tbuckley/cabot-search huggingface dataset:
In search of "non-disease"
Authors: R. Smith
Journal: BMJ (2002)

The BMJ recently ran a vote on bmj.com to identify the “top 10 non-diseases.”1 Some critics thought it an absurd exercise,2 but our primary aim was to illustrate the slipperiness of the notion of disease. We wanted to prompt a debate on what is and what is not a disease and draw attention to the increasing tendency to classify people's problems as diseases.



Results of survey in 1979 in which a range of subjects (non-medical academics, secondary school students, medical academics, and general practitioners) were asked which of 38 conditions they considered to be diseases3



In 1979 the BMJ published a study that did something similar.3 Non-medical academics, medical academics, general practitioners, and secondary school students were invited to say whether 38 terms did or did not refer to a disease. Almost 100% thought that malaria and tuberculosis were diseases, but less than 20% thought the following to be diseases: lead poisoning, carbon monoxide poisoning, senility, hangover, fractured skull, heatstroke, tennis elbow, colour blindness, malnutrition, barbiturate overdose, drowning, or starvation (figure). People were split 50:50 over whether hypertension, acne vulgaris, or gall stones were diseases. The doctors were more likely to view the terms as referring to diseases. The authors of this study included Guy Scadding, who spent much of his life spelling out to doctors that no general agreement exists on how to define a disease.

#### Summary points

The BMJ conducted a survey on the web to identify “non-diseases”—and found almost 200

The notion of “disease” is a slippery one and the concept of non-disease is therefore similarly blurred

Health is equally impossible to define

To have your condition labelled as a disease may bring considerable benefit—both material (financial) and emotional

However, the diagnosis of a disease may also create problems—you may be denied insurance, a mortgage, …
HTLV-III/LAV Antibodies in Contacts of Hemophiliacs-Reply
Authors: Janine M. Jason
Journal: JAMA (1986)

<h3>In Reply.—</h3> We are glad that Dr Girón has provided us with the opportunity to emphasize an important aspect of one of our findings. As outlined in "Subjects and Methods," this study included the following household members of 17 hemophiliacs with AIDS or ARC: 14 sexual partners, six parents, four siblings, and ten children. It also included the following household members of 26 clinically well persons with hemophilia: eight sex partners, 27 parents, 18 siblings (including four with hemophilia), and one grandparent. Sixty-three nonhemophilic participants had immune tests performed. The results cited by Dr Girón were found for both sex partners and nonsexual contacts of the hemophiliacs. Only two nonhemophilic individuals were HTLV-III/LAV antibody positive; both were sex partners of hemophiliacs. We found that HTLV-III/LAV antibody-negative household members of hemophiliacs with AIDS/ARC had fewer T-helper cells than did antibody-negative household members of the antibody-positive, asymptomatic hemophiliacs. Furthermore, these antibody-negative household
Stereoscopic Atlas of Macular Disease: Diagnosis and Treatment
Authors: Robert A. Levine
Journal: JAMA (1988)

Macular disease, being the leading cause of blindness in the United States, has become a most important societal problem. No one has contributed more to the understanding and pathogenesis of macular disease than Dr Gass. His extensive background in ophthalmic pathology, his dedication to macular disease spanning a 30-year period, his excellent rapport with colleagues and patients, and his affiliation with a prestigious, well-endowed eye institute create a matrix from which originates the most important text, now in its third edition, devoted to macular disease. This two-volume atlas is profusely illustrated, leaving little doubt as to the depth and breadth of Dr Gass' expertise. Many of the photographs sequentially follow the evolution of a maculopathy during a 20-year period of observation, adding additional credence to the author's observations. The visual impact of this atlas is augmented by numerous schematic drawings, as well as by photomicrographs of histopathological correlations. However, it
Diagnostic Strategies for Common Medical Problems
Authors: Alan Rubin
Journal: Annals of Internal Medicine (2000)

