tbuckley/cabot-search huggingface dataset:
Opioids for chronic refractory breathlessness: patient predictors of beneficial response
Authors: Miriam J. Johnson, J. Martin Bland, Stephen G. Oxberry, Amy P. Abernethy, David C. Currow
Journal: European Respiratory Journal (2012)

Chronic refractory breathlessness is common and distressing in advanced disease. Despite level I evidence to support the use of opioids for this symptom, not all patients benefit. This study aimed to discover which patient characteristics predict those most likely to gain improvement in breathlessness. This is an international, multicentre, retrospective analysis of 213 individual pooled datasets from four clinical trials of an opioid for chronic refractory breathlessness. “Response to opioid” was defined as 1) an absolute value of ≥10 mm improvement on the visual analogue scale (VAS) and 2) a relative value of ≥10% improvement from baseline VAS. We investigated baseline predictors using logistic regression. In the final model, higher baseline breathlessness intensity scores strongly predicted absolute and relative response (p&lt;0.001). Younger age also predicted relative response (p = 0.025); functional status and dominant cause of breathlessness did not. Some evidence supported the descriptor “not enough air”, but was not statistically significant (p = 0.052). A therapeutic trial of opioids is appropriate, irrespective of the cause of the breathlessness or functional status. Younger people or those with worse breathlessness are more likely to benefit. Opioids have a role in the management of chronic refractory breathlessness, but net benefit for individuals must be optimised.
Discrete Subaortic Stenosis Complicated by Aortic Valvular Regurgitation
Authors: ANDREW G. MORROW, LYNN FORT, WILLIAM C. ROBERTS, EUGENE BRAUNWALD
Journal: Circulation (1965)

Four patients are described in whom combined aortic stenosis and regurgitation was evident on examination. In each of them obstruction to left ventricular outflow was shown to be due to congenital subaortic stenosis, and aortic regurgitation resulted from the sequelae of bacterial endocarditis. The presence of this unusual combination of congenital and acquired malformations was suggested by certain clinical findings, and results of the preoperative hemodynamic and angiographic studies that established the diagnosis are presented. In three patients the subaortic membrane was resected, and aortic regurgitation was corrected by reconstruction or replacement of the aortic valve. All of the patients evidenced striking clinical improvement after operation, confirmed by the results of postoperative hemodynamic assessments. A fourth patient died before operation; the pathologic findings are presented in detail.
The isolation and in situ identification of MSCs residing in loose connective tissues using a niche-preserving organ culture system
Authors: Min-Young Choi, Hyeong-In Kim, Young-Il Yang, Jong Tae Kim, Soo Hwa Jang, Chung Mu Park, Won Hee Jang, Young-Chul Youn, Soon-Ho Cheong, Chang Soo Choi, Dae Kyeong Kim, Seung Jin Lee
Journal: Biomaterials (2012)
704. Tumor Cell Surface Display of the Immunoglobulin Heavy Chain Fc by Gene Transfer as a Means to Mimic Antibody Therapy
Authors: Susanne Lang, David Riddle, Laura Sanz, Heung Chong, Jill Thompson, Richard Vile
Journal: Molecular Therapy (2005)

We hypothesized that inducing display of the IgFc molecule on the tumor cell surface by gene transfer would promote tumor cell killing by the same mechanisms as antibody based approaches, but would alleviate some of the problems inherent in the use of antibodies for cancer therapy. We expressed the cDNA of the Fc portion of the murine IgG2a heavy chain on the surface of tumor cells thereby mimicking a natural antibody tagging event. In vitro, Fc receptor positive natural killer cells specifically recognized and lysed B16 melanoma cells expressing surface IgFc. Macrophages bound to B16-Fc, cells significantly more than to parental B16 and surface IgFc expression promoted formation of the terminal complement pore complex. Expression of the IgFc dramatically delayed the ability of B16 cells to form tumors in vivo, dependent on macrophages and NK cells.
FOXOs attenuate bone formation by suppressing Wnt signaling
Authors: Srividhya Iyer, Elena Ambrogini, Shoshana M. Bartell, Li Han, Paula K. Roberson, Rafael de Cabo, Robert L. Jilka, Robert S. Weinstein, Charles A. O’Brien, Stavros C. Manolagas, Maria Almeida
Journal: Journal of Clinical Investigation (2013)

