tbuckley/cabot-search huggingface dataset:
A Practical Guide to Palliative Care
Authors: Devi E. Nampiaparampil
Journal: JAMA (2007)

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
Private health care in developing countries
Authors: A. B Zwi, R. Brugha, E. Smith
Journal: BMJ (2001)

Private healthcare provision is growing in low and middle income countries. 1 2 The poor, as well as the rich, often seek health care from private providers, including for conditions of public health importance such as malaria, tuberculosis, and sexually transmitted infections. 3 4 5 The reasons cited by users include better and more flexible access, shorter waiting, greater confidentiality, and greater sensitivity to user needs. 1 6 International policymakers are currently recommending greater use of private providers 7 8 9 on the grounds that they offer consumers greater choice; increase competition in the healthcare market; and remove state responsibility for service provision, thereby encouraging its role as regulator and guarantor. We should, however, be concerned.

When examined, the quality of care offered by many private providers is poor. 1 2 10 Furthermore, poor people spend a greater proportion of their income on health care (private or public) than do the rich, often using less qualified or totally untrained private providers.

We have recommended three objectives in relation to the private provision of care for conditions of public health importance: widening access, improving quality, and ensuring non-exploitative prices.11 None of these will be simple to achieve; and multifaceted interventions, involving policymakers, providers, and …
Genetic Deficiency of Plasminogen Activator Inhibitor-1 Promotes Cardiac Fibrosis in Aged Mice
Authors: Asish K. Ghosh, William S. Bradham, Linda A. Gleaves, Bart De Taeye, Sheila B. Murphy, Joseph W. Covington, Douglas E. Vaughan
Journal: Circulation (2010)

Background— Elevated levels of plasminogen activator inhibitor-1 (PAI-1), a potent inhibitor of urokinase plasminogen activator and tissue plasminogen activator, are implicated in the pathogenesis of tissue fibrosis. Paradoxically, lack of PAI-1 in the heart is associated with the development of cardiac fibrosis in aged mice. However, the molecular basis of cardiac fibrosis in aged PAI-1–deficient mice is unknown. Here, we investigated the molecular and cellular bases of myocardial fibrosis. Methods and Results— Histological evaluation of myocardial tissues derived from aged PAI-1–deficient mice revealed myocardial fibrosis resulting from excessive accumulation of collagen. Immunohistochemical characterization revealed that the levels of matrix metalloproteinase-2, matrix metalloproteinase-9, and transforming growth factor-β1/2 and the number of Mac3-positive and fibroblast specific protein-1–positive cells were significantly elevated in aged PAI-1–deficient myocardial tissues compared with controls. Zymographic analysis revealed that matrix metalloproteinase-2 enzymatic activity was elevated in PAI-1–deficient mouse cardiac endothelial cells. Real-time quantitative polymerase chain reaction analyses of RNA from myocardial tissues revealed the upregulation of profibrotic markers in aged PAI-1–deficient mice. The numbers of phosphorylated Smad2–, phosphorylated Smad3–, and phosphorylated ERK1/2 MAPK–, but not pAkt/PKB–, positive cells were significantly increased in PAI-1–deficient myocardial tissues. Western blot and immunocytochemical analysis revealed that PAI-1–deficient mouse cardiac endothelial cells were more susceptible to endothelial-to-mesenchymal transition in response to transforming growth factor-β2. Conclusions— These results indicate that spontaneous activation of both Smad and non-Smad transforming growth factor-β signaling may contribute to profibrotic responses in aged PAI-1–deficient mice hearts and establish a possible link between endothelial-to-mesenchymal transition and cardiac fibrosis in PAI-1–deficient mice.
Phosphoinositide-3-Kinase Catalytic Alpha and KRAS Mutations are Important Predictors of Resistance to Therapy with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Patients with Advanced Non-small Cell Lung Cancer
Authors: Vienna Ludovini, Fortunato Bianconi, Lorenza Pistola, Rita Chiari, Vincenzo Minotti, Renato Colella, Dario Giuffrida, Francesca Romana Tofanetti, Annamaria Siggillino, Antonella Flacco, Elisa Baldelli, Daniela Iacono, Maria Grazia Mameli, Antonio Cavaliere, Lucio Crinò
Journal: Journal of Thoracic Oncology (2011)
Computed Tomography of the Heart and Great Vessels: Present and Future
Authors: BRUCE H. BRUNDAGE
Journal: Annals of Internal Medicine (1984)

