tbuckley/cabot-search huggingface dataset:
Underrepresentation of Older Adults in Cancer Trials—Reply
Authors: Harvey Jay Cohen, Mary Naylor, Arti Hurria
Journal: JAMA (2014)

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
Will the Real Third Revolution Please Stand Up?
Authors: MARTIN FLEISHMAN
Journal: American Journal of Psychiatry (1968)

Although the first and second psychiatric revolutions are unequivocally credited to Pinel and Freud respectively, the true designation of the third revolution in psychiatry is still in question. This author presents his argument for awarding the title to the development and use of psychoactive drugs; community psychiatry, he feels, should be considered the fourth psychiatric revolution.
American Medicine and Statistical Thinking, 1800-1860
Authors: Abraham M. Lilienfeld
Journal: JAMA (1985)

Since World War II, the preclinical and clinical disciplines of contemporary medicine have increasingly used quantitative methods in elucidating etiologic factors in disease, or evaluating therapeutic drugs and procedures. However, as reported here, this had also occurred in the first half of the 19th century with much cruder statistical methods. American 19th-century development was modeled after similar efforts in Europe, particularly in Great Britain and France, but it also reflected the more general effort to inventory the social assets and liabilities of this newly founded nation. After an introductory background, the author considers the role of statistical thinking in specific areas of American medicine. He shows the relationship of statistical thinking to initiating a philosophical approach to medicine based on observation, experience, and the collection of facts, in contrast to devising theoretical systems. This occurred in treatment evaluation, obstetrics, surgery, and mental disease. A statistical approach also played an important
Antibiotic Sensitivity Testing for Infections in Developing Countries: Lacking the Basics
Authors: Richard C. Brown
Journal: JAMA (1996)

<h3>To the Editor.</h3> —In my experience internationally, I believe the United States could aid many people in the developing world by helping test antibiotic sensitivities of commonly occurring pathogens. Clinicians in developing countries often treat infected patients on a trial-and-error basis, which may be costly, time-consuming, and dangerous. It would be preferable if clinicians knew with reasonable certainty to which antibiotics specific organisms are susceptible. Clinicians ought to know for example, that 90% of gonorrhea isolates in their area are susceptible to tetracycline. This information would allow them to make a reasonably informed antibiotic choice. At present, most physicians in developing nations must consult guidelines based on US or European surveys. For gonorrhea, they are advised to use ceftriaxone, an impossible drug choice for destitute people in impoverished countries. The World Health Organization already operates a network of regional laboratories for testing<i>Mycobacterium tuberculosis</i>, including 4 regional laboratories in Africa.
International Union of Pharmacology. LXIV. Estrogen Receptors
Authors: Karin Dahlman-Wright, Vincent Cavailles, Suzanne A. Fuqua, V. Craig Jordan, John A. Katzenellenbogen, Kenneth S. Korach, Adriana Maggi, Masami Muramatsu, Malcolm G. Parker, Jan-Åke Gustafsson
Journal: Pharmacological Reviews (2006)

Estrogen receptors (ERs[1][1]) are ligand-activated transcription factors that belong to the nuclear hormone receptor superfamily. In the late 1950s, the existence of a receptor molecule that could bind 17β-estradiol was demonstrated by Jensen and Jacobsen ([Jensen and Jordan, 2003][2]). The first
Effects of polychlorinated biphenyls on estrogen receptor-beta expression in the anteroventral periventricular nucleus.
Authors: Jacklyn Salama, Tandra R Chakraborty, Laurie Ng, Andrea C Gore
Journal: Environmental Health Perspectives (2003)

