tbuckley/cabot-search huggingface dataset:
Cell-surface expression of the TLR homolog CD180 in circulating cells from splenic and nodal marginal zone lymphomas
Authors: L Miguet, S Lennon, L Baseggio, A Traverse-Glehen, F Berger, N Perrusson, M-P Chenard, A-C Galoisy, A Eischen, C Mayeur-Rousse, A Maar, L Fornecker, R Herbrecht, P Felman, A Van Dorsselaer, C Carapito, S Cianférani, L Mauvieux
Journal: Leukemia (2013)
Editorial: Jangled semantics
Authors: R. H. Moser
Journal: JAMA (1975)

Yesterday, I stumbled once again over that most offensive expression "health care delivery (HCD)." It was sticking out like porcupine quills from a very badly written manuscript. I suspect what disturbs me about HCD is a combination of the semantics and implied philosophy. I honestly don't know what "health care" is—and the only "deliverers" I know (since the iceman no longer cometh) are the milkman, the postman, the obstetrician, or Moses. We are still mostly engaged in "sickness cure," counterpunching—responding—after the patient becomes ill. We are a long way from maintaining "health"—keeping people well—which gets into the whole gestalt of prophylacticpreventive medicine. There are some soft-headed savants—scientic planners in high places—who become enraptured with the sibilance of certain words. "Salvation will come through an enlightened program of health care delivery." Well, aside from chlorinating and fluorinating water, taking the appropriate immunization inoculations at the appropriate age and washing one's hands
Renal Tubular Permeability during Increased Intrarenal Pressure
Authors: William B. Lorentz, William E. Lassiter, Carl W. Gottschalk
Journal: Journal of Clinical Investigation (1972)

Renal tubular permeability was studied by microinjection techniques during increased intrarenal pressure in anesthetized diuretic rats. Intrarenal pressure, as evidenced by intratubular pressure (ITP), was increased by elevation of ureteral pressure, partial renal venous constriction, or massive saline diuresis. Various combinations of radioactive inulin, creatinine, mannitol, sucrose, and iothalamate in isotonic saline were microinjected into superficial proximal and distal convolutions, and recovery of the isotopes was measured in the urine. Inulin was completely recovered in the urine from the injected kidney at both normal and elevated ITP. Creatinine, mannitol, sucrose, and iothalamate were also completely recovered at normal ITP, but recoveries were significantly lower, averaging 73, 85, 89, and 85%, respectively, after early proximal injection when proximal ITP was increased to 30+/-2 mm Hg by elevation of ureteral pressure. Since transit time is prolonged under these conditions, mannitol recovery was also studied during aortic constriction, which prolongs transit time but lowers ITP. Recovery was complete. A significant loss of mannitol was observed during massive saline diuresis, which shortens transit time but increases ITP. During renal venous constriction producing a proximal ITP of 30+/-2 mm Hg, mannitol recovery was significantly less than 100% even after microinjection into distal convolutions, but the loss was greater injection at more proximal puncture sites. Mannitol recovery was complete during elevation of ureteral pressure in the contralateral kidney. These studies demonstrate a change in the permeability characteristics of all major segments of the renal tubule during elevation of intrarenal pressure. This change is rapidly reversible and does not appear to be due to a humoral factor which gains access to the general circulation.
A sign of the time
Authors: D. Spence
Journal: BMJ (2009)

One of my friends in general practice has that rarest of gifts, interesting opinions. He has a challenging suggestion: that top medical students intercalate a year in a trade college studying plumbing or joinery, rather than spending time on the metabolism of protactinium in osteopenic pygmy guinea pigs in a science degree. His reasons are twofold: firstly, the medical hoi polloi would be spared the pulled faces of academic supremacy; secondly, we could defend the profession from the common jibe that we are “bright but can’t change …
SYPHILITIC DISEASES OF THE EYE.Read to the Kentucky State Medical Society at Shelbyville, June 7, 1894.
Authors: DUDLEY S. REYNOLDS
Journal: JAMA (1894)

The syphilitic diseases of the eye should be divided into classes, and for the sake of convenience, I should prefer to consider them as of the acquired and inherited. Then I should divide the inherited types: 1, those in whom the disease has been so recently acquired by the mother as that the secondary roseola appears some time after birth, or, about that time; 2, those in whom the syphilitic evolution has been apparently completed in the mother before pregnancy. Just how to reach that class of the third and fourth generations of syphilitic patients it is difficult to formulate rules, and I prefer making my third division embrace victims of<i>remote inheritance</i>. If the syphilized mother has apparently recovered, and gives birth to a child with certain structural defects, such for example, as those imperfect developments of the lymphatic system described by Dr. Formad in his report on the
Immunoglobulin M antibody to hepatitis C virus core antigen: Correlations with viral replication, histological activity, and liver disease outcome
Authors: Juan Antonio Quiroga, Jan van Binsbergen, Chang Yi Wang, Margarita Pardo, Sonia Navas, Chantal Trines, Montserrat Herrero, Vicente Carreno
Journal: Hepatology (1995)

