tbuckley/cabot-search huggingface dataset:
The 104-week efficacy and safety of telbivudine-based optimization strategy in chronic hepatitis B patients: A randomized, controlled study
Authors: Jian Sun, Qing Xie, Deming Tan, Qin Ning, Junqi Niu, Xuefan Bai, Rong Fan, Shijun Chen, Jun Cheng, Yanyan Yu, Hao Wang, Min Xu, Guangfeng Shi, Mobin Wan, Xinyue Chen, Hong Tang, Jifang Sheng, Xiaoguang Dou, Junping Shi, Hong Ren, Maorong Wang, Hongfei Zhang, Zhiliang Gao, Chengwei Chen, Hong Ma, Jidong Jia, Jinlin Hou
Journal: Hepatology (2013)

An optimization strategy based on the Roadmap concept is supposed to improve the clinical outcomes of patients with suboptimal antiviral response. The aim of this study was to prove the concept with a multicenter, open-label, randomized, controlled study. In all, 606 hepatitis B e antigen (HBeAg)-positive, nucleos(t)ide-naive chronic hepatitis B patients were randomized to the Optimize or Mono group. Patients in the Optimize group were treated with telbivudine for 24 weeks, after which those suboptimal responders with HBV DNA ≥300 copies/mL at week 24 received telbivudine plus adefovir until week 104, while the early virological responders continued telbivudine monotherapy. Patients in the Mono group received telbivudine monotherapy. All patients with telbivudine monotherapy had adefovir added if viral breakthrough developed. Sixty-eight percent (204/300) of patients in the Optimize group had adefovir added due to suboptimal response. At week 104, compared to the Mono group, more patients in the Optimize group achieved HBV DNA <300 copies/ml (76.7% versus 61.2%, P < 0.001) with less genotypic resistance (2.7% versus 25.8%, P < 0.001). The rates of HBeAg seroconversion and alanine aminotransferase (ALT) normalization were comparable between the two groups (23.7% versus 22.1%; 80.7% versus 79.2%). For week 24 suboptimal responders, telbivudine plus adefovir showed an additive antiviral potency, with 71.1% achieving virological response at week 104 and only 0.5% developing genotypic resistance, compared with 46.6% who achieved virological response and 37.8% who developed genotypic resistance with telbivudine monotherapy. Both treatment regimens were well tolerated, with an observed persistent increase of the glomerular filtration rate.For suboptimal virological responders to telbivudine at week 24, adjusting the treatment strategy is recommended. Adding adefovir can benefit these patients with additive antiviral potency and low resistance without increased side effects.
Complement in antibody therapy: friend or foe?
Authors: Martino Introna, Josée Golay
Journal: Blood (2009)

Whether complement activation plays a role in the therapeutic efficacy of unconjugated therapeutic monoclonal antibodies such as rituximab has been widely debated.In this issue of Blood, Wang and colleagues suggest that complement has an inhibitory effect on NK cell-mediated cytotoxicity in vitro and therapeutic monoclonal antibody efficacy in vivo.
C reactive protein levels are increased in non-allergic but not allergic asthma: a multicentre epidemiological study
Authors: I S Olafsdottir
Journal: Thorax (2005)

<b>Background:</b> High sensitivity C reactive protein (HsCRP) is an inflammatory marker known to be related to smoking, obesity, and cardiovascular disease. A study was undertaken to determine whether HsCRP is related to respiratory symptoms, asthma, atopy, and bronchial hyperresponsiveness in population samples from three countries. <b>Methods:</b> HsCRP was measured in 1289 subjects from three centres in ECRHS II: Reykjavik, Uppsala and Tartu. The HsCRP values ranged from &lt;0.01 mg/l to 70.0 mg/l and were divided into four equal groups (⩽0.45, 0.46–0.96, 0.97–2.21, and &gt;2.21 mg/l). <b>Results:</b> HsCRP increased with increasing body mass index (<i>r</i> = 0.41; p&lt;0.0001) and was higher in smokers than in never smokers (p = 0.02). A significant relationship was found between increased HsCRP levels and respiratory symptoms such as wheeze, attacks of breathlessness after effort, and nocturnal cough (p&lt;0.0001). The crude odds ratio (95% CI) for the probability of non-allergic asthma was 3.57 (1.83 to 6.96) for subjects in the 4th quartile compared with the 1st quartile of HsCRP. This association remained significant after adjusting for study centre, age, sex, body weight, and smoking history (OR 2.19 (95% CI 1.04 to 4.63)). No significant relationship was observed between HsCRP and allergic asthma or bronchial responsiveness. <b>Conclusions:</b> Raised levels of HsCRP are significantly associated with respiratory symptoms and non-allergic asthma but not with allergic asthma.
William Ian McDonald
Authors: Caroline Richmond
Journal: BMJ (2007)

