tbuckley/cabot-search huggingface dataset:
A New Ethical Dilemma — Hazards in the Emergency Room — Long-Haired Boys
Authors: John Lister
Journal: New England Journal of Medicine (1971)

IMMEDIATELY after graduation the young doctor has two immediate responsibilities: he must register his qualifications with the General Medical Council, and he must join a medical protection society. He cannot legally practice without doing the first, and he cannot safely practice without doing the second; indeed, membership of one of these societies is a condition of employment in all hospitals of the National Health Service.This membership of course, will protect the doctor from financial disaster in the event of successful litigation by patients. It also ensures that he will have the right kind of legal representation in the event . . .
Body surface mapping during percutaneous transluminal coronary angioplasty. QRS changes indicating regional myocardial conduction delay.
Authors: H Spekhorst, A SippensGroenewegen, G K David, M J Janse, A J Dunning
Journal: Circulation (1990)

Using a radiotransparent electrode array, body surface maps (BSMs) were constructed based on simultaneous recordings from 62 leads on the entire thorax before, during, and after balloon inflation during percutaneous transluminal coronary angioplasty (PTCA). Twenty-five patients were studied, and 30 angioplasties were performed; 20 patients had one-vessel disease, and five patients had two-vessel disease. In total, 15 dilations in the left anterior descending artery (LAD), seven in the right coronary artery (RCA), and eight in the left circumflex artery (LCx) were studied. For each patient, the BSM and the QRS integral map before, during, and after the inflation was compared by subtraction of recordings "during-minus-before" inflation and "before-minus-after" inflation. The subtraction was performed on the results of the QRS integral maps. The conclusions derived from the inspection of the BSMs and the difference maps show specific changes in the QRS complex during ischemia related to the corresponding ischemic segment in 21 of 25 patients in the three groups. An area of positive potentials remained present on the BSM during dilation, indicating a depolarization wave front. For the LAD group, positive potentials were seen on the anterior thorax and, for the RCA group, on the lower part of the thorax. By subtraction analysis, these changes were extracted and presented as difference maps. For the LCx group, the BSM revealed no changes in pattern but the difference map showed a difference vector pointing in a anteroposterior direction. A regional myocardial conduction delay was hypothesized as the most likely cause for the results.
Lipoprotein composition in insulin-dependent diabetes mellitus with chronic renal failure: Effect of kidney and pancreas transplantation
Authors: Thomas A. Hughes, A.Osama Gaber, Hosein S. Amiri, Xiaohu Wang, Debra S. Elmer, Rebecca P. Winsett, Donna K. Hathaway, Suzanne M. Hughes, Maher Ghawji
Journal: Metabolism (1994)
Folate and Vitamin B12 in Epilepsy
Authors: N. Gordon
Journal: BMJ (1970)

JOHRNALconcentrate available resources into fewer and larger units."Mr. Roper's report was dealing with the office of Health Economics' latest publication Building for Health.This wellconsidered document, the result of wideseeking research, seriously challenges the concept of huge hospitals and suggests that resources would be better employed in the development of about 1,000 community care units.Any one properly interested in the future pattern of hospitals (and therefore in the future pattern of medical care because the two are intimately related) would know that the subject is very much open and the decisions involved are ones that will profoundly affect all of us, both as doctors and as potential patients for the next half century or more.May I ask, therefore, through your col- umns if the originator of this press pro- nouncement will reveal himself, and also the authority on which he bases his "wis- dom.
Crystal Structure of Mouse H2-M
Authors: Daved H Fremont, Frances Crawford, Philippa Marrack, Wayne A Hendrickson, John Kappler
Journal: Immunity (1998)

