tbuckley/cabot-search huggingface dataset:
The Future of HMOs
Authors: John K. Iglehart
Journal: New England Journal of Medicine (1982)

For more than a decade, Republican and Democratic administrations alike have been promoting health-care-delivery concepts that differ fundamentally from the traditional way medical care is rendered in the United States. Through the provision of grants and loans, loan guarantees, and a law that compelled private employers to offer their workers a choice of health-care plans when available, the federal government has nurtured the development of "health-maintenance organizations" (HMOs). Such organizations offer a comprehensive range of benefits for a price fixed in advance. The care is usually provided by doctors who deliver the services on a basis that places them at . . .
Philosophy in Medicine: Conceptual and Ethical Issues in Medicine and Psychiatry
Authors: Robert L. Sadoff
Journal: JAMA (1982)

This relatively small (201 pages) paperback book is a gem. It may be difficult to read for those uninitiated in philosophy and logic, but it is invaluable to the practitioner of medicine for understanding clearly what she is doing. There are so many issues that physicians take for granted inthe treatment of patients that Drs Culver and Gert analyze and criticize. The authors acknowledge that "the book could not have been written by either of us working separately," and indeed, it is a result of the collaboration of two disciplines—philosophy and medicine (psychiatry)—that is unique. The authors, professors at Dartmouth Medical School and Dartmouth College, have written extensively on philosophy and medicine and in this book provide definitions for rationality, competence, and maladies. They define and discuss these issues along with paternalism in medicine in a manner designed to alert the practitioner to what he does with patients and why
Relief of intractable pruritus in polycythemia vera with recombinant interferon alfa
Authors: Carlo Finelli, Luigi Gugliotta, Barbara Gamberi, Nicola Vianelli, Giuseppe Visani, Sante Tura
Journal: American Journal of Hematology (1993)

Abstract Following reports that recombinant interferon alfa (rIFNα), besides inducing clinical and hematologic remission in polycythemia Vera (PV), can also resolve intractable pruritus, we used rIFNα to treat 13 PV patients complaining of severe pruritus refractory to conventional treatment (venesection and/or cytostatics). rFNα was administered intramuscularly three times a week at a dosage of 3.0 × 10 6 U. Eight patients (61.5%) reported a ± 50% reduction of pruritus, which occurred within 2–8 weeks from the start of rIFNα treatment, leading to a substantial improvement in their quality of life. Three patients had to stop rIFNα within the first month of therapy because of unacceptable side effects. Thus rIFNα seems to be capable of providing considerable relief of otherwise intractable pruritus in a good proportion of PV patients.
Community based treatment for schizophrenia is effective in low income countries
Authors: J. Wise
Journal: BMJ (2014)

Schizophrenia can be treated successfully by mobile community teams in India, a randomised trial has shown.1 Such an approach could be valuable in other low and middle income countries that have few mental health specialists, the authors say.

The Community Care for People with Schizophrenia in India (COPSI) trial found that treatment in the community led by community health workers is more effective than standard facility based care at reducing disability and psychotic symptoms and making sure that patients take their …
A quantitative genetic approach to understanding aggressive behavior
Authors: Bart Kempenaers, Wolfgang Forstmeier
Journal: Behavioral and Brain Sciences (2009)

Abstract Quantitative genetic studies of human aggressive behavior only partly support the claim of social role theory that individual differences in aggressive behavior are learnt rather than innate. As to its heritable component, future studies on the genetic architecture of aggressive behavior across different contexts could shed more light on the evolutionary origins of male-female versus male-male aggression.
Christine Laine: Internist, Medical Journalist, and Editor,<i>Annals of Internal Medicine</i>—2009
Authors: Eric B. Larson
Journal: Annals of Internal Medicine (2009)

