tbuckley/cabot-search huggingface dataset:
Duration of cognitive dysfunction after concussion, and cognitive dysfunction as a risk factor: a population study of young men
Authors: T. W Teasdale, A. Engberg
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objectives:</b> To establish how long cognitive dysfunction lasts after concussion, and the extent to which it may be a predisposing risk factor for concussion, by examining the prevalence of cognitive dysfunction among young men who have sustained concussion. <b>Design:</b> Observational study. <b>Setting:</b> Denmark. <b>Subjects:</b> 1220 young men who had been admitted to hospital for concussion between the ages of 16 and 24 (identified in a national register of admissions) and who had also been cognitively tested by the Danish conscription draft board. <b>Main outcome measure:</b> Score on the draft board9s cognitive screening test, dichotomised as dysfunctional or non-dysfunctional (20.4% of the general population of Danish men appearing before the draft board had a dysfunctional score). <b>Results:</b> 700 of the 1220 men had been tested after sustaining concussion; 520 had been tested before concussion. Four (50%) of the eight men who were tested less than seven days after the injury had a dysfunctional score. Among groups of the remaining 692 men who were tested at later time points after injury, the rates were only marginally raised (range 21.4% to 26.5%) above the population level. Among men tested before injury, the rate of dysfunctional scores was higher (30.4% (158/520)). Apart from suggesting cognitive dysfunction as a risk factor for concussion, this higher proportion seems to relate to the fact that they were typically injured as young adults, whereas those men who were tested after concussion had more often been injured as adolescents. The relative risk for concussion in the presence of cognitive dysfunction is estimated to be 1.57 (95% confidence interval 1.32 to 1.86). <b>Conclusions:</b> Cognitive dysfunction is not only a short term consequence of concussion but also a predisposing risk factor for concussion, more so for young adults than for adolescents. <h3>Key messages</h3> How should academic medicine look in the 21st century Cognitive dysfunction is also a risk factor for sustaining concussion The risk factor is greater among young adults than among adolescents
Plasma lipid levels in insulin-dependent diabetes mellitus
Authors: Wayne V Moore, Joyce Knapp, Ralph L Kauffman, William G Perkins
Journal: Diabetes Care (1979)

Because several recent reports have indicated a high incidence of hyperlipidemia in insulin-dependent juvenile diabetes, the plasma lipid levels were measured in a population of insulin-dependent diabetic patients to determine if hyperlipidemia is necessarily associated with diabetes. Only one patient had an elevated cholesterol concentration (greater than 220 mg. per deciliter) and two patients had an elevated triglyceride concentration (greater than 140 mg. per deciliter), giving an incidence of 6.4 per cent. A normal control group had an incidence of hyperlipidemia of 5.7 per cent. The mean cholesterol level (164 "/- 38 mg. per deciliter) of the diabetic population was significantly less than that of the normal control group (183 +/- 38 mg. per deciliter). The diabetic patients were divided into groups on the basis of 24-hour urinary glucose excretion and records of glycosuria. The serum triglyceride of the patients in group 4 (highest urinary glucose content and spills) was significantly elevated above three other groups with less glucosuria. Dietary history revealed that group 4 patients consumed a significantly higher percentage of fat. Cholesterol levels did not correlate with parameters of regulation of the diabetes.
Risks of intracranial haematoma in head injured adults.
Authors: A D Mendelow, G Teasdale, B Jennett, J Bryden, C Hessett, G Murray
Journal: BMJ (1983)

A study was conducted to estimate the risk that an adult (age 15 or over) will develop a surgically significant intracranial haematoma after a head injury. Two simple features were used that can be recognised by clinicians with minimal training: a skull fracture and the conscious level. The risks were calculated from samples of 545 patients with haematomas, 2773 head injured patients in accident and emergency departments, and 2783 head injured patients in primary surgical wards. With radiological evidence of skull fracture and any impairment of consciousness (including disorientation) one patient in four in an accident and emergency department or primary surgical ward will develop a haematoma. With no skull fracture and preserved orientation the risk to a patient in an accident and emergency department is one in 6000. The use of risk levels as a basis for decision making about head injured patients may result in fewer haematomas being detected too late and savings of resources by reducing the admission and investigation of low risk categories of patients.
Total dose imferon (iron-dextran complex) infusion therapy in severe hookworm anaemia.
Authors: K. M. Patel, J. A. Tulloch
Journal: BMJ (1967)

