tbuckley/cabot-search huggingface dataset:
Saving (Internal) Medicine
Authors: Ashok V. Daftary
Journal: Annals of Internal Medicine (2006)

Letters2 May 2006Saving (Internal) MedicineAshok V. Daftary, MDAshok V. Daftary, MDFrom Sutter Gould Medical Group, Stockton, CA 95210.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-144-9-200605020-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A thoughtful editorial (1) bemoans a decline in the number of practicing internists but admits to a paucity of information in literature and among physician workplace researchers to explain its causes. I have previously made comments (2) relevant to this problem. Thirty years of practice as an internist allow me to make further observations.Academic medicine is the carpenter that fashioned the coffin of internal medicine. Instead of reengineering internal medicine to accommodate change, it cannibalized the discipline by reducing its worth, creating the hospitalist and ambulatory care internist. These were both nails that helped seal the ...References1. Sox HC. Leaving (internal) medicine [Editorial]. Ann Intern Med. 2006;144:57-8. [PMID: 16389255] LinkGoogle Scholar2. Daftary AV. Reimbursement [Letter]. Accessed at www.acponline.org/journals/news/march04/letters.htm on 13 March 2006. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Sutter Gould Medical Group, Stockton, CA 95210.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLeaving (Internal) Medicine Harold C. Sox Who Is Maintaining Certification in Internal Medicine—and Why? A National Survey 10 Years after Initial Certification Rebecca S. Lipner , Wayne H. Bylsma , Gerald K. Arnold , Gregory S. Fortna , John Tooker , and Christine K. Cassel Saving (Internal) Medicine Richard L. Neubauer Metrics Cited byStructural Studies of the Sputnik VirophageThe Mimivirus Genome Encodes a Mitochondrial Carrier That Transports dATP and dTTPMimivirus Giant Particles Incorporate a Large Fraction of Anonymous and Unique Gene Products 2 May 2006Volume 144, Issue 9Page: 702KeywordsAcademic medicineConflicts of interestHospitalistsMemorySub-specialty care ePublished: 2 May 2006 Issue Published: 2 May 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
DO PATIENTS WITH SEVERE ASYMPTOMATIC CAROTID ARTERY STENOSIS HAVE A HIGHER RISK OF STROKE AND MORTALITY FOLLOWING CORONARY ARTERY BYPASS GRAFTING?
Authors: Michael Mahmoudi, Peter Hill, Zhenyi Xue, Rebecca Torguson, Gholam Ali, Steven Boyce, Ammar Bafi, Paul Corso, Ron Waksman
Journal: Journal of the American College of Cardiology (2011)
Mark Twain's Cat
Authors: George M. Andes
Journal: Annals of Internal Medicine (1998)

On Being a Patient15 June 1998Mark Twain's CatGeorge M. AndesGeorge M. AndesWorcester, MA 01602Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-12_Part_1-199806150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Mark Twain has been credited with the following bit of wisdom: “The boy who carries a cat around by its tail learns a lesson that can be taught in no other way.”Fourteen years ago, I discovered I was holding a cat by its tail. My cat was a great-grandchild of the breed first identified in 1817 by James Parkinson. In the beginning, my cat was a small kitten-a bad-tempered kitten, to be sure, but still just a kitten.Those of us with a chronic, progressive illness are scarce enough to be objects of mild curiosity but also common enough ... Author, Article, and Disclosure InformationAuthors: George M. AndesAffiliations: Worcester, MA 01602Acknowledgments: The author thanks Oscar E. Starobin, MD, for encouraging him to submit this article for publication. The article was prepared from a Commencement address given in June 1996.Corresponding Author: George M. Andes, 51 Hunthurst Circle, Worcester, MA 01602. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWhat to Try When Nothing’s WorkingDisabilityMark Twain's CatLloyd W. Kitchens Jr., MD 15 June 1998Volume 128, Issue 12_Part_1Page: 1043-1044KeywordsBehaviorChildrenForecastingHabitsMuscular dystrophiesParkinson diseaseProgressive diseasesRheumatoid arthritisSleepWheelchairs ePublished: 15 August 2000 Issue Published: 15 June 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The expanding spectrum of<scp>I</scp>g<scp>A</scp>pemphigus: a case report and review of the literature
Authors: S. Geller, A. Gat, T. Zeeli, A. Hafner, R. Eming, M. Hertl, E. Sprecher
Journal: British Journal of Dermatology (2014)

