tbuckley/cabot-search huggingface dataset:
Health System Reform: The Case for a Single-Payer Approach
Authors: Francis X. Brickfield
Journal: JAMA (1994)

<h3>To the Editor.</h3> —While generally agreeing with Representative McDermott<sup>1</sup>on the need for a single-payer approach to health system finance, I would point out a fundamental flaw in his plan. I was particularly surprised at this missing element given that the author has worked overseas and had the opportunity to observe health care systems in a number of countries. The examples he cites of single-payer systems are, in fact, not. In every case, while the government coordinates the bulk of health care expenditures, individuals retain the right to directly purchase health care services outside the governmental financing mechanism and may do so without penalty. In Australia, this is what is meant by "right of private practice." In England, the National Health Service has occasion to buy surgical services from the private sector when it is overloaded. Throughout the Middle East and Africa, when the wealthy want a medical service,
The Ca<sup>2+</sup>‐sensitizer levosimendan improves oxidative damage, BNP and pro‐inflammatory cytokine levels in patients with advanced decompensated heart failure in comparison to dobutamine
Authors: Catherine Avgeropoulou, Ioanna Andreadou, Sophia Markantonis‐Kyroudis, Maritina Demopoulou, Platon Missovoulos, Aris Androulakis, Ioannis Kallikazaros
Journal: European Journal of Heart Failure (2005)
Self management of type 2 diabetes
Authors: Frank J Snoek
Journal: BMJ (2007)

More efforts are needed to capture the patients' perspective

The introduction of home blood glucose monitoring in the late 1970s was instrumental in shifting the focus of the management of diabetes from doctors to patients.1 It is now a common view that patients are primarily responsible for the daily management of their diabetes, which includes self monitoring, at least in patients treated with insulin. The usefulness of self monitoring in patients with type 2 diabetes not treated with insulin is controversial, a debate that was recently fuelled by findings from the DIGEM trial.2

Two studies in this week's BMJ are related to optimising the treatment of type 2 diabetes.3 4 In the first, Peel and colleagues3 report the results from a longitudinal qualitative study of the views of patients with type 2 diabetes about self monitoring, using a repeat interview design. The authors rightly point out that the patient's view has been largely absent in discussions on self monitoring in type 2 diabetes. While self testing of blood glucose has the potential to empower patients, …
Tuberculosis, Atypical Mycobacteriosis, and the Acquired Immunodeficiency Syndrome Among Haitian and Non-Haitian Patients in South Florida
Authors: ARTHUR E. PITCHENIK
Journal: Annals of Internal Medicine (1984)

To study the association between mycobacterial disease and the acquired immunodeficiency syndrome, we reviewed the records of all cases of tuberculosis and all cases of the syndrome reported in Dade County, Florida, from January 1980 through June 1983. Tuberculosis was diagnosed in 27 of 45 Haitians with the syndrome, but in only 1 of 37 non-Haitians with the syndrome (p < 0.001). Among the 27 Haitians with the syndrome and tuberculosis, 19 had extrapulmonary tuberculosis, whereas among 286 Haitian patients with tuberculosis without the syndrome, only 56 had extrapulmonary tuberculosis (p < 0.001). Tuberculosis preceded the syndrome by 1 to
Of Mugs and Marketing-Reply
Authors: Drummond Rennie
Journal: JAMA (1991)

<h3>In Reply.</h3> —To Drs Johnson and Kirkland, I can confess that my personal editorial preference would be for advertisements to be segregated at the front and back of<i>JAMA</i>, but as must be clear from my editorial, this editor doesn't sell advertisements. To Dr Kirkland, I would add that<i>JAMA</i>has a far lower advertisement ratio than the throwaways—journals that do nothing to further the biomedical enterprise by going to the expense of reviewing, selecting, and publishing research. I am happy to tell Dr Kelly that the AMA intends to start up the<i>Archives of Family Medicine</i>within the next year. (See<i>JAMA</i>. 1991;266:2527; Medical News &amp; Perspectives.)
Oversupply of Medical Graduates—A Remedy in Medical Missions.
Authors: Frank W. Hendley
Journal: JAMA (1901)