Digital Artery Disease-Birnstingl ,Baff 605without operation.Of the 21 women 15 had collagen disorder, which, though varying in tempo in the individual patient, had a tendency towards marked chronicity in the hands.It was also characteristically resistant to sympathectomy, with the pro- viso that the operation allowed the fingers to remain healed in more than half the patients with actual tissue necrosis.Until more is known of the prognosis of digital necrosis in the untreated patient it seems reasonable to continue to recommend sympathectomy to all patients of both sexes with trophic changes, bearing in mind that amelioration rather than cure is the best that can be expected in most women.This advice applies whatever the nature of the underlying condition, since, as already mentioned, some permanent improvement can be expected even in severe collagen disorder.In view of the poor prognosis in women without actual necrosis, 11 out of 12 (92%) being uninfluenced or eventually worse, it seems doubtful if the operation should be advised in these circumstances. SummaryForty-three patients are reviewed in whom upper thoracic sympathectomy was performed for severe digital ischaemia due to digital artery obstruction, confirmed by arteriography-in 34.The extent of digital artery blockage failed to correlate with the severity of the symptoms.The probable underlying patho- logical conditions at final review was atherosclerosis in 23, acrosclerosis in 12, systemic scleroderma in six, and neuropathy and rheumatoid arthritis in one each.Actual necrosis of one or more fingers was the presenting symptom in 23 patients and severe episodic ischaemia without necrosis in 20, but this variation in symptomatology related to rapidity of onset of the thrombosis rather than to the under- lying pathology.The late results of sympathectomy were best in men, about 60% of whom were completely cured of their symptoms.Of the women 56% were cured of necrosis, but milder ischaemic symptoms usually persisted; when sympathectomy was per- formed in the absence of necrosis, only 8% of women received permanent benefit.When digital necrosis is present upper thoracic sympath- ectomy can be expected to confer permanent benefit in rather more than half the patients, even in the presence of collagen disorder.Sympathectomy should not be advised in women when digital ischaemia is unaccompanied by local necrosis.I would like to thank Professor G. W. Taylor for permission to study a number of patients under his care.
NONSURGICAL REMOVAL OF PARAFFIN IN THE URINARY BLADDER
Authors: DAVID R. MELEN
Journal: JAMA (1923)

The literature concerning foreign bodies in the bladder describes a large variety of articles. These have either been introduced from without by the patient or the medical attendant, or have ulcerated their way into the bladder from a neighboring viscus. Among the articles may be mentioned hairpins, straws, quills, gum, broken catheters or filiforms, nails, closed safety-pins, gauze, sponges and bullets. Rarely, nonabsorbable ligature material may erode its way through the bladder wall, following an operation on nearby pelvic organs. The silk, silkworm, or silver wire may then be seen lying free in the bladder or adherent to the mucous membrane, usually still knotted. Luys 1 has illustrated such an occurrence.  Occasionally the urologist is confronted with a case of wax or paraffin in the urinary bladder. The method and the reason for introducing the object are well known. The patient usually fashions a bougie out of wax or paraffin,
Side effects of long-term oral antiviral therapy for hepatitis B
Authors: Robert J. Fontana
Journal: Hepatology (2009)

