tbuckley/cabot-search huggingface dataset:
Challenge to Osteopathic Education
Authors: Mark Cummings
Journal: JAMA (1992)

<h3>THE OSTEOPATHIC TRADITION: A PRIMARY CARE ORIENTATION</h3> Of the 15 accredited colleges of osteopathic medicine, 10 were founded between 1969 and 1981. Of these 10, six are state-supported medical colleges, which, like the others, were originally created with a generalist focus. The primary care orientation of the osteopathic physician has been reinforced by the medical college curriculum and clinical education and by the prominent roles given to generalist physicians. The osteopathic educational system helped foster primary care education through its orientation to the health care needs of the community—ambulatory clinics and smaller hospitals were staffed by competent generalists (role models); the patient population was diverse; and clinical education emphasized prevention, ambulatory medicine, and acquisition of broad-based medical knowledge and practical skills. Students traditionally received their clinical training through the network of about 100 osteopathic hospitals, located chiefly in small communities and in America's inner cities. They had limited opportunities to
Sponge Biopsy: A Contribution to Improved Diagnosis of Lung Pathology
Authors: John J. Nolan
Journal: JAMA (1962)

CANCER OF THE LUNG now causes more deaths than any other form of cancer in the male. Furthermore, its incidence is increasing not only in the male but also in the female. Cigarette smoking, one of the etiologic factors of bronchogenie carcinoma, will not disappear from the American scene because of varied social and economic factors. Therefore, as in other forms of neoplasia, early diagnosis offers the only other logical solution for this increasing problem. For the past 10 months we have applied the cellulose sponge of Gladstone<sup>2-9</sup>in the diagnosis of lung lesions and have been gratified with its results. It is our feeling that this method has merit and adds to the over-all accuracy of bronchoscopic examinations. It is equal, if not superior, to the cytology of bronchial washings stained by the Papanicolaou technique. The method is not a new one. It has been serially reported since 1948
INJECTION TREATMENT OF COMPLETE RECTAL PROLAPSE
Authors: A. S. Morley
Journal: BMJ (1934)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~IMEDICAL JOURNALover an hour, anld were associated with great emotional dis- turbance, shouting, and other evidence of cerebral irritability.On one occasion, while we were doing out-patients, this man was brought into hospital in a typical state of epilepsy; four attendants were necessary to hold him down, and he was very violent and twitching all over.He was given 10 c.cm. of evipan intravenously and his condition quieted at once into normal evipan sleep; on recovery, about an hour later, he was far less excited and almost normal.This is the only case so far in wh.ch opportunity has occurred of using this drug in this way, but it would seem to indicate further possib.litiesfor exploration.Doses of 5 to 10 c.cm. have also been used with success in cases of renal and gall-stone colic. ConclusionsSodium evipan in the majority of cases can be con- siCered a safe anaesthetic.It should not, however, be administered single-handed, in view of the possibility of respiratory spasm, or of obstruct-on of the airway, which may occur while the doctor's attention is engaged else- where.
Recognition of Fetal Alcohol Syndrome
Authors: Sterling K. Clarren
Journal: JAMA (1981)

THERE has been concern since antiquity that the ingestion of alcohol by the pregnant woman could damage her unborn child. Modern scientific warnings about gestational alcoholism began with Sullivan in 1899,<sup>1</sup>Rouquette in 1957,<sup>2</sup>and Lemoine et al in 1967,<sup>3</sup>who all noted the increased rates of stillbirth, growth deficiency, and malformations among the offspring of alcoholic women. Alcohol teratogenesis was brought to widespread public attention by Jones et al<sup>4</sup>in 1973. These authors believed that alcohol could produce a specific recognizable pattern of malformation, which they termed "fetal alcohol syndrome" (FAS). Over the last eight years, maternal consumption of alcohol has become recognized through extensive human and animal studies as a major fetal health hazard—a leading known cause of mental retardation. <h3>Syndrome Recognition</h3> Variability in phenotype occurs in most dysmorphic syndromes. By clinical appearance alone, both false-positive and false-negative cases are found in conditions that
Laboratory Errors and the Misdiagnosis of Tuberculosis-Reply
Authors: Annette T. Nitta
Journal: JAMA (1997)

