tbuckley/cabot-search huggingface dataset:
Case of Acute Lithiasis
Authors: H. Payne
Journal: BMJ (1857)

myself, and gave it to one of the hospital staff on quitting the statioin.It is a pity the queen cannot afford to allow her servants the use of a frying-pan!!I was told the pant lids are intendecl to answer the purpose; a very cleanly substitute it must be admitted.Indeed, official correspondence often took place about the most ridiculous and trifling matters, the surgeon nlot having the power to purchase requisite articles, save strictly according to "regulation and routine", instead of his being made a responsible and comparatively inde- pendent officer in all matters of hospital arrangement, de- tail, and expenditure.The medical department has never yet hadsufficient independent authority, the War Office stepping *in and interfering in matters purely medical: e. g., had the director-general's suggestions and wishes been attended to, at the breakinc, out of the late war, howv much misery, neglect, and mortality might have been avoided!Military hygiene should surely be exclusively under the control of the heads of the medical department, and every regimental surgeon should be in a position to act at once, without consultation and correspondence with any one, when sickness and emergencies arise.Contracted and hampered on every si(le, talent and skill, low-
Asthma Intervention Program Prevents Readmissions in High Healthcare Users
Authors: Mario Castro, Nina A. Zimmermann, Sue Crocker, Joseph Bradley, Charles Leven, Kenneth B. Schechtman
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

The largest portion of the cost for asthma healthcare is due to hospitalizations. Improved methods of healthcare delivery for patients with asthma are needed to prevent readmissions. From 1996 to 1999, 96 adult subjects (predominantly young African American women) hospitalized with an asthma exacerbation, who had a history of frequent healthcare use, were randomized to an asthma nurse specialist intervention (n = 50) or a usual care group (n = 46) for 6 months. Our aim was to decrease rates of readmissions within 6 months of hospital discharge, to reduce cost, and to improve health-related quality of life. Our results demonstrate a 60% reduction in total hospitalizations (31 readmissions in the intervention group and 71 in the control group, p = 0.04), with no significant change in emergency department visits. Readmissions for asthma were reduced by 54% (21 vs. 42 in the control group; p = 0.04). We found a marked reduction in lost work or school days: 246 versus 1040 days in the control group (p = 0.02). The intervention resulted in a substantial reduction in direct and indirect healthcare costs, saving US dollars 6462 per patient (p = 0.03). A brief intervention program focusing on high healthcare users with asthma can result in improved asthma control and reduced hospital use with substantial cost savings.
Asthma self-management education program by home monitoring of peak expiratory flow.
Authors: J M Ignacio-Garcia, P Gonzalez-Santos
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

A prospective controlled trial of home monitoring of peak expiratory flow rate (PEFR) was conducted to determine the usefulness of an objective measure of lung function in association with an education program and a medication self-management plan in reducing morbidity in adult patients with asthma. Thirty-five patients managed themselves, using peak flow readings as the basis for the therapeutic plan coupled with educational intervention, whereas 35 control patients used symptoms and spirometric data for following physicians' treatment plans. After a 6-mo study period, patients in the experimental group showed statistically significant improvements in morbidity parameters (days lost from work, acute asthma attacks, days on antibiotic therapy, physician consultations, and emergency room admissions for asthma), increases in FVC, FEV1, and FEV1/FVC, mean PEFR and mean morning PEFR, decrease in percentage of the mean PEFR amplitude, and a reduction in the use of inhaled beta-agonists, oral theophylline, and oral prednisone. Although improvements in some of these parameters were also found in the control group, they did not reach the levels of significance obtained in the experimental group. The personal use of an objective measure of lung function in association with a medication self-management plan leads to improvement in the patient's condition.
Paroxysmal Atrial Fibrillation in a Physically Active Man
Authors: Timothy J. Ingall
Journal: JAMA (1988)