Wnt/β-catenin/TCF signaling stimulates bone formation and suppresses adipogenesis. The hallmarks of skeletal involution with age, on the other hand, are decreased bone formation and increased bone marrow adiposity. These changes are associated with increased oxidative stress and decreased growth factor production, which activate members of the FOXO family of transcription factors. FOXOs in turn attenuate Wnt/β-catenin signaling by diverting β-catenin from TCF- to FOXO-mediated transcription. We show herein that mice lacking Foxo1, -3, and -4 in bipotential progenitors of osteoblast and adipocytes (expressing Osterix1) exhibited increased osteoblast number and high bone mass that was maintained in old age as well as decreased adiposity in the aged bone marrow. The increased bone mass in the Foxo-deficient mice was accounted for by increased proliferation of osteoprogenitor cells and bone formation resulting from upregulation of Wnt/β-catenin signaling and cyclin D1 expression, but not changes in redox balance. Consistent with this mechanism, β-catenin deletion in Foxo null cells abrogated both the increased cyclin D1 expression and proliferation. The elucidation of a restraining effect of FOXOs on Wnt signaling in bipotential progenitors suggests that FOXO activation by accumulation of age-associated cellular stressors may be a seminal pathogenetic mechanism in the development of involutional osteoporosis.
Supporting Treatment Decision Making in Advanced Cancer: A Randomized Trial of a Decision Aid for Patients With Advanced Colorectal Cancer Considering Chemotherapy
Authors: Natasha B. Leighl, Heather L. Shepherd, Phyllis N. Butow, Stephen J. Clarke, Margaret McJannett, Philip J. Beale, Nicholas R.C. Wilcken, Malcolm J. Moore, Eric X. Chen, David Goldstein, Lisa Horvath, Jennifer J. Knox, Monika Krzyzanowska, Amit M. Oza, Ronald Feld, David Hedley, Wei Xu, Martin H.N. Tattersall
Journal: Journal of Clinical Oncology (2011)

Decision making in advanced cancer is increasingly complex. We developed a decision aid (DA) for patients with advanced colorectal cancer who are considering first-line chemotherapy and reviewing treatment options, prognostic information, and toxicities. We examined its impact on patient understanding, treatment decisions, decisional conflict, decision making, consultation satisfaction, anxiety, and quality of life by using a randomized trial design.In all, 207 patients with colorectal cancer who were considering first-line chemotherapy for metastatic disease were randomly assigned to receive a standard medical oncology consultation or a consultation in which the DA (take-home booklet with audio recording, reviewed by an oncologist) was used. Participants completed questionnaires postconsultation, postdecision, and 1 month later.In this study, 100 patients were randomly assigned to the control arm, and 107 received the DA. Median age of the sample was 62 years, 58% were male, 89% had a performance status of 0 or 1, and 36% had received prior adjuvant chemotherapy. Patients receiving the DA demonstrated a greater increase in understanding of prognosis, options, and benefits, with higher overall understanding (P < .001). Decisional conflict, treatment decisions, and achievement of involvement preferences were similar between the groups. Anxiety was similar across groups and decreased over time. Most patients were confident in a decision during the first consultation; 74% chose chemotherapy, 7% supportive care alone, and 10% observation.This randomized trial of a decision aid in advanced cancer showed that its use in advanced colorectal cancer improved patient understanding of prognosis, treatment options, risks, and benefits without increasing anxiety. DAs can improve informed consent and can be tested through randomized trials even in the advanced cancer setting.
Handbook of Clinical Nutrition and Aging
Authors: Judy A. Driskell
Journal: JAMA (2011)

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
Are Health Care Professionals Advising Obese Patients to Lose Weight?
Authors: Deborah A. Galuska
Journal: JAMA (1999)

