tbuckley/cabot-search huggingface dataset:
Graduate Medical Education
Authors: Anne E. Crowley
Journal: JAMA (1986)

The annual surveys of residency programs on which this statistical report is based have had a higher than 95% response for the past four years. The number of accredited programs increased in 1984 and again in 1985, primarily as a result of the accreditation of additional subspecialty programs. Discussions about the sources and methods of financing graduate medical education may have an impact on the number and the size of programs in the near future. The count of available residency positions is a fluid entity and seems to be dependent on many factors, one of which appears to be the number of qualified candidates seen by program directors. The number of PGY-1 positions has not changed significantly over the past three years. The number of reported unfilled positions, including PGY-1 unfilled positions, has been declining since 1983. The special survey of PGY-1 programs conducted for the past three years reveals that about 10% of programs withdrew positions between October and July. However, another group of programs (some of which are new) added to the number of positions offered. The primary reason cited for withdrawing positions has changed. In 1983, the reason was cited as "financial" by 32% of program directors. In 1985, despite the national discussions about financing medical education, a financial reason was cited by only 16% of program directors. Reasons related to candidates, ie, "absence of suitable candidate" and giving the position to an "applicant at the PGY-2 or higher level," were cited by 49% of program directors in 1983 and by 67% in 1985. The total number of residents on duty (exclusive of newly accredited subspecialties) increased in 1983 and 1984 but decreased in 1985. Decreases were noted in family practice, internal medicine, pathology, and surgery. The number of new entry residents (PGY-1) decreased in 1983 (when the number of US graduates had decreased), increased in 1984, and decreased again in 1985. Forty-two percent of residents were training in family practice, internal medicine, or pediatrics. This statistic has not changed significantly over the past three years. (ABSTRACT TRUNCATED AT 400 WORDS)
ROENTGEN EXAMINATION OF GASTROINTESTINAL TRACT
Authors: Gregory Connell
Journal: JAMA (1941)

<h3>To the Editor:—</h3> In the communication by Dr. Ramsay Spillman inThe Journal, January 18, referring to the first two paragraphs concerning "A complete g-i examination," I am prompted to ask Why an incomplete g-i examination? Failure to follow a barium sulfate meal through the entire gastrointestinal tract has always seemed a deplorable waste of valuable clinical material. A complete study may prevent mistakes or reveal coincidental disease. In cases of suspected disease of the lower portion of the bowel mistakes will be reduced if both barium meal and enema are observed. The gastrointestinal tract is, and should be considered as, a physiologic unit. Failure to detect a pathologic condition in this tract (with history and symptoms justifying a gastrointestinal roentgen examination) calls for a cholecystogram. Complete gastrointestinal roentgen examinations will be less frequently misinterpreted if test meal and stool examinations are routine preliminaries. These remarks do not pertain to
The White Lesion That Kills — Aneuploid Dysplastic Oral Leukoplakia
Authors: Deborah Greenspan, Richard C.K. Jordan
Journal: New England Journal of Medicine (2004)

Perhaps the earliest link between oral leukoplakia and cancer was made by James Paget, for whom Paget's disease was named; he also recognized the connection between oral leukoplakia and smoking. Leukoplakia is a clinical term that refers to an oral mucosal white patch that will not rub off and is not attributable to any other known disease. It is considered to be potentially malignant, with a transformation rate in various studies and locations ranging from 0.6 to 18 percent. Clinically, oral leukoplakia is in the same spectrum of disease as the more sinister red or speckled lesion erythroplakia, which has . . .
2-Chlorodeoxyadenosine: A Newer Purine Analog Active in the Treatment of Indolent Lymphoid Malignancies
Authors: Alan Saven
Journal: Annals of Internal Medicine (1994)

