tbuckley/cabot-search huggingface dataset:
New Item on Pediatric Menu: Food Allergy
Authors: Rebecca Voelker
Journal: JAMA (2010)

at the University of California-Davis and a former president of the academy, said that otherwise physicians may simply choose to prescribe short-acting opioids instead of long-acting or extendedrelease versions, even if a short-acting formulation is not the best option for the patient. That is exactly what happened, he said, when the state of California instituted a prescription monitoring program in which physicians were required to obtain triplicate prescription pads from law enforcement agencies to prescribe Schedule II (longacting or sustained-release) opioids. He explained that many physicians substituted short-acting opioids rather than participate in the program. In turn, while abuse of Schedule II drugs decreased, abuse of the short-acting drug hydrocodone increased. “We need to level the field for all these drugs, so all are equal when physicians are choosing one in the best interest of the patient,” said Fishman. Jenkins said during the briefing that the FDA has chosen to focus on the long-acting products because the agency has detected a strong safety signal for these products, particularly methadone. However, he agreed that immediate-release products also pose safety concerns, and that the agency had not yet decided whether the scope of the safety plan should be extended to include them. The American Academy of Pain Medicine has also proposed the creation of a national program or a linked state prescription monitoring program to allow physicians and pharmacists to access up-to-date information on their patients’ prescriptions. Such a program could help prevent individuals from obtaining multiple opioid prescriptions from different clinicians. Whilehebelievesthatillegaluseofprescription opioid drugs is largely driving the increase in opioid-associated deaths andinjuries,Fishman,whoalsowrotethe federation’sopioidprescribingguide,said that a lack of physician education on proper use is contributing. He said such training should begin in medical school and extend to all licensed physicians, to ensure that patients have access to good painmanagement.Onewaytoaccomplish thismightbetohavestatemedicalboards make such training a requirement for license renewal. “Pain is the most common reason patients visit a doctor,” Fishman said. “It’s an essential part of what we do. At some point, we must say if you are going to be a doctor, you must treat pain.”
A primary care market?
Authors: C. Ham
Journal: BMJ (1996)

want to know specifically what to recommend, and to members of the public, many of whom want to know how lit- tle they can get away with while still reaping the benefits.Studies suggest that increasing one's activity reduces the risk of coronary heart disease even if the recommended dose is not achieved.There is no apparent threshold, and each incre- ment further reduces the risk.12Among people who are already active, vigorous activity probably adds benefit, but how much and at what risk is uncertain.Injuries, and sudden death, may increase more with intensity than volume."'Developing a more active society will not be easy.Industrialised society systematically excludes physical activity from our daily lives.Even walking, the simplest and most natural of all activities, can require the commitment of a salmon swimming upstream to spawn.Many American communities have few pavements, no cycle paths, inaccessible stairways, inadequate public transport systems, problems with safety on the streets, and stores, schools, and workplaces that are many miles from homes.All of these factors make staying at home or driving cars more attractive than walking or bicycling.Highly individualised messages will be necessary.Despite their inadequate representation in the research literature, non- white men and women of all racial and etinic groups seem to accrue the same relative benefits from activity as white men.However, attitudes and behaviours are significantly influenced by sex, age, weight, marital status, socioeconomic status, 1 Berryman JW.The tradition of the "six things non-natural": exercise and medicine from
A new step toward standardization of serum hepatitis C Virus-RNA quantification in patients with chronic hepatitis C
Authors: Michèle Martinot-Peignoux, Nathalie Boyer, Véronique Le Breton, Gaëlle Le Guludec, Corinne Castelnau, Raoudha Akremi, Patrick Marcellin
Journal: Hepatology (2000)

