tbuckley/cabot-search huggingface dataset:
The science of the art of the clinical examination
Authors: D. L. Sackett
Journal: JAMA (1992)

Our first moments with a patient are packed with visual, auditory, and tactile information that determines both the effectiveness and the costs of our subsequent care. Of all the diagnoses that ever will be made, most are made during the history, and most of the rest during the physical examination. For example, Crombie<sup>1</sup>documented that 88% of diagnoses in primary care were established by the end of a brief history and some subroutine of the physical examination. Similarly, Sandler<sup>2</sup>found that 56% of patients in a general medical clinic had been assigned correct diagnoses by the end of their history, and that this figure rose to 73% by the end of their physical examination. Even when patients are referred to See also pp 2638 and 2645. specialty centers after exhaustive workups elsewhere, attention is appropriately refocused on the clinical examination: the patient's "story" and the physical examination. Indeed,
Atypical mycobacterial infection complicating mineral oil pneumonia
Authors: G. M. Hutchins
Journal: JAMA (1978)

Two patients had pulmonary infections with atypical mycobacteria superimposed on mineral oil pneumonia. In both cases, long-standing laxative use and neurological disorders led to development of the lipid pneumonia. The pathogenicity of the rapidly growing mycobacteria causing infection in the two patients is apparently enhanced by the presence of mineral oil, a relationship supported by experimental studies. The clinical diagnosis of both atypical mycobacterial infection and mineral oil pneumonia may be difficult, but the presence of one should suggest the possibility of occurrence of the other. (<i>JAMA</i>240:539-541, 1978)
The Efficacy of Zidovudine Is Time Limited
Authors: Daniel S. Berman
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Dr Lundgren and colleagues<sup>1</sup>report a survival advantage in the first year in patients who received zidovudine, with decreased survival in the third year. Since publication of the study, several patients have asked us if we had heard or read the "news" that "AZT" was of no benefit. The study confirms previous studies that demonstrate a survival advantage in zidovudine-treated patients.<sup>2</sup>Other studies have shown slower progression of acquired immunodeficiency syndrome (AIDS) and fewer cases of dementia.<sup>3,4</sup>Lundgren et al explain the increased third-year mortality as an expected outcome, with patients having had their lives prolonged for the first 2 years. Zidovudine might be of even more benefit than demonstrated in the study. Optimal dosage, aggressive prophylactic antibiotic therapy, and combination antiretroviral therapy might enhance the beneficial effects of zidovudine. It is clear that zidovudine is of benefit and has limited side effects.<sup>3</sup>
Transactions of the Indiana State Medical Society, 1897.
Journal: JAMA (1897)

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
Oral HPV infection in HPV-positive oropharyngeal cancer cases and their spouses.
Authors: Gypsyamber D'Souza, Neil D. Gross, Sara I. Pai, Robert I. Haddad, Maura L. Gillison, Marshall R. Posner
Journal: Journal of Clinical Oncology (2013)

