tbuckley/cabot-search huggingface dataset:
Health Care Reform — Why So Slow?
Authors: E Ginzberg
Journal: New England Journal of Medicine (1990)

Recent opinion surveys have disclosed the American public's deepening restiveness over the shortcomings of U.S. health care, which has grown to such a point that the majority of the respondents now look favorably on alternative systems, particularly the Canadian one.1 In the face of increasingly severe and widespread criticism and discontent, why has movement toward health reform been at best modest and at worst ineffectual?To begin with, one must distinguish clearly between actions and effectiveness. The challenge of slowing the steep rise in health care expenditures has been the focus of both public and private policy for the past . . .
MYBL2 haploinsufficiency increases susceptibility to age-related haematopoietic neoplasia
Authors: M Clarke, S Dumon, C Ward, R Jäger, S Freeman, B Dawood, L Sheriff, M Lorvellec, R Kralovics, J Frampton, P García
Journal: Leukemia (2012)

The haematopoietic system is prone to age-related disorders ranging from deficits in functional blood cells to the development of neoplastic states. Such neoplasms often involve recurrent cytogenetic abnormalities, among which a deletion in the long arm of chromosome 20 (del20q) is common in myeloid malignancies. The del20q minimum deleted region contains nine genes, including MYBL2, which encodes a key protein involved in the maintenance of genome integrity. Here, we show that mice expressing half the normal levels of Mybl2 (Mybl2+/Δ) develop a variety of myeloid disorders upon ageing. These include myeloproliferative neoplasms, myelodysplasia (MDS) and myeloid leukaemia, mirroring the human conditions associated with del20q. Moreover, analysis of gene expression profiles from patients with MDS demonstrated reduced levels of MYBL2, regardless of del20q status and demonstrated a strong correlation between low levels of MYBL2 RNA and reduced expression of a subset of genes related to DNA replication and checkpoint control pathways. Paralleling the human data, we found that these pathways are also disturbed in our Mybl2+/Δ mice. This novel mouse model, therefore, represents a valuable tool for studying the initiation and progression of haematological malignancies during ageing, and may provide a platform for preclinical testing of therapeutic approaches.
Coronary sinus thermography in idiopathic dilated cardiomyopathy: Correlation with systemic inflammation and left ventricular contractility
Authors: Konstantinos Toutouzas, Pavlos Stougiannos, Maria Drakopoulou, John Mitropoulos, Eirini Bosinakou, Virginia Markou, George Latsios, Ioannis Karabelas, Elli Stefanadi, Christodoulos Stefanadis
Journal: European Journal of Heart Failure (2006)
Underuse of Percutaneous Coronary Intervention
Authors: Joseph D. Restuccia, Michael Shwartz, Bernard E. Kreger
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
Opting in or out of organ donation.
Authors: R. M. Taylor
Journal: BMJ (1992)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Opting in or out of organ donation. Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Diets for diabetics: no added sucrose.
Authors: H Trowell
Journal: BMJ (1976)

neither can be compare the UK in 1946, when there were 3 million motors, and in 1974, when there were 17 million.We must have some comparative rate, and if this is improving we are entitled to claim that we are making progress.The large number of deaths is at least partly due to the enormous number of motors.It is also remarkable that your profession, who are in the best position to know, should neglect the large saving in lives made by the motor in enabling you to get to your patients more quickly and to get them to hospital promptly, in enabling the fire brigade to reach fires early, and so on.This mistake has been made twice, if not three times, with tragic results, Between 1946 and 1956 the number of deaths rose slightly, although the "Smeed rate"-which allows for the population and number of motors-and the deaths per 100 million vehicle-kilometres both fell markedly.The rise in deaths, slight though it was, was blamed wholly on the drivers, though the number of motors had risen from 3 million to 61 million.An Act increasing penalties was passed, the trend of the deaths rose sharply, and both rates rose.This was again blamed on the drivers and another Act, much increasing penalties, was passed in 1962.The deaths then rocketed upwards to the highest
749 RISK OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH HEPATITIS B VIRUS PRE-S MUTATION: LONG-TERM FOLLOW-UP DATA
Authors: D.H. Sinn, H.Y. Park, M.S Choi, Y.W. Min, Y.J. Kim, G.-Y. Gwak, Y.-H. Paik, J.H. Lee, K.C. Koh, S.W. Paik, B.C. Yoo
Journal: Journal of Hepatology (2012)
The emerging role of asymmetric dimethylarginine as a novel cardiovascular risk factor
Authors: R BOGER
Journal: Cardiovascular Research (2003)

