tbuckley/cabot-search huggingface dataset:
Coming to Terms with Large Databases
Authors: Christine Laine
Journal: Annals of Internal Medicine (1998)

Letters1 May 1998Coming to Terms with Large DatabasesChristine Laine, MD, Deputy EditorChristine Laine, MD, Deputy EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-9-199805010-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:It is unfortunate that Dr. Romano believes that third parties will use information in the Annals supplement to hurt patients and their physicians. Our intent in publishing this supplement was to begin to educate internists about the potential benefits and risks of using large latabases to evaluate health care. Dr. Romano fears that managed care organizations, the federal government, and administrators use such data to justify withholding funds for patient care, and they sometimes do. However, research done by using large databases often supports the directing of resources toward certain clinical activities. One such example is given in ...References1. McCarthy EP, Burns RB, Coughlin SS, Freund KM, Rice J, Marwill SL, et al. Mammography use helps to explain differences in breast cancer stage at diagnosis between older black and white women. Ann Intern Med. 1997; 128:729-36. Google Scholar Author, Article, and Disclosure InformationAuthors: Christine Laine, MD, Deputy EditorAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1998Volume 128, Issue 9Page: 781KeywordsBreast cancerDatabasesFearHealth careMammographyPatients ePublished: 15 August 2000 Issue Published: 1 May 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Banning the Handshake From the Health Care Setting
Authors: Mark Sklansky, Nikhil Nadkarni, Lynn Ramirez-Avila
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
Abstract 200: Methylation of GATA4 and GATA5 transcription factor genes in gastric cancers
Authors: Yoshimitsu Akiyama, Hiromi Nagasali, Ayako Kawamoto, James G. Herman, Stephen B. Baylin, Yasuhito Yuasa
Journal: Cancer Research (2010)

Abstract GATA factors comprise a small family of transcription regulatory proteins containing two conserved zinc finger DNA binding domains for the consensus sequence (WGATAR). Among the six GATA factors, GATA-1/2/3 factors are prominently expressed in the hematopoietic cell lineage, while GATA-4/5/6 factors show a partly overlapping expression pattern in the heart and endoderm-derived organs. We previously reported that GATA4 and GATA5 were silenced by their promoter hypermethylation in gastrointestinal, lung and ovarian cancers. However, it remains unknown the mechanism underlying loss of GATA transcription factors in gastric carcinogenesis. To clarify the role of GATA, we examined GATA4/5 methylation and their downstream target genes in gastric cancer (GC). By using methylation specific PCR, the methylation frequency of GATA5 (30, 39%) was significantly higher than that of GATA4 (10, 13%) in 77 GC tissues (P&amp;lt;0.01). However, methylation of GATA6 was not observed in GCs examined. We transiently over-expressed GATA4 or GATA5 in GC cell lines lacking their expression by aberrant methylation. Both GATA4 and GATA5 suppressed colony formation and cell proliferation in MKN74 cells. After GATA4/5 over-expression in MKN74 and KATO-III cells, enhanced expression of numerous genes including ones indicating tumor-suppressive functions, such as TFF1, disabled-2 and IQGAP2, was observed by microarray and RT-PCR analyses. The target genes of GATA4 and GATA5 were closely similar in MKN74 cells. We also preformed siRNA transfection of GATA4 and GATA5 in AGS and HSC43 cells which basally expressed them. Reduced expression of above predicted GATA target genes was detected in these two cell lines after siRNA transfection. These data suggest that loss of GATA4 and GATA5 expression may contribute to gastric carcinogenesis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 200.
Surgery for Acquired Valvular Heart Disease
Authors: John W. Kirklin, Albert D. Pacifico
Journal: New England Journal of Medicine (1973)