Cincinnati, Ohio, July 30, 1901. <h3>To the Editor:</h3> —Your editorial<sup>1</sup>on "Oversupply of Medical Graduates," presents statistics which are startling, because they prove that relief from the present oversupply is impossible under present conditions. There is also little prospect that those conditions will be altered so as to reduce the output of the "doctor factories" to any appreciable extent. In fact, we can only expect an increase. While everybody knows that there are four or five times more medical colleges than are necessary, the benefits attached to a professorship in even the poorest of them are such that "few die and none ever resign," while in order to attract the guileless student, and incidentally, his matriculation and other fees, we find the free clinics and hospitals are multiplied, in order that they may be advertised as evidence of "teaching facilities" and "abundant clinical material," etc. It would be right
Elevated serum interleukin-6 has prognostic significance for postoperative outcome in patients undergoing cardiothoracic surgery
Authors: Matthew D. Bacchetta, Matthew R. Moore, Daniel M. Levine, Thomas S. Parker, Bruce R. Gordon, O.Wayne Isom, Karl H. Krieger, Leonard N. Girardi, Wilson Ko, Stuart D. Saal
Journal: Journal of the American College of Cardiology (2002)
The developmental dynamics of the maize leaf transcriptome
Authors: Pinghua Li, Lalit Ponnala, Neeru Gandotra, Lin Wang, Yaqing Si, S Lori Tausta, Tesfamichael H Kebrom, Nicholas Provart, Rohan Patel, Christopher R Myers, Edwin J Reidel, Robert Turgeon, Peng Liu, Qi Sun, Timothy Nelson, Thomas P Brutnell
Journal: Nature Genetics (2010)
First-line combination therapy with rituximab and corticosteroids provides a high complete remission rate in moderate-to-severe bullous pemphigoid
Authors: Y.T. Cho, C.Y. Chu, L.F. Wang
Journal: British Journal of Dermatology (2014)

Funding sources: none. Conflicts of interest: none declared. Dear Editor, Bullous pemphigoid (BP) is the most common autoimmune blistering disease, mainly affecting the elderly. Despite improvements in treatment modalities, the 1‐year mortality rate of patients with BP is still high, ranging from 13% to 38%.1 2 Recently, we reported the effectiveness of rituximab, a monoclonal anti‐CD20 antibody, as first‐line therapy for pemphigus.3 Therefore, we have attempted to measure the utility of rituximab as first‐line therapy for BP. From 2010 to 2012 we performed a retrospective case–control study in a referral centre in Taiwan, including patients with the generalized form of BP requiring systemic treatment. Diagnosis of BP was based on typical clinical presentations, characteristic histopathological findings, and the presence of autoantibodies on direct and/or indirect immunofluorescence studies. In the first‐line combination therapy group (group R), the regimen included four weekly infusions of 500 mg rituximab (MabThera™; Roche, Basel, Switzerland), and corticosteroids, with a starting dose of prednisolone of 0·5 mg kg−1 daily (Table 1). The dose of corticosteroids was tapered rapidly after disease was controlled. Each dose lasted for 3–4 weeks, with a total duration of < 6 months. As a comparison (group C), to ensure the similarity of severity, we included patients from the same period receiving a similar starting dose of prednisolone for at least 6 months (Table 1). We excluded those with localized or mild disease, which could be controlled by topical treatment or a short course of systemic treatment. All patients were followed for 1 year or until death. In both groups, the average age, BP Disease Area Index values,4 blood eosinophil counts and the presence of comorbidities were similar (Table 2). More than 90% of patients in group R achieved complete remission (CR), a status of no established or new lesions for at least 2 months,4 which was significantly higher than in group C (P =0·02). Notably, eight of the patients achieving CR in group R achieved CR off therapy (CRoff). Of these eight patients, four maintained CRoff during the follow‐up period of > 2 years. The other four experienced disease recurrence. Nevertheless, relapses in these cases were mild and easily controlled. The mean duration of CRoff in these four patients was 27 weeks (range 22–35 weeks). The risk of infection was slightly lower in group R than in group C (31% vs. 53%), but it was not statistically significant (P =0·22). Urinary tract infection and pneumonia were the leading infections in groups R and C, respectively. The 1‐year mortality rate of group R was much lower than that of group C (15% vs. 37%), but it was not significantly different (P =0·18).
Vomiting as a diagnostic aid--or diagnostic pitfall.
Authors: A M Gardner
Journal: BMJ (1980)

arm into the shoulder but not the praecordium and was accompanied by an episode of vomiting.It was relieved only by diamorphine.Physical examination was normal but later the patient became mildly pyrexial, and serial electrocardiograms and cardiac enzyme assays confirmed an inferior myocardial infarct.The patient made an uncomplicated recovery but has subsequently developed classical symptoms of angina.This patient presented in a busy accident and emergency department and was admitted only because of the severity of her pain.This case emphasises the difficulty of diagnosing atypical cardiac pain.
Role of secretory leukocyte protease inhibitor in the development of subclinical emphysema
Authors: T. Betsuyaku, K. Takeyabu, M. Tanino, M. Nishimura
Journal: European Respiratory Journal (2002)

