tbuckley/cabot-search huggingface dataset:
Achieving Excellence in Medical Education
Authors: Paul Gordon
Journal: JAMA (2011)

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
Treatment of plaque psoriasis by sequential therapy with two ‘biologics’: the ‘hit and run’ approach, a report of two cases
Authors: C. Barde, A-M. Thielen, S. Kuenzli, J-H. Saurat
Journal: British Journal of Dermatology (2006)

Conflicts of interest: none declared. Sir, Conventional treatment strategies for psoriasis rely on sequential, rotational and combination therapies to minimize cumulative adverse events.1 So far, the new biological agents have always been administered as monotherapy. However, it is reasonable to expect that these new treatments for psoriasis will probably be included in the rotational, sequential and combination therapies already used with the traditional drugs. Infliximab is a monoclonal chimeric tumour necrosis factor (TNF)‐α antibody targeting monomer and trimer forms of soluble and cell‐bound TNF‐α.2 It also activates a complement‐dependent and cell‐mediated cytolysis,3 normalizes keratinocyte proliferation and differentiation and decreases epidermal inflammation.4 The response rates to this agent are similar to those observed with ciclosporin.5 Efalizumab is a monoclonal humanized antibody directed against lymphocyte function‐associated antigen‐1 on T lymphocytes, which inhibits its interaction with intercellular adhesion molecule (ICAM)‐1, 2 and 3 and interferes with T‐cell activation and trafficking into the inflamed tissues.2 It has also been shown to reduce dermal and epidermal T cells, thickness of the epidermis, ICAM‐1 and keratin‐16 expression on keratinocytes. This molecule does not cause lymphocyte depletion as the effects on T lymphocytes are reversible.6 It is also the biologic with the most important long‐term use and safety data for psoriasis.7
Mortality rate during interferon alfa-ribavirin combination therapy of chronic hepatitis C
Authors: Alejandro Soza, Jay H. Hoofnagle
Journal: Hepatology (2003)

To the Editor:It has been drawn to our attention that the numbers of deaths that have occurred during combination therapy of chronic hepatitis C were stated incorrectly in the discussion section of our article entitled "Neutropenia during combination therapy of interferon alfa and ribavirin for chronic hepatitis C." 1 In the first sentence on page 1278 we stated, "Only 1 of the 23 deaths reported from these studies was caused by infection."Actually, in the 3 large, multicenter studies of combination therapy with interferon alfa-2b and ribavirin that were referenced in the previous sentence, 2-4 there were only 3 deaths during treatment and 3 during the follow-up period, none of which were caused by infection.The report of 23 deaths was taken from a review article 5 on adverse events from combination therapy that included the deaths from these 3 trials as well as subsequent open-access studies that incorporated information on more than 25,000 treated patients.Thus, the mortality rate associated with combination therapy is less than 0.1% and not in the range of 1%, which was suggested by our statement.We apologize for this error and the confusion it may have caused.
Decline in altruism threatens blood supplies
Authors: A. Ferriman
Journal: BMJ (1998)

The National Blood Authority is worried about the future of blood supplies after the publication of research suggesting that altruism is slowly declining as a feature of British society.

“We commissioned research because we are constantly struggling to keep up with the demand for blood, which is rising at 3-4% a year,” said Sue Cunningham, spokeswoman for the authority. “We also have to deal with the government waiting list initiative.”

The research, presented at a conference in London last week, showed that there has been a slow but steady decline in altruism …
Immune response genes controlling responsiveness to major transplantation antigens. Specific major histocompatibility complex-linked defect for antibody responses to class I alloantigens.
Authors: G W Butcher, J R Corvalán, D R Licence, J C Howard
Journal: The Journal of Experimental Medicine (1982)