THE value to the patient of valve repair or replacement is determined by the resulting improvement in length and quality of life over that imposed by the natural history of the disease. The length and quality of life are determined by the initial hospital mortality rate, the hemodynamic function of the repaired valve or substituting device, adverse effects of the repaired valve or device (thromboembolism, infection, hemolysis, need for special therapy such as anticoagulants, or mechanical interference with cardiac performance), and the regression, persistence, or progression after operation of the abnormalities of cardiac structure and function that resulted originally from . . .
Inhibitory effect of the mi transcription factor encoded by the mutant mi allele on GA binding protein–mediated transcript expression in mouse mast cells
Authors: Eiichi Morii, Hideki Ogihara, Keisuke Oboki, Chika Sawa, Takahiko Sakuma, Shintaro Nomura, Jeffrey D. Esko, Hiroshi Handa, Yukihiko Kitamura
Journal: Blood (2001)
Mortality and Hospital Stay Associated with Resistant Staphylococcus aureus and Escherichia coli Bacteremia: Estimating the Burden of Antibiotic Resistance in Europe
Authors: Marlieke E. A. de Kraker, Peter G. Davey, Hajo Grundmann
Journal: PLoS Medicine (2011)

Background The relative importance of human diseases is conventionally assessed by cause-specific mortality, morbidity, and economic impact. Current estimates for infections caused by antibiotic-resistant bacteria are not sufficiently supported by quantitative empirical data. This study determined the excess number of deaths, bed-days, and hospital costs associated with blood stream infections (BSIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) and third-generation cephalosporin-resistant Escherichia coli (G3CREC) in 31 countries that participated in the European Antimicrobial Resistance Surveillance System (EARSS). Methods and Findings The number of BSIs caused by MRSA and G3CREC was extrapolated from EARSS prevalence data and national health care statistics. Prospective cohort studies, carried out in hospitals participating in EARSS in 2007, provided the parameters for estimating the excess 30-d mortality and hospital stay associated with BSIs caused by either MRSA or G3CREC. Hospital expenditure was derived from a publicly available cost model. Trends established by EARSS were used to determine the trajectories for MRSA and G3CREC prevalence until 2015. In 2007, 27,711 episodes of MRSA BSIs were associated with 5,503 excess deaths and 255,683 excess hospital days in the participating countries, whereas 15,183 episodes of G3CREC BSIs were associated with 2,712 excess deaths and 120,065 extra hospital days. The total costs attributable to excess hospital stays for MRSA and G3CREC BSIs were 44.0 and 18.1 million Euros (63.1 and 29.7 million international dollars), respectively. Based on prevailing trends, the number of BSIs caused by G3CREC is likely to rapidly increase, outnumbering the number of MRSA BSIs in the near future. Conclusions Excess mortality associated with BSIs caused by MRSA and G3CREC is significant, and the prolongation of hospital stay imposes a considerable burden on health care systems. A foreseeable shift in the burden of antibiotic resistance from Gram-positive to Gram-negative infections will exacerbate this situation and is reason for concern. Please see later in the article for the Editors' Summary
AIDS, associated disorders pose complex therapeutic challenges
Authors: Helene Cole
Journal: JAMA (1984)

Very T ery little optimism emerged from a panel discussion entitled "AIDS [acquired immunodeficiency syndrome] Therapeutic Trials and Alternative Treatments" at the recent annual meeting of the American Association of Physicians for Human Rights, held in Chicago. Panel members Paul Volberding, MD; Stephen Follansbee, MD; and Donald Abrams, MD, agreed that the usual therapeutic approaches to malignancy, infection, and associated manifestations of the syndrome (such as immune thrombocytopenic purpura [ITP]) may not be optimum in the setting of AIDS. "AIDS is not a disease to approach in the traditional way," said Volberding. In discussing his approach to patients with Kaposi's sarcoma, Volberding (who is codirector of the Kaposi's sarcoma clinic at the University of California, San Francisco) emphasized that Kaposi's in the setting of AIDS does not appear to be the same disease as that seen in the original cases occurring in elderly men of Ashkenazi Jewish and Mediterranean ancestry
Hepatic expression of intercellular adhesion molecule-1 (ICAM-1) in viral hepatitis B
Authors: Riccardo Volpes, Joost J. van den Oord, Valeer J. Desmet
Journal: Hepatology (1990)