To the Editor. —  In the May 20 issue ofJAMA, several questions were asked about the management of paroxysmal atrial fibrillation.1Dr Dunn advises that the patient undergo long-term anticoagulation therapy with warfarin sodium. I would like to make two comments. First, the article that Dr Dunn refers to (The Framingham Study) does not document an increased risk of embolism in patients with paroxysmal atrial fibrillation but rather documents an increase in overall mortality in patients with chronic atrial fibrillation.2Second, there is no adequately documented evidence that long-term anticoagulation therapy decreases the risk of systemic embolization in patients with any form of atrial fibrillation. In addition, the patient in question can be characterized as having lone atrial fibrillation, ie, atrial fibrillation with no evidence of any other primary cardiac disorder. There is evidence that for patients 60 years of age and younger, lone atrial fibrillation, whether
Role of contextual factors in health-related quality of life in ankylosing spondylitis
Authors: V S Gordeev, W P Maksymowych, S M A A Evers, A Ament, L Schachna, A Boonen
Journal: Annals of the Rheumatic Diseases (2009)

In the bio-psycho-social model of health, the role of contextual factors, either environmental or personal, is recognised.To assess the impact of a number of contextual factors on self-reported disease-specific and generic health-related quality of life in patients with ankylosing spondylitis (AS).522 patients with AS from Canada and Australia completed a postal questionnaire including sociodemographic variables, disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)) function (Bath Ankylosing Spondylitis Functional Index (BASFI)) health-related quality of life (ASQoL and EQ-5D) and Rheumatoid Attitudes Index Helplessness Subscale. The contribution of contextual factors (nationality, ethnicity, marital status, education, employment and helplessness) in addition to functioning and disability (BASDAI and BASFI) to health-related quality of life was analysed using multivariate regression analyses. Interactions between contextual variables were explored.Contextual factors explained 37% and 47% of the variance in EQ-5D and ASQoL, respectively. Helplessness and employment were the most important contextual factors. Their role was independent of the strong effect of disease activity (BASDAI) and functional limitations (BASFI). When ASQoL was the outcome, an interaction was seen between employment and education and when EQ-5D was the outcome, an interaction was seen between helplessness and education.Of the contextual factors explored in this study, helplessness and employment had an important and independent contribution to health-related quality of life. In patients with lower education, the effect of not being employed on ASQoL and the effect of helplessness on EQ-5D were stronger. Contextual factors, especially helplessness and employment, should receive more attention when interpreting data on health-related quality of life.
Balancing Disclosure of Diagnosis and Assent for Research in Children With HIV
Authors: Raymond C. Barfield
Journal: JAMA (2008)

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
Learning from Big Health Care Data
Authors: Sebastian Schneeweiss
Journal: New England Journal of Medicine (2014)

Interview with Dr. Sebastian Schneeweiss on opportunities for and obstacles to the use of big health care data. (11:18)Download Two key applications of big health care data are generating knowledge about treatment effectiveness and predicting outcomes. Though the analytic tools exist, our health care system hasn't been able to use them to create an ongoing learning-and-improvement process.
Activation of nuclear factor of activated T cells (NFAT) molecular species by aspirin (acetylsalicylic acid: ASA) in human T cells*1
Authors: A.S. Hellquist, U. De Fanis, T.S.L. Holland, V. Gupta, R.J. Kurnat, A. Cianferoni, V. Casolaro
Journal: Journal of Allergy and Clinical Immunology (2004)
Adipose Tissue–derived Mesenchymal Stem Cells Expressing Prodrug-converting Enzyme Inhibit Human Prostate Tumor Growth
Authors: Ilaria T Cavarretta, Veronika Altanerova, Miroslava Matuskova, Lucia Kucerova, Zoran Culig, Cestmir Altaner
Journal: Molecular Therapy (2009)

