tbuckley/cabot-search huggingface dataset:
Stop using military metaphors for disease
Authors: N. M. Wiggins
Journal: BMJ (2012)

In oncology I come across this terminology often: patients “battle” and “courageously fight” against cancer; some “win” and some “give up the fight” and “lose.” The biomilitary metaphor has subtly worked its way into our psyche over centuries. When the remarkable metaphysical poet (and suspected drama queen) John Donne thought he was dying he wrote Devotions Upon Emergent Occasions , in which he described his illness as a “cannon shot” and a “siege [that] blows up the heart.” In 1864, Louis Pasteur used invasion imagery to introduce his fundamentally new germ theory of illness to the public. Then, in 1971, US president Nixon publically declared “war” on cancer, calling it a “relentless and insidious enemy.” Newspapers have been affirming this battle ever since.

It is difficult to think of alternative metaphors. The concept of body as battlefield is instilled in us through school textbooks with images of cells “battling” for …
Sex on the Rates: Memoirs of a Family Planning Doctor
Authors: Deborah J Lee
Journal: BMJ (2004)

Libby Wilson Argyll Publishing, £7.99, pp 224 ISBN 1 902831 70 5Argyll.publishing@virgin.net Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> This really is the sort of book that, once you start to turn the pages, you can't put down. If, like me, you have a fanatical interest in family planning and reproductive health you cannot help being seduced by it. Wilson has achieved something very admirable in putting this account together. Not only has she detailed the shaky, haphazard emergence of family planning services over the last 50 years and their metamorphosis into the rather more robust … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Doctor in the raw
Authors: T Greenhalgh
Journal: BMJ (1994)

Sunday had begun hot and was now damp and chilly. The half marathon was over save for stragglers. Someone called across the crowd. “Oi, Trish! You're a doctor, aren't you? Can you give us a hand?”

A woman in a pastel jogging suit was being transferred from the back of a Cortina into the first aid vehicle. The St John Ambulance lady made the diagnosis from 10 feet away. “That's another collapse. I'll get the usual, shall I?”

The ambulance was dark, the bed narrow, and the casualty large and prone. I began pulling off multiple layers of cotton fleece in the hope of …
Effect of bullectomy on diaphragm strength.
Authors: J M Travaline, V P Addonizio, G J Criner
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Surgical removal of bullous lesions in selected patients with chronic obstructive pulmonary disease may significantly improve lung function, gas exchange, and functional status and reduce dyspnea. Proposed mechanisms by which bullectomy may produce these beneficial effects include (1) improving ventilation and perfusion matching by allowing compressed viable lung to re-expand and participate in gas exchange; (2) restoring outward elastic tension on small airways, thereby reducing airways obstruction; and (3) reducing end-expiratory lung volume, thereby diminishing the adverse effects of chronic hyperinflation on chest wall elastic recoil and inspiratory muscle force generation. In this report, we demonstrate the effect of bullectomy on transdiaphragmatic pressure generation, gas exchange, and exercise capacity in a patient with severe bullous emphysema who underwent unilateral bullectomy.
The Greening of Pesticide–Environment Interactions: Some Personal Observations
Authors: John E. Casida
Journal: Environmental Health Perspectives (2012)

