tbuckley/cabot-search huggingface dataset:
Duodenal total and ionised calcium secretion in normal subjects, chronic alcoholics, and patients with various stages of chronic alcoholic pancreatitis.
Authors: J Lohse, A Pfeiffer
Journal: Gut (1984)

Previous studies have shown increased secretion of total calcium in the duodenal juice of patients with chronic alcoholic pancreatitis compared with healthy subjects. In order to get more detailed information on calcium secretion and pancreatic stone formation in chronic alcoholic pancreatitis, ionised and total calcium concentrations were determined in the duodenal juice of normal subjects, chronic alcoholics, and patients with various stages of chronic alcoholic pancreatitis. Total calcium secretion was in agreement with previously published data. Chronic alcoholics presented a significant increase of ionised calcium. In the course of pancreatitis all calcium fractions increased progressively revealing highest concentrations in patients with severe exocrine insufficiency. In non-calcified and calcified pancreatitis all calcium fractions were identical. It is suggested that the increase of ionised calcium originates from serum ionised calcium passing by diffusion into the damaged pancreatic duct system.
A 44-Year-Old Woman With Difficulty Walking, 2 Years Later
Authors: Erin E. Hartman
Journal: JAMA (2002)

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
Unwarranted variations in healthcare delivery: implications for academic medical centres
Authors: J. E Wennberg
Journal: BMJ (2002)

Everyday clinical practice is characterised by wide variations that cannot be explained by illness severity or patient preference. Professor Wennberg examines the causes for these variations and suggests ways to remedy the situation 

Academic medicine has had only limited success in improving the scientific basis of everyday clinical practice, even within the walls of its own hospitals. Patterns of practice among academic medical centres—as among other institutions—are often idiosyncratic and unscientific, and local medical opinion and local supply of resources are more important than science in determining how medical care is delivered. In short, after nearly 100 years of academic medicine as we know it, much of medicine in the United States remains empirical.

The evaluative clinical sciences—those disciplines whose role in medicine is to evaluate medical theory, understand patient preferences, and improve systems—are capable of improving the scientific basis of clinical practice and warrant high priority in the national research agenda and full adoption into medical school curriculums. These sciences are essential to the development of organised healthcare systems in the 21st century, not least because they expose unwarranted variations in care and can be used to remedy them.

#### Summary box

I will begin with a summary of the facts of unwarranted variations in clinical practice, derived from the Dartmouth Atlas of Health Care project, a US national study of traditional (fee for service) Medicare. The atlas project reports on the rates of …
Developmental effects of chlorpyrifos extend beyond neurotoxicity: critical periods for immediate and delayed-onset effects on cardiac and hepatic cell signaling.
Authors: Armando Meyer, Frederic J Seidler, Theodore A Slotkin
Journal: Environmental Health Perspectives (2003)

The fetal and neonatal neurotoxicity of chlorpyrifos (CPF) and related insecticides is a major concern. Developmental effects of CPF involve mechanisms over and above cholinesterase inhibition, notably events in cell signaling that are shared by nonneural targets. In the present study, we evaluated the immediate and long-term effects of CPF exposure of rats during different developmental windows [gestational days (GD) 9-12 or 17-20, postnatal days (PN) 1-4 or 11-14] on the adenylyl cyclase (AC) signaling cascade in the heart and liver. In addition to basal AC activity, we assessed the responses to direct AC stimulants (forskolin, Mn2+); to isoproterenol and glucagon, which activate signaling through specific membrane receptors; and to sodium fluoride, which activates the G-proteins that couple the receptors to AC. Few immediate effects on AC were apparent when CPF doses remained below the threshold for systemic toxicity. Nevertheless, CPF exposures on GD9-12, GD17-20, or PN1-4 elicited sex-selective effects that emerged by adulthood (PN60), whereas later exposure (PN11-14) elicited smaller, nonsignificant effects, indicative of closure of the window of vulnerability. Most of the effects were heterologous, involving signaling elements downstream from the receptors, and thus were shared by multiple inputs; superimposed on this basic pattern, there were also selective alterations in receptor-mediated responses. These results suggest that the developmental toxicity of CPF extends beyond the nervous system, to include cell signaling cascades that are vital to cardiac and hepatic homeostasis. Future work needs to address the potential implications of these effects for cardiovascular and metabolic disorders that may emerge long after the end of CPF exposure.
Hope Hype Hit
Authors: Gabriela Radulescu
Journal: JAMA (1990)

