tbuckley/cabot-search huggingface dataset:
MENINGITIS IN FILIPINOS ON AMERICAN SHIPS FROM THE ORIENT
Journal: JAMA (1930)

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
Who defines futility?
Authors: S. J. Youngner
Journal: JAMA (1988)

FOR THE past two decades, our society has struggled to identify the proper circumstances under which life-sustaining medical treatment should be limited. In fact, we seem to have reached a consensus on some aspects of the problem. It is generally agreed that a competent patient has the right to refuse life-sustaining treatment; when the patient is not competent, family members may limit treatment to serve the patient's best interests. The report by Murphy<sup>1</sup>in this issue ofTHE JOURNALexamines a more controversial question that is currently at the forefront of the treatment-limitation debate—ie, under what circumstances can life-sustaining interventions be limited<i>without</i>the informed consent of the patient or family? Murphy notes correctly that cardiopulmonary resuscitation (CPR) is "rarely effective and in many cases futile" in the setting of a long-term—care facility, where many elderly patients are chronically ill or severely demented. He proposes a policy that "enables
Clinical Summaries
Journal: Circulation (2010)

Ventricular conduction delay due to left bundle branch block alters the left ventricular (LV) electric activation sequence.The resulting electric asynchrony is manifest in prolonged QRS durations due to slow myocardial conduction.This causes regional heterogeneity in contraction and stretch (mechanical asynchrony) that reduces pump function and stimulates negative LV reverse remodeling, indicated by increased LV volumes.The conceptual basis of cardiac resynchronization therapy (CRT) for asynchronous heart failure is to minimize LV conduction delay, which reduces contractile asynchrony and instantaneously improves LV mechanics.Sustained resynchronization of electromechanical activation induces "reverse" remodeling (LV volume reductions) and improved pump function (increased LV ejection fraction).Reverse LV remodeling is associated with reduced heart failure morbidity and mortality.Up to one third of CRT patients do not improve.The reasons for this are complex and incompletely characterized but can be explained by interactions between substrate conditions and pacing-induced changes in ventricular activation derived from analysis of the standard 12-lead ECG before and after CRT.Longer LV activation time and smaller LV scar volume during left bundle branch block on the baseline ECG predict higher probability of reverse remodeling.Evidence for activation wavefront fusion on the CRT-paced ECG, indicating conduction defect reversal, also predicts reverse remodeling and provides the translational mechanism for volumetric reverse remodeling.Knowledgeable application of the standard 12-lead ECG can be used to accurately predict the probability of a reverse remodeling response to CRT.See p 626.
Prognosis of Asymptomatic Hepatitis B Surface Antigen Carriers
Authors: Roberto de Franchis
Journal: Annals of Internal Medicine (1993)