The need to improve efficacy of antiviral therapy for chronic hepatitis C has prompted the development of quantitative assays, which allows the assessment of viral load before therapy. The aim of our study was to evaluate the clinical relevance of 3 serum HCV-RNA quantitative assays in 87 patients with chronic hepatitis C, the noncommercially available SuperQuant assay (National Genetic Institute), recently used in large international controlled trials, the most early and widely used Quantiplex HCV RNA v2.0 assay (branched DNA [bDNA] v2.0; Bayer Diagnostics, Puteaux, France), and the new generation Cobas Amplicor HCV Monitor assay (COBAS v2.0; Roche Diagnostics Systems, Meylan, France), which is a semiautomated reverse transcription-polymerase chain reaction (RT-PCR) assay. The level and range of quantification were similar between all assays and a strong correlation was observed over all HCV genotypes among the assays. Recent publications have suggested that the baseline cut-off level of 2 x 10(6) copies/mL, as determined by the SuperQuant assay, is able to discriminate between patients with low viral load from those with high viral load and can be used to predict responses to therapy. Because all 3 assays use different testing technologies we examined how many of our patients fell above this defined cut-off level when tested by the other assays; of 22 patients measured below 2 x 10(6) copies/mL with the SuperQuant assay, 17 of 22 and 19 of 22 patients were eligible with the bDNA v2. 0 and the COBAS v2.0 assays, respectively (P >.05). Our results indicate that the 2 commercial assays can be used to determine treatment schedules in patients with chronic hepatitis C, providing a flexibility in multicenter controlled trials by offering better accessibility of test results.
Editorial Matters
Authors: Phil B. Fontanarosa
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
Contribution of environmental fibers to respiratory cancer.
Authors: G S Omenn, J Merchant, E Boatman, J M Dement, M Kuschner, W Nicholson, J Peto, L Rosenstock
Journal: Environmental Health Perspectives (1986)

This article reviews studies of the carcinogenicity of mineral fibers, notably asbestos, and presents seven major recommendations for further research. Mineral fibers represent the greatest cause--after cigarette smoke--of respiratory cancer due to air pollutants. Past asbestos exposure may currently account for 2000 mesothelioma deaths per year and 4000 to 6000 lung cancer deaths per year. All major commercial types of asbestos (crocidolite, amosite, and chrysotile) can cause each of the major asbestos-related respiratory diseases. Lung cancers in asbestos-exposed individuals probably do not have a different distribution of histological types from that of non-asbestos-related lung cancers. Nonoccupational exposures are likely to be associated with malignant disease outcomes qualitatively similar to those associated with occupational exposures. Further investigations of fibers are needed to characterize the relationships among physicochemical properties, patterns of migration and clearance, dose, and adverse health effects. Transmission electron microscopy has been found to be the preferred method of analysis of environmental fibers. Relations among time factors (e.g., age at first exposure), dose, and risk for adverse health effects require analyses of existing and new epidemiologic studies of exposed cohorts. Concomitant exposure, behavioral factors, and host factors affecting susceptibility to asbestos should be identified.
INCREMENTAL PROGNOSTIC VALUE OF RENAL DYSFUNCTION FOR THE PREDICTION OF CLINICAL OUTCOME IN PATIENTS UNDERGOING COMPUTED TOMOGRAPHY CORONARY ANGIOGRAPHY
Authors: Kai Hang Yiu, Joanne D. Schuijf, Jacob M. van Werkhoven, Fleur R. de Graaf, Joella D. van Velzen, Mark J. Boogers, C.J. Roos, Aju Pazhenkottil, J Wouter Jukema, Lucia J. Kroft, Eric Boersma, Bernhard Herzog, Albert de Roos, Philipp A. Kaufmann, Jeroen J. Bax
Journal: Journal of the American College of Cardiology (2011)
METABOLISM AND MOUTH-DISEASE
Authors: HENRY R. HARROWER
Journal: JAMA (1910)

