tbuckley/cabot-search huggingface dataset:
Psychiatry and the resource-based relative value scale
Authors: R A Dorwart, L R Chartock
Journal: American Journal of Psychiatry (1988)

Attention to reform of reimbursement for psychiatric inpatient services largely focuses on the use of prospective payment systems, e.g., payment based on diagnosis-related groups (DGRs), for hospitals. Recently, there also has been interest in proposals for altering physician reimbursement (inpatient and outpatient) by using physician DRGs, capitation models, or relative value scales instead of the charge-based, fee-for-service model. The authors review the resource-based relative value scale (RBRVS) as an option for psychiatry. The RBRVS uses the setting, the time spent, the difficulty in treating the patient, the training, and the psychiatrist's role to determine reimbursement rates.
425PD Clinical activity and safety of the EGFR mutant-specific inhibitor, BI1482694, in patients (pts) with T790M-positive NSCLC
Authors: J.-S. Lee, K. Park, J.-Y. Han, K.H. Lee, J.-H. Kim, E.K. Cho, J.Y. Cho, Y.J. Min, J.-S. Kim, H.-G. Kim, B.-S. Kim, J. Jung, D.-W. Kim
Journal: Annals of Oncology (2015)
Extragonadal Testicular Tissue and Teratomas
Authors: A G SMITH
Journal: JAMA (1963)

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
P-262 Multivisceral resections for gastric cancer - Should all patients with locally-disease receive them?
Authors: P. Viapiana, V. Simonetti, W.L. Costa, S. de Castro Ribeiro Heber, L. Diniz Alessandro, F. Antonio Cury, I. Farias, A. Godoy, J. Fernandez Coimbra Felipe
Journal: Annals of Oncology (2016)
Alexithymia: examining the development of a psychological concept
Authors: I M Lesser, B Z Lesser
Journal: American Journal of Psychiatry (1983)

Alexithymia is a clinically derived concept that refers to difficulty patients have with verbal expression of emotions and with fantasy elaborations. Since its recent introduction into the literature, it has been discussed in various contexts and has been considered by some to be a useful concept in integrating data from a variety of disciplines. The authors contend that many of the speculations about alexithymia are based on an inadequately researched data base and that its application in some areas is premature. They recommend careful investigation of any newly introduced psychological concept to avoid either its premature rejection or its reification.
Unique and shared signaling pathways cooperate to regulate the differentiation of human CD4+ T cells into distinct effector subsets
Authors: Cindy S. Ma, Natalie Wong, Geetha Rao, Akira Nguyen, Danielle T. Avery, Kathryn Payne, James Torpy, Patrick O’Young, Elissa Deenick, Jacinta Bustamante, Anne Puel, Satoshi Okada, Masao Kobayashi, Ruben Martinez-Barricarte, Michael Elliott, Sara Sebnem Kilic, Jamila El Baghdadi, Yoshiyuki Minegishi, Aziz Bousfiha, Nic Robertson, Sophie Hambleton, Peter D. Arkwright, Martyn French, Annaliesse K. Blincoe, Peter Hsu, Dianne E. Campbell, Michael O. Stormon, Melanie Wong, Stephen Adelstein, David A. Fulcher, Matthew C. Cook, Polina Stepensky, Kaan Boztug, Rita Beier, Aydan Ikincioğullari, John B. Ziegler, Paul Gray, Capucine Picard, Stéphanie Boisson-Dupuis, Tri Giang Phan, Bodo Grimbacher, Klaus Warnatz, Steven M. Holland, Gulbu Uzel, Jean-Laurent Casanova, Stuart G. Tangye
Journal: The Journal of Experimental Medicine (2016)