There is abundant evidence that the endothelium plays a crucial role in the maintenance of vascular tone and structure. One of the major endothelium-derived vasoactive mediators is nitric oxide (NO). Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of NO synthase. ADMA inhibits vascular NO production at concentrations found in pathophysiological conditions (i.e., 3-15 micromol/l); ADMA also causes local vasoconstriction when it is infused intraarterially. The biochemical and physiological pathways related to ADMA are now well understood: dimethylarginines are the result of the degradation of methylated proteins; the methyl group is derived from S-adenosylmethionine. Both ADMA and its regioisomer, SDMA, are eliminated from the body by renal excretion, whereas only ADMA, but not SDMA, is metabolized via hydrolytic degradation to citrulline and dimethylamine by the enzyme dimethylarginine dimethylaminohydrolase (DDAH). DDAH activity and/or expression may therefore contribute to the pathogenesis of endothelial dysfunction in various diseases. ADMA is increased in the plasma of humans with hypercholesterolemia, atherosclerosis, hypertension, chronic renal failure, and chronic heart failure. Increased ADMA levels are associated with reduced NO synthesis as assessed by impaired endothelium-dependent vasodilation. In several prospective and cross-sectional studies, ADMA evolved as a marker of cardiovascular risk. With our increasing knowledge of the role of ADMA in the pathogenesis of cardiovascular disease, ADMA is becoming a goal for pharmacotherapeutic intervention. Among other treatments, the administration of L-arginine has been shown to improve endothelium-dependent vascular function in subjects with high ADMA levels.
Relation of Coronary Collateral Circulation with and Neutrophil/Lymphocyte ratio in Patients with Non-ST Elevation Acute Coronary Syndrome
Authors: Erhan Tenekecioğlu, Adem Bekler, Dursun Topal, Bedrettin Boyraz, Ferdi Kahraman, Ömür Aydın, Pınar Yağcıoğlu, Burhan Aslan, Tezcan Peker, Mustafa Yılmaz
Journal: Journal of the American College of Cardiology (2013)
Hazards and hazard ratios
Authors: P. Sedgwick
Journal: BMJ (2012)

Researchers investigated the risk of colorectal cancer after screening with flexible sigmoidoscopy. A randomised controlled study was undertaken in Norway with a population based sample. The intervention consisted of once only flexible sigmoidoscopy screening with or without a single round of faecal occult blood testing. The control treatment was no screening. The main outcome measures included length of time from randomisation until death from colorectal cancer.1 After a median of six years of follow-up, the hazard ratio for mortality from colorectal cancer, comparing intervention with control, was 0.73 (95% confidence interval 0.47 to 1.13). The researchers concluded that mortality from colorectal cancer was not significantly reduced in the screening group but that it seemed to be lower among participants who attended screening.
Diagnosing and investigating adverse reactions in metal on metal hip implants
Authors: C. Fary, G. E. R. Thomas, A. Taylor, D. Beard, A. Carr, S. Glyn-Jones
Journal: BMJ (2011)

Use of metal bearings in hip replacements and resurfacing operations has led to adverse reactions to metal debris in many patients. This article examines how to assess and manage any patient with a metal on metal total hip replacement who presents with potential joint failure
Daily progestogen for contraception: a clinical study.
Authors: J. Martinez-Manautou, J. Giner-Velasquez, V. Cortes-Gallegos, R. Aznar, B. Rojas, A. Guitterez-Najar, H. W. Rudel
Journal: BMJ (1967)

