tbuckley/cabot-search huggingface dataset:
Graduate Medical Education, 1998-1999
Authors: Rebecca S. Miller, Marvin R. Dunn, Thomas Richter
Journal: JAMA (1999)

Despite the ever-present risk of a critical imbalance in the physician workforce total numbers and specialty distribution, no systematic planning mechanism is in place. Furthermore, the length of training for graduate medical education (GME) precludes timely rectification of imbalances. We report GME activities collected in the American Medical Association Annual Survey of Graduate Medical Education Programs for 1998-1999, along with trends during the last 3 to 6 years. These data initially suggest that little has changed during the past several years; however, on closer examination, small but significant changes during the past 2 years may have serious consequences if continued. The total number of resident physicians, which has been constant during the last several years, decreased in 1998 by 760 from the previous year, while the number of programs continues to increase (6.1% since 1993). The number of US medical graduates entering GME programs remained stable during the last 6 years, the number of osteopathic graduates entering GME increased by 55.7%, and the number of international medical graduates (IMGs) entering GME continued to drop (down 13.2% since 1993). More IMGs tend to pursue additional training than do US graduates (in 1997, 32.9% vs 23.6%). Because IMGs are remaining in GME programs for longer periods, the total number of IMGs has not yet reflected significant change. About 62% of IMGs now entering GME training are either US citizens or permanent residents; ethnic minority residents are not decreasing in numbers as some predicted; and for the first time in the past 5 years, the primary care specialties have ceased their persistent growth. Toward the end of GME, the number of residents leaving programs before completion increased by 5.7% during the last 3 years. While some of these changes may be ascribed to reduced GME funding through the Balanced Budget Act of 1997, other factors clearly are at play. To anticipate future changes in the physician workforce, these factors should be identified to permit them to be monitored and modified as needed.
New Scientific Evidence and Public Health Imperatives
Authors: Nicholas A. Ashford
Journal: New England Journal of Medicine (1987)

The two articles in this issue of the Journal on occupational exposure to benzene1 and prenatal exposure to lead2 confirm the suspicion that very low levels of toxins are capable of causing serious health effects. These impressive studies should quiet the insistence that governmental efforts to control these hazards are excessive and irrational responses to chemophobic social forces. Furthermore, the investigations should make us appreciate the difficulty of reconstructing past exposures to suspected agents in retrospective cohort studies and the value of follow-up, however burdensome, in prospective studies.These investigations are relevant in terms of regulating exposure to benzene and . . .
TCT-278 Radial arterial access with ultrasound trial.
Authors: Arnold Seto, Jonathan S. Roberts, Mazen Abu-Fadel, Steven Czak, Faisal Latif, Suresh Jain, Jaffar Raza, Aditya Mangla, George Panagopoulos, Morton J. Kern, Zoran Lasic
Journal: Journal of the American College of Cardiology (2013)
COSMIC: the catalogue of somatic mutations in cancer
Authors: Nidhi Bindal, Simon A Forbes, David Beare, Prasad Gunasekaran, Kenric Leung, Chai Yin Kok, Mingming Jia, Sally Bamford, Charlotte Cole, Sari Ward, Jon Teague, Michael R Stratton, Peter Campbell, Andrew P Futreal
Journal: Genome biology (2011)

Deep exome resequencing is a powerful approach for delineating patterns of protein-coding variation among genes, pathways, individuals and populations.We analyzed exome data from 2,440 individuals of European and African ancestry as part of the National Heart, Lung, and Blood Institute's Exome Project, the aim of which is to discover novel genes and mechanisms that contribute to heart, lung and blood disorders.Each exome was sequenced to a mean coverage of 116×, allowing detailed inferences about the population genomic patterns of both common variation and rare coding variation.We identifi ed more than 500,000 single nucleotide variations, the majority of which were novel and rare (76% of variants had a minor allele frequency of less than 0.1%), refl ecting the recent dramatic increase in the size of the human population.The unprecedented magnitude of this dataset allowed us to rigorously characterize the large variation in nucleotide diversity among genes (ranging from 0 to 1.32%), as well as the role of positive and purifying selection in shaping patterns of proteincoding variation and the diff erential signatures of population structure from rare and common variation.This dataset provides a framework for personal genomics and is an important resource that will allow inferences of broad importance to human evolution and health.
Wage increase averts threatened doctors' strike in Hungary
Authors: C. Kovac
Journal: BMJ (1998)

With national elections looming in May, the Hungarian government has granted healthcare workers a 16% wage increase, averting a threatened strike.