Pesticide-environment interactions are bidirectional. The environment alters pesticides by metabolism and photodegradation, and pesticides in turn change the environment through nontarget or secondary effects.Approximately 900 currently used commercial pesticides of widely diverse structures act by nearly a hundred mechanisms to control insects, weeds, and fungi, usually with minimal disruption of nature's equilibrium. Here I consider some aspects of the discovery, development, and use of ecofriendly or green pesticides (i.e., pesticides that are safe, effective, and biodegradable with minimal adverse secondary effects on the environment). Emphasis is given to research in my laboratory.The need for understanding and improving pesticide-environment interactions began with production of the first major insecticide approximately 150 years ago: The arsenical poison Paris Green was green in color but definitely not ecofriendly. Development and use of other pesticides has led to a variety of problems. Topics considered here include the need for high purity [e.g., hexachlorocyclohexane and polychloroborane isomers and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T)], environmental degradation and the bioactivity of resulting photoproducts and metabolites, pesticide photochemistry (including the use of structural optimization, photostabilizers, and photosensitizers to achieve suitable persistence), the presence of multiple active ingredients in botanical insecticides, the need to consider compounds with common mechanisms of action, issues related to primary and secondary targets, and chemically induced or genetically modified changes in plant biochemistry. Many insecticides are bird, fish, and honeybee toxicants, whereas herbicides and fungicides pose fewer environmental problems.Six factors have contributed to the greening of pesticide-environment interactions: advances in pesticide chemistry and toxicology, banning of many chlorinated hydrocarbons, the development of new biochemical targets, increased reliance on genetically modified crops that reduce the amount and variety of pesticides applied, emphasis on biodegradability and environmental protection, and integrated pest- and pesticide-management systems.
Acute Pancreatitis and Acute Cholecystitis Caused by Hemobilia after Percutaneous Ultrasound-Guided Liver Biopsy
Authors: W. Albuquerque, V. Arantes, K. de Paula Farah, J. R. Lambertucci
Journal: Endoscopy (2005)

We report here a patient who suffered three complications after ultrasound-guided percutaneous liver biopsy: hemobilia, acute biliary pancreatitis, and acute cholecystitis. Endoscopic sphincterotomy and cholecystectomy were successfully carried out, allowing a minimally invasive approach to manage these events.
Swimming pool wheezing.
Authors: P T Penny
Journal: BMJ (1983)

<h3>Abstract</h3> The genome sequencing of Atlantic cod revealed an immune system absent of specific cell surface toll-like receptors (TLRs), major histocompatibility complex (MHC) class II, invariant chain (CD74) and the CD4 (cluster of differentiation 4) receptor. Despite the loss of these major components considered as critical to vertebrate innate and adaptive immune systems the cod system is fully functional, however the underlying mechanisms of the immune response in cod remain largely unknown. In this study, <i>ex vivo</i> cod macrophages were challenged with various bacterial and viral microbe-associated molecular patterns (MAMP) to identify major response pathways. Cytosolic MAMP-PRR pathways based upon the NOD-like receptors (NLRs) and RIG-I-like receptors (RLRs) were identified as the critical response pathways. Our analyses suggest that internalization of exogenous ligands through scavenger receptors drives both pathways activating transcription factors like NF-kB (Nuclear factor-kappa B) and interferon regulatory factors (IRFs). Further, ligand-dependent differential expression of a unique TLR25 isoform and multiple NLR paralogues suggests (sub)neofunctionalisation toward specific immune defensive strategies. Our results further demonstrate that the unique immune system of the Atlantic cod provides an unprecedented opportunity to explore the evolutionary history of PRR-based signalling in vertebrate immunity.
1016-152 Rebirth of bedside cardiovascular examination using hand-carried ultrasound
Authors: Sergio L Kobal, Luca Trento, Simin Baharami, Kirsten Tolstrup, Tasneem Z Naqvi, Bojan Cercek, Yoram Neuman, James Mirocha, Saibal Kar, James S Forrester, Robert J Siegel
Journal: Journal of the American College of Cardiology (2004)
Prostaglandins are not mediators of the intestinal response to cholera toxin.
Authors: G S Smith, G Warhurst, A Tonge, L A Turnberg
Journal: Gut (1985)

We have determined the release of prostaglandin E2 into the lumen of closed ileal loops in the rat and have measured the capacity of the mucosa to synthesise and degrade prostaglandin E2 both in control animals and after exposure to cholera toxin or bisacodyl. Exposure to cholera toxin caused no change in any of these measurements whereas bisacodyl caused an increase in the luminal PGE2 content. We conclude that the secretion stimulated by cholera toxin is not mediated by locally produced prostaglandins.
Superoxide production by phagocytic leukocytes: the scientific legacy of Bernard Babior
Authors: John T. Curnutte
Journal: Journal of Clinical Investigation (2004)