Abstract The aim of this review is to summarize the safety profile of the five approved oral nucleoside analogs used to treat chronic hepatitis B virus (HBV) infection, focusing on both the class adverse effects and those that have been reported with individual agents, as well as their safety in pregnancy. All nucleoside analogs have a “Black Box” warning because of their potential for inhibition of human DNA polymerase gamma involved in mitochondrial DNA replication. A reduction in intracellular mitochondrial DNA levels can lead to varying clinical manifestations of mitochondrial toxicity (i.e., neuropathy, myopathy, lactic acidosis), but these side effects are rarely reported with the oral antiviral agents active against HBV. Adefovir and tenofovir are associated with a dose-dependent but usually reversible proximal renal tubular toxicity. For these reasons, patients receiving these agents should be monitored for renal toxicity and the dose modified for renal insufficiency. Prolonged use of tenofovir has also been reported to lead to reduced bone mineral density in patients with human immunodeficiency virus infection, but prospective studies in patients with HBV infection are lacking. Telbivudine treatment is associated with moderate serum creatine phosphokinase elevations in up to 12% of patients. There have been few prospective studies on the safety of nucleoside analogs during pregnancy. According to the Antiretroviral Pregnancy Registry, the incidence of birth defects associated with lamivudine and tenofovir use during pregnancy is not increased. Studies on the safety of long-term therapy with the nucleoside analogs, alone and in combination, are needed as are further studies of children, the elderly, pregnant women, and patients with renal insufficiency. (Hepatology 2009;49:S185–S195.)
Healthy Cities: Research and Practice
Authors: I. Harvey
Journal: BMJ (1994)

The healthy cities movement draws on various sources: the idea, sustained by the work of the epidemiologist Thomas McKeown and others, that medical interventions and services are not the major determinants of the health of populations--rather nutrition, sanitation, housing, and ultimately poverty are much more potent; the view that conventional data on morbidity and mortality do not capture what many people consider important when asked to consider what constitutes “good health”--namely, that sense of physical, mental, and social wellbeing that the World Health Organisation has incorporated into its definition of health; and the conviction that social (and hence health) inequalities are, quite simply, wrong and that their reduction should be an overriding objective. The first two of these are in principle empirical issues, while the third--as one of the contributors to Healthy Cities: Research and Practice freely acknowledges--is a matter of moral and political belief.

By 1990, 30 European cities were officially part of the WHO “Healthy Cities” project and the book has its origins in a conference held in one of those cities--Glasgow--in 1991 with …
NICKEL DERMATITIS: A NEW SOURCE
Authors: Everett S. Lain
Journal: JAMA (1931)

Metallic dermatitis is occasionally observed in the practice of every dermatologist who attends the laboring people of various occupations, more especially by dermatologists who look after the skin eruptions of employees of large public utility and industrial plants. It has been my observation that the occurrence of a dermatitis occurring on the hands and faces of professional polishers and platers, caused by either the solvent or the salt of a metal, is of more frequent occurrence than the leading textbooks would infer. Nickel dermatitis has been a subject of rather common discussion in European literature ever since Blaschko,<sup>1</sup>in 1889, first called attention to the susceptibility of workers in industrial plants handling nickel. R. Prosser White<sup>2</sup>relates several incidents of a nickel dermatitis; also he quotes Rambousek in describing nickel rash as occurring in nickel platers and concludes that the disease is most probably caused by the action
‘Optimal’ Directional Coronary Atherectomy
Authors: Charles A. Simonton, Martin B. Leon, Donald S. Baim, Tomoaki Hinohara, Kenneth M. Kent, Robert M. Bersin, B. Hadley Wilson, Gary S. Mintz, Peter J. Fitzgerald, Paul G. Yock, Jeffrey J. Popma, Kalon K. L. Ho, Donald E. Cutlip, Cynthia Senerchia, Richard E. Kuntz
Journal: Circulation (1998)

