tbuckley/cabot-search huggingface dataset:
Managing medical mishaps
Authors: P. Richards, I M Kennedy, L. Woolf
Journal: BMJ (1996)

No one likes admitting that things have gone wrong, least of all politicians and doctors. Even if not culpable, they feel vulnerable and tend to react defensively. Medical defence societies used to encourage this attitude, advising their members to behave like motorists involved in an accident and to admit no liability. Fortunately, their policy has changed. Accidents may or may not be avoidable or negligent. A chain of minor errors may cascade into a major mishap. Without a frank and sympathetic explanation accompanied by timely expression of regret or apology, a relationship of trust disintegrates into an adversarial contest between an embattled doctor and bruised families. The time, cost, and turmoil is often out of all proportion to any compensation due or to the extent to which the public interest may be served by the outcome of any legal proceedings. Legal disputes cannot, of course, always be avoided. The task is to find ways of resolving them fairly …
Acetaminophen and Warfarin
Authors: William R. Bell
Journal: JAMA (1998)

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
DERMATITIS DUE TO NUPERCAINE
Authors: Richard W. Fowlkes
Journal: JAMA (1933)

In a fairly extensive search of the literature I have not found any reference to a severe localized and mild generalized dermatitis due to local applications of nupercaine. <h3>REPORT OF CASE</h3> J. E. T., a man, aged 37, was first given a 1 per cent nupercaine ointment eighteen months before the present attack of dermatitis. At that time a few hemorrhoidal tags were removed by a proctologist, and the ointment was given to relieve pain and a mild pruritus with complete success and without causing any irritation. Six months ago the patient again noticed some pruritus and, without consulting the proctologist, used nupercaine ointment for relief. Within a few days the local inflammation had increased considerably, and burning and itching had developed in addition to the original pruritus. Of his own accord he discontinued the nupercaine ointment, substituting phenolated petrolatum. Within a week he was well. The patient was seen
Rational Psychopharmacotherapy and the Right to Treatment
Authors: John F. Greden
Journal: JAMA (1975)

<b>Current Developments in Psychopharmacology,</b>by Walter B. Essman and L. Valzelli, vol 1; 345 pp, with illus, $24, Spectrum Publications (New York, Wiley &amp; Sons), 1975. <b>Psychopharmacology: A Biological Approach,</b>by Robert A. Levitt, 502 pp, with illus, $17.50, Hemisphere Publishing (New York, Wiley &amp; Sons), 1975. Psychopharmacology has attained maturity. Analagous to human development, in the two decades since its birth the field initially passed through periods of growth, exploration, enthusiasm, and confidence, followed by internal uncertainty and external criticism. Now, in its symbolic 21st year of existence (the first American paper on chlorpromazine was published in<i>JAMA</i>on May 7, 1954), the simultaneous publication of these three books from different sources suggests a stable pattern of development. One book reflects a mature concern for current deficiencies; the second, an eager anticipation of future developments; and the third, a comfortable sharing of knowledge with other disciplines. Rational Psychopharmacotherapy and
Carvedilol Inhibits Reactive Oxygen Species Generation by Leukocytes and Oxidative Damage to Amino Acids
Authors: Paresh Dandona, Rajaram Karne, Husam Ghanim, Wael Hamouda, Ahmad Aljada, Cesar H. Magsino
Journal: Circulation (2000)

The purpose of this study was to test whether carvedilol has an antioxidant effect in humans in vivo.We administered 3.125 mg of carvedilol twice daily to normal subjects for 1 week. ROS generation by polymorphonuclear leukocytes and mononuclear cells fell from 314+/-183.43 and 303+/-116 mV to 185+/-157 and 189+/-63 mV (P<0.025), respectively. m-Tyrosine fell from 4.24+/-0.99 to 4.03+/-0.97 ng/mL (P=0.01), and o-tyrosine fell from 4.59+/-1.10 to 4.24+/-0.99 ng/mL (P=0.004) in the absence of a change in phenylalanine concentrations.We conclude that carvedilol significantly inhibits ROS generation by leukocytes and oxidative conversion of phenylalanine to m- and o-tyrosine.
IN MEMORIAM: WILHELM MEYER
Authors: HOLGER MYGIND
Journal: JAMA (1910)

