tbuckley/cabot-search huggingface dataset:
Medical Student Externship as an Opportunity to Expand the Base of Medical Education
Authors: Bruce G. Fagel
Journal: JAMA (1970)

The medical student externship has probably been one of the most complex and confusing, yet potentially most important and valuable positions in medical education in recent years. It represents a basic desire by medical students to gain clinical experience in community hospitals and demonstrates the great disparity between the base for medical education and the base for medical service in the United States. In an effort to increase this base of experience and education, the Student American Medical Association has been involved in several separate but related programs, including an international exchange externship program for clinical students, a model educational program for preclinical students in community hospitals, and discussions with many groups attempting to solve the "externship problem." Most of these problems with the externship are related to the peculiar position of the medical student extern in the delivery of health care, and the ensuing legal implications. Because the term
Combined Rasagiline and Antidepressant Use in Parkinson Disease in the ADAGIO Study
Authors: Kara M. Smith, Eli Eyal, Daniel Weintraub
Journal: JAMA Neurology (2014)

Depression, cognitive impairment, and other nonmotor symptoms (NMSs) are common early in Parkinson disease (PD) and may be in part due to disease-related dopamine deficiency. Many patients with PD are treated with antidepressants for NMSs, and the effect of the combination of PD medications that enhance dopamine neurotransmission and antidepressants on NMSs has not been studied. We report the effects of the addition of a monoamine oxidase B inhibitor, rasagiline, to antidepressant treatment in PD.To evaluate the effect of rasagiline on depression, cognition, and other PD NMSs in patients taking an antidepressant in the Attenuation of Disease Progression With Azilect Given Once Daily (ADAGIO) study.The ADAGIO study was a double-blind, placebo-controlled, delayed-start trial of rasagiline in de novo PD. In this exploratory post hoc analysis, we analyzed patients taking an antidepressant during the 36-week phase 1 period, in which patients were randomized to rasagiline (1 or 2 mg/d) or placebo.We evaluated the change in NMSs in patients taking an antidepressant and rasagiline compared with those taking placebo. The NMSs were assessed by Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale Nonmotor Experiences of Daily Living, the original Unified Parkinson's Disease Rating Scale, and the Parkinson Fatigue Scale.A total of 191 of the 1174 patients (16.3%) were treated with antidepressants during phase 1 and provided efficacy data. Depression and cognition scores revealed significantly less worsening in the rasagiline group compared with the placebo group (differences in Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale item-adjusted means [SEs], -0.19 [0.10], P = .048, and -0.20 [0.05], P < .001, respectively). Parkinson Fatigue Scale (mean [SE] difference, -0.42 [0.09], P < .001) and daytime sleepiness (mean [SE] difference, -0.24 [0.09], P = .006) scores also revealed significantly less worsening in the rasagiline group compared with placebo. There was a nonsignificant trend toward less worsening in apathy and no significant between-group differences in anxiety or sleep. The effect on depression remained significant after controlling for improvement in motor symptoms (mean [SE] difference, -0.23 [0.09], P = .009). There were no serious adverse events in the combined rasagiline-antidepressant group suggestive of serotonin syndrome.The combination of rasagiline and antidepressants in patients with de novo PD is associated with reduced worsening of a range of NMSs in preliminary analyses. Adverse effects appear uncommon with this combination. These findings suggest a role for dopamine-enhancing therapies in NMSs in early PD and encourage further study and confirmation.clinicaltrials.gov Identifier: NCT00256204.
Double bandaging of sprained ankles
Authors: S. Wilson, M. Cooke
Journal: BMJ (1998)

The healthcare establishment generally ignores mundane important issues, preferring to consider popular (sexy) topics. Who wants to assess the cost effectiveness of different management strategies for sprained ankles when you could be introducing a new technology (toys for the boys)? Most of the contacts patients have with the NHS relate to non-life threatening conditions, and their management does not require state of the art technology. However, if the NHS is to operate in the most effective and efficient manner all aspects of health care must be appropriately evaluated. This short paper uses the management of sprained ankles as an example.

