tbuckley/cabot-search huggingface dataset:
Formulation of Treatment Recommendations for Statins—Reply
Authors: Paul M Ridker, Peter W. F. Wilson
Journal: JAMA (2014)

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
The Application of a Molecular Clock Based on Molecular Sequences and the Fossil Record to Explain Biogeographic Distributions Within the Alexandrium tamarense "Species Complex" (Dinophyceae)
Authors: U. John
Journal: Molecular Biology and Evolution (2003)

The cosmopolitan dinoflagellate genus Alexandrium, and especially the A. tamarense species complex, contain both toxic and nontoxic strains. An understanding of their evolution and paleogeography is a necessary precursor to unraveling the development and spread of toxic forms. The inclusion of more strains into the existing phylogenetic trees of the Alexandrium tamarense species complex from large subunit rDNA sequences has confirmed that geographic distribution is consistent with the molecular clades but not with the three morphologically defined species that constitute the complex. In addition, a new clade has been discovered, representing Mediterranean nontoxic strains. The dinoflagellates fossil record was used to calibrate a molecular clock: key dates used in this calibration are the origins of the Peridiniales (estimated at 190 MYA), Gonyaulacaceae (180 MYA), and Ceratiaceae (145 MYA). Based on the data set analyzed, the origin of the genus Alexandrium was estimated to be around late Cretaceous (77 MYA), with its earliest possible origination in the mid Cretaceous (119 MYA). The A. tamarense species complex potentially diverged around the early Neogene (23 MYA), with a possible first appearance in the late Paleogene (45 MYA). A paleobiogeographic scenario for Alexandrium is based on (1) the calculated possible ages of origination for the genus and its constituent groups; (2) paleogeographic events determined by plate movements, changing ocean configurations and currents, as well as climatic fluctuations; and (3) the present geographic distribution of the various clades of the Alexandrium tamarense species complex.
Self-Esteem and Social Adjustment in Depressed Youths: A Randomized Trial Comparing Psychodynamic Psychotherapy and Family Therapy
Authors: Gerasimos Kolaitis, George Giannakopoulos, Vlasis Tomaras, Stelios Christogiorgos, Valeria Pomini, Effie Layiou-Lignos, Chara Tzavara, Maria Rhode, Gillian Miles, Ilan Joffe, Judith Trowell, John Tsiantis
Journal: Psychotherapy and Psychosomatics (2014)
Radiation, Chromosomes and Viruses in the Etiology of Leukemia
Authors: Robert W. Miller
Journal: New England Journal of Medicine (1964)

IN the last decade epidemiologic research has contributed evidence implicating ionizing radiation and chromosomal aberrations in the genesis of leukemia. By comparison, the epidemiologic evidence for the viral etiology of human leukemia is scanty despite the anticipation generated by continuing successes in identifying leukemogenic viruses in mice.As is true of other research approaches, epidemiology may describe a disease, explore it empirically or test specific ideas about it. The patterns of leukemia mortality that have been ascertained by descriptive epidemiology, though they do not per se suggest the etiology, do provide considerable intelligence against which suspected principal causes of the . . .
Out-of-Hospital CPR-Reply
Authors: Paul E. Pepe
Journal: JAMA (1994)

