tbuckley/cabot-search huggingface dataset:
Pills and the Public Purse: The Routes to National Drug Insurance
Authors: Bruce Stuart
Journal: JAMA (1982)

This book offers both less and more than the title promises. Readers expecting a full-blown analysis of drug coverage under government auspices—either current or proposed— will be disappointed. The scant 12 pages devoted to prescription drug coverage under existing private insurance policies and government programs in the United States are insufficient for an understanding of why national drug insurance is necessary or what form it should take. On the other hand, readers are treated to a well-written, wide-ranging discussion of policy issues affecting the use, provision, financing, and regulation of drugs in this country and abroad. In fact, the work is really a primer on the drug sector as a whole rather than a technical treatise on either "pills" or the "public purse." The first third of the book provides a rapid-fire overview of the components of the system, beginning with the drug industry itself and progressing to patients, physicians,
High-Riding Pericardial Recess Mimicking Metastatic Mediastinal Lymph Node
Authors: Archan M. Shah, Rodolfo C. Morice, David Ost, Georgie A. Eapen, Sonia L. Betancourt, Carlos A. Jimenez
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

A 65-year-old female nonsmoker with a newly diagnosed lung adenocarcinoma in the left upper lobe was referred for mediastinal staging via endobronchial ultrasound guided transbronchial needle aspiration.Her clinical stage was IIIB (T1aN3M0) based on computed tomography findings (Figure 1).Positron emission tomography was unavailable.Endobronchial ultrasound (Figure 2) of that area showed a 1.25-cm-diameter, well-circumscribed, homogenously isoechoic structure (outlined arrow, Figs. 1 and2).Cytology of the lesion showed fragments of adipose tissue.Review of the coronal images (Figure 3) confirmed a supra-aortic extension of a pericardial recess mimicking a lymph node at station 2R.The prevalence of a "high-riding" superior pericardial recess is 6.6% (1, 2).
Empiricist word learning
Authors: Dan Ryder, Oleg V. Favorov
Journal: Behavioral and Brain Sciences (2001)

At first, Bloom's theory appears inimical to empiricism, since he credits very young children with highly sophisticated cognitive resources (e.g., a theory of mind and a belief that real kinds have essences), and he also attacks the empiricist's favoured learning theory, namely, associationism. We suggest that, on the contrary, the empiricist can embrace much of what Bloom says.
Clinical and Manometric Effects of Nitroglycerin in Diffuse Esophageal Spasm
Authors: Roy C. Orlando, Eugene M. Bozymski
Journal: New England Journal of Medicine (1973)

THE major function of the esophagus is to transport material from the pharynx to the stomach. In diffuse esophageal spasm, a neuromuscular abnormality exists that can lead to painful swallowing, impairment of the transport process or both. Patients with pain rather than dysphagia as the primary complaint occasionally benefit from nitrite therapy. We have recently observed a patient with diffuse esophageal spasm who obtained rapid relief of chest pain by sublingual nitroglycerin administration and prolonged reduction in the number of attacks by daily therapy with a long acting nitrite. This clinical response led us to investigate, by esophageal manometry, the . . .
Physician-Nurse Relationships
Authors: PATRICIA A. PRESCOTT
Journal: Annals of Internal Medicine (1985)

Disagreement between physicians and nurses regarding patient care is not always a negative factor and often serves to protect patients. How disagreement is handled, however, and whether it is adequately resolved may adversely affect patient care. Physicians and nurses were questioned regarding the nature of their relationship, areas of disagreement related to patient care, and how disagreement gets resolved. Seventy percent of the physicians and 69% of the nurses described relationships as mostly positive. Disagreements were categorized into four areas, with the greatest number relating to the patient's general plan of care. Resolutions of these disagreements were described by 65% of physician and 53% of nurse descriptions as competitive in nature. Few examples of joint problem-solving (collaboration) were seen.
A Strategy for Health Care Reform — Toward a Value-Based System
Authors: Michael E. Porter
Journal: New England Journal of Medicine (2009)

Despite many waves of debate and piecemeal reforms, the U.S. health care system remains largely the same as it was decades ago. We have seen no convincing approach to changing the unsustainable trajectory of the system, much less to offsetting the rising costs of an aging population and new medical advances.Today there is a new openness to changing a system that all agree is broken. What we need now is a clear national strategy that sets forth a comprehensive vision for the kind of health care system we want to achieve and a path for getting there. The central . . .
“Right to die”: Summary of responses
Authors: Birte Twisselmann
Journal: BMJ (2005)

