tbuckley/cabot-search huggingface dataset:
Interpreting Surgical Trials With Subjective Outcomes
Authors: David R. Flum
Journal: JAMA (2006)

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
Moss' Heart Disease In Infants, Children and Adolescents
Authors: Antoni M. Diehl
Journal: JAMA (1989)

This is the fourth edition of this comprehensive reference textbook, originally published in 1968. In subsequent editions in 1977 and 1983, the contents were updated and new chapters added commensurate with the advances in the field of pediatric cardiology. The current edition is divided into sections including general cardiology, congenital defects, infectious diseases, connective tissue and metabolic and degenerative diseases, and special problems. The chapter on fetal and neonatal circulation has been updated. The chapter on echocardiography has been extensively revised with particular emphasis on Doppler ultrasound techniques. A discussion of magnetic resonance imaging and positron emission tomography has been added. The modalities of interventional cardiology, including cardiac catheterization and angiocardiography, have been updated with particular emphasis on electrophysiology, myocardial biopsy, and interventional therapeutic cardiology. A new chapter on congenital heart disease in the adult has been added. New expert contributors have updated the chapters on rheumatic fever and atherosclerosis.
Beneficial effects of amrinone-hydralazine combination on resting hemodynamics and exercise capacity in patients with severe congestive heart failure.
Authors: L A Siegel, E Keung, S J Siskind, R Forman, H Feinberg, J Strom, D Efstathakis, E H Sonnenblick, T H LeJemtel
Journal: Circulation (1981)

The effects of combined administration of low-dose amrinone (100 mg) and hydralazine (75-100 mg) on resting hemodynamics and exercise capacity were studied in nine patients with severe con- gestive heart failure.Five patients were in New York Heart Association (NYHA) functional class IV and four were in class III.Cardiac index increased from 1.92 ± 0.36 I/min/m' (mean SD) to 3.23 ± 0.63 I/min/m' (p < 0.001); pulmonary wedge pressure decreased from 23.6 ± 4.1 to 15.1 i 4.7 mm Hg (p < 0.001) and systemic vascular resistance from 1666 ± 210 to 1063 189 dyn-sec-cm-' (p <0.001).Mean arterial pressure and heart rate were not significantly changed.The onset of action ranged from 30-150 minutes and the duration of action from 4-6 hours after oral administration.When compared with amrinone alone (100 mg) or hydralazine alone (75-100 mg), the increase in stroke volume index and the decrease in pulmonary wedge pressure induced by the combined therapy were significantly greater (p < 0.01).The hemodynamic benefits at rest were associated with an improvement in NYHA functional class in all but one patient during chronic therapy.Exercise capacity (Naughton protocol) increased during the first week of therapy from 6.1 ± 4.3 to 10.6 ± 5.3 minutes (p < 0.01).This increase in exercise capacity was sustained or further improved at 3 weeks.Thus, the hemodynamic effects of low-dose amrinone can be amplified by simultaneous administration of a vasodilator such as hydralazine in patients with severe congestive heart failure.This combined therapy results in a substantial and sustained improvement in functional class and exercise capacity.
An Opportunity to Oppose: Physicians' Role in the Campaign Against Tobacco
Authors: Louis Sullivan
Journal: JAMA (1990)

Cigarette smoking and other uses of tobacco are the single most important preventable cause of death in our society. Physicians have a responsibility to inform patients of the health consequences of smoking, to assist patients who do not smoke from starting, and to help smokers to kick the habit. Physicians should make use of the prestige and credibility of their medical training and their position in their communities to speak out on the dangers of smoking in every appropriate forum. Recently, I released a report entitled<i>Smoking and Health: A National Status Report</i>.<sup>1</sup>Regrettably, the death rate from tobacco-related disease remains shocking. Each year, smoking kills almost 400 000 Americans; that is more than 1000 persons a day, accounting for greater than one of every six deaths in our country. The number of Americans who die each year of diseases caused by smoking exceeds the number of Americans who
1060. The MSCV_U3 Internal Promoter Strongly Activates Surrounding Cellular Promoter in Combination with Self_Inactivating (SIN)_MSCV Vector Backbone
Authors: Hideki Hanawa, Takashi Shimada
Journal: Molecular Therapy (2006)

