tbuckley/cabot-search huggingface dataset:
Management of intracranial metastases.
Authors: M M Sharr, J S Garfield
Journal: BMJ (1978)

Of 223 patients with intracranial metastases, 161 underwent removal of a presumed solitary lesion and 29 were treated by burr-hole biopsy. Results of radical surgery were better than those of biopsy alone in terms of survival. Quality and duration of survival were poorer in patients who had infratentorial metastases removed than in those who underwent surgery for supratentorial metastases. In this second group only patients with breast cancer benefited from surgery, though a few women with bronchial carcinoma also did well. The interval removal of a primary tumour and development of intracranial symptoms did not influence outcome. Evidence of a previous primary tumour should not lead to the assumption that intracranial symptoms are caused by a metastasis.
New GP contract sets out less bureaucracy and more responsibility for patients
Authors: Z. Kmietowicz
Journal: BMJ (2014)

All general practices in England will have to display GPs’ average net earnings in 2014-15 on their websites by the end of March 2016, under terms agreed in the new general medical services (GMS) contract for GPs.1

From next April practices must also provide all patients with a named accountable GP who will be responsible for coordinating their care. They will also have to expand the information that patients can see in their medical records online and make more appointments available to book online. Practices have had to provide a named GP for the four million people aged 75 or over since April this year.2 The requirement includes monitoring …
Role of renin in the pathogenesis of renal hypertension.
Authors: O P Gulati, O A Carretero, N B Oza, L A Fernandez, A Schork
Journal: Circulation Research (1975)

To test the hypothesis that renin is circulating in pressor amounts in renal hypertension, two-kidney Goldblatt hypertension was produced in rats. After hypertension had been present for a variable period of time (4 to 21 days), the ischemic kidney was removed, and an infusion of rat renin was started immediately to replace the endogenous renin that the ischemic kidney had been releasing. Since the amount of renin released by the clipped kidney was not known, the amount infused was regulated by a feedback mechanism set to keep the mean blood pressure at the same level as before ipsilateral nephrectomy. Hypertension remission was therefore prevented by this procedure. The PRA at the end of the renin infusion was similar to that prior to the ipsilateral nephrectomy. This finding indicates that the levels of the PRA circulating in renal hypertension are within the pressor range, thus supporting the hypothesis that renin plays a role in the pathogenesis of the acute or semiacute phase of renal hypertension. However, the participation of other factors cannot be ruled out since no correlation was found between PRA and blood pressure.
Introduction of a partial shift system for house officers in a teaching hospital.
Authors: D. J. Vassallo, J. Chana, C. L. Clark, R. E. Smith, R. F. Wood
Journal: BMJ (1992)

OBJECTIVES--(1) To introduce a partial shift system to reduce the hours of work of preregistration house surgeons to an average of 64 a week to comply with the New Deal for junior doctors; (2) to test linking the partial shift concept to an existing structure of "on call" firms. DESIGN--Formal assessment after three months of a pilot partial shift system for eight house surgeons on three firms instituted on 1 November 1991, followed by questionnaire and interview evaluation at three and six months of a revised system implemented on 1 February 1992. SETTING--Department of general surgery at St Bartholomew9s Hospital, London. SUBJECTS--24 house surgeons attached to three surgical firms. RESULTS--In eight weeks each house surgeon worked one week (five shifts) of night duty, one week of "cover" (afternoon and evening) duty, and six weeks of normal daytime hours. Each weekday a house surgeon from the firm on call worked an extended daytime on call shift until 10 pm. Weekend duties were split between two house surgeons from the firm on call. A computer generated graphical display of the rota was used to facilitate leave planning. Average working hours were reduced to below 64 per week, including prospective cover, without detriment to patient care and educational standards. Within the shift system individual house surgeons could be on call with their own firm by day and at weekends. Opinions were equally divided among junior staff as to their preference for either on call or partial shift systems. CONCLUSIONS--The principles of this partial shift system are generally applicable and the model can readily be adopted by district general hospitals.
Disorders of Neurohumoural Transmission
Authors: André Barbeau
Journal: JAMA (1983)

