TGF-β alone had no impact. The number of tumor antigen–specific CTL with high functional avidity as measured by IFN-γ production and lytic activity was significantly increased in vaccinated mice by TGF-β neutralization. Although TGF-β is known to play a critical role in CD4+Foxp3+ Treg cells, Treg depletion/suppression by an anti-CD25 monoclonal antibody (PC61) before tumor challenge did not enhance vaccine efficacy, and adding anti–TGF-β did not affect Treg numbers in lymph nodes or tumors or their function. Also, TGF-β neutralization had no effect on interleukin-17–producing T cells, which are induced by TGF-β and interleukin-6. Absence of type II NKT cells, which induce myeloid cells to produce TGF-β, was not sufficient to eliminate all sources of suppressive TGF-β. Finally, the synergistic protection induced by anti–TGF-β vaccine augmentation was mediated by CD8+ T cells since anti-CD8 treatment completely abrogated the effect. Conclusions: These results suggest that TGF-β blockade may be useful for enhancing cancer vaccine efficacy. (Clin Cancer Res 2009;15(21):6560–9)
Virus Removal: A Size‐Exclusion Nanocellulose Filter Paper for Virus Removal (Adv. Healthcare Mater. 10/2014)
Authors: Giorgi Metreveli, Linus Wågberg, Eva Emmoth, Sándor Belák, Maria Strømme, Albert Mihranyan
Journal: Advanced Healthcare Materials (2014)

On page 1546, A. Mihranyan and team demonstrate for the first time a 100% natural, unmodified nanofibrous polymer-based membrane, capable of removing viruses solely based on the size exclusion principle, with a log10 reduction value (LRV) ≥ 6.3 as limited by the assay lower detection limit and the feed virus titre, thereby matching the performance of industrial synthetic polymer virus removal filters.
Establishment of a Pediatric Oncology Program and Outcomes of Childhood Acute Lymphoblastic Leukemia in a Resource-Poor Area
Authors: Scott C. Howard
Journal: JAMA (2004)

The cure rate for childhood acute lymphoblastic leukemia (ALL) differs markedly between developed and developing countries.To assess the effect of a multidisciplinary team approach and protocol-based therapy on the event-free survival of children with ALL in an area with limited resources. DESIGN, POPULATION, AND SETTING: A retrospective cohort study at a pediatric hospital in the resource-poor city of Recife, Brazil. We reviewed medical records of the outcomes of 375 children with ALL diagnosed between 1980 and 2002. Eighty-three children were diagnosed in the early period (1980-1989), in the absence of a dedicated pediatric oncology unit, protocol-based therapy, specially trained nurses, 24-hour on-site physician coverage, and ready access to intensive care. Seventy-eight children were treated (all according to protocol) during the middle period (July 1994 to March 1997). During the recent period (April 1997 to December 2002), 214 children were treated with protocol in a dedicated pediatric oncology unit staffed 24 hours by pediatric oncologists and oncology nurses. Improvements were implemented gradually during the middle period and were completed during the recent period.Event-free survival was estimated by the Kaplan-Meier method. Events included death from toxicity, disease progression or relapse, and abandonment of treatment.The 5-year event-free survival improved steadily: 32% (95% CI, 21%-43%) in the early period, 47% (95% CI, 36%-58%) in the middle period, and 63% (95% CI, 55%-71%) in the recent period. The probability of cause-specific treatment failure in the early, middle, and late periods, respectively, within 1 year of diagnosis was 14% vs 3.8% vs 3.3% for relapse; 6.0% vs 12% vs 9.8% for death from infection; 2.4% vs 13% vs 4.2% for death from noninfectious toxicity; and 16% vs 1.3% vs 0.5% for abandonment of therapy.Treatment of childhood ALL in a dedicated pediatric oncology unit using a comprehensive multidisciplinary team approach, protocol-based therapy, and local support and funding is associated with improved outcomes in a resource-poor area.
Bacterial Endocarditis from 1938 to 1967 at the Presbyterian Hospital in New York City.
Authors: Charles Cherubin
Journal: Annals of Internal Medicine (1969)