In Reply.  —The laboratory procedure instituted by Dr Kaye and colleagues is an excellent response to the problem of misdiagnosis of TB due to laboratory contamination. Recently, Frieden et al 1 reported that 12 (2.7%) of the 441 patients in New York City whose specimens grew M tuberculosis in April 1991 had false-positive cultures due to crosscontamination in the laboratory. The laboratory procedure described by Kaye et al, which includes medical record review for clinical correlation, is especially important in light of these findings.  The mycobacteriology section of the Public Health Laboratory in Los Angeles County has also instituted measures to prevent cross-contamination. Single-use containers to dispense processing reagents are kept outside of the biological safety cabinet and are only brought into the cabinet for immediate dispensing. Procedures to limit aerosol generation also have been instituted, including avoiding removing specimen container caps and stoppers until enough time has passed to allow settling
Treatment of radiation-induced distal rectal lesions with argon plasma coagulation: use of a transparent cap
Authors: R. Coriat, C. Wolfers, U. Chaput, S. Chaussade
Journal: Endoscopy (2008)

The increasing incidence of chronic radiation proctitis (CRP) is due to the increasing use of radiotherapy in prostate cancer. The incidence ranges between 2 % and 20 % in various retrospective studies. Median time to clinical symptoms ranges from 8 to 13 months [1]. Argon plasma coagulation (APC) has now been established as an effective, safe, and well-tolerated endoscopic therapy, with success rates between 80 % and 100 % [2]. The dose–volume toxicity is a well-proven factor in rectal bleeding. Intensity-modulated radiotherapy (IMRT) has reduced the overall rectal toxicity, but rectal lesions induced by IMRT often begin right above the anus [3]. The use of APC is difficult for lesions located immediately above the dentate line in the upper part of the anal canal. These can generally only be approached in the retroflexed position. Disadvantages include a higher risk of rectal scarring, less mobility of the endoscope, and greater patient discomfort.
Abstract 4059: Development of a point-of-care device for circulating tumor cell/cluster detection
Authors: Yang Zhou, Wael A. Harb, Guoqiang Shao, Bin Hong
Journal: Cancer Research (2012)

Abstract Circulating tumor cell (CTC) has recently grabbed numerous headlines with the promise for personalized cancer diagnostics and treatment. Its clinical value, in terms of presence and the number, has been demonstrated in accumulated results for prognosis of cancer progression and mortality, and prediction of therapy response. CTCs, the leukemic phase of solid tumor, further give us the hope for a rapid and affordable optical imaging tool as CTCs are readily accessible and optically observable. Fluorescence based cell imaging has been widely spread to detect CTCs. However, it is still a challenge to accomplish a point-of-care test (POCT) due to many limitations such as the cost, fluorescence stability, variations in fluorescence detection and image processing, and data interpretation. Chromogenic labeling may offer exciting perspectives in POCT for CTC detection along with the application of metallic signal enhancement. Based on this concept, TeloVISION LLC developed a palm-sized, manually operated, POCT device for CTC detection. The device, which bears a membrane with rod-shaped, micron-sized pores, processes the whole blood without vigorous manipulation. By manually rotating the device counter-clockwise, the entire CTC assay is split into 7 steps, performed inside the device, and completed in 40 minutes. To validate the device, whole blood was withdrawn from the animals bearing metastatic tumors. Due to the restriction of the membrane, CTCs larger than 5µm size were retained while majority of the normal cells were removed due to the discrepancy in deformability. In addition, the filtration was driven by gravity so that the mechanical damage from external force was avoided. After filtration, enriched CTCs were identified by DAB stain in the presence of horseradish peroxidase (HRP) tagged anti-cytokeratin (CK) and the signal was intensified 50-fold by metal precipitation. CTCs were found in blood as well as the circulating tumor microemboli (CTM) by both chromogenic labeling and fluorescence staining (control). Heterogeneity in the CK expression was seen for both CTCs and CTM. The recovery of the device was 94% compared to that by hemocytometer. We conclude that chromogenic labeling with the signal enhancement by in situ metal precipitation can provide high-resolution, sensitive CTC detection, and prevent the false positive results as seen in fluorescent labeling due to autofluorescence and fluorescence ghost in the blood. This new portable device may provide an efficient low-cost CTC detection in clinical settings. Adjustment of the antibodies will expand the field of application such as sarcoma and melanoma, non-epithelial derived CTCs. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4059. doi:1538-7445.AM2012-4059
Pooled RCTs: Atorvastatin did not increase renal-related serious adverse events
Authors: William Herrington, Richard Haynes
Journal: Annals of Internal Medicine (2014)

