tbuckley/cabot-search huggingface dataset:
ADAPTATION TO OPEN HEART SURGERY: A PSYCHIATRIC STUDY OF RESPONSE TO THE THREAT OF DEATH
Authors: HARRY S. ABRAM
Journal: American Journal of Psychiatry (1965)

This report is a clinical study of 23 patients undergoing open heart surgery and how some responded to it. It is evident that these patients reacted to the operation as presenting not merely a symbolic but realistic threat to life. The presence of anxiety and the use of denial preoperatively are described. Two cases of postoperative "cardiac psychosis" are reported and their relationship to the "catastrophe reaction" and "post-cardiotomy delirium" commented upon. The intensive care unit is seen as a life-saving necessity in modern heart surgery but at the same time frequently perceived by the patient as psychologically threatening. Certain prophylactic psychological measures are discussed.
American Medicine: The Quest for Competence
Authors: Andrew D. Hunt
Journal: JAMA (1996)

This ethnographic study deals with several aspects of competence within the culture of American medicine. There is emphasis on the impacts of various ways in which "competence" is interpreted not only by various branches of the profession, but also by other professions such as law. The medical malpractice crisis of the 1980s is given considerable space, as are the various ways in which medical practice has modified itself through such means of self-regulation as risk management and quality assurance. The "astonishing" increase in claims against obstetricians is noted, as is the medical feeling of a "demise of the golden era of trust." The book's first major section describes obstetrical care in a rural setting in Northern California, with transformation from small general practitioner—owned hospitals to larger nonprofit institutions whose boards of trustees attracted young specialists to the community. Conflict with the new arrivals—young, confident, and to the established general practitioners,
Pathophysiology of coronary occlusion in acute infarction.
Authors: A Maseri, S Chierchia, G Davies
Journal: Circulation (1986)

Coronary angiography has proved beyond doubt that complete coronary occlusion is the rule in the very early hours of infarction. The 60% to 80% rate of coronary recanalization after thrombolytic therapy has proved that thrombosis is a major component of the occlusion at the time when the procedure is performed a few hours after the onset of symptoms. However, the trigger for coronary thrombosis and the causes of failure of thrombolytic therapy are still a matter of speculation. The relatively rare occurrence of acute coronary occlusion in the life of an individual with even severe coronary disease can be explained on the basis of the necessity of either extremely powerful isolated stimuli, which only occurs rarely, or the casual simultaneous presence in one coronary arterial segment of multiple unfavorable events, such as plaque fissuring, enhanced reactivity of coronary smooth muscle to constrictor stimuli and displacement of the thrombotic-thrombolytic equilibrium toward thrombosis. Coronary artery constriction possibly caused by vasoconstrictor substances released by thrombus, represents the potential element of a vicious cycle causing persistent coronary occlusion and reocclusion when reflow occurs with thrombolysis.
Dark Passage
Authors: Carrie A. Butt
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
Predicting mental illness in soldiers
Authors: Matthew P Newton Ede, Su-Wen Goh
Journal: BMJ (2006)

How doctors' anonymity in family courts is under threat Gornall is way out of dateEditor-Gornall is embarrassingly out of date in his detailed analysis of the B case (which was dealt with by the family courts nearly three years ago), and its relevance to proposed changes in the law to make the English family court system more transparent. 1 Since then, notwithstanding the ever increasingly exaggerated claims from some quarters that opening the family courts would harm children and deter court experts, the courts themselves are acknowledging the need for English family courts to do their business in the more transparent way that courts in Canada, Australia, and of course Scotland have done without apparent difficulty for years.Several High Court judgments have recorded judicial support for more openness to increase public confidence, and Gornall fails to mention that the president and many of his senior judges are in favour of change in this direction.In a landmark case which was decided on 3 November, Munby J agreed that an ongoing case where parents dispute expert evidence that they injured their child should be open to the media.The local authority concerned issued a "position statement" to the press and the reporting in the Times, Guardian, and the Mail on Sunday set out both sides' cases, as did the broadcasting media.A BBC "Real Story" programme on the case allowed a senior official from the local authority ample time to put their case.No vilification of any experts involved was reported.It is likely that more judges will follow Munby J's example and more public interest cases will be opened to the media pending any change in the law.Will the skies fall in?I doubt it, but your readers can judge for themselves.Hopefully they will understand that in complex childcare cases where expert evidence may be tenuous and the stakes for children are very high, public debate can stimulate awareness of the problems faced by all professionals involved in child protection.It's difficult getting the balance right, but doing it in secret doesn't help.
Laterality of lower limb amputation in diabetic patients: retrospective audit
Authors: J. P Coxon, I. W Gallen
Journal: BMJ (1999)