Naive CD4+ T cells differentiate into specific effector subsets—Th1, Th2, Th17, and T follicular helper (Tfh)—that provide immunity against pathogen infection. The signaling pathways involved in generating these effector cells are partially known. However, the effects of mutations underlying human primary immunodeficiencies on these processes, and how they compromise specific immune responses, remain unresolved. By studying individuals with mutations in key signaling pathways, we identified nonredundant pathways regulating human CD4+ T cell differentiation in vitro. IL12Rβ1/TYK2 and IFN-γR/STAT1 function in a feed-forward loop to induce Th1 cells, whereas IL-21/IL-21R/STAT3 signaling is required for Th17, Tfh, and IL-10–secreting cells. IL12Rβ1/TYK2 and NEMO are also required for Th17 induction. Strikingly, gain-of-function STAT1 mutations recapitulated the impact of dominant-negative STAT3 mutations on Tfh and Th17 cells, revealing a putative inhibitory effect of hypermorphic STAT1 over STAT3. These findings provide mechanistic insight into the requirements for human T cell effector function, and explain clinical manifestations of these immunodeficient conditions. Furthermore, they identify molecules that could be targeted to modulate CD4+ T cell effector function in the settings of infection, vaccination, or immune dysregulation.
Excessively High-Affinity Single-Chain Fragment Variable Region in a Chimeric Antigen Receptor Can Counteract T-Cell Proliferation
Authors: Keisuke Watanabe, Seitaro Terakura, Susumu Uchiyama, Anton C. Martens, Tom van Meerten, Hitoshi Kiyoi, Tetsuya Nishida, Tomoki Naoe, Makoto Murata
Journal: Blood (2014)
Flashbacks among soldiers discharged as unfit who abused more than one drug
Authors: J Yager, E Crumpton, R Rubenstein
Journal: American Journal of Psychiatry (1983)

Of 280 soldiers discharged from military service in 1971 as unfit, 207 reported the heavy use of at least one drug (most of these abused more than one drug) and 146 (52%) reported having flashbacks. Most flashbacks were of a simple visual nature, but repeat "trips," complex subjective experiences, and persistent difficulties in concentration were often reported. The prevalence and severity of flashbacks increased with drug use, particularly with hallucinogens and marijuana. Because psychological, social, and physiological factors may all contribute to flashback phenomena, other populations need to be studied to determine the extent to which these findings can be generalized.
Women with nausea and vomiting in pregnancy should be offered more support, say RCOG guidelines
Authors: Jacqui Wise
Journal: BMJ (2016)

Healthcare professionals should offer more support to pregnant women affected by nausea and vomiting or hyperemesis gravidarum, say new guidelines from the Royal College of Obstetricians and Gynaecologists.1

Nausea and vomiting affects as many as 80% of pregnant women and is one of the most common reasons that they are admitted to hospital. Hyperemesis gravidarum affects 1-3% of pregnant women, and the guidelines say that this can be diagnosed when protracted nausea and vomiting are associated with a triad of symptoms: weight loss of more than 5% of pre-pregnancy weight, dehydration, and electrolyte imbalance.

The guidelines say that women who have vomiting but are not dehydrated can be managed …
Case 42-1975
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, Denise J. Strieder, Max L. Goodman
Journal: New England Journal of Medicine (1975)

Presentation of CaseA 68-year-old man was admitted to the hospital because of respiratory distress.He was well until 18 months previously, when he began to cough. He continued to have an intermittent brassy cough and during the year before entry experienced mild dysphagia accompanied by a loss of 14 kg in weight. Nine months before admission wheezing respirations began to occur, particularly when he was in the left lateral decubitus position. An x-ray film of the chest revealed changes consistent with pulmonary emphysema. Five months before entry tetracycline and potassium iodide were administered, without benefit. One month later pulmonary-function . . .
Association of Plasma DPP4 Activity With Mild Cognitive Impairment in Elderly Patients With Type 2 Diabetes: Results From the GDMD Study in China
Authors: Tianpeng Zheng, Linyuan Qin, Bo Chen, Xueping Hu, Xiaoxi Zhang, Yihong Liu, Hongbo Liu, Shenghua Qin, Gang Li, Qinghua Li
Journal: Diabetes Care (2016)