Right to die" Legal view of right to life and death could threaten philosophy of palliative careEditor-Grayling claims that the "right to life" means quite a rich life; withholding treatment with death as the result and giving treatment that causes death are indistinguishable; and death is the ultimate analgesic. 1 Grayling also implies that the double effect is widely abused.The EC Convention for the Protection of Human Rights and Fundamental Freedoms protects against intentional deprivation of life. 2 Quality of life is not mentioned, and terminating a life at a person's request is clearly not permitted."Right to life" is perhaps a "right not to be killed," in medicine, generally relating to survival and not assisted death.However, some interpret it as giving patients a right to cardiopulmonary resuscitation regardless of the clinical circumstances 3 ; extrapolation to all potential interventions at the life-death interface could have disastrous consequences for the medical profession.Patients obviously can wish for their life to be terminated without needing to explain why, and they arguably have a right to attempt suicide.However, a right to assisted dying equates to a right that somebody else will kill or help to kill them on request-very different from withholding treatment or the double effect.Withholding treatment relates to interventions unable to produce the desired benefit. 4 In palliative care withholding treatment does not directly cause death that arises from an irreversible and unsustainable pathological burden.And death without adequate analgesia is possibly the ultimate pain for everyone.Judicious use of analgesia is an essential part of good terminal care, and, in 15 years as a doctor, I have yet to see a death attributable to deliberate analgesic overdose by a doctor.Palliative care affirms life until the moment of death, regarding death from advanced incurable disease as a natural process. 5 It aims to relieve pain and other distressing symptoms, enhance remaining quality of life, and neither hasten nor postpone death.These human "death rights" should perhaps be protected by legislation.Ill-conceived legislative changes that take the right to life or the right to death beyond sensible limits or give certain doctors the right to kill on request could jeopardise palliative care.
Ancient SINEs from African Endemic Mammals
Authors: M. Nikaido
Journal: Molecular Biology and Evolution (2003)

Afrotheria is a newly recognized taxon comprising elephants, hyraxes, sea cows, aardvarks, golden moles, tenrecs, and elephant shrews, each of which originated in Africa. Although some members of this taxon were once classified into distantly related groups, recent molecular studies have demonstrated their close relationships. It was suggested that this group emerged as a result of physical isolation of the African continent during the successive breakup events of Gondowanaland. In this study, a novel family of SINEs, designated AfroSINEs, was isolated and characterized from the genomes of afrotherians. This SINE family is distributed exclusively among the afrotherian species, confirming their monophyletic relationships. Furthermore, a distinct subfamily, which shares a deletion in the middle region of the SINE, was identified. The distribution of this subfamily is apparently restricted to the genomes of hyraxes, elephants, and sea cows, suggesting monophyly of these three groups, which was previously proposed as Paenungulata. We characterized the structures of the AfroSINEs from all afrotherian representatives by PCR, and we discuss how they were generated as well as the phylogenetic relationships of their host species.
Matching Taxpayer Funding to Population Health Needs
Authors: Michael Hanna
Journal: Circulation Research (2015)

In an era of economic recession and budget cutbacks,Americans may be curious to know how the government is distributing their taxes for medical research, relative to their health needs. Previous reports recommended that the National Institutes of Health (NIH) allocate funding proportional to the burden-of-illness from diseases and conditions. But the most recent publicly available data on burden-of-illness and NIH funding show that infectious diseases are still overfunded relative to their health burden on the American population, especially HIV/AIDS. By contrast, several lifestyle/environmental health conditions are still underfunded, including importantly: chronic obstructive pulmonary disease, lung cancer, stroke, heart disease, depression, violence, and road injury. NIH's allocation of research funding is often disproportionate to the current health needs of the American people. Greater decision-making involvement of Congress and the public would be helpful, if Americans want their taxes spent fairly on the illnesses that actually burden their health.
Interleukin 28B polymorphism predicts pegylated interferon plus ribavirin treatment outcome in chronic hepatitis C genotype 4
Authors: Stella De Nicola, Alessio Aghemo, Maria Grazia Rumi, Enrico Galmozzi, Luca Valenti, Roberta Soffredini, Raffaele De Francesco, Gian Maria Prati, Roberta D'Ambrosio, Cristina Cheroni, Maria Francesca Donato, Massimo Colombo
Journal: Hepatology (2011)

