tbuckley/cabot-search huggingface dataset:
Bedside Aids to Auscultation of the Heart
Authors: Paul T. Cochran
Journal: JAMA (1978)

WITH THE PROFUSION of cardiac diagnostic tools that have appeared in the past few years, the continued importance of careful physical examination of the heart must be emphasized. In spite of the great benefits that have been reaped from invasive and noninvasive studies of the cardiovascular system, all too frequently the decision to obtain such studies and the interpretation of their results are not firmly based on careful assessment of the physical findings. Heart disease is sometimes diagnosed where none exists and is missed where it does because of too great a reliance on the infallibility of technologic tools of cardiac diagnosis. The pathophysiologic lessons learned from echocardiography, cardiac catheterization, and angiocardiography have been especially helpful in extending our understanding of heart sounds and murmurs. Noting the changes in auscultatory findings that result from physical maneuvers and vasoactive drugs administered at the bedside has been recently emphasized by deLeon and
Medical Uses of the Orthopantomogram
Authors: Joseph S. Panella
Journal: JAMA (1979)

ORTHOPANTOMOGRAPHY is a roentgenographic technique allowing examination of the entire dentoalveolar region on a single film. It is used primarily as a rapid screening examination to show the general anatomic relationships of the maxilla, mandible, and adjacent structures. Although dental films provide much finer detail, the orthopantomogram is a simple, rapid, and comfortable examination that can provide useful information on a wide variety of pathological processes with less cost and radiation exposure than the conventional full-mouth periapical series.<sup>1</sup>The orthopantomogram is obtained with the patient standing or sitting with the alveolar ridge parallel to the floor. Only a single exposure is required, during which the x-ray tube makes a sweep about the patient's head. Although a wide variety of lesions can be well demonstrated by this examination, appreciation of its uses has been largely limited to those in dentistry and oral surgery. Medical uses of the orthopantomogram are numerous
Cardiac Arrest and Anaphylaxis With Anesthetic Agents
Authors: Keith Beard
Journal: JAMA (1985)

To the Editor.—  Intravenous anesthetic agents and muscle paralyzing drugs can occasionally cause anaphylaxis or anaphylactoid reactions, and we were interested to note that Keenan and Boyan 1 observed no such cases in their large study of cardiac arrest due to anesthesia. In order to provide information on the frequency of allergic events occurring in the operating room, we examined data collected from 1977 until 1981 by the Boston Collaborative Drug Surveillance Program encompassing 4,395 administrations of general anesthesia in five surgical units in the United States, New Zealand, and Scotland. 2 Among other observations, all clinical events occurring in the operating room were recorded and described.  We examined data on all patients recorded as having suffered anaphylaxis, rash, or bronchospasm in the operating room after the induction of anesthesia. A total of 20 patients suffered at least one of these events of which only one was thought to be
The local is running on the express track: Localist models better facilitate understanding of nervous system function
Authors: Paul A. Koch, Gerry Leisman
Journal: Behavioral and Brain Sciences (2004)

Artificial neural networks have weaknesses as models of cognition. A conventional neural network has limitations of computational power. The localist representation is at least equal to its competition. We contend that locally connected neural networks are perfectly capable of storing and retrieving the individual features, but the process of reconstruction must be otherwise explained. We support the localist position but propose a “hybrid” model that can begin to explain cognition in anatomically plausible terms.
How infectious is gonorrhea?
Authors: W F Felton
Journal: BMJ (1972)

I have found in the investigation of patients with Raynaud's phenomenon ("secondary" Raynaud's), utilizing oesophageal motility studies, that those patients with no oeso- phageal symptoms in whom evidence of aper.stalsis or incoordination was found in- variably developed scleroderma.On the other hand, when there was a normal motility pattern scleroderma did not develop.This simple investigation greatly helps when considering the prognosis and the natural history of Raynaud 's phenomenon.-I am, etc.,
Dyspepsia, Ulcer and Gastric Cancer
Authors: Thomas J. Anglem
Journal: New England Journal of Medicine (1946)

