tbuckley/cabot-search huggingface dataset:
Improving access to primary care
Authors: P. R. Alper
Journal: JAMA (1993)

To the Editor.  —I agree with Dr Ginzberg's 1 statements that the professional satisfaction of the individual physician—and especially the primary physician—is critically important to the outcome of health reform of whatever stripe, and that a system based on massively second-guessing the myriad decisions of the individual physician is unlikely to work.  However, his solution consisted of three suggestions for manipulating graduate medical education programs and their funding as a way to reverse the inexorable weakening of the American primary care physician base. Thus, a long-term solution was proposed in place of more immediate measures to alleviate the present and near-term distress of the practicing internist and family practitioner. This let the chips fall where they may view of primary care is likely to undermine even well-conceived, longer-term plans.  The current reality for all physicians is managed care and managed competition. The consequences to primary physicians remain unique, however. Only
Two-dimensional cell sheet manipulation of heterotypically co-cultured lung cells utilizing temperature-responsive culture dishes results in long-term maintenance of differentiated epithelial cell functions
Authors: Maya A. Nandkumar, Masayuki Yamato, Ai Kushida, Chie Konno, Motohiro Hirose, Akihiko Kikuchi, Teruo Okano
Journal: Biomaterials (2002)
Adams and Victor’s Principles of Neurology
Authors: Douglas J. Lanska
Journal: JAMA (2010)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Retransplantation in patients with hepatitis C recurrence after liver transplantation
Authors: José A. Carrión, Miquel Navasa, Xavier Forns
Journal: Journal of Hepatology (2010)

Hepatitis C virus (HCV) infection recurs universally after liver transplantation (LT) and fibrosis progression is accelerated in the graft. Retransplantation (RT) is the only therapeutic option to achieve long-term survival in patients with decompensated cirrhosis after LT. Patient and graft survival rates after RT are inferior to those after primary LT. It is generally accepted that severe hepatitis C recurrence (cholestatic hepatitis) and forms with rapid fibrosis progression have a poor survival after RT. However, it is not clear whether rapid fibrosis progression in the first graft will be followed by the same rate of fibrosis progression in the second graft. The use of prognostic scores as screening tools has shown an improvement in survival in HCV-infected patients after RT, reaching similar survival rates as those obtained in non HCV-infected patients. Moreover, these scores can identify candidates with a high risk of mortality in whom the use of a new organ would be unreasonable. Prevention of severe hepatitis C recurrence could be the first step to avoid RT. Thus, antiviral treatment on the waiting list (if possible) and early identification and treatment of patients with severe hepatitis C recurrence may be a good strategy to avoid RT. In addition, active management of factors which can accelerate fibrosis progression (donor age, post-transplant diabetes, high dose of corticosteroids) might reduce the incidence of severe forms of hepatitis C recurrence.
Structure of non-(1-84) PTH fragments secreted by parathyroid glands in primary and secondary hyperparathyroidism
Authors: Pierre D'Amour, Jean-Hugues Brossard, Louise Rousseau, Loan Nguyen-Yamamoto, Edgard Nassif, Claude Lazure, Dany Gauthier, Jeffrey R. Lavigne, Richard J. Zahradnik
Journal: Kidney International (2005)
Clearance and acid-stimulating action of human big and little gastrins in duodenal ulcer subjects.
Authors: J H Walsh, J I Isenberg, J Ansfield, V Maxwell
Journal: Journal of Clinical Investigation (1976)

