tbuckley/cabot-search huggingface dataset:
Community-Acquired Bacterial Meningitis: Risk Stratification for Adverse Clinical Outcome and Effect of Antibiotic Timing
Authors: Steven I. Aronin
Journal: Annals of Internal Medicine (1998)

Background: Community-acquired bacterial meningitis causes substantial morbidity and mortality in adults. Objective: To create and test a prognostic model for persons with community-acquired bacterial meningitis and to determine whether antibiotic timing influences clinical outcome. Design: Retrospective cohort study; patients were divided into derivation and validation samples. Setting: Four hospitals in Connecticut. Patients: 269 persons who, between 1970 and 1995, had community-acquired bacterial meningitis microbiologically proven by a lumbar puncture done within 24 hours of presentation in the emergency department. Measurements: Baseline clinical and laboratory features and times of arrival in the emergency department, performance of lumbar puncture, and administration of antibiotics. The target end point was the development of an adverse clinical outcome (death or neurologic deficit at discharge). Results: For the total group, the hospital mortality rate was 27%. Fifty-six of 269 patients (21%) developed a neurologic deficit, and in 9% the neurologic deficit persisted at discharge. Three baseline clinical features (hypotension, altered mental status, and seizures) were independently associated with adverse clinical outcome and were used to create a prognostic model from the derivation sample. The prediction accuracy of the model was determined by using the concordance index (c-index). For both the derivation sample (c-index, 0.73 [95% CI, 0.65 to 0.81]) and the validation sample (c-index, 0.81 [CI, 0.71 to 0.92]), the model predicted adverse clinical outcome significantly better than chance. For the total group, the model stratified patients into three prognostic stages: low risk for adverse clinical outcome (9%; stage I), intermediate risk (33%; stage II), and high risk (56%; stage III) (P = 0.001). Adverse clinical outcome was more common for patients in whom the prognostic stage advanced from low risk (P = 0.008) or intermediate risk (P = 0.003) at arrival in the emergency department to high risk before administration of antibiotics. Conclusions: In persons with community-acquired bacterial meningitis, three baseline clinical features of disease severity predicted adverse clinical outcome and stratified patients into three stages of prognostic severity. Delay in therapy after arrival in the emergency department was associated with adverse clinical outcome when the patient's condition advanced to the highest stage of prognostic severity before the initial antibiotic dose was given.
Abstract A21: Expression of placental growth factor in hepatocellular carcinoma and peritumoral liver and its prognostic significance
Authors: Hui-Chuan Sun, Hua-Xiang Xu, Xiao-Dong Zhu, Zhao-You Tang
Journal: Clinical Cancer Research (2010)

Abstract Vascular endothelial growth factor targeted therapy is a promising treatment for hepatocellular carcinoma (HCC), but its clinical benefit is often accompanied by acquired resistance. Antiplacental growth factor (PlGF) therapy is effective in animal study with less resistance. Role of PlGF in the progression of HCC is not clear. In this study, we investigated PlGF expression in tumor and peritumoral liver tissues from 105 HCC patients by immunohistochemistry in tissue microarrays. Intratumoral and peritumoral PlGF mRNA expression was analyzed in another cohort containing 37 patients. Peritumoral PlGF expression was significantly higher than intratumoral PlGF expression (P &amp;lt; 0.001). Intratumoral PlGF expression was not associated with patients’ overall survival (OS) or time to recurrence (TTR). However, peritumoral PlGF expression, which was associated with tumor size (P = 0.002), presence of intrahepatic metastasis (P = 0.005), TNM stage (P = 0.048), and BCLC stage (P = 0.001), was an independent risk factor for OS (P &amp;lt; 0.001) and TTR (P = 0.001). Prognostic value of peritumoral PlGF expression was validated in a validated cohort. Furthermore, we inferred that elevation of PlGF in peritumoral liver might be induced by hypoxia. And we found that peritumoral PlGF expression was associated with hypoxia-inducible factor 1α (HIF-1α) (P = 0.003) and PlGF expression was elevated in hepatic cell line L02 under hypoxia in vitro. These findings indicate that high peritumoral PlGF expression was associated with tumor recurrence and survival after resection of HCC. PlGF could be a target of adjuvant therapy and deserves further investigations. Citation Information: Clin Cancer Res 2010;16(14 Suppl):A21.
Making New Drugs via Combinatorial Chemistry
Authors: Donald F. Phillips
Journal: JAMA (1996)