The discovery of a dopamine deficit in Parkinson's disease and of cholinergic-receptor abnormalities in myasthenia gravis contributed to a revolution in the neurosciences and to the delineation of an emerging field of neurology: disorders of neurohumoral transmission. In recent years innumerable monographs and symposia have addressed one or more of these disorders, particularly those of the extrapyramidal system. For a new text to be worthwhile, it should give a balanced overview of the subject and be written by experts in the field. In recent years two such books have appeared:<i>Textbook of Neuropharmacology by</i>H. J. Klawans and collaborators and the present text edited by T. J. Crow. Dr Crow, from Great Britain, is best know for his own important research in the biochemistry of schizophrenia, a subject that he reviews in a clear and lucid chapter. Affective disorders and their intricate biochemical parameters are studied by his colleague E.
Changes in Theophylline Clearance During Acute Illness
Authors: Samuel Vozeh
Journal: JAMA (1978)

Three patients demonstrated twofold to threefold changes in total-body theophylline clearance during the course of a single hospitalization for an acute illness. These changes paralleled the changes in the patients' clinical status. Theophylline clearance decreased in one patient with worsening airway obstruction, whereas clearance increased in one patient with resolving pneumonia and in one patient with improving congestive heart failure. Total-body theophylline clearance may be unstable in acute, severe illness. Close monitoring of plasma theophylline concentration in such situations will allow appropriate dose adjustments to be made and is, therefore, indicated. (<i>JAMA</i>240:1882-1884, 1978)
Chronic overuse injuries of the piso-triquetral joint in racquet game players.
Authors: B. Helal
Journal: British Journal of Sports Medicine (1978)

Three squash racquets and one badminton player presented with pain in the base of the hypothenar eminence, due to minor degrees of subluxation of the pisiform bone. Two of them also showed chondromalacia of the articular cartilage of the pisotriquetral joint. All four patients were relieved by excision of the pisiform bone and had returned to their normal daily and sporting activities within three months of their operation.
Prosciuto Consumption in Roseto, Pa
Authors: Michael C. Ritato, Roger W. Cooper
Journal: JAMA (1964)

<h3>To the Editor:—</h3> We would like to add an observation to those given by Drs. Stout, Brandt, and Wolf in the paper "Unusually Low Incidence of Death from Myocardial Infarction," which was an excellent epidemiological study on myocardial infarction in Roseto, Pa (<i>JAMA</i><b>188:</b>845 [June 8] 1964). We visited every grocery store and meat market in Roseto. Prosciuto is sold in sparing amounts in only one store. There is little demand and it costs more than $2 per pound. Prosciuto is a delicacy eaten only on special occasions by Italians. Those in Roseto are no exception. We have no argument with the statistical conclusion of this study. However, the inference drawn by the lay press and some physicians that excessive calories and high fat diets are of no consequence in the causation of myocardial infarction is unwarranted at this time. Whether the fortuitous situation in Roseto arises from genetics
Predicting Mortality in Nursing Home Residents With Lower Respiratory Tract Infection
Authors: David R. Mehr, Ellen F. Binder, Robin L. Kruse, Steven C. Zweig, Richard Madsen, Lori Popejoy, Ralph B. D'Agostino
Journal: JAMA (2001)

