tbuckley/cabot-search huggingface dataset:
Repudiation of the ‘magic bullet’ approach to health improvement: a call to empower people to get moving and take charge
Authors: James R Hébert, Steven N Blair
Journal: British Journal of Sports Medicine (2011)

Healthcare spending and reliance on single-agent approaches to cure disease and reduce disability are spiralling out of control in the USA.1,–,5 Meanwhile, sentinel health indicators such as mortality and incidence of many diseases are stagnating or, in many population subgroups, worsening.6,–,15 With the exception of cigarette smoking, where overall rates have fallen while becoming a habit concentrated in the poor and less educated, the underlying causes of most chronic diseases that constitute the bulk of both human suffering and healthcare spending have failed to improve much, if at all, over the past couple of generations.5 14 16 17 Obesity rates, inclusive of those in children, are the highest ever recorded in human history.11 17,–,19 Sedentariness has become the norm,18 20 21 and diets are increasingly nutrient sparse,22,–,26 especially in the majority of individuals who select calorie-dense, and shun whole-grain, foods.27,–,30

What is the typical American response to this? An article by Gardiner Harris in the 23 January 2011 New York Times entitled ‘New Federal Research Center Will Help Develop Medicines’ describes a plan to create a new US$1 billion centre on Advancing Translational Sciences at the National Institutes of Health (NIH). This plan typifies the search for a ‘magic bullet’, in pill form, that will cure all diseases and health problems.1 2 31

According to the article, large drug companies have spent ∼US$400 billion on drug research over the past 15 years. We should examine the effectiveness of this huge expenditure in terms of public health …
Author's response: 'risk disclosure prior to bronchoscopy'--Bianchi et al
Authors: S. T. O'Keeffe, M. Uzbeck, C. Quinn
Journal: Thorax (2010)

<h3>Objectives</h3> To determine the performance of procalcitonin (PCT), C reactive protein (CRP) and absolute neutrophil count (ANC) in identifying invasive bacterial infection (IBI) among well-appearing infants ≤21 days old with fever without source and no leukocyturia. To compare this performance with that in those 22–90 days old. <h3>Design</h3> Substudy of a prospective single-centre registry performed between September 2008 and August 2017. <h3>Setting</h3> Paediatric emergency department of a tertiary teaching hospital. <h3>Patients</h3> 196 infants ≤21 days old and 1331 infants 22–90 days old. <h3>Main outcome measures</h3> Sensitivity and negative likelihood ratio of blood tests for ruling out IBI (positive blood or cerebrospinal fluid culture). Abnormal blood test results: PCT ≥0.5 ng/mL, CRP &gt;20 mg/L and ANC &gt;10 000/µL. <h3>Results</h3> Prevalence of IBI in infants ≤21 days old with normal or any abnormal blood test result was 3.6% and 6.8%, respectively (OR 0.52 (95% CI 0.13 to 2.01)), compared with 0.2% and 4.5% in older infants (OR 0.03 (95% CI 0 to 0.17)). Sensitivity and negative likelihood ratio of the blood tests for ruling out IBI in infants ≤21 days were 44.4% (95% CI 18.9% to 73.3%) and 0.79 (95% CI 0.43 to 1.44), respectively (vs 84.6% (95% CI 57.8% to 95.7%)%) and 0.19 (95% CI 0.05 to 0.67) in older infants). The values improved in infants with fever ≥6 hours aged 22–90 days, but not in those ≤21 days. <h3>Conclusions</h3> PCT, CRP and ANC are not useful for ruling out IBI in febrile infants ≤21 days old. It is still recommended that these patients are admitted and given empirical antibiotic therapy, regardless of their general appearance or blood test results.
Oral cholecalciferol decreases albuminuria and urinary TGF-β1 in patients with type 2 diabetic nephropathy on established renin–angiotensin–aldosterone system inhibition
Authors: Min Jeong Kim, Andrew H. Frankel, Mandy Donaldson, Sarah J. Darch, Charles D. Pusey, Peter D. Hill, Michael Mayr, Frederick W.K. Tam
Journal: Kidney International (2011)
HIV Care in South Africa
Authors: Rebecca Voelker
Journal: JAMA (2001)

