tbuckley/cabot-search huggingface dataset:
The Language of Case Histories
Authors: Norman Delanty
Journal: Annals of Internal Medicine (1998)

Letters15 May 1998The Language of Case HistoriesNorman Delanty, MDNorman Delanty, MDHospital of the University of Pennsylvania; Philadelphia, PA 19104Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-10-199805150-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read with interest and pleasure Dr. Donnelly's essay [1], and I agree with most of its sentiments. My complaint about language in case history presentation is more specific. I am a graduate of an Irish medical school who has been in the United States for the past 3 and a half years. Since coming here, I have found the use of the term “status post” in referring to aspects of the patient's history (recent or remote) to be appalling, both linguistically and humanely. “The patient had bypass surgery” is much gentler to my ear than “the ...References1. Donnelly WJ. The language of medical case histories. Ann Intern Med. 1997; 127:1045-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: Hospital of the University of Pennsylvania; Philadelphia, PA 19104 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 May 1998Volume 128, Issue 10Page: 877KeywordsGraduate medical educationSurgery Issue Published: 15 May 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Crossing 'threshold' of hepatitis B control awaits greater vaccine use
Authors: M. F. Goldsmith
Journal: JAMA (1984)

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
Hope in Primary Pulmonary Hypertension?
Authors: John T. Reeves
Journal: New England Journal of Medicine (1980)

Since Dresdale et al.1 described the clinical syndrome of pulmonary hypertension of unknown cause, i.e., primary pulmonary hypertension, in 1951, the disease has been considered uniformly fatal. Its occurrence is dramatic because young people are affected, and the symptoms of dyspnea and syncope are progressively severe. Treatment has been unsatisfactory even though Dresdale found that tolazoline (Priscoline) given intravenously caused a transient fall in pulmonary arterial pressure. In the years since then, physicians have rarely attempted to treat primary pulmonary hypertension chronically with vasodilating drugs.2 It seemed unlikely that benefit would come from chronic treatment since none occurred from acute . . .
SPECIFICITY OF STREPTOCOCCI IN ETIOLOGY OF DISEASES OF NERVOUS SYSTEM
Authors: EDWARD C. ROSENOW
Journal: JAMA (1924)

During an extended study of the infecting power of bacteria isolated in various diseases, I have been impressed by the extremely specific effects of green-producing streptococci, especially those isolated from infection atria, and from the brain and cord in diseases of the nervous system. Herpes zoster, associated with lesions in the interverbral ganglions, was produced in rabbits and dogs by intravenous injection of a green-producing streptococcus from infection atria in patients at the time of acute attacks. This was not accomplished after recovery, nor after long cultivation of the organism. A similar streptococcus from four patients with intercostal neuralgia produced marked lesions of the posterior or sensory roots, usually unassociated with herpes, on intravenous injection in rabbits. A gieen-producing streptococcus obtained on two occasions from infected tonsils and teeth of a patient with severe multiple neuritis showed marked affinity for nerves, especially peripheral nerves, in three species of animals, a
Early evolution of metazoan serine/threonine and tyrosine kinases: identification of selected kinases in marine sponges
Authors: M. Kruse, I. M. Muller, W. E. Muller
Journal: Molecular Biology and Evolution (1997)

The phylum Porifera (sponges) was the first to diverge from the common ancestor of the Metazoa. In this study, six cDNAs coding for protein-serine/threonine kinases (PS/TKs) are presented; they have been isolated from libraries obtained from the demosponges Geodia cydonium and Suberites domuncula and from the calcareous sponge Sycon raphanus. Sequence alignments of the catalytic domains revealed that two major families of PS/TK, the "conventional" (Ca(2+)-dependent) protein kinase C (PKC), the cPKC subfamily, as well as the "novel" (Ca(2+)-independent) PKC (nPKC), form two separate clusters. In each cluster, the sequence from S. raphanus diverges first. To approach the question about the origin of protein-tyrosine kinases (PTK), which are found only in Metazoa, we analyzed two additional PS/TKs which have been cloned from S. domuncula: the stress-responsive protein kinase (KRSvSD) and the protein-kinase-C-related kinase (PRKvSD). The construction of the phylogenetic tree, comprising the eight PS/TKs and the PTK cloned previously from G. cydonium, revealed that the PTK derived from the branch including the KRSvSD kinase. These data facilitate the first molecular approach to elucidate the origin of metazoan PTK within the PS/TK superfamily.
Serious implications for prospective medical students of the Shape of Training report
Authors: R. Wakeford
Journal: BMJ (2014)