Medical Writings: Book Notes21 November 2000Diagnostic Strategies for Common Medical ProblemsAlan Rubin, MDAlan Rubin, MDUniversity of Vermont College of Medicine, Burlington, Vermont. (Rubin)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-10-200011210-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Second edition. Black ER, Bordley DR, Tape TG, Panzer RJ, eds. 674 pages. Philadelphia: ACP–ASIM; 1999. $45.00. ISBN 0943126746. Order phone 800-523-1546, ext. 2600.Field of medicine: General internal medicine.Format: Softcover book.Audience: Medical practitioners and trainees.Purpose: To provide evidence-based information for accurately diagnosing a wide range of clinical problems in internal medicine.Content: The first 5 chapters are a concise guide to the operating characteristics and interpretation of diagnostic tests and methods of keeping up with evolving evidence about diagnostic tests. The next 50 chapters apply the principles covered in the first 5 chapters to discuss strategies ... Author, Article, and Disclosure InformationAffiliations: University of Vermont College of Medicine, Burlington, Vermont. (Rubin) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 21 November 2000Volume 133, Issue 10Page: 840KeywordsClinical epidemiologyInpatientsMagnetic resonance imagingMuscular dystrophiesOsteomyelitisOsteoporosisOutpatientsOvarian cancerPeptic ulcersSoftware tools ePublished: 21 November 2000 Issue Published: 21 November 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Cost-Effectiveness of Screening and Vaccinating Asian and Pacific Islander Adults for Hepatitis B
Authors: David W. Hutton, Daniel Tan, Samuel K. So, Margaret L. Brandeau
Journal: Annals of Internal Medicine (2007)

Background: As many as 10% of Asian and Pacific Islander adults in the United States are chronically infected with hepatitis B virus (HBV), and up to two thirds are unaware that they are infected. Without proper medical management and antiviral therapy, up to 25% of Asian and Pacific Islander persons with chronic HBV infection will die of liver disease. Objective: To assess the cost-effectiveness of 4 HBV screening and vaccination programs for Asian and Pacific Islander adults in the United States. Design: Markov model with costs and benefits discounted at 3%. Data Sources: Published literature and expert opinion. Target Population: Asian and Pacific Islander adults (base-case age, 40 years; sensitivity analysis conducted on ages 20 to 60 years). Time Horizon: Lifetime. Perspective: U.S. societal. Interventions: A universal vaccination strategy in which all individuals are given a 3-dose vaccination series; a screen-and-treat strategy, in which individuals are given blood tests to determine whether they are chronically infected, and infected persons are monitored and treated; a screen, treat, and ring vaccinate strategy, in which all individuals are tested for chronic HBV infection and close contacts of infected persons are screened and vaccinated if needed; and a screen, treat, and vaccinate strategy, in which all individuals are tested and then vaccinated with a 3-dose series if needed. In all cases, persons found to be chronically infected are monitored and treated if indicated. Outcome Measures: Costs (2006 U.S. dollars), quality-adjusted life-years (QALYs), and incremental cost-effectiveness. Results of Base-Case Analysis: Compared with the status quo, the screen-and-treat strategy has an incremental cost-effectiveness ratio of $36 088 per QALY gained. The screen, treat, and ring vaccinate strategy gains more QALYs than the screen and treat strategy and incurs modest incremental costs, leading to incremental cost-effectiveness of $39 903 per QALY gained compared with the screen and treat strategy. The universal vaccination and screen, treat, and vaccinate strategies were weakly dominated by the other 2 strategies. Results of Sensitivity Analysis: Over a wide range of variables, the incremental cost-effectiveness ratios of the screen and treat and screen, treat, and ring vaccinate strategies were less than $50 000 per QALY gained. Limitations: Results depend on the accuracy of the underlying data and assumptions. The long-term effectiveness of new and future HBV treatments is uncertain. Conclusions: Screening programs for HBV among Asian and Pacific Islander adults are likely to be cost effective. Clinically significant benefits accrue from identifying chronically infected persons for medical management and vaccinating their close contacts. Such efforts can greatly reduce the burden of HBV-associated liver cancer and chronic liver disease in the Asian and Pacific Islander population.
Effect of Hydrochloric Acid on Iron Absorption
Authors: Stanley G. Schade, Richard J. Cohen, Marcel E. Conrad
Journal: New England Journal of Medicine (1968)

