tbuckley/cabot-search huggingface dataset:
Caring for the Uninsured Choices for Reform
Authors: Robert J. Blendon, Jennifer N. Edwards
Journal: JAMA (1991)

These recent events provide the impetus for this theme issue ofThe Journal: (1) Government reports show a 24% increase in the last decade in the total number of uninsured people and a 40% increase in the number of uninsured children.<sup>1-4</sup>Most uninsured children are part of a family with a working adult. (2) Recent studies have found that, despite considerable amounts of uncompensated care provided by hospitals and physicians, Americans without health insurance face major barriers to the receipt of needed health services. Although they suffer from higher rates of ill health than the insured population, the uninsured report fewer hospitalizations and fewer visits to a physician, shorter hospital stays, and fewer discretionary inpatient hospital treatments and tests, at higher cost. The uninsured also experience higher mortality rates when hospitalized than persons with health insurance coverage who have similar medical diagnoses.<sup>5-11</sup>(3) There is evidence of growing
An immunoelectron microscopy study of the relationship between herpes gestationis and polymorphic eruption of pregnancy
Authors: W. JURECKA, R.C. HOLMES, M.M. BLACK, P. McKEE, A.K. DAS, B. BHOGAL
Journal: British Journal of Dermatology (1983)

Five patients with typical bullous herpes gestationis and five patients with polymorphic eruption of pregnancy were studied. Shave biopsies were taken from both involved and uninvolved skin and examined by routine immunofluorescence. They were also examined by immunoelectron microscopy employing a multistep peroxidase‐antiperoxidase technique which has been shown to be more sensitive than immunofluorescence. Despite the increased sensitivity of immunoelectron microscopy all cases of polymorphic eruption of pregnancy were completely negative. Although there is a considerable clinical and histopathological overlap between herpes gestationis and polymorphic eruption of pregnancy our findings indicate that these conditions are pathogenetically distinct and should be classified as separate disorders.
Memory of intraoperative events
Authors: M. Wang, I. F Russell
Journal: BMJ (1995)

EDITOR,—We were disappointed to read in J G Jones's editorial on memory of intraoperative events that Jones believes that the isolated forearm technique is “unsuitable for prolonged monitoring because of the risk of ischaemia in the isolated arm.”1 We have described how prolonged monitoring is easily achieved simply by releasing the forearm cuff after 20 minutes and then reinflating it some minutes later if further muscle relaxation is required.2 3 This cycle of isolation of the forearm and release can then be maintained indefinitely. Using “train of four” nerve stimulation in more than 100 cases, we …
Prevention of Cancer of the Oral Cavity and Pharynx
Authors: E. Baden
Journal: CA A Cancer Journal for Clinicians (1987)

Multiple environmental factors and a multistage pathogenic mechanism appear to be involved in oropharyngeal carcinogenesis. Tobacco and alcohol are the most important risk factors, but other agents may also contribute to malignant transformation. Individual susceptibility to environmental carcinogens, although significant, is still incompletely understood. Based on our present-day knowledge of risk factors, prevention should be possible in about two thirds of all oropharyngeal cancers. It cannot be achieved, however, without both public and professional education. A rational approach to prevention of oropharyngeal cancer should start in school before habits are formed, continued throughout adolescence, and reinforced in adults. Reduction or elimination of risk factors is of prime importance. For those who cannot quit tobacco, a reduction of tar content in cigarettes, cigars, pipes, and chewing tobacco, and elimination of nitrosamines, especially from smokeless tobacco, might also help to reduce risks. Control of chronic alcoholism is more difficult, but diet supplementation, especially with proteins, vitamins, and trace metals, would decrease the promoter effect of alcohol. Control of occupational risks is of less significance. The clinician must have a state-of-the-art understanding of all known risk factors for the prevention, early detection, and control of oropharyngeal cancer. The history should review in detail exposure to tobacco, alcohol, actinic radiation, and other agents. Age of first exposure or onset of habit; duration (years); quantity of tobacco smoked, chewed, or snuffed; and its relationship with the anatomic site at risk should all be precisely recorded. Exposure to alcohol or any other risk factor should be evaluated in the same way. This review has emphasized the relationship between the various risk factors and the site prevalence of malignant lesions. Habits, customs, and cultures, as well as anatomic physiologic factors, all have a bearing on the actual target sites at which the carcinogen(s) and promotor(s) are brought in contact with the oral mucosa. Habits and customs vary widely, both geographically and among individuals. Dentists and physicians should be aware of these individual factors as they examine their patients.
One Night on the Porch at Meyer's Creek
Authors: Gary Stein
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
Suppression of HER2/HER3-Mediated Growth of Breast Cancer Cells with Combinations of GDC-0941 PI3K Inhibitor, Trastuzumab, and Pertuzumab
Authors: Evelyn Yao, Wei Zhou, Si Tuen Lee-Hoeflich, Tom Truong, Peter M. Haverty, Jeffrey Eastham-Anderson, Nicholas Lewin-Koh, Bert Gunter, Marcia Belvin, Lesley J. Murray, Lori S. Friedman, Mark X. Sliwkowski, Klaus P. Hoeflich
Journal: Clinical Cancer Research (2009)

