tbuckley/cabot-search huggingface dataset:
P149 Management Algorithm For Pulmonary Embolism (PE) with Right Heart Strain: A Case Series
Authors: V Smith, G Tunnicliffe, G Fiorino, A Draper, I Vlahos, M Shannon, BP Madden
Journal: Thorax (2012)

Current guidelines state thrombolysis is first line therapy in hypotensive PE patients and may be of benefit in normotensive patients with right heart strain. There is, however, no specific guidance on selecting these patients. In 2010, St George’s Hospital, under the guidance of a multidisciplinary team of specialists, initiated an algorithm for the management of patients with massive PE. The aim of this study was to determine whether the algorithm is an effective means of assessing a series of nine patients who received thrombolytic therapy over a two year period. The age range of the patients was 36–81 years, 5 were male.5 patients had identifiable thromboembolic risk factors: pregnancy and protein S deficiency (1), recent lower limb surgery (2), new cancer diagnosis (1) and chronic immobility (1). All 9 patients had a computed tomography pulmonary angiogram (CTPA) confirming large proximal PEs with elevated troponin I and NT-pro-BNP levels at diagnosis. Right heart strain was demonstrated on echocardiogram in five patients with evidence of intracardiac thrombus in two. The remaining patients had right heart strain demonstrated by CTPA. The indications for thrombolysis were cardiac arrest (1), hypotension (1), intracardiac thrombus (2) and significant right ventricular strain(5).There was one mortality within this cohort following retroperitoneal bleed. This patient underwent an echocardiogram 5 days post thrombolysis revealing severely dilated right heart and RVSP of 61mmHg. Patients achieved good resolution of thrombus on repeat CTPA, and no evidence of right heart strain on follow up echocardiogram. The majority of these patients had improved right ventricular function post thrombolysis. This small cohort study demonstrates the variability in the clinical presentations and physiological manifestations of massive PE, hence the need for early specialist input. The algorithm is an effective tool in identifying high mortality risk patients and those likely to develop pulmonary hypertension, thus allowing early specialist review and intervention.
Successful Case of Intra-arterial Blood Transfusion
Authors: D. C. Devitt, C. Wigderow
Journal: BMJ (1951)

HEPATIC COMA IN A CYSTINURIC BDHJORNAL and ethanolamine on paper chromatography.A further spezimen of urine on December 29, when the patient was fully convalescent, showed abnormal quantities of cystine, lysine, and methyl histidine, but was otherwise normal.Dr. Dent interprets these findings as follows.The first specimen (October 18) was compatible with severe liver damage, but not so severe as would be regarded as inevitably fatal.It also suggested that the patient was a cystinuric.The second specimen (December 29) confirmed the fact that he was a true cystinuric-that is, was one of those people who all their lives excrete in the urine exceptionally large quantities of cystine, lysine, and sometimes also arginine (Dent and Rose, 1951).The increased quantity of methyl histidine cannot yet be interpreted. SummaryA record is given of a case of infective hepatitis developing coma which recovered after 36 hours.The Latner regime of therapy was used.The patient showed a slight generalized amino-aciduria to paper chromatography at the height of coma.It was a surprise to find that he was a cystinuric, a fact which was confirmed later when he was convalescent.The significance of this is briefly discussed.I am greatly indebted to Dr.
F-18 FDG PET/CT Incidental Finding of Large Ischiogluteal Bursitis
Authors: Ba Duong Nguyen, Michael C. Roarke
Journal: Clinical Nuclear Medicine (2007)

The ischiogluteal bursa is located posteroinferior to the ischial tuberosity and anteromedial to the gluteus maximus muscle. Inflammatory changes of this bursa, relatively uncommon, may mimic an abscess or necrotic primary or secondary malignancy on cross-sectional imaging. The authors present the incidental detection of a large and asymptomatic ischiogluteal bursitis during F-18 FDG PET/CT staging for head and neck cancer.
School-Based Screening for Tuberculous Infection
Authors: Janet C. Mohle-Boetani
Journal: JAMA (1995)