The ability of human adipose tissue–derived mesenchymal stem cells (AT-MSCs), engineered to express the suicide gene cytosine deaminase::uracil phosphoribosyltransferase (CD::UPRT), to convert the relatively nontoxic 5-fluorocytosine (5-FC) into the highly toxic antitumor 5-fluorouracil (5-FU) together with their ability to track and engraft into tumors and micrometastases makes these cells an attractive tool to activate prodrugs directly within the tumor mass. In this study, we tested the feasibility and efficacy of these therapeutic cells to function as cellular vehicles of prodrug-activating enzymes in prostate cancer (PC) therapy. In in vitro migration experiments we have shown that therapeutic AT-MSCs migrated to all the prostate cell lines tested. In a pilot preclinical study, we observed that coinjections of human bone metastatic PC cells along with the transduced AT-MSCs into nude mice treated with 5-FC induced a complete tumor regression in a dose dependent manner or did not even allow the establishment of the tumor. More importantly, we also demonstrated that the therapeutic cells were effective in significantly inhibiting PC tumor growth after intravenous administration that is a key requisite for any clinical application of gene-directed enzyme prodrug therapies. The ability of human adipose tissue–derived mesenchymal stem cells (AT-MSCs), engineered to express the suicide gene cytosine deaminase::uracil phosphoribosyltransferase (CD::UPRT), to convert the relatively nontoxic 5-fluorocytosine (5-FC) into the highly toxic antitumor 5-fluorouracil (5-FU) together with their ability to track and engraft into tumors and micrometastases makes these cells an attractive tool to activate prodrugs directly within the tumor mass. In this study, we tested the feasibility and efficacy of these therapeutic cells to function as cellular vehicles of prodrug-activating enzymes in prostate cancer (PC) therapy. In in vitro migration experiments we have shown that therapeutic AT-MSCs migrated to all the prostate cell lines tested. In a pilot preclinical study, we observed that coinjections of human bone metastatic PC cells along with the transduced AT-MSCs into nude mice treated with 5-FC induced a complete tumor regression in a dose dependent manner or did not even allow the establishment of the tumor. More importantly, we also demonstrated that the therapeutic cells were effective in significantly inhibiting PC tumor growth after intravenous administration that is a key requisite for any clinical application of gene-directed enzyme prodrug therapies.
Clampless Off-Pump Versus Conventional Coronary Artery Revascularization
Authors: Jochen Börgermann, Kavous Hakim, André Renner, Amin Parsa, Anas Aboud, Tobias Becker, Marc Masshoff, Armin Zittermann, Jan Fritz Gummert, Oliver Kuss
Journal: Circulation (2012)

This study aimed to assess if clampless off-pump coronary artery bypass grafting (CABG) decreases risk-adjusted mortality, stroke rate, and morbidity in unselected patients in comparison to conventional CABG.Between July 2009 and November 2010, data of 1282 consecutive patients undergoing isolated CABG were prospectively recorded. In 30.8% (n=395), clampless off-pump revascularization was used, either with the PAS-Port automated central venous anastomosis system (n=310) or as total arterial revascularization without central anastomoses (n=85). Propensity score (PS) matching was performed based on 15 preoperative risk variables to correct for selection bias. In-hospital mortality and stroke rate as primary end point, as well as major complications and follow-up outcome of clampless off-pump (lessOPCAB) and conventional CABG (cCABG) were compared in 394 matched patient pairs (total: 788 patients). The clampless off-pump technique decreased the in-hospital rate of death (odds ratio, 0.25; 95% confidence interval, 0.05-1.18, P=0.080) and stroke (odds ratio, 0.36; 95% confidence interval, 0.13-0.99, P=0.048) significantly. Complications such as low cardiac output syndrome, prolonged ventilation and rethoracotomy were also reduced by lessOPCAB. Over a 2-year follow-up period overall survival, cerebrovascular and major adverse event rate were significantly lower in the lessOPCAB group, while the repeat revascularization rate was comparable.In a retrospective PS-matched analysis, clampless off-pump CABG lowers mortality, stroke rate and other morbidity in an unselected group of patients with coronary artery disease.
General practitioners' attendance at child protection case conferences.
Authors: J A Main, P G Main
Journal: BMJ (1991)