EARLY ONE FOURTH OF US adults are obese, which is defined as having a body mass index (BMI) of 30 kg/m 2 or more 1 and thus are at risk for numerous chronic health conditions. 2 Clinicians treating obese patients have an opportunity not only to improve the health of these individuals but also to affect positively the nation's public health by implementing the Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. 3In these 1998 guidelines, an expert panel convened by the National Institutes of Health, recommended that all obese persons should try to lose weight and that health care professionals should discuss weight control with their obese patients.This study, using data from 1996 Behavioral Risk Factor Surveillance System (BRFSS), describes the proportion and characteristics of obese persons who received advice about weight loss from their health care professional and determines whether this advice was associated with attempts to lose weight.
AN EXPERIMENTAL STUDY OF DIATHERMY
Authors: Carl A. L. Binger, Ronald V. Christie
Journal: The Journal of Experimental Medicine (1927)

1. Prevention of the access of air to one lung, while its circulation is intact, results in little, if any, change in the rate of heating of the lung by the diathermy current. 2. Occlusion of a main branch of the pulmonary artery during the flow of the current results in a sudden rise in temperature in the lung whose artery has been occluded, with subsequent heating, however, at the original rate. Under these circumstances death of the animal is accompanied by a precipitous rise in the temperature of both lungs. 3. When the pulmonary veins as well as the artery to one lung are ligated the circulation through the bronchial vessels is also stopped. Diathermy then results in a local rise in temperature in the lung equivalent to that seen in the other lung after death.
Laminin deposition to type IV collagen enhances haptotaxis, chemokinesis, and adhesion of hepatoma cells through β1-integrins
Authors: Takuji Torimura, Takato Ueno, Motoaki Kin, Riko Harada, Toru Nakamura, Masaharu Sakamoto, Ryukichi Kumashiro, Hirohisa Yano, Masamichi Kojiro, Michio Sata
Journal: Journal of Hepatology (2001)
Estimation of Divergence Times for Major Lineages of Primate Species
Authors: G. V. Glazko
Journal: Molecular Biology and Evolution (2003)

Although the phylogenetic relationships of major lineages of primate species are relatively well established, the times of divergence of these lineages as estimated by molecular data are still controversial. This controversy has been generated in part because different authors have used different types of molecular data, different statistical methods, and different calibration points. We have therefore examined the effects of these factors on the estimates of divergence times and reached the following conclusions: (1) It is advisable to concatenate many gene sequences and use a multigene gamma distance for estimating divergence times rather than using the individual gene approach. (2) When sequence data from many nuclear genes are available, protein sequences appear to give more robust estimates than DNA sequences. (3) Nuclear proteins are generally more suitable than mitochondrial proteins for time estimation. (4) It is important first to construct a phylogenetic tree for a group of species using some outgroups and then estimate the branch lengths. (5) It appears to be better to use a few reliable calibration points rather than many unreliable ones. Considering all these factors and using two calibration points, we estimated that the human lineage diverged from the chimpanzee, gorilla, orangutan, Old World monkey, and New World monkey lineages approximately 6 MYA (with a range of 5–7), 7 MYA (range, 6–8), 13 MYA (range, 12–15), 23 MYA (range, 21–25), and 33 MYA (range 32–36).
A New Look for<i>JAMA Dermatology</i>!
Authors: June K. Robinson, Jeffrey P. Callen
Journal: JAMA Dermatology (2013)

With this issue we launch the new format of JAMA Dermatology. This is the first major redesign in more than 2 decades. Every article type, including research, opinion, news, humanities, clinical reviews, and letters, was redesigned across all 10 journals that comprise the JAMA Network. The font, tables, graphs, and figure styles have been reviewed and revised. The redesign will be most evident in the print issue, but it will also improve the readability of our content on the web. The goals of the redesign were to create a more modern look with improved navigation across the JAMA Network, reinforce the scholarly importance of our research and evidence-based review sections, and ensure that our viewpoints and editorials are more welcoming.
Potentially ineffective care. A new outcome to assess the limits of critical care
Authors: L. Esserman
Journal: JAMA (1995)

