tbuckley/cabot-search huggingface dataset:
HIV-1 Antibody Testing
Authors: Lynn W. Kitchen
Journal: JAMA (1988)

<h3>To the Editor.—</h3> Schwartz et al<sup>1</sup>recently presented in<i>JAMA</i>a comprehensive summary of the current status of human immunodeficiency virus (HIV) serum antibody testing. However, two points raised by the authors concerning HIV-1 antibody testing by enzyme-linked immunoassay (EI A) warrant further comment. The authors state that "the more reactive the HIV test result, the greater the likelihood of disease. Most false-positive EI A results occur in specimens that have a low specimen-to-control optical density ratio." I suggest that it would be more accurate to say that "the higher the absorbance value corresponding to HIV-1 antibody level, the greater the likelihood of minimally symptomatic HIV-1 infection," since loss of antibody to<i>gag-</i>encoded HIV-1 proteins is frequently associated with development of HIV-related disease among persons in the developed world and may complicate serodiagnosis.<sup>2</sup>I agree that a highly reactive EIA is more likely to represent a true-positive
Cardiovascular and All-Cause Mortality Over a 23-Year Period Among Chinese With Newly Diagnosed Diabetes in the Da Qing IGT and Diabetes Study
Authors: Yali An, Ping Zhang, Jinping Wang, Qiuhong Gong, Edward W. Gregg, Wenying Yang, Hui Li, Bo Zhang, Ying Shuai, Yanyan Chen, Michael M. Engelgau, Yiling Cheng, Yinghua Hu, Peter H. Bennett, Guangwei Li
Journal: Diabetes Care (2015)

OBJECTIVE Despite its growing prevalence in China, the extent to which diabetes leads to excess cardiovascular disease (CVD) mortality and all-cause mortality is unclear. RESEARCH DESIGN AND METHODS We compared death rates and causes of death among 630 people with newly diagnosed diabetes (NDD) and 519 with normal glucose tolerance (NGT) who, in 1986, were identified as a result of screening 110,660 adults aged 25–74 years for diabetes in Da Qing, China. RESULTS During 23 years of follow-up, 338 (56.5%) participants with NDD and 100 (20.3%) with NGT died. CVD was the predominant cause of death in those with diabetes (47.5% in men and 49.7% in women), almost half of which was due to stroke (52.3% in men and 42.3% in women). The age-standardized incidence of all-cause death was three times as high in those with NDD as in those with NGT with incidences (per 1,000 person-years) of 36.9 (95% CI 31.5–42.3) vs. 13.3 (10.2–16.5) in men (P &amp;lt; 0.0001) and 27.1 (22.9–31.4) vs. 9.2 (7.8–10.6) in women (P &amp;lt; 0.0001). The incidence of CVD deaths in men and women with NDD (17.5 [13.8–21.2] vs. 13.5 [10.5–16.5]) did not differ significantly. Significantly higher death rates attributable to renal disease and infection were also found in the NDD group. CONCLUSIONS Diabetes is associated with a substantially increased risk of death in Chinese adults, especially from CVD, almost half of which is due to stroke.
The long QT syndrome in children. An international study of 287 patients.
Authors: A Garson, M Dick, A Fournier, P C Gillette, R Hamilton, J D Kugler, G F van Hare, V Vetter, G W Vick
Journal: Circulation (1993)

