tbuckley/cabot-search huggingface dataset:
Development of a Clinical Registry-Based 30-Day Readmission Measure for Coronary Artery Bypass Grafting Surgery
Authors: David M. Shahian, Xia He, Sean M. O’Brien, Frederick L. Grover, Jeffrey P. Jacobs, Fred H. Edwards, Karl F. Welke, Lisa G. Suter, Elizabeth Drye, Cynthia M. Shewan, Lein Han, Eric Peterson
Journal: Circulation (2014)

Background— Reducing readmissions is a major healthcare reform goal, and reimbursement penalties are imposed for higher-than-expected readmission rates. Most readmission risk models and performance measures are based on administrative rather than clinical data. Methods and Results— We examined rates and predictors of 30-day all-cause readmission following coronary artery bypass grafting surgery by using nationally representative clinical data (2008–2010) from the Society of Thoracic Surgeons National Database linked to Medicare claims records. Among 265 434 eligible Medicare records, 226 960 (86%) were successfully linked to Society of Thoracic Surgeons records; 162 572 (61%) isolated coronary artery bypass grafting admissions constituted the study cohort. Logistic regression was used to identify readmission risk factors; hierarchical regression models were then estimated. Risk-standardized readmission rates ranged from 12.6% to 23.6% (median, 16.8%) among 846 US hospitals with ≥30 eligible cases and ≥90% of eligible Centers for Medicare and Medicaid Services records linked to the Society of Thoracic Surgeons database. Readmission predictors (odds ratios [95% confidence interval]) included dialysis (2.02 [1.87–2.19]), severe chronic lung disease (1.58 [1.49–1.68]), creatinine (2.5 versus 1.0 or lower:1.49 [1.41–1.57]; 2.0 versus 1.0 or lower: 1.37 [1.32–1.43]), insulin-dependent diabetes mellitus (1.45 [1.39–1.51]), obesity in women (body surface area 2.2 versus 1.8: 1.44 [1.35–1.53]), female sex (1.38 [1.33–1.43]), immunosuppression (1.38 [1.28–1.49]), preoperative atrial fibrillation (1.36 [1.30–1.42]), age per 10-year increase (1.36 [1.33–1.39]), recent myocardial infarction (1.24 [1.08–1.42]), and low body surface area in men (1.22 [1.14–1.30]). C-statistic was 0.648. Fifty-two hospitals (6.1%) had readmission rates statistically better or worse than expected. Conclusions— A coronary artery bypass grafting surgery readmission measure suitable for public reporting was developed by using the national Society of Thoracic Surgeons clinical data linked to Medicare readmission claims.
Norwegian scabies during immunosuppressive therapy.
Authors: W D Paterson, B R Allen, G W Beveridge
Journal: BMJ (1973)

More recently the antisecretory activity of other prostaglandin analogues has been reported (Robert and Magerlein, 1973; Karim et al., 1973 c).Absence of uterine stimulant activity among these compounds would be an additional advantage.They could never, .however,remove the need for scrupulous anaesthetic technique.Oral administration of prostaglandin 15 (R) 15-methyl-E2methyl ester (100-200 [lg, 2-hourly) would probably constitute a safe means of inducing labour, especially in high anaesthetic risk patients (Crawford, 1970).The prostaglandin used in this study was supplied by the Upjohn Company of Canada.We are grateful to Sister C. Flory, Sister F. Kibuka, and Nurse M. Kanakulya for technical
Acute Cerebellar Ataxia Associated With Epstein-Barr Virus Infection
Authors: Thomas G. Cleary
Journal: JAMA (1980)

MENINGOENCEPHALITIS, Bell's palsy, transverse myelitis, and Guillain-Barré syndrome has been associated with infectious mononucleosis. Recently, patients with these neurologic complications have had serologic studies performed that link these conditions to Epstein-Barr virus (EBV) infections.<sup>1,2</sup>The association of acute cerebellar ataxia with infectious mononucleosis is rare in adults<sup>3-9</sup>and children,<sup>10</sup>and patients with this condition have not had extensive serologic confirmation of EBV infections. We describe here a child who had an EBV infection manifesting as acute cerebellar ataxia. <h3>Report of a Case</h3> A 7-year-old girl was admitted to the pediatric service of the University of Texas Medical School, Houston, with a four-week history of increasing clumsiness and ataxia. Several days prior to the development of difficulty walking, she had complained of headache, nausea, and vomiting. She did not have sore throat, fever, or rash. The only medication she was receiving was aspirin. Physical examination showed a temperature
Human Babesiosis on Nantucket Island
Authors: Trenton K. Ruebush, Dennis D. Juranek, Emily S. Chisholm, Patricia C. Snow, George R. Healy, Alexander J. Sulzer
Journal: New England Journal of Medicine (1977)