DRUG DEVELOPMENT, as a problemsolving enterprise, uses a combination of two different approaches—one deductive, the other inductive. The deductive approach is characterized by a shotgun approach of testing a host of compounds thought to have specific pharmacologic properties to see which have the greatest effect on the test subject. The process moves from generalized knowledge to specific application and has always been time-consuming and labor-intensive. The inductive approach, which is considered more intellectually challenging, starts with a structural understanding of a drug's binding site to more narrowly search for, or design and synthesize, its specific complement. This structure-based design approach moves from specific information to more generalized application. Structure-based design has made substantial strides in the past decade. Six months ago, for example, Jane E. Brody in the<i>New York Times</i>(November 7, 1995) described the work of a Cornell University research team that received a $3.3 million grant from
1108-128 Myocardial stunning in hypertrophic cardiomyopathy is associated with progression to mild-to-moderate heart failure
Authors: Francesco Pelliccia, Cinzia Cianfrocca, Christian Pristipino, Vincenzo Pasceri, Antonino Granatelli, Antonio Auriti, Massimo Santini, Giuseppe Richichi
Journal: Journal of the American College of Cardiology (2004)
Diagnosis of Scarlatina.
Authors: E. W. Holmes
Journal: JAMA (1904)

Philadelphia, Aug. 8, 1904. <h3>To the Editor:</h3> —I was very much interested in your issue of August 6, page 397,<i>in re</i>Schamberg's differential diagnosis between scarlet fever and "scarlatiniform erythema," of which teachers and text-books in my student days said nothing. Several years ago I was called to see a young lady, about 17 years old, with sore throat, temperature about 100, a somewhat rapid pulse, muscular soreness and a universal red eruption, which I declared to be scarlatinous. The mother and daughter both laughed and the former said: "Doctor, she has had this several times before, and Dr. — and Dr. — have pronounced it each time to be scarlet fever." There was later on some desquamation. My patient and I agreed to disagree, though she followed my directions as to treatment, and she recovered, but forgot to pay the bill.
Unusual Regulation of a STAT Protein by an SLC6 Family Transporter in C. elegans Epidermal Innate Immunity
Authors: Katja Dierking, Jolanta Polanowska, Shizue Omi, Ilka Engelmann, Marta Gut, Frederique Lembo, Jonathan J. Ewbank, Nathalie Pujol
Journal: Cell Host & Microbe (2011)
Tom Rivers: Reflections on a Life in Medicine and Science
Authors: Howard A. Schneider
Journal: JAMA (1968)

This is an unusual and fascinating book about an unusual and fascinating man. When you read it you may hear the sounds of heavy breathing, from some important people of American medicine who will be reading this book with an attention as rapt as yours, although perhaps even a little more so. They will be anxious to see how they fared in the opinion and judgment of Tom Rivers, MD, of the Rockefeller Institute for Medical Research, a power in American medical science until his death in 1962, a man noted for his frank opinion, frankly and sometimes brutally expressed, and a man who was warm to his friends, hot to his enemies, a firebrand, a curmudgeon—a great guy. He was chairman of the Virus Research Committee of the National Foundation from 1938 until 1955. And he was Director of the Hospital of the Rockefeller Institute for Medical Research. During
SCINTIGRAPHIC DETECTION OF ATHEROSCLEROTIC LESIONS AND VENOUS THROMBI IN MAN BY INDIUM-111-LABELLED AUTOLOGOUS PLATELETS
Authors: HarmonH. Davis, BarryA. Siegel, J. Heinrich Joist, W.Andrew Heaton, CarlaJ. Mathias, LaurenceA. Sherman, MichaelJ. Welch
Journal: The Lancet (1978)
STUDIES IN THE COMMON COLD
Authors: A. R. Dochez, Gerald S. Shibley, Katherene C. Mills
Journal: The Journal of Experimental Medicine (1930)

1. Chimpanzees are highly suitable animals for the experimental study of human upper respiratory infections. 2. Human colds have been successfully transmitted to apes and human volunteers in 44 per cent of instances tried by means of filtered nasal washings obtained from colds. 3. Certain types of infectious colds are caused by a filtrable agent.
Measuring symptomatic relief in men with lower urinary tract symptoms
Authors: M. H. Blanker, K. R. v. Deventer, D. Bijl
Journal: BMJ (2014)