IgA pemphigus (IGAP) is a rare, distinct variant of pemphigus, currently classified, depending upon the histological features, immunofluorescence staining pattern and autoantibody profile, into two types: subcorneal pustular dermatosis (SPD) and intraepidermal neutrophilic IgA dermatosis. In a patient with a widespread blistering disease of the skin resembling SPD-type IGAP, we demonstrate the coexistence of IgA reactivity to both epidermal (desmocollins 2 and 3) and basement membrane-associated (BP180) proteins, suggesting the coexistence of atypical IGAP and linear IgA bullous dermatosis, respectively. This case, together with 20 previous reports of atypical IGAP, underscores the limitations of current classification schemes. Therefore, we suggest reclassifying these cases under the general term 'IGAP spectrum'.
Cost-effectiveness of Monoclonal Antibodies to Gram-negative Endotoxin in the Treatment of Gram-negative Sepsis in ICU Patients
Authors: Donald B. Chalfin
Journal: JAMA (1993)

<h3>Objective.</h3> —To evaluate the fiscal impact and the cost-effectiveness of monoclonal antibodies against gram-negative endotoxin (MAbGNE) in the treatment of presumed gram-negative sepsis. <h3>Design.</h3> —A decision analysis model was developed from (1) data from two phase III trials that studied the E5 or HA-1A MAbGNE, and (2) financial data from 1405 septic patients who required intensive care at a large tertiary hospital. <h3>Setting.</h3> —Intensive care unit (ICU) patients with presumed gram-negative sepsis. <h3>Patients.</h3> —The E5 trial evaluated 468 patients, and the HA-1A study enrolled 543 patients with presumed gram-negative sepsis. <h3>Interventions.</h3> —The addition of MAbGNE to standard regimens or standard regimens alone. <h3>Main Outcome Measures.</h3> —Total expected charges and the expected probability of survival were determined for each option. Cost-effectiveness and marginal cost-effectiveness ratios were also derived. Multiple sensitivity and Monte Carlo analyses were performed to test the underlying assumptions. <h3>Results.</h3> —MAbGNE therapy always resulted in higher expected charges; however, these differences were less than its acquisition cost by $870. The cost-effectiveness ratio for MAbGNE, for $2000 and $4000 acquisition costs, was $71 674 and $74 900 per probability of survival, respectively. Sensitivity analysis showed that cost-effectiveness was most affected by diagnostic accuracy, patient selection, and acquisition cost. Monte Carlo analysis showed that MAbGNE was more costly for 71% of simulations, yet the most efficacious option for 79% of simulations. <h3>Conclusions.</h3> —From the perspective of acute care institutions, MAbGNE is expensive and cannot be justified on a cost-saving basis. However, it may be cost-effective throughout a reasonable range of assumptions. (<i>JAMA</i>. 1993;269:249-254)
CRITICAL RELATIONSHIPS BETWEEN CONSTITUENTS OF THE ANTIGEN-ADJUVANT EMULSION AFFECTING EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS IN A COMPLETELY SUSCEPTIBLE MOUSE GENOTYPE
Authors: Johanna M. Lee, Howard A. Schneider
Journal: The Journal of Experimental Medicine (1962)

The production of EAE in the fully susceptible BSVS mouse genotype has been found to be dependent on the ratio of proteolipid antigen and adjuvant mycobacterial concentration as used in the emulsion, of the Freund type. Disturbance of this ratio, by manipulation of either component, by diminution or increase, results in a decrease in the frequency by which EAE is produced. Simultaneous reduction of antigen and mycobacteria, so that the ratio remains unchanged, retains the full EAE-producing power of the emulsion. The limit of this has not been ascertained. Emulsifying agents have been found to restrict further the permissible limits of the antigen-mycobacterial ratio for full EAE production. Such effects of the emulsifier have been found to vary with the qualitative nature of the emulsifier. Aquaphor has been found to be less restrictive than falba. These phenomena, systematically analyzed here for the mouse, may have an application for other antigen-adjuvant systems and for other hosts.
Radio: Beyond the Genome
Authors: J. Emery
Journal: BMJ (2002)