ContextLower respiratory tract infection (LRI) is a leading cause of mortality and hospitalization in nursing home residents. Treatment decisions may be aided by a clinical prediction rule that identifies residents at low and high risk of mortality.ObjectiveTo identify patient characteristics predictive of 30-day mortality in nursing home residents with an LRI.Design, Setting, and PatientsProspective cohort study of 1406 episodes of LRI in 1044 residents of 36 nursing homes in central Missouri and the St Louis, Mo, area between August 15, 1995, and September 30, 1998.Main Outcome MeasureThirty-day all-cause mortality.ResultsThirty-day mortality was 14.7% (n = 207). In a logistic analysis, using generalized estimating equations to adjust for clustering, we developed an 8-variable model to predict 30-day mortality, including serum urea nitrogen, white blood cell count, body mass index, pulse rate, activities of daily living status, absolute lymphocyte count of less than 800/µL (0.8 × 109/L), male sex, and deterioration in mood over 90 days. In validation testing, the model exhibited reasonable discrimination (c = .76) and calibration (nonsignificant Hosmer-Lemeshow goodness-of-fit statistic, P = .54). A point score based on this model's variables fit to the entire data set closely matched observed mortality. Fifty-two percent of residents had low (score of 0-4) or relatively low (score of 5-6) predicted 30-day mortality, with 2.2% and 6.2% actual mortality, respectively.ConclusionsOur model distinguishes nursing home residents at relatively low risk for mortality due to LRI. If independently validated, our findings could help physicians identify nursing home residents in need of different therapeutic approaches for LRI.
Systematic Review and Meta-analysis of Candidate Gene Association Studies of Lower Urinary Tract Symptoms in Men
Authors: Rufus Cartwright, Altaf Mangera, Kari A.O. Tikkinen, Prabhakar Rajan, Jori Pesonen, Anna C. Kirby, Ganesh Thiagamoorthy, Chris Ambrose, Juan Gonzalez-Maffe, Phillip R. Bennett, Tom Palmer, Andrew Walley, Marjo-Riitta Järvelin, Vik Khullar, Chris Chapple
Journal: European Urology (2014)

Although family studies have shown that male lower urinary tract symptoms (LUTS) are highly heritable, no systematic review exists of genetic polymorphisms tested for association with LUTS.To systematically review and meta-analyze studies assessing candidate polymorphisms/genes tested for an association with LUTS, and to assess the strength, consistency, and potential for bias among pooled associations.A systematic search of the PubMed and HuGE databases as well as abstracts of major urologic meetings was performed through to January 2013. Case-control studies reporting genetic associations in men with LUTS were included. Reviewers independently and in duplicate screened titles, abstracts, and full texts to determine eligibility, abstracted data, and assessed the credibility of pooled associations according to the interim Venice criteria. Authors were contacted for clarifications if needed. Meta-analyses were performed for variants assessed in more than two studies.We identified 74 eligible studies containing data on 70 different genes. A total of 35 meta-analyses were performed with statistical significance in five (ACE, ELAC2, GSTM1, TERT, and VDR). The heterogeneity was high in three of these meta-analyses. The rs731236 variant of the vitamin D receptor had a protective effect for LUTS (odds ratio: 0.64; 95% confidence interval, 0.49-0.83) with moderate heterogeneity (I(2)=27.2%). No evidence for publication bias was identified. Limitations include wide-ranging phenotype definitions for LUTS and limited power in most meta-analyses to detect smaller effect sizes.Few putative genetic risk variants have been reliably replicated across populations. We found consistent evidence of a reduced risk of LUTS associated with the common rs731236 variant of the vitamin D receptor gene in our meta-analyses.Combining the results from all previous studies of genetic variants that may cause urinary symptoms in men, we found significant variants in five genes. Only one, a variant of the vitamin D receptor, was consistently protective across different populations.
Points: McIlroy was here. Or was he?
Authors: N M C Mayne, T P Ormerod
Journal: BMJ (1979)

A N Bamji (14 April, p 973) with great interest.We were medical students resident in separate Dublin hospitals in 1966.At this time McIlroy appeared at the casualty department of the Royal City of Dublin Hospital complaining of chest pain.One of us (JRN) was connecting him to an ECG machine which required to be earthed.Unfortunately, this was not done and the patient obviously experienced an electric shock.He leapt from the trolley and, putting his finger over his tracheostomy, confirmed in no uncertain terms that this was the case.He took his own discharge.Later that evening this somewhat ruffled student called at the Adelaide Hospital three kilometres or so away.There CED was found to be examining McIlroy, still complain- ing of chest pain but not referring to his recent experience.When he saw JRN he had the grace to look a little embarrassed.The ECG machine in the Adelaide Hospital evidently caused the patient no further upset-and the tracing showed no abnormality.Nevertheless, he spent a comfortable night in hospital and subsequently took his own discharge.There is no doubt in our minds that this man was McIlroy....
The Impact of United States Law on Medicine as a Profession
Authors: Sara Rosenbaum
Journal: JAMA (2003)