The in situ distribution patterns of intercellular adhesion molecule–1 and human leukocyte antigen–DR antigens were studied in serial sections of 61 liver biopsy specimens from patients with hepatitis B virus infection using immunohistochemical techniques. In addition, the topographical relationship between the display of HBcAg on one hand and the expression of intercellular adhesion molecule–1 by hepatocytes on the other was analyzed with a double–staining immunohistochemical procedure in 14 selected liver biopsy samples showing chronic persistent or chronic active hepatitis and signs of active hepatitis B virus replication as reflected by the presence of variable amounts of HBcAg in a nuclear or cytoplasmic pattern of immunoreactivity. Coexpression of intercellular adhesion molecule–1 and human leukocyte antigen–DR antigens by hepatocytes correlated positively with the site and extent of the inflammatory infiltrate, which was composed of lymphocytes expressing lymphocyte function-associated antigen–1. In healthy HBsAg–positive carriers without inflammatory liver disease, no intercellular adhesion molecule–1 or human leukocyte antigen–DR expression was found on hepatocytes; in acute hepatitis, intercellular adhesion molecule–1 and human leukocyte antigen–DR were strongly expressed throughout the liver parenchyma on liver cell membranes and on sinusoidal lining cells. In chronic persistent and chronic active hepatitis and in active cirrhosis, intercellular adhesion molecule–1 and human leukocyte antigen–DR showed membranous positivity on focal clusters of hepatocytes in areas of periportal or intraacinar inflammation. Double–staining for HBcAg and intercellular adhesion molecule–1 revealed variable numbers of HBcAg–positive hepatocytes expressing intercellular adhesion molecule–1 on their cell membranes; these cells may represent the “cytotoxic” model, in which cell–cell interactions between lymphocyte function-associated antigen–1-positive lymphocytes and hepatitis B virus-infected hepatocytes are facilitated. Furthermore, intercellular adhesion molecule–1-positive hepatocytes lacking HBcAg were found in areas of inflammation, indicating that the virus itself does not directly trigger intercellular adhesion molecule–1 expression. These intercellular adhesion molecule–1-positive, HBcAg–negative liver cells might “guide” lymphocytes through the parenchyma toward virally infected target cells. Finally, in many cases, variable numbers of HBcAg–positive liver cells lacked membranous intercellular adhesion molecule–1 expression; these cells may represent the “tolerogenic” model, in which incomplete clearance of virally infected hepatocytes adds to the chronic nature of hepatitis B virus infection. (Hepatology 1990;12:148-154).
Generalised allergy to porcine and bovine monocomponent insulins.
Authors: J M Goldman, H C Brynildsen
Journal: BMJ (1980)

One explanation of these anomalies is that talc may be acting as a particulate adjuvant, promoting cell-mediated hypersensitivity reactions to polysaccharide antigens of starch in susceptible individuals.For these reasons we would support efforts to eliminate talc, which although not directly pathogenic in low con- centration, may facilitate cell-mediated re- action to other agents on the surface of surgical gloves.
Ileostomy or ileorectal anastomosis for ulcerative colitis.
Authors: D G Jagelman
Journal: BMJ (1978)

Cerebral blood flow in diabetes mellitus SIR,-Dr P Dandona and his colleagues (29 July, p 325) appear to conclude from their most interesting demonstration of altered reactivity of the cerebral vasculature to CO2 in diabetics that these patients have an "inability to compensate with increased cerebral blood flow when metabolic requirements of the brain demand this."Such a conclusion is almost certainly not justified.Although CO2 has been suspected as a factor in the mechanism which couples blood flow to metabolism in the brain since Roy and Sherrington's classic study,' no direct evidence exists for this supposition and recent evidence is against it.2Failure to react to one specific stimulus can surely not be taken as evidence of an impaired ability of cerebral vessels to dilate under any circumstances.They may yet respond to the factors, as yet unidentified, which do couple blood flow to metabolism in the brain.
Is the NHS getting better or worse?: Just who gets to choose which data will matter?
Authors: P. Davies
Journal: BMJ (2004)

EDITOR—Smith's editorial asks an important question about whether the NHS is getting better.1 He places a lot of faith in gathering better data about the workings of the NHS to help us answer this question.