We have identified two major histocompatibility complex (MHC)-linked Ir genes that control the antibody response made by rats against class I major alloantigens. We have named these genes Ir-RT1Aa and Ir-RT1Ac. These Ir genes determine responsiveness of the immunized animal in a typical codominant fashion. There is no evidence so far for trans-complementation between low-responder haplotypes. Detailed studies of Ir-RT1Aa indicate that it controls the antibody response to at least two distinct alloantigenic determinants on RT1Aa molecules. These class I molecules thus behave like hapten-carrier conjugates when the response against the carrier is under Ir gene control. Analysis of the origin of alloantibody-forming cells in tetraparental radiation chimeras indicates that Ir-RT1Aa must control the provision of effective help to B cells. In many respects therefore, the properties of Ir-RT1Aa are broadly similar to those described for Ir genes controlling antibody responses to conventional antigens. The existence of apparently conventional Ir genes controlling the antibody response to major alloantigens strongly suggest that the processing of these transmembrane molecules by host antigen-presenting cells is a prerequisite for immune induction, and that it is the MHC of the responder rather than that of the allograft to which T helper cells are restricted in alloimmune responses in vivo.
Is sensory gating a form of cognitive coordination?
Authors: Michael A. Kisley, Deana B. Davalos
Journal: Behavioral and Brain Sciences (2003)

Abstract Neurophysiological investigations of the past two decades have consistently demonstrated a deficit in sensory gating associated with schizophrenia. Phillips &amp; Silverstein interpret this impairment as being consistent with cognitive coordination dysfunction. However, the physiological mechanisms that underlie sensory gating have not been shown to involve gamma-band oscillations or NMDA-receptors, both of which are critical neural elements in the cognitive coordination model.
Treatment of Addicts
Authors: NATHAN BEGELMAN
Journal: Annals of Internal Medicine (1975)

Comments and Correction1 October 1975Treatment of AddictsNATHAN BEGELMAN, M.D., ROGER P. TARTER, M.D.NATHAN BEGELMAN, M.D.Search for more papers by this author, ROGER P. TARTER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-83-4-580_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The paper by Fultz and Senay about the treatment of methadone and heroin addicts (Ann Intern Med 82:815-818, 1975) is a fine review of a topic in which few physicians have any formal training. However, we believe two points deserve comment.First, the review states that methadone-maintained patients should be started on the full once-a-day dosage given daily at their drug maintainance program. Such a procedure may be dangerous and result in overdosage. Many methadone-maintained patients skim off part of their total daily dosage for eventual illicit sale on the street. In other cases, less than the...References1. : Food and Drug Administration Federal Register, vol. 37, no. 242, part III, 1972 Google Scholar2. Report of the task force on methadone maintenance and narcotic blocking drugs. Am J Psychiatry 131:745-746, 1974 CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Drug Abuse Treatment Program Coney Island Hospital Brooklyn, New York 11235 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1975Volume 83, Issue 4Page: 580-581KeywordsAddictsDrugsHeroin Issue Published: 1 October 1975 PDF DownloadLoading ...
Diplopod Hemocyanin Sequence and the Phylogenetic Position of the Myriapoda
Authors: Kristina Kusche, Thorsten Burmester
Journal: Molecular Biology and Evolution (2001)

Hemocyanins are copper-containing respiratory proteins of the Arthropoda that have so far been thoroughly investigated only in the Chelicerata and the Crustacea but have remained unstudied until now in the Myriapoda. Here we report the first sequence of a myriapod hemocyanin. The hemocyanin of Spirostreptus sp. (Diplopoda: Spirostreptidae) is composed of two distinct subunits that are arranged in a 6 × 6 native molecule. The cloned hemocyanin subunit cDNA codes of for a polypeptide of 653 amino acids (75.5 kDa) that includes a signal peptide of 18 amino acids. The sequence closely resembles that of the chelicerate hemocyanins. Molecular phylogenetic analyses reject with high statistical confidence the integrity of the Tracheata (i.e., Myriapoda + Insecta) but give conflicting results on the position of the myriapod hemocyanin. While distance matrix and maximum-likelihood methods support a basal position of the Spirostreptus hemocyanin with respect to the other hemocyanins, parsimony analysis suggests a sister group relationship with the chelicerate hemocyanins. The latter topology is also supported by a unique shared deletion of an alpha-helix. A common ancestry of Myriapoda and Chelicerata should be seriously considered.
Intracardiac Oximetry in Congenital Heart Disease
Authors: YALE ENSON, A. GREGORY JAMESON, ANDRÉ COURNAND
Journal: Circulation (1964)