Acid-stimulating action and clearance of pure natural human big gastriin (HG-34-I) and little gastrin (HG-17-I) were assessed in four male subjects with inactive duodenal ulcer (DU) disease. Disappearance half-times for HG-17-I after intravenous infusion (5.2 min) or rapid intravenous injection (6.4 min) were six to eight times shorter than those for HG-34-I (41.5 and 37.8 min, respectively). Studies of clearance of synthetic human little gastrin (HG-17-I) were performed in three of these same four DU subjects, eight additional male DU subjects, and eleven normal male subjects. The disappearance halftime of synthetic HG-17-I averaged 6.2 min in both the DU subjects and the normal subjects. These data suggest that clearance of exogenous gastrin is not altered in patients with DU. Acid secretion in response to rapid intravenous injection of HG-34-I reached a higher peak and lasted longer than in response to an equimolar dose of HG-17-I; the total response to HG-34-I was about three times that to HG-17-I. During constant intravenous infusion, acid responses to equimolar exogenous doses of the two peptides were similar but the increment in molar concentration of circulating gastrin was six to eight times greater with HG-34-I than with HG-17-I. Chromatography of serum obtained during infusions of HG-34-I revealed no evidence of conversion to HG-17-I, nor was there any increase in circulating G-34 activity during infusions of HG-17-I. The increment in serum gastrin concentration required to produce half-maximal stimulation of gastric acid secretion (D50) was estimated in each subject for each gastrin from curves relating acid secretion to change in serum gastrin concentration produced by infusion of these peptides. After instilling peptone solution into the stomach, acid secretion was measured by intragastric titration, and increases in circulating G-17 and G-34 were determined by chromatography and radioimmunoassay of serum. Increases in circulating G-17 and G-34 in response to the peptone meal, taken together, were equivalent to 1.5 times the D50 determined from infusions of G-34 and G-17. Acid secretion during the same time period averaged 55% of maximal rates. Although G-34 comprised approximately three-fourths of the total molar concentration of circulating gastrin after stimulation, it was estimated to contribute less than half of the acid-stimulating activity.
Falcipain‐2 inhibitors
Authors: Roberta Ettari, Floriana Bova, Maria Zappalà, Silvana Grasso, Nicola Micale
Journal: Medicinal Research Reviews (2009)

Abstract Malaria, particularly that one caused by Plasmodium falciparum , remains a serious health problem in Africa, South America, and many parts of Asia where it afflicts about 500 million people and is responsible for the death of more than one million children each year. The main reasons for the persistence of malaria are the emergence of resistance to common antimalarial drugs, inadequate control of mosquito vectors, and the lack of effective vaccines. Therefore, the identification and characterization of new targets for antimalarial chemotherapy are of urgent priority. This review is focused on inhibitors of falcipain‐2, a cysteine protease from P. falciparum , which represents one of the most promising targets for antimalarial drug design. Falcipain‐2 is a key enzyme in the life cycle of P. falciparum since it degrades hemoglobin, at the early trophozoite stage, and cleaves ankyrin and protein 4.1, the cytoskeletal elements vital to the stability of red cell membrane, at the schizont stage. The main classes of falcipain‐2 inhibitors are peptides or peptidomimetics bearing the most popular pharmacophores of cysteine protease inhibitors, such as vinyl sulfones, halomethyl ketones, and aldehydes. Furthermore, many other chemotypes have been identified as inhibitors of falcipain‐2, such as isoquinolines, thiosemicarbazones, and chalcones. These inhibitors represent all classes, which, to the best of our knowledge, have been disclosed in journal articles to date. © 2009 Wiley Periodicals, Inc. Med Res Rev, 30, No. 1, 136–167, 2010
Health Insurance in Canada — An Overview and Commentary
Authors: Sidney S. Lee
Journal: New England Journal of Medicine (1974)

Abstract Whereas the United States has used a "beneficiary" approach in providing selected segments of the population with national health insurance, Canada has gradually increased "benefits" to all its people so that today more than 98 per cent of the population is covered by a national-health-insurance program that is broadly comprehensive and includes physician's services. The insurance reflects federal standards but is administered provincially, with both parties sharing the cost about equally. Since fee-for-service is the principal method of payment extensive negotiations are necessary between provincial governments and medical organizations. In one province (Quebec) all physicians are unionized. Hospital utilization rates are high and are leading to increasing provincial efforts to control costs. In spite of its problems, the Canadian system deserves study by the United States as it considers various forms of national health insurance. (N Engl J Med 290:713–716, 1974)
Randomized Trial of Cisplatin and Ifosfamide With or Without Bleomycin in Squamous Carcinoma of the Cervix: A Gynecologic Oncology Group Study
Authors: Jeffrey D. Bloss, John A. Blessing, Brent C. Behrens, Robert S. Mannel, Janet S. Rader, Anil K. Sood, Maurie Markman, Jo Benda
Journal: Journal of Clinical Oncology (2002)