<h3>Background:</h3> Early Periodic Screening, Diagnosis, and Treatment visits are designed to address physical, mental, and developmental health of children enrolled in Medicaid. <h3>Methods:</h3> We conducted a mixed methods intervention by using a quality improvement theory. We assessed preintervention and postintervention screening rates of development, anemia, lead, oral health, vision and hearing, interventions for improvement, and barriers for the well-child visits at an academic family medicine clinic. For quantitative analysis, we assessed the preintervention baseline for 183 children and postintervention outcome for 151 children. For qualitative analysis, we used group interviews and key informant interviews to develop interventions in the preintervention stage and to explore potential barriers for further improvement in the postintervention stage. <h3>Results:</h3> Interventions based on baseline results included user-friendly materials, checklists, posters, education, and order sets. After the intervention, there were significant statistical improvements (<i>P</i> &lt; .05) for the anemia test ordered rate, serum lead test ordered rate, oral health screening and referral rates, and ordered and confirmed test rates for both vision and hearing. Despite these improvements, 3 qualitative findings indicated barriers for further improvement, including difficulties in venipuncture, medical assistant aversion to vision screening, and poor fit of equipment for hearing assessment. The procedures prompted further continuous quality improvement activities using fingerstick hemoglobin testing, a child-friendly vision screener, and manual audiometer with headphones. <h3>Conclusions:</h3> The trial findings demonstrated potential benefits of improving screenings in an office-based intervention by using a quality improvement process. Postintervention qualitative findings illustrate additional factors that could be addressed for further improvements.
Reformation of an Ovarian Dermoid Cyst
Authors: Alexander A. Levi
Journal: New England Journal of Medicine (1951)

IN A previous paper entitled "Ovarian Conservation during Surgery"1 particular attention was paid to bilateral ovarian dermoids and ovarian endometriosis. Two patients were reported therein who had bilateral ovarian dermoid cysts and in whom at operation a piece of normal-appearing ovary was preserved. In both cases this small piece of tissue, about half the size of a dime, was salvaged from the left ovarian cyst and was able to produce normal, regular periods. One of these 2 patients has not married. The other has married and has been delivered of 3 healthy, well-formed babies — on October 24, 1940, December . . .
THE LS-ANTIGEN OF VACCINIA
Authors: Theodore Shedlovsky, Alexandre Rothen, Joseph E. Smadel
Journal: The Journal of Experimental Medicine (1943)

Studies on LS-protein, the soluble double antigen of vaccinia, and on the degradation products L'S and L''S' have been made with electrophoresis and in the analytical ultracentrifuge. LS, which is homogeneous electrically and in the ultracentrifuge, has an isoelectric point at pH 4.8. At 4 degrees C. its partial specific volume is 0.72 cc./gm., and its diffusion constant is 1.50 x 10(-7) cm.(2)/sec. The sedimentation constant is 6.35 at 20 degrees C., the molecular weight is 214,000, and the molecule appears to have an elongated ellipsoidal shape with an axis ratio of 1:20. L'S and L''S' are homogeneous electrically but not in the ultracentrifuge, L''S' being extremely polydisperse.
Heparan sulfate: lessons from knockout mice
Authors: Erik Forsberg, Lena Kjellén
Journal: Journal of Clinical Investigation (2001)

