tbuckley/cabot-search huggingface dataset:
MEDIASTINOSCOPY.
Authors: H. C. NOHL-OSER
Journal: BMJ (1965)

Dissection of Aorta-Sleight BJOURNAL 1167 relieved the tamponade.In support of this was the action of isoprenaline, which has no vasoconstrictor action but which also maintained the pressure.Although it might be thought that an increase in arterial pressure would predispose to further bleeding, a high arterial pressure after the dissection does not appear to influence the prognosis (Hirst et al., 1958).After the initial period of shock the peripheral vessels did not appear unduly constricted, despite the low arterial pres- sure; it is possible that aortic baroreceptor stimulation by the dissection led to peripheral vasodilatation in addition to in- appropriate vagal slowing of the heart, and thus aided tissue survival, despite the low perfusion pressure, by preventing extreme vasoconstriction.Bradycardia is unusual in dissection of the aorta and occurred in only 4 % of the cases of Hirst et al. (1958).The increase in pulse rate caused by atropine suggests that a vagal mechanism was involved.In Sherman's series of 143 recent dissections death occurred within 12 hours in 77 patients.The cause of death in 89% of these acute cases was pericardial tamponade.If anything surgical is to be attempted in this grave condition (and the results of De Bakey et al. (1961) are encouraging in this respect), then a close watch should be kept for signs of pericardial tamponade, and facilities should be available for its relief.In the present case a direct surgical approach under local anaesthesia was considered preferable to attempted aspira- tim.This had the advantage of unequivocal confirmation of the diagnosis, and it was possible to leave a drain in position in case of further bleeding. SummaryA case of dissecting aneurysm presenting with acute circulatory collapse due to pericardial tamponade is described.The diagnosis was made clinically and confirmed by arterial pres- sure recordings.The beneficial effects of noradrenaline and isoprenaline are reported, and the uncomplicated recovery from three to four hours' severe hypotension is discussed.Surgical relief of the pericardial tamponade appeared to be life-saving.I am grateful to Dr.
Oral contraceptives, thrombosis, and sickle cell hemoglobinopathies
Authors: R. L. Haynes
Journal: JAMA (1967)

IN A CASE previously reported by us,<sup>1</sup>pulmonary infarction occurred in a patient who had sicklethalassemia disease and was taking an oral contraceptive. During pregnancy, the patient had a similar episode. Oral contraceptives, while not primary agents in intravascular coagulation, may cause thromboembolism in women with predisposing conditions.<sup>2</sup>We have not seen a report documenting the concurrence of thrombosis, sickle cell hemoglobinopathy, and the use of oral contraceptives. Two additional cases noted here suggest that sickle cell hemoglobinopathies may be a contraindication to the administration of the contraceptive drugs. <h3>Report of Cases</h3><h3>CASE 1.—</h3> A 26-year-old, gravida 3, para 3, Negro woman with sickle cell—hemoglobin C disease had had no thromboembolic episode until the eighth month of use of an oral contraceptive (norethynodrel with mestranol [Enovid] 5 mg daily), when she experienced sudden fever, chest pain, and a cough. She was hospitalized, and a diagnosis of pneumonitis with
Update: Interim Guidance for Health Care Providers Caring for Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016
Authors: Emily E. Petersen, Kara N.D. Polen, Dana Meaney-Delman, Sascha R. Ellington, Titilope Oduyebo, Amanda Cohn, Alexandra M. Oster, Kate Russell, Jennifer F. Kawwass, Mateusz P. Karwowski, Ann M. Powers, Jeanne Bertolli, John T. Brooks, Dmitry Kissin, Julie Villanueva, Jorge Muñoz-Jordan, Matthew Kuehnert, Christine K. Olson, Margaret A. Honein, Maria Rivera, Denise J. Jamieson, Sonja A. Rasmussen
Journal: MMWR Morbidity and Mortality Weekly Report (2016)
Abnormalitis in tyrosine degradation in subjects with advanced liver disease . Divisions of Gastroenterology/Hepatology and Hematology, University of Colorado School of Medicine, Denver
Journal: Hepatology (1995)