PURPOSE: Phase II trial reports have suggested that the addition of bleomycin to the combination of cisplatin and ifosfamide may improve response rates and possible survival in squamous carcinoma of the cervix. This study prospectively evaluates the combination of bleomycin to this regimen in women with histologically proven advanced recurrent or persistent squamous cell carcinoma of the cervix. PATIENTS AND METHODS: Eligible women were randomized to receive either cisplatin (50 mg/m 2 ), ifosfamide (5 g/m 2 over 24 hours), and mesna (6 g/m 2 during ifosfamide infusion and the following 12 hours) (CI) versus bleomycin 30 units over 24 hours on day 1 followed by cisplatin (50 mg/m 2 ), ifosfamide (5 g/m 2 over 24 hours), and mesna (6 g/m 2 during ifosfamide infusion and the following 12 hours) (CIB). Three hundred three women were enrolled onto this trial, of which 287 were assessable. RESULTS: There were no significant differences between CI and CIB with regard to response rates (32% v 31.2%, respectively), progression-free survival (PFS), or overall survival. PFS and survival were associated with initial performance status (PS). Patients with a PS of 0 experienced a lower rate of failure (P = .013) and a lower risk of death (P = .009) compared with patients with PS of 2. The most frequent grade 3/4 toxicities were leukopenia, neutropenia, anemia, thrombocytopenia, and nausea and vomiting. Neither regimen was associated with a significant increase in incidence of these toxicities. CONCLUSION: The CI regimen was virtually identical to CIB with regard to response rate, PFS, survival, and toxicity profile. Thus, the addition of bleomycin in the dose-schedule employed to cisplatin and ifosfamide did not improve outcome in patients with advanced cervical cancer.
Erythromycin and the gut.
Authors: S M Catnach, P D Fairclough
Journal: Gut (1992)

The commonly reported gastrointestinal side effects that occur with erythromycin are related to its prokinetic action on the gut, mediated, at least in part, by its motilin receptor stimulating activity. This action may be of clinical use in conditions associated with gastrointestinal hypomotility such as diabetic gastroparesis and intestinal pseudo-obstruction, although further work needs to be done to establish the long term therapeutic uses of erythromycin in these disorders. Macrolide compounds with no antibacterial properties but which have a pronounced prokinetic action on the gut have already been synthesised and are currently being developed for future use in man. These 9motilides9 should provide a useful addition to our rather limited armamentarium of effective gastrointestinal prokinetic agents.
Enteroaggregative Escherichia coli elaborate a heat-stable enterotoxin demonstrable in an in vitro rabbit intestinal model.
Authors: S J Savarino, A Fasano, D C Robertson, M M Levine
Journal: Journal of Clinical Investigation (1991)

Enteroaggregative Escherichia coli (EAggEC) have been associated with persistent diarrhea in young children, but little is known about its pathogenesis. We assayed for enterotoxic activity in culture filtrates (CF) of EAggEC strains in Ussing chambers mounted with rabbit ileal mucosa. CF from strain 17-2, a prototype Chilean EAggEC strain, caused a greater rise in potential difference and short circuit current (SCC) than that seen in HB101 control, and this effect was abolished by protease pretreatment and partially stable after heat treatment. Ultrafiltration of 17-2 CF preparations localized the active moiety to the 2-5 kD Mr size range. CF from HB101 transformed with the 17-2 plasmid showed Ussing chamber activity. less than 10-kD CF fractions from five of six other EAggEC strains screened in Ussing chambers gave SCC responses of similar magnitude to 17-2. The 17-2 CF activity was not neutralized after pretreatment with polyclonal anti-STa antibody. Additionally, all of the seven EAggEC strains studied were nonreactive by heat-stable enterotoxin variant STa ELISA, were negative in the suckling mouse assay, and failed to hybridize with heat-stable enterotoxin variant STh and STp DNA probes. In summary, our data indicate that 17-2 produces a low molecular weight, partially heat-stable, protease-sensitive enterotoxin which appears to be plasmid associated, and genetically and immunologically distinct from E. coli STa. Preliminary screening suggests that this tox+ phenotype may be common among EAggEC.
Supernumerary Pectineus Bursa Causing Femoral Vein Compression
Authors: P. Winston, F. A. Henley
Journal: BMJ (1954)

