tbuckley/cabot-search huggingface dataset:
Palliative care: views of patients and their families.
Authors: I Higginson, A Wade, M McCarthy
Journal: BMJ (1990)

OBJECTIVE--To investigate the current problems and needs of terminally ill cancer patients and their family members, and to discover their views of hospital, community, and support team services. DESIGN--Prospective study of patients and families by questionnaire interviews in the patients9 homes. SETTING--Inner London and north Kent (London suburbs). SUBJECTS--65 Patients, each with a member of their family or a career. MAIN OUTCOME MEASURES--Ratings of eight current problems and ratings and comments on three services-hospital doctors and nurses, general practitioners and district nurses, and the support team staff-obtained after a minimum of two weeks9 care from palliative care support teams. RESULTS--Effect of anxiety on the patient9s nearest career. and symptom control were rated as the most severe current problems by both patients and families; a few patients and families identified other severe problems. Families9 ratings of pain control, symptom control, and effect of anxiety on the patient were significantly worse than the patients9 ratings (p less than 0.05). Support teams received the most praise, being rated by 58 (89%) patients and 59 (91%) of family members as good as excellent. General practitioners and district nurses were rated good or excellent by 46 (71%) patients and 46 (71%) family members, but six (9%) in each group rated the service as poor or very bad, and ratings in the inner London district were significantly worse than those in the outer London district. Hospital doctors and nurses were rated good or excellent by 22 (34%) patients and 35 (54%) of family members, and 14 (22%) patients and 15 (23%) family members rated this service as poor or very bad. Negative comments referred to communication (especially at diagnosis), coordination of services, the attitude of the doctor, delays in diagnosis, and difficulties in getting doctors to visit at home. Family members were more satisfied with the services than were patients. CONCLUSIONS--Palliative care needs to include both the patient and family because the needs of the family may exceed those of the patient. Support teams and some hospital and community doctors and nurses met the perceived needs of dying patients and families, but better education and organisation of services are needed.
Statewide Quality Improvement Initiatives and Mortality After Cardiac Surgery
Authors: William A. Ghali
Journal: JAMA (1997)

Recent reports from New York and northern New England claim that statewide quality improvement initiatives and outcome reporting are leading to decreased mortality following coronary artery bypass graft (CABG) surgery.To compare trends in mortality after CABG surgery in Massachusetts (a state that has not instituted statewide outcome reporting) with the decreases reported from New York and northern New England.Surgical cohorts from 1990, 1992, and 1994 were used to evaluate the risk-adjusted mortality trend for Massachusetts. We present this trend along with the published trends from New York and northern New England. For comparison, we also present unadjusted Medicare mortality trends from Massachusetts, New York, northern New England, and the entire United States.All 12 Massachusetts hospitals performing cardiac surgery (excluding a Veterans Affairs hospital). PATIENTS AND DATA SETS: Massachusetts administrative data were used to identify all patients undergoing isolated CABG surgery in 1990, 1992, and 1994.Observed and risk-adjusted in-hospital mortality.Observed mortality rates in Massachusetts decreased from 4.7% in 1990 to 3.5% in 1992 and to 3.3% in 1994. The corresponding risk-adjusted mortality reductions for 1992 and 1994 (relative to 1990) were 35% and 42%, respectively. The mortality reduction seen in Massachusetts is comparable to the reductions seen in New York and northern New England over similar periods. Unadjusted Medicare mortality trends were generally similar in the states under study, and in the United States as a whole.In-hospital mortality after CABG surgery has decreased in Massachusetts despite the absence of statewide outcome reporting. Direct program evaluations are needed to better characterize the efficacy of the ongoing statewide outcome studies in New York and northern New England.
TREATMENT OF PERIUTERINE SEPTIC DISEASES.
Authors: W. E. B. DAVIS
Journal: JAMA (1897)

