tbuckley/cabot-search huggingface dataset:
Some Physicians Protest "High-Stakes" Tests
Authors: Mike Mitka
Journal: JAMA (2001)

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
Transthoracic 3-D echocardiography improves the quantification of atrial septal defect size before amplatzer closure
Authors: Jaroslaw D. Kasprzak, Andrzej Sysa, Maria Krzeminska-Pakula, Michal Ciesielczyk, Pawel Dryzek, Jadwiga Moll, Josef Masura, Jaroslaw Drozdz
Journal: Journal of the American College of Cardiology (2003)
First clinical evaluation of sagittal laser optical tomography for detection of synovitis in arthritic finger joints
Authors: A K Scheel
Journal: Annals of the Rheumatic Diseases (2004)

<b>Objective:</b> To identify classifiers in images obtained with sagittal laser optical tomography (SLOT) that can be used to distinguish between joints affected and not affected by synovitis. <b>Methods:</b> 78 SLOT images of proximal interphalangeal joints II–IV from 13 patients with rheumatoid arthritis were compared with ultrasound (US) images and clinical examination (CE). SLOT images showing the spatial distribution of scattering and absorption coefficients within the joint cavity were generated. The means and standard errors for seven different classifiers (operator score and six quantitative measurements) were determined from SLOT images using CE and US as diagnostic references. For classifiers showing significant differences between affected and non-affected joints, sensitivities and specificities for various cut off parameters were obtained by receiver operating characteristic (ROC) analysis. <b>Results:</b> For five classifiers used to characterise SLOT images the mean between affected and unaffected joints was statistically significant using US as diagnostic reference, but statistically significant for only one classifier with CE as reference. In general, high absorption and scattering coefficients in and around the joint cavity are indicative of synovitis. ROC analysis showed that the minimal absorption classifier yields the largest area under the curve (0.777; sensitivity and specificity 0.705 each) with US as diagnostic reference. <b>Conclusion:</b> Classifiers in SLOT images have been identified that show statistically significant differences between joints with and without synovitis. It is possible to classify a joint as inflamed with SLOT, without the need for a reference measurement. Furthermore, SLOT based diagnosis of synovitis agrees better with US diagnosis than CE.
AIDS and Accusation: Haiti and the Geography of Blame
Authors: Swailem S. Hennein
Journal: JAMA (1993)

Diligence and a strong sense of mission have shaped how Paul Farmer, a well-published anthropologist physician, undertook the study of Do Kay, a small Haitian village struck by the acquired immunodeficiency syndrome (AIDS). His method of research goes beyond his being the participant observer who conducted interviews and recorded what he saw and heard over a period of almost a decade. Farmer evidently identified with the Do Kay community, winning the confidence of its people, becoming the trusted recipient of their intimate insights and disclosures. Casual discussions, rumors, complaints, spontaneous reactions to radio and TV broadcasts, political and religious opinions are all ably assimilated and interwoven into the narrative. Thus this work supersedes the limitations normally attached to the rigors of scientific objectivity. Even if this approach departs somewhat from the conventions of traditional anthropology and closes the door on the likelihood of its ever being replicated, the work is
Primary Prevention With Metoprolol in Patients With Hypertension
Authors: John Wikstrand
Journal: JAMA (1988)

The present study of primary prevention in white men aged 40 to 64 years attempts to investigate whether a beta-blocker given as initial antihypertensive treatment would lower total mortality to a greater extent than thiazide diuretics. Patients were randomized to metoprolol (n = 1609, 8110 patient-years) or a thiazide diuretic (n = 1625, 8070 patient-years). The median follow-up time was 4.2 years. The mean dose of metoprolol was 174 mg/d, and of thiazide diuretics, 46 mg/d of hydrochlorothiazide or 4.4 mg/d of bendroflumethiazide. Identical control of blood pressure was achieved using a fixed therapeutic schedule. Total mortality was significantly lower for metoprolol than for thiazide diuretics because of fewer deaths from coronary heart disease and stroke. Total mortality was also significantly lower in smokers randomized to metoprolol. The benefit demonstrated in patients treated with metoprolol seems to have important implications for clinical practice.
API5 Confers Tumoral Immune Escape through FGF2-Dependent Cell Survival Pathway
Authors: Kyung Hee Noh, Seok-Ho Kim, Jin Hee Kim, Kwon-Ho Song, Young-Ho Lee, Tae Heung Kang, Hee Dong Han, Anil K. Sood, Joanne Ng, Kwanghee Kim, Chung Hee Sonn, Vinay Kumar, Cassian Yee, Kyung-Mi Lee, Tae Woo Kim
Journal: Cancer Research (2014)

