tbuckley/cabot-search huggingface dataset:
Effect on Physician-Scientists of the Low Funding Rate of NIH Grant Applications
Authors: M A Movsesian
Journal: New England Journal of Medicine (1990)

The threat to the future of the physician-scientist is currently the focus of considerable attention. Addresses to the scientific community and articles in the medical press frequently express concern over projected shortages in the number of physicians going into biomedical research and emphasize the need for organizations of physician-scientists to reverse this trend by promoting biomedical research as a national priority.1 2 3 4 5 The future of physician-scientists will ultimately depend on the existence of a funding system for biomedical research that provides medical schools with incentives to hire new physician-scientists and that ensures prospective physician-scientists of a reasonable chance of secure long-term . . .
Experts Weigh Pros and Cons of Screening and Treatment for Childhood Obesity
Authors: Mike Mitka
Journal: JAMA (2008)

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 Journals 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 2024 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
Down-regulation of the Sodium/Iodide Symporter Explains 131I-Induced Thyroid Stunning
Authors: Madeleine M. Nordén, Fredrik Larsson, Sofia Tedelind, Therese Carlsson, Charlotta Lundh, Eva Forssell-Aronsson, Mikael Nilsson
Journal: Cancer Research (2007)

Abstract 131I radiation therapy of differentiated thyroid cancer may be compromised by thyroid stunning (i.e., a paradoxical inhibition of radioiodine uptake caused by radiation from a pretherapeutic diagnostic examination). The stunning mechanism is yet uncharacterized at the molecular level. We therefore investigated whether the expression of the sodium/iodide symporter (NIS) gene is changed by irradiation using 131I. Confluent porcine thyroid cells on filter were stimulated with thyroid-stimulating hormone (TSH; 1 milliunit/mL) or insulin-like growth factor-I (IGF-I; 10 ng/mL) and simultaneously exposed to 131I in the culture medium for 48 h, porcine NIS mRNA was quantified by real-time reverse transcription-PCR using 18S as reference, and transepithelial iodide transport was monitored using 125I− as tracer. TSH increased the NIS expression &amp;gt;100-fold after 48 h and 5- to 20-fold after prolonged stimulation. IGF-I enhanced the NIS transcription at most 15-fold but not until 5 to 7 days. 131I irradiation (7.5 Gy) decreased both TSH-stimulated and IGF-I–stimulated NIS transcription by 60% to 90% at all investigated time points. TSH and IGF-I stimulated NIS synergistically 15- to 60-fold after 5 days. NIS expression was reduced by 131I also in costimulated cells, but the transcription level remained higher than in nonirradiated cells stimulated with TSH alone. Changes in NIS mRNA always correlated with altered 125I− transport in cultures with corresponding treatments. It is concluded that down-regulation of NIS is the likely explanation of 131I-induced thyroid stunning. Enhanced NIS expression by synergistically acting agents (TSH and IGF-I) partly prevents the loss of iodide transport expected from a given absorbed dose, suggesting that thyroid stunning might be pharmacologically treatable. [Cancer Res 2007;67(15):7512–17]
Node negative breast cancer.
Authors: R W Blamey, C W Elston, I O Ellis, D A Morgan, J L Haybittle
Journal: BMJ (1990)

It is true that the Priory Hospitals Group is the largest provider of private psychiatric care in Britain.The authors fail to make it clear, however, that this group is the "encouraging exception"2 that they refer to.Thus the exception becomes the rule.Following the example set by the Priory group there is reason to be optimistic that private psychiatric hospitals in the United Kingdom will take a different approach to their American counterparts.Responsibilities to research and training are taken seriously.A recently held Priory Fellows Day, devoted entirely to projects associated with this hospital and attended by 120 psychiatrists, provides further evidence.In arguing that private care is elitist the authors again overlook the fact that 71 NHS patients have been successfully cared for in the Priory Hospital over the past three years.These were very disturbed patients who would otherwise have been admitted to a locked ward.They were mostly patients of social class V from the deprived inner city area in which Professor Marks and Dr Thorni- croft work.Surely the future lies in close cooperation between the private, academic, and NHS sectors.To achieve this we need to be fair minded, not prejudiced.
Itraconazole pulse therapy is effective in the treatment of tinea capitis in children: an open multicentre study
Authors: A.K. GUPTA, M.E. ALEXIS, N. RABOOBEE, S.L.R. HOFSTADER, C.W. LYNDE, P. ADAM, R.C. SUMMERBELL, P. DE DONCKER
Journal: British Journal of Dermatology (1997)

