tbuckley/cabot-search huggingface dataset:
P215 Left Ventricular Hypertrophy in Chronic Obstructive Pulmonary Disease Without Hypoxaemia: The Elephant in the Room?
Authors: WJ Anderson, BJ Lipworth, S Rekhraj, AD Struthers, J George
Journal: Thorax (2012)

<h3>Background</h3> Chronic obstructive pulmonary disease (COPD) is associated with significant cardiovascular mortality. Left ventricular hypertrophy (LVH) is a pivotal cardiovascular risk factor. The prevalence of LVH in COPD is currently unknown. <h3>Methods</h3> We performed a pilot study of 93 normoxaemic COPD patients and 34 controls. Patients underwent echocardiography to measure left ventricular (LV) dimensions; electrocardiography; 24-hour blood pressure (BP) recording; and serum B-type natriuretic peptide (BNP) levels, along with spirometry and oxygen saturations. <h3>Results</h3> COPD patients’ oxygen saturations were normal at 96.5% (95%CI: 96.1–97.0%), with a mean FEV1 of 70.0% predicted (95% CI: 65.2–74.8%). 30.1% of COPD patients met echocardiographic criteria for LVH based on LV mass index, with more LVH in females than males (43.2% vs. 21.4%, p=0.02). LV mass index in COPD was 96.2g/m2 (95%CI: 90.1–102.7g/m2) vs. controls 82.9g/m2 (95%CI: 75.8–90.6g/m2), p=0.017 (Figure 1). LV mass index remained high in COPD patients in the absence of hypertension history (94.5g/m2 vs. 79.9g/m2, p=0.015) and with 24-hr systolic BP&lt;135mmHg (96.7g/m2 vs. 82.5g/m2, p=0.024). LV ejection fraction (mean=63.4%) and BNP (mean=28.7pg/ml) were normal in COPD patients. Mean 24hr BP was normal in COPD patients at 125/72mmHg. Electrocardiography was less sensitive for detecting LVH than echocardiography. <h3>Conclusion</h3> LVH was present in a significant proportion of normotensive, normoxaemic COPD patients, especially in females, along with normal LV ejection fraction and BNP levels. Clinical trials are therefore indicated to evaluate treatments to regress LVH in patients with COPD.
Pediatric Nursing Homes
Authors: Phyllis S. Glick, Bernard Guyer, Barbara H. Burr, Ilse E. Gorbach
Journal: New England Journal of Medicine (1983)

Pediatric nursing homes were established in Massachusetts in 1971, in response to the crisis created by the deinstitutionalization of children with multiple severe handicaps for whom care in the community was unrealistic. Although these residential beds provided short-term relief for the system, failure both to plan for the improved long-term survival of the children and to develop alternative community services for those whose functional and medical status changed has left fundamental problems unresolved. A review of the 421 residents of pediatric nursing homes since 1972 shows that most have been bedridden and nonverbal, requiring provision of basic care: feeding, dressing, maintaining hygiene, and sensory and motor stimulation. Three quarters of the residents were severely or profoundly retarded and had seizures. About 4 per cent died each year, and another 5 per cent were discharged; few beds were available for new admissions. Low standards of care and financial disincentives have resulted in less than optimal educational and rehabilitative services. Other states are facing similar problems, which can be resolved only through better funding and coordination of the relevant state agencies.
The biggest debate since the NHS was founded
Authors: Kamran Abbasi
Journal: Journal of the Royal Society of Medicine (2010)

New leaders are advised to implement major change at the start of their term in power. Andrew Lansley, the new secretary of state for health, is certainly playing from the management consultant's script. Health experts have described the Con–Lib coalition's proposals for health as the most dramatic restructuring of our health service since the NHS was founded. When the new health white paper revealed that primary care trusts would be scrapped and budgets controlled by GP consortia, shockwaves were created by the extent of the proposals not the nature of them.

Indeed, this is not new thinking to readers familiar with GP fundholding. Clinician leadership has been a mantra of Conservative health policy in opposition. As has a preference for quality outcomes focused on clinical indicators rather than process measures. Yet the early GP fundholding experiments were inconclusive and a limited roll out. We now have a blanket national policy that many clinicians will view as simply another redisorganization of the NHS.