During past decade, most efforts were made to improve transduction efficiency and gene expression by retrovirus vectors. Now the main concern shifted toward improvement of safety, in response to development of leukemia in SCID_X1 patient treated with retrovirus vector. Although recent comparative studies suggest that lentiviral vector may be safer than oncoretroviral vector because of the difference of the integration pattern, there is no direct evidence to prove it. In this experiment, we developed exon_trap vectors to measure the activation of cellular promoter directly (Fig. 1Fig. 1). These vectors were based on self_inactivating (SIN)_HIV1 vector or SIN_MSCV vector, and MSCV_U3 or EF1α promoter was used to express EGFP reporter gene. To trap transcription from the cellular promoter of integration site, a synthetic exon was inserted at upstream of internal promoter in reverse orientation. The activation level was estimated by comparing with trapping vector without the internal promoter. As shown in table, SIN_MSCV vector with MSCV_U3 promoter revealed substantial trapping level. The increase of trapping level by SIN_MSCV vector with EF1α promoter was milder but still higher than that with SIN_HIV1 vectors. We performed 5′RACE analysis on SIN_MSCV vector with MSCV_U3 promoter, and confirmed proper trapping of cellular promoter transcription in 5 out of 9 RACE products. However, the rest of RACE products have their 5′ cap sites within the MSCV_U3 promoter. To evaluate the magnitude of this retrograde cryptic transcription, we constructed additional SIN_vectors which express DsRed_Express and EGFP as anterograde and retrograde transcription reporters (fig. 2fig. 2), and detected weak retrograde transcription in both HIV1 based and MSCV based vectors, but that in HIV1 based vector was higher than that in MSCV vector. These results imply that the higher exon_trapping level of SIN_MSCV vector reflects higher cellular promoter activation, but not higher retrograde cryptic transcription. In conclusion, we recommend avoiding MSCV_U3 as an internal promoter in MSCV based vector since the combination substantially activate surrounding cellular promoter and may cause leukemia. This assay system may be useful to evaluate newly developed therapeutic vectors before clinical application to minimize insertional mutagenesis event. Fold increase of cellular promoter activity detected using exon_trap vectors MSCV_U3 EF1α SIN_HIV1 1.8 1.5 SIN_MSCV 3 8 2.4 The values were calculated from triplicated experiment. View Large Image | View Hi-Res Image | Download PowerPoint Slide View Large Image | View Hi-Res Image | Download PowerPoint Slide
Primary Tumors of the Ureter
Authors: Victor L. Robards, Ian M. Thompson, Gilbert Ross
Journal: JAMA (1964)

THE INFREQUENT incidence of primary ureteral tumors is probably responsible for the concept that all ureteral neoplasms are similarly malignant and all require nephro-ureterectomy and bladder cuff removal as the definitive therapy. The paucity of information in regard to metastasis, local extension, pathological description, and follow-up presently precludes the determination of the best form of management for the many varieties of primary ureteral tumors. The purpose of this paper is to show that extensive surgical therapy is not the only form of treatment. Approximately 1,200 ureteral tumors of all types have been reported and about 75% of these have been interpreted as being malignant. Of the benign tumors, only the papilloma and polyp have occurred with sufficient frequency to be other than the rare single case report. Of the malignant neoplasms, the transitional cell and epidermoid carcinomata occur with similar frequency. A three-to-one preponderance of ureteral tumors in males and
Pitfall to Modified In Vivo Method of Technetium-99m Red Blood Cell Labeling
Authors: JAMES L. TATUM, TIMOTHY S. BURKE, JERRY I. HIRSCH, WILLIAM W. MILLER, MELVIN J. FRATKIN
Journal: Clinical Nuclear Medicine (1983)