In an open multicentre study we have demonstrated that itraconazole pulse therapy, 5 mg/kg per day, is effective and safe in the management of tinea capitis in 10 children (seven boys, three girls, mean age: 6.6 years, age range 4–11 years). The causative organisms were Trichophyton tonsurans (six cases), T. violaceum (two cases), T. soudanense (one case) and Microsporum gypseum (one case). Each pulse of drug therapy lasted 1 week with 2 weeks off between consecutive pulses. One, two and three pulses produced complete, clinical and mycological, cure in one, six and three patients, respectively. The children tolerated the treatment well and there were no clinical or laboratory adverse effects. This 1‐week pulse therapy regimen resulted in a high degree of compliance. The preliminary results of this study are promising and need to be evaluated in a larger sample of patients.
The Trouble with Uncompensated Hospital Care
Authors: Joel S. Weissman
Journal: New England Journal of Medicine (2005)

An implicit assumption of the U.S. health care system is that poor, uninsured persons who become ill can obtain free or discounted care. Although many individual physicians provide such services, uncompensated hospital care represents our safety net of last resort. Uncompensated care is defined as the sum of free care, for which the hospital does not expect payment, and bad debt, for which it attempts to collect payment. As free care and bad debt are currently reported, it is difficult to distinguish between them, but uncompensated care is not free. A small portion is covered by in-kind donations, and the . . .
Elimination of Local Abnormal Ventricular Activities
Authors: Pierre Jaïs, Philippe Maury, Paul Khairy, Frédéric Sacher, Isabelle Nault, Yuki Komatsu, Mélèze Hocini, Andrei Forclaz, Amir S. Jadidi, Rukshen Weerasooryia, Ashok Shah, Nicolas Derval, Hubert Cochet, Sebastien Knecht, Shinsuke Miyazaki, Nick Linton, Lena Rivard, Matthew Wright, Stephen B. Wilton, Daniel Scherr, Patrizio Pascale, Laurent Roten, Michala Pederson, Pierre Bordachar, François Laurent, Steven J. Kim, Philippe Ritter, Jacques Clementy, Michel Haïssaguerre
Journal: Circulation (2012)

Catheter ablation of ventricular tachycardia (VT) is effective and particularly useful in patients with frequent defibrillator interventions. Various substrate modification techniques have been described for unmappable or hemodynamically intolerable VT. Noninducibility is the most frequently used end point but is associated with significant limitations, so the optimal end point remains unclear. We hypothesized that elimination of local abnormal ventricular activities (LAVAs) during sinus rhythm or ventricular pacing would be a useful and effective end point for substrate-based VT ablation. As an adjunct to this strategy, we used a new high-density mapping catheter and frequently used epicardial mapping.Seventy patients (age, 67±11 years; 7 female) with VT and structurally abnormal ventricle(s) were prospectively enrolled. Conventional mapping was performed in sinus rhythm in all, and a high-density Pentaray mapping catheter was used in the endocardium (n=35) and epicardially. LAVAs were recorded in 67 patients (95.7%; 95% confidence interval, 89.2-98.9). Catheter ablation was performed targeting LAVA with an irrigated-tip catheter placed endocardially via a transseptal or retrograde aortic approach or epicardially via the subxiphoid approach. LAVAs were successfully abolished or dissociated in 47 of 67 patients (70.1%; 95% confidence interval, 58.7-80.1). In multivariate analysis, LAVA elimination was independently associated with a reduction in recurrent VT or death (hazard ratio, 0.49; 95% confidence interval, 0.26-0.95; P=0.035) during long-term follow-up (median, 22 months).LAVAs can be identified in most patients with scar-related VT. Elimination of LAVAs is feasible and safe and is associated with superior survival free from recurrent VT.
Application of Homeostatic Principles to the Practice of Parenteral Fluid Therapy
Authors: Nathan B. Talbot, Gerald A. Kerrigan, John D. Crawford, Winston Cochran, Mary Terry
Journal: New England Journal of Medicine (1955)