HS binds to many proteinsHS proteoglycans on cell surfaces, in basement membranes, or in cartilage (see Figure 1) influence biological processes by interacting with a large number of physiologically important macromolecules.The HS polysaccharide chains of the proteoglycans, covalently attached to different core proteins, carry negatively charged sulfate groups, whose position on the disaccharide building blocks of the polysaccharide (Nacetylglucosamine-hexuronic acid; see Esko and Lindahl, this Perspective series, ref. 1) contributes to the specificity of the interactions.Many signaling molecules, such as FGFs, VEGF, TGF-β1 and -β2, as well as several chemokines and cytokines, bind to HS present on cell surface proteoglycans (2) (see Figure 1).As first demonstrated for FGFs, the proteoglycans act as coreceptors for the signaling molecules (see ref.3).In addition, ECM proteins, proteases, protease inhibitors, lipases, lipoproteins, and microbial proteins are known to show affinity for HS.The pharmacologically important interaction between the protease inhibitor antithrombin and heparin (a highly sulfated variant of HS), which results in inhibition of blood coagulation, depends on several essential sulfate groups (4).In particular, the 3-O-sulfate group of the glucosamine residue in the middle of the interacting pentasaccharide sequence contributes greatly to the high-affinity binding between the polysaccharide and the protein.The interaction results in a conformational change in antithrombin, which now becomes a much more efficient inhibitor of blood coagulation.Signaling of bFGF (FGF-2) through its receptor will not occur without binding of the growth factor to HS.In this case, 2-Osulfate groups of iduronic acid residues have been shown to be part of the interacting saccharide sequence (see Gallagher, this Perspective series, ref. 5).
<i>Intersex-like</i> (<i>IXL</i>) Is a Cell Survival Regulator in Pancreatic Cancer with 19q13 Amplification
Authors: Riina Kuuselo, Kimmo Savinainen, David O. Azorsa, Gargi D. Basu, Ritva Karhu, Sukru Tuzmen, Spyro Mousses, Anne Kallioniemi
Journal: Cancer Research (2007)

Pancreatic cancer is a highly aggressive disease characterized by poor prognosis and vast genetic instability. Recent microarray-based, genome-wide surveys have identified multiple recurrent copy number aberrations in pancreatic cancer; however, the target genes are, for the most part, unknown. Here, we characterized the 19q13 amplicon in pancreatic cancer to identify putative new drug targets. Copy number increases at 19q13 were quantitated in 16 pancreatic cancer cell lines and 31 primary tumors by fluorescence in situ hybridization. Cell line copy number data delineated a 1.1 Mb amplicon, the presence of which was also validated in 10% of primary pancreatic tumors. Comprehensive expression analysis by quantitative real-time reverse transcription-PCR indicated that seven transcripts within this region had consistently elevated expression levels in the amplified versus nonamplified cell lines. High-throughput loss-of-function screen by RNA interference was applied across the amplicon to identify genes whose down-regulation affected cell viability. This screen revealed five genes whose down-regulation led to significantly decreased cell viability in the amplified PANC-1 cells but not in the nonamplified MiaPaca-2 cells, suggesting the presence of multiple biologically interesting genes in this region. Of these, the transcriptional regulator intersex-like (IXL) was consistently overexpressed in amplified cells and had the most dramatic effect on cell viability. IXL silencing also resulted in G(0)-G(1) cell cycle arrest and increased apoptosis in PANC-1 cells. These findings implicate IXL as a novel amplification target gene in pancreatic cancer and suggest that IXL is required for cancer cell survival in 19q13-amplified tumors.
Recombinant Human Antibodies Against Aldehyde-Modified Apolipoprotein B-100 Peptide Sequences Inhibit Atherosclerosis
Authors: Alexandru Schiopu, Jenny Bengtsson, Ingrid Söderberg, Sabina Janciauskiene, Stefan Lindgren, Mikko P.S. Ares, Prediman K. Shah, Roland Carlsson, Jan Nilsson, Gunilla Nordin Fredrikson
Journal: Circulation (2004)

