tbuckley/cabot-search huggingface dataset:
Kawasaki Disease Without Epstein-Barr Virus
Authors: Stuart Trust
Journal: JAMA (1979)

<h3>To the Editor.—</h3> The association of Epstein-Barr virus with Kawasaki disease (mucocutaneous lymph node syndrome) proposed by Barbour et al (241:397, 1979) was examined by following up the viral capsid antigen titers in a patient with this entity. We could not demonstrate any prior experience with Epstein-Barr virus in our patient. <h3>Report of a Case.—</h3> A 6-year-old white girl was admitted to the hospital on July 23, 1978, with Kawasaki disease. The diagnosis was based on findings that met the six criteria established by the Center for Disease Control.<sup>1</sup>These included the following: (1) temperature elevation 38 to 40 °C of six days' duration that did not respond to antibiotic treatment, (2) conjunctival congestion bilaterally, with no exudate, (3) brightly erythematous and edematous oral and pharyngeal mucosa, with brightened dry and cracked lips, (4) erythema and edema of the palmar and plantar surfaces, (5) a truncal maculopapular rash, and (6)
Getting to know yourself … and others
Authors: Candice M. Mills, Judith H. Danovitch
Journal: Behavioral and Brain Sciences (2009)

Abstract Carruthers rejects developmental evidence based primarily on an argument regarding one skill in particular: understanding false beliefs. We propose that this rejection is premature; and that identifying and examining the development of other subcomponent skills important for metacognition and mindreading, such as the ability to assess levels of knowledge, will in fact be useful in resolving this debate.
Urea and the Sickle Cell Crisis
Authors: Raymond L. Henry
Journal: JAMA (1974)

<h3>To the Editor.—</h3> Intravenous urea therapy for acute sickle cell crisis has been evaluated as ineffective in controlled studies undertaken by the Co-operative Urea Trials Groups.<sup>1,2</sup>These reports are flawed by (1) a breach of the scientific method and (2) an overreaching and therefore misleading conclusion. The dazzling demonstration of scientific amenities in these articles may divert the reader from serious defects. The statement that we have stated and published several times has never been challenged and still holds: Where our protocols have been faithfully followed, there has not been a therapeutic failure, a medical misadventure, or a death. It is a fundamental rubric of science that investigators first duplicate original methods to verify claims. This principle was violated in these reports since protocols other than ours were used in these studies. Furthermore, the conclusion that intravenous urea therapy is ineffective in acute sickle cell crisis is too broad
Biomarkers for Prediction of Cardiovascular Events—Reply
Authors: Olle Melander, Christopher Newton-Cheh, Thomas J. Wang
Journal: JAMA (2009)

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
PHARMACOLOGY AND DRUG THERAPY
Authors: Norman A. David
Journal: JAMA (1966)

With the great influx of new therapeutic agents, the physician feels frustrated in having to depend on promotional literature for information. Rarely has he an opportunity to read the fine print of the package insert which, by law, now serves as a legal document giving "complete disclosure" of the uses, effectiveness, and toxicity of a preparation. What is needed is an authoritative drug reference book which would adequately and truthfully describe the actions and uses of the thousands of drug preparations now available. <h3>Textbooks</h3> Two new editions of major general texts appeared in 1965. Both are magnificent works and similar in size, scope, and cost.<i>Drill's Pharmacology in Medicine</i>, skillfully edited by J. Di Palma (ed 3, Blakiston, 1965, $22.50), appeared first. Each of the 93 authors injects his own style, knowledge, and judgment in the complete revision of the 91 chapters. The result is a very readable set of
Disclosure of medical error: policies and practice
Authors: J. Kalra
Journal: Journal of the Royal Society of Medicine (2005)

In any healthcare process, some error is inevitable.1 As indicated in the US Institute of Medicine's report To Err is Human,2 the challenge is to cut the rate of error to a minimum. In Canada, various strategies are being applied to this end and the Federal Government has established a Patient Safety Institute. The UK likewise has a National Patient Safety Agency. However, in the many countries3 where efforts are being made to reduce adverse events and errors, a neglected issue is honest disclosure to the patient or family. In this paper we examine the central issues, discuss the dilemmas concerning 'apology' and suggest how we might work towards a systematic and effective process.
Studies of osmotic diarrhea induced in normal subjects by ingestion of polyethylene glycol and lactulose.
Authors: H F Hammer, C A Santa Ana, L R Schiller, J S Fordtran
Journal: Journal of Clinical Investigation (1989)

