tbuckley/cabot-search huggingface dataset:
Monitoring Osteoporosis Therapy With Bone Densitometry&lt;SUBTITLE&gt;Misleading Changes and Regression to the Mean&lt;/SUBTITLE&gt;
Authors: Steven R. Cummings
Journal: JAMA (2000)

ContextThe principle of "regression to the mean" predicts that patients with unusual responses to treatment might represent outliers who are likely to have more typical responses if treatment is continued without change.ObjectiveTo test whether women who lose bone mineral density (BMD) during the first year of treatment for osteoporosis continue to lose BMD if the same treatment is continued beyond 1 year.Design and SettingTwo randomized, double-blind, placebo-controlled trials in 11 US clinical research centers for the Fracture Intervention Trial and 180 centers in the United States and other countries for the Multiple Outcomes of Raloxifene Evaluation Trial.Participants and InterventionsPostmenopausal women with low BMD assigned to treatment with 5 mg/d of alendronate sodium in the Fracture Intervention Trial who completed 2 years of BMD monitoring and adhered to study medication (n = 2634), and postmenopausal women with osteoporosis assigned to treatment with 60 or 120 mg/d of raloxifene hydrochloride in the Multiple Outcomes of Raloxifene Evaluation trial who similarly completed 2 years of monitoring while adhering to study medication (n = 3954).Main Outcome MeasuresBaseline, 12-, and 24-month hip and spine BMD.ResultsWomen with the greatest loss of BMD during the first year of treatment were the most likely to gain BMD during continued treatment. Specifically, among women taking alendronate whose hip BMD decreased by more than 4% during the first year, 83% (95% confidence interval [CI], 82%-84%)had increases in hip BMD during the second year, with an overall mean increase of 4.7%. In contrast, those who seemed to gain at least 8% during the first year lost an average of 1% (95% CI, 0.1%-1.9%) during the next year. Similar results were observed among women taking raloxifene for 2 years.ConclusionsOur data suggest that most women who lose BMD during the first year of treatment with alendronate or raloxifene will gain BMD if the same treatment is continued for a second year. These results illustrate the principle of regression to the mean and suggest that effective treatments for osteoporosis should not be changed because of loss of BMD during the first year of use.
A continent in chaos: Africa's environmental issues.
Authors: R Clay
Journal: Environmental Health Perspectives (1994)

Half of Africa's almost 450 million inhabitants have no access to health services, while two-thirds lack safe drinking water, according to a 1991 report by the World Bank. Most Africans are also seriously affected by poverty, civil war, indoor and outdoor pollutants, diarrhea-causing microbes, tropical diseases such as malaria, rapid population growth, inadequate sanitation and sewage treatment, poor environmental management, corrupt government policies, desertification and deforestation, mining, and the overuse of pesticides and insecticides. Environmentally-related diseases compromise the continent's productivity, making it more difficult to generate revenue to fight the environmental health problems. Industrial pollutants remain rare, however, since almost 80% of sub-Saharan Africa remains pastoral or agro-pastoral. Even so, urbanization is exposing growing numbers of sub-Saharan Africans to hazardous and toxic wastes. Developing countries ship their most dangerous wastes to Africa because their own domestic environmental laws and the high costs of disposal make it difficult and expensive to dispose of them at home. The author discusses population growth in Africa; the lack of good data on the environment and health in Africa; infant and child mortality; water, sewage, and garbage; agriculture, mining, and industry; and sustainable development and the future.
"Existential" suffering not a justification for euthanasia
Authors: T. Sheldon
Journal: BMJ (2001)

A legal test case has defined the limits within which doctors in the Netherlands, especially general practitioners, can agree to a patient's request for mercy killing.