Single nucleotide polymorphisms (SNPs) near the interleukin 28B (IL28B) region are the strongest baseline predictors of a sustained virologic response (SVR) to peg-interferon (PegIFN) and ribavirin (Rbv) in patients with hepatitis C virus (HCV) genotype 1 infection. Whether this holds true for HCV-4 patients too is unknown. The aim was to investigate the predictive power of the rs12979860 IL28B SNP for a response to Peg-IFN and Rbv in HCV-4 patients. All HCV-4 patients consecutively treated between September 2004 and June 2010 with PegIFN and Rbv at two liver centers at the Maggiore Hospital Milan (Italy) underwent TaqMan SNP Genotyping assays for testing rs12979860 genotype. Of 112 treated patients (98 males, 75 of Egyptian descent, 26 with cirrhosis) 103 were included in the final analysis; five discontinued treatment for nonvirologic reasons and four did not consent to genetic testing. Twenty-four (23%) were genotype CC, 65 (63%) CT, and 14 (14%) TT. Overall, 50 (49%) achieved an SVR: 21 (88%) CC patients versus 29 (37%) CT/TT (P < 0.0001). CC patients more often had a rapid virologic response (RVR) than CT/TT patients (12, 50% versus 23, 29%; P = 0.08), while also showing lower relapse rates (0% [0/21] versus 36% [16/45] P = 0.0013). In non-RVR patients, SVR rates were higher in CC than CT/TT patients (9 [75%] versus 13 [23%] P = 0.001). By logistic regression, the IL28B rs12979860 CC genotype was an independent predictor of SVR with an odds ratio of 8.0 (95% confidence interval 2.00-32.01; P = 0.003).The IL28B rs12979860 SNP may have an added value in the treatment algorithm of HCV-4 patients because it is the strongest predictor of an SVR to PegIFN/Rbv therapy.
Effects of U-61, 431F, a stable prostacyclin analogue, on the proliferation of bovine vascular edothelial and smooth muscle cells
Authors: Manabu Shirotani, Yoshiki Yui, Ryuichi Hattori, Mamoru Takahashi, Takeshi Aoyama, Yoshiharu Murohara, Hiroshi Morishita, Kazushige Kadota, Chuichi Kawai
Journal: Journal of the American College of Cardiology (1990)
POST-TRAUMATIC BONE TUMORS
Authors: S. D. FOSTER
Journal: JAMA (1923)

The actual part that trauma plays as a causative factor in any human disease would be an interesting matter of research. Any solution of continuity of tissue invariably brings to that place the condition of lowered resistance, if it does not actually become the place of least resistance. There has been a general supposition that repeated slight trauma is the cause of carcinoma, while it is one severe blow that causes sarcoma. Such reasoning must be based on the coincidences that have happened in many cases, rather than any scientific research. We do know that these malignancies are post-traumatic. That is all we know of the bone tumor to be reported in this paper. The intelligent roentgen-ray readings have been the most wonderful addition to the diagnostic armamentarium. These, with the minute history of the relation of the tumor to the haversian system, as well as whether or not it
Protein synthesis in hepatocytes isolated from patients with gastrointestinal malignancy.
Authors: H F Starnes, R S Warren, M F Brennan
Journal: Journal of Clinical Investigation (1987)

To investigate the effect of remote and proximate cancer on hepatic protein metabolism, we determined rates of total protein synthesis by hepatocytes (HPS) isolated from 31 patients undergoing liver wedge biopsy: 7 patients with benign disease, 14 with gastric cancer, and 10 with colorectal cancer (5 of whom had liver metastases). Patients with malignant disease without weight loss had a threefold higher rate of total HPS (4,980 +/- 814 pmol/h per 10(5) viable cells) than patients with benign disease without weight loss (1,278 +/- 318 pmol/h per 10(5) viable cells, P less than 0.001). Among the patients with gastric cancer, eight with preoperative weight loss had lower rates of HPS (380 +/- 90 pmol/h per 10(5) viable cells) than those without weight loss (4,061 +/- 401 pmol/h per 10(5) viable cells, P less than 0.002). The highest rates of HPS were seen in patients with colorectal cancer with liver metastases (8,005 +/- 1,975 pmol/h per 10(5) viable cells) vs. colorectal cancer patients without liver metastases (3,060 +/- 575 pmol/h per 10(5) viable cells, P less than 0.03). These data indicate that modulation of hepatic protein synthesis occurs in malignancy in man. However, the stimulatory influence of the tumor-bearing state may be overridden by the inhibitory effects of cachexia.
Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study
Authors: W. Clemente, E. Vidal, E. Girão, A.S.D. Ramos, F. Govedic, E. Merino, P. Muñoz, N. Sabé, C. Cervera, G.F. Cota, E. Cordero, A. Mena, M. Montejo, F. López-Medrano, J.M. Aguado, P. Fernandes, M. Valerio, J. Carratalá, A. Moreno, J. Oliveira, P.H.O. Mourão, J. Torre-Cisneros
Journal: Clinical Microbiology and Infection (2014)
Bone Density Testing in Older Women—Reply
Authors: Elaine W. Yu, Joel S. Finkelstein
Journal: JAMA (2012)

