tbuckley/cabot-search huggingface dataset:
Relapsing Polychondritis With Glomerulonephritis
Authors: Abraham Weinberger
Journal: JAMA (1981)

To the Editor.—  James L. Ruhlen, MD, and Kent A. Huston, MD, described a patient with relapsing polychondritis (RP) associated with glomerulonephritis (1981;245:847). The authors did not mention whether a search for cryoglobulin was done. We recently observed a patient with essential cryoglobulinemia (EC) with vasculitis, arthritis, and Raynaud's phenomenon, in whom RP developed 18 months after the establishment of the diagnosis of EC. Renal involvement may occur in EC. 1 Therefore, we wonder whether the first patient had the association of cryoglobulinemia, renal involvement, and RP, especially since unexplained liver function test abnormalities recorded by the authors had been previously reported in patients with EC. 2
The Decreasing Supply of Registered Nurses
Authors: Geraldine Bednash
Journal: JAMA (2000)

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
378 SIMULTANEOUS MULTITARGET IRRADIATION USING HELICAL TOMOTHERAPY FOR ADVANCED HEPATOCELLULAR CARCINOMA WITH MULTIPLE EXTRAHEPATIC METASTASES
Authors: J.W. Jang, C.S. Kay, S.H. Bae, J.Y. Choi, H.J. Jung, C.R. You, C.W. Kim, S.H. Cho, S.K. Yoon, J.Y. Han, C.W. Han, I.B. Choi
Journal: Journal of Hepatology (2008)
Academic medicine: time for reinvention: Summary of responses
Authors: J. Clark
Journal: BMJ (2004)

<h3>Abstract</h3> The emergence of mutant SARS-CoV-2 strains associated with an increased risk of COVID-19-related death necessitates better understanding of the early viral dynamics, host responses and immunopathology. While studies have reported immune profiling using single cell RNA sequencing in terminal human COVID-19 patients, performing longitudinal immune cell dynamics in humans is challenging. Macaques are a suitable model of SARS-CoV-2 infection. We performed longitudinal single-cell RNA sequencing of bronchoalveolar lavage (BAL) cell suspensions from adult rhesus macaques infected with SARS-CoV-2 (n=6) to delineate the early dynamics of immune cells changes. The bronchoalveolar compartment exhibited dynamic changes in transcriptional landscape 3 days post-SARS-CoV-2-infection (3dpi) (peak viremia), relative to 14-17dpi (recovery phase) and pre-infection (baseline). We observed the accumulation of distinct populations of both macrophages and T-lymphocytes expressing strong interferon-driven inflammatory gene signature at 3dpi. Type I IFN response was highly induced in the plasmacytoid dendritic cells. The presence of a distinct HLADR<sup>+</sup>CD68<sup>+</sup>CD163<sup>+</sup>SIGLEC1<sup>+</sup> macrophage population exhibiting higher angiotensin converting enzyme 2 (ACE2) expression was also observed. These macrophages were significantly recruited to the lungs of macaques at 3dpi and harbored SARS-CoV-2, while expressing a strong interferon-driven innate anti-viral gene signature. The accumulation of these responses correlated with decline in viremia and recovery. The recruitment of a myeloid cell-mediated Type I IFN response is associated with the rapid clearance of SARS-CoV-2 infection in macaques.
Pure Neural Tuberculoid Leprosy
Authors: S. G. Browne
Journal: BMJ (1965)

Charter will do anything to help us with this impossible work load."With the present net loss of principals running at a rate of over 200 in five months, the general practitioner is faced with an in- evitable increase in this load which seems likely to be a geometric progression.On the other hand, as a result of these losses the Pool will be £600,000 the poorer.The pro- fession must decide whether the Minister's suggestions for a publicity campaign are likely to be more effective in reducing un- necessary demand than a discretionary charge
Neutrophils in Human Diseases
Authors: Harry L. Malech, John I. Gallin
Journal: New England Journal of Medicine (1987)