H2-M (HLA-DM in humans) resides in an acidic endosomal compartment, where it facilitates the loading of antigenic peptides into the peptide-binding groove of class II MHC. The crystal structure of a soluble form of H2-M has been solved to 3.1 Å resolution, revealing a heterodimer with structural similarities to the MHC family of proteins. In contrast to its antigen-presenting cousins, the membrane distal α helices of H2-M pack closely together, occluding most of the binding groove except for a single large pocket near the center. The structure of H2-M has several unique features that may play a role in its function as a molecular chaperone and peptide exchange factor.
First-line Treatment of Pemphigus Vulgaris With a Combination of Rituximab and High-Potency Topical Corticosteroids
Authors: Saskia Ingen-Housz-Oro, Laurence Valeyrie-Allanore, Anne Cosnes, Nicolas Ortonne, Sophie Hüe, Muriel Paul, Pierre Wolkenstein, Olivier Chosidow
Journal: JAMA Dermatology (2014)

The main component of the first-line treatment of pemphigus vulgaris is high doses of systemic corticosteroids, but adverse effects of these drugs are frequent and sometimes severe. Rituximab has shown effectiveness as a corticosteroid-sparing agent or in case of relapse. To our knowledge, the effectiveness of rituximab as a first-line treatment without systemic corticosteroids has not been evaluated.Five women in their 50s, 60s, or 70s with pemphigus vulgaris (Pemphigus Disease Area Index score, 15-84 at diagnosis) and contraindications to systemic corticosteroid treatment received rituximab with high-potency topical corticosteroids as first-line treatment. All patients experienced a favorable response, with a mean time to healing of skin and mucosal lesions of 15 weeks. Two patients, with 42- and 48-month follow-up evaluations, did not experience relapse. Three patients developed 2 to 4 relapses, with effective retreatment achieved using rituximab and topical corticosteroids. No severe adverse effects were observed.Considering the high rate of severe adverse effects induced by prolonged administration of high doses of systemic corticosteroids, new therapeutic options are warranted in the treatment of pemphigus vulgaris. The combination of rituximab and topical corticosteroids could be considered in mild to severe cutaneous disease. Larger long-term studies are needed to evaluate the optimal treatment strategies according to the severity of the disease and the benefit-risk ratio of rituximab.
Low or absent SPARC expression in acute myeloid leukemia with MLL rearrangements is associated with sensitivity to growth inhibition by exogenous SPARC protein
Authors: J F DiMartino, N J Lacayo, M Varadi, L Li, C Saraiya, Y Ravindranath, R Yu, B I Sikic, S C Raimondi, G V Dahl
Journal: Leukemia (2006)
Olive pollen allergen Ole e 8: identification in mature pollen and presence of Ole e 8‐like proteins in different pollens
Authors: A. Ledesma, M. Villalba, F. Vivanco, R. Rodríguez
Journal: Allergy (2002)

In a first approach, Ole e 8, a novel Ca2+-binding protein from olive pollen, was cloned and produced in Escherichia coli. We have obtained the natural form of Ole e 8 (nOle e 8) from the pollen and examined its immunologic equivalence with its recombinant form (rOle e 8). Size exclusion chromatography and a phenyl-Sepharose CL-4B affinity column were used to obtain nOle e 8 from the olive pollen. Inhibition assays by immunoblotting, using rOle e 8-specific rabbit antiserum, were performed to analyze the immunologic equivalence between the natural and the recombinant allergen, as well as to detect its presence in other pollens. Recombinant and natural Ole e 8 resulted immunologically equivalents, since they completely inhibited the IgG binding of the polyclonal antiserum to each other. Ole e 8-like proteins were detected in Oleaceae and Juniperus communis pollen, and might contribute to cross-reactivity processes between taxonomically related pollens.
Patients Who Faint During Office Visits
Authors: Richard P. Bergen
Journal: JAMA (1966)

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 Kahn and Davidson. The Reality of Type 2 Diabetes Prevention. Diabetes Care 2014;37:943–949
Authors: Edward W. Gregg, Mohammed K. Ali, Ann Albright
Journal: Diabetes Care (2014)

In the April 2014 issue, Kahn and Davidson (1) assert that implementing structured lifestyle programs to prevent diabetes in U.S. communities is not supported by science, nor justified economically. We interpret the same evidence differently and argue that integrating lifestyle programs in clinical and public health systems is necessary and good value.

