tbuckley/cabot-search huggingface dataset:
Correction: Henry Clay and the Great State of Kentucky
Authors: Timothy Kelley
Journal: JAMA (1995)

To  Editor.  —May a nonphysician offer humble corrections to  article on Oliver Wendell Holmes? 1   As a onetime history major who now finds himself an editor for a magazine for physicians, I remember I could pass college science courses only when they took a historical approach. It seems fair to return that favor now by presenting my historical corrections in surgical terms. Your column speaks of  Carolina Senator Henry Clay's Fugitive Slave Act. The removal of South Carolina from  US body politic is a procedure that has been recommended at least twice, and performed once. (Unfortunately,  patient almost bled to death.) Henry Clay, however, could not have been extracted using this operation. That would have required a Kentuckiectomy. Similarly, you fail to account for  migration (metastasis?) of what you term the New Hampshire senator Daniel Webster. Born in New Hampshire, Webster was elected to
GPs to produce a strategy for the future Academic staff seek prime minister's help over funding Calman proposals will affect hospital manpower Tobacco companies curb advertising NHS chairmen will have charters Correction
Authors: L. Beecham
Journal: BMJ (1996)

# GPs to produce a strategy for the future {#article-title-2}

The General Medical Services Committee will begin to discuss its strategy for the future of general practice at its September meeting. This will be the first stage of the GMSC's response to the government's document Primary Care: The Future (15 June, p 1500). Dr Ian Bogle, who was re-elected unopposed as chairman but said that it would be the last year that he stood, said last week that he and the negotiators planned a weekend meeting to draft the strategy. This would be wide-ranging and cover a definition of core services, contractual options, recruitment, workload, and funding.

Welcoming the move Dr Tony Stanton, secretary of the inner London local medical committees, said that the committee needed to debate all the issues urgently. General practitioners' wish to recruit more doctors and reduce list sizes might not be achievable. He did not believe that they wanted to see the hospital service depleted further to pay for additional primary care services.

The GMSC has set up a task group to examine how it conducts its business. Dr John Ball will chair the group, and its other members are Dr Lawrence Buckman, Dr John Canning, Dr Grant Kelly, and Dr Fay Wilson. Dr Ball, a former chairman of the GMSC, told the committee that there was a wealth of talent on the committee that was never tapped and he wondered whether concentrating so much work and responsibility on a few people was the right way …
The Clinical Investigator as an Endangered Species
Authors: James B. Wyngaarden
Journal: New England Journal of Medicine (1979)

THIS paper deals with the physician-investigator as an endangered species and with the future of clinical research. Clinical research includes the wide range of activities extending from epidemiology to studies of patients, to laboratory studies of specimens and tissues. Clinical research is usually conducted by physician-investigators working in a clinical department of a medical school or in a clinical division of an institute. An increasing number of Ph.D.'s are also engaging in clinical research, but this paper will be largely devoted to the physician-investigator.For several years there has been a declining interest in biomedical research on the part of . . .
Understanding the Determinants of Exceptional Longevity
Authors: Thomas Perls
Journal: Annals of Internal Medicine (2003)

