tbuckley/cabot-search huggingface dataset:
An 'ideal' serum cholesterol level?
Authors: J. Elliott
Journal: JAMA (1979)

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
213 COMPARISON BETWEEN PEI AND RF IN THE TREATMENT OF HCC IN CIRRHOTIC PATIENTS WITH 3 CM OR LESS SINGLE NODULE: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL
Authors: A. Giorgio, G. de Stefano, A. Di Sarno, U. Scognamiglio, F. Nunzia, G. Sabino, G. Liorre, A. Mariniello, V. Giorgio
Journal: Journal of Hepatology (2010)
THE GRADIENT OF VASCULAR PERMEABILITY
Authors: Peyton Rous, Frederick Smith
Journal: The Journal of Experimental Medicine (1931)

A steeply mounting gradient of permeability is demonstrable along the meshwork of capillaries which connects the arterioles and venules of the skin of the frog. The venules incorporated in the meshwork are even more permeable than the capillary meshes giving into them. The presence of the gradient under such differing conditions as exist along frog and mammalian capillaries enables one to rule out certain factors which might be invoked to explain it; and it is not explainable in terms of those influences generally recognized as conditioning exchange between the blood and tissues. Not improbably it results from a structural differentiation along the capillary.
The Earthquake in Haiti — Dispatch from Port-au-Prince
Authors: Jean William Pape, Warren D. Johnson, Daniel W. Fitzgerald
Journal: New England Journal of Medicine (2010)

At 4:53 p.m. on Tuesday, January 12, an earthquake killed or gravely injured hundreds of thousands of people in Port-au-Prince, Haiti. Even more were left homeless. The devastation is incomprehensible. Chaos followed, since the centers of law, order, and functioning society were destroyed or suffered severe losses. The Haitian national palace, government ministries, and police stations collapsed with major losses of life. The headquarters of the United Nations was in rubble, and hundreds of staff members were missing. Banks, churches, food stores, hospitals, hotels, schools, and communications capabilities were destroyed. As a result, piles of bodies lay in the streets. . . .
Routine audit is an ethical requirement of screening
Authors: P. Sasieni
Journal: BMJ (2001)

Routine audit is an ethical requirement of screeningEditor-Cervical screening saves about 1300 lives each year in England and Wales. 1 We regard audit as an essential part of the screening programme and urge health authorities to continue this activity despite recent concerns about using patient information without informed consent.Poor quality screening is ineffective and may do more harm than good.Women screened in the NHS can expect a high quality service in which smears are properly taken and read to a high standard and the results stored to ensure appropriate management.Audit is part of the quality assurance that is integral to the screening that each woman receives.
Selected Readings in Pathology
Authors: Lester S. King
Journal: JAMA (1961)

The first edition of this volume appeared in 1929. In the intervening years there has been a greatly enhanced interest in medical history. It is only appropriate that pathology should share in this renascence, and it is gratifying that a selection of writings from the great pathologists should once more be readily available. In this second edition Dr. Long has greatly expanded the scope of the work. The first edition had offered selections ranging from Hippocrates to Virchow. The new edition extends the range over the intervening years, to the present. We meet, for example, Fitz, Welch, Theobald Smith, Mallory, MacCallum, Rous, Opie, Hektoen, and Whipple, among the thirty authors added since Virchow. For each author a brief but informative introduction precedes the selections. The entire collection offers a fine synoptic view of the problems that pathologists face over the course of history, the methods of medical scientists, of careful
Anaphylactic Reaction to Chymotrypsin
Authors: Donald M. Sherline
Journal: JAMA (1962)

MANY TECHNIQUES have been suggested for the relief of the painful episiotomy wound. Enzymatic treatment is one of the newer methods.  Chymotrypsin, one of the drugs used for this purpose, is a proteolytic enzyme extracted from the mammalian pancreas. As with any foreign protein there is danger of a hypersensitivity response after its administration, and, in fact, the anaphylactic reaction to chymotrypsin in guinea pigs was once suggested as a means of differentiating chymotrypsin from trypsin. It has been further demonstrated that bovine chymotrypsin can produce strong allergic sensitization with transferable skin-sensitizing antibodies against the enzyme.  There have been at least 2 reports in the literature of well documented accidental hypersensitivity in laboratory personnel dealing with trypsin and chymotrypsin. There are at least 3 anaphylactic responses to chymotrypsin reported among patients receiving it in an attempt to provide an enzymatic debridement. This is the first case report in obstetrics.  Prior
Balancing the intended and unintended effects of statins
Authors: A. A. Alsheikh-Ali, R. H. Karas
Journal: BMJ (2010)