Editorials6 October 2009Christine Laine: Internist, Medical Journalist, and Editor, Annals of Internal Medicine—2009Eric B. Larson, MD, MPHEric B. Larson, MD, MPHFrom Group Health Research Institute, Seattle, WA 98101-1448.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-7-200910060-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Annals of Internal Medicine has chronicled research and scholarship of internal medicine for 83 years, ably serving many generations of internists and nourishing the intellectual curiosity and passion for learning that uniquely characterizes internal medicine specialists. The journal also serves an important archival function, providing a place where researchers can deposit the results of their scientific endeavors—a function that legendary Annals editor Ed Huth established and defended as Annals chronicled numerous papers related to emergence of new and important conditions (such as AIDS and Legionnaire disease) even before the research had any immediate value for clinicians caring for individual ...References1. Sox HC. Medical journal editing: who shall pay? [Editorial]. Ann Intern Med. 2009;151:68-9. [PMID: 19581649] LinkGoogle Scholar2. Laine C. Christine Laine: embracing the challenges of medical journalism. Interview by Kelly Morris. Lancet. 2009;373:1839. [PMID: 19482203] CrossrefMedlineGoogle Scholar3. Moynihan R, Cassels A. Selling Sickness. Vancouver: Greystone Books; 2005. Google Scholar Author, Article, and Disclosure InformationAuthors: Eric B. Larson, MD, MPHAffiliations: From Group Health Research Institute, Seattle, WA 98101-1448.Disclosures: None disclosed.Corresponding Author: Eric B. Larson, MD, MPH, Executive Director, Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1448. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 6 October 2009Volume 151, Issue 7Page: 511-512KeywordsDietForecastingHealth careHealth information technologyIntelligenceInternetLegionellosisPublic policyRiversScientists ePublished: 6 October 2009 Issue Published: 6 October 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Controlled oral food challenges in children – when indicated, when superfluous?
Authors: B. Niggemann, C. Rolinck‐Werninghaus, A. Mehl, C. Binder, M. Ziegert, K. Beyer
Journal: Allergy (2005)

The diagnostic work‐up of suspected food allergy includes the skin prick test (SPT), the measurement of food specific immunoglobulin E (IgE) antibodies using serologic assays, and more recently the atopy patch test (APT). For specific serum IgE and the SPT, decision points have been established for some foods allowing prediction of clinical relevance in selected cases. The APT may be helpful, especially when considered in combination with defined levels of specific IgE. Controlled oral food challenges still remain the gold standard in the diagnostic work‐up of children with suspected food allergy. Most food allergic children will lose their allergy over time. As there is no laboratory parameter, which can accurately predict when clinical tolerance has been developed, controlled oral food challenges are the measure of choice. In this article, the current knowledge of predictors for the outcome of oral food challenges is reviewed and proposals for the daily practical work‐up in the case of suspected food related clinical symptoms are presented.
Grafts and the art of mind's reconstruction
Authors: John D. Sinden, Helen Hodges, Jeffrey A. Gray
Journal: Behavioral and Brain Sciences (1995)

Abstract The use of neural transplantation to alleviate cognitive deficits is still in its infancy. We have an inadequate understanding of the deficits induced by different types of brain damage and their homologies in animal models against which to assess graft-induced recovery, and of the ways in which graft growth and function are influenced by factors within the host brain and the environment in which the host is operating. Further, use of fetal tissue may only be a transitory phase in the search for appropriate donor sources. Nevertheless, findings from our laboratory and elsewhere have made a prima facie case for successful cognitive reconstruction by graft methods.
Human B1 cells are CD3−: A reply to “A human equivalent of mouse B-1 cells?” and “The nature of circulating CD27+CD43+ B cells”
Authors: Daniel O. Griffin, Nichol E. Holodick, Thomas L. Rothstein
Journal: The Journal of Experimental Medicine (2011)

Griffin et al. respond: 

In the January 2011 issue of the JEM , we identified a population of B cells in human umbilical cord and adult peripheral blood that manifests three key functional features of mouse B1 cells (spontaneous immunoglobulin secretion, tonic intracellular signaling, and efficient
Fanya Kazi Pamoja
Authors: Erik Austin
Journal: JAMA (1997)