THE comments on parenteral fluid therapy that follow are based on the fact that there are limits to the body's capacity to conserve and to eliminate, in accordance with homeostatic needs, water and solutes given either orally or parenterally.1 , 2 For each substance there is a physiologic minimum requirement, which is the least intake of the substance in question needed to balance output and hence to prevent deficits when conservation forces are acting maximally. There is also for each substance a physiologic maximum tolerance, defined as the largest amount of the substance that can be taken and eliminated without seriously disturbing . . .
The Mechanism of Synchronization in Isorhythmic A-V Dissociation
Authors: ALBERT L. WALDO, KARI J. VITIKAINEN, PAUL D. HARRIS, JAMES R. MALM, BRIAN F. HOFFMAN, Bruce J. Innes, Gerard A. Kaiser
Journal: Circulation (1968)

We studied 11 patients with spontaneous isorhythmic atrioventricular (A-V) dissociation occurring during cardiac surgery. The period of synchronization or accrochage was shown to result from retrograde capture of the atria by an A-V junctional rhythm. The P wave in leads II, III, and aV F was biphasic (–, +) during the period of synchronization, with the initial negative portion of the P wave or the entire P wave often buried within the QRS complex. It was concluded that isorhythmic A-V dissociation occurs only during the period when the rhythm alternates between an atrial rhythm and an A-V junctional rhythm and results when either the dominant pacemaker slows or the latent pacemaker accelerates.
Discordant HER2 Total and HER2 Homodimer Levels by HERmark Analysis in Matched Primary and Metastatic Breast Cancer FFPE Specimens.
Authors: K. Leitzel, P. Conte, V. Guarneri, E. Barbieri, W. Huang, S. Ali, S. Ali, M. Haddad, J. Sperinde, Y. Lie, J. Weidler, M. Bates, A. Lipton
Journal: Cancer Research (2009)

Abstract Background: HER-2/neu is over-expressed in approximately 25% of primary invasive breast cancers and selection of patients for consideration of trastuzumab is a critical step in defining the treatment plan. We have previously reported that quantitative measurements of HER2 protein expression (H2T) and HER2 homodimers (H2D) using the HERmark assay identifies sub-populations of “HER2-positive” patients (by IHC and/or FISH) that have different clinical outcomes on trastuzumab (Leitzel, ASCO 2008; Lipton, SABCS 2008). Previous studies report up to a 20 % discordance in HER2 status using conventional IHC or FISH analysis between the primary and metastatic breast tumors. Here we correlate HER2 total and homodimer levels in matched primary and metastatic tissue from the same patient.Methods: 27 patients had matched primary and metastatic FFPE (formalin-fixed, paraffin-embedded) specimens tested in the HERmark assay to quantitate and compare their H2T and H2D expression levels.Results: FFPE tissue was available from 27 primary breast cancers and metachronous metastatic sites. Metastatic lesions included 7 skin, 5 lymph node, 3 bone, 3 pleura, 2 brain, 2 chest wall, and 5 other soft tissue lesions. The median elapsed time between matched primary and metastatic sites was 71 mo. (range 9-137 mo). During the time period between the primary specimen harvest and the metastatic biopsy, 6 patients were treated with chemotherapy alone, 10 received hormonal therapy without trastuzumab, 3 patients received trastuzumab, and 3 received no treatment. Treatment was not known for 5 patients. For the whole population, there was a weak to moderate positive correlation between primary and metastatic cancers with H2T (r2=0.36, p&amp;lt;0.001) and for H2D (r2=0.27, p&amp;lt;0.006). Using the optimized time to progression (TTP) positional scanning cutpoints for H2T and H2D defined in our previous reports, 4/20 patients (20%) converted from low to high, and 1/7 (14%) converted from high to low H2T. Using the H2D cutpoint, 7/15 patients (47%) converted from low to high, and 3/12 (25%) converted from high to low H2D. Overall discordance between primary and metastatic sites was 19% for H2T, and 37% for H2D.Conclusions: HERmark analysis of matching primary and metastatic breast cancers revealed 19% discordance for H2T, and 37% for H2D. The most frequent conversion was from low HER2 in the primary tissue to high HER2 in the metastatic site. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2131.
Gonadal Agenesis with Tetany and Severe Osteoporosis
Authors: T. J. Geffen
Journal: BMJ (1956)

