tbuckley/cabot-search huggingface dataset:
PSRO: Friend or Foe?
Authors: Anne R. Somers
Journal: New England Journal of Medicine (1973)

I was among those who opposed PSRO (Professional Standards Review Organization) throughout the Congressional debate. I believed that the objective —effective professional review of the quality and quantity of health care within a context of public accountability — could be achieved more easily, for more patients, at less cost, and with less danger of political manipulation, by strengthening existing hospital-based peer review, extending it to noninstitutional services in the area, and making its accountability more explicit.This would mean fixing responsibility on the hospital professional staff and clarifying its accountability to the public via the board of trustees, in line . . .
Lifestyle and Structured Interventions to Increase Physical Activity
Authors: Paul T. Williams
Journal: JAMA (1999)

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
Calcium plus Vitamin D<sub>3</sub>Supplementation and Colorectal Cancer in Women
Authors: Michele R. Forman, Bernard Levin
Journal: New England Journal of Medicine (2006)

The effect of vitamin and mineral supplementation and diet on the risk of colorectal cancer is an active area of research. In this issue of the Journal, Wactawski-Wende et al.1 report the results of a Women's Health Initiative (WHI) trial to test the hypothesis that postmenopausal women randomly assigned to receive 1000 mg of elemental calcium as calcium carbonate with 400 IU of vitamin D3 daily would have a lower risk of hip fracture and, secondarily, a lower risk of any type of fracture and colorectal cancer than women receiving placebo. The calcium plus vitamin D study involved 36,282 . . .
Diabetes With Mitochondrial Gene tRNALYS Mutation
Authors: Susumu Suzuki, Yoshinori Hinokio, Satoshi Hirai, Masatoshi Onoda, Masahiro Matsumoto, Masataka Ohtomo, Hiromasa Kawasaki, Yoshinori Satoh, Hiroaki Akai, Kohji Abe, Takayoshi Toyota
Journal: Diabetes Care (1994)

OBJECTIVE To solve a possible relationship between mtDNA mutation of tRNALYS(8344) and diabetes, we have surveyed the tRNALYS mutation, glucose intolerance, and insulin secretory capacity in a Japanese family with diabetes and myoclonic epilepsy with ragged-red fiber disease. Several lines of evidence suggested possible linkage between mtDNA mutation and diabetes (1–4). RESEARCH DESIGN AND METHODS DNA was isolated from peripheral lymphocytes. The polymerase chain reaction analysis for the tRNALYS(8344) mutation of the mtDNA was conducted as described by Larsson (5). Insulin secretory capacity was assessed by 24-h urinary C-peptide immunoreactivity response (CPR) excretion and plasma CPR to glucagon administration. RESULTS We identified seven subjects with the tRNALYS mutation as well as seven non-mutated members in the pedigrees. Oral glucose tolerance tests in the pedigree indicated that five of the mutated subjects were diabetic, one had impaired glucose tolerance, and one had normal glucose tolerance (NGT), whereas all nonmutated family members had NGT. The pedigree shows maternal transmission of diabetes and the tRNALYS mutation over three generations. Twenty-four-hour urinary excretion of CPR was significantly reduced in the mutant subjects (mean ± SD, 67.8 ± 79.2 nmol/day, n = 6, P &amp;lt; 0.001) compared with the nonmutant members (276.6 ± 41.8 nmol/day, n = 5) and the age-matched normal control subjects (263 ± 64.3 nmol/day, n = 12). Plasma CPR 6 min after glucagon injection demonstrated a marked reduction in the mutant subjects (3.68 ± 3.45 nmol/l, n = 5, P &amp;lt; 0.001) compared with the nonmutant members (19.4 ± 1.17 nmol/l, n = 5) and the normal control subjects (15.8 ± 3.81 nmol/l, n = 12). Bilateral neurosensory deafness was demonstrated in five of seven (71.4%) mutant subjects (five of five [100%] mutated diabetic patients), but not detected in six nonmutant members. CONCLUSIONS This observation is the first report of association of diabetes with the mitochondrial tRNALYS mutation. Insulin secretory capacity was significantly lower in the mutant members than in the nonmutated members. These findings suggest that the pancreatic β-cell secretory defect of insulin might be one of the phenotypes of the mitochondrial tRNALYS mutation.
Enhanced levels of asymmetric dimethylarginine in a serum of middle age patients with myelodysplastic syndrome
Authors: Jana Štikarová, Jiří Suttnar, Kristýna Pimková, Leona Chrastinová-Mášová, Jaroslav Čermák, Jan E Dyr
Journal: Journal of Hematology & Oncology (2013)

