tbuckley/cabot-search huggingface dataset:
Regular review: Endometriosis
Authors: A. Prentice
Journal: BMJ (2001)

Many doctors, both general practitioners and specialists, find endometriosis difficult to manage.Equally, many patients are dissatisfied with the care they receive.Endometriosis is the presence of endometrium at sites outside the endometrial cavity.It has long been known that the symptoms experienced by a patient may seem disproportionate to the extent of the disease observed within that patient's pelvis.For the patient it is not the endometriosis that is important but rather the illness that they experience.In this article I address the treatment of symptomatic endometriosis and infertility associated with the disease. MethodsThis review is based on information from the controlled trials register of the Cochrane Library and the personal experience of the author.
Preemployment Low-Back X-ray Films
Authors: Arthur M. Small
Journal: JAMA (1982)

<h3>To the Editor.—</h3> I read with great interest in the QUESTIONS AND ANSWERS section the discussion concerning routine preemployment low-back x-ray films (1982;247:1650). What I found most disconcerting was that nowhere in the article was the issue raised concerning the need to perform a roentgenogram of the pelvic region of an essentially normal population group. As physicians, even though we may be employed by a private company, we should have the best interests of our patients in mind before agreeing to order a potentially harmful test when no clear clinical indication exists. This is especially important when x-ray films are ordered for young women who are not aware that they may be in the early weeks of pregnancy. It is sad, but most people who are seeking employment will consent to these x-ray examinations if failure to do so would eliminate them from consideration for employment. The routine ordering of
Disappearance of Thyrotropin-Blocking Antibodies and Spontaneous Recovery from Hypothyroidism in Autoimmune Thyroiditis
Authors: Nobuyuki Takasu, Takashi Yamada, Mika Takasu, Ichiro Komiya, Yoshitaka Nagasawa, Takayuki Asawa, Toshio Shinoda, Toru Aizawa, Youichi Koizumi
Journal: New England Journal of Medicine (1992)

Hypothyroidism may result from the production of antibodies that block the actions of thyrotropin. How often these thyrotropin-blocking antibodies are a cause of hypothyroidism and whether their production may cease, causing hypothyroidism to disappear, have not been extensively studied.
ON UTILIZING INSTITUTIONALIZED MENTAL PATIENTS TO INFLUENCE OTHER PATIENTS PSYCHOTHERAPEUTICALLY
Authors: Frederic Storchheim
Journal: American Journal of Psychiatry (1935)

Can a patient, whose personality agrees with that of another patient, influence that patient favorably from a psychotherapeutic standpoint? An answer in the affirmative appears indicated by several observations of the writer. These observations were all made on chronic wards. Usually a homosexual component was noted. was not of serious import and did not interfere with the beneficial results of the patient relationships.
Expression of platelet-derived growth factor (PDGF)-A, PDGF-B and the PDGF-alpha receptor, but not the PDGF-beta receptor, in human malignant melanoma in vivo
Authors: R.L. BARNHILL, M. XIAO, D. GRAVES, H.N. ANTONIADES
Journal: British Journal of Dermatology (1996)

There has been considerable interest in the potential role of growth fctclors in the initiation and development of cutaneous malignant melanoma (CMM). Platelet‐derived growth factor (PDGF) has been shown to be secreted by melanoma cell lines and by metastatic melanoma in vivo. PDGF also has been reported to stimulate the development of tumour stroma and new blood vessels. We studied the expression of PDGF and its receptors by both immunohistt)chcmistry (IHC) and in situ hybridization (ISH) in primary and metastatic melanoma and in normal skin specimens. Cryostat sections were incubated with 35S‐labelled riboprobes and antibodies for PDGF‐AA. PDGF‐alpha receptor. PDGF‐BB and PDGF‐beta receptor. Both primary and metastatic melanoma exhibited significant expression of PDGF‐AA. PDGF‐BB and PDGF‐alpha receptor by both IHC and ISH. compared with only background expression in normal skin. We did not observe expression of PDGF‐beta receptor in melanoma. Our results suggest that PDGF may function as an autocrine growth factor, as well as an angiogenesis factor, in CMM tumour development. This expression of the PDGF‐alpha receptor rather than the beta receptor may be unique among solid tumours.
Intraabdominal Pregnancy after Hysterectomy
Authors: Harold C Wiesenfeld, Richard S Guido
Journal: New England Journal of Medicine (2003)