HUMAN neutrophilic polymorphonuclear leukocytes (neutrophils) provide an effective host defense against bacterial and fungal infection, but they are also important in the pathogenesis of tissue damage in certain noninfectious diseases. Some important events in neutrophil function that will be discussed in this review are shown in Figure 1.Mild to moderate abnormalities of neutrophil function have been reported in many acquired and congenital diseases.1 2 3 4 5 In most of these disorders, the biochemical or morphologic basis of the defects is unknown and the relevance of the neutrophil defect to the manifestations of the disease is unclear. In contrast, persons with marked neutropenia6 or . . .
The BCG Controversy-Reply
Authors: John D. Clemens
Journal: JAMA (1983)

<h3>In Reply.—</h3> We agree with Dr Pust that our methodological and statistical analysis does not exclude the possibility that some of the variation in the results of the eight BCG trials may have been caused by biologic differences among the trials. However, when the animal data published by Palmer and Long<sup>1</sup>were evaluated quantitatively by Hart,<sup>2</sup>differing prevalence rates of atypical mycobacteria were regarded as an unlikely source for much of the variation in the results. Similarly, other proposed biologic explanations, such as the hypothesis that the trials differed because of the differing nutritional status of the trial populations<sup>3</sup>or the more recent hypothesis that frequent infections with<i>Mycobacterium tuberculosis</i>of low virulence vitiate apparent BCG efficacy,<sup>4</sup>lack convincing empiric demonstrations in human populations. Consequently, we do not believe that BCG should be discounted in developing countries simply because several possible—and, as yet, unknown—biologic factors may be
Managing chronic diseases
Authors: Parvaiz A Koul
Journal: BMJ (2005)

Managing chronic diseases Palliative care spectrum starts early onEditor-Palliative care does not start when a patient is dying. 1 A whole spectrum of palliation begins from the day of diagnosis of a potentially terminal disease, such as soft tissue sarcoma.Palliation, in the sense of needing to absorb what this means for the patient, becomes even then a medical imperative.The "How long have I got, Doc?" question may not be articulated, but it will be there and needs an empathetic response.Curative treatment is sought, but-with sarcoma-lung metastases signal the end of that phase and the beginning of palliative treatment.The doctor and the patient know the dragon can be disabled but never slain.Palliation is then partnership, working to decide what may be gained at what cost.(This may apply during curative treatment: to take chemotherapy drugs now "just in case," or to keep them for later?)Palliative treatment can be long (in sarcoma up to 20 years or more), or it can be brief.Its ending is not solely a medical judgment.Doctors may decide they can do no more, but active patients use online support groups, seeking new treatment options across the world.Patients may decide to end palliative treatment.Grown weary of painful chemotherapy offering diminishing returns, they may prefer a shorter but better life.Making that choice together is an aspect of palliation.When death is near, palliative care becomes terminal care.If throughout doctors and patients have aligned their understanding of the disease, and have taken decisions jointly, have explored the holistic meaning of disease in life and death, the palliative spectrum may offer healing if not cure.If, however, being palliative begins only when the patient is dying doctors cannot then meet patients, where they are most needed, in the ground of their being and their not being.
Severity-Adjusted Mortality and Length of Stay in Teaching and Nonteaching Hospitals
Authors: Gary E. Rosenthal, Dwain L. Harper, Linda M. Quinn, Gregory S. Cooper
Journal: JAMA (1997)