CRA6031 Background: Incidence of human papillomavirus-positive oropharyngeal cancer (HPV-OPC) is increasing, and spouses of these patients have high anxiety about their own HPV-related cancer risk. Methods: Partner study of 149 HPV-OPC and 81 of their spouse/long-term partners. Data collection included a 30-second rinse and gargle (at diagnosis and again 1 year later for 103 cases and 46 partners), computer-assisted risk factor survey, tumor collection (cases), and visual oral examination (spouses). Oral rinse samples were tested for 36 types of HPV DNA using PGMY09/11 primers and line-blot amplification, and HPV16 copy-number using real-time PCR. Results: Cases were primarily male (89%), white non-Hispanic (92%), had performed oral sex (94%), and never-smokers (51%) with a median age of 56 years. Twelve-month survival was high among never- and ever-smoking HPV-OPC (100% vs 93%, p=0.18). The 81 spouses of HPV-OPC were primarily female (81%), white non-Hispanic (92%), never-smokers (54%), with a median age of 53 years. Spouses were significantly less likely than cases to have &gt;10 lifetime oral sex partners (11% vs 39%, p&lt;0.001). Prevalence of any oral HPV (65%) and oral HPV16 (52%) was high among HPV-OPC at diagnosis. Four (7.7%) of 52 HPV-OPC with HPV16 DNA detectable before therapy, had HPV16 persistently detected one year after diagnosis/therapy. Prevalence of any oral HPV DNA among partners was significantly lower than among HPV-OPC (7.3% vs 65%, p&lt;0.001). Oral HPV prevalence was significantly higher among the 7 male partners than the 74 female partners (29% vs 5%, p=0.025). Oral HPV infections among partners included HPV16 (n=2), HPV62 (n=2), HPV 83 and 51 (1 each). Both partners with oral HPV16 infections were female and no longer had oral HPV16 detected at the one year follow-up. 64% of spouses had a visual oral exam, and no pre-cancers or cancers were identified. However, two (2.5%) enrolled spouses reported a personal history of cervical cancer, and 6 HPV-HNC cases (4.0%) reported a previous spouse who developed cervical or vaginal cancer. Conclusions: Oral HPV16 DNA is common among HPV-OPC, but not among their spouses. Spouses of HPV-OPC may have an elevated risk or history of cervical cancer.
Civil Defense Agency
Authors: Thomas F. Maher
Journal: New England Journal of Medicine (1954)

EMERGENCY IMPROVISED HOSPITAL PLANNING IN MASSACHUSETTSMany existing hospitals of the Commonwealth are located within critical target areas and would probably be rendered inoperable in the event of a large-scale disaster such as an enemy attack. It is therefore imperative, in long-term disaster planning, to exclude the available hospital bed space in critical target areas. A step toward the solution of the ensuing problem is the development of an improvised hospital system that makes maximum use of existing facilities. This improvised hospital system will ultimately be composed of 200-bed units, which will provide early hospitalization for casualties in the vicinity . . .
Abstract 12203: Clinical Characteristics of Patients With Acute Myocardial Infarction Who Did Not Receive Primary Percutaneous Coronary Intervention in Japan -Report From the Miyagi-AMI Registry Study
Authors: Kiyotaka Hao, Jun Takahashi, Kenta Ito, Yuanji Cui, Satoshi Miyata, Kensuke Nishimiya, Ryuji Tsuburaya, Yasuharu Matsumoto, Yasuhiko Sakata, Satoshi Yasuda, Hiroaki Shimokawa
Journal: Circulation (2015)

Background: In the current primary percutaneous coronary intervention (PCI) era, some patients in acute myocardial infarction (AMI) still do not undergo primary PCI in Japan. We thus aimed to elucidate the characteristics of AMI patients who did not receive primary PCI. Methods and Results: We analyzed the patients enrolled between 2002 and 2010 in the Miyagi-AMI Registry Study, where all AMI patients in the Miyagi prefecture have been prospectively registered for 34 years since 1979. Among a total of 8,640 patients with AMI (M/F 6205/2435, mean age 68.9±13.0 [SD] years), 1,879 (21.7%) did not receive primary PCI and their in-hospital mortality was significantly worse compared with those who received it (21.4% vs. 6.4%, P&lt;0.01). Multivariate analysis demonstrated that female sex was significantly associated with non-performance of primary PCI [odds ratio (95% confidence intervals); 1.40(1.22-1.61), P&lt;0.001], along with aging [1.01(1.01-1.02), P&lt;0.001] and heart failure on admission [2.69(2.29-3.16), P&lt;0.001]. When dividing by age, non-performance rate of primary PCI in female showed U-shaped prevalence, whereas it simply increased with aging in male (Figure A) . Importantly, female patients aged &lt;80 years had a significantly higher non-performance rate of primary PCI compared with male patients, regardless of disease severity as evidenced by co-existing heart failure on admission (Figure B) . Conclusions: These results indicate that in the current PCI era, various factors, including aging, heart failure on admission and sex differences, are associated with non-performance of primary PCI, which remain to be resolved in order to further improve critical care of AMI.
Formate in Serum and Urine after Controlled Methanol Exposure at the Threshold Limit Value
Authors: Alessandra d'Alessandro, John D. Osterloh, Patricia Chuwers, Patricia J. Quinlan, Thomas J. Kelly, Charles E. Becker
Journal: Environmental Health Perspectives (1994)