However, this approach begs the question of “what would the appropriate data be?” And behind that is the intensely political …
Recurrent lobar atelectasis in a child with cystic fibrosis
Authors: Prasad Nagakumar, Tom Hilliard
Journal: Journal of the Royal Society of Medicine (2012)

Cystic fibrosis pulmonary exacerbations in children usually manifest with increased cough and a fall in lung function. We report a challenging case where an 8-year-old girl has had frequent prolonged exacerbations over the last 3 years needing aggressive management, associated with multi-lobar collapse.

She was born at term and presented with meconium ileus needing bowel resection and stoma formation which was reversed during first year of life. Cystic fibrosis was diagnosed on sweat testing, with a ΔF508 homozygous genotype. She has a younger brother aged 5 years, who also has cystic fibrosis. She was admitted as an infant with respiratory syncytial virus bronchiolitis at 7 months of age, requiring CPAP for few days. She was later admitted at 15 months of age with a pulmonary exacerbation, and a chest X-Ray showed left lower lobe collapse. Pseudomonas aeruginosa was isolated for the first time from bronchoalveolar lavage and she was treated with intravenous and nebulized antibiotics; she had a normal chest X-ray few weeks later. Nebulized dornase alpha (DNase) was started at 3 years of age and a gastrostomy inserted at age 6. A port-a-cath was inserted at age 7.

Over the last 3 years she has had 2 to 3 pulmonary exacerbations per year requiring prolonged hospital admissions for up to 3 weeks. During these admissions she is treated with intravenous antibiotics, intensive physiotherapy, up to 4 times per day of nebulised hypertonic saline and twice daily DNase. In 2011 she had 5 hospital admissions for pulmonary exacerbations. Pulmonary exacerbations are preceded by trivial viral upper respiratory tract infection followed a few days later by acute onset of tachypnoea, dyspnoea and profound hypoxemia (oxygen saturations of 80–82% on admission). The chest X-ray shows lobar collapse with the left lower lobe most frequently involved as well as involvement of other lobes. Our approach is to treat her with humidified high flow oxygen, intravenous antibiotics, intensive physiotherapy and at least one early therapeutic bronchoscopy to re-inflate the collapsed lobe. Bronchoscopy is usually performed on the first or second day of admission and reveals very thick tenacious mucus, which is difficult to clear. We instill DNase during the procedure, and on some occasions she has chest physiotherapy under general anesthesia. Large mucus plugs can be removed, sometimes as bronchial casts. We believe that early bronchoscopy results in clinical and radiological improvement and she can be discharged home after 2 weeks with no respiratory distress and normal oxygen saturations (Figure 1).






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Figure 1


Serial chest X-rays in a typical pulmonary exacerbation. a) X-ray on day of admission showing left, right lower & middle lobe collapse; b) X-ray 36 hr post bronchoscopy showing good inflation of right lung; c) X-ray 6 weeks later showing no lobar collapse
Bone morphogenetic protein signaling by hemojuvelin regulates hepcidin expression
Authors: Jodie L Babitt, Franklin W Huang, Diedra M Wrighting, Yin Xia, Yisrael Sidis, Tarek A Samad, Jason A Campagna, Raymond T Chung, Alan L Schneyer, Clifford J Woolf, Nancy C Andrews, Herbert Y Lin
Journal: Nature Genetics (2006)
Health-Care Workers Positive for Hepatitis B Surface Antigen
Authors: Harvey J. Alter, Thomas C. Chalmers, Bonnie M. Freeman, Janet L. Lunceford, Thomas L. Lewis, Paul V. Holland, Phillip A. Pizzo, Paul H. Plotz, Walter J. Meyer
Journal: New England Journal of Medicine (1975)