Material and MethodsChlormadinone acetate 0.5 mg.daily was given continuously to two groups of fertile women.Group 1 comprised 945 non- lactating regularly menstruating women under 36 years of age, and group 2 comprised 100 lactating women, varying from 1 to 15 months post partum.Each received a thorough gynaecological examination, with a Papanicolaou smear, the latter on 19 August
Cancer Epidemiology and Prevention
Authors: Dexter L. Morris
Journal: JAMA (1982)

In the past several decades, epidemiology has emerged as an integral part of cancer research. It has become important not only as related to risk factors, but in the investigation of molecular theories, in issues of environmental regulation, and in providing rational approaches to cancer prevention and control. This text, edited by Drs Schottenfeld and Fraumeni, containing contributions by many notable experts, is a highly successful attempt to put much of this wealth of information together in a useable format. The text is divided into five sections. The first, "Basic Concepts," contains six chapters on epidemiologic methods and the biology of cancer. While impossible in a single chapter to present full discussions, a suitable framework of definitions and concepts is provided. Section 2, "The Magnitude of Cancer," has six chapters that include not only national and international cancer data but information on survival and the economic impact of cancer. The
Multicentre evaluation of central nervous system infections due to Flavi and Phleboviruses in Turkey
Authors: Koray Ergunay, A. Arzu Sayiner, Nadine Litzba, Sabine Lederer, Remi Charrel, Petra Kreher, Durdal Us, Matthias Niedrig, Aykut Ozkul, Gulsen Hascelik
Journal: Journal of Infection (2012)
The Epidemiology of Found Experiments
Authors: David F. Phillips
Journal: JAMA (1995)

In much scientific work, researchers construct an experiment in which they assign subjects to experimental or control groups. Sometimes, instead of constructing an experiment, researchers may find one that was created by natural or social events beyond the researchers' control. The study by Kark et al<sup>1</sup>in this issue of<i>JAMA</i>is one example of a "found" experiment. In this study the authors document an abrupt increase in mortality after the first Iraqi missile attack on Israel in January 1991. Found experiments of this sort have three characteristics: (1) the independent variable (eg, the presence or absence of a missile attack) shows a marked change in a short time; (2) the dependent variable (eg, mortality) also displays a large, abrupt change in level; and (3) the investigation seeks a short-term link between independent and dependent variables. For example, the present study found a sharp increase See also p 1208.
Do patients with skin allergies have higher levels of anxiety than patients with allergic respiratory diseases? Results of a large-scale cross-sectional study in a French population
Authors: I. Annesi-Maesano, A. Beyer, F. Marmouz, P. Mathelier-Fusade, D. Vervloet, V. Bauchau
Journal: British Journal of Dermatology (2006)

Background Psychological comorbidity is a known aspect of allergic disease. However, there is recent evidence that a large proportion of allergic patients remains undiagnosed and untreated for psychological disease. In addition, the complexities of the anxiety–allergy relationship, i.e. differences for current and past disease, or differences among allergic disease types, are not well understood. Objectives To measure the level of anxiety in a large allergic population in France using a standardized measure, the State/Trait Anxiety Inventory (STAI). Methods Allergy patients in France (n = 3939) who visited their allergy specialists participated in the study. The patients completed a questionnaire which was then linked to the questionnaire completed by their physician. Only patients with both subject and physician questionnaire were kept in the analyses. Mean STAI scores for the State (S) and Trait (T) scales were obtained for each allergic disease. ancova models testing group differences on the mean scores, using the categories 'current disease', 'past disease' and 'allergic disease ever', were assessed along with relevant confounders. Results Allergic rhinitis (AR), asthma and atopic dermatitis (AD) were the most prevalent conditions of the 12 allergic diseases assessed in the study. Women had higher mean STAI S/T scores than men and age was also found to be associated with higher S scores; therefore, both age and gender were included as covariates where relevant. A single ancova model for each STAI scale showed a statistical difference among the various allergic diseases. Using the category 'current disease' each allergic disease was assessed separately regarding the presence or absence of that disease. Higher, statistically significant mean STAI scores were found for AD and allergic urticaria on the S scale and for AD on the T scale. Similarly, for the category 'allergic disease ever', AD and allergic urticaria reached statistical significance on the S scale, while on the T scale only AD was statistically significant. When patients were assessed for anxiety based on their past disease, asthma, AR and sinusitis were significant on the S scale while asthma and nasal polyps were statistically significant on the T scale. When asthma and AD were tested simultaneously, only the latter was significant. Conclusions High mean scores for State and Trait anxiety were mostly associated with AD.
BIOCHEMISTRY OF THE PSYCHONEUROSES— A REVIEW
Authors: R. A. McFarland, H. Goldstein
Journal: American Journal of Psychiatry (1937)