<h3>Introduction</h3> About 20% patients with perianal Crohn’s (pCD) undergo proctectomy with a significant number developing unhealed wounds. The purpose of this study was to determine factors which may be associated with poor wound healing in patients with pCD who had undergone proctectomy in the biologics era. <h3>Methods</h3> Case record review was carried out of 79 patients with pCD who underwent proctectomy at St Mark’s Hospital between 2005 and 2017. Healing rates at 6 and 12 months post proctectomy were considered and univariate regression analysis was performed. <h3>Results</h3> Complete data regarding healing were available for 97.5% (77/79) at 6 months and 100% at 12 months. 45/77 (43.7%) patients had failure of wound healing at 6 months and 34/79 (33%) at 12 months. A younger age at diagnosis of Crohn’s disease was significantly associated with failure of healing at 12 months (median age 21± 9.7 unhealed; median age 27 ± 13.6 healed; p=0.03). 76.7% (61/79) patients received biologic treatments prior to proctectomy, however exposure to biologics was not a significant factor in predicting failure of wound healing (Infliximab p=0.74; Adalimumab p=0.57; Vedolizumab p=0.21). Current smoking status was not associated with poor wound healing (p=0.18). Other parameters which were not associated with failure of wound healing in our cohort included gender, corticosteroid exposure in the previous one month, thiopurine exposure in previous 3 months, number of biologics exposed to, perianal sepsis on MRI within the last 12 months, Montreal Classification, duration of CD prior to proctectomy, albumin and CRP. <h3>Conclusion</h3> A third of patients have unhealed wounds after 1 year follow-up after protectomy. A younger age at diagnosis of Crohn’s disease was the only factor associated with an unhealed perineal wound; this may in part be due to more severe disease progression in patients diagnosed at a younger age. Larger scale studies are required to determine if other parameters such as exposure to biologics play a role in predicting rates of wound healing.
Temporal Trends in Ischemic Heart Disease Mortality in 21 World Regions, 1980 to 2010
Authors: Andrew E. Moran, Mohammad H. Forouzanfar, Gregory A. Roth, George A. Mensah, Majid Ezzati, Christopher J.L. Murray, Mohsen Naghavi
Journal: Circulation (2014)

Background— Ischemic heart disease (IHD) is the leading cause of death worldwide. The Global Burden of Diseases, Risk Factors and Injuries 2010 Study estimated global and regional IHD mortality from 1980 to 2010. Methods and Results— Sources for IHD mortality estimates were country-level surveillance, verbal autopsy, and vital registration data. Regional income, metabolic and nutritional risk factors, and other covariates were estimated from surveys and a systematic review. An estimation and validation process led to an ensemble model of IHD mortality for 21 world regions. Globally, age-standardized IHD mortality has declined since the 1980s, and high-income regions (especially Australasia, Western Europe, and North America) experienced the most remarkable declines. Age-standardized IHD mortality increased in former Soviet Union countries and South Asia in the 1990s and attenuated after 2000. In 2010, Eastern Europe and Central Asia had the highest age-standardized IHD mortality rates. More IHD deaths occurred in South Asia in 2010 than in any other region. On average, IHD deaths in South Asia, North Africa and the Middle East, and sub-Saharan Africa occurred at younger ages in comparison with most other regions. Conclusions— In most world regions, particularly in high-income regions, age-standardized IHD mortality rates have declined significantly since 1980. High age-standardized IHD mortality in Eastern Europe, Central Asia, and South Asia point to the need to prevent and control established risk factors in those regions and to research the unique behavioral and environmental determinants of higher IHD mortality.
Abstract 42: Expression of interleukin-7 and its signalling intermediates in human neuroblastoma tumours.
Authors: Linda Prasad, Andrew Gayagay, Amanda Charlton, Anthony Henwood, Nicole Graf, Susan Arbuckle, Daniel R. Catchpoole
Journal: Cancer Research (2012)