The purpose of these studies was to gain insight into the pathophysiology of pure osmotic diarrhea and the osmotic diarrhea caused by carbohydrate malabsorption. Diarrhea was induced in normal volunteers by ingestion of polyethylene glycol (PEG), which is nonabsorbable, not metabolized by colonic bacteria, and carries no electrical charge. In PEG-induced diarrhea, (a) stool weight was directly correlated with the total mass of PEG ingested; (b) PEG contributed 40-60% of the osmolality of the fecal fluid, the remainder being contributed by other solutes either of dietary, endogenous, or bacterial origin; and (c) fecal sodium, potassium, and chloride were avidly conserved by the intestine, in spite of stool water losses exceeding 1,200 g/d. Diarrhea was also induced in normal subjects by ingestion of lactulose, a disaccharide that is not absorbed by the small intestine but is metabolized by colonic bacteria. In lactulose-induced diarrhea, (a) a maximum of approximate 80 g/d of lactulose was metabolized by colonic bacteria to noncarbohydrate moieties such as organic acids; (b) the organic acids were partially absorbed in the colon; (c) unabsorbed organic acids obligated the accumulation of inorganic cations (Na greater than Ca greater than K greater than Mg) in the diarrheal fluid; (d) diarrhea associated with low doses of lactulose was mainly due to unabsorbed organic acids and associated cations, whereas with larger doses of lactulose unmetabolized carbohydrates also played a major role; and (e) the net effect of bacterial metabolism of lactulose and partial absorption of organic acids on stool water output was done dependent. With low or moderate doses of lactulose, stool water losses were reduced by as much as 600 g/d (compared with equimolar osmotic loads of PEG); with large dose, the increment in osmotically active solutes within the lumen exceeded the increment of the ingested osmotic load, and the severity of diarrhea was augmented.
Advertisements for doctors with particular religious beliefs
Authors: T J Hamblin
Journal: BMJ (1983)

child whose parents are typhoid carriers.Health visitors and general practitioners would have to become more involved than at present, but at least health visitors have a statutory right of entry.Social work would continue to be vital: it would be wrong (and impossible) to take all these children into care, and with skilled help such as that available at present most of the problem families could be kept together, to the eventual benefit of the children.But the decision to intervene would not have to be taken by a social worker and his senior colleagues, who would perhaps be deeply involved in helping the family.A case conference called by a community doctor would be more likely to be attended by the general practitioner caring for the family.
Doctor of Primary Medicine
Authors: Jack Froom
Journal: JAMA (1972)

<h3>To the Editor.—</h3> It is apparent to one who has been a primary care physician that the skills required for comprehensive, longitudinal family medical care, with modifications based on the realities of community healthcare needs, plus meaningful, concerned interactions with families and individuals expressing psychosocial problems, require the highest level of scientific skills and individual maturity. It is difficult to believe that a shortened training period, as suggested by Dr. Proger, would be conducive to the production of such a physician, unless one proposes that the PMD change his goals and act as a sophisticated medical first aid person. On the other hand, it may well be that such a period of training might be suitable for the provision of skills required to perform portions of tasks now done by other specialists. One might propose such new specialties as nonsurgical ophthalmologist, orthopedist, and obstetrician, as examples. There is no wish
Spinal and General Anesthesia
Authors: Simon V. Scalia
Journal: JAMA (1983)

To the Editor.—  Spielman and Watson, in their article entitled Spinal Anesthesia (1983;249:734), present an overly optimistic view of spinal anesthesia. However, there are caveats to be noted.   Arterial hypotension induced by spinal anesthesia that can be eliminated by 500 to 1,000 mL of fluid or α-and β-stimulating drugs places the cardiac patient at high risk, since he may be unable to tolerate such therapy. Overall mortality, postoperative myocardial infarction, and arrhythmia are not diminished by spinal anesthesia.1 In the elderly with hip fractures, spinal and general anesthesia have the same mortality.2  Although evidence may indicate that a normal person does not suffer impaired resting ventilation, patients with pulmonary disease are at high risk for pulmonary complications. With general anesthesia and intubation, support and convalescence can be continued as long as needed.2   There is no question that spinal anesthesia is safe in a normal person,
Reasonable Accommodations for Medical Faculty With Disabilities
Authors: Annie G. Steinberg
Journal: JAMA (2002)