Source Citation Bangalore S, Fayyad R, Hovingh GK, et al; Treating to New Targets Steering Committee and Investigators. Statin and the risk of renal-related serious adverse events: analysis from the IDEAL, TNT, CARDS, ASPEN, SPARCL, and other placebo-controlled trials. Am J Cardiol. 2014;113:2018-20. 24793673
Mycotic aneurysm of the aortic arch masquerading as systemic lupus erythematosus.
Authors: K Chakravarty, D.G Scott
Journal: Annals of the Rheumatic Diseases (1992)

The case is described of a patient with mycotic aneurysm of the aortic arch whose clinical and serological features were indistinguishable from those of systemic lupus erythematosus. Surgical resection and repair of the aneurysm resolved her clinical symptoms and the serological abnormalities.
EU reshuffle has health potential
Authors: T. Richards
Journal: BMJ (2010)

<b>Objectives</b> To explore the predictive power of a risk stratification method for people with hypertension based on “essential” procedures (that is, available in economically less developed areas of the world), comparing it in the same population with the results given by the method suggested by the 1999 World Health Organization-International Society of Hypertension (WHO-ISH) guidelines. <b>Design</b> Prospective cohort study of outcomes according to cardiovascular risk profile at baseline. <b>Setting</b> Primary care in a poor rural area of the Ecuadorian forest. <b>Participants</b> 504 people with hypertension prospectively monitored for a mean of 6.7 (SD 2.3) years. <b>Interventions</b> Essential data included blood pressure, medical history, smoking, age, sex, and diagnosis of diabetes; the WHO-ISH methods additionally included measurement of fasting blood glucose, total cholesterol, and creatinine, urinalysis, and electrocardiography. <b>Main outcome measures</b> Cardiovascular events and total deaths. <b>Results</b> With both methods there was a highly significant association between the level of predicted risk and the incidence of cardiovascular events and of total deaths: up to three quarters of all cardiovascular events and two thirds of all deaths were reported among people classified as at high or very high risk with either method. The predictive discrimination of the essential method is comparable with the WHO-ISH with C statistics (95% confidence interval) of 0.788 (0.721 to 0.855) and 0.744 (0.673 to 0.815), respectively, for cardiovascular events and 0.747 (0.678 to 0.816) and 0.705 (0.632 to 0.778) for total mortality. <b>Conclusions</b> The risk stratification of patients with hypertension with an essential package of variables (that is, available and practicable even in the economically less developed areas of the world) serves at least as well as the more comprehensive method proposed by WHO-ISH.
STUDIES ON STREPTOCOCCUS BACTERIOPHAGE
Authors: Gregory Shwartzman
Journal: The Journal of Experimental Medicine (1927)

1. The "sludge" phage obtained by Clark and Clark answers all requirements for pronouncing it identical with the classical bacteriophage. 2. The "sludge" phage failed to produce lysis in any of the 102 human pathogenic streptococci tested. 3. Numerous attempts to induce regeneration of various lytic principles by human streptococci resulted in failure. 4. It was possible, however, to "train" erysipelas streptococci to regenerate a lytic principle active against 76 per cent of strains of this group. 5. The erysipelas phage showed remarkable specificity.
Identification of plasma membrane autoantigens in autoimmune hepatitis type 1 using a proteomics tool
Authors: Fatima Tahiri, François Le Naour, Stéphanie Huguet, René Lai-Kuen, Didier Samuel, Catherine Johanet, Bruno Saubamea, Viviane Tricottet, Jean-Charles Duclos-Vallee, Eric Ballot
Journal: Hepatology (2008)

