tbuckley/cabot-search huggingface dataset:
Working hours in the career grades
Authors: G Ingrams, S Binyon
Journal: BMJ (1994)

EDITOR, - Linda Beecham notes that the NHS Management Executive does not believe that career grade doctors will be bound by the European Union's directive on the organisation of working time.1 The management executive believes that consultants determine their own working patterns and would therefore be covered by one of the derogations written into the directive. We suggest that consultants' intensity of work is determined by purchasers and the health of the local population. Also, for many consultants a large proportion of …
Meningitis Due to Ceftriaxone-Resistant<i>Streptococcus pneumoniae</i>
Authors: John R. Lonks, Margaret R. Durkin, Andrea N. Meyerhoff, Antone A. Medeiros
Journal: New England Journal of Medicine (1995)

To the Editor: Penicillin-resistant strains of Streptococcus pneumoniae are found in many countries and are spreading, especially among children in day-care centers. Many authorities now recommend ...
Expert Panel Convened by FDA Recommends Haemophilus influenzae Type B Vaccine Should Continue in Use for Children Older Than 2 Years
Authors: Charles Marwick
Journal: JAMA (1987)

DESPITE RESULTS FROM one study that questions efficacy, use of the vaccine for immunizing children older than 2 years against<i>Haemophilus influenzae</i>type b (Hib) should continue. That recommendation comes from a group of experts called together by the Food and Drug Administration (FDA). While the FDA has not made a formal decision on the matter, it has indicated that immunizations should indeed continue. A case-control study in Minnesota had questioned the efficacy and perhaps even the safety of the current vaccine. In 45 children aged 18 to 24 months with confirmed<i>H influenzae</i>infection, 17 cases occurred among vaccinated children. So far, this is the only study to show lack of efficacy of this vaccine. But the report resulted in the FDA's conducting a workshop for experts in polysaccharide bacterial diseases and epidemiology to review data from ongoing studies of this vaccine. A seven-member panel chaired by David Karzon,
New Tests for Hepatitis B Virus
Authors: Arie J. Zuckerman
Journal: New England Journal of Medicine (1974)

Recent developments in the understanding of hepatitis B may result in the introduction of new screening and diagnostic tests, adding to the bewildering array of technics that are currently available for the detection of hepatitis B antigen (Australia antigen) and its homologous antibody. These developments stem from two discoveries made in England with the aid of the electron microscope. The description by Dane et al.1 of distinct virus-like, double-shelled, 42-nm spheroidal particles in the serum of some patients with acute illness associated with hepatitis B antigen was followed by the finding, by immune electron microscopy, of a second antigen–antibody system . . .
Thirty years of the NHS.
Authors: D G Seymour
Journal: BMJ (1978)

This situation occurs because points for medical problems contribute little to the points total.Data from six housing authorities in Wales (see table) that use the points system show that the total number of points which can be granted on medical grounds, and therefore the effectiveness of normal medical intervention, varies markedly.'Within these authorities the maximum number of medical points attainable as a percentage of the lowest Vaclue of miiedical points in relati'oni to qucallfing thrXeslhold for rehousislg in six housing authorities in lt"ales* Qualifying Maximum Maximum threshold medical Housinig illedical for points aulthorit!
The Clinical Management of Incest and Sexual Abuse of Children
Authors: Alvin A. Rosenfeld
Journal: JAMA (1979)

SINCE the publication of "The Battered Child Syndrome" by Kempe et al in 1962,<sup>1</sup>physicians have been increasingly concerned with the problem of child abuse. Early thinking in the field focused on children who were seriously injured by their caretakers. As practice has evolved and experience has grown, it has become clear that battering of children is but the tip of an iceberg of childhood maltreatment. Professionals have started to be increasingly aware of the existence of sexual and emotional abuse, as well as of the gross neglect of children by their caretakers. In the early 1960s, child abuse was seen as an attack by a malicious adult against an unsuspecting child in need of protection. As workers have become more familiar with abusing adults, they have realized that these people had themselves been the unfortunate victims of abusive situations in their past. A more compassionate attitude toward these
Mortality as a Measure of Quality
Authors: Robert G. Holloway, Timothy E. Quill
Journal: JAMA (2007)