A fiberoptic reflection oximeter has been adapted to the diagnostic study of patients suspected of having congenital heart disease. The results of 10 successive catheterizations with use of this technic are reported and compared with the results obtained in the same subjects with a standard sampling technic. A large number of determinations was possible without blood loss. The results were immediately available for use in directing the manipulation of the catheter. Freedom from the distortions attendant upon catheter sampling permitted precise observation of the nature of flow across a ventricular septal defect and of the relationship between blood oxygen saturation in the main pulmonary artery and the pulmonary arterial wedge position.
Outcome of patients with chest pain discharged from an accident and emergency department.
Authors: S S Tachakra, S Pawsey, M Beckett, D Potts, A Idowu
Journal: BMJ (1991)

The results and conclusions from this study, however, were derived from a fairly small number of patients and outcome events in one patient population.The estimates are imprecise owing to the potential for sampling error and cannot necessarily be generalised to other patient populations until they have been tested and confirmed in other studies.
Skin metastases in metastatic uveal melanoma:<i>GNAQ</i>/<i>GNA11</i>mutational analysis as a valuable tool
Authors: A. Tsianakas, M.R.R. Böhm, V. Getova, D. Metze, N. Eter, T. Spieker, A. Bräuninger, T. Luger, M. Schiller, C. Sunderkötter
Journal: British Journal of Dermatology (2013)

Uveal melanomas represent 3.1% of all melanomas, with a high potential of metastatic disease of up to 50%, where the median survival time is 6 months. Though liver metastases dominate as the primary site for metastasis, the existence of primary skin metastases is still under discussion but has been reported in only a few studies.We present two cases in which patients with a known history of uveal melanoma developed melanoma skin metastases.Mutational analysis was performed to clarify the origin of the metastases (uvea or skin).The analyses revealed GNA11 mutations, which are typical for uveal melanoma. These cases strongly suggest the skin to be the primary site of uveal melanoma.Knowledge about the mutational status of uveal melanomas opens the opportunity for future targeted therapies that directly interact with the mutation and its activated signal cascades. First trials in uveal melanoma have shown promising results with MEK inhibitors.
Retinoblastoma protein expressed in human non-Hodgkin's lymphoma cells generates resistance against radiation-induced apoptosis
Authors: Hideshi Ishii, Tadahiko Igarashi, Toshiyuki Saito, Takashi Nakano, Masahiko Mori, Harumi Ohyama, Tadaaki Miyamoto, Yasushi Saito, Hakumei Oh
Journal: American Journal of Hematology (1997)

Inactivation of the retinoblastoma susceptibility (Rb) gene has been observed in various cancers. Nevertheless, in several cancer cases, including non-Hodgkin's lymphoma, previous investigations showed that the Rb gene product (pRb) was abundantly expressed with varying degree. Here we report the THS-SP1.1 cell line isolated from non-Hodgkin's lymphoma. The THS-SP1.1 cells abundantly expressed pRb and showed resistance against radiation-induced apoptosis. Culture with the antisense phosphorothioate oligonucleotide complementary to the Rb gene augmented the apoptosis of THS-SP1.1 cells after radiation, whereas the control oligonucleotides did not. These data showed that pRb abundantly expressed in the lymphoma cells inhibited radiation-induced apoptosis. Am J. Hematol. 55:46-48, 1997. © 1997 Wiley-Liss, Inc.
Long-Term Immunogenicity and Efficacy of Hepatitis B Vaccine in Homosexual Men
Authors: Stephen C. Hadler, Donald P. Francis, James E. Maynard, Sumner E. Thompson, Franklyn N. Judson, Dean F. Echenberg, David G. Ostrow, Paul M. O'Malley, Kent A. Penley, Norman L. Altman, Erwin Braff, Gregory F. Shipman, Patrick J. Coleman, Eric J. Mandel
Journal: New England Journal of Medicine (1986)