Abstract Identifying immune escape mechanisms used by tumors may define strategies to sensitize them to immunotherapies to which they are otherwise resistant. In this study, we show that the antiapoptotic gene API5 acts as an immune escape gene in tumors by rendering them resistant to apoptosis triggered by tumor antigen-specific T cells. Its RNAi-mediated silencing in tumor cells expressing high levels of API5 restored antigen-specific immune sensitivity. Conversely, introducing API5 into API5low cells conferred immune resistance. Mechanistic investigations revealed that API5 mediated resistance by upregulating FGF2 signaling through a FGFR1/PKCδ/ERK effector pathway that triggered degradation of the proapoptotic molecule BIM. Blockade of FGF2, PKCδ, or ERK phenocopied the effect of API5 silencing in tumor cells expressing high levels of API5 to either murine or human antigen-specific T cells. Our results identify a novel mechanism of immune escape that can be inhibited to potentiate the efficacy of targeted active immunotherapies. Cancer Res; 74(13); 3556–66. ©2014 AACR.
Evaluation of Kidney Morphology
Authors: Ramesh B. Patel
Journal: JAMA (1982)

To the Editor.—  In response to a question from a New York physician regarding contraindications and risks of retrograde pyelography as a first procedure in a patient with toxic drug reaction to the kidneys, the responding consultant, Chester C. Winter, MD (1982;247:2152), did not make a comment on retrograde pyelography in that particular clinical situation. The procedure was done on the patient to rule out obstructive uropathy. As stated by Dr Winter, retrograde pyelography is associated with considerable risks, both of the procedure itself and the associated anesthesia. Some of the risks are serious. A renal ultrasonogram, with modernday equipment and technical and interpretive expertise, has been shown to be a sensitive method by which obstructive uropathy can be ruled out. Moreover, it is a noninvasive method without associated risks from surgical procedure and anesthesia. It is also cheaper and less time consuming than retrograde pyelography. In the opinion of
Abstract 2292: Absent E2 liganded AhR inhibits tumor inhibition by ERα in Min mice
Authors: Adelaide M. Carothers, Hira Rizvi, Ronald Lubet, Monica Bertagnolli
Journal: Cancer Research (2011)

Abstract Previously, we showed that E2 and ERα prevent intestinal tumor formation in the Min mouse. Others showed that Aryl hydrocarbon Receptor (AhR) associates with ubiquitin ligase to down-regulate β-catenin and Wnt signaling. AhR activity also may affect ERα. AhR has endogenous, dietary, and xenobiotic ligands. We hypothesized that the tumor inhibiting function of ERα promotes Wnt signaling in vivo and is antagonized by liganded-AhR in the absence of E2. In groups of 10, ovariectomized Min (OvxMin) mice were treated w/wo AhR ligand 5, 6-benzoflavone (BF; 2,000 ppm) by diet for 17 weeks. Treated mice developed more tumors in the small intestine (54.7±11.1) than controls (38.3±4.5 P&amp;lt;0.0001). Protein expression was evaluated in non-tumor ileum of study mice by immunohistochemistry, immunoprecipitation (IP), and immunoblotting (IB). ERα and β-catenin nuclear expression in crypt base cells, total β-catenin and ERα protein amounts, and Wnt signaling-dependent Paneth cell markers (Sox9 and Lysozyme) were significantly reduced in BF-treated OvxMin compared to control mice. Reciprocal IP/IBs using total cell lysates from study mice and antibodies for β-catenin and ubiquitin (Ub) showed increased expression of ubiquitylated β-catenin in BF-treated OvxMin mice relative to controls. Wnt signaling-dependent cell proliferation (Ki67+ nuclei/crypt) was reduced in BF-treated OvxMin (11.4±2.5) relative to controls (16.2±3.0) and untreated intact Min (20.7±3.2) mice (P&amp;lt;0.01). AhR was expressed throughout the crypt-villus unit of OvxMin ileum; its activity was assessed by induction of Cyp1A1. A minimal amount of Cyp1A1, but elevated levels were found in untreated mucosa of intact Min vs. OvxMin mice w/wo BF, respectively. Lower expression of the AhR negative regulator, AhR Repressor, was present in ileum of OvxMin mice regardless of treatment relative to untreated intact Min mice. In study mice mucosa, other xenobiotic responsive regulators (Pxr, Nrf2, Car1/2) were minimally expressed, not affected by BF, hence not implicated in Cyp1A1 induction. In conclusion, these results indicate that E2 loss reduces AhR feedback inhibition and Wnt signaling in Min intestine. Since liganded-AhR promoted β-catenin turnover and reduced ERα expression absent E2, our data suggest that deficient Wnt signaling in the non-tumor mucosa of Min mice provides a selective pressure for Apc functional loss in intestinal stem cells and tumor initiation. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2292. doi:10.1158/1538-7445.AM2011-2292
Abstract 2284: Investigation of notch-1, ErbB-2, and ERα crosstalk in breast cancer
Authors: Allison S. Rogowski, Clodia Osipo
Journal: Cancer Research (2011)