Secretory leukocyte protease inhibitor (SLPI) is a potent inhibitor of human leukocyte elastase. In some chronic airway diseases, the level of SLPI is decreased in sputum, leading to the continuation of neutrophil inflammation. In this study, the role of SLPI in subclinical pulmonary emphysema was examined. Sequential bronchoalveolar lavage was performed in an attempt to separately evaluate the levels of SLPI in the large airways and in the peripheral airways for two groups of smokers. One group had subclinical emphysema by computed-tomography scans and one group did not. SLPI localized in alveolar macrophages (AM) was also assessed. The level of SLPI was significantly elevated in the peripheral airways from the subjects with emphysema compared to those without emphysema (1589.2±353.9 versus 729.1±31.0 ng·mL −1 ), although it was similar in the large airways (3442.3±499.6 versus 2535.7±578.8 ng·mL −1 ). There was a trend for higher amount of SLPI to be released from AM in subjects with subclinical emphysema, although this did not reach statistical significance. In conclusion, there is compensatory upregulation of secretory leukocyte protease inhibitor in peripheral airways in subclinical pulmonary emphysema, which is in sharp contrast to the decreased level of secretory leukocyte protease inhibitor reported in some chronic airway diseases.
NICE guidance to prevent strokes and heart attacks lacks evidence
Authors: Susan Mayor
Journal: BMJ (2005)

An expert adviser for a report that was used to develop the guidance from the National Institute for Health and Clinical Excellence (NICE) claims that the guidance is not supported by adequate evidence from clinical trials.

The NICE guidance recommends that a combination of modified release dipyridamole and aspirin should be used in patients who have had an ischaemic stroke or a transient ischaemic attack for two years from the most recent event. …
Colon Tumours and Colonoscopy
Authors: B. P. Saunders
Journal: Endoscopy (2005)

Colonoscopic practice continues to be a major theme of Digestive Disease Week. At this year’s meeting, radical new colonoscope designs were described for the first time, and there was a particular emphasis on initial evaluations of new optical detection technologies. The quality of colonoscopy, in terms of insertion and examination during withdrawal, was an important topic, as was the increasing potential of therapeutic colonoscopy. Japanese researchers were again seen to be leading the way in pushing back the boundaries of endoscopic polyp detection and early cancer resection.
Paracoccidioidomycosis (South American blastomycosis) successfully treated with terbinafine: first case report
Authors: J.M. Ollague, A.M. de Zurita, G. Calero
Journal: British Journal of Dermatology (2000)

We describe a 63-year-old man who presented with painful malodorous lesions in the perianal, perineal and scrotal regions. Following definitive diagnosis of paracoccidioidomycosis, he was treated initially with trimethoprim/sulphamethoxazole, but there was no clinical improvement. He then received terbinafine (Lamisil) 250 mg twice daily for 6 months. There was rapid resolution of all lesions and complete relief of symptoms, without any associated side-effects. The patient remains clinically well and without any evidence of infection 2 years after discontinuation of terbinafine treatment.
SHP-2-Dependent Mitogen-Activated Protein Kinase Activation Regulates EGFRvIII but not Wild-Type Epidermal Growth Factor Receptor Phosphorylation and Glioblastoma Cell Survival
Authors: Yi Zhan, Donald M. O’Rourke
Journal: Cancer Research (2004)

