tbuckley/cabot-search huggingface dataset:
A piece of my mind. Hands on
Authors: M. R. Fleisher
Journal: JAMA (1994)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Congenital Syphilis — Breaking through the Safety Net
Authors: K McIntosh
Journal: New England Journal of Medicine (1990)

"Almost certainly preventable, the occurrence of a case of congenital syphilis can usually be attributed to ignorance or neglect."1 This statement, made by Platou in his exhaustive description of the treatment of congenital syphilis with penicillin in 1949, was unusually prophetic in every detail, including its use of the word "almost." The report by Dorfman and Glaser in this issue of the Journal warns that even with the best of preventive programs, in the face of the present syphilis epidemic pediatricians must be prepared to find and treat congenital syphilis.2 The authors describe seven infants with previously unsuspected congenital syphilis . . .
The Gilman Files: Computerized Medical Histories and Automated Physical Examination Reporting System
Authors: Leslie L. Cortés
Journal: JAMA (1996)

Rating: 1.5 (O=worse than a virus, 1=harmless but useless, 2=useful but klutzy, 3=useful, 4=better than most, 5=1 already bought mine). From stethoscopes to computer equipment, our choices of professional tools are often shaped by cost and personal idiosyncrasy. Yet, the search for better tools is always driven by a desire to make ourselves more efficient and more effective. Efficiency means greater productivity and reduced work burden. Effectiveness, we hope, translates into better patient outcomes. Clinical software, like all other tools, must be evaluated from that perspective. Software that automates the production of clinical narrative can be based on commercial word processors or designed de novo. Commercial word processors offer versatility, medical spellchecking, high-quality output, and the ability to export completed narratives not only as paper but also as electronic documents. In theory, special-purpose software may be easier to use and may help us connect the meaning of the clinical narrative
439. CXCR4 and CCR5 shRNA Transgenic Macrophages Are Functionally Normal and Resist HIV-1 Infection
Authors: Joseph Anderson, Ramesh Akkina
Journal: Molecular Therapy (2005)

The effectiveness of shRNAs in targeted gene silencing offers promise for long term HIV gene therapy. Previous work targeting the major coreceptors, CXCR4 and CCR5 by a bispecific lentiviral vector showed efficacy in down regulating their surface expression and thus conferring viral resistance to both X4 and R5-tropic strains of HIV-1. In extending these results to a stem cell setting, here we show that this bispecific lentiviral vector confers viral resistance to CD34+ stem cell derived macrophages. ShRNA vector transduced macrophages showed effective down regulation of CXCR4 and CCR5 compared to control cells as measured by FACS. This dual coreceptor down regulation conferred simultaneous resistance to both X4 and R5-tropic strains of HIV-1. To determine if shRNA expression and/or decreased levels of coreceptors affects normal macrophage functions, functionality assays were performed. FACS analysis was used to analyze expression of CD14, MHCII, and B7.1 with or without LPS stimulation. IL-1 and TNF|[alpha]| ELISAs were also performed to analyze cytokine secretion with LPS stimulated macrophages. ShRNA vector transduced macrophages showed comparable levels of B7 upregulation and IL-1 and TNF|[alpha]| secretion upon LPS stimulation. Thus the transgenic macrophages appear to be phenotypically and functionally normal. These data show that a bispecific lentiviral vector targeting both CXCR4 and CCR5 can down regulate surface expression and confer HIV-1 resistance in CD34+ derived macrophages. Using shRNA expressing lentiviral vectors to inhibit HIV-1 infection offers a promising approach to HIV gene therapy.
IMMUNOCHEMICAL STUDY OF ANTIGENIC SPECIFICITY IN DELAYED HYPERSENSITIVITY
Authors: Sidney Leskowitz
Journal: The Journal of Experimental Medicine (1963)