The full-length cDNA of hydroxyphenylpyruvate dioxygenase (HPPD; E.C. 1.13.11.27) was cloned from Coleus blumei (Lamiaceae) by polymerase chain reaction with primer sequences deduced from already known HPPDs. The cloned cDNA had a length of 1657 base pairs containing an open reading frame (ORF) of 1308 base pairs which coded for a protein of 436 amino acid residues with a calculated molecular mass of 47 736 Da. Identities of 62.7–76.0% on amino acid level and 64.8–74.9% on nucleotide level were shown to HPPDs from other plant sources. HPPD transforms 4-hydroxyphenylpyruvate to homogentisate and, therefore, competes for the same substrate as hydroxyphenylpyruvate reductase (HPPR), an enzyme of rosmarinic acid (RA) biosynthesis from C. blumei. The ORF of HPPD was ligated into the expression vector pTrc99A and transferred into Escherichia coli DH5α. HPPD was functionally expressed after induction with isopropyl-β-d-thiogalactoside (IPTG). Highest specific activities of HPPD were observed in bacterial protein extracts 5 h after induction. At the same time point the highest homogentisate concentration (110 nmol/ml) was measured in the cell-free media. The excretion of homogentisate was accompanied by a successive browning of the medium due to the formation of oxidation and polymerization products of homogentisate. The enzyme characteristics of the heterologously expressed C. blumei HPPD were determined.
Subject Index
Authors: Ilkka T. Harvima, Heimo Viinamäki, Anita Naukkarinen, Kari Paukkonen, Heikki Neittaanmäki, Rauno J. Harvima, Maija Horsmanheimo, Denise M. Tope, Tim A. Ahles, Peter M. Silberfarb, Andrew B. Littman, M.G. Madianos, D. Madianou-Gefou, C.N. Stefanis, Michael W. Otto, Ronald A. Yeo, Brüt-Maj Wikström, Töres Theorell, Sven Sandström, Graeme J. Taylor, K.M. Bagby, J.D.A. Parker, Paul C. Horton, Herbert Gewirtz, Karole J. Kreutter, P. Bech, Jean Cottraux, Michael Bach, Doris Bach
Journal: Psychotherapy and Psychosomatics (1993)

therapy 116 Community cross-sectional survey 177 Consultation liaison 116 Corticotropin 8 Corticotropin-releasing factor 39 Corticotropin-releasing hor mone 8 Cortisol 8. 33
LORD KINNEAR.
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
PORTUGUESE MAN-OF-WAR
Journal: JAMA (1965)

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
Insufficiency Fractures of the Upper Femurs Five-year Lapse Between Occurrence on Opposite Sides
Authors: JAMES D. SLAVIN, JORDAN A. NEGRIN, RICHARD P. SPENCER, BARBARA SABINSKY-KALMAN
Journal: Clinical Nuclear Medicine (1990)

SLAVIN, JAMES D. JR. M.D.; NEGRIN, JORDAN A. M.D.; SPENCER, RICHARD P. M.D., Ph.D.; SABINSKY-KALMAN, BARBARA M.D.Author Information
Discontinuation of antistreptococcal prophylaxis. A double-blind study in rheumatic patients free of heart disease
Authors: A. R. Feinstein
Journal: JAMA (1966)

Antistreptococcal prophylaxis was discontinued, by double-blind techniques, in selected older adolescents, without heart disease, who had remained free of recurrent rheumatic fever for 3 to 5 years after an unequivocal episode. In 138 patient-years of observation, the group receiving oral potassium penicillin G, 200,000 units daily, developed 30 streptococcal infections (attack rate, 22%) and 1 rheumatic recurrence (attack rate, 0.7%). During 140 patient-years, the placebo group developed 30 streptococcal infections (attack rate, 21%) and 2 rheumatic recurrences (attack rate, 1.4%). None of the attack rate differences was statistically significant, and no overt new cardiac damage appeared in the three patients who developed rheumatic recurrences. Further studies would be desirable to determine the value of maintaining (or discontinuing) prophylaxis in the particular type of patient described here.
Differences in etiology of pneumonias in nursing home and community patients
Authors: J. L. Garb
Journal: JAMA (1978)

Comparison of 35 elderly patients hospitalized with pneumonia acquired in nursing homes and 35 elderly patients hospitalized with community-acquired pneumonia showed that 16 (47.1%) of the nursing home patients had received previous antibiotic therapy compared with two (5.9%) of the community patients.<i>Klebsiella pneumoniae</i>was isolated in 14 (40%) of the nursing home patients, but in only three (8.6%) of the community patients.<i>Staphylococcus aureus</i>was also more frequent in nursing home patients (nine, 25.7%) compared with community patients (five, 14.3%). Persons hospitalized with nursing home—acquired pneumonia should be treated initially with antimicrobial agents active against<i>K pneumoniae and S aureus</i>unless the clinical picture strongly suggests otherwise. (<i>JAMA</i>240:2169-2172, 1978)
Intensity of Anticoagulation To Prevent Stroke in Patients with Atrial Fibrillation
Authors: John V.L. Sheffield
Journal: Annals of Internal Medicine (1998)

