tbuckley/cabot-search huggingface dataset:
Ethics, Consent, and Controlled Clinical Trial
Authors: Maxwell Finland
Journal: JAMA (1966)

Considerable interest has been focused recently on the moral, ethical, and legal issues involved in human experimentation.The obvious and gross encroachments on the rights, feelings, and even life of individuals disclosed in the Nuremberg trials exemplified, in a grossly distorted manner, the extreme potentials of investigations in humans which first gave rise to this renewed concern. In another sphere, the large number of deaths that resulted from the use of an improperly chosen solvent for sulfanilamide led to the first group of amendments to the federal Food, Drug and Cosmetic Act designed to insure the safety of drugs. The more recent thalidomide tragedy hastened the passage of the Kefauver-Harris amendments and also spurred the provision of many new regulations to insure the efficacy as well as the safety of drugs. In each of these instances, the uncovering of some major tragedy, and scrutiny of the events leading to it, have
A double‐blind study of hyposensitization with an alginate conjugated extract of <i>D. pteronyssinus</i> (Conjuvac®) in patients with perennial rhinitis
Authors: O. J. Corrado, E. Pastorello, S. Ollier, L. Cresswell, C. Zanussi, C. Ortolani, A. Incorvaia, A. Fugazza, J. R. Lovely, R. L. Harris, H. K. Watson, R. J. Davies
Journal: Allergy (1989)

The efficacy of hyposensitization with standardised extract of Dermatophagoides pteronyssinus (D. pteronyssinus) conjugated to alginate and containing known amounts of antigen P1 (Conjuvac®) was tested in a double blind, placebo controlled, multi‐centre study in 66 adult patients with perennial rhinitis. Patients received 11 weekly injections of increasing concentrations of Conjuvac containing from 56 × 10 1 to 448 × 10 3 IU D. pteronyssinus or placebo injections of the alginate diluent to some of which 5 μg of histamine has been randomly added This was followed by 15 monthly injections of Conjuvac or placebo. The severity of nasal blockage, sneezing and rhinorrhoea was recorded twice daily in a diary and visual analogue assessments (VAS) made at each clinic visit. Nasal provocation testing (NPT) was performed with increasing concentrations of the same extract of D. pteronyssinus as used in the hyposensitization injections, and changes in nasal airways resistance measured by passive anterior rhinomanometry. VAS was recorded and NPT was performed on entry to the study and after the fifth, ninth and final monthly injection. Conjuvac injections were well tolerated. Large local reactions (&gt; 5 cm) occurred within 30 min in only 1% of patients but later in 23%. No systemic reactions or anaphylaxis occurred within 30 min of injections, but urticaria or worsening of asthma and rhinitis was reported later in 3% of patients. A significant improvement in nasal obstruction occurred in the Conjuvac compared to the placebo treated group ( P &lt; 0.01) and there was significant increase in the percentage of patients able to tolerate provocation with the highest concentrations of D. pteronyssinus extract after nine and 15 maintenance injections of Conjuvac compared to the placebo ( P 0.02, P &lt; 0.001). Patient use of additional therapy decreased sooner in the Conjuvac treated group but was minimal in both groups after 5 months of the study.
Multiple Lessons for Multiple Sclerosis
Authors: Stephen L. Hauser
Journal: New England Journal of Medicine (2008)

Multiple sclerosis is a cruel disease. It strikes young adults, runs a chronic, unpredictable course, and is eventually disabling for many patients.1 Both inherited and environmental factors influence the risk and course of the disease.2 Multiple sclerosis is one of the great unsolved mysteries in modern medicine, with a number of striking epidemiologic features, including an increasing global frequency, an inverse relationship between serum 25-hydroxyvitamin D levels and disease risk, and a tantalizing association with Epstein–Barr virus infection.Multiple sclerosis usually begins as a relapsing–remitting disease, but in most patients a steadily progressive neurologic disorder ultimately ensues. As a general . . .
What's embodied in a smile?
Authors: Disa A. Sauter, Stephen C. Levinson
Journal: Behavioral and Brain Sciences (2010)