In theory, clinical leadership is to be encouraged. Clinicians are eminently capable of acquiring the necessary strategic, management, and financial skills to control budgets and resources. A proportion of clinicians, the entrepreneurs and frustrated businessmen, will embrace this dramatic reform. Others will be ambivalent, unsure how it will affect them and how they might cope. The remainder will be unhappy that their focus might be diverted from clinical care; a career in medicine was supposed to be about managing patients not budgets.

But whichever category clinicians fit into, they will require support. You might have the inclination but you probably won't have the time to delve into the finer dealings of your consortium. You might not even have the inclination. Medical school barely prepares doctors to treat patients; it certainly isn't any preparation for running a multimillion pound budget.

If the first question is who will support clinicians in running the new world, the second is who will provide them with the appropriate information to make sensible decisions about the population that they are responsible for? Private companies will be queuing up to provide solutions with huge pound – and dollar – signs in their hungry eyes.

The world has also changed for hospital specialists. Will the new system make them disempowered service providers to their colleagues in primary care? We want to hear your views. The editorial and essay pages of the JRSM are ideal channels for this explosive debate – the biggest healthcare debate since the inception of the NHS.
CD28 costimulation independence of target organ versus circulating memory antigen-specific CD4+ T cells
Authors: Andrew P. Fontenot, Laia Gharavi, Sean R. Bennett, Scott J. Canavera, Lee S. Newman, Brian L. Kotzin
Journal: Journal of Clinical Investigation (2003)

T cell receptor engagement with CD28 costimulation is generally required for naive T cell activation, whereas reactivation of memory cells is less dependent on CD28 costimulation. We studied this process in chronic beryllium disease, in which the frequency of antigen-specific CD4+ T cells in the lung is large and circulating antigen-specific cells are also detectable. In the lung, a large fraction of CD4+ T cells stopped expressing CD28 mRNA and protein, and this change in phenotype correlated with lung inflammation. In the presence of concentrations of CTLA-4Ig that inhibited the CD28-B7 interaction, beryllium-specific CD4+ T cells in lung were still able to proliferate and secrete IFN-gamma in response to beryllium in culture. This functional independence of CD28 costimulation included lung CD28+ effector cells. Although lung CD4+CD28- cells retained the ability to secrete Th1-type cytokines in response to beryllium, they showed less proliferative capacity and were more susceptible to cell death compared with CD28+ T cells. In contrast to lung cells, inhibition of the CD28-B7 interaction markedly reduced responses of beryllium-specific T cells in blood. Taken together, these findings suggest transition within memory CD4+ T cells from CD28 dependence in central memory cells to functional independence and then loss of CD28 expression in effector cells.
The Mind and its Computer
Authors: Alfred B. Sundquist
Journal: JAMA (1973)

<h3>To the Editor.—</h3> A point of view, perhaps an odd one, that intrigues me is the frequent resemblance of the human mind to a computer, particularly in those areas dealing with reactionary as opposed to instinctive behavior. When the input to a person's mind is nonsense, the output is also apt to be nonsense—just as it is in the case of the computer. There are numberless examples that I believe will show that this is so. When people's minds are programmed to react in a certain way, it is only with the greatest effort that they can be made to respond in any other way. This may explain in part the conditioned reflex, the mechanism of habit, so-called "brain washing," and the compelling forces of tradition or custom. A simple hypothetical case to illustrate the above thesis could be structured as follows: A little old lady was accustomed to crossing
Identification of human immunodeficiency virus (HIV) envelope type-specific T helper cells in an HIV-infected individual.
Authors: C M Walker, K S Steimer, K L Rosenthal, J A Levy
Journal: Journal of Clinical Investigation (1988)

Two T helper cell clones recognizing the gp 120 envelope protein of HIV were generated from the peripheral blood of a healthy seropositive individual. These cells were type specific as they proliferated and produced IL 2 when stimulated by an epitope in the amino-terminal half of gp 120 of HIVSF2, but not by a similar region of HIVZr6, a Zairian HIV-1 isolate. These two viruses differ by 26% in the deduced amino sequence of the gp 120 protein. Moreover, the antigenic site(s) recognized by the cloned T cells are distinct from those recognized by envelope-specific antibodies. These observations have important implications for the development and use of anti-HIV vaccines.
Medicine and Literature
Authors: Samuel Vaisrub
Journal: JAMA (1980)