Accumulation and oxidation of LDL are believed to be important initiating factors in atherosclerosis. Oxidized LDL is recognized by the immune system, and animal studies have suggested that these immune responses have a protective effect against atherosclerosis. Aldehyde-modified peptide sequences in apolipoprotein B-100 (apoB-100) are major targets for these immune responses.Human IgG1 antibodies against 2 malondialdehyde (MDA)-modified apoB-100 peptide sequences were produced through screening of a single-chain antibody-fragment library and subsequent cloning into a pcDNA3 vector. Three weekly doses of these antibodies were injected into male apoE-/- mice. Phosphate-buffered saline and human IgG1 antibodies against fluorescein isothiocyanate were used as controls. One of the IgG1 antibodies significantly and dose-dependently reduced the extent of atherosclerosis as well as the plaque content of oxidized LDL epitopes and macrophages. In cell culture studies, human monocytes were incubated with native LDL or oxidized LDL, in the presence of antibodies. The same antibody induced an increase in monocyte binding and uptake of oxidized LDL.These findings suggest that antibodies are important mediators of atheroprotective immune responses directed to oxidized LDL. Thus, passive immunization against MDA-modified apoB-100 peptide sequences may represent a novel therapeutic approach for prevention and treatment of cardiovascular disease.
ATP Depletion, a Possible Role in the Pathogenesis of Hyperuricemia in Glycogen Storage Disease Type I
Authors: Harry L. Greene, Frederick A. Wilson, Patrick Hefferan, Annie B. Terry, Jose Roberto Moran, Alfred E. Slonim, Thomas H. Claus, Ian M. Burr
Journal: Journal of Clinical Investigation (1978)

Other investigators have shown that fructose infusion in normal man and rats acutely depletes hepatic ATP and Pi and increases the rate of uric acid formation by the degradation of preformed nucleotides. We postulated that a similar mechanism of ATP depletion might be present in patients with glucose-6-phosphatase deficiency (GSD-I) as a result of ATP consumption during glycogenolysis and resulting excess glycolysis. The postulate was tested by measurement of: (a) hepatic content of ATP, glycogen, phosphorylated sugars, and phosphorylase activities before and after increasing glycolysis by glucagon infusion and (b) plasma urate levels and urate excretion before and after therapy designed to maintain blood glucose levels above 70 mg/dl and thus prevent excess glycogenolysis and glycolysis.
Understanding variation in rates of referral among general practitioners: are inappropriate referrals important and would guidelines help to reduce rates?
Authors: A Fertig, M Roland, H King, T Moore
Journal: BMJ (1993)

OBJECTIVES--To determine the extent to which variation in rates of referral among general practitioners may be explained by inappropriate referrals and to estimate the effect of implementing referral guidelines. SETTING--Practices within Cambridge Health Authority and Addenbrooke9s Hospital, Cambridge. MAIN OUTCOME MEASURES--Data on practice referral rates from hospital computers, inappropriate referrals as judged by hospital consultants, and inappropriate referrals as judged against referral guidelines which had been developed locally between general practitioners and specialists. Effect of referral guidelines on referral patterns as judged by general practitioners using the guidelines in clinical practice. RESULTS--There was 2.5-fold variation in referral rates among general practices. According to the specialists, 9.6% (95% confidence interval 6.4% to 12.9%) of referrals by general practitioners and 8.9% (2.6% to 15.2%) of referrals from other specialists were judged possibly or definitely inappropriate. Against locally determined referral guidelines 15.9% of referrals by general practitioners were judged possibly inappropriate (11.8% to 20.0%). Elimination of all possibly inappropriate referrals could reduce variation in practice referral rates only from 2.5-fold to 2.1-fold. An estimate of the effect of using referral guidelines for 60 common conditions in routine general practice suggested that application of guidelines would have been unlikely to reduce rates of referral in hospital (95% confidence interval -4.5% to 8.6% of consultations resulting in referral). CONCLUSION--The variation in referral rates among general practitioners in Cambridge could not be explained by inappropriate referrals. Application of referral guidelines would be unlikely to reduce the number of patients referred to hospital.
Nephrocalcinosis: another cause of renal erythrocytosis.
Authors: T G Feest, S Proctor, R Brown, O M Wrong
Journal: BMJ (1978)