<h3>Objective.</h3> —To compare tuberculin screening of all kindergartners and high school entrants (screen-all strategy) vs screening limited to high-risk children (targeted screening). <h3>Design.</h3> —Decision, cost-effectiveness, and cost-benefit analyses. <h3>Setting and Subjects.</h3> —Students in a large urban and rural county. <h3>Definitions.</h3> —High risk of tuberculous infection was defined as birth in a country with a high prevalence of tuberculosis. Low risk was defined as birth in the United States. <h3>Outcome Measures.</h3> —Tuberculosis cases prevented per 10000 children screened. Net costs, net cost per case prevented, benefit-cost ratio, and incremental cost-effectiveness. <h3>Results.</h3> —The screen-all strategy would prevent 14.9 cases per 10 000 children screened; targeted screening would prevent 84.9 cases per 10000 children screened. The screen-all strategy is more costly than no screening; the benefit-cost ratio is 0.58. Targeted screening would result in a net savings; the benefit-cost ratio is 1.2. Screening all children is cost saving only if the reactor rate is 20% or greater. The cost per additional case prevented for screening all children compared with targeted screening ($34 666) is more than twice as high as treatment and contact tracing for a case of tuberculosis ($16392). <h3>Conclusions.</h3> —Targeted screening of schoolchildren is much less costly than mass screening and is more efficient in prevention of tuberculosis. (<i>JAMA</i>. 1995;274:613-619)
US health care needs higher taxes and rationing
Authors: David Spurgeon
Journal: BMJ (2005)

Higher taxes and possibly eventual limiting or rationing of services are inevitable if US citizens are to get universal health care. And healthcare professionals should lead the way in helping the public confront this unpleasant truth, say James Mongan and Thomas Lee in the New England Journal of Medicine (2005;352:1260-3).

Their article says that the recent US election might have considered whether broader health coverage should be a high priority. The anti-tax movement should, they say, be recognised as the “main enemy of those who …
Germany's Health System: One Nation, United With Health Care for All
Authors: Bradford Kirkman-Liff
Journal: JAMA (1994)

The health care system of Germany is often advocated as an alternative model to the Canadian system for lessons for health reform in the United States. As described in an earlier article inThe Journal,<sup>1</sup>the German system is pluralistic and relies on a regulated system of private financing and delivery to provide virtually universal coverage. The system in Germany has received less attention than the Canadian system over the past decades for several reasons, one of the most important having been lack of accessible information. Less than a handful of American health policy researchers read German, and few German health policy researchers have published in English. This lack of easy access to information on health care in this complex system has been eliminated by the publication of Richard Knox's exhaustive examination. For a book of such scope, it is also very readable. Knox avoids jargon and clearly presents
Percepts are selected from nonconceptual sensory fields
Authors: Edmond Wright
Journal: Behavioral and Brain Sciences (2003)

Steven Lehar allows too much to his direct realist opponent in using the word “subjective” of the sensory field per se. The latter retains its nonconceptual, nonmental nature even when explored by perceptual judgement. He also needs to stress the evolutionary value of perceptual differences between person and person, a move that enables one to undermine the direct realist's superstitious certainty about the singular object.
Prevalence of symptoms related to asthma and risk factors for asthma of the adult in an urban area in Northeastern Mexico
Authors: F. Vazquez-Nava, A.H. Saldivar-González, J. Perez-Martin, H.R. Sanchez-Nuncio, J. Varon, F.J. Beltran-Guzman
Journal: Journal of Allergy and Clinical Immunology (2005)
dld-1 suppression attenuates the detrimental effects of amyloid beta deposition in a Caenorhabditis elegans model of Alzheimer’s disease
Authors: Waqar Ahmad, Paul Ebert
Journal: Molecular Neurodegeneration (2013)