Objective: To review the structure, mechanism of action, pharmacologic features, and clinical trial results of the newer purine analog, 2-chlorodeoxyadenosine (2-CdA). Data Sources and Study Selection: English-language medical literature review of more than 70 articles. Data Synthesis: 2-Chlorodeoxyadenosine is unique compared with traditional antimetabolite drugs in that it is equally active against dividing and resting lymphocytes, which may be especially important in indolent lymphoid malignancies, such as chronic lymphocytic leukemia, because most cells in these disorders are in the resting phase. In patients with alkylator-refractory chronic lymphocytic leukemia who were treated with 2-CdA, 44% achieved a response (4% complete responses, 40% partial responses), and 54%, scored as nonresponders, had a sustained reduction in their peripheral lymphocytosis. Patients with untreated chronic lymphocytic leukemia had an 85% response rate (25% complete responses, 60% partial responses). Patients with previously treated low-grade lymphoma achieved an overall response rate of 43%. The most striking clinical effects of this drug have been seen in hairy cell leukemia, in which a single course of therapy induces complete remissions in 85% of partial remissions in 12%. Activity has also been shown in cutaneous T-cell lymphoma and the myeloid leukemias. Conclusions: 2-Chlorodeoxyadenosine is a newer purine analog with potent activity in the treatment of indolent lymphoproliferative diseases and illustrates the model for rational drug development.
Dimenhydrinate (Dramamine) Abuse: Hallucinogenic Experiences with a Proprietary Antihistamine
Authors: ROBERT MALCOLM, WILLIAM C. MILLER
Journal: American Journal of Psychiatry (1972)

Individuals have recently abused antihistamines in order to obtain hallucinogenic-like effects. While toxic reactions may result from such abuse, the authors cite two cases in which they did not. The authors conclude that dosage may be a critical factor related to toxic side effects; they also discuss treatment of toxic reactions to the antihistamines.
Should We Watch What We Eat and Drink? Report on the International Workshop on Hormones and Endocrine Disrupters in Food and Water: Possible Impact on Human Health, Copenhagen, Denmark, 27–30 May 2000
Authors: Niels E kkebæk, Henrik Leffers, Ewa Rajpert-De Meyts, Elisabeth Carlsen, Kenneth M Grigor
Journal: Trends in Endocrinology and Metabolism (2000)
Tet3 regulates synaptic transmission and homeostatic plasticity via DNA oxidation and repair
Authors: Huimei Yu, Yijing Su, Jaehoon Shin, Chun Zhong, Junjie U Guo, Yi-Lan Weng, Fuying Gao, Daniel H Geschwind, Giovanni Coppola, Guo-li Ming, Hongjun Song
Journal: Nature Neuroscience (2015)
Artificially giving nutrition and fluids is not one action
Authors: T. Finucane
Journal: BMJ (2003)

EDITOR—The and colleagues' description of decision making for patients with severe dementia who have difficulties in eating and drinking, raises several troubling issues.1

Firstly, they implicitly consider tube feeding to be life sustaining. In fact, no credible data show that tube feeding prolongs life in advanced dementia.2–5 An honest summary of the data is, “We have no good evidence …
Activation of Apoptotic Caspase Cascade During the Transition to Pressure Overload-Induced Heart Failure
Authors: Narain Moorjani, Manzoor Ahmad, Pedro Catarino, Robin Brittin, Danyah Trabzuni, Futwan Al-Mohanna, Navneet Narula, Jagat Narula, Stephen Westaby
Journal: Journal of the American College of Cardiology (2006)
Care of the Aged: The Barriers of Traditions
Authors: CARL EISDORFER
Journal: Annals of Internal Medicine (1981)

The growing population of older persons in our society will require increased attention. It is contended that the current pattern of third-party reimbursement for hospitalization and technical procedures focuses upon acute care and cure. The philosophy underlying medical education and practice is a barrier to the provision of quality care to older persons with chronic disorders. A changing emphasis for future practice is indicated.
Clinical Analysis of 100 Cases of Severe Megaloblastic Anaemia of Pregnancy
Authors: P. B. B. Gatenby, E. W. Lillie
Journal: BMJ (1960)

