tbuckley/cabot-search huggingface dataset:
Evaluation of Two Different Educational Interventions for Adult Patients Consulting with an Acute Asthma Exacerbation
Authors: JOHANNE CÔTÉ, DENNIS M. BOWIE, PATRICIA ROBICHAUD, JEAN-GUY PARENT, LIVIA BATTISTI, LOUIS-PHILIPPE BOULET
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Asthma education decreases the number of emergency visits in specific subgroups of patients with asthma. However, it remains unknown whether this improvement is related only to the use of an action plan alone or to other components of the educational intervention. A total of 126 patients consulting urgently for an acute asthma exacerbation were recruited; 98 completed the study. The first 45 patients were assigned to Group C (control; usual treatment). Thereafter, patients were randomized to either Group LE (limited education; teaching of the inhaler technique plus self- action plan given by the on call physician) or Group SE (same as group LE plus a structured educational program emphasizing self-capacity to manage asthma exacerbations). At baseline, there was no difference between groups in asthma morbidity, medication needs, or pulmonary function. After 12 mo, only Group SE showed a significant improvement in knowledge, willingness to adjust medications, quality of life scores, and peak expiratory flows. In the last 6 mo, the number of unscheduled medical visits for asthma was significantly lower in Group SE in comparison with groups C and LE (p = 0.03). The number (%) of patients with unscheduled medical visits also decreased significantly in Group SE compared with Groups C and LE (p = 0.02). We conclude that a structured educational intervention emphasizing self-management improves patient outcomes significantly more than a limited intervention or conventional treatment.
Another media scare about MMR vaccine hits Britain
Authors: P. Anderson
Journal: BMJ (1999)

“Researchers deal new blow to vaccination” and “London study links children's vaccine to serious disease” proclaimed Britain's newspapers last week.

This latest media scare about the measles, mumps, and rubella (MMR) vaccine has left UK doctors fighting a rearguard action to try to minimise damage to vaccine uptake rates, already compromised by previous scares. The research on which the media reports were based linked paramyxovirus infection in childhood with subsequent inflammatory bowel disease (Gastroenterology 1999;116:796-803).

Scott Montgomery and colleagues from the Royal Free and University College Medical School in London analysed data from 7019 members of a nationally representative British cohort born in 1970. They identified subjects with inflammatory bowel disease and looked at the pattern of childhood infections recorded before the onset of the condition. They found that measles and mumps infections occurring together in the same year of life were significantly associated with ulcerative colitis and Crohn's disease, with odds ratios of 7.47 (95%confidence interval 2.42 to 23.06) and 4.27 (1.24 to 14.46) respectively, but not with insulin dependent diabetes mellitus, which they studied as a control disease. They concluded that atypical paramyxovirus infections in childhood may be risk factors for later development of inflammatory bowel disease.

Some sections of the UK media leapt on the new research …
External Fixation in Orthopedics
Authors: Joseph J. Gugenheim, Jr
Journal: JAMA (2004)

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
Managed Care Ethics
Authors: Michael R. Moore
Journal: Annals of Internal Medicine (1998)

Letters15 October 1998Managed Care EthicsMichael R. Moore, MDMichael R. Moore, MDWillis-Knighton Medical Center; Shreveport, LA 71103Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-8-199810150-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A lawyer and a physician propose a set of compromises designed to address “the realities” of medical practice under managed care [1]. Although these are couched in terms of pro-patient ethics, hidden among the authors' disclaimers is a compromise so pernicious as to pervert their entire premise (as well as our profession if we accept it). The authors propose to replace the principle of devotion to the individual under our care with the best interests of the “group” of patients under our care. This distinction may be casual to the authors, but dedication to an individual patient ...References1. Hall MA, Berenson RA. Ethical practice in managed care: a dose of realism. Ann Intern Med. 1998; 128:395-402. Google Scholar Author, Article, and Disclosure InformationAffiliations: Willis-Knighton Medical Center; Shreveport, LA 71103 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 October 1998Volume 129, Issue 8Page: 673KeywordsPatient advocacyPatients Issue Published: 15 October 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
P3-18-01: cMET Inhibitor and the Inhibition of Growth of Breast Cancer Cells in Bone Marrow Matrix Environment.
Authors: L Ye, MD Mason, P Bramble, WG Jiang
Journal: Cancer Research (2011)