Computed tomography (CT) has emerged as a new imaging method for the diagnosis and evaluation of cardiovascular disease. With CT body scanners and contrast enhancement, evaluation of aortic dissections and aneurysms, coronary bypass graft patency, cardiovascular thrombus, cardiac tumors, and pericardial disease is possible. On occasion, this technique provides clinically useful information that is not available with other imaging methods. Electrocardiographic gating retrospectively or prospectively improves the image resolution of CT scans, but a new ultrafast CT scanner with a scan time of 30 to 50 milliseconds offers the greatest promise for expanding the application of the technology for cardiovascular diagnosis. Accurate measurement of cardiac chamber volume, mass, wall motion, and wall thickening will be feasible. Ultrafast CT scanning also shows great promise for the measurement of myocardial infarct size and regional myocardial blood flow.
Hyperbaric oxygen. Restores normal metabolic activity.
Authors: P James
Journal: BMJ (1993)

Fresh frozen plasmaUsefil as a volume expander in children EDITOR,-We welcome Hannah Cohen's advice that hospital transfusion committees should draw up guidelines for the use of fresh frozen plasma.'We take issue, however, with her claim that "fresh frozen plasma has no role as a volume expander."Although this is true in most circumstances, we believe that this embargo should not be applied to infants and children whose vascular integrity fails because of endothelial dysfunction-for example, after cardiopulmonary bypass surgery.Cardiopulmonary bypass surgery in children may be associated with considerable tissue oedema.This increase in total body water is particularly apparent in infants who have undergone prolonged cardiopulmonary bypass.2In such cases intra- vascular hypovolaemia occurs despite an overall increase in total body water, with extravasation of salts and small protein molecules such as albumin.When vascular integrity is lost fresh frozen plasma may have advantages over human albumin solution because of the larger size of macromolecules,3 which may allow a more sustained effect with slower leakage through damaged capillaries into perivascular tissues.4This permits better main- tenance of intravascular volume, which is an important determinant of oxygen delivery and survival in patients at risk of multisystem failure.This point may apply to other patients requiring critical care such as neonates or patients with thermal bums.4Until the use of synthetic colloids with large macromolecular structure has been validated and proved to be safe in young infants and children we believe that fresh frozen plasma is the safest and most effective option in children with intravascular hypovolaemia and failure of vascular endothelial integrity despite the small risk of hazard.'
The pulmonary vascular bed in patients with complete transposition of the great arteries.
Authors: P M Clarkson, J M Neutze, J C Wardill, B G Barratt-Boyes
Journal: Circulation (1976)

Histological material obtained at autopsy from 35 patients over three months of age with complete transposition of the great arteries (TGA) was examined. Two of six patients less than a year of age with an intact ventricular septum and closed ductus arteriosus were found to have pulmonary vascular changes of at least grade 3 severity; in addition, two of seven patients with a large ventricular septal defect in this age group showed changes of similar severity. The reported low incidence of marked pulmonary vascular changes in patients with only an interatrial communication dying during the first year of life would appear to be due in part to the high proportion of cases less than three months old in whom there was not sufficient time for such changes to develop. Although the incidence is not as high as that found beyond a year of age, it is sufficiently high to influence the management of infants beyond three months of age. Hemodynamic studies were performed following atrial baffle repair in 34 patients. All but one of the 16 patients operated upon prior to two years of age had a pulmonary arteriolar resistance (Rpa) less than 3 units M2 at the time of review, including three with a large communication at ventricular or great vessel level who underwent surgery before two months of age. Repair at an older age did not preclude a low Rpa on follow-up, but in 11 of the 18 patients who were two or more years of age at the time of repair it was greater than 3 units M2. None of these latter patients had a large ventricular septal defect or patent ductus arteriosus. Comparison of postoperative hemodynamic data with autopsy studies would suggest that advanced pulmonary vascular disease is associated with earlier death among patients with complete transposition of the great arteries.
Vitreous levels of IGF-I, IGF binding protein 1, and IGF binding protein 3 in proliferative diabetic retinopathy: a case-control study.
Authors: R Burgos, C Mateo, A Cantón, C Hernández, J Mesa, R Simó
Journal: Diabetes Care (2000)