B leading to thyroid hyperplasia; instead of the gland behaving as in hypothyroidism, the patient's diet intake may have contained enough iodine to overcome the blockage by sudden excessive formation and release of thyroid hormone (Paschkis et al., 1941).Alternatively, all the cases so far reported might have had a tTansient period of hyperthyroidism followed later by hypothyroidism, which might have happened in our case had we continued with the drug for a longer period. SummaryA case of P.A.S.-induced hyperthyroidism is reported.An attempt is made to explain the mechanism.The literature on hypothyroidism and thyroid enlargement caused by P.A.S. is briefly reviewed.
Endothelial Progenitor Obsolescence and Atherosclerotic Inflammation**Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology.
Authors: Chunming Dong, Lawrence E. Crawford, Pascal J. Goldschmidt-Clermont
Journal: Journal of the American College of Cardiology (2005)
The So-Called Gold Treatment of Inebriety
Authors: L. E. Keeley
Journal: BMJ (1892)

GOLD-LTEATMENT OF INEBRIETY.[LY 3, 1. of grain.Our analysis of the extraet enables us subst"MAlAt to confirm the more important analytical data quoted by the proprietors, while we are unable to agree entirely with -some A 'res of minor importance.-The ";Extract " iisthe substan rw.ich.gives.-thename.to the other food preparations of44he proprietors."Frame Food Diet," previously known under ttie name of " Frame Food Porridge, 'is a fine dry pewder'of tfie character of a biscuit 'food.It is a cooked wheatevrfood containing-" Frate Food Extract."Both preparationa -axe well .manufaqtqred1and are free from adulterants andt from
Seborrhoeic wart or basal cell papilloma: what's in a name? Commentary
Authors: D.N. Slater
Journal: British Journal of Dermatology (2002)

Journal Article Seborrhoeic wart or basal cell papilloma: what's in a name? Commentary Get access D.N. Slater D.N. Slater Department of Histopathology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, U.K. E‐mail: David.Slater@.sth.nhs.uk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 147, Issue 5, 1 November 2002, Page 1020, https://doi.org/10.1046/j.1365-2133.2002.49592.x Published: 01 November 2002
Respiratory Sensation and Ventilatory Mechanics during Induced Bronchoconstriction in Spontaneously Breathing Low Cervical Quadriplegia
Authors: M. Diane Lougheed, John Flannery, Katherine A. Webb, Denis E. O'Donnell
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Intensity of dyspnea during induced bronchoconstriction in asthma is strongly related to the reduction in inspiratory capacity (IC) as a result of dynamic hyperinflation. To determine the role of rib cage and intercostal muscle afferents in symptom perception during bronchoconstriction, we measured the relationship between dyspnea intensity and IC during induced bronchoconstriction in six subjects with complete C4-C7 quadriplegia who did not require assisted ventilation. Spirometry, lung volumes, breathing pattern, esophageal pressure (Pes), and dyspnea intensity (Borg Scale) were measured during high-dose methacholine bronchoprovocation up to 256 mg/ml or a maximum change (Δ) in FEV1 of 50%. Contemporaneous control data from subjects with asthma (n = 12) who had completed the same protocol were used for comparison. At maximum response in quadriplegia, FEV1 decreased by 1.42 ± 0.18 L (62 ± 4%predicted) (mean ± SEM), and IC decreased by 0.89 ± 0.12 L (30 ± 4%predicted). Dyspnea at maximum response was rated “moderate” to “severe”: Borg 3.6 ± 0.3. The predominant qualitative respiratory sensations were inspiratory difficulty and unsatisfied inspiration. The best correlate of dyspnea (Borg) was ΔIC(%predicted) (p < 0.0005), whereas changes in FEV1, Pes-derived measurements and breathing pattern did not contribute further to the strength of this relationship. Dyspnea intensity, quality, and changes in spirometry and lung volumes at maximum response were similar to those reported previously in asthma. The relationship between dyspnea intensity and ΔIC(%predicted) was linear and consistent across groups. We conclude that the quality and intensity of dyspnea during methacholine-induced bronchoconstriction and dynamic hyperinflation was not altered by extensive chest wall deafferentation.
Clinical Features of Hypertrophic Cardiomyopathy Caused by Mutation of a “Hot Spot” in the Alpha-Tropomyosin Gene
Authors: Domenico A Coviello, Barry J Maron, Paolo Spirito, Hugh Watkins, Hans-Peter Vosberg, Ludwig Thierfelder, Frederick J Schoen, J.G Seidman, Christine E Seidman
Journal: Journal of the American College of Cardiology (1997)
In septic shock, early goal-directed or standard protocol-based therapy did not reduce mortality
Authors: Kevin M. King, Bruce D. Adams
Journal: Annals of Internal Medicine (2014)