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
Ocular Effects of Gravity Inversion
Authors: Alfredo A. Sadun
Journal: JAMA (1985)

<h3>To the Editor.—</h3> I enjoyed reading the article entitled, "Ocular Manifestations of Gravity Inversion" by Drs Friberg and Weinreb.<sup>1</sup>The authors demonstrated changes in the pressure flow of the retinal arterioles, changes in intraocular pressure, and external ocular findings, all associated with gravity inversion. Indeed, others have described some of the ophthalmologic clinical manifestations of clinical inversion such as petechiae of the eye-lids.<sup>2</sup> 61-year-old man with complaints attributable to defects of his visual field was recently referred to me. Fortunately, by the time I made a full neurophthalmological assessment of him, which included testing with Octopus visual fields, his visual field defect seemed to have resolved. The patient's story, however, is germane. Because of chronic low back pain, the patient had on three occasions tried gravity-inversion therapy. He estimates that on each occasion he spent five to ten minutes in the inverted position. After each of these treatments,
Carotene absorption. A screening test for steatorrhea
Authors: G. R. Onstad
Journal: JAMA (1972)

Serum carotene levels before and after oral administration of carotene and quantitative fecal fat excretion were measured in 158 patients. Low levels of serum carotene did not reliably select the patient with steatorrhea since values less than 70μg/100 ml were associated with normal fecal fat excretion in 30%. Values greater than 70μg/100 ml were associated with steatorrhea in 18%. However, after oral loading, an increase in serum carotene of 35μg/100 ml or more indicated normal fat absorption. Lesser increases were associated with steatorrhea in 80% of patients. The carotene absorption test is a simple, sensitive, and reliable screening test for steatorrhea.
Toward Evidence-Based Statistics
Authors: Steven Goodman
Journal: Annals of Internal Medicine (2000)

Letters21 March 2000Toward Evidence-Based StatisticsSteven Goodman, MD, PhDSteven Goodman, MD, PhDJohns Hopkins University; Baltimore, MD 21205 (Goodman)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-6-200003210-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:I thank the correspondents for their thoughtful reactions to these articles. I agree wholeheartedly with Dr. Sulmasy that Bayes does not “give all the answers,” and I tried to communicate that in my article; perhaps I did not navigate deftly enough between the Scylla and Charybdis of frequentism and Bayesianism. I also support his criticism of labeling frequentist probabilities as “objective” and inductive ones as “subjective.” The clinical trial example in the first article showed how the frequentist P value could be affected by the mental states of the investigators. The deeper one delves, the more the line ...References1. Greenland S. Probability logic and probabilistic induction. Epidemiology. 1998;9:322-32. CrossrefMedlineGoogle Scholar2. Savage L. The Foundations of Statistics. New York: Wiley; 1956. Google Scholar3. Goodman SN. Probability at the bedside: the knowing of chances or the chances of knowing? [Editorial]. Ann Intern Med. 1999;130:604-6. LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Johns Hopkins University; Baltimore, MD 21205 (Goodman) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFlock Worker's Lung William S. Beckett Probability at the Bedside: The Knowing of Chances or the Chances of Knowing? Steven N. Goodman Metrics 21 March 2000Volume 132, Issue 6Page: 508KeywordsBayesian methodClinical trialsDecision analysisStatistical models Issue Published: 21 March 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
GMP-140, a platelet alpha-granule membrane protein, is also synthesized by vascular endothelial cells and is localized in Weibel-Palade bodies.
Authors: R P McEver, J H Beckstead, K L Moore, L Marshall-Carlson, D F Bainton
Journal: Journal of Clinical Investigation (1989)