Abstract Background: Hepatocyte growth factor (HGF) is a cytokine that has a diverse but potential role in cancer including breast cancer. HGF, which action is mediated by its specific receptor, cMET, stimulate the aggressiveness of cancer cells by increasing the invasiveness and cellular migration. HGF is also a potent angiogenic factor. Small inhibitors to the HGF receptor are currently investigated in clinical trials of various cancers. In solid tumours which have potency of bone metastasis, HGF and particularly the HGF receptor, cMET, have been found to be particularly over-expressed in tumour cells metastasised to bones. Materials and methods. A panel of breast cancer cell lines were used. Cell growth was determined using a colorimetic method. Cell adhesion and migration were investigated using a ECIS model. Bone matrix proteins were prepared from fresh bones. A small inhibitor to human cMET, PF02341066 was used in the present study in all the cell models. Results. Depending on cell types, cancer cells tended to grow at a faster rate in bone marrow microenvironment than under normal conditions (12% higher for MDA MB 231 cells, for example). While PF02341066 have a concentration dependent effect on the growth of breast cancer, this effect became more marked when cells were growing in the bone marrow matrix. Breast cancer cells migrated rapidly in the presence of bone marrow environment, in comparison with controls. This was also inhibited by the cMET inhibitor. The study further showed that cells over-expressing a molecule linked to bone metastasis, namely ALCAM (1,2), responded more vigorously to cMET inhibitor in the matrix adhesion and cellular migration. Conclusions. The present study has shown that the HGF receptor inhibitor has an inhibitory effect on breast cancer cells. This is particularly so when cells are grown in bone matrix microenvironment. It is concluded therefore that inhibitors to the HGF receptor may have a particular role in the management of bone metastasis in breast cancer. References: 1. Davies S, Jiang WG. ALCAM, activated leukocyte cell adhesion molecule, influences the aggressive nature of breast cancer cells, a potential connection to bone metastasis. Anticancer Res. 2010, 30(4):1163–8; 2. King JA, et al. Activated leukocyte cell adhesion molecule in breast cancer: prognostic indicator. Breast Cancer Res. 2004;6(5):R478–87 Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-18-01.
Book: Regulating How We Die: The Ethical, Medical and Legal Issues Surrounding Physician-Assisted Suicide
Authors: A. R. King
Journal: BMJ (1998)

Ed Linda L Emanuel Harvard University Press, 11$.95, pp 315 ISBN 0 674 66654 2 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>![Graphic][4]</img> All physicians are confronted with dying, which is difficult emotionally when dealing with patients and their relatives, and professionally when the question of “helping” a patient to die is raised. Associations that come to mind are compassion, alleviation of pain, autonomy, dying with dignity, and withdrawing treatment—but, above all else, “Do no harm.” These terms conjure up intense emotions, opinions, expectations, and, for some, memories. As the book notes, “Physician-assisted suicide and euthanasia may appear to be a hot new topic. But … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif
Principles of Chest X-ray Diagnosis
Authors: Marvin L. Daves
Journal: JAMA (1971)

