tbuckley/cabot-search huggingface dataset:
International Differences in the Use of Obstetric Interventions
Authors: Francis C Notzon
Journal: JAMA (1990)

This study investigated current levels and trends between 1975 and 1986 in the rates of cesarean section in 21 countries and of operative vaginal delivery in 14 countries. Sharp differences in national obstetric practice were found, with cesarean rates ranging from a high of 32 (Brazil) to 7 (Czechoslovakia) per 100 hospital deliveries, and operative vaginal rates from 16 (Canada) to 2 (Czechoslovakia) per 100 hospital deliveries. For most countries, rates of cesarean section have risen as operative vaginal rates have fallen, but some important exceptions exist. A comparison of cesarean section rates for two complications of labor and delivery that can be objectively diagnosed, multiple births and breech delivery, demonstrates that cesarean section rates for these complications rose sharply in almost every country from 1980 to 1985. A comparison of 1985 national rates of intervention and measures of birth outcome found no significant relationship between the two. While such ecological comparisons are imperfect at best, this does indicate that low levels of early infant mortality can be achieved in some populations despite a low rate of cesarean deliveries. (<i>JAMA</i>. 1990;263:3286-3291)
Targeting CD4+ T-Helper Cells Improves the Induction of Antitumor Responses in Dendritic Cell–Based Vaccination
Authors: Erik H.J.G. Aarntzen, I. Jolanda M. De Vries, W. Joost Lesterhuis, Danita Schuurhuis, Joannes F.M. Jacobs, Kalijn Bol, Gerty Schreibelt, Roel Mus, Johannes H.W. De Wilt, John B.A.G. Haanen, Dirk Schadendorf, Alexandra Croockewit, Willeke A.M. Blokx, Michelle M. Van Rossum, William W. Kwok, Gosse J. Adema, Cornelis J.A. Punt, Carl G. Figdor
Journal: Cancer Research (2012)

To evaluate the relevance of directing antigen-specific CD4(+) T helper cells as part of effective anticancer immunotherapy, we investigated the immunologic and clinical responses to vaccination with dendritic cells (DC) pulsed with either MHC class I (MHC-I)-restricted epitopes alone or both MHC class I and II (MHC-I/II)-restricted epitopes. We enrolled 33 stage III and IV HLA-A*02:01-positive patients with melanoma in this study, of whom 29 were evaluable for immunologic response. Patients received intranodal vaccinations with cytokine-matured DCs loaded with keyhole limpet hemocyanin and MHC-I alone or MHC-I/II-restricted tumor-associated antigens (TAA) of tyrosinase and gp100, depending on their HLA-DR4 status. In 4 of 15 patients vaccinated with MHC-I/II-loaded DCs and 1 of 14 patients vaccinated with MHC-I-loaded DCs, we detected TAA-specific CD8(+) T cells with maintained IFN-γ production in skin test infiltrating lymphocyte (SKIL) cultures and circulating TAA-specific CD8(+) T cells. If TAA-specific CD4(+) T-cell responses were detected in SKIL cultures, it coincided with TAA-specific CD8(+) T-cell responses. In 3 of 13 patients tested, we detected TAA-specific CD4(+)CD25(+)FoxP3(-) T cells with high proliferative capacity and IFN-γ production, indicating that these were not regulatory T cells. Vaccination with MHC-I/II-loaded DCs resulted in improved clinical outcome compared with matched control patients treated with dacarbazine (DTIC), median overall survival of 15.0 versus 8.3 months (P = 0.089), and median progression-free survival of 5.0 versus 2.8 months (P = 0.0089). In conclusion, coactivating TAA-specific CD4(+) T-helper cells with DCs pulsed with both MHC class I and II-restricted epitopes augments TAA-specific CD8(+) T-cell responses, contributing to improved clinical responses.
DESENSITIZATION IN THE TREATMENT OF MENSTRUAL INTOXICATION AND OTHER ALLERGIC SYMPTOMS.
Authors: J. GEBER
Journal: British Journal of Dermatology (1939)

Journal Article DESENSITIZATION IN THE TREATMENT OF MENSTRUAL INTOXICATION AND OTHER ALLERGIC SYMPTOMS. Get access J. GEBER J. GEBER Budapest Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 51, Issue 6, 1 June 1939, Pages 265–268, https://doi.org/10.1111/j.1365-2133.1939.tb10741.x Published: 01 June 1939
Monet's Cataracts
Authors: James G. Ravin
Journal: JAMA (1985)