Abstract Differentiation of the forms and functions of different smiles is needed, but they should be based on the empirical data on distinctions that senders and receivers make and on the physical cues that are employed. Such data would allow for a test of whether smiles can be differentiated using perceptual cues alone or whether mimicry or simulation are necessary.
Managing Behavioral Health in Medicaid
Authors: David Mechanic
Journal: New England Journal of Medicine (2003)

Mental health and substance abuse services, commonly referred to as behavioral health services, have been more aggressively managed than most other medical and surgical services.1 Managed behavioral health organizations came to public programs from the private sector, where they substantially reduced the number of inpatient days for behavioral health problems, as well as the overall expenditures related to behavioral health. Many state Medicaid administrators, concerned about growing expenditures, have contracted with such organizations or capitated local providers, such as community mental health centers, to manage behavioral health benefits separately from other medical care.2 Such behavioral health "carve-out" programs come in . . .
Foods of the Future
Authors: Henry I. Miller
Journal: JAMA (1993)

ALTHOUGH most of the genetically altered "foods of the future" are similar to the foods we are familiar with, the techniques of the new biotechnology are subtly changing and improving the foods we eat. The Food and Drug Administration (FDA) already has paved the way for the arrival of the new food products and processes by announcing on May 29, 1992, its policy on the oversight of new varieties of food plants.<sup>1</sup>But because of the scientific issues involved (eg, allergenicity) as well as consumers' reservations about such products and their general lack of understanding of the FDA's policy, it is important that physicians—a trusted source of health-related advice—be informed on the nuances of the subject. This article attempts to place in a scientific perspective new crop varieties obtained by conventional and new techniques and describes the FDA's approach to their oversight. <h3>The History of Genetic Engineering Applied to</h3>
Meckel’s Scan: Pitfall in Patients With Active Small Bowel Bleeding
Authors: Mark Tulchinsky
Journal: Clinical Nuclear Medicine (2006)

Potential for a false-positive Meckel's scan is highlighted in this patient with intermittent, low-volume small bowel bleeding. Meckel's scan showed late appearance of focal activity mimicking a positive diverticulum finding. This was secondary to extravasated tracer during a coincidental bleeding as shown by a Tc-99m tagged red blood cell scan obtained 2 days earlier. Inaccurate diagnosis of Meckel diverticulum was avoided by: 1) noticing the late appearance in relationship to the gastric uptake, and 2) showing motility of the focus on delayed dynamic imaging that confirmed transit of extravasated tracer along the small bowel with peristalsis. Subsequent capsule endoscopy showed a bleeding ulcer in the ileum.
1094 100% SVR IN IL28B CC PATIENTS TREATED WITH 12 WEEKS OF TELAPREVIR, PEGINTERFERON AND RIBAVIRIN IN THE PROVE2 TRIAL
Authors: J.-P. Bronowicki, C. Hezode, L. Bengtsson, S. Pol, M. Bourliere, L. Serfaty, V. de Ledinghen, A. Tran, Y. Benhamou, J.-D. Grange, P. Mathurin, P. Marcellin, C. Trepo, J.-P. Zarski, S. Seepersaud, K. Kelliher, M. Botfield, J.-M. Pawlotsky
Journal: Journal of Hepatology (2012)
The Importance of Placebo Effects
Authors: Ton J. M. Cleophas
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The issue of bias was not raised in the otherwise excellent article by Dr Turner and colleagues<sup>1</sup>on placebo effects. The point is that the placebo arm of a trial is particularly vulnerable to specific types of bias. In clinical trials, as opposed to regular patient care, patients are generally highly compliant and have a good feeling about the trial because they think it will provide something from which they can benefit. They also do not want to disappoint the investigators who have taken so much interest in them. This wish not to disappoint may produce an enhanced placebo effect on the part of the participants. Investigators, on the other hand, may find it difficult or impossible to tell the complete truth about the dummy<sup>2</sup>and usually exaggerate the potential of the trial. Furthermore, many phase IV trials do not include a written informed consent
THE RADICAL CURE OE HYDROCELE BY A NEW AMBULATORY METHOD.
Authors: J. N. BARTHOLOMEW
Journal: JAMA (1897)