"In Africa, one needs to negotiate the evening meal—if there is one," or so the saying goes. As a medical student commissioned with an international disaster and relief agency, I assisted an African physician in his three-room clinic in Kisongo, a remote outpost on the Masai Plains in Tanzania, which is situated on Africa's east coast, along the Indian Ocean. This country of approximately 28 million, known for the great Mount Kilimanjaro, is home to the seminomadic Masai people, who constantly struggle for survival because they cannot support themselves agriculturally in the dry, desertlike plains. The Masai have very little food, almost no water, and no consistent medical care. In our outpost, one physician serves more than 8000 people spread across four villages, requiring many to walk over 50 km to a rather primitive medical facility. Each day, young and old wait patiently in long lines in the hot sun
Rehabilitation after Stroke
Authors: Bruce H. Dobkin
Journal: New England Journal of Medicine (2005)

A 66-year-old man was suddenly unable to speak, follow directions, or move his right arm and leg. He received tissue plasminogen activator within 90 minutes. Four days later, his speech was limited to effortful answers of yes or no. He could not walk or use his right arm, and self-care tasks required maximal assistance. What advice would you offer him and his family regarding rehabilitation for his disabilities?
Expression of epithelial-cadherin, alpha-catenin and beta-catenin during human intrahepatic bile duct development: a possible role in bile duct morphogenesis
Authors: Tadashi Terada, Keigo Ashida, Yukisato Kitamura, Yoshiko Matsunaga, Kazuaki Takashima, Masako Kato, Tetsuo Ohta
Journal: Journal of Hepatology (1998)
OPTIMIZED DURATION OF CLOPIDOGREL THERAPY FOLLOWING TREATMENT WITH THE ENDEAVOR ZOTAROLIMUS-ELUTING STENTS IN THE REAL-WORLD CLINICAL PRACTICE (OPTIMIZE) TRIAL: RATIONALE, DESIGN AND PRELIMINARY RESULTS OF A LARGE-SCALE, RANDOMIZED, MULTICENTER STUDY
Authors: Fausto Feres, Ricardo A. Costa, Alexandre Abizaid
Journal: Journal of the American College of Cardiology (2011)
Control Programs for Heroin Addiction
Authors: Hans H. Neumann
Journal: JAMA (1969)

<h3>To the Editor:—</h3> A recent paper inThe Journal(<b>208</b>:2297, 1969) by Kramer and Bass expressed the increasing disillusionment with present approaches to the narcotics problem. At present the emphasis is on education to prevent and on treatment to rehabilitate. Unfortunately there is little cause for satisfaction with the results of either. How much will increased education accomplish as a deterrent? It can have the paradoxical effect of stimulating a morbid curiosity and daring in an immature group that tends to be rebellious and defiant. As to treatment of heroin addiction, the high rate of relapse after the patient's long and costly confinement is discouraging. Yet, another more serious problem arises in connection with both residential care and methadone hydrochloride programs. This therapy may help some individuals, but for the overall problem little is accomplished. For every addict who no longer uses heroin, two novices are introduced to the
Pioneering Work in Several Fields in Spain
Authors: Xavier Bosch
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
The Opioid Growth Factor (OGF)–OGF Receptor Axis Uses the p16 Pathway to Inhibit Head and Neck Cancer
Authors: Fan Cheng, Ian S. Zagon, Michael F. Verderame, Patricia J. McLaughlin
Journal: Cancer Research (2007)