<h3>In Reply.</h3> —The letter from Dr Jolly addresses a very important issue and we concur with his remarks. Implementing a policy that would allow for on-scene termination of resuscitation efforts may not be so easy in many communities. The traditional expectation of the public has been that the EMS system was established primarily to transport patients to a hospital. However, this simplistic perception of the role of EMS is rapidly evolving.<sup>1</sup>The provision of out-of-hospital care does not always necessitate hospital transport, particularly in sophisticated EMS systems with intensive and expert medical supervision.<sup>1-3</sup> Nevertheless, because of traditional public expectations, field termination policies would require the clear support (and widespread education of the public) by the EMS medical director. Communities such as Seattle and Milwaukee, Wis, have always allowed for termination of resuscitative efforts at the scene. In these EMS programs, the physician leadership and overall survival rates have
Clinical Characteristics of Patients in a Case Control Study of Sarcoidosis
Authors: ROBERT P. BAUGHMAN, ALVIN S. TEIRSTEIN, MARC A. JUDSON, MILTON D. ROSSMAN, HENRY YEAGER, EDDY A. BRESNITZ, LOUIS DePALO, GARY HUNNINGHAKE, MICHAEL C. IANNUZZI, CAROL J. JOHNS, GEOFFREY McLENNAN, DAVID R. MOLLER, LEE S. NEWMAN, DAVID L. RABIN, CECILE ROSE, BENJAMIN RYBICKI, STEVEN E. WEINBERGER, MICHAEL L. TERRIN, GENELL L. KNATTERUD, REUBEN CHERNIAK, A CASE CONTROL  ETIOLOGIC STUDY OF SARCOIDOSIS (ACCESS) RESE GROUP
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Sarcoidosis may be affected by sex, race, and age. A Case Control Etiologic Study of Sarcoidosis (ACCESS) enrolled 736 patients with sarcoidosis within 6 mo of diagnosis from 10 clinical centers in the United States. Using the ACCESS sarcoidosis assessment system, we determined organ involvement for the whole group and for subgroups differentiated by sex, race, and age (less than 40 yr or 40 yr and older). The study population was heterogeneous in terms of race (53% white, 44% black), sex (64% female, 36% male), and age (46% < 40 yr old, 54% ⩾ 40 yr old). Women were more likely to have eye and neurologic involvement ( χ2 = 4.74, p < 0.05 and χ2 = 4.60, p < 0.05 respectively), have erythema nodosum ( χ2 = 7.28, p < 0.01), and to be age 40 yr or over ( χ2 = 6.07, p < 0.02) whereas men were more likely to be hypercalcemic ( χ2 = 7.38, p < 0.01). Black subjects were more likely to have skin involvement other than erythema nodosum ( χ2 = 5.47, p < 0.05), and eye ( χ2 = 13.8, p < 0.0001), liver ( χ2 = 23.3, p < 0.0001), bone marrow ( χ2 = 18.8, p < 0.001), and extrathoracic lymph node involvement ( χ2 = 7.21, p < 0.01). We conclude that the initial presentation of sarcoidosis is related to sex, race, and age.
Screening for polymorphisms in exon 5 of the glutathione S-transferase Pl gene
Authors: F. RODRIGUEZ-FRIAS
Journal: Thorax (2000)

A recent paper by Ishii et al 1 suggested an association between glutathione S - transferase P1 (GSTP1) polymorphism in exon 5 (Ile105Val) and the development of chronic obstructive pulmonary disease (COPD) in a sample from a Japanese population. The authors reported that GSTP1 homozygous wild type Ile105 polymorphism was found more frequently in patients with COPD than in controls (79% vs 52%). In an ongoing COPD genetic study (unpublished preliminary results) we determined the prevalence of GSTP1 polymorphisms in exon 5 in 200 healthy Caucasian volunteers from the Barcelona area. Genetic variants were detected using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). The amplification products were digested with the restriction enzyme BsmaI at 55°C, subjected to electrophoresis, and visualised by ethidium bromide staining. Of the 200 healthy volunteers, 99 (49.5%) were homozygous wild type Ile105 (additionally, 88 (44%) … Dr T Matsuse email:matsuse{at}vrahp.yokohama-cu.ac.jp
Invest now in adaptive strategies to cope with weather instability
Authors: P. Michelozzi, M. Davoli
Journal: BMJ (2012)

Climate change will increase weather instability and the occurrence of extreme hot and cold episodes, even in regions and populations not usually affected.1 From the end of January to mid-February 2012 Italy experienced record low temperatures over 10-18 days. Mean daily temperatures were 10°C lower than normal, and …
CARCINOMA OF THE ISLANDS OF LANGERHANS WITH HYPOGLYCEMIA AND METASTASIS TO THE LIVER
Authors: Lewis B. Flinn
Journal: JAMA (1941)

