tbuckley/cabot-search huggingface dataset:
A Brief Review of Bone Adaptation to Unloading
Authors: Ping Zhang, Kazunori Hamamura, Hiroki Yokota
Journal: Genomics Proteomics & Bioinformatics (2008)

Weight-bearing bone is constantly adapting its structure and function to mechanical environments. Loading through routine exercises stimulates bone formation and prevents bone loss, but unloading through bed rest and cast immobilization as well as exposure to weightlessness during spaceflight reduces its mass and strength. In order to elucidate the mechanism underlying unloading-driven bone adaptation, ground-based in vitro and in vivo analyses have been conducted using rotating cell culturing and hindlimb suspension. Focusing on gene expression studies in osteoblasts and hindlimb suspension studies, this minireview introduces our recent understanding on bone homeostasis under weightlessness in space. Most of the existing data indicate that unloading has the opposite effects to loading through common signaling pathways. However, a question remains as to whether any pathway unique to unloading (and not to loading) may exist.
Providing High-Value, Cost-Conscious Care: A Critical Seventh General Competency for Physicians
Authors: Steven E. Weinberger
Journal: Annals of Internal Medicine (2011)

There is general agreement that the U.S. economy cannot sustain the staggering economic burden imposed by the current and projected costs of health care. Whereas governmental approaches are focused primarily on decreasing spending for medical care, it is the responsibility of the medical profession to become cost-conscious and decrease unnecessary care that does not benefit patients but represents a substantial percentage of health care costs. At present, the 6 general competencies of the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) that drive residency training place relatively little emphasis on residents' understanding of the need for stewardship of resources or for practicing in a cost-conscious fashion. Given the importance in today's health care system, the author proposes that cost-consciousness and stewardship of resources be elevated by the ACGME and the ABMS to the level of a new, seventh general competency. This will hopefully provide the necessary impetus to change the culture of the training environment and the practice patterns of both residents and their supervising faculty.
Indirect laryngoscopy as a screening test for laryngeal cancer
Authors: W. C. Taylor
Journal: JAMA (1991)

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
Update on the UK law on consent
Authors: D. K. Sokol
Journal: BMJ (2015)

Last week's case of Montgomery v Lanarkshire Health Board has important implications for doctors All doctors should be aware of the landmark decision in Montgomery v Lanarkshire Health Board, given by the UK Supreme Court on 11 March 2015.1 2 Nadine Montgomery was a woman with diabetes who gave birth by vaginal delivery. Her baby, Sam, was born with serious disabilities after shoulder dystocia during delivery. The doctor, Dina McLellan, did not tell Montgomery of the 9-10% risk of shoulder dystocia. McLellan said that she did not routinely discuss the risk of shoulder dystocia with women with diabetes for fear that, if told, such women would opt for a caesarean section. The court held that McLellan should have informed Montgomery of the risk and discussed with her the option of a caesarean section. After the Montgomery case, the so called Bolam test, which asks whether a doctor's conduct would be supported by a responsible body of medical opinion, no longer applies to the issue of consent. The law now requires a doctor to take "reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments." So doctors must now ask themselves three questions:
Diffuse large B-cell lymphoma outcome prediction by gene-expression profiling and supervised machine learning
Authors: Margaret A. Shipp, Ken N. Ross, Pablo Tamayo, Andrew P. Weng, Jeffery L. Kutok, Ricardo C.T. Aguiar, Michelle Gaasenbeek, Michael Angelo, Michael Reich, Geraldine S. Pinkus, Tane S. Ray, Margaret A. Koval, Kim W. Last, Andrew Norton, T. Andrew Lister, Jill Mesirov, Donna S. Neuberg, Eric S. Lander, Jon C. Aster, Todd R. Golub
Journal: Nature Medicine (2002)
Hydroxyurea-Associated Leg Ulceration
Authors: B.J. Kennedy
Journal: Annals of Internal Medicine (1998)