Abstract Purpose: Oncogenic activation of the phosphatidylinositol 3-kinase (PI3K) signaling pathway is prevalent in breast cancer and has been associated with resistance to HER2 inhibitors in the clinic. We therefore investigated the combinatorial activity of GDC-0941, a novel class I PI3K inhibitor, with standard-of-care therapies for HER2-amplified breast cancer. Experimental Design: Three-dimensional laminin-rich extracellular matrix cultures of human breast cancer cells were utilized to provide a physiologically relevant approach to analyze the efficacy and molecular mechanism of combination therapies ex vivo. Combination studies were done using GDC-0941 with trastuzumab (Herceptin), pertuzumab, lapatinib (Tykerb), and docetaxel, the principal therapeutic agents that are either approved or being evaluated for treatment of early HER2-positive breast cancer. Results: Significant GDC-0941 activity (EC50 &amp;lt;1 μmol/L) was observed for &amp;gt;70% of breast cancer cell lines that were examined in three-dimensional laminin-rich extracellular matrix culture. Differential responsiveness to GDC-0941 as a single agent was observed for luminal breast cancer cells upon stimulation with the HER3 ligand, heregulin. Combined treatment of GDC-0941, trastuzumab, and pertuzumab resulted in growth inhibition, altered acinar morphology, and suppression of AKT mitogen-activated protein kinase (MAPK) / extracellular signed-regulated kinase (ERK) kinase and MEK effector signaling pathways for HER2-amplified cells in both normal and heregulin-supplemented media. The GDC-0941 and lapatinib combination further showed that inhibition of HER2 activity was essential for maximum combinatorial efficacy. PI3K inhibition also rendered HER2-amplified BT-474M1 cells and tumor xenografts more sensitive to docetaxel. Conclusions: GDC-0941 is efficacious in preclinical models of breast cancer. The addition of GDC-0941 to HER2-directed treatment could augment clinical benefit in breast cancer patients.
Experimental Pulmonary Edema Following Rapid Carotid Infusion: Mechanism and Therapy
Authors: ALDO A. LUISADA, STEPHEN CONTRO
Journal: Circulation Research (1953)

The mechanism and therapy of acute pulmonary edema are studied in animals with rapid intracarotid infusion of saline solution toward the brain. Sympatholytic drugs and heparin have a marked beneficial action and prevent the occurrence of pulmonary edema.
Oral Fluoroquinolone Therapy for Clostridium difficile Enterocolitis-Reply
Authors: Dale N. Gerding
Journal: JAMA (1989)

In Reply.—  The observations of Dr Lettau, while anecdotal, are of great interest because they suggest that treatment with an oral fluoroquinolone (ciprofloxacin) may allow the resolution of symptoms ofC difficiletoxin-positive diarrhea that resulted from use of another antibiotic (ceftriaxone). These observations require verification in a controlled manner and may even warrant a controlled trial of a fluoroquinolone agent for the treatment ofC difficilediarrhea.  As Dr Lettau correctly points out, the diarrhea may have resolved simply as a result of discontinuation of ceftriaxone therapy. In our therapeutic trial we observed cessation of diarrhea without treatment in 34 of 149 patients within 48 to 72 hours after discontinuation of the offending antibiotic.1Discontinuation of antibiotic therapy remains the first choice for treatment ofC difficile-associated diarrhea. We reserve metronidazole or vancomycin therapy for seriously ill patients or for those whose diarrhea does not resolve after
Should 24-h Ambulatory Blood Pressure Monitoring Be Done in Every Patient With Diabetes?
Authors: Gianfranco Parati, Grzegorz Bilo
Journal: Diabetes Care (2009)