Polychlorinated biphenyls (PCBs) can disrupt the reproductive axis, particularly when the exposure occurs during the vulnerable developmental periods. Some effects of environmental endocrine disruptors such as PCBs may be exerted through binding to estrogen receptors (ERs). In this study we examined the endocrine-disrupting effects of Aroclor 1221 (a commercial PCB mixture), focusing on its actions on the ER-ss, which has been implicated in mediating effects of endocrine-disrupting chemicals. A low, ecologically relevant dose of Aroclor 1221 or vehicle (ethanol) was administered three times each to rat dams, on gestational day 16 and on postpartum days 1 and 4, a developmental period during which steroid hormones have permanent effects on adult brain structure and function. Effects on ER-ss cell number in the anteroventral periventricular nucleus (AVPV) were quantified; this sexually dimorphic nucleus of the brain is essential to female reproductive function. For comparison, we quantified ER-ss cell number in another hypothalamic region, the supraoptic nucleus (SON). Using a stereologic approach, we found that Aroclor 1221 caused a highly significant down-regulation of the number of ER-ss-expressing cells in the AVPV, but had no effect in the SON. Thus, PCB exposure has consequences for neural ER expression, and these findings have implications for wildlife and humans that have been exposed to environmental estrogens, particularly during the susceptible periods of early development.
Plasma corticotrophin levels in addison-schilder's disease.
Authors: L H Rees, D B Grant, J Wilson
Journal: BMJ (1975)

Raised plasma immunoreactive corticotrophin (ACTH) levels were found in five boys with the sex-linked disorder progressive leucodystrophy associated with adrenal insufficiency (Addison-Schilder9s disease) and in a symptom-free brother of one of them. Similar ACTH concentrations were found using two antisera, one against the N-terminal part of the ACTH molecule and the other against the C-terminal part. In one patient the circulating ACTH had normal biological activity as measured using the cytochemical ACTH bioassay. Immunoreactive beta/-melanocyte-stimulating hormone was also determined in one patient and found to be raised.
Cost-Effectiveness of Genotype-Guided and Dual Antiplatelet Therapies in Acute Coronary Syndrome
Authors: Dhruv S. Kazi, Alan M. Garber, Rashmee U. Shah, R. Adams Dudley, Matthew W. Mell, Ceron Rhee, Solomon Moshkevich, Derek B. Boothroyd, Douglas K. Owens, Mark A. Hlatky
Journal: Annals of Internal Medicine (2014)

The choice of antiplatelet therapy after acute coronary syndrome (ACS) is complicated: Ticagrelor and prasugrel are novel alternatives to clopidogrel, patients with some genotypes may not respond to clopidogrel, and low-cost generic formulations of clopidogrel are available.To determine the most cost-effective strategy for dual antiplatelet therapy after percutaneous coronary intervention for ACS.Decision-analytic model.Published literature, Medicare claims, and life tables.Patients having percutaneous coronary intervention for ACS.Lifetime.Societal.Five strategies were examined: generic clopidogrel, prasugrel, ticagrelor, and genotyping for polymorphisms of CYP2C19 with carriers of loss-of-function alleles receiving either ticagrelor (genotyping with ticagrelor) or prasugrel (genotyping with prasugrel) and noncarriers receiving clopidogrel.Direct medical costs, quality-adjusted life years(QALYs), and incremental cost-effectiveness ratios (ICERs).The clopidogrel strategy produced$179 301 in costs and 9.428 QALYs. Genotyping with prasugrel was superior to prasugrel alone, with an ICER of $35 800 per QALY relative to clopidogrel. Genotyping with ticagrelor was more effective than genotyping with prasugrel ($30 200 per QALY relative to clopidogrel). Ticagrelor was the most effective strategy($52 600 per QALY relative to genotyping with ticagrelor).Stronger associations between genotype and thrombotic outcomes rendered ticagrelor substantially less cost-effective ($104 800 per QALY). Genotyping with prasugrel was the preferred therapy among patients who could not tolerate ticagrelor.No randomized trials have directly compared genotyping strategies or prasugrel with ticagrelor.Genotype-guided personalization may improve the cost-effectiveness of prasugrel and ticagrelor after percutaneous coronary intervention for ACS, but ticagrelor for all patients may bean economically reasonable alternative in some settings.
Activity of 17β-hydroxysteroid dehydrogenase in various tissues of human skin
Authors: S. ITAMI, S. TAKAYASU
Journal: British Journal of Dermatology (1981)

The activity of 17β-hydroxysteroid dehydrogenase (17β-HSD) was assayed in various tissues microdissected from the freeze-dried human skin of fourteen subjects. The apocrine sweat gland, sebaceous gland and hair follicle possessed a high activity of 17β-HSD. The enzyme activity was negligible in the epidermis, except that the scalp epidermis showed much the same activity as the hair follicle. The dermis showed variable activity because of contamination with other components.
Recent developments in the use of biologics in psoriasis and autoimmune disorders. The role of autoantibodies
Authors: Silja Rott, Ulrich Mrowietz
Journal: BMJ (2005)

Treatment of autoimmune disorders such as psoriasis, rheumatoid arthritis, and Crohn's disease with so called biologics (selective immunomodulatory drugs) has become a standard way to treat severe or recalcitrant forms of these diseases. In particular, antagonists of tumour necrosis factor α (TNF-α) have been proved to be highly efficacious. In this review we summarise the current knowledge on problems associated with treatment with biologics, with particular emphasis on TNF-α inhibitors and autoantibody development. We also discuss the possible increased risk of lymphoma.

