tbuckley/cabot-search huggingface dataset:
Intramyocardial Lesions in Patients Dying Suddenly and Unexpectedly
Authors: Howard L. Richardson
Journal: JAMA (1966)

In a 2,000-bed neuropsychiatric hospital, one to two cases of sudden, unexpected death occur per year in patients in whom the postmortem examination reveals no obvious cause of death. Serial electrocardiograms revealed some disorder of electrical activity rhythm and conduction. Between the years 1957 to 1962, small heart sections did not adequately explain abnormal ECGs. Four patients receiving tranquilizers who died suddenly and unexpectedly during 1964 and 1965 were studied. The hearts of 49 nontranquilized patients were compared. Histochemical techniques were used. Lesions were in the intramyocardial arterioles (40μ -80μ ) and the arteriolarcapillary bed (14μ-40μ). Acid mucopolysaccharide was in and about these altered arterioles and degenerating myocardial muscle. The lesions were subendocardial in the right and left atrioventricular conduction bundle and papillary muscles.
THE STATE CARE OF THE INEBRIATE
Authors: IRWIN H. NEFF
Journal: JAMA (1910)

Although drunkenness is generally considered a misdemeanor, its association with criminality and criminal procedure has given the public the impression that the drunkard, if not a criminal in a legal sense, is so closely allied to these delinquents that the measures applicable for the control of the criminal can be consistently used in the management of the inebriate. The impracticability of such methods is recognized by those familiar with the varied types of inebriety. Credit must be given to the judiciary and particularly to the various probation commissions for the heroic efforts which they have made to formulate some satisfactory method for dealing with the drunkard. They have recognized that the drunkard has an individuality, but owing to the diversities of the types and lack of facilities for studying these cases they frankly acknowledge their helplessness and are ready and willing to cooperate with the medical profession in any reasonable
Pollen genetic markers for detection of mutagens in the environment.
Authors: R A Nilan, J L Rosichan, P Arenaz, A L Hodgdon, A Kleinhofs
Journal: Environmental Health Perspectives (1981)

To utilize and exploit pollen for in situ mutagen monitoring, screening and toxicology, the range of genetic traits in pollen must be identified and analyzed. Traits that can be considered include ornamentation, shape and form, male sterility viability, intraspecific incompatibility, proteins and starch deposition. To be useful for the development of mutagen detection systems proteins should be: (1) activity stainable or immunologically identifiable in the pollen, (2) the products of one to three loci, and (3) gametophytic and nuclear in origin. Several proteins including alcohol dehydrogenase in maize, which meet those criteria will be discussed. The waxy locus in barley and maize which controls starch deposition has been characterized genetically and methods have been developed for pollen screening and mutant detection. At Washington State University a waxy pollen system is being developed in barley for in situ mutagen monitoring. The basis is an improved method for staining and scoring waxy pollen mutants. Specific base substitution, frameshift, and deletion mutant lines are being developed to provide information about the nature of the mutations induced by environmental mutagens. Thirty waxy mutant lines, induced by sodium azide and gamma-rays have been selected and are being characterized for spontaneous and induced reversion frequencies, allelism, karyotype, amylose content, and UDP glucose glucosyltransferase (waxy gene product) activity. Twelve mutant alleles are being mapped by recombinant frequencies.
Genetic Counselling: Practice and Principles
Authors: I D Young
Journal: BMJ (1994)

Ed Angus Clarke, Routledge, £13.99, pp 266, ISBN 0-415-08258-7

Why does genetic counselling arouse such strong emotions? Here we have an applied clinical science whose practitioners have striven for decades to maintain a non-controversial stance. Horror at the excesses of prewar eugenics movements and an unshakable belief in the principle of non- directive counselling have been the cornerstones of clinical genetic services throughout the Western world. Yet rarely a day passes without media attention. Where here we gone wrong?