Abstract In human glioblastomas, the most common mutation of epidermal growth factor receptor (EGFR) is an in-frame deletion of an 801-bp sequence in the extracellular domain of EGFR termed EGFRvIII. The EGFRvIII does not bind ligand EGF but has constitutive tyrosine phosphorylation (pTyr) content and kinase activity that result in enhanced transformation, reduced apoptosis, and resistance to therapy. Here we report that the protein tyrosine phosphatase SHP-2 modulates a mitogen-activated protein kinase (MAPK) kinase (MEK)-mediated signaling pathway that regulates EGFRvIII pTyr and cell survival in U87MG.EGFRvIII cells. Overexpression of the phosphatase-inactive form of SHP-2 inhibited EGFRvIII pTyr by decreasing MAPK phosphorylation. Consistent with this, we observed that the MEK inhibitor PD98059, but not the phosphatidylinositol 3′-kinase inhibitor LY294002, inhibited EGFRvIII pTyr. Furthermore, constitutive EGFRvIII pTyr content observed in U87MG, LN229, and U373MG glioblastoma cells, but not in NR6.EGFRvIII fibroblasts, correlated with elevated MAPK levels in these cells. Interestingly, LY294002, but not PD98059, inhibited wild-type EGFR pTyr in response to EGF treatment in U87MG parental cells and in wild-type EGFR-overexpressing U87MG cells. Inhibition of EGFRvIII pTyr by PD98059 was not observed to be phosphorylation site specific. However, LY294002 more specifically inhibited wild-type EGFR pTyr at residues Tyr992 and Tyr1068 in the COOH terminus. Treatment of U87MG.EGFRvIII cells with PD98059, but not LY294002, also resulted in increased cell death in response to cisplatin. Collectively, a distinct MEK-mediated pathway in human glioblastoma cells appears to differentially modulate EGFRvIII and wild-type EGFR pTyr, and inhibition of the MAPK pathway sensitizes EGFRvIII-containing human glioblastoma cells to cisplatin-induced cell death.
DD-05 * GSK3BETA INHIBITORY DRUGS ATTENUATE INVASION OF GLIOBLASTOMA CELLS
Authors: T. Fueur, M. Nakada, S. Hemragul, Y. Dong, K. Miyashita, T. Minamoto, Y. Hayashi
Journal: Neuro-Oncology (2014)

PURPOSE: Glycogen synthase kinase (GSK) 3beta is an emerging and attractive therapeutic target against glioblastoma (GBM). Here, we investigated the efficacy of existing approved drugs inhibiting GSK3beta activity in vitro and in vivo on the basis of drug repositioning. METHOD: The effects of GSK3beta inhibiting drugs, cimetidine, lithium carbonate, olanzapine, and valproic acid, on the invasive ability of glioma cells (U87, T98G, U251) were evaluated using migration and invasion assays. GSK3beta activity after adding GSK3b inhibiting drugs was evaluated by detecting phosphorylation of glycogen synthase (GS) that is the primary substrate for GSK3beta. Expression and activity of matrix metalloproteinase (MMP)-2 were examined with gelatin zymography. These drugs were administered orally to GBM mouse model at therapeutic doses once daily for 2 weeks. Tissue sections were stained by standard hematoxylin and eosin technique, and satellite lesions that did not connect tumor bulk were counted. Immunohistochemistry was performed to detect the phosphorylated GS and nestin. RESULTS: Inhibition of GSK3beta activity by each drug was confirmed in GBM cells in vitro and GBM mouse model. Each drug attenuated GBM cell migration and invasion in dose-dependent manner. Combination of all 4 drugs remarkably decreased MMP-2 expression and activity. All drugs reduced satellite lesions and nestin-positive cells in vivo. No adverse effect was observed in mice. CONCLUSION: GSK3beta-targeted therapy for GBM patients with approved 4 drugs showed promising effect to attenuate glioma invasion, possibly via suppression of stemness.
Combined Mitral and Pulmonic Stenosis
Authors: HERBERT SHUBIN, DAVID C. LEVINSON, MAURICE H. ROSENFELD
Journal: Circulation (1957)

A case of combined pulmonic and mitral stenosis with cardiac catheterization studies is presented. A modification of the formula for calculating pulmonic valvular resistance is discussed. The importance of calculating cardiac output on the basis of the systolic ejection phase is noted. The pulmonic valvular resistance by this modified formula was 210 dynes seconds cm. -5 The pulmonary vascular resistance was 250 dynes seconds cm. -5 The pulmonic valvular resistance tended to protect against the development of pulmonary edema, much as a high pulmonary vascular resistance protects against pulmonary edema. The right ventricular output, which was 1.6 L. per minute, was limited by the pulmonic stenosis. Other mechanisms that might mechanically limit right ventricular output are significant tricuspid stenosis or limb tourniquets. In situations of impending pulmonary edema, any one of these factors that decrease right ventriccular output may be advantageous.
The Usefulness and Significance of Naso-pharyngo-laryngo-tracheal Fiberscopy in Thyroid Surgery
Authors: A. Sugenoya, S. Kobayashi, Y. Kasuga, T. Yokozawa, G. Kaneko, N. Hanamura, O. Senga, M. Miyakawa, F. Iida
Journal: Endoscopy (1987)