To elucidate the role of gastric acid in iron absorption, six normal subjects and six with pernicious anemia were given ferric iron, mixed with ascorbate to form a chelate that remained soluble after alkalinization with sodium hydroxide, and ferric iron that had been precipitated with sodium hydroxide before the addition of ascorbate and remained insoluble. Either 59Fe or 55Fe was added to the iron preparations, and the absorption of 59Fe was measured with a whole-body counter. Achlorhydric subjects with pernicious anemia absorbed significantly (p less than 0.01) more iron from the solubilized chelates than from the precipitated preparation, but these differences were not found in the normal group. Normally, gastric acid appears to facilitate the chelation in the stomach of ferric salts with ascorbate and other exogenous or endogenous agents. Since these chelates then remain soluble in the more alkaline duodenum and jejunum, iron absorption is enhanced.
A Successful Experience in Managing a Chylous Reflux
Authors: Gholam Hossein Kazemzadeh, Ramin Sadeghi, Emad Ebrahimi, Mohammad Ali Ghodsi Rad
Journal: Clinical Nuclear Medicine (2014)

Chylous reflux is described as the backflow of chyle through the varicose lymphatics with incompetent lymph valves and leakage of the lymph. The valves in the dilated, varicose, tortuous lymph vessels become incompetent, and as a result, the lymph blended with chyle, reflux into the lower limbs or the genitalia. Reflux causes delayed lymphatic transport in the affected lower extremity and chronic lymphedema can develop. Vesicles containing chyle could appear on the skin of the involved parts, and milky fluid discharge of the lymph and chyle interferes greatly with quality of life.
Does perception replicate the external world?
Authors: Donald D. Hoffman
Journal: Behavioral and Brain Sciences (2003)

Vision scientists standardly assume that the goal of vision is to recover properties of the external world. Lehar's “miniature, virtual-reality replica of the external world inside our head” (target article, sect. 10) is an example of this assumption. I propose instead, on evolutionary grounds, that the goal of vision is simply to provide a useful user interface to the external world.
Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study
Authors: A. Lalmohamed, F. de Vries, M. T. Bazelier, A. Cooper, T.-P. van Staa, C. Cooper, N. C. Harvey
Journal: BMJ (2012)

<b>Objectives</b> To estimate fracture risk in patients receiving bariatric surgery versus matched controls. <b>Design</b> Population based, retrospective cohort study. <b>Setting</b> Use of records from the United Kingdom General Practice Research Database, now known as the Clinical Practice Research Datalink (from January 1987 to December 2010). <b>Participants</b> Patients with a body mass index of at least 30, with a record of bariatric surgery (n=2079), and matched controls without a record (n=10 442). Each bariatric surgery patient was matched to up to six controls by age, sex, practice, year, and body mass index. Patients were followed from the date of bariatric surgery for the occurrence of any fracture. We used time dependent Cox regression to calculate relative rates of fracture, adjusted for disease and previous drug treatment, and time-interaction terms to evaluate fracture timing patterns. <b>Main outcome measure</b> Relative rates of any, osteoporotic, and non-osteoporotic fractures. <b>Results</b> Mean follow-up time was 2.2 years. Overall, there was no significantly increased risk of fracture in patients who underwent bariatric surgery, compared with controls (8.8 <i>v</i> 8.2 per 1000 person years; adjusted relative risk 0.89, 95% confidence interval 0.60 to 1.33). Bariatric surgery also did not affect risk of osteoporotic and non-osteoporotic fractures. However, we saw a trend towards an increased fracture risk after three to five years following surgery, as well as in patients who had a greater decrease in body mass index after surgery, but this was not significant. <b>Conclusion</b> Bariatric surgery does not have a significant effect on the risk of fracture. For the first few years after surgery, these results are reassuring for patients undergoing such operations, but do not exclude a more protracted adverse influence on skeletal health in the longer term.
Indications, complications, and short-term clinical outcome of percutaneous transvenous mitral commissurotomy.
Authors: M Nobuyoshi, N Hamasaki, T Kimura, H Nosaka, H Yokoi, H Yasumoto, H Horiuchi, H Nakashima, T Shindo, T Mori
Journal: Circulation (1989)