A 31-year-old woman underwent total abdominal hysterectomy for menorrhagia. Her reported last menstrual period had occurred six days before surgery. Twelve weeks after surgery, computed tomography of the abdomen and pelvis was performed because of persistent abdominal pain and revealed an intraabdominal pregnancy. The crown–rump length of the fetus was 6.3 cm, consistent with a gestation of 12 weeks and 5 days (±7 days). Laparotomy confirmed the intraabdominal pregnancy and showed placental tissue implanted on the broad ligament and ovary. The fetus was removed, and the patient was transferred to our institution, where she recovered without further treatment. We hypothesize . . .
German patients rush to doctors before new 10 charge starts
Authors: A. Tuffs
Journal: BMJ (2004)

Throughout December, doctors' surgeries in Germany, especially in the east, have been overcrowded with patients who want to escape the extra cost of a flat rate “entrance fee” that was due to start on 1 January.

As a result of the recent health reforms patients in Germany will have to pay €10 (£7; $12) for a visit to their GP, though any subsequent visit in the next …
Furosemide-induced natriuresis is augmented by ultra-low-dose captopril but not by standard doses of captopril in chronic heart failure.
Authors: J G Motwani, M K Fenwick, J J Morton, A D Struthers
Journal: Circulation (1992)

BACKGROUND Ten chronic heart failure patients were studied on three occasions in randomized double-blind fashion to compare the acute hemodynamic, neurohormonal, and renal sodium-handling responses to 1 mg captopril versus 25 mg captopril, both in the absence of loop diuretic therapy and during furosemide-stimulated natriuresis. METHODS AND RESULTS Compared with placebo, 1 mg captopril caused nonsignificant decreases in mean arterial pressure and circulating angiotensin II level and had no effect on glomerular filtration rate as determined by 51Cr-EDTA elimination. Captopril (25 mg) produced marked suppression of serum angiotensin II with or without oral furosemide (both p less than 0.002), a marked decrease in mean arterial pressure (p less than 0.001) that was accentuated by furosemide (p less than 0.00001), and a decrease in glomerular filtration rate (p = 0.0007). No difference from placebo in renal sodium excretion was noted with either 1 or 25 mg captopril in the absence of furosemide. In contrast, while 25 mg captopril caused slight attenuation of the natriuretic response to furosemide, 1 mg captopril significantly enhanced furosemide-induced natriuresis (p less than 0.05). No correlation was found in our patients between the natriuretic effect of furosemide and either absolute mean arterial pressure or change in mean arterial pressure during the furosemide phase of each study session. This suggests that blood pressure is not the important factor mediating the divergent renal responses to furosemide of the two captopril dosage regimens. CONCLUSIONS We propose that in the face of furosemide-induced postglomerular vasodilatation in chronic heart failure, captopril at a starting dose of 1 mg (but not 25 mg) preserves enough circulating angiotensin II to maintain efferent arteriolar tone and thus glomerular filtration, while offsetting the antinatriuretic renal tubular effects of angiotensin II.
Scintigraphic Diagnosis of Jejunoileal Duplication
Authors: Mehmet Reyhan, Mehmet Aydin, A Fuat Yapar, Nebil Bal, Dilek Eker
Journal: Clinical Nuclear Medicine (2004)

A 10-month-old male infant was hospitalized with a history of chronic intermittent gastrointestinal bleeding. A tentative diagnosis of Meckel's diverticulum was made, and Tc-99m pertechnetate scintigraphy demonstrated extensive uptake in the abdomen. At laparotomy, a 65-cm long jejunoileal tubular duplication was resected. Pathologic examination of the specimen revealed extensive gastric mucosal lining and hemorrhagic areas. In this report, the importance of Tc-99m pertechnetate scans for the diagnosis of jejunoileal duplication with heterotopic gastric mucosa is highlighted.
Inferring pattern and process: maximum-likelihood implementation of a nonhomogeneous model of DNA sequence evolution for phylogenetic analysis
Authors: N. Galtier, M. Gouy
Journal: Molecular Biology and Evolution (1998)