Abstract Neuroblastoma (NB) is the most common extracranial childhood malignant solid tumour which shows remarkable biological heterogeneity. It has been speculated that schwann cells influence NB tumour growth, by secreting as yet to be identified ‘soluble factors’ that serve as anti-proliferative and differentiation signals for neuronal cells. Several gene expression studies indicate that interleukin 7 (IL7) has increased expression in NB specifically in tumours with a better prognosis, making IL7 a key candidate for this soluble factor. In this study, the expression of IL7, IL7 receptor (IL7R) and its downstream signalling proteins, including the Janus Kinases (JAK1 and JAK3), Signal Transducers and Activators of Transcription (STAT5) and Phosphorylated STAT5 (pSTAT5) were analysed using immunohistochemical stains in a cohort of 100 patients with stroma poor NB and 24 with stroma rich ganglioneuroma (GN). The expression of these proteins were correlated to the expression of the diagnostic markers S100 (stromal marker), NB84 (neuroblast marker) and CD99 (negative marker for NB). The immunohistochemical analysis showed that IL7 expression was strongly positive exclusively in schwannian stroma in both favourable and unfavourable histology whilst staining ganglionic cells as well. The levels of expression, as quantified by specialised digital image analysis algorithms (Aperio, USA), revealed IL7, IL7R, JAK1, STAT5 and pSTAT5 were all increased in GNs compared to NBs. There was no correlated change in expression levels of JAK3 in the tumours. Expression of pStat5 was found to be significantly reduced (t-test, p=0.00013) in stroma poor NB compared to GN. Our findings implicate IL7 within the schwannian stroma of the tumour architecture as having a paracrine signalling effect on neighbouring neuroblasts which may provide the anti-proliferative and differentiation signals postulated. Further investigation of the importance of IL7 in neuroblastoma will define the biological significance of the IL7-Stat5 signalling cascade and whether targeting the specific IL7 signalling pathway proteins will raise novel treatment strategies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 42. doi:1538-7445.AM2012-42
Implementing Evidence-Based Health Policy in Washington State
Authors: Gary M. Franklin, Brian R. Budenholzer
Journal: New England Journal of Medicine (2009)

The Obama administration's infusion of stimulus funds into enhanced comparative-effectiveness research (CER) is in keeping with the conclusion of a recent Commonwealth Fund report that, of the top 15 ways of bringing health care costs under control, CER promises the greatest short- and long-term savings.1 In addition, the report notes, CER efforts are the most likely to reduce the out-of-pocket health care costs of ordinary households. To address the unsustainable increase in overall health care expenditures — a matter made more urgent by the financial challenge of providing health care coverage for all citizens in the state — the Washington . . .
A Very Rare Case of Nonfunctioning Pituitary Adenoma Incidentally Disclosed at 18F-FDG PET/CT
Authors: Pietro Maffei, Maria Cristina Marzola, Alessandra Musto, Francesca Dassie, Gaia Grassetto, Eugenio De Carlo, Lucia Rampin, Sotirios Chondrogiannis, Arianna Massaro, Maria Rosa Pelizzo, Domenico Rubello
Journal: Clinical Nuclear Medicine (2012)

This is a case of a 48-year-old man treated with surgery and (131)I for papillary thyroid carcinoma: a follow-up (18)F-FDG PET/CT incidentally evidenced pituitary uptake, also seen in (111)In-octreoscan as increased uptake in the sellar area. MRI confirmed a pituitary mass. The patient did not show any signs or symptoms related to this lesion; 1 year later, both PET/CT and MRI findings remained unchanged. Surgery confirmed nonfunctioning benign pituitary adenoma. This single case observed in 12,873 consecutive patients scanned in our center confirms the possibility that nonfunctioning benign pituitary adenomas may be FDG-avid: uptake mechanisms remain unknown, and targeted studies are needed.
New function for high density lipoproteins. Isolation and characterization of a bacterial lipopolysaccharide-high density lipoprotein complex formed in rabbit plasma.
Authors: R J Ulevitch, A R Johnston, D B Weinstein
Journal: Journal of Clinical Investigation (1981)