OBJECTIVE: To evaluate vitreous levels of IGF-I and its binding proteins IGFBP-1 and IGFBP-3 in patients with proliferative diabetic retinopathy (PDR). Because intravitreal proteins are elevated in patients with PDR due to the disruption of the blood-retinal barrier, we have corrected vitreal IGF-I and IGFBPs by total vitreal proteins to avoid this confounding factor. RESEARCH DESIGN AND METHODS: We compared 21 diabetic patients with proliferative retinopathy (group A) and 13 nondiabetic patients (group B) in whom a vitrectomy was performed. Both groups were matched by age, serum IGF-I, IGFBP-1, and IGFBP-3 levels. Serum and vitreous levels of IGF-I, IGFBP-1, and IGFBP-3 were measured by immunological methods. Vitreal proteins were assessed by turbidimetric method. RESULTS: Vitreal levels of IGF-I were elevated in group A (median 1.35 ng/ml [range 0.3-8.7]) in comparison with group B (median 0.25 ng/ml [range 0-1.38]), P&amp;lt;0.001. After adjusting by vitreal proteins [ratio IGF-I (ng/ml)/protein (mg/ml)], the differences remain significant (P&amp;lt;0.005). Vitreal levels of IGFBP-1 and IGFBP-3 were also elevated in diabetic patients (IGFBP-1: group A, median 1.6 ng/ml [range 0.6-20.7]; group B, median 0.4 ng/ml [range 0.3-1.9], P&amp;lt;0.001. IGFBP-3: group A, median 102.6 ng/ml [range 53.9-350.8]; group B, median 29.0 ng/ml [range 3.2-87.8], P&amp;lt;0.001). However, when the ratio IGFBP/protein was considered, the differences were not significant. CONCLUSIONS: Intraocular synthesis contributes to elevated vitreous concentrations of IGF-I found in PDR. By contrast, unspecific increase of intravitreal proteins is the main factor explaining the elevated vitreous levels of IGFBP-1 and IGFBP-3 found in diabetic patients.
1120-64 High left ventricular mass does not limit the utility of fractional flow reserve for the physiologic assessment of lesion severity
Authors: Adnan K Chhatriwalla, Kurt G Barringhaus, Michael Ragosta, Eric R Powers, J.Christopher McClish, Joshua Fischer, Andrew H Bishop, Lawrence W Gimple, Ian J Saremocck, C.Joon Choi, Christopher M Kramer, Habib Samady
Journal: Journal of the American College of Cardiology (2004)
Childhood Body-Focused Behaviors and Social Behaviors as Risk Factors of Eating Disorders
Authors: Barbara Mangweth, Armand Hausmann, Claudia Danzl, Thomas Walch, Claudia I. Rupp, Wilfried Biebl, James I. Hudson, Harrison G. Pope Jr.
Journal: Psychotherapy and Psychosomatics (2005)

The risk factors for adolescent eating disorders are poorly understood. It is generally agreed, however, that interactions with one's body and interactions with others are two important features in the development of anorexia and bulimia nervosa. Therefore, we assessed a variety of childhood body-focused behaviors and childhood social behaviors in eating-disordered patients as compared to non-eating-disordered subjects.We compared 50 female inpatients with eating disorders (anorexia or bulimia nervosa), 50 female inpatients with polysubstance dependence, and 50 nonpatient female control subjects with no history of eating or substance abuse disorders (all defined by DSM-IV criteria), using a semi-structured interview of our own design. We asked questions about (1) childhood body-focused behaviors (e.g. thumb-sucking) and body-focused family experiences (e.g. bodily caresses), and (2) childhood social behaviors (e.g. numbers of close friends) and family social styles (e.g. authoritarian upbringing).Many body-focused measures, such as feeding problems, auto-aggressive behavior, lack of maternal caresses, and family taboos regarding nudity and sexuality, characterized eating-disordered patients as opposed to both comparison groups, as did several social behaviors, such as adjustment problems at school and lack of close friends. However, nail-biting, insecure parental bonding, and childhood physical and sexual abuse were equally elevated in both psychiatric groups.It appears that eating-disordered patients, as compared to substance-dependent patients and healthy controls, show a distinct pattern of body-focused and social behaviors during childhood, characterized by self-harm, a rigid and 'body-denying' family climate, and lack of intimacy.
Cellular and Serologic Profiling of Adults with Peanut Allergen Sensitization
Authors: E.C. McGowan, J.H. Savage, J.P. Courneya, P.M. Sterba, A.S. Parihar, R.A. Wood, R.G. Hamilton, S.S. Saini
Journal: Journal of Allergy and Clinical Immunology (2012)
Doxorubicin-loaded polysaccharide nanoparticles suppress the growth of murine colorectal carcinoma and inhibit the metastasis of murine mammary carcinoma in rodent models
Authors: Mingqiang Li, Zhaohui Tang, Dawei Zhang, Hai Sun, Huaiyu Liu, Ying Zhang, Yuanyuan Zhang, Xuesi Chen
Journal: Biomaterials (2015)
NATIONAL MEDICAL TREATMENT
Authors: W. J. Howarth, B. A. Richmond
Journal: BMJ (1919)

