tbuckley/cabot-search huggingface dataset:
Mutations in human cytomegalovirus UL97 gene confer clinical resistance to ganciclovir and can be detected directly in patient plasma.
Authors: D G Wolf, I L Smith, D J Lee, W R Freeman, M Flores-Aguilar, S A Spector
Journal: Journal of Clinical Investigation (1995)

Specific mutations in the UL97 region of human cytomegalovirus (HCMV) have been found to confer resistance to laboratory-adapted strains subjected to ganciclovir selection. In this study, mutations in the UL97 region of HCMV isolates obtained from patients receiving ganciclovir therapy were examined to determine whether they would confer ganciclovir resistance, and if these mutations could be detected directly in the plasma of AIDS patients with progressive HCMV disease despite ganciclovir treatment. A single nucleotide change within a conserved region of UL97 was found in five resistant isolates, resulting in an amino acid substitution in residue 595: from leucine to phenylalanine in one, and from leucine to serine in four resistant isolates. A sixth resistant isolate demonstrated a single nucleotide change, leading to a threonine to isoleucine substitution in residue 659. The role of the 595 amino acid substitution in conferring ganciclovir resistance was confirmed by marker transfer experiments. In further studies, direct sequencing of HCMV DNA present in plasma obtained from persons with resistant viruses revealed the identical amino acid substitutions in plasma as those present in the cultured viruses. These findings indicate that clinical resistance to ganciclovir can result from specific point mutations in the UL97 gene, and that the emergence of the resistant genotype can be detected directly in patient plasma.
ON THE CAUSATION BY FILTERABLE AGENTS OF THREE DISTINCT CHICKEN TUMORS
Authors: Peyton Rous, James B. Murphy
Journal: The Journal of Experimental Medicine (1914)

A causative agent has been separated from three chicken tumors of very different sort, namely a spindle-celled sarcoma, an osteochondrosarcoma, and a spindle-celled sarcoma peculiarly fissured by blood sinuses. This was accomplished after the tumors had been transplanted repeatedly and their malignancy enhanced. Each of the tumor-producing agents is a distinct entity in that it gives rise only to growths of the precise kind from which it has been derived. All pass through Berkefeld cylinders impermeable at the same test to small bacteria, and two of the three retain their activity in tumor tissue that has been dried or glycerinated. All are strikingly dependent for their action on derangement of the tissue with which they are brought in contact. The general findings strongly suggest that the agents are of about the same size, and of the same natural class. It is perhaps not too much to say that their recognition points to the existence of a new group of entities which cause in chickens neoplasms of diverse character.
Sample Selection and the Natural History of Disease
Authors: Jonas H. Ellenberg
Journal: JAMA (1980)

We have compared published reports on the frequency of unfavorable sequelae in a common disorder of childhood, febrile seizures, as ascertained from hospital clinics or referral units, with the frequency as reported from population-based studies. Studies on defined populations, in which the attempt was made to recognize and follow up all affected persons regardless of medical care sought for the condition, are in close agreement and indicate relatively low rates of unfavorable sequelae. Clinic-based studies of febrile seizures have reported disparate results, including high frequencies of adverse outcomes. A possible explanation is that patients in clinic-based studies may not be representative of persons with the disorder in the general population. (<i>JAMA</i>243:1337-1340, 1980)
An improved method for nasojejunal feeding tube placement in patients requiring endoscopic nasobiliary drainage
Authors: Z.-W. Lv, X.-H. Wang, B. Qu, M.-N. Liu, H. Xing, W. Zhou, C.-Q. Lv, B. Du
Journal: Endoscopy (2012)

Enteral nutritional support is economical, simple, safe, and effective, and is an essential component of the treatment of patients with severe diseases [1]. The most common method of enteral nutrition is through nasojejunal tube placement [2] [3]. There are several methods of nasojejunal feeding tube placement (NFTP) [4], with endoscopic placement currently the most common because it is effective, quick, and comparatively successful [5].
Finding a balance on the question of free NHS care for overseas visitors
Authors: M. Rollin, A. A. Narula
Journal: BMJ (2014)