The tendency of modern surgery is toward methods that shorten convalescence as much as is compatible with safety and toward ambulatory treatment when possible. As far as I have been able to ascertain no satisfactory ambulatory treatment of hydrocele by any radical method has been described. The nearest approach to it being the old method by injection, which in many instances is far from satisfactory. I wish here very briefly to detail a method of treatment that has been put to the test in a few cases with very gratifying results. Before describing this method I wish to review briefly the operations that have been most used and are usually employed today; to point out some of the deficiencies of these methods and contrast them with the procedure I am about to describe. In speaking of hydrocele I refer to an abnormal accumulation of fluid in the tunica vaginalis testis,
Mechanism of abnormal interventricular septal motion during delayed left ventricular activation.
Authors: W C Little, R C Reeves, J Arciniegas, R E Katholi, E W Rogers
Journal: Circulation (1982)

To evaluate the mechanism of the abnormal motion of the interventricular septum (IVS) seen echocardiographically in some patients with relatively delayed ventricular activation, we simultaneously recorded high-fidelity left and right ventricular pressures and electrograms and echocardiograms of the IVS in nine open-chest dogs. During sinus rhythm and during left IVS pacing, the IVS was activated from left to right, preejection left ventricular pressure exceeded right ventricular pressure, and IVS motion was normal. During right ventricular pacing from the outflow tract, apex, free wall or right IVS was activated from right to left, right ventricular pressure increased before left ventricular pressure and simultaneously there was an abrupt posterior IVS motion. Simultaneous pacing from the right IVS and left ventricular free wall activated the IVS from right to left and produced a normal transseptal preejection pressure gradient and normal IVS motion. Simultaneous pacing from the left IVS and right ventricular free wall activated the IVS from left to right, and produced abrupt preejection posterior IVS motion coincident with an altered transseptal pressure gradient. During right ventricular pacing, IVS motion after the abrupt preejection posterior movement was variable. Anterior motion was associated with a greater asynchrony of right and left ventricular contraction than was normal posterior motion. We conclude that abrupt preejection posterior IVS motion seen with delayed left ventricular activation from right ventricular pacing is due to passive IVS displacement from an altered transseptal pressure gradient, and subsequent IVS motion depends on the degree of asynchrony between right and left ventricular contraction.
Of Red Cell Bondage
Authors: Walter B. Shelley
Journal: JAMA (1983)

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 2408: Identification of R-Spondin fusions in various types of human cancer
Authors: Gabriela Martinez Cardona, Katherine Bell, Joseph Portale, Dana Gaffney, Christopher Moy, Suso Platero, Matthew V. Lorenzi, Jayaprakash Karkera
Journal: Cancer Research (2014)