Immunoglobulin M (IgM) antibody to hepatitis C core antigen (anti-HCV-core) was tested by enzyme immunoassay against a synthetic peptide representing amino acids 1 to 62 of the core protein. Of 214 patients with different categories of histological activity, 193 (90%) showed positive results for IgM anti-HCV-core, and 207 (97%) had HCV RNA; most cases (186, 87%) had both markers detectable simultaneously. No differences in the frequency of IgM anti-HCV-core were observed with respect to epidemiological, biochemical, or histological parameters. In 175 interferon alfa (IFN-alpha) recipients, and in 39 untreated controls, pretreatment IgM anti-HCV-core frequencies were similar: 28 of 32 (88%) in sustained responders; 55 of 61 (90%) in responders with relapse; 72 of 82 (88%) in nonresponders; and 38 of 39 (97%) in untreated controls. After IFN-alpha therapy, IgM anti-HCV-core levels became undetectable with significantly greater frequency in sustained responders (P = .014); a similar trend was observed for HCV RNA (P < .0001). IgM anti-HCV-core levels decreased after therapy in responders (P < .001) but increased in nonresponders. Fifty-one cases were longitudinally tested in relation to long-term disease outcome. Both markers remained detectable in most nonresponders with persistent liver disease, in most responders before relapse, and in all but one case at the time of biochemical relapse. IgM anti-HCV-core and HCV RNA became undetectable in most sustained responders, but reappeared despite a long-lasting transaminase normalization, behaving as asymptomatic HCV carriers; the possibility that disease reactivation may take place years afterwards cannot be excluded.(ABSTRACT TRUNCATED AT 250 WORDS)
The Resource-Based Relative Value Scale
Authors: Jan R. J. deVries
Journal: JAMA (1989)

<h3>To the Editor.—</h3> Hsiao and associates<sup>1</sup>calculate the "ratio of Medicare mean charge to resource-based relative values" in their article. Fairness seems to suggest that Medicare maximum allowable actual charges be recalculated to more closely conform to the reasonable goal that all physicians, regardless of specialty choices, be paid on a comparable scale. The predicted shortage of family physicians in a world of a predicted "glut" of physicians in general could then probably be avoided, and patients better served. Several editorials<sup>2-4</sup>comment on that matter, and especially on the "budget neutrality," which is of such interest to Congress. In the discussions on the matter of converting resource-based relative values into a fee schedule, one element seems not to be given the attention it deserves. Medicare does not "set" fees, physicians do. Medicare determines a schedule of maximum allowable charges, and physicians must decide if they can or cannot
Withdrawing Payment for Nonscientific Drug Therapy
Authors: Stephen B. Soumerai
Journal: JAMA (1990)

Little is known about the effect on clinical decision making of nonreimbursement for ineffective medical technologies. Using a time-series design, we studied the effects of cessation of government payment for 12 categories of drugs of questionable efficacy (Drug Efficacy Study Implementation drugs) in a random sample of the New Jersey Medicaid population (N = 390 465) and in four cohorts of regular users of these products. We measured changes in the overall levels of prescriptions, expenditures, and physicians' use of substitute drugs. Although withdrawn drugs accounted for 7% of prescriptions in the base year, there was no measurable reduction in overall drug use or expenditures after the regulation; prescription rates actually rose from 0.86 to 1.00 monthly prescriptions per enrollee throughout the 42-month study. Controlling for preexisting trends, an estimated drop in the use of study drugs of 21.7 prescriptions per 1000 enrollees per month was offset by an increase in the use of substitute drugs of 33.7 prescriptions. Both desirable and unimproved therapeutic substitutions were observed. Used alone, curtailment of reimbursement for marginally effective therapies results in both desirable and unintended clinical substitutions and may not reduce costs. Supplementing such restrictions with education may be necessary to promote practices that are more therapeutically and economically appropriate. (<i>JAMA</i>. 1990;263:831-839)
Beyond Belief: Scenes from the Shipman Inquiry
Authors: Bruno Rushforth
Journal: BMJ (2004)

Edited by Dennis Woolf Library Theatre, Manchester, until 20 November 2004 Rating: ![Graphic][1]</img>![Graphic][2]</img> T he public inquiry into the criminal activities of Harold Shipman, a general practitioner in Hyde, Greater Manchester, found that the once much respected family doctor had killed more than 200 of his patients by diamorphine injection. Most of us are familiar with these bare facts. But what about the personal stories behind the statistics of Britain's most prolific mass murderer? For me it was only through the chilling experience of coming across his name in patients' notes and chance meetings with those who had known him, during my community training as a medical student in Manchester, that the true horror of his crimes began to take on any real meaning. Beyond Belief: Scenes from the Shipman Inquiry uses edited verbatim transcripts from the public inquiry, with actors playing lawyers and witnesses, to piece together how Shipman escaped detection for so long. But in addition to presenting this stark narrative, the production also focuses on the personal tragedies of those affected by his … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif
Decline in US abortion rate has stalled, report says
Authors: J. H. Tanne
Journal: BMJ (2011)

Numbers of abortions in the United States, which have been falling since 1981, rose slightly from 19.4 per 1000 women aged 15 to 44 in 2005 to 19.6 in 2008, the non-profit Guttmacher Institute has reported.