To study the duration of antibody persistence and protection provided by the hepatitis B vaccine, we followed 773 homosexual men for five years after completion of vaccination. Among the 635 participants in whom antibody levels above 9.9 sample ratio units (SRU) developed after vaccination, 15 percent lost antibody altogether, and in another 27 percent, antibody levels declined below 10 SRU within five years. The extent of the maximal antibody response strongly predicted the persistence of protective antibody. Hepatitis B infection occurred in 55 men; 8 of these infections were clinically important (characterized by the presence of the hepatitis B surface antigen and elevation of liver-enzyme levels), and two of the patients became hepatitis B virus carriers. The long-term risk of hepatitis B infection was inversely related to the maximal antibody response to vaccine. Most severe infections occurred among those who responded poorly or had no response to the vaccination. The risk of late infection with hepatitis B in those with an initially adequate vaccine response increased markedly when antibody levels decreased below 10 SRU, but only 1 of 34 late infections resulted in viremia and liver inflammation. A second series of vaccinations induced a moderate antibody response in 50 percent of the subjects who initially had no response or a poor response; however, the persistence of antibody was poor. Both antibody loss and the risk of severe disease should be considered when booster-dose strategies for the hepatitis B vaccine are being designed. (N Engl J Med 1986; 315:209–14.)
Effectiveness of provider incentives for anaemia reduction in rural China: a cluster randomised trial
Authors: G. Miller, R. Luo, L. Zhang, S. Sylvia, Y. Shi, P. Foo, Q. Zhao, R. Martorell, A. Medina, S. Rozelle
Journal: BMJ (2012)

To test the impact of provider performance pay for anaemia reduction in rural China.A cluster randomised trial of information, subsidies, and incentives for school principals to reduce anaemia among their students. Enumerators and study participants were not informed of study arm assignment.72 randomly selected rural primary schools across northwest China.3553 fourth and fifth grade students aged 9-11 years. All fourth and fifth grade students in sample schools participated in the study.Sample schools were randomly assigned to a control group, with no intervention, or one of three treatment arms: (a) an information arm, in which principals received information about anaemia; (b) a subsidy arm, in which principals received information and unconditional subsidies; and (c) an incentive arm, in which principals received information, subsidies, and financial incentives for reducing anaemia among students. Twenty seven schools were assigned to the control arm (1816 students at baseline, 1623 at end point), 15 were assigned to the information arm (659 students at baseline, 596 at end point), 15 to the subsidy arm (726 students at baseline, 667 at end point), and 15 to the incentive arm (743 students at baseline, 667 at end point).Student haemoglobin concentrations.Mean student haemoglobin concentration rose by 1.5 g/L (95% CI -1.1 to 4.1) in information schools, 0.8 g/L (-1.8 to 3.3) in subsidy schools, and 2.4 g/L (0 to 4.9) in incentive schools compared with the control group. This increase in haemoglobin corresponded to a reduction in prevalence of anaemia (Hb <115 g/L) of 24% in incentive schools. Interactions with pre-existing incentives for principals to achieve good academic performance led to substantially larger gains in the information and incentive arms: when combined with incentives for good academic performance, associated effects on student haemoglobin concentration were 9.8 g/L (4.1 to 15.5) larger in information schools and 8.6 g/L (2.1 to 15.1) larger in incentive schools.Financial incentives for health improvement were modestly effective. Understanding interactions with other motives and pre-existing incentives is critical.ISRCTN76158086.
Lichen Ruber Mucosae with Esophageal Involvement
Authors: Ph. Van Maercke, M. Günther, W. Groth, Th. Gheorghiu, U. Habermann
Journal: Endoscopy (1988)

The clinical course of a 50-year-old woman with oral lichen ruber planus (lrp) and prolonged dysphagia is described. The swallowing problems of this patient were related to an inflammatory lesion of the middle third of the esophagus, leading to stenosis. Distal to this area, the esophagus was covered with mucosa of the cardia type, as seen in endobrachyesophagus. Apart from reflux disease, the lrp may have accounted for the stenosis of the mid-esophagus. The mucosal lesions disappeared after administration of etretinate (Tigason). After endoscopic dilatation the patient was able to swallow normally again.
Iron status of inner‐city African‐American infants
Authors: Betsy Lozoff, Mary Lu Angelilli, Jigna Zatakia, Sandra W. Jacobson, Agustin Calatroni, John Beard
Journal: American Journal of Hematology (2006)