Ankle injuries are common (estimated at 600 000 attendances at accident and emergency departments per year in …
Clinical validity of a negative venogram in patients with clinically suspected venous thrombosis.
Authors: R Hull, J Hirsh, D L Sackett, D W Taylor, C Carter, A G Turpie, P Powers, M Gent
Journal: Circulation (1981)

Although it is generally accepted that negative venography excludes deep vein thrombosis (DVT) in patients in whom it is clinically suspected, there is no evidence to support this conclusion. To test the correctness of withholding anticoagulant therapy in these patients, we followed 160 consecutive patients who had clinically suspected DVT and negative venograms to determine the frequency of postvenographic DVT. Anticoagulant therapy was withheld in all patients. No patient died or developed pulmonary embolism during 3 months of follow-up. Two of the 160 patients (1.3%) attended the clinic on an emergency basis during follow-up with new symptoms of DVT and in both patients, DVT was confirmed by objective testing. These events developed within 5 days of venography, which suggests that they were induced by venography. Nevertheless, the findings indicate it is safe to withhold treatment in patients with clinically suspected DVT and negative venograms.
ICOS:ICOS-Ligand Interaction Is Required for Type 2 Innate Lymphoid Cell Function, Homeostasis, and Induction of Airway Hyperreactivity
Authors: Hadi Maazi, Nisheel Patel, Ishwarya Sankaranarayanan, Yuzo Suzuki, Diamanda Rigas, Pejman Soroosh, Gordon J. Freeman, Arlene H. Sharpe, Omid Akbari
Journal: Immunity (2015)
Progress Study of 590 Consecutive Nonsurgical Cases of Coronary Disease Followed 5-9 Years
Authors: ALBERT V. G. BRUSCHKE, WILLIAM L. PROUDFIT, F. MASON SONES
Journal: Circulation (1973)

The clinical progress was studied in a series of 590 consecutive nonsurgical patients with coronary disease documented by selective coronary arteriography. All had 50% or more obstruction in at least one major artery. Patients who were operated on within 5 years were excluded. Observations of the survivors ranged from 5 to 9 years. During the total observation period 263 patients died; only 19 deaths were not due to coronary disease. The 5-year cardiac mortality rate was 34.4% for the entire population, 14.6% for patients with one-vessel involvement, 37.8% for patients with two-vessel involvement, 53.8% for patients with three-vessel involvement, and 56.8% for those with at least 50% narrowing of the left main coronary artery. In patients with single-vessel disease the presence or absence of additional lesions causing less than 50% narrowing was of significant prognostic influence.
Serum selenium concentration related to myocardial infarction and fatty acid content of serum lipids.
Authors: T A Miettinen, G Alfthan, J K Huttunen, J Pikkarainen, V Naukkarinen, S Mattila, T Kumlin
Journal: BMJ (1983)

A longitudinal case-control study of 33 patients with one or more risk factors for coronary heart disease and 64 controls showed that the serum selenium concentration (range 0.63-1.33 mumol/l (50-105 micrograms/l] was not associated with development of clinical manifestations of coronary heart disease during a follow up of five to seven years. The content of polyunsaturated fatty acids, especially eicosapentaenoic acid, in serum cholesterol esters and phospholipids was positively correlated with selenium concentration. As a low content of polyunsaturated fatty acids in serum lipids was an independent risk factor for coronary heart disease in these subjects it may be hypothesised that the high coronary risk in subjects with a very low serum selenium concentration (less than 0.57 mumol/l (less than 45 micrograms/l] might be due not to selenium deficiency but to the coexisting low concentrations of polyunsaturated fatty acids in serum.
Upper gastrointestinal endoscopy: its effects on patient management.
Authors: C D Holdsworth, K D Bardhan, G V Balmforth, R A Dixon, G E Sladen
Journal: BMJ (1979)