Abstract Notch-1 is a breast oncogene that is overexpressed with its ligand Jagged-1 in human breast cancers-associated with the poorest overall survival. Notch signaling can be inhibited by a gamma-secretase inhibitor (GSI). We have recently determined that the estrogen receptor-alpha or ErbB-2 inhibits Notch-1 activation in breast cancer cells. In the current study, we sought to uncover the complex crosstalk between ER, ErbB-2, and Notch-1 and ask whether triple combination treatment can disrupt this complex cross-talk model to inhibit growth of ER positive breast cancer cells (MCF-7) and possibly prevent anti-hormone resistance. The results demonstrated that following 1 week of estrogen deprivation, MCF-7 cells develop resistance and regrow. Canonical Notch gene targets: Hes-1, Hey-1, Hes-5, and Deltex-1 are significantly increased at this 1 week time point. Similarly, ErbB-2 mRNA increased significantly after 72 hours of estrogen deprivation. Upon treatment with fulvestrant, a pure ant-estrogen, ER transcriptional activity as measured by PS2 mRNA is inhibited after one week. Interestingly, the combination of fulvestrant and lapatinib, an anti-ErbB-2 tyrosine kinase inhibitor, synergistically increased both Deltex-1 and ErbB-2 mRNAs which were reduced upon GSI treatment. Western blot analysis showed an increase in ER and tyrosine-phosphorylated ErbB-2 and total ErbB-2 proteins. This increase in protein expression was further increased upon dual treatment with fulvestrant and lapatinib. Conversely, treatment with a Notch inhibitor, GSI caused a decrease in both total and tyrosine-phosphorylated ErbB-2. Cell cycle analysis showed that fulvestrant treatment significantly growth arrested cells in G1 while decreasing cells in S-phase. However, lapatnib or GSI or the combination treatments did not further enhance the growth inhibitory effects of fulvestrant. Similar results were observed using Annexin-V analysis by flow cytometry as a measure of early apoptosis. These results suggest that while inhibiting ER and ErbB-2 simultaneously increases Notch activation in a synergistic manner, this dramatic increase in Notch activity in the short term does not sensitize ER positive breast cancer cells to a Notch inhibitor to undergo cell death. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2284. doi:10.1158/1538-7445.AM2011-2284
Incorrect Values for Intractable and Cluster Headaches at Enrollment Shown in Figure 1 and Incorrect Prevalence of Headache at Ten Years in Text of the Article by Hanly et al (Arthritis Rheum, November 2013)
Authors: John G. Hanly, Murray B. Urowitz, Aidan G. O'Keeffe, Caroline Gordon, Sang‐Cheol Bae, Jorge Sanchez‐Guerrero, Juanita Romero‐Diaz, Ann E. Clarke, Sasha Bernatsky, Daniel J. Wallace, Ellen M. Ginzler, David A. Isenberg, Anisur Rahman, Joan T. Merrill, Michelle Petri, Paul R. Fortin, Dafna D. Gladman, Barri J. Fessler, Graciela S. Alarcón, Ian N. Bruce, Mary Anne Dooley, Kristjan Steinsson, Munther A. Khamashta, Rosalind Ramsey‐Goldman, Susan Manzi, Gunnar K. Sturfelt, Ola Nived, Asad A. Zoma, Ronald F. van Vollenhoven, Manuel Ramos‐Casals, Cynthia Aranow, Meggan Mackay, Guillermo Ruiz‐Irastorza, Kenneth C. Kalunian, S. Sam Lim, Murat Inanc, Diane L. Kamen, Christine A. Peschken, Soren Jacobsen, Chris Theriault, Kara Thompson, Vernon Farewell
Journal: Arthritis & Rheumatology (2014)