The 100 cases of severe megaloblastic anemia diagnosed from 1953-58 at the Rotunda Hospital Dublin represent an incidence of 1 in 240 confinements.  No significant seasonal pattern was noted.  30% of cases presented as patients with progressive anemia of pregnancy which failed to respond to oral or parenteral iron.  51 had edema 44 had albuminuria 23 had hypertension 17 had vomiting 71 had pyrexia 11 had urinary infection and 10 had diarrhea.  20 mg of folic acid daily caused a reticulocyte response and a rise in the hemoglobin level.  Megaloblastic anemia arose as a complication of carcinoma of the stomach in 1 case Hodgkins disease in 1 case lymphoadenopathy in 1 case and epilepsy in 3 cases.  41 of 96 cases were diagnosed between 31 and 40 weeks gestation.  Hypertension occurred in 23% of cases hypertension with edema or albuminuria in 22% and hypertension edema and albuminuria in 14% creating difficulties in the differentiation of the anemia from toxemia of pregnancy.  The 100 cases included primagravidae; average parity was 3.8.  8 cases were multiple pregnancies and hydramnios was noted in 9.  22 of 80 known cases delivered before the 38th week an incidence of 27%.  23 infants from 17 pregnancies were premature by weight.  The premature incidence in single pregnancies was 12.5%.  2 cases of postpartum hemorrhage and 1 of placenta previa were noted.  Duration of labor method of delivery and incidence of induction of labor were not very different from the general population.  There were 3 stillbirths not ascribed to the anemia.  5 neonatal deaths were due to prematurity and 1 to anencephaly.  Puerperal morbidity occurred in 30% of cases and there were 2 deaths due to underlying significant disease.  Recurrence of megaloblastic anemia occurred in a 2nd pregnancy in 4 cases in the 6-year period.  The argument in favor of routine antenatal administration of folic acid is very strong.
More evidence is needed to inform practice
Authors: D. Farrar
Journal: BMJ (2011)

<h3>Objective</h3> Abatacept (ABA), a selective T cell costimulation modulator that binds to CD80 and CD86 on antigen-presenting cells, was investigated for its antiinflammatory effect in treating severe chronic uveitis associated with juvenile idiopathic arthritis (JIA). <h3>Methods</h3> Our retrospective study was conducted by members of the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC). Patients with JIA who are receiving ABA treatment for active uveitis were included. In all patients, uveitis had been refractory to previous topical and systemic corticosteroids, immunosuppressives, and at least 1 tumor necrosis factor–α inhibitor. A standardized protocol was used to document uveitis (MIWGUC) and arthritis. Baseline visit and visits at 3, 6, 9, and 12 months before and after ABA start were evaluated. Primary outcome measure was defined as achievement of uveitis inactivity; secondary outcome measures were tapering of corticosteroid and/or immunosuppressive treatment, and occurrence of complications. <h3>Results</h3> In all, 21 patients (16 female) with active uveitis (n = 21) and arthritis (n = 18) were included (mean age 11.8 ± 3.6 yrs). In 7 of 18 patients with active arthritis at baseline, inactivity was achieved following ABA treatment. Uveitis inactivity was achieved in 11 patients, but recurred later in 8 of them, and remained active in another 10 cases. Systemic corticosteroids or immunosuppression were tapered in 3 patients, but uveitis recurred in all of them during further followup. Ocular complications secondary to uveitis were present in 17 patients at baseline, while 3 patients developed new ocular complications during followup. <h3>Conclusion</h3> A sustained response to ABA was uncommon in patients with severe and refractory uveitis.
Climate change will reduce excess death rate from cold in UK, report shows
Authors: N. Hawkes
Journal: BMJ (2014)

Climate change will reduce the temperature related death rate in the United Kingdom over the next 70 years, but not the absolute numbers of such deaths, a new analysis has found.

A warming climate will reduce more deaths from cold than it will increase those from high temperatures, the study found. But population growth—particularly among elderly people, who are most vulnerable to weather extremes—means that the absolute numbers of such deaths will rise, assuming no changes in behaviour or technology.