Neurologist who refined the diagnosis and understanding of multiple sclerosis

William Ian McDonald (“Ian”) greatly advanced knowledge of multiple sclerosis and was also an expert in neuro-ophthalmology and, in retirement, an outstanding Harveian librarian at the Royal College of Physicians. 

He transformed the study of multiple sclerosis from a series of disjointed approaches to a coherent and scientific entity, and the current diagnostic criteria are called the McDonald criteria. He was one of the few neurologists to do substantial laboratory research. When magnetic imaging was introduced he quickly recognised its potential value in diagnosis, monitoring, and establishing the pathogenesis of multiple sclerosis. He carried out studies that showed his hunch was correct, and, thanks to him, imaging is now used to speed up the monitoring of clinical trials. He was a great mentor and an excellent lecturer. 

Ian was born into a Presbyterian family in Wellington, New Zealand, the son of an insurance manager. From St Andrew's College he went to Otago University, earning a BMedSci in 1955 and qualifying MBChB in 1957 with distinctions in pharmacology, microbiology, medicine, and gynaecology. After house jobs in Dunedin Hospital he spent three years, from 1959 …
The Human Genome Project
Authors: Eric D. Green, Robert H. Waterston
Journal: JAMA (1991)

The recently initiated human genome project is a large international effort to elucidate the genetic architecture of the genomes of man and several model organisms. The initial phases of this endeavor involve the establishment of rough blueprints (maps) of the genetic landscape of these genomes, with the long-term goal of determining their precise nucleotide sequences and identifying the genes. The knowledge gained by these studies will provide a vital tool for the study of many biologic processes and will have a profound impact on clinical medicine.
759 Outcome of liver transplantation for hepatitis B in the U.S.
Authors: W KIM, J POTERUCHA, M ISHITANI, E DICKSON
Journal: Hepatology (2003)

Background/Aims: There may be a relationship between autoimmune hepatitis and viral infection. To examine this relationship, 19 patients with autoimmune hepatitis and/or chronic hepatitis C were studied.Methods: Patients were selected initially on the basis of having autoantibodies (anti-nuclear, anti-smooth muscle, or anti-liver-kidney microsomal) in serum. Formalin-fixed, paraffin-embedded liver biopsies from these patients were tested for HCV-RNA by polymerase chain reaction. The biopsies were examined histologically to detect features suggestive of chronic hepatitis C or autoimmune hepatitis. The results were correlated with serum anti-HCV and HCV-RNA, and with response to steroid therapy.Results: Five of the nineteen patients had detectable HCV-RNA in their liver biopsies. In two of three patients from whom serum was available, HCV-RNA was detectable. The remaining 14 patients were negative for HCV-RNA by tissue polymerase chain reaction. Serum was available from 11 of these patients, and serum HCV-RNA was negative in all. All of the three HCV-RNA-positive patients who were treated with steroids showed a partial response; tissue positivity for HCV-RNA was significantly higher in partial responders than in complete responders (60% vs 0%, p=0.01). Severe portal and periportal inflammation with prominent plasma cells together with bridging parenchymal necrosis were seen more often in HCV-negative biopsies. Mild portal and periportal inflammation with portal lymphoid aggregates apoptosis and spotty parenchymal necrosis were seen more in HCV-positive biopsies.Conclusions: These results show that hepatitic C virus can be detected in some patients with circulating auto-antibodies. The ability to detect HCV-RNA in paraffin-embedded archival material provides a valuable addition to the battery of available HCV tests.
Treatment of Snakebite
Authors: Robert E. Arnold
Journal: JAMA (1976)

