tbuckley/cabot-search huggingface dataset:
CHATTANOOGA AS A HEAETH RESORT.Read in the Section of Stale Medicine at the Forty-first Annual Meeting of the American Medical Association, Nashville, Tenn., May 21, 1890.
Authors: W. C. TOWNES
Journal: JAMA (1890)

It has been said, "Earth has no sorrow that Heaven can not heal," It may be quite true, and may be otherwise. In a medical way it is prognostic rather than diagnostic. We prefer to admit it, but it does not fully satisfy. Most persons continue to seek relief in this life. The afflicted appeal to us now as ever before, and will hereafter till the causes be removed. The world is full of victims, and it is said not less than several thousand years ago, they are with us always, those with too much poverty, as also too much wealth. The consumptive, the strumous, the cachectic of wide degree, all ask to be cured<i>now</i>. The vast majority of invalids are so surrounded, and have such maladies, that they are best attended to in hospitals, or their own homes. There are, however, few practitioners who do
Quantitative analysis of transforming growth factor β1 messenger RNA in the liver of patients with chronic hepatitis C: Absence of correlation between high levels and severity of disease
Authors: Dominique Roulot, Hervé Durand, Thierry Coste, Jacques Rautureau, Donny A. Strosberg, Richard Benarous, Stefano Marullo
Journal: Hepatology (1995)

Transforming growth factor beta 1 (TGF beta 1) is a cytokine involved in liver fibrogenesis. Previous semiquantitative studies of patients with chronic viral hepatitis showed that liver TGF beta 1 messenger RNA (mRNA) was increased, compared with normal controls and with patients with chronic hepatitis C virus (HCV) infection who responded favorably to interferon alfa (IFN alpha) treatment. To evaluate its potential prognostic significance, we measured liver TGF beta 1 mRNA, using a new competitive reverse gene amplification assay, in a total of 35 patients with chronic HCV. This technique was reproducible and sensitive; we could measure as few as 5,000 molecules of TGF beta 1 mRNA per microgram of total liver RNA. In patients with chronic HCV, the mean level of TGF beta 1 mRNA was 200-fold higher than in controls. However, no correlation could be found between TGF beta 1 mRNA and either the biological (serum amino-terminal peptide of type III procollagen) and histological (Knodell scores) indices of liver fibrosis or a favorable response to IFN alpha therapy. In 9 patients, second liver specimens were obtained after treatment; in most cases, TGF beta 1 mRNA levels and hepatic histological findings varied in parallel. These data are consistent with the hypothesis that TGF beta 1 plays a role in stimulating liver fibrogenesis during chronic HCV, despite the lack of prognostic value of TGF beta 1 mRNA levels measured before treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Advanced Age, Anticoagulation Intensity, and Risk for Intracranial Hemorrhage among Patients Taking Warfarin for Atrial Fibrillation
Authors: Margaret C. Fang, Yuchiao Chang, Elaine M. Hylek, Jonathan Rosand, Steven M. Greenberg, Alan S. Go, Daniel E. Singer
Journal: Annals of Internal Medicine (2004)