Letters15 September 1993Prognosis of Asymptomatic Hepatitis B Surface Antigen CarriersRoberto de Franchis, MD, Gianmichele Meucci, MD, and Maurizio Vecchi, MDRoberto de Franchis, MDSearch for more papers by this author, Gianmichele Meucci, MDSearch for more papers by this author, and Maurizio Vecchi, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-6-199309150-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We believe Dr. Kiyosawa and colleagues are correct that the main difference is the prevalence of HBeAg. This may account for the high morbidity and mortality rates found in Japanese HBsAg carriers who have initially normal liver function tests when evaluated, regardless of the HBe status [1]. In fact, it has been suggested that HBeAg-positive carriers with normal liver function tests cannot be considered healthy carriers because chronic hepatitis may return in these patients when an impaired immune function is restored [2]. On the other hand, the outcome of anti-HBe-positive carriers, as reported by Dr. Kiyosawa and colleagues, ...References1. Sakuma K, Takahara T, Okuda K, Tsuda F, Mayumi M. Prognosis of hepatitis B virus surface antigen carriers in relation to routine liver function tests: a prospective study. Gastroenterology. 1982; 83:114-7. Google Scholar2. Hoofnagle JH, Shafritz DA, Popper H. Chronic type B hepatitis and the healthy HBsAg carrier state. Hepatology. 1987; 7:758-63. Google Scholar3. de Franchis R, Meucci G, Vecchi M, Tatarella M, Colombo M, Del Ninno E, et al. The natural history of asymptomatic hepatitis B surface antigen carriers. Ann Intern Med. 1993; 118:191-4. Google Scholar4. Villeneuve JP, Desrochers M, Infante-Rivard C, Richer G. Long-term follow-up of healthy hepatitis B virus (HBV) carriers in Montreal (Abstract). Hepatology. 1992; 16:66A. Google Scholar5. Sakuma K, Saitoh N, Kasai M, et al. Relative risks of death due to liver disease among Japanese male adults having various status for hepatitis B surface and e antigen/antibody in serum: a prospective study. Hepatology. 1988; 8:1642-6. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 September 1993Volume 119, Issue 6Page: 535KeywordsChronic hepatitisDeath ratesHepatitis B surface antigenHepatocellular carcinomaLiverLiver function testsMorbidity Issue Published: 15 September 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
A6.15 Characterisation of systemic lupus erythematosus subgroups with features of antiphospholipid or sjögrens´s syndrome utilising affinity proteomics
Authors: H Idborg, A Zandian, JT Gustafsson, I Gunnarsson, E Svenungsson, P Nilsson, PJ Jakobsson
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background and objectives</h3> Systemic Lupus Erythematosus (SLE) is an autoimmune disease that covers a wide range of phenotypes, from subtle symptoms to life-threatening conditions. The heterogeneous presentation of SLE is a major obstacle in clinical trials and the lack of biomarkers also hampers accurate diagnosis and choice of treatment. In this study we explored biochemical pathways in two suggested subgroups of SLE utilising affinity proteomics in order to characterise subgroups and identify biomarkers for personalised medicine. <h3>Materials and methods</h3> We have utilised Karolinska SLE cohort consisting of 320 well-characterised SLE patients and 320 individually matched population based controls in a cross-sectional study. SLE subgroups were defined only based on patients´ autoantibody profile: an Antiphospholipid Syndrome-like (APS-like, n = 55) and a Sjögren9s Syndrome-like (SS-like, n = 58) subgroup. Based on literature and clinical knowledge we have made a targeted selection of 281 proteins targeted by in total 367 antibodies from the Human Protein Atlas. Antibodies were covalently coupled to colour-coded magnetic beads. EDTA-plasma samples were labelled with biotin and screened in a 384 bead array format. The read-out was made by adding a streptavidin fluorophore and using the Luminex-technology. <h3>Results</h3> We identified differences in protein profiles comparing APS-like and SS-like SLE subgroups: The top most significantly different proteins were Integrin beta 1 (p = 9.8e-8, Log2 fold change=1.5), renin (p = 2.7e-5, Log2 fold change=0.5), glutamic-oxaloacetic transaminase 1 (p = 2.9e-5, Log2 fold change=0.5) and Apolipoprotein M (p = 3.4e-5, Log2 fold change=0.3) that all were increased in SS-like SLE, while Apolipoprotein H (β2-GPI, p = 6.6e-5, Log2 fold change=-0.3) were increased in the APS-like subgroup. <h3>Conclusions</h3> The two suggested SLE subgroups were defined exclusively on autoantibody profile as the APS-like and the SS-like subgroups. Our results demonstrate that the two subgroups differ in their protein profiles and that these observations indicate underlying pathogenic differences between SS-like and APS-like SLE. A common aetiology of the presence of β2-GPI in both APS and in APS-like SLE is suggested. Therefore, we believe that stratification of SLE patients should be further explored towards personalised medicine.
AVITAMINOTIC DYSENTERY
Journal: JAMA (1941)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The Foreskin
Authors: Ronald F. Goldman
Journal: JAMA (1993)