Delayed hypersensitivity in guinea pigs was produced by immunization. with a conjugate prepared by coupling diazotized arsanilic acid to polytyrosine. The resulting sensitivity could be demonstrated by skin test with conjugates prepared from a wide variety of tyrosine-containing proteins. Definite but smaller degrees of sensitivity could be induced with conjugates of proteins containing little or no tyrosine. The apparent absence of carrier-specificity is considered to be due to the narrowed range of immunologic response produced by immunization with polytyrosine-azobenzenearsonate. Injections of the hapten N-acetyltyrosine-azobenzenearsonate was found to suppress completely the delayed reaction attributable to the tyrosine-azobenzenearsonate group. The same hapten was only slightly effective in suppressing reactions in guinea pigs immunized with guinea pig serum albumin-azobenzenearsonate, suggesting that a broader range of specificities is involved with such antigens. Confirmation of such increased range of specificity attributable to antigenic determinants contributed by the carrier protein was obtained by desensitization studies with N-acetyltyrosine-azobenzenearsonate and guinea pig serum albumin-azobenzoate. While separately these materials produced only a slight decrease in skin reactivity to guinea pig serum albumin-azobenzenearsonate, the combination was found to give almost complete suppression.
Polymyositis Associated With AIDS Retrovirus
Authors: Marinos C. Dalakas
Journal: JAMA (1986)

Two homosexual men were initially seen with polymyositis as the only manifestation of the acquired immunodeficiency syndrome (AIDS) retrovirus infection. They developed AIDS-related complex a few weeks later and typical AIDS two to six months after onset of muscle weakness. By use of anti-human T-cell lymphotropic virus type III antiserum and monoclonal antibodies to lymphocyte subsets in an immunofluorescence technique, viral antigens were found in the OKT4-positive lymphoid cells surrounding muscle fibers and invading the endomysia septa. We concluded that an initial infection with the AIDS retrovirus can be associated with polymyositis, which may be the first clinical manifestation of an impending AIDS-related complex or AIDS.
Should drug companies be allowed to talk directly to patients?: NO
Authors: W. Garlick
Journal: BMJ (2003)

Health care in Britain is undergoing a radical shift, with a series of high profile investigations (such as the Bristol Royal Infirmary inquiry report, published in 2001, and the Shipman inquiry, set up in 2002), changes in NHS delivery, and advances in technology. Traditional approaches are increasingly being challenged, and many people are becoming more involved in managing their own health care.

While health professionals must respect the wishes of patients who are content with the traditional “doctor knows best” approach, they cannot ignore the growing number of people keen to become more equal partners in decision making about their own health or that of the relatives or friends they care for. Central to shared decision making is the ability for people to make informed choices. To do this, they must be able to gain access to high quality, balanced, accurate, full, and up to date information as well as have it effectively communicated to them by health professionals and others (such as the media). We are therefore campaigning for a more constructive approach to the provision of information based on patients' individual needs.

The pharmaceutical industry claims to have a direct part to play in educating the public and improving patient information (as set out in the aims of its current “My Medicine” campaign for patient friendly information). On the surface, this may seem attractive. After all, the industry produces the drugs we use. But the Consumers' Association believes that such an approach …
Note on the Role of the Horse Fly in the Transmission of Trypanosoma Infection, with a Reply to Colonel Bruce's Criticisms
Authors: L. Rogers
Journal: BMJ (1904)

TRYPANOSOME INFECTION.[Nov. 26, I9D4 caused by tick fever; and a Congo Free State official knew the disease well, stating that certain camps on the other side of Lake Albert were always avoided by his soldiers for that reason.In the Upper Congo the ticks are known as kumputu, on the Swahili coast as kupe, by the Bunyoro as kibo, by the Naibian soldier as the Unyoro dudu (Kiswabili insect).From inquiries amongst the l nyoro natives, it seemed that fever
Selenium and Cancer Prevention
Authors: Graham A. Colditz
Journal: JAMA (1996)