The 2008 rate was well below the peak of 29.3 abortions per 1000 women in 1981, but the steady decline in the US rate “appears to have stalled,” the report says. The study was unable to verify claims that the recession has led to a higher number of abortions, because “the small increase in abortion incidence began before the recession,” which started in late 2007.

The US has one of the highest abortion rates in the developed world, said Lawrence Finer, associate director for domestic research at the institute.

The US Centers …
Changing Patterns of In-Hospital Deaths Following Implementation of Damage Control Resuscitation Practices in US Forward Military Treatment Facilities
Authors: Nicholas R. Langan, Matthew Eckert, Matthew J. Martin
Journal: JAMA Surgery (2014)

Analysis of combat deaths provides invaluable epidemiologic and quality-improvement data for trauma centers and is particularly important under rapidly evolving battlefield conditions.To analyze the evolution of injury patterns, early care, and resuscitation among patients who subsequently died in the hospital, before and after implementation of damage control resuscitation (DCR) policies.In a review of the Joint Theater Trauma Registry (2002-2011) of US forward combat hospitals, cohorts of patients with vital signs at presentation and subsequent in-hospital death were grouped into 2 time periods: pre-DCR (before 2006) and DCR (2006-2011).Injury types and Injury Severity Scores (ISSs), timing and location of death, and initial (24-hour) and total volume of blood products and fluid administered.Of 57,179 soldiers admitted to a forward combat hospital, 2565 (4.5%) subsequently died in the hospital. The majority of patients (74%) were severely injured (ISS > 15), and 80% died within 24 hours of admission. Damage control resuscitation policies were widely implemented by 2006 and resulted in a decrease in mean 24-hour crystalloid infusion volume (6.1-3.2 L) and increased fresh frozen plasma use (3.2-10.1 U) (both P < .05) in this population. The mean packed red blood cells to fresh frozen plasma ratio changed from 2.6:1 during the pre-DCR period to 1.4:1 during the DCR period (P < .01). There was a significant increase in mean ISS between cohorts (pre-DCR ISS = 23 vs DCR ISS = 27; P < .05) and a marked shift in injury patterns favoring more severe head trauma in the DCR cohort.There has been a significant shift in resuscitation practices in forward combat hospitals indicating widespread military adoption of DCR. Patients who died in a hospital during the DCR period were more likely to be severely injured and have a severe brain injury, consistent with a decrease in deaths among potentially salvageable patients.
Parental Electrocardiographic Screening Identifies a High Degree of Inheritance for Congenital and Childhood Nonimmune Isolated Atrioventricular Block
Authors: Alban-Elouen Baruteau, Albin Behaghel, Swanny Fouchard, Philippe Mabo, Jean-Jacques Schott, Christian Dina, Stéphanie Chatel, Elisabeth Villain, Jean-Benoit Thambo, François Marçon, Véronique Gournay, Francis Rouault, Alain Chantepie, Sophie Guillaumont, François Godart, Raphaël P. Martins, Béatrice Delasalle, Caroline Bonnet, Alain Fraisse, Jean-Marc Schleich, Jean-René Lusson, Yves Dulac, Jean-Claude Daubert, Hervé Le Marec, Vincent Probst
Journal: Circulation (2012)

The origin of congenital or childhood nonimmune isolated atrioventricular (AV) block remains unknown. We hypothesized that this conduction abnormality in the young may be a heritable disease.A multicenter retrospective study (13 French referral centers, from 1980-2009) included 141 children with AV block diagnosed in utero, at birth, or before 15 years of age without structural heart abnormalities and without maternal antibodies. Parents and matched control subjects were investigated for family history and for ECG screening. In parents, a family history of sudden death or progressive cardiac conduction defect was found in 1.4% and 11.1%, respectively. Screening ECGs from 130 parents (mean age 42.0 ± 6.8 years, 57 couples) were compared with those of 130 matched healthy control subjects. All parents were asymptomatic and in sinus rhythm, except for 1 with undetected complete AV block. Conduction abnormalities were more frequent in parents than in control subjects, found in 50.8% versus 4.6%, respectively (P<0.001). A long PR interval was found in 18.5% of the parents but never in control subjects (P<0.0001). Complete or incomplete right bundle-branch block was observed in 39.2% of the parents and 1.5% of the control subjects (P<0.0001). Complete or incomplete left bundle-branch block was found in 15.4% of the parents and 3.1% of the control subjects (P<0.0006). Estimated heritability for isolated conduction disturbances was 91% (95% confidence interval, 80%-100%). SCN5A mutation screening identified 2 mutations in 2 patients among 97 children.ECG screening in parents of children affected by idiopathic AV block revealed a high prevalence of conduction abnormalities. These results support the hypothesis of an inheritable trait in congenital and childhood nonimmune isolated AV block.
Medical Care of the Cancer Patient
Authors: Richard J. Ugoretz
Journal: JAMA (1993)