CLAUDE Monet (1840-1926), the first painter to be called an Impressionist, is of particular medical interest because of the way failing eyesight due to cataracts affected his late style. As his vision deteriorated, Monet had difficulty distinguishing colors, and he began delineating details less clearly. After lens opacities had made him officially blind, he underwent surgery in the right eye. Postoperatively he continued to paint, although he had severe difficulty with color balance and in adjusting to cataract glasses. The influence of ocular difficulties on Monet's health and work has often been misunderstood. I have studied a collection of Monet's letters to his eye surgeon that were recently acquired by the French Ophthalmologic Society, examined a pair of his glasses, and discussed his problems with the laboratory technician of Monet's last ophthalmologist as well as with art historians. <h3>The Onset of Visual Loss</h3> Since Monet's Impressionistic style was deliberately based
Ouabain-Uninhibited Sodium Transport in Human Erythrocytes. EVIDENCE AGAINST A SECOND PUMP
Authors: Michael J. Dunn
Journal: Journal of Clinical Investigation (1973)

Others have concluded that a second Na "pump" (active Na outflux) exists in human erythrocytes. This second pump was said to be ouabain-insensitive, unlike the classic ouabain-sensitive Na-K pump. An alternative explanation is that "pump II" is Na exchange diffusion. These hypotheses were examined in the present experiments, utilizing (22)Na influx and outflux measurements, net Na fluxes, and ATPase determinations. Ouabain-uninhibited Na outflux was reduced 0.58+/-0.05 mmol/liter cells per h when extracellular Na (Na(o)) was replaced by Mg. Ethacrynic acid or furosemide produced similar decrements of outflux (0.50 mmol) in the presence of ouabain and Na(o). However, these diuretics had minimal inhibitory effects on outflux in the absence of Na(o) suggesting that they inhibited principally the Na(o)-dependent outflux. Whereas this ouabain-uninhibited portion of outflux was dependent on Na(o), it was independent of K(o). Contrary to expectations, Na influx did not change when intracellular Na was altered. No uphill, net Na transport (ouabain-uninhibited) could be demonstrated under a variety of circumstances. Furosemide at high concentrations inhibited ATPase, reducing both ouabain-sensitive and ouabain-insensitive enzyme at 1.0 mM concentration while showing no effect on ATPase at 0.05-0.1 mM concentration. The effects of furosemide on ATPase and on Na flux were dissociable on a dose-response curve. Energy depletion for 22 h practically eliminated the Na(o)-dependent, diuretic-inhibited Na outflux. Activation energies and temperature coefficients for the diuretic-inhibited outflux were one-half the values for the classic ouabain-inhibited pump. These data are interpreted as evidence against a second Na pump. Exchange diffusion accounts adequately for most of these observations; however, the ouabain-insensitive fluxes may be complex and composed of several processes.
How to Manage Pain in Malignant Disease
Authors: Dogan M. Perese
Journal: JAMA (1961)

Between 1953 and 1960, the author treated 714 patients who had pain due to a histologically proved malignant disease. Of these patients, three fourths were older than 40, and slightly more than half were female. From daily follow-up, it was learned that only a rare patient complained of severe pain. Consequently, these patients did not have to be "snowed under" with narcotics to make them comfortable. An individualized approach made it possible to select the best method of therapy—medical, surgical, or ionizing radiation—for a particular pain problem. Of the 714 patients, 53 were not followed. Of the remaining 661 patients, 244 received analgesic medication. Relief was obtained by 206 (74.6 per cent). In the group of 299 patients treated surgically, good results with long-term relief of pain occurred for 251 (74.4 per cent).
Diagnostic Imaging for the Emergency Physician
Authors: Laurel R. Berge
Journal: JAMA (2012)

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
Renal transplantation from HBsAg positive donors to HBsAg negative recipients.
Authors: M. K. Chan, W. K. Chang
Journal: BMJ (1988)