Abstract Head and neck squamous cell carcinoma (HNSCC) represents 5.5% of malignancies worldwide, with ∼30,000 new cases and ∼11,000 deaths reported in the United States annually. The opioid growth factor (OGF; [Met5]-enkephalin) and the OGF receptor (OGFr) form an endogenous growth regulating system; the OGF-OGFr axis influences the G0-G1 phase of the cell cycle in HNSCC. Cells treated with small interfering RNA (siRNA) for OGFr no longer responded to the growth inhibitory effects of OGF or the growth stimulatory effects of naltrexone, indicating that these activities are entirely mediated by OGFr. In this investigation, we examined the precise target of OGF in the cell cycle. Using SCC-1 cells, OGF decreased the phosphorylation of retinoblastoma protein. This change was correlated with reduced Cdk4, but not Cdk2, kinase activity. OGF treatment increased cyclin-dependent kinase inhibitor p16 protein expression. Importantly, p16 complexed with Cdk4 was increased by OGF treatment at all time points, consistent with the hypothesis that OGF mediated growth inhibition through p16. Blockade of OGF-OGFr interactions with naloxone abolished the increased expression of p16 protein by OGF. Inhibition of p16 (INK4a) activation by p16-specific siRNA blocked OGF's repressive action on proliferation of SCC-1, CAL-27, and SCC-4 HNSCC cells. These data are the first to reveal that the target of cell proliferative inhibitory action of OGF in human HNSCC is a cyclin-dependent kinase inhibitory pathway, and this may be useful in the diagnosis and treatment of HNSCC. [Cancer Res 2007;67(21):10511–8]
Implications of Prodromal Angina Pectoris in Anterior Wall Acute Myocardial Infarction: Acute Angiographic Findings and Long-Term Prognosis
Authors: Masaharu Ishihara, Hikaru Sato, Hironobu Tateishi, Takuji Kawagoe, Yuji Shimatani, Satoshi Kurisu, Kazuko Sakai, Kentarou Ueda
Journal: Journal of the American College of Cardiology (1997)
New approaches to atherosclerosis: An overview
Authors: Peter A. McCarthy
Journal: Medicinal Research Reviews (1993)

The mechanisms of action and selected agents for a variety of approaches to the treatment of atherosclerosis have been reviewed. In Table I, each approach is listed according to its primary physiological effect. This is a simplification, of course, and some agents, such as ACAT inhibitors, may have primary effects in all of these categories. As one goes from left to right, the benefit of each physiological effect becomes more speculative. There is no question of the benefit of LDL reduction, but less evidence exists for the clinical benefits of HDL elevation. With regard to direct anti-atherosclerotic effects, most approaches have yet to gather clinical data of any type. Perhaps as a result, the degree of medicinal chemistry effort in each area to date declines as one goes from left to right. This situation is changing rapidly, however. As evidence supporting the HDL hypothesis accumulates and knowledge of how to elevate HDL levels grows, very exciting opportunities for medical advances present themselves. Likewise, the knowledge base for nonlipid intervention is growing and very rapid advances are being achieved with the plaque-imaging techniques needed for evaluating such agents in man. Such results can only lead to greater opportunities for pharmacological intervention. Thus, in the future, much greater research effort will likely be dedicated to HDL elevation and nonlipid approaches. Through these efforts, physicians of the future should be armed with several complementary agents that can reduce the risk of cardiovascular disease in all patient populations.
Coexistent hyperdiploidy does not abrogate poor prognosis in myeloma with adverse cytogenetics and may precede IGH translocations
Authors: Charlotte Pawlyn, Lorenzo Melchor, Alex Murison, Christopher P. Wardell, Annamaria Brioli, Eileen M. Boyle, Martin F. Kaiser, Brian A. Walker, Dil B. Begum, Nasrin B. Dahir, Paula Proszek, Walter M. Gregory, Mark T. Drayson, Graham H. Jackson, Fiona M. Ross, Faith E. Davies, Gareth J. Morgan
Journal: Blood (2014)
Amyloid-β, Anxiety, and Cognitive Decline in Preclinical Alzheimer Disease
Authors: Robert H. Pietrzak, Yen Ying Lim, Alexander Neumeister, David Ames, Kathryn A. Ellis, Karra Harrington, Nicola T. Lautenschlager, Carolina Restrepo, Ralph N. Martins, Colin L. Masters, Victor L. Villemagne, Christopher C. Rowe, Paul Maruff
Journal: JAMA Psychiatry (2015)