Major teaching hospitals are perceived as being more expensive than other hospitals and, thus, unattractive to managed care. However, little empirical data exist about their relative quality and efficiency. The current study compared severity-adjusted mortality and length of stay (LOS) in teaching and nonteaching hospitals.Retrospective cohort study.Thirty hospitals in northeast Ohio.A total of 89851 consecutive eligible patients discharged in 1991 through 1993 with myocardial infarction, congestive heart failure, obstructive airway disease, gastrointestinal hemorrhage, pneumonia, or stroke.In-hospital mortality and LOS of patients in major teaching (n=5), minor teaching (n=6), and nonteaching (n=19) hospitals were adjusted for admission severity of illness using multivariable models based on demographic and clinical data abstracted from patients' medical records.The adjusted odds of death was 19% lower (95% confidence interval [CI], 2%-34%; P=.03) for patients in major teaching hospitals compared with non-teaching hospitals but was similar (95% CI, 7% lower to 28% higher; P=.28) for patients in minor teaching hospitals. The findings were generally consistent in analyses stratified according to diagnosis, age, race, predicted risk of death, and other covariates. In addition, risk-adjusted LOS was 9% lower (95% CI, 8%-10%; P<.001) among patients in major teaching hospitals relative to nonteaching hospitals but was similar (95% CI, 2% lower to 11% higher; P=.17) in minor teaching hospitals. Major teaching hospitals also cared for higher proportions of nonwhite and poorly insured patients.Risk-adjusted mortality and LOS were lower for patients in major teaching hospitals than for patients in minor teaching and nonteaching hospitals. If generalizable to other regions, the results provide evidence that hospital performance, as assessed by 2 commonly used indicators, may be higher in major teaching hospitals. These findings are noteworthy at a time when the viability of many major teaching hospitals is threatened by powerful health care market forces and by potential changes in federal financing of graduate medical education.
Diagnosis and management of "endocrine impotence".
Authors: A J Cooper
Journal: BMJ (1972)

Aetiologically speaking impotence may be predominantly "constitutional," "psychogenic," or "organic."To summarize the main characteristics, "constitutional" impotence is usually associated with persisting evidence of low sexual drive and responsiveness; some extreme cases, because of profound sexual indifference, will neither have engaged in self masturbation nor have sought out heterosexual or homosexual contacts during their entire lives.There is no demonstrable organic pathology in these cases.Unless constitutional factors are dominant or the condition is congenital, "organic impotence" will have developed from previous competence in association with some pathological lesion.Clinically, "organic" impotence is stated to be constant and persists unchanged irrespective of the nature of any sexual stimulation which might be provided.By contrast "psychogenic" impotence is alleged to be selective and transient, occurring in certain situations and at certain times.These, then, are the theoretical differences between the three postulated aetiological types of impotence.Nevertheless, in practice the distinction is not always easy or even possible.Simpson' reminds us that aetiological overlap may occur; thus, though impotence may be predominantly "constitutional," "organic," or "psychogenic," in some cases the three factors may co-exist and complicate each other to a greater or lesser degree.The clinician's task is to institute the relevant investigations and to determine any aetiology in the individual case, so that he can institute rational treatment.Organic Impotence "Organic impotence," which is usually considered to account for only about 5% of all cases, may occur with any debilitating disease, metabolic disorders, disorders of the central nervous system, cardiovascular diseases, after the use of some drugs, and diseases of the endocrine system.This article is concerned with the diagnosis and management of "endocrine disease impotence."The following disorders may be associated with difficulty or failure to achieve erection: acromegaly, Addison's disease, adrenal neoplasms (with or without Cushing's syndrome), castration, chromophobe ade- noma, craniopharyngioma, diabetes mellitus, eunuchoidism (including Klinefelter's syndrome), feminizing interstitial- cell tumour, infantilism, ingestion of female hormones and antiandrogen substances (both iatrogenic), myxoedema, obesity, and thyrotoxicosis.This diverse list of endocrine causes of impotence has been taken from the published work.*It is, in *In some cases the cause can be only presumed, since only a few clinical reports are available in the literature.
Peter Bryant, M.D
Authors: W. A. R. Chapin, Jane B. Armstrong
Journal: New England Journal of Medicine (1957)