Excess deaths attributable to …
Reversible blockade of myelinated and non-myelinated cardiac afferents in cats by instillation of procaine into the pericardium
Authors: J. O ARNDT, U. PASCH, L. F SAMODELOV, H. WIEBE
Journal: Cardiovascular Research (1981)

Pericardial local anaesthesia was instituted in 33 chloralosed cats through catheters implanted into the pericardium. The activity of 1531 single fibres teased from either vagus in the neck was identified and classified according to source. Random testing with 2% procaine instilled into the pericardium revealed that only cardiac afferents could be blocked. Arterial and other receptors were unaffected. Blocking concentrations were determined for 38 non-myelinated cardiac afferents (mean conduction velocity 1.3 m.s-1) and for 43 myelinated fibres (mean conduction velocity 19 m.s-1). Blocking concentrations varied widely but equally for both fibre categories between 0.05% and 2.0% procaine. Non-myelinated fibres required a mean concentration of 0.26% procaine for block, whereas myelinated fibres needed a mean concentration of 0.45% (P less than 0.01). The large overlap in the frequency distributions of the blocking concentrations for both sets of fibres, would not, however, allow the blocking of one fibre category without affecting the other. Additionally two cardiac sympathetic afferents were blocked at 0.25 and 0.5% procaine. Mean times for block onset and recovery for non-myelinated fibres were 3.05/1.98 min and for myelinated fibres 1.4/0.59 min, respectively. Pericardial local anaesthesia is selective for cardiac afferents but does not allow for differential block of a given fibre category. A 1% solution of procaine will eliminate the heart as a reflexogenic area.
Comparative Effectiveness of<i>Clostridium difficile</i>Treatments
Authors: Dimitri M. Drekonja, Mary Butler, Roderick MacDonald, Donna Bliss, Gregory A. Filice, Thomas S. Rector, Timothy J. Wilt
Journal: Annals of Internal Medicine (2011)

Background: Clostridium difficile infection is increasing in incidence and severity. The optimal treatment is unknown. Purpose: To determine whether, among adults with C. difficile infection, treatment with certain antibiotics compared with others results in differences in initial cure, recurrence, and harms. Data Sources: MEDLINE, AMED, ClinicalTrials.gov, and Cochrane databases (search dates: inception through August 2011, limited to English-language reports); bibliography review. Study Selection: Randomized, controlled trials of adults with C. difficile infection, independent of outcomes, who were treated with medications available in the United States. Observational studies reporting strain were included. Data Extraction: Study design, inclusion and exclusion criteria, quality and strength of evidence as assessed by 2 reviewers, study definitions, and duration of treatment and follow-up. Outcomes included initial cure, recurrence, and treatment harms. Data Synthesis: 11 trials that included 1463 participants were identified. Three trials compared metronidazole with vancomycin; 8 compared metronidazole or vancomycin with another agent, combined agents, or placebo. Strain was analyzed in 1 trial and 2 cohort studies. No study comparing 2 antimicrobial agents demonstrated a statistically significant difference for initial cure; all comparisons were of low to moderate strength of evidence. Moderate-strength evidence from 1 study demonstrated that recurrence was decreased with fidaxomicin versus vancomycin (15% vs. 25%; difference, −10 percentage points [95% CI, −17 to −3 percentage points]; P = 0.005). Subgroup analysis of a single study comparing metronidazole with vancomycin for patients who have severe C. difficile infection showed no difference by intention-to-treat analysis; this was rated as insufficient-strength evidence. Harms, when reported, did not differ between treatments in any study. Limitations: Definitions of diarrhea, C. difficile infection, initial cure, and relapse varied. Some studies reported insufficient detail to allow assessment of all randomly assigned participants or of harms. Conclusion: No antimicrobial agent is clearly superior for the initial cure of C. difficile infection. Recurrence is less frequent with fidaxomicin than with vancomycin. Primary Funding Source: U.S. Department of Health and Human Services.
MI Risks Linked to Rosiglitazone
Authors: Tracy Hampton
Journal: JAMA (2007)

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
Comment on: Cherney and Sochett. Evolution of Renal Hyperfiltration and Arterial Stiffness From Adolescence Into Early Adulthood in Type 1 Diabetes. Diabetes Care 2011;34:1821–1826
Authors: Su Chi Lim, Clara SH Tan
Journal: Diabetes Care (2011)