1 HBsAg+anti-HBeAg+ HBsAg-, anti-HBsAg-, anti-HBc+ rransient at 2-21/2 years No No 276 2 HBsAg+anti-HBeAg+ HBsAg-, anti-HBsAg-, anti-HBc+ Persistent from 1 year onwards No No 136 3 HBsAg+anti-HBeAg+ HBsAg-, anti-HBsAg-, anti-HBc-Persistent from 1 year onwards
Thallium-201 myocardial scintigraphy in patients with triple-vessel disease and ischemic exercise stress tests.
Authors: J Leppo, T Yipintsoi, R Blankstein, R Bontemps, L M Freeman, L Zohman, J Scheuer
Journal: Circulation (1979)

Thirty patients with triple-vessel coronary artery disease proven by angiography, symptomatic angina and a positive ECG stress test were evaluated with thallium-201 (201TI) scintigraphy. Twenty patients also had aortocoronary saphenous vein bypass surgery; 15 of them had repeat noninvasive evaluation. Seventy percent of these patients showed ischemia by 201TI scintigraphy, of which one-half returned to normal after surgery. Postoperative reversion of the ECG stress test together with 201TI stress/reperfusion imaging correlated well with the completeness of surgical revascularization. We could not explain the prevalence (80%) of infarcts detected by 201TI in this group, of which 76% could be anatomically correlated to epicardial scars. The positivity of infarcts by 201TI exceeded that predicted by previous history of infarction, Q waves on resting ECG or ventriculographic akinesis. These observations suggest that 201TI scintigraphy is a useful noninvasive tool in the follow-up and understanding of patients with coronary heart disease. These conclusions also support the concept that 201TI stress imaging need not have the identical connotation as the ECG stress test.
Prevalence of hyperhomocyst(e)inemia in patients with peripheral arterial occlusive disease.
Authors: M R Malinow, S S Kang, L M Taylor, P W Wong, B Coull, T Inahara, D Mukerjee, G Sexton, B Upson
Journal: Circulation (1989)

A micromethod adapted for automated determinations was used to measure basal plasma levels of homocyst(e)ine [H(e)]. These levels included the sum of free and bound forms of homocysteine, its disulfide oxidation product, homocystine, and the homocysteine-cysteine-mixed disulfide. Two groups of subjects were studied: apparently healthy individuals (n = 103) and patients with peripheral arterial occlusive disease (PAOD) (n = 47). Because age in PAOD patients was higher than in control subjects, the control subjects were subdivided into younger and older groups (aged 60 years or less and more than 60 years, respectively). The H(e) levels in the younger groups were 11.18 +/- 3.58 (mean +/- SD, expressed as homocysteine) and 8.58 +/- 2.82 nmol/ml in men and women, respectively; in the older groups, the levels were 10.74 +/- 2.16 and 9.04 +/- 2.16 nmol/ml in men and women, respectively. There was a positive correlation of H(e) levels with age in the younger control women (r = 0.373; p less than 0.02); no significant correlations were present in the other three control groups. Levels of H(e) in PAOD patients (15.44 +/- 5.76 and 17.04 +/- 8.26 nmol/ml in men and women, respectively) were significantly higher than those indicated above in the older controls. Next, the PAOD patients were assigned to two subgroups: 1) those with normal levels of H(e) (within two standard deviations of the mean of the control values) and 2) those with elevated levels of H(e). Age, cholesterolemia, and the prevalence of smoking and diabetes were similar in both subgroups. These results suggest that elevated plasma H(e) is an independent risk factor for arterial occlusive disease.
Antibiotic Selection Pressure and Macrolide Resistance in Nasopharyngeal Streptococcus pneumoniae: A Cluster-Randomized Clinical Trial
Authors: Alison H. Skalet, Vicky Cevallos, Berhan Ayele, Teshome Gebre, Zhaoxia Zhou, James H. Jorgensen, Mulat Zerihun, Dereje Habte, Yared Assefa, Paul M. Emerson, Bruce D. Gaynor, Travis C. Porco, Thomas M. Lietman, Jeremy D. Keenan
Journal: PLoS Medicine (2010)