Background Amyloid beta (Ab) aggregation is well studied as a major marker and determinant of Alzheimer’s disease (AD) pathology. While less work has been carried out on the role of energy metabolism in AD, there is good evidence that it also contributes to the disease. For example, low metabolic rate and ATP levels are also correlated with AD, which also extends to specific enzymes, metabolites, and proteins associated with glycolysis and the TCA cycle. Dihydrolipoamide dehydrogenase (DLD-1), the subject of this study, is a core metabolic enzyme with specific sequence variants that are associated with increased risk of late onset AD. DLD-1 contributes to four major metabolic multi-enzyme complexes, including a-ketoglutarate dehydrogenase (KGDH). A non-DLD subunit of KGDH also has variants that are associated with AD. Additionally, the activity level of the enzyme is significantly inversely correlated with the disease state in humans.
A CASE OF SUBACUTE INFECTIVE ENDOCARDITIS
Authors: B. Hudson
Journal: BMJ (1918)

MAAL SUBACUTE INFECTIVE ENDOCARDITIS. [Nov.9, I9g8 This inierease(1 proportioin of agglatinable str-ains, which was also founid in the 19i7 epidemic, period, coilstitutes a second dander signad.(Seearticle previously cited.)7. Cases ceased to occur as soonl as the ddpot was spaced out to some extent (barrack-rooms 30, huts 27, tents 7 men in each)and carrier rates declined, those of the barrack-rooms remaining high for two months.Effects of Spacing Outt in Other Untits.The results of "spacing out" beds to 21 ft. in otlher units were equally remarkable.The table gives the results in four instances with men sleeping in barrackrooms all severely overcrowded when the inen were first examined.Etects of "'Sparipi Otut .n "Screiely Oreircroirded Barruc,,rk.oows.
Blindness and vision impairment in a rural south Indian population: the Aravind Comprehensive Eye Survey
Authors: R.D Thulasiraj, Praveen K Nirmalan, R Ramakrishnan, R Krishnadas, T.K Manimekalai, N.P Baburajan, Joanne Katz, James M Tielsch, Alan L Robin
Journal: Ophthalmology (2003)
The Physician's Contribution to the Health System
Authors: F.J. Ingelfinger
Journal: New England Journal of Medicine (1976)

The current expectation that the physician be familiar with all the intricacies of modern medical science as well as a competent philosopher, psychiatrist, sociologist, economist, and public health expert is unrealistic, for the true indicators of good medical -anagement are knowledge, honesty, wisdom, and compassion. Furthermore, the personal attributes are of little value if the physician does not possess the essential basic core of knowledge. Although the physician needs to be aware of the multiple influences affecting an individual's health, a doctor's basic responsibility is sickness, not overall health. As evidenced by specialization, 1 physician cannot be an expert in all of medical science, yet the average doctor is expected to be an authority on all family relations, and so forth. There can be no question that the complexities of modern life require an "umbrella of care," but these needs must be met by multiple and integrated services designed for the maineenance of health with the role of physicians remaining as the comfort and possible cure of the sick. If this role of the physician were clearly recognized, many present problems could be managed more easily. The average doctor and medical pedagogy could concentrate on scientifically accurate diagnosis and treatment.
Research Compensation and the Monetarization of Medicine
Authors: Stanley Joel Reiser
Journal: JAMA (2005)

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
Spatial variability of vasodilatation in human forearm skin
Authors: ETHEL TUR, H.I. MAIBACH, R.H. GUY
Journal: British Journal of Dermatology (1985)

Journal Article Spatial variability of vasodilatation in human forearm skin Get access ETHEL TUR, ETHEL TUR Department of Dermatology, Schools of Medicine, University of California, San Francisco, CA94143, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar H.I. MAIBACH, H.I. MAIBACH Department of Dermatology, Schools of Medicine, University of California, San Francisco, CA94143, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar R.H. GUY R.H. GUY Departments of Pharmacy and Pharmaceutical Chemistry, School of Pharmacy, University of California, San Francisco, CA94143, U.S.A. Richard H.Guy, Phd. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 113, Issue 2, 1 August 1985, Pages 197–203, https://doi.org/10.1111/j.1365-2133.1985.tb02065.x Published: 01 August 1985 Article history Accepted: 10 January 1985 Published: 01 August 1985
Undernutrition, Growth and Development
Authors: Richard L. Naeye
Journal: New England Journal of Medicine (1970)