The settlement also includes a promise by the government to set aside 2.3 billion Hungarian forints (£6.7m; $10.7m) this year and three billion forints in ensuing years for bonus payments for medical staff. …
901-2 Randomized, Double-Blind Multicenter Trial of a Novel Modified t-PA, E6010 by i.v. Bolus Injection in Treatment of Acute Myocardial Infarction (AMI) – Comparison with Native t-PA
Authors: C. Kawai, S. Hosoda, Y. Yui, S. Kimata, K. Kanmatsuse, S. Suzuki, T. Motomiya, Y. Yabe, F. Takatsu, K. Kodama, R. Minamlno, H. Sato, M. Nobuyoshi, M. Nakashima
Journal: Journal of the American College of Cardiology (1995)
Exercise technetium-99m sestamibi tomography for cardiac risk stratification of patients with stable chest pain.
Authors: H G Stratmann, G A Williams, M D Wittry, B R Chaitman, D D Miller
Journal: Circulation (1994)

This study was designed to evaluate the prognostic value of symptom-limited maximal exercise treadmill testing with tomographic technetium-99m sestamibi (MIBI) myocardial imaging in patients referred for evaluation of stable angina. Exercise stress thallium-201 myocardial imaging provides prognostic information in coronary artery disease subsets including patients with stable chest pain. The prognostic value of exercise technetium-99m MIBI myocardial tomography has not been established.Of 548 consecutive patients with stable angina pectoris who underwent maximal exercise treadmill stress testing in combination with a same-day "rest-stress" tomographic technetium-99m MIBI myocardial imaging protocol, 521 patients were followed for 13 +/- 5 months to determine the univariate and multivariate variables associated with cardiac events and to define their cardiac event-free survival. Ten patients were lost to follow-up (98% complete), and 17 who had coronary revascularization within 6 months of testing were excluded. Major cardiac events occurred in 24 patients (9%)--nonfatal myocardial infarction in 11 and cardiac death in 13. Univariate Cox survival analysis demonstrated significant relative risk (RR) and 95% confidence intervals (CI) for exercise ST segment depression (RR = 2.3; 95% CI, 1.0 to 5.3), an abnormal MIBI scan (RR = 13.8; 95% CI, 1.9 to 102.3), and a reversible MIBI perfusion defect (RR = 3.2; 95% CI, 1.4 to 7.5). Multivariate models demonstrated that both exercise MIBI perfusion abnormalities (RR = 11.9; 95% CI, 1.6 to 89.4) and reversible MIBI perfusion defects (RR = 2.9; 95% CI, 1.2 to 7.0) had independent predictive value. During 1 year of follow-up, cardiac events occurred in only 0.5% of patients with normal MIBI scans compared with 7% of those with abnormal MIBI scans (P < .001). One-year, cardiac event-free survival was 92% in patients with reversible MIBI perfusion defects (P < .01 versus normal), 96% in patients with fixed defects (P < .01), and 93% in patients with combined reversible and fixed MIBI myocardial perfusion abnormalities (P < .02).As with exercise thallium-201 myocardial imaging, exercise stress technetium-99m MIBI myocardial tomography provides significant independent information concerning the subsequent risk of serious cardiac events (death, myocardial infarction) in patients with stable angina pectoris. The identification of MIBI perfusion abnormalities, in particular, the presence of reversible MIBI defects, was associated with reduced 1-year, event-free survival. The recognized imaging and radiotracer biokinetic differences between thallium-201 and MIBI do not appear to modulate the prognostic value associated with scintigraphic evidence of ischemic myocardial jeopardy in the stable angina population.
220. AAV Mediated Gene Transfer of Smad7 in Different Models of Cystic Kidney Diseases
Authors: Andrea Keppler, Barbara Leuchs, Carolin Stump, Steven Dooley, Juergen Kleinschmidt, Norbert Gretz
Journal: Molecular Therapy (2006)