Perhaps we have become complacent. A prevailing …
OUR EXPERIENCE OF TRANSIENT ELASTOGRAPHY AND FIBROTEST<sup>®</sup>IN MONITORING PATIENTS TAKING METHOTREXATE FOR PSORIASIS
Authors: M Lynch, E Higgins, P A McCormick, B Kirby, A Lally, S Rogers, A Vellinga, H Omar, P Collins
Journal: Gut (2013)

<h3>Introduction</h3> Frequent evaluation of liver enzymes, procollagen III peptide (PIIINP) levels, and periodic liver biopsy are used to assess liver toxicity during methotrexate therapy for psoriasis, but some patients who proceed to biopsy do not have fibrosis or cirrhosis. <h3>Aims/Background</h3> Our study aimed to evaluate transient elastography (TE) (Fibroscan<sup>®</sup>, Echosens, Paris) and Fibrotest<sup>®</sup> (Biopredictive, Cambridge) in patients taking methotrexate for psoriasis. <h3>Method</h3> Chi square test was used for the comparison of dichotomous variables, and Mann-Whitney U test for continuous variables. <h3>Results</h3> Forty-five patients (26 female, 58%), mean age 55 (±sd 14.6) years, had TE assessments. The median cumulative methotrexate dose was 3.3g (range 0.125–17.5). The mean body mass index (BMI) was 28.7 (±sd 7.2) kgm-2, and 62% were overweight or obese. Three (7%) patients had type 2 diabetes mellitus, and 13 (29%) had psoriatic arthritis (PsA). No patients reported excessive alcohol intake. Twenty-seven (60%) TE results were valid. The risk of TE failure was significantly higher in patients with a higher BMI (p&lt;0.01). Of the 27 valid TE results, 6 (22%) were abnormal (&gt;7.1 kPa). Of 21 patients with normal TE results, 4 had persistently elevated PIIINP levels, and did not have PsA. Twenty-nine patients had Fibrotest<sup>®</sup>, three (10%) of whom had abnormal results (&gt;0.31/&gt;F1). Five liver biopsies were done because of persistently elevated PIIINP levels, and showed mild or moderate steatosis. Three of these could have been avoided based on normal TE or Fibrotest<sup>®</sup> results. Older age was associated with an abnormal TE result (p&lt;0.05). Older patients, those on methotrexate for a longer duration, and with a higher cumulative dose were more likely to have an abnormal Fibrotest<sup>®</sup> result (p&lt;0.05). <h3>Conclusion</h3> We suggest that unnecessary liver biopsies may be avoided if abnormalities in at least two tests (PIIINP, TE or Fibrotest<sup>®</sup>) are required prior to biopsy. This strategy will need to be evaluated in prospective studies. Funding for Fibrotest<sup>®</sup> was received from "City of Dublin Skin and Cancer Hospital Charity".
Pemphigus Disease Activity Measurements
Authors: Ziba Rahbar, Maryam Daneshpazhooh, Mostafa Mirshams-Shahshahani, Nafiseh Esmaili, Kazem Heidari, Nessa Aghazadeh, Pardis Hejazi, Mahsa Ghajarzadeh, Cheyda Chams-Davatchi
Journal: JAMA Dermatology (2014)