Most currently used drugs have been given too easy a ride

Lower urinary tract symptoms are common in the ageing population and have many causes.1 In men the various symptoms are still often attributed to benign prostatic hyperplasia, whatever their true cause2 and despite the remarks repeatedly made about nomenclature.3 Recently published guidelines and reviews on the evaluation and treatment of men with lower urinary tract symptoms rate four categories of drugs as efficacious: α blockers, 5-α reductase inhibitors, anticholinergics, and phosphodiesterase-5 inhibitors. 1 2 4 5

We are surprised at how highly these drugs are recommended given how well they work. While treatment effects are reported as being significantly better than those of placebo, we wonder whether the small differences in patient-reported symptom scores are perceptible to patients.

Most drugs used for these symptoms were investigated using the International Prostate Symptom Score (IPSS), …
Permanent left atrial pacing therapy may improve symptoms in heart failure patients with preserved ejection fraction and atrial dyssynchrony: a pilot study prior to a national clinical research programme
Authors: Gabriel Laurent, Jean Christophe Eicher, Anaëlle Mathe, Géraldine Bertaux, Olivier Barthez, Régine Debin, Clotilde Billard, Jean Luc Philip, Jean Eric Wolf
Journal: European Journal of Heart Failure (2012)
P767 PLASMA LEVELS OF GRO ASSOCIATE WITH FIBROSIS AND PLATELET COUNTS IN HCV INFECTED PATIENTS FROM THE VIRAHEP-C COHORT
Authors: S. Johansson, W. Talloen, M. Tuefferd, J. Darling, A. Scholliers, G. Fanning, M.W. Fried, J. Aerssens
Journal: Journal of Hepatology (2014)
Antibody Detection in Pernicious Anaemia
Authors: B. K. Armstrong, H. J. Woodliff
Journal: BMJ (1967)

injections of Primolut Depot (17-alpha-hexanoyl- preg-4-ene 3:20-dione), 250 mg.intramuscularly once weekly.She was Rh-positive, group A.On admission her haemoglobin estimation, total, and differential white-cell counts were within normal limits.On 14 October repeat blood count showed her total W.B.C. to be 11,100 cu.mm., of which 14% were eosinophils.From 10 to 24 September she was given A.C.T.H. injections daily, but she declined treatment by corticosteroid drugs.The rash at this stage was "less troublesome"-possibly under the influence of A.C.T.H. Weekly Primolut Depot injections were continued until she left the ward on 21 October.This preg- nancy terminated at seven and a half months with a stillbirth, and on 21 July 1964 pregnancy number five was diagnosed.At that time she complained of itching feet and spots on the arms.This pregnancy also terminated spon- taneously at about 12 weeks.She was next seen here on 11 December 1964 with a three-month history of recurrence of rash, which commenced soon after she began taking Ovulen (ethynodiol acetate 1 mg.-and mestranol 0.1 mg.).The Ovulen was stopped, and one week later the rash was fading.On 30 March she recommenced taking Ovulen, and on 17 April she developed a mild itchy eruption scattered over the trunk and limbs.She resumed her course of "pills" on 26 April, and by 13 May she had an extensive eruption on the trunk and limbs, especially over the
Quality of Care
Authors: Peter E. Friedell
Journal: JAMA (1992)

<h3>To the Editor.</h3> —The articles on quality of breast cancer care by Hand et al<sup>1</sup>and Lazovich et al,<sup>2</sup>along with the Editorial by Chassin,<sup>3</sup>were of special interest to me from my perspective as president of a small Chicago community hospital and as a clinical oncologist. This is the era of continuous quality improvement in our hospitals. We avoid placing blame, ie, finding bad apples (as the lay press has done in reporting<i>JAMA</i>articles), but we identify those problems that lead to the variations in indicators identified by the authors. A striking feature of Chicago's medical landscape is the lack of radiation therapy facilities on the south side of the city. Most small urban hospitals have no radiation therapy. Our machine, a small, rebuilt cobalt unit originally destined for a third-world country, was not installed until 1987. There is no other machine within the city
Changes of ventricular and peripheral performance in patients with heart failure and normal ejection fraction: insights from ergometry stress echocardiography
Authors: Jing Wang, Fang Fang, Gabriel Wai‐Kwok Yip, John E Sanderson, Pui‐Wai Lee, Wei Feng, Jun‐Min Xie, Xiu‐Xia Luo, Yat‐Yin Lam
Journal: European Journal of Heart Failure (2014)
The Investigator-Participant Relationship—Reply
Authors: Neal W. Dickert
Journal: JAMA (2009)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Patient Ratings of Case Managers in a Medical Home: Associations With Patient Satisfaction and Health Care Utilization
Authors: Lindsay E. Jubelt, Jove Graham, Daniel D. Maeng, Huilin Li, Andrew J. Epstein, Joshua P. Metlay
Journal: Annals of Internal Medicine (2014)