Background It is widely thought that widespread antibiotic use selects for community antibiotic resistance, though this has been difficult to prove in the setting of a community-randomized clinical trial. In this study, we used a randomized clinical trial design to assess whether macrolide resistance was higher in communities treated with mass azithromycin for trachoma, compared to untreated control communities. Methods and Findings In a cluster-randomized trial for trachoma control in Ethiopia, 12 communities were randomized to receive mass azithromycin treatment of children aged 1–10 years at months 0, 3, 6, and 9. Twelve control communities were randomized to receive no antibiotic treatments until the conclusion of the study. Nasopharyngeal swabs were collected from randomly selected children in the treated group at baseline and month 12, and in the control group at month 12. Antibiotic susceptibility testing was performed on Streptococcus pneumoniae isolated from the swabs using Etest strips. In the treated group, the mean prevalence of azithromycin resistance among all monitored children increased from 3.6% (95% confidence interval [CI] 0.8%–8.9%) at baseline, to 46.9% (37.5%–57.5%) at month 12 (p = 0.003). In control communities, azithromycin resistance was 9.2% (95% CI 6.7%–13.3%) at month 12, significantly lower than the treated group (p<0.0001). Penicillin resistance was identified in 0.8% (95% CI 0%–4.2%) of isolates in the control group at 1 year, and in no isolates in the children-treated group at baseline or 1 year. Conclusions This cluster-randomized clinical trial demonstrated that compared to untreated control communities, nasopharyngeal pneumococcal resistance to macrolides was significantly higher in communities randomized to intensive azithromycin treatment. Mass azithromycin distributions were given more frequently than currently recommended by the World Health Organization's trachoma program. Azithromycin use in this setting did not select for resistance to penicillins, which remain the drug of choice for pneumococcal infections. Trial registration www.ClinicalTrials.gov NCT00322972 Please see later in the article for the Editors' Summary
Evidence for the cofactor role of human T-cell lymphotropic virus type 1 in mycosis fungoides and Sézary syndrome
Authors: None Shohat, None Hodak, None Hannig, None Bodemer, None David, None Shohat
Journal: British Journal of Dermatology (1999)

The aetiology of mycosis fungoides (MF) and Sézary syndrome (SS) is unknown. A pathogenic role for the human T-cell lymphotropic virus type 1 (HTLV-1) has been suggested but remains controversial. We used an animal model to test the possibility that peripheral blood mononuclear cells (PBMC) obtained from MF patients harbour the HTLV-1 virus which may be infective. The polymerase chain reaction (PCR) was used to detect HTLV-1 proviral DNA sequences in PBMC of 27 MF patients and one SS patient of non-Iranian origin. Positive results were found in six of the patients. Twelve of the 28 patients tested by Western blot showed HTLV-1 antibodies. Twenty-eight immunosuppressed inbred Fisher F344 rats were inoculated intravenously with cultures of PBMC obtained from the 28 patients. Eight of these 28 rats showed antibodies to HTLV-1 while the proviral genome was demonstrated in the blood of only two of the rats. PBMC from two MF patients, in spite of showing negative results for the proviral genome by PCR, still induced HTLV-1 antibody formation in the F344 rat model. None of 10 control rats inoculated with normal donor PBMC showed antibodies to HTLV-1, nor the proviral genome. The present study suggests that HTLV-1 plays a cofactor role in MF/SS patients.
USE OF APONEUROSIS OF EXTERNAL OBLIQUE AS A SOURCE OF LIVING SUTURES FOR INGUINAL HERNIOTOMY
Authors: Frank Adair
Journal: JAMA (1924)

In 1881, Gluck,1during his experimenting on the direct transplantation of muscle in chickens, found that tendon remains viable when transplanted. This fact led several surgeons successfully to transplant tendons in man. Kirschner,2in 1910, was the first to suggest the use of fascia for purposes of transplantation; he also suggested its practical possibilities. The next year Lewis and Davis,3by a most finished set of animal experiments, greatly stimulated interest in this field of surgery. These workers followed their first report by a second paper,4clearly demonstrating the practical applicability; particularly the value of the fascial transplant in making up for deficiencies in injured tendon. Lewis and Davis demonstrated that, no matter what the size or shape of the fascial transplant, it remains alive. If placed in the subcutaneous tissues, the fascial graft shrinks to about one-third its original size. If sutured carefully into a
Labor-Associated Gene Expression in the Human Uterine Fundus, Lower Segment, and Cervix
Authors: Radek Bukowski, Gary D. V Hankins, George R Saade, Garland D Anderson, Steven Thornton
Journal: PLoS Medicine (2006)