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
Problem of Estimating Respiratory Lead Dose in Children
Authors: John H. Knelson
Journal: Environmental Health Perspectives (1974)

Children may be exposed to lead in their environment by a variety of mechanisms, but the final two common pathways involve ingestion and/or inhalation. The serious public health problem of overt lead intoxication from eating lead-based paint has tended to obscure low level toxicity which may be related to atmospheric lead pollution. No data exist which relate potential body burden or blood lead levels in children to ambient air lead levels. Extrapolation from respiratory lead uptake kinetics in adults is complicated by the differences in respiratory physiology, metabolism, and body compartment sizes existing between children and adults. These differences and models from pediatric pharmacology have been used to approach the problem of predicting respiratory lead dose in children from data based on adult uptake studies.
A Military Medical School
Authors: Richard M. Magraw
Journal: New England Journal of Medicine (1971)

Do most physicians or most Americans want medical students trained under military auspices? HR 2, "a bill to establish a Uniformed Services University of Health Sciences," is apparently soon to be enacted into law by the Congress. The salient features of the proposal include the development of a medical school within a 25-mile radius of Washington, D.C., the armed forces and other federal hospitals in the area being used as a clinical base. Expenditures of $100 million are authorized (approximately $30 million of new construction for offices, laboratories and basic-science departments) by the time the school is required to graduate . . .
GST M1 Polymorphism Associates with DNA Oxidative Damage and Mortality among Hemodialysis Patients
Authors: Yi-Sheng Lin, Szu-Chun Hung, Yau-Huei Wei, Der-Cherng Tarng
Journal: Journal of the American Society of Nephrology (2008)

Leukocyte 8-hydroxy-2′-deoxyguanosine (8-OHdG) is a surrogate marker of oxidant-induced DNA damage in patients undergoing maintenance hemodialysis (MHD). Glutathione S-transferase M1 (GST M1) is a member of the GST family of proteins, which protect cellular DNA against oxidative damage. This study tested the association of a common GST M1 gene polymorphism [GST M1(−)], known to produce a dysfunctional enzyme, with levels of 8-OHdG in peripheral blood leukocytes and all-cause mortality among MHD patients. Among 488 MHD patients and 372 gender-matched healthy subjects, the frequency of the GST M1(−) genotype was 63.1 and 60.2%, respectively. The GST M1(−) genotype was associated with significantly higher levels of leukocyte 8-OHdG compared with the GST M1(+) genotype, even after adjustment for potential confounders (P < 0.001). Moreover, GST M1(−) patients who also had a common polymorphism in the DNA repair enzyme 8-oxoguanine DNA glycosylase 1 or who underwent dialysis with a bioincompatible cellulose membrane had the highest median levels of leukocyte 8-OHdG. Multivariate Cox regression revealed that among MHD patients, GST M1(−) genotype approximately doubled the risk for all-cause mortality (hazard ratio 2.24; 95% confidence interval 1.30 to 4.51) during the mean follow-up of 34 mo. In conclusion, patients without GST M1 activity are more vulnerable to oxidative stress and are at greater risk for death compared with those who possess GST M1 activity.
Working with Schizophrenia
Authors: D. Kingdon
Journal: BMJ (1995)

Gwen Howe Jessica Kingsley, pounds sterling9.95, pp 208, ISBN 1 85302 242 X

Those who speak from personal experience are the best teachers of what it is like to have schizophrenia or to care for someone with it. But though their accounts can be harrowing, and damning of the way service professionals respond—whether nurse or social worker, general practitioner or psychiatrist—they can also be hopeful and uplifting, enabling others with, or caring for those with, schizophrenia to learn new ways of coping and making sense of their perplexing and often frightening world.

In Working with Schizophrenia Howe provides a varied selection of the first …
The Shame of the Cities
Authors: LEONARD J. DUHL
Journal: American Journal of Psychiatry (1968)

The totality of urban life is the only rational focus for concern with mental illness. No longer can we be concerned solely with treatment institutions; our problem now embraces all of society and we must examine every aspect of it to determine what is conducive to mental health. And just as the psychiatric patient must participate in his own treatment, the citizenry of the cities must determine what they want and how to achieve it.
Storage of human organs prompts three inquiries
Authors: R. Woodman
Journal: BMJ (2000)

The clinical negligence lawyer Michael Redfern QC is to chair the independent inquiry into the mass storage of human organs at the Alder Hey Royal Liverpool Children's Hospital, the government has announced.