Following proof of concept established in five major diabetes prevention outcome trials, over 35 practical trials have tested community, clinical, and virtual/telephonic intervention delivery (2–4). These trials were not intended to measure diabetes incidence; rather, they aimed to identify feasible avenues to deliver interventions in the complex market-oriented U.S. health care system and test whether similar process and intermediate outcomes as observed in the principal outcomes trials could be achieved. Across these practical translation trials, an average 4% weight loss was observed at 1 year, which was comparable to that achieved in the Finnish Diabetes Prevention Study (DPS), less than the 7% in the U.S. Diabetes Prevention Program (DPP), …
Intraluminal fat digestion in the chronic alcoholic
Authors: G. M. Roggin, F. L. Iber, W. G. Linscheer
Journal: Gut (1972)

Intraluminal fat digestion and absorption were evaluated in 15 chronic alcoholic and nine healthy volunteer males by aspiration of a standard meal from the jejunum. Intraluminal bile salts were present in normal concentrations and micellar solubilization of fatty acids and monoglycerides was within normal limits. Pancreatic lipase concentrations, however, were significantly lower in the alcoholic patients. As a consequence, hydrolysis of triglycerides was slower resulting in abnormally low concentrations of fatty acids and micellar lipids. Recovery of lipase production toward normal was demonstrated after four to six weeks by repeated intubation studies. Thus, in the chronic alcoholic insufficient production of pancreatic lipase seems to be responsible for the reversible abnormality in the intraluminal digestion of fat.
GASTROINTESTINAL HEMORRHAGE IN INFANCY AND CHILDHOOD
Authors: Donald Brayton
Journal: JAMA (1952)

During recent years, we have become increasingly aware of the difficulties occasionally encountered in determining the cause of gastrointestinal hemorrhage in patients treated at the Los Angeles Childrens Hospital. Although the etiology is readily apparent in most of these cases, in some, it can be determined only after an extended period of investigation. There is one group of particular interest, in which the cause of the bleeding remains unknown despite thorough studies, including laparotomy.  GENERAL CONSIDERATIONS  Cases of gastrointestinal hemorrhage in infancy and childhood were studied from Jan. 1, 1937, to Jan. 1, 1952. During this 15 year period, 428 patients were studied. For 65 patients (15%) the cause was listed, on  discharge, as unknown, but after further follow-up studies, a reasonable etiology could be assigned to 40 cases. The remaining 25 cases (6%) continue to be recorded as gastrointestinal bleeding of unknown etiology.  The various causes of hemorrhage from
Decreased serum apolipoprotein AII/AI ratio in systemic amyloidosis
Authors: T. Yamada, T. Ozawa, F. Gejyo, Y. Okuda, K. Takasugi, O. Hotta, Y. Itoh
Journal: Annals of the Rheumatic Diseases (1998)

<h3>OBJECTIVE</h3> To investigate if serum apolipoprotein A-I and A-II (apoAI and apoAII) concentrations change in subjects with systemic amyloidosis secondary to underlying disorders. <h3>METHODS</h3> Serum concentrations of apoAI and apoAII were measured in 21 multiple myeloma patients, including eight with amyloidosis; 95 rheumatoid arthritis patients, including 45 with amyloidosis; and 73 haemodialysis patients, including 32 with amyloidosis. <h3>RESULTS</h3> ApoAII values tended to be reduced in subjects with amyloidosis in each group, but could not effectively distinguish amyloidosis. However, apoAII/AI ratios were significantly lower in subjects with amyloidosis in all groups. The ratio of 0.2 had diagnostic sensitivity and specificity for amyloidosis; 50% and 100%, respectively, in multiple myeloma; 80% and 78%, respectively, in rheumatoid arthritis; and 46% and 90%, respectively, in patients requiring long term haemodialysis. <h3>CONCLUSION</h3> The apoAII/AI ratio can be a useful biochemical marker of suspect amyloidosis in patients with underlying diseases, especially those with rheumatoid arthritis.
Morbidity and treatment in elderly patients surviving hospital admission with bleeding peptic ulcer.
Authors: N Hudson, G Faulkner, S J Smith, R F Logan, C J Hawkey
Journal: Gut (1995)