Like Gaul, this collection of essays is divided into three parts. Gaul comes to mind automatically, because 12 of the book's 24 contributing essayists are professors of French. The flavor, if not exclusively French, is distinctly continental. Part 1 deals with physician-writers, part 2 with physicians portrayed in literature, and part 3 with disease as an altered state of consciousness. Despite the subdivisions, the book retains a basic thematic unity. Biography, history, philosophy, literary criticism, and clinical medicine blend harmoniously—albeit with varying emphasis—in almost every essay. The reader may wonder why relatively little space is devoted to American physician-writers. William Carlos Williams receives his due, and Richard Selzer is not neglected, but surely Lewis Thomas deserves more than casual mention and Walker Percy more than no mention at all. The reader may also wonder why, two psychiatrists excepted, not a single contributing essayist is a physician. A book on medicine
Enhaced cortisol secretion does not control aspirin-insensitivess thromboxane biosynthesis in patients with acute coronary syndromes
Authors: Giulia Renda, Maria G. Sciulli, Francesca Seta, Stefania Tacconelli, Marta L. Capone, Antonio Rebuzzi, Paola Patrignani
Journal: Journal of the American College of Cardiology (2002)
Metabolism and Toxicity of Ammonia
Authors: William V. McDermott
Journal: New England Journal of Medicine (1957)

THE recent and continuing interest in the possible toxic effects of ammonia in diseases of the liver and portal circulation has led to this progress report, which must of necessity begin with the origin of the problem.Ammonia is a highly toxic substance, and since it is a by-product of various phases of protein metabolism, mechanisms are required for its detoxification and disposal. In vertebrates existing in a water environment, this problem is handled very easily by a simple diffusion of ammonia into the surrounding fluid environment. The adaptation to a terrestrial environment, however, requires the conversion to a nontoxic . . .
Use of Children as Interpreters
Authors: Carol Levine
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
Potential human health effects of acid rain: report of a workshop
Authors: Robert A. Goyer, John Bachmann, Thomas W. Clarkson, Benjamin G. Ferris, Judith Graham, Paul Mushak, Daniel P. Perl, David P. Rall, Richard Schlesinger, William Sharpe, John M. Wood
Journal: Environmental Health Perspectives (1985)

This report summarizes the potential impact of the acid precipitation phenomenon on human health. There are two major components to this phenomenon: the predepositional phase, during which there is direct human exposure to acidic substances from ambient air, and the post-depositional phase, in which the deposition of acid materials on water and soil results in the mobilization, transport, and even chemical transformation of toxic metals. Acidification increases bioconversion of mercury to methylmercury, which accumulates in fish, increasing the risk to toxicity in people who eat fish. Increase in water and soil content of lead and cadmium increases human exposure to these metals which become additive to other sources presently under regulatory control. The potential adverse health effects of increased human exposure to aluminum is not known at the present time.
Influence of Mutational and Sampling Factors on the Estimation of Demographic Parameters in a "Continuous" Population Under Isolation by Distance
Authors: R. Leblois
Journal: Molecular Biology and Evolution (2003)

In numerous species, individual dispersal is restricted in space so that "continuous" populations evolve under isolation by distance. A method based on individual genotypes assuming a lattice population model was recently developed to estimate the product Dσ2, where D is the population density and σ2 is the average squared parent-offspring distance. We evaluated the influence on this method of both mutation rate and mutation model, with a particular reference to microsatellite markers, as well as that of the spatial scale of sampling. Moreover, we developed and tested a nonparametric bootstrap procedure allowing the construction of confidence intervals for the estimation of Dσ2. These two objectives prompted us to develop a computer simulation algorithm based on the coalescent theory giving individual genotypes for a continuous population under isolation by distance. Our results show that the characteristics of mutational processes at microsatellite loci, namely the allele size homoplasy generated by stepwise mutations, constraints on allele size, and change of slippage rate with repeat number, have little influence on the estimation of Dσ2. In contrast, a high genetic diversity (≈0.7–0.8), as is commonly observed for microsatellite markers, substantially increases the precision of the estimation. However, very high levels of genetic diversity (>0.85) were found to bias the estimation. We also show that statistics taking into account allele size differences give unreliable estimations (i.e., high variance of Dσ2 estimation) even under a strict stepwise mutation model. Finally, although we show that this method is reasonably robust with respect to the sampling scale, sampling individuals at a local geographical scale gives more precise estimations of Dσ2.
ETUDE COMPARATIF DU DEBIT INSTANTANE MAXIMUM EXPIRATOIRE – DIME – ET DU VOLUME EXPIRATOIRE MAXIMUM SECONDE – VEMS – DANS LE DIAGNOSTIC FONCTIONEL DES ASTHMATIQUES
Authors: J. GALVǍO LUCAS, A. G. PALMA CARLOS, MARIA LAURA PALMA CARLOS
Journal: Allergy (1967)
Care and Cost Savings at the End of Life-Reply
Authors: Ezekiel J. Emanuel
Journal: JAMA (1996)