Out of 95 patients referred for upper gastrointestinal endoscopy after a barium-meal examination, 44 underwent a change in management. Some changes were minor but in 12 patients a decision on surgery was required. Seven of these patients were among a group of 13 for whom the referring consultant would have recommended laparotomy had endoscopy not been available, while the other five were subjected to an unplanned laparotomy. These findings support the practice of performing endoscopy on patients whose symptoms are not fully explained by barium-meal examination, especially patients aged over 45. In such cases the procedure also seems to be cost-effective.
An enzymatic basis for Lewis blood Types in man
Authors: Evelyn F. Grollman, Akira Kobata, Victor Ginsburg
Journal: Journal of Clinical Investigation (1969)

Milk from women with blood type Le(a+) or Le(b+) contains a specific fucosyltransferase not found in the milk of women with blood type Le(a- b-). The enzyme, a guanosine diphosphate L-fucose: N-acetyl-beta-D-glucosaminylsaccharide alpha-4-L-fucosyltransferase is apparently required for the synthesis of the structural determinants of Le(a) and Le(b) specificity, both of which contain fucose in an alpha-1,4 linkage to N-acetylglucosamine. The same enzyme is also involved in the synthesis of milk oligosaccharides, as two oligosaccharides which contain this linkage are absent from the milk of women with Le(a- b-) blood type.
The Principles and Practice of Medicine
Authors: Frank D. Gray
Journal: JAMA (1989)

The authors of the 22nd edition of<i>The Principles and Practice of Medicine</i>trace its lineage to the first edition by Sir William Osler published in 1892. Osler saw the need for an American textbook of medicine and conceived a plan to publish one written by members of his department at The Johns Hopkins Hospital to be revised at regular intervals. Unable to find anyone to take over this "one-department book" at Hopkins when he left there, Osler first recruited Thomas McCrae at Jefferson Medical College and later Henry Christian at Harvard Medical School, who assumed responsibility for the 10th through the 16th editions (1926 through 1947). A 21-year hiatus followed until, in 1968, Hopkins again took up the task beginning with the 17th edition, and with two decades of sponsorship by Hopkins the textbook appears to have a durable home there. At the time of Osler's early editions the
Interaction of Duloxetine and Warfarin Causing Severe Elevation of International Normalized Ratio
Authors: Charles J. Glueck, Qasim Khalil, Magdalena Winiarska, Ping Wang
Journal: JAMA (2006)

To the Editor: We describe what we believe is the first report of a drug interaction between duloxetine hydrochloride and warfarin. The patient has provided consent for publication of this report, and it has received institutional review board approval.
Ventilation Perfusion Relationships Following Correction of Kyphoscoliosis
Authors: Daniel C. Shannon
Journal: JAMA (1971)

Lung function was evaluated in 13 patients before and after surgical correction of spinal deformity. Lung volumes were unchanged, physiologic dead space fell from 155 to 90 ml, and minute ventilation fell from 9.22 to 7.67 liters/min. Arterial oxygen tension (P0<sub>2</sub>) rose from 87 to 93 mm Hg at rest and from 80 to 85 mm Hg during exercise. The alveolar-arterial Po<sub>2</sub>gradient fell from 26 to 20 mm Hg at rest and was unchanged (90 mm Hg) while breathing oxygen. Distribution of ventilation and perfusion, studied with xenon Xe 133, was normal in patients with curves less than 65°. In those with curves exceeding 70°, ventilation in each lung zone was variable. The normal perfusion gradient from upper to lower lung zones was equally reduced both before and after correction.
Scale errors by very young children: A dissociation between action planning and control
Authors: Judy S. DeLoache
Journal: Behavioral and Brain Sciences (2004)

Very young children occasionally commit scale errors, which involve a dramatic dissociation between planning and control: A child's visual representation of the size of a miniature object is not used in planning an action on it, but is used in the control of the action. Glover's planning–control model offers a very useful framework for analyzing this newly documented phenomenon.
Improved islet transplantation outcome by the co-delivery of siRNAs for iNOS and 17β-estradiol using an R3V6 peptide carrier
Authors: Hyo-Jeong Hwang, Minhyung Lee, Jin Hyeong Park, Hye Seung Jung, Jun Goo Kang, Chul Sik Kim, Seong Jin Lee, Sung-Hee Ihm
Journal: Biomaterials (2014)
Recruitment of new osteoblasts and osteoclasts is the earliest critical event in the pathogenesis of human multiple myeloma.
Authors: R Bataille, D Chappard, C Marcelli, P Dessauw, P Baldet, J Sany, C Alexandre
Journal: Journal of Clinical Investigation (1991)