Sheather and Davies’s argument seems to be more political than ethical, ignoring the question of how concerns of fairness can be balanced with doctors’ professional obligations.1

All who believe in democracy are morally obliged to abide by their elected representatives’ decisions and not cherry pick which laws to ignore on the basis of personal distaste. Employees are …
Bacillary angiomatosis associated with cytomegalovirus infection in a patient with AIDS
Authors: C. LOPEZ-ELZAURDIA, J. FRAGA, MIRIAM SOLS, E. BURGOS, M.SANCHEZ GARCIA, A. GARCIA-DIEZ
Journal: British Journal of Dermatology (1991)

Summary A patient with AIDS is reported with the recently described bacillary angiomatosis and with cytomegalovirus infection (CMV).
Must diabetes be a fatal disease in Africa? Study of costs of treatment.
Authors: S. S. Chale, A. B. Swai, P. G. Mujinja, D. G. McLarty
Journal: BMJ (1992)

OBJECTIVE--To estimate the costs of diagnosis and treatment of diabetes in Tanzania. DESIGN--Costs estimated from the reported and recorded experience of patients with newly presenting diabetes in 1989-90 and of diabetic patients first seen in 1981-2. SETTING--Muhimbili Medical Centre, Dar es Salaam. SUBJECTS--464 patients (315 men and 149 women). 262 patients diagnosed during 1 September 1989-31 August 1990 (group 1) and 202 during 1 June 1981-31 August 1982 (group 2). RESULTS--The average annual direct cost of diabetes care in 1989-90 was $287 for a patient requiring insulin and $103 for a patient not requiring insulin. Purchase of insulin accounted for 68.2% ($156) of the average annual outpatient costs for patients requiring insulin. For patients not requiring insulin the cost of oral hypoglycaemic drugs and treatment of chronic complications and infections accounted for 42.5% ($29.3) and 48.8% ($33.7) of costs respectively. Cost of outpatient care of diabetic patients for the whole of Tanzania was estimated at $2.7m, *75,128 (32.2%) of which was for insulin. Doctors9 and nurses9 costs accounted for 0.2% of total costs of outpatient care. The annual direct inpatient care costs were estimated at $1.25m. Around 0.2% of the Tanzanian population aged 15 years and over used the equivalent of 8% of the total government health expenditure, which was $47,4088,382. CONCLUSION--Diabetes places a severe strain on the limited resources of developing countries. If African patients with diabetes have to pay for their treatment most will be unable to do so and will die.
A more independent NHS
Authors: Fiona Godlee
Journal: BMJ (2007)

Hydrocoele of the canal of Nuck in an adult female is a rare entity and analogous to hydrocoele in males. Its usual presentation is in children, and its occurrence in adults is very uncommon, more so of the hour-glass variety. We report a case of a 38-year-old woman presenting with a right inguinal swelling of 3-month duration. On physical examination, the swelling was non-tender, cystic and irreducible. There was no cough impulse. Ultrasonography and contrast-enhanced CT revealed a cystic swelling with clear contents in the right inguinal region. Surgery was performed with excision of the cyst. The histopathology report suggested flat mesothelium cells, confirming the diagnosis.
Technology must not replace human contact in drive for self care, conference hears
Authors: M. Limb
Journal: BMJ (2014)

Technology assisted “self care” will struggle to take off if regular health services and human contact are lost, a conference has heard.

Nick Goodwin, co-founder and chief executive of the International Foundation for Integrated Care, said that many people, including GPs, were not yet ready to accept greater use of technology even though it was already an “absolutely essential component” in high quality health and care systems. He said, “What a lot of systems are doing is beginning to shift the onus of responsibility for care onto individuals and families, but they’re doing it in a way that is there for cost containment.

“We’re in a dangerous place. If any individual in receipt of this care gets a whiff of the fact that this feels as though you’re substituting their normal care with technology, it feels like you’re removing their benefits and support.”