s1 May 1969Bacterial Endocarditis from 1938 to 1967 at the Presbyterian Hospital in New York City.Charles Cherubin, M.D., Harold C. Neu, M.D., F.A.C.P.Charles Cherubin, M.D.Search for more papers by this author, Harold C. Neu, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1089_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe records of 900 patients indexed as having bacterial endocraditis between 1938 and 1967 were reviewed. Seven hundred records contained sufficient clinical and bacteriological data to confirm the diagnosis. Definite changes in the nature of the disease were noted throughout the three decades. The introduction of penicillin caused a marked fall in the case fatality rate. Except for the disappearance of endocarditis caused byDiplococcus pneumoniaeandNeisseria gonorrhoeaeantibiotics did not change the type of organisms or heart value affected. In the last 2 decades the following changes occurred: Older patients and patients lacking a history of rheumatic heart... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Charles Cherubin, M.D.; Harold C. Neu, M.D., F.A.C.P.Affiliations: New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1969Volume 70, Issue 5Page: 1089-1089KeywordsAntibioticsEndocarditisFallsHeartNeisseria gonorrhoeaePenicillinPneumonia ePublished: 1 December 2008 Issue Published: 1 May 1969 PDF downloadLoading ...
Impact of hepatitis B virus (HBV) preS/S genomic variability on HBV surface antigen and HBV DNA serum levels
Authors: Teresa Pollicino, Giuliana Amaddeo, Agnese Restuccia, Giuseppina Raffa, Angela Alibrandi, Giuseppina Cutroneo, Angelo Favaloro, Sergio Maimone, Giovanni Squadrito, Giovanni Raimondo
Journal: Hepatology (2012)

To evaluate whether hepatitis B virus (HBV) preS/S gene variability has any impact on serum hepatitis B surface antigen (HBsAg) levels and to analyze the replication capacity of naturally occurring preS/S variants, sera from 40 untreated patients with HBV-related chronic liver disease (hepatitis B e antigen [HBeAg]-positive, n = 11; HBeAg-negative, n = 29) were virologically characterized. Additionally, phenotypic analysis of three different preS/S variant isolates (carrying a 183-nucleotide deletion within the preS1 region, the deletion of preS2 start codon, and a stop signal at codon 182 within the S gene, respectively) was performed. HBV infecting 14 (35%) patients had single or multiple preS/S genomic mutations (i.e., preS1 and/or preS2 deletions, preS2 start codon mutations, C-terminally truncated and/or "a" determinant mutated S protein). Presence of preS/S variants negatively correlated with HBsAg titers (r = -0.431; P = 0.005) and its prevalence did not significantly differ between HBeAg-positive and HBeAg-negative patients. No correlation was found between HBsAg and HBV DNA levels in patients infected with preS/S mutants, whereas a significant correlation was found between HBsAg and viremia levels (r = 0.607; P = 0.001) in patients infected with wild-type HBV strains. HepG2 cells replicating the above-mentioned three preS/S variants showed significant reduction of HBsAg secretion, retention of envelope proteins in the endoplasmic reticulum, less efficient virion secretion and nuclear accumulation of significantly higher amounts of covalently closed circular DNA compared with wild-type HBV replicating cells.In patients infected with preS/S variants, HBV DNA replication and HBsAg synthesis/secretion appear to be dissociated. Therefore, the use of HBsAg titer as diagnostic/prognostic tool has to take into account the frequent emergence of preS/S variants in chronic HBV infection.
Climate change will increase number of displaced persons, UN agency says
Authors: P. Moszynski
Journal: BMJ (2009)

If current predictions are proved to be accurate, climate change could lead to large scale population movements that will require a coordinated response by the international community, the United Nations’ high commissioner for refugees has said.

Antonio Guterres, who is due to address the Copenhagen summit on climate this week, cautioned in a recent position paper: “Although there is a growing awareness of the perils of climate change, its likely impact on human displacement and mobility has received too little attention.”

His agency, the Office of the UN High Commissioner for Refugees (UNHCR), points out: “The impact of climate change, which already challenges UNHCR’s operations, adds to the scale and complexity of human mobility and displacement. It contributes …
David Anthony Earnshaw
Authors: J. Earnshaw, T. Earnshaw
Journal: BMJ (2012)

Born a Yorkshireman, who never forgot his heritage, David Anthony Earnshaw (“Tony”) excelled at Heath Grammar School, and won a place at Cambridge University, where he studied medicine (and met his life partner, Gill). After clinical medicine and qualification at Guy’s Hospital he did house jobs and then National Service.