Suboptimal labeling of red blood cells with Tc–99m, using the modified in vivo technique, was observed in three patients in whom labeling was attempted following IV administration of iodinated contrast media in the previous 24 hours. The mechanism is not understood, but it may represent a change in either stannous ion distribution or redox potential. It is recommended that studies employing Tc–99m RBC labeling using this technique be performed prior to administration of iodinated contrast media. This effect should be kept in mind in gastrointestinal bleeding studies performed using Tc–99m RBC, as well as in cardiac imaging studies.
Rosmarinic acid and baicalin epigenetically derepress peroxisomal proliferator-activated receptor γ in hepatic stellate cells for their antifibrotic effect
Authors: Melissa D. Yang, Yi-Ming Chiang, Reiichi Higashiyama, Kinji Asahina, Derek A. Mann, Jelena Mann, Clay C.C. Wang, Hidekazu Tsukamoto
Journal: Hepatology (2011)

Hepatic stellate cells (HSCs) undergo myofibroblastic transdifferentiation (activation) to participate in liver fibrosis and identification of molecular targets for this cell fate regulation is essential for development of efficacious therapeutic modalities for the disease. Peroxisomal proliferator-activated receptor γ (PPARγ) is required for differentiation of HSCs and its epigenetic repression underlies HSC activation. The herbal prescription Yang-Gan-Wan (YGW) prevents liver fibrosis, but its active ingredients and molecular mechanisms are unknown. Here we demonstrate YGW prevents and reverses HSC activation by way of epigenetic derepression of Pparγ involving reductions in MeCP2 expression and its recruitment to Pparγ promoter, suppressed expression of PRC2 methyltransferase EZH2, and consequent reduction of H2K27di-methylation at the 3' exon. High-performance liquid chromatography / mass spectrometry (HPLC/MS) and nuclear magnetic resonance (NMR) analyses identify polyphenolic rosmarinic acid (RA) and baicalin (BC) as active phytocompounds. RA and BC suppress the expression and signaling by canonical Wnts, which are implicated in the aforementioned Pparγ epigenetic repression. RA treatment in mice with existing cholestatic liver fibrosis inhibits HSC activation and progression of liver fibrosis.These results demonstrate a therapeutic potential of YGW and its active component RA and BC for liver fibrosis by way of Pparγ derepression mediated by suppression of canonical Wnt signaling in HSCs.
Patatin-like phospholipase domain containing-3 Ile148Met and fibrosis progression after liver transplantation
Authors: Luca Valenti, Silvia Fargion
Journal: Hepatology (2011)

Recent reports demonstrated that the PNPLA3 (patatin-like phospholipase domain containing-3) isoleucine-to-methionine variant at residue 148 (I148M) influences steatosis and liver damage progression in chronic hepatitis C (CHC).1-4 The article by do O and coworkers now report that in 176 German patients with CHC who underwent liver transplantation, there was no significant effect of PNPLA3 genotype on fibrosis after 5 years of follow-up.5 Unfortunately, steatosis assessment was not available. Other major drawbacks limit the validity of these findings. First, previous studies have shown that the effect of PNPLA3 on fibrosis in CHC follow a recessive model,1-4 so that this study5 had only 30% power to detect a two-fold increased risk. Furthermore, the effect might be less relevant in patients carrying genotype-3 hepatitis C virus, but viral features were not reported. Most importantly, the authors could only evaluate recipient genotype, so that they had no information on PNPLA3 status in the transplanted liver. However, it is most commonly held that the 148M PNPLA3 variant predisposes to liver damage by acting directly at the level of hepatocytes.6 Therefore, the purported evidence does not exclude a clinically relevant role of PNPLA3 genotype in determining the outcome of orthotopic liver transplantation for CHC, opposite to what has been suggested. Additional, adequately powered studies with systematic evaluation of steatosis, viral features, and both donor and recipient PNPLA3 genotype are required to clarify this issue. Indeed, such a study would be of utmost importance for the following reasons: (1) it would clarify the cell type (hepatocytes versus adipocytes, or both) whose metabolic function is deranged due to PNPLA3 variants, which has not been possible in mouse studies due to different expression pattern and mechanism of regulation of this gene, with implications for the design of new therapies, and (2) it would possibly provide useful information for organ allocation. A cooperative effort is warranted to achieve these goals. Luca Valenti M.D.*, Silvia Fargion M.D.*, * Centro Malattie Metaboliche del Fegato, Department of Internal Medicine, Università degli Studi Fondazione Ca' Granda IRCCS, Ospedale Maggiore Policlinico, Padiglione Granelli, Milan, Italy.
Alpha-adrenoceptor stimulation and blockade modulates cesium-induced early afterdepolarizations and ventricular tachyarrhythmias in dogs.
Authors: J Ben-David, D P Zipes
Journal: Circulation (1990)