Recently, the clinical pemphigus disease activity indexes of Pemphigus Disease Area Index (PDAI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS), and Pemphigus Vulgaris Activity Score (PVAS) were validated to correlate with physician global assessment. The antidesmoglein (anti-Dsg) autoantibodies are known to correlate mostly with pemphigus disease activity. The correlation between these indexes and anti-Dsg1 and anti-Dsg3 enzyme-linked immunosorbent assay values has not been previously evaluated.To evaluate the PDAI, ABSIS, and PVAS in a large number of patients with pemphigus vulgaris and to compare the interrater reliability of these indexes and the convergent validity according to anti-Dsg values.A cross-sectional study was performed in 2012 in a referral university center for autoimmune bullous diseases. One hundred patients with confirmed diagnoses of pemphigus vulgaris and clinical pemphigus lesions (mean [SD] age, 43.3 [1.7] years; age range, 14-77 years; female-male ratio, 1:3) were studied. Three dermatologists familiar with immunobullous diseases and the indexes rated the patients.All 100 patients were evaluated with the PDAI, ABSIS, and PVAS. Three dermatologists independently rated all 3 indexes for each of the patients on the same day. Serum anti-Dsg1 and anti-Dsg3 enzyme-linked immunosorbent assay values were measured simultaneously.Analyses of interrater reliabilities, convergent validities according to anti-Dsg titers, correlation between the distribution and types of lesions with disease activity, predictors of higher titers of antibody (multiple regression analysis), and cutoff values of measures for 2 titers of anti-Dsg with optimal area under the curve, sensitivity, and specificity were performed.The interrater reliabilities were highest for the PDAI, followed by the ABSIS and the PVAS (intraclass correlation coefficients of 0.98 [95% CI, 0.97-0.98], 0.97 [95% CI, 0.96-0.98], and 0.93 [95% CI, 0.90-0.95], respectively). The convergent validity was highest for the PDAI, followed by the PVAS and the ABSIS (Spearman ρ = 0.67, 0.52, and 0.33, respectively). Head, neck, and trunk involvement were predictors of higher titers of anti-Dsg1.Among the 3 studied indexes, the PDAI had the highest validity and is recommended for use in multicenter studies for rare diseases, such as pemphigus vulgaris.
What's Ahead for Health Insurance in the United States?
Authors: Victor R Fuchs
Journal: New England Journal of Medicine (2002)

The announcement that most of the nation's biggest insurers — Aetna, CIGNA, Humana, the United Health Group, and Wellpoint Health Network — will be introducing a new kind of health plan during the next year or two signals the beginning of a new era in health insurance in the United States.1 These plans feature a complicated menu of premiums, copayments, and deductibles that will add impetus to the trend of employers' offering a defined contribution for health benefits. Each employee will get a fixed amount of money to spend as he or she sees fit and will use the Internet . . .
The Tyranny of Standards
Authors: William R. Fifer
Journal: JAMA (1975)

IMPROVING medical care quality is a goal shared by the physician, the patient, and the bill payer. The ability to do so first of all, implies knowledge of the current quality of care level, and second, existence of mechanisms to alter substandard conditions. Quality has been defined as "the degree of adherence to a standard," and assessing the quality of medical care generally involves comparing actual care with some standard or criterion of excellence. Differences between the real and the stated ideal are then analyzed and deficiencies identified. Improved quality is determined by increased compliance with standards at the time of reassessment. We are rapidly being surrounded by standards or criteria designed for use in determining the necessity of hospital admission, appropriateness of medical service utilization, and quality of care. Criteria sets are being prepared by professional specialty societies, foundations for medical care, and experimental medical care review organizations. The
Should I Go to Medical School?
Authors: Frederick Stenn
Journal: JAMA (1967)

Not infrequently I am asked by high school seniors and college undergraduates whether I would advise them, or indeed my own children, to study medicine as a career. If I understand the implications of their question, some of these bright and highly idealistic young men and women are searching for a profession which offers more than financial security or scientific achievement (in the sense of predominantly research activities). Would it not be reasonable and intellectually honest to describe medicine as an art rather than as a science? Can we not assure these students that a medical career is appropriate for them if they seek the warmth of human relations and the trust of patients gained by extending sympathy and understanding? How would you describe the practice of medicine?
Myocardial substrate utilization during exercise in humans. Dual carbon-labeled carbohydrate isotope experiments.
Authors: E W Gertz, J A Wisneski, W C Stanley, R A Neese
Journal: Journal of Clinical Investigation (1988)