Bleeding peptic ulcer in the elderly is associated with use of non-steroidal, anti-inflammatory drugs (NSAIDs) and aspirin, presenting a therapeutic dilemma for the treatment of survivors. To determine the longterm morbidity of patients surviving bleeding peptic ulcer and their treatment, with particular reference to NSAID use, this study followed up 487 patients aged over 60 years, who survived an episode of bleeding peptic ulcer in Nottingham during 1986 to 1991. Information was gathered by evaluation of general practitioner and hospital records, scrutiny of death certificates, and postal questionnaire to surviving patients. Of 487 patients surviving a bleeding peptic ulcer, 345 were alive at the follow up, a mean 34.2 months after discharge. Of these 201 (58%) had taken NSAIDs before their ulcer bleed (104 non-aspirin NSAIDs, 77 aspirin, 20 both). Compared with non-users, the patients using NSAIDs at the time of presentation were significantly more likely subsequently to consult their general practitioner with locomotor symptoms (56% v 35%, p &lt; 0.001) and receive further NSAIDs (34% v 13%, p &lt; 0.001), but significantly less likely to consult their general practitioner for dyspepsia (31% v 54%, p &lt; 0.001). Antiulcer drug use was widespread in both groups, with an overall point prevalence of 44%. Seventy five patients received NSAIDs during the follow up period (69% with coprescription of antiulcer drugs, usually H2 antagonists). Recurrent peptic ulcer, ulcer complications, and ulcer related deaths were uncommon. Antiulcer drug use was lower in those with ulcer recurrence compared with the point prevalence in those without (17% v 44%, p &lt; 0.05). Patient questionnaire responses confirmed a high level of locomotor symptoms especially in patients previously admitted with NSAID associated ulcer bleeding. In conclusion, in patients surviving peptic ulcer bleeding, recurrent ulcer complications and death seem to be lower than reported by studies that preceded the advent of antiulcer drugs. It is suggested that this low incidence may be a consequence of their use. Granted the low level of recurrent ulceration and the high level of locomotor symptoms in patients studied, current treatment may unduly emphasise the importance of stopping NSAIDs in this group of patients.
Serum adenosine deaminase activity in pleural effusion
Authors: V. SINGH, S. KHARB, P S GHALAUT, A. JANMEJA
Journal: Thorax (1998)

