tbuckley/cabot-search huggingface dataset:
Effectiveness of Differential Leukocyte Count in Case Finding in the Ambulatory Care Setting
Authors: Eugene C. Rich
Journal: JAMA (1983)

The value of the differential leukocyte count in case finding in the ambulatory care setting was evaluated by retrospectively reviewing 799 encounters resulting in complete blood cell counts. Four hundred seventy-five differential leukocyte counts, of which 63 were abnormal, met criteria for case finding. No clinically inapparent disease was discovered through the use of these tests. These data suggest that the quantitative cell counts of the differential leukocyte examination may be of no value in case finding in the ambulatory care setting. (<i>JAMA</i>1983;249:633-636)
Portable lung ventilators: the potential risk from bacterial colonisation
Authors: M. P. Shelly, G. R. Park, R. E. Warren, R. J. Whetstone
Journal: Intensive Care Medicine (1986)

Seven portable lung ventilators were investigated to assess the risk of bacterial colonization of the ventilator valve. One valve was deliberately contaminated with Serratia marcescens and the survival of organisms within the valve studied. Periods of colonization by Acinetobacter were found in all the hospital ventilators studied but none of those from the ambulance service. The potential risk to the patient from this organism is discussed and the importance of adequate storage and regular cleaning of the ventilator valve emphasised. Since humidification of the patients inspired gas during transfer is desirable, the use of a combined heat and moisture exchanger and microbiological filter would appear advisable.
Reported Practice Behaviors for Medical Care of Patients With Diabetes Mellitus by Primary-Care Physicians in Pennsylvania
Authors: CHM Jacques, Robert L Jones, Peter Houts, Laurence C Bauer, Kathleen M Dwyer, James C Lynch, Toni San Maria Casale
Journal: Diabetes Care (1991)

Objective To compare the American Diabetes Association standards for the medical care of diabetic patients with reported care patterns. Research Design and Methods These standards were compared with reported care patterns obtained from a stratified random telephone survey of general practitioners, family physicians, and general internists in Pennsylvania. A total of 610 physicians completed the survey for a response rate of 73%. Results All primary-care physicians reported measurement of glycosylated hemoglobin, routine referrals to eye doctors, and patient self-monitoring of blood glucose &amp;lt; recommended. Nearly all physicians performed foot exams, but the exams were infrequent for many of the physicians. Significant and independent differences (P &amp;lt; 0.05) were noted between different groups of physicians. Older physicians and general practitioners reported patterns of care most different from the recommended standards for referral to eye doctors, measurement of glycosylated hemoglobin, and use of patient self-monitoring of blood glucose. General practitioners reported the lowest frequency of foot exams. Conclusions Educational programs on diabetes for primary-care physicians should focus on reported behaviors most different from recommended standards and may need to target subgroups of physicians to achieve a more uniform level of care for all diabetic patients.
Workshop III. Management of Reiter's syndrome.
Authors: A Calin
Journal: Annals of the Rheumatic Diseases (1979)

Reiter's syndrome (RS) may be defined as shown in the Table .The various manifestations may provide a triad, tetrad, pentad, or hexad of features.Depend- ing on the severity of the disease, the time at which the patient is seen, the obsession of the physician, and other variables, few or many characteristics may be found.For example, the patient may present with only urethritis and Achilles tendinitis or may have all the features shown in the Table 53 as well as fever, anaemia, cardiac disease, and other mani- festations52.There is no cure for RS.Few rheumatic syndromes are more frustrating to treat.False expectations of the patient (and sometimes physician) often result in doctor 'shopping'.The plethora of new non-steroidal anti-inflammatory drugs has not improved therapy.Explanation is a major part of management.The disease is often bewildering and disturbing for the patient and family.Feelings of guilt and anxiety about sexual misconduct should be allayed.Although anecdotal evidence suggests that certain patients with post-venereal RS are more likely to relapse after a sexual indiscretion, many develop an exacerbation without obvious cause.It may be useful to provide the patient with an 'allergic' analogy-that some people have a tendency to develop asthma or hayfever on exposure to known or unknown allergens while others have a genetically determined susceptibility to develop RS after con- tact with an unrecognised (or recognised) precipitating event.This approach provides the patient with some insight into the recurrent nature of the condition and aids discussion about prognosis.Although there are no control data, there is some suggestion that the use of a condom protects the patient from a post-venereal exacerbation.Apart *In our experience arthritis or enthesiopathy dan in a sizeable proportion of patients continue unabated despite anti- inflammatory treatment to tolerance (for example, phenylbutazone 800 mg/day)-Editor.
Fixed dose combinations of cardiovascular drugs
Authors: M. D. Huffman
Journal: BMJ (2014)