Centenarians represent an extreme of life expectancy. They achieve their exceptional longevity in part by lacking genetic variations linked to premature death. Pedigree studies have shown a substantial familial component in the ability to survive to extreme old age, and a recent study demonstrated a locus on chromosome 4 linked to exceptional longevity, indicating the likely existence of at least one longevity-enabling gene in humans. The children of centenarians have markedly reduced relative risks for age-related diseases, particularly heart disease, hypertension, and diabetes, and are a promising model for genetic and phenotypic studies of 1) aging slowly relative to the general population and 2) the delay of and perhaps escape from important age-related diseases. These studies and those of other mammals and lower organisms show great promise for the delineation of important environmental and genetic determinants of aging well.
Randomised, double blind, placebo controlled trial of penicillin V and amoxycillin in treatment of acute sinus infections in adults
Authors: M. Lindbaek, P. Hjortdahl, U. L-H Johnsen
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To compare the effectiveness of penicillin V and amoxycillin with placebo in treatment of adult patients with acute sinusitis. <b>Design</b>: Randomised, double blind, placebo controlled trial. <b>Setting</b>: Norwegian general practice. <b>Subjects</b>: 130 adult patients with a clinical diagnosis of acute sinusitis confirmed by computed tomography. <b>Main outcome measures</b>: Subjective status after three and 10 days of treatment, difference in clinical severity score between day 0 and day 10 as evaluated by the general practitioner, difference in score from computed tomography on day 0 and day 10, and duration of sinusitis. <b>Results</b>: Amoxycillin and penicillin V led to significantly faster and better recovery than placebo. By day 10, 71 patients receiving antibiotic treatment (86%) considered themselves to be recovered or much better compared with 25 (57%) receiving placebo. The mean (95% confidence interval) reductions in clinical severity scores by day 10 were 5.4 (5.0 to 5.8) for penicillin V, 5.5 (4.9 to 6.0) for amoxycillin, and 3.4 (2.8 to 4.0) for placebo. For the antibiotic groups combined the number of patients with the greatest degree of improvement on computed tomography (scale 0-16)—that is, score 5-16 on day 10—was 31/83 (37%) compared with 10/44 (23%) receiving placebo. The median duration of the sinusitis was nine days in the amoxycillin group, 11 days in the penicillin V group, and 17 days in the placebo group. <b>Conclusion</b>: Penicillin V and amoxycillin are significantly more effective than placebo in the treatment of acute sinusitis. <h3>Key messages</h3> The median duration of sinusitis with different treatment was nine days for amoxycillin, 11 days for penicillin V, and 17 days for placebo More than half of the patients receiving antibiotic treatment reported side effects but few gave severe discomfort Half of the patients receiving placebo tablets felt restored or much better after 10 days
A Peripatetic Post
Authors: John Lister
Journal: New England Journal of Medicine (1969)

THE reporting of two cases of leprosy in an English town prompted Professor Maegrath, of the School of Tropical Medicine in Liverpool, to write a letter to the Times 1 calling attention once again to the increased dangers of importing communicable diseases that inevitably result from high-speed jet-age travel.Admittedly, the problem with leprosy is not great, the leprosy register in 1967 showing only 357 cases in England and Wales. Professor Maegrath believes that the risk to the population of other communicable diseases such as tuberculosis and smallpox is well understood and that cases are competently managed by the health authorities. . . .
Transforming Growth Factor-β in Human Diabetic Nephropathy
Authors: Robyn G. Langham, Darren J. Kelly, Renae M. Gow, Yuan Zhang, Daniel J. Cordonnier, Nicole Pinel, Phillipe Zaoui, Richard E. Gilbert
Journal: Diabetes Care (2006)

Studies in rodent models have suggested that reduction in renal transforming growth factor (TGF)-beta1 may underlie the renoprotective effects of the renin-angiotensin system (RAS) blockade. However, the role of the RAS blockade in abrogating TGF-beta in human disease is unknown. Accordingly, we sought to examine TGF-beta gene expression and biological activity in human renal biopsies, before and after ACE inhibition.RNA was extracted from renal biopsies taken from participants in the Diabiopsies study, a randomized controlled 2-year trial of 4 mg/day perindopril versus placebo that reported a reduction in proteinuria and cortical matrix expansion in type 2 diabetic nephropathy. Biopsies taken at study entry and at 2 years were obtained in 12 patients (6 placebo and 6 taking perindopril). TGF-beta1 and its receptor mRNA were quantified by real-time PCR, and its biological activity was assessed by examining the activation of its intracellular signaling pathway (phosphorylated Smad2) and the expression TGF-beta-inducible gene H3 (betaig-H3).At baseline, TGF-beta1 expression was similar in both placebo- and perindopril-treated groups and was unchanged over a 2-year period in biopsies of placebo-treated subjects. In contrast, perindopril treatment led to a substantial diminution in TGF-beta1 mRNA (mean 83% reduction, P < 0.05). Phosphorylated Smad2 immunolabeling and betaig-H3 mRNA were similarly reduced with ACE inhibition (P < 0.05) but unchanged in the placebo group. No differences were noted in the gene expression of TGF-beta receptor II in biopsies of either placebo- or perindopril-treated subjects.This study demonstrates that over a 2-year period, treatment with perindopril in patients with type 2 diabetes and nephropathy leads to a reduction in both renal TGF-beta1 gene expression and its downstream activation.
Chemotherapy Targeted to Cancer Tissue Potentiates Antigen-specific Immune Response Induced by Vaccine for In Vivo Antigen Loading and Activation of Dendritic Cells
Authors: Hakan Akbulut, Yucheng Tang, K. Gonca Akbulut, Jonathan Maynard, Albert Deisseroth
Journal: Molecular Therapy (2008)