The iron status of African-American infants continues to be subject to debate. We characterized the iron status of 198 9-month-old inner-city infants (94% fed iron-fortified formula) using a comprehensive panel of measures and assessing lead and inflammation markers. The proportion with iron deficiency was calculated based on three approaches (> or = 2 abnormal iron measures with or without anemia for MCV model--NHANES II, ferritin model--NHANES III, or Sweden/Honduras study) and a promising new measure-body iron, calculated from ferritin and transferrin receptor (TfR). There were no sex differences for any iron measure. Hb < 110 g/l was observed in 25%; Hb < or = 105 g/l in 10.1%. Free erythrocyte protoporphyrin (FEP) values were elevated without elevated lead concentrations or an inflammatory response: mean FEP = 86.6 microg/dl red blood cells [75.5 micromol/mol heme]; 52.3% were > 80 microg/dl (1.42 micromol/l), almost half of which were accompanied by a second abnormal iron measure. The estimated prevalence of iron deficiency was 14.4, 5.3, and 2.5% for the MCV model, ferritin model, and Sweden/Honduras cutoffs, respectively, and 4.1% for body iron < 0 mg/kg. Regulation of iron storage is immature at < 1 year of age, making estimates of iron deficiency that depend on ferritin, including body iron, suspect in this age period. Thus, the "true" prevalence of iron deficiency could not be established with confidence due to major differences in the results, depending on the guidelines used. Functional indicators of poor iron status in young infants are urgently needed.
Serum Autoantibodies Against Sulfatide and Phospholipid in NIDDM Patients With Diabetic Neuropathy
Authors: Hirofumi Shigeta, Makiko Yamaguchi, Koji Nakano, Hiroshi Obayashi, Reiji Takemura, Michiaki Fukui, Mitsuhiro Fujii, Kuniaki Yoshimori, Goji Hasegawa, Naoto Nakamura, Yoshihiro Kitagawa, Motoharu Kondo
Journal: Diabetes Care (1997)

OBJECTIVE We investigated the presence of antisulfatide and antiphospholipid antibodies and the relationship between these antibodies and the results of quantitative tests of nerve function in NIDDM patients with diabetic neuropathy. RESEARCH DESIGN AND METHODS Antisulfatide and antiphospholipid antibodies were measured in serum samples obtained from 68 NIDDM patients with diabetic neuropathy by an enzyme-linked immunosorbent assay (ELISA). Each patient was classified into one of three groups based on the combined neuropathy score (determined by the symptom score, the results of autonomic nerve function tests, and the vibration perception test), as follows: mild (n = 26), moderate (n = 22), and severe (n = 20). Nerve conduction studies were performed in a subgroup of 37 patients. RESULTS The antisulfatide antibody was detected in 1 (4%) of 26 patients in the mild group, 4 (18%) of 22 patients in the moderate group, and 8 (40%) of 20 patients in the severe group (P &amp;lt; 0.01 vs. mild group). The antiphospholipid antibody was detected in none of the patients in the mild group, 8 (36%) of 22 patients in the moderate group (P &amp;lt; 0.001 vs. mild group), and 6 (30%) of 20 patients in the severe group (P &amp;lt; 0.01 vs. mild group). The threshold amplitude, determined by the vibration perception test, was significantly higher in antibody-positive patients than in antibody-negative patients: antisulfatide antibody, 55.9 ± 46.8 μm (n = 13) vs. 22.9 ± 13.7 μm (n = 55), P &amp;lt; 0.001; antiphospholipid antibody, 47.2 ± 32.5 μm (n = 14) vs. 24.5 ± 23.2 μm (n = 54), P &amp;lt; 0.01. The conduction velocity of the sural nerve was slower in the antisulfatide antibody-positive group (37.9 ± 11.1 m/s, n = 12) than in the antisulfatide antibody-negative group (45.2 ± 6.0 m/s, n = 19) (P &amp;lt; 0.05). CONCLUSIONS These results suggest that autoimmune nerve destruction may be involved in diabetic neuropathy in NIDDM patients.