BBC Radio 4, Wednesdays at 9 pm, 2 to 23 January 2002 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> The post-genomic era promises to offer new insights into the nature of disease, its prevention, and treatment. But now that we have a draft code of the human genome, what does this knowledge mean and how might it be applied? In these four programmes (the first two of which were available for preview), Steve Jones—who has done much to make genetics more accessible to the public through his writing—provides some answers. The first programme starts with the age-old debate of nature versus nurture. It uses two cross-cutting themes to … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Anaemia in the elderly.
Authors: J H Thomas
Journal: BMJ (1973)

Anaemia is always pathological and the clinical impression of its presence or absence often erroneous; it is not a con- comitant of ageing.The reported incidence has varied greatly.Pincherle and Shanks' found it in only 0-42% of 2,000 busi- ness executives, 300 of whom were over 60 years.On the other hand, Parsons and his colleagues,2 in a community survey, found an incidence of 7-2% in men and 11-1% in women in the age group 65-74 years, and in 20-8% and 23-3% respec- tively in those who were older.The Health Department's Nutritional Panel3 gave a figure of 7 3%, which was about the same for men and women.The incidence among hospital ad- missions is about 30%.The following groups of old people are particularly at risk of developing anaemia: those living alone, with mental deteri- oration, with apathy or depression, over 75 years of age, with diminished mobility, who have had gastric surgery, and who have been anaemic in the past. CausesOccult bleeding from the gastrointestinal tract is a frequent cause, but others-including insufficient intake of nutrients, diminished absorption, and general disease-are also impor- tant.Contributory factors, such as atrophic gastritis, chronic infection, carcinoma, renal disease, and the development of antibodies may also be present, and several factors may oper- ate simultaneously.Red cells from the marrow circulate for about 120 days and are then destroyed by the reticuloendothelial system, their iron and globin being reutilized.Derangement at any stage leads to anaemia.
Effect Size Estimates of Lifestyle and Dietary Changes on All-Cause Mortality in Coronary Artery Disease Patients
Authors: J.A. Iestra, D. Kromhout, Y.T. van der Schouw, D.E. Grobbee, H.C. Boshuizen, W.A. van Staveren
Journal: Circulation (2005)

Guidelines for lifestyle and dietary modification in patients with coronary artery disease (CAD) are mainly supported by evidence from general population studies. CAD patients, however, differ from the general population in age (older) and treatment with preventive drugs. This review seeks to provide evidence for a prognostic benefit of lifestyle and dietary recommendations from studies in CAD patients.A literature search was performed on the effect of lifestyle and dietary changes on mortality in CAD patients. Prospective cohort studies and randomized controlled trials of patients with established CAD were included if they reported all-causes mortality and had at least 6 months of follow-up. The effect estimates of smoking cessation (relative risk [RR], 0.64; 95% CI, 0.58 to 0.71), increased physical activity (RR, 0.76; 95% CI, 0.59 to 0.98), and moderate alcohol use (RR, 0.80; 95% CI, 0.78 to 0.83) were studied most extensively. For the 6 dietary goals, data were too limited to provide reliable effect size estimates. Combinations of dietary changes were associated with reduced mortality (RR, 0.56; 95% CI, 0.42 to 0.74).Available studies show convincingly the health benefits of lifestyle changes in CAD patients. Effect estimates of combined dietary changes look promising. Future studies should confirm these findings and assess the contribution of the individual dietary factors.
ACE, MACE, and GRACE: Time to Put the Pieces Together
Authors: Lisa M. Walke, Mary E. Tinetti
Journal: JAMA Internal Medicine (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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
THE INITIATING AND PROMOTING ELEMENTS IN TUMOR PRODUCTION
Authors: William F. Friedewald, Peyton Rous
Journal: The Journal of Experimental Medicine (1944)