My first words to-day must be words of thanks to the chairman of the Section on Laryngology and Otology of the American Medical Association, Dr. Chevalier Jackson, and to the other members of the committee for the honor they have shown me by inviting me to this session and asking me to read a paper here. Permit me to say that it is a great and heartfelt pleasure for me to be among you and to meet so many confrères, whose names have for years been familiar to me; above all I appreciate the opportunity of seeing again the faces of old and faithful friends, though, alas! I miss some, who, having completed their appointed task, are now at rest. It is, however, not without considerable hesitation that I have accepted your kind and gratifying invitation, for I have but little news to tell you with regard to our specialty—a
Modern trends in anaesthesia. 2: Aspects of hydrogen ion regulation and biochemistry in anaesthesia.
Authors: Leroy D. Vandam
Journal: JAMA (1963)

This latest volume,<i>Modern Trends in Anaesthesia</i>, represents a departure from the earlier purpose of presenting reports at infrequent intervals of progress in the specialty to anticipation of more frequent reviews on single aspects of topical interest. The first four chapters on nomenclature and presentation of pH data, measurement of pH and pCO<sub>2</sub>, effects of hypercapnia, and hyperventilation are presented rather well, as they have been written by men productive in these fields. The references are well chosen and authoritative. The succeeding two chapters on acid-base balance in hypothermia and acid-base changes due to cardiac bypass overlap are less lucid—possibly because of the contradictory nature of the work in this area. A section on trends in the biochemistry of anesthesia presents a potpourri of adrenocortical mechanisms, nutrition via the intravenous route, and biochemistry of massive blood replacement, the latter two subjects being controversial and still inconclusive. Nowhere is
Shared care obesity management in 3-10 year old children: 12 month outcomes of HopSCOTCH randomised trial
Authors: M. Wake, K. Lycett, S. A. Clifford, M. A. Sabin, J. Gunn, K. Gibbons, C. Hutton, Z. McCallum, S. J. Arnup, G. Wittert
Journal: BMJ (2013)

<b>Objective</b> To determine whether general practice surveillance for childhood obesity, followed by obesity management across primary and tertiary care settings using a shared care model, improves body mass index and related outcomes in obese children aged 3-10 years. <b>Design</b> Randomised controlled trial. <b>Setting</b> 22 family practices (35 participating general practitioners) and a tertiary weight management service (three paediatricians, two dietitians) in Melbourne, Australia. <b>Participants</b> Children aged 3-10 years with body mass index above the 95th centile recruited through their general practice between July 2009 and April 2010. <b>Intervention</b> Children were randomly allocated to one tertiary appointment followed by up to 11 general practice consultations over one year, supported by shared care, web based software (intervention) or "usual care" (control). Researchers collecting outcome measurements, but not participants, were blinded to group assignment. <b>Main outcome measures</b> Children's body mass index z score (primary outcome), body fat percentage, waist circumference, physical activity, quality of diet, health related quality of life, self esteem, and body dissatisfaction and parents' body mass index (all 15 months post-enrolment). <b>Results</b> 118 (60 intervention, 56 control) children were recruited and 107 (91%) were retained and analysed (56 intervention, 51 control). All retained intervention children attended the tertiary appointment and their general practitioner for at least one (mean 3.5 (SD 2.5, range 1-11)) weight management consultation. At outcome, children in the two trial arms had similar body mass index (adjusted mean difference −0.1 (95% confidence interval −0.7 to 0.5; P=0.7)) and body mass index z score (−0.05 (−0.14 to 0.03); P=0.2). Similarly, no evidence was found of benefit or harm on any secondary outcome. Outcomes varied widely in the combined cohort (mean change in body mass index z score −0.20 (SD 0.25, range −0.97-0.47); 26% of children resolved from obese to overweight and 2% to normal weight. <b>Conclusions</b> Although feasible, not harmful, and highly rated by both families and general practitioners, the shared care model of primary and tertiary care management did not lead to better body mass index or other outcomes for the intervention group compared with the control group. Improvements in body mass index in both groups highlight the value of untreated controls when determining efficacy. <b>Trial registration</b> Australian New Zealand Clinical Trials Registry ACTRN12608000055303.
Childhood stroke linked to iron deficiency, study shows
Authors: David Spurgeon
Journal: BMJ (2007)