OBJECTIVE Hyperglycemia, inflammation, and oxidative stress are thought to be involved in the pathogenesis of cognitive decline. Dipeptidyl peptidase-4 (DPP4) is a newly identified adipokine related to these risk factors. Hence, we aimed to investigate the association between plasma DPP4 activities and mild cognitive impairment (MCI) in elderly patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We evaluated plasma DPP4 activity, inflammatory markers, and oxidative stress parameters in a cross-sectional sample of 1,160 patients with type 2 diabetes aged 60 years or older in China. MCI was diagnosed based on criteria established by the National Institute on Aging-Alzheimer's Association workgroups RESULTS Patients in the highest quartile of DPP4 activity had higher HbA1c, interleukin 6 (IL-6), CRP, nitrotyrosine, 8-iso-PGF2a, and lower Montreal Cognitive Assessment (MoCA) scores compared with subjects in the lowest quartile (P &amp;lt; 0.001). In the highest DPP4 quartile, MCI risk was higher (odds ratio 3.49; 95% CI 1.97–4.57) than in the lowest quartile after adjustment for potential confounders. The risk for MCI increased more with higher levels of DPP4 activity, IL-6, CRP, nitrotyrosine, and 8-iso-PGF2a (P &amp;lt; 0.05), but not with higher levels of HbA1c. CONCLUSIONS This study shows that increased DPP4 activities are independently associated with MCI in elderly patients with type 2 diabetes. The mechanisms might be partly explained by the effect of DPP4 on inflammation and oxidative stress. These observations raise further interest in DPP4 activity for its potential effect on these MCI-related risk factors as a biological marker or even a possible therapeutic target for MCI.
The patterns of care studies for operable breast cancer in China
Authors: Y. Tian, D. Hua, Y. Ji, X. Li, J. Liu, B. Wang, D. Yu
Journal: Journal of Clinical Oncology (2009)

e11607 Background: To present the results of clinical practices for operable breast cancer (BC) in the developed areas of China during the past decade. Methods: Four academic levels of radiotherapy (RT) departments, located in the Southeast coast of China, were selected. A pattern of care study, about women with operated BC and post-operative RT during 1999 and 2006, was conducted. The recruited samples were evaluated for their medical files completeness at first. For qualified documentations, data collected included patient characteristics, clinical and pathologic features, and treatment course received. Frequencies and corresponding percentages were calculated and analyzed for comparisons between 1999 and 2006. Results: 97 in 1999 and 271 in 2006 were identified as qualified files. Patient's diagnosis median age were 48 (1996) and 46 (2006) years. The clinical staging with I, II, and III (UICC 1997) were in 11%, 69%, 13% of 1999 patients and 15%, 74%, 7% of the 2006. The pathological characteristics were clearly defined in 78% (1999) and 84% (2006), but hormonal receptors and Her2neu were performed in 59% and 0% in the 1999 vs. 73% (p &lt; 0.05) and 1% in 2006 survey. As type and extent of surgery and RT, the percentage of conservative treatment was increased from 4% in 1999 to 12% in 2006 (p&lt; 0.05), postmastectomy RT was done for all the others. The time interval from operation to initiation of RT were longer in 2006, the mean was delayed from 23.8 to 43.4 days. The axillary operation pattern including lymph node dissection, level I/II dissection, and sentinel lymph node biopsy (SLNB), were documented in 61%, 24%, and 8% of patients in 2006. For patients of 1999, no SLNB was performed and 16% with level I/II operation (p&lt; 0.05). Systemic chemotherapy (CT) and/or hormonal therapy were used in 74% (1999) and 98% (2006) of patients respectively (p&lt; 0.05). Anthracyclines and paclitaxel-based CT regimens use significantly increased between 1999 and 2006 (31% vs. 52% and 12% vs. 36%). Conclusions: The practice patterns established in this study provide a baseline data. The present results demonstrate a low level of compliance with Western guidelines of clinical practices with current BC standards and continued improvement in many categories. Establishment and widespread use of international guidelines in China are desirable. No significant financial relationships to disclose.
Idelalisib monotherapy and durable responses in patients with relapsed or refractory Waldenstroms Macroglobulinemia (WM).
Authors: Steven Coutre, John Leonard, Christopher Flowers, Andrew John Davies, Wojciech Jurczak, John C. Byrd, Stephen Edward Forbes Spurgeon, Sissy Peterman, Leanne Holes, Yoonjin Cho, Bess Sorenson, Wayne Russell Godfrey, Ajay K. Gopal
Journal: Journal of Clinical Oncology (2015)