Letters1 August 1998Hydroxyurea-Associated Leg UlcerationB.J. Kennedy, MDB.J. Kennedy, MDUniversity of Minnesota; Minneapolis, MN 55455Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-3-199808010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Best and colleagues' article [1] describes hydroxyurea-induced leg ulceration in 14 patients who were receiving daily therapy. Treatment required cessation of hydroxyurea therapy.The phenomenon of skin atrophy and ulceration due to hydroxyurea is not new. In 1975 [2], we described hydroxyurea-induced dermatologic toxicity that included atrophy of skin and subcutaneous tissues sometimes accompanied by ulceration. The effects were hydropic degeneration of basal cells, loss of staining of germinative cells of the epidermis, and hypergranulosis. Hyaline bodies similar to the Civatte bodies of lichen planus were positive on periodic acid-Schiff staining but were diastase resistant. The explanation ...References1. Best PJ, Daoud MS, Pittelkow MR, Petitt RM. Hydroxyurea-induced leg ulceration in 14 patients. Ann Intern Med. 1997; 128:29-32. Google Scholar2. Kennedy BJ, Smith R, Goltz RW. Skin changes secondary to hydroxyurea therapy. Arch Dermatol. 1975; 111:183-7. Google Scholar3. Leavell UW Jr, Yarbro JW. Hydroxyurea: a new treatment for psoriasis. Arch Dermatol. 1970; 102:144-50. Google Scholar4. Kennedy BJ. The evolution of hydroxyurea therapy in chronic myelogenous leukemia. Semin Oncol. 1992; 19(3 Suppl 9):21-6. Google Scholar Author, Article, and Disclosure InformationAuthors: B.J. Kennedy, MDAffiliations: University of Minnesota; Minneapolis, MN 55455 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDermatological Toxicity of HydroxycarbamideCutaneous ulcers associated with hydroxyurea therapyEmerging Adverse Cutaneous Drug Reactions 1 August 1998Volume 129, Issue 3Page: 252KeywordsAtrophyBasal cellsCellsDNA synthesisDrug administrationPeriodic acid SchiffPsoriasisStainingToxicityUlcers ePublished: 15 August 2000 Issue Published: 1 August 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Expression of the Gene Defect in X-Linked Agammaglobulinemia
Authors: Mary Ellen Conley, Persymphonie Brown, Allan R. Pickard, Rebecca H. Buckley, Debra S. Miller, Wendy H. Raskind, Jack W. Singer, Philip J. Fialkow
Journal: New England Journal of Medicine (1986)

Although X-linked agammaglobulinemia was one of the first immunodeficiencies described,1 the genetic defect responsible for this disorder has not yet been identified. X-linked agammaglobulinemia is characterized by the onset of recurrent bacterial infections in the first few years of life. Concentrations of serum immunoglobulins are markedly decreased, and the number of B cells in the peripheral circulation is less than 1 percent of the normal value.2 3 4 5 However, approximately normal numbers of preB cells, the noncirculating precursors of B cells, can be detected in the bone marrow of affected persons.6 The failure of preB cells to differentiate into B cells may . . .
Molecular single-cell analysis reveals that CD5-positive peripheral blood B cells in healthy humans are characterized by rearranged Vkappa genes lacking somatic mutation.
Authors: M Fischer, U Klein, R Küppers
Journal: Journal of Clinical Investigation (1997)