Background: The risk for atrial fibrillation–associated stroke increases at low anticoagulation intensities. However, higher intensities increase hemorrhage risk. Optimal use of warfarin for atrial fibrillation requires precise information on the risk for intracranial hemorrhage as a function of patient age and anticoagulation intensity. Objective: To examine the relationship of age, anticoagulation intensity, and risk for intracranial hemorrhage. Design: Case–control study. Setting: Academic medical center. Patients: 170 case-patients who developed intracranial hemorrhage during warfarin therapy and 1020 matched controls who did not; both case-patients and controls were taking warfarin for atrial fibrillation. Measurements: The authors performed multivariable conditional logistic regression to determine the odds of intracranial hemorrhage with regard to age and international normalized ratio (INR), controlling for comorbid conditions and aspirin use. Results: Case-patients were older than controls (median age, 78 years vs. 75 years; P < 0.001) and had higher median INRs (2.7 vs. 2.3; P < 0.001). The risk for intracranial hemorrhage increased at 85 years of age or older (adjusted odds ratio, 2.5 [95% CI, 1.3 to 4.7]; referent age, 70 to 74 years) and at an INR range of 3.5 to 3.9 (adjusted odds ratio, 4.6 [CI, 2.3 to 9.4]; referent INR, 2.0 to 3.0). The risk for intracranial hemorrhage at INRs less than 2.0 did not differ statistically from the risk at INRs of 2.0 to 3.0 (adjusted odds ratio, 1.3 [CI, 0.8 to 2.2]). Limitations: Although duration of anticoagulation has been associated with hemorrhage in other studies, the current study could not control for this potential confounder. Conclusions: The risk for intracranial hemorrhage increases at age 85 years. International normalized ratios less than 2.0 were not associated with lower risk for intracranial hemorrhage compared with INRs between 2.0 and 3.0. Therefore, anticoagulation management should focus on maintaining INRs in the 2.0 to 3.0 range, even in elderly patients with atrial fibrillation, rather than targeting INRs less than 2.0. Similarly, INRs of 3.5 or greater should be avoided.
Book Review Gender and Health: The Effects of Constrained Choices and Social Policies By Chloe E. Bird and Patricia P. Rieker. 256 pp. New York, Cambridge University Press, 2008. $85 (cloth); $29.99 (paper). 978-0-521-86415-2 (cloth); 978-0-521-68280-0 (paper).
Authors: Sana Loue
Journal: New England Journal of Medicine (2008)
Segmental isolation of pulmonary veins during atrial fibrillation
Authors: Hakan Oral, Bradley P. Knight, Hiroshi Tada, Mehmet Ozaydin, Radmira Greenstein, Aman Chugh, Christoph Scharf, Sohail Hassan, Frank Pelosi, S.Adam Strickberger, Fred Morady
Journal: Journal of the American College of Cardiology (2002)
Counseling the HIV-Positive Woman Regarding Pregnancy-Reply
Authors: James Chin
Journal: JAMA (1987)

<h3>In Reply.—</h3> The recommendations made by Dr Chin and myself are exactly that—recommendations. Physicians are obliged to compile the most recent data so as to make the best possible recommendations for the health of their patients. But it is the patient who must make the ultimate decision. In this context, I think our recommendations would be considered nondirective according to Dr Hecht's definition.
A Rose for Dr. Martin
Authors: Michael J. Schott
Journal: Annals of Internal Medicine (2004)

On Being a Doctor7 December 2004A Rose for Dr. MartinMichael J. Schott, MA, MLSMichael J. Schott, MA, MLSFrom West Virginia University, Charleston, WV 25304.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-11-200412070-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I am the clinical medical librarian at a teaching hospital, who sits in the back during morning report while medical residents tell their tales to the attending physician. It is a time when teacher–physicians fill white boards with chief complaints, physical exams, lab values, and drug regimens and try to coax correct answers out of sleep-deprived residents.I have sat in the back of the room at morning report for over 15 years at 2 different hospitals in 2 states. My job is to listen to the stories, record the facts to find the supporting literature, talk to residents, and ... Author, Article, and Disclosure InformationAffiliations: From West Virginia University, Charleston, WV 25304.Corresponding Author: Michael J. Schott, MA, MLS, West Virginia University, Charleston Division, 3110 MacCorkle Avenue SE, Charleston, WV 25304; e-mail, [email protected]wvu.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 7 December 2004Volume 141, Issue 11Page: 887KeywordsDrugsHeartHemorrhageLibrariesPatent ductus arteriosusScientistsSleep ePublished: 7 December 2004 Issue Published: 7 December 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
On Genu Valgum: With some Remarks on Operations for its Removal
Authors: B. E. Brodhurst
Journal: BMJ (1879)

6s9 forming a bow, with the tendo Achillis stretching along its base like a bow-string.More often the lower two-thirds are implicated, and some- * Read is the Section of Surgery at the Annual Mfeeting of the British Medical Association in Cork, August I879.t This view was forcibly proved, I believe, to all present at a meeting of the Clini- cal Society in June, when a case thus treated was shown.
Jejunal Gallstone Ileus-Distorted Cholecystoduodenal Fistula
Authors: Nathan Hiatt
Journal: JAMA (1981)