Between 1969 and 1975, seven patients infected with Babesia microti, a tick-borne intraerythrocytic protozoan parasite, were reported from Nantucket Island, Massachusetts.1 2 3 Although all seven patients had prolonged illnesses characterized by fever, chills, sweating, myalgia and mild to moderately severe hemolytic anemia, reports of asymptomatic cases of human babesiosis (species undetermined) from Georgia and Mexico suggested that similar infections might occur on Nantucket.4 , 5 Since subclinical and mild, self-limited B. microti infections had never been documented in human beings, we undertook a serologic survey of visitors to and residents of Nantucket Island in an attempt to identify such infections.Materials and . . .
Getting to the bottom of evidence based medicine
Authors: Susan Bewley
Journal: BMJ (2008)

“Which way up should I put the suppository?” I’ve asked this question of countless junior obstetricians over the years as we administer rectal analgesia after a caesarean section.1 Despite thinking it might be a trick question, they all want to insert the pointed end of the bullet shaped object first.2 Surely that’s how they are designed, and it would be more comfortable? 

Well, no. It was Minerva herself who drew this to my attention: a trial confirms that blunt end first is preferable.3 Possibly because of the tapered shape and tone of the sphincter, fingers rarely need to be inserted into the anal canal (1% v 83%) …
Activated fluid transport regulates bacterial-epithelial interactions and significantly shifts the murine colonic microbiome
Authors: Simon Keely, Caleb J. Kelly, Thomas Weissmueller, Adrianne Burgess, Brandie D. Wagner, Charles E. Robertson, J. Kirk Harris, Sean P. Colgan
Journal: Gut Microbes (2012)

Within the intestinal mucosa, epithelial cells serve multiple functions to partition the lumen from the lamina propria. As part of their natural function, intestinal epithelial cells actively transport electrolytes with passive water movement as a mechanism for mucosal hydration. Here, we hypothesized that electrogenic Cl- secretion, and associated mucosal hydration, influences bacterial-epithelial interactions and significantly influences the composition of the intestinal microbiota. An initial screen of different epithelial secretagogues identified lubiprostone as the most potent agonist for which to define these principles. In in vitro studies using cultured T84 cells, lubiprostone decreased E. coli translocation in a concentration-dependent manner (p < 0.001) and decreased S. typhimurium internalization and translocation by as much as 71 ± 6% (p < 0.01). Such decreases in bacterial translocation were abolished by inhibition of electrogenic Cl- secretion and water transport using the Na-K-Cl- antagonist bumetanide (p < 0.01). Extensions of these findings to microbiome analysis in vivo revealed that lubiprostone delivered orally to mice fundamentally shifted the intestinal microbiota, with notable changes within the Firmicutes and Bacteroidetes phyla of resident colonic bacteria. Such findings document a previously unappreciated role for epithelial Cl- secretion and water transport in influencing bacterial-epithelial interactions and suggest that active mucosal hydration functions as a primitive innate epithelial defense mechanism.
Clinical Viral Hepatitis B Among Minnesota Hospital Personnel
Authors: Michael T. Osterholm, Susan M. Garayalde
Journal: JAMA (1985)

We report a ten-year survey of clinical hepatitis B virus (HBV) infections in Minnesota hospital personnel. Between 1974 and 1983, a total of 561 personnel cases of viral hepatitis were identified. Four hundred twelve cases were diagnosed as type B, with 399 cases (97%) identified as work related. Of the 177 hospitals in the state, only 42 (24%) reported cases during the ten-year period. The highest annual incidence of type B cases was in 1975 (127/100,000 personnel) and decreased to the lowest incidence in 1983 (8/100,000 personnel). The incidence for personnel at hospitals with long-term hemodialysis decreased from 418/100,000 personnel in 1975 to 16/100,000 personnel in 1983, while the incidence for employees in hospitals without hemodialysis decreased from 16 to 5/100,000 personnel for the same time. The decrease in the incidence of hepatitis B in personnel occurred before the use of HBV vaccine. Our findings indicate that HBV seroprevalence studies significantly overestimate the current incidence of HBV infections among personnel in most hospital settings.
How to solve the distinguishability problem: Triangulation without explicit training
Authors: Robert W. Lurz
Journal: Behavioral and Brain Sciences (2001)