Autoimmune hepatitis (AIH) is a liver disease with circulating autoantibodies predominantly directed against widely held cellular components. Because AIH is a liver-specific disease, autoantibodies against plasma membrane antigens may be involved in its pathogenesis and have been reported; however, no definite identification has been described. We thus investigated the fine specificity of anti-hepatocyte plasma membrane autoantibodies in type 1 AIH (AIH-1) using a proteomic tool. A plasma membrane-enriched fraction was validated using enzymatic activity and western blot analysis experiments. Sera from AIH-1 patients (n = 65) and from 90 controls, that is, healthy blood donors (n = 40) and patients with systemic diseases (n = 20) or other liver diseases (n = 30), were studied by immunoblot performed with plasma membrane proteins resolved by either sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) or 2-dimensional (2D) electrophoresis. Proteins contained in the immunoreactive spots were identified by sequences provided by ion-trap mass spectrometry. Hepatocytes probed with sera were also studied using confocal immunofluorescence and immunoelectron microscopy. The more prominent bands stained by patient sera were located at 38 kDa, 48, 50, 52 kDa, 62 kDa, 70 kDa, and a 95-kDa double band. Six proteins with known potential plasma membrane expression were identified: liver arginase (38 kDa), cytokeratins (CK) 8 and 18 (48-52 kDa), heat shock proteins (HSP) of 60, 70, 90 kDa, and valosin-containing protein (VCP) of 92 kDa. The presence of anti-membrane antibodies was confirmed by immunofluorescence and immunoelectron microscopy.Overall, our data demonstrate that liver arginase, CK 8/18, HSP 60, HSP 70, HSP 90, and VCP represent potential candidate targets on liver membrane for autoantibodies in AIH-1.
Protocolized Sedation in Critically Ill Children
Authors: Sangeeta Mehta
Journal: JAMA (2015)

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
Left atrial contribution to ventricular filling during the course of evolving heart failure.
Authors: T Kono, H N Sabbah, H Rosman, M Alam, P D Stein, S Goldstein
Journal: Circulation (1992)

Abnormal left ventricular (LV) filling has been observed in patients with heart failure and is characterized by marked heterogeneity of mitral inflow velocity. In the present study, the contribution of the left atrium to LV filling was examined in eight dogs during the course of evolving heart failure.Heart failure was produced by multiple sequential intracoronary embolizations with microspheres. Pulsed Doppler echocardiography was used to measure mitral inflow velocity at baseline, before embolization, and at 3, 8, 15, 23, and 33 weeks after initiation of microembolization. The early rapid LV filling (Ei) and late left atrial filling (Ai) components were quantitated based on the time-velocity integral of the early and late mitral inflow velocity waveforms, respectively. Ei decreased progressively from 7.6 +/- 1.5 cm at baseline to 4.0 +/- 0.4 cm at 33 weeks (p less than 0.01). In contrast, Ai initially increased from 1.8 +/- 0.9 cm at baseline to 2.7 +/- 0.4 cm at 3 weeks (p less than 0.01) and subsequently decreased gradually to below baseline values reaching 0.8 +/- 0.4 cm at 33 weeks (p less than 0.01). These temporal changes of Ei and Ai were accompanied by a gradual reduction of LV ejection fraction (56 +/- 5% versus 22 +/- 2%) (p less than 0.01) (baseline versus 33 weeks) and by a gradual increase of LV end-diastolic wall stress (24 +/- 7 versus 92 +/- 8 g/cm2) (p less than 0.01), left atrial dimension (2.4 +/- 0.2 cm to 3.3 +/- 0.3 cm) (p less than 0.01), and left atrial fractional shortening (22 +/- 3% versus 15 +/- 2%) (p less than 0.01).The initial rise in left atrium contribution to LV filling may represent a compensatory response to the diminution of the rapid early component of LV filling. With further progression of LV dysfunction, the left atrium contribution to LV filling gradually decreased. This reduction may be mediated by increased workload imposed on the left atrial myocardium due to increased LV diastolic wall stress, which, over time, may have lead to intrinsic left atrium dysfunction.
Goodbye to routine chest x-rays?
Authors: Beverly Merz
Journal: JAMA (1983)