<h3>To the Editor.</h3> —We appreciate the book review by Cromie and Kelleher<sup>1</sup>of<i>The Joy of Uncircumcising: Restore Your Birthright and Maximize Sexual Pleasure</i>and<i>Say No to Circumcision: 40 Compelling Reasons Why You Should Respect His Birthright and Keep Your Son Whole</i>and believe it is important for physicians to read them to learn why thousands of men are dissatisfied with being circumcised. The main reason is a loss of sexual pleasure. Foreskin contains erogenous tissue with a high concentration of sensitive nerves. According to Dr Ritter, it comprises more than one third of the skin on the penile shaft, about 12 sq in for the average male. During erection part of the foreskin shifts to cover the upper shaft of the penis, a location that would contact the vaginal wall during intercourse and ease penetration. The penile shaft is designed to be loose not taut at erection,
Napkin Psoriasis
Authors: Robert P. Warin
Journal: British Journal of Dermatology (1968)

Journal Article Napkin Psoriasis Get access Robert P. Warin Robert P. Warin Bristol Royal Hospital, Bristol Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 80, Issue 5, 1 May 1968, Pages 341–342, https://doi.org/10.1111/j.1365-2133.1968.tb12311.x Published: 01 May 1968
The Pocket Anatomist. Founded upon Gray.
Journal: JAMA (1891)

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
Female Pseudohermaphroditism and Renal Anomalies
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 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
IN THIS ISSUE
Journal: JNCI Journal of the National Cancer Institute (2011)

Computer-Aided Detection in MammographyAlthough computer-aided detection (CAD) is used during screening mammography in the United States to help radiologists interpret mammograms, the effectiveness of this technology in improving breast cancer detection is unclear.Using mammograms and patient data from twenty-seven U.S. facilities before and after CAD implementation, Fenton et al. (p.1152) investigated the specificity, sensitivity, positive predictive value, rate of detection, and prognostic characteristics associated with CAD use.The authors found that CAD was associated with decreased specificity and positive predictive value.No statistically significant improvements in cancer detection rates or prognostic characteristics of breast cancer were associated with CAD use.The authors also found that CAD use was associated with a higher likelihood of being recalled for further testing.The authors conclude that the overall health benefits of CAD use in realworld practice are limited and may not justify the risks to patients and the added costs to healthcare programs.In an editorial, Berry (p.1139) discusses the potential for overdiagnosis and the difficulty in measuring the impact of improved sensitivity of screening mammograms in terms of meaningful changes in breast cancer mortality.He also considers the potential reasons why CAD has been universally accepted as standard practice in screening mammography in the United States with little evidence to support routine use.
69th Annual Report on Medical Education
Journal: JAMA (1969)

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
Adult advanced cardiac life support: the European Resuscitation Council guidelines 1992 (abridged). European Resuscitation Council Working Party.
Journal: BMJ (1993)

The European Resuscitation Council, established in 1990, is committed to saving lives by improving standards of cardiopulmonary resuscitation across Europe and coordinating the activities of interested organisations and individuals. In this regard the council has successfully brought together physicians and surgeons from eastern and western Europe and, in addition, has established relations with the American Heart Association and equivalent organisations in Canada, Australia, and South Africa. A main objective of the European Resuscitation Council is to produce guidelines for cardiopulmonary and cerebral resuscitation, and in this paper members of a working party of 14 experts from 11 countries set out an abridged version of the council's guidelines for adult advanced cardiac life support. The council hopes that the guidelines and accompanying algorithms will serve as a ready use "how to do it" for ordinary practitioners and paramedics inside and outside hospital.
OC-167 Calculating the “missed opportunity” of thiopurine monotherapy overcome with thiopurine and allopurinol combination therapy
Authors: M A Smith, P Blaker, A M Marinaki, S H Anderson, P M Irving, J D Sanderson
Journal: Gut (2012)