Our laboratory has created an Ad-sig-TAA/ecdCD40L vaccine platform designed to activate dendritic cells (DCs). Two subcutaneous (s.c.) injections of the TAA/ecdCD40L protein following the s.c. injection of the Ad-sig-TAA/ecdCD40L vector (TAA/ecdCD40L VPP vaccine) further increases the levels of the tumor-associated antigen (TAA)-specific CD8 effector T cells induced by the vector. We tested the combined effect of chemotherapy-induced destruction of tumor cells and TAA/ecdCD40L VPP vaccine which further increases the levels of TAA available to the DCs at the time of vaccination. The chemotherapy was delivered selectively to the tumor cells using intratumoral (i.t.) injection of the AdCDIRESE1A vector followed by intraperitoneal (i.p.) 5-fluorocytosine (5FC). The 5-fluorouracil (5FU) produced in the vector infected the tumor cells, destroys them and releases the TAA for processing and presentation by the DCs. This mode of delivery spares the TAA CD8 effector T cells from the destructive effect of the 5FU when their proliferation is induced by the vaccine. Test mice treated with both the s.c. administered TAA/ecdCD40L VPP vaccine and the AdCDIRESE1A/5FC chemosensitization vector had the smallest tumor volumes and survived longer than mice treated with either of these agents alone (P < 0.001).
Iron absorption and transport?An update
Authors: Marcel E. Conrad, Jay N. Umbreit
Journal: American Journal of Hematology (2000)

Iron is vital for all living organisms. However, excess iron is hazardous because it produces free radical formation. Therefore, iron absorption is carefully regulated to maintain an equilibrium between absorption and body loss of iron. In countries where heme is a significant part of the diet, most body iron is derived from dietary heme iron because heme binds few of the luminal intestinal iron chelators that inhibit absorption of non-heme iron. Uptake of luminal heme into enterocytes occurs as a metalloporphyrin. Intracellularly, iron is released from heme by heme oxygenase so that iron leaves the enterocyte to enter the plasma as non-heme iron. Ferric iron is absorbed via a β3 integrin and mobilferrin (IMP) pathway that is not shared with other nutritional metals. Ferrous iron uptake is facilitated by DMT-1 (Nramp-2, DCT-1) in a pathway shared with manganese. Other proteins were recently described which are believed to play a role in iron absorption. SFT (Stimulator of Iron Transport) is postulated to facilitate both ferric and ferrous iron uptake, and Hephaestin is thought to be important in transfer of iron from enterocytes into the plasma. The iron concentration within enterocytes reflects the total body iron and either upregulates or satiates iron-binding sites on regulatory proteins. Enterocytes of hemochromatotics are iron-depleted similarly to the absorptive cells of iron-deficient subjects. Iron depletion, hemolysis, and hypoxia each can stimulate iron absorption. In non-intestinal cells most iron uptake occurs via either the classical clathrin-coated pathway utilizing transferrin receptors or the poorly defined transferrin receptor independent pathway. Non-intestinal cells possess the IMP and DMT-1 pathways though their role in the absence of iron overload is unclear. This suggests that these pathways have intracellular functions in addition to facilitating iron uptake. Am. J. Hematol. 64:287–298, 2000. © 2000 Wiley-Liss, Inc.
Long hours of work in junior doctors.
Authors: J. H. Gruzelier, D. I. Orton
Journal: BMJ (1989)

complications but inadequately comprehend the expected blood glucose profile.""Comprehend" is used to imply limited understanding, but this is often a function of inadequate instruction.Any test is potentially harmful if the operator does not understand how to interpret or react to the data generated.This paper highlights that the keystone to good diabetic care is education.It in no way proves that blood glucose monitoring may itself be harmful by generating neurosis in patients with or without obsessional traits.
Subacute cutaneous lupus erythematosus associated with interferon beta-1a
Authors: Hossein C Nousari, Arash Kimyai-Asadi, Francisco A Tausk
Journal: The Lancet (1998)