Preterm labor, failure to progress, and postpartum hemorrhage are the common causes of maternal and neonatal mortality or morbidity. All result from defects in the complex mechanisms controlling labor, which coordinate changes in the uterine fundus, lower segment, and cervix. We aimed to assess labor-associated gene expression profiles in these functionally distinct areas of the human uterus by using microarrays.Samples of uterine fundus, lower segment, and cervix were obtained from patients at term (mean +/- SD = 39.1 +/- 0.5 wk) prior to the onset of labor (n = 6), or in active phase of labor with spontaneous onset (n = 7). Expression of 12,626 genes was evaluated using microarrays (Human Genome U95A; Affymetrix) and compared between labor and non-labor samples. Genes with the largest labor-associated change and the lowest variability in expression are likely to be fundamental for parturition, so gene expression was ranked accordingly. From 500 genes with the highest rank we identified genes with similar expression profiles using two independent clustering techniques. Sets of genes with a probability of chance grouping by both techniques less than 0.01 represented 71.2%, 81.8%, and 79.8% of the 500 genes in the fundus, lower segment, and cervix, respectively. We identified 14, 14, and 12 those sets of genes in the fundus, lower segment, and cervix, respectively. This enabled networks of co-regulated and co-expressed genes to be discovered. Many genes within the same cluster shared similar functions or had functions pertinent to the process of labor.Our results provide support for many of the established processes of parturition and also describe novel-to-labor genes not previously associated with this process. The elucidation of these mechanisms likely to be fundamental for controlling labor is an important prerequisite to the development of effective treatments for major obstetric problems--including prematurity, with its long-term consequences to the health of mother and offspring.
European law, medicine, and the social charter.
Authors: C. Hughes
Journal: BMJ (1992)

general hospitals have all helped.However, many components of courses remain anachronistic, while Conflicting issuesThe European Commission and the United Kingdom government are in conflict over the following commis- sion proposals7: * Protection for pregnant and nursing mothers from being obliged to work shifts * Fourteen weeks' maternity leave on full pay * Equal rights for part time and temporary staff to pensions, holidays, training, and rights in redundancy * Minimum wage * Rights of workers to participate in employer decisions * Action to assist disabled people * Greater protection for employees threatened with collective dismissal * Controls on hours of work
Development and Evaluation of a Decision Aid on Mammography Screening for Women 75 Years and Older
Authors: Mara A. Schonberg, Mary Beth Hamel, Roger B. Davis, M. Cecilia Griggs, Christina C. Wee, Angela Fagerlin, Edward R. Marcantonio
Journal: JAMA Internal Medicine (2013)

Guidelines recommend that women 75 years and older should be informed of the benefits and risks of mammography before being screened. However, few are adequately informed.To develop and evaluate a mammography screening decision aid (DA) for women 75 years and older.We designed the DA using international standards. Between July 14, 2010, and April 10, 2012, participants completed a pretest survey and read the DA before an appointment with their primary care physician. They completed a posttest survey after their appointment. Medical records were reviewed for follow-up information.Boston, Massachusetts, academic primary care practice. Eligible women were aged 75 to 89 years, English speaking, had not had a mammogram in 9 months but had been screened within the past 3 years, and did not have a history of dementia or invasive or noninvasive breast cancer. Of 84 women approached, 27 declined to participate, 12 were unable to complete the study for logistical reasons, and 45 participated.The DA includes information on breast cancer risk, life expectancy, competing mortality risks, possible outcomes of screening, and a values clarification exercise.Knowledge of the benefits and risks of screening, decisional conflict, and screening intentions; documentation in the medical record of a discussion of the risks and benefits of mammography with a primary care physician within 6 months; and the receipt of screening within 15 months. We used the Wilcoxon signed rank test and McNemar test to compare pretest-posttest information.The median age of participants was 79 years, 69% (31 of 45) were of non-Hispanic white race/ethnicity, and 60% (27 of 45) had attended at least some college. Comparison of posttest results with pretest results demonstrated 2 findings. First, knowledge of the benefits and risks of screening improved (P < .001). Second, fewer participants intended to be screened (56% [25 of 45] afterward compared with 82% [37 of 45] before, P = .03). Decisional conflict declined but not significantly (P = .10). In the following 6 months, 53% (24 of 45) of participants had a primary care physician note that documented the discussion of the risks and benefits of screening compared with 11% (5 of 45) in the previous 5 years (P < .001). While 84% (36 of 43) had been screened within 2 years of participating, 60% (26 of 43) were screened within 15 months after participating (≥ 2 years since their last mammogram) (P = .01). Overall, 93% (42 of 45) found the DA helpful.A DA may improve older women's decision making about mammography screening.