tbuckley/cabot-search huggingface dataset:
Principles of Educational Outreach ('Academic Detailing') to Improve Clinical Decision Making
Authors: Stephen B. Soumerai
Journal: JAMA (1990)

With the efficacy and costs of medications rising rapidly, it is increasingly important to ensure that drugs be prescribed as rationally as possible. Yet, physicians' choices of drugs frequently fall short of the ideal of precise and cost-effective decision making. Evidence indicates that such decisions can be improved in a variety of ways. A number of theories and principles of communication and behavior changes can be found that underlie the success of pharmaceutical manufacturers in influencing prescribing practices. Based on this behavioral science and several field trials, it is possible to define the theory and practice of methods to improve physicians' clinical decision making to enhance the quality and cost-effectiveness of care. Some of the most important techniques of such "academic detailing" include (1) conducting interviews to investigate baseline knowledge and motivations for current prescribing patterns, (2) focusing programs on specific categories of physicians as well as on their opinion leaders, (3) defining clear educational and behavioral objectives, (4) establishing credibility through a respected organizational identity, referencing authoritative and unbiased sources of information, and presenting both sides of controversial issues, (5) stimulating active physician participation in educational interactions, (6) using concise graphic educational materials, (7) highlighting and repeating the essential messages, and (8) providing positive reinforcement of improved practices in follow-up visits. Used by the nonprofit sector, the above techniques have been shown to reduce inappropriate prescribing as well as unnecessary health care expenditures.
Routine Use of Penicillin Skin Testing on an Inpatient Service
Authors: N. F. Adkinson, W. L. Thompson, W. C. Maddrey, L. M. Lichtenstein
Journal: New England Journal of Medicine (1971)

The routine use of prospective penicillin skin testing on hospitalized patients was evaluated over a six-month period. Patients with clinical indications for the use of penicillin drugs were tested with penicilloyl-poly-L-lysine (PPL) and a mixture of minor penicillin antigens (MDM), regardless of past history of penicillin reactions. Fifty-four patients with reasonable histories of penicillin hypersensitivity but nonreactive skin tests were treated, with only one mild possible reaction occurring within the first three days of therapy; this patient had active systemic lupus erythematosus. Ten of 163 patients without histories of prior penicillin reactions had positive skin tests and were denied penicillin drugs. As compared to a similar study of the same inpatient population in 1964–65, penicillin reactions were markedly less frequent. The routine use of PPL and MDM skin tests by house officers on a busy ward service is practical, safe and useful in predicting penicillin reactions.
Atrial Giant Cell Myocarditis
Authors: Brandon T. Larsen, Joseph J. Maleszewski, William D. Edwards, Leslie T. Cooper, Richard E. Sobonya, V. Eric Thompson, Simon G. Duckett, Charles R. Peebles, Iain A. Simpson, Henry D. Tazelaar
Journal: Circulation (2012)

Giant cell myocarditis (GCM) typically causes fulminant heart failure, arrhythmias, or heart block, necessitating aggressive immunosuppression, ventricular assist device insertion, or cardiac transplantation. We describe a novel variant of GCM, primarily involving the atria, that displays distinctive clinical features and follows a more benign course than ventricular GCM.We identified 6 patients (median age 67.5 years, 4 male) with atrial GCM in our pathology consultation practices from 2010 to 2012. Clinical history, imaging, and pathology materials were reviewed. Clinically, 4 patients had atrial fibrillation, 1 had acute heart failure, and 1 had incidental disease at autopsy. Among the 5 living patients, echocardiography revealed severe atrial dilatation (5 cases), mitral/tricuspid regurgitation (5), atrial mural thrombus (3), atrial wall thickening (2), and atrial hypokinesis (2). Ventricular function was preserved in all 5. Histological review of surgically resected atria showed giant cell and lymphocytic infiltrates, lymphocytic myocarditis-like foci, cardiomyocyte necrosis, and cardiomyocyte hypertrophy in all cases. Other features included interstitial fibrosis (5), poorly-formed granulomas (4), eosinophils (4), neutrophils (1), and vasculitis (1). Treatment consisted of steroids and cyclosporine (1), pacemaker placement for sick sinus syndrome (1), and supportive care (3). All 5 living patients returned to baseline exercise tolerance after 6 to 16 weeks of follow-up.Atrial GCM represents a distinct clinicopathologic entity with a more favorable prognosis than classic ventricular GCM. This disorder should be included in the differential diagnosis of atrial dilatation, particularly when associated with atrial wall thickening. The utility of immunomodulatory therapy for this condition remains unknown.
Some Bottlenecks Towards Family Medicine
Authors: LeRoy P. Levitt
Journal: JAMA (1971)