The evolution of US law has had an enormous influence on medicine as a profession, and much of this legal evolution can be attributed to changes in the science and practice of medicine. This changing legal framework and its intersection with medicine has many facets. Three of the most important facets concern the evolution of the no duty-to-treat principle and the role of modern health care financing and civil rights law in altering this rule, the manner in which advances in medicine led courts and legislatures to change the standards against which professional medical liability is measured, and the basic loss of highly preferential treatment under US laws aimed at preventing anticompetitive conduct by businesses. However, despite the impact on the profession of an evolving legal system, concern over the integrity of medical professionalism continues to significantly influence both laws and lawmakers, including legislatures, regulatory agencies, and the courts.
Anatomic and Pathologic Studies in Ventricular Septal Defect
Authors: LUIS M. BECU, ROBERT S. FONTANA, JAMES W. DUSHANE, JOHN W. KIRKLIN, HOWARD B. BURCHELL, JESSE E. EDWARDS
Journal: Circulation (1956)

In a necropsy study of 50 cases of ventricular septal defects, the anatomic position and relations of ventricular septal defects, the causes of and ages at death, and association of ventricular septal defects with other cardiovascular malformations were determined. The present availability of surgical closure of ventricular septal defects makes this information of practical significance.
Academic Medical Centers and Conflicts of Interest
Authors: Orin M. Goldblum, Michael J. Franzblau
Journal: JAMA (2006)

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
Interobserver Agreement in the Nuclear Grading of Primary Pulmonary Adenocarcinoma
Authors: Yoshimasa Nakazato, Akiko Miyagi Maeshima, Yuichi Ishikawa, Yasushi Yatabe, Junya Fukuoka, Tomoyuki Yokose, Yasuhiko Tomita, Yuko Minami, Hisao Asamura, Keisei Tachibana, Tomoyuki Goya, Masayuki Noguchi
Journal: Journal of Thoracic Oncology (2013)
A reader and reviewer has sent this amplification of
Authors: Larry R. Kirkland
Journal: JAMA (1997)

The acknowledged (though not by Vesalius) artist who designed the woodblocks, Jan Stephen of Calcar, was a pupil of Titian. Done in pearwood, these blocks were sawed with the grain and cut with knives (ie, not engraved), which makes their beauty and detail the more remarkable. Their journey through the centuries is worth a brief recapping.<sup>1</sup> After the editions of the<i>Fabrica</i>of 1543 and 1555, the blocks were kept by Vesalius, then purchased from his heirs after his death in 1564. Disappearing for over a century, they resurfaced in Augsburg for limited printings in 1706, 1723, and 1783, after which they again disappeared. In 1893,141 small and six large blocks were accidentally discovered in a cupboard in the library of the University of Munich, but the discovery went largely unnoticed. Then, in 1932, at the prompting of the New York Academy of Medicine, another search was done in Munich
Genotypes of the glutathione S-transferase superfamily do not correlate with outcome of childhood acute lymphoblastic leukemia
Authors: Alessandra Sala, Marina Lanciotti, Maria Grazia Valsecchi, Paola di Michele, Carlo Dufour, Riccardo Haupt, Giuseppe Basso, Carmelo Rizzari, Andrea Biondi
Journal: Leukemia (2003)
What is a good death?: Good death will happen if life was good
Authors: S. Stagnaro
Journal: BMJ (2003)

Editor—Smith's Editor's Choice should be included in the medical literature that students around the world need to understand.1 A  doctor cares for a patient's body and soul. Doctors must take into consideration not only contingent questions related to a patient's health condition but also the fundamental questions about the sense and significance of the destiny of human beings.