To the Editor.—  Cholecystoduodenal fistula is not uncommon—nor is small intestinal obstruction caused by gallstone. The site of gallstone obstruction is usually the narrow distal ileum; the less common jejunal obstruction almost always occurs where the lumen has been reduced by an adhesion. 1 A calculus large enough to occlude the lumen of the normal jejunum is unusual—that a stone of such size could pass through a narrow, distorted, fistulous tract is surprising—the combination seems worthy of recording.  Report of a Case.—  A 91-year-old woman was brought from an extended care facility in an obtunded state, with a history of vomiting for 24 hours and of gallbladder trouble one and two years ago. The patient was severely dehydrated, with a moderately distended but soft, nontender abdomen without palpable masses, somewhat hyperactive bowel sounds, and a well-healed, old, lower midline scar. Flat abdominal film showed dilated small loops. No air was
All parents should be given leaflet outlining full details of antenatal screening
Authors: W M O Moore
Journal: BMJ (1999)

EDITOR—Price's unhappy experience of scanning during pregnancy is not uncommon.1 Many women are poorly informed about the role of screening tests in the first half of pregnancy.2 Health professionals often provide little and sometimes inaccurate information about these tests.3 Once an abnormality has been suspected or diagnosed many women report inadequacies in the information they receive or the way it is given.4 Guidelines for screening are discussed in a report from the Royal College of Obstetricians and …
Coeliac disease-associated antibodies correlate with psoriasis activity
Authors: W.K. Woo, S.A. Mcmillan, R.G.P. Watson, W.G. Mccluggage, J.M. Sloan, J.C. Mcmillan
Journal: British Journal of Dermatology (2004)

Antigliadin antibodies (AGA) have been reported in patients with psoriasis.To determine if AGA and other coeliac disease (CD)-associated antibodies correlate with clinical features and activity in patients with psoriasis.Patients with psoriasis (n = 130) were investigated for serum IgG and IgA AGA, IgA antitransglutaminase antibody and IgA antiendomysial antibody. Disease characteristics and associated bowel and joint symptoms were determined. All patients were invited to undertake endoscopy with duodenal biopsy.A significantly higher proportion of patients with elevated CD-associated antibody levels was currently on or had previously required systemic immunosuppressants (methotrexate, ciclosporin or etretinate; P = 0.04) or psoralen plus ultraviolet A phototherapy (P = 0.03). One case of CD was diagnosed.The presence of CD-associated antibodies in psoriasis patients correlates with greater disease activity.
THE ACTION OF ANTISEPTICS ON THE TOXIN OF BACILLUS WELCHII
Authors: Herbert D. Taylor, J. Harold Austin
Journal: The Journal of Experimental Medicine (1918)

1. Dakin's hypochlorite and chloramine-T solutions will protect pigeons against multiple fatal doses of the toxin of Bacillus welch when the antiseptic and the toxin are mixed in vitro and allowed to stand in contact for 5 minutes before injection. 2. The detoxicating action of the solutions is demonstrable also in the presence of serum. 3. Phenol solution, 0.25 per cent, has no such action.
Strategies for Financing National Health Insurance: Who Wins and Who Loses
Authors: Bridger M. Mitchell, William B. Schwartz
Journal: New England Journal of Medicine (1976)

Two sources of funds are available to underwrite the costs of any national health-insurance plan: prepayments (premiums, payroll taxes and income taxes) and out-of-pocket payments (coinsurance and deductibles). The extent to which taxes rather than premiums are used to finance an insurance program will be the major determinant of how large a share of the costs of health care will be borne by higher-income groups. The extent to which coinsurance and deductible provisions are reduced or waived for low-income persons will have a less important, but still substantial, role in determining how the costs of a program are distributed. These financing principles, once understood, provide a basis for the design of health-insurance legislation that will achieve any pattern of income redistribution that may be desired.
Autonomic Neuropathy Predicts Deterioration in Glomerular Filtration Rate in Patients With IDDM
Authors: Göran Sundkvist, Bo Lilja
Journal: Diabetes Care (1993)