One of the most feasible ways to improve adherence

Drug treatment for cardiovascular disease remains inadequate globally,1 and many adults with cardiovascular disease or a high risk of cardiovascular disease receive no drug treatment. In response, the World Health Organization and its member states have agreed on a target to treat 50% of eligible adults with a multidrug regimen by 2025 as part of its wider “25×25” goal: to reduce the burden of premature, non-communicable, chronic diseases by 25% by 2025.2

Fixed dose combinations, or polypills, combine multiple drugs into one tablet and often include an antiplatelet agent, a lipid lowering drug, and at least one blood pressure lowering drug. Fixed dose combinations improve adherence to treatment for people with hypertension and HIV by approximately 25%.3 They are also an attractive drug delivery mechanism for adults with cardiovascular disease, not just to achieve the 50% drug treatment and premature mortality targets of the 25×25 goal but more specifically to reduce the global burden of cardiovascular disease.

In a linked paper, Selak and colleagues (doi:10.1136/bmj.g3318) sought to evaluate the effect of two fixed dose combination treatments on self reported adherence, blood pressure, and lipid levels in primary care patients from New Zealand with cardiovascular disease or a high risk …
Gene Conversion Drives the Evolution of HINTW, an Ampliconic Gene on the Female-Specific Avian W Chromosome
Authors: Niclas Backström, Helene Ceplitis, Sofia Berlin, Hans Ellegren
Journal: Molecular Biology and Evolution (2005)

The HINTW gene on the female-specific W chromosome of chicken and other birds is amplified and present in numerous copies. Moreover, as HINTW is distinctly different from its homolog on the Z chromosome (HINTZ), is a candidate gene in avian sex determination, and evolves rapidly under positive selection, it shows several common features to ampliconic and testis-specific genes on the mammalian Y chromosome. A phylogenetic analysis within galliform birds (chicken, turkey, quail, and pheasant) shows that individual HINTW copies within each species are more similar to each other than to gene copies of related species. Such convergent evolution is most easily explained by recurrent events of gene conversion, the rate of which we estimated at 10−6–10−5 per site and generation. A significantly higher GC content of HINTW than of other W-linked genes is consistent with biased gene conversion increasing the fixation probability of mutations involving G and C nucleotides. Furthermore, and as a likely consequence, the neutral substitution rate is almost twice as high in HINTW as in other W-linked genes. The region on W encompassing the HINTW gene cluster is not covered in the initial assembly of the chicken genome, but analysis of raw sequence reads indicates that gene copy number is significantly higher than a previous estimate of 40. While sexual selection is one of several factors that potentially affect the evolution of ampliconic, male-specific genes on the mammalian Y chromosome, data from HINTW provide evidence that gene amplification followed by gene conversion can evolve in female-specific chromosomes in the absence of sexual selection. The presence of multiple and highly similar copies of HINTW may be related to protein function, but, more generally, amplification and conversion offers a means to the avoidance of accumulation of deleterious mutations in nonrecombining chromosomes.
Pharmaceutical Benefits Managers and Optimizing Prescribing
Authors: Stephen B. Soumerai, Helene L. Lipton
Journal: JAMA (1999)