The introduction to the text is, appropriately, a glossary and serves to illustrate that Americans are not alone in their struggle with the English language. Just as one becomes accustomed to the iambic pentameter at a Shakespearean play, one soon feels at home with such incongruities as "high-density shadows" vs "hypertransradiancies" and the text becomes very readable. Too many radiologists today are obsessed with separating pulmonary diseases into alveolar and interstitial categories. Dr. Simon's basic approach is to answer the tyro's question, "what is that shadow on the film?" This approach precludes any systemic discussion of disease entities. "Bilateral Homogeneous Opacity Occupying Only the Major Part of the Lungs" and "Large Homogeneous Shadows Occupying Only a Part of One Side" are illustrative section headings. The author is best when correlating pulmonary shadow with the underlying anatomy and pathology. (An exception is his tendency to perpetuate the myth that Kerley lines
Tumor angiogenesis correlates with histologic type and metastasis in non-small-cell lung cancer.
Authors: A Yuan, P C Yang, C J Yu, Y C Lee, Y T Yao, C L Chen, L N Lee, S H Kuo, K T Luh
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

This study investigated the clinico-pathologic correlation of tumor angiogenesis in non-small-cell lung cancers. Formalin-fixed, paraffin-embedded surgical specimens of 55 consecutive patients with primary non-small-cell lung cancers were examined. Included were 26 squamous cell carcinomas and 29 adenocarcinomas. Twenty-five patients had stage I disease, eight patients had stage II disease, and 22 patients had stage IIIA or IIIB disease. Among them, 28 had nodal metastasis and 27 did not. The microvessel was demonstrated by immunocytochemical staining for factor VIII and platelet endothelial cell adhesion molecules (PECAM-1). The microvessels in the areas of highest neovascularization were counted under light microscopy in 200x field by two independent observers without knowledge of clinical information. At least three separate fields were counted for each specimen. The Mann-Whitney U test was used for statistical analysis. The microvessel counts in adenocarcinoma were significantly higher than in the squamous cell carcinoma (54.4 +/- 35.65 versus 26.16 +/- 20.46 in factor VIII staining and 80.52 +/- 48.42 versus 40.04 +/- 32.33 in PECAM-1 staining; p < 0.001). The microvessel counts in patients with Stages I-II disease were significantly lower than that of stages IIIA-IIIB disease (23.63 +/- 16.21 versus 65.36 +/- 31.92 in factor VIII staining and 41.85 +/- 36.76 versus 93.00 +/- 43.08 in PECAM-1; p < 0.001). Patients with nodal metastasis had higher microvessel density than those without nodal metastasis (56.67 +/- 35.55 versus 23.44 +/- 15.77 in factor VIII staining and 86.89 +/- 46.46 versus 36.30 +/- 25.83 in PECAM-1 staining; p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Expanding Psychiatric Service in a Hospital Emergency Room
Authors: Wayne S. Barry, Fereidoon Kharabi, Gary Nyman, Chester W. Schmidt
Journal: JAMA (1979)

Senior medical residents were used to extend psychiatric coverage in a busy hospital emergency room. Their service was supported by the backup consultation of senior psychiatric physicians. The medical residents worked in conjunction with psychiatric residents to provide 24-hour daily emergency psychiatric service to more than 350 patients during a 12-month period. There were no significant differences in the demographic composition of the patient population seen or in the disposition of individual patients made between the medical and psychiatric residents. The hospital was able to expand its psychiatric service in the emergency room without major increases in cost. The medical residents benefited by experiencing a more diversified patient care training program, and they earned a modest supplement to their houser officer salary.
Monoamine Transporter Gene Polymorphisms and Antidepressant Response in Koreans With Late-Life Depression
Authors: Hyeran Kim, Shinn-Won Lim, Seonwoo Kim, Jong-Won Kim, Yun Hee Chang, Bernard J. Carroll, Doh Kwan Kim
Journal: JAMA (2006)