Parrot, a French pediatrician, gave the first detailed description of the organs of undernourished children after studying the famine victims of the Paris Commune of 1870.1 He reported fatty degeneration of the brain and abnormalities in other organs. Surprisingly enough, more sophisticated studies of early childhood undernutrition have only recently been undertaken, and they are still incomplete. In the present issue of the Journal, Chase and Martin give evidence that undernutrition during the first year of life retards the mental and physical development of some American children. Similar retardation is observed in undernourished children in various undeveloped nations.Severe . . .
Fat-mobilizing action of amphetamine
Authors: E. J. Pinter, C. J. Pattee
Journal: Journal of Clinical Investigation (1968)

The effects of amphetamine and methamphetamine on plasma free fatty acid (FFA), blood glucose, serum total fat, and triglyceride concentrations were investigated in 21 subjects; the effect of epinephrine were studied in an identical manner in 14 subjects.
Ethics as Practiced.
Authors: Geo. M. Stiles
Journal: JAMA (1898)

Conshohocken, Pa., Aug. 15, 1898. <h3>To the Editor:</h3> —It seems to me that this letter is a good text for an editorial on "Medical Ethics." Is this the ethics recognized by the New York profession and recommended by a teacher in a medical college, even though a subordinate? Respectfully,
Defective nuclear accumulation of androgen receptors in disorders of sexual differentiation.
Authors: S Gyorki, G L Warne, B A Khalid, J W Funder
Journal: Journal of Clinical Investigation (1983)

Nuclear transfer of androgen receptors (AR) and glucocorticoid receptors (GR) was determined in cultured genital skin fibroblasts from 10 normal controls and eight patients with abnormalities of the external genitalia. In whole cell studies, cultures were incubated for 20 min at 37 degrees C with [3H]methyltrienolone (3H-R1881) or tritiated dexamethasone, and specific binding was determined in whole cell, cytoplasmic, and crude nuclear fractions. Between normal and affected fibroblasts no difference was seen in cellular levels of GR, or in cytoplasmic and nuclear distribution of GR. In normal fibroblasts, cytoplasmic binding of 3H-R1881 represented 56%, and crude nuclear binding 44%, of total binding; in fibroblasts from five of the eight patients similar values (cytoplasmic 55% and nuclear 44%) were seen for 3H-R1881 binding. In fibroblasts from the other three patients no decrease in total cellular levels of AR were seen; nuclear compartmentalization, however, was much lower (approximately 20%) than in other cultures. In vitro reconstitution studies, combining 3H-R1881-loaded cytosol with naive nuclei, lead us to suggest that the defect in nuclear compartmentalization lies at the level of the nuclear acceptor site rather than the cytoplasmic binder in affected cells. We interpret the data to suggest that defective nuclear binding of AR complexes may be involved in a proportion of cases of abnormal development of the external genitalia.
Medical Society Review Programs
Authors: Howard Hassard
Journal: JAMA (1966)

Many years before Medicare came to pass, the California Medical Association set out to develop a series of disciplinary mechanisms for the medical profession. Self-discipline among professional men and organizations is far more efficient than any sort of "discipline" that could possibly come out of a government bureau. Self-imposed review of medical practice and utilization of health facilities are necessary at all levels; the informed judgments of our peers can often be much harsher than the uninformed judgments from outside bodies. There are four key areas of medical care in which the public expects help from the medical profession: cost, quality, availability, and scope of service. The California medical review programs have been developed carefully over the past few years to provide just that help. CMA has sought to serve as a catalyst in the state-wide development of these programs. One pioneering program, called "Guiding Principles for Physician-Hospital Relationships," was
Confidentiality of Patients' Case Notes
Authors: J. Slowe
Journal: BMJ (1967)