When I agreed to make this presentation, I had not realized what a difficult task it would be at this moment in time. Deans are not known for their reticence in talking, and are given to great bursts of eloquence on matters of budgets, fund-raising and faculty appointments, as well as the ubiquitous problems of curriculum. I had thought I might speak about the role of the general practitioner in Europe, having but a few weeks ago returned from a World Health Organization fellowship which took me to eight countries; by the end of the week in each country, I wasn't so sure I understood what prevailed there, since opinions were too varied and anecdotal. I then considered relating some data concerning our preceptorship program with the DuPage County Medical Society, now of three years' vintage. It continues to be quite successful, but somehow it did not seem fitting as
Study Proposes to Examine Football Players, Power Lifters for Possible Long-term Sequelae From Anabolic Steroid Use in 1970s Competition
Authors: Virginia S. Cowart
Journal: JAMA (1987)

MOST PHYSICIANS agree that athletes who take anabolic steroids may be at risk for later health problems. Now, a proposed case-control study involving former college football players and power lifters who competed between 1970 and 1979 may provide new information. A pilot study involving some 200 former athletes from six schools was completed in April, and the researchers hope to begin the full-scale study this summer. The principal investigators are Charles Yesalis, PhD, professor in the College of Human Development at Pennsylvania State University, University Park, and MAJ James Wright, PhD, chief of the Exercise Science Branch at the Soldier Physical Fitness School at Fort Benjamin Harrison, Indianapolis. Yesalis, an epidemiologist, says the short-term effects of steroid use are fairly well-known (changes in blood lipid concentrations and a decrease in sperm production, for example) and that more can be gained by looking at men who have had a latency period
Cancer Disparities by Race/Ethnicity and Socioeconomic Status
Authors: E. Ward, A. Jemal, V. Cokkinides, G. K. Singh, C. Cardinez, A. Ghafoor, M. Thun
Journal: CA A Cancer Journal for Clinicians (2004)

This article highlights disparities in cancer incidence, mortality, and survival in relation to race/ethnicity, and census data on poverty in the county or census tract of residence. The incidence and survival data derive from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) Program; mortality data are from the National Center for Health Statistics (NCHS); data on the prevalence of major cancer risk factors and cancer screening are from the National Health Interview Survey (NHIS) conducted by NCHS. For all cancer sites combined, residents of poorer counties (those with greater than or equal to 20% of the population below the poverty line) have 13% higher death rates from cancer in men and 3% higher rates in women compared with more affluent counties (less than 10% below the poverty line). Differences in cancer survival account for part of this disparity. Among both men and women, five-year survival for all cancers combined is 10 percentage points lower among persons who live in poorer than in more affluent census tracts. Even when census tract poverty rate is accounted for, however, African American, American Indian/Alaskan Native, and Asian/Pacific Islander men and African American and American Indian/Alaskan Native women have lower five-year survival than non-Hispanic Whites. More detailed analyses of selected cancers show large variations in cancer survival by race and ethnicity. Opportunities to reduce cancer disparities exist in prevention (reductions in tobacco use, physical inactivity, and obesity), early detection (mammography, colorectal screening, Pap tests), treatment, and palliative care.
Timolol and Myasthenia Gravis
Authors: Stephen A. Shaivitz
Journal: JAMA (1979)