His father …
Gastric Syphilis: Five Recent Cases and a Review of the Literature
Authors: Harry A. Winters, Vincent Notar-Francesco, Kenneth Bromberg, Sarah A. Rawstrom, Joseph Vetrano, Veronica Prego, Jackson Kuan, Jean-Pierre Raufman
Journal: Annals of Internal Medicine (1992)

Objective: To describe five cases of early syphilis with gastric involvement and to review the literature pertaining to this disorder. Data Identification: Five patients were diagnosed with gastric syphilis at Kings County Hospital and the Brooklyn Veterans Affairs Hospital between 1987 and 1990. English-language articles pertaining to gastric syphilis were identified by searching MEDLINE and by manually reviewing bibliographies of retrieved articles. Study Selection: Sources containing information pertinent to the clinical manifestations and diagnosis of gastric syphilis were selected. Data Synthesis: The most common clinical manifestations of gastric syphilis are abdominal pain, vomiting, and weight loss. Endoscopic findings in the stomach range from minimal nodularity and erythema to deep ulceration. Complications of gastric syphilis include hemorrhage, gastric outlet obstruction, and perforation. The diagnosis can be confirmed by serologic testing and by demonstration of spirochetes on silver and immunofluorescent stains of gastric mucosal biopsy specimens. Response to treatment is usually prompt and complete. Conclusions: The current syphilis epidemic will likely result in an increased incidence of gastric syphilis. Unless syphilis is considered as a cause of gastric mucosal inflammation and ulceration, misdiagnosis may delay appropriate treatment, and serious complications can occur.
Distinct effects of two CD44 isoforms on tumor growth in vivo.
Authors: M S Sy, Y J Guo, I Stamenkovic
Journal: The Journal of Experimental Medicine (1991)

Tumor growth is dependent in part on interactions between tumor cells and the extracellular matrix of host tissues. Expression of the cell surface glycoprotein CD44/Pgp-1, which mediates cell-substrate interactions is increased in many types of malignancies, but the role of CD44 in tumor growth is largely undefined. Recently, two isoforms of CD44 have been identified: an 80-90 kD form, which has high affinity for cell bound hyaluronate and a 150 kD form which does not mediate attachment to hyaluronate-coated surfaces. In this work, human B cell lymphoma cells stably transfected with cDNA clones encoding either of the two CD44 isoforms were compared for tumorigenicity and metastatic potential in nude mice. Expression of the 80-90 kD form but not the 150 kD form of CD44 greatly enhanced both local tumor formation and metastatic proclivity of the lymphoma cells. Our results suggest that CD44 polypeptides may play an important role in regulating primary and metastatic tumor development in vivo.
Computer training for doctors and students
Authors: T D Dombal, S Clamp, M Margulies, M Chan
Journal: BMJ (1994)

EDITOR, - We agree with the comments by Ronald LaPorte and colleagues1 and Ray Jones and Sue Kinn.2 The information superhighway, an important technical development of immense potential impact in clinical medicine, will not fulfil its potential if doctors do not, will not, or cannot use it because they do not know how. Education is clearly the key - a fact recognised by the General …
THE FORMATION OF COLLAGEN FIBERS BY THE ACTION OF HEPARIN ON SOLUBLE COLLAGEN: AN ELECTRON MICROSCOPE STUDY
Authors: Thomas G. Morrione
Journal: The Journal of Experimental Medicine (1952)

Collagen fibers have been formed in vitro by the action of heparm on solutions of collagen. Heparin was found to be effective in inducing collagen fiber formation when present in concentrations as low as 1-80,000. It is postulated that mast cells, by virtue of the heparin which they produce, may play a role in the formation of collagen.
Complementary Strategies to Prevent Firearm Injury
Authors: Thomas B. Cole
Journal: JAMA (2001)