An unknown number of medical school faculty have disabilities, and their experiences have generally escaped notice and scrutiny. Although most medical schools offer long-term insurance and extended leaves of absence for disability, relatively few have policies explicitly addressing accommodations for faculty with disabilities as they perform teaching, research, and clinical duties. We discuss accommodating active medical school faculty with disabilities, drawing on University of Pennsylvania School of Medicine initiatives exploring the concerns of faculty with sensory and physical disabilities. Anecdotal reports suggest that many faculty, fearing reprisals, resist seeking job accommodations such as those mandated in the 1990 Americans with Disabilities Act (ADA). Although some faculty with disabilities have found supportive academic mentors, others report that lax institutional enforcement of ADA requirements, including physical access problems, demonstrates a tepid commitment to disabled staff. Potentially useful job accommodations include adjusting timelines for promotion decisions; reassessing promotions requirements that inherently require extensive travel; improving physical access to teaching, research, and clinical sites; and modifying clinical and teaching schedules. Faculty with disabilities bring identical intellectual and collegial benefits to medical schools as their nondisabled counterparts. In addition, they may offer special insights into how chronic illness and impairments affect daily life.
Medical School Admission Interview and Licensing Examination Scores—Reply
Authors: Kevin W. Eva, Geoffrey R. Norman
Journal: JAMA (2013)

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
Diffuse Lung Disease in Young Children
Authors: Gail H. Deutsch, Lisa R. Young, Robin R. Deterding, Leland L. Fan, Sharon D. Dell, Judy A. Bean, Alan S. Brody, Lawrence M. Nogee, Bruce C. Trapnell, Claire Langston, Eric A. Albright, Frederic B. Askin, Peter Baker, Pauline M. Chou, Carlyne M. Cool, Susan C. Coventry, Ernest Cutz, Mary M. Davis, Megan K. Dishop, Csaba Galambos, Kathleen Patterson, William D. Travis, Susan E. Wert, Frances V. White
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Considerable confusion exists regarding nomenclature, classification, and management of pediatric diffuse lung diseases due to the relative rarity and differences in the spectrum of disease between adults and young children.
Clinical Experience with the Transvenous Catheter Pacemaker.
Authors: Harold S. Marcus
Journal: Annals of Internal Medicine (1965)

s1 May 1965Clinical Experience with the Transvenous Catheter Pacemaker.Harold S. Marcus, M.D., Richard S. Goodwin, M.S., Joseph M. Ryan, M.D., F.A.C.P., Charles F. Wooley, M.D.Harold S. Marcus, M.D.Search for more papers by this author, Richard S. Goodwin, M.S.Search for more papers by this author, Joseph M. Ryan, M.D., F.A.C.P.Search for more papers by this author, Charles F. Wooley, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-5-1069_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe problem of management of disturbances of cardiac impulse formation and transmission has been long standing. In the past 2 years we have treated 40 such patients (aged 9 to 90) with a transvenous dual electrode catheter pacemaker.Twenty-five patients had either intermittent or established heart block and were paced with the transvenous electrode as primary management of the Adams-Stokes syndrome and as a temporary measure prior to implantation of a permanent pacer unit. In the majority of these patients the catheter was inserted as an emergency procedure as part of a resuscitative effort,ral instances was considered lifesaving. No permanent... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Columbus, Ohio PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1965Volume 62, Issue 5Page: 1069-1069KeywordsCathetersHeartPacemakers Issue Published: 1 May 1965 PDF DownloadLoading ...
Genetic Testing and Informed Consent-Reply
Authors: Jeffrey R. Botkin
Journal: JAMA (1997)

<h3>In Reply.</h3> —The purpose of our article was not to advance the debate about informed consent for the use of stored DNA. Our goal was to outline what should be done prospectively when obtaining informed consent for nonanonymous cancer susceptibility tests when the results will be disclosed to individual patients. Drs Page and Jensen overlook 2 important distinctions: one between existing samples and those being obtained in new projects, and the other between identifiable and "anonymized" samples. Are Page and Jensen suggesting that genetic testing on identifiable samples be permitted without specific consent? The authors support institutional review board review of protocols as an alternative to the guidelines emerging from multidisciplinary panels. However, the Office of Protection From Research Risks 1993 guidelines for institutional review boards states in the "Human Genetic Research" section: "Particular attention should be paid to protecting the confidentiality of the data and obtaining consent from the participants for
Gamma-tocopherol Treatment Alters Expression of Cytokine and Major Histocompatibility Molecules
Authors: M. Kwan, J. Wiser, W.J. Brickey, N.E. Alexis, C. Robinette, R.A. Roubey, J.P.Y. Ting, D.B. Peden
Journal: Journal of Allergy and Clinical Immunology (2009)
Delayed clinical and ex vivo response to mammalian meat in patients with IgE to galactose-alpha-1,3-galactose
Authors: Scott P. Commins, Hayley R. James, Whitney Stevens, Shawna L. Pochan, Michael H. Land, Carol King, Susan Mozzicato, Thomas A.E. Platts-Mills
Journal: Journal of Allergy and Clinical Immunology (2014)
Does treatment of hypertension explain the decline in mortality from stroke?
Authors: R Bonita, R Beaglehole
Journal: BMJ (1986)