specimen showed greatly increased cellularity with a blast cell infiltrate typical of acute myeloblastic leukaemia.Immunophenotyping (HLA-DR 85%, CD34 84%, CD13 81%, CD33 74%, CD7 55%, Tdt 40% positive) was consistent with a primitive acute myeloblastic leukaemia.Cytogenetic analysis showed a 45XY, -5, -7 karyotype with multiple clonal abnormalities typical of secondary acute myeloblastic leukaemia.The patient died two months later.Postmortem examination was not performed.Like many heavily treated patients with lymphoma (or other cancer) our patient was at risk of developing secondary acute myeloblastic leukaemia.2In this disease the cells are known to express receptors for granulocyte colony stimulating factor.The temporal relation between the start of treatment with recombinant granulocyte colony stimulating factor and the development of leukaemia is disturbing.The case indicates that the statement by Drs Khwaja and Goldstone above may, unfortunately, already require modification.As the use of haemopoietic growth factors rises clinicians should be aware of their adverse, as well as beneficial, effects.
Institutional Responsibility in Graduate Medical Education and Highlights of Historical Data
Authors: Carlos J. M. Martini
Journal: JAMA (1993)

THIS year's report on graduate medical education (GME) is based on information maintained in the American Medical Association's (AMA's) Medical Education Research and Information (MERI) database, which consists of extensive, current information about the residents, programs, and institutions that constitute the GME enterprise in the United States (Table 1). The report includes • special analyses of selected educational characteristics, resident workload, benefits, compensation, and program outcomes (described below) of specialties and subspecialties by type of institutional control and • descriptive statistics (Appendix II), published annually on all three categories (residents, programs, and institutions) of the database, using similar variables from year to year to permit viewing GME data over time. Most of the MERI database is updated through the AMA Annual Survey of GME Programs (which contains the Census of Graduate Medical Trainees [CGMT]) and the companion AMA Annual Survey of GME Teaching Institutions. The first survey, sent in August
SKIN GRAFT—INCISION TO PREVENT SCARS.
Authors: CARL BECK
Journal: JAMA (1895)

In operations on the face and neck, we are often confronted with the difficult problem, "how to prevent ugly scars." The rules of surgery require extensive incisions, while cosmetic reasons call for the opposite, and even the most exact coaptation will not prevent cicatrices. It is evident that if we found a method which would enable us to make an ample incision, and leave little or no trace of it, this method would be of great advantage. After having studied this question theoretically and by experiments I have, in a few instances, made use of a special method. The results, though few as yet, and not conclusive, are so much encouraging that I venture to publish it. The method is simple. Contrary to the accepted rule of our technique, the incision is made obliquely to the surface with a razor or a scalpel, one border of the wound forming a
The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment
Authors: Paul M Pronyk, Maria Muniz, Ben Nemser, Marie-Andrée Somers, Lucy McClellan, Cheryl A Palm, Uyen Kim Huynh, Yanis Ben Amor, Belay Begashaw, John W McArthur, Amadou Niang, Sonia Ehrlich Sachs, Prabhjot Singh, Awash Teklehaimanot, Jeffrey D Sachs
Journal: The Lancet (2012)
Net Clinical Benefit of Adding Clopidogrel to Aspirin Therapy in Patients With Atrial Fibrillation for Whom Vitamin K Antagonists Are Unsuitable
Authors: Stuart J. Connolly
Journal: Annals of Internal Medicine (2011)