Considering the special relation of human multiple myeloma (MM) to bones, it is of importance to clarify the early steps of bone involvement in this disease. In this work, using bone histomorphometry (including histoenzymologic and kinetic studies for the first time), we have evaluated the bone remodeling (i.e., bone resorption and bone formation rates) of 16 individuals with early MM in comparison with that of 10 with benign monoclonal gammopathy (BMG) and that of 17 patients with previously untreated overt MM. A significantly increased osteoblastic recruitment was observed in the individuals with early MM when compared with those with BMG (P less than 0.01). A significant (P less than 0.01) increased bone resorption (i.e., eroded surfaces, osteoclast numbers and surfaces) was observed from the early stage of MM in comparison with the BMG status where bone resorption remained within the normal range. At the tissue level, there was no difference in terms of bone resorption between early and overt MM. On the other hand, osteoblast activity was significantly reduced in patients with overt MM (P less than 0.05 by comparison with those with early MM). A significant enhancement of osteoblastic recruitment with an increased generation of new osteoclasts is an early critical event in the pathogenesis of human MM. Of particular importance is the early stimulation of osteoblasts, since these cells produce high amounts of IL-6, a potent myeloma cell growth factor and a critical cytokine for the formation of osteoclasts in the bone marrow.
Implantable devices for treating tachyarrhythmias
Authors: T. Houghton
Journal: BMJ (2003)

Pacing treatment for tachycardia control has achieved success, notably in supraventricular tachycardia. Pacing termination for ventricular tachycardia has been more challenging, but an understanding of arrhythmia mechanisms, combined with increasingly sophisticated pacemakers and the ability to deliver intracardiac pacing and shocks, have led to success with implantable cardioverter defibrillators.

There are two methods of pace termination.

Underdrive pacing was used by early pacemakers to treat supraventricular and ventricular tachycardias. Extrastimuli are introduced at a constant interval, but at a slower rate than the tachycardia, until one arrives during a critical period, terminating the tachycardia. Because of the lack of sensing of the underlying tachycardia, there is a risk of a paced beat falling on the T wave, producing ventricular fibrillation or ventricular tachycardia, or degenerating supraventricular tachycardias to atrial fibrillation. It is also not particularly successful at terminating supraventricular tachycardia or ventricular tachycardia and is no longer used routinely.



Changes in implantable cardioverter defibrillators over 10 years (1992-2002). Apart from the marked reduction in size, the implant technique and required hardware have also dramatically improved—from the sternotomy approach with four leads and abdominal implantation to the present two-lead transvenous endocardial approach that is no more invasive than a pacemaker implant



Overdrive pacing is more effective for terminating both supraventricular and ventricular tachycardias. It is painless, quick, effective, and associated with low battery drain of the pacemaker. Implantation of devices for terminating supraventricular tachycardias is now rarely required because of the high success rate of radiofrequency ablative procedures (see previous article). Overdrive pacing for ventricular tachycardia is often successful but may cause acceleration or induce ventricular fibrillation. Therefore, any device capable of pace termination of ventricular tachycardia must also have defibrillatory capability.