The judgment draws a line between suffering of a medical nature—the result of a physical illness or mental condition on which doctors can act under the euthanasia law—and “existential” suffering, often associated with ageing, resulting from loneliness, emptiness, and fear of further decline. It accepted expert opinion that doctors had no expertise to judge …
Flexible sigmoidoscopy screening reduced colorectal cancer incidence and mortality in older adults
Authors: Charles J. Kahi, Thomas F. Imperiale
Journal: Annals of Internal Medicine (2012)

ACP Journal Club18 September 2012Flexible sigmoidoscopy screening reduced colorectal cancer incidence and mortality in older adultsCharles J. Kahi, MD, MSc, FACP, FACG, AGAF, Thomas F. Imperiale, MD, FACP, AGAFCharles J. Kahi, MD, MSc, FACP, FACG, AGAFIndiana University; Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA (C.J.K., T.F.I.), Thomas F. Imperiale, MD, FACP, AGAFIndiana University; Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA (C.J.K., T.F.I.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-6-201209180-02003 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationSchoen RE, Pinsky PF, Weissfeld JL, et al; PLCO Project Team. Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy. N Engl J Med. 2012;366:2345-57. https://pubmed.ncbi.nlm.nih.gov/22612596Clinical Impact RatingsGIM/FP/GP: Gastroenterology: References1 Atkin WS, Edwards R, Kralj-Hans I, et al; UK Flexible Sigmoidoscopy Trial Investigators. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010;375:1624-33. [PMID: 20430429] Google Scholar2 Segnan N, Armaroli P, Bonelli L, et al; SCORE Working Group. Once-only sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian Randomized Controlled Trial—SCORE. J Natl Cancer Inst. 2011;103:1310-22. [PMID: 21852264] Google Scholar3 Baxter NN, Sutradhar R, Forbes SS, et al. Analysis of administrative data finds endoscopist quality measures associated with postcolonoscopy colorectal cancer. Gastroenterology. 2011;140:65-72. [PMID: 20854818] Google Scholar Author, Article, and Disclosure InformationAuthors: Charles J. Kahi, MD, MSc, FACP, FACG, AGAF; Thomas F. Imperiale, MD, FACP, AGAFAffiliations: Indiana University; Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA (C.J.K., T.F.I.)This article was published at Annals.org on 4 September 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEvaluation of Blood Stool Test Utilization for Colorectal Cancer Screening in Georgia, USABetween-ward disparities in colorectal cancer incidence and screening in Washington DCClinical Decision Support With Natural Language Processing Facilitates Determination of Colonoscopy Surveillance IntervalsNatural Language Processing Accurately Categorizes Findings From Colonoscopy and Pathology Reports 18 September 2012Volume 157, Issue 6Page: JC3-3KeywordsCancer screeningCancer treatmentColonoscopyColorectal cancerElderlyFlexible sigmoidoscopyLung and intrathoracic tumorsMortalityOvarian cancerSmall cell lung cancer ePublished: 18 September 2012 Issue Published: 18 September 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Inflammasomes in Kidney Disease
Authors: Hans-Joachim Anders, Daniel A. Muruve
Journal: Journal of the American Society of Nephrology (2011)

Renal inflammation is a universal response to infectious and noninfectious triggers. Sensors of the innate immune system, such as Toll-like receptors or RIG-like receptors, provide danger recognition platforms on renal cells that integrate and translate the diverse triggers of renal inflammation by inducing cell activation and the secretion of proinflammatory cytokines and chemokines. As a new entry, the inflammasome-forming NLR genes integrate various danger signals into caspase-1-activating platforms that regulate the processing and secretion of pro-IL-1β and pro-IL-18 into the mature and active cytokines. Accumulating data now document a role for the NLRP3 inflammasome and IL-1β/IL-18 in many diseases, including atherosclerosis, diabetes, amyloidosis, malaria, crystal-related diseases, and other autoinflammatory disorders, identifying this innate immune pathway as an attractive therapeutic target. Here we review the current knowledge regarding inflammasome signaling and outline existing evidence on the expression and functional role of the inflammasome-caspase-1-IL-1β/IL-18 axis in kidney disease. We further provide a perspective on the potential roles of the inflammasomes in the pathogenesis of acute and chronic kidney diseases.
Platelet-Derived MHC Class I Confers a Pseudonormal Phenotype to Cancer Cells That Subverts the Antitumor Reactivity of Natural Killer Immune Cells
Authors: Theresa Placke, Melanie Örgel, Martin Schaller, Gundram Jung, Hans-Georg Rammensee, Hans-Georg Kopp, Helmut Rainer Salih
Journal: Cancer Research (2011)