B cells expressing the CD5 cell surface antigen are involved in certain B cell malignancies and autoimmune diseases. From studies in the mouse, it emerged that CD5+ B cells represent a separate lineage of B lymphocytes that, in contrast to conventional (CD5-) B cells, are not driven into T cell-dependent immune responses in which rearranged variable (V) region genes are diversified by somatic hypermutation. Against this background it came as a surprise that human disease-involved CD5-positive autoreactive B cells as well as B cell chronic lymphocytic leukemias can harbor somatically mutated V region genes. Recent V gene analyses on CD5+ B cells in healthy adults did not give rise to a clear picture about the fraction of somatically mutated among all CD5+ B cells. In this work we used a molecular single-cell analysis to determine reliably the frequency of mutated CD5+ B cells in healthy humans: single, kappa light chain-expressing CD5+ peripheral blood B cells were isolated by flow cytometry, and rearranged Vkappa genes were amplified by PCR. From one donor, CD5+CD19+ B cells were analyzed. Since CD5+ B cells were found among IgM+IgD+ and IgM+IgD- cells (but almost not among class-switched cells) from two other donors, individual cells corresponding to these IgM-expressing subsets were investigated separately. The sequence analysis of rearranged Vkappa genes revealed that most if not all CD5+ B cells in healthy humans carry unmutated V region genes. From one of the donors, a novel polymorphic Jkappa2 gene segment was identified. To explain the discrepancy between the frequent occurrence of disease-associated somatically mutated CD5+ B cells and the low incidence or absence of somatic mutation in normal CD5+ B cells, we speculate that CD5+ B cells usually do not participate in germinal center reactions, but if they occasionally do so, they may be at an increased risk to become involved in autoimmune diseases or B cell malignancies.
Artifactual Hypoglycemia Associated With Polycythemia Vera
Authors: Charles J. Billington, Dennis A. Casciato, Debra L. Choquette, John E. Morley
Journal: JAMA (1983)

Artifactual hypoglycemia in patients with leukemia is well recognized. We report herein that patients with polycythemia vera and erythrocytosis demonstrate a similar spurious hypoglycemia caused by accelerated in vitro metabolism of glucose. (<i>JAMA</i>1983;249:774-775)
Metoclopramide as an Antiemetic
Authors: STEPHEN B. STRUM
Journal: Annals of Internal Medicine (1981)

Letters and Corrections1 December 1981Metoclopramide as an AntiemeticSTEPHEN B. STRUM, M.D., JONATHAN E. MCDERMED, PHARM. D.STEPHEN B. STRUM, M.D., JONATHAN E. MCDERMED, PHARM. D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-95-6-782_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We read with interest the review by Seigel and Longo (1) on the control of chemotherapy-induced emesis. The authors' conclusion that "the phenothiazines are the only class of antiemetics that have shown both efficacy and safety in large numbers of cancer patients" is misleading. Although the phenothiazines have been shown to be effective in controlling mild nausea and vomiting, they are clearly inadequate with potent emetogenic chemotherapy agents such as cisplatin (2). Although the number of patients treated is not large, studies by Gralla and colleagues (3) and Strum and associates (4) have shown high-dose metoclopramide (Reglan;...References1. SEIGEL L and LONGO D. The control of chemotherapy-induced emesis. Ann Intern Med. 1981;95:352-9. LinkGoogle Scholar2. FRYTACK S and MOERTEL C. Management of nausea and vomiting in the cancer patient. JAMA. 1981;245:393-6. CrossrefMedlineGoogle Scholar3. GRALLA R, SQULLANTE A, ITRI L, PISKO S, KELSEN D, and YOUNG C. High dose metoclopramide: effective antiemetic against cisplatin (DDP) in randomized trials vs placebo and prochlorperazine (PCP). Proc Am Soc Clin Oncol. 1981;22:420. Abstract. Google Scholar4. STRUM S, OPFELL R, MCDERMED J, and RIECH L. Intravenous metoclopramide (MCP) prevention of cisplatinum (DDP)-induced nausea and vomiting. Proc Am Soc Clin Oncol. 1981;22:391. Abstract. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: STEPHEN B. STRUM, M.D.; JONATHAN E. MCDERMED, PHARM. D.Affiliations: 9808 Venice Boulevard, Suite 206; Culver City, CA 90230 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAntiemetic Efficacy of Metoclopramide 1 December 1981Volume 95, Issue 6Page: 782-783KeywordsChemotherapeutic agentsChemotherapyNauseaPhenothiazineSafetyVomiting ePublished: 1 December 2008 Issue Published: 1 December 1981 PDF downloadLoading ...
Huge inequalities in access to drugs partly because of intellectual property rights, says UN expert
Authors: J. Zarocostas
Journal: BMJ (2009)

Nearly two billion people lack access to essential drugs partly because of how intellectual property rights are interpreted, says a report by a United Nations independent expert.