Mortality from stroke has been declining in New Zealand since 1950 and at an accelerating rate since the early 1970s. Hypertension is the single most important risk factor for stroke. The temporal association between the recent decline in mortality and an increase in the proportion of patients with hypertension detected and treated led to the assumption of a cause and effect relation. Data from studies of the prevalence of blood pressure carried out in the community and from therapeutic trials of the treatment of hypertension were used to estimate the proportion of the decline in mortality from stroke that could be accounted for by increased treatment of hypertension during 1973-82 in New Zealand. Treatment of hypertension was estimated to account for roughly 10% of the observed reduction in deaths from stroke. Greater understanding of the reasons for the decline in mortality from stroke is required.
Efficacy of a single-lead unipolar transvenous defibrillator compared with a system employing an additional coronary sinus electrode. A prospective, randomized study.
Authors: P J Kudenchuk, G H Bardy, G L Dolack, J E Poole, R Mehra, G Johnson
Journal: Circulation (1994)

BACKGROUND Recent development of a prototype single-lead unipolar transvenous defibrillator offers the possibility of device implantation with the ease of a permanent pacemaker. Lowering defibrillation energy requirements would allow for a further reduction in defibrillator generator size and enhance the feasibility of pacemaker-like placement. However, if achieving a lower defibrillation energy requires placing additional intracardiac leads, the potential advantage of a smaller generator may be offset by the disadvantages of a more complex lead system. The purpose of this study was to compare defibrillation energy requirements of a single-lead unipolar defibrillator with a three-electrode system employing an additional lead in the coronary sinus. METHODS AND RESULTS Testing of a single-lead unipolar biphasic pulse defibrillation system versus a three-electrode system with an additional coronary sinus lead was performed in prospective, randomized fashion in 15 patients with a history of ventricular tachycardia or fibrillation. Ventricular fibrillation was induced with alternating current, and defibrillation threshold was measured by a pulse given 10 seconds after arrhythmia induction. The mean defibrillation threshold stored energy and mean leading edge voltage did not significantly differ between the two systems (11.3 +/- 5.9 J versus 9.9 +/- 5.2 J and 418 +/- 118 V versus 390 +/- 112 V, respectively; P &gt; .4). Using either defibrillation system, all patients were successfully defibrillated by &lt; 24 J and over half of patients by &lt; 10 J. CONCLUSIONS A unipolar transvenous biphasic defibrillation system is an effective means of treating ventricular fibrillation. The added complexity of additional leads is not offset by any significant improvement in defibrillation efficacy or energy requirements. Given the simplicity and effectiveness of a single-lead system coupled with a small generator, placement of defibrillation systems may now approach the ease of pacemaker implantation.
Tubular reabsorption of sodium during acute and chronic volume expansion in man
Authors: Edward A. Alexander, David W. Doner, R. Brewer Auld, Norman G. Levinsky
Journal: Journal of Clinical Investigation (1972)

Renal hemodynamics and tubular fractional sodium reabsorption (FSR) were evaluated by clearance techniques during acute and chronic extracellular volume expansion in man. (1 - V/GFR) x 100 was used as an index of proximal and (C(H2O)/V) x 100 as an estimate of distal fractional reabsorption. After acute loading with isotonic saline 37 ml/kg body wt, proximal FSR decreased by 4.8% and distal FSR decreased by 4.4%. After comparable chronic expansion by mineralocorticoids ("escape"), proximal FSR also decreased by 3.9%, but distal reabsorption was not altered.In separate studies, subjects were progressively infused with saline to 57 (E(1)) and to 80 (E(2)) ml/kg body wt, and appeared to divide into "excreters" (maximum U(Na)V > 1000 muEq/min) and "nonexcreters" (maximum U(Na)V < 550 muEq/min). In the excreters, GFR rose, proximal FSR decreased by 7.1% after E(1) and only 0.9% further after E(2). Distal FSR fell by 14.8% after E(1) and by an additional 4.9% after E(2). In the nonexcreters, GFR was stable and proximal FSR did not fall significantly after E(1) or E(2). Distal FSR decreased 4.5% after E(1) and 1.3% further after E(2). It is concluded that both acute and chronic extracellular expansion decrease proximal FSR in man, but only acute loading depresses distal FSR. Ability of some men to excrete sodium rapidly after acute infusion is related to larger increases in GFR and greater decreases in both proximal and distal FSR than occur in men in whom natriuresis is more limited.