The other panel members are Jean Keeling, consultant in paediatric pathology at the Royal Sick Children's Hospital in Edinburgh, and Liz Powell, chief officer at Liverpool Central and Southern Community Health Council.

The inquiry will look into the circumstances surrounding the removal and retention of human tissues, …
Deletion of integrated hepatitis B virus genome and cellular flanking sequences in hepatocellular carcinoma cells in BALB/c mice*1
Authors: Poa Chun Chang, Cheng Po Hu, Shu-Hsia Chen, Sheng Wang-Wuu, Chungming Chang
Journal: Hepatology (1995)

We have previously reported the establishment of well-differentiated BALB/c mouse liver (ML) cell lines. Transfection of these cell lines with hepatitis B virus (HBV) DNA led to the expression of HBV-specific antigens and integration of HBV sequences in the cellular genome. Two cloned HBV-transfected ML cell lines, ML-2(HBV) and ML-3(HBV), expressed viral antigens and were highly tumorigenic in nude mice. However, the tumorigenicity of the two cell lines was significantly reduced in BALB/c mice. Southern blot analyses showed that the integrated HBV sequences were retained in tumors growing in nude mice but deleted in tumors growing in BALB/c mice. Furthermore, the deletion of HBV DNA was accompanied by deletion of chromosomal sequences flanking the HBV integration sites. In ML-2(HBV) cells, a significant reduction in chromosomal number was also observed. These results suggest that the immune response of BALB/c mice selected against hepatocellular carcinoma (HCC) cells expressing viral antigens and led to the proliferation of cells with deleted HBV sequences and concomitant chromosome aberrations. By using this mechanism, HCC cells escape the immune surveillance and gain the advantage of cell growth.
Penicillin Treatment of Patients with Cardiovascular Syphilis in Congestive Failure
Authors: JOSEPH EDEIKEN, WILLIAM T. FORD, MORTIMER S. FALK, JOHN H. STOKES
Journal: Circulation (1950)

Congestive failure has been considered a relative contraindication to antisyphilitic therapy in cardiovascular syphilis since the arsphenamine era, when severe reactions were reported following administration of this vasculotoxic drug. After having observed no severe reactions to penicillin in a series of patients with cardiovascular syphilis, it was decided to administer the antibiotic as initial therapy for individuals in congestive failure. This report summarizes observations on twelve such patients. There were no severe reactions during the course of treatment in the entire group. Digitalis and other measures to restore compensation were used concomitantly with penicillin. All the patients were improved upon completion of therapy. Case histories of 2 patients who died two months after treatment, are given. The significance of observations on the entire group is discussed.
Treatment of Chronic Painful Diabetic Neuropathy With Isosorbide Dinitrate Spray
Authors: Kevin C.J. Yuen, Neil R. Baker, Gerry Rayman
Journal: Diabetes Care (2002)

OBJECTIVE—Considerable evidence implicates impaired nitric oxide (NO) generation in the pathogenesis of diabetic neuropathic pain. We therefore conducted a pilot study to examine the effects of isosorbide dinitrate (ISDN), a NO donor with local vasodilating properties, in spray form in the management of chronic neuropathic pain. RESEARCH DESIGN AND METHODS—The study was of double-blind, randomized, placebo-controlled, and two-period cross-over design. After a 2-week run-in period, 22 diabetic patients (13 men, 20 with type 2 diabetes, age [mean ± SE] 63.7 ± 1.8 years, duration of diabetes 9.1 ± 1.5 years, duration of painful neuropathy 2.6 ± 0.4 years) were randomized to receive ISDN or placebo sprays for 4 weeks, exchanging their treatment for a further 4 weeks after a 2-week wash-out period. The patients administered the spray to both feet before bedtime. Biweekly pain and other sensory symptoms were assessed using a visual analog scale (VAS) and the Lickert scale, respectively. RESULTS—ISDN spray reduced overall neuropathic pain (P = 0.02) and burning sensation (P = 0.006). No treatment difference was observed with other sensory modalities (hot/cold sensation, tingling, numbness, hyperesthesia, and jabbing-like sensation). At study completion, 11 patients (50%) reported benefit and wished to continue using the ISDN spray, 4 (18%) preferred the placebo spray, and the remaining 7 (32%) were undecided. CONCLUSIONS—ISDN spray offers an alternative and effective pharmacological option in relieving overall pain and burning sensation in the management of painful diabetic neuropathy. The potential of ISDN spray in alleviating other specific sensory symptoms associated with diabetic peripheral neuropathy merits further study.
Imported and autochthonous kala-azar in France.
Authors: D Jeannel, P Tuppin, G Brucker, M Danis, M Gentilini
Journal: BMJ (1991)