Twenty-four–hour ambulatory blood pressure monitoring (ABPM) is a method widely used in hypertension diagnosis and management. Also in diabetic subjects, it may be a powerful tool for a better stratification of cardiovascular risk related to elevated blood pressure (BP), one of the most important causes of morbidity and mortality in this population. This is due to its capacity, as compared with isolated office measurements, to more precisely diagnose and quantify a high BP condition in daily life and to detect alterations of 24-h BP profiles such as absence of nocturnal BP fall, postprandial hypotension, or an increased BP variability, which may reflect a deranged cardiovascular regulation often associated with a reduced heart rate variability. It is also an important tool to obtain an accurate assessment of the efficacy of antihypertensive treatment over day and night. Admittedly, this method has its disadvantages, which include relatively high cost, problems with validation of the devices (particularly relevant in special populations such as diabetic patients), and undefined diagnostic threshold in high-risk populations. A number of studies have shown that ABPM may be a useful tool in improving outcome and quality of life in diabetes, suggesting that it should be an integral part of the clinical management in this setting. However, due to its limited availability in clinical practice, it may not be easily applied in every diabetic subject and thus priority should be given to those of diabetic patients, who may derive the most evident benefits from the use of this diagnostic tool.

The 24-h ABPM is a method widely used in hypertension diagnosis and management (1–3). Numerous studies over the years have confirmed its advantages over the traditional clinic measurement, including a higher reproducibility, lack of placebo and white coat effect, and, most importantly, its superiority in predicting adverse consequences of …
Routine Preoperative Screening for HIV
Authors: Joseph S. Carey
Journal: JAMA (1988)

<h3>To the Editor.—</h3> I wish to take issue with the SPECIAL COMMUNICATION entitled "Routine Preoperative Screening for HIV: Does the Risk to the Surgeon Outweigh the Risk to the Patient?"<sup>1</sup>The authors, three nonsurgeons, make a number of assumptions, such as a "first-order approximation" of the rate of skin penetration from intraoperative injuries to the surgeon's hands of 2%. The reverse calculation of skin-puncture rate from seroconversion to hepatitis B virus among surgeons is farfetched and not particularly pertinent. More pertinent would be an attempt to estimate the highest possible risk. Such data are critical to those of us who are exposed. The skin-puncture rate could be assumed to be equal to the glove-puncture rate, since multiple punctures may occur during the same procedure and frequent glove changes are common. If the glove-puncture rate is 25% and the risk of human immunodeficiency virus (HIV) infection after skin puncture is
Right Axis Deviation, Clockwise QRS Loop, and Signs of Left Ventricular Underdevelopment in a Child with Complete Type of Persistent Common Atrioventricular Canal
Authors: DAVID BAUM, GILBERT J. ROTH, S. ALLISON CREIGHTON
Journal: Circulation (1964)

Clinical data and findings at necropsy are presented on a 2-year-old girl who had persistent complete common atrioventricular canal, hypoplastic left ventricle, and obstruction to the left ventricular outflow tract. Electro-cardiographic findings were atypical of common atrioventricular canal in that right axis deviation and a clockwise inscription of the QRS loop in the frontal plane were present. Findings in this case suggest that under-development of the left ventricle should be suspected when (1) displacement of the interventricular sulcus is noted on roentgenographic examinations and (2) predominant left-to-right shunting at ventricular level is found in the absence of electrocardiographic evidence of left ventricular overload.
The Roles of IgG, IgM Rheumatoid Factor, and their Complexes in the Induction of Polymorphonuclear Leukocyte Chemotactic Factor from Complement
Authors: Teresa Wagner, George Abraham, John Baum
Journal: Journal of Clinical Investigation (1974)