Abstract Myelodysplastic syndromes (MDS) are hematological malignancies of unclear etiology where oxidative stress may contribute to the pathogenesis. Methylarginines, naturally occurring inhibitors of NO synthase, can increase superoxide generation from uncoupled NO synthase. We found significant increase in concentrations of asymmetric dimethylarginine (0.84 ± 0.32 μmol/L, p = 0.0022) and malondialdehyde (0.77 ± 0.11 μmol/L, p &lt; 0.001) in sera of MDS patients vs controls (asymmetric dimethylarginine: 0.56 ± 0.16 μmol/L, malondialdehyde: 0.52 ± 0.07 μmol/L). On the contrary, nitrites concentrations were significantly decreased in MDS patients (1.71 ± 0.46 μmol/L, p = 0.0028) vs controls (2.16 ± 0.38 μmol/L). We suppose that the oxidative stress in MDS is enhanced due to methylated arginines influence on NO synthase activity impairment.
In Vitro Fertilization
Authors: Bradley J. Van Voorhis
Journal: New England Journal of Medicine (2007)

A 37-year-old woman who has never been pregnant and her 40-year-old husband have been attempting to conceive a child for the past 3 years. An infertility evaluation has shown no cause for the difficulty. She is ovulating regularly, and a hysterosalpingogram shows that her reproductive tract is anatomically normal. He has a normal sperm count; he has not fathered any children. They are frustrated and want to proceed with in vitro fertilization. What should you advise?
THE RESOURCEFUL GENERAL PRACTITIONER OF MODERN MEDICINE
Authors: FRANK BILLINGS
Journal: JAMA (1923)

The time has come for plain statements in regard to modern medical practice, with the purpose of bringing the public and the members of the medical profession as a whole back to good common sense views. It is my purpose to attempt to show how the general practitioner may continue to occupy the important place in the field of practice which was his until recently. For the time being, therefore, specialists in medicine and surgery and special forms of the prevailing methods of modern practice, such as diagnostic groups and pay clinics, will not be discussed. In a consideration of the general practitioner it will be necessary to discuss the opportunities which he enjoys, and the problems and difficulties which beset him. In their work, not all general practitioners are resourceful and sure of themselves. This fault is due in some instances to inadequate early training, but in a majority
Mechanisms of HBV-related hepatocarcinogenesis
Authors: Christine Neuveut, Yu Wei, Marie Annick Buendia
Journal: Journal of Hepatology (2010)

The hepatitis B virus (HBV) is a small enveloped DNA virus, which primarily infects hepatocytes and causes acute and persistent liver disease. Epidemiological studies have provided overwhelming evidence for a causal role of chronic HBV infection in the development of hepatocellular carcinoma, but the molecular mechanisms underlying virally-induced tumourigenesis remain largely debated. In the absence of a dominant oncogene encoded by the HBV genome, indirect roles have been proposed, including insertional activation of cellular cancer-related genes by HBV DNA integration, induction of genetic instability by viral integration or by the regulatory protein HBx, and long-term effects of viral proteins in enhancing immune-mediated liver disease. Recent genetic studies indicate that HBV-related tumours display a distinctive profile with a high rate of chromosomal alterations and low frequency of β-catenin mutations. This review will discuss the evidence implicating chronic HBV infection as a causal risk factor of primary liver cancer. It will also discuss the molecular mechanisms that are critical for the tumourigenic process due to long lasting infection with HBV.
Effect of treatment with peginterferon or interferon alfa-2b and ribavirin on steatosis in patients infected with hepatitis C
Authors: Thierry Poynard, Vlad Ratziu, John McHutchison, Michael Manns, Zachary Goodman, Stefan Zeuzem, Zobair Younossi, Janice Albrecht
Journal: Hepatology (2003)