Natural killer (NK) cells are cytotoxic lymphocytes that play an important role in tumor immunosurveillance, preferentially eliminating targets with low or absent expression of MHC class I and stress-induced expression of ligands for activating NK receptors. Platelets promote metastasis by protecting disseminating tumor cells from NK cell immunosurveillance, but the underlying mechanisms are not well understood. In this study, we show that tumor cells rapidly get coated in the presence of platelets in vitro, and circulating tumor cells of cancer patients display coexpression of platelet markers. Flow cytometry, immunofluorescent staining, confocal microscopy, and analyses on an ultrastructural level using immunoelectron microscopy revealed that such coating may cause transfer of MHC class I onto the tumor cell surface resulting in high-level expression of platelet-derived normal MHC class I. The resulting "phenotype of false pretenses" disrupts recognition of tumor cell missing self, thereby impairing cytotoxicity and IFN-γ production by NK cells. Thus, our data indicate that platelets, by conferring an unsuspicious "pseudonormal" phenotype, may enable a molecular mimicry that allows metastasizing tumor cells to downregulate MHC class I, to escape T-cell-mediated immunity without inducing susceptibility to NK cell reactivity.
The Costs of Doctoring, the Distribution of Physicians, and Caring for the Underinsured
Authors: James A. Albright
Journal: JAMA (1991)

<h3>To the Editor.</h3> —The articles in a recent issue of<i>JAMA</i>on the cost of medical care in Canada<sup>1</sup>and in this country<sup>2</sup>are misleading. Both report that medical costs increase as the number of physicians increases. The "solution" recommended is to ration medical care and to limit the number of physicians. There are two major problems with these articles, the most serious being the economic concepts. The other is philosophic and attitudinal. The underlying assumption considers the market system ineffective (and immoral) when applied to medical care. But the market system has been nonexistent in medicine for many years. Apparently, this creates the right to eliminate it a priori from serious consideration. A market system requires a consumer. The only valid consumer is the patient, but the patient has been replaced by third parties. As a result, neither patients nor physicians have much concern over costs because
A six-nucleotide insertion-deletion polymorphism in the CASP8 promoter is associated with susceptibility to multiple cancers
Authors: Tong Sun, Yang Gao, Wen Tan, Sufang Ma, Yuankai Shi, Jiarui Yao, Yongli Guo, Ming Yang, Xuemei Zhang, Qingrun Zhang, Changqing Zeng, Dongxin Lin
Journal: Nature Genetics (2007)
The Creation of Adam: Divine Funster Decrees We Are What We Eat: Chicken?
Authors: Howard L. Mussell
Journal: JAMA (1991)

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
Potent activity of carfilzomib, a novel, irreversible inhibitor of the ubiquitin-proteasome pathway, against preclinical models of multiple myeloma
Authors: Deborah J. Kuhn, Qing Chen, Peter M. Voorhees, John S. Strader, Kevin D. Shenk, Congcong M. Sun, Susan D. Demo, Mark K. Bennett, Fijs W. B. van Leeuwen, Asher A. Chanan-Khan, Robert Z. Orlowski
Journal: Blood (2007)
The hair cycle on the human thigh and upper arm
Authors: SANDRA V. SEAGO, F.J. EBLING
Journal: British Journal of Dermatology (1985)