Despite advances in diagnosis and treatment, morbidity and mortality from cancer continue to represent a major health burden. Given the potentially devastating consequences and the fear associated with a diagnosis of cancer, it is not surprising that physicians, patients, and the public may hold substantial optimism for and have considerable interest in seemingly simple and relatively easily implemented measures, such as dietary modification or use of vitamin and trace element supplementation, that appear rapidly effective for cancer prevention. Previous studies examining the potential effects of dietary supplements, such as antioxidant vitamins<sup>1,2</sup>for prevention of cancer, have produced mixed results. In this issue ofTHE JOURNAL, Clark and colleagues<sup>3</sup>present promising but preliminary findings from a randomized trial evaluating the possible effectiveness of selenium supplementation for cancer prevention. See also p 1957. The Nutritional Prevention of Cancer Study by Clark et al<sup>3</sup>randomized 1312 patients to receive placebo
The Costs of Colonoscopy in Patients with Ulcerative Pan-Colitis in Sweden
Authors: C. A. Rubio, P. Slezak, R. Befrits
Journal: Endoscopy (1994)

The costs of colonoscopy examinations at a hospital in Sweden were calculated in ten consecutive patients with ulcerative pan-colitis. Since colonoscopy in such patients is incomplete if not followed by microscopic study of the state of the colon mucosa, the costs of both the endoscopic and histological examinations were calculated together. The costs of the material used (disposable items, recycled items and durable items) and the wages for personnel involved (endoscopists, pathologists, nurses, laboratory technicians, secretaries and clerks) were calculated for each colonoscopic and histological examination. The mean cost per complete examination was US$ 223, which is moderate despite the high personnel costs in Sweden. Since the biopsy material obtained in an endoscopic examination is of value not only for conventional histological study but also for DNA analysis, periodic colonoscopy is still to be recommended in patients with long-standing ulcerative pan-colitis until new methods of cancer detection and prevention become available.
How accurate is the visual assessment of basal carcinoma margins?
Authors: ERNST EPSTEIN
Journal: British Journal of Dermatology (1973)

This study evaluated the accuracy of visual determination of tumour margins in basal cell carcinomas. Using a 2.5 × binocular magnifier, the apparent tumour margin was marked pre-operatively by light electrodesiccation. Following excision, the electrodesiccation mark was compared to the actual tumour edge by microscopy of step level sections. It was possible to delineate the tumour margins with an accuracy of 1 mm in 94% of a selected series of 101 basal cell carcinomas. These findings support the view that a 2 mm margin of normal tissue is adequate in the surgical treatment of most basal cell carcinomas.
THE DIFFUSE AND MULTIVESSEL POSITIVE CORONARY SPASM INCREASE THE INCIDENCE OF RECURRENT CHEST PAIN DURING 3-YEAR FOLLOW-UP PERIOD IN PATIENT WITH CORONARY ARTERY SPASM AS ASSESSED BY ACETYLCHOLINE PROVOCATION TEST
Authors: SangHo Park, Seung-Woon Rha, Taehoon Ahn, Won Yu Kang, Wonyoung Shin, Dongkyu Jin, Byoung Geol Choi, Cheol Ung Choi, Chang Gyu Park, Hong-Seog Seo, Dong Joo Oh
Journal: Journal of the American College of Cardiology (2014)
Dose adjustment in renal impairment: Response from <i>AHFS Drug Information</i>
Authors: Gerald K McEvoy
Journal: BMJ (2005)

EDITOR—For almost 50 years American Hospital Formulary System Drug Information (AHFS DI) has had the most widely vetted, evidence based process for content development of any drug compendium in the US—a process that is not limited to the professional labelling (package insert) approved by the Food and Drug Administration (FDA) but includes extensive ongoing review and professional analysis of the medical literature identified through resources such as PubMed (Medline).1 2

Vidal et al's criticisms should have been directed principally at the inadequacies of the drug regulatory processes and pharmaceutical manufacturers in researching and publishing such information rather than at the drug information publishers (p 263).3 In the US the FDA does not require manufacturers to conduct research establishing the impact of renal function on dosing. Instead an FDA guidance document merely provides opinion and advice and carries no regulatory force …
Portal fibrosis and hepatic steatosis in morbidly obese subjects: A spectrum of nonalcoholic fatty liver disease
Authors: Gary A. Abrams, Sachin S. Kunde, Audrey J. Lazenby, Ronald H. Clements
Journal: Hepatology (2004)

Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD) that can lead to hepatic fibrosis and cirrhosis. Portal fibrosis in the absence of NASH, called isolated portal fibrosis (IPF), has received less attention and has not been classified as a spectrum of NAFLD. The aims of this study were to determine the prevalence of IPF in subjects undergoing gastric bypass surgery, to identify biochemical variables associated with IPF, and to assess the metabolic syndrome as defined by the AdultTreatment Panel III criteria. We analyzed liver biopsies from 195 morbidly obese subjects after excluding all other causes of liver disease. The prevalence of fatty liver (FL) only, IPF, and NASH was 30.3%, 33.3%, and 36.4%, respectively. Several biochemical parameters significantly trended across the 3 groups, with IPF falling between FL and NASH. Hyperglycemia was the only metabolic parameter associated with NASH (OR, 5.4; 95% CI, 2.4-12; P &lt; .0001) and IPF (OR, 2.8; 95% CI, 1.2-6.5; P = .01). Subjects with diabetes had the greatest risk for NASH (OR, 8; 95% CI, 3.3-19.7; P &lt; .0001) and IPF (OR, 4.3; 95% CI, 1.6-11.6; P = .003). The metabolic syndrome was identified in 78.5% of subjects, and a significant trend for the number of metabolic criteria was observed across the spectrum of FL, IPF, and NASH. In conclusion , a significant subset of morbidly obese individuals has portal fibrosis in the absence of NASH that is associated with glycemic dysregulation. Therefore, IPF should be considered a spectrum of NAFLD that may prelude NASH in morbid obesity. (Hepatology 2004;40:475-483.)
Monitoring exposure to atomic bomb radiation by somatic mutation.
Authors: M Akiyama, S Kyoizumi, Y Kusunoki, Y Hirai, K Tanabe, J B Cologne
Journal: Environmental Health Perspectives (1996)

Atomic bomb survivors are a population suitable for studying the relationship between somatic mutation and cancer risk because their exposure doses are relatively well known and their dose responses in terms of cancer risk have also been thoroughly studied. An analysis has been made of erythrocyte glycophorin A (GPA) gene mutations in 1,226 atomic bomb survivors in Hiroshima and Nagasaki. The GPA mutation frequency (Mf) increased slightly but significantly with age at the time of measurement and with the number of cigarettes smoked. After adjustment for the effect of smoking, the Mf was significantly higher in males than in females and higher in Hiroshima than in Nagasaki. All of these characteristics of the background GPA Mf were in accord with those of solid tumor incidence obtained from an earlier epidemiological study of A-bomb survivors. Analysis of the dose effect on Mf revealed the doubling dose to be about 1.20 Sv and the minimum dose for detection of a significant increase to be about 0.24 Sv. No significant dose effect for difference in sex, city, or age at the time of bombing was observed. Interestingly, the doubling dose for the GPA Mf approximated that for solid cancer incidence (1.59 Sv). And the minimum dose for detection was not inconsistent with the data for solid cancer incidence. The dose effect was significantly higher in those diagnosed with cancer before or after measurement than in those without a history of cancer. These findings are consistent with the hypothesis that somatic mutations are the main cause of excess cancer risk from radiation exposure.
Purified T-depleted, CD34+ peripheral blood and bone marrow cell transplantation from haploidentical mother to child with thalassemia
Authors: Pietro Sodani, Antonella Isgrò, Javid Gaziev, Paola Polchi, Katia Paciaroni, Marco Marziali, Maria Domenica Simone, Andrea Roveda, Aldo Montuoro, Cecilia Alfieri, Gioia De Angelis, Cristiano Gallucci, Buket Erer, Giancarlo Isacchi, Francesco Zinno, Gaspare Adorno, Alessandro Lanti, Lawrence Faulkner, Manuela Testi, Marco Andreani, Guido Lucarelli
Journal: Blood (2009)
Renin concentrations and effects of propranolol and spironolactone in patients with hypertension.
Authors: B E Karlberg, B Kagedal, L Tegler, K Tolagen
Journal: BMJ (1976)

