tbuckley/cabot-search huggingface dataset:
Computer-assisted decision support: a new available reality
Authors: D. K. Harris
Journal: JAMA (1987)

Computer technology is now commonplace in society in general, and in physicians' offices and homes in particular. For the most part, these applications take the form of medical practice and office management systems such as accounting packages and word processing. In addition, an increasing number of physicians are now using computer-assisted literature search services. As the availability of and familiarity with computer technology increase among clinicians, there will be an increasing demand for using the technology to obtain medical knowledge relevant to particular clinical questions. In this issue ofThe Journal, two studies are presented that concern the important application known as<i>computerbased decision support</i>. The first, by Dr Shortliffe,<sup>1</sup>considers the different issues and questions involved in the development of computer systems to support clinical decision making. The second, by Dr Barnett et al,<sup>2</sup>describes a new computer-based decision-support system developed with the support and collaboration of
The 1995 health policy debate
Authors: D. Altman
Journal: JAMA (1995)

Three big problems brought us the health system reform debate, and with the collapse of this year's historic reform effort, all three are destined to get worse. The number of uninsured will continue to grow, as it did by more than 1 million between 1992 and 1993.<sup>1</sup>Middle-class health insurance problems and insecurities will also grow, as more and more Americans find their benefits cut and their out-of-pocket costs increased, their insurance dropped, or their choices constrained.<sup>2,3</sup>And despite the recent moderation in price increases in health, even the most optimistic forecasts see health care spending rising to levels that will consume an ever-larger share of the federal budget.<sup>4</sup> These realities will force renewed debate about health system reform in 1995. However, the starting point will not be the sweeping proposals of last year, but more likely the incremental reform plans we saw considered as Congress adjourned.
Reply
Authors: William D. Carey, Sherif Saadeh, David Barnes
Journal: Hepatology (2001)

Saadeh et al. retrospectively evaluated the role of liver biopsy in 126 cases of chronic hepatitis C (evaluated between 1990 and 1997).They found that biopsy offered no alternative diagnosis and few additional diagnoses.However, it was superior to a discriminant scoring system in predicting cirrhosis.The investigators concluded that liver biopsy provides indispensable information for staging, prognosis, and probably also for the treatment of chronic hepatitis C. 1 But is it necessary to have information on fibrosis and cirrhosis before therapy can start? 2 Liver biopsy is not useful for prognosis unless it is repeated over several years to provide an estimate of fibrosis progression; progression would be an indication for treatment, but serial biopsy is not the current standard of care. 3Additionally, there is no reliable evidence that patients with fibrosis on biopsy are more likely to progress to cirrhosis than those without fibrosis. 4 Pretreatment and posttreatment biopsy may show definitive histologic improvement beyond viral eradication, but histologic improvement almost always occurs with viral eradication. 2,5,6 In addition, some studies have found histologic improvement even in patients without a long-term viral response. 7,8 It is true that patients with cirrhosis are unlikely to respond to therapy-and liver biopsy is the standard for diagnosing cirrhosis-but they are at high risk of developing decompensated disease or hepatocellular carcinoma, 9 and the benefits of successful treatment are enormous, so it is currently recommended to treat cirrhosis anyway.This will be all the more true if the data reported by Heathcote et al. are confirmed: they reported a virologic response in 30% and histologic improvement in 54% of patients with cirrhosis and or bridging necrosis treated with peginterferon. 10 Biopsies are invasive, costly, and potentially risky, with a mortality of 0.018% according to Wong et al. 2 ; the morbidity is such that even in tertiary centers about one third of the patients do not come back for a follow-up biopsy after therapy. 11Routine liver biopsy before treatment increases the cost of managing patients without improving health outcomes 2 : in almost all studies, therapeutic efficacy is measured as the disappearance of hepatitis C virus RNA from serum and/or normalization of transaminases.It may be that liver biopsy serves only to satisfy our stubborn quest for diagnostic certainty. 12 We suggest further review of the role of liver biopsy in the treatment of chronic hepatitis C and cirrhosis.
Cytomegalic inclusion disease following multiple blood transfusions
Authors: D. Henson
Journal: JAMA (1967)