Background: Case managers are employed in medical homes to coordinate care for clinically complex patients. Objective: To measure the association of patient perceptions of case manager performance with overall satisfaction and subsequent health care utilization. Design: Retrospective cohort study. Setting: Integrated health system in Pennsylvania. Patients: Members of the health system–owned health plan who 1) received primary care in the health system's clinics, 2) were exposed to clinic-embedded case managers, and 3) completed a survey of satisfaction with care. Measurements: Survey assessment of case manager performance and overall satisfaction with care and claims-based assessment of case manager performance and subsequent hospitalizations or emergency department visits. Survey measures were dichotomized into very good versus less than very good. Results: A total of 1755 patients (44%) completed the survey and 1415 met study criteria. Survey respondents who reported very good ratings of case manager performance across all items had a higher probability of reporting very good overall satisfaction with care (92.2% vs. 62.5%; P < 0.001) and had a lower incidence of subsequent emergency department visits (incidence rate ratio, 0.79 [95% CI, 0.64 to 0.98]; P = 0.029) but not hospitalizations (incidence rate ratio, 0.92 [CI, 0.75 to 1.11]; P = 0.37) up to 2 years after the survey compared with survey respondents who reported less-than-very good case manager performance on 1 or more questions on the survey. Limitations: Satisfaction data demonstrated substantial ceiling effects. Survey nonresponse may have introduced bias in the results. Conclusion: Patients' favorable perceptions of case managers are associated with higher overall satisfaction with care and may lower risk for future acute care use. Primary Funding Source: Robert Wood Johnson Foundation and the U.S. Department of Veterans Affairs.
Childhood Leukemia — Successes and Challenges for Survivors
Authors: Joseph V. Simone
Journal: New England Journal of Medicine (2003)

I was a brand-new fellow in pediatric hematology–oncology, in July 1963, when I first cared for a child with acute leukemia. By then, with chemotherapy we were able to induce temporary remissions in many patients, but none of them were cured.At that time, the immediate clinical concerns arose mainly from thrombocytopenia and neutropenia. Life-threatening hemorrhage was a constant worry in patients with newly diagnosed or relapsed disease, and platelet transfusions were not yet widely available. Fatal intracranial or gastrointestinal hemorrhage was distressingly common. Infection, mainly by gram-negative organisms, threatened all patients who were not in remission. The most dreaded . . .
Amiodarone for Atrial Fibrillation
Authors: Peter Zimetbaum
Journal: New England Journal of Medicine (2007)

A 73-year-old man with coronary artery disease, hypertension, and renal insufficiency presents with recurrent, symptomatic atrial fibrillation despite a well-controlled ventricular rate. Amiodarone is recommended for rhythm control. Amiodarone is among the most effective antiarrhythmic agents, but its use is associated with potentially serious toxic effects — is it right for this patient?
The Interferons and Their Inducers: Molecular and Therapeutic Considerations
Authors: Sidney E. Grossberg
Journal: New England Journal of Medicine (1972)

THE interferon system is a mechanism of cellular defense or immunity, which man shares with most animals, including the teleost fishes. This natural defense system operates in numerous viral infections by means of the interferons, which are proteins produced by appropriately stimulated vertebrate cells. An interferon is operationally defined by its ability to confer antiviral resistance upon normally virus-susceptible animal cells, usually of the same species. This review, necessarily interpretive rather than completely comprehensive, will cover the following points: (1) certain aspects of the production of interferon, including the different kinds of compounds that stimulate its . . .
FDA Lifts Ban on Women in Early Drug Tests, Will Require Companies to Look for Gender Differences
Authors: Paul Cotton
Journal: JAMA (1993)