A survey of the biochemical work in this field reveals a confusion of results. The lack of agreement among investigators may result from any one or more of a variety of uncontrolled factors. Differences in psychiatric diagnosis, poor research technique, including inadequate sampling and the lack of adequate normal control groups, lack of refinement in the biochemical techniques as well as lack of precision in the biochemical technicians, inadequate standards to indicate where the normal leaves off and the pathological begins, and insufficient or inept statistical treatment of the obtained data have all been more or less influential in presenting distorted and unreliable biochemical pictures of the mental disorders. These factors are in some measure within the control of the experimenter. Another factor over which the experimenter has no control and which is not a negligible one in explaining the variety and abundance of conflicting results is the variability of the psychoneurotic. The variability is uncontrolled and may yield high normal results oné day and low normal results the next in the same individual. A vegetative and vasomotor instability is probably a more or less constant symptom of neurotic behavior. The variability of the results of chemical studies of the blood appears to reflect the instability of the intermediary metabolism of the psychoneurotic. Hence the degree or kind of emotional stability may be a function of the amount of variability in the blood constituents. In the final analysis the variability of the psychoneurotic probably implies fatigue and over or under correction or loss of adaptability, which ultimately results in irritability, dysfunction and irreversibility of certain organic mechanisms.
Monoamine Oxidase A–Mediated Enhanced Catabolism of Norepinephrine Contributes to Adverse Remodeling and Pump Failure in Hearts With Pressure Overload
Authors: Nina Kaludercic, Eiki Takimoto, Takahiro Nagayama, Ning Feng, Edwin W. Lai, Djahida Bedja, Kevin Chen, Kathleen L. Gabrielson, Randy D. Blakely, Jean C. Shih, Karel Pacak, David A. Kass, Fabio Di Lisa, Nazareno Paolocci
Journal: Circulation Research (2009)

Rationale : Monoamine oxidases (MAOs) are mitochondrial enzymes that catabolize prohypertrophic neurotransmitters, such as norepinephrine and serotonin, generating hydrogen peroxide. Because excess reactive oxygen species and catecholamines are major contributors to the pathophysiology of congestive heart failure, MAOs could play an important role in this process. Objective : Here, we investigated the role of MAO-A in maladaptive hypertrophy and heart failure. Methods and Results : We report that MAO-A activity is triggered in isolated neonatal and adult myocytes on stimulation with norepinephrine, followed by increase in cell size, reactive oxygen species production, and signs of maladaptive hypertrophy. All of these in vitro changes occur, in part, independently from α- and β-adrenergic receptor–operated signaling and are inhibited by the specific MAO-A inhibitor clorgyline. In mice with left ventricular dilation and pump failure attributable to pressure overload, norepinephrine catabolism by MAO-A is increased accompanied by exacerbated oxidative stress. MAO-A inhibition prevents these changes, and also reverses fetal gene reprogramming, metalloproteinase and caspase-3 activation, as well as myocardial apoptosis. The specific role of MAO-A was further tested in mice expressing a dominant-negative MAO-A (MAO-A neo ), which were more protected against pressure overload than their wild-type littermates. Conclusions : In addition to adrenergic receptor–dependent mechanisms, enhanced MAO-A activity coupled with increased intramyocardial norepinephrine availability results in augmented reactive oxygen species generation, contributing to maladaptive remodeling and left ventricular dysfunction in hearts subjected to chronic stress.
Cancer Survivors and Unemployment
Authors: Angela G. E. M. de Boer, Taina Taskila, Anneli Ojajärvi, Frank J. H. van Dijk, Jos H. A. M. Verbeek
Journal: JAMA (2009)