Background —Previous clinical trials of directional coronary atherectomy (DCA) have failed to show significant improvement in early or late outcomes compared with balloon angioplasty (PTCA). The present study tested the hypothesis that more aggressive “optimal” atherectomy could be performed safely to produce larger initial lumen diameters and a lower late restenosis rate. Methods and Results —The present study was a prospective multicenter registry of consecutive patients undergoing optimal DCA of de novo or restenotic lesions in 3.0- to 4.5-mm native coronary arteries. Optimal DCA was defined as using a 7F atherectomy device and adjunctive PTCA if necessary to achieve a &lt;15% residual stenosis. Six-month angiographic and 1-year clinical follow-up was planned in all patients. A total of 199 patients with 213 lesions met eligibility criteria for enrollment. Short-term procedural success was achieved in 97.5%, with a major complication rate (death, emergency bypass surgery, or Q-wave myocardial infarction [MI]) of 2.5%. There were no early deaths. Non–Q-wave MI (CK-MB &gt;3 times normal) occurred in 14% of patients. Mean reference vessel diameter was 3.28 mm. Mean diameter stenosis was reduced from 63.5% to a final stenosis of 7%. Late 1-year clinical follow-up revealed one cardiac death and a target lesion revascularization rate of 17.8%. The angiographic restenosis rate at 6 months was 28.9%, with the major predictor of restenosis being a smaller postprocedure lumen diameter. Conclusions —Optimal DCA produced a low residual percent diameter stenosis and a lower restenosis rate than seen in previous trials without an increase in early or late major adverse events.
Treatment of Depression Following Acute Myocardial Infarction
Authors: Robert M. Carney, Allan S. Jaffe
Journal: JAMA (2002)

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
A fibrin net brings in kidney stone catch
Authors: Roger S. Johnson
Journal: JAMA (1980)

Urologists at the University of Michigan have developed a method for more effectively removing kidney stones that is beginning to find widespread acceptance. The stones are entrapped by a human fibrin clot, and the clot is then removed through the same type of incision conventionally used for kidney stone removal. "Surgical removal of kidney stones can sometimes be very difficult, but this technique makes the complicated cases simpler," said L. Paul Sonda, MD, who developed this technique together with C. Peter Fischer, MD, and Ananias C. Diokno, MD, of the University of Michigan Medical School and affiliated hospitals, Ann Arbor. They reported their success in 65 patients at the American College of Surgeons clinical congress in Atlanta. Their scientific exhibit included a video teaching film of the procedure. "The surgical opening and exposure of the kidney follow the conventional procedure," Sonda told<i>JAMA</i>MEDICAL NEWS, "but after the kidney is
Rifampicin and isoniazid and liver function.
Authors: C O Anah
Journal: BMJ (1972)

increased serum F.D.P. levels in women with clinically significant menorrhagia, as compared with those in women without abnormal menstrual symptoms.Further studies being undertaken indicate that raised serum F.D.P. levels found in women with menorrhagia are often associated with in- creased levels of fibrin monomer complexes in the blood.Thus raised serum F.D.P. levels in women complaining of menorrhagia may be a manifestation of exaggerated intravascular microcoagulation associated with secondary fibrinolytic activity.-Iam, etc.,
Proton pump inhibitor therapy does not increase the incidence of spontaneous bacterial peritonitis in cirrhosis: A multicenter prospective study
Authors: Rubén Terg, Paola Casciato, Cecilia Garbe, Mariano Cartier, Teodoro Stieben, Manuel Mendizabal, Carla Niveyro, Javier Benavides, Mónica Marino, Luis Colombato, Daniel Berbara, Marcelo Silva, Pablo Salgado, Fernando Barreyro, Eduardo Fassio, Adrian Gadano
Journal: Journal of Hepatology (2014)
THE TUBERCULIN TEST, AND THE NEED OF A MORE COMPLETE DIAGNOSIS OF TUBERCULOSIS.
Authors: CHABLES DENISON
Journal: JAMA (1900)