Cystic diseases of the kidney (CDK) with consecutive interstitial fibrosis represent the most frequent hereditary causes of end-stage renal failure in children and adults. Up to now no causal treatment for any of them is available in humans. It is shown that the TGF-β pathway is playing a major role in the development of interstitial fibrosis and an overexpression of Smad7, the negative inhibitor of TGF-β, is able to prevent fibrosis. Therefore we want to analyse the effect of a long term expression of Smad7 on renal function and interstitial fibrosis in our CDK animal models. To achieve this goal we produced an adeno associated virus (AAV-2) expressing Smad7. 1E11 genome containing particles were injected into the rat kidney via a femoral catheter and 48h after infection the expression of Smad7 in the kidney and a spectrum of other organs was tested. We could show 48h after infection an increase of Smad7 expression in the infected kidneys up to 7 fold compared to control animals. Now we started a long term experiment with 3 month of AAV-2 mediated Smad7 expression in the CDK animals. In this study we will analyse the development of renal function over time. Finally histology will be performed with special emphasis on interstitial fibrosis and cyst number and size.
Fras1 deficiency results in cryptophthalmos, renal agenesis and blebbed phenotype in mice
Authors: Sophia Vrontou, Petros Petrou, Barbara I Meyer, Vassilis K Galanopoulos, Kenji Imai, Masayuki Yanagi, Kamal Chowdhury, Peter J Scambler, Georges Chalepakis
Journal: Nature Genetics (2003)
Gallstone Intestinal Obstruction
Authors: Kirby C. Kirkland
Journal: JAMA (1961)

An analysis has been made of 154 reports of intestinal obstruction caused by gallstones, including 142 from English and American literature and 12 from the experience at the authors' hospital. In 75 (69%) of the cases the patients were between the ages of 60 and 79 years. The condition was 12 times as frequent in women as in men. In 65 out of 98 cases the stone was found in the ileum. Three of the patients in the authors' series suffered recurrences. They were women aged 53, 83, and 95 years, and all made good recoveries from the second operation.
Vascular Remodeling in the Internal Mammary Artery Graft and Association With In Situ Endothelin-1 and Receptor Expression
Authors: Allison J. Sutherland, Maria I. Nataatmadja, Philip J. Walker, Leila Cuttle, R. Bruce Garlick, Malcolm J. West
Journal: Circulation (2006)

The vasoconstricting peptide endothelin-1 (ET-1) has been associated with atherosclerotic cardiovascular disease, vascular smooth muscle cell (VSMC) growth stimulation, and intimal thickening. ET-1 binds 2 receptor subtypes, endothelin A and B, and the ETA receptor mediates vasoconstriction and VSMC growth. This study aims to quantitatively assess arterial remodeling variables and compare them with changes in ET-1, ETA, and ETB expression in the internal mammary artery (IMA).Specimens from 55 coronary artery disease (CAD) patients (45 men, 10 women; mean age 65 years) and 14 control IMA specimens (from 7 men and 7 women; mean age 45 years) were collected. IMA cross sections were assessed by histochemical and immunohistochemical staining methods to quantify the levels of medionecrosis, fibrosis, VSMC growth, ET-1, ETA, ETB, and macrophage infiltration. The percentage area of medionecrosis in the patients was almost double that in the controls (31.85+/-14.52% versus 17.10+/-9.96%, P=0.0006). Total and type 1 collagen was significantly increased compared with controls (65.8+/-18.3% versus 33.7+/-13.7%, P=0.07, and 14.2+/-10.0% versus 4.8+/-2.8%, P=0.01, respectively). Despite ACE and/or statin therapy, ET-1 expression and cell cycling were significantly elevated in the patient IMAs relative to the controls (46.27+/-18.46 versus 8.56+/-8.42, P=0.0001, and 37.29+/-12.88 versus 11.06+/-8.18, P=0.0001, respectively). ETA and ETB staining was elevated in the patient vessels (46.88+/-11.52% versus 18.58+/-7.65%, P=0.0001, and 42.98+/-7.08% versus 34.73+/-5.20%, P=0.0067, respectively). A mild presence of macrophages was noted in all sections.Elevated distribution of collagen indicative of fibrosis coupled with increased cell cycling and high levels of ET-1 and ETA expression in the absence of chronic inflammation suggests altered IMA VSMC regulation is fundamental to the remodeling process.
Time dependent impairment of vagally mediated inhibition of noradrenaline release in the dog heart
Authors: Y. FURUKAWA, Y. OGIWARA, K. SAEGUSA, M. TAKEDA, H. TSUBOTA, A. TADA, H. ZENDA, S. CHIBA
Journal: Cardiovascular Research (1987)