Only recently has the extremely radical procedure of hysterectomy been practiced in this country for septic diseases of the internal genitals. A wave, which had its origin in Paris at the hands of Péan, aided by Richelot, Segond, Jacobs and others, reached our shores three years ago and has found a considerable following among our leading operators. There has been much rivalry for some years in this country as to who could do the largest number of hysterectomies most successfully, but I will not say that it is possible this innovation was more readily embraced as it afforded great opportunity for such ambitious ones, who had almost ceased to be interested in the more simple operation of salpingo-oöphorectomy, to increase their cases of hysterectomy more rapidly. They claim that there is no use in leaving the uterus behind after the removal of the appendages; that "in every operation for septic
Bariatric Surgery before Pregnancy — Is This a Solution to a Big Problem?
Authors: Aaron B. Caughey
Journal: New England Journal of Medicine (2015)

Obesity has reached epidemic levels in the United States. According to data from the Centers for Disease Control and Prevention (CDC), in 1990 no state in the United States had a prevalence of obesity of 15% or more, but by 2010, no state had a prevalence of obesity below 20%, and a third of states had a prevalence of 30% or higher.1 This trend extends to pregnancy; almost a third of women entering pregnancy in the United States are obese.2 Moreover, the prevalence of extreme obesity is also increasing. For example, in pregnant women, the subcategories of obesity that are . . .
Abstract A35: Discovery of driver-type therapeutic targets to reverse glucocorticoid resistance in T-ALL
Authors: Jiyang Yu, Ericah Piovan, Maria Sol Flaherty, Jose Silva, Adolfo Ferrando, Andrea Califano
Journal: Cancer Research (2012)

Abstract Glucocorticoid (GC) resistance is a major driver of therapeutic failure in T-cell acute lymphoblastic leukemia (T-ALL). Here we developed a systems biology framework, Network-based Bayesian Inference of Disease Drivers (NetBID2), using transcriptomic data, to predict signaling or regulatory factors driving GC-resistance in T-ALL. With this algorithm, we identified the AKT1 kinase as a signaling modulator of GC-resistance. Mechanistically, AKT1 directly phosphorylates the glucocorticoid receptor (GCR) NR3C1 protein at position S134 and blocks glucocorticoid-induced NR3C1 translocation to the nucleus. Consistently, pharmacologic inhibition of AKT1 increases the response of T-ALL cells to glucocorticoid therapy and effectively reverses glucocorticoid resistance in vitro and in vivo. These results warrant the clinical testing of ATK1 inhibitors and glucocorticoids in combination for the treatment of T-ALL. Genome-wide RNA interference screening emerges as a powerful tool for loss-of-function studies and searching for new therapeutic targets of diseases. We integrated this technology with our computational framework and identified 16 master regulators of GC-resistance in T-ALL, when repressed, sensitizing resistant cells. Out of 16 candidates, 13 were validated in vitro, and 10 outperformed positive controls. Moreover, 75% of only predicted drivers demonstrated significant effects on changing GC-sensitivity. Network analysis of validated drivers indicated that they might work cooperatively to induce resistance, suggesting potential combinatorial therapies to reverse GC-resistance in T-ALL. Citation Format: Jiyang Yu, Ericah Piovan, Maria Sol Flaherty, Jose Silva, Adolfo Ferrando, Andrea Califano. Discovery of driver-type therapeutic targets to reverse glucocorticoid resistance in T-ALL [abstract]. In: Proceedings of the AACR Special Conference on Chemical Systems Biology: Assembling and Interrogating Computational Models of the Cancer Cell by Chemical Perturbations; 2012 Jun 27-30; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2012;72(13 Suppl):Abstract nr A35.
Self-Expanding Metal Stents in Benign Biliary Strictures Due to Chronic Pancreatitis
Authors: A. van Berkel, D. Cahen, D. van Westerloo, E. Rauws, K. Huibregtse, M. Bruno
Journal: Endoscopy (2004)