IN ADULTS generalized cytomegalic inclusion disease, disseminated cytomegalovirus infection, is rare, and when it occurs, is often associated with malignant disorders of the hematopoietic and reticuloendothelial systems, immunosuppressive therapy, or debilitating diseases.<sup>1-3</sup>Clinically, generalized cytomegalic inclusion disease has not been completely defined in adults. Morphologically, it is manifested by the appearance within the lungs, liver, and other viscera of greatly enlarged cells containing intranuclear and less frequently cytoplasmic inclusions. The following is a case of generalized cytomegalic inclusion disease in a debilitated adult who died after receiving multiple blood transfusions for trauma. Diagnosis was made microscopically by recognition of characteristic nuclear and cytoplasmic inclusions in tissues obtained by autopsy. The case is presented to emphasize the fact that in adults with morphologic evidence of cytomegalic inclusion disease, there is frequently a history of having received multiple blood transfusions.<sup>3-5</sup> <h3>Report of a Case</h3> A 44-year-old Negro man was admitted
Pharmaceutical dosage forms: disperse systems, 2nd edn (vols 1 and 2) edited by Herbert A. Lieberman, Martin M. Rieger and Gilbert S. Banker, Marcel Dekker, 1996. Vol. 1: $165.00 (xviii + 532 pages) ISBN 0 8247 9387 0 Vol. 2: $165.00 (xx + 506 pages) ISBN 0 8247 9713 2
Journal: Trends in Pharmacological Sciences (1996)
Symposium on Radioimmunoassay and Related Procedures in Medicine
Journal: JNCI Journal of the National Cancer Institute (1977)

Journal Article Symposium on Radioimmunoassay and Related Procedures in Medicine Get access JNCI: Journal of the National Cancer Institute, Volume 58, Issue 5, May 1977, Page 1543, https://doi.org/10.1093/jnci/58.5.1543-b Published: 01 May 1977
The transcriptional cycle of HIV-1 in real-time and live cells
Authors: Stéphanie Boireau, Paolo Maiuri, Eugenia Basyuk, Manuel de la Mata, Anna Knezevich, Bérangère Pradet-Balade, Volker Bäcker, Alberto Kornblihtt, Alessandro Marcello, Edouard Bertrand
Journal: The Journal of Experimental Medicine (2007)
Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men. The San Francisco/Berkeley Young Men's Survey
Authors: G. F. Lemp
Journal: JAMA (1994)

<h3>Objective.</h3> —To estimate the prevalence of human immunodeficiency virus (HIV) infection and risk behaviors among young homosexual and bisexual men sampled from public venues in San Francisco and Berkeley, Calif. <h3>Design.</h3> —A survey of 425 young homosexual and bisexual men sampled from 26 locations during 1992 and 1993. Participants were interviewed and blood specimens were drawn and tested for HIV, level of CD4<sup>+</sup>T lymphocytes, and markers of hepatitis B and syphilis. <h3>Setting.</h3> —Public venues in San Francisco and Berkeley, including street corners and sidewalks, dance clubs, bars, and parks. <h3>Population Studied.</h3> —Homosexual and bisexual men aged 17 to 22 years. Main Outcome Measures. —Prevalence of HIV infection and risk behaviors. <h3>Results.</h3> —The HIV seroprevalence was 9.4% (95% confidence interval, 6.8% to 12.6%). The prevalence of markers for hepatitis B was 19.8% (95% confidence interval, 16.1% to 23.9%), and that for syphilis was 1.0% (95% confidence interval, 0.3% to 2.4%). The HIV seroprevalence was significantly higher among African Americans (21.2%) than among other racial/ethnic groups (<i>P</i>=.002). Approximately one third (32.7%) of the participants reported unprotected anal intercourse, and 11.8% reported injecting drug use in the previous 6 months. At the time of interview, 70.0% of the HIV-infected men did not know that they were HIV seropositive, and only 22.5% were receiving medical care for HIV infection. <h3>Conclusions.</h3> —The prevalence of HIV infection is high among this young population of homosexual and bisexual men, particularly among young African-American men. The high rates of HIV-related risk behaviors suggest a considerable risk for HIV transmission in this population. Prevention programs and health services need to be tailored to address the needs of a new generation of homosexual and bisexual men. (<i>JAMA</i>. 1994;272:449-454)
Addendum for Euro Surveill. 2019;24(38)
Journal: Eurosurveillance (2019)