The purpose of this study was to investigate myocardial substrate utilization during moderate intensity exercise in humans. Coronary sinus and arterial catheters were inserted in nine healthy trained male subjects (mean age, 25 +/- 6 (SD) years). Dual carbon-labeled isotopes were infused, and substrate oxidation was quantitated by measuring myocardial production of 14CO2. Supine cycle ergometer exercise was performed at 40% of the subject's maximal O2 uptake. With exercise there was a significant increase in the arterial lactate level (P less than 0.05). A highly significant positive correlation was observed between the lactate level and the isotopic lactate extraction (r = 0.93; P less than 0.001). The myocardial isotopic lactate uptake increased from 34.9 +/- 6.5 mumol/min at rest to 120.4 +/- 36.5 mumol/min at 5 min of exercise (P less than 0.005). The 14CO2 data demonstrated that 100.4 +/- 3.5% of the lactate extracted as determined by isotopic analysis underwent oxidative decarboxylation. Myocardial glucose uptake also increased significantly with exercise (P less than 0.04). The [14C]glucose data showed that only 26.0 +/- 8.5% of the glucose extracted underwent immediate oxidation at rest, and during exercise the percentage being oxidized increased to 52.6 +/- 7.3% (P less than 0.01). This study demonstrates for the first time in humans an increase in myocardial oxidation of exogenous glucose and lactate during moderate intensity exercise.
A Cyberday in the Life
Authors: David W. Bates
Journal: JAMA (1996)

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
Potential Impact of Seatbelt Use on the Spectrum of Ocular Injuries and Visual Acuity Outcomes after Motor Vehicle Accidents with Airbag Deployment
Authors: Sunil K. Rao, Paul B. Greenberg, Theodoros Filippopoulos, Ingrid U. Scott, Nickolas P. Katsoulakis, Yoash R. Enzer
Journal: Ophthalmology (2007)
Angiosarcoma of the scalp associated with renal transplantation
Authors: Y. KIBE, S. KISHIMOTO, N. KATOH, H. YASUNO, T. YASUMURA, T. OKA
Journal: British Journal of Dermatology (1997)

A case of cutaneous angiosarcoma occurring in a 51-year-old male renal transplant patient is reported. Multiple violaceous nodules surrounded by poorly demarcated red to purple discoloration were found on his scalp. Immunosuppressants consisting of azathioprine and prednisolone had been administered during the 12-year period since the renal transplantation. We diagnosed the lesion clinically as a cutaneous angiosarcoma and performed a wide surgical excision. The histopathological findings confirmed the diagnosis and showed tumour cells in the peripheral margin. Postoperatively, the patient started immunotherapy with systemic administration of recombinant interleukin-2 (rIL-2), but he refused to continue it because of the acute rejection of the transplanted kidney induced by the rIL-2. Instead he received radiation therapy (total 7000 rad) of the scalp. Although no recurrence was noticed for 15 months after the completion of radiation, he died due to lung metastasis from angiosarcoma. We review the seven cases, including ours, of angiosarcoma after renal transplantation that are reported in detail in the literature.
Early Increase of von Willebrand Factor Predicts Adverse Outcome in Unstable Coronary Artery Disease
Authors: Gilles Montalescot, François Philippe, Annick Ankri, Eric Vicaut, Etienne Bearez, Jean Ernest Poulard, Didier Carrie, Daniel Flammang, Albert Dutoit, Alain Carayon, Claude Jardel, Monique Chevrot, Jean Philippe Bastard, Fredérique Bigonzi, Daniel Thomas
Journal: Circulation (1998)

Background —The pathogenesis of unstable angina and non–Q-wave myocardial infarction is still poorly understood, and early evaluation of prognosis remains difficult. We therefore studied the predictive value of 5 biological indicators of inflammation, thrombogenesis, vasoconstriction, and myocardial necrosis, and we examined the effects of enoxaparin and unfractionated heparin on these markers after 48 hours of treatment. Methods and Results —Sixty-eight patients with unstable angina or non–Q-wave myocardial infarction randomized in the international ESSENCE trial participated in this French substudy. C-reactive protein, fibrinogen, von Willebrand factor antigen, endothelin-1 and troponin I were measured on admission and 48 hours later. The composite end point of death, myocardial infarction, recurrent angina, or revascularization was significantly lower at 14 and 30 days of follow-up in patients allocated to enoxaparin compared with unfractionated heparin. All acute-phase reactant proteins were elevated on admission and increased further at 48 hours. Multivariate analysis demonstrated that the rise of von Willebrand factor over 48 hours was a significant and independent predictor of the composite end point at both 14 days and 30 days. Moreover the early increase of von Willebrand factor was more frequent and more severe with unfractionated heparin than with enoxaparin (mean change was +8.7±8.8% with enoxaparin versus +93.9±11.7% with unfractionated heparin, P &lt;0.0001). The other clinical and biological variables did not predict outcome. Conclusions —In patients with unstable angina or non–Q-wave myocardial infarction, the acute-phase proteins increase over the first 2 days despite medical treatment. The early rise of von Willebrand factor is an independent predictor of adverse clinical outcome at 14 days and at 30 days. Enoxaparin provides protection as evidenced by the reduced release of von Willebrand factor, which represents a favorable prognostic finding.
The effect of pure aerobic training on aerobic and anaerobic capacity.
Authors: G. Keren, Y. Epstein
Journal: British Journal of Sports Medicine (1981)