<h3>To the Editor.—</h3> The SPECIAL COMMUNICATION by Thomas G. Glass, Jr, MD, mentioned the use of cortisone, tourniquets, and ice bags. I think the following points are worth bringing out. Cortisone has never been demonstrated to have any effect whatsoever on any snake venom known. Cortisone has never been shown to have any effect on the tissue product breakdown of the actions of snake venom. Cortisone has never been demonstrated to be of any benefit in the systemic manifestations of pit viper envenomation. The fact that Dr Glass uses it and his patients survive can not be used as proof of efficacy. The hyperdynamic shock state so characteristic of Gram-negative shock has never been demonstrated in pit viper bites. The use of tourniquets will decrease perfusion. This combined with cryotherapy will enhance tissue loss. This fact is well known to both physicians and lawyers, and
Role of Physicians and Mental Health Professionals in Discussions of Public Figures
Authors: Richard A. Friedman
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
Principles of Neurological Surgery
Authors: A. Earl Walker
Journal: JAMA (1964)

About two decades ago the senior author of this book wrote a text on neurological surgery, the popularity of which may be judged by the fact that it went through four editions, the last appearing in 1953. This book contains a great deal of the material presented in the earlier edition, although the format has been markedly altered and certain new sections have been introduced to describe the recent developments of neurological surgery. The book is written for the student and the physician rather than for the specialist in diseases of the nervous system. Accordingly it presents the general picture of neurological disease amenable to neurosurgical treatment without entering into minutiae of differential diagnosis and of surgical techniques. The material is evenly covered with an impartial, yet critical, viewpoint. The authors have achieved a well-illustrated text which is easily read and yet sufficiently detailed to acquaint the student with the
THE CLINICAL MANIFESTATIONS OF HYDROPHOBIA.
Authors: D. J. McCARTHY
Journal: JAMA (1903)

The usual text-book descriptions of hydrophobia give a clinical course of the disease divided into three stages. It is, however, difficult in practice to separate the clinical manifestations by any fixed rule. The incubation period is usually about six weeks. In both the cases reported in this paper it was about that length. The onset of the disease is marked by several days of malaise, with slight fever, anxiety and, in a large number of cases, irritation at the seat of the infecting wound. The temperature at this stage is usually elevated one or two degrees, although it may remain at normal. This stage of irritation soon passes over to the convulsive stage. In some cases there is no convulsion or spasm, and the premonitory stage is followed by the paralytic symptoms. The symptoms of the second stage begin with more or less difficulty in the act of swallowing. Anything
DYSINSULINISM: A DISCUSSION AND CASE REPORT
Authors: Julian Love
Journal: JAMA (1933)

Naming diabetes mellitus on the basis of its aberrant endocrine physiology, one would call the disease hypo-insulinism. In this disease hyperglycemia and glycosuria are essential features. The discovery of insulin by Banting, Best and their co-workers led to the rational therapy of this disease and to the discovery of perhaps two others—hyperinsulinism and dysinsulinism. Insulin, when given in overdosage to diabetic patients, causes a train of symptoms that is very well known. There is a feeling of nervousness, hunger and weakness accompanied by a profuse sweat, dizziness, diplopia, pallor, faintness, syncope and convulsions; ultimately, coma may result. From this reaction, which is more or less acute in its onset, the patient can be aroused dramatically in a few moments by the administration of carbohydrates. Seale Harris had noted patients who presented symptom complexes very similar to those obtained in diabetic patients during insulin shock. He was the first to reason
The Clinical Course of Idiopathic Dilated Cardiomyopathy
Authors: Declan D. Sugrue, Richard J. Rodeheffer, Mary B. Codd, David J. Ballard, Valentin Fuster, Bernard J. Gersh
Journal: Annals of Internal Medicine (1992)