In 84 open-chest dogs, we studied the effects on early afterdepolarizations (EADs) and ventricular tachyarrhythmias (VTs) induced by cesium chloride (168 mg/kg i.v.) of alpha-adrenoceptor stimulation with phenylephrine (100 micrograms plus 0.25 microgram/kg/min i.v.) and with left ansa subclavia stimulation (LAS; 2 Hz, 4 msec, 2 mA) after propranolol (0.5 mg/kg) administration. We also studied the effects of alpha-adrenoceptor blockade with phentolamine (3 mg/kg), prazosin (25-500 micrograms/kg), yohimbine (10-500 micrograms/kg), WB 4101 (2 mg/kg), and benoxathian (2 mg/kg) during decentralized LAS. EAD amplitude, presented as a percentage of monophasic action potential amplitude, was recorded simultaneously with contact electrodes from the right and left ventricular endocardium. Phenylephrine and LAS plus propranolol increased EAD amplitude (31.5 +/- 8.8% to 47.8 +/- 9.7% and 34.8 +/- 4.1% to 46.1 +/- 6.4%, respectively) and the prevalence of VT (from three to nine of 11 dogs and from the three to five of six dogs, respectively). Prazosin produced a dose-response decrease in EAD amplitude and reduced the prevalence of VT. Yohimbine did not alter the amplitude of EADs or the prevalence of VT. WB 4101 and phentolamine reduced the amplitude of EADs produced by cesium and LAS (from 44.3 +/- 10.2% to 32.6 +/- 9.4% and from 39.8 +/- 6.9% to 30.3 +/- 6.3%, respectively) and the prevalence of VT (from eight to one of 10 dogs and from 13 to 5 of 20 dogs, respectively). Benoxathian did not alter significantly the amplitude of EADs (41.6 +/- 11.4% to 37.5 +/- 9.4%) or the prevalence of VT (from six to five of 10 dogs).(ABSTRACT TRUNCATED AT 250 WORDS)
Castleman's disease
Authors: Alexander Slotwiner, Christopher P. Garwacki, Stephan Moll
Journal: American Journal of Hematology (2003)

A 44-year-old woman presented with a several month history of fatigue, night sweats, increasing abdominal girth, bilateral leg swelling, and a 25-pound weight loss.Her past medical history was significant for intravenous drug use, a habit she claimed to have discontinued 5 years earlier, and chronic, asymptomatic hepatitis C infection.On physical examination, her vital signs were normal including a temperature of 36.7°C.Generalized, nontender lymphadenopathy was found throughout the cervical, axillary, and inguinal regions bilaterally, the largest nodes measuring approximately 2 × 4 cm.The liver and spleen were noted to be slightly enlarged and nontender, and there was 2+ ankle edema present in the lower extremities.
Antihypertensive Drug Therapy and the Initiation of Treatment for Diabetes Mellitus
Authors: Jerry H. Gurwitz
Journal: Annals of Internal Medicine (1993)