It has been suggested that hepatitis C virus (HCV) and especially genotype 3 is associated with steatosis. We assess the effect of treatment with peginterferon or interferon alfa-2b and ribavirin on steatosis. We analyzed 1,428 naïve patients included in a randomized trial. A single pathologist scored steatosis at baseline and 24 weeks after the treatment. At baseline, steatosis was present in 935 of 1,428 patients (65%), including 175 (83%) of 210 patients with genotype 3 versus 760 (62%) of 1,218 with other genotypes (P <.001). The variables associated with steatosis in logistic regression were genotype 3 (P <.001), triglycerides greater than 1.7 mmol/L (P <.001), body mass index greater than 27 (P <.04), age greater than 40 years (P <.001), and septal fibrosis (P =.007). In genotype 3-infected patients, steatosis was associated with high viral load and with lower serum cholesterol. Steatosis was associated with lower sustained response rate, even after taking into account other factors (P <.001). Among virologic responders, steatosis was much improved in genotype 3, improvement of at least 1 grade in 77%, and disappearance in 46% compared with other genotypes, 46% and 29%, respectively (P <.001 both comparisons). In genotype 3 responders, the baseline low serum cholesterol was corrected by treatment (P <.001). Steatosis was associated with HCV genotype 3, triglycerides, high body mass index, age, fibrosis stage, and lower virologic response to treatment. In conclusion, sustained disappearance of the virus is associated with reduction of steatosis in genotype 3 as well as a correction of baseline low serum cholesterol.
Comment on Article by Misra et al.
Authors: M. Behnke, H. M. Seitz, W. Kruis
Journal: Endoscopy (1998)

See also: Endoscopy-Assisted Emergency Treatment of Gastroduodenal and Pancreatobiliary AscariasisEndoscopy 1996; 28(07): 629-632DOI: 10.1055/s-2007-1005560
Fractional Esterification Rate of HDL Particles in Patients With Type 2 Diabetes: Relation to coronary heart disease risk factors
Authors: Meng-Hee Tan, Keh-Chuan Loh, Milada Dobiasova, Jiri J Frohlich
Journal: Diabetes Care (1998)

OBJECTIVE To study the fractional esterification rate of cholesterol on HDL particles (FERHDL) in adults with type 2 diabetes and assess its correlation with serum lipids and other coronary heart disease (CHD) risk factors. RESEARCH DESIGN AND METHODS FERHDL was measured in 90 adult (57 men, 33 women) patients by an isotopic assay method involving several steps, including preparation of VLDL- and LDL-depleted plasma, labeling of the sample with a trace amount of tritiated cholesterol, separation of free and esterified cholesterol fractions by chromatography post incubation, and subsequent counting of radioactivity in the individual fractions. RESULTS Male patients have higher FERHDL values than their female counterparts. When HDL cholesterol was controlled for in a multivariate regression analysis, the sex factor was not significant. There was a significant positive correlation between FERHDL and plasma total cholesterol (r = 0.32), triglycerides (r = 0.82), apolipoprotein B (apo B; r = 0.48), insulin (r = 0.46), BMI (r = 0.31), and waist-to-hip ratio (WHR; r = 0.50). There was a negative correlation between FERHDL and HDL cholesterol (r = −0.76) and apolipoprotein AI (r = −0.60). When both HDL cholesterol and triglycerides were controlled for, the only significant correlation was between FERHDL and BMI. CONCLUSIONS Non-insulin-requiring type 2 diabetic patients have FERHDL, which correlated positively with triglycerides and negatively with HDL cholesterol. The positive correlation of FERHDL with serum insulin, WHR, total cholesterol, and apo B, but not that with BMI, loses its significance when HDL cholesterol and triglycerides are controlled. The sex difference between men and women in FERHDL also loses its significance when HDL cholesterol is controlled.
Ursodeoxycholic Acid Vs. Chenodeoxycholic Acid As Cholesterol Gallstone–Dissolving Agents: A Comparative Randomized Study
Authors: Enrico Roda, Franco Bazzoli, Antonio M. Morselli Labate, Giuseppe Mazzella, Aldo Roda, Claudia Sama, Davide Festi, Rita Aldini, Francesco Taroni, Luigi Barbara
Journal: Hepatology (1982)