Hair follicle density, and definitive length, root status and rate of growth of hairs were determined for defined areas of the thigh and upper arm in 11 females and nine males aged 20-30 years. Hair follicle density did not differ between males and females. However, on the thigh the definitive length of hair was on average three times greater in males. This was attributable mainly to a longer duration of anagen (X 2 X 46), but also to a greater rate of growth (X 1 X 22). On the upper arm the hair was only 1 X 42 times longer and the duration of anagen only 1 X 27 times greater in males than in females. On the thigh the estimated average duration of anagen was 54 days in males and 22 days in females, with corresponding figures of 151 days and 84 days for the complete cycles. On the upper arms the duration of anagen was 28 days in males and 22 days in females, with corresponding figures of 108 and 106 days for the complete cycle. In females, oral contraceptives had no significant effects on any measurement.
European healthcare systems are useful models for US healthcare reform, congressional briefing told
Authors: B. Roehr
Journal: BMJ (2008)

Three European countries—Germany, the Netherlands, and Switzerland—are particularly useful examples for the United States to consider in the upcoming debate on healthcare reform, a congressional briefing was told on 14 November.

Each nation relies substantially on regulated competition for the purchase of health insurance in the marketplace and uses a public-private mix of providers and payers, which is regulated by a decentralised system through national and regional activities.

“No country is the best or the worst, each performs well on some measures and worse on others. There are a lot of opportunities for learning from other countries and approaches,” said the moderator Robin Osborn, vice president of the Commonwealth Foundation, the charity that cosponsored the …
Cardiac Manifestations of Friedreich's Ataxia
Authors: Alexander S. Nadas, Mariano M. Alimurung, Louis A. Sieracki
Journal: New England Journal of Medicine (1951)

SINCE Friedreich's original description1 of 6 cases of familial hereditary ataxia in 1863, numerous papers have been written on this subject. The vast majority of these elaborate on the neurologic and pathological features of the disease.There are few reports of cardiac manifestations in Friedreich's disease, and almost all of them have appeared in publications concerned primarily with the circulation; hence, it seems worth while to draw the attention of physicians in general to this aspect of the syndrome. We are presenting 6 cases of Friedreich's ataxia with cardiac changes that were seen within the past few years at the . . .
Navajo Peyote Use: Its Apparent Safety
Authors: ROBERT L. BERGMAN
Journal: American Journal of Psychiatry (1971)

An American Indian religion uses significant quantities of peyote, a hallucinogenic plant containing mescaline. Since there have been many reports of serious emotional disturbance caused by similar drugs, the rate of such illness in this population was investigated. The rate was found to be very low, probably because the feelings evoked by the drug experience are channeled by church belief and practice into ego-strengthening directions and there are built-in safeguards against bad reactions.
Thymectomy for Myasthenia Gravis
Authors: M. Nellen
Journal: BMJ (1943)

BRITISHfound in one patient only, who had a ruptured disk severe enough to produce almost complete spinal block.Postural deformities of the back are non-specific, and Las6gue's test (straight leg raising) is valueless on its own in diagnosis, though useful in assessment of severity and progress.The result of the test should be compared with the patient's ability to touch his toes, and, in organic cases, these two will correspond.The foot plantar-flexion and dorsiflexion modifica- tions of this test seem to be of no diagnostic value.A raised protein in the cerebrospinal fluid signifies an organic lesion, and is common in, but by no means confined to, cases of ruptured disk.Symonds remarks that in any "long-standing sciatica" the protein may be raised to between 40 and 100 mg. per 100 c.cm. Tendon Reflexes.-Diminutionor absence of ankle-jerk is
Seminars in Alcohol and Drug Misuse
Authors: K. Williams
Journal: BMJ (1995)

Ed Jonathan Chick, Roch Cantwell-Gaskell/Royal College of Psychiatrists, £13.50, pp 246ISBN 0 902241 70 2

As a psychiatrist pursuing a career with special responsibility for treating substance misuse, I am often asked to justify my decision by friends and colleagues who seem to think that all substance misusers are manipulative, lying psychopaths who are totally unresponsive to their treatment—which, given the self inflicted nature of their condition, they probably don't deserve.