Pleural effusion is a common complication of many disease processes. Tuberculosis is still one of the most important causes of exudative effusions.1 Over the last decade many workers have emphasised the importance of estimating adenosine deaminase (ADA) in pleural fluid.2 ADA activity in human biological fluid results from the action of two isoenzymes—namely, ADA1 and ADA2—with different affinities on two substrates, 2′ deoxyadenosine and adenosine, respectively. The deaminase ratio (ADA1/ADA2) is …
Metronidazole and Alcohol in Pregnancy
Authors: Ivan Damjanov
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Concerning the recent question about the safety of metronidazole use in pregnancy,<sup>1</sup>I would like to add a note of caution based on our experimental data. As correctly pointed out by Dr Friedrich, who answered the letter to<i>JAMA</i>, there are no reports on the teratogenicity of metronidazole in humans. For all practical purposes metronidazole is not teratogenic in experimental animals,<sup>2</sup>unless administered in extremely high doses. However, if metronidazole together with ethyl alcohol is given to pregnant mice, fetotoxicity and teratogenicity occur far in excess of that noted in animals exposed to each of these drugs administered separately.<sup>2</sup>It seems that, in mice, metronidazole potentiates the teratogenicity of alcohol. Since metronidazole may cause intolerance to alcohol<sup>3</sup>as well as dizziness and nausea if taken together with alcohol, a warning against the simultaneous use of two drugs in pregnancy may be warranted.
CONFORMATIONAL CHANGES IN COMMERCIALLY AVAILABLE NITINOL STENTS IMPLANTED IN THE FEMORO–POPLITEAL ARTERIAL SEGMENT IN A CADAVERIC MODEL
Authors: Eric Matthew Shurtleff, Mariam Vanderhyde, Fallon Fitzwater, Bassem Chehab, Lorin Maletsky, Karthik Vamanan, Pamela Thomas, Peter Tadros, Kamal Gupta
Journal: Journal of the American College of Cardiology (2013)
Female stress urinary incontinence
Authors: R. Daniel, C. D. Mallen, J. Cooper
Journal: BMJ (2010)

A 55 year old postmenopausal woman presents with episodes of leaking urine exacerbated by coughing and exercise. She has had three vaginal deliveries, two of which were instrumental. Her symptoms have worsened since menopause and she often has to wear a pad.

Female urinary incontinence is common and increases with age. Prevalence ranges from 10% to 50% but fewer than half of affected women consult primary care.

A clear history of symptoms and a good obstetric and gynaecological history are essential, as is a history of bowel habits, as constipation can be associated with stress incontinence. Differentiating between stress and urge incontinence is important as they often exist together and treatment options differ. Elicit a medication history—α blockers and diuretics could worsen symptoms—and a smoking history.

Although urinary incontinence can occur in nulliparous women, risk factors include pregnancy, childbirth, age, obesity (BMI >30), and postmenopausal status. Prolonged labour and instrumentation increase the chance of incontinence in later life. Prolapse and prolapse surgery are often associated with urinary incontinence.

Symptoms include leakage of urine with activities that increase intra-abdominal pressure, such as laughing, coughing, and sneezing. In …
Serial Tuberculin Testing and Isoniazid Therapy in General Hospital Employees
Authors: Nuzhet O. Atuk
Journal: JAMA (1971)

A tuberculin testing program for hospital employees was conducted at the University of Virginia Hospital over a two-year period. The rate of positive reactions was 13.6% among 1,980 employees tested in 1968 and 16.0% among 1,013 employees evaluated in 1969. The yearly conversion rate was 1.9%. Most of the converters were detected during follow-up of employees in contact with patients with active disease. Minimal, active pulmonary tuberculosis was observed on x-ray films of the chest in two converters. After one year of isoniazid treatment, 50% of the newly tuberculin converted employees reverted to negative, 25% had a decreased reaction, and 25% remained unchanged. The results reported in this study strongly support the need for the continuation of tuberculosis control programs in general hospitals.
Fundamental Principles of Circulation Physiology for Physicians
Authors: Samuel Zoneraich
Journal: JAMA (1980)

Kuida's book is a clear presentation of a central area of physiology that appears complex to the general physician. The 18 chapters provide brief and understandable summaries of fundamental principles of circulation physiology. The book is easy to read, and appropriate illustrations clarify the text. The discussion covers a great deal of material and is generally accurate.  The author shares with the reader his experience and knowledge about the general aspects of circulation physiology, eg, oxygen supply and utilization, relevant fluid mechanics, and the physics of cardiac blood flow. The strength of this work lies in the chapters on cardiac muscle, the heart as a pump, the arterial system, cardiac output, the pulmonary circulation, and specialized properties of certain vascular beds. The chapter on hypertension, only five pages long, is a good summary of the present status of the art. Controversial topics, such as renin, are skillfully avoided.  One of