Cholesterol gallstones are dissolved in man by chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA). To test the comparative efficacy of these two cholelitholytic bile acids, 223 gallstones patients were randomly treated with either UDCA or CDCA at two different doses: 7 to 8 mg per kg per day and 14 to 15 mg per kg per day. Efficacy and factors influencing dissolution (dose, size of the stones, and time) were evaluated after 3, 6, and 12 months of treatment. UDCA was significantly more efficacious than was CDCA after 3 and 6 months of treatment, whereas after 12 months, no significant differences were observed. UDCA was equally effective at high and low doses, both on small and large stones. CDCA was significantly more effective at high doses and on small stones. Seventy-four per cent of the total dissolutions with UDCA and 42% with CDCA occurred within the first 6 months of treatment. Diarrhea and hypertransaminasemia occurred only in the CDCA-treated patients. We conclude that UDCA seems to be the bile acid of choice in dissolving cholesterol gallstones.
Effect of plaque debulking and stenting on short- and long-term outcomes after revascularization of chronic total occlusions
Authors: Luis Gruberg, Roxana Mehran, George Dangas, Mun K Hong, Gary S Mintz, Ran Kornowski, Alexandra J Lansky, Kenneth M Kent, Augusto D Pichard, Lowell F Satler, Gregg W Stone, Martin B Leon
Journal: Journal of the American College of Cardiology (2000)
Poisonings and Other Health Hazards Associated With Use of Detergents
Authors: Jay M. Arena
Journal: JAMA (1964)

BECAUSE they are such necessary and familiar household items, cleaners are not usually regarded as hazardous substances. However, in 1962, 1,727 incidents involving ingestion of detergents, as well as soaps and cleaners, in children under 5 years of age were reported to the National Clearinghouse for Poison Control Centers. This represented 4.2% of all the reported accidental ingestions in this age group. Although severe toxic effects occur infrequently and fatalities are rare, these are still rather significant statistics for a potential cause of injury that is largely preventable by handling and storing these products properly to keep them out of reach of children. Unfortunately, the terms soap and detergent are synonymous to many laymen, and I know of an incident, for example, in which significant injury occurred from the misuse of a detergent instead of a soapsuds enema. To prevent this type of erroneous substitution, the physician should give very
Probiotics to counteract biofilm-associated infections: promising and conflicting data
Authors: Claudia Vuotto, Francesca Longo, Gianfranco Donelli
Journal: International Journal of Oral Science (2014)

Altered bowel flora is currently thought to play a role in a variety of disease conditions, and the use of Bifidobacterium spp. and Lactobacillus spp. as probiotics has been demonstrated to be health-promoting, even if the success of their administration depends on the applied bacterial strain(s) and the targeted disease. In the last few decades, specific probiotics have been shown to be effective in the treatment or the prevention of acute viral gastroenteritis, pediatric post-antibiotic-associated diarrhea, some pediatric allergic disorders, necrotizing enterocolitis in preterm infants, inflammatory bowel diseases and postsurgical pouchitis. The potential application of probiotics is continuously widening, with new evidence accumulating to support their effect on the prevention and treatment of other disease conditions, including several oral diseases, such as dental caries, periodontal diseases and oral malodor, as well as genitourinary and wound infections. Considering the increasingly widespread ability of pathogens to generate persistent biofilm-related infections, an even more attractive proposal is to administer probiotics to prevent or counteract biofilm development. The response of biofilm-based oral, intestinal, vaginal and wound infections to probiotics treatment will be reviewed here in light of the most recent results obtained in this field. There is both conflicting and promising evidence that administration of "good" bacteria, or probiotics, prevents biofilm-related infections. Despite data showing that probiotics contribute to maintaining a healthy gut, a review by Claudia Vuotto and colleagues from the IRCCS Fondazione Santa Lucia, Rome, Italy, suggests that the effects of probiotics on other conditions in which bacteria grow as aggregates in biofilms are unclear. Several lactic-acid producing bacteria benefit the host by reducing the growth of toxic bacteria and stimulating an immune response. However, for the treatment of biofilm-associated oral diseases, genitourinary and wound infections, the effects are highly dependent on the biofilm's composition and the probiotic strain that is used. Further studies are required to identify the most effective strains to eradicate such biofilms and tackle one of the most urgent challenges in anti-bacterial drug development.
Effect of 16,16-dimethyl prostaglandin E2 on oxygen uptake and microcirculation in the perfused rat liver
Authors: Haruya Meren, France Varin, Mary Ruwart, Ronald G. Thurman
Journal: Hepatology (1986)