IN 1928 Sir Berkeley Moynihan1 wrote, "Not a little of the incredulity of patients and the apathy of medical men is based upon the undisputed conviction that cancer of the stomach is incurable." When it is realized that under the favorable circumstances existing in large metropolitan hospitals only 5 of every 100 patients who apply for treatment are cured of their disease, this becomes understandable, perhaps, but is still not justifiable. It is an undoubted fact that most practitioners of medicine have never seen a cured case of gastric cancer but that they have seen large numbers of patients die . . .
BBC2 Horizon: "Death Wish" 7 February Genes that fail in their duty?
Authors: J Goldman
Journal: BMJ (1994)

In an era when science consists too often of armies of researchers using similar techniques to pursue almost identical objectives, it was refreshing to be reminded in this Horizon programme that real advances in biology and medicine start often enough as embryonic ideas in the mind of just one person - ideas which attract little attention or even ridicule from the cognoscenti of the day. Such of course was the fate of Semmelweiss when he proposed in the last century that bacteria transmitted from person to person might be a potent cause of disease, and such might have been the fate of Andrew Wyllie and Alastair Currie had not the current revolution in molecular biology gone some considerable way to proving the merit of their …
CAN THE 3D ECHOCARDIOGRAPHIC MITRAL VALVE GEOMETRY ANALYSIS PREDICT THE SURGICAL VALVULOPLASTY RESULT IN PATIENTS WITH MITRAL VALVE PROLAPSE?
Authors: Mirian Magalhães Pardi, Maria Abduch, Wilson Mathias, Carlos Brandão, Pablo Pomerantzeff, Marcelo Vieira
Journal: Journal of the American College of Cardiology (2014)
Old age swimming
Authors: C. Hilton
Journal: BMJ (2008)

A retired colleague sent me an email remarking that he had just mown his giant lawn. He added that, according to Who’s Who , Professor Jeremy (Jerry) Noah Morris, pioneer of social medicine who emphasised the link between exercise and health, is now 98 years old.

A swim before work at the local pool on a Thursday is part of my regular routine. This week, there was an 85 year old vigorously swimming …
Paternal Urinary Concentrations of Parabens and Other Phenols in Relation to Reproductive Outcomes among Couples from a Fertility Clinic
Authors: Laura E. Dodge, Paige L. Williams, Michelle A. Williams, Stacey A. Missmer, Thomas L. Toth, Antonia M. Calafat, Russ Hauser
Journal: Environmental Health Perspectives (2015)

Human exposure to phenols, including bisphenol A and parabens, is widespread. Evidence suggests that paternal exposure to environmental chemicals may adversely affect reproductive outcomes.We evaluated associations of paternal phenol urinary concentrations with fertilization rate, embryo quality, implantation, and live birth.Male-female couples who underwent in vitro fertilization (IVF) and/or intrauterine insemination (IUI) cycles in a prospective study of environmental determinants of fertility and pregnancy outcomes were included. The geometric mean of males' specific gravity-adjusted urinary phenol concentrations measured before females' cycle was quantified. Associations between male urinary phenol concentrations and fertilization rate, embryo quality, implantation, and live birth were investigated using generalized linear mixed models to account for multiple cycles per couple.Couples (n = 218) underwent 195 IUI and 211 IVF cycles. Paternal phenol concentrations were not associated with fertilization or live birth following IVF. In adjusted models, compared with the lowest quartile of methyl paraben, paternal concentrations in the second quartile were associated with decreased odds of live birth following IUI (adjusted odds ratio = 0.19; 95% CI: 0.04, 0.82).To our knowledge, these are some of the first data on the association of paternal urinary phenol concentrations with reproduction and pregnancy outcomes. Although these results do not preclude possible adverse effects of paternal paraben exposures on such outcomes, given the modest sample size, further understanding could result from confirmation using a larger and more diverse population.
The Effects of Long-Term Administration of Tolbutamide to (Alloxan)-Subdiabetic Rats
Authors: Arnold Lazarow, Biruta Treibergs
Journal: New England Journal of Medicine (1959)