© This work is licensed under a Creative Commons Attribution 4.0 International License. Addendum This article is an addendum to the following content: Prevalence of new variants of Chlamydia trachomatis escaping detection by the Aptima Combo 2 assay, England, June to August 2019
THE MEDICAL EXAMINATION OF CHAUFFEURS.
Journal: JAMA (1906)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Reduction of Cancer-Specific Thought Intrusions and Anxiety Symptoms With a Stress Management Intervention Among Women Undergoing Treatment for Breast Cancer
Authors: Michael Antoni
Journal: American Journal of Psychiatry (2006)

Objective: After surgery for breast cancer, many women experience anxiety relating to the cancer that can adversely affect quality of life and emotional functioning during the year postsurgery. Symptoms such as intrusive thoughts may be ameliorated during this period with a structured, group-based cognitive behavior intervention. Method: A 10-week group cognitive behavior stress management intervention that included anxiety reduction (relaxation training), cognitive restructuring, and coping skills training was tested among 199 women newly treated for stage 0-III breast cancer. They were then followed for 1 year after recruitment. Results: The intervention reduced reports of thought intrusion, interviewer ratings of anxiety, and emotional distress across 1 year significantly more than was seen with the control condition. The beneficial effects were maintained well past the completion of adjuvant therapy. Conclusions: Structured, group-based cognitive behavior stress management may ameliorate cancer-related anxiety during active medical treatment for breast cancer and for 1 year following treatment. Group-based cognitive behavior stress management is a clinically useful adjunct to offer to women treated for breast cancer.
Abstract 5417: Inducible 20S β Subunit LMP-2 is Down-Regulated in db/db Mouse Hearts with Diabetic Cardiomyopathy
Authors: Lingyun Zu, Djahida Bedja, Lewis C Becker, Zheqing P Cai
Journal: Circulation (2008)

Background: The ubiquitin-proteasome system (UPS) plays an important role in cell growth, differentiation, and survival. Low molecular mass polypeptide (LMP)-2 is an inducible 20S beta subunit and its role in diabetic cardiomyopathy has not been previously studied. We investigated the hypothesis that LMP-2 is down-regulated in diabetic hearts and is involved in diabetic cardiomyopathy. Methods: db/db mice and control db/+ littermates were studied at 20 weeks of age. Cardiac function was measured by echocardiography. Chymotryptic-like activity of the 20S proteasome was analyzed by fluorogenic assay using the substrate Suc-LLVY-aminomethycoumarin (-AMC). Results: db/db mice had a severe increase in blood glucose and a decrease in heart weight compared with db/+ mice (135±6 vs. 168±7 mg, n = 4, p &lt; 0.01). Left ventricular function was decreased with a lower fractional shortening in db/db mice (48.7±3.2 vs. 60.7±0.4 %, n = 4, p &lt; 0.05). LMP-2 was constitutively expressed in both db/+ and db/db mouse hearts, but its level was severely depressed in the db/db hearts (78±11 vs. 245±18 AU, n = 4, p &lt; 0.01). Consistent with the change in LMP-2, chymotryptic-like activity was also significantly down-regulated in these diabetic hearts (3286±112 vs. 3598±52 AU, n = 3, p &lt; 0.05). Furthermore, the role of LMP-2 in regulating 20S proteasome function and cardiac mass was determined in LMP-2 knockout and wildtype mice. Chymotryptic-like activity was significantly decreased in LMP-2 knockout mouse hearts (11156±360 vs. 18280±454 AU, n = 4, p &lt; 0.01), and cardiac atrophy was found in these knockout mice (147±7.1 vs 178±10.5 mg, n=10; p &lt; 0.01). Taken together, these results suggest that LMP-2 is necessary for normal proteasome function in the heart and its down-regulation may contribute to the development of diabetic cardiomyopathy.
Biomarkers and Mechanistic Approaches in Environmental Epidemiology
Authors: J. M. Links
Journal: Annual Review of Public Health (1995)