A nonhomogeneous, nonstationary stochastic model of DNA sequence evolution allowing varying equilibrium G + C contents among lineages is devised in order to deal with sequences of unequal base compositions. A maximum-likelihood implementation of this model for phylogenetic analyses allows handling of a reasonable number of sequences. The relevance of the model and the accuracy of parameter estimates are theoretically and empirically assessed, using real or simulated data sets. Overall, a significant amount of information about past evolutionary modes can be extracted from DNA sequences, suggesting that process (rates of distinct kinds of nucleotide substitutions) and pattern (the evolutionary tree) can be simultaneously inferred. G + C contents at ancestral nodes are quite accurately estimated. The new method appears to be useful for phylogenetic reconstruction when base composition varies among compared sequences. It may also be suitable for molecular evolution studies.
Health Care in the Czech Republic
Authors: Alexa Albert
Journal: JAMA (1992)

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
Metabolic Profile (Blood Pressure, Lipids and Body Mass Index) in Relation to Breast Cancer Mortality.
Authors: A. Emaus, M. Veierød, S. Tretli, S. Finstad, R. Selmer, A. Furberg, L. Bernstein, E. Schlichting, I. Thune
Journal: Cancer Research (2009)

Abstract Background: Metabolic profile (body mass, blood pressure, lipids) may affect biological mechanisms of importance for breast cancer. In the present study we have studied whether these factors are related to breast cancer mortality.Material and Methods: Within the Norwegian Counties Study, a population-based study (1974-2005), we identified 1364 female invasive breast cancer cases.Results: The 1364 cases had a mean age at diagnosis 57.5 years (range 27.1-79.4 years), mean body mass index (BMI) was 24.0 kg/m2, mean systolic blood pressure was 128.1 mmHg, mean diastolic blood pressure 78.6 mmHg, mean serum cholesterol was 6.17 mmol/L and mean HDL-cholesterol was 1.45 mmol/L. A total of 429 cases died during a mean follow-up of 8.2 years. Those with a BMI ≥30 kg/m2 had a 1.45 (CI, 1.07 to 1.95) higher risk of dying during the follow-up than women with a BMI of 18.5–25 kg/m2. Women in the highest tertile of blood pressure had a 43% increase in mortality compared to women in the lowest tertile of blood pressure (HR=1.43, 95% CI, 1.10 to 1.85). Additionally, women in the highest tertile of total cholesterol had a 29% increase in mortality compared to women in the lowest tertile (HR=1.29, 95% CI, 1.01 to 1.65).Conclusion: Our study supports a relationship between total mortality among breast cancer patients and metabolic profile. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3047.
Bobel-24 and Derivatives Induce Caspase-Independent Death in Pancreatic Cancer Regardless of Apoptotic Resistance
Authors: Matilde Parreño, Isolda Casanova, María Virtudes Céspedes, Jose Pedro Vaqué, Miguel Angel Pavón, Javier Leon, Ramon Mangues
Journal: Cancer Research (2008)

Abstract The poor prognosis of pancreatic cancer and poor sensitivity to current therapeutics, associated with resistance to apoptosis, urge the search for new drugs. We previously described the induction of caspase-independent mithochondrial death in leukemia cells by Bobel-24 (AM-24) and derivatives. Here, we explored whether these compounds induce a similar cytotoxicity in human pancreatic carcinoma cell lines (NP18, NP9, NP31, and NP29). Bobel-24 or Bobel-16 induced cytotoxicity and DNA synthesis inhibition in all cell lines and apoptosis in all lines, except for NP9. Caspase and/or poly(ADP-ribose) polymerase-1 (PARP-1) activity inhibition experiments showed that cytotoxicity was mainly induced through apoptosis in NP18 and through a caspase-independent process in NP9. Moreover, in NP29 or NP31 cell lines, both caspase-dependent and caspase-independent cell death mechanisms coexisted. Cell death was associated with reactive oxygen species (ROS) production, mitochondrial depolarization, cytochrome c and apoptosis-inducing factor (AIF) release, AIF nuclear translocation, and lysosomal cathepsin release. Inhibition of ROS production, mitochondrial pore permeability, PARP-1, or phospholipase A2 partially prevented cell death. Moreover, cathepsin B inhibition or down-regulation by small interfering RNA partially blocked cell death. In conclusion, Bobel-24 and derivatives trigger caspase-independent lysosomal and mitochondrial death in all tested human pancreatic cancer lines, irrespective of their degree of apoptotic sensitivity, becoming the only active cytotoxic mechanism in the apoptosis-resistant NP9 line. This mechanism may overcome the resistance to apoptosis observed in pancreatic carcinoma when treated with current genotoxic drugs. [Cancer Res 2008;68(15):6313–23]
Painful Diabetic Neuropathy
Authors: Elena A. Gillespie, Brenda W. Gillespie, Martin J. Stevens
Journal: Diabetes Care (2007)