Previously healthy children with stroke were 10 times more likely to have iron deficiency anaemia than children without stroke, a Canadian study has shown ( Pediatrics 2007;120:1053-7 doi: 10.1542/peds.2007-0502). Also, children with iron deficiency anaemia accounted for more than half of all cases of stroke in children without an underlying medical illness.

Primary prevention and early identification of iron deficiency anaemia must therefore remain a priority, say the authors. This anaemia occurs with a peak prevalence of 4-8% in children aged 1-3 years.

“Establishing a link between a common and preventable childhood illness, iron deficiency anemia and stroke due to thrombosis of the …
A Surprising Inverse Correlation Between the Degree of Malignancy and the Level of FDG Uptake in a Colon Tumor
Authors: Ming-Tsung Chen, Yen-Kung Chen, Yeh-You Shen, Cheng-Tau Su
Journal: Clinical Nuclear Medicine (2004)

A 66-year-old woman was hospitalized because of hematochezia. She underwent sigmoidoscopy, and a cauliflower tumor measuring 3.0 × 1.5 cm was found at the 25-cm level. A biopsy was performed and the tumor was diagnosed as sigmoid adenocarcinoma. The CEA value was 12.1. An FDG PET scan was performed for staging. A lesion showing increased FDG uptake was seen in the ascending colon, and one showing much less uptake was seen in the sigmoid colon. At colonoscopy, a polypoid tumor was seen that measured 3 cm was sampled at the 60-cm level. The polypoid tumor was diagnosed as villotubular adenoma. An anterior resection for sigmoid cancer and a colostomy with wedge resection for an ascending colon adenoma were performed.
Antifibrotic effects of a tissue inhibitor of metalloproteinase-1 antibody on established liver fibrosis in rats
Authors: Christopher J. Parsons, Blair U. Bradford, Clark Q. Pan, Ellen Cheung, Michael Schauer, Andreas Knorr, Barbara Krebs, Sabine Kraft, Stefan Zahn, Bodo Brocks, Nikki Feirt, Baisong Mei, Myung-Sam Cho, Roopa Ramamoorthi, Greg Roldan, Paul Ng, Peggy Lum, Claudia Hirth-Dietrich, Adrian Tomkinson, David A. Brenner
Journal: Hepatology (2004)

Liver fibrosis is characterized by increased synthesis, and decreased degradation, of extracellular matrix (ECM) within the injured tissue. Decreased ECM degradation results, in part, from increased expression of tissue inhibitor of metalloproteinase-1 (TIMP-1), which blocks matrix metalloproteinase (MMP) activity. TIMP-1 is also involved in promoting survival of activated hepatic stellate cells (HSCs), a major source of ECM. This study examined the effects of blocking TIMP-1 activity in a clinically relevant model of established liver fibrosis. Rats were treated with carbon tetrachloride (CCl(4)), or olive oil control, for 6 weeks; 24 days into the treatment, the rats were administered a neutralizing anti-TIMP-1 antibody derived from a fully human combinatorial antibody library (HuCAL), PBS, or an isotype control antibody. Livers from CCl(4)-treated rats exhibited substantial damage, including bridging fibrosis, inflammation, and extensive expression of smooth muscle alpha-actin (alpha-SMA). Compared to controls, rats administered anti-TIMP-1 showed a reduction in collagen accumulation by histological examination and hydroxyproline content. Administration of anti-TIMP-1 resulted in a marked decrease in alpha-SMA staining. Zymography analysis showed antibody treatment decreased the activity of MMP-2. In conclusion, administration of a TIMP-1 antibody attenuated CCl(4)-induced liver fibrosis and decreased HSC activation and MMP-2 activity.
733-2 Total Versus Standard Orthotopic Heart Transplantation: Prolonged Ischemic Time Does not Impair Resting Hemodynamics
Authors: Ivan Aleksic, Lawrence S.C. Czer, Dov Freimark, Johanna J.M. Takkenberg, Mario Valenza, Carlos Blanche, Peter Barath, Carmen A. Queral, Alfredo Trento
Journal: Journal of the American College of Cardiology (1995)
Tests to detect asymptomatic urinary tract infections
Authors: L. L. Keeler
Journal: JAMA (1994)