BECAUSE of the increasing use of the sulfourea drugs in the treatment of diabetes1 2 3 it has become important to study the long-term effects of these compounds. The evidence thus far obtained suggests that after administration of a single dose of the sulfourea drugs, insulin is released into the pancreatic vein.4 The sulfourea drugs have likewise been shown to have hypoglycemic effects in the totally depancreatized animal treated with suboptimal doses of insulin.5 If the sulfourea drugs stimulate the beta cells in the islands of Langerhans of the pancreas, their prolonged administration could have deleterious effects on the islands similar to . . .
Effect of a Clinic-Based Referral System to Head Start
Authors: Michael Silverstein, Christopher Mack, Nicole Reavis, Thomas D. Koepsell, Gregory S. Gross, David C. Grossman
Journal: JAMA (2004)

Early childhood development programs such as Head Start have proven benefits for impoverished children. However, few physicians assist families with enrollment.To test if a primary care-based intervention is efficacious in increasing Head Start attendance.Randomized controlled trial of 246 Head Start-eligible children aged 0 through 4 years recruited in spring 2003 from 4 health clinics in Seattle, Wash.List of Head Start telephone contacts provided to families of all children and, for those in the intervention group, a computer-generated packet containing a physician referral letter (and a physical examination form and immunization record, if available) mailed directly to Head Start by study personnel.Head Start attendance by January 2004.The 123 children analyzed in each study group were similar at baseline. Overall, 72 children (29%) were successfully connected with Head Start (ie, actively attending or on a waiting list) by January 2004. Among the intervention group, 50 children (41%) were successfully connected with Head Start, contrasted with 22 (18%) in the control group (adjusted difference, 17%; 95% confidence interval [CI], 8%-27%). Among the intervention group, 31 children (25%) were actively attending Head Start, contrasted with 14 (11%) in the control group (adjusted difference, 12%; 95% CI, 3%-21%). Only 2 clinics contributed children to Head Start waiting lists. Among children from these clinics, 19 of 87 (22%) in the intervention group got onto a Head Start waiting list, vs 8 of 94 (9%) in the control group (adjusted difference, 13%; 95% CI, 5%-21%). To get 1 child either into Head Start or onto a waiting list, we needed to refer 4 children.Facilitating an initial connection to Head Start on families' behalf substantially increased Head Start attendance.
Should beta-blockers be given immediately and concomitantly with thrombolytic therapy in acute myocardial infarction?
Authors: E Rapaport
Journal: Circulation (1991)

T he efficacy of /3-blockers in the setting of acute myocardial infarction has been extensively studied.Over 50 randomized clinical trials involving more than 50,000 patients have been car- ried out to evaluate either /3-blockers begun intrave- nously early after infarction or their long-term chronic oral use as secondary prevention.Pooled data from trials in which therapy was usually initiated before hospital discharge and generally maintained for at least 1 year indicate that mortality can be reduced by an average of 21% and reinfarction by 24%.1 Trials of the early use of intravenous /3-blockers on mortality in the prethrombolytic era have been less impressive.Pooled data from 27 trials involving approximately 27,000 patients reveal only a 13% reduction in mortality (p<0.01).2The three largest of these trials were the Goteborg Metoprolol Trial,3 the Metoprolol in Acute Myocardial Infarction (MIAMI) See p 422 Trial,4 and the first International Study of Infarct Survival (ISIS-I) Trial.5In the Goteborg Trial3 intravenous and then oral metoprolol was used.Among 697 patients random- ized to placebo, the 7-day mortality rate was 3.3% and the mortality rate in the 698 patients receiving metoprolol was 2.6%.6 Initiation of therapy took place after a mean time lapse of 11.3 hours.This led the same group of investigators to carry out a much larger study, the MIAMI Trial,4 with the express purpose of studying very early intervention.The MIAMI Trial4 involved 2,901 patients who received placebo and 2,877 patients randomized to receive intravenous and then oral metoprolol.The median delay time from onset of symptoms to ran- domization was 7 hours.Seven-day mortality was
Large-scale genetic fine mapping and genotype-phenotype associations implicate polymorphism in the IL2RA region in type 1 diabetes
Authors: Christopher E Lowe, Jason D Cooper, Todd Brusko, Neil M Walker, Deborah J Smyth, Rebecca Bailey, Kirsi Bourget, Vincent Plagnol, Sarah Field, Mark Atkinson, David G Clayton, Linda S Wicker, John A Todd
Journal: Nature Genetics (2007)
Prevention and Management of Organophosphate Poisoning
Authors: Thomas H. Milby
Journal: JAMA (1971)