In a crossover study 32 patients with hypertension were randomly allocated to treatment with spironolactone 200 mg/day for two months, propranolol 320 mg/day for two months, and a combination of both drugs at half the dose. Between the treatments placebo was given for two months. Both spironolactone and propranolol lowered the blood pressure significantly in both positions. The initial plasma renin activity (PRA) levels ranged from 0-4 to 5-0 mug angiotensin I l-1 h-1, and there was a close correlation between these levels and the effects of the drugs: with increasing PRA the response to propranolol was better while the opposite was true for spironolactone. Spironolactone reduced the blood pressure more at eight than at four weeks, while no such difference could be shown for propranolol. Spironolactone and propranolol together decreased the blood pressure still further irrespective of the initial PRA. All patients achieved a normal supine blood pressure.
Solitary Unicameral Bone Cyst in a Seven-Week-Old Infant
Authors: M. E. Tausend, Milton Marcus
Journal: New England Journal of Medicine (1959)

THE purpose of this report is to place on record a case of proved solitary unicameral bone cyst in an infant seven weeks of age, and to indicate that the origin of such a cyst may be a congenital defect present in the cartilaginous matrix or occurring at the time of ossification of cartilage.In an extensive review of the literature no case report of a solitary unicameral bone cyst at this age could be found. Aside from the early age of this patient, the site and size of the bone cyst permit certain deductions.No attempt to review the . . .
Relationship between molecular connectivity and carcinogenic activity: a confirmation with a new software program based on graph theory.
Authors: D Malacarne, R Pesenti, M Paolucci, S Parodi
Journal: Environmental Health Perspectives (1993)

For a database of 826 chemicals tested for carcinogenicity, we fragmented the structural formula of the chemicals into all possible contiguous-atom fragments with size between two and eight (nonhydrogen) atoms. The fragmentation was obtained using a new software program based on graph theory. We used 80% of the chemicals as a training set and 20% as a test set. The two sets were obtained by random sorting. From the training sets, an average (8 computer runs with independently sorted chemicals) of 315 different fragments were significantly (p < 0.125) associated with carcinogenicity or lack thereof. Even using this relatively low level of statistical significance, 23% of the molecules of the test sets lacked significant fragments. For 77% of the molecules of the test sets, we used the presence of significant fragments to predict carcinogenicity. The average level of accuracy of the predictions in the test sets was 67.5%. Chemicals containing only positive fragments were predicted with an accuracy of 78.7%. The level of accuracy was around 60% for chemicals characterized by contradictory fragments or only negative fragments. In a parallel manner, we performed eight paired runs in which carcinogenicity was attributed randomly to the molecules of the training sets. The fragments generated by these pseudo-training sets were devoid of any predictivity in the corresponding test sets. Using an independent software program, we confirmed (for the complex biological endpoint of carcinogenicity) the validity of a structure-activity relationship approach of the type proposed by Klopman and Rosenkranz with their CASE program.
Ocular Examinations in Outpatients Given Long-Term Chlorpromazine Therapy
Authors: Lov K. Sarin
Journal: JAMA (1966)

GRANULAR LESIONS of the lens and cornea can occur in patients receiving long-term therapy with chlorpromazine and other phenothiazines, usually at high dosages.<sup>1-3</sup>These lesions, which have been described in detail<sup>4,5</sup>rarely result in visual impairment. They occur in most patients who have abnormal skin pigmentation and are often more advanced than the lesions that occur in patients who do not have abnormal skin pigmentation. Their development seems to be related to total dosage and duration of treatment. DeLong and Prien estimate the incidence of eye lesions in such patients to be approximately 20%.<sup>6</sup>To determine whether eye lesions can also occur with long-term therapy at low and moderate dosages, 44 outpatients were studied. <h3>Material and Methods</h3> This series consisted of 28 women and 16 men, either private outpatients or outpatients at the Sidney Hillman Medical Center. Eighteen were psychotics and 26 were psychoneurotics. Their average age