8532 Background: Idelalisib (Zydelig), a selective oral inhibitor of PI3Kδ, demonstrated considerable anti-tumor activity in patients with relapsed/refractory iNHL in phase 1 (p1; Flinn, 2014), and refractory iNHL in phase 2 trials (p2; Gopal, 2014). This analysis evaluates the outcomes in the subset with WM. Methods: Eligible WM patients (pts) included those with relapsed/refractory disease (p1), or those with disease refractory to both rituximab and an alkylating agent (p2). Idelalisib dosages were 150 mg QD, and 50 mg-200 mg BID (p1), and 150 mg PO BID (p2) and were administered continuously until disease progression. WM response was assessed by IgM levels and CT-imaging (Owen, 2013). Results: Enrolled pts, (p1 N = 9; p2 N=10), had a median age of 63 and 60 years [range 42-83] and 78% and 80% were male, respectively. Patients had received a median of 4 prior regimens in both groups. Overall response rate (ORR) was 5/9 (56%), and 8/10 (80%; Table 1). Median time to minor or first response was 2 months, and most responses continued to improve over 6 months or longer. Median DOR was 32.8 months (p1), and not yet reached (p2). 67% have continued response at 2 years (p2). Median PFS is 33.3 months, and 22.1 months, respectively. Interestingly, > 3 gram/dL improvements in hemoglobin were noted in 5/9 and 7/10 subjects respectively over 3-6 month timeframe. Grade ≥ 3 adverse events included increased ALT/AST 5/9, and 1/10, and diarrhea/colitis 1/9, and 3/10. One G3 ALT elevation and 1 G3 diarrhea resulted in study discontinuation. Conclusions: These combined data suggest single agent idelalisib monotherapy is active in Waldenstroms macroglobulinemia. Durable responses were seen in the majority of subjects. Marked improvements in hemoglobin level are also associated with response. The safety profile was acceptable and manageable, with no apparent disease specific safety signals. Phase 3 clinical trials of idelalisib with combination therapy are in progress for iNHL subjects, including WM subjects.Clinical trials: (p1) NCT00710528. (p2) NCT01282424. Clinical trial information: NCT01282424. 02 (n=9) 09 (n=10) ORR, n (%) [95% CI] 5 (56%) [21-86] 8 (80%) [44-98] CR 0 0 PR 1 (11%) 7 (70%) MR 4 (44% ) 1 (10%) SD 2 (22%) 1 (10%) PD 1 (11%) 1 (10%) NE 1 (11%) 0
On the Potential Origins of the High Stability of Reconstructed Ancestral Proteins
Authors: Devin L. Trudeau, Miriam Kaltenbach, Dan S. Tawfik
Journal: Molecular Biology and Evolution (2016)

Ancestral reconstruction provides instrumental insights regarding the biochemical and biophysical characteristics of past proteins. A striking observation relates to the remarkably high thermostability of reconstructed ancestors. The latter has been linked to high environmental temperatures in the Precambrian era, the era relating to most reconstructed proteins. We found that inferred ancestors of the serum paraoxonase (PON) enzyme family, including the mammalian ancestor, exhibit dramatically increased thermostabilities compared with the extant, human enzyme (up to 30 °C higher melting temperature). However, the environmental temperature at the time of emergence of mammals is presumed to be similar to the present one. Additionally, the mammalian PON ancestor has superior folding properties (kinetic stability)-unlike the extant mammalian PONs, it expresses in E. coli in a soluble and functional form, and at a high yield. We discuss two potential origins of this unexpectedly high stability. First, ancestral stability may be overestimated by a "consensus effect," whereby replacing amino acids that are rare in contemporary sequences with the amino acid most common in the family increases protein stability. Comparison to other reconstructed ancestors indicates that the consensus effect may bias some but not all reconstructions. Second, we note that high stability may relate to factors other than high environmental temperature such as oxidative stress or high radiation levels. Foremost, intrinsic factors such as high rates of genetic mutations and/or of transcriptional and translational errors, and less efficient protein quality control systems, may underlie the high kinetic and thermodynamic stability of past proteins.
Abstract 19897: Better Detection of Adverse Risk Profiles in the General Population Through a Novel Family History Definition: First Results From the ASKLEPIOS Family History Database
Authors: Caroline M Van daele, Marc L De Buyzere, Dirk De Bacquer, Tim De Meyer, Guy G De Backer, Sofie Bekaert, Patrick Segers, Thierry C Gillebert, Ernst R Rietzschel
Journal: Circulation (2010)