Heyes's (1998) triangulation approach to distinguishing a “theory” of mind (ToM) from a “theory” of behavior (ToB) in chimpanzees fails. The ToB theorist can appeal to the explicit training sessions and analogical reasoning to explain/predict the chimpanzees' behaviors. An alternative triangulation experiment is sketched, demonstrating how the removal of such training sessions paves the way toward solving the distinguishability problem.
Specific Peptide Ligand for Grb7 Signal Transduction Protein and Pancreatic Cancer Metastasis
Authors: Shinji Tanaka, Stephanie C. Pero, Kenichi Taguchi, Mitsuo Shimada, Masaki Mori, David N. Krag, Shigeki Arii
Journal: JNCI Journal of the National Cancer Institute (2006)

Pancreatic cancer is one of the most aggressive malignancies, with high rates of invasion and metastasis and with generally poor prognosis. We previously found that metastasis was strongly associated with the expression of growth factor receptor-bound protein 7 (Grb7), which contains a Src homology 2 (SH2) domain. In this study, we evaluated Grb7 protein as a molecular target of therapy for metastatic pancreatic cancer.Grb7 protein expression was measured by immunohistochemistry in 36 human pancreatic cancer specimens and adjacent normal pancreatic tissue. We synthesized a nonphosphorylated peptide inhibitor that binds specifically to the SH2 domain of Grb7. Intracellular signaling was assessed by immunoprecipitation and immunoblot assays in cultured human pancreatic cancer cells. Cell migration was measured with a modified Boyden chamber method. Peritoneal metastasis of the pancreatic cancer cells was measured with a mouse model. All statistical tests were two-sided.We found that 22 (61%) of 36 pancreatic cancer specimens had higher levels of Grb7 protein than their corresponding normal pancreatic tissue specimens. Grb7 expression was statistically significantly different between specimens from patients without lymph node metastasis (stage N0; two of the 10 patients) and patients with lymph node metastasis (stages N1 + N2; 20 of the 26 patients) (P = .006). The Grb7 peptide inhibitor selectively blocked the interaction between Grb7 and focal adhesion kinase and blocked the phosphorylation of Grb7 protein. In vivo Grb7 peptide inhibitor statistically significantly attenuated cell migration (for control peptide, 87.5 cells migrated, 95% confidence interval [CI] = 82.6 to 92.4 cells; for Grb7 peptide, 5.7 cells migrated, 95% CI = 2.3 to 9.0 cells; P < .001) and peritoneal metastasis of the pancreatic cancer cells in a mouse model, as assessed by the number of nodules (control = 72.6 nodules, 95% CI = 55.8 to 89.4 nodules; and for Grb7 peptide = 3.2 nodules, 95% CI = 1.6 to 4.8 nodules; P < .001, t test) and their weight (control = 4.13 g, 95% CI = 3.40 to 4.86 g; Grb7 peptide = 0.19 g, 95% CI = 0.06 to 0.32 g; P < .001, t test).The Grb7 peptide inhibitor appears to be a promising molecularly targeted therapeutic agent against metastatic pancreatic cancer.
STUDIES IN ASCORBIC ACID WITH ESPECIAL REFERENCE TO THE WHITE LAYER. II. THE RELATION OF INTAKE TO BLOOD LEVELS IN NORMAL CHILDREN AND THE EFFECT OF ACUTE AND CHRONIC ILLNESS 1
Authors: May G. Wilson, Rose Lubschez
Journal: Journal of Clinical Investigation (1946)