Background: Adding clopidogrel to aspirin therapy reduces stroke in patients with atrial fibrillation (AF) but increases hemorrhage. Objective: To quantify the net benefit of adding clopidogrel to aspirin therapy, accounting for differences in clinical significance between ischemic and hemorrhagic events. Design: Observational cohort study to assign the relative weighting of events and post hoc analysis of randomized trial data to assess net benefit of dual antiplatelet therapy in the ACTIVE (Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events) clinical trials. Setting: Global randomized clinical trial. Patients: 10 041 patients with AF, 7554 of whom were not candidates for warfarin therapy. Measurements: Ischemic events (ischemic stroke or myocardial infarction) and hemorrhagic events (hemorrhagic stroke or subdural or extracranial bleeding), weighted by the hazard ratio for death (or death or disability) after an event relative to death (or death or disability) after ischemic stroke. The net clinical benefit of dual antiplatelet therapy in the ACTIVE A trial participants was defined as the sum of weighted event incidence with dual antiplatelet therapy subtracted from the sum of weighted event incidence on control treatment, expressed as ischemic stroke equivalents prevented per 100 patients years. Results: Adding clopidogrel to aspirin therapy prevented 0.57 ischemic stroke equivalent (95% CI, −0.12 to 1.24) per 100 patient-years of treatment when weighted by hazard for death after ischemia or hemorrhage and 0.67 ischemic stroke equivalent (CI, −0.03 to 1.18) when weighted by death or disability after ischemia or hemorrhage. Limitation: No attempt was made to relate deaths used for weighting to events; disability data were missing for more than one half of patients. Conclusion: Adding clopidogrel to aspirin therapy resulted in a modest net benefit among patients with AF for whom warfarin was unsuitable. The benefit would probably be clinically relevant for some patients, but estimates could not exclude the possibility of either no benefit or very small harm in this population. Primary Funding Source: Bristol-Myers Squibb and sanofi-aventis.
PREDICTED AND UNPREDICTED CROSS-REACTIONS OF AN ACETYLPHOSPHOGALACTAN OF SPOROBOLOMYCES YEAST. II
Authors: Michael Heidelberger, Morey E. Slodki
Journal: The Journal of Experimental Medicine (1970)

The teichoic acid of streptococcal Group N, with end groups of galactose phosphate, had been shown to cross-react with antipneumococcal sera of types VI, XIV, XVI, and XXVII. End groups of D-galactose-1-phosphate in the phosphogalactans of Sporobolomyces yeasts made it predictable that these galactans would precipitate the same antipneumococcal sera and also antisera to streptococcal Group N. The predictions were verified, and other unpredicted reactions were found. Precipitation of much of the antibody in an antipneumoccal type XVIII horse serum was shown to be due to O-acetyl-D-galactose residues in the phosphogalactan, in accord with earlier information that an O-acetyl sugar was a principal determinant of S XVIII. The new results identify this sugar as D-galactose. Since it is linked 1,3- in S XVIII, the O-acetyl group in the Sporobolomyces galactan is probably also on a 1,3-linked residue. Another major cross-reaction in anti-S. paratyphi A serum characterizes the galactose residues in the "O" polysaccharide of the bacillus as members of the D-series probably linked in tandem 1,6-, 1,6-; 1,6-, 1,3-; 1,3-, 1,6-; or 1,3-, 1,3-. Reactions of periodate-oxidized-reduced products confirm the conclusions stated above. Quantitative data are given.
High-level, stable expression of blood group antigens in a heterologous system
Authors: K. Yazdanbakhsh, R. �yen, Q. Yu, S. Lee, M. Antoniou, A. Chaudhuri, M.E. Reid
Journal: American Journal of Hematology (2000)

The detection and identification of blood group antibodies in patients is crucial for successful allogeneic blood transfusions. Current methods are highly subjective and rely on red blood cells (RBCs), which simultaneously express many blood group antigens, have a short shelf-life, and carry potential biohazard risks. To overcome these problems, we have used the approach of expressing individual blood group antigen-bearing proteins in a heterologous system. We report here the high-level surface expression of type I (Knops), type II (Kell), and type III/multi-pass (Duffy) membrane proteins that carry blood group antigens in mouse erythroleukaemic (MEL) cells using a vector containing the beta-globin locus control region. Importantly, the antigens expressed were detected specifically by a panel of patients' sera containing alloantibodies at sensitivities that are comparable to antigen-positive RBCs. Furthermore, in contrast to other mammalian expression systems, antigen expression was stable following freezing and thawing of the cell lines. Thus, this system has the potential both to replace the current use of RBCs by providing a one step method to detect and identify blood group antibodies and to allow the automation of antibody identification for the clinical laboratory.