The effects of right vagal nerve stimulation on changes in heart rate, mean coronary sinus blood flow, and noradrenaline overflow rate induced by right cardiac sympathetic nerve stimulation were investigated in anaesthetised decentralised, open chest dogs, when autonomic nerve fibres were stimulated tonically at a frequency of 4 or 5 Hz for 2.5 min. Sympathetic nerve stimulation produced a mean(SEM) increase in each of the variables (50(7.0)% in heart rate, 48(6.3)% in coronary sinus blood flow, and 87.0(12.3) ng.min-1 in noradrenaline overflow rate into coronary sinus blood at 30 s), and the increments remained almost constant during continued stimulation. Vagal nerve stimulation induced a decrease of 34(3.4)% in heart rate and of 22(4.5)% in coronary sinus blood flow and a slight reduction (-9(3.2) ng.min-1) in noradrenaline overflow rate at 30 s. Only the decrease in heart rate faded slightly with time. Combined stimulation of the sympathetic and parasympathetic nerves induced a decrease of 19(5.0)% in heart rate and 4(7.5)% in coronary sinus blood flow and an increase of 34.3(12.0) ng.min-1 in noradrenaline overflow rate at 30 s. The decrease in heart rate and coronary sinus blood flow faded, and noradrenaline overflow rate increased significantly to 86.4(17.3) ng.min-1 at 120 s. The temporal changes in heart rate, coronary sinus blood flow, and noradrenaline overflow rate caused by combined nerve stimulation were readily inhibited by treatment with atropine.(ABSTRACT TRUNCATED AT 250 WORDS)
Home treatment for acute psychiatric disorder. A marvellous advance.
Authors: P Tyrer, S Merson, N Gandhi, B Ferguson
Journal: BMJ (1993)

benefit from clozapine.So what has got into the therapeutic experts of the Committee on Safety of Medicines?Surely the first principle of therapeutics is that those likely to benefit the most should be those who take the largest risk.As things stand now in Britian, clozapine is often reserved for the worst cases of chronic vegetative schizophrenia, with relatively little chance of success.Why should these unfortunate patients, who are less likely to respond, also shoulder the risk of agranulocytosis, while those most likely to respond are denied the drug and left to endure the severe extrapyramidal side effects of the partially effective classic anti- psychotic drugs?Schizophrenia is a devastating and destructive medical condition whose sufferers are third class citizens and third class patients.Clozapine gives them the best chance of recovery to date.The Clozaril monitoring system is working superbly.Clozapine should be available to all patients.We then predict that a cost-benefit analysis would show dramatic improvements.
Referrals in General Practice
Authors: P. Hopkins
Journal: BMJ (1956)

The primary objects of the investigation described in this paper were two in number: (1) to examine the reasons for which patients may be referred by a general practitioner to his consultant and specialist colleagues ; and (2) to discover what functions are most required by the patient and his doctor from the hospital service. Analysis of the results has not only answered these questions, it has also provided further evidence of the high incidence of psychoneurosis and stress disorders. This study was based on a single practice.
Coal Mining, Pneumoconiosis, and Lung Cancer
Authors: A. G. Heppleston
Journal: BMJ (1968)