Having been at work on similar lines<sup>1</sup>, I am much interested in the perusal, just finished, of the excellent paper of Dr. Edward B. Otis, on the "Value of the Tuberculin Test in the Diagnosis of Tuberculosis<sup>2</sup>." My friend Otis may say that I am too sanguine in my discussion of his paper. I will return such a compliment by saying that he is too conservative, especially in his conclusions. For, though agreeing with him, in his high estimation of the test, I think he could have added from 10 to 20 per cent. to his successes, had he varied his procedure or differently estimated its results. 1. As to the tuberculin used: While allowing it to be preferable to use the same standard material as to virulency, the particular make—if it be pure—does not count for so much if the plan I propose be followed out, namely, to
Inhibition of experimentally-induced liver cirrhosis in rats by a nonpeptidic mimetic of the extracellualr matrix-associated Arg-Gly-Asp epitope
Authors: Rafael Bruck, Rami Hershkoviz, Ofer Lider, Hussein Aeed, Liliana Zaider, Zipora Matas, Jacob Barg, Zamir Halpern
Journal: Journal of Hepatology (1996)
A Bloody Mystery
Authors: Adam Cuker, Jean M. Connors, Joel T. Katz, Bruce D. Levy, Joseph Loscalzo
Journal: New England Journal of Medicine (2009)

A 62-year-old woman presented to the urgent care clinic with gingival bleeding after periodontal scaling of her lower-right second molar 5 hours earlier. Bleeding had persisted despite the application of pressure and ice. The patient recalled a similar episode approximately 6 months earlier, also after a periodontal procedure.
Penetration of Bowel by a Stab: Recovery
Authors: W. Cooper
Journal: BMJ (1874)

often have I had patients sent up to me from the country, especially from some of the damp close valleys in the West of England, where asthma is very rife; and their troubles have sometimes ceased the first night they passed in town, even before they had seen me, or undergone any special treatment.In most, however, the improvement is more
Effect of Calcitonin and Glucocorticoids in Combination on the Hypercalcemia of Malignancy
Authors: MARTIN L. BINSTOCK
Journal: Annals of Internal Medicine (1980)

The effects of the combination of glucocorticoids and calcitonin on serum calcium levels were compared with the responses to calcitonin alone in 14 patients with malignant disease and hypercalcemia. The serum calcium concentrations of those patients treated with calcitonin alone returned to pretreatment concentrations within 48 hours, whereas those treated with the combination of calcitonin and glucocorticoids maintained the lower serum calcium concentrations for more than 4 days. These results suggest that the combination of calcitonin and glucocorticoids is a rapidly effective form of medical treatment for hypercalcemia and that glucocorticoids help to maintain the acute response to calcitonin in patients with hypercalcemia.
Contribution of a general practitioner hospital: a further study.
Authors: R A Treasure, J A Davies
Journal: BMJ (1990)

To audit the workload of a general practitioner hospital and to compare the results with an earlier study.Prospective recording of discharges from the general practitioner hospital plus outpatient and casualty attendances and of all outpatient referrals and discharges from other hospitals of patients from Brecon Medical Group Practice during one year (1 June 1986-31 May 1987).A large rural general group practice which staffs a general practitioner hospital in Brecon, mid-Wales.20,000 Patients living in the Brecon area.1540 Patients were discharged from the general practitioner hospital during the study period. The hospital accounted for 78% (1242 out of 1594) of all hospital admissions of patients of the practice. There were 5835 new attendances at the casualty department and 1896 new outpatient attendances at consultant clinics at the hospital. Of all new outpatient attendances by patients of the practice, 71% (1358 out of 1896) were at clinics held at the general practitioner hospital. Since the previous study in 1971 discharges from the hospital have increased 37% (from 1125 to 1540) and new attendances at consultant clinics 30% (from 1450 to 1896). The average cost per inpatient day is lower at this hospital than at the local district general hospital (pounds 71.07 v pounds 88.06 respectively).The general practitioner hospital deals with a considerably larger proportion of admissions and outpatient attendances of patients in the practice than in 1971 and eases the burden on the local district general hospital at a reasonable cost.General practitioner hospitals should have a future role in the NHS.
PUVA treatment of psoriasis in the United Kingdom
Authors: P. M. FARR, B. L. DIFFEY
Journal: British Journal of Dermatology (1991)

Information concerning the operation of 134 PUVA units in 96 dermatology centres in the U.K. was collected by a postal questionnaire. The most common protocol was to give PUVA three times weekly in the treatment of psoriasis, and to choose the initial dose of UVA according to skin type. However, the initial UVA dose encompassed a range of five or more within each skin type.