Goodwin was speaking at a conference, “Self care in the digital age,” held in London on 24 June at …
Luxurious Cars: Should Physicians Flaunt Their Wealth?
Authors: Don B. Cauthen
Journal: JAMA (1989)

<h3>To the Editor. —</h3> While waiting at a hotel as a medical specialty meeting was adjourning, I watched as the attendees got in a line of valet-driven Mercedes automobiles. I assume that the Internal Revenue Service encourages physicians to acquire luxurious cars, but what did the laypersons think who saw that parade of fine cars and what impact does it have on those who see it daily in the physicians' parking lot? Once, a physician told me that a good car indicated to your patients that you are a good physician since you are successful. Is that true today? Does a regal car underscore our tradition of helping people? Does it make the public more sensitive to our profession as we speak about government infringement on the physician-patient relationship, the inequities in our reimbursement, the liability crisis, and our declining income? When I was a child, I heard of the
Ethics of using preimplantation genetic diagnosis to select a stem cell donor for an existing person
Authors: R. J Boyle, J. Savulescu
Journal: BMJ (2001)

Preimplantation genetic diagnosis (PGD) involves genetic analysis of artificially fertilised embryos to select an embryo with a desired genotype before it is implanted. 1 2 Since the 1980s, over 2500 cycles of PGD have been performed worldwide.3 The technique has been used to test for disorders caused by a single gene (cystic fibrosis, thalassaemia, sickle cell disease, muscular dystrophy) and chromosomal abnormalities (Down's syndrome, trisomy 18).4 The procedure is regulated in the United Kingdom by the Human Fertilisation and Embryo Authority, which says it should be used only for detecting “very serious, life threatening conditions”5 and not for minor genetic abnormalities. 4 6

The technique has been used to detect genes for adult onset disorders such as Huntington's disease and for familial predisposition to cancer, such Li-Fraumeni syndrome (which involves mutations in p53 cancer suppressor genes).3 It has been used in Australia by fertile couples without a history of sex linked disorders to select the sex of their child.7

#### Summary points

A common objection to using preimplantation genetic diagnosis (PGD) to choose an embryo that may produce a child who would provide stem cells for an existing person is that children conceived for the benefit of their siblings are not valued in their own right

The uptake of this procedure will have few social consequences and is likely to be a reasonable use of limited health resources

Using PGD to choose a stem cell donor is unlikely to cause harm to anyone and is likely be beneficial to some

In countries where PGD is already permitted, using PGD solely for choosing a HLA compatible embryo to provide stem cells for treating an existing person should also be permitted

Children have been conceived to provide stem cells for their siblings. In the most publicised case, the Ayala case, …
Media induced anti-vaccination sentiment can even affect health workers, vaccine researcher says
Authors: B. Roehr
Journal: BMJ (2012)

Opposition to vaccination, which has been induced in large part by media scare stories, extends even to healthcare workers, a vaccine expert and co-inventor of a rotavirus vaccine told a research meeting this week.

Paul A Offit, professor of vaccinology and paediatrics at the University of Pennsylvania, was addressing a meeting in Washington, DC of the American Society for Microbiology, on the subject of biodefence and emerging diseases.

He described the efforts that were needed at his own hospital, the 600 bed Children’s Hospital of Philadelphia, to achieve 100% vaccination for seasonal influenza among its 10 000 workers.

Many of the hospital patients were particularly vulnerable because they were too …
Decision Curve Analysis
Authors: Mark Fitzgerald, Benjamin R. Saville, Roger J. Lewis
Journal: JAMA (2015)

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
Type 1 neurofibromatosis: selective expression of extracellular matrix genes by Schwann cells, perineurial cells, and fibroblasts in mixed cultures.
Authors: S Jaakkola, J Peltonen, V Riccardi, M L Chu, J Uitto
Journal: Journal of Clinical Investigation (1989)