Painful diabetic neuropathy (PDN) can be refractory to conventional pharmacologic therapy (1–3), which may have significant side effects. Reiki is a hands-on therapy based on the theoretical existence of a bioenergy field intrinsic to the human body (4). Reiki practitioners believe that this bioenergy field can be altered by a trained practitioner and that this can ameliorate disabling symptoms. However, its therapeutic efficacy remains unclear (5). This trial therefore assessed the efficacy of Reiki therapy to alleviate pain and improve mobility and quality of life in subjects with type 2 diabetes and PDN.

A total of 207 subjects with type 2 diabetes and PDN were recruited. Analgesics including anticonvulsants, tricyclic antidepressants, and nonsteroidal antiflammatory agents were permitted and equally distributed across groups, but no dosing adjustments were allowed. Subjects were stratified according to age, diabetes duration, diabetes control, and recruitment site. Written informed consent and ethical approval was obtained.

The study design was a randomized, semidouble–blind, placebo-controlled, 12-week trial. Subjects were randomized into one of three treatment groups (Reiki, mimic Reiki, or usual care) in a 1:1:1 fashion. Mimic practitioners were actors trained to mimic Reiki practitioners in style of practice. Reiki was applied as previously described (6). Practitioners …
INFLUENCE OF SMOKING ON THE ANTIPLATELET EFFECT OF CLOPIDOGREL DIFFERS ACCORDING TO DOSING STRATEGY: INSIGHTS FROM THE GRAVITAS TRIAL
Authors: Grant W. Reed, Christopher P. Cannon, Jill Waalen, Paul S. Teirstein, Jean–Francois Tanguay, Peter B. Berger, Eric J. Topol, Matthew J. Price
Journal: Journal of the American College of Cardiology (2013)
Impact of Preoperative Symptoms on Survival After Surgical Correction of Organic Mitral Regurgitation
Authors: Christophe M. Tribouilloy, Maurice Enriquez-Sarano, Hartzell V. Schaff, Thomas A. Orszulak, Kent R. Bailey, A. Jamil Tajik, Robert L. Frye
Journal: Circulation (1999)

Background —Surgical correction of mitral regurgitation in patients with no or mild symptoms remains controversial, particularly because the impact of preoperative symptoms on postoperative outcome is unknown. Methods and Results —The long-term outcome of 478 patients with organic mitral regurgitation (199 in NYHA functional class I/II and 279 in class III/IV before surgery) operated on between 1984 and 1991 was analyzed. In patients in NYHA class I/II before surgery compared with those in class III/IV, postoperative long-term survival was higher (at 10 years, 76±5% versus 48±4%, P &lt;0.0001), with lower operative mortality (0.5% versus 5.4%, P =0.003) and better late survival ( P &lt;0.0001). Comparison of observed and expected survival showed identical curves in patients in class I/II before surgery ( P =0.18), whereas excess mortality was observed in patients in class III/IV before surgery ( P &lt;0.0001). Excess mortality associated with severe symptoms was also confirmed in all subgroups (all P &lt;0.003) and in multivariate analysis ( P =0.0036; adjusted hazard ratio [95% CI], 1.81 [1.21 to 2.70]). Conclusions —In patients with organic mitral regurgitation, preoperative functional class III/IV symptoms are associated with excess short- and long-term postoperative mortality independently of all baseline characteristics. These data should lead to consideration of surgical correction of severe organic mitral regurgitation when no or minimal symptoms are present in patients at low operative risk, especially if repair is feasible.
Clinical leadership and management in the NHS – Paired Learning
Authors: Robert E Klaber, John Lee
Journal: Journal of the Royal Society of Medicine (2011)

Dame Turner-Warwick's podium piece1 highlights some of the historic differences between managers and clinical leaders within the NHS. It also expresses frustration at the failure to advance proposals to support the development of non-clinical managers, in order to create an equal partnership between clinicians and managers.