Interferons, especially interferon alpha, have been associated with the induction or exacerbation of autoimmune and inflammatory disorders, including systemic lupus erythematosus (LE), rheumatoid-like arthritis, bone-marrow aplasia, and glomerulonephritis, as well as autoimmune thyroiditis, hepatitis, thrombocytopenia, and anaemia. 1 Vial T Descotes J Immune-mediated side-effects of cytokines in humans. Toxicology. 1995; 105: 31-57 Crossref PubMed Scopus (154) Google Scholar We report a case of subacute cutaneous LE associated with recombinant human interferon beta-1a.
949 IDENTIFICATION OF TWO CLINICALLY DISTINCT SUBTYPES IN AUTOIMMUNE HEPATITIS BY COMPARATIVE FUNCTIONAL GENOMICS
Authors: J.U. Marquardt, P. Ploch, D. Becker, J.B. Andersen, D. Seidel, I. Eickmeier, T. Gamstätter, T. Hansen, L.A. Conner, P.R. Galle, E. Schott, S.S. Thorgeirsson, A. Teufel
Journal: Journal of Hepatology (2013)
The flow cytometry-defined light chain cytoplasmic immunoglobulin index and an associated 12-gene expression signature are independent prognostic factors in multiple myeloma
Authors: X Papanikolaou, D Alapat, A Rosenthal, C Stein, J Epstein, R Owens, S Yaccoby, S Johnson, C Bailey, C Heuck, E Tian, A Joiner, F van Rhee, R Khan, M Zangari, Y Jethava, S Waheed, F Davies, G Morgan, B Barlogie
Journal: Leukemia (2015)

As part of Total Therapy (TT) 3b, baseline marrow aspirates were subjected to two-color flow cytometry of nuclear DNA content and cytoplasmic immunoglobulin (DNA/CIG) as well as plasma cell gene expression profiling (GEP). DNA/CIG-derived parameters, GEP and standard clinical variables were examined for their effects on overall survival (OS) and progression-free survival (PFS). Among DNA/CIG parameters, the percentage of the light chain-restricted (LCR) cells and their cytoplasmic immunoglobulin index (CIg) were linked to poor outcome. In the absence of GEP data, low CIg <2.8, albumin <3.5 g/dl and age ⩾65 years were significantly associated with inferior OS and PFS. When GEP information was included, low CIg survived the model along with GEP70-defined high risk and low albumin. Low CIg was linked to beta-2-microglobulin >5.5 mg/l, a percentage of LCR cells exceeding 50%, C-reactive protein ⩾8 mg/l and GEP-derived high centrosome index. Further analysis revealed an association of low CIg with 12 gene probes implicated in cell cycle regulation, differentiation and drug transportation from which a risk score was developed in TT3b that held prognostic significance also in TT3a, TT2 and HOVON trials, thus validating its general applicability. Low CIg is a powerful new prognostic variable and has identified potentially drug-able targets.
Cool Question: Warm Reply-Reply
Authors: Jan V. Hirschmann
Journal: JAMA (1992)

<h3>In Reply.</h3> —Dr Kaufman's observations over 60 years are interesting and confirm that some people's morning temperatures may be well below 98.6°F (37°C). Ivy<sup>1</sup>measured the oral temperatures of 276 medical students while seated in class between 8 AM and 9 AM and found the lowest to be 96.5°F (35.8°C). With some lectures, this level would presumably be even less! A total of six students (2%) had temperatures below 97°F (36.1°C). The question that the querying physician asked, however, was whether some people's "normal" temperature never exceeds 97°F (36.1°C). Since body temperature rises during the day, with its peak in late afternoon or evening, an accurate answer requires information from studies that have recorded levels throughout the day for many days. In such reports, which I reviewed in my original answer, I could find no cases in which the temperature in healthy adults was consistently below 97°F (36.1°C). I
<i>Liberty Loan Parade</i>
Authors: Jeanette M. Smith
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
NIH Study of Rheumatoid Arthritis
Authors: Dimitrios T. Boumpas
Journal: Annals of Internal Medicine (1994)