Complications associated with diabetic patients' feet remain common and major problems for clinicians and patients.We conducted an audit after observing that lower limb amputations in diabetic patients who attended hospital seemed to occur more on the right side than on the left. Subjects, methods, and resultsWe obtained information from the database of the Chiltern Diabetes Centre, which records the details of around 2000 diabetic patients attending hospital clinics in South Buckinghamshire.Patients' details are recorded on the computer system at each clinic visit.For our audit, we extracted details from the database by setting up structured queries in the Microsoft Access program.Raw data consisted of one entry per patient.If a patient had more than one amputation, the level of the last amputation only was recorded.We excluded patients with bilateral amputations (0.5%).We performed 2 tests (without continuity correction) to investigate any difference in laterality of amputation.The table shows data for 1876 diabetic patients, 219 (11.7%) of whom had had unilateral amputation.When we used 2 tests to compare the sites of amputation between the left and right side, the differences between the two sides were highly significant for all levels.
Tuberculosis and HIV infection in Africa.
Authors: D. J. Roberts, A. D. Harries
Journal: BMJ (1989)

rhe numbers of cases reported yearly to the Public Health Laboratory Service Communicable Disease Surveillance Centre is about 3000.Among children aged under 5 cryptosporidiosis may be found more commonly than salmonella infection.4Detailed follow up study of cases diagnosed by the laboratory commonly shows other cases among contacts,' including adults, and the number of cases reported clearly represents only a proportion of the actual incidence.
Multiple Sclerosis and Poliomyelitis in Australasia
Authors: M. J. Eadie, J. M. Sutherland, J. H. Tyrer
Journal: BMJ (1965)

In recent years various workers?for example, Kurland (1952), Kurland and Westlund (1953), Alter, Allison, Talbert, and Kurland (1960), and Acheson, Bachrach, and Wright (1960) ?have shown that in the northern hemisphere multiple sclerosis becomes increasingly prevalent with increasing distance from the equator. No comparable series of prevalence studies has yet been reported from the southern hemisphere, but in Australasia mortality statistics and a postal survey suggested that there is a similar gradient with latitude (Sutherland, Tyrer, and Eadie, 1962), and studies of the prevalence of multiple sclerosis in various regions of the State of Queensland, Australia, also suggest that this gradient occurs (Sutherland, Tyrer, Eadie, Casey, and Kurland, 1965). A recent hypothesis suggested by Poskanzer, Schapira, and Miller (1963) to explain the geographical distribution is of interest. It is widely recognized that poliovirus infection is very common in infancy in areas with poor standards of sanitation (as in many parts of the tropics), yet paralytic polio myelitis is rare. Where there are higher standards of sanitation (in general, in the more temperate zones) poliovirus infection occurs later in life and paralytic disease is more frequent. Poskanzer et al. (1963) drew attention to a resemblance between the geographical distributions of multiple sclerosis and clinical poliomyelitis, and to other features which suggested that the two diseases had similar epidemiological patterns. They postulated that multiple sclerosis, like paralytic poliomyelitis, represents an occasional neurological manifestation of a wide spread subclinical enteric infection. For each disease, age at initial infection determines the chances of neurological involve ment. From other data Schapira, Poskanzer, and Miller (1963) inferred that there may be some 20 years' delay between the original enteric infection and the subsequent development of multiple sclerosis.
Evaluation of chitosan–anionic polymers based tablets for extended-release of highly water-soluble drugs
Authors: Yang Shao, Liang Li, Xiangqin Gu, Linlin Wang, Shirui Mao
Journal: Asian Journal of Pharmaceutical Sciences (2014)

The objective of this study is to develop chitosan–anionic polymers based extended-release tablets and test the feasibility of using this system for the sustained release of highly water-soluble drugs with high drug loading. Here, the combination of sodium valproate (VPS) and valproic acid (VPA) were chosen as the model drugs. Anionic polymers studied include xanthan gum (XG), carrageenan (CG), sodium carboxymethyl cellulose (CMC-Na) and sodium alginate (SA). The tablets were prepared by wet granulation method. In vitro drug release was carried out under simulated gastrointestinal condition. Drug release mechanism was studied. Compared with single polymers, chitosan–anionic polymers based system caused a further slowdown of drug release rate. Among them, CS–xanthan gum matrix system exhibited the best extended-release behavior and could extend drug release for up to 24 h. Differential scanning calorimetry (DSC) and Fourier transform infrared spectroscopy (FTIR) studies demonstrated that polyelectrolyte complexes (PECs) were formed on the tablet surface, which played an important role on retarding erosion and swelling of the matrix in the later stage. In conclusion, this study demonstrated that it is possible to develop highly water-soluble drugs loaded extended-release tablets using chitosan–anionic polymers based system.
Biochemical studies of isolated hamster tracheal epithelium.
Authors: D G Kaufman
Journal: Environmental Health Perspectives (1976)