The organophosphates are the pesticides most often involved in serious human poisoning. That involvement is likely to increase, because recent governmental actions against the use of DDT and related organochlorine pesticides will likely increase the domestic and agricultural use of the organophosphate pesticides. Accordingly, practicing physicians in all communities should know how to diagnose and treat organophosphate intoxication and how to advise patients on the principles of poisoning prevention. The organophosphate pesticides, a closely related family of chemicals, share a number of characteristics which are of considerable importance to the clinician. They are widely used as insecticides, and all are cholinesterase inhibitors of varying potency. All may penetrate the intact skin but do not accumulate in body tissues as do many of the chlorinated hydrocarbon pesticides. The organophosphates are nonpersistent in the environment; that is, after application they rapidly break down into relatively nontoxic substances. Lastly, all are capable of
Castleman's Disease
Authors: J Z Sickel
Journal: New England Journal of Medicine (1995)

Figure 1. A 31-year-old woman who had had painless, right-sided cervical adenopathy for three months was given antibiotics, but the adenopathy persisted. She had no systemic symptoms and no other palpable lymph nodes, and the remainder of her physical examination was unremarkable. The results of all laboratory studies were normal. At surgery the node was 3 cm in diameter, tannish yellow, and rubbery. Histologic examination revealed numerous germinal centers pierced by capillaries emanating from a hypervascular pericortex and cuffed by small lymphocytes arranged in a concentric onionskin pattern (hematoxylin and eosin, ×925). These morphologic features are characteristic of Castleman's disease. . . .
Immunofluorescent plasma cell labeling indices (LI) using a monoclonal antibody (BU‐1)
Authors: Philip R. Greipp, Thomas E. Witzig, Nick J. Gonchoroff
Journal: American Journal of Hematology (1985)

Abstract Tritiated thymidine labeling indices (LI), although useful in diagnosis and prognosis of multiple myeloma, have not found wide‐spread application because autoradiographic analysis is diffucult and time consuming. Using a monoclonal antibody (BU‐1) reactive with 5‐bromo‐2‐deoxyuridine (BrdUrd), we have developed an immuno‐fluorescent procedure that allows DNA S‐phase measurements to be determined in 4 hr. Plasma cells are easily identified by reactivity with a fluorescein isothiocya‐nate‐conjugated antihuman immunoglobulin, and cells in DNA S phase are detected via BU‐1 and a rhodamine‐conjugated antimouse immunoglobulin. Results using this method on 12 patients with multiple myeloma compare favorably (correlation coefficient 0.84), with those obtained by tritiated thymidine. This immunofluorescent slide method will facilitate application of labeling indices as a clinical test to measure disease activity in patients with multiple myeloma and other hematologic neoplasms.
Oral chloramphenicol for bacterial meningitis: effective and safe
Authors: W. A. Check
Journal: JAMA (1980)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Tripodal amphiphiles tunable for self-assembly to polymersomes
Authors: Yong Joo Jun, Min Kyoung Park, Vithal B. Jadhav, Ju Hee Song, Song Wha Chae, Hwa Jeong Lee, Kyung Su Park, Byeongmoon Jeong, Jin Ho Choy, Youn Soo Sohn
Journal: Journal of Controlled Release (2009)
RECOVERY OF ANTIBODY ACTIVITY FROM INACTIVE HYBRIDS OF H AND L CHAINS
Authors: O. A. Roholt, G. Radzimski, D. Pressman
Journal: The Journal of Experimental Medicine (1967)