THE father of the first distinctly enduring American poet was Dr. Peter Bryant, a son of Dr. Philip Bryant. Peter was born in 1767 in North Bridgewater, Massachusetts, and in order that the medical line established before him should be continued he hoped that his son would become a physician also. His hopes even took the form of naming the boy William Cullen, after the author of the first materia medica of recently modern times, published in 1790.Peter, one of nine children, was a direct descendant of John Alden. He succeeded to his father's practice in North Bridgewater but . . .
NIH fares relatively well, but dollars buy less
Authors: Charles Marwick
Journal: JAMA (1984)

Biomedical research, even in times of unprecedented budgetary deficit, still has some clout compared with other federal health efforts. Alone among the agencies of the Public Health Service, the National Institutes of Health (NIH) expects a 2% increase—$89,118,000 in all—over its present budget allocation. (In the 1985 budget sent to Congress by President Reagan, the NIH would receive $4.5 billion.) Still, when an annual inflation rate of 4.2% —the figure used by the Reagan Administration—is taken into account, this actually represents a reduction of 2.2% over the 1984 budget in dollar purchasing power. But, at least by comparison with other agencies in the Public Health Service, the NIH fares well in this budget. For instance, the budget for the Centers for Disease Control in Atlanta has been cut by $10 million from its 1984 total of $290 million. The result is a reduction of 7.3% in terms of actual purchasing
An Unusual Complication of Miller-Abbott Intubation
Authors: Joseph E. Caruolo
Journal: New England Journal of Medicine (1948)

INTUBATION of the small intestine has become an invaluable diagnostic and therapeutic measure, so fundamental that when indicated it is used routinely and not extraordinarily. Too often, however, a procedure seems to attract attention proportional only to its novelty. All are concerned with what an intestinal decompression tube is doing for the patient, but few are concerned with what is being done for the tube so long as it appears to be functioning.There is much literature on intubation. It teaches that the procedure should be used with deliberation at all times. This report stresses care in its use routinely, . . .
Adiponectin and Lipoprotein Particle Size
Authors: Ram Weiss, Jeremy D. Kark
Journal: Diabetes Care (2009)

We thank Tsuzaki et al. (1) for their comments and for the interesting data they share. The association of serum adiponectin concentration with LDL particle size in middle-aged and elderly Japanese adults confirms our findings in young Israeli adults, points to the generalizability of the …
Desquamative gingivitis: a form of cicatricial pemphigoid?
Authors: ROBERT M. FINE, DWIGHT R. WEATHERS
Journal: British Journal of Dermatology (1980)

SUMMARY Desquamative gingivitis, a sub-epithelial vesiculo-bullous disease involving the gingiva, has been shown to have positive direct immunofluorescent findings similar to those of cicatricial pemphigoid. However, the lack of severe scarring, limitation of lesions to the anterior portion of the mouth and the tendency toward limitation of lesions to the oral mucosa over long periods of time in desquamative gingivitis, suggest that desquamative gingivitis and cicatricial pemphigoid are distinct and separate entities.
Contact dermatitis from propolis
Authors: BIRGITTE WANSCHER
Journal: British Journal of Dermatology (1976)

Journal Article Contact dermatitis from propolis Get access BIRGITTE WANSCHER BIRGITTE WANSCHER Department of Dermatology, University of Copenhagen, Rigshospital, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 94, Issue 4, 1 April 1976, Pages 451–456, https://doi.org/10.1111/j.1365-2133.1976.tb06125.x Published: 01 April 1976
The movement towards the professionalization of medicine.
Authors: I Waddington
Journal: BMJ (1990)