Previous work demonstrated that collagen deposition in the liver of rats fed a nutritionally deficient diet for 3 to 4 months was diminished markedly by 16,16-dimethyl prostaglandin E 2 treatment. In this study, rats were fed a high-fat diet or a high-fat diet deficient in lipotropes for 2 to 4 weeks prior to liver perfusion. Rates of O 2 uptake by the liver were not changed by dietary manipulation. Infusion of 16,16-dimethyl prostaglandin E 2 (10 μM ), however, decreased O 2 uptake by the whole organ by 20 to 40% in both groups. O 2 tension was measured at the liver surface with a miniature O 2 electrode placed alternatively on periportal and pericentral regions of the liver lobule. Mean O 2 tensions in both periportal and pericentral regions were reduced 2- to 3-fold during the infusion of 16,16-dimethyl prostaglandin E 2 suggesting an action on the microcirculation. This hypothesis was supported by the observation that fluorescein isothiocyanate-dextran fluorescence detected from the liver surface as well as hepatic vascular volume determined by dye dilution techniques were decreased 30 to 50% by 16,16-dimethyl prostaglandin E 2 . In addition, 16,16-dimethyl prostaglandin E 2 increased portal pressure by about 10 mm Hg in a reversible manner. Thus, it is concluded that pharmacological levels of 16,16-dimethyl prostaglandin E 2 affects the microcirculation dramatically in the isolated perfused liver.
The non-event worth a thousand successful procedures
Authors: Tim McCormick
Journal: BMJ (2005)

measurements and lower CD4 counts than other treated individuals, virological failure is an imperfect surrogate for the presence of resistance mutations, and some of these patients may not have developed resistance to both protease inhibitors and nonnucleoside reverse transcriptase inhibitors.Close links with the UK HIV Drug Resistance Database 9 will allow us to deal with this question directly once the use of resistance testing has become routine in this group.Further follow up of clinical events in these patients will allow us to assess whether our definition of three class failure is a good indicator of subsequent poorer clinical outcome.Our findings show that new drugs with low toxicity, which are not associated with cross resistance to existing drugs, will be needed for such patients.The authors thank all the clinicians, data managers, and research nurses in participating clinical centres (see bmj.com) who have helped with the provision of data for this project.
Office Management of Arrhythmias
Authors: Ghazi Jawad
Journal: JAMA (1983)

This is a concise, but all-inclusive, easy-to-understand review of arrhythmias for the practicing physician. The chapters are well illustrated with review problems that are relevant to those problems faced daily in practice. However, I would wish more of those review problems were included. In addition, no chapter was devoted to pacemakers.  The book is a brilliant and clinically oriented study that would be a useful addition to any medical library, but it would be especially useful to internists, family physicians, cardiologists, nurses, and students. I hope the author will expand the review problems chapter in the next edition.
Treating Tobacco Dependence in a Medical Setting
Authors: R. D. Hurt, J. O. Ebbert, J. T. Hays, D. D. McFadden
Journal: CA A Cancer Journal for Clinicians (2009)

The US Public Health Service Guideline for Treating Tobacco Use and Dependence 2008 Update emphasizes tobacco use as a chronic medical disorder; highlights both behavioral counseling and the use of 1 or more of the 7 approved medications; and points out the utility, efficacy, and reach of telephone quitlines. The treatment of users of smokeless tobacco continues to be less than optimal. Although providing evidence-based treatment for tobacco- dependent patients is a challenge for busy physicians, a team approach including trained and certified tobacco treatment specialists (TTS) provides an efficient treatment model. TTS represent a new and growing part of the health care team and hold great potential for expanding the collective tobacco treatment expertise in the medical setting. The effective treatment of tobacco dependence frequently requires tailoring, and often intensifying, interventions (both counseling and pharmacotherapy) to meet the needs of the individual patient.