<h3>To the Editor.—</h3> Contributions that extol the virtue of a particular drug (albeit in its generic form) unsupported by any study or reference to the existent literature and unaccompanied by a balanced go-with editorial are, to our knowledge, unprecedented in<i>JAMA</i>. Yet, such a contribution appeared in<i>JAMA</i>in the disguise of a pharmacologic manufacturer's insert published in "A Piece of My Mind."<sup>1</sup> The author supplies no references whatsoever and baldly admits to relying on anecdotal experience ("living proof "). The agent described is strongly implied to be a universal remedy for just about any ailment, irrespective of the form or dose in which it is administered. No reference is made to studies with negative findings, such as the one by Averill and Catlin<sup>2</sup>that concluded that hope is neither a necessary nor a universal requirement of life. The same workers argue that far from availability in the unique,
Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy
Authors: Mary Eapen, John P. Klein, Annalisa Ruggeri, Stephen Spellman, Stephanie J. Lee, Claudio Anasetti, William Arcese, Juliet N. Barker, Lee Ann Baxter-Lowe, Maria Brown, Marcelo A. Fernandez-Vina, John Freeman, Wensheng He, Anna Paola Iori, Mary M. Horowitz, Franco Locatelli, Susana Marino, Martin Maiers, Gerard Michel, Guillermo F. Sanz, Eliane Gluckman, Vanderson Rocha
Journal: Blood (2013)
Absence of the canalicular isoform of the MRP gene-encoded conjugate export pump from the hepatocytes in Dubin-Johnson syndrome
Authors: J Kartenbeck, U Leuschner, R Mayer, D Keppler
Journal: Hepatology (1996)

The Dubin-Johnson syndrome is characterized by an inherited defect in the secretion of amphiphilic anionic conjugates from hepatocytes into the bile. We have recently identified the membrane protein mediating the adenosine triphosphate (ATP)-dependent transport of glutathione and glucuronate conjugates as a multidrug-resistance protein (MRP) and localized it to the canalicular as well as to the lateral hepatocyte plasma membrane. In the present study we show the selective absence of the canalicular isoform of MRP (cMRP) from the hepatocytes in a patient with Dubin-Johnson syndrome by double-label immunofluorescence and confocal laser scanning microscopy using antibodies directed against MRP and dipeptidyl-peptidase IV (DPPIV). Another isoform of MRP was detected, however, in the lateral hepatocyte membrane of the patient. Moreover, MRP was present on immunoblots of erythrocyte membranes from Dubin-Johnson syndrome and normal humans. These findings are analogous to our recent observations on the localization of the rat homolog of MRP and its canalicular isoform, cMrp, in normal and transport-deficient GY/TR- Wistar rat liver. The elucidation of the selective absence of an isoform of MRP and from the canalicular membrane domain in conjunction with the defined substrate specificity of the MRP and cMRP gene-encoded conjugate export pumps contributes to the molecular definition of the transport defect in Dubin-Johnson syndrome.
Carcinogenicity of airborne fine particulate benzo(a)pyrene: an appraisal of the evidence and the need for control.
Authors: F Perera
Journal: Environmental Health Perspectives (1981)