To the Editor.  —I was pleased to see the article by Bachman et al 1 regarding the various tests to detect asymptomatic urinary tract infections (AUTIs). I have long been a proponent of Gram's stain of the spun urinary sediment as the prime method for diagnosing UTI. It is inexpensive and fast and can be done in the office as part of the office visit. It saves the health care system a lot of money, and I am suspicious that this is the reason that it has not succeeded.  There is little need for performing urine cultures in the office. If Gram's stain of the spun urinary sediment is positive, the patient can be treated 98% of the time with an inexpensive drug such as trimethoprim in combination with a sulfa drug or nitrofurantoin, since practically all organisms seen in outpatients are easily treated. If Gram's stain of the spun
Patient-Centered Care and Informed Consent
Authors: Leon Morgenstern
Journal: JAMA (2010)

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
Using geographic information systems to assess individual historical exposure to air pollution from traffic and house heating in Stockholm.
Authors: T Bellander, N Berglind, P Gustavsson, T Jonson, F Nyberg, G Pershagen, L Järup
Journal: Environmental Health Perspectives (2001)

A specific aim of a population-based case-control study of lung cancer in Stockholm, Sweden, was to use emission data, dispersion models, and geographic information systems (GIS) to assess historical exposure to several components of ambient air pollution. Data collected for 1,042 lung cancer cases and 2,364 population controls included information on residence from 1955 to the end of follow-up for each individual, 1990-1995. We assessed ambient air concentrations of pollutants from road traffic and heating throughout the study area for three points in time (1960, 1970, and 1980) using reconstructed emission data for the index pollutants nitrogen oxides (NO(x)/NO(2)) and sulfur dioxide together with dispersion modeling. NO(2) estimates for 1980 compared well with actual measurements, but no independently measured (study-external) data were available for SO(2), precluding similar validation. Subsequently, we used linear intra- and extrapolation to obtain estimates for all other years 1955-1990. Eleven thousand individual addresses were transformed into geographic coordinates through automatic and manual procedures, with an estimated error of < 100 m for 90% of the addresses. Finally, we linked annual air pollution estimates to annual residence coordinates, yielding long-term residential exposure indices for each individual. There was a wide range of individual long-term average exposure, with an 11-fold interindividual difference in NO(2) and an 18-fold difference in SO(2). The 30-year average for all study subjects was 20 microg/m(3) NO(2) from traffic and 53 microg/m(3) SO(2) from heating. The results indicate that GIS can be useful for exposure assessment in environmental epidemiology studies, provided that detailed geographically related exposure data are available for relevant time periods.
Amelioration of arthritis through mobilization of peptide-specific CD8+ regulatory T cells
Authors: Jianmei W. Leavenworth, Xiaolei Tang, Hye-Jung Kim, Xiaoyang Wang, Harvey Cantor
Journal: Journal of Clinical Investigation (2013)