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
Correlation between Clinical Parameters of Asthma and Airway Dimension, Air Trapping and Airway Collapsibility Measured by Volumetric Inspiration and Expiration CT
Authors: H. Moon, T. Kim, E. Chae, N. Kim, Y. Lee, C. Park, B. Yoo, J. Seo, Y. Cho
Journal: Journal of Allergy and Clinical Immunology (2007)
Fully covered self-expandable metallic stents in benign biliary strictures: a multicenter study on efficacy and safety
Authors: I. Tarantino, B. Mangiavillano, R. Di Mitri, L. Barresi, F. Mocciaro, A. Granata, E. Masci, G. Curcio, M. Di Pisa, A. Marino, M. Traina
Journal: Endoscopy (2012)

<b>Background and study aim: </b>Benign biliary diseases include benign biliary stricture (BBS), lithiasis, and leaks. BBSs are usually treated with plastic stent placement; use of uncovered or partially covered metallic stents has been associated with failure related to mucosal hyperplasia. Some recently published series suggest the efficacy of fully covered self-expandable metal stents (FCSEMSs) in BBS treatment. We aimed to assess the efficacy and safety of FCSEMS in a large series of patients with BBS and a long follow-up. <b>Patients and methods:</b> Prospective multicenter clinical study at three tertiary referral centers: ISMETT/UPMC Italy, Palermo, San Paolo Hospital, Milan, and the ARNAS Civico Hospital, Palermo, Italy. All consecutive patients with BBS were treated with placement of FCSEMS rather than plastic stents, as first approach (11 patients, 17.7 %), or as a second approach after failure of other treatments (51 patients, 82.2 %). <b>Results: </b>From January 2008 to March 2011, 62 patients (40 male) were included. Mean period of FCSEMS indwelling was 96.7 days (standard deviation [SD] 6.5 days). In 15 patients (24.2 %) the SEMS migrated. Resolution of BBS occurred in 56 patients (90.3 %), while in 6 (9.6 %) the treatment failed. Mean (SD) follow-up after SEMS removal was 15.9 (10) months. FCSEMS placement as first- or second-line approach showed no difference in failure. Recurrence was observed in 4 /56 patients (7.1 %); all were transplant recipients: <i>P</i> = 0.01; odds ratio (OR) 1.2, confidence interval (CI) 1.1 – 1.3. <b>Conclusions:</b> Despite the noteworthy migration rate, FCSEMSs should be considered effective for refractory benign biliary strictures. Further studies are needed to assess their role as a first approach in the management of BBS.
Effect of Vacuolar Proton ATPase on pH <sub>i</sub> , Ca <sup>2+</sup> , and Apoptosis in Neonatal Cardiomyocytes During Metabolic Inhibition/Recovery
Authors: Ewa Karwatowska-Prokopczuk, Judith A. Nordberg, Hai Ling Li, Robert L. Engler, Roberta A. Gottlieb
Journal: Circulation Research (1998)

Abstract —Recently, we found that vacuolar proton ATPase (VPATPase) operates in cardiomyocytes as a complementary proton-extruding mechanism. Its activity was increased by preconditioning with resultant attenuation of intracellular acidification during ischemia. In this study, we examined whether VPATPase-mediated proton efflux during metabolic inhibition/recovery may spare Na + overload via Na + -H + exchange, attenuate Na + -Ca 2+ exchange, and decrease apoptosis. Neonatal rat cardiomyocytes were subjected to 2- to 3-hour metabolic inhibition with cyanide and 2-deoxyglucose and 24-hour recovery. The effect of VPATPase inhibition by 50 nmol/L bafilomycin A 1 on apoptosis, pH i , and [Ca 2+ ] i was studied by flow cytometry with propidium iodide, seminaphthorhodafluor (SNARF)-1-AM, and indo-1-AM staining, respectively. VPATPase inhibition increased the amount of apoptosis measured after 24 hours of recovery and abrogated the protective effect of inhibition of Na + -H + exchange by (5- N -ethyl- N -isopropyl)amiloride (EIPA). Dual blockade of VPATPase and Na + -H + exchange was additive in effect with EIPA on pH i during metabolic inhibition/recovery and recovery from the acid challenge with sodium propionate. VPATPase blockade increased the rate of accumulation of intracellular Ca 2+ at the beginning of metabolic inhibition and abrogated the delaying effect of EIPA on intracellular Ca 2+ accumulation. These results indicate that VPATPase plays an important accessory role in cardiomyocyte protection by reducing acidosis and Na + -H + exchange–induced Ca 2+ overload.