Purpose: The importance of family history, the integration of risk within a family from shared genetic susceptibilities and familial clustering of environmental exposures, lifestyles and behaviors,...
Case 74-1963
Authors: Jacob Lerman, Benjamin Castleman
Journal: New England Journal of Medicine (1963)

Presentation of Case First admission. A twenty-two-year-old woman entered the hospital because of anemia.At the age of six years the patient bled profusely after a tonsillectomy and was found to have a low platelet count. A year later, during an attack of measles, hematemesis occurred, and studies revealed hemolytic anemia as well as thrombocytopenia. At the age of nine years the patient had jaundice, headache, purpura, hematuria and thrombocytopenia for several weeks. The hemoglobin fell to 7 gm., and the nonprotein nitrogen was 51 mg. per 100 ml.; two L.E.-cell tests and a Coombs test were negative. Thereafter . . .
Self-derogation and adjustment in the community: a longitudinal study of psychiatric patients
Authors: R J Lorimor, H B Kaplan, A D Pokorny
Journal: American Journal of Psychiatry (1985)

The authors assessed the symptoms and role performance of a group of psychiatric inpatients 1 year after their discharge to determine their level of adjustment in the community. Level of self-derogation at the time of discharge was consistently found to predict the level of adjustment. The occurrence of stressful life events was also predictive of symptoms but was not found to be significantly related to role performance. The chronicity of the disease was unrelated to adjustment. The change in self-derogation level and its ability to predict community adjustment is interpreted in terms of reestablishing the patient's belief in his or her own worth and efficacy.
A Gene Signature in Breast Cancer
Authors: François Bertucci
Journal: New England Journal of Medicine (2007)

Sunnybrook Health Sciences Centre Toronto, ON M4N 3M5, Canada Boyd NF, Rommens JM, Vogt K, et al. Mammographic breast density as an intermediate phenotype for breast cancer. Lancet Oncol 2005;6:798-808. [Erratum, Lancet Oncol 2005;6:826.] Kerlikowske K. The mammogram that cried Wolfe. N Engl J Med 2007;356:297-300. McCormack VA, dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2006;15:1159-69. Pawluczyk O, Augustine BJ, Yaffe MJ, et al. A volumetric method for estimation of breast density on digitized screen-film mammograms. Med Phys 2003;30:352-64. 1.
Matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry as a tool for rapid diagnosis of potentially toxigenic Corynebacterium species in the laboratory management of diphtheria-associated bacteria
Authors: R Konrad, A Berger, I Huber, V Boschert, S Hörmansdorfer, U Busch, M Hogardt, S Schubert, A Sing
Journal: Eurosurveillance (2010)

The rapid identification of the potentially toxigenic Corynebacterium species, C. diphtheriae, C. ulcerans and C. pseudotuberculosis is essential for diagnosis and treatment of diphtheria and diphtheria-like diseases. We used matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) in comparison with classical microbiological and molecular methods on 116 Corynebacterium strains. All 90 potentially toxigenic Corynebacterium strains collected by the German National Consiliary Laboratory on Diphtheria in a period of more than ten years were correctly identified by MALDI-TOF MS. We propose an algorithm for fast and reliable diagnosis of diphtheria incorporating MALDI-TOF MS, real-time tox PCR and Elek testing.