The authors conducted naso-pharyngo-laryngo-tracheal fiberscopic examinations before and after thyroid surgery. Preoperative examination included an inspection of vocal cord movement, the compression and deformity of the trachea caused by goiters, changes in the color of the tunica mucosa tracheae, and the presence of tumorous invasion. Postoperatively, this method was employed primarily to determine the presence of recurrent laryngeal nerve paralysis, changes in the tracheal mucosa caused by manipulations in thyroid surgery and in cases in which surgery involved the tracheal wall, and to inspect the treated condition at the original tracheal site and detect the presence of possible recurrences. The manipulations can be easily carried out, causing little pain, and the procedure is economically feasible. Since it can provide more useful information than any other examination method, the active use of endoscopic examination by surgeons themselves at numerous facilities would appear desirable.
Healthy life expectancy: evaluation of global indicator of change in population health.
Authors: J M Robine, K Ritchie
Journal: BMJ (1991)

OBJECTIVE--To review and evaluate the usefulness of healthy life expectancy as a global indicator of changes in a population9s health. DESIGN--Review of all known studies to date from the United States, mainland Europe, Canada, and the United Kingdom that have used Sullivan9s method of calculating disability free life expectancy. MAIN OUTCOME MEASURES--Life expectancy and disability free life expectancy. RESULTS--Over the past decade the average healthy life expectancy was 60 years for men and 64 for women, with the proportion of years of disability ranging from 11% to 21% in men and from 14% to 24% in women. At the age of 65 men could expect eight years of disability free life and women 10, with the life expectancy being respectively 14 and 19 years. The difference between the wealthiest and poorest income quintiles was 6.3 years in life expectancy and 14.3 in disability free life expectancy for men and 2.8 and 7.6 respectively for women. These results suggest that disparities in health are greater between social groups than between the sexes. Diseases affect mortality and morbidity differently. The order of importance for affecting life expectancy was circulatory disease, cancer, and accidents and for disability free life expectancy, circulatory disease, locomotor disorders, and respiratory disorders. CONCLUSIONS--Healthy life expectancy is a valuable index for the appreciation of changes in both the physical and the mental health states of the general population, for allocating resources, and for measuring the success of political programmes. Future calculations should also take into account the probability of recovery and thus extend the applicability of the indicator to populations in poor health rather than focusing on the well population.
Repair of Inguinal Hernia vs Watchful Waiting
Authors: Gardner W. Smith
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
Upregulation of Hypoxia-Inducible Factor-1α mRNA and its Clinical Significance in Non-small Cell Lung Cancer
Authors: Tomofumi Yohena, Ichiro Yoshino, Tomoyoshi Takenaka, Toshifumi Kameyama, Taro Ohba, Yukio Kuniyoshi, Yoshihiko Maehara
Journal: Journal of Thoracic Oncology (2009)
Sudden Death in Young Athletes
Authors: Barry J. Maron
Journal: New England Journal of Medicine (2003)

This article summarizes the available information regarding the cardiac risks of participation in athletics. Hypertrophic cardiomyopathy remains the leading cause of sudden death from cardiac causes among young athletes. Although controlled studies are lacking, there is indirect evidence to suggest that screening and sidelining young athletes with high-risk cardiac findings are justified and should decrease the number of sudden deaths in this population.
Bilateral Paget Disease of the Calcaneus Diagnosed by Conventional Bone Scintigraphy
Authors: Joan Duch, David Fuster, Jaime Ortín, Xavier Setoain, Francesca Pons
Journal: Clinical Nuclear Medicine (2006)

An 85-year-old woman who had an invasive ductal carcinoma of the breast and elevated alkaline phosphatases (420 U/L) was referred for Tc-99m MDP bone scintigraphy for initial evaluation of skeletal metastases. Bone symptoms were limited to chronic pain in both knees. A bone scan revealed pagetoid findings in both calcanei. Feet and toes on plain x-rays of the calcaneus were unremarkable. Findings were stable in the 2-year follow up, excluding other potential diagnosis as extensive metastases or stress fractures.