Benzo(a)pyrene(BaP) originating from fossil fuel and other organic combustion processes is largely adsorbed on fine particulate and hence is a widespread atmospheric pollutant. Available emissions and air quality data are based on the total weight of particulate matter without reference to size and give little information on trends and concentrations of fine particulate BaP. Greater reliance on coal, synfuels and diesel fuel for energy production and transportation will significantly increase ambient levels of BaP. Because of the particulate size, BaP is substantially deposited in the lower lung and readily eluted into surrounding tissue. After elution in the lung, BaP is metabolically activated to its electrophilic, carcinogenic from by a complex enzyme system whose activity is increased by prior exposure to air pollutants, cigarette smoke and certain drugs. The resultant diol epoxide metabolite has been shown to bind covalently with the DNA of the lung. In experimental animals, BaP is a potent initiating carcinogen whose action is enhanced by sulfur dioxide, promoting agents and carrier fine particles. The effect of small, divided doses of BaP has been shown to be greater than that of a single high dose; no threshold has been established. Epidemiological studies show that mixtures containing BaP (such as urban air, industrial emissions and cigarette smoke) are carcinogenic and may interact synergistically. Occupational studies indicate that the action of BaP-containing mixtures is enhanced in the presence of SO2. However, quantitative risk assessment for BaP is precluded by problems in extrapolating to the general population from small-scale animal studies; uncertainties in findings of epidemiology; and imprecise exposure data. Existing stationary and mobile controls preferentially remove coarse particulate matter and are inefficient collectors of the particulate BaP. In the current absence of health and environmental standards for BaP, there is little incentive to control BaP emissions. BaP meets the criteria for regulation under the Clean Air Act; however, no such BaP standards have yet been proposed.
Outpatient Evaluation of Dietary Intake and Nitrogen Removal in Continuous Ambulatory Peritoneal Dialysis
Authors: G. M. GAHL
Journal: Annals of Internal Medicine (1981)

Five patients on continuous ambulatory peritoneal dialysis were studied to evaluate dietary intake, glucose absorption from the dialysate, and urinary and dialysate nitrogen removal. The study was done on an outpatient basis, while the patients ingested their usual diets and went about their usual activities. The results indicate that patients greatly overestimated their caloric and protein intake, which was 0.71 to 0.96 g/kg bodyweight per day. Dialysate glucose contributed considerably to total caloric intake, because approximately 75% of the dialysate glucose was absorbed independent from total glucose administered, providing 20% to 29% of the total caloric intake. We concluded that protein requirement in clinically stable continuous ambulatory peritoneal dialysis patients still needs defining because the patients may be anabolic with lower protein intakes than previously recommended.
Notable Reduction in Illegitimate Integration Mediated by a PPT-deleted, Nonintegrating Lentiviral Vector
Authors: Boris Kantor, Matthew Bayer, Hong Ma, Jude Samulski, Chengwen Li, Thomas McCown, Tal Kafri
Journal: Molecular Therapy (2010)

Nonintegrating lentiviral vectors present a means of reducing the risk of insertional mutagenesis in nondividing cells and enabling short-term expression of potentially hazardous gene products. However, residual, integrase-independent integration raises a concern that may limit the usefulness of this system. Here we present a novel 3' polypurine tract (PPT)-deleted lentiviral vector that demonstrates impaired integration efficiency and, when packaged into integrase-deficient particles, significantly reduced illegitimate integration. Cells transduced with PPT-deleted vectors exhibited predominantly 1-long terminal repeat (LTR) circles and a low level of linear genomes after reverse transcription (RT). Importantly, the PPT-deleted vector exhibited titers and in vitro and in vivo expression levels matching those of conventional nonintegrating lentiviral vectors. This safer nonintegrating lentiviral vector system will support emerging technologies, such as those based on transient expression of zinc-finger nucleases (ZFNs) for gene editing, as well as reprogramming factors for inducing pluripotency.
The management of overactive bladder syndrome
Authors: S. P. Marinkovic, E. S. Rovner, R. M. Moldwin, S. L. Stanton, L. M. Gillen, C. M. Marinkovic
Journal: BMJ (2012)