The addition of bacterial lipopolysaccharide (LPS) from Salmonella minnesota R595 to rabbit plasma results in a marked reduction of the hydrated buoyant density of the parent R595 LPS, from 1.38 to less than 1.2 g/cm3. Using immunopurified anti-R595 LPS antibody covalently linked to Sepharose 4B, we were able to separate the altered R595 LPS (d less than 1.2 g/cm3) from the remainder of the plasma proteins by elution of the bound material with 2.5 M KSCN. The KSCN eluate was shown to have a d less than 1.2 g/cm3 and to contain both R595 LPS as well as protein and lipid characteristic of high density lipoprotein (HDL). The major protein in the KSCN eluate is a single polypeptide chain with an apparent molecular weight of 26,000 in sodium dodecyl sulfate and an amino acid composition essentially identical to that of apoprotein AI, the major protein of rabbit HDL. The lipid composition of the KSCN eluate is similar to that of HDL, although marked differences in the cholesterol ester/cholesterol ration and the phosphatidyl choline/phosphatidyl ethanolamine ratio were observed when the KSCN eluate and rabbit HDL were compared. The formation of this R595 LPS-protein-lipid complex in plasma accounts for the marked reduction in buoyant density found when LPS is added to plasma.
Notch Pathway Targets Proangiogenic Regulator Sox17 to Restrict Angiogenesis
Authors: Seung-Hun Lee, Sungsu Lee, Hanseul Yang, Sukhyun Song, Kangsan Kim, Thomas L. Saunders, Jeong K. Yoon, Gou Young Koh, Injune Kim
Journal: Circulation Research (2014)

The Notch pathway stabilizes sprouting angiogenesis by favoring stalk cells over tip cells at the vascular front. Because tip and stalk cells have different properties in morphology and function, their transcriptional regulation remains to be distinguished. Transcription factor Sox17 is specifically expressed in endothelial cells, but its expression and role at the vascular front remain largely unknown.To specify the role of Sox17 and its relationship with the Notch pathway in sprouting angiogenesis.Endothelial-specific Sox17 deletion reduces sprouting angiogenesis in mouse embryonic and postnatal vascular development, whereas Sox17 overexpression increases it. Sox17 promotes endothelial migration by destabilizing endothelial junctions and rearranging cytoskeletal structure and upregulates expression of several genes preferentially expressed in tip cells. Interestingly, Sox17 expression is suppressed in stalk cells in which Notch signaling is relatively high. Notch activation by overexpressing Notch intracellular domain reduces Sox17 expression both in primary endothelial cells and in retinal angiogenesis, whereas Notch inhibition by delta-like ligand 4 (Dll4) blockade increases it. The Notch pathway regulates Sox17 expression mainly at the post-transcriptional level. Furthermore, endothelial Sox17 ablation rescues vascular network from excessive tip cell formation and hyperbranching under Notch inhibition in developmental and tumor angiogenesis.Our findings demonstrate that the Notch pathway restricts sprouting angiogenesis by reducing the expression of proangiogenic regulator Sox17.
Smoking and the Coronary Arteries
Authors: Burritt S. Lacy
Journal: JAMA (1968)

To the Editor:—  Dr. Seltzer's thoughtful and well-documented review of  and Coronary Heart Disease ( 203 :193, 1968) makes no reference to personality factors. Perhaps there are no research data about personality differences of the cigarette smoker in contrast to the pipe or cigar smoker, but popular attitudes generally suggest that the pipe or cigar smoker is more phlegmatic and less likely to suffer from tension states. A striking difference in the incidence of coronary disease is found between the two groups. Apparently the Surgeon General's Advisory Committee on Smoking and Health (quoted by Dr. Seltzer) in its list of predisposing factors mentioned only occupations involving—stress and ignored individual personality factors basic to psychomatic disturbances, which may predispose to coronary heart disease.
Post-mastectomy breast reconstruction
Authors: P. T. R. Thiruchelvam, F. McNeill, N. Jallali, P. Harris, K. Hogben
Journal: BMJ (2013)

#### Summary points

Breast cancer is the most common cancer in women, with almost 1.38 million new cases a year worldwide; it accounts for 23% of all cancers and 14% of deaths from cancer.1 However, mortality from breast cancer is declining—increasing numbers of women are long term survivors (>5 years) (currently 549 000 in the United Kingdom).2 3 Surgery remains a mainstay of treatment, either breast conservation or mastectomy, but any breast surgery can greatly alter breast aesthetics and body image.