ACETONURIA has been found by Harris in 84.8 per cent. of cases of scarlet fever in children.'I have examined daily the urine of seven consecutive cases with moderate aittacks, estimating the acidity, the proportion of urea and ammonia-amnido nitrogen, and testing for acetone and diacetic acid, with the following, results:1. Acidosis lasting from three to twelve days, reaclhing its maximum on the third to fifth day of disease.2. Acetone and diacetic acid not always, though genaerally, present.J. Urine not alkaline duriing administration of sodiun bicarbonate gr. 10 to gr. 15 every four hours.4. One return of acetone, increase in ammonia nitrogen from 1.7 per cent.to 6.3 per cent., and rise in acidity from 2 per cent.to 68 per cent.N/1O acid, after halving the dose of soda.5. Nephritis (leveloped later in the two patients who showed the most severe acidosis.Clinically none of the cases suggested diphtheria, but routine nose and throat cultures, to discover carriers, gave two positive results from the nose.I consider the acidosis in these cases was due to scarlet fever, although it hats b)een shown to oecur in diphtheria.2Finding acidesis at the start of my examinations I at onCe gave sodium bicarbonate.As this did good in moderate and severe cases I have made it routine for all, with satisfactory results.I ask that it shall be given for a week to ten day to all children who have searlet fever, the dose being regulated by the reaction of the urine.Furtlher, I am so convinced that acidosis is present in every otier acute febrile complaint of children that I plead for the giving of soda to them pending the proof of this contejition.Methods.
Treatment of refractory Wegener's granulomatosis with antithymocyte globulin (ATG): An open study in 15 patients
Authors: Wilhelm H. Schmitt, E. Christiaan Hagen, Irmgard Neumann, Rainer Nowack, Luis Felipe Flores-Suárez, Fokko J. van der Woude, None for the European Vasculitis Study Group
Journal: Kidney International (2004)
Noninvasive Coronary Angiography With a Prototype 256-Row Area Detector Computed Tomography System Comparison With Conventional Invasive Coronary Angiography
Authors: Sadako Motoyama, Hirofumi Anno, Masayoshi Sarai, Takahisa Sato, Yoshihiro Sanda, Yukio Ozaki, Teruhito Mochizuki, Kazuhiro Katada, Hitoshi Hishida
Journal: Journal of the American College of Cardiology (2008)
Noncritical Aortic Stenosis in Two Men Unable to Quit Running Marathons—Well, One Quit
Authors: Juhani Partanen
Journal: JAMA (1992)

<h3>To the Editor.</h3> —Jogging has become part of a way of life thought to promote health.<sup>1</sup>We describe unfavorable outcomes in two patients with noncritical aortic valve stenosis who did not give up their endurance exercise despite warnings from their physicians. <h3>Report of Cases.—Case 1.</h3> —As an 11-year-old boy, the patient had a successful commissurotomy for congenital aortic valve stenosis, after which he was told to avoid severe exertion. At age 18 years, his clinical signs and echocardiography suggested only insignificant residual stenosis and regurgitation of the aortic valve. Electrocardiogram was normal. At age 20 years, he started jogging daily, running between 120 and 210 km a week. One year later he completed a marathon race without symptoms. At 22 years of age, he was still asymptomatic. The electrocardiogram showed gross left ventricular hypertrophy. Ultrasonography revealed a fibrotic aortic valve with a peak systolic gradient of 29 mm Hg
As others see us: views from abroad: A great leap for humankind?
Authors: S. Westin
Journal: BMJ (1998)

Technological milestones, like Neil Armstrong's first step on the moon, are easily visible and readily celebrated. This is not so with the introduction of new ideas, such as the ideas and political thinking behind the British National Health Service. Fifty years on, is it worth celebrating and is there enough left to celebrate? Here is a view from Norway.