<h3>Importance</h3> Alzheimer disease (AD) is now known to have a long preclinical phase in which pathophysiologic processes develop many years, even decades, before the onset of clinical symptoms. Although the presence of abnormal levels of amyloid-β (Aβ) is associated with higher rates of progression to clinically classified mild cognitive impairment or dementia, little research has evaluated potentially modifiable moderators of Aβ-related cognitive decline, such as anxiety and depressive symptoms. <h3>Objective</h3> To evaluate the association between Aβ status and cognitive changes, and the role of anxiety and depressive symptoms in moderating Aβ-related cognitive changes in the preclinical phase of AD. <h3>Design, Setting, and Participants</h3> In this multicenter, prospective cohort study with baseline and 18-, 36-, and 54-month follow-up assessments, we studied 333 healthy, older adults at hospital-based research clinics. <h3>Main Outcomes and Measures</h3> Carbon 11–labeled Pittsburgh Compound B (PiB)–, florbetapir F 18–, or flutemetamol F 18–derived measures of Aβ, Hospital Anxiety and Depression Scale scores, and comprehensive neuropsychological evaluation that yielded measures of global cognition, verbal memory, visual memory, attention, language, executive function, and visuospatial ability. <h3>Results</h3> A positive Aβ (Aβ+) status at baseline was associated with a significant decline in global cognition, verbal memory, language, and executive function, and elevated anxiety symptoms moderated these associations. Compared with the Aβ+, low-anxiety group, slopes of cognitive decline were significantly more pronounced in the Aβ+, high-anxiety group, with Cohen<i>d</i>values of 0.78 (95% CI, 0.33-1.23) for global cognition, 0.54 (95% CI, 0.10-0.98) for verbal memory, 0.51 (95% CI, 0.07-0.96) for language, and 0.39 (95% CI, 0.05-0.83) for executive function. These effects were independent of age, educational level, IQ,<i>APOE</i>genotype, subjective memory complaints, vascular risk factors, and depressive symptoms; furthermore, depressive symptoms and subjective memory complaints did not moderate the association between Aβ and cognitive decline. <h3>Conclusions and Relevance</h3> These results provide additional support for the deleterious effect of elevated Aβ levels on cognitive function in preclinical AD. They further suggest that elevated anxiety symptoms moderate the effect of Aβ on cognitive decline in preclinical AD, resulting in more rapid decline in several cognitive domains. Given that there is currently no standard antiamyloid therapy and that anxiety symptoms are amenable to treatment, these findings may help inform risk stratification and management of the preclinical phase of AD.
Assessment of the Efficacy of Interventions to Limit Ischemic Injury by Direct Measurement of Intramural Carbon Dioxide Tension after Coronary Artery Occlusion in the Dog
Authors: L. David Hillis, Shukri F. Khuri, Eugene Braunwald, Robert A. Kloner, Donald Tow, Ernest Barsamian, Peter R. Maroko
Journal: Journal of Clinical Investigation (1979)

Although numerous interventions have been shown to exert a salutary effect on the ischemic myocardium, the severity of ischemia generally has been measured by indirect techniques. In the present investigation the effect of ischemia on intramural carbon dioxide tension (PmCO2) was measured directly in the open-chest, anesthetized dog with a mass spectrometer during repetitive 10-min coronary artery occlusions separated by 45-min periods of reflow; simultaneously, regional myocardial blood flow in the ischemic area was measured by 127Xenon washout. In all dogs the increase in PmCO2 from before to 10 min after the first occlusion (ΔPmCO2) exceeded that during subsequent occlusions. In those dogs not receiving an intervention (controls), ΔPmCO2 during the third occlusion was similar to that during the second occlusion. When propranolol, hyaluronidase, and nitroglycerin were administered to different groups of dogs before the third occlusion, each caused significantly smaller elevations in ΔPmCO2 than those occurring during the control second occlusion, and the combination of all three interventions induced the smallest increase in ΔPmCO2. Regional myocardial blood flow rose with hyaluronidase and was unchanged with propranolol, nitroglycerin, and the three drugs in combination. In contrast to these beneficial interventions, isoproterenol infused with the third occlusion caused a higher ΔPmCO2 than during the control second occlusion. It is concluded, first, that interventions that modify the severity of ischemia can be evaluated by measuring intramural carbon dioxide tension; second, that propranolol, hyaluronidase, and nitroglycerin reduce ischemic injury, whereas isoproterenol increases it; and third, that the combination of propranolol, hyaluronidase, and nitroglycerin exerts an additive beneficial effect on ischemia.