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
Anticoagulants in venous thromboembolism.
Authors: A. Fennerty, I. A. Campbell, P. A. Routledge
Journal: BMJ (1988)

year: rather it cumulatively lowers the ability of the hospital and community services to meet health care needs.2On the capital side the hospital and community services are to receive an extra £89m (11% extra), taking their provision to £92 1m.The government estimates that land and other estate sales will raise another £280m, bringing total capital spending to just over £1-2 billion.As with revenue, money raised by health authorities -in this case from the once and for all sale ofland and buildings-makes the most important contribution to financial growth.The supply of salable NHS land is, however, strictly limited and will not provide an inexhaustible supply of cash.Inflation at 6% would reduce the capital allocation increase to about £300m, and yet the Public Accounts Committee has estimated that some £2 billion is needed just to bring existing hospitals up to standard.3The family practitioner services will receive an increase of £280m next year, 6-6% above this year's estimated spending.Inflation at 6% will reduce this to a real increase of just £2-6m (0 6%).Yet again it is savings in the form of reduced superannuation contributions of £40m that recover the budget.The resulting real increase of 1 6% is, however, the lowest since 1981-2 apart from that in 1985-6.
An Evaluation of Endoscopic Retrograde Pancreatography (ERP) in Chronic and Relapsing Acute Pancreatitis
Authors: Cl. Liguory, G. Caletti
Journal: Endoscopy (1976)

The results of ERP carried out in a series of cases of established and suspected chronic and acute relapsing pancreatitis are presented. Radiological findings are divided into major and minor alterations of the pancreatic secretory system. X-ray findings are easy to interprete in chronic pancreatitis with major alterations. Minor anomalies of the pancreas are difficult to interprete in the absence of supporting evidence. Biliary tract involvement is useful for diagnosis of chronic pancreatitis.
Interleukin interrupted: A new strategy for the treatment of pancreatic cancer
Authors: Steven D. Leach
Journal: The Journal of Experimental Medicine (2015)

![Figure][1] 

Insight from Steven Leach



Pancreatic cancer is an aggressively metastatic cancer with a high mortality rate, but the mechanisms underlying this aggression are not yet fully understood. In this issue, [Wu et al.][2] shed some light on this subject. They report that pancreatic
S22 Analysis of the lung microbiome in human asthma using whole genome shot-gun metagenomics
Authors: TSC Hinks, S Handley, B Keller, L Droit, KJ Staples, C Smith, PH Howarth, HW Virgin, SD Gadola, R Djukanovic
Journal: Thorax (2013)

<h3>Introduction and Objectives</h3> Evidence is accumulating for the presence of bacteria in the airways and the existence of a commensal airway microbiome. Molecular techniques reveal complex microbial assemblages in bronchiectasis and COPD, but little is known about the airway microbiome in asthma or in health. Immunopathology in asthma may be driven by bacteria or fungi or even by chronic viral persistence. We undertook an analysis of the entire respiratory microbial metagenome in airway samples from carefully phenotyped subjects across a spectrum of asthma and health. <h3>Methods</h3> 55 subjects (9 mild asthmatics, 16 moderate asthmatics, 15 with severe neutrophilic asthma without bronchiectasis and 15 healthy controls) underwent detailed clinical and immunological phenotyping, sputum induction, and bronchoscopy during periods of clinical stability. Protected bronchoalveolar lavage (BAL) and induced sputum were analysed by whole genome shot-gun sequencing for RNA and DNA from bacterial, viral and fungal genomes. Data were analysed using the VirusHunter analysis pipeline. <h3>Results</h3> We found no evidence of novel viral species or of persistent viral infection. Protected BAL samples typically contained 500–5000 bacterial reads for organisms typical of the oral cavity or upper respiratory tract, consistent with microaspiration rather than a distinct airway microbiome. Bacterial abundance was not increased in asthma. Hierarchical cluster analysis revealed no general association between disease and the presence of bacteria, with the exception of two individuals with severe neutrophilic asthma in whom single pathogenic species were detected with high abundance. In the first subject, chronic <i>Haemophilus influenzae </i>infection was present, correlating with standard culture and a striking Th17 cell response in BAL. Specific antibiotic treatment resulted in a dramatic clinical improvement. In the second individual <i>Tropheryma whipplei</i> was present, and correlated with the presence of foamy macrophages and a deficiency of BAL Th17 cells. <h3>Conclusions<i>:</i></h3> The data from this study argue against the existence of a distinct airway microbiome in health or in asthma, but rather that lung microbes are a result of microaspiration. Conversely, in specific cases chronic low grade infection may drive immunopathology in asthma. It remains to be seen whether very severe forms of asthma have a more prominent microbiome.
Impact of Haemophilus influenzae Type b Polysaccharide-Tetanus Protein Conjugate Vaccine on Responses to Concurrently Administered Diphtheria-Tetanus-Pertussis Vaccine
Authors: John D. Clemens
Journal: JAMA (1992)