Monoclonal antibodies and fusion proteins have become an important group of drugs (known as biologic drugs) for treatment of chronic autoimmune disorders.w1 Advances in antibody engineering and new techniques have allowed the generation of fusion proteins and chimeric, humanised, and fully humanised monoclonal antibodies. Fourteen biologic drugs have already been approved in the United States (by the US Food and Drug Administration (FDA)) and in other countries; over 70 are in late stage clinical trials (at least phase II) and over 1000 in preclinical development.w2

Treatment with these agents is well established for patients with rheumatoid arthritis and Crohn's disease, and in recent years a major focus of research into new biologics was psoriasis, an inflammatory T cell mediated skin disease. In particular, inhibitors of TNF-α were found to be very effective in the treatment of chronic plaque-type psoriasis, pustular psoriasis, and psoriatic arthritis.w3-w5 The mechanism of action of these drugs is either binding free TNF-α to the soluble receptor-like fusion protein etanercept (Enbrel) or direct inhibition of TNF-α bioactivity with the monoclonal antibodies infliximab (chimeric, Remicade) or adalimumab (fully human, Humira).1–5 w6 Other biologics targeting activated T cells and/or their migration into the skin are alefacept (Amevive) and efalizumab (Raptiva). Alefacept is a dimeric fusion protein consisting of a CD2-binding portion …
Doctors should not discuss resuscitation with terminally ill patients: FOR
Authors: C. Manisty
Journal: BMJ (2003)

<b>Aims:</b> To examine the visual outcome and identify risk factors for postoperative uveitis, macular oedema and neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy after phacoemulsification and intraocular lens (IOL) implantation in patients with uveitis. <b>Method:</b> This is a retrospective review of the medical records of 101 eyes of 101 patients. One eye was randomly selected for inclusion in patients who had bilateral surgery. Patients with juvenile arthritis, keratouveitis and lymphoma-associated uveitis were excluded. <b>Results:</b> At the first postoperative and final visits, visual acuity was significantly better (p&lt;0.001), and 64.4% and 71.3% of patients, respectively, had achieved ⩾2 Snellen's lines of visual improvement. The cumulative probability of doubling of the visual angle was 52% over 6 years of follow-up, and this occurred at a higher rate in the presence of preoperative retinal or optic nerve lesions (HR (95% CI) 4.49 (1.41 to 14.29)). Within 3 months after operation, uveitis was more likely to develop in female patients (OR (95% CI) 6.21 (1.41 to 27.43)) and in the presence of significant intraoperative posterior synechiae (OR (95% CI) 8.43 (1.09 to 65.41)); macular oedema was more likely to develop in patients who developed postoperative uveitis (OR (95% CI) 7.45 (1.63 to 34.16)). Nd:YAG capsulotomy occurred at a higher rate in patients aged ⩽55 years (HR (95% CI) 2.28 (1.06, 4.93)) and in those with hydrogel IOLs (HR (95% CI) 3.71 (1.04 to 13.20)), and occurred at a lower rate in patients who had prophylactic systemic corticosteroids (HR (95% CI) 0.25 (0.11 to 0.59)), with plate-haptic silicone IOLs (HR (95% CI) 0.23 (0.08 to 0.64)) and three-piece silicone IOLs (HR (95% CI) 0.19 (0.05 to 0.74)) in comparison to those with polymethylmethacrylate IOLs. <b>Conclusion:</b> Most patients with uveitis achieve improved visual acuity after phacoemulsification, but an increasing rate of visual loss is observed in those with pre-existent macular or optic nerve lesions. Identifying patients who are at risk of postoperative complications should help in patient counselling and to pre-empt these complications by using preoperative prophylactic corticosteroids, careful IOL selection and postoperative intensive corticosteroids.
THE SPECIFIC SERUM TREATMENT OF PNEUMOCOCCUS TYPE II PNEUMONIA
Authors: MAXWELL FINLAND
Journal: JAMA (1933)