A voluminous literature has accumulated on the effect of various conditions of ascorbic acid intake on plasma levels and urinary excretion in children (1 to 3).Based on these studies, a daily allowance of 50 to 75 mgm. of ascorbic acid has been recom- mended for children by the National Research Council (4).Current opinion differs as to whether or not these recommended intakes are in excess of normal requirements.This difference of opinion stems in part from the variability of plasma and urine values as related to intake and vitamin status, but in greater measure from the belief that these values are a reflection of the ascorbic acid concentration in the circulation, rather than the tissue stores
ISOLATION AND PROPERTIES OF A GROUP ANTIGEN OF STAPHYLOCOCCUS ALBUS
Authors: Stephen I. Morse
Journal: The Journal of Experimental Medicine (1963)

An antigen composed of glycerophosphate and glucose has been isolated from the cell walls of a strain of Staphylococcus albus. The antigen reacted with homologous and heterologous S. albus antisera. Similar material was isolated from the cell walls of three other S. albus strains. The antigen did not react with S. aureus antiserum nor with normal human or rabbit serum. The antigen appeared to have a backbone structure of glycerophosphate with appended monoglucoside units. The antigenic determinant was shown to be glucose in alpha linkage.
Characterisation of dendritic cell subsets in lung cancer micro-environments
Authors: A. Bergeron, F. El Hage, M. Kambouchner, D. Lecossier, A. Tazi
Journal: European Respiratory Journal (2006)

The aim of the current study was to seek evidence for a correlation between mediators present in lung cancer micro-environments and subsets of dendritic cells (DCs) infiltrating these tumours. Immunohistochemistry and recently available antibodies were used to define the phenotype of DCs present in surgical biopsies from 12 patients with lung carcinomas, and the local expression of chemokines potentially involved in the recruitment of these cells was evaluated, both at mRNA and protein levels. Real-time PCR was used to analyse the expression of mRNA coding for cytokines known to influence the maturation of DCs in vitro . Different subsets of myeloid DCs were present in lung cancers, but no plasmocytoid DCs were identified. Both Langerhans cells and CD1a+/Langerin cells were interspersed among tumour cells, in numbers that were correlated to the amounts of CC chemokine ligand 20 produced in these tumours. In most specimens, DC-specific intercellular adhesion molecule-grabbing nonintegrin-postive DCs were also present at the periphery of the tumour beds. No DC-lysosomal associated membrane protein-positive DCs were identified and CD83+ DCs were rarely present in the tumour stroma. All tumours expressed interleukin (IL)-10, transforming growth factor-β and vascular endothelial growth factor, whereas IL-12 was virtually absent. Thus, various types of dendritic cells infiltrate lung carcinomas and display an immature phenotype, presumably because of the inhibitory cytokine micro-environment.
Q Fever Endocarditis on Porcine Bioprosthetic Valves
Authors: MANUEL L. FERNÁNDEZ-GUERRERO
Journal: Annals of Internal Medicine (1988)

Three patients developed Q fever endocarditis on porcine bioprosthetic valves. They had a subacute or chronic course with nonspecific symptoms, enlargement of the liver and spleen, and cardiac failure due to destruction of the cusps, without disruption of the valve ring. High-phase I-specific IgG and IgA antibody titers against Coxiella burnetii were found. C. burnetii was isolated in each patient by inoculating suspensions of valve tissue into a human fetal diploid fibroblast cell line, which was grown as monolayers on slides contained inside rubber-stoppered tube cultures. Patients were treated successfully with doxycycline, cotrimoxazole, and valve replacement and were followed up for periods of 24 to 42 months; no evidence of deterioration was found. The human fetal diploid cell culture may be an expeditious, easy, and safe method to isolate C. burnetii from cardiac valves. Valve replacement seemed necessary to cure prosthetic-valve endocarditis due to C. burnetii infection. Combined therapy with doxycycline and cotrimoxazole may control the disease and prevent reinfection of the homografts replacing the valves.
Advanced Radiology in US Emergency Departments
Authors: Vance Lauderdale
Journal: JAMA (2011)

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
Angiotensin-independent mechanism for aldosterone synthesis during chronic extracellular fluid volume depletion.
Authors: S Okubo, F Niimura, H Nishimura, F Takemoto, A Fogo, T Matsusaka, I Ichikawa
Journal: Journal of Clinical Investigation (1997)