#### Summary points 

In 2010, the International Continence Society restated the definition of overactive bladder syndrome as a condition with characteristic symptoms of “urinary urgency, usually accompanied by frequency and nocturia, with or without urgency incontinence, in the absence of urinary tract infection or other obvious pathology.”1 In 2009, disease specific total expenditures for this syndrome exceeded $24.9bn (£15.76bn; €19.01bn).2 However, overactive bladder syndrome remains underdiagnosed and undertreated, despite prevalence estimates in men and women of 17% in the United States (National Overactive Bladder Evaluation study) and 12-17% in six European nations.2 3 One population based prevalence study found that 60% of older or disabled patients seek treatment but only 27% receive it.4 The study also showed that overactive bladder syndrome is associated with worse quality of life scores than those in hypertension, depression, diabetes, and asthma. In fact, many patients are unaware that useful medical treatment is available.4 Retrospective observational studies have shown that the medical and surgical consequences of overactive bladder—particularly in older or disabled patients—include depression, falls, fractures, urinary …
Thoracoplasty after Twenty Years
Authors: Paul Dufault
Journal: New England Journal of Medicine (1948)

THORACOPLASTY for pulmonary tuberculosis, at Rutland State Sanatorium, began in 1927. By January 1, 1947, 362 patients had received that form of treatment. This is a review of the work done and of the results obtained in those twenty years.IndicationsThe clinical indications have changed very little, if at all, throughout the whole period. The general rules established by Alexander‡ remain: "... those patients are chosen for operation who have moderately or far advanced chronic tuberculosis, with or without hemoptysis; whose lesions are of the fibroulcerative type, with or without cavitation or empyema, and are principally confined to one . . .
Synopsis of Clinical Pulmonary Disease
Authors: Edward H. Bergofsky
Journal: JAMA (1989)

This volume is an exemplary synopsis of pulmonary medicine that has grown from a house staff manual into a minitest over a few short years. It combines excellent tabular summaries with "howto-do-its." It has the advantage of clear language, short sentences, and simplified approaches. Its level is still that of student, house staff, and primary care physician, and this simplicity and directness are among its chief advantages. The editors, Drs Mitchell, Petty, and Schwarz, have long been associated with the strong University of Colorado (Boulder) pulmonary medicine group and have recruited other contributors with varying experience from among their senior faculty members and fellows. Despite these differences, the resulting chapters are all good and every effort has been made to use the clearest and most direct prose. In many cases, the authors of the individual chapters are physicians who have very great perspective, created through long experience, in a given
Abstract LB-322: Cruciferous vegetable intake after diagnosis of breast cancer and survival: a report from the shanghai breast cancer survival study
Authors: Sarah J. Nechuta, Wei Lu, Hui Cai, Ying Zheng, Ping-Ping Bao, Wei Zheng, Xiao Ou SHu
Journal: Cancer Research (2012)