Recent clinical leadership initiatives, such as the development of the Medical Leadership Competency Framework,2 have moved away from training small numbers of top leaders to a model of shared leadership with a focus on supporting the development of leadership capabilities in all clinicians. Focused primarily on developing personal qualities and team working skills to plan, deliver and evaluate services, this encourages a work-based approach to leadership development. With the launch of the NHS Leadership Framework3 there is now a common approach to leadership development for all staff in health and care.

As many organizations move towards working practices and structures where managers work closely alongside clinical leaders to plan and deliver care, we believe this also provides an opportunity for clinicians and managers to learn together through peer-learning initiatives.

At Imperial College Healthcare NHS Trust we have established an innovative ‘paired learning’ scheme which has paired SpR level clinicians and Band 7 and 8a managers together in a leadership development scheme. This work-based programme uses a combination of informal conversation, work-shadowing, workshops and improvement project work to enable participants to better understand each other's perspectives and to drive learning. Evaluation of the programme showed demonstrable outcomes related to improved quality of patient care and greater efficiency. In addition participants reflected on their personal learning and the potential for future culture change in terms of stronger partnerships and collaborative working.

We would encourage other organizations to consider a ‘paired learning’ approach to leadership development, which is flexible, inexpensive and focused on managers and clinicians working and learning together.
Inappropriate publication of trial results and potential for allegations of illegal share dealing.
Authors: D S Freestone, H Mitchell
Journal: BMJ (1993)

There is increasing evidence of fraud in clinical research, and one aspect concerns trading in pharmaceutical company shares by people who may have confidential information about the results of clinical trials. Plainly this has implications for honest investigators, who may find themselves exposed to such allegations. In this paper Dr D S Freestone and Mr H Mitchell, QC, identify three interlinked issues which they think underlie the potential for these allegations. They are pressure for premature or inappropriate communication of research results; trading in pharmaceutical company shares by academic clinical investigators; and the possibility that clinical investigators might succumb to temptation. Dr Freestone and Mr Mitchell suggest that whenever possible results of clinical studies should be published in appropriate medical journals without prior public disclosure. This conflicts with Stock Exchange rules, which require that price sensitive information should be published at the earliest opportunity and preclude priority of publication in medical journals. Freestone and Mitchell believe that rarely rapid public disclosure is acceptable if it is to protect patients' interests but that it must not prejudice publication in the medical or scientific press. When rapid public disclosure is needed, they say, every attempt should be made to inform prescribers before patients. Dr Freestone and Mr Mitchell warn that academic clinical investigators who have access to unpublished price sensitive information about pharmaceutical companies whose shares they trade in will almost certainly be in breach of the Company Securities (Insider Dealing) Act 1985. Furthermore, disclosing such information to third parties, they say, exposes those people also to potential criminal liability. Freestone and Mitchell advise that when potential for allegations of conflict of interest exists clinical investigators should consider declaring their position to ethics committees and any sponsoring organisations.
Suicide after parasuicide
Authors: B. S Runeson
Journal: BMJ (2002)

Predicting suicide is a delicate matter, certainly difficult even in groups of patients at high risk. A paper in this issue focuses on previous parasuicide as a predictor of suicide (p 1155) and shows that the risk persists without decline for two decades.1 This observation is relevant for the clinical assessment of risk of suicide and has implications for the treatment of parasuicide as well.

In a large meta-analysis, a history of parasuicide or attempted suicide increased the risk of suicide to 40 times that of the general population.2 An attempted suicide that was recognised in health care thus implied a higher risk than having a mental disorder such as major depression, personality disorder, or dependence on alcohol. The risk of suicide is generally most prominent during the first months after psychiatric care.3 The …