Improving access to drugs “could save 10 million lives a year, four million in Africa and South East Asia,” says the author, Anand Grover, UN special rapporteur on the right to physical and mental health.

The report presented to the 47 member state UN Human Rights Commission on 2-3 June concludes that “diseases of poverty,” such as communicable, perinatal, and nutritional diseases, still account for half of the disease burden in poor countries, which is nearly 10 times higher than the proportion in rich nations.

It also claims that 100 million people fall into poverty every year worldwide because they have to pay for health care.

Mr Grover says that because laws that cover intellectual property rights affect the affordability …
Managed Care May Feature Behavioral Medicine
Authors: Charles Marwick
Journal: JAMA (1996)

AS MANAGED CARE groups become major players in providing and financing health care services, experts in behavioral medicine see a golden chance to fulfill their objective of integrating psychosocial with biomedical approaches to health and illness. "The impetus for behaviorial and psychosocial approaches in disease prevention, treatment, and rehabilitation comes from public health and the efforts to change lifestyles. Along with this has come an interest in health care utilization, so there's an opportunity here," said C. Barr Taylor, MD, speaking at the Fourth International Congress of Behavioral Medicine, held in Washington, DC. "We think that, as more capitated systems take over in health care, this gives us the chance to intervene and apply new models that might be successful in treating illness. At least 25% of the patients in a primary care practice present with emotional problems, like anxiety, depression, or drug or alcohol abuse," Taylor said. He is
Quinidine-Induced Lupus Nephritis
Authors: Melvin Yudis
Journal: JAMA (1976)

MANY DRUGS can precipitate a syndrome resembling systemic lupus erythematosus (SLE). The most common are hydralazine hydrochloride, procainamide hydrochloride, and various anticonvulsants. To our knowledge, only two previous cases of quinidine-related lupus have been recorded.<sup>1,2</sup>Our case involved the musculoskeletal system and the kidneys. <h3>Case Report</h3> A 49-year-old woman was first admitted to Holy Redeemer Hospital in August 1970 with a diagnosis of rheumatic mitral stenosis with atrial fibrillation. At that time, the antistreptolysin O titer, hemoglobin value, blood cell count, and urinalysis results were normal. Digoxin therapy was started with a dosage of 0.25 mg daily. The patient was also receiving warfarin sodium (Coumadin), 7.5 mg daily, and meprobamate, 200 mg four times a day. Her rhythm reverted to normal with digoxin therapy. The patient remained well until July 1973, when she was readmitted because of recurrence of atrial fibrillation with an uncontrolled ventricular response. Her treatment consisted
Reply to Lrp5 regulation of bone mass and gut serotonin synthesis
Authors: Yajun Cui, Paul J Niziolek, Bryan T MacDonald, Natalia Alenina, Susann Matthes, Christina M Jacobsen, Ronald A Conlon, Robert Brommage, David R Powell, Xi He, Michael Bader, Bart O Williams, Matthew L Warman, Alexander G Robling
Journal: Nature Medicine (2014)
Anchorage-independent colony growth of pulmonary fibroblasts derived from fibrotic human lung tissue.
Authors: D J Torry, C D Richards, T J Podor, J Gauldie
Journal: Journal of Clinical Investigation (1994)

Fibroblast heterogeneity is known to exist in chronically inflamed tissue such as pulmonary fibrosis (IPF) and scleroderma. We have previously shown differences in proliferation rates in primary lines and cloned lines of fibroblasts derived from IPF tissue compared with normal lung. In this study, we report that cell lines derived from fibrotic tissue demonstrate anchorage-independent growth in soft agarose culture whereas normal lung fibroblast lines do not. We also show that fibroblast lines derived from neonatal lung tissue form colonies at about the same frequency as the fibrotic cells. Colonies from both fibrotic and neonatal lines were shown to be positive for vimentin, laminin, fibronectin, fibronectin receptor, beta-actin, and tropomyosin by immunohistochemistry but were negative for desmin, keratin, Factor VIII, alpha-smooth muscle cell actin, and tenascin. Treatment with cytokines TGF-beta and PDGF or with corticosteroid modified the colony-forming capacity of fibrotic and neonatal cell lines, however, none of these treatments induced normal lung cell lines to form colonies. The presence of cells in adult fibrotic tissue with growth characteristics similar to those exhibited by neonatal cells is further evidence of fibroblast heterogeneity and suggests newly differentiated fibroblasts may be prevalent in fibrotic tissue and contribute directly to the matrix disorder seen in this disease.
Prostaglandin E2 abrogates endothelin-induced vasoconstriction in renal outer medullary descending vasa recta of the rat.
Authors: E P Silldorff, S Yang, T L Pallone
Journal: Journal of Clinical Investigation (1995)