It was 32 years ago that Bernard Babior, Ruby Kipnes, and I submitted a paper to the JCI reporting that polymorphonuclear leukocytes produce superoxide (O(2) (-)) during phagocytosis and that this highly reactive oxygen radical might function as a microbicidal agent. The story of how our lab came to this discovery is one of a special relationship between a student and his brilliant mentor.
COMPRESSION OF BRACHIAL PLEXUS: THE SCALENUS ANTICUS SYNDROME
Authors: FREDERICK LEET REICHERT
Journal: JAMA (1942)

This report concerns the relief of symptoms by nonsurgical means in 60 of 74 patients with compression of the brachial plexus (medial cord) due to displacement. The symptoms of compression of the brachial plexus are the same as those produced by cervical ribs. The condition has been described in the past six years by a number of authors. Some have used the term "neuritis of the brachial plexus, mechanical in origin," or "scalenus neurocirculatory compression" to indicate that the chief factor is pressure on the brachial plexus by the anterior scalenus muscle. Compression of the brachial plexus by a first dorsal rib was described over thirty years ago by Murphy.<sup>1</sup> Scant attention has been given in the literature to the nonoperative treatment of the symptoms produced by cervical ribs, by abnormal first dorsal ribs or by the squeezing mechanism of the scalenus muscles and the first rib, the so-called
Off-label Atypical Antipsychotics
Authors: Bridget M. Kuehn
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
Compensating Physicians for Telephone Calls
Authors: Alan R. Nelson
Journal: JAMA (1995)

<h3>To the Editor.</h3> —In reading the Commentary by Dr Sorum,<sup>1</sup>I was surprised that the ASIM was not mentioned as a key player in the fight for compensation of telephone services. The ASIM has been a leader in the charge for reimbursement of phone services over the last decade. In fact, Medicare's recent decision to pay for some care plan oversight services, including phone services, for home- and hospice-bound patients was a direct result of ASIM's leadership. We spearheaded the development of the Current Procedural Terminology codes for care plan oversight and organized a coalition of other medical organizations in support of Medicare's reimbursement for these important services. The recent decision was particularly significant because it represented Medicare's first recognition of the value of services that are not delivered face-to-face. The ASIM views this as only the beginning, and we are continuing our leadership to gain reimbursement for care
Effects of alveolar recruitment maneuvers on clinical outcomes in patients with acute respiratory distress syndrome: a systematic review and meta-analysis
Authors: Erica Aranha Suzumura, Mabel Figueiró, Karina Normilio-Silva, Lígia Laranjeira, Claudia Oliveira, Anna Maria Buehler, Diogo Bugano, Marcelo Britto Passos Amato, Carlos Roberto Ribeiro Carvalho, Otavio Berwanger, Alexandre Biasi Cavalcanti
Journal: Intensive Care Medicine (2014)
TCT-648 The Optimal Strategy for Restenosis With Stent Fracture After Drug-Eluting Stent Implantation: Plain Old Balloon Angioplasty vs. Paclitaxel-Coated Balloon vs. Drug-Eluting Stent
Authors: Suguru Otsuru, Kazushige Kadota, Shunsuke Kubo, Yusuke Hyodo, Daiji Hasegawa, Seiji Habara, Takeshi Tada, Hiroyuki Tanaka, Yasushi Fuku, Tsuyoshi Goto, Kazuaki Mitsudo
Journal: Journal of the American College of Cardiology (2014)
STUDIES ON THE PATHOGENESIS OF FEVER
Authors: Helmut H. Hahn, David C. Char, Wilfred B. Postel, W. Barry Wood
Journal: The Journal of Experimental Medicine (1967)

Macrophages from oil-induced peritoneal exudates in rabbits produce endogenous pyrogen when first activated by incubation in 4 hr exudate fluid and then stimulated by incubation in potassium-free isotonic sodium chloride solution. The failure of earlier investigators to obtain pyrogen from macrophages is explained, and the relevance of macrophage pyrogen to fevers of agranulocytosis and other diseases, in which mononuclear rather than granulocytic exudates predominate, is discussed.
Going to law to get treatment.
Authors: C Dyer
Journal: BMJ (1987)