Abstract Autocrine or paracrine constitutive Wnt pathway activation occurs at a high frequency in several tumor types. The R-spondin (RSPO) protein family is comprised of four secreted growth factors. The four paralogs share 40-60% pairwise amino acid sequence identity and are predicted to share substantial structural homology. RSPO proteins are involved in vertebrate development and their ligand-type activities overlap substantially with those of canonical Wnt ligands. A characteristic feature of all four RSPO members is their ability to activate β-catenin signaling and enhance WNT-mediated β-catenin activation. It has recently been described that recurrent gene fusions involving RSPO family members RSPO2 and RSPO3 occur in ∼10% of colon tumors. In this study we developed a TaqMan qRT-PCR-based approach to evaluate the expression of these three (3) RSPO fusion transcripts in formalin-fixed paraffin embedded tissue (FFPET) samples. We examined 324 lung cancer, 81 colorectal cancer, 71 head &amp; neck, 11 esophageal, 92 ovarian cancer, and 103 breast cancer FFPET samples for the presence of EIF3E(e1)-RSPO2(e1), PTPRK(e1)-RSPO3(e2), and PTPRK(e7)-RSPO3(e2). EIF3E(e1)-RSPO2(e1), a fusion which is expected to produce a functional RSPO2 protein driven by the EIF3E promoter, was identified in ∼1-2% of most of cancer types with the exception of breast cancer. The PTPRK(e1)-RSPO3(e2) fusion was expressed by ∼1-11% of the samples in the different cancers, making it the most prevalent of the fusions. PTPRK(e1)-RSPO3(e2) fusion is an in-frame fusion that preserves the entire coding sequence of RSPO3 and replaces its secretion signal sequence with that of PTPRK. The PTPRK(e7)-RSPO3(e2) fusion is also an in-frame fusion in which the RSPO3 native signal peptide is replaced by the secretion signal of PTPRK. The PTPRK(e7)-RSPO3(e2) was the least prevalent of all the fusions, positive samples were found exclusively in the head and neck (∼2%) and breast cancer samples (∼2%). All of the fusions detected were mutually exclusive. The RSPO gene fusions identified may provide new potential opportunities for therapeutic intervention. Citation Format: Gabriela Martinez Cardona, Katherine Bell, Joseph Portale, Dana Gaffney, Christopher Moy, Suso Platero, Matthew V. Lorenzi, Jayaprakash Karkera. Identification of R-Spondin fusions in various types of human cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2408. doi:10.1158/1538-7445.AM2014-2408
Black-white differences in risk of developing retinopathy among individuals with type 2 diabetes.
Authors: E L Harris, S H Sherman, A Georgopoulos
Journal: Diabetes Care (1999)

OBJECTIVE: To assess racial differences in risk of developing retinopathy among individuals with type 2 diabetes, after taking into account differences in the distribution of risk factors for retinopathy. RESEARCH DESIGN AND METHODS: The participants were 105 individuals with type 2 diabetes, aged 40-69 years, who had no evidence of retinopathy at the time of a diabetic eye disease screening project. After an average of 4 years of follow-up, the subjects were reevaluated using nonmydriatic funds photography. RESULTS: Retinopathy occurred more often among black than white participants (50 vs. 19%). This difference could not be explained by differences in risk factors for retinopathy or potential confounders (odds ratio [95% CI] 2.96 [1.00-8.78] after adjustment for level of glycosylated hemoglobin, systolic blood pressure, type of diabetes treatment, and sex). CONCLUSIONS: These results are consistent with the concept that racial differences in risk of developing retinopathy exist among individuals with type 2 diabetes and that these differences may be caused by differential (genetic) susceptibility to the adverse effects of increased levels of blood glucose and/or blood pressure. Discovery of the etiology of this differential susceptibility would allows us to identify and target secondary prevention efforts to individuals with type 2 diabetes who are at increased risk of retinopathy.
Relative lactose intolerance. A clinical study of tube-fed patients
Authors: B. C. Walike
Journal: JAMA (1977)

A relative intolerance of lactose was demonstrated in 14 of 16 patients receiving nasogastric tube feedings following surgery for head or neck carcinoma. Two liquid diets differing only in the presence or absence of lactose, were administered for eight to 20 days per patient in a double-blind crossover study. Increased stool frequency, decreased stool consistency, and more frequent flatulence, borborygmi, and distention were found with the lactose diet, although classic lactose intolerance (plasma glucose rise of less than 26 mg/dl) was indicated in only two patients. Differences between amounts and times of peak rise following the glucose tolerance test and lactose tolerance test for each patient indicated the advisability of locating patients on a continuum of ability to hydrolyze lactose. The results indicate that lactose should be reduced or eliminated from tube-feeding diets to improve patient tolerance and comfort and to reduce diarrhea. (<i>JAMA</i>238:948-951, 1977)
Induced and spontaneous diabetes mellitus and suppression of cell-mediated immunologic responses. Granuloma formation, delayed dermal reactivity and allograft rejection.
Authors: A A Mahmoud, H M Rodman, M A Mandel, K S Warren
Journal: Journal of Clinical Investigation (1976)