We read the insightful article by Cherney and Sochett (1) with interest. The authors carefully compared changes in kidney hemodynamic function and arterial stiffness in young subjects with type 1 diabetes with and without renal hyperfiltration. During the transition from adolescence to early adulthood, hyperfiltration was not sustained, whereas glomerular filtration rate remained stable in normofiltering subjects. In contrast, arterial stiffness decreased in all patients regardless of filtration status, suggesting that age-related increases in arterial stiffness occur at older ages. It was also mentioned that a variety of factors influence hyperfiltration including the renin-angiotensin system (measured in the study by Cherney and Sochett), cyclo-oxygenase 2, reduced bioavailability of nitric oxide, etc. However, it was unclear why only …
mTOR and GSK-3 shape the CD4+ T-cell stimulatory and differentiation capacity of myeloid DCs after exposure to LPS
Authors: Hēth R. Turnquist, Jon Cardinal, Camila Macedo, Brian R. Rosborough, Tina L. Sumpter, David A. Geller, Diana Metes, Angus W. Thomson
Journal: Blood (2010)
Gastric Varices Without Esophageal Varices
Authors: Reed P. Rice
Journal: JAMA (1977)

THE ROENTGENOGRAPHIC demonstration of fundal gastric varices by the conventional upper gastrointestinal examination is notoriously difficult.<sup>1-3</sup>Though it is generally believed that most patients with esophageal varices will also have gastric varices, the latter are rarely verified with the conventional upper gastrointestinal examination.<sup>2</sup>The normal gastric rugae frequently have a rather coarse, beaded contour that effectively conceals the dilated veins in the wall of the fundus of the stomach. Gastric fundal varices may assume either a localized polypoid configuration or produce multiple, rounded, submucosal projections throughout the gastric fundus.<sup>4</sup>In either of these situations, the diagnosis of gastric varices may be suspected if the patient has evidence of portal hypertension or pancreatic disease. Doublecontrast examination of the stomach usually provides optimal delineation of polypoid masses in the fundus. Absolute roentgenographic diagnosis depends on opacification of the dilated veins by angiography or splenoportography.<sup>1,2,5</sup> The possibility of gastric
Interactions of human alpha/beta and gamma/delta T lymphocyte subsets in shear flow with E-selectin and P-selectin.
Authors: T G Diacovo, S J Roth, C T Morita, J P Rosat, M B Brenner, T A Springer
Journal: The Journal of Experimental Medicine (1996)

We have compared the ability of human alpha/beta and gamma/delta T lymphocytes to adhere to selectin-bearing substrates, an interaction thought to be essential for homing and localization at sites of inflammation. Both T cell populations form rolling adhesions on E- and P-selectin substrates under physiologic flow conditions. Although equivalent to alpha/beta T cells in binding to E-selectin, gamma/delta T cells demonstrated greater ability to adhere to P-selectin that was purified or expressed on the surface of activated, adherent platelets. Under static conditions, 80% of gamma/delta T cells and 53% of alpha/beta T cells formed shear-resistant adhesions to P-selectin, whereas only 30% of gamma/delta and alpha/beta T cells adhered to E-selectin. The enhance ability of gamma/delta T cells to adhere to P-selectin cannot be attributed to differences in expression of the P-selectin glycoprotein ligand (PSGL-1), as all alpha/beta T cells versus approximately 75% of gamma/delta T cells expressed PSGL-1. Both cell populations expressed a similar percentage of the carbohydrate antigens sialyl LewisX and cutaneous lymphocyte-associated antigen. Depletion of lymphocyte populations or T cell clones bearing these oligosaccharides with the monoclonal antibody CSLEX-1 and HECA-452, respectively, resulted in a substantial reduction in adhesion to E-selectin and slight reduction in adhesion to P-selectin under flow conditions. Treatment of cells with an endopeptidase that selectively degrades O-sialomucins such as PSGL-1, abolished P-selectin but not E-selectin adhesion. Removal of terminal sialic acids with neuraminidase or protease treatment of cells abrogated cell adhesion to both selectin substrates. These results provide direct evidence for the presence of distinct E- and P-selectin ligands on T lymphocytes and suggest that gamma/delta T cells may be preferentially recruited to inflammatory sites during the early stages of an immune response when P-selectin is upregulated.