Judicial review as a remedy for National Health Service patients in Britain who suffer delays in, or even denial of, treatment is explored. Two cases are described where publicity combined with the threat of legal action and pressure from members of Parliament rather than a court ruling resulted in patients receiving the treatment they sought, even though the Court of Appeal turned down one patient's application on the day he had his operation. The court may review NHS decisions, but jurisdiction will be exercised sparingly, and only if the Secretary of State's discretion has been exercised "unreasonably" according to the "Wednesbury principle." This principle holds that "a person entrusted with a discretion must...call his own attention to the matters he is bound to consider [and] exclude from his consideration matters which are irrelevant."
Cesarean Section
Authors: Ben P. Sachs
Journal: JAMA (1983)

We studied the effects of cesarean section on neonatal mortality for breech infants and low-birth weight vertex infants using data from the Georgia neonatal surveillance network on 392,241 singleton deliveries between 1974 and 1978. The risk of neonatal death for breech infants weighing 4,000 g or less delivered vaginally was significantly higher than the risk for those delivered by cesarean section. The lower the birth weight, the higher the risk for a vaginal breech delivery. For breech infants weighing 1,000 to 2,500 g, the risk was almost 2 1/2 times greater for a vaginal delivery<i>v</i>a cesarean delivery. The best outcome for high-risk vertex infants weighing 1,000 to 1,500 g was for those delivered by cesarean section in a tertiary perinatal center. An increase in the cesarean section rate may be associated with increased neonatal survival; however, the benefits must be weighed against the costs of an increased maternal mortality and morbidity. (<i>JAMA</i>1983;250:2157-2159)
Temporal Changes in Coronary Revascularization Procedures, Outcomes, and Costs in the Bare-Metal Stent and Drug-Eluting Stent Eras
Authors: Jason Ryan, Walter Linde-Zwirble, Luella Engelhart, Liesl Cooper, David J. Cohen
Journal: Circulation (2009)

Although drug-eluting stents have been shown to be cost-effective compared with bare-metal stents for select clinical trial patients, whether these findings apply to the general population is unknown.We used data from the Medicare 5% Standard Analytic Files to compare the practice and outcomes of coronary revascularization (by either percutaneous coronary intervention or coronary artery bypass grafting) in the United States between 2001 (pre-drug-eluting stent era, n=14 362) and 2004 (post-drug-eluting stent era, n=16 374). Between 2001 and 2004, the rate of revascularization increased from 837 to 931 per 100 000, whereas the proportion of patients who underwent percutaneous coronary intervention as an initial revascularization procedure increased from 67.5% to 75.2% (P<0.001). Over a median follow-up period of 25.5 months, no significant changes in mortality were found between 2001 and 2004 (13.8% versus 13.3%, P=0.193). Significant decreases were seen, however, in the incidence of repeat revascularization (17.1% versus 16.0%, P=0.012) and myocardial infarction (10.6% versus 8.5%, P<0.001). Over this same time period, total cardiovascular care costs per revascularized patient decreased by $1680 (95% confidence interval $1164 to $2196, P<0.001) whereas total noncardiovascular costs increased by $2481 per patient (95% confidence interval $1844 to $3118, P<0.001). When the impact of overall procedural volumes was considered, aggregate cost to the Medicare program for cardiovascular services increased by $544 million over the 2-year follow-up period. Risk-adjusted results for both the clinical and economic outcomes showed similar trends.Among the Medicare population undergoing coronary revascularization, the introduction of drug-eluting stents was associated with increased use of initial percutaneous coronary intervention and reduced bypass surgery along with improved clinical outcomes over approximately 2 years of follow-up. Although total cardiovascular-related costs per revascularized patient decreased over this time period, total cost to the Medicare system still increased owing to greater overall use of revascularization procedures.
The untouchables: Benefits, costs, and risks of tenure in real cases
Authors: Frank Farley
Journal: Behavioral and Brain Sciences (2006)

The exceptional importance of the Ceci et al. study for the debate over tenure is noted, particularly the perceived importance of academic rank relative to tenure status. Beyond the significance of academic freedom lie important issues of the costs and benefits of tenure that now need to be addressed in equally rigorous research involving extensive, detailed consideration of actual cases.
Someone for Syndromes
Authors: Wallace Marshall
Journal: JAMA (1964)