Current therapies to treat autoimmune disease focus mainly on downstream targets of autoimmune responses, including effector cells and cytokines. A potentially more effective approach would entail targeting autoreactive T cells that initiate the disease cascade and break self tolerance. The murine MHC class Ib molecule Qa-1b (HLA-E in humans) exhibits limited polymorphisms and binds to 2 dominant self peptides: Hsp60p216 and Qdm. We found that peptide-induced expansion of tetramer-binding CD8+ Tregs that recognize Qa-1–Hsp60p216 but not Qa-1–Qdm strongly inhibited collagen-induced arthritis, an animal model of human rheumatoid arthritis. Perforin-dependent elimination of autoreactive follicular Th (TFH) and Th17 cells by CD8+ Tregs inhibited disease development. Infusion of in vitro–expanded CD8+ Tregs increased the efficacy of methotrexate treatment and halted disease progression after clinical onset, suggesting an alternative approach to this first-line treatment. Moreover, infusion of small numbers of Qa-1–Hsp60p216–specific CD8+ Tregs resulted in robust inhibition of autoimmune arthritis, confirming the inhibitory effects of Hsp60p216 peptide immunization. These results suggest that strategies designed to expand Qa-1–restricted (HLA-E–restricted), peptide-specific CD8+ Tregs represent a promising therapeutic approach to autoimmune disorders.
A PRACTICAL NOTE ON SUICIDE
Authors: F. Dillon
Journal: BMJ (1934)

A PRACTICAL NOTE .ON SUICIDE Rr THEBRITIS of the spleen consists chiefly of cells similar to those found in the bone marrow.There is an extensive central fatty change in the liver, and a moderate amount of free iron in the cells around the portal area.Some.well-circumscribed periportal co'lections of lymphoid cells are present.Summary The blood and post-mortem examinations and the histological findings leave no doubt that the case was one of lymphadenosis, for the greater part of its course subleukaemic, the special features being the relative chronicity and the presence of subcutaneous deposits of lymphoid cells, both extremely rare occurrences in this disease in children.
Effect of dietary salt on bronchial reactivity to histamine in asthma
Authors: W. Cookson
Journal: BMJ (1988)

occupational medicine has not incorporated its wealth of experience in the workplace into the environmental sciences.There may still be a place for a generalist in industrial practice, but more so for a specialist with a specific, deeper scientific and research background and experience in inter- preting scientific data.In universities the principles of occupational medicine may be taught to undergraduate medical students by clinicians who are not specialists in the subject.Consequently the role of an undergraduate teaching department of occupational medicine is not clear and is reflected in its accorded position and reputation.Professional training in occupational medicine is the responsibility of the faculty and, although this has been rationalised and improved in recent years, it is still confined to training posts in industry.At present there is no requirement for a period in academic research or on a training rotation in a university or the health service, which is in contrast to every other medical specialty.Joint training programmes between industry and academic departments would broaden the clinical experience, scientific ability, and, ultimately, the credibility of occupational physicians.
Short term linear growth in asthmatic children during treatment with prednisolone.
Authors: O D Wolthers, S Pedersen
Journal: BMJ (1990)

OBJECTIVE--To see whether small daily doses of prednisolone have any adverse effect on short term linear growth in children with mild asthma. DESIGN--Double blind, random order crossover trial of two dosages of prednisolone. During run in and washout periods patients were given placebo. All treatment periods were of two weeks9 duration. SETTING--Outpatient clinic referrals in a secondary referral centre. PATIENTS--14 Children (10 boys) aged 7-11 years with normal growth velocity during the previous year, no signs of puberty, and no history of receiving systemic or topical steroids during the two months before the study. One child was excluded because his pulmonary function deteriorated and another was withdrawn because of varicella. INTERVENTIONS--2.5 and 5.0 mg prednisolone daily given in divided dosage in the morning and evening. MAIN OUTCOME MEASURE--Growth of the lower leg as measured twice a week by knemometry. RESULTS--A significant reduction in mean growth velocity of the lower leg occurred in both prednisolone treatment periods. The mean difference between the run in period and the treatment period with 2.5 mg prednisolone daily was 0.63 mm/week (95% confidence interval 0.47 to 0.80 mm/week) and between the run in period and the treatment period with 5.0 mg prednisolone daily 0.57 mm/week (0.38 to 0.77 mm/week). CONCLUSION--Small daily doses of prednisolone suppress short term linear growth in children with mild asthma. The clinical relevance of this finding needs further study.