Benzpyrene brings about neoplastic changes in rabbit epidermis much sooner than has been supposed. The long interval that elapses before visible growths appear is due in the main to the relatively slight power of the carcinogen to encourage multiplication of the cells it renders neoplastic. Yet some slight power of this sort it has. Methylcholanthrene has somewhat more but not nearly so much as tar. It may initiate neoplastic changes within less than 17 days, as compared with less than 10 days for tar, but tumors due to it do not ordinarily appear until months after those called forth by tarring. All three agents give rise to growths of essentially the same kinds, but most of those due to benzpyrene and methlycholanthrene remain for a long while small, dry, and indolent whereas many of the tar tumors are fleshy, vigorous, and rapidly enlarging,-differences wholly consequent on differences in the ability to promote growth. Such ability is an important element in the effectiveness of carcinogens. Tar and the polycyclic hydrocarbons cause many more cells to become tumor cells than give rise to visible growths. Benzpyrene is as effective in initiating neoplastic changes when dissolved in mineral oil as when in benzene, yet no tumors result from it until months after the benzene solution has given rise to them, the reason being that when in oil it is almost devoid of influence to encourage cell proliferation. Benzene itself has a very slight influence of the sort. Solvents may determine not only whether carcinogens initiate neoplastic change but may condition to a crucial degree the influence of these agents to encourage tumor formation. Rabbit epidermis is much more responsive to carcinogenic influences than that of the mouse, as measured in terms of time taken to elicit benign neoplasms. Even benzene will call forth these growths from rabbit skin. In appraising the relative responsiveness to carcinogens of various animal species it is essential to reckon in terms of cells of identical type.
Benetton team designs WHO's road safety posters
Authors: James Maskalyk
Journal: BMJ (2004)

But are images too elegant to drive home true horror of road trauma? 

Road trauma is a leading cause of death and lingering disability around the world. However, low and middle income countries bear a disproportionate part of the global burden. As safety standards improve along with the infrastructure in wealthier nations, the persistent mechanisation of industry and increasingly motorised transportation in developing countries thunders well ahead of the …
Attachment Representation and Cortisol Response to the Adult Attachment Interview in Idiopathic Spasmodic Torticollis
Authors: C.E. Scheidt, E. Waller, H. Malchow, U. Ehlert, F. Becker-Stoll, J. Schulte-Mönting, C.H. Lücking
Journal: Psychotherapy and Psychosomatics (2000)

&lt;i&gt;Objective:&lt;/i&gt; The study investigates individual differences in the mental representation of attachment and their impact on the cortisol response to psychosocial stress in idiopathic spasmodic torticollis (IST). It was hypothesized (a) that in IST insecure attachment is more prevalent than in a non-clinical control group and (b) that subjects with dismissing attachment respond with higher physiological arousal to a specific stimulus activating the attachment behavioural system than subjects with secure attachment. &lt;i&gt;Method:&lt;/i&gt; 20 patients with IST and 20 healthy controls matched for age and sex underwent the Adult Attachment Interview, an hour-long, semiclinical interview on attachment experiences. During the interview salivary cortisol levels were monitored. The subjects’ mental state with regard to attachment was classified using the attachment Q-sort method. Anxiety and depression were measured as potential covariates of the adrenocortical stress response. &lt;i&gt;Results:&lt;/i&gt; Compared to the non-clinical group, dismissing attachment was strongly overrepresented in IST. In IST, but not in the healthy control group, dismissing attachment correlated with an elevated cortisol response to the interview. &lt;i&gt;Conclusion:&lt;/i&gt; In clinical, but not in non-clinical samples dismissing attachment may be associated with increased vulnerability to psychosocial stress. The factors contributing to this interaction are not yet fully elucidated.
Treating Cancer With Coffee Enemas and Diet
Authors: Benjamin T. Brown
Journal: JAMA (1993)

<h3>To the Editor.</h3> —It is crucial that we, as physician-scientists, remain objective especially when dealing with matters that are as emotive as the diet and cancer issue. The Special Communication entitled "A Critique of the Rationale for Cancer Treatment With Coffee Enemas and Diet"<sup>1</sup>carries a proselytizing tone against this therapy, as much as those who proselytize for the therapy. Can't we in the medical profession rise above this type of subjectivity? The author identified only those aspects of the Gerson therapy that cannot be supported by current scientific knowledge. He conspicuously omits references to the Gerson therapy's emphasis on fresh fruits and vegetables as a high-quality vitamin source, which has been strongly suggested to be of potential benefit in recent medical literature. He does not comment on the proposed long-term effects of our contemporary sodium-rich, potassium-poor diet on cellular function, the reversal of which formed a large part of
Treatment of Peripheral Arterial Occlusion by Streptokinase Perfusion
Authors: G. P. McNicol, W. Reid, W. H. Bain, A. S. Douglas
Journal: BMJ (1963)