The clinical entity   is gradually coming to be recognized as comprising a group of specific infectious diseases.1This is due primarily to the interest aroused by the serologic classification of the pneumococci and the elaboration of specific therapeutic serums against two of the most frequent of these types, namely, types I and II.  The beneficial effects of specific antipneumococcic serum in the treatment of pneumonia due to the type I pneumococcus have been repeatedly demonstrated. In pneumonia due to this type, the death rate has been reduced by one half,2and rapid symptomatic improvement has been observed3in cases treated early in the disease.  The type II pneumococcus occupies an important place in the etiology of lobar pneumonia. It causes between 134and 235per cent of all pneumococcic pneumonias with a mortality, in non-serum treated cases, of from 302bto 46
Abstract 1153: Stromal FoxM1 and p53 in lung cancer as mediators of tumor progression, metastatic spread and chemo-resistance
Authors: Iris Kamer, Inbal Daniel, Gili Perry, Amir Onn, Jair Bar
Journal: Cancer Research (2014)

Abstract Introduction: Insight into the processes of tumor initiation and progression as well as metastatic spread and response to therapies requires studies that take into consideration the stromal and epithelial components of tumors. Both FoxM1 and p53 have a major role in the progression, metastasis and chemo-resistance of non-small cell lung cancer (NSCLC). p53 is a well-recognized tumor-suppressor gene, commonly mutated in NSCLC and correlated with tumor aggressiveness. An anti-tumor role of p53 in the stroma has been demonstrated by us and others. p53 is reported to suppress FoxM1 transcription. FoxM1 is an oncogene, contributing to lung cancer progression and metastatic spread. Little is known about the role of FoxM1 in cancer's micro-environment. We hypothesized that tumor-induced-downregulation of p53 and upregulation of FoxM1 in the stromal compartments promotes lung cancer progression, metastatic spread and chemo-resistance. Materials and Methods: Cancer associated fibroblasts (CAFs) and normal fibroblasts (NFs) were produced from fresh lung tumor specimens. Cell lines and primary cells were grown in standard tissue culture conditions. Co-cultures were performed using transwell culture systems. DNA damage was induced by cisplatin treatment. Expression levels of mRNA and proteins were tested by real-time RT-PCR and western blots. Results: We have found FoxM1 levels to be higher in primary lung CAFs compared to NFs. In addition, CAFs that were treated with conditioned media of transformed epithelial cells showed down-regulation of stromal-p53 and up-regulation of FoxM1, in DNA damage conditions. mRNA levels of FoxM1 remain stable. While cancer-cells-CM up-regulate FoxM1 in CAFs, it was found to down-regulates it in NFs, suggesting both cancer and CAFs have evolved a unique mechanism of FoxM1 induction in stroma. In order to examine a possible paracrine effect between p53 levels in the stroma, and FoxM1 levels in tumor cells, we co-cultivated fibroblasts knocked-down for p53 with lung cancer cells and found up-regulation of FoxM1 the tumor cells. Summary: We demonstrate up-regulation of stromal FoxM1 by cancer-secreted-factors as well as by stable CAFs modifications, concomitantly to stromal p53 down-regulation. High stromal FoxM1 may promote tumor cells aggressiveness, similarly to low stromal p53, possibly being downstream to p53. Elaboration of these pathways will deepen our understanding of lung cancer and suggest novel therapeutic targets. Citation Format: Iris Kamer, Inbal Daniel, Gili Perry, Amir Onn, Jair Bar. Stromal FoxM1 and p53 in lung cancer as mediators of tumor progression, metastatic spread and chemo-resistance. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1153. doi:10.1158/1538-7445.AM2014-1153
Comparison of two consecutive fat-rich and carbohydrate-rich meals on postprandial myeloperoxidase response in women with and without type 2 diabetes mellitus
Authors: Roger K. Schindhelm, Marjan Alssema, Michaela Diamant, Tom Teerlink, Jacqueline M. Dekker, Astrid Kok, Piet J. Kostense, Giel Nijpels, Robert J. Heine, Peter G. Scheffer
Journal: Metabolism (2008)
Therapeutic use of granulocyte-colony stimulating factor could conceal residual malignant cells in patients with AML1/ETO+ acute myelogenous leukemia
Authors: H W Moon, S Shin, H Y Kim, Y R Kim, H I Cho, S S Yoon, S Park, B K Kim, H Chun, H C Kim, C J Park, Y H Min, D S Lee
Journal: Leukemia (2006)
Using evidence to inform health policy: case study
Authors: S. Macintyre
Journal: BMJ (2001)