▪ Objective: To describe the prognosis of individuals with idiopathic dilated cardiomyopathy in a population-based sample and to compare this with the prognosis of patients in a previous referral center case series of idiopathic dilated cardiomyopathy. ▪ Design: Cohort study. ▪ Setting: Population-based in Olmsted County, Minnesota. ▪ Patients: Forty residents of Olmstead County, Minnesotawith idiopathic dilated cardiomyopathy initially diagnosed between 1975 and 1984 who were followed through 1 July 1989 and 104 patients from a Mayo Clinic referral case series from 1960 to 1973. ▪ Measurements: Survival for the population-based cohort at 1 year and 5 years. ▪ Results: Survival at 1 year differed dramatically betweenthe population-based cohort and the referral case series at 1 year (95% compared with 69%, respectively) and at 5 years (80% compared with 36%, respectively) (P < 0.001). Long-term survival for the population-based cohort was nonetheless impaired when compared with an age- and sex-matched cohort, that is, the 1980 Minnesota white population (8-year survival: observed, 58% compared with expected, 83%; P < 0.001). Among community patients, older age (adjusted Cox model hazard ratio for 10-year increase in age, 1.59; 95% Cl, 1.08 to 2.35) and lower left ventricular ejection fraction (adjusted hazard ratio for 10% decrease, 1.90; Cl, 1.04 to 3.50) were independently associated with impaired survival. ▪Conclusions: These population-based data challenge the clinical perception of the clinical course of idiopathic dilated cardiomyopathy based on referral practice prognostic studies and suggest that the clinical course of this condition may be more favorable than previously recognized.
Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980-2012
Authors: Marie Ng, Michael K. Freeman, Thomas D. Fleming, Margaret Robinson, Laura Dwyer-Lindgren, Blake Thomson, Alexandra Wollum, Ella Sanman, Sarah Wulf, Alan D. Lopez, Christopher J. L. Murray, Emmanuela Gakidou
Journal: JAMA (2014)

<h3>Importance</h3> Tobacco is a leading global disease risk factor. Understanding national trends in prevalence and consumption is critical for prioritizing action and evaluating tobacco control progress. <h3>Objective</h3> To estimate the prevalence of daily smoking by age and sex and the number of cigarettes per smoker per day for 187 countries from 1980 to 2012. <h3>Design</h3> Nationally representative sources that measured tobacco use (n = 2102 country-years of data) were systematically identified. Survey data that did not report daily tobacco smoking were adjusted using the average relationship between different definitions. Age-sex-country-year observations (n = 38 315) were synthesized using spatial-temporal gaussian process regression to model prevalence estimates by age, sex, country, and year. Data on consumption of cigarettes were used to generate estimates of cigarettes per smoker per day. <h3>Main Outcomes and Measures</h3> Modeled age-standardized prevalence of daily tobacco smoking by age, sex, country, and year; cigarettes per smoker per day by country and year. <h3>Results</h3> Global modeled age-standardized prevalence of daily tobacco smoking in the population older than 15 years decreased from 41.2% (95% uncertainty interval [UI], 40.0%-42.6%) in 1980 to 31.1% (95% UI, 30.2%-32.0%;<i>P</i> &lt; .001) in 2012 for men and from 10.6% (95% UI, 10.2%-11.1%) to 6.2% (95% UI, 6.0%-6.4%;<i>P</i> &lt; .001) for women. Global modeled prevalence declined at a faster rate from 1996 to 2006 (mean annualized rate of decline, 1.7%; 95% UI, 1.5%-1.9%) compared with the subsequent period (mean annualized rate of decline, 0.9%; 95% UI, 0.5%-1.3%;<i>P</i> = .003). Despite the decline in modeled prevalence, the number of daily smokers increased from 721 million (95% UI, 700 million–742 million) in 1980 to 967 million (95% UI, 944 million–989 million;<i>P</i> &lt; .001) in 2012. Modeled prevalence rates exhibited substantial variation across age, sex, and countries, with rates below 5% for women in some African countries to more than 55% for men in Timor-Leste and Indonesia. The number of cigarettes per smoker per day also varied widely across countries and was not correlated with modeled prevalence. <h3>Conclusions and Relevance</h3> Since 1980, large reductions in the estimated prevalence of daily smoking were observed at the global level for both men and women, but because of population growth, the number of smokers increased significantly. As tobacco remains a threat to the health of the world’s population, intensified efforts to control its use are needed.
Resuscitation: How Do We Decide?
Authors: David Gary Smith
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Charlson et al<sup>1</sup>al1 present a rich analysis of the clinical practice in their hospital concerning levels of intervention in the care of the hospitalized patient. Such a project offers much insight from the perspective of descriptive ethics but does not, in and of itself, lead to any prescriptive statements from the viewpoint of normative ethics. First, they argue that discussions with patients concerning appropriate levels of care can provoke undue anxiety. Although there are some empiric data to support this statement,<sup>2</sup>I do not believe that this concern is alone sufficient to avoid such dialogue. In fact, such discussion might allow for a greater sense of patient control and input, which may not only be clinically beneficial<sup>3</sup>but also, more importantly, morally required. Second, they list the "legal standards for evaluating resuscitation status" as irreversible disease, irreparable physiologic deterioration, and imminent death. I am
A New Look at Peptic Ulcer
Authors: MORTON I. GROSSMAN
Journal: Annals of Internal Medicine (1976)