Supernumerary Pectineus Bursa CausingFemoral Vein Compression Supernumerary pectineus bursa is a rarity.In the following case recurrent attacks of bursitis had led to femoral vein compression with consequent swelling of the affected leg.
CCL27–CCR10 interactions regulate T cell–mediated skin inflammation
Authors: Bernhard Homey, Harri Alenius, Anja Müller, Hortensia Soto, Edward P. Bowman, Wei Yuan, Leslie McEvoy, Antti I. Lauerma, Till Assmann, Erich Bünemann, Maili Lehto, Henrik Wolff, David Yen, Heather Marxhausen, Wayne To, Jonathon Sedgwick, Thomas Ruzicka, Percy Lehmann, Albert Zlotnik
Journal: Nature Medicine (2002)
Comparison of L-Thyroxine (T_4) and L-Triiodothyrone (T_8) in Suppressive Therapy of Nontoxic Nodular Goiter.
Authors: Katsutaro Shimaoka
Journal: Annals of Internal Medicine (1971)

Meeting Abstracts1 May 1971Comparison of L-Thyroxine (T4) and L-Triiodothyrone (T8) in Suppressive Therapy of Nontoxic Nodular Goiter.Katsutaro Shimaoka, M.D., J. E. Sokal, M.D., F.A.C.P.Katsutaro Shimaoka, M.D.Search for more papers by this author, J. E. Sokal, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-5-825_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPatients with nontoxic nodular goiter were treated with T8, 50 µg/day, or T4, 200 µg/day, in a double-blind study. Their nodules were measured independently by two examiners at 4-week intervals, without access to previous measurements or to the results of thyroid function studies. The study lasted for 28 weeks; phase 1 for 12 weeks and phase 2 for 16 weeks. At the end of phase 1, decrease in goiter size was evident in 47% of the patients, who were carried on to phase 2 without dosage modification. The others were then randomized to continue the same medication at the same... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Katsutaro Shimaoka, M.D.; J. E. Sokal, M.D., F.A.C.P.Affiliations: Buffalo, N.Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1971Volume 74, Issue 5Page: 825-825KeywordsThyroidThyroxine ePublished: 1 December 2008 Issue Published: 1 May 1971 PDF downloadLoading ...
Surgical Master Builder — New Cottage Hospital
Authors: John Lister
Journal: New England Journal of Medicine (1958)

LORD Webb-Johnson, who died at the end of May at the age of seventy-seven, must have been one of the greatest physicians that this country has ever known. Coming to the Middlesex Hospital from Manchester, he was appointed to the staff a few years before World War I. On his return from distinguished service with the Medical Corps he became dean of the Middlesex Hospital Medical School, where he showed the amazing ability for organization and for raising money for good causes that was to become the outstanding characteristic of his long career. The hospital itself needed rebuilding, and although . . .
Effect of Haemorrhage upon Red Cell Size and Red Cell Distribution
Authors: G. L. Brown, J. A. R. Miles, J. M. Vaughan, L. E. H. Whitby
Journal: BMJ (1942)

In 1940 Brennan reported that " as a result of haemorrhage individual red corpuscles increase very appreciably in size, often by 30 to 50%."From his observations, which Con- sisted in making red cell counts and in haematocrit deter- minations, he concluded that "following haemorrhage many patients' red cells become side-tracked-probably in the muscle capillaries; often more than 20%."Brennan also claimed that transfusion of 500 to 1,000 c.cm. of
Abstract 2793: A hypermethylated phenotype in anaplastic oligodendroglial brain tumors is a better predictor of survival than MGMT methylation in the EORTC 26951 study
Authors: Martin van den Bent, Lonneke Gravendeel, Thierry Gorlia, Johan M. Kros, Pieter Wesseling, Johannes Teepen, Ahmed Idbaih, Marc Sanson, Pim French
Journal: Cancer Research (2011)