BACKGROUND The Pediatric Electrophysiology Society studied children with the long QT syndrome (LQTS) to describe the features of LQTS in patients less than 21 years old, define potential "low-risk" and "high-risk" subpopulations, and determine optimal treatment. METHODS AND RESULTS Patients less than 21 years old were included if either QTc was more than 0.44; they had unexplained syncope, seizures, or cardiac arrest preceded by emotion or exercise; or family history of LQTS. We found 287 patients from 26 centers in seven countries. Mean +/- SD age at presentation was 6.8 +/- 5.6; 9% presented with cardiac arrest, 26% with syncope, and 10% with seizures. Of those with symptoms, 67% had symptoms related to exercise. Family history was positive for long QT interval in 39% and for sudden death in 31%. Hearing loss was present in 4.5%. A normal QTc was present in 6%, and QTc of more than 0.60 was in 13%. Atrioventricular block occurred in 5%, but 13 of 15 patients had second-degree atrioventricular block (2:1), and only two of 287 had complete atrioventricular block. Ventricular arrhythmias were found on 16% of initial routine ECGs: 4% uniform premature ventricular contractions, 5% multiform premature ventricular contractions, 1% monomorphic ventricular tachycardia, and 6% torsade de pointes. Overall, treatment was effective for symptoms in 76% and for ventricular arrhythmias in 60%. There was no difference between propranolol and other beta-blockers in effective treatment. Left stellectomy was performed in nine patients, and defibrillators were implanted in four; no sudden death occurred in these 13 patients. In follow-up (duration, 5.0 +/- 4 years; age, 10.9 +/- 6.3 years), 5% had cardiac arrest, 4% had syncope, and 1% had seizures. The two multivariate predictors of symptoms at follow-up were symptoms at presentation and propranolol failure. Sudden death occurred in 8%; multivariate predictors of sudden death were length of QTc at presentation of more than 0.60 and medication noncompliance. CONCLUSIONS The appearance of 2:1 atrioventricular block, multiform premature ventricular contractions, and torsade de pointes are relatively more common in children with LQTS than other children and should raise the index of suspicion for LQTS. Because 9% of patients presented with cardiac arrest and no preceding symptoms, perhaps prophylactic treatment in asymptomatic children is indicated. Asymptomatic patients with normal QTc and positive family history may be a low-risk group. Patients with QTc of more than 0.60 are at particularly high risk for sudden death, and if treatment is not effective, consideration should be given to cardiac sympathetic denervation, pacemaker implantation, and perhaps implantation of a defibrillator.
Genetic and Environmental Sources of Covariation Between Generalized Anxiety Disorder and Neuroticism
Authors: John M. Hettema, Carol A. Prescott, Kenneth S. Kendler
Journal: American Journal of Psychiatry (2004)

The authors examined the sources of covariation between generalized anxiety disorder and the personality trait of neuroticism. Because women have higher levels of neuroticism and twice the risk of lifetime generalized anxiety disorder of men, gender-specific effects were also explored.Lifetime generalized anxiety disorder and neuroticism were assessed in more than 8,000 twins from male-male, female-female, and opposite-sex pairs through structured diagnostic interviews. Sex-limited Cholesky structural equation models were used to decompose the correlations between generalized anxiety disorder and neuroticism into genetic and environmental components, including sex-specific factors.Genetic correlations between generalized anxiety disorder and neuroticism were high and differed (nonsignificantly) between men and women (1.00 and 0.58, respectively). When nonsignificant gender differences were removed from the models, correlations between generalized anxiety disorder and neuroticism were estimated at 0.80 (95% confidence interval=0.52-1.00). The individual-specific environmental correlation between generalized anxiety disorder and neuroticism was estimated at 0.20 for both genders.There is substantial overlap between the genetic factors that influence individual variation in neuroticism and those that increase liability for generalized anxiety disorder, irrespective of gender. The life experiences that increase vulnerability to generalized anxiety disorder, however, have only modest overlap with those that contribute to an individual's level of neuroticism.
Pertussis Vaccine Encephalopathy
Authors: Vincent Garbitelli
Journal: JAMA (1990)

<h3>7b the Editor.—</h3> It seems that Dr Cherry<sup>1</sup>almost misses the point of the pertussis vaccine controversy. In the last line of his editorial he states, "New vaccines are needed... to decrease the many disquieting reactions such as high fever, persistent uncontrollable crying, and hypotonic, hyporesponsive state, that do occur...." That is the point. Because an infant cannot ever describe an awful headache, the infant would behave in exactly the "disquieting" manner that Dr Cherry describes. Like most diagnoses in medicine, encephalopathy is a clinical diagnosis. At this point in medicine, no computed tomographic scan, magnetic resonance imaging, or spinal tap could really prove the diagnosis. What is clear is that those babies reacting to the pertussis vaccine are sick and probably do have an encephalopathy. Most physicians do recognize that a sequence of events does not mean that one event caused a subsequent event, but clinical diagnosis is
A model for NICE in the US
Authors: R E Ferner, S. E McDowell
Journal: BMJ (2009)

Will provide data on comparative efficacy and cost-effectiveness to improve health care

The US Congress has recently allocated $1.1bn for research to compare the effectiveness of different treatments.1 As McGreal explains,2 some groups fiercely oppose the plans. Conservatives for Patient Rights (CPR) argue that “choice, competition, accountability and personal responsibility” should determine better health care. Spokesmen from the pharmaceutical industry have tried to discredit the investigation of cost effectiveness, which “puts a ceiling on price and can limit the treatment options for patients. Critics have faulted the UK National Institute for Health and Clinical Excellence (NICE) for that.” One UK critic of NICE, Karol Sikora (medical director of CancerPartnersUK), is quoted as saying: “As a practicing oncologist, I am forced to give patients older, cheaper medicines. The real cost of this penny-pinching is premature death for thousands of patients—and higher overall health costs than if they had been treated properly: sick people are expensive.” Should Americans welcome cost effectiveness analysis?