Methanol will be present as a new air pollutant when methanol-powered vehicles are introduced in the United States. Little is known about the effect of low-dose methanol exposure. It is controversial whether or not formate, the main metabolite responsible for methanol's acute toxicity, is a sensitive biological marker of toxicity or exposure. We studied the effect of a 4-hr exposure at rest to 200 ppm of methanol vapors on endogenous serum formate and on urinary formic acid excretion. A randomized, double-blind study of human exposure to a constant concentration of methanol was performed in a whole-body exposure chamber. Twenty-six healthy volunteers, each serving as his or her own control, participated in sham and methanol exposures. Urine (at 0, 4, 8 hr) and serum specimens (15 time points over 8 hr) collected before, during, and after the exposure were measured for formate. We found no significant differences in serum formate concentration between exposure and control conditions either at any time point or for area under the curve. Mean concentrations at the end of the exposure were: exposed 14.28 +/- 8.90 mg/l and control 12.68 +/- 6.43 mg/l. A slight, but nonsignificant (p = 0.08), increase in urine formate excretion rate was found at 4 hr (exposed 2.17 +/- 1.69 mg/4 hr and control 1.67 +/- 1.02 mg/4 hr). Age, sex, folic acid level, and smoking were not significant covariates. At 200 ppm, methanol exposure does not contribute substantially to endogenous formate quantities. Serum and urine formate determinations are not sensitive biological markers of methanol exposure at the threshold limit value.
Proton radiotherapy: some perspectives
Authors: T. F. Kirn
Journal: JAMA (1988)

DEVELOPMENT of stereotaxic radiosurgery is the result of contributions from physicists, radiologists, and neurosurgeons, says Jacob Fabrikant, MD, head of the Arteriovenous Malformation Program at the University of California's Lawrence Berkeley Laboratory (<i>JAMA</i>1987;258:3217-3220). It also appears to have been the product of Harvard University (Boston) and University of California (Berkeley) cooperation. Robert R. Wilson, PhD, now a professor emeritus at Cornell University, Ithaca, NY, is credited with proposing the medical use of charged particles (<i>Radiology</i>1946;47:487-491). Wilson, a physicist, says that the idea occurred to him while he was at Berkeley in the mid-1940s, designing the cyclotron to be built at Harvard. Although he was aware of their work, he does not remember discussing it with Robert Stone, MD, or John Lawrence, MD (brother of Ernest O. Lawrence, PhD, builder and designer of Berkeley's cyclotron), who only a few years earlier at Berkeley had begun the initial medical experiments
The Treatment of Common Female Ailments
Journal: JAMA (1935)

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
Government Services
Journal: JAMA (1923)

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 Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Gene scene: a master control switch for myogenesis muscles its way into the clinic
Authors: T. Randall
Journal: JAMA (1992)

AFTER YEARS of speculation, scientists are finally peering into the black box of differentiation, the prophetic moment during development when a cell closes off all options but one and commits to a singular lineage. It has long been postulated that this moment is controlled, not by a cohort of genes, but by a "master regulatory switch," a single gene that, once activated, sets in motion the cell's machinery to make only one cell type. In 1987, the first master regulatory gene was identified by a team led by Harold Weintraub, MD, PhD, at the Fred Hutchinson Cancer Research Center, Seattle, Wash. Called<i>MyoD</i>, this gene is thought to activate the entire program of skeletal muscle differentiation. Furthermore, when researchers transfect<i>MyoD</i>into primary cultures of other cell types—such as fibroblasts, adipocytes, and brain cells—these cells also convert to muscle. This capacity has been demonstrated repeatedly in cell types derived from
DELIRIUM TREMENS.
Authors: JAMES T. WHITTAKER
Journal: JAMA (1885)