Endothelins (ET) and prostaglandin E2 are synthesized in the inner medulla by collecting duct epithelium and interstitial cells, respectively. All ascending vasa recta (AVR) blood returns from the inner medulla to the cortex in outer medullary vascular bundles. We reasoned that hormones might influence medullary blood flow by diffusing across AVR fenestrations to modulate vasoconstriction of outer medullary descending vasa recta (OMDVR). To investigate this possibility, OMDVR dissected from vascular bundles were exposed to ET-1, 2, or 3. Each endothelin isoform induced stable vasoconstriction with potency, ET-1 > ET-2 > ET-3 (EC50, 1.8 x 10(-15), 5.9 x 10(-12), and 8.8 x 10(-10) M, respectively). The ETA receptor antagonist BQ-123 and BQ-610 (10(-6) M), as well as an ETA and ETB receptor antagonist combination, attenuated vasoconstriction due to ET-1 (10(-12) M). BQ-123 had no effect on the response to ET-3 (10(-8) M). The ETB receptor antagonist BQ-788 (10(-6) M) attenuated the response to ET-3 (10(-10) M), but not that to ET-1 (10(-12) M). Finally, PGE2 (10(-6) M) reversibly dilated OMDVR preconstricted with ET-1 (10(-12) M) or ET-3 (10(-8) M) but not ET-1 (10(-10) M). We conclude that ET-1,2, and 3 are potent constrictors of OMDVR and the response to ET-1 is mainly ETA receptor subtype mediated, while ET-3 acts via the ETB. PGE2 modulates ET induced constriction. These findings are consistent with interactive feedback and control of medullary perfusion by locally synthesized hormones.
A FURTHER CONSIDERAION OF THE QUSTION OF PERMANENT DRAINAGE IN CERTAIN CASES OF PANCREATITIS
Authors: Le GRAND GUERRY
Journal: JAMA (1910)

working basis though a comprehensive statement cannot be entered into at this time.We may assume perhaps that a chemical balance has been broken.The latter would seem to be necessary in the explanation of the formation of metastasis, while the former might obtain as a preliminary factor in the development.I will remind you that epithelial métastases occur most fre- quently in those regions where leukocytes are most abundant (the lymph-glands) or where this prefibrin substance is most abundant (in subendothelial tissues).Metastasis, according to this hypothesis; becomes very
Estrogen Dosage-Reply
Authors: Wayne S. Maxson
Journal: JAMA (1984)

<h3>In Reply.—</h3> Dr Hustead's perceptive comments on the relative potencies of conjugated estrogen and ethinyl estradiol are appreciated. While previous reports had suggested that 25 to 50 μg of ethinyl estradiol was protective against osteoporosis,<sup>1</sup>these dosages were arbitrarily chosen. Mandel et al<sup>2</sup>recently reported that 10 μg of ethinyl estradiol is approximately equivalent to 1.25 mg of conjugated estrogens on the basis of both hepatic and nonhepatic measurements, suggesting that ethinyl estradiol is far more potent than previously believed. Bolton et al<sup>3</sup>found that 20 μg of ethinyl estradiol is equivalent to 1.25 mg of conjugated estrogen in the suppression of luteinizing hormone. However, Rudel and Kincl<sup>4</sup>concluded that conjugated estrogen at a dose of 1.25 mg daily is more potent than 20 μg of ethinyl estradiol when compared on the basis of endometrial proliferation, vaginal cytology, and cervical mucus ferning. Therefore, while 5 to