<h3>To the Editor:—</h3> Your editorial, "Anyone For Syndromes?" (<i>JAMA</i><b>190</b>:465 [Nov 2] 1964), has a modicum of truth but authors must be given some credit for keeping themselves aware of new concepts and events. It is very easy to be hypercritical and satisfied with one's own smugness while writing an editorial. After all, many physicians desire to improve themselves intellectually—whether or not they discover new syndromes. Through this editorial, which is far from being humorous or cute, if you intended it to be so, you are asking doctors not to be themselves. Just because you desire conformity is no sign others must follow suit. Conformity is not a sign of actual progress. Freedom of expression still remains paramount, whether it is in voting or in writing medical articles!
Reservations about conservative surgery for early breast cancer
Authors: E A Benson
Journal: BMJ (1996)

EDITOR,—Several points need to be made before there is a wholesale switch to conservative surgery for breast cancer.1

I find the proposal that tumours up to 4 cm in diameter are suitable for conservation surgery extremely worrying. Whenever new and apparently less radical treatment becomes available it is important that patients should be carefully selected. Experience in Nottingham suggested that tumour size of over 2 cm was a risk factor for local …
Urinary Saturation Measurements in Calcium Nephrolithiasis
Authors: DAVID V. WEBER
Journal: Annals of Internal Medicine (1979)

Urinary saturation with respect to calcium oxalate monohydrate was measured in 111 consecutive patients with calcium nephrolithiasis. Each patient also was evaluated by a detailed conventional metabolic protocol. Patients with idiopathic hypercalciuria produced abnormally oversaturated urine more frequently than normal subjects and normocalciuric patients, but normocalciuric patients had unexpectedly high levels of urine saturation. Measuring levels of calcium concentration, oxalate concentration, or the chemical concentration product of calcium and oxalate in urine did not predict oversaturation. During thiazide treatment, saturation level tended to fall if it was initially elevated, whether the patient was hypercalciuric or not. Patients whose urine was not remarkably oversaturated showed no tendency to elaborate even less saturated urine during thiazide treatment; instead, the average calcium oxalate saturation level remained constant. Direct urine saturation measurements can detect a small but significant number of normocalciuric patients who have marked oversaturation with respect to calcium oxalate and appear to benefit from treatment.
Ignore fairy tales when campaigning for NHS reform
Authors: Stephen I Black
Journal: BMJ (2005)

Time to wake up to cancer's tollEditor-As exemplified by your theme issue on Africa of 1 October, cancer has remained comparatively neglected in Africa although increasingly prevalent: 70% of people with cancer live in the economically developing world, where by 2020 the annual death toll is predicted to reach 20 million. 1 In sub-Saharan Africa measures to prevent cancer emphasised in the developed world-such as smoking cessation and screening-are not nationally adopted.One third of African cancers are preventable, but the influence of tobacco companies with mass media advertising and high crop payments is real.Traditional cancers, such as gastric and hepatocellular carcinoma, and newer cancers, such as lung cancer, breast cancer, and AIDS related Kaposi's sarcoma, are increasing in incidence. 2 3 Patients' expectations for oncological treatment are low in Africa.Lack of money, or a concern not to place their family in debt, prevents many from seeking medical help. 4 Lack of awareness of predisposing factors, warning symptoms or signs of cancer, or treatment options mean that patients present late.Cost and difficulty of travel over rough terrain also discourage service use.After diagnosis patients may tend to look for peace of mind and spiritual comfort rather than a physical cure.In Africa disease modifying cancer treatment and basic control of symptoms are largely absent.Even when analgesia is available, patients with cancer may experience severe and inadequately managed pain, as health professionals underprescribe strong analgesics, fearing drug dependency. 5 Individual sub-Saharan countries cannot tackle the challenges of cancer in isolation.A new, cooperative approach and research base are being advocated for preventing, treating, and palliating cancer to bridge the gap between developed and developing nations.