These investigations delineate the recently described suppression of a form of cellular hypersensitivity in mice with streptozotocin-induced diabetes mellitus using a variety of cell-mediated immunologic responses in animals with several different forms of diabetes. Streptozotocin- and alloxan-induced diabetic mice and db/db genetically determined diabetic mice showed reductions in the areas of inflammation around Schistosoma mansoni eggs injected into the pulmonary vasculature of 68, 70, 77%, respectively. In contrast, streptozotocin-induced diabetes had no effect on the nonimmunologic foreign body granuloma around divinyl benzene copolymer beads injected into the pulmonary arterioles. Animals protected from diabetes by treatment with nicotinamide before streptozotocin administration did not develop hyperglycemia and had normal areas of immunologic granuloma formation around schistosome eggs. Treatment with insulin reversed the suppression of schistosome egg granuloma formation in both streptozotocin- and alloxan-diabetic animals. Two additional in vivo parameters of cellular immunologic reactivity were examined in streptozotocin-induced diabetes: delayed footpad swelling was essentially eliminated; skin graft survival across the H-2 area was significantly prolonged from 10.2 days in the controls to 14.4 days in moderately diabetic A/J mice. These observations suggest that diabetes mellitus is associated with suppression of cell-mediated reactions in vivo and that the defect is reversible with insulin treatment.
SYPHILIS AS A FACTOR IN THE ETIOLOGY OF MENTAL DEFICIENCY
Authors: MAX WEISS
Journal: JAMA (1924)

There are few problems in medicine concerning which more widely divergent views are expressed than those in regard to the rôle of syphilis in the etiology of mental deficiency. Thus, Key and Pijper,<sup>1</sup>in 1922, reported an incidence of 55.2 per cent. positive Wassermann reactions in 217 cases of amentia, at the same time, however, stressing the opinion that syphilis alone cannot be responsible for the amentia in all of these cases. Atwood<sup>2</sup>is quoted as stating that 14 per cent. of the mental defectives at the New York City Children's Hospital are syphilitic on the basis of Wassermann tests. We have been unable to trace the source of Atwood's information, but we note that he must have changed his opinion; for, in a more recent contribution,3 he asserts that syphilis is an uncommon cause of mental deficiency. E. Livingston Hunt<sup>4</sup>states that: "Mental defectiveness and deficiency
Toxicity of the Common Houseplant Dieffenbachia
Authors: George Drach
Journal: JAMA (1963)

THE TOXIC MANIFESTATIONS produced by oral contact with the houseplant<i>Dieffenbachia (D. sequine</i>or "dumb cane") (figure) can be alarmingly severe.<i>Dieffenbachia</i>is described as "a decorative pot plant," and one can scarcely estimate the number of these plants present in homes of the United States. The authors were surprised, however, to find<i>Dieffenbachia</i>growing in their own homes and to notice them in public places. A child or an uniformed adult could be subjected to unnecessary morbidity or mortality by ingestion of<i>Dieffenbachia</i>, and it is hoped that the medical profession will be elerted to this possibility by the following case report. <h3>Report of a Case</h3> A 40-year-old woman was seen in the hospital emergency room at 8 pm, May 4, 1962, because of sialorrhea, dysphagia, and pain of the mouth and tongue. She stated that she had bitten into the stalk of the houseplant<i>Dieffenbachia</i>at about 2
Quality of Health and Health Care
Authors: Kenneth I. Shine
Journal: JAMA (1995)

The demise of federal efforts at health care system reform produced a number of losers. The non—Medicaid-eligible poor will continue to struggle for adequate access to appropriate health care, particularly preventive and primary care services. Academic health centers will be adversely affected by the unwillingness of managed care organizations to pay a significant portion of the research and education costs previously financed from patient care revenues. Many Americans will potentially be at risk because of the failure to create any national mechanism for adequate oversight and assessment of quality of care. Although many managed care organizations initially were established to improve the quality of care for their members and all of these organizations espouse a commitment to quality, the reality remains that a cost-driven system runs the risk of compromising quality, particularly for those least able to understand it or to assess it. With the return of the focus of