Percutaneous transvenous mitral commissurotomy was performed in 106 consecutive patients. Significant symptomatic improvement was achieved in 97 patients (92%). Mean left atrial pressure decreased (from 18 +/- 8 to 11 +/- 8 mm Hg, p less than 0.00001), mean mitral diastolic pressure gradient decreased (from 12 +/- 7 to 7 +/- 6 mm Hg, p less than 0.00001), and mitral valve area increased (from 1.40 +/- 0.40 to 2.00 +/- 0.50 cm2, p less than 0.00001). Based on echocardiographic characteristics of the mitral apparatus, patients were grouped retrospectively in three categories: pliable (group 1, n = 37), semipliable (group 2, n = 59), and rigid (group 3, n = 10). Clinical success was achieved in 36 patients of group 1 (97%) and in 55 patients of group 2 (93%). Only six patients in group 3 (60%) improved symptomatically (p less than 0.001 vs. group 1, p less than 0.001 vs. group 2). The severity of mitral regurgitation increased in five patients of group 1 (14%), in 12 of group 2 (20%), and in three of group 3 (33%). Six patients had recurrent symptoms at 9 months after commissurotomy. Recurrence of symptoms was significantly more frequent in group 3 compared with the other two groups (group 1, 3%; group 2, 4%; and group 3, 50%; p less than 0.0001 vs. groups 1 and 2). Multiple regression analysis identified the previously mentioned echocardiographic characteristics of the mitral apparatus as the significant predictor for clinical outcome. Thus, percutaneous transvenous mitral commissurotomy can be considered a safe and effective treatment for patients with pliable valves. Patients with semipliable or with rigid valves should be selected for operation very carefully.
US Can Draw Insight From Other Nations’ Experiences With Evidence-Based Medicine
Authors: Anita Slomski
Journal: JAMA (2012)

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
Primary Aldosteronism
Authors: Daniel Fine, Leonard E. Meiselas, Jacob Colsky, Sanford Oxenhorn
Journal: New England Journal of Medicine (1957)

A CLINICAL entity having the outstanding features of hypertension, muscle weakness, renal and electrolyte abnormalities and increased excretion of salt-retaining hormone in the urine has recently been described by Conn.1 This disease, primary aldosteronism, usually has its origin in a demonstrable adrenocortical tumor that secretes excessive amounts of a salt-retaining hormone.The findings in a patient with this entity are presented below to broaden the knowledge of the disease by calling attention to differences between this patient and the original one described by Conn.¶MethodsThe routine determinations were carried out by laboratory methods used in the Maimonides Hospital. Saliva . . .
Recognition and management of depression in general practice: consensus statement.
Authors: E S Paykel, R G Priest
Journal: BMJ (1992)

on behalf of conference participants Depression is a frequently occurring psychiatric dis- order, and most depressed patients in the United Kingdom are treated in general practice.The Royal College of Psychiatrists, in association with the Royal College of General Practitioners, has embarked on a "defeat depression" campaign.'Anticipating that an increased proportion of the large numbers of the general population who do not at present receive treatment for depressive illness will present to helping agencies, the two colleges are preparing professional educational materials and guidelines.In recent years there has been a great deal of new knowledge regarding diagnosis, recognition, and effects of treatment.Two consensus meetings in which participants were mainly representatives of the two colleges, together with other experts, were therefore held in 1991 to consider, firstly, diagnosis and recog- nition (21 October 1991) and, secondly, management (15 November 199 1).Specific questions were addressed by a presenter with a prepared paper, and a discussant, followed by extensive general discussion to reach an agreed consensus, which was circulated to participants for further approval.We present views that reflect the agreed conclusions.We emphasise, however, that they do not necessarily reflect the official policy of either of the two colleges.They are intended to form guidelines which we hope will be useful in practice and also in audit. Diagnosis and recognition of depressionWHAT IS DEPRESSION?
Defining Human Differences in Biomedicine
Authors: Maggie Brown
Journal: PLoS Medicine (2007)

A study is published reporting that a new drug works better in black people than in whites. Is this an informative study or is it based on archaic, incorrect, even harmful notions of human difference?