OBJECTIVE--To study the epidemiological, clinical, and biological features of imported and autochthonous kala-azar in France. DESIGN--Prospective survey of all patients in France with kala-azar diagnosed over the two years 1986-7. Information was obtained from parasitology laboratories in regional hospitals and all hospital laboratories and haematology departments capable of diagnosing leishmaniasis in the south of France. SETTING--107 public hospitals in France. PATIENTS--89 patients with kala-azar. INTERVENTIONS--All patients were treated with drugs. In the first instance meglumine antimonate was given to all but two patients. MAIN OUTCOME MEASURES--Prevalence of the various clinical and biological features of kala-azar; proportion of patients with HIV infection. RESULTS--Half (44) of the patients were children under 8 years old. Seventy patients acquired the disease in France. Imported kala-azar was acquired mainly in Mediterranean countries (9/18 cases). Only 46 (52%) of the patients had all three of the classic associated clinical features of fever, splenomegaly, and hepatomegaly. Anaemia was the commonest biological sign, and the association of the four usual biological signs--anaemia, leucopenia, thrombocytopenia, and hypergammaglobulinaemia--was present in only 14 (33%) of the children under 8 and 26 (60%) adults. Fourteen of the patients over 8 years old were infected with HIV. CONCLUSION--Doctors must be aware of kala-azar in Mediterranean areas, especially as patients often present without the characteristic features and the disease affects young children preferentially.
Abstract 448: Mechanism of action differences of transmembrane versus secretory tumor necrosis factor-α on tumor growth; role of tumor-associated myeloid cells
Authors: Shidrokh Ardestani, Bin Li, Desirae Deskins, Pampee Young
Journal: Cancer Research (2011)

Abstract Tumor Necrosis Factor alpha (TNF-α) is a major inflammatory cytokine, produced by a wide variety of cell types including macrophages, T lymphocytes endothelial cells and tumor cells. TNF-α is expressed as a membrane-tethered protein (tmTNF-α), cleaved by tumor necrosis factor-α-converting enzyme (TACE) and subsequently released into extracellular space as a soluble TNF-α (sTNF-α). Recent studies from our laboratory and others have shown that low level expression of TNF-α by tumor cells substantially increases tumor growth, vascularity and decreases tumor necrosis, in part by increasing tumor content of a proangiogenic myeloid subtype (Li et al., Cancer Res. 2009, 1;69(1):338-48). To better understand the mechanism by which TNF-α modulates the myeloid phenotype, we generated murine Lewis lung carcinoma (LLC) and B16F10 melanoma tumor cells transduced with retrovirus expression vectors directing modest overexpression of a membrane tethered moiety, tmTNF-α. Heterotopic implantation of tmTNF-α expressing lines resulted in significantly decreased growth than control tumors in both tumor models. Our studies showed that this was not due to effects on the tumor cells themselves but likely due to effects on tumor stroma as the effect of tmTNF-α was lost in TNF-α receptor deficient mice. Further evaluation showed an absence of tumor associated myeloid cells within the tumor, which suggested apoptosis of migrated myeloid cells or inhibition of myeloid recruitment into the tumor environment. There is a significant gap in our knowledge on the mechanism of transmembrane isoform of TNF-α and its potential anti-tumorogenic role. In this study our goal is to identify the mechanism in which tmTNF-α promotes tumor regression and to understand how it modulates host bone marrow derived myeloid cells. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 448. doi:10.1158/1538-7445.AM2011-448
Governance of research that uses identifiable personal data
Authors: Robert Souhami
Journal: BMJ (2006)