After the discovery of insulin in 1922 the signs and symptoms of acute hypoglycemia became well known. These, in cases of mild involvement, were weakness, perspiration and anxiety and in severe instances more serious mental changes, convulsions, coma and death. The mental changes have received more attention lately, especially in association with insulin therapy in some of the psychoses. Apparently the hypoglycemic effect on nervous tissue may reach a point at times which is irreversible. Malamud and Grosh<sup>1</sup>and Klein and Ligterink<sup>2</sup>have discussed this problem recently. Hypoglycemia may be due to many causes—pituitary tumors; adrenal cortical tumors; advanced hepatic disease such as yellow atrophy, carcinoma or fatty infiltration in which 70 to 80 per cent of hepatic substance is replaced; cachectic states; excessive physical exercise, and, most spectacularly, to tumors of the island cells of the pancreas. Since Harris<sup>3</sup>first described this condition as hyperinsulinism in
Nonabandonment: Medical Ethics
Authors: Timothy E. Quill
Journal: Annals of Internal Medicine (1995)

Letters15 September 1995Nonabandonment: Medical EthicsTimothy E. Quill, MD and Christine K. Cassel, MDTimothy E. Quill, MDThe Gennessee Hospital; Rochester, NY 14607University of Chicago; Chicago, IL 60637-1470Search for more papers by this author and Christine K. Cassel, MDThe Gennessee Hospital; Rochester, NY 14607University of Chicago; Chicago, IL 60637-1470Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-6-199509150-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Patrick, Lindquist, Kafka, and Rifas lament the assault against the longitudinal, personal nature of the physician–patient relationship and the associated obligation of nonabandonment for managed care and the progressive corporatization of medicine. Physicians must become actively involved in the formation of these emerging systems and advocate for quality and continuity of care, lest the essence of our profession become lost in this economic transformation [1].Dr. Cohen suggests substituting a “commitment to caring” for nonabandonment because it is a more positive, intuitively appealing concept. Although caring about and caring for patients are essential elements [2], they do ...References1. Emanuel EJ, Brett AS. Managed competition and the patient–physician relationship. N Engl J Med. 1993; 329:879-92. Google Scholar2. Peabody FW. The care of the patient. N Engl J Med. 1927; 88:877-82. Google Scholar Author, Article, and Disclosure InformationAffiliations: The Gennessee Hospital; Rochester, NY 14607University of Chicago; Chicago, IL 60637-1470 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 September 1995Volume 123, Issue 6Page: 475-476KeywordsAssaultDecision makingEmotionsMedical ethicsOpioidsProblem solving Issue Published: 15 September 1995 CopyrightCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Prescribing for RITA
Authors: Giridhar P Kalamangalam
Journal: BMJ (2006)

And so it ends—a decade in the training grade. The last rites performed with a final RITA (record of in training assessment): I'm finally grown up, the authorities deem. In fact, my consultant job starts tomorrow.

After 10 years with it, do I have positive suggestions for postgraduate training in the NHS? Of course, dozens, most involving workforce, reorganisation, and resources. …
Preventive medicine makes us miserable
Authors: Fiona Godlee
Journal: BMJ (2005)

<h3>Abstract</h3> The transition from controlled drug use to drug addiction depends on an interaction between a vulnerable individual, their environment and a drug. Here we tested the hypothesis that conditions under which individuals live influence behavioral vulnerability traits and experiential factors operating in the drug taking environment to determine the vulnerability to addiction. The role of behavioural vulnerability traits in mediating the influence of housing conditions on the tendency to acquire cocaine self-administration was characterised in 48 rats housed in either an enriched (EE) or a standard (SE) environment. Then, the influence of these housing conditions on the individual vulnerability to develop addiction-like behaviour for cocaine or alcohol was measured in 72 EE or SE rats after several months of cocaine self-administration or intermittent alcohol drinking, respectively. The determining role of negative experiential factors in the drug taking context was further investigated in 48 SE rats that acquired alcohol drinking as a self-medication strategy. The environment influenced the acquisition of drug intake through its effect on behavioral markers of resilience to addiction. In contrast, the initiation of drug taking as a coping strategy or in a negative state occasioned by the contrast between enriched housing conditions and a relatively impoverished drug taking setting, facilitated the development of compulsive cocaine and alcohol intake. These data demonstrate that addiction vulnerability depends on environmentally determined experiential factors, suggesting that initiating drug use through negative reinforcement-based self-medication facilitates the development of addiction in vulnerable individuals. <h3>Significance Statement</h3> The factors that underlie an individual’s vulnerability to switch from controlled, recreational drug use to addiction are not well understood. We showed that in individuals housed in enriched conditions, the experience of drugs in the relative social and sensory impoverishment of the drug taking context, and the associated change in behavioural traits of resilience to addiction, exacerbate the vulnerability to develop compulsive drug intake. We further demonstrated that the acquisition of alcohol drinking as a mechanism to cope with distress increases the vulnerability to develop compulsive alcohol intake. Together these results demonstrate that experiential factors in the drug taking context shape the vulnerability to addiction.
Reuse of Nevirapine in Exposed HIV-Infected Children After Protease Inhibitor–Based Viral Suppression
Authors: Ashraf Coovadia, Elaine J. Abrams, Renate Stehlau, Tammy Meyers, Leigh Martens, Gayle Sherman, Gillian Hunt, Chih-Chi Hu, Wei-Yann Tsai, Lynn Morris, Louise Kuhn
Journal: JAMA (2010)