Wild-type (Agt+/+) and homozygous angiotensinogen deletion mutant (Agt-/-) littermates were placed on normal (NS) or low Na diet (LS) for 2 weeks. Plasma aldosterone levels (P(aldo)) were comparable during NS, and similarly elevated during LS in Agt+/+ and Agt-/-. Moreover, in both, the elevation in P(aldo) was accompanied by marked increase in adrenal zona glomerulosa cells and adrenal P450aldo mRNA. Agt-/- mice were distinguished from Agt+/+ mice by their higher plasma K level, by approximately 1.5 and approximately 3.8 mEq/liter during NS and LS, respectively. Within the Agt-/- group, P(aldo) was directly proportional to plasma K. The importance of K for the hyperaldosteronism during dietary Na restriction was verified by the observation that superimposition of K restriction led to hypotension in Agt+/+ and uniform death in Agt-/- mice along with a reduction in P(aldo) by 75 and 90%, respectively. Thus, suppression of potassium, but not angiotensin, led to a marked attenuation of hyperaldosteronism during dietary Na restriction. Therefore, (a) a powerful angiotensin-independent mechanism exists for the hyperaldosteronism during LS; (b) high K is a central component of this mechanism; (c) contrary to current belief, the tonic effect of high K on aldosterone synthesis and release does not require an intact renin-angiotensin system; and (d) normally, intermediary feedback signals for hyperaldosteronism, i.e., both hypotension and high K, are effectively masked by aldosterone actions.
Requirement for cyclin D3 in lymphocyte development and T cell leukemias
Authors: Ewa Sicinska, Iannis Aifantis, Laurent Le Cam, Wojciech Swat, Christine Borowski, Qunyan Yu, Adolfo A Ferrando, Steven D Levin, Yan Geng, Harald von Boehmer, Piotr Sicinski
Journal: Cancer Cell (2003)
A Woman's Place
Authors: Patricia Wanning
Journal: JAMA (1964)

<h3>To the Editor:—</h3> Never was a communication better designed to prove that psychiatrists don't know children. "Training in Psychiatry for Physician Mothers" (<i>JAMA</i><b>189</b>:11 [July 6] 1964) by Dr. H. I. Kaplan et al reveals that psychiatric thinking at the New York Medical College equates motherhood with fatherhood. Hasn't all their deep analysis taught them better? Apparently they also don't understand the basic facts of housewifery. Making it possible for young mothers to desert their small children throughout most of the latter's waking hours suggests an unawareness of the importance of imprinting on fresh young minds. Theirs is a blueprint for emotional instability, if I ever saw one! The physician mothers are to get<i>some</i>night duty in order to help them to gain "a sense of responsibility." But their own children would be far better teachers. Twenty years ago I might have signed up for such a program,
Metabolic acidosis may increase fibroblast growth factor-23 and cardiovascular mortality in the community
Authors: Supawat Ratanapo, Narat Srivali, Wonngarm Kittanamongkolchai, Napat Leeaphorn, Saeed Ahmed, Wisit Cheungpasitporn, Daych Chongnarungsin
Journal: Kidney International (2013)
DNA Probes Promise to Transform Diagnosis of Infectious Disease
Authors: Beverly Merz
Journal: JAMA (1987)

DNA PROBES are about to revolutionize the diagnosis of infectious disease. So predicted several representatives of laboratory medicine and the biotechnology industry who spoke at a symposium, "DNA Probes in the Practice of Medicine," sponsored by the American Medical Association this spring in Washington, DC. It is hard to challenge such a forecast. In theory, the probes—tiny fragments of DNA that bind to identical complementary DNA fragments—have unsurpassed diagnostic potential. They can identify any living organism, be it virus, bacterium, or cellular parasite, by a certain stretch of DNA that belongs to that organism exclusively. Thus, probes may be developed for DNA that is exclusive to one species of bacterium or viral strain or common to all species in a given bacterial genus or viral class. It is this property that makes geneprobe diagnosis so attractive, according to David C. Ward, MD, professor of human genetics, biophysics, and biochemistry, Yale
Perspectives on Medical Outsourcing and Telemedicine — Rough Edges in a Flat World?
Authors: Sanjiv N. Singh, Robert M. Wachter
Journal: New England Journal of Medicine (2008)

Outsourcing of health care services, such as the reading of imaging studies by offshore radiologists, has become common and has raised a number of regulatory issues related to reimbursement, patient privacy, health care quality, and malpractice. The authors review the legal context and challenges relevant to medical outsourcing.