I am sure that this opinion is widely …
Rational sequence of tests for pancreatic function.
Authors: C J Mitchell, E Elias, J E Agnew, J Summerfield, R Dick
Journal: BMJ (1976)

<h3>ABSTRACT</h3> Anthocyanins are the principal color-producing compounds synthesized in developing fruits of strawberry (<i>Fragaria</i> spp.). Substantial natural variation in color have been observed in fruits of diploid and octoploid accessions, resulting from distinct accumulation and distribution of anthocyanins in fruits. Anthocyanin biosynthesis is controlled by a clade of R2R3 MYB transcription factors, among which <i>MYB10</i> has been shown as the main activator in strawberry fruit. Here, we show that <i>MYB10</i> mutations cause most of the anthocyanin variation observed in diploid woodland strawberry <i>(F. vesca)</i> and octoploid cultivated strawberry (<i>F</i>. ×<i>ananassa</i>). Using a mapping-by-sequencing approach, we identified a <i>gypsy</i>-transposon insertion in <i>MYB10</i> that truncates the protein and knocks out anthocyanin biosynthesis in a white-fruited <i>F. vesca</i> ecotype. Two additional loss-of-function <i>MYB10</i> mutations were identified among geographically diverse white-fruited <i>F. vesca</i> ecotypes. Genetic and transcriptomic analyses in octoploid <i>Fragaria spp.</i> revealed that <i>FaMYB10-2,</i> one of three <i>MYB10</i> homoeologs identified, residing in the <i>F. iinumae-derived</i> subgenome, regulates the biosynthesis of anthocyanins in developing fruit. Furthermore, independent mutations in <i>MYB10-2</i> are the underlying cause of natural variation in fruit skin and flesh color in octoploid strawberry. We identified a CACTA-like transposon <i>(FaEnSpm-2)</i> insertion in the <i>MYB10-2</i> promoter of red-fleshed accessions that was associated with enhanced expression and anthocyanin accumulation. Our findings suggest that putative cis regulatory elements provided by <i>FaEnSpm-2</i> are required for high and ectopic <i>MYB10-2</i> expression and induction of anthocyanin biosynthesis in fruit flesh. We developed <i>MYB10-2</i> (sub-genome) specific DNA markers for marker-assisted selection that accurately predicted anthocyanin phenotypes in octoploid segregating populations.
Rheumatoid Arthritis Associated with Characteristic Chest X-ray Appearances in Coal-workers
Authors: W. E. Miall, A. Caplan, A. L. Cochrane, G. S. Kilpatrick, P. D. Oldham
Journal: BMJ (1953)

A new syndrome has been described in coal-workers (Caplan, 1953) in which rheumatoid arthritis is associ- ated with -nodular fibrosis of the lung which is radio- logically similar to, but distinguishable from, the massive fibrosis appearing in complicated pneumoconiosis.A
FAILURE OF DIAGNOSIS OF MASTOIDITIS
Authors: J. L. Johnson
Journal: JAMA (1922)

<h3>To the Editor:</h3> —Drs. Isidore Friesner and Wendell C. Phillips (The Journal, June 10), in reporting five cases of mastoiditis with atypical symptoms, conclude that textbooks and teachers have failed to describe this condition adequately to students. I feel that the average medical student in the best schools is not only not taught to diagnose atypical mastoiditis but also is not taught to diagnose any mastoiditis. A physician of good reputation as to ability recently solemnly assured me that a patient did not have mastoiditis because no postauricular edema was present; and as to any of the other textbook signs, he did not know whether they were present or not. After I had been in general practice for some years and had done a fair amount of major surgery, I saw a child with a moderate rise of temperature and a pain in the ear. The tympanum ruptured spontaneously the