<h3>In Reply.</h3> —Ms Madden questions the time frame I used in estimating cost savings. Cost savings can be estimated by using 2 different time frames. The first estimates cost savings from <h3>Guidelines for Letters</h3> Letters will be published at the discretion of the editors as space permits and are subject to editing and abridgment. Letters will be considered if they are typewritten double-spaced and do not exceed 500 words of text and 5 references. Please include a word count. Letters discussing a recent<i>JAMA</i>article should be received within 4 weeks of the article's publication. Letters must not duplicate other material published or submitted for publication. A signed statement for authorship criteria and responsibility, financial disclosure, copyright transfer, and acknowledgment is essential for publication. Letters not meeting these specifications are generally not considered. Letters will not be returned unless specifically requested. Also see<i>JAMA</i>Instructions for Authors (July 3,1996). Letters may be
Assuming that developing countries could not afford xenotransplantation is patronising
Authors: C R V Tomson
Journal: BMJ (1997)

Editor–Neville Goodman is referring to me when he describes a colleague throwing articles about xenotransplantation into the bin.1 He sent me the articles when I questioned his opposition to xenotransplantation at a meeting of our local ethical committee. One of the articles discussed the gap between health spending in rich and poor countries but had the same difficulties as Goodman in reaching useful conclusions. The other was a newspaper letter questioning the value of high technology treatments in …
A Dendritic-Cell-Stromal Axis Maintains Immune Responses in Lymph Nodes
Authors: Varsha Kumar, Dragos C. Dasoveanu, Susan Chyou, Te-Chen Tzeng, Cristina Rozo, Yong Liang, William Stohl, Yang-Xin Fu, Nancy H. Ruddle, Theresa T. Lu
Journal: Immunity (2015)
Health Services Financing
Authors: L. L. Wilson
Journal: BMJ (1970)

further "dram" before entering the ambulance.On admission he was confused and in pain with noticeably cold extremities.Oral temperature was 97' F. (36' C.).Blood pressure 140/80, pulse 72 and small volume.The abdomen was distended and diffusely tender.There was some guarding, and bowel sounds were faint and infrequent.The pupils were unequal, moderately dilated, and did not react to light.Tendon jerks were brisk and the plantar responses flexor.Urine: some albumin and trace of acetone, but no sugar.Blood pH 7-08, Pco2
Beneficial Effects of Clopidogrel Combined With Aspirin in Reducing Cerebral Emboli in Patients Undergoing Carotid Endarterectomy
Authors: David A. Payne, Chris I. Jones, Paul D. Hayes, Matthew M. Thompson, Nicholas J. London, Peter R. Bell, Alison H. Goodall, A. Ross Naylor
Journal: Circulation (2004)