Protease inhibitor (PI)-based therapy is recommended for infants infected with human immunodeficiency virus (HIV) who were exposed to nevirapine for prevention of mother-to-child HIV transmission. However, there are limitations of continuing PI-based therapy indefinitely and reuse of nevirapine has many advantages.To test whether nevirapine-exposed infants who initially achieve viral suppression with PI-based therapy can maintain viral suppression when switched to nevirapine-based therapy.Randomized trial conducted between April 2005 and May 2009 at a hospital in Johannesburg, South Africa, among 195 children who achieved viral suppression less than 400 copies/mL for 3 or more months from a cohort of 323 nevirapine-exposed children who initiated PI-based therapy before 24 months of age.Control group children continued to receive ritonavir-boosted lopinavir, stavudine, and lamivudine (n = 99). Switch group children substituted nevirapine for ritonavir-boosted lopinavir (n = 96).Children were followed up for 52 weeks after randomization. Plasma HIV-1 RNA of greater than 50 copies/mL was the primary end point. Confirmed viremia greater than 1000 copies/mL was used as a criterion to consider regimen changes for children in either group (safety end point).Plasma viremia greater than 50 copies/mL occurred less frequently in the switch group (Kaplan-Meier probability, 0.438; 95% CI, 0.334-0.537) than in the control group (0.576; 95% CI, 0.470-0.668) (P = .02). Confirmed viremia greater than 1000 copies/mL occurred more frequently in the switch group (0.201; 95% CI, 0.125-0.289) than in the control group (0.022; 95% CI, 0.004-0.069) (P < .001). CD4 cell response was better in the switch group (median CD4 percentage at 52 weeks, 34.7) vs the control group (CD4 percentage, 31.3) (P = .004). Older age (relative hazard [RH], 1.71; 95% CI, 1.08-2.72) was associated with viremia greater than 50 copies/mL in the control group. Inadequate adherence (RH, 4.14; 95% CI, 1.18-14.57) and drug resistance (RH, 4.04; 95% CI, 1.40-11.65) before treatment were associated with confirmed viremia greater than 1000 copies/mL in the switch group.Among HIV-infected children previously exposed to nevirapine, switching to nevirapine-based therapy after achieving viral suppression with a ritonavir-boosted lopinavir regimen resulted in lower rates of viremia greater than 50 copies/mL than maintaining the primary ritonavir-boosted lopinavir regimen.clinicaltrials.gov Identifier: NCT00117728.
Guidelines for Medical and Health Information Sites on the Internet
Authors: Margaret A. Winker, Annette Flanagin, Bonnie Chi-Lum, John White, Karen Andrews, Robert L. Kennett, Catherine D. DeAngelis, Robert A. Musacchio
Journal: JAMA (2000)

Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.
Needed: New Therapy for Hypercholesterolemia
Authors: David W. Bilheimer
Journal: New England Journal of Medicine (1977)