OBJECTIVE To evaluate whether autonomic neuropathy predicts deterioration in glomerular filtration rate in IDDM patients. RESEARCH DESIGN AND METHODS A prospective study in which 35 IDDM patients have been followed for 10–11 yr. Autonomic nerve function tests included heart-rate reactions to deep breathing (expiration-to-inspiration ratio) and to tilt (acceleration and brake indexes). GFR was evaluated by the 51Cr-EDTA plasma clearance method. RESULTS At entry to the study, no significant differences were noted in age (39 ± 2 [mean ± SE] vs. 42 ± 4 yr), duration of diabetes (20 ± 3 vs. 23 ± 4 yr), supine blood pressures (120/79 ± 3/2 mmHg vs. 121/78 ± 6/3 mmHg), and GFR (113 ± 6 vs. 107 ± 3 ml·min−1·1.73 m−2) between 20 patients with and 15 without autonomic neuropathy (age-corrected criteria). After 10–11 yr, GFR had decreased significantly (22 ± 4 ml·min−1·1.73 m−2 P &amp;lt; 0.001) in patients with autonomic neuropathy but not (8 ± 5 ml·min−1·1.73 m−2, NS) in patients without. In keeping with this, GFR decreased more than expected (difference in GFR/ expected decrease in GFR) in patients with autonomic neuropathy, compared with those without (4.46 ± 0.98 vs. 0.48 ± 0.73, P &amp;lt; 0.005). CONCLUSIONS Autonomic neuropathy predicts future deterioration in GFR in IDDM patients.
Ampicillin for Typhoid Carriers
Authors: K. F. Anderson
Journal: BMJ (1964)

MEDIBA ORNAL 571 in the asthmatic condition-namely, the measurement of airway resistance either by the body plethysmograph, the interrupter technique, or by means of plotting flow against transpulmonary pressure during flow.Although these other indices give useful information they are not as practical as the indirect M.B.C. in assessing the change in the asthmatic condition, and anyhow not many people are equipped with body plethysmographs.Asthma by definition means difficult breathing, and in the great majority of the cases of asthma it is simply the " bellows " function of the lungs that becomes impaired.The indirect M.B.C. (or F.E.V.) gives an overall measure of this bellows function whatever the cause of impairment may be, and is now widely used as an index of change in asthma and other lung conditions.-Weare, etc.,
Mechanical Chest Compressions and Simultaneous Defibrillation vs Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest
Authors: Sten Rubertsson, Erik Lindgren, David Smekal, Ollie Östlund, Johan Silfverstolpe, Robert A. Lichtveld, Rene Boomars, Björn Ahlstedt, Gunnar Skoog, Robert Kastberg, David Halliwell, Martyn Box, Johan Herlitz, Rolf Karlsten
Journal: JAMA (2013)

A strategy using mechanical chest compressions might improve the poor outcome in out-of-hospital cardiac arrest, but such a strategy has not been tested in large clinical trials.To determine whether administering mechanical chest compressions with defibrillation during ongoing compressions (mechanical CPR), compared with manual cardiopulmonary resuscitation (manual CPR), according to guidelines, would improve 4-hour survival.Multicenter randomized clinical trial of 2589 patients with out-of-hospital cardiac arrest conducted between January 2008 and February 2013 in 4 Swedish, 1 British, and 1 Dutch ambulance services and their referring hospitals. Duration of follow-up was 6 months.Patients were randomized to receive either mechanical chest compressions (LUCAS Chest Compression System, Physio-Control/Jolife AB) combined with defibrillation during ongoing compressions (n = 1300) or to manual CPR according to guidelines (n = 1289).Four-hour survival, with secondary end points of survival up to 6 months with good neurological outcome using the Cerebral Performance Category (CPC) score. A CPC score of 1 or 2 was classified as a good outcome.Four-hour survival was achieved in 307 patients (23.6%) with mechanical CPR and 305 (23.7%) with manual CPR (risk difference, -0.05%; 95% CI, -3.3% to 3.2%; P > .99). Survival with a CPC score of 1 or 2 occurred in 98 (7.5%) vs 82 (6.4%) (risk difference, 1.18%; 95% CI, -0.78% to 3.1%) at intensive care unit discharge, in 108 (8.3%) vs 100 (7.8%) (risk difference, 0.55%; 95% CI, -1.5% to 2.6%) at hospital discharge, in 105 (8.1%) vs 94 (7.3%) (risk difference, 0.78%; 95% CI, -1.3% to 2.8%) at 1 month, and in 110 (8.5%) vs 98 (7.6%) (risk difference, 0.86%; 95% CI, -1.2% to 3.0%) at 6 months with mechanical CPR and manual CPR, respectively. Among patients surviving at 6 months, 99% in the mechanical CPR group and 94% in the manual CPR group had CPC scores of 1 or 2.Among adults with out-of-hospital cardiac arrest, there was no significant difference in 4-hour survival between patients treated with the mechanical CPR algorithm or those treated with guideline-adherent manual CPR. The vast majority of survivors in both groups had good neurological outcomes by 6 months. In clinical practice, mechanical CPR using the presented algorithm did not result in improved effectiveness compared with manual CPR.clinicaltrials.gov Identifier: NCT00609778.
Hyperthyroidism induces apoptosis in rat liver through activation of death receptor-mediated pathways
Authors: Ashok Kumar, Rohit A. Sinha, Meenakshi Tiwari, Rajesh Singh, Takehiko Koji, Namratta Manhas, Leena Rastogi, Lily Pal, Ashutosh Shrivastava, Ravi P. Sahu, Madan M. Godbole
Journal: Journal of Hepatology (2007)
Education with an angle
Authors: J. Smith
Journal: BMJ (2009)