Abstract BACKGROUND: Cruciferous vegetables are a major source of glucosinolate-derived bioactive compounds, such as isothiocyanates and indoles, which have been shown in animal studies and in vitro to inhibit cancer growth and progression. However, little is known regarding the role of cruciferous vegetables in breast cancer prognosis. Using resources from the Shanghai Breast Cancer Survival, a large population-based prospective cohort study of Chinese breast cancer survivors, we evaluated the association of cruciferous vegetable consumption after cancer diagnosis and breast cancer outcomes with repeated dietary assessments after diagnosis. METHODS: Women with incident breast cancer aged 20-75 years were recruited within 6-months of diagnosis during 2002-2006. In-person baseline interviews collected detailed data on clinic characteristics, socio-demographics, and lifestyle factors. Medical records were used to verify clinical data. The cohort has been followed-up by a combination of in-person follow-up surveys and record linkage to the Shanghai Vital Statistics Registry. Cruciferous vegetable intake (g/day) was reassessed at 18- and 36-months. Cox regression models were used to derive hazard ratios (HR) and 95% confidence intervals (CIs) for the associations of cruciferous vegetables and breast cancer outcomes. Analyses include 4,886 women with stage I-IV breast cancer. RESULTS: After a median follow-up of 5.2 years, 587 deaths (496 breast cancer deaths) and 615 recurrences occurred. Cruciferous vegetable intake increased after diagnosis (mean (SD)=62.5 (44.5) at 6-months and 133.8 (93.3) at 36-months). After adjustment for socio-demographics, clinical characteristics including treatment and tumor characteristics, and lifestyle factors, cruciferous vegetable intake was associated with improved breast cancer survival in a dose-response pattern (P for trend &amp;lt; 0.01). The multivariable hazard ratios (95% confidence intervals) across increasing quartiles (vs. Q1) were 0.73 (0.60-0.90), 0.51 (0.41-0.64), and 0.38 (0.29-0.49) for total mortality; 0.78 (0.62-0.97), 0.53 (0.41-0.68), and 0.38 (0.29-0.51) for breast cancer-specific mortality; 0.79 (0.63-0.98), 0.71 (0.57-0.88), and 0.65 (0.52-0.81) for recurrence. These associations persisted after excluding the first year of observation, although the association for recurrence was no longer statistically significant. CONCLUSION: Cruciferous vegetable intake after breast cancer diagnosis was associated with improved prognosis among Chinese women. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-322. doi:1538-7445.AM2012-LB-322
The mitotic index in psoriatic plaques and their response to PUVA therapy
Authors: L. H. GOLDBERG, A. J. COX, E. A. ABEL
Journal: British Journal of Dermatology (1980)

SUMMARY The mitotic index of pretreatment plaques of chronic psoriasis was determined before treatment with PUVA. There was a wide variation in mitotic indices in different patients. Treatment was given with UV-A 2 h after oral ingestion of 8-methoxypsoralen (8-MOP) two or three times per week, with increasing doses of UV-A. Patients were considered cleared if there was 95% clearing of all psoriatic plaques. There was no correlation between the mitotic index and the response to treatment, as measured by either the number of joules administered or the number of treatments until the lesions cleared. This suggests that the action of PUVA in psoriasis is not dependent on the amount of increase in epidermal proliferation.
Clinical Assessment of Pathological Personality Traits
Authors: Drew Westen
Journal: American Journal of Psychiatry (2006)

Objective: Research has raised questions about the ability of clinicians to make reliable diagnostic judgments about personality. The aim of this study was to assess the reliability and validity of the dimensional diagnosis of pathological personality traits with the Shedler-Westen Assessment Procedure-200 (SWAP-200) Q sort. Method: Two clinician/judges independently described 24 outpatients using the SWAP-200, based on a systematic clinical interview. Treating clinicians described the patients using the SWAP-200 based on their knowledge of the patients over the course of treatment while they were blind to interview data. Results: Interrater reliability was high. Convergent and discriminant validity between interviewers and clinicians was also strong. A procedure recently developed for providing precise estimates of construct validity with contrast analysis applied to correlational data documented strong evidence of validity. Conclusions: Clinicians and independent interviewers can reliably assess complex personality traits associated with personality pathology using the SWAP-200.
Violence in Health Care: A Practical Guide to Coping With Violence and Caring for Victims
Authors: Jeffrey L. Metzner
Journal: JAMA (1995)

This book, which is edited by a professor of oral and maxillofacial surgery at the University of Wales College of Medicine, contains chapters by psychiatrists, criminologists, a surgeon, a nurse, a lawyer, and a family practitioner. The target audience includes all health care workers who come into contact with victims of violent crime in a variety of settings, including emergency departments and community clinics within Great Britain. The handbook provides a summary of the epidemiology of violence, issues pertinent to victims, and basic guidelines for developing safe working environments within a health care setting. A clear summary describes the psychological, physical, and behavioral effects on health care providers who have been assaulted by patients. Studies described in this book were often specific to the United Kingdom, although the principles apply generally and are pertinent for US health care providers. A 1987 London study indicated that 11% of general practitioners had