We used an immunoperoxidase procedure to examine the tissue distribution of the platelet alpha-granule membrane protein, GMP-140. In addition to its presence in megakaryocytes and platelets, GMP-140 antigen was found in vascular endothelial cells of diverse human organs, but it was not detected in other types of secretory cells. [35S]Cysteine-labeled human umbilical vein endothelial cells synthesized a GMP-140 molecule containing complex N-linked oligosaccharides similar to those previously demonstrated in platelets and the megakaryocytic HEL cell line. Using an immunogold procedure on frozen thin sections of endothelial cells, we found GMP-140 antigen to be localized to membranes of electron-dense storage granules. In double-label experiments there was colocalization of GMP-140 with vWf, indicating that these granules are Weibel-Palade bodies. When endothelial cells were stimulated with histamine, GMP-140 rapidly redistributed to the plasma membrane. Immunoassays of cell lysates indicated that, relative to total cell protein, less GMP-140 is present in human umbilical vein endothelial cells than in platelets. The restricted expression of GMP-140 in secretory granules of platelets and endothelium suggests that it has a specific function in the vascular system rather than a general role related to inducible secretion.
Mortality risk prediction in COPD by a prognostic biomarker panel
Authors: Daiana Stolz, Anja Meyer, Janko Rakic, Lucas Boeck, Andreas Scherr, Michael Tamm
Journal: European Respiratory Journal (2014)

Chronic obstructive pulmonary disease (COPD) is a complex disease with various phenotypes. The simultaneous determination of multiple biomarkers reflecting different pathobiological pathways could be useful in identifying individuals with an increased risk of death. We derived and validated a combination of three biomarkers (adrenomedullin, arginine vasopressin and atrial natriuretic peptide), assessed in plasma samples of 385 patients, to estimate mortality risk in stable COPD. Biomarkers were analysed in combination and defined as high or low. In the derivation cohort (n = 142), there were 73 deaths during the 5-year follow-up. Crude hazard ratios for mortality were 3.0 (95% CI 1.8–5.1) for one high biomarker, 4.8 (95% CI 2.4–9.5) for two biomarkers and 9.6 (95% CI 3.3–28.3) for three high biomarkers compared with no elevated biomarkers. In the validation cohort (n = 243), 87 individuals died. Corresponding hazard ratios were 1.9 (95% CI 1.1–3.3), 3.1 (95% CI 1.8–5.4) and 5.4 (95% CI 2.5–11.4). Multivariable adjustment for clinical variables as well as the BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) index and stratification by the Global Initiative for Chronic Obstructive Lung Disease stages provided consistent results. The addition of the panel of three biomarkers to the BODE index generated a net reclassification improvement of 57.9% (95% CI 21.7–92.4%) and 45.9% (95% CI 13.9–75.7%) at 3 and 5 years, respectively. Simultaneously elevated levels of adrenomedullin, arginine vasopressin and atrial natriuretic peptide are associated with increased risk of death in patients with stable COPD.
Essential Otolaryngology: Head and Neck Surgery
Authors: Gregory J. Matz
Journal: JAMA (1983)

This is a review book from 35 contributors, which will serve as a reference for residents finishing in otolaryngology or for practitioners of this specialty. The book is basically in outline form with 38 chapters. It is designed to include many facts in an encyclopedic style and contains a chapter on syndromes and eponyms. Especially pertinent and valuable are chapters on anatomy, and audiology, including brain-stem responses and the vestibular system. Chapters on facial plastic surgery, radiology, anesthesia, frequently omitted elsewhere, are included in this textbook. The editor has evidently made an attempt to update, which is manifested by chapters in immunology and chemotherapy. As is inevitable in a book of this type, a number of chapters, such as the one on antibiotics, are poorly drawn together. The editor would have been much more successful to include a short chapter on antibiotics by Dr David Fairbanks, whose chapters on this
Book Review Basic Mechanisms of Pediatric Respiratory Disease: Cellular and Integrative Edited by Victor Chernick and Robert B. Mellins. 449 pp., illustrated. Philadelphia, B.C. Decker, 1991. $92. 1-55664-137-0 (Distributed in the U.S. by Mosby-Year Book, St. Louis).
Authors: Julian L. Allen
Journal: New England Journal of Medicine (1993)
Graft-versus-host resistance induced by class II major histocompatibility complex-specific T cell clones.
Authors: P V Lehmann, K Drexler, M Tary-Lehmann, F Falcioni, U Hurtenbach, Z A Nagy
Journal: The Journal of Experimental Medicine (1991)