The epithelial lining of respiratory air passageways is a primary target tissue for toxicity and carcinogenesis in man and in animal models of human disease. The importance of this target tissue was the basis for development of methods to study its biochemistry, and with this information to distinguish the unique properties of this tissue from properties common to all cell types. Biochemical methods employed labeling of macromolecules in isolated hamster treacheas during brief (less than 4 hr) incubation in vitro. Studies of RNA metabolism in isolated tracheas demonstrated a pattern of maturation of ribosomal RNA like that shown for other cell types. Alterations in RNA metabolism were observed in isolated tracheas obtained from vitamin A-deficient hamsters and hamsters previously treated by intratracheal administration of benzo[a]pyrene (BP) plus ferric oxide (Fe2O3) in vivo. Studies with toyocamycin, actinomycin D, and alpha-amanitin, all inhibitors of RNA metabolism, were performed to characterize the class of RNA molecules with a decreased proportion of labeling in tracheas from vitamin A deficient hamsters. In another series of experiments, BP was shown to bind to DNA in epithelial cells of isolated tracheas. The quantity of BP binding was increased by prior intratracheal treatment of hamsters with BP plus Fe2O3 in vivo, this induced binding was inhibited by addition of 7,8-benzoflavone to the incubation medium. Increased BP binding was also observed in isolated tracheas from hamsters believed to be in states of increased susceptibility to respiratory carcinogenesis in vivo. The results show that biochemical studies are feasible with this tissue. Furthermore, a number of questions of importance with regard to this target epithelium are best studied directly in its constituent cells.
Do Medical Journals Suppress Information?
Authors: Jerome P. Kassirer
Journal: New England Journal of Medicine (1992)

Given the meticulous attention we pay to objectivity and fairness in the editorial process at the New England Journal of Medicine, it annoyed me to read in a newsmagazine several weeks ago fatuous allegations that medical journals suppress or censor important studies.1 Similar charges have appeared recently in newspapers.2 These accusations are simply not true.An author accused the Journal of failing to publish a paper that linked fluorescent lights to childhood leukemia, and an editor was quoted (out of context) as saying that the manuscript was rejected because it did not warrant the publicity. The author was quoted . . .
Gastro-duodenal Haemorrhage as a Surgical Emergency
Authors: J. M. Large
Journal: BMJ (1960)

MONONUCLEOSIS BRDITIJSoHwere increased in the first week of illness, were usually maximal during the second week, and returned to normal about five weeks from its commencement.The S.G.O.T. and S.G.P.T. levels ran roughly parallel, the S.G.P.T. exceeding the S.G.O.T. in about two-thirds of the cases.Transaminase values were below 500 units per ml. in all but two patients; high levels were not necessarily associated with severe illness.Variations in individual patients' clinical state were reflected in alterations of their transaminase levels.Conventional liver-function tests were less often abnormal and were not affected so early.The zinc sulphate turbidity and serum y-globulin were sometimes raised some months after recovery, when other tests were normal; this was thought to be related to persisting antibody.Transaminase determination was helpful in early diagnosis and differential diagnosis, and may assist case management.Our findings confirm that liver involve- ment is a usual feature of the disease.We thank Dr. J. Pryse-Davies and Dr. J. Henry Wilkinson for permission to publish transaminase data of Cases 1, 2, and 3 from their paper; Dr. R. 1. S. Bayliss, who supervised the care of the nursing staff; the practitioners who referred cases to us; the technical staff of the chemical pathology and haematology
Aneurysms: Diagnosis and Treatment
Authors: Alan T. Marty
Journal: JAMA (1982)

While hospital mortality for abdominal aneurysmectomy has fallen tenfold since 1951, most vascular surgery texts neglect mentioning that life after aneurysm surgery is still too short. Not so this book, which emphasizes the need to liberalize coronary angiography and surgery in abdominal aneurysm patients, 40% of whom will otherwise die too early from myocardial infarction. As 30% of aortic dissection patients succumb to another aneurysm after the initial "successful" repair, better diagnostic follow-up and closer control of blood pressure are also advised. Other dark recesses of this field, such as why some atherosclerotic arteries develop aneurysms while others stenose, or why anastomotic false aneurysms occur, are brightly illuminated. The pros and cons of routine preoperative aortography, the prevention and treatment of complications, and unusual manifestations of aneurysmal disease are all brilliantly reviewed. Visceral, peripheral, mycotic, and pediatric aneurysms are articulated with notable cogency. Special problems, like infected groin aneurysms in heroin addicts,
Colonoscopic Evaluation of Rectal Bleeding
Authors: FRANCIS J. TEDESCO
Journal: Annals of Internal Medicine (1978)