Cutaneous neurofibromas, characteristic lesions of neurofibromatosis 1, are composed of an abundant extracellular matrix and nerve connective tissue-derived cell types: Schwann cells, perineurial cells, and fibroblasts. In this study, the extracellular matrix gene expression by these cells was examined under culture conditions that allowed them to be metabolically active and readily identifiable by morphologic and immunocytochemical criteria. Northern hybridizations demonstrated expression of genes for type I, III, IV, and VI collagens, as well as for fibronectin, laminin, and elastin. In situ hybridizations revealed that all three cell types expressed pro alpha 1 (I), pro alpha 2 (VI), and laminin B1 chain genes. However, fibroblasts did not contain [35S]cDNA-mRNA hybrids specific for type IV collagen, whereas both Schwann cells and perineurial cells expressed these genes. Perineurial cells and fibroblasts readily expressed the fibronectin gene whereas Schwann cells were essentially devoid of the corresponding mRNA. Perineurial cells also expressed the gene for laminin A chain. The results indicate that the extracellular matrix gene expression profiles of Schwann cells, perineurial cells, and fibroblasts are distinct: all three cell types are capable of expressing some of the genes for extracellular matrix components, such as type I and VI collagens, whereas Schwann cells and perineurial cells may have the primary role in synthesizing basement membrane zone components, type IV collagen and laminin. These observations potentially relate to the mechanisms of growth and development of human neurofibromas. The results attest to the applicability of the methodology utilized here to study other human tumors with mixed cell populations.
Staphylococcus aureus peptidoglycan upregulates expression of toll-like receptor 2, CD14, ICAM-1, HLA-DR and release of TNFα and IL-8 from human conjunctival epithelial cells
Authors: E.B. Cook, J.L. Stahl, F.M. Graziano, N.P. Barney
Journal: Journal of Allergy and Clinical Immunology (2003)
Circumstances of death from asthma.
Authors: A J Johnson, A J Nunn, A R Somner, D E Stableforth, C J Stewart
Journal: BMJ (1984)

Mortality from asthma in England and Wales has remained unchanged for at least 20 years, even in the age group 15-44. Yet in those 20 years "modern" drugs have been introduced for the treatment of asthma, such as beta 2 agonist bronchodilators and corticosteroids. Why do patients still die? Detailed review of the circumstances of 90 deaths from asthma showed that a few were inevitable but that in the remainder four main sets of circumstances in the fatal attack contributed to the death. These were, firstly, the patient's failure to recognise the severity of the asthma; secondly, very rapid progress in the severity of the attack; thirdly, misjudgment in the management of the attack; and, fourthly, delay from many causes. Patients admitted to hospital with severe acute asthma usually survive. Those at risk of a life threatening attack should be identified and taught to monitor the severity and progress of their asthma objectively. Their direct admission to hospital should be facilitated.
Reciprocity in Medical Licensure.
Authors: H. B. Young
Journal: JAMA (1902)

Burlington, Iowa, May 31, 1902. <h3>To the Editor:</h3> —In all that I have seen written (and I have seen a good deal) in the medical journals to which I have access, about "reciprocity in medical licensure," I fail to note the one simple solution of the question, namely: An amendment, to the medical law, in each of the several states having medical practice laws, which shall provide that the penalties shall not attach to those legally qualified to practice in other states. Heaven knows there are already exemptions in plenty and far more dangerous than this would be; and there is scarcely a chance for such an amendment to fail in any legislative body. But what a spectacle for the masses it is, to see so much remonstrance about the exact adminis tration of the laws we have fought so valiantly to have enacted! For myself I want to say,
Thrombotic Thrombocytopenic Purpura
Authors: Lee R. Berkowitz, Frederic G. Dalldorf, Philip M. Blatt
Journal: JAMA (1979)

A retrospective analysis of 12 patients with the diagnosis of thrombotic thrombocytopenic purpura was undertaken with a review of pathological material. The gingival biopsy was found to be a poor method of diagnosing thrombotic thrombocytopenic purpura. Pathological review also verified chronicity of disease. The pancreas was found to be the most severely involved organ, although serum amylase values did not always reflect pancreatic disease.
Cellular characteristics of sputum from patients with asthma and chronic bronchitis.
Authors: P G Gibson, A Girgis-Gabardo, M M Morris, S Mattoli, J M Kay, J Dolovich, J Denburg, F E Hargreave
Journal: Thorax (1989)