To examine the limits of the effectiveness of critical care through the study of patients for whom it was ineffective.We studied the relationship between resource use and long-term outcome (2-year follow-up) in 402 consecutively admitted critical care patients to develop a benchmark for ineffective applications of critical care. We defined an outcome called potentially ineffective care (PIC), developed and evaluated a model with an independent data set to predict PIC from a patient's response to treatment, and estimated the economic effects of limiting care after a prediction of PIC.The combined medical and surgical intensive care unit at a 600-bed university teaching hospital.Two groups of 402 consecutively admitted critical care patients, one from 1989, the other from 1991.Based on observations from a two-dimensional plot of resource use vs benefit for 402 critical care patients, PIC was defined as resource use in the upper 25th percentile and survival for less than 100 days after discharge. Thirteen percent of the patients fell into the PIC category and used 32% of the resources. A product of the APACHE risk estimates on days 1 and 5 of at least 0.35 predicted 37% of PIC outcomes with a specificity of 98%. In a second data set, PIC outcome prediction had a sensitivity of 43% and a specificity of 94%, and a positive predictive value of 80%. For the hospital studied, reduction of intensity of treatment after a prediction of a PIC outcome would result in a reduction of hospital charges in the range of $1.8 million to $5 million per year.Patients in the PIC category consumed a large portion of the resources devoted to critical care at an academic teaching hospital. We suggest a change in focus from assessment of the quality of critical care and risk-adjusted mortality to an assessment of ineffective care based on outcome and resource use and a patient's response to treatment over time.
Cost Containment and the Physician-Reply
Authors: Marcia Angell
Journal: JAMA (1986)

In Reply.—  I thank Drs Ross, Matthews, Blondell, and O'Brien for their thoughtful comments. I agree with Dr Matthews that the amount of testing that goes on in teaching hospitals may be different from that in nonteaching hospitals and in the outpatient setting, and for this reason I limited my consideration to teaching hospitals, for which we have reasonably good data. However, Dr Matthews' estimate that no more than 10% of laboratory tests in his hospital could be considered unnecessary strikes me as unusually low. In any case, I would certainly not argue for a czar to review orders, but for a change in education and practice styles that acknowledges the limitations of testing. By and large, education does work, and like most physicians, I prefer it to regulation. Dr Blondell is similarly mistaken in thinking that I was calling for peerreview mechanisms to decide which new technologies are beneficial;
A single‐center experience in 20 patients with infantile malignant osteopetrosis
Authors: Evelina Mazzolari, Concetta Forino, Alessia Razza, Fulvio Porta, Anna Villa, Luigi Daniele Notarangelo
Journal: American Journal of Hematology (2009)

Infantile malignant osteopetrosis (IMO) includes various genetic disorders that affect osteoclast development and/or function. Genotype-phenotype correlation studies in IMO have been hampered by the rarity and heterogeneity of the disease and by the severity of the clinical course, which often leads to death early in life. We report on the clinical and molecular findings and treatment in 20 consecutive patients (11 males, nine females) with IMO, diagnosed at a single center in the period 1991-2008. Mean age at diagnosis was 3.9 months, and mean follow-up was 66.75 months. Mutations in TCIRG1, OSTM1, ClCN7, and TNFRSF11A genes were detected in nine, three, one, and one patients, respectively. Six patients remain genetically undefined. OSTM1 and ClCN7 mutations were associated with poor neurologic outcome. Among nine patients with TCIRG1 defects, six presented with hypogammaglobulinemia, and one showed primary pulmonary hypertension. Fourteen patients received hematopoietic cell transplantation; of these, nine are alive and eight of them have evidence of osteoclast function. These data may provide a basis for informed decisions regarding the care of patients with IMO.
Comments on the Affordable Care Act and the Future of Clinical Medicine
Authors: Robert A. Donato
Journal: Annals of Internal Medicine (2011)