BRrTisH diastolic pressure gradient the Austin Flint murmur could well be due to forward flow of blood through a functionally narrowed mitral valve, as originally suggested.In more severe cases, however, with a reversed pressure gradient, diastolic mitral incompetence seems to be a likely explanation of the pathogenesis of the murmur.Coal Mining, Pneumoconiosis, and Lung CancerIn 1936 N. M. Kennaway and E. L. Kennaway' drew atten- tnon to the low mortality from lung cancer among coal miners as compared with the general male population.Further studies by the Kennaways' and by other workers46 led to the same conclusion ; and according to the Decennial Supplement of the Registrar General published in 1938' the standardized mortality ratio (S.M.R.) for lung cancer in men working on the coal face for the three years 1930-2 was 67 (compared with 100 for all males).The S.M.R. for lung cancer in underground workers in coal mines other than coal- face workers was lower still-namely, 36.In a more critical study conducted in South Wales W. R. L. James8 found lung cancer at necropsy in 5.4%' of 1,531 non-miners but in only 3.3% of 1,827 coal miners.When he subdivided the miners into those with simple pneumoconiosis and those with pro- ,gressive massive fibrosis (P.M.F.) the rates were 5.1°% and 1.4%°O, respectively.More recently K. P. Goldman9 has analysed unpublished data collected by the Medical Research Council's Epidemiology Unit in South Wales.These data onsisted of records of radiological examinations for pneumo- coniosis and information on causes of death as written on dcath certificates for a community of 5,096 miners and ex-miners in the Rhondda Fach Valley in Glamorganshire.The results of Goldman's analysis were somewhat in conflict with the findings of James': the mortality from lung cancer was highest, and equal to the national average, among mrners with P.M.F., lowest in those with simple pneumoconiosis, and intermediate in those free of radiological evidence of dust disease.
Association Health Plans
Authors: Mike Mitka
Journal: JAMA (2006)

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
An overview of skin scores used for quantifying hand eczema: a critical update according to the criteria of evidence-based medicine
Authors: W. Weistenhöfer, T. Baumeister, H. Drexler, B. Kütting
Journal: British Journal of Dermatology (2009)

The present review gives an overview of the enormous variety of skin scores used for assessing severity in patients suffering from hand eczema. In order to evaluate the validity and practical relevance of different scoring systems according to the criteria of evidence-based medicine, in May 2009 we performed a systematic search of the literature using PubMed and the Cochrane Library. A total of 69 articles reporting on 45 different methods for quantifying hand eczema were identified. The panel of methods varied from pure subjective categories to more or less quantitative scoring systems. Furthermore, by focusing on skin scores used in clinical trials in which the results led to the licensing of a systemic or topical drug for treatment of hand eczema, a panel of different scoring systems was identified. In addition to morphological pattern, some scoring systems included subjective complaints, which might cause an individual bias by overestimation of self-reports. Inter- and intraobserver reliability was rarely reported except for three scores. Among these validated scores interobserver reliability was reported for three scores, but only one of the three included reliability within observers (repeatability). Advantages and disadvantages of the different scoring systems are critically discussed. Depending on different indications and particular settings (e.g. occupational screening vs. clinical examinations, evaluating progress of treatment in everyday clinical practice or for research purposes) scoring systems have to fulfil diverging demands. We draw the conclusion that a standardized diagnostic procedure for assessing the severity of hand eczema would facilitate the comparability of outcome of clinical trials. However, scoring systems used for occupational screening have to fulfil different demands compared with scoring systems used for licensing of drugs. This striking difference might be explained by the skin condition, which is generally supposed to be much better in subjects at medical check-ups at the workplace.
Thiazides and Acute Cholecystitis
Authors: Lynn Rosenberg, Samuel Shapiro, Dennis Slone, David W. Kaufman, Olli S. Miettinen, Paul D. Stolley
Journal: New England Journal of Medicine (1980)

An association between acute cholecystitis and the use of thiazide-containing drugs was observed during routine screening of data from a case-control drug-surveillance program. Evaluation of this relation among 419 patients with acute cholecystitis and 1676 control patients yielded a relative risk estimate of 2.0 for subjects who had used thiazides in the month before admission, as compared with subjects who had never used these drugs (95 per cent confidence interval, 1.4 to 2.7). There was a significant trend of increasing relative risk with increasing duration of use (P < 0.01), and the estimate for subjects who had used thiazides for five or more years was 2.9. The association was not explained by confounding due to the indications for thiazide use, such as hypertension, or other factors, such as obesity or the use of other drugs. No single epidemiologic study can eliminate chance or bias as an explanation for an association; the relation found here should be regarded as a hypothesis that requires independent confirmation.