Polymorphisms in the serotonin transporter gene (5-HTT) may influence antidepressant response to selective serotonin reuptake inhibitors (SSRIs). The norepinephrine transporter (NET) is the analogous target for norepinephrine reuptake inhibitors (NRIs).To determine whether antidepressant responses to SSRIs or NRIs are associated with genetic polymorphisms of the corresponding monoamine transporters.A 6-week naturalistic treatment study with blinded outcome evaluation of 241 Korean inpatients and outpatients with major depression at an academic psychiatry service. Patients were recruited to the study from March 1998 through February 2003.Treatment with an SSRI (fluoxetine or sertraline; n = 136) or an NRI (nortriptyline; n = 105) antidepressant. Adherence was assessed by measuring plasma concentration at 4 weeks. Patients were genotyped for s/l polymorphisms in 5-HTT promoter region (5-HTTLPR), 5-HTT intron 2 s/l variation, and NET G1287A variation of exon 9.An SSRI and NRI response (defined as > or =50% decrease in Hamilton Rating Scale for Depression score at 6 weeks).NRI response was associated with the NET G1287A polymorphism (odds ratio [OR], 7.54; 95% confidence interval [CI], 2.53-22.49; P<.001). An SSRI response was associated with the 5-HTT intron 2 s/l variation (OR, 20.11; 95% CI, 4.27-94.74; P<.001). The 5-HTTLPR was also associated with an SSRI response (OR, 3.34; 95% CI, 1.41-7.91; P = .006). In contrast to studies in white patients, the favorable allele for SSRI response was S 5-HTTLPR. The S 5-HTTLPR was associated also with NRI response (OR, 3.73; 95% CI, 1.32-10.53; P = .01). The NET polymorphism was not associated with an SSRI response. The NET G1287A GG genotype (56% of the population) was associated with better response to the NRI (83.3% [35/42]) than to SSRI (58.7% [44/75]) (OR, 3.52; 95% CI, 1.39-8.95; P = .006). Some genotype combinations were associated with high rates of antidepressant response and others with low rates of response.Monoamine transporter gene polymorphisms were associated with response to antidepressants with homologous monoamine transporter targets. Combinations of polymorphisms were informative for response and nonresponse. Confirmation of these preliminary findings would permit refined pharmacogenetic selection of antidepressant treatment.
The Placebo Effect-Reply
Authors: Michael S. Kramer
Journal: JAMA (1985)

<h3>In Reply.—</h3> We are in complete agreement with Dr Baughan's two points about the role of placebo effects in randomized trials. In our discussion of blinding and unblinding, however, we were concerned not with the etiology of placebo effects in general, but rather with the uncontrolled placebo effect that can arise when the subject or his physician becomes aware of (ie, is unblinded to) the treatment received. Placebos are used in clinical trials to control for placebo effects. If unblinding occurs, eg, through differential side effects of the active and placebo treatments, the placebo effect will no longer be adequately controlled. Dr Baughan's suggestion about description of the results of placebocontrolled trials is a strategy we recommend for attempting to assess bias due to unblinding. However, we do not advocate this strategy for the primary analysis of the trial's results, which "should be based on a comparison of the groups
Temporary Skin Transplantation and Immunosuppression for Extensive Burns
Authors: John F. Burke, James W. May, N. Albright, W. C. Quinby, P. S. Russell
Journal: New England Journal of Medicine (1974)

CHILDREN with full-thickness burns of over 70 per cent of the body surface whose total burn injury covers over 80 per cent do not ordinarily survive despite the use of temporary skin substitutes and topical antibacterial therapy.1 , 2 This lack of success is related to the short time that available skin substitutes last as an effective physiologic cover. Viable allografts of skin, if obtained from random donors, are rejected in about 14 days,3 and, in our experience, even if obtained from a parent and selected by tissue type matching of at least two genotypes, will seldom last over 20 days in . . .
Increased Mortality Associated With Low Use of Clopidogrel in Patients With Heart Failure and Acute Myocardial Infarction Not Undergoing Percutaneous Coronary Intervention
Authors: Lisbeth Bonde, Rikke Sorensen, Emil Loldrup Fosbøl, Steen Zabell Abildstrøm, Peter Riis Hansen, Lars Kober, Tina Ken Schramm, Ditte-Marie Bretler, Peter Weeke, Jonas Olesen, Christian Torp-Pedersen, Gunnar Hilmar Gislason
Journal: Journal of the American College of Cardiology (2010)
THE USE OF THE TURKISH BATH IN INEBRIETY.Read before the American Association for the Study and Cure of Inebriety, New York, April 15, 1890.
Authors: CHAS. H. SHEPARD
Journal: JAMA (1892)