Hybrid IgG molecules were prepared from the heavy and light chains of specifically purified antibody against two different haptens. One hybrid consisted of the H chains from the anti-p-azobenzoate antibody from one rabbit and L chains from the anti-p-azobenzenearsonate antibody from the second rabbit, and the second hybrid consisted of the opposite combination, light chains from the first rabbit and heavy chains from the second. The two hybrids were mixed at pH 8 and were found to be so stable in the mixture that even after 2 wk at 5°C there was still only low hapten-binding activity toward p-iodobenzoate and p-iodobenzenearsonate. However, exposure of the mixture of hybrids to 1 M propionic acid followed by buffer at pH 8 resulted in recovery of binding activity for p-iodobenzoate and p-iodobenzenearsonate. Thus no exchange occurred between the light and heavy chains of the hybrids in the buffer, but exchange did occur on exposure to propionic acid, and this exchange favored a preferential combination among the chains in such a manner that effective antibody sites resulted.
867 THE ROLE OF MICRORNA-125B REPRESSION IN THE PATHOGENESIS OF HEPATOCELLULAR CARCINOMA
Authors: N. Elfimova, M. Quasdorff, I. Strack, A. Noetel, J. Riemer, T. Goeser, M. Kwiecinski, U. Protzer, H.-P. Dienes, M. Odenthal
Journal: Journal of Hepatology (2010)
Coronary Surgery: When, Where and for Whom?
Authors: Stephen G. Pauker
Journal: New England Journal of Medicine (1975)

Ideally, therapy for patients with ischemic heart disease should both relieve disabling symptoms and increase life expectancy. Aortocoronary bypass grafts1 can relieve severe angina in most patients2 , 3 but have appreciable immediate costs. The decision about such operations therefore involves balancing these short-term costs (e.g., peri-operative morbidity and mortality) against possible long-term benefits (e.g., relief of pain and prolonged survival). Although the physician caring for a patient with coronary disease can provide advice about these costs and benefits, the ultimate decision must be made by the patient and must depend, in part, upon the relative importance of relief of pain and . . .
INCREASED ARTERIAL STIFFNESS AND CAROTID INTIMA-MEDIA THICKNESS CORRELATE WITH INCREASED MRNA AND PROTEIN EXPRESSION OF ADIPONECTIN RECEPTORS ON MONOCYTES DERIVED FROM PATIENTS WITH CORONARY ARTERY DISEASE
Authors: Ignatios Ikonomidis, Nikolaos P.E. Kadoglou, Anastasios Kollias, John Lekakis, Ioannis Palios, Panayoula Tsiotra, Eirini Maratou, Katerina Fountoulaki, George Dimitriadis, Sotirios Raptis, Dimitrios Kremastinos, Maria Anastasiou-Nana
Journal: Journal of the American College of Cardiology (2011)
Overriding a Patient's Refusal of Treatment after an Iatrogenic Complication
Authors: David Casarett, Lainie F. Ross
Journal: New England Journal of Medicine (1997)

An iatrogenic complication is an unfavorable response to medical treatment that is induced by the therapeutic effort itself.1 Although some are minor, others are life-threatening. Serious or fatal iatrogenic complications occur in 4 to 9 percent of hospitalized patients.24 One retrospective series found that 14 percent of cardiac arrests could be traced to an iatrogenic event.5 Physicians often treat conditions caused by iatrogenic complications differently from other medical conditions.6 In this article we shall consider various reasons that might be used to justify making a distinction, in particular the arguments used to justify overriding a do-not-resuscitate (DNR)7 order after . . .
Disease of Intemperance.
Authors: J. Ackerman Coles
Journal: JAMA (1898)

Newark, N. J., Oct. 4. <h3>To the Editor:</h3> —In your timely article on "The International Temperance Congress," in theJournal of the American Medical Association(Oct. 1, 1898), you well say, "The questions concerning the action of alcohol and inebriety and its cure and prevention, are vital in almost every neighborhood of the for land, and it would seem to be a most practical subject medical men to discuss and study," for physicians pre-eminently possess the power to arrest and prevent the spread of the disease of intemperance. They alone can prohibit with authority the use of alcohol in the nursery, hospital and general practice, and so prevent the acquirement of the appetite for alcoholic drinks—slowly induced in some, in some more rapidly—which, Tantalus-like, torments and devours the sufferer with a perpetual thirst. According to the best authority, experience has demonstrated it to be a fact that as regards the