The effect of ATP and its congeners on the adrenergic neuroeffector transmission was evaluated in isolated blood vessels of the rabbit. ATP, ADP, AMP and adenosine inhibited the contractile response of the portal vein to adrenergic nerve stimulation, with a threshold concentration of the order of 0.1 muM and ED50 of about 1 microM. These agents, but not papaverine, inhibited the nerve stimulation-induced response in preference to the norepinephrine- or serotonin-induced response in the portal and saphenous veins and pulmonary and ear arteries. In the portal vein labeled with [3H]norepinephrine, ATP diminished the nerve stimulation-induced efflux of tritiated material. This nucleotide also reduced the KCl-induced tritium efflux but not the tyramine induced-efflux in the [3H]norepinephrine-labeled thoracic aorta. ATP had no significant effect on the uptake of [3H]norepinephrine in the portal vein, ear artery and thoracic aorta. Indomethacin and theophylline partially blocked the inhibitory action of ATP on the neurogenic constrictor response in some of the ear artery and saphenous vein preparations. Desipramine, atropine, propanolol, haloperidol and 2,29-pyridylisatogen, a blocking agent against ATP in the taenia coli, were without such antagonistic effect. The results are consistent with a proposed negative feedback modulator role of ATP or a related purine compound in adrenergic transmission.
One and two sided tests of significance Statsitical hypothesis should be brought into line with clinial hypothesis
Authors: R Wolterbeek, M W Enkin, J M Bland, D G Altman
Journal: BMJ (1994)

with uptake rates for medical prescriptions in general.4Those attending were not the "worried well" but patients referred by their general prac- titioners for help with a range of medical conditions such as obesity, hypertension, depression, and raised cholesterol concentrations.The full evaluation report is available from the leisure services department of Stockport Metropolitan Borough Council (tel 061 474 4415).There is no doubt about the validity of the findings of the Stockport scheme, and we urge general practices not to look too long before leaping into a health promotion activity that could contribute towards improved cardiovascular and mental health.
Improving the Care of Patients with Chronic Mental Illness
Authors: D Mechanic, L H Aiken
Journal: New England Journal of Medicine (1987)

THE organization of community care for patients with the most severe chronic mental illnesses is seriously deficient. Most of these patients depend exclusively on underfinanced, fragmented, and often inaccessible public services. The difficulties of providing adequate medical and psychiatric services are compounded by homelessness, abuse of alcohol and drugs, and large gaps in the continuum of services necessary to meet the profound needs of these people. Patients lost to the system are commonly found in shelters or jails or on the streets.Before 1955, when deinstitutionalization began, serious chronic mental illness was treated in public mental hospitals that had responsibility . . .
A DIET HIGH IN LONG CHAIN FATTY ACIDS WORSENS SYSTOLIC FUNCTION IN TYPE II DIABETIC PATIENTS, BUT A DIET RICH IN MEDIUM CHAIN FATTY ACIDS DOES NOT: A RANDOMIZED, DOUBLE-BLIND STUDY
Authors: Sophia LaHusen-Bair, Andrew R. Coggan, Adil Bashir, Marsha Farmer, Robert O'Connor, Catherine Anderson-Spearie, Alan D. Waggoner, Pamela Woodard, Cylen Javidan, Babak Banan, Kitty Krupp, Victor G. Davila-Roman, Linda R. Peterson
Journal: Journal of the American College of Cardiology (2013)
Tuberculosis treatment and management—an update on treatment regimens, trials, new drugs, and adjunct therapies
Authors: Alimuddin Zumla, Jeremiah Chakaya, Rosella Centis, Lia D'Ambrosio, Peter Mwaba, Matthew Bates, Nathan Kapata, Thomas Nyirenda, Duncan Chanda, Sayoki Mfinanga, Michael Hoelscher, Markus Maeurer, Giovanni Battista Migliori
Journal: The Lancet Respiratory Medicine (2015)