The induction of chemotactic factor by rheumatoid factor (RF) and by rheumatoid complexes and their constituents was investigated. The presence of chemotactic factor was measured by the number of polymorphonuclear leukocytes (obtained from normal individuals) attracted through a 3 μm Millipore filter and is expressed as a “chemotactic index.” The chemotactic index was used to measure the effect of immunoglobulins and their complexes in stimulating production of complement-derived chemotactic factors from the sera of normal individuals.
Efficacy of an air‐cleaning device equipped with a high efficiency particulate air filter in house dust mite respiratory allergy
Authors: L. Antonicelli, M.B. Bilò, S. Pucci, C. Schou, F. Bonifazi
Journal: Allergy (1991)

The efficacy of an air‐cleaning device equipped with a high efficiency particulate air (HEPA) filter (without further avoidance measures) was studied in patients allergic to house dust mite. The effects of the air‐cleaner on indoor Dermatophagoides sp. levels, symptom score and bronchial hyperresponsiveness in nine mite‐allergic patients were assessed using a cross‐over controlled study. No significant effect was demonstrated on indoor Dermatophagoides sp. levels when comparing the period of air‐cleaner activity (2 months) with the control period (2 months). The Dermatophagoides sp. levels in the houses studied were lower than the risk level for asthmatic attacks, making it difficult to assess any effect on asthma; however, neither bronchial hyperresponsiveness nor rhinitis symptom score were changed by air‐cleaner activity. During the trial period, however the mean level of Dermatophagoides sp. allergen in the houses changed spontaneously from 4.4 Hg/g (mean level in the first 2 trial months) to 1. 75 μg/g of dust (second 2 months) ( P &lt; 0.05). Owing to this change, the mean rhinitis symptom score also decreased ( P &lt; 0.05), even if no significant correlation was demonstrated (r = 0.4 P = 0.089). HEPA filter air‐cleaners appear insufficient as substitutes for standard avoidance measures in mite allergic patients.
Malignant Pleural Effusion and Tc-99m MDP Accumulation
Authors: LAMK LAMKI, PHIL COHEN, ALBERT DRIEDGER
Journal: Clinical Nuclear Medicine (1982)

Two case reports of malignant pleural effusion from breast carcinoma, with scans showing a striking accumulation of Tc-99m MDP, are presented. The Tc-99m MDP was in the pleural fluid and not in the pleura as demonstrated by shift with gravity. Possible mechanisms of malignant effusion accumulation of Tc-99m MDP are suggested. The scant literature on the subject is reviewed.
Germany's organ procurement body wants powers to run donation process
Authors: A. Tuffs
Journal: BMJ (2009)

Germany’s national organ procurement organisation is demanding more power after a decline of almost 9% in organ donation in 2008.

About 12 000 patients are waiting for a transplant in Germany, and dialysis patients often have to wait 5-6 years for a new kidney.

The national organ body, Deutsche Stiftung Organtransplantation (DSO), says that the decline is partly because of the indifference of hospitals to transplantation—they are meant to register potential donors, but often …
Preclinical Studies in Support of Defibrotide for the Treatment of Multiple Myeloma and Other Neoplasias
Authors: Constantine S. Mitsiades, Cecile Rouleau, Cinara Echart, Krishna Menon, Beverly Teicher, Maria Distaso, Antonio Palumbo, Mario Boccadoro, Kenneth C. Anderson, Massimo Iacobelli, Paul G. Richardson
Journal: Clinical Cancer Research (2009)