Environmental epidemiological research involves the identification of relationships between previous exposures to putative causative agents and subsequent biological effects with study populations. Such relationships are often hard to fully characterize because of difficulties in accurately quantifying exposure, dose, and effect. Biomarkers are indicators, residing in biological systems or samples, of exposure, dose, effect, or susceptibility. Biomarkers of exposure indicate the presence of previous exposure to an environmental agent; a biomarker of dose bears a quantitative relationship to previous exposure or dose; these include exogenous substances, interactive products, or interactions that change the status of the target molecule. Biomarkers of effect indicate the presence and magnitude of a biological response to exposure to an environmental agent; these include endogenous components, or measures of the functional capacity or state of the system. Biomarkers of susceptibility indicate an elevated sensitivity to the effects of an environmental agent; these include the presence or absence of an endogenous component, or abnormal functional responses to an administered challenge. The development of molecular biomarkers for environmental agents is based upon specific knowledge of metabolism, interactive product formation, and general mechanisms of action. The validation of any biomarker-effect link requires parallel experimental animal and human epidemiological studies.
174PD A randomized phase III trial of capecitabine with or without irinotecan driven by UGT1A1 in neoadjuvant chemoradiation of locally advanced rectal cancer (CinClare)
Authors: T. Zhang, J. Zhu, J.Y. Chen, Y. Zhu, J. Zhou, Y. Zhu, J.H. Jia, C. Zhang, X. Wang, Y.H. Gao, G. Cai, B. Luo, J. Wu, A. Liu, B. Xu, Z. Zhang
Journal: Annals of Oncology (2016)
Nonpituitary Neoplasms and Cushing's Syndrome
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
Medical Education, Registration and Hospital Service
Journal: JAMA (1924)

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 Journals 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 2024 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
PTU-023 The use of proton pump inhibitors and clopidogrel in a district general hospital
Authors: C Butcher, S K Butt, L Fuller, M Ifijen, B Good, N Van Someren, K Besherdas
Journal: Gut (2010)

<h3>Introduction</h3> Clopidogrel is an important anitiplatelet agent used to protect patients from acute coronary syndromes (ACS), cerebrovascular events (CVA) and prevent coronary stent thromboses. Patients receiving clopidogrel are commonly treated with proton pump inhibitors (PPIs) to protect from GI bleeding. Recent studies have sugessted PPIs (in particular omeprazole) which are inhibitors of cytochrome P-450, may decrease the efficacy of clopidogrel, which is metabolised to its active form by the same enzyme complex. Clinically, this is important, since the decrease in antiplatelet efficacy may be associated with an increased risk. Therefore, has been suggested that the concomitant use of PPI and clopidogrel be discouraged and other agents with no such interaction, for example, famotidine be used for GI protection. <h3>Methods</h3> The aim was to assess the reasons for concomitant use of PPIs and clopidogrel in our hospital. This was a retrospective analysis of patients identified from May 09 to November 09 from the pharmacy JAC Medicines database with prescriptions of PPI and clopidogrel. Patients with PPI/clopidogrel therapy were scrutinised for indications of use, prescriber, and whether patients underwent foregut imaging to obtain accurate diagnosis prior to initiation of PPI. <h3>Results</h3> 36 patients who were on PPI therapy with clopidogrel were identified from the database. There were 24 females and mean age was 75 (41–96). Of these 33/36 (92%) patients had an acute coronary event of which 7/33 (21%) had a coronary stent inserted. 3/36 (8%) patients had a CVA as indication for clopidogrel. All 33/36 (92%) patients with a diagnosis of ACS had PPI therapy started by a cardiologist. The PPI of choice was omeprazole with 20/36 (57%) with the remainder being lansoprazole 15/36 (42%) and 1/36 (1%) on nexium. 8/36 (22%) underwent endoscopy post initiation of PPI therapy. Just over half of these patients 19/36 (53%) were prescribed PPI therapy for prophylaxis against GI bleeding with the remainder being prescribed PPI for uninvestigated dyspepsia/GORD (10/36) 28%, gastric/duodenal ulceration (4/36) 11% and oesophagitis (3/36) 6%. <h3>Conclusion</h3> This study demonstrates that despite emerging evidence and widespread publicity of the reduced efficacy of clopidogrel with PPIs, in particular omeprazole, this PPI continues to be used particularly in cardiac patients without an accurate gastrointestinal diagnosis requiring prophylaxis. Furthermore this places those patients with coronary stents at risk of thromboses. We propose that other GI protective agents, such as famotidine (for which there is evidence base) be prescribed to those patients on clopidogrel.
Environmental Radiation and the Lung
Authors: Philip E. Hamrick, Phillip J. Walsh
Journal: Environmental Health Perspectives (1974)

Environmental sources of radioactive materials and their relation to lung doses and lung burdens are described. The approaches used and the problems encountered in estimating lung doses are illustrated. Exposure to radon daughter products is contrasted to exposure to plutonium as particular examples of the hazards associated with radioactive materials of different chemical and physical characteristics.
Zeitschrift für Kinderheilkunde, Berlin
Journal: JAMA (1964)

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