In selected patients with chronic pancreatitis in whom conventional plastic stenting fails and in whom surgery is contraindicated or declined, insertion of a biliary self-expanding metal stent (SEMS) may be a valuable treatment option.Between 1994 and 1999, 13 patients with chronic pancreatitis received SEMS for benign biliary strictures (four women and nine men; mean age 56). The indications for SEMS placement were: contraindication to surgery (n = 10), presumed inoperable pancreatic carcinoma (n = 1), concomitant unresectable lung cancer (n = 1), and declined surgery (n = 1). The success of treatment was defined as adequate biliary drainage due to SEMS therapy.The mean follow-up period was 50 months (range 6 days - 86 months). Nine patients (69 %) were successfully treated with SEMS therapy: a patent first SEMS (n = 5); a patent second SEMS inserted through the first SEMS (n = 3); and one patent SEMS after balloon cleaning. SEMS treatment was not successful in four patients (due to stent migration in one case and occlusion in three ). The mean patency period of the SEMS was 60 months (95 % CI, 43 months - 77 months). At 33 months, the probability of adequate biliary drainage with SEMS therapy was 75 %.SEMS therapy was safe and provided successful and prolonged biliary drainage in a selected group of patients with benign biliary strictures due to chronic pancreatitis in whom surgical intervention was not possible or desirable.
Hyper-responsiveness to EBV in ankylosing spondylitis.
Authors: V R Winrow, J D Perry
Journal: Annals of the Rheumatic Diseases (1987)

Alternatives to allopurinol SIR, In their letter to the Annals Kelsey et al state that there is 'no available alternative to allopurinol with its unique mode of action'.'There are at least two alter-
Social class and serum uric acid level
Authors: R. Singh
Journal: BMJ (1969)

MzDIwSUNL 303time in a population of women.The pre- valence rates determined in this study are based on the first cytological examinations done on the women attending the Planned Parenthood clinics.This, however, may well not be the first cytological examination these women have ever had, and it is not at all unlikely that the study and control groups differ in their prior cytology experience before cytological examinations were introduced in the Planned Parenthood clinics.Carcinoma in situ prevalence rates build up rapidly in women through their twenties, continue at a high plateau through their thirties into their forties, and then decline.Carcinoma in situ incidence rates, on the other hand, peak in the 25-29 year age groups and decline thereafter.The age specific prevalence and incidence rates, for carcinoma in situ per 1,000 women to age 50, and their ratios, determined for British Columbia are as in the Table above.Prior cytology will have a considerable effect on the initial cytological findings at the
Increased protein binding to a −530 mutation of the human β‐globin gene associated with decreased β‐globin synthesis
Authors: Patricia E. Berg, Moshe Mittelman, Jacques Elion, Dominique Labie, Alan N. Schechter
Journal: American Journal of Hematology (1991)

Abstract Although some cases of the syndrome of hereditary persistence of fetal hemoglobin (HPFH) have been correlated with mutations causing a change in the binding of trans‐acting factors to DNA sequences flanking the γ‐globin gene, this mechanism has not been described in β‐thalassemias upstream of the canonical promoter of the β‐globin gene. In this report we describe such a change in binding of a protein that may explain a silent carrier phenotype of β‐thalassemia. We have previously demonstrated the binding of a protein (BP1) derived from a nuclear extract of human K562 cells to DNA 5′ to the human β‐globin gene in a region having a negative regulatory function. The binding of BP1 in this region can be detected by DNAse I footprinting and by gel mobility shift analysis. We have now compared binding of BP1 to the normal sequence and a mutated sequence (+ATA/‐T at −530 bp from the cap site) from the silent carrier of β‐thalassemia. Using mobility shift assays we show that BP1 binds about nine times more strongly to the mutated sequence than the normal sequence. These results suggest the possibility that the decreased expression of the β‐globin gene exhibited by the carrier may be due, at least in part, to tighter binding of a protein which functions as a negative control element or represser.
Person centred care or public health improvement?
Authors: A. Matalon
Journal: BMJ (2008)

In recent months I have being thinking about what the most important value in family medicine is. Some doctor friends say that the single most important value is knowledge. I initially thought that experience was the most important, but then what about compassion? Compassion means bringing your whole presence to treat your patients—by listening and understanding and offering love and hope. 