NEW POLICIES at the Food and Drug Administration (FDA) should substantially aid the understanding and advancement of women's health issues. The date of the official announcement and policy change had not been set at press time. But Eileen Leonard, MD, of the agency's Center for Drug Evaluation and Research, confirms that the rule against including fertile women in early clinical trials, enacted in 1977, is being lifted. "We are increasingly aware that there are approaches to ensuring the safety of the fetus other than completely excluding women of childbearing potential," says Leonard. Other precautions can be taken, such as informing women of the risks, ensuring that they practice contraception, doing pre-enrollment pregnancy testing, and the like, she says. <h3>'Other Players'</h3> "Also, we recognize that there are other players in clinical trials who should have a say in that decision. Clearly the women, the investigators, and IRBs [institutional review boards] should
DIABETIC COMA AND INSULIN
Authors: LEWIS FOX FRISSELL
Journal: JAMA (1926)

Before Banting's discovery of insulin, diabetic coma was a serious condition to treat, both in the wards of the hospital and in private practice. Since the advent of insulin, the mortality has diminished to such an extent and with such rapidity that death caused by diabetic coma now appears as unnecessary. In this article, an attempt is being made to show the difference in mortality before the discovery of insulin and since that time, with especial reference to diabetic coma. For this purpose, all diabetic patients admitted to the wards of St. Luke's Hospital during a period of four years are made subjects of study; they are divided into two groups, group 1 covering the preinsulin and group 2 the postinsulin years. It will be noted that the first, or preinsulin, group covers the two years just prior to the discovery of insulin, and the second group covers the first
Phonocardiographic Diagnosis of Aortic Ball Variance
Authors: JOHN C. HYLEN, FRANK E. KLOSTER, RODNEY H. HERR, PAUL Q. HULL, ALAN W. AMES, ALBERT STARR, HERBERT E. GRISWOLD
Journal: Circulation (1968)

Fatty infiltration causing changes in the silastic poppet of the Model 1000 series Starr-Edwards aortic valve prostheses (ball variance) has been detected with increasing frequency and can result in sudden death. Phonocardiograms were recorded on 12 patients with ball variance confirmed by operation and of 31 controls. Ten of the 12 patients with ball variance were distinguished from the controls by an aortic opening sound (AO) less than half as intense as the aortic closure sound (AC) at the second right intercostal space (AO/AC ratio less than 0.5). Both AO and AC were decreased in two patients with ball variance, with the loss of the characteristic high frequency and amplitude of these sounds. The only patient having a diminished AO/AC ratio (0.42) without ball variance at reoperation had a clot extending over the aortic valve struts. The phonocardiographic findings have been the most reliable objective evidence of ball variance in patients with Starr-Edwards aortic prosthesis of the Model 1000 series.
Seamless shoes in rheumatoid arthritis--preliminary trial.
Authors: A. S. Dixon, A. Franklin
Journal: BMJ (1968)

and severely crippling disease is accorded the attention that its importance merits.If leprosy is diagnosed early enough and is treated properly, nerve damage can generally be prevented, social dislocation avoided, and the cycle of transmission interrupted.Every doctor working in the tropics should strive towards this ideal.
Critics attack decision to allow federally funded researchers more time to publish trial results
Authors: C. Santry
Journal: BMJ (2012)

Rules on publishing publicly funded medical research in Canada are being relaxed in a move that has been criticised as “backwards.”

From January 2013 researchers will have a year to make peer reviewed work that is funded by the Canadian Institutes of Health Research (CIHR) freely available online after it is published in journals.

The CIHR’s new policy on open access gives researchers twice as long as the current guidance does to make their findings public. The decision comes in spite of strong pressure for medical research in Canada to be made more transparent.

The open access policy, which covers bioinformatics, atomic, and …
Altered glycosylation of platelet-derived von Willebrand factor confers resistance to ADAMTS13 proteolysis
Authors: Rachel T. McGrath, Maartje van den Biggelaar, Barry Byrne, Jamie M. O’Sullivan, Orla Rawley, Richard O’Kennedy, Jan Voorberg, Roger J. S. Preston, James S. O’Donnell
Journal: Blood (2013)