To assess whether serum antibody responses to diphtheria-tetanus-pertussis (DTP) vaccine were affected by coadministration of Haemophilus influenzae type b capsular polyribosylribitol phosphate polysaccharide-tetanus protein (PRP-T) conjugate vaccine when given to patients at 2, 4, and 6 months of age.Randomized, double-blind clinical trial.Urban Santiago, Chile.Healthy infants assembled from health centers. Two hundred seventy-eight (74%) of 375 eligible infants participated; 222, who complied with the complete protocol, constituted the primary group under analysis.One of three vaccine regimens was given to study participants at 2, 4, and 6 months of age, either DTP mixed in the same syringe as PRP-T (group 1); DTP and PRP-T given at separate injection sites (group 2); or DTP without PRP-T (group 3).Titers of serum antidiphtheria toxoid, antitetanus toxoid, and pertussis agglutinin antibodies were measured in blood samples taken from patients 2 months after each dose.Serum antidiphtheria toxoid and antitetanus toxoid responses showed no important depressions in the patients receiving PRP-T. In contrast, geometric mean titers (GMTs) of pertussis agglutinins, expressed as reciprocal serum dilutions, after both the second and third doses (GMT2, GMT3) were lowest in group 1 (GMT2 = 89; GMT3 = 1230), intermediate in group 2 (GMT2 = 123; GMT3 = 1995), and highest in group 3 (GMT2 = 210; GMT3 = 3090; P less than .05 for trend group 1 less than group 2 less than group 3 after each dose). Antipertussis toxin and antipertussis filamentous hemagglutinin antibody titers also were depressed in patients who received PRP-T. Follow-up of a subset at 18 months revealed an expected decline of pertussis agglutinin titers to near baseline levels in each group.Concurrent administration of PRP-T vaccine with DTP vaccine, either in the same syringe or at different sites, interfered with antipertussis responses to a primary series of immunizations. Although the clinical significance of this antagonism is uncertain, these data underscore the caution required in decisions to add new vaccines to existing immunization regimens.
Hypersensitive Carotid Sinus Reflex Associated with Spontaneous, Transient Complete Heart Block
Authors: IRVING L. SCHWARTZ, LUDWIG W. EICHNA
Journal: Circulation (1950)

A patient with transient, intermittent, complete heart block had periods of asystole, accompanied by syncope, whenever his cardiac rhythm shifted spontaneously from regular sinus rhythm to complete auriculoventricular dissociation. Similar clinical and electrocardiographic findings were produced by carotid sinus pressure when there was regular sinus rhythm. During the periods of heart block carotid sinus stimulation produced no effects. Physiologic studies suggested that the site of sensitivity of the hyperactive carotid sinus reflex was located at the effector end of the reflex arc. The possibility of structural damage to the heart from repeated stimulation of a hyperactive carotid sinus reflex is considered.
Reviews and Notes: Humanities: What the Body Told
Authors: Sandra L. Bertman
Journal: Annals of Internal Medicine (1996)