Since there is a very close relationship between the functions of the various organs of the body, it is not unreasonable to suppose that disorganization in one part will be accompanied or followed by disturbances elsewhere. From a study of conditions as they are to-day in both medicine and dentistry, however, it would seem that this important fact is not as fully appreciated as might be expected.  It is generally believed that certain more or less intractable diseases of the mouth or its contents are, to a greater or less degree, either accompanied by or associated with changes in the normal metabolic functions of the body. In spite of this comparatively few physicians are stimulated to look carefully into the mouth when evident errors of the metabolism are known to be present; nor do our dental confreres investigate the metabolism of those of their patients who are suffering from the all-too-common
General System Theory: Foundations, Development, Applications
Authors: Marjorie C. Meehan
Journal: JAMA (1969)

When, in the forties, von Bertalanffy, a biologist, started writing about general system theory, relatively little attention was paid him. Gradually, however, scientists have become interested in seeing relationships among their fields and have been impressed by this promising effort to find common laws applying to such widely diverse subjects as biology, economics, psychology, and demography. Developments in information theory, computer and technology, and cybernetics are related to general system theory and have contributed to it. In this book von Bertalanffy presents nine papers which he had published from 1940 to 1969 and a newly written introductory chapter. Together they present a clear picture of the theory and some of its applications, although with some repetition. Two chapters include mathematical formulations which are difficult for the nonmathematician to follow, but the rest of the book is easily comprehended. The section on psychiatry and psychology is a brief condensation of the
Housewives with raw potato‐induced bronchial asthma
Authors: S. QUIRCE, M. L. DÍEZ GÓMEZ, M. HINOJOSA, M. CUEVAS, V. UREÑA, M. F. RIVAS, J. PUYANA, J. CUESTA, E. LOSADA
Journal: Allergy (1989)

Allergy to white potato has rarely been described. We report two cases of atopic patients, housewives, in whom peeling raw potatoes precipitated rhinoconjunctivitis and asthmatic attacks, and, in one of them, contact urticaria. Type I hypersensitivity to raw potato antigens was demonstrated by means of immediate skin test reactivity, specific IgE determination by RAST, basophil degranulation, histamine release test and an immediate bronchial provocation test response to raw potato extract. The controls did not react to any of these tests. Potato allergenic constituent is currently being investigated but, as far as we know, it is heat‐labile and has an MW of more than 10 Kd.
Clinical pharmacology and toxicology of dichloroacetate.
Authors: P W Stacpoole, G N Henderson, Z Yan, M O James
Journal: Environmental Health Perspectives (1998)

Dichloroacetate (DCA) is a xenobiotic of interest to both environmental toxicologists and clinicians. The chemical is a product of water chlorination and of the metabolism of various drugs and industrial chemicals. Its accumulation in groundwater and at certain Superfund sites is considered a potential health hazard. However, concern about DCA toxicity is predicated mainly on data obtained in inbred rodent strains administered DCA at doses thousands of times higher than those to which humans are usually exposed. In these animals, chronic administration of DCA induces hepatotoxicity and neoplasia. Ironically, the DCA doses used in animal toxicology experiments are very similar to those used clinically for the chronic or acute treatment of several acquired or hereditary metabolic or cardiovascular diseases. As a medicinal, DCA is generally well tolerated and stimulates the activity of the mitochondrial pyruvate dehydrogenase enzyme complex, resulting in increased oxidation of glucose and lactate and an amelioration of lactic acidosis. By this mechanism, the drug may also enhance cellular energy metabolism. DCA is dehalogenated in vivo to monochloroacetate and glyoxylate, from which it can be further catabolized to glycolate, glycine, oxalate, and carbon dioxide. It remains to be determined whether important differences in its metabolism and toxicology exist in humans between environmentally and clinically relevant doses.
Analysis of TCR antagonism and molecular mimicry of an HLA-A*0201-restricted CTL epitope in primary biliary cirrhosis
Authors: Hiroto Kita, Shuji Matsumura, Xiao-Song He, Aftab A. Ansari, Zhe-Xiong Lian, Judy Van de Water, Ross L. Coppel, Marshall M. Kaplan, Eric M. Gershwin
Journal: Hepatology (2002)