Letters18 January 2011Comments on the Affordable Care Act and the Future of Clinical MedicineRobert A. Donato, MDRobert A. Donato, MDFrom Memphis, TN 38119.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-2-201101180-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Frank Lloyd Wright said, “A free America … means just this: individual freedom for all, rich or poor, or else this system of government we call democracy is only an expedient to enslave man to the machine and make him like it.” This “reform” that Kocher and colleagues support remains a thinly veiled usurpation of choice from both patients and physicians alike, leaving the government in the position to determine what a person may or may not pursue toward his or her own health. People collectively have rejected this concept. Physicians, despite Kocher and colleagues' (1) progressive ...Reference1. Kocher R, Emanuel EJ, DeParle . The Affordable Care Act and the future of clinical medicine: the opportunities and challenges. Ann Intern Med. 2010;153:536-9. [PMID: 20733178] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Memphis, TN 38119.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Affordable Care Act and the Future of Clinical Medicine: The Opportunities and Challenges Robert Kocher , Ezekiel J. Emanuel , and Nancy-Ann M. DeParle Comments on the Affordable Care Act and the Future of Clinical Medicine Douglas A. Perednia Comments on the Affordable Care Act and the Future of Clinical Medicine Quentin D. Young Comments on the Affordable Care Act and the Future of Clinical Medicine Ardis D. Hoven Comments on the Affordable Care Act and the Future of Clinical Medicine Frank J. Kadel Comments on the Affordable Care Act and the Future of Clinical Medicine Albert Davis Comments on the Affordable Care Act and the Future of Clinical Medicine John A. Goldman Comments on the Affordable Care Act and the Future of Clinical Medicine Lee S. Gross Comments on the Affordable Care Act and the Future of Clinical Medicine G. Andrew McIntosh Comments on the Affordable Care Act and the Future of Clinical Medicine Arvind R. Cavale Comments on the Affordable Care Act and the Future of Clinical Medicine Robert G. Luke Comments on the Affordable Care Act and the Future of Clinical Medicine J. Fred Ralston Jr. Comments on the Affordable Care Act and the Future of Clinical Medicine Christine Laine Comments on the Affordable Care Act and the Future of Clinical Medicine Ezekiel J. Emanuel and Nancy-Ann M. DeParle Metrics 18 January 2011Volume 154, Issue 2Page: 142KeywordsConflicts of interestForecastingHealth careNurses ePublished: 18 January 2011 Issue Published: 18 January 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Biopsy in Syphilitic Proctitis-Reply
Authors: Malek Nazemi
Journal: JAMA (1975)

<h3>In Reply.—</h3> We agree with Dr. Lewis that rectal biopsy is not a wholly benign procedure; however, for the following reasons we believe that it is still best to perform a biopsy in the case of a rectal mass: (1) it is generally better to establish a diagnosis than not to establish one; (2) syphilitic proctitis is thought to be sufficiently unusual that we would want to exclude the other diseases cited in our article (numerous biopsies might show this condition to be more frequent than we now believe); (3) we would be most unhappy to treat a patient who really has a granulomatous or malignant lesion with penicillin on the presumption that he had syphilis and for him to then fail to return for follow-up examination. Taking everything into consideration, we still vote for the biopsy.
A STUDY OF THE REFRACTION OF SEVENTEEN HUNDRED EYES.
Authors: H. BERT. ELLIS
Journal: JAMA (1895)

The question of refraction is one that plays no unimportant part in the daily work of many oculists in our large cities, and of most oculists in our medium and smaller cities. With many it forms the great bulk of their work. I present for your consideration to-day, in tabular form, a study of the refraction of 1,700 eyes, representing 869 patients taken from the last 1,000 consecutive eye cases coming under the care of the writer in his private practice. Of the 131 cases not incorporated in this study, some were infants with various inflammatory troubles and some operative cases, five only being presbyopes with emmetropic eyes. Thus you will see that about 87 per cent. of all my eye cases required correction of ametropia. Dr. Geo. M. Gould in a paper on these very lines, read before this Section in 1891 said that 93 per cent. of his