Abstract We have performed methylation profiling (Illumina Human Methylation 27 beadchip) on 69 anaplastic oligodendrogliomas (AOD) or anaplastic mixed oligoastrocytomas (MOA) and one non-diseased normal brain. Fifty-two of these samples were treated as part of the EORTC 26951 study, the primary objective of which was to compare the overall survival (OS) of patients with AOD or MOA treated with radiotherapy (59.4 Gy) vs. ± PCV chemotherapy. Remaining samples were also AOD or MOA and received similar treatment paradigms. Unsupervised clustering using hierarchical ordered partitioning and collapsing hybrid (Hopach) was performed using all or the 10,000, 5,000, 2,000, 1,000, 500, 200 or 100 most variably methylated CpG loci. In all analyses, we identified two main clusters that were highly stable (determined by Fuzzy clustering). In general, these clusters could be separated by predominantly methylated vs. unmethylated CpG loci. Survival (as determined from the date of resection) in the “hypermethylated” subgroup was markedly better than the survival of the unmethylated subgroup (5. 62 vs. 1.24 years, P&amp;lt;0.0001). In fact, methylation profiling was able to better separate long vs. short survivors than histology, MGMT promoter methylation status (as determined by MLPA), 1p/19q LOH (as determined by FISH) or IDH1 mutation status. Methylation phenotype remained an independent prognostic marker in a multivariate analysis that includes diagnosis, age, sex, 1p19q LOH and IDH1 mutation status. We validated our results on methylation profiling data from the cancer genome atlas (TCGA) by assigning TCGA samples to one of the molecular clusters identified in our dataset. 14/80 and 66/80 samples of were assigned to the “hypermethylated” and “unmethylated” cluster respectively. Similar to the initial “test” dataset, survival between the hypermethylated and unmethylated subgroups were significantly different (2.87 vs. 1.02 years, P&amp;lt;0.0001). In conclusion, methylation profiling has identified two main subgroups of oligodendroglial brain tumors. These methylation subgroups correlate better with survival than histology, MGMT promoter methylation, 1p19q LOH and IDH1 mutation status. We are currently integrating methylation data with expression data. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2793. doi:10.1158/1538-7445.AM2011-2793
Comparison of Captopril and Enalapril in Patients with Severe Chronic Heart Failure
Authors: Milton Packer, Wai Hung Lee, Madeline Yushak, Norma Medina
Journal: New England Journal of Medicine (1986)

To evaluate the concept that long duration of action is an advantageous property of angiotensin-converting enzyme inhibitors in the treatment of severe heart failure, we randomly assigned 42 patients to therapy with either a short-acting inhibitor (captopril, 150 mg daily) or a long-acting inhibitor (enalapril, 40 mg daily) for one to three months while concomitant therapy with digoxin and diuretics was kept constant. The treatment groups had similar hemodynamic and clinical characteristics at base-line evaluation and similar initial responses to converting-enzyme inhibition. During long-term therapy, captopril and enalapril produced similar decreases in systemic blood pressure, but the hypotensive effects of enalapril were more prolonged and persistent than those of captopril. Consequently, although the patients in both groups improved hemodynamically and clinically during the study, serious symptomatic hypotension (syncope and near syncope) was seen primarily among those treated with enalapril. Sustained hypotension also probably accounted for the decline in creatinine clearance (P<0.05) and the notable retention of potassium (P<0.05) observed in the patients treated with enalapril but not in those treated with captopril. We conclude that when large, fixed doses of converting-enzyme inhibitors are used in the treatment of patients with severe chronic heart failure, long-acting agents may produce prolonged hypotensive effects that may compromise cerebral and renal function, and thus they may have disadvantages in such cases, as compared with short-acting agents. (N Engl J Med 1986; 315:847–53.)
Doctors and researchers in Italy protest against dismissal of drug regulator
Authors: F. Turone
Journal: BMJ (2008)

Several Italian researchers and clinicians have sent open letters to the media in recent weeks to protest about the removal of Nello Martini as the head of the Italian drug regulatory agency, Agenzia Italiana del Farmaco.

The group say that Dr Martini was doing an exemplary job. He had kept the agency free from drug industry pressure and had managed to contain the Italian drugs bill to 13% of the country’s health expenditure. But in doing so he incurred the industry’s wrath.

The situation began with an incident earlier this year in which a member of the agency was arrested for alleged falsification of data ( BMJ 2008;336:1208-9, …