View this table:

Mechanisms of arrhythmias



Initially, cardioverter defibrillator implantation was a major operation requiring thoracotomy and was associated with 3-5% mortality. …
Abstract 2631: IL-6 promotes ICAM-1 expression and cell motility in human osteosarcoma.
Authors: Yi-Chin Fong, Chih Hsin Tang
Journal: Cancer Research (2013)

Abstract Osteosarcoma is characterized by a high malignant and metastatic potential. Interleukin-6 (IL-6) is a multifunctional cytokine that is associated with the disease status and outcomes of cancers. However, the effect of IL-6 on migration activity in human osteosarcoma cells is mostly unknown. Here we found that IL-6 increased the migration and expression of intercellular adhesion molecule-1 (ICAM-1) in human osteosarcoma cells. Transfection of cells with ICAM-1 siRNA reduced IL-6-mediated cell migration. We also found that expression of IL-6 was significantly greater in human osteosarcoma tissues than in normal bone. The integrin-linked kinase (ILK)/Akt/AP-1 pathway was activated after IL-6 treatment, and IL-6- induced expression of ICAM-1 and migration activity was inhibited by the specific inhibitor and siRNA of ILK, Akt, and AP-1 cascades. In addition, over-expression of IL-6 shRNA inhibited the migratory ability and ICAM-1 expression in osteosarcoma cells. Taken together, these results indicate that IL-6 and IL-6 receptor interaction occurs through ILK and Akt, which in turn activates AP-1, resulting in the activations of ICAM-1 and contributing the migration of human osteosarcoma cells. Citation Format: Yi-Chin Fong, Chih Hsin Tang. IL-6 promotes ICAM-1 expression and cell motility in human osteosarcoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2631. doi:10.1158/1538-7445.AM2013-2631
VA Mental Health
Authors: Mike Mitka
Journal: JAMA (2012)

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
What Saunders and van Brakel chose to ignore in color and cognition research
Authors: Kimberly A. Jameson
Journal: Behavioral and Brain Sciences (1997)

Saunders &amp; van Brakel set out to review color science research and to topple the belief that color-vision neurophysiology sets strong deterministic constraints on the cognitive processing of color. Although their skeptism and mission are worthwhile, they fail to give proper treatment to (1) findings that dramatically support some positions they aim to tear down, (2) existing research that anticipates criticisms presented in their target article, and (3) the progress made in the area toward understanding the phenomenon. At the very minimum these oversights weaken the credibility of their arguments and leave the reader to wonder why their discussion ignores what is clearly omitted.
Combination therapy with tacrolimus and mycophenolate mofetil in heart transplantation prevents rejection completely
Authors: B.M. Meiser, M. Pleiffer, M. Jagrello-Kraatz, D. Schmidt, P. Uberfuhr, H. Reichenspumer, W.v. Scherdt, B. Reichart
Journal: Journal of the American College of Cardiology (1998)
The health visitor and prevention
Authors: M. E Briscoe, A. W Clare
Journal: BMJ (1982)

SIR,-It is somewhat unfair to the health visiting profession to assume, as Dr R P Snaith is tempted to do (14 August, p 512), that the absence of specific mention of postnatal depression in Shirley Goodwin's article (17 July, p 182) indicates a lack of concern with psychiatric disorder on the part of health visitors in general.As part of a programme of research undertaken here by the General Practice Research Unit, and funded by the Department of Health and Social Security, we are currently studying health visitors in one London borough, with particular reference to their role in the identification and management of psychosocial problems in the families they visit.Our preliminary results indicate that health visitors do not concern themselves merely with the detection of abnormalities in child development and with physical health but are keenly aware of the significance of emotional problems and of psychiatric ill health in families.'Indeed, the support and
In vitro cell alignment obtained with a Schwann cell enriched microstructured nerve guide with longitudinal guidance channels
Authors: Ahmet Bozkurt, Ronald Deumens, Christina Beckmann, Leon Olde Damink, Frank Schügner, Ingo Heschel, Bernd Sellhaus, Joachim Weis, Wilhelm Jahnen-Dechent, Gary A. Brook, Norbert Pallua
Journal: Biomaterials (2008)
Deal expected over breast implants
Authors: D. Josefson
Journal: BMJ (1998)

Women who received silicone breast implants manufactured by Dow Corning may soon receive financial compensation under the terms of a tentative $3.2bn (£2bn) agreement announced by a US bankruptcy judge.

The settlement will compensate 170000 women in the United States who filed a class action suit against Dow Corning, charging that ruptured silicone implants caused them a variety …