We studied 258 patients with rectal bleeding and 46 patients with anemia and occult blood in the stool. All 304 patients had negative proctosigmoidoscopies, single-contrast barium studies that were negative or showed diverticula only, and colonoscopic evaluation. In the 258 patients, the overall incidence of finding significant lesions by colonoscopy was 41.5%. Twenty-nine patients (11.2%) had carcinoma and 17 patients (6.6%) had cecal telangiectasia. In the 46 patients, the overall incidence of finding significant lesions was 19.6%. Three patients with carcinoma were found in this group. A significant number of both benign and malignant lesions were detected by colonoscopy proximal to the splenic flexure. Colonoscopy should be done in patients with rectal bleeding or anemia and occult blood in the stool who have had negative proctosigmoidoscopies and single-contrast barium studies interpreted as normal or showing diverticula.
Uterine-specific p53 deficiency confers premature uterine senescence and promotes preterm birth in mice
Authors: Yasushi Hirota, Takiko Daikoku, Susanne Tranguch, Huirong Xie, Heather B. Bradshaw, Sudhansu K. Dey
Journal: Journal of Clinical Investigation (2010)

Many signaling pathways that contribute to tumorigenesis are also functional in pregnancy, although they are dysregulated in the former and tightly regulated in the latter. Transformation-related protein 53 (Trp53), which encodes p53, is a tumor suppressor gene whose mutation is strongly associated with cancer. However, its role in normal physiological processes, including female reproduction, is poorly understood. Mice that have a constitutive deletion of Trp53 exhibit widespread development of carcinogenesis at early reproductive ages, compromised spermatogenesis, and fetal exencephaly, rendering them less amenable to studying the role of p53 in reproduction. To overcome this obstacle, we generated mice that harbor a conditional deletion of uterine Trp53 and examined pregnancy outcome in females with this genotype. These mice had normal ovulation, fertilization, and implantation; however, postimplantation uterine decidual cells showed terminal differentiation and senescence-associated growth restriction with increased levels of phosphorylated Akt and p21, factors that are both known to participate in these processes in other systems. Strikingly, uterine deletion of Trp53 increased the incidence of preterm birth, a condition that was corrected by oral administration of the selective COX2 inhibitor celecoxib. We further generated evidence to suggest that deletion of uterine Trp53 induces preterm birth through a COX2/PGF synthase/PGF(2alpha) pathway. Taken together, our observations underscore what we believe to be a new critical role of uterine p53 in parturition.
New Perspective on Cancer of the Contralateral Breast: A Marker for Assessing Tamoxifen as a Preventive Agent
Authors: B. Fisher, C. Redmond
Journal: JNCI Journal of the National Cancer Institute (1991)

For most of this century, when a woman has had a primary breast cancer, issues have been raised regarding her opposite (contralateral) breast. One major and persistent consideration relates to how frequently a contralateral breast cancer might be expected to occur. Vigorous debate questions whether a woman's risk for such an event might be considered great enough to justify a prophylactic mastectomy or, at least in some circumstances (e.g., when the primary tumor is a lobular invasive cancer), whether a random biopsy of the contralateral breast should routinely be done. Deliberations have also taken place regarding how to distinguish between a metastatic lesion and a second primary tumor in the contralateral breast; whether the prognosis of a patient who has had a breast cancer is altered when a new primary tumor appears in the opposite breast; whether the first and second primary tumors were synchronous in origin but metachronous in expression or whether they were metachronous from their inception; and whether radiation therapy after removal of a primary tumor by mastectomy or lumpectomy increases the incidence of contralateral breast cancer. Most of these issues have been either fairly well resolved or supplanted by more important ones. The contralateral breast of a woman with breast cancer has recently taken on new significance: It has assumed importance as a marker for assessing the worth of a putative breast cancer preventive agent. Because a patient with breast cancer is at increased risk for developing a primary tumor in the opposite breast, an agent that can decrease the incidence of second primary cancers deserves consideration for evaluation in a trial to test the hypothesis that the agent can prevent breast cancer in a normal woman at increased risk for such an event. This strategy is analogous to selecting for testing, in the adjuvant therapy setting, agents that have demonstrated efficacy in the treatment of systemic disease.