Although the etiology and mechanism of primary biliary cirrhosis (PBC) is unknown, growing evidence suggests a major role for T cells. We have recently identified the first CD8 T-cell epitope, amino acid 159-167 of the E2 component of pyruvate dehydrogenase complexes (PDC-E2). To seek for analogue peptide-antagonizing effector function of CTLs specific for this autoantigen, we examined the effector functions of the PDC-E2-specific CTLs against alanine substituted peptides. Furthermore, because molecular mimicry has been postulated as a possible cause of initiating PBC, we carried out studies aimed at identifying naturally occurring peptides for the 159-167 peptide of PDC-E2 that may serve as agonists. An alanine substitution at position 5 of this epitope significantly reduced peptide-specific effector functions of CTLs. Moreover, this analogue peptide inhibited effector functions of the CTLs to the prototype peptide, including cytotoxicity and IFN-gamma production. We also identified a peptide derived from Pseudomonas aeruginosa, which showed a higher binding affinity to the HLA-A*0201 than the prototype peptide. This homologous peptide was recognized by CTLs specific for the prototype epitope on PDC-E2. In conclusion, a modification of the immunodominant autoepitope can be utilized to manipulate the CD8 T-cell responses against the autoantigen PDC-E2. Our finding also supports the thesis that molecular mimicry may be implicated in the initiation of the autoreactive CD8 T-cell responses and has implications for the use of such peptides for immunotherapy.
Organizing and Delivering Health Care
Authors: Milford O. Rows
Journal: JAMA (1967)

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
Culture and selection of viable blastocysts: a feasible proposition for human IVF?
Authors: D. Gardner
Journal: Human Reproduction Update (1997)

In human in-vitro fertilization (IVF) embryos are routinely transferred to the uterus on day 2 or day 3 of development. Resultant implantation and pregnancy rates are disappointingly low, with only 10% of embryos transferred leading to a live birth. The ability to culture embryos to the blastocyst stage should help to resolve this problem by synchronizing the embryos with the female reproductive tract, and by identifying those embryos with little developmental potential. Co-culture has offered a possible means of producing blastocysts capable of high implantation rates. However, recent developments in the field of embryo physiology and metabolism have led to the formulation of new sequential serum-free culture media capable of supporting the development of viable blastocysts in several mammalian species, including the human. It is therefore proposed that blastocyst transfer should be considered for routine use in human IVF. The high viability of blastocysts cultured in the appropriate sequential media means that fewer embryos are required for transfer to achieve a pregnancy, culminating in fewer multiple births. Furthermore, the development of suitable non-invasive tests of embryo viability should further increase the overall success of human IVF by the ability to select before transfer those blastocysts most able to establish a pregnancy.
Incidence and severity of childhood pneumonia in the first year of life in a South African birth cohort: the Drakenstein Child Health Study
Authors: David M le Roux, Landon Myer, Mark P Nicol, Heather J Zar
Journal: The Lancet Global Health (2015)