Possible mechanisms of graft-vs.-host (GVH) resistance have been studied using a panel of seven class II major histocompatibility complex-specific T cell clones for elicitation and challenge. One clone recognized I-Ak,d,f, and expressed V beta 8.3 together with J beta 1.5. The remaining six clones were I-Ek specific and expressed V beta 15 rearranged to J beta 1.1 or J beta 1.3. The I-Ek-specific clones were also homologous to each other and different from the I-A-reactive one in the D and N regions. Four of the seven clones exhibited I-Ek-specific cytolytic activity. Each clone, when injected in sublethal numbers into appropriate recipients, could induce resistance to a subsequent lethal dose of any other clone in the panel. The resistance did not require sharing of either T cell receptor beta chains or antigen specificity, or MHC molecules by the eliciting and challenging clone. Cytolytic and noncytolytic clones were equally efficient in inducing GVH resistance. A prerequisite of resistance induction was the activation of eliciting clone subsequent to recognition of class II molecules in the host. Clones preactivated with high concentrations of recombinant interleukin 2, in vitro, could induce GVH resistance also in syngeneic hosts, suggesting that resistance induction was associated with the activated state of clone, rather than antigen recognition per se. In all instances of resistance, the challenging clones failed to induce vascular leakage, which was the cause of death in susceptible recipients (Lehmann, P. V., G. Schumm, D. Moon, U. Hurtenbach, F. Falcioni, S. Muller, and Z. A. Nagy. 1990. J. Exp. Med. 171:1485). Lipopolysaccharide (LPS) induced resistance to vascular leakage did not provide crossresistance to GVH and vice versa, suggesting that interleukin 1 alpha and tumor necrosis factor alpha implicated in LPS resistance are not involved in GVH resistance. Although the mechanism remains unclear, the most likely explanation for GVH resistance in this system is either the downregulation of permeability increasing effect in the challenging clone, or an induced refractoriness of blood vessels to this effect.
Activated Complement Component 3 (C3) Is Required for Ultraviolet Induction of Immunosuppression and Antigenic Tolerance
Authors: Craig Hammerberg, Santosh K. Katiyar, Michael C. Carroll, Kevin D. Cooper
Journal: The Journal of Experimental Medicine (1998)

Complement component 3 (C3), a critical regulator of innate immunity, may also play a role in the regulation of cognate immunity, such as contact sensitivity responses. Because ultraviolet (UV) radiation also activates C3 in the skin, we determined whether the immunosuppressed state that results when a contact sensitizer is applied through UVB-exposed skin requires the presence and activation of C3. This question was addressed through the use of C3-deficient mice, blockade of C3 cleavage to C3b, and accelerated degradation of iC3b by soluble complement receptor 1 (sCR1). Both C3-modulated systems totally reversed the failure to induce a contact sensitivity response to dinitrofluorobenzene (DNFB) upon primary sensitization at the UV-exposed site, as well as immunologic tolerance to a second DNFB immunization through normal skin. Treatment with sCR1 reduced the infiltration of CD11b+ leukocytes into the epidermis and dermis of UV-irradiated skin but did not reverse the UV-induced depletion of epidermal class II MHC+CD11blo Langerhans cells. These data, taken together with previous results showing abrogation of locally induced UV immunosuppression by in vivo anti-CD11b treatment, suggest a novel mechanism by which ligation of the leukocyte β2 integrin, CD11b, by iC3b molecules formed from C3 activation in UV-exposed skin, modifies cutaneous CD11b+ cells such that skin antigen-presenting cells are unable to sensitize in a primary immune response, but actively induce antigenic tolerance.
Frequent Mutation of the <i>PIK3CA</i> Gene in Ovarian and Breast Cancers
Authors: Douglas A. Levine, Faina Bogomolniy, Cindy J. Yee, Alex Lash, Richard R. Barakat, Patrick I. Borgen, Jeff Boyd
Journal: Clinical Cancer Research (2005)