A Clinical Lecture Delivered at the Good Samaritan Hospital, Cincinnati, December 1, 1884. [<i>Reported by James M. French, M. D., Assistant to the Chair</i>.] Gentlemen—The resident physician, Dr. Carter, will read us the history of the case: "<i>History</i>—Thomas D., æt. 48, a laborer, has been a hard drinker for twenty-seven years. For a period of five or six years just preceding the present year, he abstained from drink, but during the year just past he has indulged very freeely. He has had two attacks of delirium tremens—the first in 1861, the second in 1865. During the first attack he says that he imagined he was lying in a bed of serpents, and that the room seemed to be filled with demons of the most fantastic shapes. At an unguarded moment he ran from the house, pursued, as he imagined, by a huge snake that seemed to crawl through his clothing,
SURGICAL INJURY OF THE PARATHYROIDS.
Journal: JAMA (1907)

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
A Phase I Clinical Trial Testing the Combination of Bortezomib and Tipifarnib in Relapsed/Refractory Multiple Myeloma.
Authors: Sagar Lonial, Dixil Francis, Chatchada Karanes, Suzanne Trudel, Akari M. Dollard, Fermin Aceo, Engin Gul, Sumeet Kakar, Amrita Y. Krishnan, Donna E. Reece, R. Donald Harvey, Jonathan L. Kaufman
Journal: Blood (2009)
Die forensische Blutuntersuchung.
Journal: JAMA (1910)

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
Abstract 311: Osteogenic Transcription Factor Runx2 Represses Connective Tissue Growth Factor Gene Expression And TGFβ Signaling In Vascular Smooth Muscle Cells
Authors: Toru Tanaka, Takehisa Shimizu, Norimichi Koitabashi, Hiroki Matsui, Hiroshi Doi, Tatsuya Iso, Masashi Arai, Masahiko Kurabayashi
Journal: Circulation (2007)

[Objective] Runx2, a key transcription factor in osteoblast differentiation, is expressed in calcified atherosclerotic plaques. We have recently shown that Runx2 represses vascular smooth muscle cells (VSMCs) differentiation and promotes their osteogenic differentiation. Connective tissue growth factor (CTGF) has been implicated in the progression to vulnerable plaque by inducing mononuclear cell chemotaxis and VSMCs apoptosis despite of its potent stimulatory effect on connective tissue cell the proliferation and extracellular matrix synthesis. To assess the role of Runx2 in the process of plaque development, we investigated the molecular mechanism of the CTGF gene expression by Runx2 in VSMCs. [Methods and Results] RT-PCR analyses showed that adenovirally overexpressed Runx2 significantly repressed the basal expression of the CTGF gene in human aortic SMCs (HASMCs). Consistent with this, knockdown of the Runx2 expression in HASMCs by small interfering RNA (siRNA) increased CTGF mRNA levels. Luciferase assays showed that Runx2 reduced the transcriptional activity of the CTGF promoter. Transfection of a series of 5′-deletion constructs revealed that Runx2 inhibited CTGF expression through the sequence element located at 5′ untranslated region of CTGF mRNA. We next examined the effects of Runx2 on the TGFβ-induced CTGF expression. Runx2 overexpression significantly repressed CTGF expression in HASMCs stimulated with TGFβ, and knockdown of Runx2 by siRNA enhanced the induction of CTGF expression in response to TGFβ. Runx2 repressed TGFβ-induced CTGF promoter activity through the sequence including Smad binding element (SBE). Overexpression of Runx2 significantly reduced TGFβ- and Smad3-mediated luciferase activity of Smad-dependent promoter which contains four copies of SBE. Biotinylated DNA pulldown assay using SBE of CTGF promoter showed that Runx2 formed a complex with Smad3 and Smad4. [Conclusion] Runx2 repressed basal and TGFβ-induced CTGF gene expression in VSMCs. Thus, in addition to the potential for inducing vascular calcification, Runx2 may affect plaque stability by modulating extracellular matrix synthesis through inhibiting CTGF gene expression and TGFβ signaling.
LIPURIA ASSOCIATED WITH CHRONIC NEPHRITIS
Journal: JAMA (1920)

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