BackgroundChildhood pneumonia causes substantial mortality and morbidity. Accurate measurements of pneumonia incidence are scarce in low-income and middle-income countries, particularly after implementation of pneumococcal conjugate vaccine. We aimed to assess the incidence, severity, and risk factors for pneumonia in the first year of life in children enrolled in a South African birth cohort.MethodsThis birth cohort study is being done at two sites in Paarl, a periurban area of South Africa. We enrolled pregnant women (>18 years) and followed up mother–infant pairs to 1 year of age. We obtained data for risk factors and respiratory symptoms. Children received 13-valent pneumococcal conjugate vaccine according to national immunisation schedules. We established pneumonia surveillance systems and documented episodes of ambulatory pneumonia and pneumonia warranting hospital admission. We calculated incidence rate ratios for pneumonia with mixed-effects Poisson regression.FindingsBetween May 29, 2012 and May 31, 2014, we enrolled 697 infants who accrued 513 child-years of follow-up. We recorded 141 pneumonia episodes, with an incidence of 0·27 episodes per child-year (95% CI 0·23–0·32). 32 (23%) pneumonia cases were severe pneumonia, with an incidence of 0·06 episodes per child-year (95% CI 0·04–0·08). Two (1%) of 141 pneumonia episodes led to death from pneumonia. Maternal HIV, maternal smoking, male sex, and malnutrition were associated with an increased incidence of pneumonia.InterpretationPneumonia incidence was high in the first year of life, despite a strong immunisation programme including 13-valent pneumococcal conjugate vaccine. Incidence was associated with pneumonia risk factors that are amenable to interventions. Prevention of childhood pneumonia through public health interventions to address these risk factors should be strengthened.FundingBill & Melinda Gates Foundation, South African Thoracic Society, Federation of Infectious Diseases Societies of South Africa, and University of Cape Town.
Diabetes Is Not Caused by Cassava Toxicity: A study in a Tanzanian community
Authors: A B M Swai, D G Mclarty, B L Mtinangi, S Tatala, H M Kitange, N Mlingi, H Rosling, W P Howlett, G R Brubaker, K G M M Alberti
Journal: Diabetes Care (1992)

OBJECTIVE To test the hypothesis that consumption of cassava with liberation of cyanide causes diabetes in malnourished individuals. RESEARCH DESIGN AND METHODS Glucose tolerance was assessed in two rural communities in Tanzania; in one (Nyambori), the main source of calories was cassava; and in the other (Uswaa), cassava was rarely eaten. Undernutrition was prevalent in both communities. The people of Nyambori were known to have high dietary cyanide exposure for many years from consumption of insufficiently processed cassava. Of the 1435 people in Nyambori ≥ 15 yr old, 1067 (74%) were surveyed, and 1429 of 1472 (97%) eligible subjects in Uswaa were surveyed. All had 75-g oral glucose tolerance tests and measurement of BMI. Plasma and urine thiocyanate and blood cyanide also were measured in some subjects. RESULTS Mean ± SD plasma and urine thiocyanate levels in Nyambori were 296 ± 190 and 497 ± 457 μM (n = 204), respectively, compared with 30 ± 37 and 9 ± 13 μM, respectively, in Uswaa (n = 92) (P &amp;lt; 0.001 for all differences). The mean blood cyanide level in Nyambori was elevated (1.4 [range 0.1–30.2] μM; n = 91). The prevalence of diabetes in the cassava village (Nyambori) was 0.5% compared with 0.9% in Uswaa (NS). The prevalence of IGT was similar in the two villages in the 15- to 34- and the 34- to 54-yr-old age-groups; but in those ≥ 55 yr old, IGT was higher in Nyambori (17.4 vs 7.2%, P = 0.029). Mean fasting and 2-h blood glucose levels were slightly higher in Nyambori village after adjusting for age, sex, and BMI (4.5 vs. 4.2 and 5.0 vs. 4.4 mM, respectively). CONCLUSIONS High dietary cyanide exposure was not found to have had a significant effect on the prevalence of diabetes in an undernourished population in Tanzania. Cassava consumption is thus highly unlikely to be a major etiological factor in so-called MRDM, at least in East Africa.
Naturally Attenuated HIV — Lessons for AIDS Vaccines and Treatment
Authors: Kathleen L. Collins, Gary J. Nabel
Journal: New England Journal of Medicine (1999)

The pathogenic effects of infection by the human immunodeficiency virus (HIV) are controlled by genes encoded by the virus and the host. One of the HIV genes, called nef, is associated with increased viral loads in animal models.1 Nef protein promotes efficient production of virus and evasion of host immune defenses2,3 through diverse mechanisms. The protein modulates T-cell signaling and also decreases the expression of important cell-surface proteins, including the class I histocompatibility and CD4 antigens.4 In this issue of the Journal, Learmont and colleagues provide insight into the natural history of infection by an attenuated virus with a . . .