<h3>To the Editor.—</h3> Timolol maleate (Timoptic) was recently released for use topically in glaucoma. When one of my patients with myasthenia gravis began using it, he had a major immediate deterioration in his myasthenia. <h3>Report of a Case.—</h3> A 71-year-old man has a 14-month history of moderate generalized (group 11-B) myasthenia gravis. Before the onset of this condition, he had mild diabetes controlled with diet alone and glaucoma that had been controlled with a variety of topical medications. He had started receiving high doses of prednisone for his myasthenia gravis shortly after the onset and had a moderate improvement but a notable deterioration in his diabetic condition, with fasting blood glucose levels in the range of up to 600. Under my care the patient's prednisone therapy was discontinued, and he was treated with pyridostigmine bromide and orally administered hypoglycemic agents. The patient did not wish to take insulin. At the
MINERS' SILICOSIS: ITS PATHOLOGY, SYMPTOMATOLOGY AND PREVENTION
Authors: ROBERT T. LEGGE
Journal: JAMA (1923)

Dust as a causative agent in the production of lung diseases has been known by writers of medicine from early times. Ramazzini, that pioneer observer of diseases of artificers, published in 1700 a treatise on the effect of dust inhalation. Stratton, in 1838, proposed the name of anthracosis to designate the condition found in coal miners as a result of inhaling coal dust, the term silicosis being applied to miners' consumption produced by quartz, flint and other silicon dusts. Probably the application of the term pneumonoconiosis, as proposed by Zenker in 1867, should be the proper nomenclature in occupational medicine for all inorganic and organic dusts that produce lung disease among workers. The experimental work and observations of Haldane<sup>1</sup>and of Mavrogordato<sup>2</sup>particularly revealed a new aspect of the problem as to how pneumonoconiosis is developed, and in view of the recent investigations of the fundamental changes arising
Abstract 4165: Identification of flotillin-1 as a regulator of H-Ras activation in lipid raft
Authors: Hae-Young Yong, Hwajin Son, Eun-Sook Kim, Jin-Sun Hwang, Myeong-Ok Kim, Wahn Soo Choi, Dong-Young Noh, Ki-Tae Hwang, Ki-Bum Kim, Jae-Seon Lee, Hyung Joon Kim, Hong-Hee Kim, Yoomi Choi, Eun Joo Kim, So Yeon Park, Hyeong-Reh Choi Kim, You Rim Jeon, Aree Moon
Journal: Cancer Research (2012)

Abstract Metastatic spread is the major cause of death from breast cancer. We previously showed that H-Ras, but not N-Ras, induces invasive/migratory phenotypes of MCF10A human breast epithelial cells, while both H-Ras and N-Ras induce proliferation/transformation. Here, we identified flotillin-1 as an H-Ras-induced lipid raft protein through comparative proteome profiling of lipid raft proteins. Flotillin-1 interacts with H-Ras in lipid raft at a higher affinity than with N-Ras. Small interfering RNA(siRNA)-mediated flotillin-1 knockdown significantly reduced H-Ras activation and H-Ras-mediated motility/invasion in MCF10A cells engineered to express active H-Ras as well as in Hs578T breast carcinoma and T24 bladder carcinoma cells that express endogenous active mutant of H-Ras. These results suggest a positive signal amplification loop between flotillin-1 and H-Ras for the invasive signaling program. Flotillin-1 was crucial for the activation of the Ras-GRF1 exchange factor and its interaction with H-Ras in lipid rafts. Using a xenograft tumor model, we show that knockdown of flotillin-1 reduces the tumor growth in vivo. Importantly, tissue microarrays of 289 breast cancer patients revealed that flotillin-1 expression in the plasma membrane positively correlates with HER2/neu expression(p&amp;lt;0.001) and high histologic grade(p=0.014). Although infrequent, the membranous flotillin-1 expression is significantly associated with poor disease-free survival of patients(p=0.005), suggesting the clinical importance of predicting the characteristics of a small subpopulation of malignant breast cancer. Taken together, our findings provide new insight into the molecular basis of the Ras isoform-specific signaling mechanism leading to cell invasion that depends on the lipid-based sorting platforms. 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 4165. doi:1538-7445.AM2012-4165
Splenosis, Autotransplantation of Splenic Tissue Following Trauma
Authors: Stephen L. Gammill
Journal: JAMA (1969)