Nearly half of adult cancer survivors are younger than 65 years, but the association of cancer survivorship with employment status is unknown.To assess the association of cancer survivorship with unemployment compared with healthy controls.A systematic search of studies published between 1966 and June 2008 was conducted using MEDLINE, CINAHL, EMBASE, PsycINFO, and OSH-ROM databases.Eligible studies included adult cancer survivors and a control group, and employment as an outcome.Pooled relative risks were calculated over all studies and according to cancer type. A Bayesian meta-regression analysis was performed to assess associations of unemployment with cancer type, country of origin, average age at diagnosis, and background unemployment rate.Twenty-six articles describing 36 studies met the inclusion criteria. The analyses included 20,366 cancer survivors and 157,603 healthy control participants. Studies included 16 from the United States, 15 from Europe, and 5 from other countries. Overall, cancer survivors were more likely to be unemployed than healthy control participants (33.8% vs 15.2%; pooled relative risk [RR], 1.37; 95% confidence interval [CI], 1.21-1.55). Unemployment was higher in breast cancer survivors compared with control participants (35.6% vs 31.7%; pooled RR, 1.28; 95% CI, 1.11-1.49), as well as in survivors of gastrointestinal cancers (48.8% vs 33.4%; pooled RR, 1.44; 95% CI, 1.02-2.05), and cancers of the female reproductive organs (49.1% vs 38.3%; pooled RR, 1.28; 95% CI, 1.17-1.40). Unemployment rates were not higher for survivors of blood cancers compared with controls (30.6% vs 23.7%; pooled RR, 1.41; 95% CI, 0.95-2.09), prostate cancers (39.4% vs 27.1%; pooled RR, 1.11; 95% CI, 1.00-1.25), or testicular cancer (18.5% vs 18.1%; pooled RR, 0.94; 95% CI, 0.74-1.20). For survivors in the United States, the unemployment risk was 1.5 times higher compared with survivors in Europe (meta-RR, 1.48; 95% credibility interval, 1.15-1.95). After adjustment for diagnosis, age, and background unemployment rate, this risk disappeared (meta-RR, 1.24; 95% CI, 0.85-1.83).Cancer survivorship is associated with unemployment.
The art of surgery.
Authors: T. Groves
Journal: BMJ (1989)

Professor Sir Roy Calne transplants livers and carries heavy responsibility: when patients die he feels that he has betrayed them and their families' trust, but the practical demands of surgery leave him little room to express himself.Last year he began to paint his patients and staff.He says that painting is just as hard as liver transplantation, save for the fact that unsuccessful paintings can be thrown away.Roy Calne has painted and drawn since childhood, encouraged by his aunt and by his art teacher at school, the son of the painter Russell Flint.As a medical student at Guy's Hospital in London he spent much of his spare time in galleries, particularly the Tate, where staff assumed that his careful copying of work by Degas was an art school assignment.But painting was just a hobby until about five years ago, when he began to seek more technical training.Chinese surgeon Earl Lu showed him how to use oriental brushes to apply broad sweeps of colour, and artist Ron Ranson helped him to translate this into his personal style.Since then Calne has taken every opportunity to learn: he believes that thorough knowledge of technique is essential to good art.His large paintings are executed in oil and acrylic, and he also enjoys doing quick