We need to consider whether the Beveridge plan and the War Cabinet's ideas leading up to the 1948 NHS reforms were unique to Britain. Of course not, although the idea of a publicly financed health service available to all according to need, was truly a revolutionary thought, possibly of greater importance to most people in Europe than Armstrong's step on the moon. Universally available health care was soon to become a cornerstone of the emerging welfare states in postwar Europe, not only in Britain. Indeed, some of the well reputed Dutch health services can be traced to measures implemented by the Germans during the occupation. The political ideas on how to provide health services were “ripe” at that time, some would say as a result of the labour movement's influence during the 1930s, softened and mellowed by wartime sufferings.

#### Summary points

A publicly financed health service available to all according to need grew out of the labour movement earlier this century, and examples were implemented in several European countries after the second world war

Views of the NHS from abroad include high professional and intellectual standards in spite of meagre resources

The spirit of British general practice continues …
Common variation at 3q26.2, 6p21.33, 17p11.2 and 22q13.1 influences multiple myeloma risk
Authors: Daniel Chubb, Niels Weinhold, Peter Broderick, Bowang Chen, David C Johnson, Asta Försti, Jayaram Vijayakrishnan, Gabriele Migliorini, Sara E Dobbins, Amy Holroyd, Dirk Hose, Brian A Walker, Faith E Davies, Walter A Gregory, Graham H Jackson, Julie A Irving, Guy Pratt, Chris Fegan, James A L Fenton, Kai Neben, Per Hoffmann, Markus M Nöthen, Thomas W Mühleisen, Lewin Eisele, Fiona M Ross, Christian Straka, Hermann Einsele, Christian Langer, Elisabeth Dörner, James M Allan, Anna Jauch, Gareth J Morgan, Kari Hemminki, Richard S Houlston, Hartmut Goldschmidt
Journal: Nature Genetics (2013)
The Pulmonary Circulation and Congenital Heart Disease
Authors: Abraham M. Rudolph, Alexander S. Nadas
Journal: New England Journal of Medicine (1962)

Interrelations between the Pulmonary Vasculature and Congenital Heart LesionsThe role of the pulmonary circulation in determining the clinical course of congenital heart lesions in the immediate postnatal and neonatal period was discussed in the first section of this review. However, the developmental changes in the pulmonary circulation are affected in turn by the presence of some congenital cardiac malformations. Persistence of the thick-walled, muscular small pulmonary vessels of the fetal type in infants and children with ventricular septal defect, patent ductus arteriosus and other lesions is well recognized in pathological material. Whereas normally the development of the pulmonary vessels . . .
Activation of Ca-permeable cation channels by myocarditis-associated antibody in guinea pig ventricular myocytes.
Authors: M Tominaga, A Matsumori, M Horie, H Yoshida, Y Okada
Journal: Journal of Clinical Investigation (1993)

The pathogenesis of myocarditis and dilated cardiomyopathy is though to involve autoimmunological processes and myocardial calcium overload. Serum containing antiheart antibodies associated with a murine model of myocarditis increased [Ca2+]i in guinea pig ventricular myocytes only in the presence of extracellular Ca2+. The antiheart antibody-positive serum activated Ca(2+)-permeable cation channels that were insensitive to dihydropyridines and membrane stretch. The permeability sequence was Ba2+ > Ca2+ > Na+ approximately K+, and the single-channel conductance to Ba2+ was 12 pS. The channel was activated by extracellular application of the serum during on-cell recording, which suggests that a soluble intracellular messenger may be involved. The antibody-positive serum did not alter voltage-gated Ca2+ currents. We propose that excess Ca entry in myocarditis and dilated cardiomyopathy results from activation of a Ca(2+)-permeable cationic channel by the autoantibodies.