This is the first case of splenosis we have found in which the patient had a filling defect in the stomach as seen from roentgenographic examination of the gastrointestinal tract. This communication is in programmed form, which is, to our knowledge, the first time that a journal communication has been presented in this manner.
<i>De novo</i> CpG Island Methylation in Human Cancer Cells
Authors: Kam-Wing Jair, Kurtis E. Bachman, Hiromu Suzuki, Angela H. Ting, Ina Rhee, Ray-Whay Chiu Yen, Stephen B. Baylin, Kornel E. Schuebel
Journal: Cancer Research (2006)

Abstract A major obstacle toward understanding how patterns of abnormal mammalian cytosine DNA methylation are established is the difficulty in quantitating the de novo methylation activities of DNA methyltransferases (DNMT) thought to catalyze these reactions. Here, we describe a novel method, using native human CpG island substrates from genes that frequently become hypermethylated in cancer, which generates robust activity for measuring de novo CpG methylation. We then survey colon cancer cells with genetically engineered deficiencies in different DNMTs and find that the major activity against these substrates in extracts of these cells is DNMT1, with minor contribution from DNMT 3b and none from DNMT3a, the only known bona fide de novo methyltransferases. The activity of DNMT1 against unmethylated CpG rich DNA was further tested by introducing CpG island substrates and DNMT1 into Drosophila melanogaster cells. The exogenous DNMT1 methylates the integrated mammalian CpG islands but not the Drosophila DNA. Additionally, in human cancer cells lacking DNMT1 and DNMT3b and having nearly absent genomic methylation, gene-specific de novo methylation can be initiated by reintroduction of DNMT1. Our studies provide a new assay for de novo activity of DNMTs and data suggesting a potential role for DNMT1 in the initiation of promoter CpG island hypermethylation in human cancer cells. (Cancer Res 2006; 66(2): 682-92)
Understanding Choice
Authors: Amol A. Verma, Fahad Razak, Allan S. Detsky
Journal: JAMA (2014)

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
Abstract 3500: Analysis of the prevalence and prognostic significance of 92 endpoints using high throughput multiplexed qPCR In archival tissue from multiple NSCLC trials.
Authors: An D. Do, Teiko Sumiyoshi, Yulei Wang, Erica Schleifman, Yuanyuan Xiao, Barbara Klughammer, Cheryl V. Wong, Ilma Abbas, Ling Fu, Lukas C. Amler, Rajiv Raja, David S. Shames
Journal: Cancer Research (2013)