Breast reconstruction restores breast symmetry after a mastectomy by creating a breast mound, similar in size, shape, contour, and “out of bra position” to the contralateral breast. In England and Wales in 2002, about 10% of women had immediate breast reconstruction; by 2009 this had risen to 21%.4 Post-mastectomy breast reconstruction is associated with improved body image, quality of life, self confidence, and wellbeing.5

In this review, we outline the indications for breast reconstruction along with the timing and techniques available to patients after mastectomy.

#### Sources and selection criteria

We searched Medline, Embase, and the Cochrane collaboration for articles using the keywords “breast reconstruction”. Wherever possible we used evidence from randomised controlled trials, systematic reviews, and meta-analyses from the past five years to provide an up to date review. We also consulted …
Why Pakistani Medical Graduates Must Remain Free to Emigrate
Authors: Zarmeneh Aly, Fawad Taj
Journal: PLoS Medicine (2008)

The current debate about the brain drain of health professionals from low-income countries such as Pakistan to the rich world often demonizes medical graduates who choose to leave their countries. Such graduates are sometimes considered to be insensitive to the plight of their country's struggling health sector. But what is forgotten in this debate is that some doctors who emigrate to the West have every intention of returning after their higher-level training overseas. And while the brain drain is often blamed for Pakistan's difficulty in meeting its people's health care needs, other factors play a major role, including the increasing demand for health care from the growing population and the adverse conditions that cause disease [1].
Enhanced gene delivery in porcine vasculature tissue following incorporation of adeno-associated virus nanoparticles into porous silicon microparticles
Authors: Kellie I. McConnell, Jessica Rhudy, Kenji Yokoi, Jianhua Gu, Aaron Mack, Junghae Suh, Saverio La Francesca, Jason Sakamoto, Rita E. Serda
Journal: Journal of Controlled Release (2014)
Risk of gastrointestinal effects with COX-2 inhibitors and NSAIDs: COX-2 inhibitors were thought of as a safe option
Authors: Michael R Lewis, Diana Kay
Journal: BMJ (2005)

Rationing in response to NHS deficits: rural patients are likely to be affected most See News, p 1426Editor-News that pressing financial problems have caused NHS trusts in Suffolk to set new "thresholds" to treatments such as joint replacements reinforces concerns raised by a recent BMA survey of medical directors of trusts in which over a third of respondents anticipated reductions of key services in response to funding shortfalls. 1 2 What has hitherto escaped comment is how cuts in services are far more likely to be felt in some parts of the country than others.Deficits in the NHS are invariably presented as a problem of financial mismanagement, but the pattern of deficits shows that the current resource allocation model discriminates against particular communities.According to the recently published accounts for 2004-5, 3 89 out of 303 (30%) English primary care trusts ended the year in deficit.The table shows how 301 of these trusts are distributed accorded to fifths of deprivation and rurality.Primary care trusts serving populations that are in both the most rural and the least deprived fifth were most likely to be in financial difficulties.Seventeen of the 25 (68%) in this category were in deficit.These trusts received the lowest funding allocation per head (£995).By contrast, only 3% (one of 34) of the primary care trusts serving populations that are in both the most urban and the most deprived fifths failed to break even in 2004-5.These trusts received the highest funding allocations per head (£1405).This shows that poor financial management can at best only partly explain why some trusts are in deficit.The pattern of deficits implies that NHS funding provides insufficient resources for rural areas, for comparatively affluent areas, and, most particularly, for areas that are both rural and affluent.The risk is that such measures will result in NHS services being subject to a new postcode lottery, in which rural residents are more likely to lose out.