Health care is certainly expensive in the United States. Expenditure in 2005 was $6350 per US citizen (45% publicly financed) compared …
Toward Asthma Prevention — Does All That Really Matters Happen before We Learn to Read?
Authors: Fernando D. Martinez
Journal: New England Journal of Medicine (2003)

Patients with asthma and their caregivers are currently faced with a remarkable paradox. Considerable progress has been made during the past 20 years in the pharmacotherapy, educational tools, and environmental measures available for the control of symptoms of asthma. As a result of these advances, more than 90 percent of patients with asthma now have the potential to lead a normal life. The bad news, however, is the absence of any universally accepted strategy for the prevention of the disease. With the exception, perhaps, of measures for the avoidance of infrequent forms of asthma caused by very specific types of . . .
Childhood poisoning. An unfortunate consequence of methadone availability
Authors: R. Aronow
Journal: JAMA (1972)

Accidental ingestion of methadone hydrochloride by 18 children less than seven years of age occurred during a nine-month period. In each situation, someone in the environment was taking methadone for heroin addiction. Although the lethal dose for children has not been established, even a small amount may threaten life and result in a varying clinical course for 48 hours. Therapy to maintain adequate respiration should include nalorphine hydrochloride and precise supportive care.
Spinal Anesthesia in Obstructive Cardiomyopathy
Authors: John F. Butterworth
Journal: JAMA (1986)

To the Editor.—  The authors of the recent article on perioperative anesthetic risks in patients with hypertrophic obstructive cardiomyopathy that appeared inThe Journal, 1 make claims regarding the safety of spinal anesthesia that would seem unwarranted. A single instance of myocardial infarction in a patient with coronary artery disease, as well as obstructive cardiomyopathy, is used as evidence for avoiding spinal anesthesia. Such a blanket recommendation would seem ill-advised.  There is no mention in the article of the level of spinal anesthesia employed in the four instances in which it was used. There are major differences between low and high dermatomal levels of spinal anesthesia in their hemodynamic consequences. For example, saddle block anesthesia for a patient requiring dilatation and curettage of the cervix would not be expected to produce the profound changes in venous capacitance and arterial resistance that are seen when high levels of spinal anesthesia are
The Elephant in the Room—Your Patient Is Dying
Authors: Tanya H. Tajouri, Timothy J. Moynihan
Journal: JAMA Internal Medicine (2013)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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 Internal Medicine journal
Virulence of 1918 Influenza Virus Linked to Inflammatory Innate Immune Response
Authors: Tracy Hampton
Journal: JAMA (2007)

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
Diurnal variation in nerve conduction, hand volume, and grip strength in the carpal tunnel syndrome.
Authors: J Wilson-MacDonald, M A Caughey, D B Myers
Journal: BMJ (1984)

injury produced by an adult fingernail.An open safety pin, which was impacted at the thoracic inlet, was retrieved.A similar incident occurred one month later, but the safety pin had already passed into the stomach and was subsequently voided.The mother was convicted of assault.The child subsequently had a dead ear, with loss of stapes superstructure and a fistula below the facial nerve into the vestibule.
Augmented hepatic interferon gamma expression and T-cell influx characterize acute hepatitis progressing to recovery and residual lifelong virus persistence in experimental adult woodchuck hepatitis virus infection
Authors: Paul D. Hodgson, Tomasz I. Michalak
Journal: Hepatology (2001)

Woodchucks infected with woodchuck hepatitis virus (WHV) have profiles of liver disease and age-dependent rates of progression to chronic hepatitis (CH) comparable with those seen in human hepatitis B. The mechanism of recovery from acute hepadnaviral infection or its evolution to chronicity remains unknown, although the liver immune responses are expected to play an important role. To determine the dynamics of intrahepatic cytokine expression and T-cell involvement, and to assess their value in predicting the outcome of acute hepatitis (AH) in the adult onset of WHV infection, we evaluated liver transcription of interferon gamma (IFN-γ); tumor necrosis factor α (TNF-α); interleukins (IL)-2, -4, and -6; and the T-cell influx in relation to disease histologic severity and virus load in serial liver biopsies collected during the life span of experimentally infected woodchucks. Our results show that recovery from viral AH in adulthood is preceded by a significantly greater hepatic expression of IFN-γ and CD3, an increased TNF-α transcription, lower hepatic WHV load, and a greater degree of liver inflammation than those in acute infection with CH outcome. Furthermore, we have learned that the elevated IFN-γ, TNF-α, and CD3 expression in the liver endures for years not only in CH, but also, although to a lesser extent, in apparently completely resolved infection. This is consistent with our previous findings that residual WHV replication and remnant liver inflammation continue for life after recovery from AH. This study indicates that antiviral cytokines, in particular IFN-γ, may play a central role in the long-term control of occult hepadnavirus persistence in the liver.
Cerebrospinal Fluid and the Brain Edemas
Authors: Oscar Sugar
Journal: JAMA (1989)