The American College of Radiology (ACR) has recommended that chest roentgenograms of asymptomatic persons be discontinued as a part of routine prenatal examinations, hospital admissions, tuberculosis screening, and pre-employment examinations. The recommendation is based on studies (<i>N Engl J Med</i>1974;291:1001-1004 and<i>South Med J</i>1977; 70:579-580) indicating that such examinations do not detect a high enough incidence of occult disease to justify the inconvenience, cost, and radiation exposure to the patient. However, the ACR says that chest roentgenograms should still be taken if indicated by the patient's history, results of physical examination or diagnostic tests, or his inclusion in a high risk population. To this end, it recommends that roentgenograms of persons with occupational exposure to substances implicated in pulmonary diseases be taken at intervals appropriate to the latency of the disease. According to Reynold Brown, MD, clinical professor of radiology, University of California Medical School, San Francisco, who
The codon 64 polymorphism of the β3-adrenergic receptor gene is not associated with coronary heart disease or insulin resistance in nondiabetic subjects and non-insulin-dependent diabetic patients
Authors: Arto Pulkkinen, Anu Kareinen, Laura Saarinen, Sami Heikkinen, Seppo Lehto, Markku Laakso
Journal: Metabolism (1999)
Morbidity and Mortality in Breastfed and Formula-Fed Infants of HIV-1–Infected Women
Authors: Dorothy Mbori-Ngacha, Ruth Nduati, Grace John, Marie Reilly, Barbra Richardson, Anthony Mwatha, Jeckoniah Ndinya-Achola, Job Bwayo, Joan Kreiss
Journal: JAMA (2001)

ContextBreastfeeding among women infected with human immunodeficiency virus type 1 (HIV-1) is associated with substantial risk of HIV-1 transmission, but little is known about the morbidity risks associated with formula feeding in infants of HIV-1–infected women in resource-poor settings.ObjectiveTo compare morbidity, nutritional status, mortality adjusted for HIV-1 status, and cause of death among formula-fed and breastfed infants of HIV-1–infected women.DesignRandomized clinical trial conducted between 1992 and 1998.SettingFour antenatal clinics in Nairobi, Kenya.ParticipantsOf 401 live-born, singleton, or first-born twin infants of randomized HIV-1–seropositive mothers, 371 were included in the analysis of morbidity and mortality.InterventionsMothers were randomly assigned either to use formula (n = 186) or to breastfeed (n = 185) their infants.Main Outcome MeasuresMortality rates, adjusted for HIV-1 infection status; morbidity; and nutritional status during the first 2 years of life.ResultsTwo-year estimated mortality rates among infants were similar in the formula-feeding and breastfeeding arms (20.0% vs 24.4%; hazard ratio [HR], 0.8; 95% confidence interval [CI], 0.5-1.3), even after adjusting for HIV-1 infection status (HR, 1.1; 95% CI, 0.7-1.7). Infection with HIV-1 was associated with a 9.0-fold increased mortality risk (95% CI, 5.3-15.3). The incidence of diarrhea during the 2 years of follow-up was similar in formula and breastfeeding arms (155 vs 149 per 100 person-years, respectively). The incidence of pneumonia was identical in the 2 groups (62 per 100 person-years), and there were no significant differences in incidence of other recorded illnesses. Infants in the breastfeeding arm tended to have better nutritional status, significantly so during the first 6 months of life.ConclusionsIn this randomized clinical trial, infants assigned to be formula fed or breastfed had similar mortality rates and incidence of diarrhea and pneumonia during the first 2 years of life. However, HIV-1–free survival at 2 years was significantly higher in the formula arm. With appropriate education and access to clean water, formula feeding can be a safe alternative to breastfeeding for infants of HIV-1–infected mothers in a resource-poor setting.
Lipoid Pneumonia in Infants and Children in South India
Authors: S. Balakrishnan
Journal: BMJ (1973)

Oil-aspiration pneumonia is a common cause of mortality and morbidity in infants and young children in South India. The high incidence of this condition results from the local custom of giving oil baths to infants and of cleansing the mouth, throat, and nose with oil. The clinical findings in 12 cases, 10 of them in babies aged under 8 months, are described. The signs range from an acute segmental collapse of the lung, clearing in a few days, to a chronic picture mimicking pulmonary tuberculosis or mucoviscoidosis. Mothers in South India should be advised to abandon the practice of cleansing their baby's mouth and nose with oil.