Letters1 September 1994NIH Study of Rheumatoid ArthritisDimitrios T. Boumpas, MDDimitrios T. Boumpas, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-5-199409010-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Patients with rheumatoid arthritis who have failed to respond to treatment with prednisone and another second-line agent (such as methotrexate, azathioprine, intramuscular gold, penicillamine, cyclosporine, or alkylating agents) are being sought for a therapeutic study involving an innovative immunosuppressive regimen with fludarabine. Inquires may be directed to Dimitrios T. Boumpas, MD, (301-496-3092) or Barri J. Fessler, MD, (301-496-3092), National Institutes of Health, Building 10, Room 3N-112, Bethesda, Maryland 20892. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1994Volume 121, Issue 5Page: 389KeywordsImmunosuppressivesMethotrexateRheumatoid arthritis Issue Published: 1 September 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
A CASE OF BACILLARY DYSENTERY CONTRACTED IN THE LABORATORY
Authors: Leon S. Lippincott
Journal: JAMA (1925)

This case is reported because of the possibility of accidental infection during the carrying out of diagnostic laboratory procedures and because of the favorable outcome under the treatment used. June 21, a technician working in the laboratories of the Vicksburg Sanitarium, while performing an agglutination test for the identification of a recently isolated culture of dysentery bacilli, accidentally drew into her mouth through a pipet some of the broth culture. She immediately washed her mouth with alcohol, 95 per cent. and then reported the accident. Chlorin water was prescribed in teaspoonful doses every three hours; magnesium sulphate, saturated aqueous solution, two teaspoonfuls every two hours; and a diet to contain no uncooked foods. The chlorin water was continued three days, and the salts until 1 ounce had been taken. An autogenous vaccine was prepared from the culture being tested, and administration begun, June 24. The culture proved to be a
Rapid Kupffer cell death after intravenous injection of adenovirus vectors
Authors: Elanchezhiyan Manickan, Jeffrey S. Smith, Jie Tian, Thomas L. Eggerman, Jay N. Lozier, Jacqueline Muller, Andrew P. Byrnes
Journal: Molecular Therapy (2005)

When adenovirus vectors are injected intravenously, they are quickly taken up by Kupffer cells in the liver. We report that this causes rapid necrosis of Kupffer cells in mice at doses of 1011 particles/kg or higher. By 10 min after intravenous vector injection, Kupffer cells were permeable to propidium iodide and trypan blue. This coincided with a sharp rise in serum lactate dehydrogenase. Ultrastructural examination showed degeneration of Kupffer cells, including complete disappearance of chromatin by 1 h. After an initial intravenous injection of vector, dead Kupffer cells were unable to take up a second dose of vector, and hepatic transgene expression from the second dose was augmented. Death of Kupffer cells did not affect serum levels of IL-6 or IL-12. There was no immediate change in the number of Kupffer cells in the liver, but a significant decline was found by 4 h after injection of vector. Interestingly, substantial numbers of vector-containing Kupffer cells were found in pulmonary capillaries, indicating that they had been swept out of the liver. Together these results show that an intravenous injection of adenovirus vector causes synchronous and surprisingly rapid Kupffer cell death.
Lithotomy: Median Operation
Authors: J. S. Smyth
Journal: BMJ (1857)

myself, and gave it to one of the hospital staff on quitting the statioin.It is a pity the queen cannot afford to allow her servants the use of a frying-pan!!I was told the pant lids are intendecl to answer the purpose; a very cleanly substitute it must be admitted.Indeed, official correspondence often took place about the most ridiculous and trifling matters, the surgeon nlot having the power to purchase requisite articles, save strictly according to "regulation and routine", instead of his being made a responsible and comparatively inde- pendent officer in all matters of hospital arrangement, de- tail, and expenditure.The medical department has never yet hadsufficient independent authority, the War Office stepping *in and interfering in matters purely medical: e. g., had the director-general's suggestions and wishes been attended to, at the breakinc, out of the late war, howv much misery, neglect, and mortality might have been avoided!Military hygiene should surely be exclusively under the control of the heads of the medical department, and every regimental surgeon should be in a position to act at once, without consultation and correspondence with any one, when sickness and emergencies arise.Contracted and hampered on every si(le, talent and skill, low-