These thoughts and questions came in a period in my life when I was feeling somewhat burned out, which may have been connected to the visit of a senior medical director to my clinic some months previously. He didn’t much want to hear about our work and was critical of our poor achievement in quality outcome measures. But …
Depression in Primates
Authors: WILLIAM T. MCKINNEY, STEPHEN J. SUOMI, HARRY F. HARLOW
Journal: American Journal of Psychiatry (1971)

The authors present the results of a number of experiments designed to produce depressive behavior in young rhesus monkeys and outline their plans for further experiments with monkeys. These studies are part of a research program aimed at creating an animal model of depression that should make it possible to study the effects of manipulation of the social and biological variables that are thought to be important in human depression.
504 GLUT1 AND GLUT3 EXPRESSION ARE INCREASED IN HEPATOCELLULAR CARCINOMA AND PROMOTE TUMORIGENICITY
Authors: T. Amann, U. Maegdefrau U, A. Hartmann, O. Stoeltzing, T. Weiss, J. Schölmerich, A. Bosserhoff, C. Hellerbrand
Journal: Journal of Hepatology (2009)
742 ENTECAVIR TREATMENT PREVENTS DISEASE PROGRESSION IN HBV RELATED ACUTE-ON-CHRONIC LIVER FAILURE: ESTABLISHMENT OF A NOVEL LOGISTICAL REGRESSION MODEL
Authors: K. Ma, W. Guo, M. Han, G. Chen, T. Chen, Z. Wu, D. Yang, J. Huang, Y. Huang, X. Zhao, J. Song, J. Qi, Q. Ning
Journal: Journal of Hepatology (2011)
Thiazolidinediones, Metformin, and Outcomes in Older Patients With Diabetes and Heart Failure
Authors: Frederick A. Masoudi, Silvio E. Inzucchi, Yongfei Wang, Edward P. Havranek, JoAnne M. Foody, Harlan M. Krumholz
Journal: Circulation (2005)

Background— Insulin-sensitizing drugs of the thiazolidinedione class and metformin are commonly prescribed to treat diabetes in patients with heart failure despite strong warnings from the Food and Drug Administration against this practice. Whether this results in adverse outcomes is unknown. Methods and Results— We conducted a retrospective cohort study of 16 417 Medicare beneficiaries with diabetes discharged after hospitalization with the principal discharge diagnosis of heart failure. The association between antidiabetic drug prescriptions and outcomes was assessed in multivariable hierarchical Cox proportional hazards models, with adjustment for patient, physician, and hospital variables and accounting for the clustering of patients within hospitals. The primary outcome of the study was time to death due to all causes. Secondary outcomes included time to readmission for all causes or for heart failure. Crude 1-year mortality rates were lower among the 2226 patients treated with a thiazolidinedione (30.1%) or the 1861 treated with metformin (24.7%) compared with that among the 12 069 treated with neither insulin-sensitizing drug (36.0%, P =&lt;0.0001 for both comparisons). In multivariable models, treatment with the thiazolidinediones (hazard ratio [HR] 0.87, 95% CI 0.80 to 0.94) or metformin (HR=0.87, 95% CI 0.78 to 0.97) was associated with significantly lower risks of death. There was no association with treatment with sulfonylureas (HR=0.99, 95% CI 0.91 to 1.08) or insulin (HR=0.96, 95% CI 0.88 to 1.05) and mortality. Admissions for all causes did not differ with either insulin sensitizer. There was a higher risk of readmission for heart failure with thiazolidinedione treatment (HR 1.06, 95% CI 1.00 to 1.09) and a lower risk with metformin treatment (HR 0.92, 95% CI 0.92 to 0.99). Conclusions— This observational study suggests that thiazolidinediones and metformin are not associated with increased mortality and may improve outcomes in older patients with diabetes and heart failure. Randomized trials are warranted to corroborate these findings.
The dumping ground
Authors: D. Spence
Journal: BMJ (2008)