Interns and residents do not seem to have the same enthusiasm for building a professional library they had in years past. Perhaps this is because modern textbooks are too big, too expensive, and too quickly obsolete to be an attractive investment. Ready access to on-line databases may be another factor. The sight of a house officer searching the medical literature via computer before or during rounds is becoming commonplace. What if, however, there were a reasonably comprehensive, very current textbook of medical oncology in a format so portable that it could be easily slipped in a handbag or coat pocket? If you doubt that this can be achieved without major sacrifices of content or detail,<i>Medical Care of the Cancer Patient</i>may change your mind. Appearing six years after the first edition, this succinct and pragmatic survey of cancer medicine retains all the excellent features of the original. References, though
Mayo Clinic Internal Medicine Review
Authors: Linda Pinsky
Journal: JAMA (2009)

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
Liver Transplantation in a Hemophiliac
Authors: J H Lewis, F A Bontempo, J A Spero, M V Ragni, T E Starzl
Journal: New England Journal of Medicine (1985)

To the Editor: A cure rather than a treatment has long been the goal of those caring for and those suffering from hemophilia. Encouraging results were obtained some years ago with the transplantation of normal livers into a dog with mild hemophilia 1,2 and into four others with severe hemophilia.3 Two dogs given transplants survived more than 100 days and produced coagulation factor VIII in quantities sufficient to maintain normal levels.

The first “cure” in a human being appears to have been achieved, at least temporarily, in a 15-year-old boy with hemophilia and severe chronic active hepatitis, who received a liver from a 9-year-old “normal” donor on March 5, 1985. The patient was given the diagnosis of hemophilia A in early childhood and has been followed at the Hemophilia Center, Children’s Memorial Hospital, Northwestern School of Medicine, Chicago, by Dr. John Paul Scott. In 1969 he had severe hepatitis B; positivity for hepatitis B surface antigen and antibody to hepatitis B e has persisted. In addition, therapy-related non A,non B hepatitis may have contributed to his liver disease. About four months before liver transplantation, a splenectomy was performed for chronic thrombocytopenia, which resolved postoperatively, but a residual pancreaticogastrocutaneous fistula remained. Liver transplantation and repair of the fistula were accomplished with less than the average blood loss. Before, during, and for 18 hours after liver transplantation, the patient’s factor VIII level was maintained at 0.54 to 1.60 U per milliliter by intermittent infusions of heat-treated factor VIII concentrate. From 18 hours after operation to the time of this writing (April 17), his level has been sustained at 1.0 to 3.0 U per milliliter without exogenous treatment. The high postoperative levels of factor VIII are similar to those seen after transplantation in patients without hemophilia. Eight days after operation the patient underwent repair of a bile duct. There was no increased hemorrhage, and he required no factor VIII treatment.

Although in this case, at least temporarily, internal production of factor VIII has been achieved by the implanted liver, liver transplantation cannot be recommended as a “cure” for hemophilia. This drastic operation is justified only for end-stage liver disease because of the risks of lifelong immunosuppressive therapy, rejection, infection, and recurrence of disease. The duration of production of factor VIII is unknown. This case suggests that the antihemophilic activity (factor VIII:C) of the large factor VIII complex, synthesized in endothelium.4,5 is acquired in the liver.
Azurophilic granules in myeloma cells
Authors: Barbara J. Bain, Wenchee Siow, Amin Rahemtulla, Saad Abdalla
Journal: American Journal of Hematology (2013)

In this patient with immunoglobulin G kappa myeloma a large proportion of the myeloma cells contained azurophilic granules, sometimes round and sometimes irregular (image). By analogy with the azurophilic Auer rod-like inclusions with similar staining characteristics that may be observed in myeloma 1, 2, it is likely that these inclusions are of lysosomal origin. In one reported case, the granules were positive for acid phosphatase and weakly positive for alpha naphthyl butyrate esterase; on ultrastructural examination they were distinct from the endoplasmic reticulum and were considered likely to be vacuoles of the lysosomal system 3. Azurophilic cytoplasmic granules have been observed in association with both kappa 4 and lambda 3 light chains.