ACP Journal Club17 June 2014In septic shock, early goal-directed or standard protocol-based therapy did not reduce mortalityKevin M. King, FACEP, MD, Bruce D. Adams, FACEP, MDKevin M. King, FACEP, MDDepartment of Emergency Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA (K.M.K., B.D.A.)Search for more papers by this author, Bruce D. Adams, FACEP, MDDepartment of Emergency Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA (K.M.K., B.D.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-160-12-201406170-02009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationProCESS Investigators, Yealy DM, Kellum JA, et al. A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014;370:1683-93. https://pubmed.ncbi.nlm.nih.gov/24635773Clinical Impact RatingsEmergency Med: Infectious Disease: Critical Care: References1 Swan HJ. The pulmonary artery catheter in anesthesia practice. 1970. Anesthesiology. 2005;103:890-3. [PMID: 16192783] Google Scholar2 Rivers E, Nguyen B, Havstad S, et al; Early Goal-Directed Therapy Collaborative Group. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368-77. [PMID: 11794169] Google Scholar3 Dellinger RP, Carlet JM, Masur H, et al; Surviving Sepsis Campaign Management Guidelines Committee. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004;32:858-73. [PMID: 15090974] Google Scholar4 Stevenson EK, Rubenstein AR, Radin GT, Wiener RS, Walkey AJ. Two decades of mortality trends among patients with severe sepsis: a comparative meta-analysis. Crit Care Med. 2014;42:625-31. [PMID: 24201173] Google Scholar5 National Quality Forum. Statement from NQF on review of sepsis measure. www.qualityforum.org/News_And_Resources/Press_Releases/2014/Statement_from_NQF_on_Review_of_Sepsis_Measure.aspx (accessed 5 May 2014). Google Scholar Author, Article, and Disclosure InformationAffiliations: Department of Emergency Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA (K.M.K., B.D.A.)This article was published at Annals.org on 3 June 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Effect of Early Goal-Directed Therapy on Outcome in Adult Severe Sepsis and Septic Shock PatientsImplementing Quality Measures for Inflammatory Bowel Disease 17 June 2014Volume 160, Issue 12Page: JC9KeywordsResuscitationRiversSepsisSystemic inflammatory response syndromeSystolic pressureVasopressors ePublished: 17 June 2014 Issue Published: 17 June 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Utility of Follow-up Tests for Detecting Recurrent Disease in Patients With Malignant Melanomas
Authors: Matthias Weiss
Journal: JAMA (1995)

To determine the effectiveness of follow-up tests for signaling recurrences in patients with intermediate- and high-risk malignant melanomas treated with curative intention.Retrospective analysis of prospectively collected data.North Central Cancer Treatment Group.A total of 261 patients with resected local (> or = 1.69 mm) and regional nodal malignant melanomas who were enrolled in a single prospective adjuvant trial were studied. All patients were scheduled to be followed up monthly for 2 months, then every 2 months for the first year, every 4 months the second year, every 6 months the next 3 years, and annually thereafter, with each visit consisting of a history, physical examination, complete blood cell count, blood chemistry panel, and a chest x-ray.Of the 145 evaluable patients who developed recurrent melanomas, 99 patients (68%) developed symptoms that signaled the diagnosis of recurrent disease. Physical examination of asymptomatic patients led to the diagnosis of recurrent disease in 37 patients (26%). The other nine patients (6%) with recurrent disease had abnormal chest x-rays. Laboratory results were never a sole indicator of recurrent disease.The majority of recurrences following resection of primary melanomas are discovered by history and/or physical examination despite the frequent use of other follow-up tests. The present data indicate that routine blood analyses and chest x-rays have limited value in the postoperative follow-up of patients with resected intermediate- and high-risk melanomas.