<h3>Background</h3> The Government of Rwanda has nationally implemented performance-based financing (PBF) to improve the satisfaction and motivation of health workers, as well as access and quality of HIV/AIDS services in the context of scaling-up services. The scheme pays for 10 HIV/AIDS indicators (two related to HIV testing and counselling (HTC), which is believed to be a core strategy for decreasing HIV incidence and improving prevention and care). We present the effect of Rwanda9s PBF program on individual and couple/partner testing as an entry point to other HIV services and in the context of scale up. <h3>Methods</h3> Taking advantage of a prospective quasi-experimental design, an impact evaluation was conducted during phase-in of the Rwanda9s PBF program in 2006 and 2008. Individual HTC was measured by whether or not the individual has ever been tested for HIV (371 treatment individuals (61.1% female), 378 control (56.6% female)), and partner testing was assessed by whether or not the sexual partners they had in the 12 months prior to the survey had ever been tested for HIV (208 treatment individuals (57.2% female), 202 control (52.0% females)). To evaluate the outcomes, a difference-in-difference fixed effects model was used with SEs clustered by district*year. <h3>Results</h3> PBF increased HTC at the individual level by 9.45% from baseline (p=0.07). This effect was mainly found among married individuals (10.87% increase, p=0.02), specifically males (15.75% increase, p=0.06). PBF also increased testing among couples by an estimated 16.14% (p=0.034) increase from baseline, as reported by one of two partners. <h3>Conclusion</h3> Our work provides evidence that PBF might be a useful tool to increase access to HTC for both individuals and couples. This is a remarkable result since couple testing has previously been difficult to encourage.
Defects of Neutrophil Function
Authors: Richard B. Johnston
Journal: New England Journal of Medicine (1982)

Discovery in medical science feeds on itself, and advances often come in clusters. This seems to be the case with new knowledge gained about the physiology of polymorphonuclear neutrophils — knowledge obtained not only from studies of normal cells but also from careful evaluation of defects in neutrophil function. In this issue of the Journal, Boxer and his colleagues describe studies of neutrophils obtained from a man with recurrent subcutaneous abscesses.1 The cells studied had an almost complete deficiency of the population of granules termed specific, or secondary. This defect — in fact, the same patient — has been . . .
Hospital Use in a Fee-for-Service System
Authors: John H. Kleinman
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The SPECIAL COMMUNICATION "Hospital Use in a Fee-for-Service System" by Nobrega and co-workers (1982;247:806) failed to discuss one explanation for lower discharge and hospitalization rates in Olmsted County, Minnesota. If the incidence of specific chronic diseases in the population of Rochester and the surrounding rural community varied from the national averages, significant utilization differences would occur. A study by Zook and Moore<sup>1</sup>of 42,880 hospital discharges in 1976 found that "the high cost 13% of patients consumed as many resources as the low cost 87%." Six diagnostic categories accounted for 66% of the most costly (high utilizing) patients. Four of these diagnoses—degenerative diseases of the heart and peripheral vessels, malignancy, renal failure (diseases of the urinary system), and alcoholism—are underrepresented by as many as 50% fewer discharges in Olmsted County when compared with the US average. The argument that this represents a true decreased incidence of disease
Antithyroid Activity of N-Phthalyl Glutamic Acid Imide (K 17)
Authors: J. McC. Murdoch, G. D. Campbell
Journal: BMJ (1958)

N-phthalyl glutamic acid imide (K 17) was first synthesized in Germany by Kunz et al. ( 1956) while seeking to produce a drug combining the advantages of the barbiturates without their undesirable side-effects.This
Case 34-1969
Authors: John H. Knowles, Robert E. Scully
Journal: New England Journal of Medicine (1969)

Presentation of CaseA twenty-seven-year-old Negro man was admitted to the hospital because of dyspnea.He had been well until eight days previously, when he began to experience arthralgias, myalgias and fatigue and stayed at home in bed. On the following day a nonproductive cough developed. Four days before admission the temperature rose 104°F; his physician treated him with penicillin for the next four days. Two days before entry there was the onset of progressive dyspnea.There was no history of trauma, pleurisy, hemoptysis or exposure to tuberculosis or toxins.The patient was a robust man with acute respiratory distress . . .