Although telephone consultations are widely used in the delivery of healthcare, they are vulnerable to breaches of patient confidentiality. Current guidelines on telephone consultations do not address adequately the issue of confidentiality. In this paper, we propose a solution to the problem: a password system to control access to patient information. Authorised persons will be offered the option of selecting a password which they will use to validate their request for information over the telephone. This simple yet stringent method of access control should improve security while allowing the continuing evolution of telephone consultations.
P900 LIVER TRANSPLANTATION FOR ALCOHOLIC CIRRHOSIS WITH RESPECT TO ALCOHOL RELAPSE AND LONG-TERM OUTCOME
Authors: G.A. Berlakovich, D. Kollmann, S. Rasoul-Rockenschaub, E. Freundorfer, G. Gyoeri, G. Silberhumer, F. Muehlbacher, T. Soliman
Journal: Journal of Hepatology (2014)
Preexisting human antibodies neutralize recently emerged H7N9 influenza strains
Authors: Carole J. Henry Dunand, Paul E. Leon, Kaval Kaur, Gene S. Tan, Nai-Ying Zheng, Sarah Andrews, Min Huang, Xinyan Qu, Yunping Huang, Marlene Salgado-Ferrer, Irvin Y. Ho, William Taylor, Rong Hai, Jens Wrammert, Rafi Ahmed, Adolfo García-Sastre, Peter Palese, Florian Krammer, Patrick C. Wilson
Journal: Journal of Clinical Investigation (2015)

The emergence and seasonal persistence of pathogenic H7N9 influenza viruses in China have raised concerns about the pandemic potential of this strain, which, if realized, would have a substantial effect on global health and economies. H7N9 viruses are able to bind to human sialic acid receptors and are also able to develop resistance to neuraminidase inhibitors without a loss in fitness. It is not clear whether prior exposure to circulating human influenza viruses or influenza vaccination confers immunity to H7N9 strains. Here, we demonstrate that 3 of 83 H3 HA-reactive monoclonal antibodies generated by individuals that had previously undergone influenza A virus vaccination were able to neutralize H7N9 viruses and protect mice against homologous challenge. The H7N9-neutralizing antibodies bound to the HA stalk domain but exhibited a difference in their breadth of reactivity to different H7 influenza subtypes. Mapping viral escape mutations suggested that these antibodies bind at least two different epitopes on the stalk region. Together, these results indicate that these broadly neutralizing antibodies may contribute to the development of therapies against H7N9 strains and may also be effective against pathogenic H7 strains that emerge in the future.
An Early Human Seminoma
Authors: Raymond G. Bunge
Journal: JAMA (1965)

EARLY SEMINOMA of the human testis is seldom detected in the living patient, although routine section of testes removed for other purposes in the younger age group might well result in their detection. For biopsy material, randomly selected for infertility study, to contain a microscopic malignancy is a very rare phenomenon. Indeed, to encounter the same patient months later, with a grossly palpable testicular cancer whose cytology is identical with that in the biopsy, borders on the mystical. This case report precisely demonstrates this chain of events.  Report of a Case  A 27-year-old white man was first seen in February 1962 for fertility-potential evaluation. He had been married for 20 months and no children had been born. There was nothing in the history to suggest noxious agents, trauma, or delayed descent of the testes which might have contributed to his infertility. Erection, ejaculation, and intercourse were entirely satisfactory.  A physical
A delivery system to avoid self-aggregation and to improve in vitro and in vivo skin delivery of a phthalocyanine derivative used in the photodynamic therapy
Authors: Fábia Cristina Rossetti, Luciana Biagini Lopes, Aline Regina H. Carollo, José A. Thomazini, Antônio Cláudio Tedesco, Maria Vitória Lopes Badra Bentley
Journal: Journal of Controlled Release (2011)