Objective: To quantify the risk for the occurrence of hyperglycemia requiring initiation of therapy among patients taking various antihypertensive regimens. Design: Case-control study. Setting: New Jersey Medicaid program. Patients: The study included New Jersey Medicaid enrollees 35 years of age or older. The 11 855 case patients were newly started on a hypoglycemic agent (oral agent or insulin) between 1981 and 1990. The 11 855 controls were selected randomly from among other Medicaid enrollees. Measurements and Main Results: The frequency of initiation of hypoglycemic therapy was increased for users of virtually all antihypertensive agents relative to nonusers after adjustment for age, gender, race, nursing home residency, number of days hospitalized, total number of prescriptions, and selected medication exposures. The estimated relative risk for initiation of hypoglycemic therapy was 1.40 for patients receiving thiazide diuretics (95% CI, 1.26 to 1.58) and ranged from 1.56 to 1.77 for patients receiving other antihypertensive medications, depending on the medication category. A higher risk was associated with multiple-agent regimens, whether they excluded a thiazide diuretic (odds ratio, 1.76; CI, 1.49 to 2.07) or included one (odds ratio, 1.93; CI, 1.75 to 2.13). When the analysis was restricted to users of antihypertensive agents (n = 8005), the risk associated with other single-agent antihypertensive regimens was not significantly different from that associated with thiazide diuretics. However, patients receiving multiple-agent regimens continued to be at increased risk for hyperglycemia requiring hypoglycemic therapy relative to those who used thiazide diuretic therapy alone. Conclusion: The association between antihypertensive therapy and the initiation of treatment for diabetes mellitus is more closely related to the intensity of therapy than to the individual agent used. Our data do not support the hypothesis that thiazide diuretics are more strongly associated with the initiation of hypoglycemic therapy than are other antihypertensive agents.
Differential expression of Op18 phosphoprotein during human thymocyte maturation.
Authors: J Gratiot-Deans, D Keim, J R Strahler, L A Turka, S Hanash
Journal: Journal of Clinical Investigation (1992)

Op18 (also termed prosolin/stathmin) is a highly conserved 18-kD cytosolic phosphoprotein expressed in low levels in mature resting G0 lymphocytes, but induced in late G1 and S phases after entry into the cell cycle. In addition to its induction in normal proliferating lymphocytes, Op18 has been found to occur at high levels in acute leukemias and in neuroendocrine tissue. The presence and rapid phosphorylation of Op18 after stimulation of proliferating cells correlates with subsequent functional responses of the cells, and, therefore, Op18 has been suggested to play a key role in signal transduction. The pattern of expression of Op18 during lymphoid development is of interest in view of its high levels of expression in acute leukemias, representing cells arrested at an immature stage, thus raising the possibility that Op18 may be regulated differently in mature and immature lymphoid cells. We report here that immature human thymocytes bearing the cortical double positive phenotype (CD4+CD8+) constitutively express high levels of Op18 protein. In contrast, in mature single positive thymocytes (CD3+CD4+ or CD3+CD8+), Op18 protein is expressed at a lower level, comparable to that seen in peripheral blood T cells. Cell cycle analysis demonstrated that most of the cells in the double positive thymocyte population expressing high levels of Op18 were noncycling and arrested in G0. Furthermore, there was no correlation between Op18 levels and the proportion of cycling cells in double positive thymocyte populations isolated from different thymuses. Interestingly, although Op18 protein levels did not increase any further after mitogenic stimulation of double positive thymocytes, an increase in Op18 phosphorylation was observed, thus coupling of Op18 phosphorylation to cell activation remained intact. Our results show that during lymphoid maturation Op18 expression is uncoupled from cell proliferation. These data also suggest that the ordered expression of proliferation-associated genes seen in mature T cells may be disrupted during T cell maturation.
Osteogenic differentiation of adipose-derived stem cells and calvarial defect repair using baculovirus-mediated co-expression of BMP-2 and miR-148b
Authors: Ya-Hsin Liao, Yu-Han Chang, Li-Yu Sung, Kuei-Chang Li, Chia-Lin Yeh, Tzu-Chen Yen, Shiaw-Min Hwang, Kun-Ju Lin, Yu-Chen Hu
Journal: Biomaterials (2014)
Prevalence and incidence
Authors: P. Sedgwick
Journal: BMJ (2010)

A randomised controlled trial investigated whether screening and treating women for chlamydial infection reduced the subsequent occurrence of pelvic inflammatory disease.1 Between 2004 and 2006, vaginal swabs were provided by 2529 sexually active female students. The samples were randomly allocated to immediate testing (screening group), or storage and deferred screening after a year (control group). After screening, treatment for chlamydial infection was offered to women where necessary. All women were able to undertake independent testing for chlamydia during the follow-up period of one year. At baseline, 5.4% of the women in the screened group tested positive for chlamydia compared to 5.9% of the controls. Over the following twelve months, 1.3% of the screened women developed pelvic inflammatory disease compared with 1.9% of the controls. Which of the following statements, if any, are true?