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 Journals 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
Atrial wave front instability induced by progressive action potential duration shortening: a mechanism of conversion from atrial flutter to atrial fibrillation
Authors: T.-J. Wu, M. Yashima, H.-L.A. Huang, Y.-H. Kim, C.A. Athill, H.S. Karagueuzian, P.-S. Chen
Journal: Journal of the American College of Cardiology (1998)
Baby should be allowed to die, UK court rules
Authors: Clare Dyer
Journal: BMJ (2004)

A profoundly handicapped baby at the centre of a legal battle between her parents and doctors should be allowed to die peacefully and not be subjected to further aggressive treatment, a High Court judge ruled in London last week.

Prolonging Charlotte Wyatt's life by ventilating her if she has breathing difficulties would not be in her best interests, Mr Justice Hedley ruled, in the first dispute over a child's treatment to be heard in an open court in England.

Portsmouth Hospitals NHS Trust took the case to court after Charlotte's parents, Darren and Debbie, …
Notes on a Case of Double Facial Palsy
Authors: F. W. Wright
Journal: BMJ (1869)

AFTER some introductory remarks, the Lecturer urged that, whenever it is possible, we should study each case of nervous disease in a three-fold manner:-I, as it shows damage at a certain point in a sensori-motor tract (Organ); 2, as it is an instance of local change of some wide-spread Tissue; and, 3, as it is one of disorder of Function.He took the word organ to imply not only nervous centres, but-illustrating by motor or- gans-the nerves to the mnuscles which they are known to governi.He remarked, too, on the importance of considering the relations parts have by their arterial supply.Artelies give to parts which have no relation- ship by continuity of duties a relationship by community of nutrition.He tried to show the importance of this relationship in the physiolo- gical study of epilepsies.When a certain muscular tract is affected-face, arm, and leg-we infer that the corresponding internal lesion is in the region of the oppo- site corpus striatum, or thalamus opticus.Hlemiplegia, and its mobile
Statistical Evaluation of Clinical Usefulness of Microarrays for Cancer Prognosis Needs to be Placed in the Context of Clinical Reality—Response
Authors: Weida Tong, Xiaohui Fan
Journal: Clinical Cancer Research (2010)

It is our pleasure to see the comments from Dr. Serge Koscielny and Stefan Michiels regarding our re-evaluation (1) of their study (2). We agree that the current challenge in developing predictive models using clinical genomics data is not to construct a statistically robust model, but in developing a model with the capability and accuracy for real-world applications such as, in this case, cancer prognosis. Many factors, including gene selection rules, sample resubstitution approaches, sample size concerns, classification methods, and validation strategies, contribute to the variation in microarray-based models (3–6). We believe that by exploring this vast parameter space, one can find what appears to be a good model as demonstrated by internal validation, if he tries hard enough. Thus, we stressed in our study that “caution should be taken when a general conclusion is made on the basis of a single statistical practice without alternative validation”.Thinking retrospectively, many published studies, including that by Michiels et al. (2) and our reanalysis (1), draw conclusions based on the analysis of one population of samples that is split randomly into two, one for training and the other for validation. This commonly adopted strategy does not represent clinical medicine well, where a diagnostic test needs to be validated in a different population than the one that is used to develop the test. This may explain why many gene signatures, even those with significant prediction accuracy over chance, are then rejected in independent validation studies. An improved strategy would include validation using only those patients whose genomic profiles and clinical assessment were done at a different time period (preferably at a later date) as compared with those used in the training set.Fortunately, the Food and Drug Administration (FDA)-led, community-wide MicroArray Quality Control (MAQC) project applied this strategy of generating validation samples profiled at a later date than training samples in its second phase of study, aiming at establishing best practices for the use of microarrays in real-world scenarios by comparing different approaches to the development and validation of microarray-based models (7). Over 30,000 models for 13 endpoints from 6 relatively large data sets (including 3 clinical data sets: breast cancer, multiple myeloma, and neuroblastoma) were generated by 36 teams. The main conclusions of this large-scale study were summarized in over 10 manuscripts that were published in Nature Biotechnology and The Pharmacogenomics Journal in August, 2010. This effort will advance our knowledge on the best ways to validate clinical genomics signatures.See the original Letter to the Editor, p. 6180The views presented in this article do not necessarily reflect those of the U.S. Food and Drug Administration.