Milhorat, a long-time worker in the field of cerebrospinal fluid formation and circulation, has chosen in this monograph to emphasize the lymphatic-like arrangement of the cerebrospinal fluid pathways. With this, he reverts to Harvey Cushing's concept of "The Third Circulation," with emphasis on the fluid as a closely regulated internal milieu, and as a vehicle for intracerebral transport. This fluid is formed in the ventricles by the choroid plexuses and by passage into these chambers of interstitial fluid filtering through the blood-brain barrier, having taken up metabolic products and secretions. Milhorat repeatedly describes (and pictures in simplified diagrams) the "other" route that the fluid may take to end up in the cerebrospinal fluid proper; that is, by filtering through the pial surfaces (eg, Figures 13 and 30). This raises the immediate intriguing question, unfortunately not answered: Why does this pial route not take care of the excess fluid in the
Current Experience with Pheochromocytoma.
Authors: J. Richard Crout
Journal: Annals of Internal Medicine (1969)

s1 May 1969Current Experience with Pheochromocytoma.J. Richard Crout, M.D., F.A.C.P., Burnell R. Brown Jr., M.D., Federico A. Dostal, M.D.J. Richard Crout, M.D., F.A.C.P.Search for more papers by this author, Burnell R. Brown Jr., M.D.Search for more papers by this author, Federico A. Dostal, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1061_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSince January 1964 the diagnosis of pheochromocytoma has been established in 20 patients on the basis of urinary catecholamine studies performed in this laboratory. Six were members of 2 separate families harboring pheochromocytoma, while the remaining 14 developed tumors in the absence of genetic predisposition. Urinary free norepinephrine was increased in 90% of patients, free epinephrine in 55%, normetanephrine and metanephrine in 100%, and vanilmandelic acid in 95%. Mean excretion values for the group, although markedly elevated, were only about one third of those reported in a similar series in 1964 (CROUT, J. R., SJOERDSMA, A.:J. Clin. Invest. 43:... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Dallas, Texas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1969Volume 70, Issue 5Page: 1061-1062KeywordsCatecholaminesEpinephrineExcretionGenetic predispositionNorepinephrinePheochromocytomaResearch laboratories Issue Published: 1 May 1969 PDF downloadLoading ...
Inference on Population Histories by Approximating Infinite Alleles Diffusion
Authors: J. Siren, W. P. Hanage, J. Corander
Journal: Molecular Biology and Evolution (2012)

Reconstruction of the past is an important task of evolutionary biology. It takes place at different points in a hierarchy of molecular variation, including genes, individuals, populations, and species. Statistical inference about population histories has recently received considerable attention, following the development of computational tools to provide tractable approaches to this very challenging problem. Here, we introduce a likelihood-based approach which generalizes a recently developed model for random fluctuations in allele frequencies based on an approximation to the neutral Wright–Fisher diffusion. Our new framework approximates the infinite alleles Wright–Fisher model and uses an implementation with an adaptive Markov chain Monte Carlo algorithm. The method is especially well suited to data sets harboring large population samples and relatively few loci for which other likelihood-based models are currently computationally intractable. Using our model, we reconstruct the global population history of a major human pathogen, Streptococcus pneumoniae. The results illustrate the potential to reach important biological insights to an evolutionary process by a population genetics approach, which can appropriately accommodate very large population samples.
Current "corrected" calcium concept challenged.
Authors: R W Pain, K M Rowland, P J Phillips, B M Duncan
Journal: BMJ (1975)

There is wide individual variation in the number of millimoles of calcium bound per gram of albumin in the serum. Individual regression coefficients for serum calcium concentration on serum albumin concentration have been determined in 62 people (25 of our own patients and 37 reported by others). The 95 percentile range was 0-007-0-053 mmol/g, with a median value of 0-025 mmol/g. Accordingly, it is not valid to "correct" a person9s measured serum total calcium concentration for variations in serum albumin concentration using an average regression coefficient. Rather, the individual9s own regression coefficient must be used. A tourniquet test seems to be the simplest technique for determining this value. Even then, precise interpretation of an individual9s corrected serum calcium concentration is possible only when an appropriate reference range for corrected serum calcium concentration has been established. Such an appropriate reference range must be determined from an adequate number of normal people using the individual9s own correction factor in each case.