Abstract Over one third of all cancer related deaths worldwide are caused by non-small cell lung cancer (NSCLC). Until recently, tumor histology was rarely a factor in treatment decisions. However, this paradigm is shifting with the recent emergence of molecularly targeted therapies and next-generation chemotherapies. To better define the molecular sub-types of NSCLC that associate with active therapies and to evaluate their prognostic significance in historical clinical trials, we developed a microfluidics-based multiplexed PCR platform that enables analyses of 96 gene transcripts in 96 samples using material from as little as a single biopsy slide. The multiplexed assay panel consists of Taqman assays for markers of histology, chemo-resistance, prognosis, oncogenic pathway activity, epithelial vs. mesenchymal biology, as well as NSCLC drug targets. We report here on the development and validation of this 96-gene transcript-profiling panel. Using titrations of several lung biopsy formalin-fixed paraffin embedded (FFPE) tissues, we show that as little as 10 ng of FFPE RNA is feasible and yields robust gene expression data across all assays of the profiling panel. Using this technology, we tested archival lung biopsy samples from multiple Phase II and III studies to assess the prevalence and potential prognostic significance of 92 endpoints in parallel. We identified several markers that were strongly associated with histology as defined by TTF1 or p63 expression. In addition, several of the these markers were also associated with longer survival regardless of therapy, and will be discussed. These data suggest that retrospective analyses of clinical trial samples using Fluidigm-based expression analysis can be used to better inform future trial design in NSCLC. Citation Format: An D. Do, Teiko Sumiyoshi, Yulei Wang, Erica Schleifman, Yuanyuan Xiao, Barbara Klughammer, Cheryl V. Wong, Ilma Abbas, Ling Fu, Lukas C. Amler, Rajiv Raja, David S. Shames. Analysis of the prevalence and prognostic significance of 92 endpoints using high throughput multiplexed qPCR In archival tissue from multiple NSCLC trials. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3500. doi:10.1158/1538-7445.AM2013-3500
POSTPARTUM ECLAMPSIA FOLLOWING THE DELIVERY OF SINGLE OVUM TRIPLETS
Authors: David Cohen
Journal: JAMA (1926)

De Lee says that multiple pregnancy is distinctly abnormal and that it has been stated by an observer who studied more than 50,000,000 births that while twins occur only once in eighty-seven cases, triplets occur only once in 7,103 births. He further says that plural pregnancy always gives rise to disturbances on the part of both mother and child. On the part of the mother, nausea and vomiting, toxemia, varices and edema are more marked, while nephritis and eclampsia are much more common than in single pregnancy. He adds, "About 70 per cent of duplex pregnancies terminate before term, and practically all triplet and quadruplet gestations do so." The fatality of the disturbances of pregnancy in plural gestations is increased, especially of the toxemia resulting in eclampsia. Triplets and quadruplets offer a much higher percentage in mortality than twins, as regards the prognosis of the child. <h3>REPORT OF CASE</h3><h3>History</h3>
Dwarfism Following Long-term Topical Corticosteroid Therapy
Authors: Hans Henning Bode
Journal: JAMA (1980)

THE USE of topical glucocorticoids has greatly advanced therapy for several dermatologic conditions. When properly applied, glucocorticoids produce minimal systemic side effects, even though percutaneous absorption of these hormones is sufficient to suppress adrenal cortisol secretion.<sup>1-3</sup>The beneficial effects of prolonged therapy with topical glucocorticoids are, however, outweighed by detrimental side effects, such as adrenal suppression,<sup>1-4</sup>dermal atrophy, axillary and inguinal striae,<sup>5</sup>hyperglycemia,<sup>6</sup>and even multiple gastric ulcers,<sup>7</sup>that have been observed. In this communication, we report a case in which this therapy caused stunted growth and permanent short stature along with adrenal insufficiency unresponsive to adrenocorticotropic hormone (ACTH) stimulation. <h3>Report of a Case</h3> A 13-year-old boy was referred to the Pediatric Endocrine Unit by his physician-father for evaluation of short stature. He was born after a full-term, uncomplicated pregnancy as the fifth of eight children. His birth weight, length, and early infantile development were
New childhood leukaemia identified by gene chip technology
Authors: D. Josefson
Journal: BMJ (2001)

Infants and children diagnosed with chemotherapy resistant acute lymphoblastic leukaemia, the most common childhood malignancy, may in fact have a different type of leukaemia altogether, a new study has shown.

Researchers at Harvard University's Dana Farber Cancer Institute in Boston, Massachusetts, have used gene chip technology to distinguish “mixed lineage” leukaemias from the acute form.

The study, to be published in the journal Nature Genetics in January 2002 but already available online (at genetics.nature.com), not only …