We have to remember that death is the last of our habits: a  death can be achieved only if a patient, as well as his or her doctor, has spent life in a good manner. Where might human beings seek the answer to dramatic questions such as pain, the suffering of the innocent, and death, if not in the light streaming from the mystery of Christ's passion, death, and resurrection?2
Splanchnic Ischemia and Multiple Organ Failure
Authors: Charles L. Rice
Journal: JAMA (1990)

This timely volume focuses the contributions of 37 authors on the role of splanchnic ischemia as both a cause and effect in the development of organ failure following shock and sepsis. Grouped in four sections, "Splanchnic Vascular Anatomy and Physiology," "Pathophysiology," "Splanchnic Organ Injury Syndromes," and "Multiple Organ Failure Syndromes," individual chapters provide concise background to covered topics in a well-organized and generally readable format. Although the early sections on anatomy and physiology are lengthy for a book of this type, which is in general beyond the interest of those for whom these chapters seem written, the illustrations and photographic reproductions are well done, and the electron and light microscopy of mucosal pathology serve particularly well to highlight the discussion of gastrointestinal barrier breakdown. Notable are the six chapters on "Systemic Mediators of Splanchnic Origin." These represent an excellent distillation of a complex and often fragmented body of information, interesting
Effect of a combination of gastrin, secretin, cholecystokinin, glucagon, and gastric inhibitory polypeptide on jejunal absorption in man.
Authors: P Poitras, R Modigliani, J J Bernier
Journal: Gut (1980)

In 11 conscious volunteers, the jejunal absorption was measured during basal state and during the simultaneous intravenous infusion of small doses of gastrin, secretin, cholecystokinin, glucagon and gastric inhibitory polypeptide. The blood levels of gastrin, secretin, glucagon, and GIP were measured by RIA and were close to those achieved after a meal. The basal net absorption of water and electrolytes was reversed to a net secretion during the hormonal infusion. These results suggest that the jejunal secretion observed after a meal in man may be mediated by hormones released by the meal.
Small- and Large-Fiber Neuropathy After 40 Years of Type 1 Diabetes
Authors: Kari Anne Sveen, Bassam Karimé, Ellen Jørum, Svein Ivar Mellgren, Morten Wang Fagerland, Vincent M. Monnier, Knut Dahl-Jørgensen, Kristian F. Hanssen
Journal: Diabetes Care (2013)

OBJECTIVE To study large- and small-nerve fiber function in type 1 diabetes of long duration and associations with HbA1c and the advanced glycation end products (AGEs) N-ε-(carboxymethyl)lysine (CML) and methylglyoxal-derived hydroimidazolone. RESEARCH DESIGN AND METHODS In a long-term follow-up study, 27 persons with type 1 diabetes of 40 ± 3 years duration underwent large-nerve fiber examinations, with nerve conduction studies at baseline and years 8, 17, and 27. Small-fiber functions were assessed by quantitative sensory thresholds (QST) and intraepidermal nerve fiber density (IENFD) at year 27. HbA1c was measured prospectively through 27 years. Serum CML was measured at year 17 by immunoassay. Serum hydroimidazolone was measured at year 27 with liquid chromatography–mass spectrometry. RESULTS Sixteen patients (59%) had large-fiber neuropathy. Twenty-two (81%) had small-fiber dysfunction by QST. Heat pain thresholds in the foot were associated with hydroimidazolone and HbA1c. IENFD was abnormal in 19 (70%) and significantly lower in diabetic patients than in age-matched control subjects (4.3 ± 2.3 vs. 11.2 ± 3.5 mm, P &amp;lt; 0.001). IENFD correlated negatively with HbA1c over 27 years (r = −0.4, P = 0.04) and CML (r = −0.5, P = 0.01). After adjustment for age, height, and BMI in a multiple linear regression model, CML was still independently associated with IENFD. CONCLUSIONS Small-fiber sensory neuropathy is a major manifestation in type 1 diabetes of 40 years duration and more prevalent than large-fiber neuropathy. HbA1c and the AGEs CML and hydroimidazolone are important risk factors in the development of large- and small-fiber dysfunction in long-term type 1 diabetes.