Twenty men (Group I) and twenty-seven men (group II) took part in a 3-week training course. The training was aerobic and consisted of marching and hiking. The intensity of the training regimen in Group II was greater than for Group I. The maximal oxygen uptake (VO2 max) increased significantly in both groups, more in Group II than in Group I, though no significant change was found in anaerobic capacity. It can be concluded that aerobic training cannot induce improvement in anaerobic capacity.
Metabolic and Skeletal Complications of HIV Infection
Authors: Caryn G. Morse, Joseph A. Kovacs
Journal: JAMA (2006)

Over the past 10 years, in conjunction with the broad availability of potent antiretroviral regimens, the care of human immunodeficiency virus (HIV)-infected patients has shifted from prevention and treatment of opportunistic infections and malignancies to management of the metabolic and related complications associated with HIV infection and its treatment. Metabolic disorders, including lipodystrophy, dyslipidemia, and insulin resistance, occur at a high rate in HIV-infected individuals receiving highly active antiretroviral therapy (HAART). These disorders are associated with increased risk of cardiovascular disease and have become an important cause of morbidity and mortality in HIV-infected patients. Herein, we present the case of a patient with HIV infection who responded well to HAART but developed multiple complications potentially related to this therapy. This article reviews the clinical characteristics of the metabolic and skeletal disturbances observed in HIV infection and discusses strategies for their management.
LASTING BIOLOGICAL EFFECTS OF EARLY ENVIRONMENTAL INFLUENCES
Authors: René Dubos, Russell W. Schaedler, Richard Costello
Journal: The Journal of Experimental Medicine (1968)

Newborn specific-pathogen-free mice (SPF) were separated from their mothers shortly after birth and immediately reallocated at random to foster mothers, each of which received eight young. Under these conditions, the growth rate and adult size of the young were profoundly and lastingly conditioned by some unidentified influence exerted by the foster mother. In SPF mice nursed by their own mothers, the diet of the latter during gestation and lactation, or during lactation alone, conditioned the weight of the young at weaning time, and throughout their whole life span. Lasting depression of growth has been achieved by minor alterations of the dam's diet, for example by lowering its content in magnesium, or in lysine and threonine. The growth-depressing effect so achieved persisted throughout the whole life-span of the young, even though they were given at weaning time and constantly thereafter unlimited amounts of an optimum diet. In contrast, the weight-depressing effect of a diet deficient in lysine and threonine administered to adult animals was completely and rapidly reversible when a complete diet was later substituted for the deficient one. Depression of growth resulting from nutritional experiences during gestation or lactation did not seem to affect adversely the health of the young, or to decrease their longevity. In fact, the results of two experiments in which the animals nursed by mothers on different diets, were kept undisturbed and on optimum diets throughout their whole life span, suggest that the smaller animals had a greater average life expectancy than the larger ones.
Dissociation of lethal and nonlethal events in the cardiac arrhythmia suppression trial (CAST)
Authors: Debra S. Echt, Philip R. Liebson, L.Brent Mitchell, Robert W. Peters, Dulce Obias-Manno, Allan H. Barker, Daniel Arensberg, Andrea Baker, Lawrence Friedman, Leon Greene, Melissa Huther, David Richardson
Journal: Journal of the American College of Cardiology (1991)