To assess the hepatitis risk to patients exposed to HBs AG-positive health-care workers, 228 contacts were followed prospectively for six to nine months. Health workers included two physicians with chronic hepatitis, a chronic asymptomatic carrier nurse, a food handler with acute HBs Ag-positive hepatitis and a physician who was HBs Ag-positive for 25 days before the onset of acute hepatitis. Controls (167) consisted of identically followed patients who had not been exposed to an HBs Ag-positive health worker. No exposed or control patient acquired clinical hepatitis or HBs Ag. Isolated elevations in serum glutamic pyruvic transaminase occurred equally in both groups and did not correlate with serologic evidence for hepatitis B infection. One exposed patient demonstrated antibody seroconversion (anti-HBs), as did two of the controls. These data do not demonstrate hepatitis B transmission from HBs Ag-positive health workers to their patients. Restriction of such carriers is not warranted at present.
Chronology of the Sodium Hypothesis and Hypertension
Authors: GEORGE A. PORTER
Journal: Annals of Internal Medicine (1983)

The observations that have provided the foundation of the sodium hypothesis of human hypertension are reviewed. Clinical observations made over 125 years ago initiated an investigative effort that has encompassed epidemiologic data, development of salt-related experimental models, and elucidation of theoretical mechanisms that interface Na+ balance with abnormal regulation of peripheral vascular resistance. In spite of the data available, a consensus is lacking on the relevance of applying the link between sodium intake and increased blood pressure in certain hypertensive patients to all persons.
Matrix Metalloproteinases As Novel Biomarker s and Potential Therapeutic Targets in Human Cancer
Authors: Roopali Roy, Jiang Yang, Marsha A. Moses
Journal: Journal of Clinical Oncology (2009)

The matrix metalloproteinase (MMP) family of enzymes is comprised of critically important extracellular matrix remodeling proteases whose activity has been implicated in a number of key normal and pathologic processes. The latter include tumor growth, progression, and metastasis as well as the dysregulated angiogenesis that is associated with these events. As a result, these proteases have come to represent important therapeutic and diagnostic targets for the treatment and detection of human cancers. In this review, we summarize the literature that establishes these enzymes as important clinical targets, discuss the complexity surrounding their choice as such, and chronicle the development strategies and outcomes of their clinical testing to date. The status of the MMP inhibitors currently in US Food and Drug Administration approved clinical trials is presented and reviewed. We also discuss the more recent and successful targeting of this enzyme family as diagnostic and prognostic predictors of human cancer, its status, and its stage. This analysis includes a wide variety of human cancers and a number of human sample types including tissue, plasma, serum, and urine.
THE REFRACTIVE INDEX OF THE SPINAL FLUID
Authors: Gunnar F. Blix
Journal: JAMA (1930)

<h3>To the Editor:</h3> —InThe Journal, January 11, the refractive index of the spinal fluid was discussed in an editorial comment. The paper by Penfold and Price, whose work was mentioned, is not available to me. However, to judge from the data given it appears as if the questions of the normal variation, the significance and the utility of the refractive index of the spinal fluid are carried a bit further in the careful study by Bernhard Jacobowsky (Liquorstudien bei progressiver Paralyse mit besonderer Berücksichtigung der Veränderungen während der Impfmalaria, Upsala, Almqvist &amp; Wiksells, 1929, pp. 14-48, 126-128). Unfortunately, this work has been published merely as a dissertation. On the whole, the refractive index of the spinal fluid seems<i>a priori</i>not to have much qualification as a diagnostic aid. Jacobowsky (p. 20) says: An increased refractive index proves that the composition of the spinal fluid is abnormal but does
Scintigraphic Demonstration of a Large Communicating Posterior Fossa Cyst
Authors: FARROKH DEHDASHTI, ARTHUR Z. KRASNOW, B DAVID COLLIER, ALI T. ISITMAN, ROBERT S. HELLMAN, THOMAS M. JOESTGEN
Journal: Clinical Nuclear Medicine (1989)

A 33-year-old white man who underwent surgery for correction of a cervical spine congenital anomaly (Klippel Feil syndrome) was referred for radionuclide cisternography for evaluation of hydrocephalus. CT and magnetic resonance imaging revealed a cystic structure in the posterior fossa. Radionuclide cisternography offered physiologic information in this case by demonstrating the presence of a communication between this cyst and the CSF.