In the lower panel of Figure 1 of the article by Hanly et al in the November 2013 issue of Arthritis & Rheumatism (pages 2887–2897), the data points for intractable headaches and cluster headaches at the enrollment visit were inadvertently reversed. The correct values are 6.49% for intractable headaches at the enrollment visit and 2.36% for cluster headaches at the enrollment visit. Additionally, in the text of the article the prevalence of headache at 10 years was incorrectly stated. The first full sentence on page 2888 should have read, “The prevalence of headache increased to 42% after 10 years” and the last sentence on page 2890 (continuing onto page 2891) should have read, “The established proportion of patients who ever reported a headache (Kaplan-Meier estimate) increased to 42% after 10 years (Figure 2).”
Transfusion Hepatitis Arising From Addict Blood Donors
Authors: Stephen N. Cohen
Journal: JAMA (1968)

A number of narcotics addicts and suspected addicts sold blood at a local proprietary blood bank. The state Department of Health determined the effect of this source on the incidence of hepatitis in the recipients. A control group of recipients was studied for comparison. Although the incidence of hepatitis was not higher than expected in the recipients of this bank's blood, it was much higher than in the control group, and higher yet when related to addict and suspected-addict donations. The narcotics addict seems to be a significant source of homologous serum hepatitis.
Reoperation of Left Heart Valve Bioprostheses According to Age at Implantation
Authors: Vincent Chan, Tarek Malas, Harry Lapierre, Munir Boodhwani, B-Khanh Lam, Fraser D. Rubens, Paul J. Hendry, Roy G. Masters, William Goldstein, Thierry G. Mesana, Marc Ruel
Journal: Circulation (2011)

Background— Evidence supporting the use of bioprostheses for heart valve replacement in young adults is accumulating. However, reoperation data, which may help guide clinical decision making in young patients, remains poorly defined in the literature. Methods and Results— We examined the need for reoperation in 3975 patients who underwent first-time bioprosthetic aortic valve replacement (AVR) (n=3152) or mitral valve replacement (MVR) (n=823). There were 895 patients below the age of 60 years at bioprosthesis implant (AVR, n=636; MVR, n=259). The median interval to reoperation of contemporary, stented aortic bioprostheses was 7.74 years (95% CI 7.28 to 9.97 years) in patients less than 40 years, and 12.93 years (95% CI 11.10 to 15.76 years) in patients between 40 and 60 years of age. Multivariable risk factors associated with reoperation following bioprosthetic AVR include age (hazard ratio [HR] 0.94 per year, 95% CI 0.91 to 0.96, P &lt;0.001) and concomitant coronary artery bypass grafting (HR 0.34, 95% CI 0.11 to 0.99, P =0.04). The median interval to reoperation of contemporary mitral bioprostheses was 8.11 years (95% CI 5.79 to 16.50 years) in patients less than 40 years, and 10.14 years (95% CI 8.64 to 11.14 years) in patients between 40 and 60 years of age. As for AVR, age (HR 0.96 per year, 95% CI 0.95 to 0.98, P &lt;0.001) and concomitant coronary artery bypass grafting (HR 0.55, 95% CI 0.32 to 0.93, P =0.03) were associated with decreased reoperation risk following bioprosthetic MVR. Conclusions— These data constitute clinically relevant age-specific prognostic information regarding reoperation in young patients, who may wish to select a bioprosthesis at initial left heart valve replacement.
611 Poor prognostic factors in heavier patients with chronic hepatitis C (CHC) result in less favourable treatment outcomes
Authors: M.G. Swain, G.R. Foster, S.J. Hadzivannis, E.J. Heathcote, D. Jensen, S.S. Lee, P.J. Pockros, M. Sulkowski, R. Reddys, C. Trepo
Journal: Journal of Hepatology (2006)
Urinary Leak After Renal Transplantation Proven by SPECT-CT Imaging
Authors: Roland Talanow, Donald Neumann, Richard Brunken, Bohdan Bybel, Guiyun Wu
Journal: Clinical Nuclear Medicine (2007)