Abstract Purpose of the Study: Defibrotide, an orally bioavailable polydisperse oligonucleotide, has promising activity in hepatic veno-occlusive disease, a stem cell transplantation–related toxicity characterized by microangiopathy. The antithrombotic properties of defibrotide and its minimal hemorrhagic risk could serve for treatment of cancer-associated thrombotic complications. Given its cytoprotective effect on endothelium, we investigated whether defibrotide protects tumor cells from cytotoxic antitumor agents. Further, given its antiadhesive properties, we evaluated whether defibrotide modulates the protection conferred to multiple myeloma cells by bone marrow stromal cells. Methods-Results: Defibrotide lacks significant single-agent in vitro cytotoxicity on multiple myeloma or solid tumor cells and does not attenuate their in vitro response to dexamethasone, bortezomib, immunomodulatory thalidomide derivatives, and conventional chemotherapeutics, including melphalan and cyclophosphamide. Importantly, defibrotide enhances in vivo chemosensitivity of multiple myeloma and mammary carcinoma xenografts in animal models. In cocultures of multiple myeloma cells with bone marrow stromal cells in vitro, defibrotide enhances the multiple myeloma cell sensitivity to melphalan and dexamethasone, and decreases multiple myeloma–bone marrow stromal cell adhesion and its sequelae, including nuclear factor-κB activation in multiple myeloma and bone marrow stromal cells, and associated cytokine production. Moreover, defibrotide inhibits expression and/or function of key mediators of multiple myeloma interaction with bone marrow stromal cell and endothelium, including heparanase, angiogenic cytokines, and adhesion molecules. Conclusion: Defibrotide's in vivo chemosensitizing properties and lack of direct in vitro activity against tumor cells suggest that it favorably modulates antitumor interactions between bone marrow stromal cells and endothelia in the tumor microenvironment. These data support clinical studies of defibrotide in combination with conventional and novel therapies to potentially improve patient outcome in multiple myeloma and other malignancies.
1116-30 Effect of apolipoprotein E, gender, and exercise on lipase activities
Authors: Richard L Seip, Cherie Bilbie, Niall Moyna, Mary Miles, Robert F Zoeller, Paul S Visich, Theodore J Angelopoulos, Linda Pescatello, Paul Gordon, Gregory Tsongalis, Linda Bausserman, Paul D Thompson
Journal: Journal of the American College of Cardiology (2004)
Assessing a microrNA panel in diagnosing early cholangiocarcinoma
Authors: Tetsuji Fujita
Journal: Hepatology (2014)

Potential conflict of interest: Nothing to report. To the Editor: Dr. Li and colleagues1 are to be congratulated on the success in developing a novel method for extracting stable microRNA‐laden extracellular vesicles from human bile, determining five microRNA species (miRs) (miR‐191, miR‐486‐3p, miR‐1274b, mi‐R 16, and miR‐484) using computer‐based classifiers, and discriminating cholangiocarcinoma (CCA) from benign biliary diseases with a five‐miRNA panel. A sensitivity of 67% and a specificity of 96% would be sufficient to use the panel in clinical practice, although use of the panel may be time‐consuming and expensive. Li et al. conclude that their panel is superior to CA 19‐9 in detecting early CCA, because the panel diagnosed more N0M0 tumors than CA 19‐9 and two patients were correctly diagnosed as having a T1N0M0 tumor only by the panel. The outcome of surgery for CCA is affected by not only nodal status but also tumor size and tumor stage. The patients suffering from stage 1 or stage 2 intrahepatic cholangiocarcinoma (ICC) had a significantly better postoperative outcome than stage 3 patients and all other patients.2 When looking at table 1B,1 a sensitivity of the panel (55%) is the same as that of CA 19‐9 in stage 1 (T1N0M0) and stage 2 (T2N0M0) tumors. Further studies enrolling stage 1/2 CCAs would be warranted because the diagnostic accuracy of an enhanced computed tomography (CT) scan and magnetic resonance imaging (MRI) for larger liver tumors is high.3 Among the five miRs making up the panel in the study by Li et al., miR‐191 was found to be highly expressed also in hepatocellular carcinomas (HCCs) taken from patients, and was shown to be a potential therapeutic target.4 Conversely, higher expression of miR‐486‐3p in nontumor liver tissues in patients with HCC was associated with a better survival, meaning that miR‐486‐3p might down‐regulate the growth of HCC.5 Despite advances in noninvasive diagnosis of liver nodules, it is difficult to discriminate a small (<2 cm) ICC from other small liver nodules such as HCC, focal fatty infiltration, arterioportal shunt, immature abscesses, macroregenerative nodules, hepatic tuberculosis, focal nodular hyperplasia, dysplastic nodules, hemangiomas, and metastatic nodules from other sites. Since some miRs are likely involved in the regulation of both ICC and HCC, it would be interesting to investigate whether the panel is applicable to discrimination between small ICCs and small HCCs.