Letters1 March 1998Intensity of Anticoagulation To Prevent Stroke in Patients with Atrial FibrillationJohn V.L. Sheffield, MD and Eric B. Larson, MD, MPHJohn V.L. Sheffield, MDUniversity of Washington; Seattle, WA 98195Search for more papers by this author and Eric B. Larson, MD, MPHUniversity of Washington; Seattle, WA 98195Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-5-199803010-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree that INRs of 2.0 or greater seem to provide optimal protection against embolic stroke and that the case–control study by Hylek and colleagues [1] demonstrates some protection against embolic stroke in the INR range of 1.6 to 2.0 Although it may be reasonable to target an INR of 2.0 within a range of 1.6 to 2.5 for some patients, we believe that several points must be considered before a less effective level of anticoagulation is accepted for elderly patients, who are also at highest risk for embolic stroke.According to the results of a physician survey, ...References1. Hylek EM, Skates SJ, Sheehan MA, Singer DE. An analysis of the lowest effective intensity of prophylactic anticoagulation for patients with nonrheumatic atrial fibrillation, N Engl J Med. 1996; 335:540-6. Google Scholar2. McCrory DC, Matchar DB, Samsa G, Sanders LL, Pritchett EL. Physician attitudes about anticoagulation for nonvalvular atrial fibrillation in the elderly. Arch Intern Med. 1995; 155:277-81. Google Scholar3. Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: stroke prevention in atrial fibrillation III randomized clinical trial. Stroke Prevention in Atrial Fibrillation Investigators. Lancet. 1996; 348:633-8. Google Scholar4. Optimal oral anticoagulant therapy in patients with nonrheumatic atrial fibrillation and recent cerebral ischemia. The European Atrial Fibrillation Trial Study Group. N Engl J Med. 1995; 333:5-10. Google Scholar Author, Article, and Disclosure InformationAuthors: John V.L. Sheffield, MD; Eric B. Larson, MD, MPHAffiliations: University of Washington; Seattle, WA 98195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAntithrombotic Therapy in Atrial FibrillationAntithrombotic Therapy in Atrial Fibrillation 1 March 1998Volume 128, Issue 5Page: 408KeywordsAtrial fibrillationElderlyHemorrhageHemorrhagic strokeInternational normalized ratioStroke ePublished: 15 August 2000 Issue Published: 1 March 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Recovery, resterilization, and donation of unused surgical supplies
Authors: W. H. Rosenblatt
Journal: JAMA (1992)

THE CRITICAL shortages of medical supplies in many impoverished nations limit the provision of basic health care and may be as demoralizing to physicians and nurses as is their huge workload.<sup>1</sup>Arthur Hartman, former US ambassador to the Soviet Union, writes, "The new commonwealth can produce only 15 to 20 percent of the medical supplies it needs, and it does not have the hard currency to import them... medical workers are forced to reuse syringes and needles."<sup>2</sup>While it may be difficult to anticipate the usefulness of elaborate medical equipment in developing nations, it is clear that the people of such countries desperately need basic supplies. For editorial comment, see p 1462. Although poverty will affect health care in developing nations for decades to come, this does not preclude effective care of the sick and injured.<sup>3-5</sup>"Poverty in material resources is not matched by poverty of intellect
Media Advertising for Tobacco Products
Journal: JAMA (1986)

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
Erythropoiesis
Authors: Robert S. Hillman, Clement A. Finch
Journal: New England Journal of Medicine (1971)

ERYTHROPOIESIS is responsible for the maintenance of a level of circulating red cells or hemoglobin optimal for oxygen transport. Any decrease in blood oxygen concentration normally results in an increased production of red cells until the deficit is corrected. There are three components essential to this response: appropriate stimulation of the erythroid marrow by erythropoietin; an adequate substrate supply of iron to meet production needs; and a normal functioning erythroid generating tissue.ErythropoietinThe regulating center for erythropoiesis is located largely, although not exclusively, in the kidney. Renal output of the marrow-stimulating hormone, erythropoietin, varies according to both the oxygen . . .
Per Minute Omitted
Journal: JAMA (1975)

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
Epidermoid Cancer of the Anal Margin and Canal
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
"Cure"
Authors: R. W. Steube
Journal: JAMA (1974)

<h3>To the Editor.—</h3> The topics in radiology/therapy article (229:328, 1974) discusses the treatment of Hodgkin disease, in which the term "curable" is given as advice to patients. "Cure" has a definitive connotation, one in which the patient may interpret as a guarantee that could prove embarrassing to the physician in the event of litigation. In my opinion, it would be more prudent, in dealing with the Hodgkin disease patient, to use the term "survival," since in the medical literature it is well documented that recurrences may become apparent even after 20 years. "Cure" is a trap in the field of medicine; the term, however, is quite appropriate when applied to a shed of tobacco leaf.
Hyperviscosity syndrome secondary to a myeloma-associated IgG1κ paraprotein strongly reactive against the HIV-1 p24gag antigen
Authors: D K Jin, M Nowakowski, M Kramer, D W Essex
Journal: American Journal of Hematology (2000)

Hyperviscosity syndrome secondary to hypergammaglobulinemia is a rare and potentially fatal complication in patients with human immunodeficiency virus type-1 (HIV-1) infection. We studied an HIV-1-positive patient with symptomatic hyperviscosity attributable to IgG(1)kappa multiple myeloma. The patient initially responded to plasmapheresis and was subsequently treated with cytotoxic immunosuppressive chemotherapy. The patient remained asymptomatic during a 3-year follow-up period. The monoclonal IgG(1)kappa gammopathy evolved to a biclonal variant of the same subtype with an expansion of marrow plasma cell population. Western blot analysis demonstrated that this myeloma-associated paraprotein was strongly reactive against the HIV-1 p24 gag antigen.
Managing Danazol Patients
Journal: JAMA (1987)

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
CHICAGO'S COMMISSIONER OF HEALTH.
Journal: JAMA (1905)

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