<h3>Introduction</h3> A proportion of patients preferentially methylate thiopurines, resulting in high levels of methylated metabolites and low levels of thioguanine nucleotides. This can result in hepatotoxicity and treatment non-response. Co-prescription of thiopurines (at 25%–50% of standard dose) with allopurinol, (which blocks xanthine oxidase) circumvents this problem, optimising metabolite profile and clinical outcome and additionally overcomes atypical side effects experienced on thiopurine monotherapy. Using data from a large cohort of patients receiving combination therapy, we aimed to establish what proportion of all patients starting thiopurines could benefit from combination treatment. <h3>Methods</h3> Using data from a cohort of 109 patients recruited retrospectively, all receiving combination therapy in our clinic, 1yr clinical response rates were calculated by indication. Using data from a published prospective cohort and side effect rates from meta-analysis, we calculated the proportion of all patients starting thiopurines that could be salvaged from treatment failure to 1yr remission by combination therapy. <h3>Results</h3> 10/17 (59%) of hyper-methylating non-responders to thiopurine monotherapy, 8/17 (47%) of those treated for atypical side effects and 11/15 (73%) switched for hepatotoxicity achieved remission at 1 year. Using these response rates, potential gain was calculated from a prospective cohort (n=207) from our centre. 60 patients discontinued thiopurine monotherapy due to non-specific side effects, eight due to hepatitis and 32 were hyper-methylating non-responders, a total of 100 patients with clear indications for combination treatment. Our results predict that 53/100 could have achieved 1-year remission, representing 26% of the original cohort. Using a more conservative published side effect rate of 10% (Prefontaine <i>et al</i> 2010, Cochrane Database of Systematic Reviews, CD000545) and excluding 2.8% due to side effects unsuitable for combination therapy (pancreatitis and myelotoxicity), 12% of all patients started on azathioprine could have their outcome on thiopurine therapy converted from treatment failure to 1-year remission by combination therapy. <h3>Conclusion</h3> 12%–26% represents the “missed opportunity” of patients starting thiopurine monotherapy which can be realistically overcome by combination treatment with allopurinol, converting treatment failure to successful 1-year remission. Given that thiopurines remain a key part of most IBD treatment paradigms, this is an important opportunity for improved treatment outcomes in IBD. <h3>Competing interests</h3> None declared.
Abstract 952: Modulation of immune cell trafficking into human colorectal cancer by gut microbiota
Authors: Eleonora Cremonesi, Jesus G. Garzón, Valeria Governa, Valentina Mele, Francesca Amicarella, Elisabetta Padovan, Manuele Muraro, Paul Zajac, Daniel Oertli, Lubor Borsig, Giandomenica Iezzi
Journal: Cancer Research (2017)

Abstract Introduction: Colorectal cancer (CRC) is a leading cause of cancer-related death. CRC infiltration by immune cells, including cytotoxic CD8+ T cells (CTLs), IFN-gamma-producing T-helper 1 cells (Th1), Foxp3+ regulatory T cells (Tregs) and CD16+ MPO+ neutrophils, is associated with favorable prognosis. However, chemokines driving these cell populations into the tumor site, their cellular sources and their microenvironmental triggers remain to be elucidated. Aim: We investigated the chemokine/chemokine receptor network promoting CRC infiltration by immune cells associated to favorable prognosis. Results: CRC infiltration by immune cells was associated with defined chemokine gene signatures, including CCL5, CXCL9 and CXCL10 for cytotoxic T lymphocytes and T-helper 1 cells, and CCL17, CCL22 and CXCL12 for T-helper 1 and regulatory T cells. Most of these chemokine genes were expressed by tumor cells upon exposure to gut bacteria in vitro and in vivo. Indeed, chemokine expression levels were significantly higher in orthotopic xenografts than in intraperitoneal tumors, and were drastically reduced by antibiotic treatment of tumor-bearing mice. Importantly, in human CRC samples, extents of chemokine production and immune cell infiltration was significantly associated with bacterial loads. Conclusion: Gut microbiota stimulates chemokine production by CRC cells, thus favoring T cell recruitment into tumor tissues. Note: This abstract was not presented at the meeting. Citation Format: Eleonora Cremonesi, Jesus G. Garzón, Valeria Governa, Valentina Mele, Francesca Amicarella, Elisabetta Padovan, Manuele Muraro, Paul Zajac, Daniel Oertli, Lubor Borsig, Giandomenica Iezzi. Modulation of immune cell trafficking into human colorectal cancer by gut microbiota [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 952. doi:10.1158/1538-7445.AM2017-952