Eradicating Scabies SIR,-We read with great interest the letter of Dr. P. R. Danby and others (25 February, p. 496).It is our experience in Hull and the East Riding that the number of cases of scabies is steadily increasing.Realizing that we only see the tip of an iceberg the increase is still very impressive.We find the greatest difficulty with re- infection, which is probably due to the fact that patients' relations, or close contacts, are not being checked.With or without making scabies an identifiable disease, we would like to draw attention to the importance of this.We have found patients responding poorly to the standard 25% emulsion of benzyl ben- zoate B.P., and we usually account for relapsing cases by finding other members of the family insufficiently treated or not treated at all.We would also like to concur with Drs.Danby, Church, and Sneddon that detailed and very precise instructions about treatment are a crucial part of success.-Weare, etc.,
Review: Influenza vaccine reduces influenza-like illness in healthy adults
Authors: Bruno Granwehr
Journal: Annals of Internal Medicine (2014)

ACP Journal Club16 September 2014Review: Influenza vaccine reduces influenza-like illness in healthy adultsBruno Granwehr, MD, MS, FACPBruno Granwehr, MD, MS, FACPUniversity of Texas MD Anderson Cancer Center, Houston, Texas, USA (B.G.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-161-6-201409160-02006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationDemicheli V, Jefferson T, Al-Ansary LA, et al. Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev. 2014;3:CD001269.Clinical Impact RatingsGIM/FP/GP: Allerg & Immunol: Infectious Disease: References1 Chu HY, Englund JA. Maternal immunization. Clin Infect Dis. 2014;59:560-8. [PMID: 24799324] Google Scholar2 Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med. 2000;342:225-31. [PMID: 10648763] Google Scholar3 Pollyea DA, Brown JM, Horning SJ. Utility of influenza vaccination for oncology patients. J Clin Oncol. 2010;28:2481-90. [PMID: 20385981] Google Scholar4 Cooksley CD, Avritscher EB, Bekele BN, et al. Epidemiology and outcomes of serious influenza-related infections in the cancer population. Cancer. 2005;104:618-28. [PMID: 15973737] Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Texas MD Anderson Cancer Center, Houston, Texas, USA (B.G.)This article was published at Annals.org on 2 September 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe Effect of Detectable HIV Viral Load among HIV-Infected Children during Antiretroviral Treatment: A Cross-Sectional Study 16 September 2014Volume 161, Issue 6Page: JC6KeywordsCaregiversInfectious diseasesPregnancyResearch laboratoriesRisk managementSigns and symptomsVaccines ePublished: 16 September 2014 Issue Published: 16 September 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Abnormalities of the tracheobronchial lymph nodes in smokers and subjects with chronic bronchitis: A necropsy study of the distribution of immunoglobulins
Authors: C. A. Soutar
Journal: Thorax (1977)

<b>Soutar, C. A. (1977).</b><i>Thorax</i>, <b>32,</b> 397-405. <b>Abnormalities of the tracheobronchial lymph nodes in smokers and subjects with chronic bronchitis: a necropsy study of the distribution of immunoglobulins.</b> The tracheobronchial lymph nodes obtained at necropsy from small groups of subjects (normal non-smokers, normal smokers, subjects with chronic bronchitis which was incidental to the cause of death, and subjects who had died from long-standing chronic bronchitis) have been examined by immunofluorescent methods to detect immunoglobulin. Cells containing immunoglobulin were seen scattered in the medullary cords and corticomedullary junctions, and also as conglomerates within active germinal centres. Sampling methods on multiple sections were used to count the numbers of single cells containing immunoglobulin (excluding those in germinal centres) and also the numbers of germinal centres containing immunoglobulin. This work has shown that there were fewer plasma cells containing IgA and IgM in `fatal9 bronchitics than in normal non-smokers, normal smokers, and `incidental9 bronchitics (IgA p&lt;0·005; IgM p&lt;0·01). These results indicate that the reported depletion of plasma cells found in the airways in a small group of subjects with fatal chronic bronchitis was accompanied by a similar depletion in the regional lymph nodes. It was also found that the numbers of active germinal centres containing immunoglobulin (mostly IgM) were increased in normal smokers, `incidental9 bronchitics, and `fatal9 bronchitics, although in these small numbers of subjects the significance of this difference (p&lt;0·05) depends on grouping these subjects together. This suggests that cigarette smoking alters germinal centre activity even in subjects without chronic cough.