Literature of Medicine15 December 1996Reviews and Notes: Humanities: What the Body ToldSandra L. Bertman, PhDSandra L. Bertman, PhDUniversity of Massachusetts Medical Center, Worcester, MA 01655.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-12-199612150-00039 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail R Campo. 122 pages. Durham: Duke Univ Pr; 1996. $12.95. ISBN 0-8223-1742-7. Order phone 919-687-3600.The perfect opener for grand rounds or a patient care conference would be the poem titled “Ten Patients, and Another,” terse case studies that, in a very few incisive words (as only poetry can do), encapsulate what the charts document and what they leave out: The patients, “a three-year-old-black male … [who] ingested what's turned out to be/Cocaine,” “a sixty-odd-year-old/white female … The intern found a bruise behind her ear,” “a gay Latino kid … getting tubed for respiratory failure … whispered that he's lost ... Author, Article, and Disclosure InformationAffiliations: University of Massachusetts Medical Center, Worcester, MA 01655. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1996Volume 125, Issue 12Page: 1024KeywordsBoneCancer immunotherapyChartsComputed axial tomographyFearHispanic peopleImmunodeficienciesPatientsRespiratory failure ePublished: 15 August 2000 Issue Published: 15 December 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Effect of nifedipine on serum theophylline concentrations and asthma control.
Authors: S R Smith, J Wiggins, D E Stableforth, C Skinner, M J Kendall
Journal: Thorax (1987)

The effect of adding slow release nifedipine to oral theophylline has been studied in eight patients with stable but symptomatic asthma, a double blind placebo controlled crossover protocol being used. No change in asthma control occurred during the nifedipine treatment period as assessed by serial peak flow measurements and symptom scores. Serum theophylline concentrations were significantly lower after nifedipine than after placebo (6.8 v 9.7 micrograms/ml) and in three patients were well below the therapeutic range (less than 4 micrograms/ml).
Multisubject Independent Component Analysis of fMRI: A Decade of Intrinsic Networks, Default Mode, and Neurodiagnostic Discovery
Authors: Vince D. Calhoun, Tülay Adali
Journal: IEEE Reviews in Biomedical Engineering (2012)

Since the discovery of functional connectivity in fMRI data (i.e., temporal correlations between spatially distinct regions of the brain) there has been a considerable amount of work in this field. One important focus has been on the analysis of brain connectivity using the concept of networks instead of regions. Approximately ten years ago, two important research areas grew out of this concept. First, a network proposed to be "a default mode of brain function" since dubbed the default mode network was proposed by Raichle. Secondly, multisubject or group independent component analysis (ICA) provided a data-driven approach to study properties of brain networks, including the default mode network. In this paper, we provide a focused review of how ICA has contributed to the study of intrinsic networks. We discuss some methodological considerations for group ICA and highlight multiple analytic approaches for studying brain networks. We also show examples of some of the differences observed in the default mode and resting networks in the diseased brain. In summary, we are in exciting times and still just beginning to reap the benefits of the richness of functional brain networks as well as available analytic approaches.
A NEW METHOD OF VACCINATION
Authors: SIGMUND WASSERMANN
Journal: JAMA (1910)

All physicians will agree that with the vaccination method now in vogue, using the scarifier (<i>Impf-Lanzette</i>), we can never measure the extent of the trauma and therefore the resulting lesion. As a rule, with experience, we may strike just about the right thing, but in the case of a restless child an unexpected motion on our part or on the part of the patient makes us go beyond the intentional limits. A further point, which has not been considered sufficiently, is that such a large abraded area is a receptacle of a large quantity of vaccine lymph causing too strong a local reaction. Such and other drawbacks can be prevented by a new method, which I herewith present. This method revolves around the instrument to be used, which is the scarifier devised by Professor von Pirquet for his cutaneous tuberculin test. It is a small chisel with the sharpened edge