There have been notable advances in knowledge about peptic ulcer recently. Gastrin-producing tumors have been recognized as a rare cause of ulcer, and multiple physiologic defects have been found in duodenal ulcer, including excessive release of gastrin after food intake, increased sensitivity to gastrin, and decreased inhibition by low pH. The tendency of gastric ulcer patients to reflux duodenal contents into the stomach may have pathogenetic significance. Two new classes of drugs strongly inhibit acid secretion in man: chemically modified prostaglandins and histamine analogues which block the action of histamine on acid secretion. Their value in treating ulcer is now being assessed in clinical trials. A new operation for duodenal ulcer shows promise: only those vagal fibers innervating the acid-secreting part of the stomach are severed, thus obviating the need for a drainage procedure and decreasing some of the undesirable side effects of earlier operations.
Service and Education for the Insulin-dependent Child
Authors: Willaim H Hoffman, Peeg O'Neill, Catherine Khoury, Samuel S Bernstein
Journal: Diabetes Care (1978)

A pilot program of service and education was designed to actively involve the inner-city, insulin-dependent child in his own diabetes management. A telephone service for questions and advice, managed by a pediatric nurse specialist, was responsible for a significant reduction in hospital admissions. The project was enthausiastically received and utilized by inner-city residents and resulted in an increased referral rate from the entire metropolitan area.
Research into new care technologies gets 6.25m in funding
Authors: K. Chinthapalli
Journal: BMJ (2012)

Sally Davies, England’s chief medical officer, has invited researchers and academics to apply for a total of up to £6.25m (€7.7m; $1bn) to develop new devices and technologies for the care of patients. The money is part of a new round of funding in the National Institute of Health Research’s invention for innovation (“i4i”) programme. 

At a press conference on 22 November to launch the new funding, Davies introduced examples of recent awards, including a gadget for early detection of HIV in the community. Rachel McKendry, one of the study’s lead investigators, hoped that her prototype would detect the presence …
Impact of the ASCO 2007 Presentation of HOG Lun 01-24/USO-023 on the Prescribing Plans of American Medical Oncologists for Patients with Stage IIIB Non-small Cell Lung Cancer
Authors: Mark R. Green, Howard West, Mark A. Socinski, Joanne Willey, Laura Daniels, Kristine Lemke, George Rafferty, Lou Iovino
Journal: Journal of Thoracic Oncology (2009)
CONTROL OF MEDICAL PRACTICE
Authors: J. H. MEANS
Journal: Annals of Internal Medicine (1934)

Editorials1 September 1934CONTROL OF MEDICAL PRACTICEJ. H. MEANSJ. H. MEANSSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-8-3-374 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFairness, it would seem, demands, in any human transaction, that the rights of all parties shall receive due consideration. This principle should apply to the doctor-patient relationship, which is in effect the sale (when it isn't a gift) of medical care to the patient by the doctor. Both parties to the transaction are deeply interested. To the patient, it may be a life or death matter; to the doctor, a portion of his livelihood. Exploitation of either by the other is incompatible with sound ethics. Yet we have it on high authority that "all features of medical service in any... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1934Volume 8, Issue 3Page: 374-375KeywordsMedical servicesPatients ePublished: 1 December 2008 Issue Published: 1 September 1934 PDF downloadLoading ...
Modified Ham test for atypical hemolytic uremic syndrome
Authors: Eleni Gavriilaki, Xuan Yuan, Zhaohui Ye, Alexander J. Ambinder, Satish P. Shanbhag, Michael B. Streiff, Thomas S. Kickler, Alison R. Moliterno, C. John Sperati, Robert A. Brodsky
Journal: Blood (2015)