The reproducibility of sputum cell counts was examined and the cell counts in patients with asthma were compared with those in patients with chronic bronchitis. Three groups of subjects were studied. Sputum from eight patients with chronic asthma and with sputum production were studied to determine the reproducibility of sputum cell counts. The findings in 10 non-smokers with asthma uncomplicated by other airway disease examined at the time of an exacerbation with sputum (group 2) were compared with those from eight smokers with chronic cough and sputum but no features of asthma (group 3). Sputum plugs were selected by microscopy to ensure their origin from the lower respiratory tract. A total cell count was performed on a trypsinised suspension, and differential and metachromatic cell counts were performed on undiluted plugs. The within specimen and test-retest reproducibility of these measurements was high (reliability coefficient, R, = 0.99 and 0.89). The sputum of the asthmatic patients was characterised by eosinophilia (69%, range 46-92%) and the presence of formaldehyde blockable metachromatic cells (1.5%, range 0.6-2.8%). In comparison, the sputum of the patients with chronic bronchitis had few eosinophils (0.5%) or metachromatic cells (0.14%); the dominant cell type was the macrophage (83%). It is concluded that sputum cell counts are reproducible in the short term, the inflammation of asthma is characterised by eosinophilia and metachromatic cells in sputum, and sputum may provide a useful source of cells for investigating the cellular characteristics of airway inflammation.
Fitness assessments used in geriatric care benefit cancer patients, pilot studies find
Authors: G. Iacobucci
Journal: BMJ (2012)

Older patients with cancer should undergo comprehensive assessments of their existing medical conditions, physical wellbeing, mental health, and social care support to safeguard against “discriminatory” treatment recommendations, a new report has concluded.

The Cancer Services Coming of Age report gives results from government pilots that tested whether better methods of assessment of health and care would improve access to treatment for older people with cancer. The pilots found that the “comprehensive geriatric assessment” could “impact positively on treatment decision making and general quality of care” if used in care of patients …
Impact of E1a Modifications on Tumor-Selective Adenoviral Replication and Toxicity
Authors: Harald Sauthoff, Teona Pipiya, Sheila Heitner, Shu Chen, Bertram Bleck, Joan Reibman, William Chang, Robert G. Norman, William N. Rom, John G. Hay
Journal: Molecular Therapy (2004)

Replicating adenoviral vectors are capable of multiplying up to a thousandfold in the target cell, a property that might prove to be of tremendous potential for cancer therapy. However, restricting viral replication and toxicity to cancer cells is essential to optimize safety. It has been proposed that modifications of the E1a protein that impair binding to Rb or p300 will prevent S-phase induction in normal cells, resulting in selective viral replication in tumor cells. However, it remains uncertain which of the several possible E1a modifications would be most effective at protecting normal cells without compromising the oncolytic effect of the vector. In this study, we have expressed several E1a-deletion mutants at high levels using the CMV promoter and tested them for their ability to facilitate S-phase induction, viral replication, and cytotoxicity in both normal and cancer cells. Deletion of the Rb-binding domain within E1a only slightly decreased the ability of the virus to induce S phase in growth-arrested cells. The effect of this deletion on viral replication and cytotoxicity was variable. There was reduced cytotoxicity in normal bronchial epithelial cells; however, in some normal cell types there was equal viral replication and cytotoxicity compared with wild type. Deletions in both the N-terminus and the Rb-binding domain were required to block S-phase induction effectively in growth-arrested normal cells; in addition, this virus demonstrated reduced viral replication and cytotoxicity in normal cells. An equally favorable replication and cytotoxicity profile was induced by a virus expressing E1a that is incapable of binding to the transcriptional adapter motif (TRAM) of p300. All viruses were equally cytotoxic to cancer cells compared with wild-type virus. In conclusion, deletion of the Rb-binding site alone within E1a may not be the most efficacious means of targeting viral replication and toxicity. However, deletion within the N-terminus in conjunction with a deletion within the Rb-binding domain, or deletion of the p300-TRAM binding domain, induces a more favorable cytotoxicity profile.