Teasing, nicknames, and chants of “Fight! Fight!” were commonplace at school. Bullies were dealt with in the old fashioned way, by direct confrontation and with some big brother back up. Chores and work were expected in the house, and parental love was expressed only once, on the deathbed. But this is unacceptable by modern standards, indeed perhaps considered—using that most abused of all words—abuse. Our society seeks to protect children by aggressively stamping out abuse in all its perceived modern manifestations. We live in a new, …
Extra Calories Cause Weight Gain—But How Much?
Authors: Martijn B. Katan, David S. Ludwig
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 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
BARIUM CHLORIDE POISONING
Authors: Clarence F. Graham
Journal: JAMA (1934)

A recent query inThe Journalas to the toxicity of barium carbonate<sup>1</sup>prompts the report of a case of poisoning by barium chloride in an amount well beyond the commonly fatal dose. A woman, aged 25, a stenographer in a chemical laboratory, asked one of the chemists for a teaspoonful of salt to relieve slight gastric distress. The chemist took a bottle out of the chemical cabinet under the impression that it contained sodium chloride and, glancing only at the "-ium chloride" of the label, gave her about a teaspoonful of barium chloride, which she immediately washed down with a glass of water. The peculiar taste caused the error to be discovered at once, but as the young woman felt no immediate ill effects, nothing was done at the time. After a few minutes she began to have some gastric pain, which increased to such a degree that
Interactions of Warfarin with Drugs and Food
Authors: Philip S. Wells
Journal: Annals of Internal Medicine (1994)

Purpose: To evaluate the quality of studies about drugs and food interactions with warfarin and their clinical relevance. Data Sources: MEDLINE and TOXLINE databases from 1966 to October 1993 using the Medical Subject Headings warfarin, drug interactions, and English only. Study Selection: All articles reporting original data on drug and food interactions with warfarin. Data Extraction: Each report, rated independently by at least two investigators (using causality assessment), received a summary score indicating the level of assurance (level 1 = highly probable, level 2 = probable, level 3 = possible, and level 4 = doubtful) that a clinically important interaction had or had not occurred. Inter-rater agreement was assessed using a weighted κ statistic. Results: Of 793 retrieved citations, 120 contained original reports on 186 interactions. The weighted κ statistic was 0.67, representing substantial agreement. Of 86 different drugs and foods appraised, 43 had level 1 evidence. Of these, 26 drugs and foods did interact with warfarin. Warfarin's anticoagulant effect was potentiated by 6 antibiotics (cotrimoxazole, erythromycin, fluconazole, isoniazid, metronidazole, and miconazole); 5 cardiac drugs (amiodarone, clofibrate, propafenone, propranolol, and sulfinpyrazone); phenylbutazone; piroxicam; alcohol (only with concomitant liver disease); cimetidine; and omeprazole. Three patients had a hemorrhage at the time of a potentiating interaction (caused by alcohol, isoniazid, and phenylbutazone). Warfarin's anticoagulant effect was inhibited by 3 antibiotics (griseofulvin, rifampin, and nafcillin); 3 drugs active on the central nervous system (barbiturates, carbamazepine, and chlordiazepoxide); cholestyramine; sucralfate; foods high in vitamin K; and large amounts of avocado. Conclusions: Many drugs and foods interact with warfarin, including antibiotics, drugs affecting the central nervous system, and cardiac medications. Many of these drug interactions increase warfarin's anticoagulant effect.