Postoperative thromboembolic stroke affects 2% to 3% of patients undergoing carotid endarterectomy (CEA) and is preceded by 1 to 2 hours of increasing cerebral embolization. Previous work has demonstrated that high rates of postoperative embolization are associated with increased platelet reactivity to adenosine 5'-diphosphate (ADP). Our hypothesis was that preoperative administration of the platelet ADP antagonist clopidogrel could reduce postoperative embolization.One hundred CEA patients on routine aspirin therapy (150 mg) were randomized to 75 mg clopidogrel (n=46) or placebo (n=54) the night before surgery. Platelet response to ADP was assessed by whole-blood flow cytometry. The number of emboli detected by transcranial Doppler within 3 hours of CEA was independently quantified. Time taken from flow restoration to skin closure was used as an indirect measure of the time to secure hemostasis. In comparison with placebo, clopidogrel produced a small (8.8%) but significant reduction in the platelet response to ADP (P<0.05) while conferring a 10-fold reduction in the relative risk of those patients having >20 emboli in the postoperative period (odds ratio, 10.23; 95% CI, 1.3 to 83.3; P=0.01, Fisher's exact test). However, in the clopidogrel-treated patients, the time from flow restoration to skin closure (an indirect marker of hemostasis) was significantly increased (P=0.04, Fisher's exact test), although there was no increase in bleeding complications or blood transfusions.This is the first study to show that a CEA patient's postoperative thromboembolic potential can be significantly reduced by targeted preoperative antiplatelet therapy without increasing the risk of bleeding complications.
Effect of Significant Two-Vessel Versus One-Vessel Coronary Artery Stenosis on Myocardial Contrast Defects Observed With Intermittent Harmonic Imaging After Intravenous Contrast Injection During Dobutamine Stress Echocardiography
Authors: Thomas R Porter, Shouping Li, Karen Kilzer, Ubeydullah Deligonul
Journal: Journal of the American College of Cardiology (1997)
Variants of<i>DENND1B</i>Associated with Asthma in Children
Authors: Patrick M.A. Sleiman, James Flory, Marcin Imielinski, Jonathan P. Bradfield, Kiran Annaiah, Saffron A.G. Willis-Owen, Kai Wang, Nicholas M. Rafaels, Sven Michel, Klaus Bonnelykke, Haitao Zhang, Cecilia E. Kim, Edward C. Frackelton, Joseph T. Glessner, Cuiping Hou, F. George Otieno, Erin Santa, Kelly Thomas, Ryan M. Smith, Wendy R. Glaberson, Maria Garris, Rosetta M. Chiavacci, Terri H. Beaty, Ingo Ruczinski, Jordan S. Orange, Julian Allen, Jonathan M. Spergel, Robert Grundmeier, Rasika A. Mathias, Jason D. Christie, Erika von Mutius, William O.C. Cookson, Michael Kabesch, Miriam F. Moffatt, Michael M. Grunstein, Kathleen C. Barnes, Marcella Devoto, Mark Magnusson, Hongzhe Li, Struan F.A. Grant, Hans Bisgaard, Hakon Hakonarson
Journal: New England Journal of Medicine (2009)

Asthma is a complex disease that has genetic and environmental causes. The genetic factors associated with susceptibility to asthma remain largely unknown.
Heterogeneity of clonal expansion and maturation-linked mutation acquisition in hematopoietic progenitors in human acute myeloid leukemia
Authors: R B Walter, G S Laszlo, J M Lionberger, J A Pollard, K H Harrington, C J Gudgeon, M Othus, S Rafii, S Meshinchi, F R Appelbaum, I D Bernstein
Journal: Leukemia (2014)
A STUDY OF CASUALTIES OCCURRING IN INSTITUTIONS UNDER THE SUPERVISION OF THE MASSACHUSETTS DEPARTMENT OF MENTAL HEALTH
Authors: WALTER W. JETTER, ROLLIN V. HADLEY
Journal: American Journal of Psychiatry (1944)

A statistical analysis was made of 890 casualties which occurred in mental institutions coming under the jurisdiction of the Department of Mental Health during 1942. Significant observations included: 1. The casualty rate was highest among the aged. 2. The casualty rate was highest in the senile psychoses and lowest in dementia præcox. The incidence was 10 times greater in the senile group than in dementia præcox. 3. The most common causes for injury were slips, stumbles, etc., and these predominated in older patients. The next commonest cause was altercations which occurred in the younger age groups. 4. Two-thirds of the accidents occurred on the wards. 5. The peak of the casualty incidence occurred shortly after rising and appeared related to the routine of rising and preparing for the new day. 6. Resulting from the 890 casualties there were 903 separate injuries recorded, 722 of which were fractures, with 532 involving the extremities, 168 of which were located in the femur. The mortality rate of the latter was in direct proportion to the age of the victim. Suggested methods for decreasing or preventing casualties were discussed.