Pretreatment with SKF No. 525-A prolonged the hypnotic action of secobarbital, pentobarbital, hexobarbital, amobarbital, butethal, Ortal, phenobarbital and chloral hydrate. On the other hand, the hypnotic action of barbital, thioethamyl, thiopental and methylparafynol was not prolonged by pretreatment with SKF No. 525-A. Thus, it is apparent that SKF No. 525-A exhibited a certain degree of selectivity insofar as the agents which it potentiates are concerned.
Pulmonary function tests in HIV-infected patients without AIDS. Pulmonary Complications of HIV Infection Study Group.
Authors: M J Rosen, Y Lou, P A Kvale, A V Rao, M C Jordan, A Miller, J Glassroth, L B Reichman, J M Wallace, P C Hopewell
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

To determine the prevalence, incidence, and types of lung diseases that occur in association with HIV infection, 1,353 subjects, including HIV-seropositive homosexual men, injection drug users, female sexual partners of HIV-positive men, and HIV-seronegative control subjects from the first two transmission categories were evaluated prospectively in a multicenter study. Patients with AIDS at the time of initial evaluation were excluded. One thousand two-hundred ninety-four subjects who had no AIDS-defining diagnosis within 3 mo of enrollment had measurements of FVC, FEV1 and DLCO at the time of enrollment. As a group, all subjects had mean values of FVC and FEV1 close to 100% predicted. Those with CD4 counts below 200/mm3 had slightly reduced DLCO compared with the others. Subjects with a history of HIV-associated symptoms (thrush, weight loss, herpes zoster) also had a reduced DLCO compared with those without symptoms. Injection drug users had reduced FVC, FEV1 and DLCO compared with homosexual men and female sexual partners of HIV-infected men, with DLCO more substantially reduced. Part of the reduction in DLCO in drug users was attributable to factors other than HIV infection, especially cigarette smoking and race. Using predicted values that take cigarette smoking into account, the prevalence of abnormality in DLCO was higher among injection drug users (33.3%) than among homosexual men (11.2%) and female sexual partners (12.7%). These results show that advanced HIV infection, characterized by CD4 count < 200/mm3 or HIV-associated symptoms, and factors unrelated to HIV infection, including race, cigarette smoking, and injection drug use, are all associated with reductions in DLCO measurements.
Cuba pledges 165 health workers to treat Ebola patients in Sierra Leone
Authors: A. Gulland
Journal: BMJ (2014)

The World Health Organization's director general, Margaret Chan, has welcomed the Cuban government's offer of 165 nurses and doctors to join the medical response to the outbreak of Ebola virus disease, while reiterating the desperate need for health staff.In a joint press conference with Chan, Cuba's health minister, Roberto Morales Ojeda, said that 62 doctors and 103 nurses, all experienced in foreign medical missions, would be travelling to Sierra Leone at the beginning of October to help in the worst ever outbreak of Ebola virus disease.Chan thanked the Cuban government for its "generosity and solidarity" but said that in the three worst affected countries-Sierra Leone, Liberia, and Guinea-the outbreak was moving faster than the government and international partners could control it.In Liberia recently 70 patients turned up to be treated in a new healthcare facility for 30 patients, said Chan.She added that "today there is not one single bed" in the whole of Liberia for the treatment of patients with the disease.
Performance of a constant torque pedal device.
Authors: K. Sherwin
Journal: British Journal of Sports Medicine (1979)

A constant-torque oscillatory pedal-crank device using vertical movement of the feet is described and its performance compared to a conventional rotational cycle. Using a generator to measure the power output the constant-torque device produced 33% less power and thus has no practical value as an alternative to the conventional pedal-crank system.