The etiology and philosophy of inebriety have been presented very thoroughly in previous papers read before this Association, and I am now accorded the privilege of bringing to your notice a new method of treatment for that condition. It is with pleasure that we note many of the former theories held on this subject giving place to more modern ideas. Common opinion considered inebriety a vice, needing only moral treatment, while to-day it is demonstrated to be a disease, and the world is waiting to honor him who first discovers its microbe. It was not until such ever-to-be-honored men as Dr. Turner, Dr. Parrish, Dr. Mason, and a few others, made plain to the community the true standing of the inebriate, and showed that this disease was one to be treated on the same general principles as other diseases, that a right appreciation of such cases was obtained. These men
Misdiagnosis in patients with diclofenac-induced hemolysis: new cases and a concise review
Authors: Norbert Ahrens, Ramona Genth, Holger Kiesewetter, Abdulgabar Salama
Journal: American Journal of Hematology (2006)

Diclofenac has been implicated in many cases of life-threatening immune hemolytic anemia (IHA). Nevertheless, confusion still occurs at the bedside and in the laboratory. Herein we report nine new patients and summarize all published cases (total, n = 61). Direct and indirect antiglobulin tests were performed according to standard procedures. Tests for drug-dependent antibodies were performed in the presence and absence of the target drugs and their ex vivo antigens (in the urine of patients treated with the drug). Diclofenac- and/or ex-vivo-antigen-dependent red cell antibodies were detected in all new cases. We identified nine new cases with diclofenac-dependent IHA. All cases were initially suspected to have an abdominal illness and/or autoimmune hemolytic anemia of warm type. Acute renal failure was present in three of the 9 new patients and in 20 of 37 published patients. Seven of the 46 patients died (15%), and clinical information is lacking in 15 other published cases. Diclofenac-dependent and/or ex-vivo-antigen-dependent IHA should always be considered when a patient on diclofenac develops acute renal failure and/or IHA.
Creationists accuse biology professor of discrimination
Authors: S. Gottlieb
Journal: BMJ (2003)

An American biology professor who refuses to write letters of recommendation for his students if they don't believe in evolution is being accused of religious discrimination.

The Liberty Legal Institute, a religious freedom group, has filed a legal complaint against Professor Michael Dini of Texas Tech University on behalf of one of Professor Dini's former students. It describes the professor's policy as “open religious bigotry.”

“Students are being denied recommendations not because of their competence in understanding evolution, but solely because of their personal religious beliefs,” said Kelly Shackelford, chief counsel …
Uncommon Haemophilus infections.
Authors: R G Finch
Journal: BMJ (1984)

in which the incidence of the effect would be measured so that a careful benefit-risk assessment could be formed, taking account of information on other similar drugs.Resources giving rapid and accurate assessments on these lines would allow better decisions about products by both companies and regulatory authorities.Perhaps the most important conclusion of the Minster Lovell seminar was that an automated national data base linking prescriptions filled with hospital diagnoses in Britain would be extremely valuable in allowing the rapid study of drug effects and providing quantitative data.This would lessen public anxiety and restore much needed confidence.The Prescription Pricing Authority and the National Health Service -hospital system provide an opportunity for such a system of drug surveillance based on computerised linkage of prescriptions with hospital diagnoses.A start has been made in the Dundee record linkage study3 and the cimetidine postmarketing surveillance study.4Confidentiality should not be allowed to be an insuperable problem, and the Minster Lovell seminar also concluded that technical and organisational barriers could be overcome-provided that enough individuals were encouraged to make a commitment to research in pharmacoepidemiology.