Activation of the phosphatidylinositol 3-kinase (PI3K)-AKT pathway, resulting in increased cell proliferation, survival, and motility, is believed to play an oncogenic role in many cancer types. The PIK3CA gene encodes the p110alpha catalytic subunit of PI3K, and is amplified in some ovarian cancers, whereas the AKT2 gene is amplified in some ovarian, breast, and pancreatic cancers. Recently, in a mutational screen of eight PI3K genes and eight PI3K-like genes, PIK3CA was found to be the only gene affected by somatic mutations, which were observed frequently in gastrointestinal and brain cancers. Here, we test whether PIK3CA is subject to mutation in ovarian and breast cancers.Exons 9 and 20, encoding the highly conserved helical and kinase domains of PIK3CA, were subjected to sequence analysis in 198 advanced stage epithelial ovarian carcinomas and 72 invasive breast carcinomas (48 of ductal histology and 24 of lobular histology).Somatic missense mutations were observed in 24 of 198 (12%) ovarian carcinomas, and in 13 of 72 (18%) breast carcinomas.These data indicate that mutations of PIK3CA play an oncogenic role in substantial fractions of ovarian and breast carcinomas, and in consideration of mutation of other components of the PI3K-AKT pathway in both tumor types, confirm the major oncogenic role of this pathway in ovarian and breast carcinomas.
Comparison of propranolol, diltiazem, and nifedipine in the treatment of ambulatory ischemia in patients with stable angina. Differential effects on ambulatory ischemia, exercise performance, and anginal symptoms. The ASIS Study Group.
Authors: P H Stone, R S Gibson, S P Glasser, M A DeWood, J D Parker, D T Kawanishi, M H Crawford, F C Messineo, T L Shook, K Raby
Journal: Circulation (1990)

Episodes of transient myocardial ischemia during ambulatory activities are common in patients with stable coronary artery disease and who are often asymptomatic. Selection of therapy for episodes of asymptomatic ischemia is limited by a lack of direct comparative studies. To determine the most effective monotherapy for patients with stable angina and a high frequency of asymptomatic ischemic episodes, propranolol-LA (mean daily dose, 293 mg), diltiazem-SR (mean daily dose, 350 mg), nifedipine (mean daily dose, 79 mg) were each compared with placebo, each for 2 weeks, in a randomized, double-blinded, crossover trial. Entry criteria were a positive exercise treadmill test during placebo therapy characterized by 1.0 mm or more ST segment depression and angina pectoris, and six or more episodes of transient ST segment depression of 1.0 mm or more on a 48-hour ambulatory electrocardiogram. One hundred ninety-four patients were screened, 63 were eligible and received randomized therapy, of which 56 patients completed at least two of the four treatment periods and were included in an intent-to-treat analysis. Fifty patients completed all four treatment phases and were included in the protocol-completed analysis. Anti-ischemia efficacy was assessed by 48-hour ambulatory electrocardiographic monitoring, exercise treadmill tests, and anginal diaries. Ninety-four percent of all episodes of ambulatory ischemia were asymptomatic. Compared with placebo, only propranolol was associated with a marked reduction in all manifestations of asymptomatic ischemia during ambulatory electrocardiographic monitoring (2.3 versus 1.0 episodes/24 hr; mean duration of ischemia per 24 hours, 43.6 versus 5.7 minutes; both p less than 0.0001). Diltiazem's reduction of the frequency of episodes compared with placebo (2.3 versus 1.9 episodes/24 hr) was associated with a trend (p = 0.08) in the protocol-completed analysis and with a significant reduction in the intent-to-treat analysis (p = 0.03). Nifedipine had no significant effect on any measured variable of ambulatory ischemia. The dosages of medication used may have been excessive for some patients, and a more beneficial effect may have been evident at a lower dose. In contrast to the marked effects of the active agents on ambulatory asymptomatic ischemia, the effects on exercise performance and angina pectoris were slight. The active agents modestly improved treadmill exercise duration time until 1 mm ST segment depression (3%), and only propranolol and diltiazem had significant effects. Only diltiazem significantly prolonged the total exercise time. Anginal frequency was significantly decreased by both propranolol and diltiazem.(ABSTRACT TRUNCATED AT 400 WORDS)