Familial hypercholesterolemia is an unequivocal example of a single-gene defect that produces hypercholesterolemia followed by atherosclerosis. Although the disease is transmitted as a dominant trait, rare patients inherit two copies of the mutant gene and thus express the more severe homozygous form of the disease.1 Studies of these homozygotes have been particularly valuable in extending knowledge of the link between cholesterol and lipoprotein metabolism. The homozygous form of familial hypercholesterolemia is characterized by xanthomatosis, prematurely severe atherosclerosis and fourfold to six-fold elevations of plasma cholesterol in the form of low-density lipoprotein. Despite this massive elevation of plasma cholesterol levels, studies . . .
Words that count
Authors: Jeff Aronson
Journal: BMJ (2007)

I have previously described the difference between count (or unit) nouns and non-count (or mass) nouns ( BMJ 2004;329:30). Briefly, a count noun can be both singular and plural (a filler, my filler, those fillers, many fillers), whereas a non-count noun, which usually takes a singular form (furniture, some furniture, much furniture), is strictly speaking neither singular nor plural. If you can put the indefinite article, “a” or “an,” before a noun—indeed, if it requires some such determiner—it is a count noun. Some nouns can be of both types, with different meanings—two glasses (count noun), some glass (non-count noun). This happens, for example, when a …
Lesson from hypomorphic recombination-activating gene (RAG) mutations: Why asymptomatic siblings should also be tested
Authors: Catharina Schuetz, Ulrich Pannicke, Eva-Maria Jacobsen, Siegfried Burggraf, Michael H. Albert, Manfred Hönig, Tim Niehues, Oliver Feyen, Stephan Ehl, Klaus-Michael Debatin, Wilhelm Friedrich, Ansgar S. Schulz, Klaus Schwarz
Journal: Journal of Allergy and Clinical Immunology (2013)
Impaired Glucose Tolerance, but Not Impaired Fasting Glucose, Underlies Left Ventricular Diastolic Dysfunction
Authors: Michio Shimabukuro, Namio Higa, Tomohiro Asahi, Ken Yamakawa, Yoshito Oshiro, Moritake Higa, Hiroaki Masuzaki
Journal: Diabetes Care (2011)

Glucose intolerance is recognized as a predictor of congestive heart failure (CHF). However, the association of postprandial hyperglycemia or fasting hyperglycemia with CHF has not been clarified. We determined the impact of the total spectrum of glucose abnormalities on left ventricular (LV) geometry and diastolic function.Two hundred and eighty-seven Japanese subjects who visited the university hospital to be checked for glucose intolerance or known type 2 diabetes were consecutively recruited. Participants underwent an oral glucose tolerance test if they had no history of diabetes, and LV geometry and LV systolic and diastolic function were analyzed by Doppler echocardiography.The frequency of LV diastolic dysfunction in subjects with normal glucose tolerance, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), newly detected diabetes, and known diabetes were 13, 22, 50, 51, and 61%, respectively (χ(2) = 54.2, P < 0.0001). IGT was a predictor for LV diastolic dysfunction after adjusting for age, sex, systolic blood pressure, and heart rate (odds ratio 3.43 [95% CI 1.09-11.2]), but IFG was not (0.49 [0.06-3.08]). IGT was a predictor after adjusting for established CHF risk factors but was no longer significant after adjusting for BMI and homeostasis model assessment of insulin resistance.In this hospital-based registry of subjects without CHF, the prevalence of LV diastolic dysfunction was higher in subjects with IGT but not in those with IFG. Results suggest that IGT, as well as newly detected and known diabetes, could be linked to an increased risk of cardiovascular events, partly through LV diastolic dysfunction.
622 SAFETY, AND TOLERABILITY OF NIM811, A NOVEL CYCLOPHILIN INHIBITOR FOR HCV, FOLLOWING SINGLE AND MULTIPLE ASCENDING DOSES IN HEALTHY VOLUNTEERS AND HCV-INFECTED PATIENTS
Authors: J. Ke, E. Lawitz, R. Rozier, T. Marbury, N. Nguyen, D. Serra, K. Dole, J. Praestgaard, M. Huang, T. Evans
Journal: Journal of Hepatology (2009)