OBJECTIVE: To assess the distribution of widespread pain, tenderpoints (TP), and fibromyalgia (FM) in young African American (AA) and Caucasian (C) women. METHODS: A community population of 1334 young (21-26 yrs old) women (684 AA and 650 C) was surveyed and classified for body pain spread [chronic widespread pain (CWP), axial regional chronic pain (RCP), nonaxial RCP, or no pain]. Of these women, 553 were examined for TP based on American College of Rheumatology criteria. RESULTS: Overall, 5.6% reported CWP, while 22% reported axial RCP, and 16% reported nonaxial RCP. From the CWP group, 57% were confirmed as FM cases. C women had significantly more TP and greater TP pain score than AA women (p &lt;or= 0.005). Overall FM prevalence was 2.4% (95% confidence interval: 1.7-3.5%), with 3.0% in AA and 2.0% in C women. Increase in body pain and tenderness was significantly associated with decreased subjective socioeconomic status (SSS), worse self-reported health, greater impact of premenstrual symptoms on activities, and greater depressive symptoms. The effect of depressive symptoms on pain differed by race. CONCLUSIONS: Widespread pain and tenderness is highly prevalent in these young women. Racial differences seem to exist; C women had significantly increased tenderness while AA women had more widespread pain. The association of depressive symptoms and pain was stronger in AA women. Racial differences emerged relatively early in these young women.
Defective release of tissue plasminogen activator in patients with sickle cell anemia
Authors: George Phillips, Lanetta B. Mitchell, Salvatore V. Pizzo
Journal: American Journal of Hematology (1988)

Abstract Recent studies suggest that intravascular coagulation occurs in sickle cell anemia. There is also some evidence that decreased fibrinolytic activity may be associated with the disorder. In the current study we measured tissue plasminogen activator levels (t‐PA) in seven asymptomatic patients with sickle cell anemia. The mean level of releasable t‐PA was only 0.01 lU/mL ± 0.005 (SEM) as compared to 118 healthy volunteers with levels of 0.70 ± 0.10 (SEM). Despite the small sample size, the difference between the two groups was statistically significant (P &lt; .001). These data suggest that defective release of t‐PA may contribute to a hypercoagulable state in sickle cell anemia.
PTU-258 A UK national comparative audit of appropriateness of red cell transfusion in medical patients
Authors: S Coda, K Pendry, T Davies, J Grant-Casey, J Wallis, C Taylor, B Astbury, E Hughes, J Reid, M Horan, T Davies, A V Thillainayagam
Journal: Gut (2012)

<h3>Introduction</h3> The decrease in red cell usage (15%) that has been achieved in recent years has mainly been achieved through the use of blood conservation strategies adopted for surgical patients. Despite national guidelines for blood transfusion being available, agreed triggers for transfusion still need to be established in clinical practice, together with better decision-making in anaemia management to further reduce inappropriate transfusion of red cells in medical patients. <h3>Methods</h3> The main aim of this audit was to observe the extent of inappropriate red cell transfusions, taking account of relevant clinical information and pretransfusion assessment. In autumn 2011, a total of 8759 red cell transfusions in medical units from almost all UK hospitals (&gt;90%) were audited in 3 selected weeks. Through an algorithm based on clinical and diagnostic information provided, a panel of expert physicians estimated the appropriateness of the transfusion. Subgroup analysis was also undertaken to identify patients with a reversible cause of anaemia in whom timely diagnosis and treatment of the original condition would have almost certainly prevented the recourse to blood transfusion. <h3>Results</h3> Preliminary analysis has revealed many cases of red cell transfusion when the pretreatment haemoglobin (Hb) was within acceptable limits. The findings show that 4.1% cases had a pretransfusion Hb higher than 10 g/dl (median 7.8, range 2.3–17.7) and 5.8% had a posttransfusion Hb of greater than 12 g/dl (median 9.9, range 4.2–19.3). Serum ferritin was measured in only 38% of cases and of these 9.3% of patients had a ferritin &lt;15 μg/l. Of all the transfusion episodes, only 1748 were for blood loss, while 180 were for prophylaxis prior to a procedure. The vast majority were for anaemia, with the remaining 48 reports not having enough data. In blood loss, the commonest indication was haematemesis (1029 cases), while 423 were primarily for rectal bleeding. <h3>Conclusion</h3> This national comparative audit shows: (i) there is substantial inappropriate red cell transfusion in medical patients; (ii) gastrointestinal bleeding is far and away the major reason for transfusion in the setting of blood loss among medical patients. The frequent use of red cell transfusion in the absence of clinical necessity seems to derive from the use of above-threshold triggers, and suboptimal management of anaemia with a reversible cause. <h3>Competing interests</h3> None declared.