Homo sapiens has been called the species that names. An extensive literature reflects millennia of concern over what we humans call ourselves and others. All life sciences are now grappling further with how to categorize and study the nearly infinite polymorphisms within and among “species” as awareness grows that the species concept itself is inadequate. Human medicine, however, is in a unique position in that not only must it confront these problems of categorization that plague all life sciences, but this effort occurs in a complex sociopolitical context. As Smart and colleagues recently said, “One reason that race and ethnicity are difficult concepts to operationalize or examine in scientific research is that they have meaning and usage that exists beyond the domain of scientific control” [1].
Nonadrenal epinephrine-forming enzymes in humans. Characteristics, distribution, regulation, and relationship to epinephrine levels.
Authors: B Kennedy, T D Bigby, M G Ziegler
Journal: Journal of Clinical Investigation (1995)

Animal studies indicate that nonadrenal tissues may synthesize epinephrine (E). Here we demonstrate phenylethanolamine N-methyltransferase (PNMT) and/or nonspecific N-methyltransferase (NMT) enzymatic activity in human lung, kidney, heart, liver, spleen, and pancreas. There was a significant overall correlation (r = 0.34) between tissue PNMT and E. PNMT and NMT in human tissues differed in substrate and inhibitor specificity, thermal stability, and antigenicity. By these criteria, PNMT in human lung and in human bronchial epithelial cells were indistinguishable from adrenal PNMT. PNMT and/or NMT activity were present in red blood cells (RBCs), and cancer cell lines. Human kidney, lung, and pancreas showed immunohistochemical staining with an antibody to adrenal PNMT. RBC PNMT activity was lower in males than females and was increased in hyperthyroidism and decreased in hypothyroidism. PNMT activity in a human bronchial epithelial cell line was dramatically increased by incubation with dexamethasone. E and 3H-E levels in plasma and urine during an intravenous infusion of 3H-E into humans indicated that kidney may synthesize half of urinary E. We conclude that PNMT and NMT are widely distributed in human tissues, that they may synthesize E in vivo and are influenced by glucocorticoid and thyroid hormones.
RELATIONSHIP OF RIGHT VENTRICULAR RESTRICTIVE PHYSIOLOGY WITH PULMONARY REGURGITATION AND AGE OF REPAIR IN PATIENTS WITH REPAIRED TETRALOGY OF FALLOT
Authors: Jimmy C. Lu, Timothy B. Cotts, Prachi P. Agarwal, Anil K. Attili, Adam L. Dorfman
Journal: Journal of the American College of Cardiology (2010)
Combined Action of Nucleic Acid-Sensing Toll-like Receptors and TLR11/TLR12 Heterodimers Imparts Resistance to Toxoplasma gondii in Mice
Authors: Warrison A. Andrade, Maria do Carmo Souza, Espiridion Ramos-Martinez, Kamalpreet Nagpal, Miriam S. Dutra, Mariane B. Melo, Daniella C. Bartholomeu, Sankar Ghosh, Douglas T. Golenbock, Ricardo T. Gazzinelli
Journal: Cell Host & Microbe (2013)
CLASSIFICATION AND TREATMENT OF NEPHRITIS ACCORDING TO FUNCTIONAL TESTS
Authors: MILTON GOLDSMITH
Journal: JAMA (1913)

Nephritis may be defined as an affection of both kidneys in which inflammatory changes occur but do not lead to suppuration. Functionally the kidney consists of two distinct apparatus, the tubular and the vascular, the latter comprising the glomeruli with their afferent and efferent branches and the small branches of the renal artery passing between the tubules. By means of poisonous chemicals it is possible to injure either system at will and to study the other in its normal condition. Salts of chromium or corrosive sub-limate cause marked changes in the epithelium of the convoluted tubules, with no changes in the glomeruli. In such a tubular nephritis, large amounts of albumin and casts are found. On the other hand, a nephritis produced by cantharides or arsenic affects especially the glomeruli, and in this form, known as vascular nephritis, there occurs little albumin and few casts, but many red blood-corpuscles. A series of experiments recently carried on by Schlayer