A 63-year-old man underwent a living-related kidney transplantation secondary to Wegener granulomatosis. The early postoperative course was uneventful, and the patient was discharged with good renal function. On postoperative week 3, the patient presented with complaints of leg swelling and abundant watery discharge from the lower end of the surgical wound. Technetium-99m mercaptoacetylglycine-3 (Tc-99m MAG3) renal scan showed indeterminate tracer accumulation overlying the pelvic region. With a Foley catheter in place, the accumulation in the pelvis was slightly more than expected bladder activity. Suspicion for a possible urinary leak was raised. For that reason single photon emission computed tomography/computed tomography fusion (SPECT/CT) imaging was performed, which showed tracer accumulation associated with fluid collection in the pelvis anterior to the transplanted ureter, thus proving the presence of a urinary leak. This case report shows the usefulness of SPECT-CT imaging for proving questionable urinary leak of renal transplants.
OC-044 Effects of Sleeve Gastrectomy on Gastro-Oesophageal Reflux and Oesophago-Gastric Motility
Authors: J O Hayat, S Mansour, A Wan, A P Poullis, E Yazaki, D Sifrim, J-Y Kang
Journal: Gut (2013)

<h3>Introduction</h3> Sleeve gastrectomy is increasingly used as both a definitive and staggered weight loss procedure. The effect of sleeve gastrectomy on gastro-oesophageal reflux (GOR) remains uncertain. We studied the effect of sleeve gastrectomy on GOR, pressure parameters at the Lower Oesophageal Sphincter (LOS), oesophageal and gastric motility. <h3>Methods</h3> Sixteen patients (median age 46 (range 25–71)) with morbid obesity underwent high resolution oesophageal manometry and 24hr ambulatory pH-impedance monitoring, at least 2 weeks pre-op and 3 months post sleeve gastrectomy (median no. of days post-op 129 (range 84–202)). All patients documented reflux and dysphagia symptoms at the time of testing. Nine patients also underwent concurrent gastric emptying with 13C labelled octanoate breath test. Parametric data was analysed using the paired t-test and non-parametric data with Wilcoxon matched pairs test. <h3>Results</h3> Mean Body Mass Index (BMI) fell from 49 (41.3–58.3) to 38.5(35–46.3). 5/16 patients reported new or worsening reflux symptoms (31%). Basal LOS pressure fell from 14.4mmHg (9.7–28.5) pre-op to 8.9mmHg (0.7–40.5) post-op (p &lt; 0.02). Intra-gastric pressure and G-O pressure gradient increased: 8.3mmHg (4.7–12.8) pre-op Vs 10.4 mmHg (5.3–22.7) post-op (p &lt; 0.01). 8/16 patients had severe hypomotility pre-op and 9/16 post-op. 3/16 patients had pathological acid reflux pre-op, 5/16 patients having de novo reflux post-op. Mean total acid exposure time pre-op was 1.8%(0.5–5%) increasing to 4.35% (0.2–12.4%)(p &lt; 0.02) post-op. There was an increase in the number of acid: 18(8–31) pre-op vs 29(13–38) post-op (p &lt; 0.0001), and non-acid reflux episodes: 13(7–19) pre-op vs 52(35–84) post-op(p &lt; 0.0001). Non-acid reflux episodes occurred predominantly in the post-prandial period. Gastric half emptying time(t1/2) was significantly shorter post-op 193.1mins (range113–433) vs 115.8 mins (range 82–170) (p &lt; 0.05). <h3>Conclusion</h3> Both acid and non-acid gastro-oesophageal reflux is increased after sleeve gastrectomy with 31% of patients developing de novo acid reflux post-op. This is despite a reduction in BMI and accelerated gastric emptying. A reduction in LOS pressure and increased G-O pressure gradient are likely to be contributing factors. Future studies should determine whether decreased gastric compliance stimulates increased numbers of transient lower oesophageal sphincter relaxations. <h3>Disclosure of Interest</h3> None Declared