One of the things that readers tell us consistently is that they want more education in the BMJ . I hope you’ll be pleased this week: the education sections are particularly strong.

Our cover highlights the clinical review on the early management of burns and scalds, from minor burns managed in primary care to those that need referral to specialist units (doi:10.1136/bmj.b1037). “Education with an angle” might be a subtitle for the Practice section, since all the articles have a particular perspective. Thus, the article on obstructive sleep apnoea appears in our “Easily missed” series of conditions that may be commoner than doctors think …
Consciousness
Authors: Kimford J. Meador
Journal: JAMA (1999)

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 Journals 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 2024 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
Campylobacter enteritis in the community.
Authors: J Symonds
Journal: BMJ (1983)

Campylobacter enteritis in the community Recognition of the importance of Campylobacter jejuni in human enteritis has generated prolific research over the past five years.Although described early this century as a cause of infectious abortion in sheep and suspected as a cause of diarrhoea in man as early as the 1950s,' 2 campylobacter organisms were not generally recognised as common human pathogens until 1977, when the introduction of selective techniques for stool cultures made their isolation possible by suppressing normal faecal flora.3Now such procedures are used routinely in clinical laboratories, and studies have shown that the organism may be recovered from as many as 15 /o of unselected patients with acute diarrhoea in Britain,4 though isolation rates of 700 are probably more typical.3In 1980, over 9500 campylobacter infections were reported to the Communicable Disease Surveillance Centre in London.5 Campylobacter enteritis is also common in other European countries, North America, Australia, and Africa; its prevalence in some developing countries appears to be even greater than in temperate climates.6Campylobacter enteritis is often unpleasant, but is characteristically a self-limiting disease, and symptoms have frequently subsided by the time a bacteriological diagnosis is confirmed.In some cases distinctive clinical features help the physician to make a presumptive diagnosis.3 8A prodromal stage of fever and malaise, sometimes with headache and muscular and abdominal pains, affects about two-thirds of patients and lasts usually no more than 24 hours.Nausea is common but vomiting is rare.Diarrhoea may be gradual in onset but is sometimes severe and explosive, with offensive watery stools which may be bloodstained.The diarrhoea usually resolves after 24 to 72 hours, but abdominal pain may persist for several more days.3The severity of the illness varies considerably: mild cases are common, but deaths have been reported in elderly or debilitated patients.Severe illness may afflict healthy young adults, in whom diarrhoea may continue for up to 14 days.In occasional cases the condition may relapse.Severe abdominal pain may mimic a surgical emergency, especially in children, and may suggest intussusception in babies.Occasionally oedema of the gut wall leads to genuine appendicitis.In a Scandinavian survey 1100 of patients with campylobacter enteritis suffered from illness severe enough to require admission to hospital, though most of these were elderly. 9Disseminated infection may occur, and C jejuni has been isolated from blood cultures of some patients during the prodromal phase.Reactive arthritis is
BMA may seek legal challenge over curbs on private practice
Authors: R. Dobson
Journal: BMJ (2001)

Plans to bar new consultants from working in private practice for seven years have been denounced by the BMA as insulting and potentially unlawful. The BMA is taking legal advice on what grounds may exist for a potential challenge in the courts.

The government claims that its proposed new terms and conditions for consultants—increasing their starting salary by £10000 ($15000), to £60000—are designed to link pay levels to commitment to the NHS and improved service delivery and patient care.

“Since 1948 the assumption has been that the only way for consultants to get by is by doing more private work,” said Alan Milburn, secretary of state for health. “That cannot be right, either for NHS consultants or NHS patients.”

The partial ban on private work is at the heart of the government's detailed proposals for negotiating new consultants' contracts, announced on 21 …